Constrained implant arthroplasty as a secondary procedure at the distal radioulnar joint: early outcomes

J Hand Surg Am. 2013 Jun;38(6):1111-8. doi: 10.1016/j.jhsa.2013.03.030.


Purpose: To evaluate the clinical and radiological outcomes for the Scheker total joint endoprosthesis when used for previously failed surgeries of the distal radioulnar joint (DRUJ).

Methods: Eight patients with DRUJ derangement with painful instability and 1 patient with DRUJ synostosis received a Scheker DRUJ total joint endoprosthesis between 2006 and 2010. All patients had at least 1 procedure previously performed on the distal ulna (mean, 3.6 procedures). The follow-up time was on average 3.7 years (range, 2-5 y). Standardized preoperative and postoperative assessments included radiographic examination, evaluation of pain by a visual analog scale, and measurements of range of motion and grip strength. We evaluated patient-perceived function with the Disabilities of the Arm, Shoulder, and Hand questionnaire.

Results: There was significant improvement in pain and Disabilities of the Arm, Shoulder, and Hand scores. Grip strength was improved but not significantly. Range of motion was not impaired. We encountered no major complications. Radiographic evaluation showed bone resorption at the distal ulna for most patients and at the tip of a screw in 1 patient, but we found no evidence of implant loosening.

Conclusions: Our short-term results in a limited patient series show that in selected cases, the Scheker total joint endoprosthesis is a safe and efficient treatment option for previously failed surgeries of the DRUJ.

Type of study/level of evidence: Therapeutic IV.

MeSH terms

  • Adult
  • Aged
  • Arthroplasty, Replacement / methods*
  • Female
  • Hand Strength
  • Humans
  • Joint Instability / physiopathology
  • Joint Instability / surgery
  • Joint Prosthesis
  • Male
  • Middle Aged
  • Pain Measurement
  • Prosthesis Design
  • Range of Motion, Articular / physiology
  • Reoperation
  • Treatment Outcome
  • Ulna / surgery
  • Wrist Joint / physiopathology
  • Wrist Joint / surgery*