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Hones KM, Rakauskas TR, Hao KA, Densley S, Kim J, Wright TW, Chim H. Proximal Row Carpectomy with and without Capitate Resurfacing: A Preliminary Systematic Review and Meta-Analysis. JBJS Rev 2024; 12:01874474-202404000-00008. [PMID: 38648294 DOI: 10.2106/jbjs.rvw.24.00025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2024]
Abstract
BACKGROUND In wrist salvage, proximal row carpectomy (PRC) has increasingly shown superior outcomes to four-corner fusion (4CF). Furthermore, PRC with resurfacing capitate pyrocarbon implants (PRC + RCPIs) provides a treatment option that may allow patients to avoid 4CF or wrist arthrodesis and help restore natural joint function and distribute loads evenly across the implant, though RCPI has yet to be evaluated on a large scale. We aimed to compare outcomes between PRC and PRC + RCPI for the treatment of scapholunate advanced collapse (SLAC) and scaphoid nonunion advanced collapse (SNAC) wrists. METHODS A systematic review and meta-analysis was performed per Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. PubMed/MEDLINE, Embase, Web of Science, and Cochrane were queried for articles on PRC and PRC + RCPI performed for SLAC and SNAC wrist with minimum 12-month follow-up. Primary outcomes included wrist range of motion (ROM), grip strength, and outcome scores including Disabilities of Arm, Shoulder, and Hand (DASH) and QuickDASH scores, Patient-Rated Wrist and Hand Evaluation (PRWHE), and visual analog scale pain scores. RESULTS Twenty-two studies reporting on 1,804 wrists were included (1,718 PRC alone, 86 PRC + RCPI). PRC + RCPI was associated with greater postoperative radial deviation, but poorer flexion. PRC + RCPI also had significantly lower postoperative QuickDASH (less disability and symptoms) and postoperative PRWHE (lower pain and disability) scores and an improvement in PRWHE compared with PRC. There was no significant difference in grip strength. CONCLUSION PRC + RCPI demonstrated similar postoperative ROM to PRC alone. While PRC + RCPI was associated with more favorable outcome scores, further research is needed to confirm these findings and assess the incidence and profile of complications related to RCPIs. LEVEL OF EVIDENCE Level IV. See Instructions for Authors for a complete description of levels of evidence.
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Affiliation(s)
- Keegan M Hones
- Department of Orthopaedic Surgery & Sports Medicine, University of Florida, Gainesville, Florida
| | | | - Kevin A Hao
- College of Medicine, University of Florida, Gainesville, Florida
| | - Sebastian Densley
- College of Medicine, Florida Atlantic University, Boca Raton, Florida
| | - Jongmin Kim
- Department of Orthopaedic Surgery & Sports Medicine, University of Florida, Gainesville, Florida
| | - Thomas W Wright
- Department of Orthopaedic Surgery & Sports Medicine, University of Florida, Gainesville, Florida
| | - Harvey Chim
- Department of Plastic and Reconstructive Surgery, University of Florida, Gainesville, Florida
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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]
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Pelet H, Delgove A, Morchikh A, Dunet B, Harper L, Laumonerie P, Abi-Chahla ML. Long-term results of first row carpectomy with proximal capitate resurfacing using a pyrocarbon implant. J Hand Surg Eur Vol 2023; 48:561-565. [PMID: 36756730 DOI: 10.1177/17531934231151219] [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: 02/10/2023]
Abstract
The functional results of proximal row carpectomy with a proximal capitate resurfacing using a pyrocarbon implant were evaluated in a retrospective, multicentric, multi-operator study. The outcomes of patients operated on at five surgical centres between January 2005 and December 2018 were reviewed. The data were collected by an independent observer during standardized consultations. Based on 30 patients with a mean follow-up of 7 years, the median range of flexion and extension was 65° and the median radioulnar tilt was 45°. The median Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) score was 14 and the improvements in strength and pain were good. Compared with the preoperative values, significant improvements were seen in the flexion and extension range of motion, radioulnar tilt and pain score. No postoperative complications were recorded.Level of evidence: IV.
