Complications of Semiconstrained Distal Radioulnar Joint Arthroplasty

J Hand Surg Am. 2018 Jun;43(6):566.e1-566.e9. doi: 10.1016/j.jhsa.2017.11.004. Epub 2017 Dec 22.


Purpose: The Aptis total distal radioulnar joint (DRUJ) prosthesis is a semiconstrained implant designed for treatment of DRUJ arthritis and instability. The purpose of this study was to analyze short-term complications of this device.

Methods: We performed a retrospective chart review of patients undergoing semiconstrained DRUJ arthroplasty from 2007 to 2015 at a single institution. Records were analyzed for complications and the need for subsequent surgical procedures.

Results: Two senior hand surgeons at one institution performed 52 semiconstrained DRUJ arthroplasties over 8 years. Nineteen complications necessitating operative management occurred in 15 patients (29%). A total of 26 procedures were undertaken to address these complications. Complications included 4 periprosthetic fractures, 3 infections, 2 instances of aseptic loosening, 2 implant component failures, 1 instance of screw loosening, 3 neuromas requiring neurectomy, 2 instances of finger stiffness necessitating extensor tenolysis, and 2 cases of heterotopic ossification at the DRUJ. Three of the 52 implants were revised (6%) and 2 were explanted (4%); 3 of these (6%) were caused by deep infection.

Conclusions: There is limited literature on outcomes of the semiconstrained DRUJ prosthesis. Prior studies reported low complication rates, with 0% to 5% revisions. In the current clinical series, 29% of patients required further surgery for complications, the most common reasons for which were periprosthetic fracture and infection.

Type of study/level of evidence: Therapeutic IV.

Keywords: Arthritis; arthroplasty; distal radioulnar joint; instability; prosthesis.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Arthritis / surgery*
  • Arthroplasty, Replacement / adverse effects*
  • Arthroplasty, Replacement / instrumentation
  • Device Removal / statistics & numerical data
  • Female
  • Humans
  • Joint Instability / surgery*
  • Joint Prosthesis*
  • Male
  • Middle Aged
  • Postoperative Complications
  • Reoperation / statistics & numerical data
  • Retrospective Studies
  • Wrist Joint / diagnostic imaging
  • Wrist Joint / surgery*
  • Young Adult