Original ArticleNo Access

Radiological Outcomes of the Simplified Sauvé–Kapandji Procedure for Osteoarthritis of the Distal Radioulnar Joint

Department of Orthopaedic Surgery, Ishikawa Prefectural Central Hospital, Kanazawa, Japan

E-mail Address: suganumaseigo1978@yahoo.co.jp

Correspondence to: Seigo Suganuma, Department of Orthopaedic Surgery, Ishikawa Prefectural Central Hospital, Kanazawa, 2-1, Kuratsuki-Higashi, Ishikawa 920-8530, Japan, Tel: +81-76-237-8211, Fax: +81-76-238-2337.

Search for more papers by this author

Kaoru TADA

Department of Orthopaedic Surgery, Kanazawa University Hospital, Kanazawa, Japan

Search for more papers by this author

Shingo TAKAGAWA

Department of Orthopaedic Surgery, Ishikawa Prefectural Central Hospital, Kanazawa, Japan

Search for more papers by this author

Hidetoshi YASUTAKE

Department of Orthopaedic Surgery, Ishikawa Prefectural Central Hospital, Kanazawa, Japan

Search for more papers by this author

Keito SHIMANUKI

Department of Orthopaedic Surgery, Ishikawa Prefectural Central Hospital, Kanazawa, Japan

Search for more papers by this author

, and

Hiroyuki TSUCHIYA

Department of Orthopaedic Surgery, Kanazawa University Hospital, Kanazawa, Japan

Search for more papers by this author

https://doi.org/10.1142/S2424835522500552Cited by:0 (Source: Crossref)

Abstract

Background: We have been using a simplified Sauvé–Kapandji (SK) procedure using a headless compression screw for the treatment of osteoarthritis (OA) of the distal radio-ulnar joint (DRUJ). Unlike a standard SK procedure, the simplified SK procedure does not require exposure of the DRUJ to prepare the opposing surfaces of the sigmoid fossa and the ulnar head or any procedures to stabilise the proximal stump of the ulna. The aim of this study is to report the radiological outcomes of the simplified SK procedure.

Methods: We retrospectively reviewed data of all patients who underwent a simplified SK procedure for osteoarthritis of the DRUJ at our hospital between October 2008 and September 2020 with a follow-up of at least 25 weeks. Baseline demographic and clinical characteristics were investigated. We also measured radiographic parameters and performed statistical analyses to evaluate the shelf-forming region, ulnar stump and deviation of the carpal region.

Results: Our study included 10 patients with a mean follow-up of 52.3 weeks. There was no instance of complications such as nonunion of DRUJ arthrodesis, callus formation at ulnar pseudoarthrosis and painful instability at the proximal stump of the ulna. According to the Wilcoxon signed rank test, no radiographic parameters significantly changed during the follow-up period. There was a significant negative correlation between radioulnar width and the variation of ulnar translation index.

Conclusions: All radiographic parameters were well maintained, at least during the short follow-up period. There was no instance of nonunion of DRUJ arthrodesis. The simplified SK with simple headless compression screw insertion may be a reliable method for treating OA of the DRUJ.

Level of Evidence: Level IV (Therapeutic)

Keywords:

