Wrist Replacement
When arthritis makes doing even the simplest things with your hands impossible, many doctors in the United States have only recently begun to reconsider total wrist replacement. Houston Public Radio's Rod Rice reports that the surgery can have a dramatic effect.

By: Rod Rice
Posted at: kuhf.org
Monday, January 22, 2007

"It's like getting my life back again."

Ruby Chambers' everyday life had been limited by the arthritis in her left wrist.

"I had trouble using this hand, there was so much pain in the wrist that I had trouble buttoning buttons, doing things around the house, say for instance, pulling open the door to the dishwasher, to the wall oven, that sort of thing. I had gotten to the point I couldn't make up my bed."

Surgery to alleviate arthritic pain is usually the last option, and until recent years it usually meant fusing the wrist. Evan Collins is an orthopedic surgeon at Houston Methodist Hospital.

"When you fuse to bones together they don't move. So essentially you remove as much of the cartilage that's present in the wrist that's left from the arthritic wrist, and you either plate it or pin it, put large screws in or staples to essentially obliterate the joint so when to bone heals there is no motion."

Now, say Dr. Collins, total wrist replacement, which has been more popular in Europe, is an alternative finding a new acceptance in the US.

"Now, with better wrists designs, better implants that spare more bone then there has been in the past that these total wrists now have a higher success rate. For patients in the past that we would only offer fusions for now were offering an option which is a motion sparing procedure such as a total wrist."

A totally new wrist does have its limitations.

"This isn't something for someone who is a construction worker or who is a professional athlete. These are things for people who at to maintain a range of motion and a lifestyle and certainly the activities of daily living, but won't be putting a lot a pressure on it. There is a limit to what you can lift, about 15 to 20 pounds. If you are very active, if you are doing a lot of heavy lifting, this might not be an option."

But for Ruby Chambers the end result means less dependence on others for the simplest tasks.

"You have to have someone cut up your food for you, now you can do that for yourself. And, it's tremendous that you can do all of these things that you couldn't do before."