1
|
Proximal row carpectomy of the wrist in the setting of midcarpal arthritis: Survivorship and associated complications in soft tissue interposition versus capitate resurfacing. CURRENT ORTHOPAEDIC PRACTICE 2023. [DOI: 10.1097/bco.0000000000001202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
|
2
|
Surgical management of osteoarthritis of the hand and wrist. J Hand Ther 2022; 35:418-427. [PMID: 35428565 DOI: 10.1016/j.jht.2022.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Osteoarthritis of the hand and wrist is common; varying disease manifestations and a spectrum of symptoms make it imperative to approach treatment strategies in an individualized fashion. In this review, attention is focused upon site specific diagnoses and indications for various surgical treatment strategies.
Collapse
|
3
|
Zhang Y, Gillis JA, Moran SL. Management of scapholunate advanced collapse and scaphoid nonunion advanced collapse without proximal row carpectomy or four corner fusion. J Hand Surg Eur Vol 2021; 46:50-57. [PMID: 33202162 DOI: 10.1177/1753193420973322] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Four corner arthrodesis and proximal row carpectomy are the most common techniques for the management of advanced radiocarpal arthritis due to longstanding scapholunate instability and scaphoid nonunion. The advantages and short comings of each technique have been well defined in the literature. Advancements in joint replacement and arthroscopic surgery have resulted in new operations to manage radiocarpal and midcarpal arthritis. Most of these new procedures are modifications of the two classical operations, but some use modern implants and newer materials. New individualized options, like osteochondral grafting in combination with proximal row carpectomy or (arthroscopic) distal resection of the scaphoid, allowed us to improve our treatment and offer patients less invasive but equally effective procedures. We consider that four corner arthrodesis and proximal row carpectomy should not always be standard management for advanced radiocarpal arthritis.
Collapse
Affiliation(s)
- Yiyang Zhang
- Division of Orthopedic Surgery, Roth
- McFarlane Hand and Upper Limb Centre, London, ON, Canada
| | - Joshua A Gillis
- Division of Plastic and Reconstructive Surgery, Roth
- McFarlane Hand and Upper Limb Centre, London, ON, Canada
| | - Steven L Moran
- Division of Plastic and Reconstructive Surgery, Mayo Clinic, Rochester, MN, USA
| |
Collapse
|
4
|
Jamieson RP, Harvey JN, Ek ET. Bipolar osteoarticular reconstruction of the radioscaphoid joint. J Hand Surg Eur Vol 2019; 44:211-213. [PMID: 30282503 DOI: 10.1177/1753193418802559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- Richard P Jamieson
- 1 Division of Hand Surgery, Dandenong Hospital, Monash University, Melbourne, Australia.,2 Melbourne Orthopaedic Group, Melbourne, Australia
| | - Jason N Harvey
- 1 Division of Hand Surgery, Dandenong Hospital, Monash University, Melbourne, Australia.,3 Orthosports Victoria, Melbourne, Australia
| | - Eugene T Ek
- 1 Division of Hand Surgery, Dandenong Hospital, Monash University, Melbourne, Australia.,2 Melbourne Orthopaedic Group, Melbourne, Australia
| |
Collapse
|
5
|
Gaspar MP, Pham PP, Pankiw CD, Jacoby SM, Shin EK, Osterman AL, Kane PM. Mid-term outcomes of routine proximal row carpectomy compared with proximal row carpectomy with dorsal capsular interposition arthroplasty for the treatment of late-stage arthropathy of the wrist. Bone Joint J 2018; 100-B:197-204. [PMID: 29437062 DOI: 10.1302/0301-620x.100b2.bjj-2017-0816.r2] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
AIMS The aims of this study were to compare the mid-term outcomes of patients with late-stage arthritis of the wrist treated with proximal row carpectomy (PRC) and dorsal capsular interposition (DCI) arthroplasty with a matched cohort treated with routine PRC alone. PATIENTS AND METHODS A total of 25 arthritic wrists (24 patients) with pre-existing degenerative changes of the proximal capitate and/or the lunate fossa of the radius were treated with PRC + DCI over a ten-year period. This group of patients were matched 1:2 with a group of 50 wrists (48 patients) without degenerative changes in the capitate or lunate fossa that were treated with a routine PRC alone during the same period. The mean age of the patients at the time of surgery was 56.8 years (25 to 81), and the demographics and baseline range of movement of the wrist, grip strength, Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) score, and Patient-Rated Wrist Evaluation (PRWE) score were similar in both groups. RESULTS At a mean follow-up of 5.9 years (1.8 to 11.8), significant improvements in mean grip strength, the flexion-extension arc of movement of the wrist, QuickDASH, and PRWE scores were seen in both groups. There was no diifference between the groups for any of the outcomes. One patient in the PRC + DCI group required additional surgery for a deep infection, while two in the PRC group had complications (one wound dehiscence requiring revision closure, one transient radial sensory neuritis). One patient in each group required total arthrodesis of the wrist for progressive degenerative radiocarpal changes. A total of 70 patients (93%) were satisfied with the outcomes. CONCLUSION PRC with DCI is an effective form of treatment for late-stage arthritis of the wrist involving the capitolunate joint, with mid-term outcomes that are similar to those in patients without degenerative changes affecting the capitate or lunate fossa who are treated with a routine PRC alone. Cite this article: Bone Joint J 2018;100-B:197-204.
