Arthroscopic “Glider” Interposition with Associated Stabilization in Distal Radioulnar Joint Osteoarthritis: Preliminary Results
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Published:
Dec 26, 2024
Keywords:
Osteoarthritis, arthroscopy, interposition, distal radioulnar joint
Main Article Content
Abstract
Objectives: To describe an arthroscopic technique for treating distal radioulnar joint (DRUJ) osteoarthritis involving the interposition of a woven polyester cylinder and the palmaris longus, and to present preliminary results.
Materials and Methods: A retrospective analysis was conducted on five patients with DRUJ osteoarthritis, classified clinically and confirmed by arthroscopy. The patients underwent treatment using the author’s “glider” interposition technique. The average follow-up period was 11 months. Outcomes were evaluated using range of motion (ROM), grip strength, the Mayo Wrist Score, and the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire.
Results: The study included five patients (four with secondary osteoarthritis and one with primary osteoarthritis). Pain and grip strength showed improvement. The average ROM post-surgery was: 75° pronation, 70° supination, 80° extension, and 70° flexion. According to the Mayo Wrist Score, results were excellent in 83% of cases and good in 17%, with no poor outcomes. The average DASH score improved from 56 preoperatively to 20 postoperatively. Grip strength compared to the contralateral side averaged 70%.
Conclusions: The arthroscopic glider interposition technique shows promise as a minimally invasive alternative to current joint salvage procedures. This approach preserves soft tissue structures, is reproducible, stabilizes the DRUJ, and prevents proximal radioulnar impingement.
Materials and Methods: A retrospective analysis was conducted on five patients with DRUJ osteoarthritis, classified clinically and confirmed by arthroscopy. The patients underwent treatment using the author’s “glider” interposition technique. The average follow-up period was 11 months. Outcomes were evaluated using range of motion (ROM), grip strength, the Mayo Wrist Score, and the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire.
Results: The study included five patients (four with secondary osteoarthritis and one with primary osteoarthritis). Pain and grip strength showed improvement. The average ROM post-surgery was: 75° pronation, 70° supination, 80° extension, and 70° flexion. According to the Mayo Wrist Score, results were excellent in 83% of cases and good in 17%, with no poor outcomes. The average DASH score improved from 56 preoperatively to 20 postoperatively. Grip strength compared to the contralateral side averaged 70%.
Conclusions: The arthroscopic glider interposition technique shows promise as a minimally invasive alternative to current joint salvage procedures. This approach preserves soft tissue structures, is reproducible, stabilizes the DRUJ, and prevents proximal radioulnar impingement.
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How to Cite
Sala, J. M., & Ledesma, A. D. (2024). Arthroscopic “Glider” Interposition with Associated Stabilization in Distal Radioulnar Joint Osteoarthritis: Preliminary Results. Revista De La Asociación Argentina De Ortopedia Y Traumatología, 89(6), 606-625. https://doi.org/10.15417/issn.1852-7434.2024.89.6.1983
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Clinical Research
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radiological examination. Unfallchirurg 2016;119(8):673-89. https://doi.org/10.1007/s00113-016-0206-0
