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

2020 ◽  
Vol 45 (7) ◽  
pp. 687-692 ◽  
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

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

2002 ◽  
Vol 27 (1) ◽  
pp. 61-72 ◽  
Author(s):  
N. BORISCH ◽  
P. HAUSSMANN
Keyword(s):  
Retrospective Study ◽  
Joint Space ◽  
Carpal Collapse ◽  
Radiological Results ◽  
Rheumatoid Wrist ◽  
Clinical And Radiological Results ◽  
Radiolunate Arthrodesis ◽  
Midcarpal Joint ◽  
Carpal Height

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.

scholarly journals Universal 2 total wrist arthroplasty for the salvage of failed Biaxial total wrist arthroplasty

2019 ◽  
Vol 44 (6) ◽  
pp. 614-619 ◽  
Author(s):  
Hero J. A. Zijlker ◽  
Merel J. Berkhout ◽  
Marco J. P. F. Ritt ◽  
Niels van Leeuwen ◽  
Cees B. IJsselstein
Keyword(s):  
Level Of Evidence ◽  
Wrist Arthrodesis ◽  
Evaluation Scores ◽  
Total Wrist Arthroplasty ◽  
Hand Evaluation ◽  
Wrist Arthroplasty

Universal 2 implants may be an alternative to total wrist arthrodesis for the salvage of failed Biaxial total wrist prostheses. We assessed 40 Universal 2 revision implants retrospectively. Fourteen of these wrists were converted to total wrist arthrodeses, and two wrists received a third total wrist arthroplasty after a mean period of 5.5 years. Twenty-four of the Universal 2 implants that remained in situ after a mean follow-up of 9 years (range 4 to 13 years) were re-examined. Sixteen functioned satisfactorily. Patient-Rated Wrist and Hand Evaluation scores and Quick Disabilities of the Arm, Shoulder and Hand scores were 53 and 47, respectively. Twenty-nine patients would choose the Universal 2 again and would also recommend it to other patients. The survival of the revision implants was 60% at a mean follow-up of 9 years. Level of evidence: IV

scholarly journals Long-term radiological changes and functional outcomes after proximal row carpectomy: Retrospective study with 3 years’ minimum follow-up

2020 ◽  
Vol 106 (8) ◽  
pp. 1589-1595
Author(s):  
Charles Bijon ◽  
Marc Saab ◽  
Thomas Amouyel ◽  
Nadine Sturbois-Nachef ◽  
Elvire Guerre ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Functional Outcomes ◽  
Proximal Row Carpectomy ◽  
Radiological Changes

scholarly journals Long-Term Outcome and Secondary Operations after Proximal Row Carpectomy or Four-Corner Arthrodesis

2017 ◽  
Vol 07 (01) ◽  
pp. 051-056 ◽  
Author(s):  
John Williams ◽  
Hadley Weiner ◽  
Andrew Tyser
Keyword(s):  
Smoking Status ◽  
Proximal Row Carpectomy ◽  
Long Term Outcome ◽  
Wrist Arthrodesis ◽  
Conversion Rates ◽  
Significant Difference ◽  
Patient Reported ◽  
Secondary Operations

Background Proximal row carpectomy (PRC) and four-corner arthrodesis (FCA) are common surgical procedures used to treat degenerative wrist conditions; however, complications and failures can occur. Purpose This study aimed to investigate and compare the long-term rate of secondary surgeries including conversion to total wrist arthrodesis in patients who underwent PRC or FCA. Materials and Methods A retrospective chart review of all patients who underwent PRC or FCA in the past 20 years at a tertiary referral institution and associated Veterans Affairs (VA) hospital was performed. Patient demographics, comorbidities, surgical indications, and associated complications were tabulated. Patients were contacted via phone to obtain additional follow-up information regarding any additional surgeries, 10-point visual analog scale (VAS) for pain, quick Disabilities of the Arm, Shoulder, and Hand (quickDASH) scores, hand dominance, and occupational data. Results A total of 123 wrists made up the final dataset. Sixty-two wrists treated with PRC and 61 wrists treated with FCA were reviewed at a mean follow-up of 8.2 years. We did not find a significant difference in the rate of conversion to total wrist arthrodesis between the PRC (14.5%) and FCA (19.5%, p = 0.51) cohorts. Secondary operations were significantly greater in the FCA group (34.4%) compared with the PRC group (16.1%, p = 0.02). Females were 2.6 times more likely than males to undergo secondary operations when controlling for surgical procedure and smoking status (p = 0.04). We did not detect a significant difference in VAS pain or in quickDASH scores between the two groups (p = 0.35, 0.48, respectively). Conclusion PRC and FCA have comparable patient reported outcomes and wrist arthrodesis conversion rates at a mean follow-up of 8.2 years. In contrast, the FCA patient group had a significantly higher rate of secondary operations, including those for nonunion, symptomatic hardware, and other implant-related issues, when combined with wrist arthrodesis conversion. Level of Evidence Level IV, therapeutic study.