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Affiliation(s)
- Hugo Pelet
- Service de chirurgie orthopédique et de chirurgie de la main, Chu de Bordeaux, Site Pellegrin, Place du Amélie Raba-Leon, Bordeaux, France
| | - Anais Delgove
- Service de chirurgie orthopédique et de chirurgie de la main, Chu de Bordeaux, Site Pellegrin, Place du Amélie Raba-Leon, Bordeaux, France
| | | | - Bertrand Dunet
- Service de chirurgie orthopédique, Hôpital Robert Boulin, Libourne, France
| | - Luke Harper
- Service de chirurgie pédiatrique, Chu de Bordeaux, Site Pellegrin, Bordeaux, France
| | - Pierre Laumonerie
- Service de chirurgie orthopédique et de chirurgie de la main, Chu de Bordeaux, Site Pellegrin, Place du Amélie Raba-Leon, Bordeaux, France
| | - Marie-Laure Abi-Chahla
- Service de chirurgie orthopédique et de chirurgie de la main, Chu de Bordeaux, Site Pellegrin, Place du Amélie Raba-Leon, Bordeaux, France
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Perry AC, Wilkes C, Curran MWT, Ball BJ, Morhart MJ. Proximal Row Carpectomy Modifications for Capitate Arthritis: A Systematic Review. J Wrist Surg 2023; 12:86-94. [PMID: 36644731 PMCID: PMC9836777 DOI: 10.1055/s-0042-1751013] [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] [Received: 09/17/2021] [Accepted: 05/12/2022] [Indexed: 01/18/2023]
Abstract
Introduction Proximal row carpectomy (PRC) is a motion-sparing procedure for radiocarpal arthritis with reliable results. Traditionally, proximal capitate arthritis is a contraindication to PRC; however, PRC with modifications are proposed to circumvent this contraindication. PRC modifications can be broadly grouped into capitate resurfacing (CR) and capsular interposition (CI) procedures which could expand PRC indications. Our primary question was to characterize the outcomes achievable with various PRC modifications. Our secondary question was to determine which PRC modification was the optimal procedure when capitate arthritis was present. Methods A systematic review was conducted to examine the outcomes of modified PRC procedures. Independent reviewers appraised multiple databases for PRC studies with modifications for capitate arthritis in adult patients (age >18 years) with a minimum of three cases and extractable outcomes. Modified PRC procedures included capsular/allograft interposition, resurfacing capitate pyrocarbon implants, and osteochondral grafting. Pertinent outcomes included patient demographics, range-of-motion, grip strength, patient-reported outcomes, and complications, including salvage rates. Results Overall, 18 studies met the inclusion criteria-10 studies ( n = 147) on CI and 8 studies on CR ( n = 136). PRC with CI had the greatest flexion-extension arc and grip strength. Complications were marginally higher in the CR group (4%), while the CI group had a higher conversion to total wrist arthrodesis (10%). Conclusion Techniques to address capitate arthritis center around resurfacing or soft tissue interposition. PRC modifications with CI produces better range-of-motion and grip strength but higher conversion to total wrist arthrodesis. Higher conversion rates may be attributable to longer follow-up periods in studies examining CI compared with CR. Level of Evidence This is a Level III study.
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Affiliation(s)
- Alexander C. Perry
- Division of Plastic Surgery, Department of Surgery, University of Alberta, Edmonton, Alberta, Canada
| | - Courtney Wilkes
- Division of Plastic Surgery, Department of Surgery, University of Alberta, Edmonton, Alberta, Canada
| | - Matthew W. T. Curran
- Division of Plastic Surgery, Department of Surgery, University of Alberta, Edmonton, Alberta, Canada
| | - Brandon J. Ball
- Division of Plastic Surgery, Department of Surgery, University of Alberta, Edmonton, Alberta, Canada
| | - Michael J. Morhart
- Division of Plastic Surgery, Department of Surgery, University of Alberta, Edmonton, Alberta, Canada
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Artuso M, Protais M, Soubeyrand M. Arthroscopic proximal carpal row replacement by semitendinosus and gracilis graft (CArpus Row Plasty Using the Semitendinosus: CARPUS procedure). An anatomical study of 16 cases. Orthop Traumatol Surg Res 2022; 108:103124. [PMID: 34700056 DOI: 10.1016/j.otsr.2021.103124] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 06/13/2021] [Accepted: 07/16/2021] [Indexed: 02/03/2023]
Abstract
INTRODUCTION Post-traumatic lesions of the carpus (scapholunate rupture, scaphoid non-union) frequently evolve into disabling osteoarthritis (scapholunate advanced collapse or scaphoid non-union advanced collapse: SLAC or SNAC wrist). Proximal row carpectomy (PRC) is a reliable option but with poorer prognosis in case of osteoarthritis of the distal radius or capitate head. In such situations, radiocarpal arthrodesis may be necessary, sacrificing wrist motion. To circumvent this limitation, we propose a new procedure consisting in arthroscopic PRC and replacing the proximal row by tendon graft. METHODS This was a study on 16 cadaver specimens. A scapholunate pin was introduced via an approach into the anatomical snuffbox and used as a guide for a cannulated drill bit (9mm) to create a tunnel through the proximal row. The arthroscope and a reamer were introduced into the tunnel via its radial and ulnar ends. PRC was performed under arthroscopic control. The gracilis and semitendinosus tendons were harvested and folded so as to obtain a graft with the same length and diameter as the proximal row. The graft was threaded through the radial approach and fixed to the capsule. RESULTS Mean procedure time was 68min. There was no pre- to postoperative difference in joint motion or carpal height. On radiocinematography, the graft was stable between the radius and the second row of the carpus. The radial and ulnar sensory branches, median nerve and radial artery were intact at end of procedure. DISCUSSION This technique could be a solution in SLAC or SNAC wrist with osteoarthritis of the capitate head or radial glenoid. It also conserves carpal height. Being arthroscopic, the procedure avoids the major edema observed after a dorsal approach of the carpus, and also ensures graft stability, since the radiocarpal ligaments are conserved. Harvesting from a second anatomical site and the in vivo fate of the transplant are two issues that need to be discussed. CONCLUSION This anatomical study paves the way for clinical experimentation. LEVEL OF EVIDENCE IV.
