Introducing the “SOAC Wrist”: Scaphotrapeziotrapezoid Osteoarthritis Advanced Collapse

Abstract

Despite being the second most common osteoarthritis of the wrist, little is known about scaphotrapeziotrapezoid osteoarthritis. Not all patients with this type of osteoarthritis have symptoms, and, even in those symptomatic patients, the intensity of the complaint is not proportional to the severity of the degeneration. In symptomatic patients, when the conservative treatment fails, grading classifications to help define the surgical treatment are solely based on the joint characteristics, and fail to assess the rest of the carpus.In general, most carpal degenerative processes show the same evolution pattern, which varies according to the initial injury, along with the type of deformity and the inherent instabilities. Thus, we hypothesize that the degenerative evolution due to primary osteoarthritis of the scaphotrapeziotrapezoid joint also follows a logical evolutionary sequence, similar to the one that occurs in cases of scapholunate advanced collapse (SLAC), scaphoid nonunion advanced collapse (SNAC), scaphoid malunion advanced collapse (SMAC), and scaphoid chondrocalcinosis advanced collapse (SCAC), thus resulting in scaphotrapeziotrapezoid osteoarthritis advanced collapse (SOAC). We have divided the SOAC into three groups, and considered that their treatment shall be guided by the evolutionary stage of the disease, and not by the surgeon's preferred technique.

Procedimentos assistidos por artroscopia no punho e na mão: Atualização. Onde nós estamos?

“… 16 Even in symptomatic cases, with pain at the base of the thumb and weakness of the pinch, making daily activities difficult, such as opening a bottle, other conditions usually coexist that justify the symptoms, such as trapeziometacarpal arthrosis and scapholunate injury/carpal instability. 17 Arthroscopy has become an important tool in the management of OA-STT as it allows, in the same procedure, the diagnosis and staging of the injury, the diagnosis of possible associated injuries and definitive treatment, which is difficult to achieve with open techniques, in which only the target joint will be addressed.…”

“… 16 Mesmo nos casos sintomáticos, com dor na base do polegar e fraqueza de pinça, dificultando atividades do dia-a-dia, como abrir uma garrafa, habitualmente coexistem outras condições que justificam os sintomas, como artrose trapeziometacarpal e a lesão escafolunar/instabilidade carpal. 17 A artroscopia tornou-se uma ferramenta importante no manejo da OA-STT por permitir que, em um mesmo procedimento, possa realizar-se o diagnóstico e o estadiamento da lesão, o diagnóstico de possíveis lesões associadas e o tratamento definitivo, dificilmente possível com técnicas abertas, em que apenas a articulação alvo será abordada.…”