Project

Total wrist arthroplasty: A prospective randomized trial comparing two different wrist arthroplasties.

Background

The established treatment for painful wrist arthritis has until recently been total wrist fusion. Total wrist arthroplasty (TWA) is an alternative to fusion with the advantage of restoring wrist motion. Whereas earlier generations of TWA showed unsatisfactory results regarding complications and reoperations, newer designs demonstrate much better outcomes. TWA has traditionally been offered to rheumatoid patients with relatively poor function. During the last few years TWA has also been offered to patients with arthritis secondary to injury (fracture, ligamentous injury) and other non-rheumatoid causes (Kienboeck disease). These patients are often employed, many in heavy labor, therefore demanding more from the prosthesis than rheumatoid patients. There are currently two total wrist arthroplasties with published prospective data; the Remotion and the Motec prostheses.

Methods

• Patient rated outcome measures
• Radiology
• Radiostereometric analysis (RSA)
• Dual energy x-ray absorptiometry (DEXA)

Purpose

To find out which of these two wrist arthroplasties shows the best results in treating non-rheumatoid wrist arthritis.

Aim

• 2 years clinical follow-up comparing two total wrist prostheses
• 2 years follow-up comparing migration measured by model-based RSA
• 2 years follow-up comparing periprosthetic bone remodelling by DEXA

Supervisors:

Ole Reigstad, MD, Ph.D, Orthopaedic Surgeon

Magne Røkkum, MD, Ph.D, Orthopaedic Surgeon

Olav Reikerås, MD, Ph.D, Professor, Orthopaedic Surgeon