Clinical Outcomes of Arthroscopically Assisted Sauv

Arthroscopically assisted Sauvé–Kapandji (S-K) procedure has been described as a reliable minimal-invasive surgery for distal radioulnar joint (DRUJ) arthritis. This restrospective study is to investigate clinical outcomes of arthroscopically assisted S-K procedure with extensor carpi ulnaris (ECU) tenodesis. 

Between May 2015 and July 2022, ten patients underwent an arthroscopically assisted S-K procedure with ECU tenodesis. All patients were diagnosed as DRUJ osteoarthritis (OA), including seven primary DRUJ OA, two OA following distal radius fractures, and one rheumatoid arthritis (RA). Preoperative and postoperative measurements included the visual analog scale score for pain, range of motion, grip strength, the Quick Disabilities of the Arm, Shoulder and Hand (DASH) score and the Mayo Wrist Score (MWS). Fusion rate and complications were also evaluated. 

At an average follow-up duration of 23.1 months, mean VAS pain score reduced to 0.3. Mean flexion-extension arc could reach 150.7 degrees postoperatively. Postoperative grip strength averaged 87.2% of contralateral side. There was a mean QuickDASH score of 6.4 and a mean Mayo Wrist Score of 80.0 at last follow-up. All clinical assessments showed significant improvement after surgery compared with the preoperative values (p < 0.001). At final follow-up, all patients had solid bone union over the DRUJ. No major complications or ulnar stump instability were noted. 

Arthroscopically assisted S-K procedure provided satisfactory outcomes in treating DRUJ osteoarthritis. Additional ECU tenodesis may enhance the stability of ulnar stump and optimize the surgical results.

Keywords: Sauve-Kapandji procedure, arthroscopy, distal radioulnar joint, osteotomy, extensor carpi ulnaris tendon