Long-term Outcome of Proximal Row Carpectomy. Influence of the Shape of the Capitate

Study Overview
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Brief Summary
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In cases of severe arthritis of the wrist, surgical removal of the scaphoid, lunate and triquetrum bones or proximal row carpectomy (PRC) is a well-known procedure. This procedure converts the wrist in a simple hinged joint but allows us to preserve a certain range of motion in the wrist. One of the main disadvantages of PRC is the risk of developing arthritis between the head of the capitate and the lunate fossa. The long-term follow-up of this procedure has always been a reason for concern. The investigators set up this retrospective study to evaluate the long-term results of the procedure in the investigators institution. Also, the shape of the head of the capitate may play a role in the development of arthritis. A more round shape could distribute the forces more equally and thus prevent the progression of cartilage damage The study hypothesis is: PRC preserves range of motion and force in the long term (more than 10 years postoperatively). A more round head of the capitate is associated with an increased risk of developing arthritis in the new joint.

Detailed Description
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We invite all patients who underwent a PRC at our institution with a follow-up of more than 10 years for review. Questions VAS pain in rest and during activity Pain is quantified as none, minimal (pain with strenuous activity), moderate (pain with daily activity), or severe (pain at rest). If pain, use of analgetics, splint, … quick DASH patient related wrist evaluation (PRWE) score. form-36 (SF-36) general health status outcome ? Satisfaction, do it again? Complications? Re-operations? Return to work after operation, which job (manual labor?) changed job due to wrist problems? Worker's compensation claims? Clinical review grip force + other side to compare (Jamar Dynamometer) pinch grip + other side to compare range of motion measurement: absolute and compared to other side flexion-extension, ulnar-radial deviation and prosupination Radiography: Standard anterioposterior and lateral wrist radiography performed to evaluate the onset or degree of arthritis. o Radiocapitate arthrosis grading: None Minimal (joint space narrowing alone), Moderate (joint space narrowing with adjacent subchondral sclerosis) severe (bone collapse, erosion, or subchondral cyst formation) Oldest radiography of each patient was retrieved and the shape of the capitate evaluated. If available, a pre-operative MRI scan could also be interpreted. (Probably no MRI's available, but MRI gives a better indication of the shape of the capitate than plain X-ray). Review: documentation of intra-operative findings concerning capitate and lunate fossa. Statistical analysis Student's t-test on the numerical data Wilcoxon signed- rank test on the visual analog scales Differences significant at p < .05. Two-tailed tests in all cases. Subgroups according to initial diagnosis Compare results with the initial follow-up to evaluate the prospective value of this follow-up moment.

Official Title
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Long-term Outcome of Proximal Row Carpectomy. Influence of the Shape of the Capitate

Conditions
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Wrist Arthritis

Intervention / Treatment
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* Procedure: Proximal row carpectomy


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: All patients who underwent a Proximal row carpectomy Exclusion Criteria: Bilateral procedure
Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Proximal row carpectomy<br>Proximal row carpectomy | Procedure: Proximal row carpectomy<br> <br> |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| quick DASH score | The Disability of Arm, Shoulder and Hand score is a standardised outcome measure for upper limb evaluation. | more than 10 year after operation | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Arthritis between capitate and lunate fossa | radiographic evaluation of arthritis in the wrist: None Minimal (joint space narrowing alone), Moderate (joint space narrowing with adjacent subchondral sclerosis) Severe (bone collapse, erosion, or subchondral cyst formation) | 10 years after operation | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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carpectomy, proximal row, long-term, wrist, arthritis