title: Meniscal Allograft Interposition Combined with Proximal Row Carpectomy.
abstract: BackgroundProximal row carpectomy (PRC) is contraindicated in wrists with preexisting arthritis of the proximal capitate or radiolunate fossa. Patients with these conditions frequently pursue wrist arthrodesis with its associated functional limitations.Questions/PurposesThe purpose of this study was to evaluate the results of using lateral meniscal allograft interposition (LMAI), in combination with PRC, in patients with symptomatic wrist arthritis. The primary question is whether this allograft will allow wrist function comparable to that in patients having only a PRC. A secondary question was to determine the short-term longevity of the allograft.Patients/MethodBetween 2006 and 2012, nine wrists underwent PRC with LMAI. Patient demographics and rates of complication or graft failure were determined. During independent clinical exams, functional outcomes were reviewed, patients completed a Disabilities of the Arm, Shoulder, and Hand (DASH) scores, and radiographs were taken.ResultsFour patients met the inclusion criteria, having clinical follow-up at an average of 4.2 years. DASH scores at the time of follow-up ranged from 9 to 33, with an average of 24. Average radiocapitate joint space in the first postoperative radiograph was 2.8 mm compared with 1.8 mm at the time of final follow-up. No wrists went on to arthrodesis.ConclusionEarly outcomes of PRC with LMAI are comparable to those results found in the literature of PRC alone. LMAI with PRC may be a valid short-term option as a motion-preserving procedure in those patients contraindicated to having a PRC alone.Level of EvidenceLevel IV.
authors.affiliation: Department of Orthopedic Surgery, SUNY Upstate Medical University, Syracuse, New York.
authors.forename: Murphy M
authors.initials: MM
authors.lastname: Steiner
authors.affiliation: Department of Orthopedic Surgery, SUNY Upstate Medical University, Syracuse, New York.
authors.forename: Matthew R
authors.initials: MR
authors.lastname: Willsey
authors.affiliation: Department of Orthopedic Surgery, SUNY Upstate Medical University, Syracuse, New York.
authors.forename: Frederick W
authors.initials: FW
authors.lastname: Werner
authors.affiliation: Department of Orthopedic Surgery, SUNY Upstate Medical University, Syracuse, New York.
authors.forename: Brian J
authors.initials: BJ
authors.lastname: Harley
authors.affiliation: Department of Orthopedic Surgery, SUNY Upstate Medical University, Syracuse, New York.
authors.forename: Shay
authors.initials: S
authors.lastname: Klein
authors.affiliation: Department of Orthopedic Surgery, SUNY Upstate Medical University, Syracuse, New York.
authors.forename: Kevin J
authors.initials: KJ
authors.lastname: Setter
keywords: meniscal allograft; proximal row carpectomy