Total Wrist Arthroplasty and Arthrodesis Outcomes
Summary
Total wrist arthroplasty and arthrodesis represent two principal surgical strategies for managing end-stage wrist pathology. Arthroplasty seeks to restore joint mobility and alleviate pain through prosthetic implantation, while arthrodesis achieves durable pain relief by fusing the radiocarpal complex. Prosthetic designs have evolved from early fixed-bearing implants to contemporary customised, porous-coated systems that enhance bony integration and reduce mechanical failure. Despite these advances, complications such as periprosthetic loosening, component migration and revision surgery remain important considerations. Conversely, wrist arthrodesis offers predictable fusion rates and long-term stability but sacrifices range of motion, which may impact patient activity and quality of life. Contemporary practice balances these approaches according to patient age, diagnosis, functional demands and bone quality, with salvage arthrodesis available following failed arthroplasty. Global research spans biomaterials innovation, biomechanical optimisation of fixation constructs and comparative outcome studies, underscoring the ongoing refinement of both techniques and their tailored application in diverse patient populations.
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Total Wrist Arthroplasty and Arthrodesis Outcomes publication trend
The graph below shows the total number of articles in total wrist arthroplasty and arthrodesis outcomes across all publications each year (not limited to Nature Index journals).
Technical terms
Total wrist arthroplasty: Surgical replacement of the radiocarpal joint with a prosthetic implant to relieve pain while preserving wrist motion.
Total wrist arthrodesis: Fusion of the wrist joint bones to eliminate movement and provide long-term stability and pain relief.
Carpometacarpal joint (CMCJ): The articulation between the distal carpal bones and the bases of the metacarpals, important for load transfer and fusion constructs.
Microporous titanium prosthesis: A three-dimensional printed implant featuring interconnected pores in titanium to promote bone ingrowth and implant stability.
Trapezoidal wedge graft: A cortico-cancellous bone segment shaped like a trapezoid, harvested (commonly from the distal radius) to fill and support the arthrodesis site.
References
- Safety and efficacy of a novel three-dimensional printed microporous titanium prosthesis for total wrist arthroplasty in the treatment of end-stage wrist arthritis. Frontiers in Bioengineering and Biotechnology (2023).
- Biomechanical Performance of Total Wrist Arthrodesis Plates With and Without Arthrodesis of the Carpometacarpal Joint. Hand (2023).
- Wrist Arthrodesis Using a Trapezoidal Wedge Graft from the Distal Radius and a Low-Profile Reconstruction Plate. Indian Journal of Orthopaedics (2023).
- Comparative outcomes of total wrist arthrodesis for salvage of failed total wrist arthroplasty and primary wrist arthrodesis. Journal of Hand Surgery (European Volume) (2021).
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