The Orthobullets Podcast Podiums | Hand | Bioskills Lab: Total Wrist Arthroplasty
Oct 25, 2025
Dr. Jason Nydig, a hand surgery expert specializing in wrist arthroplasty, dives deep into the nuances of total wrist arthroplasty. He discusses optimal patient selection criteria, highlights cutting-edge implant technologies, and shares insights on surgical techniques. Listeners get to hear about a compelling case of wrist osteoarthritis, the importance of preoperative CT scans, and strategies for managing postoperative rehabilitation. Nydig also confronts potential failure modes and offers practical advice for patients' activity levels. This session is packed with valuable information for medical professionals!
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Careful Patient Selection
- Select total wrist arthroplasty only when both radiocarpal and midcarpal joints are involved and alternatives (PRC or partial fusion) aren't viable.
- Favor low-demand patients with good wrist motion and bone stock, especially if the other wrist is fused.
More Implant Options, Better Motion
- Growing implant options improve preservation of wrist motion compared to fusion, benefiting patient satisfaction.
- Rheumatoid patients formed the original cohort, but osteoarthritic patients with better bone quality do better now.
Preserve Carpal Bone Stock
- Preserve carpal bone stock by leaving portions of the scaphoid and using central guides to align components on the capitate.
- Place screws into the second metacarpal carefully and avoid unnecessary hamate crossing.