Download PDF
J Wrist Surg 2020; 09(05): 446-456
DOI: 10.1055/s-0040-1713728
Survey or Meta-analysis

Salvage of the Failed Total Wrist Arthroplasty: A Systematic Review

Onur Berber 
1   Oxford University Hospitals NHS Foundation Trust, Nuffield Orthopaedic Centre, Oxford, England, United Kingdom
2   Whittington Health NHS Trust, London, United Kingdom
,
Sam Gidwani
3   Guy's and St Thomas' Hospitals NHS Foundation Trust, Great Maze Pond, London, England, United Kingdom
,
Lorenzo Garagnani
3   Guy's and St Thomas' Hospitals NHS Foundation Trust, Great Maze Pond, London, England, United Kingdom
,
Michelle Spiteri
1   Oxford University Hospitals NHS Foundation Trust, Nuffield Orthopaedic Centre, Oxford, England, United Kingdom
,
Nicholas Riley
1   Oxford University Hospitals NHS Foundation Trust, Nuffield Orthopaedic Centre, Oxford, England, United Kingdom
,
Ian McNab
1   Oxford University Hospitals NHS Foundation Trust, Nuffield Orthopaedic Centre, Oxford, England, United Kingdom
,
Christopher Little
1   Oxford University Hospitals NHS Foundation Trust, Nuffield Orthopaedic Centre, Oxford, England, United Kingdom
› Author Affiliations Funding None.
› Further Information
    Permissions and Reprints

Abstract

Background Although the performance of total wrist arthroplasty systems has improved, failure is encountered and is a major challenge to manage.

Questions Does physical function improve with surgical management of the failed wrist arthroplasty? Is there an improvement in secondary outcome measures including pain, grip strength, and range of motion? What are the reasons for failure in primary total wrist arthroplasty? What are the complications associated with revision of the failed total wrist arthroplasty? What are the survival profiles of the different revision strategies?

Methods A systematic review of available literature was performed. Studies were systematically assessed, and data extracted from suitable studies for review. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) reporting guidelines were adhered to. The study protocol was modified from a previous protocol published on the PROSPERO database.

Results Fourteen studies were identified considering 218 patients/214 index operations with a follow-up duration following revision surgery of 2 months to 21 years (silicone wrist arthroplasty—42 cases; nonsilicone wrist arthroplasty—172 cases). The functional outcome of revision surgery was infrequently recorded and documented with only short-term assessments undertaken. Complications were seen in 1:2 revision procedures, with re-revision surgeries required in 21.6% of revised primary nonsilicone arthroplasties. Re-revision rate following a revision arthrodesis was 21.4% (15/70 cases) compared with revision arthroplasty of 34.8% (32/92 cases). Revision arthrodesis nonunion rate was 17.5% (22 cases).

Conclusion This review has confirmed the high level of surgical complexity and the likelihood of a complicated postoperative outcome when salvaging a failed wrist replacement.

Level of Evidence This is a Level 3, systematic review study.

Keywords

wrist arthroplasty - revision - systematic review


Publication History

Received: 28 September 2019

Accepted: 07 May 2020

Article published online:
06 July 2020

© 2020. Thieme. All rights reserved.

Thieme Medical Publishers
333 Seventh Avenue, New York, NY 10001, USA.

 

