Hemiresection Capsuloretinacular Interposition Arthroplasty for Distal Radioulnar Joint Osteoarthritis

Area of Science:

• Orthopedic Surgery
• Hand and Wrist Surgery
• Reconstructive Surgery

Background:

• Distal radioulnar joint (DRUJ) osteoarthritis impacts wrist function.
• Hemiresection interposition arthroplasty (HIA) is a surgical option preserving DRUJ and triangular fibrocartilage complex (TFCC) function.
• Preoperative ulnar variance averaged 1.8 mm in the study cohort.

Purpose of the Study:

• To evaluate the short-term functional outcomes of a modified HIA procedure for DRUJ osteoarthritis.
• To assess the efficacy of HIA combined with TFCC repair or reconstruction.
• To determine if preoperative ulnar variance affects HIA outcomes.

Main Methods:

• Twenty-one wrists in 20 patients with DRUJ osteoarthritis underwent modified HIA.
• The procedure involved an 8 cm incision and wrapping a flap around the resected ulnar head.
• Functional outcomes (VAS, DASH, PRWE, motion, grip strength) and radiographic parameters were assessed postoperatively.
• Patients with rheumatoid arthritis were excluded.

Main Results:

• Significant improvements were observed in grip strength and range of wrist/forearm motion.
• Visual analog scale (VAS) for pain and Patient-Rated Wrist Evaluation (PRWE) scores improved beyond minimal clinical importance.
• The DRUJ gap distance was maintained at an average of 5.3 mm at final follow-up.
• Outcomes were favorable regardless of preoperative ulnar variance.

Conclusions:

• The modified HIA procedure, with TFCC repair/reconstruction, provides feasible short-term functional outcomes for DRUJ osteoarthritis.
• This surgical approach is effective across varying degrees of preoperative ulnar variance.
• HIA is a viable option for managing DRUJ osteoarthritis, preserving joint function.