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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.
Hand Surg Rehabil. 2020 02; 39(1):41-47.HS

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.

Authors+Show Affiliations

Service de Chirurgie Orthopédique-Main-Membre Supérieur-SOS Main, Centre hospitalier universitaire Félix Guyon, La Réunion, Bellepierre 97405 Saint-Denis cedex, France. Electronic address: farouk.dargai@chu-reunion.fr.Service de Chirurgie Orthopédique-Main-Membre Supérieur-SOS Main, Centre hospitalier universitaire Félix Guyon, La Réunion, Bellepierre 97405 Saint-Denis cedex, France.Unité de Soutien Méthodologique, Centre hospitalier universitaire Félix Guyon, La Réunion, Bellepierre 97405 Saint-Denis cedex, France.Service de Chirurgie Orthopédique-Main-Membre Supérieur-SOS Main, Centre hospitalier universitaire Félix Guyon, La Réunion, Bellepierre 97405 Saint-Denis cedex, France.Service de Chirurgie Orthopédique-Main-Membre Supérieur-SOS Main, Centre hospitalier universitaire Félix Guyon, La Réunion, Bellepierre 97405 Saint-Denis cedex, France.Service de Chirurgie Orthopédique-Main-Membre Supérieur-SOS Main, Centre hospitalier universitaire Félix Guyon, La Réunion, Bellepierre 97405 Saint-Denis cedex, France.Service de Chirurgie Orthopédique-Main-Membre Supérieur-SOS Main, Centre hospitalier universitaire Félix Guyon, La Réunion, Bellepierre 97405 Saint-Denis cedex, France.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31683037

Citation

Dargai, F, et al. "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." Hand Surgery & Rehabilitation, vol. 39, no. 1, 2020, pp. 41-47.
Dargai F, Hoel G, Safieddine M, et al. 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. Hand Surg Rehabil. 2020;39(1):41-47.
Dargai, F., Hoel, G., Safieddine, M., Payet, E., Leonard, R., Jaffarbanjee, Z., & Daoudi, I. (2020). 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. Hand Surgery & Rehabilitation, 39(1), 41-47. https://doi.org/10.1016/j.hansur.2019.10.193
Dargai F, et al. 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. Hand Surg Rehabil. 2020;39(1):41-47. PubMed PMID: 31683037.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - 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. AU - Dargai,F, AU - Hoel,G, AU - Safieddine,M, AU - Payet,E, AU - Leonard,R, AU - Jaffarbanjee,Z, AU - Daoudi,I, Y1 - 2019/11/01/ PY - 2019/03/11/received PY - 2019/10/22/revised PY - 2019/10/22/accepted PY - 2019/11/5/pubmed PY - 2021/6/9/medline PY - 2019/11/5/entrez KW - Arthrodèse du poignet KW - Arthrodèse médiocarpienne KW - Arthrose KW - Midcarpal arthrodesis KW - Osteoarthritis KW - SLAC KW - SNAC KW - Wrist arthrodesis SP - 41 EP - 47 JF - Hand surgery & rehabilitation JO - Hand Surg Rehabil VL - 39 IS - 1 N2 - 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. SN - 2468-1210 UR - https://www.unboundmedicine.com/medline/citation/31683037/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_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S2468-1229(19)30333-0 DB - PRIME DP - Unbound Medicine ER -