Balance between stability and mobility in wrist arthroplasty: achieving optimal long-term function with the Motec ^® prosthesis

The complex function of the wrist is difficult to replace with an arthroplasty. Although the first arthroplasty was implanted in 1890, it took more than 100 years to develop implants with good long-term results. The Motec wrist arthroplasty, introduced 20 years ago, replicates wrist function with a ball-and-socket articulation with a wide modularity of uncemented implants to allow tuning for patient anatomy and an optimal balance between mobility and stability. Achieving predictable, long-term function in the majority of patients demands dedicated long-term commitment by the surgeon in a continuous process to optimize the result. This paper summarizes the authors' collective experience and research using the Motec wrist arthroplasty. We discuss biomechanics, tribology, patient selection, surgeons'prerequisites, pearls and pitfalls as well as necessary follow-up and awareness to avoid problems and identify complications to obtain pain relief, preserve motion and improve quality of life for the patients.<b>Level of evidence:</b> V.