Hoffman, Jasja Tim (J.T.) (2020) High Durability and Patient Satisfaction of the Universal 2 Total Wrist Arthroplasty A study on 57 primary TWAs in rheumatoid and non-rheumatoid patients using the Universal 2 system. thesis, Medicine.
Full text available on request.Abstract
Introduction: The wrist is a complex anatomical structure, giving humans great evolutionary benefits and unique abilities that we constantly use in our day to day life. A damaged or destroyed wrist may greatly impact functionality and reduce quality of life, accompanied with persistent pain. For centuries, doctors tried to manage this by removing or fixating the wrist joint, both not without their issues. The current fourth generation TWAs shows strongly improved survival and revision rates, but also high complication rates. Purpose: By assessing 57 patients receiving a Universal 2 Total Wrist Arthroplasty (TWA), this study aims to find more insight on durability and patient satisfaction. Methods: This study uses a retrospective cohort design in combination with additional QuickDASH (Disabilities of the Arm, Shoulder and Hand Score) and PRWHE (Patient Rated Wrist/Hand Evaluation) questionnaires. Preoperative Range of Motion (ROM) and grip strength measurements were compared with scores obtained during the first two years of follow-up. Results: A significant reduction in pain of the wrist was seen (p-values between <.001 and .008). Range of Motion did not reach normative values, but reached minimum functional flexion in 100% (CI .89-1.0) and extension in 81.8% (CI 0.66-0.93) of the patients. Grip Strength improved significantly in females, outbalancing males. Although the QuickDASH was not significant, the PRWHE’s Minimum Clinical Important Difference (MCID) was exceeded in non-rheumatoid groups. 89.7% Of patients benefitted from the procedure, with a wouldgo- through-again of 92.3%. Prosthesis survival was estimated to be 79% at 7.5 years, but with up to 30%, complication rates are high as well. Conclusion: The Universal 2 is a reliable TWA in both rheumatoid and non-rheumatoid with high patient satisfaction and good medium to long-term survival. Patients experience significant reduction of pain and often recover to functional Range of Motion and grip strength in two to six months. But complications rates are high and the polyethylene inlay may quickly wear out after trauma.
| Item Type: | Thesis (UNSPECIFIED) |
|---|---|
| Supervisor name: | Dr. Kemler, M.A. |
| Faculty: | Medical Sciences |
| Date Deposited: | 18 Oct 2023 11:24 |
| Last Modified: | 18 Oct 2023 11:24 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/3708 |
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