Wrist Joint Arthroplasty In Rheumatoid Arthritis: A Comparison Between The Meuli And Swanson Prostheses

A personal series of twelve wrist arthroplasties performed on ten patients with rheumatoid arthritis of the radio-carpal joint were reviewed in retrospect. Six arthroplasties were of the Meuli metal/plastic/metal design and six were of the Swanson silastic type with an additional silastic ulnar head prosthesis. Both prostheses were successful in giving a pain free stable joint with some degree of useful movement. The Meuli appeared to give a greater ange of movement than the more constrained Swanson prosthesis. Although complications were encountered it is concluded that wrist arthroplasty does have a place in the management of patients with rheumatoid arthritis of the radio-carpal joint. Our present policy is to continue with the use of the Swanson design because of the advantages of a cement free prosthesis. The wrist joint is commonly affected in rheumatoid arthritis. The disease process leads to destruction of ligaments and tendons and erosion of bone and cartilage, resulting in pain, deformity, instability and impaired function. In the early stages of the disease, relief can be obtained by the use of anti-inflammator