New York Hand Surgery

Wrist Joint Replacement

Wrist Joint Replacement surgery, also called Total Wrist Arthroplasty, is used to treat the symptoms of arthritis that have not responded to non-surgical treatments such as medication or therapy. Arthritis is a general term covering numerous conditions where the joint surfaces wear out. The joint surface is covered by a smooth articular surface made of cartilage that allows pain free movement in the joint. This surface can wear out for a number of reasons. Often the definite cause is unknown.

When the articular cartilage wears out, the bone ends rub on one another causing pain. There are numerous conditions that can cause arthritis and often the exact cause is never known. In general, but not always, it affects people as they get older. This type of arthritis is called “wear and tear” arthritis or Osteoarthritis.

The goal of wrist joint replacement surgery is to eliminate your pain and increase the mobility of your wrist joint.

Wrist joint replacement surgery is performed under sterile conditions in the operating room under general or regional anesthesia. The surgery may be done as day surgery enabling you to go home the same day. Your surgeon will perform the following:

  • An incision is made over the back of the wrist.
  • The tendons are moved away to expose the wrist joint. Care is taken to avoid nerves to prevent nerve damage.
  • The damaged joint surfaces of the arm bones are removed with a surgical saw to allow for a smooth surface for which to attach the implants. The first row of carpal bones may also be removed.
  • A special instrument is used to hollow out the inside of the radius bone in order to insert the radial component of the prosthesis.
  • Once a proper fit is established, the surgeon prepares for the insertion of the carpal component of the prosthesis. The carpal component may be placed in the first row of carpal bones, which may be fused together, or into the third metacarpal bone of the hand depending upon the prosthesis and surgeon’s preference.
  • The components are inserted with cement and a plastic spacer is fit between the metal components.
  • With the new prosthesis in place, the wrist joint is tested through its range of motion.
  • The surgeon then irrigates the new joint with sterile saline solution. The surgeon then sutures the joint capsule together, repairs the muscles and tendons and sutures the skin closed. The wrist is bandaged with a sterile dressing and a cast applied.
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