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The Bone & Joint Journal
Vol. 98-B, Issue 12 | Pages 1642 - 1647
1 Dec 2016
Badge R Kailash K Dickson DR Mahalingam S Raza A Birch A Nuttall D Murali SR Hayton MJ Talwalkar S Watts AC Trail IA

Aims

The aims of this study were to evaluate the clinical and radiological outcomes of the Universal-2 total wrist arthroplasty (TWA) in patients with rheumatoid arthritis.

Patients and Methods

This was a retrospective review of all 95 Universal-2 TWAs which were performed in our institution between 2003 to 2012 in patients with rheumatoid arthritis. A total of six patients were lost to follow-up and two died of unrelated causes. A total of ten patients had bilateral procedures. Accordingly, 75 patients (85 TWAs) were included in the study. There were 59 women and 16 men with a mean age of 59 years (26 to 86). The mean follow-up was 53 months (24 to 120). Clinical assessment involved recording pain on a visual analogue score, range of movement, grip strength, the Quick Disabilities of the Arm, Shoulder and Hand (DASH) and Wrightington wrist scores. Any adverse effects were documented with particular emphasis on residual pain, limitation of movement, infection, dislocation and the need for revision surgery.

Radiographic assessment was performed pre-operatively and at three, six and 12 months post-operatively, and annually thereafter. Arthroplasties were assessed for distal row intercarpal fusion and loosening. Radiolucent zones around the components were documented according to a system developed at our institution.


Orthopaedic Proceedings
Vol. 94-B, Issue SUPP_XXXIX | Pages 143 - 143
1 Sep 2012
Kailash K Raza A Mahalingham S Talwalkar S
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Introduction

Total Wrist Arthroplasty (TWA) for Rheumatoid Arthritis (RA) of wrist allows pain relief and preservation of the movements.

Aims

The aims of current study were to evaluate outcomes of Universal-2® TWA at a tertiary centre.


Orthopaedic Proceedings
Vol. 93-B, Issue SUPP_I | Pages 1 - 1
1 Jan 2011
Kailash K Guhan B Lee A
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This is a study of 24 patients (28 Knees) who underwent acute repair for quadriceps and patellar tendon ruptures using Leeds Keio ligament. Four patients had bilateral quadriceps tendon rupture.

The mean age of patients was 57.4 years (range from 20 to 85 years) with mean follow-up of 20 months (range from 2 months to 3 years). Four patients (6 knees) were lost in follow-up. Knee injury and Osteoarthritis and Outcome Score (KOOS) and Tegner Lysholm Knee Score were used to evaluate the outcome. Sixteen patients had scores of 80 and above in both scoring systems. The mean flexion was 125° and extension lag of 6.6°. The knees were not immobilised after surgery and patients were encouraged to fully weight bear.

One patient had patella fracture secondary to fall although technical error played a part in this. Two patients had bilateral ruptures secondary to fall and one patient had ectopic bone formation. There was no wound infection.

This technique permits immediate mobilisation and full weight bearing of the limb. The early results are promising but long term results are yet to be evaluated.