3. Isaacs JE, Chhabra A. Arthritis & arthroplasty: The hand, wrist and elbow. Philadelphia, PA: Elsevier; 2011.
4. Chung KC. Hand and upper extremity reconstruction. Philadelphia, PA: Elsevier Health Sciences; 2010.
5. Luchetti R, Khanchandani P, Da Rin F, Borelli PP, Mathoulin C, Atzei A. Arthroscopically assisted Sauve-
Kapandji procedure: An advanced technique for distal radioulnar joint arthritis. Tech Hand Upper Extrem Surg
2008;12(4):216-20. https://doi.org/10.1097/BTH.0b013e31818ee28a
6. Gupta RK, Soni A, Masih GD. “Quadrangular-construct” modification of Sauve-Kapandji procedure. Indian J
Orthop 2017;51(1):99-102. https://doi.org/10.4103/0019-5413.197556
7. Guo Z, Wang Y, Zhang Y. Modified Sauve-Kapandji procedure for patients with old fractures of the distal
radius. Open Med (Wars) 2017;12:417-23. https://doi.org/10.1515/med-2017-0060
8. Tomori Y, Sawaizumi T, Nanno M, Taka S. Functional outcomes after the Sauvé-Kapandji procedure for distal
radio-ulnar post-traumatic instability: a case-control comparison of three different operative methods of stabilization of the ulnar stump. Int Orthop 2028;42:2173-9. https://doi.org/10.1007/s00264-018-4042-4
9. Tolat AR, Stanley JK, Trail IA. A cadaveric study of the anatomy and stability radioulnar joint in the coronal and
transverse planes. J Hand Surg Br 1996;21(5):587-94. https://doi.org/10.1016/s0266-7681(96)80136-7
10. Schmidbauer S, Ladurner R, Hallfeldt KK, Mussack. Heavy weight versus low weight polypropylene meses for open sublay mesh repair of incisional hernia. Eur J Med Res 2005;10(6):247-53. PMID: 16033714
11. Atzei A, Luchetti R. Foveal TFCC tear classification and treatment. Hand Clin 2011;27(3):263-72. https://doi.org/10.1016/j.hcl.2011.05.014
12. Kermarrec G, Cohen G, Upex P, Fontes D. Arthroscopic foveal reattachment of the triangular fibrocartilaginous complex. J Wrist Surg 2020;9(3):256-62. https://doi.org/10.1055/s-0040-1702929
13. Bade H, Koebke J, Schloter M. Morphology of the articular surfaces of the distal radio-ulnar joint. Anat Rec
1996;246(3):410-4. https://doi.org/10.1002/(SICI)1097-0185(199611)246:3<410::AID-AR12>3.0.CO;2-R
14. Hollevoet N, Verdonk R, Van Maele G. The influence of articular morphology on non-traumatic degenerative
changes of the distal radioulnar joint. A radiographic study. J Hand Surg Br 2006;31(2):221-5.
https://doi.org/10.1016/j.jhsb.2005.10.012
15. Kaempf R, Aita M, Delgado PJ. Cirurgia minimamente invasiva. Artroscopia do Punho; Rio de Janeiro: Di Livros
Editora Limitada; 2022: cap. 17.
16. Sala JM, Ambrosi AD, Ledesma AD. Resultados del tratamiento de la artrosis radiocubital distal mediante técnica de Sauvé-Kapandji artroscópica. Artroscopia 2021;28(4). Disponible en: https://www.revistaartroscopia.com.ar/index.php/revista/article/view/159
17. Yayac M, Padua FG, Banner L, Seigerman DA, Beredjiklian PK, Aita DJ, et al. Treatment outcomes in patients
undergoing surgical treatment for arthritis of the distal radioulnar joint. J Wrist Surg 2020;9(3):230-4.
https://doi.org/10.1055/s-0040-1702200
18. Nawijn F, Verhiel SHWL, Jupiter JB, Chen NC. Hemiresection interposition arthroplasty of the distal radioulnar
joint: A long-term outcome study. Hand (NY) 2009;16(5):484-97. https://doi.org/10.1007/s00064-009-1913-2
19. Schober F, Van Schoonhoven J, Prommersberger KJ, Lanz U. Die Hemiresektions-Interpositionsarthroplastik
nach Bowers zur Behandlung der posttraumatischen Arthrose des distalen Radioulnargelenks nach distalen
Radiusfrakturen. [Bowers hemi-resection-interposition arthroplasty for treatment of post-traumatic arthrosis of the distal radio-ulnar joint after distal radius fractures]. Handchir Mikrochir Plast Chir 1999;31(6):378-82.
https://doi.org/10.1055/s-1999-13557