Osteoarthritis of the wrist
What is Osteoarthritis of the wrist?
Wrist osteoarthritis is wear of the cartilage in the radiocarpal or midcarpal joints. It may follow previous fracture, ligament injury such as scapholunate instability, inflammatory disease, avascular necrosis or gradual age-related degeneration.
Common symptoms
Patients commonly report wrist pain, stiffness, swelling, reduced grip strength, clicking, loss of extension and difficulty with push-ups, golf, tennis, manual work or weight-bearing through the hand.
Diagnosis and imaging
X-rays show joint space narrowing, collapse patterns, bone spurs and previous injury. CT can define deformity and joint involvement in greater detail. MRI is useful when early disease, ligament injury or avascular necrosis is suspected.
Non-surgical treatment
Treatment includes splinting, hand therapy, activity modification, anti-inflammatory medication and corticosteroid injection. The goal is to reduce pain while preserving as much useful motion and grip strength as possible.
Surgical treatment
Surgery is tailored to the pattern of arthritis. Options include denervation, arthroscopic debridement, proximal row carpectomy, partial wrist fusion, total wrist fusion or wrist replacement in selected patients.
Recovery and follow-up
Recovery depends on the procedure. Motion-preserving operations require therapy and gradual loading, while fusion procedures prioritise pain relief and strength but sacrifice some or all wrist movement.
Osteoarthritis of the wrist FAQs
Why does wrist arthritis occur after an old injury?
Previous fractures or ligament injuries can change wrist mechanics. Over time, abnormal loading may lead to progressive cartilage wear.
How is osteoarthritis of the wrist diagnosed?
Diagnosis starts with a focused history and examination, then uses imaging selectively to confirm the pattern of injury, exclude related problems and plan treatment accurately.
Can wrist arthritis be treated without losing all motion?
Often yes. The best option depends on which joints are involved. Some procedures preserve useful motion while reducing pain.
Will I need surgery for osteoarthritis of the wrist?
Many patients improve without surgery. Surgery is considered when symptoms remain limiting despite appropriate non-surgical care, when there is significant structural damage, or when delay may compromise function.
When can I return to manual work or sport?
Return depends on the diagnosis, treatment type, tissue healing and the physical demands of the activity. The plan is usually staged, with strength, range of motion and confidence rebuilt before unrestricted loading.
Reconstructive Orthopaedics Melbourne (ROM)
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