Wrist replacement is a surgical procedure that involves removing a damaged wrist joint and replacing it with an artificial joint. The prosthetic joint typically consists of metal and a polyethylene (plastic) spacer, designed to mimic the function of a healthy wrist. This procedure is medically known as arthroplasty.
Anatomy of the Wrist
The wrist consists of eight to nine small bones arranged in two rows, including forearm bones, carpal bones, and hand bones. It plays a crucial role in our daily activities, enabling movements such as bending, rotating, and extending the hands. Tasks like waving, picking up objects, typing, exercising, and massaging the head rely on the wrist’s function. However, when the wrist joints are damaged or stiff, these fundamental activities can become challenging.
Reasons for Wrist Replacement
Wrist replacement surgery may be necessary for various reasons. Conditions such as rheumatoid arthritis, gout, and other types of arthritis can lead to pain, swelling, and discomfort in the wrist. While pain medications and exercises can provide some relief, persistent pain may require surgical intervention.
Indications for wrist replacement surgery include:
- Fractured bones
- Osteoarthritis
- Rheumatoid arthritis
- Wrist fusion
- Osteonecrosis (death of bone tissue due to lack of oxygen)
- Carpal tunnel syndrome (causing pain, numbness, and weakness)
- Ganglion cysts (benign fluid-filled sacs)
- Gout
- Psoriatic arthritis
- Lupus (an autoimmune condition)
Pre-Surgery Evaluation
Before the wrist replacement surgery, an experienced orthopedic surgeon will evaluate the patient’s medical history and lab reports to identify the underlying cause of pain. The evaluation may include:
- Questions regarding the persistent pain and its impact on daily life
- X-rays to assess damage to the wrist
- Movement tests to evaluate pain, strength, and range of motion
- Blood tests for further assessment
The Surgical Procedure
Wrist replacement surgery typically lasts up to two hours and is performed by a skilled orthopedic surgeon. The steps include:
- Administering anesthesia through an IV to sedate the patient.
- Making an incision on the upper part of the wrist.
- Removing the damaged cartilage and bone.
- Placing a metal or plastic prosthesis.
- Securing the prosthesis to the bones with screws and pins.
- Ensuring the wrist has adequate flexibility for comfortable movement.
- Closing the incision with stitches while checking for internal bleeding or infection.
- Covering the area with a sterile bandage.
Post-Operative Care
After a successful surgery, the doctor may prescribe medication to manage any pain or discomfort. Additionally, the surgeon might recommend home therapies, including simple hand movements and exercises, to aid recovery.
Care Instructions:
- Avoid placing pressure on the prosthesis.
- Do not move your wrist in unusual positions.
- Refrain from lifting weights beyond the healthcare provider’s recommendations.
- Take precautions to protect your wrist from injury.
Pros and Cons of Wrist Replacement
Benefits:
- Reduced pain levels
- Improved mobility
- Decreased swelling and stiffness
Risks and Complications:
- Infection of the prosthesis
- Nerve damage
- Dislocation
- Premature wear and tear of the prosthesis
- Formation of blood clots
- Internal bleeding
