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Total wrist replacement perfected, popular by Heather Woolwine Public Relations Once rare to come by, total wrist replacements have increased among the population as research dollars pour into development and more orthopaedic surgeons focus on perfecting the procedure. Despite its 30-year presence within the medical community, total wrist arthroplasty only began to receive increased interest and funding in the last few years. “Total wrist fusion used to be the gold standard for any type of extensive wrist damage because everyone was very focused on hip and knee replacements,” said orthopaedic surgeon Chris Litts, M.D. “It took a while for total wrist arthroplasty to become a forefront procedure.” Litts and his colleague in the Department of Orthopaedic Surgery, Patrick O’Neil, M.D., are the only surgeons who offer the procedure east of Greenville. Used primarily for patients who suffer from rheumatoid arthritis or other types of inflammatory arthritis, total wrist arthroplasty involves a stainless steel and plastic implant whose job is to restore some functioning for otherwise destroyed wrists. While many tasks involving some light lifting or typing are okay to perform after the surgery, anyone whose job requires construction or manual type labor should not consider this option.  Total wrist fusion is better for these patients, and involves fusing together bones in the wrist. Although these patients are unable to flex or extend their wrists after surgery, they are better able to handle the jarring movements associated with manual labor. For patients receiving total wrist arthroplasty, recovery usually lasts from three to six months with half of normal wrist functioning preserved or restored. An infection control practitioner since 1978 and an MUSC employee since 1989, Betty Webster Harley, R.N., was diagnosed seven years ago with rheumatoid arthritis that resulted in joint deterioration in her right wrist. “Before I had the surgery, certain activities such as long-range driving or working on my computer might cause intense pain for days or weeks,” Harley said. “I would just put up with the pain and avoid using my right wrist. While I still experience some minor discomfort, it’s transient, and I don’t have any real limitations on my activities.” Harley worked with an occupational therapist twice a week for several months following her surgery and after four weeks in a cast, was almost back to full- speed typing on her computer. “I would recommend this to others who have deteriorated joints and are experiencing limitations on their activities,” she said. “I was the second wrist replacement performed by Dr. Litts in our area, and I had a great outcome.” “While this procedure is the newest, latest, greatest thing in terms of total wrist replacement,” Litts said, “I want to stress that the procedure is not for everyone. A 50-year-old man who may have broken his radius 30 years ago and has some arthritis would not particularly benefit from this procedure. But the 50-year-old man with inflammatory arthritis will.” For more information or to make an appointment, call 792-1414. Catalyst Online is published weekly, updated as needed and improved from time to time by the MUSC Office of Public Relations for the faculty, employees and students of the Medical University of South Carolina. Catalyst Online editor, Kim Draughn, can be reached at 792-4107 or by email, catalyst@musc.edu. Editorial copy can be submitted to Catalyst Online and to The Catalyst in print by fax, 792-6723, or by email to petersnd@musc.edu or catalyst@musc.edu. To place an ad in The Catalyst hardcopy, call Community Press at 849-1778.