Long-term results of Swanson interpositional wrist arthroplasty: Part II.

Fifty-eight Swanson silicone interpositional wrist arthroplasties were done in 47 patients between 1974 and 1984. Thirty-nine of these original wrists were available for follow-up an average of 5.8 years after operation. This is a continuation of our study previously published in this Journal. With increased follow-up, progressive deterioration of clinical results was noted. With a follow-up of less than 2.5 years, 75% had relief of pain. After a follow-up of 4.8 years, 67% had relief of pain. Finally, with an average follow-up of 5.8 years, only 51% had relief of pain. Progressive radiographic changes are now obvious in each case compared with 70% of those cases reviewed at 4.8 years. Furthermore, we now have noted cystic changes in a significant proportion of the wrists radiographically. In several of these, silicone synovitis has been documented histologically. Our indications for this procedure have drastically narrowed.