Combined semi-constrained total distal radioulnar joint (DRUJ) arthroplasty and radial head arthroplasty for severe, concomitant rheumatoid disease of the wrist and elbow joints

Semi-constrained total distal radioulnar joint (DRUJ) arthroplasty with Aptis-Scheker implant has demonstrated excellent results in patients with end-stage rheumatoid arthritis (RA) of the wrist. However, clinical success of the Scheker implant in restoring range of motion may be limited in patients with concomitant degenerative disease at the proximal radioulnar joint and radiocapitellar joint, which work in tandem with the DRUJ to allow pronosupination of the forearm. Among treatment options for elbow arthritis, standalone radial head arthroplasty remains poorly studied in the context of RA, despite being used widely in trauma patients. Here, we illustrate the surgical technique for combined total DRUJ arthroplasty with a Scheker implant and radial head arthroplasty to treat long-standing, refractory RA, at the wrist and elbow joints, with excellent results at 1-year follow-up.