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Surgical Approach and Complications of Stand-alone Lateral Trans-Psoas Interbody Fusion
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Long-Term Patient-Reported Outcomes following Proximal Row Carpectomy.

Mara Z Meulendijks1, Jonathan Lans1, Jesse B Jupiter1

  • 1Department of Orthopaedic Surgery, Hand and Upper Extremity Service, General Hospital, Harvard Medical School, Boston, Massachusetts.

Journal of Wrist Surgery
|September 19, 2024
PubMed
Summary
This summary is machine-generated.

Proximal row carpectomy (PRC) offers good long-term pain relief and function. However, pre-existing capitate cartilage damage may negatively impact outcomes, and the role of dorsal capsular interposition (DCI) requires further investigation.

Keywords:
dorsal capsular interpositionpatient-reported outcomesproximal row carpectomy

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Area of Science:

  • Orthopedic Surgery
  • Hand Surgery
  • Reconstructive Surgery

Background:

  • Proximal row carpectomy (PRC) is a surgical procedure for wrist arthrosis aimed at pain relief while preserving range of motion (ROM).
  • Dorsal capsular interposition (DCI) is a surgical technique considered when the capitate bone exhibits chondral loss.

Purpose of the Study:

  • To identify factors influencing long-term patient-reported outcomes after PRC.
  • To specifically evaluate the role and effectiveness of DCI in conjunction with PRC.
  • To report long-term postoperative ROM in patients who underwent PRC with DCI.

Main Methods:

  • Retrospective identification of 162 patients who underwent PRC between 2002 and 2017.
  • Collection of patient-reported outcomes via validated questionnaires at a median follow-up of 8.5 years.
  • Application of multivariable linear regression to determine factors associated with outcomes.

Main Results:

  • Good long-term outcomes reported, with median Patient-Rated Wrist Evaluation (PRWE) score of 17 and median Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) score of 16.
  • Mean flexion-extension ROM was 70 degrees.
  • Capitate cartilage involvement was independently associated with worse QuickDASH scores, even after adjusting for confounding factors.

Conclusions:

  • PRC demonstrates favorable long-term functional results and pain management.
  • DCI appears generally effective, but its specific benefit in cases of capitate cartilage injury remains uncertain.
  • Pre-existing capitate cartilage damage is a predictor of poorer functional outcomes (QuickDASH scores).