带软组织介入关节成形术(STIA)的近端行腕关节切除术(PRC)为解决涉及头状和/或月窝的腕关节关节炎模式提供了一种替代方法。代替腕关节固定术.本系统综述旨在评估晚期腕关节关节炎患者与PRC-STIA相关的临床结果和技术。我们使用包括PubMed,Embase,MEDLINE,和Cochrane中央受控试验登记册。纳入标准涉及报告PRC-STIA患者结局的文章,其中至少有1个相关结局。该分析涵盖了8项研究,涉及106名符合纳入标准的患者(108名手腕)。大多数患者是男性(69%,n=88),平均年龄54.4±12.7岁,平均随访4.8±6.3年。背囊是最常见的介入组织(63%,8项研究中有5项)。接受STIA的患者与仅接受PRC的患者相比,获得了可比的患者报告结果评分。术后疼痛,用视觉模拟量表测量,平均3.7±0.6。手臂的残疾,肩膀,手评分平均为27.8±8分,而患者评估腕部评分平均为41.5±25.9分。在三项研究中报告了五种并发症。对于头状和/或月状窝软骨变性患者,在PRC中添加STIA可产生类似于传统PRC的结果。改善手腕功能,疼痛,和握力以安全和直接的方式。未来的研究应该优先考虑高质量的比较研究,延长随访期,和标准化的核心结果指标,以更全面地了解其在腕关节关节炎治疗中的作用。
Proximal row carpectomy (PRC) with soft tissue interposition arthroplasty (STIA) presents an alternative approach to addressing wrist arthritis patterns involving the capitate and/or lunate fossa, in lieu of wrist arthrodesis. This systematic
review aimed to evaluate clinical outcomes and techniques associated with PRC-STIA in patients with advanced wrist arthritis. We conducted a systematic
review using databases including PubMed, Embase, MEDLINE, and the Cochrane Central Register of Controlled Trials. Inclusion criteria involved articles reporting outcomes of patients who underwent PRC-STIA with at least 1 relevant outcome. The analysis encompassed 8 studies involving 106 patients (108 wrists) meeting the inclusion criteria. A majority of patients were men (69%, n = 88), with a mean age of 54.4 ± 12.7 years and an average follow-up of 4.8 ± 6.3 years. Dorsal capsule was the most commonly interposed tissue (63%, 5 out of 8 studies). Patients receiving STIA achieved comparable patient-reported outcome measures scores to those undergoing PRC alone. Postoperative pain, measured by the Visual Analog Scale, averaged 3.7 ± 0.6. The Disabilities of the Arm, Shoulder, and Hand score averaged 27.8 ± 8, while the Patient-Rated Wrist Evaluation score averaged 41.5 ± 25.9. Five complications were reported in three studies. The addition of STIA into PRC for patients with capitate and/or lunate fossa cartilage degeneration yielded outcomes akin to traditional PRC, improving wrist function, pain, and grip strength in a safe and straightforward manner. Future research should prioritize high-quality comparative studies, extended follow-up periods, and standardized core outcome measures for a more comprehensive understanding of its role in wrist arthritis treatment.