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J Wrist Surg
DOI: 10.1055/s-0044-1791498
Scientific Article

Semiconstrained Distal Radioulnar Joint Arthroplasty: Functional Outcomes and Complications

Matthew J. Pina 
1   Christine M. Kleinert Institute for Hand and Microsurgery, Louisville, Kentucky
,
Harmony Tan Chern Yang 
1   Christine M. Kleinert Institute for Hand and Microsurgery, Louisville, Kentucky
,
Gonzalo Pintado 
1   Christine M. Kleinert Institute for Hand and Microsurgery, Louisville, Kentucky
,
Tuna Ozyurekoglu 
1   Christine M. Kleinert Institute for Hand and Microsurgery, Louisville, Kentucky
› Author Affiliations
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Abstract

Background: The semiconstrained distal radioulnar joint (DRUJ) prosthesis (Aptis Medical, Louisville, KY) is an option in the treatment of refractory DRUJ pathology that has shown promising results.

Purpose: This study aims to evaluate the short- to midterm functional outcomes, complications, and factors affecting outcomes of semiconstrained DRUJ arthroplasty.

Methods: We retrospectively reviewed 47 DRUJ arthroplasty procedures (on 46 consecutive patients) from a single surgeon between 2010 and 2022. Demographic data, range of motion, grip strength, and patient-reported outcome measures (PROMs: Quick Disability of the Arm, Shoulder, and Hand; Patient-Rated Wrist Evaluation; modified Mayo Wrist Score [mMWS]; and visual analog scale [VAS] for pain) were collected. Complications were classified as major (requiring surgery) or minor (treated conservatively).

Results: The average follow-up was 3.37 years (standard deviation, 3.51; range, 0.04–15.62 years). A total of 30% of patients (n = 14) were followed for more than 5 years. Postoperatively, supination significantly increased and VAS pain scores improved significantly. Patients also experienced improved function in the operative wrist as assessed by the mMWS. Patients with prior DRUJ and/or triangular fibrocartilage complex surgery were more likely to have additional diagnoses at the time of definitive surgery and our postoperative outcomes varied based on prior surgery and additional diagnoses, with a trend toward higher pain levels and worse PROMs. The overall complication rate was 17%, with one major complication consisting of a posttraumatic periprosthetic ulna fracture. All other complications were minor. Implant survival was 100%.

Conclusion: Semiconstrained DRUJ arthroplasty significantly improves pain levels and functional outcomes at short- to midterm follow-up. Patients who had undergone previous related surgeries were showed a trend toward higher postoperative pain levels and worse PROMs. Although complications were common, overall patient satisfaction and implant survivorship were high.

Level of Evidence: IV

Keywords

distal radioulnar joint - functional outcomes - complications - semiconstrained DRUJ arthroplasty


Publication History

Received: 02 July 2024

Accepted: 30 August 2024

Article published online:
16 October 2024

© 2024. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 

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