Procedures:

- Wrist Replacement

- Ligament Reconstruction

Wrist Replacement

A stiff painful wrist can interfere with work, hobbies or even minor activities of daily living such as dressing, cooking or bathing. A severely damaged wrist joint from injury or arthritis can be replaced with a mechanical joint called a prosthesis. This procedure is called total wrist arthroplasty. This procedure is performed by a physician with specialized training in hand surgery called a hand surgeon. There are 2 major types of prostheses used in total wrist arthroplasty.

Flexible 1 piece silicone implants were introduced in the 1960s. One end of this implant is placed into the forearm bone and one into the hand bone. The implant damns like a rubber hose and allows the wrist to bend. The other type of prosthesis is a 2 piece metallic implant that glide against one another and allow the wrist to move. Either type of prosthesis allows motion and relieves pain. However, the silicone implant has limited motion, tends to break and can cause a reaction in the body called silicone synovitis. For this reason the 2 piece type of implants have become more popular.

Are there other treatment options? Yes, another treatment for a severely damaged wrist joint is fusion. This procedure causes the hand bone to grow to the fore arm bone. This stops the pain, however, the wrist is stiff and will never bend again. Although patients can learn to live with a stiff wrist, total wrist arthroplasty which preserves motion is obviously more desirable. The disadvantage of total wrist arthroplasty is that the prosthesis can become loose or wear out, requiring additional surgery.

In a study that we conducted at the Mayo Clinic we found that 20% of patients who had total wrist arthroplasty required additional surgery. Over 80% had no pain and greater than 90% reported that they were better because of the surgery.

Prosthetic design and surgical technique have improved resulting in continued improvement and success and acceptance of this procedure.