Metallosis after Motec metal-on-PEEK wrist replacement: A case report

Despite its increasing popularity, total wrist arthroplasty (TWA) remains a treatment option that is often viewed critically and is still rarely used in patients with partial or complete osteoarthritis of the wrist. TWA is an appropriate alternative to total or partial wrist fusion, particularly for active patients with a high need for function. As the number of cases continues to increase, procedure-specific complications are becoming more common. In this report, we present a 61-year-old female Caucasian patient with increasing wrist pain after TWA performed at another institution in 2016. Metallosis was suspected after clinical and radiographic examination and was confirmed intraoperatively and by histopathological analysis. Surgical management included removal of the pseudocapsule and replacement of the mobile parts of the implant. At 12 weeks post-operatively, the patient still reported limited range of motion but a significant reduction in pain. This is one of the few reports to date of metallosis following TWA, particularly with a metal-on-polymer joint. The possibility of metallosis should always be considered, especially in cases of delayed onset of pain and reduced range of motion after TWA, to ensure appropriate management.