Sixty rheumatoid wrists operated with Swanson implant arthroplasty were evaluated after a mean observation time of thirty-three months. Grip function in daily living improved in 60%, pain decreased in 88%, range of motion increased in 83% and grip strength increased in 69% of operated wrists. Significantly impaired function was found in wrists with implant fracture (12%) and in cases with pronounced bone resorption around the implant (23%). Ulnar deviation and carpal collapse were commonly found but did not impair the function significantly. In seven patients the contralateral wrist had been fused and was compared to the arthroplasty. The merits and indications of arthroplasty are discussed.