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1. Ten-year radiological and clinical outcomes of capitolunate arthrodesis with scaphoid and triquetrum excision for advanced degenerative arthritis in the wrist: Single-center, retrospective case series with 10 patients

Author

F. Dargai, Z. Jaffarbanjee, I. Daoudi, R. Leonard, G. Hoel, M. Safieddine, and Elodie Payet

Subjects
Adult, Male, Wrist Joint, medicine.medical_specialty, Visual Analog Scale, Visual analogue scale, Arthrodesis, medicine.medical_treatment, Nonunion, Osteoarthritis, 030230 surgery, Wrist, Capitate Bone, Disability Evaluation, Triquetrum Bone, Young Adult, 03 medical and health sciences, Postoperative Complications, Return to Work, 0302 clinical medicine, medicine, Humans, Orthopedics and Sports Medicine, Lunate Bone, Aged, Retrospective Studies, Scaphoid Bone, 030222 orthopedics, business.industry, Rehabilitation, Middle Aged, medicine.disease, Surgery, Wrist osteoarthritis, Radiography, medicine.anatomical_structure, Triquetrum, Patient Satisfaction, Female, Range of motion, business
Abstract

The aim of this study was to evaluate the long-term outcomes of capitolunate arthrodesis for treating advanced wrist osteoarthritis. The arthrodesis procedures were performed in three women and seven men having a mean age of 59years (range, 20-70). Eight of the patients were manual laborers. The dominant hand was operated on in seven patients. The osteoarthritis was attributed to scapholunate dissociation (SLAC) in six patients and scaphoid nonunion (SNAC) in four patients. The arthrodesis site was stabilized with two vertical compression screws. Patients were reviewed after an average follow-up of 122months (80-172). The clinical and radiological outcomes consisted of measuring pain on a visual analog scale (VAS), determining the QuickDASH and PRWE scores, the patients' satisfaction, the radiolunate and capitolunate angles, carpal height, radiolunate joint condition, and fusion of the arthrodesis site. The mean pain level was reduced from 5 to 1 (P

Published
2020

2. Ten-year radiological and clinical outcomes of capitolunate arthrodesis with scaphoid and triquetrum excision for advanced degenerative arthritis in the wrist: Single-center, retrospective case series with 10patients.

Author

Dargai F, Hoel G, Safieddine M, Payet E, Leonard R, Jaffarbanjee Z, and Daoudi I

Subjects
Adult, Aged, Disability Evaluation, Female, Humans, Male, Middle Aged, Osteoarthritis diagnostic imaging, Osteoarthritis physiopathology, Patient Satisfaction, Postoperative Complications, Radiography, Retrospective Studies, Return to Work, Visual Analog Scale, Wrist Joint diagnostic imaging, Wrist Joint physiopathology, Young Adult, Arthrodesis methods, Capitate Bone surgery, Lunate Bone surgery, Osteoarthritis surgery, Scaphoid Bone surgery, Triquetrum Bone surgery, Wrist Joint surgery
Abstract

The aim of this study was to evaluate the long-term outcomes of capitolunate arthrodesis for treating advanced wrist osteoarthritis. The arthrodesis procedures were performed in three women and seven men having a mean age of 59years (range, 20-70). Eight of the patients were manual laborers. The dominant hand was operated on in seven patients. The osteoarthritis was attributed to scapholunate dissociation (SLAC) in six patients and scaphoid nonunion (SNAC) in four patients. The arthrodesis site was stabilized with two vertical compression screws. Patients were reviewed after an average follow-up of 122months (80-172). The clinical and radiological outcomes consisted of measuring pain on a visual analog scale (VAS), determining the QuickDASH and PRWE scores, the patients' satisfaction, the radiolunate and capitolunate angles, carpal height, radiolunate joint condition, and fusion of the arthrodesis site. The mean pain level was reduced from 5 to 1 (P<0.05). The range of motion improved by 20° in flexion-extension and 10° in radioulnar deviation, while strength improved by 8kg relative to the preoperative measurements (P<0.05). The QuickDASH was 15points (±12) and the PRWE was 20 (±32). Relative to the preoperative values, the radiolunate angle was reduced by 4.5° and the capitolunate angle by 6.5°. Carpal height was 6.5mm less on average (P<0.05). None of the patients had a nonunion or deterioration of the radiolunate joint. One patient developed Type II complex regional pain syndrome. The nine other patients were able to return to work. Capitolunate arthrodesis provided pain relief and good function in 9 of the 10patients in our case series. The results was maintained over time, both in terms of mobility and pain relief, which were clearly improved after the surgical treatment. We found no signs of deterioration of the radiolunate joint over 10years. There are very few published studies describing the long-term outcomes of this procedure. Our findings are consistent with those in the literature, which makes capitolunate arthrodesis with scaphoid and triquetrum excision a highly satisfactory and reliable technique in the long term for the treatment of advanced osteoarthritis in the wrist. LEVEL OF EVIDENCE: IV., (Copyright © 2019 SFCM. All rights reserved.)

Published
2020
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