The titanium grommet in flexible implant arthroplasty of the radiocarpal joint: a long-term review of 44 cases.

Flexible implant arthroplasty of the radiocarpal joint has come under increasing criticism since its introduction in 1967. Recent long-term reviews report high failure and revision rates. In 1984, titanium grommets became available. By providing a protective interface between sharp bone edges and the flexible hinge device, this refinement raised hope for improved performance. This report provides the first long-term review of the grommet's efficacy. The overall success rate was 95 percent. No implant fractures were observed in the setting of nondisplaced grommets; however, one implant did fracture in association with grommet displacement. Radiographic review of cortical bone density showed an increase in the region of the grommet in virtually all cases. These results offer significant improvement over those reported for flexible implant radiocarpal wrist arthroplasties done without protective grommets. The results suggest a wider indication for implant arthroplasty of the radiocarpal joint and hold promise for longer-term durability.