[Implant Arthroplasty in the Hand and Wrist].

The first implant arthroplasties were conducted as early as the end of the 19th century. After a few decades, during which surgeons focused on the hip and knee, research on joint arthroplasty of the hand and wrist was intensified. Today, it is possible to implant a prosthesis in nearly every joint of the hand and wrist, giving us an alternative to joint fusion in severe joint destruction. The main advantage of arthroplasty is the preservation of motion. In the metacarpophalangeal and proximal interphalangeal joint every new implant is rivaled by the silicone spacer which has proven its value over decades. Further, no implant in the thumb carpometacarpal joint was able to outmatch the time-tested trapezectomy with LRTI (ligament reconstruction and tendon interposition) due to high implant-loosening rates in the past. In wrist arthroplasty, studies have shown good results concerning pain reduction, function and grip strength. Complication rates however are still higher compared to joint fusion.The results improved with the latest implant designs, yet long-term outcomes, especially for the young, high-demand patients, are missing.