To evaluate the safety, efficacy, and potential advantages and disadvantages of an all-arthroscopic Proximal Row Carpectomy.
Eighteen patients underwent an all-arthroscopic Proximal Row Carpectomy (APRC). Following standard radiocarpal and midcarpal arthroscopy, the proximal carpal row was removed with the arthroscopic bur, with care being taken to protect the articular cartilage surfaces of the proximal capitate, and lunate fossa. A soft bandage was applied, which was removed two days postoperatively and early range of motion was instituted. Wrist range of motion, grip strength, and postoperative pain were compared to previous data on open PRCs.
Eighteen patients underwent the procedure, with fourteen patients available for greater than one year follow-up. There were no postoperative complications, and no instances of radiocarpal subluxation despite immediate mobilization of the wrist. There was a significant learning curve, but the procedure was consistently performed in under one hour in the latter half of the study. Patients had less postoperative pain, faster recovery of motion, and faster return to activity compared to the open procedure. Final range of motion and grip strength were nearly identical to the open procedure.
All-arthroscopic Proximal Row Carpectomy appears to be a safe, effective, and reliable procedure for a variety of wrist conditions, and allows for rapid mobilization of the wrist compared to the open procedure. Results appear to be as good as or better than similar patients treated with an open Proximal Row Carpectomy, with less postoperative pain and faster return to activity. Final range of motion and strength is equivalent to the open procedure. There is a significant learning curve, but the procedure may be appropriate for the experienced wrist arthroscopist.
© 2010 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.