Pyrocarbon capitate resurfacing implant combined with proximal row carpectomy for advanced wrist osteoarthritis

The management of advanced wrist osteoarthritis resistant to medical treatment is surgical. Proximal row carpectomy (PRC) associated with proximal capitate resurfacing with RCPI (Resurfacing Capitate Pyrocarbon Implant) widens indications of PRC. We conducted a retrospective analysis of patients who underwent PRC and RCPI with a minimum of 2 years of follow-up. Fifty-three patients were included with a mean follow-up of five years. The median age was 53 years. The etiology of osteoarthritis was secondary to: trauma in 64% of cases, carpal bone necrosis in 23%, degenerative lesions in 11% and congenital malformation in 2%. Mean clinical outcomes showed: a wrist flexion of 30 °, an extension of 43 °, a grip strength of 16 kgs, a QuickDASH of 29/100, a PRWE 26/100 and the pain 2/10 on the VAS. Four patients suffered from complex regional pain syndrome, and one patient underwent revision surgery to replace the implant with a larger size. 84% of active workers were able to resume their work after a median duration of 3 months. In our study, PRC associated with RCPI yielded satisfactory outcomes in advanced wrist arthritis, allowing pain relief, and preserving acceptable range of motion and grip strength. Study Level IV (retrospective).