gms | German Medical Science

Objectives/Interrogation: Multiple solutions exist to treat a wrist with posttraumatic degenerative changes. Depending on the extension of the degenerative osteoarthritis and on the functional condition of the patient, salvatage are indicated such as four corner fusion or proximal row carpectomy. When the degenerative osteoarthritis compromises the radiocarpal joint, the surgery more commonly performed in active patients is Total Wrist Arthrodesis that allows pain control but sacrificing mobility. Long term studies in patients with TWA have demonstrated an important functional disability. In the last years, there have been published very promissing results in non rheumatoid patients. Motec Wrist (Swemac Orthopedics) is a new model of arthroplasty, with ceramic covered implant, ball and socket joint type with a metal on metal or metal on peek pair of friction. Indicated for all kinds of degenerative osteoarthritis in high demand patients. The follow-up to 3.2 years of 30 hard-working patients operated with Motec, demonstrated good results. The aim of this study is to show the early functional and radiologic results of the first patients that underwent total wrist arthroplasty with Motec in Latin America.

Methods: Non probabilistic sample of patients that underwent Motec Wrist Arthroplasty in 2018. Patients were evaluated at pre op, 3 and 6 months post operative with AP and lateral wrist x rays, wrist range of motion (º), grip force with a JAMAR dynamometer (kgs), DASH and PRWE. Results were analyzed with tables of frequencies, ranges and medians. Statistical analysis with R software.

Results: 3 patients were operated in 2018 with Motec arthroplasty. All male, mean age of 48 yo. The pre-op diagnose was snac wrist IV in 2 cases and a failed proximal row carpectomy (due to kiembock disease) in one case.

Mean pre op DASH was 40, and PRWE 50 pts. Mean wrist extension of 30º, and 60º flexion, radial deviation 0º, ulnar deviation 10º. Mean Grip strength 17 kg. All were operated with the standard technique with no intraoperative complications.

At 6 months post-op. No signs of implant loosening at x-rays. Mean wrist extension 50º, flexion 50º, radial deviation 30º, ulnar deviation 30º. Grip strength 25 kg. All 3 patients with no pain. DASH 15, PRWE 10 pts.

Conclusion: Motec wrist arthroplasty is a good alternative of treatment for post traumatic osteoarthritis of the wrist in young high demand patients, with good functional results in the short term and no significant complications for this small sample.