REFERENCES

1. Backdähl M. The caput ulnae syndrome in rheumatoid arthritis. A study of the morphology, abnormal anatomy and clinical picture. Acta Rheumatol Scand Suppl. 1963;5:1–75. Medline, Google Scholar
2. Lichtman DM, Ganocy TK, Kim DC. The indications for and techniques and outcomes of ablative procedures of the distal ulna. The Darrach resection, hemiresection, matched resection, and Sauvé–Kapandji procedure. Hand Clin. 1998;14(2):265–277. https://doi.org/10.1016/S0749-0712(21)00163-3. Crossref, Google Scholar
3. Baldwin WI. Orthopaedic surgery of the hand and wrist. In: Jones R, ed. Orthopaedic Surgery of Injuries. Henry Frowde and Hodder & Stoughton; 1921:241–282. Google Scholar
4. Sauvé L, Kapandji M. Nouvelle technique de traitement chirurgical des luxations récidivantes isolées de l’extrémité inférieure du cubitus. J Chir Paris. 1936;47:589–594. Google Scholar
5. Blanco R, Blanco F. The use of a bone peg in the Sauvé–Kapandji operation. J Hand Surg Br. 1994;19(2):221–223. https://doi.org/10.1016/0266-7681(94)90172-4. Crossref, Google Scholar
6. Minami A, Kato H, Iwasaki N. Modification of the Sauvé–Kapandji procedure with extensor carpi ulnaris tenodesis. J Hand Surg Am. 2000;25(6):1080–1084. https://doi.org/10.1053/jhsu.2000.20158. Crossref, Google Scholar
7. Nakamura K, Oda H, Tanaka S, et al.. Usefulness of absorbable screws in the Sauvé–Kapandji procedure for rheumatoid wrist reconstruction. Mod Rheumatol. 2002;12(2):144–147. https://doi.org/10.3109/s101650200024. Crossref, Google Scholar
8. Fujita S, Masada K, Takeuchi E, et al.. Modified Sauvé–Kapandji procedure for disorders of the distal radioulnar joint in patients with rheumatoid arthritis. J Bone Joint Surg Am. 2005;87(1):134–139. https://doi.org/10.2106/JBJS.C.01600. Crossref, Google Scholar
9. Luchetti R, Khanchandani P, Da Rin F, et al.. Arthroscopically assisted Sauvé–Kapandji procedure: An advanced technique for distal radioulnar joint arthritis. Tech Hand Up Extrem Surg. 2008;12(4):216–220. https://doi.org/10.1097/BTH.0b013e31818ee28a. Crossref, Google Scholar
10. Uerpairojkit C, Leechavengvongs S, Malungpaishorpe K, et al.. Proximal ulnar stump stability after using the pronator quadratus muscle transfer combined with the Suavé-Kapandji procedure in rheumatoid wrist. Hand Surg. 2014;19(1):25–32. https://doi.org/10.1142/S0218810414500051. Link, Google Scholar
11. Maeda A, Suzuki T, Hasegawa M, et al.. Sauvé–Kapandji procedure with headless compression screw in patients with rheumatoid arthritis. Mod Rheumatol. 2018;28(1):114–118. https://doi.org/10.1080/14397595.2017.1307799. Crossref, Google Scholar
12. Rothwell AG, O’Neill L, Cragg K. Sauvé–Kapandji procedure for disorders of the distal radioulnar joint: A simplified technique. J Hand Surg Am. 1996;21(5):771–777. https://doi.org/10.1016/S0363-5023(96)80190-0. Crossref, Google Scholar
13. Nakamura R, Tsunoda K, Watanabe K, et al.. The Sauvé–Kapandji procedure for chronic dislocation of the distal radio-ulnar joint with destruction of the articular surface. J Hand Surg Br. 1992;17(2):127–132. https://doi.org/10.1016/0266-7681(92)90071-9. Crossref, Google Scholar
14. Chamay A, Della Santa DD, Vilaseca A. Radiolunate arthrodesis. Factor of stability for the rheumatoid wrist. Ann Chir Main. 1983;2(1):5–17. https://doi.org/10.1016/s0753-9053(83)80073-8. Crossref, Google Scholar
15. Youm Y, McMurthy RY, Flatt AE, et al.. Kinematics of the wrist. I. An experimental study of radial-ulnar deviation and flexion–extension. J Bone Joint Surg Am. 1978;60(4):423–431. https://doi.org/10.2106/00004623-197860040-00001. Crossref, Google Scholar
16. Kanda Y. Investigation of the freely available easy-to-use software “EZR” for medical statistics. Bone Marrow Transplant. 2013;48(3):452–458. https://doi.org/10.1038/bmt.2012.244. Crossref, Google Scholar
17. Kawabata A, Egi T, Tsuboi H, et al.. Modified Sauvé–Kapandji procedure for rheumatoid wrists: A long-term study with a minimum follow-up of 5 years. Mod Rheumatol. 2014;24(3):426–429. https://doi.org/10.3109/14397595.2013.843742. Crossref, Google Scholar
18. Shaaban H, Giakas G, Bolton M, et al.. The distal radioulnar joint as a load-bearing mechanism – A biomechanical study. J Hand Surg Am. 2004;29(1):85–95. https://doi.org/10.1016/j.jhsa.2003.10.020. Crossref, Google Scholar
19. Nakamura T, Yabe Y, Horiuchi Y. Functional anatomy of the triangular fibrocartilage complex. J Hand Surg Br. 1996;21(5):581–586. https://doi.org/10.1016/s0266-7681(96)80135-5. Crossref, Google Scholar
20. Ota N, Nakamura T, Iwamoto T, et al.. Radiographic parameter analysis on modified Sauvé–Kapandji procedure. J Wrist Surg. 2013;2(1):19–26. https://doi.org/10.1055/s-0032-1333061. Crossref, Google Scholar
21. Sanders RA, Frederick HA, Hontas RB. The Sauvé–Kapandji procedure: A salvage operation for the distal radioulnar joint. J Hand Surg Am. 1991;16(6):1125–1129. https://doi.org/10.1016/s0363-5023(10)80078-4. Crossref, Google Scholar
22. Gough A, Sambrook P, Devlin J, et al.. Osteoclastic activation is the principal mechanism leading to secondary osteoporosis in rheumatoid arthritis. J Rheumatol. 1998;25(7):1282–1289. Medline, Google Scholar
23. Ikeda M, Kawabata A, Suzuki K, et al.. Outcome of the Sauvé–Kapandji procedure for distal radioulnar joint disorder with rheumatoid arthritis or osteoarthritis: Results of one-year follow-up. Mod Rheumatol. 2018;28(3):490–494. https://doi.org/10.1080/14397595.2017.1366005. Crossref, Google Scholar
24. Bailey AJ, Sims TJ, Knott L. Phenotypic expression of osteoblast collagen in osteoarthritic bone: Production of type I homotrimer. Int J Biochem Cell Biol. 2002;34(2):176–182. https://doi.org/10.1016/s1357-2725(01)00107-8. Crossref, Google Scholar
25. Matheron AS, Gouzou S, Collon S, et al.. Comparison of distal interphalangeal fusion with and without joint preparation in cases of stage IV chondropathy. Chir Main. 2015;34(3):134–140. https://doi.org/10.1016/j.main.2015.03.002. Crossref, Google Scholar