Total joint arthroplasty of the distal radioulnar joint for rheumatoid arthritis

Elkin J. Galvis, Joel Pessa, Luis R. Scheker

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

Purpose To evaluate the clinical and radiological results of primary total distal radioulnar joint (DRUJ) replacement as well as reconstruction following ulnar head excision in patients with rheumatoid arthritis (RA). Methods Seventeen patients with RA underwent 19 total DRUJ replacement between 2005 and 2011. Mean age at the time of the surgery was 57 years. Mean follow-up was 39 months (range, 12-79 mo). Pain level was evaluated using a visual analog scale (VAS). Pronation and supination were recorded before and after surgery. A patient satisfaction survey was used, as well as postoperative Disabilities of the Arm, Shoulder, and Hand (DASH) and Patient-Related Wrist Evaluation (PRWE) scores. Ulnar translocation of the carpus was assessed radiographically, and the presence or absence of radiolucent zones around the implant were recorded. Results The preoperative average VAS score for the 19 joints was 7.3. Pain decreased after surgery to 2.2. Pronation improved from 56° before surgery to 78° afterward, a 39% improvement. Supination improved from 57° before surgery to 71° afterward, a 27% improvement. Final scores were 24 for the DASH and 24 for the PRWE. Fifteen patients reported substantial pain relief. All patients were satisfied with their surgical result. Conclusions The results of this study suggest that total replacement of the DRUJ is of benefit to the patient with RA. Pronation was significantly increased and supination was increased but did not approach significance. Improvement in VAS score suggests that pain was decreased.

Original languageEnglish (US)
Pages (from-to)1699-1704
Number of pages6
JournalJournal of Hand Surgery
Volume39
Issue number9
DOIs
StatePublished - 2014

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Arthroplasty
Rheumatoid Arthritis
Joints
Pronation
Supination
Replacement Arthroplasties
Visual Analog Scale
Pain
Wrist
Arm
Hand
Patient Satisfaction
Head

Keywords

  • Distal radioulnar joint arthritis
  • implant
  • rheumatoid arthritis
  • wrist pain

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine
  • Surgery

Cite this

Total joint arthroplasty of the distal radioulnar joint for rheumatoid arthritis. / Galvis, Elkin J.; Pessa, Joel; Scheker, Luis R.

In: Journal of Hand Surgery, Vol. 39, No. 9, 2014, p. 1699-1704.

Research output: Contribution to journalArticle

Galvis, Elkin J. ; Pessa, Joel ; Scheker, Luis R. / Total joint arthroplasty of the distal radioulnar joint for rheumatoid arthritis. In: Journal of Hand Surgery. 2014 ; Vol. 39, No. 9. pp. 1699-1704.
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AB - Purpose To evaluate the clinical and radiological results of primary total distal radioulnar joint (DRUJ) replacement as well as reconstruction following ulnar head excision in patients with rheumatoid arthritis (RA). Methods Seventeen patients with RA underwent 19 total DRUJ replacement between 2005 and 2011. Mean age at the time of the surgery was 57 years. Mean follow-up was 39 months (range, 12-79 mo). Pain level was evaluated using a visual analog scale (VAS). Pronation and supination were recorded before and after surgery. A patient satisfaction survey was used, as well as postoperative Disabilities of the Arm, Shoulder, and Hand (DASH) and Patient-Related Wrist Evaluation (PRWE) scores. Ulnar translocation of the carpus was assessed radiographically, and the presence or absence of radiolucent zones around the implant were recorded. Results The preoperative average VAS score for the 19 joints was 7.3. Pain decreased after surgery to 2.2. Pronation improved from 56° before surgery to 78° afterward, a 39% improvement. Supination improved from 57° before surgery to 71° afterward, a 27% improvement. Final scores were 24 for the DASH and 24 for the PRWE. Fifteen patients reported substantial pain relief. All patients were satisfied with their surgical result. Conclusions The results of this study suggest that total replacement of the DRUJ is of benefit to the patient with RA. Pronation was significantly increased and supination was increased but did not approach significance. Improvement in VAS score suggests that pain was decreased.

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