The third generation of total wrist arthroplasty (TWA) was designed to solve the early loosening problem, but there have been few long-term follow-ups.
The mean rate of radiolucent lines has been reported to be 80% (Bohsali et al. 2006) in a series with more than 10 years of follow-up, which indicates the scale of the loosening problem.
There were no revisions for loosening, patella problems, or tibial post fracture.
While initially popular, it fell out of favor due to early failures, mostly due to progression of the disease process, loosening, and design problems resulting in polyethylene wear and loss of fixation.
Nine Harris-Galante I cups and two Harris-Galante II cups were revised due to aseptic loosening or PE problems.
The cumulative revision rate was 7%, with the main reasons being loosening, rotator cuff problems, glenoid attrition, and periprosthetic fracture.
They are therefore insensitive for detection of the early manifestations of aseptic loosening, and often problems associated with implant design or surgical technique do not become apparent for many years after surgery.
Porous features that accommodate bone ingrowth have improved implant fixation in the short term, but long-term retrieval studies have sometimes demonstrated limited, superficial ingrowth into the pore layer of metal implants and aseptic loosening remains a problem for a subset of patients.
Producing near net shape components with graded compositions using LENS™ could potentially be a viable route for manufacturing unitized structures for metal-on-metal prosthetic devices to minimize the wear-induced osteolysis and aseptic loosening that are significant problems in current implant design.
Other tibial related complications were wound problems, screw loosening, hardware migration, loss of reduction, peroneal nerve injury, and joint contracture.
