The Operation

Some severe degenerative problems of the wrist may require replacement of the painful wrist joint with an artificial wrist joint replacement. The decision to proceed with surgery should be made jointly by you and your doctor.

Once the decision to proceed with surgery is made, your orthopaedic surgeon may suggest a complete physical examination by your family doctor to ensure you are in the best possible condition to undergo the operation. You may also need to see a physical therapist who will be managing your rehabilitation after the surgery. The therapist will prepare you before the surgery to ensure you are ready for the rehabilitation afterwards. One purpose of the preoperative visit is to record a baseline of information including measurements of your current pain levels, functional abilities, and the available movement and strength of each hand. The preoperative visit also prepares you for your upcoming surgery.

The operation to replace an arthritic wrist begins with an incision through the skin on the back of the wrist.

The surgeon can then move the tendons extending over the back of the wrist out of the way. This allows the surgeon to access the joint capsule on the back of the wrist joint, which is then opened to expose the wrist joint surfaces.

A portion of the carpal bones and the end of the radius and ulna are then removed from the wrist to make room for the new artificial wrist joint.

The bones of the hand and the radius bone of the forearm are prepared using special instruments that form holes in the bones to fit the stems of the artificial joint components.

Next the components are inserted into the holes. Once the proper fit is obtained, the surgeon will test the range of motion of the joint to ensure that it moves correctly. Once satisfied with the fit, the surgeon cements the two sides of the joint into place.

The tendons are placed back into their proper position and the wound is closed.

Following surgery, patients are placed into a bulky bandage and a splint. A small plastic tube may be used to drain any blood that gathers under the incision to prevent excessive swelling from the blood. (This is sometimes referred to as a hematoma.) This plastic drain will probably be removed within 24 hours.