Arthroscopic Pisiform Excision in Pisotriquetral Osteoarthritis Technique Using a Direct Pisotriquetral Portal

Abstract

Pisotriquetral (PT) joint arthritis is a common cause of ulnar-sided wrist pain. Open pisiform excision is a well-established procedure and is indicated when the conservative treatment fails. Although arthroscopic visualization of the PT joint is part of the routine examination in a patient with ulnar-sided wrist pain, therapeutic arthroscopy of the PT joint is limited to one case in the literature through the standard dorsal portals. Arthroscopic pisiform excision is a novel technique described by the authors. The first aim of this procedure is pain relief maintaining wrist stability and strength. With this minimally invasive approach we believe that preserving the flexor carpi ulnaris and the PT ligament complex we maintain their biomechanical function, while at the same time, reducing scar tenderness and postoperative discomfort with better esthetic results and less recovery time. In addition to standard dorsal portals, a direct PT portal was used to have access to the PT space and as a working portal to complete the pisiform excision.

Fracturas de Hueso Piramidal: Revisión Bibliográfica a Propósito de Cuatro Casos Clínicos

“…29 Se han descrito buenos resultados mediante la técnica artroscópica del manejo de esta patología. 30…”

Keeping the Swing on Par: Golfers and Upper Extremity Injuries they Face

“…Golfers with refractory pain may require pisiform excision [103]. This is now being performed with a minimally invasive arthroscopic approach [106]. To our knowledge, rehabilitation following pisiform excision has not been well-defined.…”