Hand & Wrist
Total Wrist Replacement and Wrist Fusion
Arthritis can affect the wrist joint severely causing pain, limited movements and disability. Osteoarthritis (OA) can occur as a result of a previous fracture but most patients who present with severe wrist pain have Rheumatoid arthritis (RA) or similar inflammatory type of arthritis. These patients are often on several medications to control the symptoms and also to control the progression of arthritis but the arthritis can continue and lead to severe damage to the wrist joint.
Those patients, who continue to have disability despite the medications, can have either Wrist Joint Replacement (TWR) or Total Wrist Fusion. Both are successful in easing the pain and improving function. Patient satisfaction is good for both. Younger patients who have fewer joints involved and who are still working in demanding jobs do better with Wrist fusion but newer and more effective joint replacements are now available which can be used in all types of patients.
Over 90% of patients do well and wrist fusions are generally successful in over 96%. Wrist joint Replacements carry some risk of infection, dislocation and late loosening of the implant. Overall patient satisfaction is higher with joint replacement than with fusion. Patients who have late arthritis are seen and assessed with X-rays and full discussion regarding the two choices takes place between surgeon and the patient. The final choice is made based on the clinical assessment and the life style of the patients.