Proximal row carpectomy: Clinical evaluation

Imbriglia, Joseph E.; Broudy, Arnold S.; Hagberg, William C; McKernan, Daniel

doi:10.1016/0363-5023(90)90054-u

Cited by 167 publications

(131 citation statements)

References 16 publications

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“…[4][5][6][7]18 Ideally, the proximal capitate should be free of degenerative changes, 2-7 which is not the case in stage III SLAC or stage II/III SNAC wrist. The lunate fossa usually remains free of degeneration, as the lunate/lunate fossa articulation is spherical, so abnormal carpal postures (dorsal intercalated segment instability [DISI] or volar intercalated segment instability [VISI]) does not lead to increased contact pressure or decreased contact area even in the "pan-arthritis" stage IV SLAC/SNAC.…”

Section: Discussionmentioning

confidence: 99%

“…[2][3][4][5][6]9 It is unclear what the critical amount of arthritis is to preclude a good result. Tomaino said it best: "We are unable to define more precisely than others when preexisting arthrosis represents an absolute contraindication to proximal row carpectomy.…”

Section: Discussionmentioning

confidence: 99%

“…2-8 Various authors, as well as the senior author, have maintained that when there is mild degeneration of these articular surfaces, PRC can still provide good to excellent results. [2][3][4][5][6]9 However, as wrist arthritis progresses, as in stage III scapholunate advanced collapse (SLAC) wrist or stage II/III scaphoid nonunion advanced collapse (SNAC) wrist, the proximal capitate becomes arthritic. With advanced degeneration, alternative surgical procedures include scaphoid excision, four-bone fusion, and wrist fusion.…”

mentioning

confidence: 99%

“…Imbriglia et al documented that a significant remodeling of the radiocapitate interface occurs following the standard PRC, which produces a "hinge-and-roll" rather than a ball-and-socket motion. 4 In an effort to provide a broader interface to distribute radiocarpal compressive forces more evenly, Salomon and Eaton recommended resecting the proximal capitate regardless of arthritis or pristine cartilage, with or without placement of a capsular interposition. 10 Their approach obviated any regard for the status of the capitate cartilage.…”

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confidence: 99%

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Technique: Osteochondral Grafting of Capitate Chondrosis in PRC

Tang

Imbriglia

2013

Jnl Wrist Surg

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Proximal row carpectomy (PRC) has been shown in multiple studies to be an effective motion-preserving procedure for wrist arthritis. The operation consists of resection of the scaphoid, lunate, and triquetrum. 1 The proximal capitate and lunate fossa of the radius form the new wrist articulation, which makes the ideal patient free of degenerative changes at those articular surfaces. 2-8 Various authors, as well as the senior author, have maintained that when there is mild degeneration of these articular surfaces, PRC can still provide good to excellent results. [2][3][4][5][6]9 However, as wrist arthritis progresses, as in stage III scapholunate advanced collapse (SLAC) wrist or stage II/III scaphoid nonunion advanced collapse (SNAC) wrist, the proximal capitate becomes arthritic. With advanced degeneration, alternative surgical procedures include scaphoid excision, four-bone fusion, and wrist fusion. However, there Keywords ► osteochondral graft ► proximal row carpectomy AbstractBackground Proximal row carpectomy (PRC) is a useful treatment option for wrist arthritis, but the operation is contraindicated when there is arthritis of the capitate head. We describe a technique that involves resurfacing of a capitate that has focal chondrosis, using an osteochondral graft harvested from the resected carpal bones. Materials and Methods PRC patients who had a focal area of capitate chondrosis underwent osteochondral grafting of the capitate. Pre-and postoperative pain level, employment status, motion, grip strength, and Modified Mayo Wrist Scores (MMWS) were assessed. Postoperative Disability of the Arm, Shoulder, and Hand (DASH) scores were also calculated.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Technique: Osteochondral Grafting of Capitate Chondrosis in PRC

Tang

Imbriglia

2013

Jnl Wrist Surg

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“…In addition to various partial mediocarpal arthrodesis, proximal row carpectomy is a generally accepted technique used for the treatment of carpal collapse in the presence of advanced degenerative arthrosis [5,9,14].…”

Section: Introductionmentioning

confidence: 99%

Proximal row carpectomy—an adequate procedure in carpal collapse

Streich

Martini

Daecke

2006

International Orthopaedics (SICO

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Proximal row carpectomy (PRC) is an established procedure in the treatment of advanced radiocarpal arthritis. The aim of this study was to evaluate the individual, functional and radiological results in relation to the initial diagnosis. Seventeen patients (15 men, two women), who had undergone PRC, were evaluated. Their average age at the time of the operation was 48 years (range 21-70 years). The most frequent diagnosis leading to PRC was scaphoid non-union advanced collapse (SNAC), which was observed in nine patients, while in three cases each the condition treated had been scapholunate advanced collapse (SLAC) and perilunate dislocation, and in two cases, Kienboeck's disease. At the time of the follow-up examination (median 65.41 months), a significant improvement in the range of movement was seen. While only four (36%) of the patients with SNAC had radiological signs of arthrosis of the radiocapitate joint, visible radiological involvement was noted in all patients who underwent PRC due to scapholunate dissociation and perilunate dislocation. The results of this study show that PRC is a good way of achieving long-term improvement of the degree of subjective freedom from symptoms and of the functional range of movement. Interruption of ligamentous structures, as in scapholunate dissociation and perilunate dislocation, seems to influence the radiological outcome.

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