Total wrist arthroplasty: recent advances and current recommendations.

The latest generation of wrist arthroplasties provides good clinical function and pain relief with an acceptable revision/reoperation rate. The procedure is complex and technically demanding, both for the surgeon and the patient. The available implants (with the exception of one) have not been developed or refined in the last decade, which reduces the versatility and ability to adapt to specific patient anatomy, to manage implant/treatment problems and to perform successful revisions. Medical device regulation in Europe has led to a halt in development and a reduction in available implants for niche products such as wrist arthroplasty. To improve long-term outcomes after implantation, surgeons should refine and review their skills, implement improvements, avoid complications reported by experienced colleagues, and expect a learning curve and follow-up surgery. The author reviews the pitfalls and requirements of modern wrist arthroplasty.