Wrist joint Replacement surgery

About Wrist Joint Replacement Surgery

Wrist joint replacement surgery in the wrist is less common than knee or hip replacement, but can be an option if you have painful arthritis that does not respond to other treatments.

The wrist is a more complicated joint than the hip or the knee. On the hand side of the wrist, there are two rows of bones at the base of the hand. There are four bones in each row. The bones in these rows are called the carpals. The long thin bones of the hand radiate out from one row of carpals and form the basis of the fingers and thumb.

The ends of the bones are covered with an elastic tissue, called cartilage. Cartilage creates a slick surface that enables the bones to move smoothly when they move against each other.

Causes and Risk factors of Wrist Joint Replacement

  • Wrist osteoarthritis
  • Rheumatoid arthritis
  • Post-traumatic arthritis
  • Failed wrist fusion
  • Advanced avascular necrosis of the carpal bones
  • Kienbock disease

Symptoms of Wrist Joint Disease

  • Pain
  • Stiffness
  • Swelling
  • Reduced range of motion
  • Clicking, cracking or grinding sounds on movement.

Orthopedic Evaluation

  1. Medical history :Surgeon will gather information about your general health and ask questions about the extent of your wrist pain and how it affects your ability to perform everyday activities.
  2. Physical examination: This will assess wrist mobility, strength, and alignment.
  3. Blood tests: It is also helpful the evaluation of the condition such as arthritis.
  4. X-rays: Which help to determine the extent of damage or deformity in your wrist.
  5. MRI(magnetic resonance imaging ): It may be needed to determine the condition of the bone and soft tissues of your wrist joint.

Surgery of Wrist Joint

  • Surgery is performed under general or regional anesthesia.
  • An incision is made over the back of the wrist.
  • The tendons are moved away to expose the wrist joint.
  • The damaged joint surfaces of the arm bones are removed with a surgical saw.
  • The first row of carpal bones may also be removed.
  • The radius bone is hollowed out and a radial component of the prosthesis is fixed inside it with bone cement.
  • Depending upon the design of the prosthesis, the carpal component is placed in the remaining row of carpal bones or into the third metacarpal bone of the hand.
  • The carpal bones may also be linked or fused together to better fix the carpal component.
  • A plastic spacer is then fit between the metal components.
  • With the new prosthesis in place the wrist joint is tested through its range of motion, and is irrigated with a sterile saline solution.
  • The joint capsule is then sutured together.
  • The muscles and tendons are repaired, and put back in place.
  • Close the wound with sutures (stitches).

Complication of Wrist Joint Replacement surgery

  • Implant loosening, fracturing or wearing down over time, which may require subsequent surgery
  • Infection
  • Joint stiffness or pain if the procedure or implant fails
  • Dislocation of the artificial joint
  • Damage to vessels, nerves or other structures in the region of the surgery