Scientific articleRadiolunate and Radioscapholunate Arthrodeses as Treatments for Rheumatoid and Psoriatic Arthritis: Long-Term Follow-Up
Section snippets
Materials and Methods
In a retrospective consecutive case study, we included 46 wrists in 38 patients (27 female and 11 male). Patients underwent either RL (33 wrists) or RSL arthrodesis (13 wrists) between 1989 and 1994. Our local ethics committee approved the study. A total of 42 wrists in patients with RA and 4 wrists in patients with psoriatic arthritis were entered in this study. Indication for operation was progressive radiocarpal destruction, resulting in pain, and carpal instability. Contraindication for
Results
Preoperatively, the average modified Larsen score of the RL and RSL joint was 2.7 (SD, 1.3) and 2.2 (SD, 1.2), respectively, so all wrists had early- to medium-stage disease at the time of operation. At follow-up, all RL arthrodeses demonstrated radiographic evidence of solid fusion. Of the RSL arthrodeses, 3 failed to unite at the radioscaphoid interval, but this finding did not correlate with a poor outcome (Fig. 1). Six wrists necessitated a midcarpal arthrodesis owing to pain, although they
Discussion
Table 7 lists the results of the published articles of case series and cohort studies of the RL arthrodesis. Twelve studies reported the outcome of 395 RL arthrodeses.15, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29 The indication for operation was similar for all studies: rheumatoid wrist disease with carpal instability. The preoperative Larsen score varied substantially between studies. An increase in the Larsen score was found at latest follow-up in all studies. Average follow-up was 4.4
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Radiolunate Arthrodesis in the Rheumatoid Wrist: A Retrospective Clinical and Radiologic Long-Term Follow-up
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2021, Journal of Hand Surgery Global OnlineCitation Excerpt :Of the 5 studies that reported preoperative and postoperative VAS scores, all had decreased pain after surgery; however, Stanley and Boot33 was the sole study to report this for RL arthrodesis (Table 5).6,25,28,47 For patients undergoing RSL arthrodesis, postoperative VAS scores ranged from 1629 to 42.47 Of those that reported preoperative and postoperative pain, Bain et al6 was the only one to report P values (P < .01).
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2020, Hand Surgery and RehabilitationCitation Excerpt :Both RL-A and RSL-A have slowed down radiographic lesions evolution without fully stopping them. Non-union rate ranged from 0% to 75% according to different studies [35,38,39,48,49], despite not being correlated with poor functional outcomes. Although decrease of the scapholunate angle and scapholunate space narrowing were more important in RSL-A group, this could be related to scaphoid instability correction.
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