We compared the outcomes of the Amandys® implant and four-corner fusion in patients aged over 50 years with grade 3 wrist osteoarthritis and a mean follow-up of 5 years. Clinical assessments were of pain, mobility, strength, functional scores and satisfaction. Radiographs were taken. A total of 46 patients (mean age 63 years; 28 four-corner fusion and 21 Amandys®) were included. Pain relief, mobility and functional scores were not significantly different in the two groups at inclusion. At the last follow-up, wrist extension and grip were improved after Amandys® arthroplasty. Flexion decreased after four-corner fusion. One patient in the Amandys® group was not satisfied and one dislocation required repositioning of the implant. There were six nonunions, of which one required revision surgery in the four-corner fusion group. With the Amandys®, immobilization was shorter and mobility improved, making it a valid alternative to four-corner fusion especially in older patients.Level of evidence: IV.
Keywords: Amandys®; four-corner fusion; grade 3 wrist osteoarthritis; partial wrist fusion; pyrocarbon interposition; wrist arthroplasty.