Cartilage Injuries and Posttraumatic Osteoarthritis in the Wrist: A Review

Abstract

Objective: Focal cartilage injuries, and posttraumatic osteoarthritis (OA) in the wrist are likely common and a cause of wrist pain. To estimate the incidence of cartilage lesions and to understand the pathomechanisms leading to wrist cartilage injuries and OA, a literature review on the subject was performed combined with a presentation of one of the authors’ own experience. Design: This study includes a literature review of the topic. As a comparison to the review findings, the observations of one of the authors’ consecutive 48 wrist arthroscopies, were assessed. PubMed, Scholar, and Cochrane databases were searched using the keywords “cartilage injury AND wrist AND treatment” and “wrist AND cartilage AND chondral AND osteochondral AND degenerative OA.” :Result A total of 11 articles, including 9 concerning chondral and osteochondral repair and treatment and 2 regarding posttraumatic OA, were retrieved. The cartilage repair treatments used in these articles were drilling, osteochondral autograft, juvenile articular cartilage allograft, and chondrocyte implantation. One article displayed concomitant cartilage injuries in displaced distal radius fractures in 32% of the patients. The review of our findings from a 1-year cohort of wrist arthroscopies showed 17% cartilage injuries. Conclusion: There is a lack of knowledge in current literature on cartilage injuries and treatment, as well as posttraumatic OA in the wrist. Cartilage injuries appear to be common, being found in 17% to 32% of all wrist arthroscopies after trauma, but no guidelines regarding conservative or surgical treatment can be recommended at the moment. Larger prospective comparative studies are needed.

Osteoarthritis: New Insight on Its Pathophysiology

“…Wrist OA usually results from a post-traumatic sequel and selectively arises in the joints that involve the scaphoid bone. Although well tolerated for many years, it can result in severe functional impairments consequent to mechanical pain, motion range limitation, and decreased strength [ 76 ]. These symptoms develop gradually in most patients but may be precipitated by an injury or unusual sustained activity [ 77 ].…”

New insight on the pathophysiology of osteoarthritis: A narrative review

“…Although well tolerated for many years, it can result in severe functional impairments consequent to mechanical pain, motion range limitation, and decreased strength. 58 These symptoms develop gradually in most patients but may be precipitated by an injury or unusual sustained activity. 59 In addition to motion range limitation, the physical findings may include swelling, usually at the dorsal-radial aspect of the wrist, related to a combination of osteophytes and focal synovitis.…”

Total Wrist Arthroplasty for Posttraumatic Wrist Osteoarthritis: A Cohort Study Comparing Three Indications

“…Moreover, congenital wrist abnormalities, e.g., Madelung’s deformity, and vascular supply issues of the lunate and scaphoid causing Kienböck’s and Preiser’s disease, respectively, are considered as idiopathic causes [ 2 ]. Furthermore, wrist injury is another main reason for wrist OA [ 3 ]. The term posttraumatic wrist OA itself can be subdivided into the anatomical structure affected by the causative trauma.…”

“…The term posttraumatic wrist OA itself can be subdivided into the anatomical structure affected by the causative trauma. In this regard, a classification into ligament injuries and fractures is common, although Kienböck’s and Preiser’s disease are also discussed to be caused by a single impact or repetitive micro-trauma to the nutrient artery [ 3 ].…”