Doctor performs rare wrist replacement surgery
Woman gets procedure at Henry Ford
After years of suffering with pain in her left wrist, Keisha Triplett underwent total wrist replacement surgery at Henry Ford West Bloomfield, becoming the first patient in the Henry Ford Health System to have benefited from the procedure.
While hip and knee replacements happen everyday, total wrist replacement is uncommon. Only 316 were performed in the United States last year.
Triplett, who lives in Harrison
Township, had the procedure done on May 4 at Henry Ford West Bloomfield by Dr. Charles Day, chief of hand and upper extremity surgery for the department of orthopedic surgery.
Also referred to as total wrist arthroplasty, the surgery involves replacing a severe arthritic wrist joint with an artificial joint made of metal and plastic components. The procedure relieves pain and restores function when all other treatments fail to provide relief.
“For a long time, I didn’t know what was causing the pain,”
Triplett said. “My wrist was constantly hurting and so weak that I could do very little with my left hand.”
Since 2005, Triplett dealt with constant pain and swelling in her left wrist from rheumatoid arthritis, an autoimmune disease that can cause joint pain and damage throughout the body.
The swelling and pain continued to the point where she had little use of her left arm and could no longer wear her wristwatch on her wrist.
“I couldn’t wash dishes, fold laundry, make my bed or hold a cup of coffee in the morning. Even the simplest motion like opening a bag of chips was too painful,” Triplett said.
The worst part for her is that she couldn’t hold her 1-year-old grandson.
In February 2020, she met with Dr. Day. X-rays showed that Triplett had no cartilage in her left wrist causing the bone-on-bone pain she had been experiencing for so long. Dr. Day offered Triplett the only two available surgical solutions to help alleviate the pain, total wrist replacement or fusion of the wrist.
“With a wrist fusion, you cannot bend the wrist,” explained Dr. Day who has done more than a dozen total wrist replacements during his career. He is the only orthopedic surgeon at Henry Ford to have performed the procedure and one of very few in Michigan to offer the surgery.
Dr. Day compared total wrist replacement to a total knee or hip replacement that uses metal alloy components on either side of the joint with a polyethylene insert to alleviate the bone-on-bone pain. During the procedure, the surgeon removes the first row of carpal bones and then inserts the prosthetic components. The carpal component is connected to the metacarpal bones or fingers, while a plastic spacer provides that important cushion that allows for pain-free motion between hand and wrist.
A radial component is also inserted into the radius bone and the sometimes-arthritic ulnar head may also be removed from the ulna bone.
The wrist is made up of eight small bones called the carpal bones, or the carpus. These join the hand to the two long bones in the forearm known as the radius and ulna. The carpal bones are small square, oval, and triangular bones.
While the wrist replacement allows for 80 degrees of motion, there is no degree of motion with a fusion. The biggest difference with the wrist procedure is that the surgeon has to be much more precise about the placement of the wrist joint prosthesis, since the bones are so much smaller than those in the knee.
Despite the pain, the decision between total wrist replacement and wrist fusion was still not an easy one for Triplett.
“I was very nervous about this surgery,” said Triplett who had two prior surgeries related to rheumatoid arthritis in two of her right hand’s fingers and in her left foot. “The wrist surgery was quite different. I was nervous to have the surgery, but everyone reassured me that I was going to be handled with great care and I was.”
Triplett’s surgery and hospitalization at Henry Ford West Bloomfield Hospital lasted about eight hours. Her first follow-up visit with Dr. Day 13 days following the surgery showed that she is recovering faster than expected.
“I can move my hand up and down and can move my fingers around without any pain. I am so excited about how well I’m doing,” Triplett said. “Having the total wrist replacement surgery was the best decision I ever made.”
“She’s doing great,” said Dr. Day. “She’s ahead of schedule and can already feel the positive difference the surgery has made.”
The 43-year-old Triplett started therapy at Henry Ford Macomb Health Center — Fraser where she is working with occupational therapist and certified hand therapist Heidi Spyridakis.
“Keisha is doing great and is very happy with her progress,” Spyridakis said. “I thought my first therapy visit was going to be hard, but it was very easy. My therapist Heidi is wonderful and has lots of patience,” said Triplett.
Since her surgery, Triplett is experiencing no pain and is well on her way to improving her quality of life.