- Question
- What is the commonest pattern of degenerative arthritis in the wrist and how does it progress?
- Design
- Retrospective review of a large series of wrist radiographs, with a small number of patients treated surgically.
- Patients
- Patients with radiographic degenerative arthritis of the wrist.
- Intervention
- Radiographic pattern analysis
- Comparison
- None
- Primary outcome
- Distribution and sequence of degenerative change
- Key result
- Described the scapholunate advanced collapse (SLAC) pattern as the commonest form of wrist degenerative arthritis, with scaphotrapeziotrapezoid arthritis the next most frequent; in SLAC, arthritis progresses from the radioscaphoid to the capitolunate joint while the radiolunate joint is characteristically spared.
- Limitations
- Descriptive radiographic series; the surgical results were from a small, uncontrolled group.
- Impact on practice
- Underpins the staging of SLAC (and by analogy SNAC) wrist and explains why salvage options such as proximal row carpectomy and four-corner fusion, which rely on a preserved radiolunate joint, are possible.