The authors reviewed the literature to see if joint replacement arthroplasty for the stiff wrist was justified. The review confirms the fact that total wrist arthroplasty (TWA) or interposition pyrocarbon should not be performed for wrist stiffness without pain. The active wrist extension improvement after all these procedures is very limited, insignificant after Remotion and Amandys procedures, and modest after Motec procedure. The main indication for TWA is incapacitating wrist pain in completely destroyed wrists. The results in terms of pain were gratifying for patients. However, since there is a significant complication rate of revisions after TWA and interposition pyrocarbon implants, a shared decision-making has to be made for each patient regarding the option of a motion-preserving procedure versus total wrist arthrodesis.