Replacing Worn Out Wrists

PHILADELPHIA, Penn. When James Murphy stashed his skiis at the end of the season, he was afraid they'd be in storage for good. The avid sportsman tackled some of America's toughest slopes, but rheumatoid arthritis took its toll. Murphy suffered constant pain and stiffness in his wrists.

"It was difficult, because I only had two fingers that I could hold on to the pole with," Murphy said. "I couldn't plant as much as I wanted to."

In the past, the best way to relieve pain was to fuse bones together -- limiting mobility. Now orthopedic specialists replace the entire wrist -- much more complicated than a hip or knee replacement.

"There are eight bones in the wrist," Randall Culp, M.D., a hand and wrist specialist at the Philadelphia Hand Center at Methodist Hospital in Philadelphia, Penn., told Ivanhoe. "If you add that to the two forearm bones, you're talking about ten bones that need replacement."

Surgeons make an incision in the back of the wrist. They implant metal parts to support the forearm and fingers, and a plastic spacer holds the joint together and allows movement.

"We're also using what we call porous in-growth," Dr. Culp said. "We don't use bone cement anymore. This is all done through your own bone growing into the prosthesis."

Murphy needed weeks of physical therapy to regain strength, but the pain was gone immediately after surgery.

"I'm gonna feel a whole lot better by the time ski season comes around," he said.

Doctors say the wrist prosthesis is a newer one, so they are still studying how long it will last. They say most patients will do well for at least 10 years.


Thomas Jefferson University Hospital
(800) JEFF-NOW

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