gms | German Medical Science

Objectives/Interrogation: Adaptive proximal scaphoid implant (APSI), maintaining carpal height and replacing an articular surface, prevents the worsening of arthritis and carpal collapse. Good tolerance of Pirocarbon and conformation of the implant give good expectations when there are lesions of styloscaphoid articulation.

In this retrospective study the authors describe their experience with the use of a Pirocarbon implant for proximal scaphoid in styloscaphoid arthritis linked to SNAC and SLAC wrist.

Methods: From January of 1999 to January of 2018 93 wrists were treated (85 for SNAC wrist from scaphoid pseudoarthritis grade 2 and 3; 8 for SLAC wrist from S-L lesion). All cases were evaluated pre and post-operatively with MMWS, PRWHE and DASH scores with an average follow-up of 96 months (min 6 - Max 208).

Results and Conclusions: All the patients reported relief from pain, small improvement in ROM and improvement strength. At the follow-up there was an average reduction of pain from 7,01 to 2,7 VAS. There was an improvement of grip and pinch force from 51% to 85% of controlateral side. 85% of the patients were satisfied with the results and were able to return to the precedent activities. Improvement of DASH from 89 to 29 and of PRWHE from 101 to 27,8. Radiographic controls revealed 6 cases of complication with 4 cases of dislocation of the implant, no reduction in carpal height nor worsening of radio-lunate angle.

Replacement of proximal pole of scaphoid with APSI can restore a functional range of motion free from pain in patients affected from styloscaphoid arthritis maintaining height of proximal carpal row and preventing subsequent deterioration or collapse.