Collapse
Affiliation(s)
- M P Gaspar
- Philadelphia Hand to Shoulder Center, Thomas Jefferson University, 834 Chestnut Street, The Franklin Building, Suite G114, Philadelphia, PA 19107, USA and Darden School of Business, University of Virginia, 100 Darden Boulevard, Charlottesville, Virginia 22903, USA
| | - P P Pham
- Philadelphia Hand to Shoulder Center, Thomas Jefferson University, 834 Chestnut Street, The Franklin Building, Suite G114, Philadelphia, PA 19107, USA
| | - C D Pankiw
- Philadelphia Hand to Shoulder Center, Thomas Jefferson University, 834 Chestnut Street, The Franklin Building, Suite G114, Philadelphia, PA 19107, USA
| | - S M Jacoby
- Philadelphia Hand to Shoulder Center, Thomas Jefferson University, 834 Chestnut Street, The Franklin Building, Suite G114, Philadelphia, PA 19107, USA
| | - E K Shin
- Philadelphia Hand to Shoulder Center, Thomas Jefferson University, 834 Chestnut Street, The Franklin Building, Suite G114, Philadelphia, PA 19107, USA
| | - A L Osterman
- Philadelphia Hand to Shoulder Center, Thomas Jefferson University, 834 Chestnut Street, The Franklin Building, Suite G114, Philadelphia, PA 19107, USA
| | - P M Kane
- Philadelphia Hand to Shoulder Center, Thomas Jefferson University, 834 Chestnut Street, The Franklin Building, Suite G114, Philadelphia, PA 19107, USA
| |
Collapse
|
6
|
Gaspar MP, Jacoby SM, Marchetto PA, DeLuca PF, Culp RW. Osteochondral Autograft Transplantation for Proximal Lunate Articular Defects. J Wrist Surg 2017; 6:329-333. [PMID: 29085735 PMCID: PMC5658222 DOI: 10.1055/s-0037-1599215] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2016] [Accepted: 01/20/2017] [Indexed: 10/20/2022]
Abstract
BACKGROUND No consensus treatment option for focal osteochondral defects of the proximal lunate exist in the literature. Surgical management has thus far been limited to salvage procedures such as proximal row carpectomy and partial arthrodesis. CASE DESCRIPTION We report our experience using the osteochondral autograft transplantation surgery (OATS) procedure in two young, active patients with focal osteochondral defects of the proximal lunate. At mean follow-up of 6 years, sustained improvements in pain, motion, and function were observed. Both patients reported high levels of satisfaction and neither experienced any complications. LITERATURE REVIEW To our knowledge, this is the first report describing the use of OATS to treat proximal lunate defects. CLINICAL RELEVANCE OATS is a valuable surgical option for treating focal chondral defects of the proximal lunate, with positive outcomes at greater than 5 years postoperatively. This may be an especially useful technique for younger, active patients, and those wishing to maintain maximum functionality.
Collapse
Affiliation(s)
- Michael P. Gaspar
- The Philadelphia Hand Center, P.C., Department of Orthopedic Surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania
| | - Sidney M. Jacoby
- The Philadelphia Hand Center, P.C., Department of Orthopedic Surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania
| | - Paul A. Marchetto
- Department of Orthopedic Surgery, The Rothman Institute, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania
| | - Peter F. DeLuca
- Department of Orthopedic Surgery, The Rothman Institute, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania
| | - Randall W. Culp
- The Philadelphia Hand Center, P.C., Department of Orthopedic Surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania
| |
Collapse
|
7
|
Steiner MM, Willsey MR, Werner FW, Harley BJ, Klein S, Setter KJ. Meniscal Allograft Interposition Combined with Proximal Row Carpectomy. J Wrist Surg 2017; 6:65-69. [PMID: 28119798 PMCID: PMC5258121 DOI: 10.1055/s-0036-1587315] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2014] [Accepted: 06/30/2016] [Indexed: 12/21/2022]
Abstract
Background Proximal row carpectomy (PRC) is contraindicated in wrists with preexisting arthritis of the proximal capitate or radiolunate fossa. Patients with these conditions frequently pursue wrist arthrodesis with its associated functional limitations. Questions/Purposes The purpose of this study was to evaluate the results of using lateral meniscal allograft interposition (LMAI), in combination with PRC, in patients with symptomatic wrist arthritis. The primary question is whether this allograft will allow wrist function comparable to that in patients having only a PRC. A secondary question was to determine the short-term longevity of the allograft. Patients/Method Between 2006 and 2012, nine wrists underwent PRC with LMAI. Patient demographics and rates of complication or graft failure were determined. During independent clinical exams, functional outcomes were reviewed, patients completed a Disabilities of the Arm, Shoulder, and Hand (DASH) scores, and radiographs were taken. Results Four patients met the inclusion criteria, having clinical follow-up at an average of 4.2 years. DASH scores at the time of follow-up ranged from 9 to 33, with an average of 24. Average radiocapitate joint space in the first postoperative radiograph was 2.8 mm compared with 1.8 mm at the time of final follow-up. No wrists went on to arthrodesis. Conclusion Early outcomes of PRC with LMAI are comparable to those results found in the literature of PRC alone. LMAI with PRC may be a valid short-term option as a motion-preserving procedure in those patients contraindicated to having a PRC alone. Level of Evidence Level IV.
Collapse
Affiliation(s)
- Murphy M. Steiner
- Department of Orthopedic Surgery, SUNY Upstate Medical University, Syracuse, New York
| | - Matthew R. Willsey
- Department of Orthopedic Surgery, SUNY Upstate Medical University, Syracuse, New York
| | - Frederick W. Werner
- Department of Orthopedic Surgery, SUNY Upstate Medical University, Syracuse, New York
| | - Brian J. Harley
- Department of Orthopedic Surgery, SUNY Upstate Medical University, Syracuse, New York
| | - Shay Klein
- Department of Orthopedic Surgery, SUNY Upstate Medical University, Syracuse, New York
| | - Kevin J. Setter
- Department of Orthopedic Surgery, SUNY Upstate Medical University, Syracuse, New York
| |
Collapse
|