Radiolunate Arthrodesis in the Rheumatoid Wrist: A Retrospective Clinical and Radiological Longterm Follow-Up

A retrospective study was performed to investigate the clinical and radiological results of radiolunate arthrodesis in the rheumatoid wrist. Ninety-one wrists in 78 patients were assessed at a mean follow-up of 60 months. Most patients were pain-free and content with the overall result. In 68 wrists the carpus had been repositioned or maintained in neutral or slightly ulnar alignment and no further translation occurred. Midcarpal dislocation occured in ten and midcarpal rotation in 13 wrists. The midcarpal joint underwent further arthritic destruction in 34 wrists and secondary arthrosis in 32 wrists. In 25 wrists the midcarpal joint space remained unchanged. Radiolunate arthrodesis can successfully be performed in wrists even with advanced destruction. In cases with fixed carpal collapse, anatomical repositioning of the lunate and restoration of carpal height should not be attempted as this causes midcarpal dislocation or rotation or precipitates secondary arthrosis.

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A Comparison of Two Indices for Ulnar Translation and Carpal Height in the Rheumatoid Wrist

Journal of Hand Surgery (European Volume) ◽

10.1016/j.jhsb.2003.10.008 ◽

2004 ◽

Vol 29 (2) ◽

pp. 144-147 ◽

Cited By ~ 8

Author(s):

N. BORISCH ◽

K. LERCH ◽

J. GRIFKA ◽

P. HAUSSMANN

Keyword(s):

Rheumatoid Arthritis ◽

False Negative ◽

Hand Surgery ◽

X Rays ◽

Joint Surgery ◽

Rheumatoid Wrist ◽

Two Indices ◽

Radiolunate Arthrodesis ◽

Carpal Height

The indices for ulnar translation described by Chamay et al. (1983 , Annales de Chirurgie de la Main, Vol. 2, pp. 5–17), and Bouman et al. (1994 , Journal of Hand Surgery Vol. 19B, pp. 325–329), and for carpal height described by Youm et al. (1978 , Journal of Bone and Joint Surgery, Vol. 40A, pp. 423–431) and Bouman et al. (1994) were compared in pre- and postoperative wrist X-rays of 91 patients with rheumatoid arthritis undergoing radiolunate arthrodesis. Both indices described by Bouman had a higher applicability and sensitivity than the Chamay and Youm indices and are recommended for use with the rheumatoid wrist. However false-negative values may result when the Bouman index for ulnar translation is used to follow up radiolunate arthrodesis.

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Radiocarpal Arthrodesis in the Treatment of the Rheumatoid Wrist. A Prospective Midterm Follow-up

Journal of Hand Surgery (European Volume) ◽

10.1016/j.jhse.2007.04.006 ◽

2007 ◽

Vol 32 (4) ◽

pp. 368-376 ◽

Cited By ~ 21

Author(s):

P. B. HONKANEN ◽

S. MÄKELÄ ◽

Y. T. KONTTINEN ◽

M. U. K. LEHTO

Keyword(s):

Patient Satisfaction ◽

Bone Stock ◽

Group Iii ◽

Radiocarpal Joint ◽

Grade Ii ◽

Clinical And Radiological Results ◽

Radiolunate Arthrodesis ◽

Radioscapholunate Arthrodesis ◽

Midcarpal Joint

This prospective study was performed to evaluate the clinical and radiological results of radiocarpal joint arthrodesis in the treatment of unstable Simmen group III and Larsen grade II or III rheumatoid wrists. Radiolunate arthrodesis was performed in 16 wrists and radioscapholunate arthrodesis in 7 wrists in 20 patients. When they were evaluated at a mean of 5.8 (range 3.5–9.8) years later, flexion was 29° and extension 34°, representing 67% and 92% of the preoperative values, respectively. Patient satisfaction was excellent, or good, for 20 wrists and satisfactory for 1 wrist. In two patients with poor satisfaction, arthritis progressed to the midcarpal joint and necessitated total arthrodesis of the wrist. Radiolunate joint arthrodesis, with inclusion of the scaphoid in the fusion if necessary, is a useful operation in the treatment of this degree of wrist disease as it produces a functional and pain-free wrist at the same time as preserving much of the mobility and bone stock.

