Surgical technique: about a new total and isoelastic wrist implant (Prosthelast®)

Abstract

This study describes a new total wrist implant (Prosthelast^®) designed to reduce the risk of distal migration of the carpal component. The Prosthelast^® implant consists in a one-block radial implant replacing the metaphysis and the articular surface fixed to a radial elastic centromedullar wire and a carpal component in titanium with an articular condylar surface in polyethylene. We operated on five patients (three male patients and two female patients) and followed them up for 12 months on average. Two of the patients presented with rheumatoid arthritis of the wrist, and an ulnar osteotomy (Darrach procedure) was carried out at the same time of the arthroplasty. All clinical variables improved postoperatively (Quick DASH score, pain score, range of motion) except from wrist flexion which was reduced. No patients underwent revision surgery. Two patients presented with a periprosthetic radiolucent loosening around the radial component, but no implant migration was observed. Overall, the preliminary results of our case series show that the new Prosthelast^® implant presents comparable short-term results to those described in the literature. We will follow up the patients to verify that long-term results are as satisfactory as the short-term results.

Keywords: Carpal implant; Implant; Isoelastic; Radial implant; Wrist.