Total Wrist Arthroplasty Versus Wrist Fusion: Utilization and Complication Rates as Reported by ABOS Part II Candidates.

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Abstract

[Indexed for MEDLINE] Conflict of interest statement: Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. 4. Hand (N Y). 2023 Mar;18(2_suppl):6S-16S. doi: 10.1177/15589447211066613. Epub 2022 Jan 19. Potential Role for Non-Salvage Procedures in the Treatment of Kienböck Disease Stage IV: A Systematic Review. Wang PQ(1), Charron BP(1), Chan KTK(2), Grewal R(1)(3), Suh N(1)(3). Author information: (1)Western University, London, ON, Canada. (2)Spectrum Health/Michigan State University, Grand Rapids, USA. (3)St. Joseph's Health Care London, ON, Canada. BACKGROUND: The purpose of this systematic review is to identify whether non-salvage procedures can provide satisfactory and acceptable outcomes in Lichtman stage IV disease. METHODS: The MEDLINE, Embase, and Cochrane databases were systematically searched for English publications between 1989 and 2019 that reported stage IV-specific primary treatment outcomes. Revisions and skeletally immature patients were excluded. Data extracted were patient demographics, pain scores, range of motion (ROM), grip strength, and patient-reported outcome measures (PROMs). The results were pooled into 3 categories: conservative management, non-salvage, and salvage procedures. RESULTS: Data from 24 studies (n = 114 patients) were extracted. Compared with conservative management and non-salvage treatment (joint-leveling radial osteotomies, lunate reconstruction), salvage procedures (intercarpal and radiocarpal arthrodesis, proximal row carpectomy, total wrist arthroplasty) showed significantly decreased ROM in flexion-extension arc of motion (89° vs 95° vs 73°, respectively, P = .0001) and no significant differences in grip strength as a percentage of the contralateral side (83% vs 86% vs 79%, respectively, P = .28). All reported treatments provided pain relief, ability to return to previous occupations, and variable PROMs. CONCLUSIONS: In young, active, and labor-intensive patients, motion-preserving, non-salvage options may be worth trialing as they do not preclude future salvage options. DOI: 10.1177/15589447211066613 PMCID: PMC10052625