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Proximal Row Carpectomy Using Decellularized Dermal Allograft: Preliminary Results.

Steven J Lee1, Remy V Rabinovich2, Andrew Kim1

  • 1Department of Orthopaedic Surgery, Nicholas Institute of Sports Medicine and Athletic Trauma (NISMAT), Lenox Hill Hospital, New York, New York.

Journal of Wrist Surgery
|April 5, 2021
PubMed
Summary
This summary is machine-generated.

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Proximal row carpectomy (PRC) with decellularized dermal allograft shows promising short-term results for wrist arthritis. This technique expands PRC indications, potentially avoiding motion-sacrificing surgeries.

Area of Science:

  • Orthopedic Surgery
  • Hand Surgery
  • Regenerative Medicine

Background:

  • Wrist arthritis, particularly degenerative changes in the lunate fossa or capitate, can significantly impair function.
  • Traditional proximal row carpectomy (PRC) is effective but may have limitations in specific degenerative conditions.
  • Interposition arthroplasty offers a potential solution to preserve joint function.

Purpose of the Study:

  • To evaluate the short-term outcomes of proximal row carpectomy (PRC) combined with interposition arthroplasty using a decellularized dermal allograft.
  • To assess the functional recovery, patient satisfaction, and safety of this surgical technique.

Main Methods:

  • A cohort of nine patients undergoing PRC with decellularized dermal allograft interposition were evaluated at a minimum 1-year follow-up.
Keywords:
PRCdermal allograftinterposition arthroplastywrist arthritis

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  • Clinical assessments included range of motion, grip strength, pinch strength, and Disabilities of the Arm, Shoulder, and Hand (DASH) scores.
  • Radiographs were analyzed for joint degeneration or dislocation, and patient satisfaction was measured using a modified Likert scale.

    • Main Results:

    • At a mean 18-month follow-up, patients demonstrated significant functional recovery, with motion and strength approaching contralateral levels.
    • Mean DASH scores improved substantially from preoperative to postoperative.
    • No significant complications, including graft issues or joint degeneration, were observed.

    Conclusions:

    • Proximal row carpectomy (PRC) with decellularized dermal allograft interposition arthroplasty yields favorable short-term outcomes in patients with degenerative wrist arthritis.
    • This technique expands the indications for PRC, offering a viable alternative to motion-sacrificing procedures for select patients.
    • The procedure demonstrates safety and efficacy in improving function and satisfaction.