Wrist Replacement

Your wrist has many small bones in it, not to mention ligaments, tendons and muscles. They all work together to help it move, bend, wave, type. When the joint is stiff, weak or painful, you may quickly notice these everyday things become harder.

Many things can cause your wrist to wear out or get damaged. The most common are:

• Arthritis in your wrist.
• Injuries like bone fractures.
• Osteonecrosis.

Wrist replacement surgery options

When you have wrist replacement surgery, we’ll remove your damaged wrist joint and tissues and replace them with an implant (prosthesis). After surgery, you’ll be able to move and rotate your wrist more naturally. But you won’t be able to put stress on it by grasping heavy objects.

If your lifestyle requires you to put regular stress on the joint — like using power tools or playing competitive sports — this surgery may not be right for you. But there’s an alternative — wrist fusion surgery.

Instead of replacing the joint, we’ll permanently connect (fuse) some (partial fusion) or all (total fusion) of your wrist bones to provide stability, increased strength and pain relief. Another operation can remove some of the arthritic bones (proximal row carpectomy) to provide pain relief. You won’t be able to move your wrist around like before, but you’ll be able to lift and grasp things like tools or a tennis racquet.

What to expect at your first visit

If you’ve started thinking about wrist replacement or surgery for any type of wrist arthritis, chances are you’ve tried other treatments. Maybe physical or occupational therapy (PT or OT). Or steroid injections (cortisone). You might be limiting your activities or have changed how you do things. But nothing’s worked.

It’s natural to feel hesitant about surgery — especially joint replacement. But it can be an effective treatment when other things haven’t worked. Having this surgery is a big decision, though, and we’re here to answer your questions and talk with you about your concerns and what to expect.

When you come in for your first appointment, we’ll ask you to share your story — and your concerns. We’ll want to know about your symptoms, any pain you’re having and what other treatments you’ve tried. We’ll listen carefully so we can help you decide if wrist replacement is right for you.

While you’re here, we’ll also talk with you about your medical history. We’ll check to see how strong your wrist is and how well you can move it. We’ll likely order an X-ray so we can get a better look at your wrist joint. And we’ll make sure you’re healthy enough to have surgery.

We’ll guide you as you consider your options. And we’ll craft a personalized surgery plan aimed at getting you back to doing your favorite activities.

Meet Our Wrist Replacement Team

At Cleveland Clinic, we believe in providing the most personalized care possible. Part of this is making sure you have the right healthcare providers on your side. Our team-based approach to care means we handpick a care team of providers from different specialties based on your needs and goals. Your care team could include:

• Orthopaedists.
• Orthopaedic surgeons.
• Radiologists.
• Anesthesiologists.
• Nurse practitioners.
• Physician assistants.
• Physical therapists.
• Occupational therapists.

When you have wrist replacement surgery, you’ll get a new wrist joint made from strong, durable metal and plastic.

Wrist replacement surgery usually takes less than two hours. Before surgery starts, our anesthesiologists will give you anesthesia, so you’ll be asleep during surgery and won’t feel any pain. Most procedures are done with a “regional block” where your arm can be numbed for anywhere from 12 hours to several days after the operation to decrease pain.

Then, your orthopaedic surgeon will make an incision (cut) at the top of your wrist and remove the joint, cutting away any damaged bone and cartilage. They’ll place the implant and anchor it in place with pins, screws or bone cement. After making sure your new wrist joint can move well, they’ll close the incision with stitches.

You can usually leave the hospital on the same day of your surgery. You’ll wear a wrist splint or cast for several weeks to promote healing and stabilize your wrist. Recovery will take about six to 12 weeks.

After surgery, you’ll have rehabilitation (rehab) like physical or occupational therapy to strengthen your wrist. You’ll also see your care team for several follow-up appointments to make sure your recovery stays on track.

Most wrist implants can last 10 to 15 years before needing to be replaced. You’ll visit us every one to two years so we can look at your wrist and plan for a replacement (revision surgery) if needed.

Taking the Next Step

When wrist pain makes it hard to do things you love, it’s important to know you don’t have to give them up. Wrist replacement surgery can relieve pain — and help your wrist move like it used to. Cleveland Clinic’s expert healthcare providers will walk you through every step, from your first appointment to surgery and throughout recovery and follow-up. We want you to feel confident about moving forward with wrist replacement and get back to all the things you haven’t been able to do.