Wrist Denervation for Painful Conditions of the Wrist

“…Partial wrist denervation, in particular, has gained acceptance as a viable treatment option for intractable wrist pain, with favorable outcomes and minimal morbidity and risks. 15,17,18,25 The concept of therapeutic joint denervation arises from the understanding that all joints, including the thumb CMC joint, 26,27 contain sensory receptors, some of which transmit pain signals via sensory nerve branches. Dividing these nerve branches serves…”

Section: Discussionmentioning

confidence: 99%

Selective Thumb Carpometacarpal Joint Denervation for Painful Arthritis: Clinical Outcomes and Cadaveric Study

Tuffaha¹,

Quan²,

Hashemi

et al. 2019

The Journal of Hand Surgery

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“…Grip strength and range of motion also improved in these patients. However, the improvement in pain comes at a cost of further damage to the wrist joint: 34 of the 49 patients in the study demonstrated worsening joint damage 72 months after surgery (Braga‐Silva et al, ). This implies that the neural innervation of the joint is involved in pain transmission, but also in proprioception and protective reflexes.…”

Section: Denervation Surgerymentioning

confidence: 99%

The anatomy of osteoarthritic joint pain

Witt

Vilensky

2012

Clinical Anatomy

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The anatomical understanding of the pain generators in osteoarthritis (OA) is incomplete and the teaching about these pain generators in medical school anatomy/histology courses is minimal. This review covers the nociceptive innervation of synovial joints for the purposes of teaching. Studies that discuss the presence of neuropeptides involved in pain, such as Substance P (SP) and calcitonin-gene-related peptide, are the focus of this review. Nociceptive free-nerve endings and SP staining nerves are found in the accessory ligaments, synovium, subchondral bone, menisci, and periosteum. The vasculature may also play a role in pain generation through vasospasm or ischemia, but this has yet to be proven. Joint denervation may relieve joint pain showing that it is indeed articular nerves that are carrying pain impulses but denervation does not identify the precise source of the pain. It remains unclear which of the anatomical loci of pain generation are primary in OA and if sources of pain vary in different patients and in different joints.

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Wrist Denervation for Painful Conditions of the Wrist

Cited by 76 publications

References 22 publications

Amandys® implant: Novel pyrocarbon arthroplasty for the wrist

Amandys® implant: Novel pyrocarbon arthroplasty for the wrist

Selective Thumb Carpometacarpal Joint Denervation for Painful Arthritis: Clinical Outcomes and Cadaveric Study

The anatomy of osteoarthritic joint pain

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