Indication for Radial or Carpal Resurfacing for Wrist Arthritis in Elderly Patients (over 70): A Systematic Review of the Literature

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Abstract
Background: Wrist arthritis significantly impacts the quality of life in elderly populations. While total wrist arthroplasty and wrist arthrodesis are established treatments, partial resurfacing procedures are emerging as a solution offering advantages for patients over 70 years of age. Objective: To systematically evaluate the efficacy, safety, and functional outcomes of radial versus carpal resurfacing procedures for the management of wrist arthritis in patients over 70 years of age. Methods: A comprehensive search of PubMed, Scopus, and Web of Science was conducted for studies published from these databases’ inception to May 2025. Studies reporting the outcomes of either radial or carpal resurfacing in patients ≥70 years of age with wrist arthritis were included. Primary outcomes were pain reduction, functional improvement, and complication rates. Results: Twenty studies met the inclusion criteria. Both carpal and radial resurfacing provided pain relief, with mean VAS scores ranging from 0 to 3.8 across studies and DASH scores ranging from 13 to 59 points, while carpal resurfacing showed better preservation of range of motion, with flexion/extension arcs of 27–65° compared to 22–46° for radial implants. Complication rates were comparable, though implant loosening was uncommon with both radial and carpal resurfacing. Both procedures demonstrated satisfactory patient-reported outcomes at midterm follow-up (median: 32 months; range: 6–84 months). Conclusion: In patients over 70 years of age with wrist arthritis, both radial and carpal resurfacing appear to be viable options with distinct advantages. Radial resurfacing may be preferred for patients with previous distal radius fractures, while carpal resurfacing offers better motion preservation and is indicated in SLAC and SNAC wrists. Patient selection should consider specific arthritis patterns, activity requirements, and comorbidities. Long-term studies are needed to evaluate durability beyond 5–10 years in this population.

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