Resurfacing Capitate Pyrocarbon Implant versus Proximal Row Carpectomy Alone: A Comparative Study to Evaluate the Role of Capitate Prosthetic Resurfacing in Advanced Carpal Collapse.

Details

Serval ID
serval:BIB_20CF7198B921
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Resurfacing Capitate Pyrocarbon Implant versus Proximal Row Carpectomy Alone: A Comparative Study to Evaluate the Role of Capitate Prosthetic Resurfacing in Advanced Carpal Collapse.
Journal
Plastic and reconstructive surgery
Author(s)
Giacalone F., di Summa P.G., Fenoglio A., Sard A., Dutto E., Ferrero M., Bertolini M., Garcia-Elias M.
ISSN
1529-4242 (Electronic)
ISSN-L
0032-1052
Publication state
Published
Issued date
11/2017
Peer-reviewed
Oui
Volume
140
Number
5
Pages
962-970
Language
english
Notes
Publication types: Comparative Study ; Evaluation Studies ; Journal Article
Publication Status: ppublish
Abstract
The Resurfacing Capitate Pyrocarbon Implant associated with proximal row carpectomy has been used to treat symptomatic advanced carpal collapse, widening the indications of proximal row carpectomy to patients with capitate head arthritis. The authors retrospectively compared their case series of implant versus carpectomy alone, analyzing whether prosthetic implant outcomes could be similar to those of proximal row carpectomy even with a higher stage of osteoarthritis.
Fifty-seven patients who underwent surgery for wrist osteoarthritis (minimum follow-up, 2 years) were selected retrospectively. Twenty-five patients (scapholunate advanced collapse/scaphoid nonunion advanced collapse stage III to IV and Kienböck disease stage IV) underwent proximal row carpectomy plus Resurfacing Capitate Pyrocarbon Implant (group A); 32 patients (scapholunate advanced collapse/scaphoid nonunion advanced collapse stage I to II and Kienböck disease stage III) underwent carpectomy alone (group B). Mean follow-up was 33 months. Patients were evaluated clinically and radiographically. Patient-Rated Wrist Evaluation and Disabilities of the Arm, Shoulder, and Hand questionnaire scores were assessed.
Group A showed consistent pain relief (visual analogue scale score of 2), while preserving wrist mobility (flexion, 27 degrees; extension, 33 degrees) and grip strength (54 percent compared with the contralateral side). Average Disabilities of the Arm, Shoulder, and Hand questionnaire score was 20, and average Patient-Rated Wrist Evaluation score was 28. No statistically significant difference was observed between groups for all outcomes, except for better extension (p < 0.05) in group B.
Even starting from a higher grade of osteoarthritis, Resurfacing Capitate Pyrocarbon Implant plus proximal row carpectomy showed satisfying results, compared with those obtained with just carpectomy. Data show that indications for proximal row carpectomy can be widened by using the implant, without worsening outcomes. The implant could be a useful alternative to more aggressive salvage procedures in case of capitate head and lunate fossa osteoarthritis involvement.
Therapeutic, III.

Keywords
Adult, Aged, Aged, 80 and over, Arthroplasty, Replacement/instrumentation, Arthroplasty, Replacement/methods, Carbon, Carpal Bones/diagnostic imaging, Carpal Bones/pathology, Carpal Bones/surgery, Female, Follow-Up Studies, Humans, Joint Prosthesis, Male, Middle Aged, Osteoarthritis/diagnostic imaging, Osteoarthritis/pathology, Osteoarthritis/surgery, Radiography, Retrospective Studies, Wrist Joint/surgery
Pubmed
Web of science
Create date
09/11/2017 19:30
Last modification date
20/08/2019 12:57
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