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Affiliation(s)
- Mickaël Artuso
- Service de chirurgie orthopédique, traumatologique et reconstructrice, CHU de Saint-Antoine, 184, rue du Faubourg Saint-Antoine, 75012 Paris, France.
| | - Marie Protais
- Service de chirurgie orthopédique, traumatologique et reconstructrice, CHU de Saint-Antoine, 184, rue du Faubourg Saint-Antoine, 75012 Paris, France
| | - Marc Soubeyrand
- Service de chirurgie orthopédique, clinique Saint-Jean de l'Hermitage, 272, avenue Marc-Jacquet, 77000 Melun, France
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Eschweiler J, Li J, Quack V, Rath B, Baroncini A, Hildebrand F, Migliorini F. Total Wrist Arthroplasty—A Systematic Review of the Outcome, and an Introduction of FreeMove—An Approach to Improve TWA. Life (Basel) 2022; 12:life12030411. [PMID: 35330163 PMCID: PMC8951379 DOI: 10.3390/life12030411] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 03/03/2022] [Accepted: 03/09/2022] [Indexed: 01/11/2023] Open
Abstract
The Swanson silicone prosthesis was one of the first devices to realize total wrist arthroplasty (TWA). It has been used regularly since the early 1960s. This systematic review of the literature evaluated the status quos of TWA. The present study was conducted according to the PRISMA guidelines. A literature search was made in Medline, PubMed, Google Scholar, and the Cochrane Library databases. The focus of the present study was on implant survivorship and related functional outcomes. Data from 2286 TWA (53 studies) were collected. Fifteen studies were included for the analysis of implant survivorship. Fifteen studies were included for the analysis of pain. Twenty-eight studies were included for the analysis of the Disabilities of the Arm, Shoulder, and Hand (DASH) score. Grip strength was tracked in 16 studies. The range of motion (RoM) was evaluated in 46 studies. For supination and pronation, 18 articles were available. Despite some methodological heterogeneities, TWA may be effective and safe in pain reduction and improving function and motion. There is still a range for a future improvement of the procedure.
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Affiliation(s)
- Jörg Eschweiler
- Department of Orthopaedics, Trauma and Reconstructive Surgery, RWTH Aachen University Hospital, 52074 Aachen, Germany; (J.L.); (V.Q.); (F.H.); (F.M.)
- Correspondence: ; Tel.: +49-(0)-241-8037368
| | - Jianzhang Li
- Department of Orthopaedics, Trauma and Reconstructive Surgery, RWTH Aachen University Hospital, 52074 Aachen, Germany; (J.L.); (V.Q.); (F.H.); (F.M.)
| | - Valentin Quack
- Department of Orthopaedics, Trauma and Reconstructive Surgery, RWTH Aachen University Hospital, 52074 Aachen, Germany; (J.L.); (V.Q.); (F.H.); (F.M.)
| | - Björn Rath
- Department of Orthopaedic Surgery, Klinikum Wels-Grieskirchen, 4710 Wels, Austria;
| | - Alice Baroncini
- Department of Orthopaedic and Trauma Surgery, Eifelklinik St. Brigida, 52152 Simmerath, Germany;
| | - Frank Hildebrand
- Department of Orthopaedics, Trauma and Reconstructive Surgery, RWTH Aachen University Hospital, 52074 Aachen, Germany; (J.L.); (V.Q.); (F.H.); (F.M.)
| | - Filippo Migliorini
- Department of Orthopaedics, Trauma and Reconstructive Surgery, RWTH Aachen University Hospital, 52074 Aachen, Germany; (J.L.); (V.Q.); (F.H.); (F.M.)
