Contact pressures in radiocarpal and triquetrohamate joints after vascularized capitate transposition.

ABSTRACT

The vascularized capitate transposition has been designed to treat advanced Kienböck disease, in which the necrotic lunate is excised and the vascularized capitate bone graft is proximally shifted into the lunate fossa to reconstruct the radiocarpal joint. Since it notably alters the normal anatomy of the wrist, the anatomical alterations are thought to be responsible for the increased tendency to develop symptomatic arthritis. Clinically, however, more than 1-year follow-up does not show any arthrosis in the reconstructed radiocarpal joint after this procedure. We tied to investigate the reason of no postsurgical arthrosis by documenting the contact pressures in the radiocarpal and triquetrohamate joints in a cadaveric wrist model. The contact pressures were measured by the super low pressure Fuji prescale film in 6 different wrist positions. No statistically significant difference existed in the average contact pressures of the scaphoid fossa, lunate fossa, triangular fibrocartilage, and triquetrohamate articulation in each wrist position between pre- and postsurgically. These results suggest that this procedure does not necessarily result in increased rate of postsurgical arthritis.