Proximal row carpectomy with interposition arthroplasty using both capsular flap and acellular human dermal matrix

Area of Science:

• Orthopedic Surgery
• Hand and Wrist Surgery
• Regenerative Medicine in Orthopedics

Background:

• Proximal row carpectomy (PRC) is a common treatment for wrist arthritis.
• PRC has limitations when arthritis affects the lunate fossa or capitate.
• Interposition arthroplasty techniques are emerging to address PRC limitations.

Purpose of the Study:

• To evaluate the clinical outcomes of PRC combined with dorsal capsule and acellular dermal matrix (ADM) interposition arthroplasty.
• To assess the efficacy of this combined surgical approach for wrist arthritis.

Main Methods:

• Retrospective analysis of fourteen patients undergoing PRC with dorsal capsular flap and ADM.
• Assessment of Visual Analog Scale (VAS) pain scores, DASH scores, and range of motion (ROM).
• Radiological evaluation included radiocarpal distance (RCD) and assessment for graft integrity.

Main Results:

• Statistically significant improvements in VAS pain scores, DASH scores, and ROM one year post-surgery.
• Mean RCD decreased from 4.8 mm postoperatively to 3.6 mm at one-year follow-up.
• No instances of allodermis graft failure were observed at the one-year follow-up.

Conclusions:

• PRC with ADM interposition arthroplasty yields significant clinical improvements for wrist arthritis.
• The procedure effectively maintains radiocarpal distance and demonstrates excellent graft survival.
• This combined technique offers a viable solution for advanced wrist arthritis cases previously unsuitable for standard PRC.