Current Concept of Surgical Management for Rheumatoid Arthritis of the Wrist

Sung Jong Woo; Min Jong Park

doi:10.12790/jkssh.2013.18.4.196

Journal List > J Korean Soc Surg Hand > v.18(4) > 1106445

Go to TopGo to Top Go to BottomGo to Bottom

TOOLS

Woo and Park: Current Concept of Surgical Management for Rheumatoid Arthritis of the Wrist

Reviw Article

J Korean Soc Surg Hand 2013;18(4):196-205.

Published online: 12 December 2013

DOI: https://doi.org/10.12790/jkssh.2013.18.4.196

Current Concept of Surgical Management for Rheumatoid Arthritis of the Wrist

Sung Jong Woo, Min Jong Park

Deparment of Orthopaedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea

Correspondence to: Min Jong Park Deparment of Orthopaedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 135-710, Korea TEL: +82-2-3410-3506 FAX: +82-2-3410-0061 E-mail: mjp3506@skku.edu

Received 10 November 201310 December 2013 Accepted 12 December 2013

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Rheumatoid arthritis is a systemic inflammatory disorder inducing multiple joint destruction. The wrist joint is frequently involved in early stage and proper management can preserve the ability to maintain a daily living and to work. Advances in medical treatment modalities can halt most joint destruction, however, not in all instances of joint inflammation and deformities. Most patients want to improve their own functional disability, pain, aesthetic problems in addition to medication. We review the current concept of rheumatoid wrist surgery and discuss the surgical treatment strategies for optimizing outcomes for patients with rheumatoid wrist.

Keywords: Rheumatoid arthritis, Wrist, Surgical treatment

REFERENCES

1. Crilly A, Maiden N, Capell HA, Madhok R. Genotyping for disease associated HLA DR beta 1 alleles and the need for early joint surgery in rheumatoid arthritis: a quantitative evaluation. Ann Rheum Dis. 1999; 58:114–7.

2. Manivelavan D, Vijayasamundeeswari CK. Anti-cyclic citrullinated Peptide antibody: an early diagnostic and prognostic biomarker of rheumatoid arthritis. J Clin Diagn Res. 2012; 6:1393–6.

3. Trieb K. Treatment of the wrist in rheumatoid arthritis. J Hand Surg Am. 2008; 33:113–23.

4. Alderman AK, Chung KC, Kim HM, Fox DA, Ubel PA. Effectiveness of rheumatoid hand surgery: contrasting perceptions of hand surgeons and rheumatologists. J Hand Surg Am. 2003; 28:3–11.

5. Kim SM, Park MJ, Kang HJ, Choi YL, Lee JJ. The role of arthroscopic synovectomy in patients with undifferentiated chronic monoarthritis of the wrist. J Bone Joint Surg Br. 2012; 94:353–8.

6. Park MJ, Ahn JH, Kang JS. Arthroscopic synovectomy of the wrist in rheumatoid arthritis. J Bone Joint Surg Br. 2003; 85:1011–5.

7. Backdahl M. The caput ulnae syndrome in rheumatoid arthritis: a study of the morphology, abnormal anatomv and clinical picture. Acta Rheumatol Scand Suppl. 1963; 5:1–75.

8. Grawe B, Heincelman C, Stern P. Functional results of the Darrach procedure: a long-term outcome study. J Hand Surg Am. 2012; 37:2475–80.e1-2.

9. Linscheid RL, Dobyns JH. Radiolunate arthrodesis. J Hand Surg Am. 1985; 10:821–9.

10. Leslie BM, Carlson G, Ruby LK. Results of extensor carpi ulnaris tenodesis in the rheumatoid wrist undergoing a distal ulnar excision. J Hand Surg Am. 1990; 15:547–51.

11. Chu PJ, Lee HM, Hung ST, Shih JT. Stabilization of the proximal ulnar stump after the Darrach or Sauve-Kapandji procedure by using the extensor carpi ulnaris tendon. Hand (N Y). 2008; 3:346–51.

12. Melone CP Jr, Taras JS. Distal ulna resection, extensor carpi ulnaris tenodesis, and dorsal synovectomy for the rheumatoid wrist. Hand Clin. 1991; 7:335–43.

13. Ruby LK, Ferenz CC, Dell PC. The pronator quadratus interposition transfer: an adjunct to resection arthroplasty of the distal radioulnar joint. J Hand Surg Am. 1996; 21:60–5.

14. Watson HK, Ryu JY, Burgess RC. Matched distal ulnar resection. J Hand Surg Am. 1986; 11:812–7.

15. Bowers WH. Distal radioulnar joint arthroplasty: the hemiresection-interposition technique. J Hand Surg Am. 1985; 10:169–78.

