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. 2016 Aug;5(3):217-21.
doi: 10.1055/s-0036-1572509. Epub 2016 Feb 19.

Distal Radius Hemiarthroplasty

Brian D Adams  1 , Ericka A Lawler  2 , Taften L Kuhl  2
Affiliations

Distal Radius Hemiarthroplasty

Brian D Adams et al. J Wrist Surg. 2016 Aug.

Abstract

Introduction: Due to a higher risk for implant loosening, particularly of the distal component, patients with physically demanding lifestyles are infrequently considered for total wrist arthroplasty (TWA). A distal radius hemiarthroplasty may obviate the need for the strict restrictions recommended for patients treated by TWA, thus providing another surgical option for active patients with severe wrist arthritis, especially those with articular degeneration of the lunate facet of the radius, capitate head, or combination of both, who are not typically candidates for traditional motion-preserving procedures.

Materials and methods: Eight fresh-frozen cadaver limbs (age range, 43-82 years) with no history of rheumatoid arthritis or upper extremity trauma were used. Radiodense markers were inserted in the radius and hand. Posteroanterior (PA) fluoroscopic images with the wrist in neutral, radial deviation, and ulnar deviation, and lateral images with the wrist in neutral, flexion, and extension were obtained for each specimen before implantation, after distal radius hemiarthroplasty, and after combined hemiarthroplasty and PRC.

Results: On the PA images, the capitate remained within 1.42 and 2.21 mm of its native radial-ulnar position following hemiarthroplasty and hemiarthroplasty with PRC, respectively. Lateral images showed the capitate remained within 1.06 mm of its native dorsal-volar position following hemiarthroplasty and within 4.69 mm following hemiarthroplasty with PRC. Following hemiarthroplasty, capitate alignment changed 2.33 and 2.59 mm compared with its native longitudinal alignment on PA and lateral films, respectively. These changes did not reach statistical significance. As expected, significant shortening in longitudinal alignment was seen on both PA and lateral films for hemiarthroplasty with PRC.

Conclusion: A distal radius implant hemiarthroplasty with or without a PRC provides good static alignment of the wrist in a cadaver model and thus supports the concept as potential treatment alternatives for advanced wrist arthritis; however, combined hemiarthroplasty with a PRC has more clinical relevance because it avoids the risk of proximal carpal row instability and eliminates the commonly arthritic radioscaphoid joint.

Keywords: distal radius arthroplasty; distal radius replacement; wrist arthroplasty; wrist hemiarthroplasty; wrist replacement.

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Conflict of interest statement

Conflict of Interest Brian D. Adams serves as a consultant and receives royalties from Integra Life Sciences, Plainsboro, NJ.

Figures

Fig. 1
Fig. 1
(A, B) Postoperative posteroanterior and lateral views of specimen following distal radius hemiarthroplasty.
Fig. 2
Fig. 2
(A, B) Posteroanterior and lateral views of specimen after undergoing hemiarthroplasty and PRC.
Fig. 3
Fig. 3
Posteroanterior view showing coordinate system used to perform measurements.
Fig. 4
Fig. 4
Lateral view showing coordinate system used to perform measurements.
See this image and copyright information in PMC

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References

    1. Kobayashi M, Berger R A, Nagy L. et al.Normal kinematics of carpal bones: a three-dimensional analysis of carpal bone motion relative to the radius. J Biomech. 1997;30(8):787–793. - PubMed
    1. Blankenhorn B D, Pfaeffle H J, Tang P, Robertson D, Imbriglia J, Goitz R J. Carpal kinematics after proximal row carpectomy. J Hand Surg Am. 2007;32(1):37–46. - PubMed
    1. Vicar A J, Burton R I. Surgical management of the rheumatoid wrist—fusion or arthroplasty. J Hand Surg Am. 1986;11(6):790–797. - PubMed
    1. Murray P M. Current status of wrist arthrodesis and wrist arthroplasty. Clin Plast Surg. 1996;23(3):385–394. - PubMed
    1. Kobus R J, Turner R H. Wrist arthrodesis for treatment of rheumatoid arthritis. J Hand Surg Am. 1990;15(4):541–546. - PubMed