Clinical and functional outcomes of MOTEC total wrist arthroplasty: A retrospective study of 30 patients with a minimum 6-month follow-up

Total wrist arthroplasty (TWA) is a functional alternative to arthrodesis in degenerative or post-traumatic wrist conditions. This study aimed to evaluate the clinical outcomes, functional results, and complication rates of MOTEC total wrist prostheses with a minimum postoperative follow-up of 6 months. A retrospective review was conducted on 30 patients who underwent MOTEC TWA between 2020 and 2025 with a minimum follow-up of 6 months. Collected data included pain score (0–10), patient satisfaction (0–10), wrist range of motion (flexion, extension, pronosupination), complications, and revision surgeries. Among the 30 patients (17 men, 13 women; mean age: 68 years), the main indications for TWA were primary osteoarthritis ( n = 16), failed four-corner fusion ( n = 7), rheumatoid arthritis ( n = 4), complex fractures ( n = 5), ankylosing spondylitis ( n = 1), and Kienböck's disease ( n = 1). The mean follow-up duration was 29.9 months (range: 6–64 months): – Pain: Mean score 1.9/10; 86% of patients reported pain ≤ 2, – Satisfaction: Mean score 8.5/10; 73% of patients reported a satisfaction score of 9 or 10, – Range of motion: Mean flexion 45.2°, extension 45°, and pronosupination 165°. Six complications were reported (20%): metacarpal fracture ( n = 1), rotational issue of the third metacarpal ( n = 1), M3 osteolysis ( n = 1), postoperative hematoma ( n = 1), anterior bony impingement with neuropathic palm pain ( n = 1), and severe wrist flexum ( n = 1). One patient (3.3%) required revision surgery due to the flexum. Our findings confirm that the MOTEC wrist prosthesis provides satisfactory pain relief and functional preservation in a diverse patient population. The observed range of motion supports the prosthesis’ utility in maintaining everyday hand function. Although a moderate complication rate was observed, only one patient required revision surgery, suggesting a favorable safety profile. These results are consistent with existing literature and encourage further prospective studies with standardized outcome measures. MOTEC total wrist arthroplasty provides favorable outcomes in terms of pain control, patient satisfaction, and functional wrist mobility, with a moderate complication rate and a low revision rate of the implant. These findings support its use in appropriately selected patients, provided that long-term follow-up is ensured.