- Department of Orthopaedic and Trauma Surgery, Eifelklinik St. Brigida, 52152 Simmerath, Germany;
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Tanwin Y, Maes-Clavier C, Lestienne V, Gaisne E, Loubersac T, Kerjean Y, Bellemère P. Medium-Term Outcomes for Amandys Implant: A 5-Year Minimum Follow-Up of 63 Cases. J Wrist Surg 2022; 11:6-15. [PMID: 35127258 PMCID: PMC8807105 DOI: 10.1055/s-0041-1726406] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Accepted: 02/09/2021] [Indexed: 10/21/2022]
Abstract
Background Amandys is a pyrocarbon interposition implant used as a therapeutic alternative to total wrist fusion (TWF) or total wrist arthroplasty (TWA) in painful and disabling extensive destruction of the wrist. Objective To review mid-term outcomes in a continuous prospective series of patients who underwent wrist arthroplasty Amandys with a minimum follow-up of 5 years. Methods Clinical evaluation included a satisfaction survey, pain, two functional scores, the short version of the Disabilities of the Arm, Shoulder, and Hand (QuickDASH) and the Patient-Rated Wrist Evaluation (PRWE), active wrist mobility, and grip strength compared with the contralateral side. Radiological evaluation was used to detect implant subsidence, carpal migration, bone lysis, or implant malposition. All per- and postoperative complications were collected. Results Fifty-nine patients (63 procedures) were evaluated with a mean follow-up of 7 years; 57% of the patients were males, and the mean age was 58 years. Among the patients, 90% were satisfied or very satisfied. Pain was significantly improved, with a gain of 4/10 ( p < 0.001). Functional outcomes also improved between the second and fifth year of follow-up. Active mobility was preserved and grip strength was significantly improved by 7 kg ( p < 0.001). No implant subsidence or carpal migration was observed. Ten patients (11.9%) underwent revision surgery for conflict (1%), rotation (6%), or implant dislocation (5%). All complications and revisions occurred early with no new events after 1 year of follow-up. Discussion Mid-term clinical and radiological outcomes were stable with improvement of functional scores. The survival rate was comparable to that reported for TWF with conserved mobility. We report fewer complications compared with those reported for TWA or TWF. Early instability of the implant was the main etiology of the revisions. Repositioning of the implant was successful. No conversion to TWA or TWF was necessary. Conclusions Mid-term outcomes of the Amandys implants were encouraging. Patients conserved good wrist motion with improved strength and functional scores. The implant was well tolerated. Functional outcomes continue to improve with the follow-up. The survival rate remains stable after 2 years. The level of evidence of this study is IV (therapeutic case series).
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Affiliation(s)
- Youssouf Tanwin
- Service de Chirurgie Orthopédique et Traumatologique, CHU d'Amiens, Amiens, France
| | | | - Victor Lestienne
- Service de Chirurgie de la Main, Institut de la Main Nantes-Atlantique, Santé Atlantique Saint-Herblain, France
| | - Etienne Gaisne
- Service de Chirurgie de la Main, Institut de la Main Nantes-Atlantique, Santé Atlantique Saint-Herblain, France
| | - Thierry Loubersac
- Service de Chirurgie de la Main, Institut de la Main Nantes-Atlantique, Santé Atlantique Saint-Herblain, France
| | - Yves Kerjean
- Service de Chirurgie de la Main, Institut de la Main Nantes-Atlantique, Santé Atlantique Saint-Herblain, France
| | - Philippe Bellemère
- Service de Chirurgie de la Main, Institut de la Main Nantes-Atlantique, Santé Atlantique Saint-Herblain, France
