WRIST ARTHRITIS

Arthritis Condition Osteoarthritis Wrist Arthritis

Wrist Arthritis PIP Arthritis  DIP Arthritis CMC Arthritis

Wrist arthritis is a common condition that affects a significant number of people, particularly as they age. While the more well-known forms of arthritis, such as osteoarthritis and rheumatoid arthritis, often take the spotlight, wrist arthritis can be equally debilitating and challenging to manage.

The wrist joint is by far the most complicated joint in the body. It comprises the two forearm bones, the radius and the ulna. These two bones have a very complicated cylindrical joint between them, facilitating rotation of the forearm. The wrist joint articulates in a complexity of kinematics and movements utilizing eight carpal bones. So, when we refer to any wrist arthritis, we are usually pinpointing the area between the radius and the carpal bones and, more specifically, between the radius, the scaphoid and the lunate.

When we refer to arthritis in any form, we are referring to a loss of cartilage, and the specific joints can be affected by rheumatoid arthritis or any other inflammatory arthritic conditions. Therefore, the loss of cartilage in this joint is usually secondary to other conditions, and we don't usually get the classic primary osteoarthritis. The arthritis we see in the wrist joint is usually secondary to a trauma event, like a wrist fracture. It could also be secondary to a scaphoid fracture that does not heal, and this is called a scaphoid non-union advanced collapse. Thirdly, osteoarthritis can expose itself through a ligament injury in the wrist, specifically the scapholunate ligament. This is called a scapho-lunate advanced collapse. Thus, when we are dealing with wrist arthritis, it is usually a result of one of these three conditions.

When the cartilage is lost between the radius and the carpal bones, patients will typically experience a limited range of motion with swelling of the wrist, inability to use the hand, and also a loss of grip strength, with the pain preventing them from doing most of their usual activities of daily living.

Treatment

When we evaluate the wrist clinically and radiologically, it is important to see if there is any preserved cartilage. If there is good cartilage left between the lunate and the radius, we perform a limited fusion, removing some of the scaphoid. This procedure is called a scaphoidectomy and a four-corner fusion, where the lunate, capitate, hamate and triquetrum bones are fused. This procedure gives good results for patients with advanced SNAC (scaphoid non-union advanced collapse) and SLAC (Scapholunate advanced collapse) wrists.

In certain cases where there is no cartilage preserved between the scaphoid or the lunate and where arthritis has progressed to the mid-carpal joint, the only option is to do a total wrist replacement. This procedure yields excellent results in carefully selected patients. The concept of replacing the bearing surfaces of the wrist joint is the same that one would do for a total hip or knee joint replacement. The total wrist replacement that we use has a good track record in the wrist. The wrist joint, being a ball and socket joint, is therefore expected to facilitate the improvement of range of motion, as it would in other similar anatomical structures.

It's important to consult with our qualified healthcare professionals to ensure the appropriate diagnosis and treatment plan for your specific situation.