16. Syed AA, Lam WL, Agarwal M, Boome R. Stabilization of the ulna stump after Darrach's procedure at the wrist. Int Orthop. 2003; 27:235–9.

17. Sauve L, Kapandji M. Nouvelle technique de traitement chirurgical des luxations recidivantes isolees de l'extremiite inferirure du cubitus. J Chir. 1936; 47:589–94.

18. Taleisnik J. Rheumatoid arthritis of the wrist. Hand Clin. 1989; 5:257–78.

19. Minami A, Iwasaki N, Ishikawa J, Suenaga N, Kato H. Stabilization of the proximal ulnar stump in the Sauve-Kapandji procedure by using the extensor carpi ulnaris tendon: long-term follow-up studies. J Hand Surg Am. 2006; 31:440–4.

20. Daecke W, Martini AK, Schneider S, Streich NA. Amount of ulnar resection is a predictive factor for ulnar instability problems after the Sauve-Kapandji procedure: a retrospective study of 44 patients followed for 1-13 years. Acta Orthop. 2006; 77:290–7.

21. George MS, Kiefhaber TR, Stern PJ. The Sauve-Kapandji procedure and the Darrach procedure for distal radioulnar joint dysfunction after Colles’ fracture. J Hand Surg Br. 2004; 29:608–13.

22. Kobayashi A, Futami T, Tadano I, Fujita M, Watanabe T, Moriguchi T. Radiographic comparative evaluation of the Sauve-Kapandji procedure and the Darrach procedure for rheumatoid wrist reconstruction. Mod Rheumatol. 2005; 15:187–90.

23. Mannerfelt L, Norman O. Attrition ruptures of flexor tendons in rheumatoid arthritis caused by bony spurs in the carpal tunnel: a clinical and radiological study. J Bone Joint Surg Br. 1969; 51:270–7.

24. Ertel AN, Millender LH, Nalebuff E, McKay D, Leslie B. Flexor tendon ruptures in patients with rheumatoid arthritis. J Hand Surg Am. 1988; 13:860–6.

25. Honkanen PB, Makela S, Konttinen YT, Lehto MU. Radiocarpal arthrodesis in the treatment of the rheumatoid wrist. A prospective midterm follow-up. J Hand Surg Eur Vol. 2007; 32:368–76.

26. Ishikawa H, Murasawa A, Nakazono K. Long-term follow-up study of radiocarpal arthrodesis for the rheumatoid wrist. J Hand Surg Am. 2005; 30:658–66.

27. Barbier O, Saels P, Rombouts JJ, Thonnard JL. Long-term functional results of wrist arthrodesis in rheumatoid arthritis. J Hand Surg Br. 1999; 24:27–31.

28. Toma CD, Machacek P, Bitzan P, Assadian O, Trieb K, Wanivenhaus A. Fusion of the wrist in rheumatoid arthritis: a clinical and functional evaluation of two surgical techniques. J Bone Joint Surg Br. 2007; 89:1620–6.

29. Meads BM, Scougall PJ, Hargreaves IC. Wrist arthrodesis using a Synthes wrist fusion plate. J Hand Surg Br. 2003; 28:571–4.

30. Lee DH, Carroll RE. Wrist arthrodesis: a combined intramedullary pin and autogenous iliac crest bone graft technique. J Hand Surg Am. 1994; 19:733–40.

31. Cobb TK, Beckenbaugh RD. Biaxial total-wrist arthroplasty. J Hand Surg Am. 1996; 21:1011–21.

32. Divelbiss BJ, Sollerman C, Adams BD. Early results of the Universal total wrist arthroplasty in rheumatoid arthritis. J Hand Surg Am. 2002; 27:195–204.

33. McBeath R, Osterman AL. Total wrist arthroplasty. Hand Clin. 2012; 28:595–609.

Fig. 1.

(A) Arthroscopic synovectomy of the wrist rheumatoid arthritis. (B) Intraoperative arthroscopic photographs demonstrating diffuse synovectomy of the wrist joint, and (C) subsequent removal of the synovium.

Fig. 2.

(A) Intraoperative photographs demonstrating extensive extensor tenosynovitis with synovitis and (B) subsequent open synovectomy of the dorsal wrist joint.

Fig. 3.

(A) Postoperative X-ray of Darrach procedure, (B) matched resection arthroplasty, and (C) hemiresection interposition arthroplasty.

Fig. 4.

(A) Sauvé-Kapandji procedure. (B) An asterix indicate a compression screw for the distal radioulnar joint arthrodesis, and white arrow and black arrow demonstrate pseudoarthrosis and extensor carpi ulnaris tenodesis, respectively.

Fig. 5.

Radiocarpal partial arthrodesis in rheumatoid wrist. (A) Preopertative and (B) postoperative radiographs.

TOOLS

Similar articles