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Abi-Rafeh J, ElHawary H, Azzi AJ, Thibaudeau S. Pyrocarbon Arthroplasty Implants in the Upper Extremity: A Systematic Review of Outcomes and Pooled Analysis of Complications. Plast Reconstr Surg 2021; 148:946e-958e. [PMID: 34847116 DOI: 10.1097/prs.0000000000008514] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Growing use of pyrocarbon implants in upper extremity arthroplasty has culminated in a breadth of literature ascertaining outcomes and complications at long-term follow-up. However, at present, the literature remains devoid of studies synthesizing the available evidence for upper extremity surgeons to adequately assess the safety and utility of these implants relative to other available options. METHODS A systematic search of the National Library of Medicine, MEDLINE, and Embase databases was performed to determine clinical outcomes and complication and reoperation rates following pyrocarbon arthroplasties in the upper extremity. A breakdown of complication and reoperation rates for each independent joint (shoulder, elbow, wrist, and hand joints), and according to specific causes necessitating surgery, was also compiled. RESULTS A comprehensive summary of functional outcomes following upper extremity pyrocarbon arthroplasties is presented. Overall complication and reoperation rates in the hand and wrist were determined to be 28.2 percent and 17 percent, respectively. The proximal interphalangeal joint was associated with the highest complication rate (42.7 percent), followed by carpometacarpal joint (18.8 percent), metacarpophalangeal joint (17.6 percent), wrist (16 percent), elbow (15.7 percent), and shoulder (12.9 percent). In the hand and wrist, major complications included dislocations and subluxations (8.4 percent), stiffness and limited motion (4.4 percent), deformity (3.1 percent), hardware failure (1.9 percent), fractures (1.7 percent), persistent pain (1.7 percent), and infections (0.9 percent). CONCLUSION In the absence of large clinical trials, systematic reviews such as these can help inform clinical guidelines and provide practitioners with an evidence-based reference to improve informed consent.
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Affiliation(s)
- Jad Abi-Rafeh
- From the Faculty of Medicine, McGill University; and Division of Plastic and Reconstructive Surgery, Department of Surgery, McGill University Health Centre
| | - Hassan ElHawary
- From the Faculty of Medicine, McGill University; and Division of Plastic and Reconstructive Surgery, Department of Surgery, McGill University Health Centre
| | - Alain J Azzi
- From the Faculty of Medicine, McGill University; and Division of Plastic and Reconstructive Surgery, Department of Surgery, McGill University Health Centre
| | - Stephanie Thibaudeau
- From the Faculty of Medicine, McGill University; and Division of Plastic and Reconstructive Surgery, Department of Surgery, McGill University Health Centre
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Marie C, Aribert M, Bouyer M, Forli A, Corcella D. Clinical, functional, and radiological results of the Amandys® interposition arthroplasty in 13 cases of wrist osteoarthritis. HAND SURGERY & REHABILITATION 2021; 40:420-426. [PMID: 33689925 DOI: 10.1016/j.hansur.2021.03.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 03/01/2021] [Accepted: 03/02/2021] [Indexed: 12/21/2022]
Abstract
Amandys® pyrocarbon interposition arthroplasty is intended for widespread arthritis of the wrist. The aim of this study was to assess the clinical, functional, and radiological results of this arthroplasty with a minimum follow-up of 12 months. This retrospective single-center study brought together all osteoarthritis indications that can benefit from an Amandys® arthroplasty. Twenty-one implants were used between January 2011 and October 2018. There were seven cases of distal radius malunion, eight SLAC wrists, two SNAC wrists, two cases of Kienböck's disease at Lichtman's stage 4, and two aftermaths of inflammatory arthritis. Twenty-four percent of patients had previously undergone another type of surgery for this wrist arthritis. Six implants were removed, five early for dislocation and one after 6 years for chronic pain. Thirteen patients were reviewed with an average follow-up of 40.7 months (21-90). The average pain level on a visual analog scale was 3.1/10 (0-7). The mean range motion was 36° flexion (10-60) and 33° extension (15-50). The mean grip strength at the last follow-up was 14.8 kg (2-30) (43% of contralateral). The average QuickDASH and PRWE functional scores were 37.9/100 (0-80) and 29.6/100 (0-83.5), respectively. Amandys® interposition arthroplasty is an interesting alternative to total wrist fusion or total wrist prosthesis for widespread arthritis of the wrist. For the implant to be stable, the capsulo-ligamentous systems must be intact.
