Bibliographic record
Abstract
Purpose: Management of failed total wrist arthroplasty (TWA) can be challenging, and treatment options include salvage arthrodesis or revision arthroplasty. To our knowledge, there are no previously published series on this subject. The aim of the study was to report outcome after revision arthroplasty of the wrist operated at a Swedish referral center. Methods: A cohort of 18 consecutive revision TWAs was evaluated preoperatively, 1 and 5 years postoperatively. Indication for revision arthroplasty was failed TWA. The operations were performed between 2003 and 2015. The primary endpoint was implant survivorship. Secondary outcome measures included visual analogue scale (VAS) pain scores, range of motion, hand grip strength, and functional scoring with Canadian Occupational Performance Measure (COPM). Results: Of the 18 revision cases, 4 were revised after a mean of 4.5 years (range, 3-5 years). Mean follow-up was 6.1 years (range, 1-12 years). Synthetic bone graft was used in 9 cases, allogenous corticocancellous bone graft in 1 case, and cement in 6 cases. Of the revised cases, 1 TWA was removed because of infection and 3 cases underwent total wrist arthrodesis. Range of motion and grip strength was preserved compared with preoperative results. VAS pain score at rest and in activity decreased considerably 1 year (0 at rest; 2.4 in activity) and 5 years postoperative (0.1 at rest; 1.1 in activity) compared with preoperative results (1.5 at rest; 3.8 in activity). COPM performance and satisfaction were improved considerably 1 year (5.9 performance; 6.6 satisfaction) and 5 years postoperative (4.1 performance; 4.3 satisfaction) compared with preoperative results (3.5 performance; 3.1 satisfaction). Conclusion: Revision arthroplasty of the wrist is a motion preserving option to wrist arthrodesis in the management of failed TWA. Good functional outcome can be achieved in selected cases.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.003 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".