Treatment of symptomatic osteoarthritis of the wrist and thumb base: pushing the boundaries

This thesis aims to contribute to the knowledge on different aspects and developments in the treatment of osteoarthritis and to help hand surgeons in making treatment choices. Chapter 2 evaluates the current preferred techniques in the surgical treatment of isolated CMC-1 osteoarthritis among hand surgeons in Europe. Chapter 3 explores the value of CMC-1 denervation in early CMC-1 osteoarthritis by a literature review in combination with a retrospective cohort study. In Chapter 4 the results are presented of a retrospective study on resection of the distal pole of the scaphoid for the treatment of painful STT osteoarthritis. Chapter 5 presents the surgical treatment choices in isolated STT osteoarthritis in a survey among European hand surgeons. An online survey was distributed to 20 participating member states of the FESSH. Chapter 6 investigates the kinematic outcome of RSL arthrodesis with subsequent excision of the distal pole of the scaphoid and the triquetrum. Chapter 7 compares the long-term outcomes of PRC and FCA in a consecutive series of patients surgically treated between 1989 and 1998 in a single teaching hospital. Chapter 8 investigates failed biaxial wrist protheses, being replaced by the Universal 2 prosthesis. Chapter 9 This observational pilot study aimed to investigate to what extent combined palmar and dorsal scapholunate (SL) ligament reconstruction restored 1) carpal bone positioning in the neutral wrist pose, 2) the SL rotation axis, 3) physiological SL motion, 4) the SL distance.