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Affiliation(s)
- C Marie
- SOS Main Grenoble, Unité de Chirurgie Réparatrice, de la Main et des Brûlés, Hôpital A - Michallon, CHU de Grenoble, Avenue du Marquis de Grésivaudan, BP 217, 38043 Grenoble cedex 09, France.
| | - M Aribert
- SOS Main Grenoble, Unité de Chirurgie Réparatrice, de la Main et des Brûlés, Hôpital A - Michallon, CHU de Grenoble, Avenue du Marquis de Grésivaudan, BP 217, 38043 Grenoble cedex 09, France.
| | - M Bouyer
- SOS Main Grenoble, Unité de Chirurgie Réparatrice, de la Main et des Brûlés, Hôpital A - Michallon, CHU de Grenoble, Avenue du Marquis de Grésivaudan, BP 217, 38043 Grenoble cedex 09, France.
| | - A Forli
- SOS Main Grenoble, Unité de Chirurgie Réparatrice, de la Main et des Brûlés, Hôpital A - Michallon, CHU de Grenoble, Avenue du Marquis de Grésivaudan, BP 217, 38043 Grenoble cedex 09, France.
| | - D Corcella
- SOS Main Grenoble, Unité de Chirurgie Réparatrice, de la Main et des Brûlés, Hôpital A - Michallon, CHU de Grenoble, Avenue du Marquis de Grésivaudan, BP 217, 38043 Grenoble cedex 09, France.
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Rocchi L, Fulchignoni C, Marcuzzi A. Resurfacing Capitate Pyrocarbon Implant Without Capitate Pole Resection to Improve Clinical Results in the Treatment of Chronic Wrist Arthritis. Tech Hand Up Extrem Surg 2021; 25:213-218. [PMID: 33399388 DOI: 10.1097/bth.0000000000000335] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Proximal row carpectomy (PRC) is a long-time, well-accepted, easy-to-reproduce procedure for the treatment of several painful degenerative conditions of the wrist, when capitate pole and radius lunate fossa are preserved. It has been reported to relieve pain and preserve a substantial wrist range of motion, although a partial loss of strength has to be expected because of the decreased length of the carpus. Since 2010, a new technique has been described in the literature using the resurfacing capitate pyrocarbon implant, combined with PRC. This implant has been designed to perform PRC even in the presence of degenerate joint surfaces, and thus resolves the limited indications of this procedure; however, if a resection of the capitate pole is performed to set up the implant, similar to PRC it may not positively influence the recovery of strength. The authors propose an resurfacing capitate pyrocarbon implant technique without any capitate bone resection, to preserve as much as possible the carpus length and so to improve the functional recovery. The surgical technique, is described in detail and preliminary results are discussed.
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Affiliation(s)
- Lorenzo Rocchi
- Hand Surgery and Orthopedics Unit, Department of Orthopaedics and Traumatology, University Hospital A. Gemelli IRCCS, Rome
| | - Camillo Fulchignoni
- Hand Surgery and Orthopedics Unit, Department of Orthopaedics and Traumatology, University Hospital A. Gemelli IRCCS, Rome
| | - Augusto Marcuzzi
- Department of Hand Surgery, Modena University Hospital, Modena, Italy
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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.
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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
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Ruijs ACJ, Rezzouk J. Two cases of pyrocarbon capitate resurfacing after comminuted fracture of the capitate bone. CASE REPORTS IN PLASTIC SURGERY AND HAND SURGERY 2020; 7:145-148. [PMID: 33457455 PMCID: PMC7782795 DOI: 10.1080/23320885.2020.1834398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
We present two cases of the use of a pyrocarbon capitate resurfacing implant (RCPI) after comminuted capitate fracture. Both cases were young males with a high-energy injury to the wrist. Follow-up was 21 and 29 months. Wrist ROM was decreased to about 47% and post-injury pain was limited.
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Affiliation(s)
| | - Joël Rezzouk
- Centre Aquitain de la Main et du Poignet, Dax, France
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Ferrero M, di Summa PG, Giacalone F, Senesi L, Sapino G, Battiston B. Salvage of advanced carpal collapse: proximal row carpectomy with pyrocarbon resurfacing of the capitate versus four-corner arthrodesis. J Hand Surg Eur Vol 2020; 45:687-692. [PMID: 32787664 DOI: 10.1177/1753193420931416] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
In this retrospective study we report on two comparable groups of patients with advanced carpal arthritis treated with either proximal row carpectomy combined with a pyrocarbon resurfacing of the capitate (31 patients) or a four-corner arthrodesis and dorsal plating (26 patients). Follow-up time was 46 months (24-118). Except for a modestly higher radial wrist deviation in the patients treated with four-corner arthrodesis, there were no significant differences in outcomes between the groups. Asymptomatic progression of osteoarthritis in the lunate fossa was observed in four cases in both groups. Two cases were converted to a total wrist arthrodesis in the pyrocarbon group compared with one case in the four-corner arthrodesis group. Although four-corner arthrodesis remains the reference standard in the treatment of wrist osteoarthritis with involvement of the midcarpal joint, proximal row carpectomy combined with pyrocarbon resurfacing of the capitate is an alternative option. It can even be used in selected cases with erosion of the lunate fossa.Level of evidence: III.
