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Arthroplasty of the Hand and Wrist

  • Shushan Jacob
Chapter

Abstract

Osteoarthritis (OA) is a degenerative musculoskeletal condition characterized by loss of articular cartilage. It is the leading cause of musculoskeletal morbidity in the older population. It can occur in many locations, such as the spine, knee, hip, and upper extremity, with one of the most common sites being the hand.

Risk factors for development of idiopathic (primary) OA include age, genetics, gender, and ethnicity. Secondary OA is secondary to infection, joint laxity, or trauma to a joint, commonly known as posttraumatic osteoarthritis (PTOA).

Osteoarthritis can affect the entire joint including the articular cartilage, subchondral bone, ligament, joint capsule, synovial membrane, ligaments, and tendons. In addition to cartilage loss with resultant joint space narrowing, changes such as subchondral sclerosis/cyst formation and reactive new bone formation (osteophytes) at joint margins are seen.

Inflammatory arthritis includes rheumatoid arthritis; arthritis secondary to collagen vascular diseases, such as systemic lupus erythematosus, scleroderma, vasculitis, Sjogren’s syndrome, and spondyloarthritis that includes ankylosing spondylitis; psoriatic arthritis; reactive arthritis; and arthritis of inflammatory bowel disease. Discussion of inflammatory arthritis is beyond the scope of this chapter.

This chapter reviews the current literature to elaborate on the presentation, diagnosis, and treatment options for osteoarthritis of the hand and wrist with particular focus on arthroplasty in different joints of the hand and wrist affected by both idiopathic and posttraumatic osteoarthritis. Although the use of total joint arthroplasty in the hand/wrist is uncommon following acute fractures, in select patients, arthroplasty may be necessary in the setting of acute fractures, especially in the presence of pre-existing severe idiopathic or posttraumatic arthritis or intra-articular fracture extension with resultant comminution of the articular surface.

Keywords

Osteoarthritis (OA) Proximal interphalangeal (PIP) joints Distal interphalangeal (DIP) joints Metacarpophalangeal (MCP) joint Distal radioulnar joint (DRUJ) 

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© Springer Nature Switzerland AG 2018

Authors and Affiliations

  1. 1.Department of Orthopedic SurgeryTexas Health Arlington Memorial HospitalArlingtonUSA

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