Proximal Row Carpectomy: Role of a Radiocarpal Interposition Lateral Meniscal Allograft

Purpose The purpose of this study was to determine whether use of a lateral meniscal interposition allograft combined with proximal row carpectomy would reduce the peak joint contact pressures and increase the contact area when compared with proximal row carpectomy alone. Methods Six cadaver wrists were cyclically moved through flexion-extension and radioulnar deviation ranges of motion. Joint contact pressure was measured with the carpus intact, after proximal row carpectomy, and after insertion of a lateral meniscal allograft. Contact pressure data were also collected with the wrist in 5 static positions. Results Proximal row carpectomy caused statistically greater peak pressures and smaller contact areas when compared with the intact wrist. Insertion of the allograft statistically restored the pressures and areas to that observed in the intact wrist. Conclusions These results support the clinical trial of a lateral meniscal interposition allograft in patients with contraindications for proximal row carpectomy, such as pre-existing arthritis in the capitate head or lunate facet of the radius. (J Hand Surg 2009;34A:251-257. Copyright (C) 2009 by the American Society for Surgery of the Hand. All tights reserved.)