American Association of Plastic Surgeons

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3D Printing for Total Wrist Arthroplasty: Proof of Concept Study
Ji H. Son, MD.
University Hospitals Case Medical Center, Cleveland, OH, USA.

PURPOSE:
Total wrist arthroplasty is increasing worldwide. The available implants vary in concept and design. A current, widely used system has two metallic components, the radial component and the carpal component, with a spacer between these two components. The wrist is a complex structure and the current total wrist arthroplasty systems partially replicate the anatomy of the wrist.
METHODS:
This is a proof of concept study. Cadaver wrists underwent computed tomography (CT). The right wrist was used as a reference and it was utilized to formulate the 3D model for the left total wrist prosthesis. After the 3D printout of left total wrist arthroplasty was obtained, osteotomy was performed on the cadaver left distal radius shaft, and the 3D printout model was implanted to the cadaver wrist. The model was rigidly fixated to the carpus and second and third metacarpals. Passive range of motion was measured in the cadaver wrist. Computer models were used to assess the contact stress distributions between the customized 3D model versus commercially available total wrist prosthetic.
RESULTS:
The contact stress distribution was analyzed. The passive range of motion obtained from the cadaver wrist after implanting the 3D model was 35 degrees dorsiflexion, 40 degrees flexion, 8 degrees radial deviation, and 15 ulnar deviation, which is comparable to commercial prosthetics.
CONCLUSION:
The wrist is a highly complex and dynamic structure. 3D printing has the potential to provide total wrist implant that can best restore anatomic integrity.


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