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Radiolunate fusion in the rheumatoid wrist with Shapiro staples: clinical and radiological results of 22 cases

Journal of Hand Surgery (European Volume) ◽

10.1177/1753193409342054 ◽

2009 ◽

Vol 35 (4) ◽

pp. 289-295 ◽

Cited By ~ 5

Author(s):

R. Gaulke ◽

G. Suppelna ◽

F. Hildebrand ◽

M. Citak ◽

T. Hüfner ◽

...

Keyword(s):

Case Control Study ◽

Clinical Results ◽

High Rate ◽

Radiological Results ◽

Rheumatoid Wrist ◽

Early Loosening ◽

Clinical And Radiological Results ◽

Staple Fixation ◽

Control Study

We performed a retrospective clinical and radiological case control study on 22 rheumatoid wrists following radiolunate fusion via Shapiro staples with a mean follow-up of 5 years. Radiographs showed one early loosening through dorsal staple migration and four nonunions. Six wrists fused in mild ulnopalmar dislocation of the lunate. Primary intra-articular positioning of a staple was found in nine wrists, secondary intra-articular staple dislocation was found in two wrists. Dorsal staple dislocation was found in four fused arthrodeses. Osteolysis around the staples was found in all but two wrists. In contrast to unsatisfactory radiological results the clinical results were good or excellent in 18 patients. Good and excellent clinical results in the majority of the patients following radiolunate fusion does not depend on the fixation device. Nevertheless staple fixation of the radiolunate joint in the rheumatoid wrist is associated with a high rate of radiological complications.

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Salvage of advanced carpal collapse: proximal row carpectomy with pyrocarbon resurfacing of the capitate versus four-corner arthrodesis

Journal of Hand Surgery (European Volume) ◽

10.1177/1753193420931416 ◽

2020 ◽

Vol 45 (7) ◽

pp. 687-692 ◽

Cited By ~ 1

Author(s):

Matteo Ferrero ◽

Pietro G. di Summa ◽

Francesco Giacalone ◽

Letizia Senesi ◽

Gianluca Sapino ◽

...

Keyword(s):

Retrospective Study ◽

Reference Standard ◽

Proximal Row Carpectomy ◽

Level Of Evidence ◽

Carpal Collapse ◽

Wrist Arthrodesis ◽

Dorsal Plating ◽

Midcarpal Joint ◽

Lunate Fossa

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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Clinical and Radiological Results over the Medium Term of Isolated Acetabular Revision

The Scientific World JOURNAL ◽

10.1155/2014/148592 ◽

2014 ◽

Vol 2014 ◽

pp. 1-7 ◽

Cited By ~ 4

Author(s):

Nicola Piolanti ◽

Lorenzo Andreani ◽

Paolo Domenico Parchi ◽

Enrico Bonicoli ◽

Francesco Niccolai ◽

...

Keyword(s):

Groin Pain ◽

Large Diameter ◽

Acetabular Revision ◽

Acetabular Cup ◽

Medium Term ◽

Retrospective Design ◽

Radiological Results ◽

Functional Scores ◽

Clinical And Radiological Results

Acetabular cup loosening is associated with pain, reduced function, and instability of the implant. If such event happens while the femoral implant is in a satisfactory position and is well fixed to the bone, isolated acetabular revision surgery is indicated. The aim of this single-center retrospective study was to evaluate the clinical and radiological results over the medium term (12-month follow-up mean 36, max 60) of isolated acetabular revisions surgery using a porous hemispheric revision shell matched with a cemented all-poly cup and large diameter femoral head (>32). 33 patients were enrolled. We collect any relevant data from the clinical board. Routine clinical and radiographic examinations were performed preoperatively; the postoperative follow-up was made at 1, 3, and 6 months and yearly thereafter. At the last available follow-up, we report satisfactory improvement of functional scores in all the patients; 2 patients (6.1%) showed thigh pain and only 4 hips (12.11%) presented mild groin pain; all the femoral components are well fixed and there were no potential or pending rerevisions. With bias due to the follow-up and to the retrospective design of the study, we report clinical, functional, and radiological satisfactory results.

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