Have you been experiencing wrist pain for a long time? Is the pain so severe that you can't move your hand, lift something, or do everyday tasks? Maybe you can't even do simple tasks like combing your hair, lifting a cup, or writing. If the pain hasn't subsided despite taking medication and undergoing various treatments, your doctor may have told you about "wrist replacement surgery." Hearing this name can be a little scary. But today, let's talk about everything simply and clearly.
What does this mean, replacing the wrist joint?
Simply put, wrist joint replacement surgery, or in medical terms , wrist arthroplasty , is the surgical removal of your damaged, worn-out wrist joint and the replacement with an artificial joint.
Think of it like removing an old, broken door hinge and replacing it with a new one. We call this artificial joint a prosthesis . It is usually made of metal and a special type of plastic (polyethylene). It is designed to function exactly like a healthy wrist joint.
Our wrist is not just one bone. It is a very complex joint made up of many small bones. This is where our hand and forearm (the part from the elbow to the hand) are connected. When you shake your hand, wash your hair, type on the computer, pick up something from the floor, the wrist joint is the main one in all of these. So when this joint is severely damaged or jammed, even these everyday tasks cause great pain.
What is the difference between joint replacement and joint fusion?
Your doctor may have also told you about a wrist fusion surgery, also known as arthrodesis . There is a big difference between the two. It is important for you to be clear about this.
Simply put, when a joint is fused, the movement of the joint is completely lost. However, when a joint is replaced, you can move the joint to some extent.
Let's understand this difference better from the table below.
| Characteristic | Joint replacement (Arthroplasty) | Arthrodesis/Fusion |
|---|---|---|
| Movement after surgery | The wrist can be bent and extended, with some degree of movement remaining. | The wrist is permanently fixed in one place. It cannot be moved. |
| Pain relief | The pain is relieved very well. | The pain is relieved very well. |
| Weightlifting and activities | Heavy lifting should be limited (generally, lifting more than 2-4 kg is not recommended). Using a hammer, playing tennis, etc. are not recommended. | There are no restrictions on weight lifting or strenuous activities. It lasts a lifetime. |
Why do you need to have this kind of surgery?
This surgery is not the first choice for wrist pain. Doctors recommend it as a last resort after all other treatments have failed to control the pain. Usually, the first thing they try is:
- Changing the work you do (giving your hands a break).
- Painkillers, for example anti-inflammatories.
- Wearing a splint (support) for the wrist.
- Physiotherapy treatment.
- Giving steroid injections.
If none of these things work, surgery is considered. There are several main causes of wrist pain:
- Injury: Something like a broken bone in the wrist (bone fracture).
- Arthritis:
- Osteoarthritis: A condition caused by wear and tear of the joints. This becomes more common with age.
- Rheumatoid Arthritis: A disease that causes swelling and pain in the joints due to a problem with the body's immune system.
- Osteonecrosis: Death of bone tissue due to decreased blood supply to the bone.
This surgery can be a good solution to things like unbearable pain, joint stiffness, and a "cracking" sound when moving your hand.
What happens before the surgery?
This should definitely be done by a bone and joint specialist, especially one who is experienced in hand surgery. Before recommending surgery, your doctor will:
- They will ask about your general health and any other illnesses.
- Ask about how long you've had wrist pain and how it's affecting your life.
- Your wrist will be examined, checking its strength and range of motion.
- An X-ray examination is definitely done to check the condition of the bones.
- Other tests, such as blood tests, may be done to see if you are suitable for surgery.
- They will make sure that all other treatments have been tried and that they have discussed other surgical options with you.
How is the surgery done?
This surgery is usually performed in a hospital. It takes less than two hours. The following steps are followed during the surgery:
1. You will be given a general anaesthetic to put you completely to sleep. In addition, you may be given a separate anaesthetic injection (upper extremity block) just for your arm to help reduce pain after the surgery.
2. A small incision is made above the wrist.
3. The damaged joint and worn-out cartilage and bone fragments are carefully removed.
4. The previously made artificial joint (prosthesis) is inserted and secured to the bone with small nails, screws, or a special type of cement (bone cement).
5. Make sure the artificial joint is in the correct position and is properly secured.
6. Check to see if the joint moves properly.
7. The surrounding tissues, nerves, and tendons are repositioned.
8. Finally, the incision is closed with stitches and covered with an antiseptic bandage and a splint.
How long does it take to recover? How can I take care of myself at home?
It usually takes about 6 to 12 weeks to fully heal. After the initial cast is removed, you will need to wear a splint for a while.
The best secret to a speedy recovery is to follow the doctor's instructions and exercise properly during the recovery period.
Although it may hurt a little when you exercise at first, over time the pain will decrease and your hand function will improve. Your doctor may also refer you to a physical therapist.
Take special care of these things at home:
- Someone to help: It's much easier to have someone to help you with daily tasks in the first few days after surgery.
- Avoid lifting heavy objects: This is very important. Do not lift more than the weight your doctor recommends (usually 2-3 kg), as this can damage the artificial joint. If you follow this correctly, you can use your artificial joint for a long time.
- Protect yourself from falls: Be careful of places in your home where you might slip and fall (bathroom, stairs). Stay away from sports that may cause you to fall for a while.
- Work that puts strain on your hands: Avoid work that puts strain on your hands, such as using a hammer.
How long does an artificial joint last? When should I see a doctor?
If well cared for, this artificial joint will usually last about 10 to 15 years .
After surgery, if you have any of the following symptoms, see your doctor immediately. These may be signs of an infection:
- Fever or chills.
- Redness or swelling around the wound.
- Pus or a foul-smelling fluid oozing from the cut.
- Persistent or increasing pain.
Over time, as the prosthesis wears out or other problems develop, these symptoms may occur. If this happens, tell your doctor:
- Decreased function or strength of the joint.
- Recurrence of pain, stiffness, or swelling.
- Feeling as if the joint is unstable (as if it is "jumping").
Take-Home Message
- Wrist replacement surgery is a successful treatment for severe joint pain caused by conditions such as arthritis, but it is only recommended when all other treatments have failed.
- Although some movement of the wrist is regained after this surgery, heavy lifting should be limited. Fusion surgery is more suitable for strenuous activities.
- During the recovery period, following medical instructions and physical therapy exercises exactly is essential for a quick and successful recovery.
- If you notice any signs of infection after surgery, such as fever, swelling of the wound, or pus, see your doctor without delay.
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