Abstract
Objectives
Total distal radioulnar joint (DRUJ) arthroplasty with the Aptis implant was developed
as a salvage option in complex cases of severe DRUJ involvement and after failure
of conventional procedures. This systematic review aims to update the available evidence
on this technique, assessing functional outcomes, complications, and implant survival.
Materials and Methods
A systematic search of PubMed was conducted in January 2025, following PRISMA 2020
guidelines. Observational studies reporting clinical outcomes after Aptis implant
arthroplasty were included. Extracted data comprised functional scores (DASH, PRWE,
Mayo), pain (VAS), range of motion, grip strength, complications, reoperations, and
implant survival.
Results
A total of 28 studies published between 2008 and 2024 were included, comprising 664
implants. Mean postoperative pain (VAS) was 2.2 compared with 7.4 preoperatively.
DASH, PRWE, and Mayo scores all showed significant improvement after surgery. Mean
pronation–supination arc increased by 29 degrees, with an average postoperative arc
of 148 degrees. The overall complication rate was 34%, with a reoperation rate of
23.9%. Cumulative implant survival was 94.5% at a mean follow-up of 46 months.
Conclusion
The Aptis implant provides significant functional improvement in complex DRUJ pathology,
and is frequently used in revision settings. However, the high complication rate and
lack of long-term follow-up, especially in younger patients, require careful patient
selection. Prospective comparative studies with long-term outcomes are needed to better
define the role of this implant in the therapeutic strategy.
Keywords
arthroplasty - distal radioulnar joint - implant - prosthesis - systematic review
