Wrist Fusion vs. Replacement vs. Proximal Row Carpectomy
 

I've been having right wrist pain for sometime. Today, I went to the orthopedic wrist and hand specialist. Essentially, the x-rays showed no cartilage left...basically, bone on bone. Now, I had this wrist scoped about two years ago to relieve some arthritis issues with the capitate bone. But, the joint has really degenerated.

The doctor has suggested several options, none of which have to be immediately done. But, as the pain worsens beyond where medications and taping of the wrist are beneficial, there are surgical options.

Has anyone had one of the wrist surgical procedures and are still practicing aikido (or iaido, for that matter) ? If so, what have been your experiences ?

Wrist fusion, joint replacement of the wrist, or proximal row carpectomy with fascia lata interposition....

Thank you !

Re: Wrist Fusion vs. Replacement vs. Proximal Row Carpectomy
 

Neal, sorry to hear about the problems. I shattered my left wrist about 13 years ago, multiple surgeries, plates, bone grafts, screws and whatnot and I was left with a legacy of severe arthritis, nerve damage, and very bizarre muscle cramping. My right wrist sounds a bit like yours, although not nearly as far gone, since I do still have some cartilage left. And honestly, Aikido has been the best thing for both of these. I'm not sure what style of Aikido you do, but in our style we do Tohei Sensei's Aiki Taiso exercises before the waza for every class. Those have been incredible for my wrists, not to mention the original intent of learning better aiki movement. My pain has decreased dramatically, even if it's not fully gone, and I've actually got more use of my left wrist than I did prior to Aikido.

Basically, you're going to be in pain regardless. There is just no way around that. But Aikido should actually help pain management in the long run from my experience.

--Ashley

Re: Wrist Fusion vs. Replacement vs. Proximal Row Carpectomy
 

Ashley, I hear what you are saying from your experience, you have a very mixed situation in your joints. Wrist exercises won't help with pain relief when osteoarthritis has totally got you bone on bone.

Re: Wrist Fusion vs. Replacement vs. Proximal Row Carpectomy
 

strange... x-rays cannot show soft tissue. are you sure your doctor "read" the x-ray correctly? did you have an MRI? an MRI would give analytical detail of what is going on, nothing close to the vague idea given by an x-ray

with all due respect this is utter nonsense and will lead to more problems down the road of your life.
go see an expert manual therapist who deals with the human body using all his love and soul. wrist problems, frequently, (too frequently to be accurate) are connected with problems in the neck area, upper back area, chest/rib cage area. Nerves seldom get trapped inside the carpal tunnel (which, in contradiction to what most people believe, is not located where the watch is worn but in the area 1-2 inches down the arm) and, from what you are saying, i would go and check the scalene muscles for trigger points and irritation first.
Joint degeneration (loss of movement range, loss of muscle tone and mass) can all be leading to suspects in the neck area. Please check this out before you go under the knife.
best of luck
s.

Re: Wrist Fusion vs. Replacement vs. Proximal Row Carpectomy
 

Neal,

If you have the moolah, look into having your own cartilage grown and surgically inserted. Still considered experimental by the insurance companies (who do not want to pay of course!).

Marc Abrams

Re: Wrist Fusion vs. Replacement vs. Proximal Row Carpectomy
 

Thank you for your comments !

I had an MRI on the wrist two years and at that point in time there was indication of soft tissue loss. The new x-rays showed bone resting on top of bone with no spacing, an indication of no soft tissue between. There is also bone degeneration on the radius. I saw a hand therapist after the wrist surgery two years and they had commented on the overall condition.

My grip and forearm strength is extremely good from a lot of wrist exercises and power-putty use over the years.

In class this morning, I did a 'boxer-style" taping as recommended by the Dr. and also immobilized it last night while sleeping and was pain free today. Although, I taught class this morning so, it wasn't a real test ;)

Marc, that is brilliant !! I've heard of people using grown cartilage in their knees...didn't dawn about the wrist. I will check this out :)

But, for now....taping and Aleve....

Re: Wrist Fusion vs. Replacement vs. Proximal Row Carpectomy
 

I am not a fan of surgery-first and I am a strong believer in alternative therapies. Having said that...the aikinurse says
1. the gold standard for diagnosis of osteoarthritis remains the cheap, easy X-ray, assuming the body/joint is positioned at the correct angle. You don't have to see soft tissue to find the bone on bone, subluxation and joint spurs of osteoarthritis.
2. I see a real difference between surgical procedures of limited to no documented benefit (like scoping and "scraping" or "removing debris from" arthritic knees) and actual joint replacement, which in the case of significant longterm pain and disability can be a real quality of life enhancer

Re: Wrist Fusion vs. Replacement vs. Proximal Row Carpectomy
 

I'm not sure if it is used in the smaller joints but it is certainly worth asking!

Re: Wrist Fusion vs. Replacement vs. Proximal Row Carpectomy
 

Janet:

They are starting to tinker around with that... You have to look around and find some of the cutting edge ortho places that are quietly doing that stuff. I haven't heard of any outcome data. Given the few good choices out there, if I had the money to spare, that is a no harm, no foul kind of thing. The worst that can happen is that you are back to square one, with less in your wallet..... Luckily for me, my body has not degenerated to that level. I work too damn hard on trying to stay in one piece these days...

Regards,

marc

ps- will be in napa valley this coming weekend. Need to work on preserving my liver.....:D .