Proximal row carpectomy (PRC) is a common treatment for degenerative radiocarpal arthritis and Kienbock’s disease, but questions exist regarding its durability over time. When Jonathan L. Tueting, MD, associate professor of orthopaedic surgery at the University of Wisconsin, and his colleagues performed a minimum 20-year follow-up study to investigate outcomes of the procedure, however, they concluded that PRC is a “durable, long-term treatment option” that “allows for maintenance of wrist range of motion and improvement in grip strength.”
The 20 patients had an average follow-up of 30 years (range: 23 to 37 years). The patients’ wrist range-of-motion and grip strength were measured and the results were compared to preoperative and contralateral values.
Based on patient self-reported questionnaires, 16 patients rated their wrist as “excellent” overall, while 2 patients rated their wrists as “good,” 1 as “fair,” and 1 as “poor.” Fifteen patients had no pain, while two patients had pain with strenuous activity and four patients had pain with daily activities.
Patients’ average wrist range-of-motion in flexion-extension was 77 degrees before surgery (range: 30 degrees to 150 degrees), and 74 degrees after surgery (range: 30 degrees to 122 degrees). Researchers recorded three values for grip strength from the operative and contralateral sides, and found an average preoperative value of 45 pounds of force (range: 5 pounds to 145 pounds) and an average postoperative value of 56 pounds of force (range: 7 pounds to 98 pounds).
“Wrist range-of-motion was maintained at latest follow-up and grip strength was improved compared to preoperative values,” noted the researchers. “Both patient-centered outcome measures and overall patient satisfaction with the procedure remained high more than 20 years after surgery.”
Dr. Tueting’s coauthors for “Minimum Twenty-year Follow-up of Proximal Row Carpectomy” include Brian P. D. Wills, MD; Luke J. Wenninger, BS; and William D. Engber, MD.
The authors report no conflicts.