Dr Pr. D’Agostino, MD, PhD

Hand Clinic Brussels - Lasne

LOUISE +32 2 534 29 99 LASNE +32 2 653 11 11

Osteoarthritis of the wrist

QT Pathologies (EN)

Osteoarthritis (OA) is a progressive condition that destroys the smooth articular cartilage covering the ends of bones. Healthy joints move easily because of articular cartilage. Osteoarthritis causes this cartilage to wear away.

  • Destruction of the wrist joint (radio-carpal) (aspect on Rx and CT Scan) Destruction of the wrist joint (radio-carpal) (aspect on Rx and CT Scan)

OA can develop due to normal "wear-and-tear" in the wrist, particularly in people who have a family history of arthritis (see Rheumatoid arthritis section).

It may also develop as a result of a traumatic injury, such as a broken wrist bone or a wrist sprain (see Scaphoid fracture and Wrist sprain sections).

OA of the wrist joint causes swelling, pain, limited motion, weakness and deformation of the wrist.

The diagnosis is made on the basis of physical examination and patient history.

Blood tests help to diagnose rheumatoid arthritis of the wrist.

X-rays can help distinguish among various forms of arthritis.

Non-surgical

Designed to help relieve pain and swelling, therapies include :

  • Modifying your activities. Limiting or stopping the activities that make the pain worse.
  • Immobilization. A splint can help relieve symptoms.
  • Medication. Non-steroidal anti-inflammatory médications can reduce both pain and swelling.
  • Exercise. Specific exercises can improve the range of motion in your wrist.
  • Steroid injection. Cortisone is a powerful anti-inflammatory medicine that can be injected into the wrist joint.

Surgical

When nonsurgical treatments are no longer effective, resulting in progressive loss of hand and wrist function, surgery is an option. The goal of surgery is to relieve pain and to preserve or improve hand function.

Surgical options include:

  • Removing the arthritic bones

In this procedure, three carpal bones are removed. This procedure, called a proximal row carpectomy, will relieve pain while maintaining partial wrist motion.

  • Fusion

Carpal bones can be fused together (arthrodesis) to make one, solid bone. A fusion can be partial, in which just some of the carpal bones are fused together. This eliminates pain and retains some wrist motion.

When the arthritis is extensive, a complete fusion may be necessary. In this procedure, carpal bones are fused together, as well as the radius. This completely eliminates wrist motion, but does not affect forearm rotation.

  • Joint replacement

This surgery removes the damaged joint and replaces it with an artificial device (prosthesis). This surgery may help retain or recover wrist movement.

During your consultation, Dr. D'Agostino will discuss the current treatment options and can help you choose the best treatment based on your particular case.

  • Proximal row carpectomy (Left) and Total wrist fusion (Right) Proximal row carpectomy (Left) and Total wrist fusion (Right)
  • Radiological aspect of a total wrist fusion after hardware removal Radiological aspect of a total wrist fusion after hardware removal
  • Partial radiocarpal fusion Partial radiocarpal fusion