A viable alternative to wrist fusion: The Motec arthroplasty

Background: The Motec cementless modular metal-on-metal ball-and-socket wrist arthroplasty is an implant with promising intermediate results. An alternative to primary wrist fusion, total wrist arthroplasty is an option for active patients, who wish to retain their wrist function. It is indicated in cases of degenerative osteoarthritis, post-traumatic arthritis and rheumatoid (inflammatory) arthritis.

Methods: Retrospective case note review of patient demographics, pre and post-operative Disabilities of the Arm Shoulder and Hand (DASH), MAYO scores, range of movement and grip strength, complications and follow-up duration. All complications in follow up were recorded across the 5 year period.

Results: 25 implants on 23 patients over 5 years, mean age 61; 8 females and 15 male. 10 patients with SLAC, 3 SNAC, 5 inflammatory and 7 patients with generalized Osteoarthritis. The patients showed large improvements of MAYO and DASH scores post-operatively, alongside increased in range of movement. There was just one case of implant looseing- the radial screw after a wound infection, which was revised with a longer screw. Two implants were converted to Motec fusion due to pain. One implant was dislocated and relocated. The remaining patients have had good wrist function. Only 6 patients were unable to return to work.

Discussion: Similar to results of Reigstad et al, this series shows the Motec implant to be a good motion preserving alternative to total wrist fusion.