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Wrist Replacement Surgery in India

Advanced wrist joint replacement for severe arthritis and wrist pain relief.

Overview

Wrist Replacement Surgery, also called Total Wrist Arthroplasty, is an advanced surgical procedure designed to replace a severely damaged wrist joint with artificial components, providing pain relief and restoring function for patients with debilitating wrist arthritis or injury. The wrist is a complex joint system comprising eight small carpal bones connecting the forearm (radius and ulna) to the hand, allowing for intricate movements essential for daily activities. Dr. Gurudeo Kumar at Arthoscenter brings extensive experience in upper extremity surgery, having performed numerous wrist replacement procedures with excellent outcomes. While wrist replacement is less common than knee or hip replacement due to the complexity of wrist biomechanics and the availability of alternative treatments like wrist fusion, it offers significant advantages for select patients, particularly those requiring bilateral wrist use for work or daily activities. Modern wrist implants consist of metal and plastic components that replicate the natural gliding motion of the wrist joint. The procedure involves removing damaged bone and cartilage from the radius and carpal bones, then inserting precisely designed prosthetic components that allow for flexion, extension, and some degree of side-to-side movement. Success rates for wrist replacement have improved dramatically with newer implant designs, achieving 80-90% good to excellent results at 5-10 years. Ideal candidates for wrist replacement include patients with severe rheumatoid arthritis, post-traumatic arthritis following wrist fractures, advanced osteoarthritis, or avascular necrosis who have failed conservative treatments and desire to maintain wrist motion (as opposed to wrist fusion which eliminates motion but provides stability). The procedure is particularly beneficial for elderly patients with low physical demand and those requiring use of both hands for self-care activities.

Symptoms & Indications

This surgery may be recommended if you experience:

Severe chronic wrist pain limiting daily activities

Significant loss of wrist motion and grip strength

Difficulty performing basic tasks (turning doorknobs, opening jars)

Pain at rest and night pain affecting sleep

Visible wrist deformity or swelling

Inability to bear weight on hands (push-ups, transfers)

Weakness and instability in the wrist

Failed conservative treatments (medications, splints, injections)

X-ray evidence of severe arthritis with joint space loss

Rheumatoid arthritis affecting multiple joints including wrist

Procedure Details

Duration

2-3 hours

Anesthesia

General Anesthesia or Regional Block

Preparation for Surgery

Comprehensive wrist X-rays and CT scans for surgical planning. Bone density assessment. Occupational therapy evaluation. Discussion of realistic expectations regarding motion and strength recovery. Optimization of rheumatoid arthritis medications if applicable.

Surgical Steps

General or regional anesthesia (axillary block)

Patient positioned supine with arm on hand table

Longitudinal incision on back of wrist (dorsal approach)

Careful dissection protecting tendons and nerves

Exposure of wrist joint capsule

Removal of damaged portions of radius and carpal bones

Precise bone preparation for implant components

Trial implants to test fit and motion

Insertion of final radial and carpal components

Cement or press-fit fixation depending on bone quality

Testing of wrist motion and stability

Meticulous wound closure in layers

Application of well-padded bulky dressing

Placement in short-arm splint for initial protection

Recovery Timeline

What to expect during your recovery journey

Week 1-2

Splint immobilization, finger exercises

Keep wrist in protective splint, move fingers to prevent stiffness, manage pain and swelling with ice and elevation

Week 3-6

Begin gentle wrist exercises

Start occupational therapy, gentle passive motion exercises, continue splint protection between exercises

Week 7-12

Active range of motion

Progress to active wrist movements, light daily activities permitted, no heavy lifting or twisting

Month 4-6

Strengthening exercises

Gradual grip strengthening, increase functional activities, return to light work duties

Month 7-12

Full recovery

Return to most daily activities, avoid high-impact or heavy manual labor, maintain exercise program

Long-term

Maintenance

Regular follow-ups, protect wrist from falls and impacts, maintain flexibility and strength

Tips for Faster Recovery

Elevate hand above heart level frequently for first 2 weeks

Perform finger exercises hourly to prevent stiffness

Follow occupational therapy program diligently

Avoid lifting anything heavier than a cup of coffee for 3 months

Protect wrist from falls - use walking aids if balance concerns

Wear splint as directed, especially during sleep

Apply ice to reduce swelling (20 minutes, 3-4 times daily)

Take pain medications as prescribed

Do not attempt forceful gripping or twisting motions

Report any signs of infection (redness, warmth, drainage)

Avoid high-impact activities lifelong

Consider wrist protection during activities with fall risk

Frequently Asked Questions

Common questions about this procedure

Q1.How is wrist replacement different from wrist fusion?

