This information does not replace a physician’s diagnosis and advice.

Arthrosis of the wrist

Arthrosis of the wrist: what’s that?

Arthrosis of the wrist may arise due to age-caused signs of wear to cartilage, but also as a result of single-sided stress and strain from work, as a result of inflammations (e.g. gout) or metabolic disorders (e.g. diabetes mellitus). Also cartilage loss resulting from an accident or incorrectly healed bone fractures and ligament injuries may result in the joint affected being influenced in the complex joint function and consequently facilitating cartilage loss (arthrosis).

Symptoms of arthrosis of the wrist

The typical symptoms of early wrist arthrosis normally manifest as exertion-related diffuse and nagging, or sometimes burning pain. Often, so-called “morning pain” also arises with relatively stiff joints, which declines a little during the course of the day (start-up pain). In a more advanced stage, load-dependent complaints (movement pain) are incurred increasingly. Rest pain denotes the next stage, in particular night-time pain is agonising here. The progressing cartilage degradation and damages to the bone beneath it result in restriction to the freedom of movement of the wrist, to painful swellings up to loss of function.

Causes of arthrosis of the wrist

The most frequent trigger of arthrosis of the wrist is (incorrectly healed) fractures of the wrist. Inflammatory diseases such as rheumatism of the joints can play a role as well. Further causes include chronic improper or excess stress within the scope of competitive sports or physical work. There are also debates regarding genetic disposition.

Diagnosis of arthrosis of the wrist

A tentative diagnosis can already be made based on the symptoms and the patient’s information (case history). This preliminary diagnosis can be confirmed by X-raying. Additionally, computed tomography (CT) or magnetic resonance imaging (MRI) may be applied. The loss of wrist cartilage (arthrosis of the wrist ) can be recognised on X-ray or CT/MRI images as the joint gap is either recognised to be narrower or missing completely.

How can arthrosis of the wrist and its progress be prevented?

Avoidance is hardly possible because the causes are too multifaceted. After accidents, strict implementation of special exercises for the wrist within the scope of remedial gymnastics can make sense. In case of previously existing arthrosis, protection against overstress, e.g. with supports and braces during work and in load situations makes sense. Stretching exercises and targeted exercises to mobilise the wrist and strengthen the surrounding musculature can also help.

What therapy options are available for arthrosis of the wrist?

Depending on the stage of the arthrosis, conservative treatment methods or also an operation can be applied.

Conservative treatment

Normally, treatment starts with a combination of remedial gymnastics and anti-inflammatory or analgesic medication. Moreover, movement exercises, cold or heat treatment as well as joint relief via a wrist support or brace such as the BORT ManuBasic®, BORT Generation wrist brace or BORT ManuStabil® short can help.

If these measures are not sufficiently effective, cortisone can be administered into the joint once to reduce the acute inflammation. Hyaluronic acid or autologous conditioned plasma (ACP) – extracted from own blood – are available as an alternative.

Operative treatment

In case of initial cartilage damages, an arthroscopy of the wrist can make sense. Within the scope of the arthroscopy, inflamed joint mucosa and free joint bodies are removed from the joint.

In special cases, cartilage transplantation can follow, for example in case of arthrosis of the saddle joint of the thumb (rhizarthrosis), injury-caused pseudoarthrosis or Kienböck´s disease. In case of well-advanced cartilage wear, the option of full or partial stiffening of the wrist (arthrodesis) exists.

Reference: Arthrosen der Handwurzel und des Handgelenks
https://www.d-k-h.de/leistungsspektrum/fachabteilungen/klinik-fuer-handchirurgie/art-handgelenksarthrose last visited on 04.05.2021