To design the method of 3D printing microporous titanium artificial wrist joint by ourselves, and observe the clinical effect after approval by the ethics committee of the hospital.

From February 2019 to November 2020, four cases of rheumatoid carpal arthritis, one case of open part defect of carpal joint caused by gunshot wound, and one case of osteoarthritis of carpal joint were treated with individualized 3D printing microporous titanium artificial wrist joint replacement. Inclusion criteria: obvious pain in carpal arthritis, complete wrist joint fusion, severe ischemic necrosis and collapse of carpal bone. Exclusion criteria: wrist tuberculosis or suppurative infection, poor systemic condition, combined with serious complications. Preoperative and postoperative assessments measured wrist pain using visual analogue scale(VAS), wrist range of motion (flexion and extension, radioulnar deviation, and rotational range of motion), and grip strength.The paired data were compared by rank sum test for statistical analysis.

The postoperative follow-up period was 12.5(2.7, 19.5)months. VAS score decreased from 47.5(45.0, 60.0) to 0(0, 2.5)(Z=-2.232, P<0.05). The preoperative grip strength increased from 7.0(3.0, 9.0) kg to 17.5(11.5, 20.0) kg(Z=-2.201, P<0.05) after operation. Flexion, ulnar deviation and radial deviation of wrist range of motion were significantly improved (Z =-2.214, -2.041, -2.333, all P <0.05), but dorsiflexion, pronation and supination were not significantly improved (P>0.05). There was no loosening or dislocation of the prosthesis.

The clinical effect of 3D printing microporous titanium artificial wrist joint is good and the patients are satisfied.