Wrist replacement preserves motion (typically 50-70% of normal), allowing flexion, extension, and some lateral movement, which is beneficial for daily activities. Wrist fusion (arthrodesis) eliminates pain by removing the joint and fusing bones together, providing excellent pain relief and stability but no motion. Replacement is preferred for patients needing bilateral hand function, while fusion is better for younger, active patients or manual laborers who need strength over motion.

Q2.What is the success rate and longevity of wrist implants?

Modern wrist replacement implants achieve 80-90% good to excellent results at 5-10 years. Longevity has improved significantly with newer designs, with many implants lasting 10-15 years or longer. Factors affecting longevity include patient age, activity level, bone quality, rheumatoid arthritis control, and adherence to activity restrictions. Revision surgery may be needed if the implant loosens, wears out, or complications develop.

Q3.Who is the ideal candidate for wrist replacement?

Ideal candidates are typically older patients (60+) with severe rheumatoid arthritis or post-traumatic arthritis, low physical demand lifestyle, need for bilateral hand use, and failed conservative treatments. Good bone quality, realistic expectations, and ability to comply with rehab protocols are important. Younger patients, manual laborers, or those with high activity demands are usually better candidates for wrist fusion.

Q4.What activities can I do after wrist replacement?

After full recovery, most daily activities are possible including dressing, eating, personal hygiene, light housework, computer work, and driving. Recreational activities like golf (modified swing) and swimming are typically allowed. However, you must avoid: lifting more than 5-10 pounds, high-impact sports, contact sports, push-ups or bearing full body weight on hands, and activities requiring forceful gripping or twisting. Dr. Kumar will provide specific guidelines based on your implant and recovery.

Q5.How much wrist motion will I regain?

Typical motion after wrist replacement is 50-70% of normal wrist motion, which is usually adequate for most daily activities. You can expect approximately 30-40 degrees of flexion and extension combined (normal is 130-140 degrees total), and limited side-to-side (radial-ulnar deviation) movement. While not full motion, this is significantly better than the pre-surgery arthritic state and maintains functional independence.

Q6.What are the main risks and complications?

Risks include: infection (2-3%), implant loosening requiring revision (10-15% at 10 years), dislocation of components (rare with modern designs), nerve injury causing numbness, stiffness limiting motion, fracture of surrounding bones during or after surgery, tendon irritation or rupture, complex regional pain syndrome (CRPS), and need for conversion to wrist fusion if replacement fails. Most complications can be managed if detected early through regular follow-up.

Q7.How long is the recovery and rehabilitation?

Recovery timeline: splint immobilization for 2 weeks, begin gentle therapy at 3-6 weeks, active motion by 8-12 weeks, strengthening at 3-4 months, and full recovery by 6-9 months. Occupational therapy is essential, typically 2-3 sessions weekly for 3-4 months. Most patients achieve maximum benefit by 9-12 months. Unlike knee or hip replacement, wrist replacement requires patient commitment to protective precautions lifelong.

Q8.Can both wrists be replaced at the same time?

Bilateral simultaneous wrist replacement is generally not recommended due to the need for at least one functional hand during recovery for self-care activities (eating, dressing, personal hygiene). Most surgeons recommend staging procedures 3-6 months apart, allowing the first wrist to recover sufficiently before replacing the second. However, for patients with severe bilateral disease and adequate support systems, simultaneous surgery may be considered in select cases.

Q9.What is the cost of wrist replacement in India?

At Arthoscenter, wrist replacement surgery costs approximately ₹2.5-4 lakhs all-inclusive, covering implant, surgery, hospital stay, anesthesia, and initial follow-up. This is significantly more affordable than international costs (₹8-15 lakhs abroad). Final cost depends on implant choice, hospital stay duration, and any complications. We accept insurance (PMJAY, BSKY, private insurance) and offer transparent pricing. Book a ₹999 consultation to discuss your specific case and receive detailed cost estimate.

Q10.What type of follow-up care is needed?

Follow-up schedule: first visit at 2 weeks for wound check and splint removal, then at 6 weeks, 3 months, 6 months, 1 year, and annually thereafter. X-rays are taken at each visit to monitor implant position, bone integration, and detect early loosening. Regular occupational therapy for first 3-4 months is crucial. Patients should report any new pain, swelling, weakness, or mechanical symptoms immediately. Lifelong awareness of activity restrictions is essential to protect the implant.

Considering This Surgery?

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