Osteoarthritis of the wrist is the erosion or disappearance of cartilage in the wrist joints. This pathology causes pain and progressive loss of wrist mobility. In 90% of cases, osteoarthritis of the wrist is due to trauma. This is most often due to a joint fracture of the radius or scaphoid, or a severe sprain of the carpus, leading to a rupture of the ligaments.
A wide variety of treatments are available. If surgery is envisaged, the mobility of the wrist after surgery will depend on the technique used, which in turn depends on many factors. So it’s important to choose the right treatment at the right time.
The disease manifests itself as spontaneous pain. Initially, the pain is triggered by wrist exertion, but gradually it also appears when the wrist is at rest. The wrist stiffens, losing mobility and strength. Deformities may appear over time.
Your doctor will be able to assess the extent of your osteoarthritis on the basis of a clinical and radiographic assessment. If necessary, this assessment can be supplemented by additional examinations, such as an arthroscanner or MRI. Osteoarthritis of the wrist is a slowly progressing disease, so it can occur long after the trauma. Unfortunately, it is irreversible.
The choice of treatment depends on
Patient’s age, general state of health, medical and family history
early diagnosis
extent and intensity of wrist osteoarthritis
previous trauma
the impact of the disease on the patient’s life and profession.
The main aim of treatment is to limit pain, while maintaining maximum wrist mobility.
Treatment
Initially, treatment is based on analgesics and anti-inflammatories, administered orally or topically.
Wearing an orthosis can help relieve pain by keeping the wrist in a resting position. Finally, corticosteroid infiltration is also suggested during painful flare-ups.
If drug treatment fails and the pain becomes unbearable, surgery may be considered. There are several possible solutions:
- Wrist denervation: the aim is to eliminate pain by selecting and then removing certain small nerve branches from the wrist joints.
- Resection of the first row of carpal bones: this procedure results in the definitive removal of half of the affected wrist bones, but can only be proposed if the radius and the other half of the carpus have been spared by the disease.
- Partial arthrodesis of the carpus aims to remove arthritic bones and partially block the remaining bones. This operation can only be performed in a favorable anatomical context.
- Wrist arthrodesis blocks wrist mobility, a rare indication but an alternative in cases of joint destruction involving the carpal bones and the lower end of the radius.
- Finally, the surgeon can also propose an artificial prosthesis to replace damaged joint surfaces with an artificial material.
