Younger patients had increased rates of revision, reoperation after total wrist arthroplasty

SAN DIEGO — Younger patients who underwent total wrist arthroplasty experienced increased rates of revision, carpal loosening and reoperation, according to data presented here.

“This study found that younger age at total wrist arthroplasty leads to increased rates of revision, carpal loosening and reoperation,” Casey Dedeugd, MD, said during her presentation at the American Academy of Orthopaedic Surgeons Annual Meeting.

Casey Dedeugd

Dedeugd and colleagues identified 484 primary total wrist arthroplasties performed from 1974 to 2013, of which 261 were performed in patients younger than 60 years. Researchers analyzed time to revision and reoperation using Kaplan-Meier survival curves and complications using hazard ratios.

Results showed there were 19 reoperations and 81 revisions loosening and instability. According to Dedeugd, patients younger than 60 years had a significantly lower 10-year survival.

“Since it was the most common complication, we looked specifically at carpal loosening,” Dedeugd said. “We observed the same statistically significant difference in overall survival with younger patients in this complication alone.”

She noted patients who had total wrist arthroplasty for posttraumatic arthritis had a trend toward decreased survival, but this did not reach statistical significance due to the relatively low numbers for osteoarthritis and post-traumatic arthritis.

“Finally, in terms of overall complications, excluding isolated radiographic carpal loosening which was not considered a complication unless revision was performed, we found dislocation to be the most common complication,” Dedeugd said. – by Casey Tingle

Reference:

Wagner ER, et al. Paper #755. Presented at: American Academy of Orthopaedic Surgeons Annual Meeting; March 14-18, 2017; San Diego.

Disclosure: Dedeugd reports no relevant financial disclosures.