WHAT YOU SHOULD KNOW
The term arthritis simply refers to the condition of a joint losing its smooth cartilage surface. When this happens the two bones that make up the joint begin to contact each other. This friction and grinding causes pain, swelling, stiffness and further cartilage loss.Osteoarthritis has no special cause other than use of the joint for many years throughout life. Other types of arthritis are special inflammatory conditions such as rheumatoid arthritis or post-traumatic damage to the joint causing arthritis.
The symptoms usually set in slowly over time. Eventually patients complain of lost function, pain, stiffness, swelling, weakness, and sometimes deformity. The doctor will ask questions to determine whether the arthritis is post-traumatic, osteoarthritis, or a special inflammatory arthritis.
The wrist joint is tested for range of motion, stability, alignment, and any grinding during movement.
Plain x-rays show the degree of arthritis and any bone loss or erosion that may have happened.
|NON-OPERATIVE||SURGICAL WRIST JOINT ARTHROPLASTY||SURGICAL PARTIAL WRIST FUSION||SURGICAL TOTAL WRIST FUSION|
|CONSISTS OF||Oral arthritis medications, cortisone joint injections||Removal of 3 of the arthritis bones, allowing new contact surfaces||Removal of 1 of the arthritic bones, fusion of the others||Fusion of all the wrist bones|
|FEATURES||Limited number of injections is allowed||Outpatient surgery, early rehabilitation||Outpatient surgery, screws hold the fused bones together||Requires bone graft from the hip, plate and screws hold the fusion|
|ADVANTAGES||Avoids surgery||Better motion||Some motion preserved, durable result||Solid, durable, effective for any pattern of arthritis|
|DISADVANTAGES||Only treats the symptoms not the underlying bone contact||Temporary weakness, only effective if cartilage remains on the large central wrist bone, result may worsen over time||Limited motion, need to fuse, pain relief may not be complete||No motion, plate implanted into body|
Sutures are removed in the office at 2 weeks. Splints are used for protection for the first 4 weeks. After this arthroplasty patients begin outpatient rehabilitation to increase motion and strength, a process that takes several months to develop. Fusions take between 8-10 weeks to unite solidly. After this time the outpatient rehabilitation begins. All patients are expected to use the wrist for everyday activities by just after 3 months from surgery. Strength and function continue to improve gradually over time.