  • References

  • 1 Swanson AB. Flexible implant arthroplasty for arthritic disabilities of the radiocarpal joint. A silicone rubber intramedullary stemmed flexible hinge implant for the wrist joint. Orthop Clin North Am 1973; 4 (02) 383-394
    CrossrefPubMedGoogle Scholar
  • 2 Swanson AB, de Groot Swanson G, Maupin BK. Flexible implant arthroplasty of the radiocarpal joint. Surgical technique and long-term study. Clin Orthop Relat Res 1984; (187) 94-106
    PubMedGoogle Scholar
  • 3 Comstock CP, Louis DS, Eckenrode JF. Silicone wrist implant: long-term follow-up study. J Hand Surg Am 1988; 13 (02) 201-205
    CrossrefPubMedGoogle Scholar
  • 4 Haloua JP, Collin JP, Schernberg F, Sandre J. Arthroplasty of the rheumatoid wrist with Swanson implant. Long-term results and complications. Ann Chir Main 1989; 8 (02) 124-134
    CrossrefPubMedGoogle Scholar
  • 5 Ferreres A, Lluch A, Del Valle M. Universal total wrist arthroplasty: midterm follow-up study. J Hand Surg Am 2011; 36 (06) 967-973
    CrossrefPubMedGoogle Scholar
  • 6 Sagerfors M, Gupta A, Brus O, Pettersson K. Total wrist arthroplasty: a single-center study of 219 cases with 5-year follow-up. J Hand Surg Am 2015; 40 (12) 2380-2387
    CrossrefPubMedGoogle Scholar
  • 7 Berber O, Garagnani L, Gidwani S. Systematic review of total wrist arthroplasty and arthrodesis in wrist arthritis. J Wrist Surg 2018; 7 (05) 424-440
    Article in Thieme ConnectPubMedGoogle Scholar
  • 8 Cooney III WP, Beckenbaugh RD, Linscheid RL. Total wrist arthroplasty. Problems with implant failures. Clin Orthop Relat Res 1984; (187) 121-128
    PubMedGoogle Scholar
  • 9 Ferlic DC, Jolly SN, Clayton ML. Salvage for failed implant arthroplasty of the wrist. J Hand Surg Am 1992; 17 (05) 917-923
    CrossrefPubMedGoogle Scholar
  • 10 Rettig ME, Beckenbaugh RD. Revision total wrist arthroplasty. J Hand Surg Am 1993; 18 (05) 798-804
    CrossrefPubMedGoogle Scholar
  • 11 Cobb TK, Beckenbaugh RD. Biaxial long-stemmed multipronged distal components for revision/bone deficit total-wrist arthroplasty. J Hand Surg Am 1996; 21 (05) 764-770
    CrossrefPubMedGoogle Scholar
  • 12 Beer TA, Turner RH. Wrist arthrodesis for failed wrist implant arthroplasty. J Hand Surg Am 1997; 22 (04) 685-693
    CrossrefPubMedGoogle Scholar
  • 13 Lorei MP, Figgie MP, Ranawat CS, Inglis AE. Failed total wrist arthroplasty. Analysis of failures and results of operative management. Clin Orthop Relat Res 1997; (342) 84-93
    PubMedGoogle Scholar
  • 14 Carlson JR, Simmons BP. Wrist arthrodesis after failed wrist implant arthroplasty. J Hand Surg Am 1998; 23 (05) 893-898
    CrossrefPubMedGoogle Scholar
  • 15 Vogelin E, Nagy L. Fate of failed Meuli total wrist arthroplasty. J Hand Surg [Br] 2003; 28 (01) 61-68
    CrossrefPubMedGoogle Scholar
  • 16 Talwalkar SC, Hayton MJ, Trail IA, Stanley JK. Management of the failed biaxial wrist replacement. J Hand Surg [Br] 2005; 30 (03) 248-251
    CrossrefPubMedGoogle Scholar
  • 17 Rizzo M, Ackerman DB, Rodrigues RL, Beckenbaugh RD. Wrist arthrodesis as a salvage procedure for failed implant arthroplasty. J Hand Surg Eur Vol 2011; 36 (01) 29-33
    CrossrefPubMedGoogle Scholar
  • 18 Adams BD, Kleinhenz BP, Guan JJ. Wrist arthrodesis for failed total wrist arthroplasty. J Hand Surg Am 2016; 41 (06) 673-679
    CrossrefPubMedGoogle Scholar
  • 19 Reigstad O, Holm-Glad T, Thorkildsen R, Grimsgaard C, Røkkum M. Successful conversion of wrist prosthesis to arthrodesis in 11 patients. J Hand Surg Eur Vol 2017; 42 (01) 84-89
    CrossrefPubMedGoogle Scholar
  • 20 Fischer P, Sagerfors M, Brus O, Pettersson K. Revision arthroplasty of the wrist in patients with rheumatoid arthritis, mean follow-up 6.6 years. J Hand Surg Am 2018; 43 (05) 489.e1-489.e7
    CrossrefPubMedGoogle Scholar
  • 21 Pinder EM, Chee KG, Hayton M, Murali SR, Talwalkar SC, Trail IA. Survivorship of revision wrist replacement. J Wrist Surg 2018; 7 (01) 18-23
    Article in Thieme ConnectPubMedGoogle Scholar
  • 22 Boers M, Tugwell P, Felson DT. et al. World Health Organization and International League of Associations for Rheumatology core endpoints for symptom modifying antirheumatic drugs in rheumatoid arthritis clinical trials. J Rheumatol Suppl 1994; 41: 86-89
    PubMedGoogle Scholar
  • 23 Bellamy N, Kirwan J, Boers M. et al. Recommendations for a core set of outcome measures for future phase III clinical trials in knee, hip, and hand osteoarthritis. Consensus development at OMERACT III. J Rheumatol 1997; 24 (04) 799-802
    PubMedGoogle Scholar
  • 24 Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions version 6.1.0 (updated March 2011). Cochrane, 2011. Available at www.training.cochrane.org/handbook
    PubMed
  • 25 Reigstad O, Røkkum M. Conversion of total wrist arthroplasty to arthrodesis with a custom-made PEG. J Wrist Surg 2014; 3 (03) 211-215
    Article in Thieme ConnectPubMedGoogle Scholar
  • 26 Nydick JA, Watt JF, Garcia MJ, Williams BD, Hess AV. Clinical outcomes of arthrodesis and arthroplasty for the treatment of posttraumatic wrist arthritis. J Hand Surg Am 2013; 38 (05) 899-903
    CrossrefPubMedGoogle Scholar
  • 27 Dennis DA, Ferlic DC, Clayton ML. Volz total wrist arthroplasty in rheumatoid arthritis: a long-term review. J Hand Surg Am 1986; 11 (04) 483-490
    CrossrefPubMedGoogle Scholar
  • 28 Briggs T. Getting it Right First Time: a national review of adult elective orthopaedic services in England. London: British Orthopaedic Association; 2015
    Google Scholar