关键词: Systematic review total wrist arthroplasty total wrist replacement

Mesh : Arthritis, Rheumatoid / surgery Arthrodesis Arthroplasty, Replacement Hand Strength Humans Joint Prosthesis Patient Selection Prosthesis Design Range of Motion, Articular Treatment Outcome Wrist Joint / physiopathology surgery

来  源:   DOI:10.1177/1753193414539796   PDF(Sci-hub)

Abstract:
We reviewed evidence on total wrist replacement from the last 5 years. Eight articles met a minimum set standard. The results of 405 prostheses were available, including seven different manufacturers. The mean follow up was 2.3-7.3 years with an average age of 52-63. Rheumatoid arthritis was the indication in 42% of patients. Motec demonstrated the best post-operative DASH scores. Only Maestro achieved a defined functional range of motion post-operatively. Universal 2 displayed the highest survival rates (100% at 3-5 years), while Elos had the lowest (57% at 5 years). Biaxial had the highest complication rates (68.7%), while Remotion had the lowest (11%). Wrist arthroplasty preserves some range of motion. Functional scores improved and were maintained over the mid- to long-term. Complication rates were higher than wrist fusion, with reports of radiological loosening and osteolysis. The evidence does not support the widespread use of arthroplasty over arthrodesis, and careful patient selection is essential.
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