Question 1

Will this arthritis get worse over time, and will I eventually lose use of my wrist?

Accepted Answer

DRUJ arthritis typically progresses slowly over years to decades - progression rate depends on cause (post-traumatic arthritis after wrist fracture may progress faster than age-related osteoarthritis) and activity level (repetitive forearm rotation accelerates wear). Many patients maintain reasonable function for years with non-surgical management (activity modification, splinting, occasional cortisone injections). If arthritis severe and non-surgical treatment fails, surgery provides good outcomes - joint replacement or Sauvé-Kapandji procedure achieves 70-85% good pain relief and functional improvement, allowing most patients to return to work and daily activities. You won't lose use of your wrist - modern surgical options can preserve or restore function even in severe arthritis. Key is early diagnosis and appropriate treatment (don't wait until arthritis extremely advanced, as salvage procedures work better when some bone stock and soft tissue quality preserved).

Question 2

How do I choose between joint replacement and the other surgical options - which is best?

Accepted Answer

Choice depends on your age, activity level, arthritis severity, and bone/ligament quality - your surgeon will discuss options based on your specific situation. JOINT REPLACEMENT: Best for active patients (under 65-70) with severe isolated DRUJ arthritis and good bone quality - provides best pain relief (75-85% good outcomes) and restoration of forearm rotation (close to normal range) - allows return to most activities including light manual work - implant longevity excellent in appropriate patients (10-15+ years) - NOT ideal if: severe bone loss, poor bone quality (osteoporosis), or heavy manual labor (high implant failure rate). SAUVÉ-KAPANDJI: Good alternative to joint replacement for younger patients with severe arthritis - more predictable than joint replacement (doesn't rely on implant staying in place) and can be performed even with moderate bone loss - achieves 70-80% good pain relief with functional rotation (100-120 degrees) - downside: false joint may become unstable over time (10-15%) causing pain - best for patients wanting durable solution who don't need perfect rotation. ULNAR SHORTENING: Only works for EARLY arthritis with ulnar impaction (ulna bone too long) - won't help advanced arthritis with severe cartilage loss. DARRACH: Simple procedure reserved for older, sedentary patients (over 70, minimal manual demands) - provides pain relief but limited rotation and grip strength - high complication rate (impingement, instability) makes it last choice in most patients. RECOMMENDATION: If you're under 65-70, active, and have good bone quality, joint replacement usually best option (best outcomes, allows active lifestyle). If you're over 70 with low demands, Darrach acceptable. Sauvé-Kapandji good middle ground for patients between these extremes. Your surgeon will get X-rays, CT scan, and assess your goals/expectations to recommend best option.

Question 3

What's involved in the recovery and physiotherapy after surgery, and when can I return to work?

Accepted Answer

Recovery timeline and physiotherapy vary by procedure. JOINT REPLACEMENT: Splint for 2-3 weeks (allows gentle finger motion, keep wrist/forearm protected) - weeks 2-6: physiotherapy focusing on gentle forearm rotation exercises (gradually increase range) - weeks 6-12: progressive strengthening (light weights, resistance bands) - return to sedentary work 4-6 weeks, light manual work 8-12 weeks, heavy manual work 3-4 months (or may need permanent restrictions) - driving at 4-6 weeks once off pain medications and comfortable gripping wheel - most improvement in first 3 months, continue gradual gains up to 12 months. SAUVÉ-KAPANDJI: Cast 6-8 weeks until fusion heals (critical - early motion risks fusion failure) - weeks 8-12: physiotherapy for rotation and strengthening - return to work 10-14 weeks (sedentary), 4-6 months (manual labor) - driving at 8-10 weeks. DARRACH: Splint 2-3 weeks, then gentle motion - return to sedentary work 6-8 weeks - avoid heavy lifting permanently (forearm unstable without DRUJ). PHYSIOTHERAPY CRITICAL: After joint replacement especially, aggressive physiotherapy essential to regain rotation - patients who don't do physio develop stiffness and poor outcomes - expect 2-3 sessions per week for 6-12 weeks, plus daily home exercises (30-45 minutes per day). PAIN CONTROL: Moderate pain first 2-4 weeks (prescription pain medications needed), then gradual improvement - most patients comfortable with paracetamol/ibuprofen by 4-6 weeks. REALISTIC EXPECTATIONS: Recovery slower than you expect (most patients frustrated at 4-6 weeks, but see significant improvement by 3-4 months) - patience and compliance with physiotherapy critical for good outcome. Australian context: Medicare covers surgery and initial physiotherapy sessions; private health insurance may cover hospital costs and additional physio - total out-of-pocket costs variable (discuss with surgeon/hospital pre-operatively).

Medical Disclaimer

Wrist Arthritis (Pinky Side of Wrist)

📖What is Wrist Arthritis (Pinky Side of Wrist)?

🔬What Causes It?

⚠️Risk Factors

You may be at higher risk if:

🛡️Prevention