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Affiliation(s)
- Matteo Ferrero
- Department of Hand Surgery and Microsurgery, Ospedale CTO - Città della Salute e della Scienza di Torino, Turin, Italy
| | - Pietro G di Summa
- Department of Plastic, Reconstructive, Aesthetic and Hand Surgery, University Hospital of Lausanne (CHUV), Lausanne, Switzerland
| | - Francesco Giacalone
- Department of Hand Surgery and Microsurgery, Ospedale CTO - Città della Salute e della Scienza di Torino, Turin, Italy
| | - Letizia Senesi
- Department of Hand Surgery and Microsurgery, Ospedale CTO - Città della Salute e della Scienza di Torino, Turin, Italy
| | - Gianluca Sapino
- Department of Plastic, Reconstructive, Aesthetic and Hand Surgery, University Hospital of Lausanne (CHUV), Lausanne, Switzerland.,Department of Plastic and Reconstructive Surgery, University Hospital of Modena, Modena, Italy
| | - Bruno Battiston
- Department of Hand Surgery and Microsurgery, Ospedale CTO - Città della Salute e della Scienza di Torino, Turin, Italy
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Fulchignoni C, Caviglia D, Rocchi L. Resurfacing capitate pyrocarbon implant after proximal row carpectomy: A litterature review. Orthop Rev (Pavia) 2020; 12:8679. [PMID: 32913607 PMCID: PMC7459383 DOI: 10.4081/or.2020.8679] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 06/17/2020] [Indexed: 12/21/2022] Open
Abstract
Up to a decade ago, to treat patients with chronic wrist pain due to advanced stages of arthritis, surgeons had four main solutions: partial or total wrist arthrodesis, total wrist prosthesis and proximal row carpectomy (PRC). Since 2010, a new technique has been described in literature using the Resurfacing Capitate Pyrocarbon Implant (RCPI), combined to PRC. The aim of this article is to review the literature and determine the indications, outcomes and complications associated with RCPI. An electronic literature research was carried out and pertinent articles were selected. Surgical technique, results and complications described in those articles are presented. From this review of the literature, authors conclude that Resurfacing Capitate Pyrocarbon Implant can be considered as a good alternative to arthrodesis and total wrist arthroplasty, at any ages, when proximal row carpectomy alone would not be indicated.
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Affiliation(s)
- Camillo Fulchignoni
- Orthopaedics & Hand Surgery Unit, Department of Orthopaedics, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome; Università Cattolica del Sacro Cuore, Rome, Italy
| | - Daniele Caviglia
- Orthopaedics & Hand Surgery Unit, Department of Orthopaedics, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome; Università Cattolica del Sacro Cuore, Rome, Italy
| | - Lorenzo Rocchi
- Orthopaedics & Hand Surgery Unit, Department of Orthopaedics, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome; Università Cattolica del Sacro Cuore, Rome, Italy
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Abstract
The article reviews the techniques and surgical outcomes of arthroplasties of the metacarpophalangeal, carpometacarpal and the wrist joints. In my patients, interposition pyrocarbon implants quickly achieve functional recovery and do not deteriorate time. Bony and articular tolerances are remarkable. These implants are a valid alternative to conventional arthroplasties, such as trapeziectomies, silicone implants and total joint replacements. Because of the implant's small size, the surgery can be done through minimally invasive approaches especially for young and active patients. A technical key is to properly manage the bone surfaces of the joint and the peri-articular soft tissues to avoid early implant instability.
