Long-Term Patient-Reported Outcomes following Proximal Row Carpectomy

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).