Proximal Row Carpectomy in Pre-existing Arthritis. Is This a Contraindication?

Proximal row carpectomy (PRC) is an established surgical option for wrist arthritis but is often considered contraindicated in patients with proximal capitate and/or lunate fossa arthritis. Modifications involving interposition arthroplasty have been proposed to expand the indications. This study aimed to evaluate and compare the outcomes of PRC with interposition arthroplasty using dorsal wrist capsule interposition, lateral meniscus allograft, or dermal allograft in patients with advanced wrist arthritis.

Methods

Patients who underwent PRC with interposition arthroplasty at a single institution were identified. Pre- and postoperative Visual Analogue Scale (VAS) pain, Mayo Wrist Scores, grip strength, wrist range of motion, and return to work were evaluated. Postoperative Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH), need for revision surgery, and patient satisfaction were also assessed.

Results & Conclusion 

Proximal row carpectomy with interposition arthroplasty is an effective motion-sparing procedure for patients with proximal capitate and/or lunate fossa arthritis, improving pain and function. The choice of interposition material, including dermal matrix allograft, lateral meniscus allograft, and dorsal wrist capsule interposition can be guided by surgeon preference.