Foreign Body Reaction in Wrist Arthroplasty Using a Carbon Fiber Reinforced Poly-Ether-Ether-Ketone Articulation: A Secondary Analysis of 11 Cases

Abstract Wrist arthroplasty is a motion-preserving procedure. However, despite improvements in implant design, implant failure remains an issue. The aim of this secondary analysis was to assess failures associated with synovitis and to report histopathological findings in an initial patient cohort (n = 40) reported previously. Eleven cases of implant failure and synovitis were identified among hemi and total wrist arthroplasties with a carbon fiber reinforced poly-ether-ether-ketone (CFR-PEEK) articulation. Six cases had undergone component exchange/revision; of these, five were revised to a radiocarpal arthrodesis. Pronounced wear of the CFR-PEEK articulating surface was noted. Histopathological examination indicated that CFR-PEEK particles were incorporated by macrophages, but no giant cell reactions could be seen. A high frequency of synovitis warranting reoperation was noted. We recommend caution and close monitoring of CFR-PEEK articulations in the wrist.