Treatment of Stage I and II Scapholunate Advanced Collapse (SLAC) Wrist

Scapholunate advanced collapse (SLAC) is a common pattern of wrist arthritis and provides a particular challenge for surgeons. This progressive pattern of degeneration has not been effectively stopped by any procedure or medication in literature at this time. Therefore, in patients with SLAC wrist, surgeons are forced to consider salvage procedures, such as four-corner arthrodesis and proximal row carpectomy. These procedures offer decreased pain at a cost of range of motion and grip strength. Our group has been utilizing a novel procedure for early SLAC combining joint resurfacing with dorsal wrist capsulodesis. Data for this surgical procedure is preliminary, with 11 procedures performed. While this procedure does relieve arthritis pain, it appears to have similar drawbacks to other salvage procedures.