Aptis Distal Radioulnar Joint Arthroplasty: A Systematic Literature Review

Abstract Total distal radioulnar joint (DRUJ) arthroplasty with the Aptis implant was developed as a salvage option in complex cases of severe DRUJ involvement and after failure of conventional procedures. This systematic review aims to update the available evidence on this technique, assessing functional outcomes, complications, and implant survival. A systematic search of PubMed was conducted in January 2025, following PRISMA 2020 guidelines. Observational studies reporting clinical outcomes after Aptis implant arthroplasty were included. Extracted data comprised functional scores (DASH, PRWE, Mayo), pain (VAS), range of motion, grip strength, complications, reoperations, and implant survival. A total of 28 studies published between 2008 and 2024 were included, comprising 664 implants. Mean postoperative pain (VAS) was 2.2 compared with 7.4 preoperatively. DASH, PRWE, and Mayo scores all showed significant improvement after surgery. Mean pronation–supination arc increased by 29 degrees, with an average postoperative arc of 148 degrees. The overall complication rate was 34%, with a reoperation rate of 23.9%. Cumulative implant survival was 94.5% at a mean follow-up of 46 months. The Aptis implant provides significant functional improvement in complex DRUJ pathology, and is frequently used in revision settings. However, the high complication rate and lack of long-term follow-up, especially in younger patients, require careful patient selection. Prospective comparative studies with long-term outcomes are needed to better define the role of this implant in the therapeutic strategy.