Dorsal intercarpal ligament capsulodesis: a retrospective study of 120 patients according to types of chronic scapholunate instability

2020 ◽  
Vol 45 (7) ◽  
pp. 666-672
Author(s):  
Grégoire Micicoi ◽  
Lolita Micicoi ◽  
Nicolas Dreant
Keyword(s):  
Retrospective Study ◽  
Retrospective Analysis ◽  
Good Option ◽  
Level Of Evidence ◽  
Independent Observer ◽  
Scapholunate Instability ◽  
Early Stages ◽  
Mayo Wrist Score ◽  
Radiological Data

The purpose of this study was to assess the results of dorsal intercarpal ligament capsulodesis (Mayo technique) for cases of chronic scapholunate instability and to specify the indications according to the severity of instability. A retrospective analysis was conducted and examined dorsal intercarpal ligament capsulodesis procedures performed for chronic scapholunate instability without intercarpal or radiocarpal arthritis. One-hundred and twenty patients were examined by an independent observer (48 predynamic, 48 dynamic and 24 static scapholunate instabilities). The follow-up period averaged 54 months (range 24–127). Mean final Mayo wrist score was 70, mean final Patient-Rated Wrist Evaluation was 27 and mean final QuickDASH score was 26. Functional, clinical and radiological data were improved for the operated patients. We concluded that dorsal intercarpal ligament capsulodesis is a good option for treating early stages of scapholunate instability. Level of evidence: IV

scholarly journals Comparison of Gastrocnemius Turn Flap and Hamstring Graft for the Treatment of Kuwada Type 3 Chronic Ruptures of the Achilles Tendon: A Retrospective Study

2019 ◽  
Vol 7 (12) ◽  
pp. 232596711988767
Author(s):  
Lu Bai ◽  
Siyao Guan ◽  
Tian You ◽  
Wentao Zhang ◽  
Peng Chen
Keyword(s):  
Retrospective Study ◽  
Achilles Tendon ◽  
Clinical Outcomes ◽  
Tendon Rupture ◽  
Achilles Tendon Rupture ◽  
Hamstring Graft ◽  
Early Recovery ◽  
Level Of Evidence ◽  
Type 3

Background: Chronic Achilles tendon rupture is challenging to repair, and many procedures have been suggested to fill the gap that separates the distal and proximal ends of the ruptured tendon. Purpose: To compare clinical outcomes between the free hamstring graft (HG) and gastrocnemius turn flap (GTF) procedures in the treatment of chronic Achilles tendon rupture. Study Design: Cohort study; Level of evidence, 3. Methods: This retrospective study included 26 patients (25 males, 1 female; mean age, 36.7 years; range, 22-53 years) with Kuwada type 3 chronic rupture of the Achilles tendon. A total of 11 patients underwent GTF surgery, whereas 15 patients underwent HG surgery. Follow-up assessments were conducted at 3, 6, and 12 months postoperatively. Results: The complication rate was significantly higher in the GTF group compared with the HG group (27.2% vs 6.6%, respectively; χ2 = 12.462; P = .001). At the 3-month follow-up, the degree of ankle dorsiflexion was significantly higher in the HG group than in the GTF group ( t = 3.144; P = .004). At 6-month and 1-year follow-up, no significant differences in ankle function were seen between the 2 groups. Conclusion: Hamstring tendon graft is associated with better early recovery of dorsiflexion compared with GTF. The long-term clinical outcomes of these 2 procedures are similar.

