Proximal-distal shift of the center of rotation in a total wrist arthroplasty is more than twice of the healthy wrist. Academic Article uri icon

Overview

abstract

  • Reproduction of healthy wrist biomechanics should minimize the abnormal joint forces that could potentially result in the failure of a total wrist arthroplasty (TWA). To date, the in vivo kinematics of TWA have not been measured and it is unknown if TWA preserves healthy wrist kinematics. Therefore, the purpose of this in vivo study was to determine the center of rotation (COR) for a current TWA design and to compare its location to the healthy wrist. The wrist COR for six patients with TWA and 10 healthy subjects were calculated using biplane videoradiography as the subjects performed various range-of-motion and functional tasks that included coupled wrist motions. An open-source registration software, Autoscoper, was used for model-based tracking and kinematics analysis. It was demonstrated that the COR was located near the centers of curvatures of the carpal component for the anatomical motions of flexion-extension and radial-ulnar deviation. When compared to healthy wrists, the COR of TWAs was located more distal in both pure radial deviation (P < .0001) and pure ulnar deviation (P = .07), while there was no difference in its location in pure flexion or extension (P = .99). Across all coupled motions, the TWA's COR shifted more than two times that of the healthy wrists in the proximal-distal direction (17.1 vs 7.2 mm). We postulate that the mismatch in the COR location and behavior may be associated with increased loading of the TWA components, leading to an increase in the risk of component and/or interface failure.

publication date

  • May 25, 2020

Research

keywords

  • Arthroplasty, Replacement
  • Wrist Joint

Identity

PubMed Central ID

  • PMC7336861

Scopus Document Identifier

  • 85085542424

Digital Object Identifier (DOI)

  • 10.1002/jor.24435

PubMed ID

  • 32401391

Additional Document Info

volume

  • 38

issue

  • 7