Two-, Three-, or Four-Corner Arthrodesis for Midcarpal Osteoarthritis: A Systematic Review and Meta-Analysis.

Autor:	Hundepool CA; Department of Plastic, Reconstructive Surgery and Hand Surgery, Erasmus Medical Centre, Rotterdam, The Netherlands., Duraku LS; Department of Plastic, Reconstructive Surgery and Hand Surgery, Amsterdam UMC, Amsterdam, The Netherlands., Quanjel TJM; Department of Plastic, Reconstructive Surgery and Hand Surgery, Erasmus Medical Centre, Rotterdam, The Netherlands., van Minnen LP; Grip: Hand, Wrist, and Reconstructive Surgery, Adelaide, Australia., Jansen MC; Department of Plastic, Reconstructive Surgery and Hand Surgery, Erasmus Medical Centre, Rotterdam, The Netherlands., Zuidam JM; Department of Plastic, Reconstructive Surgery and Hand Surgery, Erasmus Medical Centre, Rotterdam, The Netherlands. Electronic address: j.zuidam@erasmusmc.nl.
Jazyk:	angličtina
Zdroj:	The Journal of hand surgery [J Hand Surg Am] 2023 Jun 06. Date of Electronic Publication: 2023 Jun 06.
DOI:	10.1016/j.jhsa.2023.04.018
Abstrakt:	Purpose: Several limited midcarpal arthrodeses have been used in the treatment of midcarpal osteoarthritis as part of scapholunate advanced collapse and scaphoid nonunion advanced collapse. There is no consensus on whether two-carpal arthrodesis (2CA), three-carpal arthrodesis (3CA), bicolumnar arthrodesis, or four-carpal arthrodesis (FCA) results in the best outcomes. The objective of this study was to determine whether there is a difference in outcomes in patients undergoing FCA, 3CA, 2CA, or bicolumnar arthrodesis for midcarpal osteoarthritis. Methods: A systematic review and meta-analysis were performed in multiple databases following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Studies reporting the four surgical techniques were included. The primary outcomes were postoperative visual analog scale pain score, the Disabilities of the Arm, Shoulder, and Hand score, and the Mayo Wrist Score. The secondary outcomes were active range of motion, grip strength, and reported complications. Results: Of 2,270 eligible studies, 80 articles were selected, including a total of 2,166 wrists. The visual analog scale pain scores for both the 2CA and FCA groups reached an adequate pain reduction based on the Patient Acceptable Symptom Scale. The Disabilities of the Arm, Shoulder, and Hand score was also comparable between these two groups. The 2CA group also showed a significantly better active range of motion than the FCA group for both flexion-extension and radioulnar deviation arc. The incidence of nonunion was 6.9% in the FCA group compared with 10.0% in the 2CA group. Conclusions: Although the 2CA procedure has a theoretical advantage over the FCA method, the analysis of data showed that generally, these techniques have similar outcomes and complications. Therefore, both (2CA and FCA) are good options for midcarpal osteoarthritis in scapholunate advanced collapse and scaphoid nonunion advanced collapse wrists. Type of Study/level of Evidence: Therapeutic IV. (Copyright © 2023 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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