Total Wrist Replacement
Motec wrist replacement Sydney
When a joint is affected by arthritis, this can cause a variety of symptoms, including pain and limited mobility. In some cases, medical treatments like medications or injections may help. Unfortunately, medical treatments aren’t always able to resolve the symptoms. Patients may experience limitations on their daily activity, and their quality of life may be affected.
When other options have been tried and have not been able to allow a patient to achieve a satisfactory level of function, then joint replacement may be considered. While the knee and the hip are more commonly replaced joints, replacement of other joints is also an option. For patients who are experiencing significant symptoms in the wrist, total wrist replacement may be able to help. Recent developments in technology have allowed us to create better results with this procedure, allowing many patients to regain their mobility and improve their quality of life.
In order to understand total wrist replacement and how it can help people with arthritis of the wrists, we first need to understand the anatomy of the wrist joint, and how it becomes damaged by arthritis.
How is the wrist joint structured?
The wrist joint is fairly complex, and is made up of multiple bones. The radius, which is one of the two bones in the forearm, is widened at the wrist. The end of the bone has a shallow indentation, which forms a kind of oval-shaped cup. This forms one side of the natural wrist joint.
The other side of the wrist joint is made up of some of the carpal bones. These are the bones that make up the heel of the hand. There are eight of these bones, each with a somewhat irregular cube-like shape. The carpal bones are bound together by connective tissue to form a flexible arch. This structure fits into the cup formed by the radius. Three of the carpal bones contribute directly to forming the wrist joint.
At the wrist as at other joints, the surfaces of the bones are normally coated by a smooth layer of tissue known as hyaline cartilage. The cartilage allows the bones to glide smoothly across each other. Between the cartilage surfaces is a lubricating fluid known as synovial fluid.
What happens in a person with wrist arthritis?
When a person has arthritis, the cartilage layer of the joint becomes damaged. Damaged cartilage becomes rougher, so the joint can no longer glide smoothly during motion. The cartilage may eventually wear away, leaving unprotected bone tissue. The damage to the cartilage is what causes the pain and stiffness in the joint.
Osteoarthritis is wear-and-tear arthritis. While all joints tend to deteriorate with age, certain factors make this more likely. People who use their wrists a lot, particularly in repetitive ways, may also be more likely to develop arthritis in their wrists. For example, people doing certain types of work may be more susceptible.
Injuries to a joint sometimes lead to arthritis later. This is known as posttraumatic arthritis, and it’s common with certain types of fractures at the wrist. Even if the fracture seems like it has healed well, there may be small changes in the anatomy of the joint that make it more likely to deteriorate over time, and there may also be abnormal movement patterns after an injury that eventually lead to arthritis.
Rheumatoid arthritis is an autoimmune condition, in which the body’s immune system begins to attack the patient’s own joint tissues and break them down. This condition can affect many different joints in the body, including the wrist.
Patients with osteoarthritis, posttraumatic arthritis, or rheumatoid arthritis may be candidates for total wrist replacement.
What is total wrist replacement?
In total wrist replacement, the damaged surfaces of the joint are removed, and are replaced with artificial ones. Here at Southern Hand & Wrist, Dr. Sungaran offers Motec wrist replacement to his patients. This technologically advanced wrist replacement system offers good outcomes and helps to maintain movement in the wrist after the procedure.
With the Motec wrist replacement system, the artificial joint is a ball-and-socket joint. This design allows for a better range of motion after the surgery than other types of replacement joints typically offer. Each component comes in multiple different sizes; Dr. Sungaran will determine the correct sizes for you based on careful measurements that are taken before the surgery.
The replacement joint consists of two components: a radial component and a carpal component. The radial component has a cup-like shape on the end. The damaged cartilage and some bone tissue is removed from the end of the radius, and then the radial component of the artificial joint is anchored into the center of the radius.
To place the carpal component, some of the damaged carpal bones are removed. This makes space for the artificial joint. The carpal component of the artificial joint is anchored through the remaining row of carpal bones into the third metacarpal, which is the long bone in the center of the hand. At the end, the carpal component has a round shape, which fits into the cup of the radial component.
What are the outcomes from total wrist replacement?
Studies have shown that Motec total wrist replacement generally offers good outcomes for patients. Overall, patients have significant reductions in pain, and improvements in measures of hand function like grip strength. Additionally, they are able to maintain a relatively good range of motion of the wrist, including being able to perform certain motions that are not possible after some other types of total wrist replacement. Because the components of the Motec artificial joint are made of metal, they are highly durable, and most patients still have good outcomes years later.
It’s important to note that getting a total wrist replacement is not exactly like having your undamaged natural wrist back. Although they generally have improvements relative to their wrist function before the surgery, patients do have some limitations on movement after the procedure. Still, these are less than with other surgical options for wrist arthritis. In general, patients are satisfied with their range of motion after total wrist replacement, but it’s important to be realistic and not to think of your total wrist replacement procedure as a way to get back the undamaged wrists that you had when you were 19.
What are the alternatives to total wrist replacement?
Before trying any surgical option, it’s strongly recommended that patients try nonsurgical options first. These include splinting, injections, and hand therapy to strengthen muscles in order to stabilize the joint. If these options are not effective, then a surgical procedure can be considered.
For patients with severe arthritis of the wrist joint, another possible option is total wrist fusion, also known as wrist arthrodesis. In this procedure, the bones of the wrist joint are surgically attached to one another, so that there will be minimal to no movement at the wrist joint. Wrist fusion surgery is very good at relieving pain and may improve the grip strength of the hand. Because of this, wrist fusion has been a commonly used procedure for patients with wrist arthritis.
However, wrist fusion surgery completely eliminates mobility at the wrist joint. Over time, this can have a negative impact on the other joints of the arm, which may move in abnormal ways to make up for the lack of movement at the wrist. Additionally, the lack of wrist mobility can make certain types of activities difficult or impossible for patients. Wrist replacement offers comparable outcomes in terms of relieving pain, while allowing patients to maintain at least some degree of wrist mobility.
Motec wrist replacement Sydney
If you have arthritis of the wrist, and nonsurgical options have not been able to relieve your pain and give you back your ability to function, then you may want to consider total wrist replacement. As an expert in surgical procedures for the wrist and hand, Dr. Sungaran has found that the Motec wrist replacement system offers the best outcomes, and is pleased to be able to offer this technologically advanced option to his patients.
To find out whether you’d be a candidate for choosing total wrist replacement, we invite you to come to our office for a consultation in our offices in Caringbah or Sutherland Shire. After examining you and learning more about your medical history and your current symptoms, Dr. Sungaran will be happy to discuss your options with you, and to let you know whether he believes that total wrist replacement would be a good option for you. To book your appointment, you can simply contact our front desk.
