Artificial wrist joints are not very common, but it is an option if symptoms from arthritis do not respond to other treatments. Additionally, wrist replacement is an alternative to a wrist fusion.
The wrist is a complex joint. There are two rows of bones at the base of the hand; in each row there are four bones. The bones are called the carpal bones, which is where the long thin bones of the hand radiate out from each carpal to form the base of the fingers and thumb. The two bones of the forearm (the radius and ulna) form the wrist joint with the row of carpal bones.
The ends of the bones are covered in cartilage, an elastic tissue that creates a smooth surface that allows bones to move efficiently against each other.
When cartilage of the wrist is damaged by an injury or infection, or simply worn away overtime, the bones of the wrist will begin to rub against each other. This causes arthritis.
- Post-traumatic osteoarthritis: After wrist injuries, gradual wearing away of the cartilage can occur. This is the most common form of arthritis in the wrist.
- Rheumatoid arthritis: A chronic inflammatory disease of the joints that results in pain, stiffness and swelling. Usually affects several joints of the body.
Symptoms of wrist arthritis
- Weakness in fingers and hand
- Pain with pinching or gripping
To determine whether you need a wrist replacement, your physician will ask you for a complete medical history and when you started experiencing wrist pain, have you describe your symptoms and conduct a physical examination. An X-ray can help evaluate the problem.
Wrist replacement surgery
Wrist arthroplasty is rare. However, it may help recover wrist movements and improve the ability to perform daily activities. During surgery the worn out ends of the bones are removed and replaced by a prosthesis (artificial joint).
Most of the time wrist arthroplasty is done as an outpatient procedure. Sometimes an artificial wrist joint surgery is combined with other procedures to correct deformities or disorders of the tendons, nerves and joints of the fingers and thumb.
An incision is made on the back of the wrist and the damaged ends of the lower arm bones are removed. Sometimes the carpal bones may also be removed. The prosthesis is then inserted and held in place with bone cement.
Wrist replacement is very good for pain relief and can sometimes improve wrist strength and function for daily activities.
A cast will be worn for the first several weeks. Once the cast is removed, a splint will be needed for six to eight weeks. Exercises and wrist stretching will need to be done for several weeks to restore movement and power.
There will be some limitation on the amount of weight you can lift with your wrist. Activities that have a high risk of fall such as roller sports should be avoided.
An artificial wrist joint will usually last 10 to 15 years. But follow-up appointments every one to two years will identify any problems before conditions worsen.