Mid- to Long-term Outcomes of Aptis Distal Radioulnar Joint Arthroplasty: A Systematic Review of Studies With Minimum 5-Year Follow-up.

Abstract

Total distal radioulnar joint (DRUJ) arthroplasty with the Aptis prosthesis is an increasingly used salvage procedure for refractory DRUJ pathology, though prior studies often rely on mean rather than minimum follow-up, limiting assessment of true mid- to long-term durability. This systematic review evaluated implant survivorship, complications, and functional outcomes following total DRUJ arthroplasty with a minimum follow-up of 60 months. A systematic review of PubMed, Embase, and Cochrane databases was performed, including patients who underwent total DRUJ arthroplasty with reported survivorship or complication data and a minimum of 60-month follow-up. Seven studies met the inclusion criteria, comprising 66 implants meeting the follow-up threshold. Implant survivorship at final follow-up was 96.0%, with an overall complication rate of 51.0% and reoperation rate of 44.9%; the most common complications were extensor carpi ulnaris tendonitis, heterotopic ossification, and hardware loosening. Weighted mean postoperative supination and pronation were 74° and 78°, respectively, with mean grip strength of 29 kg. Outcome scores demonstrated meaningful improvement. Total DRUJ arthroplasty shows appropriate mid- to long-term implant survivorship and satisfactory functional gains, though complication and reoperation rates warrant cautious interpretation. It remains a viable salvage option in appropriately selected patients, underscoring the need for thorough preoperative counseling.