Wrist replacement

Overview

Wrist replacement surgery, medically termed wrist arthroplasty, is a procedure aimed at replacing the radiocarpal joint, which connects the hand to the forearm. This surgical technique enhances the range of motion and alleviates pain, making it an option for individuals suffering from wrist arthritis or injuries. A newly artificial wrist joint typically has a lifespan of around 10 to 15 years.

During wrist replacement surgery, the damaged joint is removed and substituted with an artificial joint. The replacement component, known as a prosthesis, is commonly crafted from metal and includes a polyethylene (plastic) spacer. This prosthesis is designed to mimic the functionality of a healthy wrist. The medical term for this type of procedure is arthroplasty.

The wrist is a intricate joint comprising numerous small bones, serving as the linkage between your hand and forearm. Referred to as the radiocarpal joint, it plays a pivotal role in facilitating the rotation, bending, and straightening of the hand. These movements are crucial for everyday activities like waving, hair washing, typing, lifting objects, and numerous other daily tasks. When the wrist joint is significantly damaged or stiff, these routine activities can become uncomfortable and challenging.

Reasons for undergoing the procedure

When all other methods of treating arthritis-related wrist discomfort have failed, wrist replacement surgery is another alternative. Typical first-line, nonsurgical remedies include:

• Painkillers (acetaminophen and anti-inflammatories).
• Modifications to your activities.
• Steroid injections.
• Splints for the wrist and topical medicines.
• Occupational or physical therapy.

The following are the most typical conditions that might cause wrist pain:

• Osteonecrosis, which occurs when insufficient blood flow causes bone tissue to die.
• Arthritis in your wrist, such as rheumatoid arthritis (an inflammatory condition) and osteoarthritis (a degenerative joint disease).
• Failed wrist fusion.
• Damage, such as a broken bone.

Wrist arthroplasty can offer relief when alternative treatments have proven ineffective:

• Get rid of any grinding, clicking, or cracking noises when moving.
• Keep your wrist joint’s range of motion (the amount it can bend or stretch) intact.
• Decrease edema and stiffness.
• Manage pain of the joint.
• Your wrist, hand, and fingers should be able to move without pain.

Risks

While infrequent, complications arising from wrist replacement may include:

• Damage to the nerve.
• Joint or prosthesis infection.
• Wound infection.
• Clotting of blood.
• Prosthesis malfunction (it may shatter, become loosened, or dislocate).

Before the procedure

Only an experienced orthopaedic surgeon with a preference for hand surgery should do wrist replacement. The bone and joint specialist will conduct the following before proposing the procedure:

• Inquire about your general health and any existing medical issues.
• Describe your wrist pain, including how long it has persisted and how it has affected your life.
• Check the strength and flexibility of your wrist.
• Have an X-ray taken of your wrist to see the affected bones.
• Conduct additional exams (such as blood testing) to confirm that you are healthy enough to have surgery.
• Verify that other, more conservative treatment choices have been explored and that you have been informed of all available surgical options.

During the procedure

An outpatient surgery center or hospital are both used for wrist replacement procedures. Typically, the process lasts under two hours.

The team doing the surgery will:

• To put you to sleep, administer anesthetic through an IV in your arm. In order to give more prolonged post-operative pain treatment, the majority of patients will also receive an upper extremity block.
• Cut a small slit into the top of your wrist.
• Remove your joint, then trim the bone and cartilage that are damaged.
• Puts in the prosthesis.
• Use pins, screws, or bone cement to attach it to the bones on each side of your joint.
• Verify that the artificial joint is firmly fixed in place.
• Check to see if your joint moves properly.
• Verify that the tendons and nerves that surround the injury have been properly repositioned.
• Stitch the wound closed, if necessary.
• Put a splint on your wrist and cover it with sterile bandages.

For the treatment of related issues with tendons, nerves, and the thumb or finger joints, wrist replacement surgery may be combined with additional operations.

After the procedure

After a total wrist replacement, it’s customary to immobilize the wrist with a splint covered in bandages. Additionally, a drainage tube is often inserted for approximately one day to assist in draining excess blood and prevent swelling.

Outcome

The typical recovery period for wrist replacement surgery spans from six to twelve weeks. Following the removal of the cast, it’s likely that you will be instructed to wear a splint.

Your doctor will encourage you to engage in wrist-strengthening exercises, even though there might be some initial discomfort. Over time, these movements should become less painful and more manageable. Additionally, your surgeon may recommend physical or occupational therapy to assist in your recovery process.