Factors associated with improved outcomes following proximal row carpectomy: a long-term outcome study of 144 patients

2015 ◽  
Vol 41 (5) ◽  
pp. 484-491 ◽  
Author(s):  
E. R. Wagner ◽  
D. Bravo ◽  
B. Elhassan ◽  
S. L. Moran
Keyword(s):  
Revision Surgery ◽  
Type Ii ◽  
Proximal Row Carpectomy ◽  
Level Of Evidence ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Improved Outcomes ◽  
Good Pain Relief

We conducted a review of 144 consecutive patients who underwent proximal row carpectomy from 1967 to 2010 for the diagnosis of wrist arthritis. At a mean follow-up of 13.4 years, patients experienced good pain relief with preservation (but not improvement) of wrist motion. A total of 17 patients (12%) required revision surgery at an average of 44.6 months. Improved pain, function, and survival outcomes were seen in those who underwent proximal row carpectomy after the age of 40, had a preoperative diagnosis of Kienbock’s disease, who underwent a concomitant neurectomy procedure, patients who were non-labourers, and patients who underwent surgery after 1990. Although 45% of patients developed moderate to severe radiocapitate arthrosis postoperatively, these findings did not correlate with clinical outcomes or risk of revision surgery. Patients with type II lunate and type II and III capitate shapes had higher rates of postoperative radiocapitate arthrosis. Level of Evidence: III, Prognostic

Four-Corner Arthrodesis Versus Proximal Row Carpectomy: A Retrospective Study With a Mean Follow-Up of 17 Years

2015 ◽  
Vol 40 (7) ◽  
pp. 1349-1354 ◽  
Author(s):  
Merel J.L. Berkhout ◽  
Yara Bachour ◽  
Kang He Zheng ◽  
Margriet G. Mullender ◽  
Simon D. Strackee ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Proximal Row Carpectomy

Does Proximal Row Carpectomy Improve Union in Wrist Arthrodesis? A Retrospective Cohort Study

2021 ◽  
Author(s):  
John J. Bartoletta ◽  
Dana Rioux-Forker ◽  
Raahil S. Patel ◽  
Katharine M. Hinchcliff ◽  
Alexander Y. Shin ◽  
...  
Keyword(s):  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Plate Fixation ◽  
Proximal Row Carpectomy ◽  
Level Of Evidence ◽  
Wrist Arthrodesis ◽  
Hardware Failure ◽  
Therapeutic Study

Abstract Background Some surgeons advocate for concomitant proximal row carpectomy (PRC) with total wrist arthrodesis (TWA), though there are limited data to support or oppose this view. Questions/Purposes Does concomitant PRC improve rates of union, revision, hardware loosening, hardware failure, and hardware removal in TWA? Patients and Methods A retrospective cohort study of patients who underwent TWA with and without concomitant PRC between January 2008 and December 2018 was undertaken. Patients were included if they underwent TWA using a dorsal spanning plate. Patients were excluded if they underwent partial wrist arthrodesis, revision TWA, or TWA with nondorsal spanning plate fixation. Results A total of 183 wrists in 180 patients were included in the study, 96 (52.5%) in the TWA only and 87 (47.5%) in the TWA + PRC groups. Median clinical and radiographic follow-up was 18.0 months (3.0–133.0 months) in the TWA + PRC group and 18.5 months (2.0–126.0 months) in the TWA only group (p = 0.907). No difference in nonunion (TWA + PRC: 13/87 [14.9%], TWA only: 18/96 [18.8%], odds ratio: 0.76, p = 0.494), revision (TWA + PRC: 5/87 [5.75%], TWA only: 8/96 [8.33%], hazard ratio [HR]: 0.73, p = 0.586), loosening (TWA + PRC: 4/87 [4.60%], TWA only: 6/96 [6.25%], HR: 0.74, p = 0.646), failure (TWA + PRC: 5/87 [5.75%], TWA only: 4/96 [4.17%], HR: 1.55, p = 0.530), and removal (TWA + PRC: 12/87 [13.8%], TWA only: 16/96 [16.7%], HR: 0.84, p = 0.634) were identified. Conclusion Concomitant PRC might not improve rates of union or diminish complications in patient undergoing TWA. The role of PRC and the rationale for its use in TWA need to be individualized and discussed with patients prior to surgery. Level of Evidence This is a Level IV, therapeutic study.

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