Rheumatoid Arthritis and Atypical Arthritidies-Total Joint Arthroplasty of the Distal Radioulnar Joint for Rheumatoid Arthritis

Total Joint Arthroplasty of the Distal Radioulnar Joint for Rheumatoid Arthritis

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This study evaluated the clinical and radiological outcomes of total joint replacement of the distal radioulnar joint (DRUJ) in patients with rheumatoid arthritis (RA). Seventeen patients with RA underwent 19 total DRUJ replacements. The average age of the patients was 57 years and the mean follow-up period was 39 months. Pain levels, range of motion, and patient satisfaction were evaluated before and after surgery. Radiographic assessment of ulnar translocation of the carpus and the presence of radiolucent zones around the implant were also recorded. <br /><br />The results showed that pain levels decreased significantly after surgery. Pronation and supination both improved, with supination showing statistical significance. The final scores for the Disabilities of the Arm, Shoulder, and Hand (DASH) and Patient-Related Wrist Evaluation (PRWE) were 24, indicating moderate disability. Fifteen patients reported substantial pain relief and all patients were satisfied with their surgical result. <br /><br />There was no increase in ulnar translocation of the carpus after surgery and no radiographic evidence of loosening of the implant. Bone resorption in the distal ulna was observed in 6 patients but did not progress. Two patients required additional surgery, one for revision due to loosening of the ulnar stem and the other for tenolysis. <br /><br />In conclusion, total replacement of the DRUJ in patients with RA is beneficial, resulting in improved pronation, supination, and pain relief. Complications are minimal and overall patient satisfaction is high. Further long-term studies are needed to evaluate the longevity of the prosthesis and the incidence of complications.

Keywords

total joint replacement

distal radioulnar joint

DRUJ

rheumatoid arthritis

pain levels

range of motion

patient satisfaction

ulnar translocation

implant loosening

bone resorption