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Wrist Replacement

Wrist replacements are becoming increasingly common.  These are performed when people have got regular pain and misery from an arthritic joint.  The vast majority of wrist replacements are performed in people with rheumatoid arthritis or psoriatic arthritis, but increasing numbers have been performed in people with osteoarthritis.

Generally speaking, the modern generation of wrist replacements includes a two-piece component, one of which is metal and one of which is a special type of plastic.

Previous non-operative treatments may include splintage and pain killers.

Symptoms

Pain and decreased range of movement are symptoms that may lead to a total wrist replacement

Diagnosis

The arthritic wrist is usually swollen and stiff.

X-rays usually confirm the diagnosis.  The features of arthritis on an x-ray are loss of joint space previously occupied by the articular cartilage, new bone formation at the edges of the joint (osteophyte), cysts in the bone and hardening of the ends of the bone with increased white appearance (sclerosis)

Surgery for wrist replacement

Surgery is performed under general anaesthetic or local anaesthesia and takes approximately sixty minutes.  The majority of procedures are done as day cases, however you may require an overnight stay.  During the procedure the arthritic ends of bone are removed and the wrist replacement components are inserted.  The current wrist replacements do not require cement, but allow the bones to grow onto the stems of the implants for stable fixation.

Post-surgery rehabilitation

If your consultant is happy with the stability and movement obtained at the time of surgery people are rested for the first one to two weeks to allow swelling to settle, before undertaking a gradual rehabilitation programme.

Risks

The risks associated with total wrist replacement include infection (less than 1%), dislocation (the joint comes undone), fracture, tendon and nerve injury, pain syndrome.  However, these complications are rare and patients normally enjoy an 80 to 90% success rate following this type of surgery.

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