Purpose
The use of implant arthroplasty in the distal radioulnar joint is increasing. Two
main types of implants are commonly used, ulnar head prosthesis (UHP) and hemi or
semi-constrained total distal radioulnar joint arthroplasty. The literature consists
mainly of small patient series. The purpose of this study was to examine our long-term
outcomes of distal radioulnar joint arthroplasty.
Methods
Patient data were collected in a patient registry from 2000 to 2019. The follow-up
included radiographic examination, physical examination, Mayo Wrist Scores, pain level,
range of motion, and grip strength. Reoperations were recorded. The implants were
a semi-constrained prosthesis and a metallic UHP. The mean age at surgery was 50 years.
Patient demographics were similar, but the semi-constrained group had a higher preoperative
percentage of instability (85 vs 52 percent). The median follow-up time was 30 months
for the semi-constrained implants group and 102 months for the UHP group.
Results
A total of 53 primary semi-constrained total joint arthroplasties and 102 UHPs were
included. The grip strength and Mayo Wrist Score improved for both the implant groups.
Pain reduced in 76% of the patients. Supination improved for the semi-constrained
total joint arthroplasty group. Lifting capacity was better in the semi-constrained
total joint arthroplasty patients. The unadjusted reoperation rate was 23% for the
semi-constrained implants group and 34% for the UHP group. Twenty-two implants were
bilateral; these had comparable results to unilateral implants. Kaplan–Meier survival
curves demonstrated 94% survival rate for the semi-constrained implants group and
87% survival for the UHP group after 5 years. The risk factors associated with reoperation
for the combined implant group included younger age at surgery, previous wrist surgery,
ulnar shortening, and wrist fusion.
Conclusions
Distal radioulnar joint arthroplasty improved functional outcomes in both the implant
groups, but reoperations were frequent. The semi-constrained implants group had better
lifting capacity. The bilateral implants had comparable outcomes to the unilateral
implants.
Type of study/level of evidence
Therapeutic IV.
Key words
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Article info
Publication history
Published online: May 10, 2022
Accepted:
February 11,
2022
Received:
April 21,
2021
Footnotes
No benefits in any form have been received or will be received related directly or indirectly to the subject of this article.
Identification
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