Wrist replacement is a procedure in which a damaged wrist joint is removed and replaced with an artificial joint. The prosthesis, or replacement part, is usually comprised of metal with a polyethylene (plastic) spacer. It’s designed to function like a regular, healthy wrist. Joint replacement is referred to as arthroplasty in medical terms.
Anatomy of wrist
The wrist comprises of eight to nine small bones roughly arranged in two rows. The wrist is made up of forearm bones, carpal bones, and hand bones. The wrist plays an important role in our day-to-day activities. For example, bending, rotating of hands, and stretching or straightening of hands are all controlled by wrist joints.
It moves as you are doing things like waving, picking something, typing, exercising, or massaging your head. Unfortunately, all these basic activities become difficult if your joints are damaged or stiff.
Why is it done?
There are a variety of reasons why someone could need wrist replacement surgery. Wrists can become sore and swollen as a result of rheumatoid arthritis, gout, and other types of arthritis. Wrist pain can be relieved with pain medications and exercises to some extent, and if you suffer from persistent pain, surgery may be required.
Conditions under which wrist replacement surgery might be needed:
- Fractured bone
- Rheumatoid arthritis
- Wrist fusion
- Osteonecrosis (Bone tissue dies due to a lack of oxygen)
- Carpal tunnel syndrome (pain, numbness, and weakness in the wrist)
- Ganglion cysts (benign fluid pump in the wrist)
- Psoriatic arthritis
- Lupus(when the body attacks its own tissues)
What happens before wrist replacement?
The replacement surgery is performed by an expert orthopedic surgeon, who analyses and assesses the medical history and lab reports to determine the right cause of the pain before starting with the surgery.
- The specialist may ask certain questions with respect to the persistent pain and how it has been affecting your life
- Through an X-ray, the doctor will examine the damage to the wrist
- Ask the patient to try to make some movement to understand the pain, strength, and how much movement he/she can make before the surgery
- Blood tests
What happens during wrist replacement?
This procedure takes a maximum of two hours and is performed by an expert orthopedic surgeon.
- Patient is sedated (given anesthesia) through an IV
- An incision is made on the upper part of the wrist
- The damaged cartilage and bone are removed
- Metal or plastic prosthesis is placed
- Further, the prosthesis is attached to the bones and fixed with the help of screws and pins
- After the attachment is placed, the doctor makes sure the wrist is flexible enough to move comfortably
- Then the incision is closed with the help of stitches while ensuring there is no internal bleeding or infection is there
- Finally, it is covered and secured well with a sterilised bandage
After the procedure
After the surgery is completed successfully, the doctor may prescribe drugs to help you cope with any discomfort or pain that may arise. In addition, the surgeon may recommend certain home therapies such as simple hand movements and exercises to help the bones to adjust properly.
- Avoid putting pressure and stress on your prosthesis
- Avoid moving your joint in strange postures
- Don’t lift weight more than suggested by the healthcare provider
- Take extra care of your wrist, avoid tripping or injuring the wrist
Pros & Cons
- Level of pain is reduced
- Improvement in mobility
- Less swollen and stiff
- Infection in the prosthesis
- Nerve damage
- Sudden wear and tear of prosthesis
- Formation of blood clots
- Internal bleeding
It may take a maximum of six to 12 weeks for the wrist to heal. During the healing period, doctors suggest the patient to start making slight wrist movements to help improve their flexibility.
Usually, the patient is discharged within the same day after the surgery, but it truly depends on each case.