Arthroscopic Proximal Row Carpectomy

Abstract

Arthroscopic proximal row carpectomy (APRC) is a reproducible, effective new arthroscopic procedure that compares favorably to the established open technique. The APRC can be accomplished in a reasonable amount of surgical time with routine small-joint and large-joint arthroscopic instrumentation. The APRC has shown to have several potential advantages over the open procedure with few disadvantages. With an arthroscopic PRC, an open capsulotomy is avoided and dorsal capsular ligaments are spared, allowing for increased postoperative stability of the wrist. Less soft-tissue disruption also promotes immediate postoperative motion, less postoperative pain and scarring, and potentially increased motion. APRC patients have similar long-term objective strength and improved range of motion as well as high subjective satisfaction when compared to open proximal row carpectomy patients. The open proximal row carpectomy has been shown to be an effective, motion-sparing procedure to treat many degenerative and posttraumatic conditions of the wrist. The indications for the arthroscopic PRC remain the same for the open procedure; it should be reserved for those suffering from persistent, debilitating wrist pain, with an intact lunate fossa and head of the capitate.