TOTAL WRIST ARTHROPLASTY IN RHEUMATOID-ARTHRITIS - A LONG-TERM CLINICAL REVIEW

Fourteen total wrist arthroplasties performed in 13 patients with rheu matoid arthritis between 1978 and 1982 were reviewed to evaluate long term outcome, Most patients had Stages III or IV rheumatoid arthritis at the time of surgery, Pain was the primary presenting complaint in 8 7%, Average followup was 6.5 years (range, 3.5-11.5 years), Pain relie f was achieved in 86% of patients, Using objective data obtained from their wrist scores, 72% of the patients had a goad result, 14% had a f air result, and 14% had a poor result. No patient had an excellent res ult, Twenty-seven percent suffered postoperative complications related to their surgical procedure. Although these results help confirm the usefulness of total wrist arthroplasty as an alternative to arthrodesi s of the wrist, it is a technically demanding procedure, and should be reserved for the patient who has severely involved arthritis, Additio nal improvements are needed to decrease the currently high complicatio n and failure rate.