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Bastard C, Goubier JN, Teboul F. Proximal Row Carpectomy with Resurfacing Capitate Pyrocarbon Implant with Bone Graft for Scaphoid Nonunion Advanced Collapse III Wrist with Total Intramedullary Bone Resorption of the Capitate: A Case Report. J Orthop Case Rep 2019; 8:35-37. [PMID: 30687659 PMCID: PMC6343558 DOI: 10.13107/jocr.2250-0685.1148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Introduction: One treatment of advanced carpal collapse with osteoarthritis of the midcarpal joint can be proximal row carpectomy (PRC) with pyrocarbon prosthesis implant, replacing the head of the capitate. We report a case of scaphoid nonunion advanced collapse (SNAC) III wrist with intramedullary bone resorption of the capitate. Case Report: A 55-year-old man had major functional impotence of the wrist and right hand with an extremely evolved SNAC III wrist with completely intramedullary bone resorption of the capitate. On the basis of this diagnosis and due to refractory severe pain that did not respond to conservative treatment, we discussed 3 therapeutic options: PRC with resurfacing capitate pyrocarbon implant (RCPI) in case of a possible large bone graft intraoperatively, a pyrocarbon intermediate prosthesis like adaptative proximal scaphoid implant which is interposed between the radius and the second carpal row, or a complete arthrodesis of the wrist. He was successfully managed by capitate pyrocarbon prosthesis associated with capitate bone graft. The patient presented no pain and was satisfied with the operation. The X-ray showed a stable prosthesis. Conclusion: Treatment of advanced carpal collapse with osteoarthritis of the midcarpal joint can be PRC with RCPI. However, when bone resorption of the capitate exists, surgical treatment usually is a wrist arthrodesis which is a good pain relief but blocks all movements. PRC with RCPI with bone graft can be a good alternative solution with pain relief and preservation of wrist mobility.
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Affiliation(s)
- Claire Bastard
- Private Hospital Paul d'Egine, 35 street Musselburgh, 94500 Champigny Sur Marne, France
| | - Jean Noël Goubier
- Private Hospital Paul d'Egine, 35 street Musselburgh, 94500 Champigny Sur Marne, France.,International clinic of Parc Monceau, 21 street Chazelles, 75017 Paris, France
| | - Frédéric Teboul
- Private Hospital Paul d'Egine, 35 street Musselburgh, 94500 Champigny Sur Marne, France.,International clinic of Parc Monceau, 21 street Chazelles, 75017 Paris, France
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17
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Pyrocarbon implants for the hand and wrist. HAND SURGERY & REHABILITATION 2018; 37:129-154. [DOI: 10.1016/j.hansur.2018.03.001] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2017] [Accepted: 03/04/2018] [Indexed: 11/20/2022]
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18
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Resurfacing Capitate Pyrocarbon Implant versus Proximal Row Carpectomy Alone. Plast Reconstr Surg 2017; 140:962-970. [DOI: 10.1097/prs.0000000000003759] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Barrera-Ochoa S, Mendez-Sanchez G, Mir-Bullo X. Pyrocarbon interposition arthroplasty for failed total wrist arthrodesis. J Hand Surg Eur Vol 2017; 42:968-969. [PMID: 28756731 DOI: 10.1177/1753193417723272] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- Sergi Barrera-Ochoa
- 1 Orthopedic Surgery Department, Hospital Sant Joan de Deu, Esplugues de Llobregat, Spain.,2 Hand and Microsurgery Unit, Hospital Universitari Quiron-Dexeus, Barcelona, Spain
| | | | - Xavier Mir-Bullo
- 2 Hand and Microsurgery Unit, Hospital Universitari Quiron-Dexeus, Barcelona, Spain
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Stage IV Kienböck's disease: Proximal row carpectomy and application of RCPI implant. HAND SURGERY & REHABILITATION 2017; 36:102-108. [DOI: 10.1016/j.hansur.2016.12.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2015] [Revised: 11/14/2016] [Accepted: 12/19/2016] [Indexed: 11/22/2022]
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Marcuzzi A, Ozben H, Russomando A. Salvage of a post-traumatic arthritic wrist using the scaphoid as an osteochondral graft. ACTA ACUST UNITED AC 2014; 33:303-7. [PMID: 25034309 DOI: 10.1016/j.main.2014.04.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2014] [Revised: 03/10/2014] [Accepted: 04/26/2014] [Indexed: 10/25/2022]
Abstract
The authors describe a case of post-traumatic wrist arthritis with an osteochondral defect in the scaphoid fossa of the radius. The patient was treated with proximal row carpectomy, radial styloidectomy and reconstruction of the defect using the proximal half of the scaphoid as an autologous osteochondral graft. Pain relief was achieved while wrist motion and strength were improved. The carpal bones are a source of osteochondral grafts and can be used to expand the indications of motion-preserving wrist salvage procedures.
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Affiliation(s)
- A Marcuzzi
- Hand and Microvascular Unit, Azienda Ospedaliera Policlinico di Modena, Via del Pozzo 71, 41100 Modena, Italy
| | - H Ozben
- Hand and Microvascular Unit, Azienda Ospedaliera Policlinico di Modena, Via del Pozzo 71, 41100 Modena, Italy.
| | - A Russomando
- Hand and Microvascular Unit, Azienda Ospedaliera Policlinico di Modena, Via del Pozzo 71, 41100 Modena, Italy
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