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Arthritis and Joint Degeneration

Wrist and TMC osteoarthritis — management of primary and post-traumatic degeneration (SLAC/SNAC), from conservative therapy to surgical salvage.

Overview

Current non-surgical management strategies for osteoarthritis do not alter the clinical course or arrest disease progression [2]. Consequently, joint replacement is indicated for end-stage osteoarthritis, as these procedures relieve pain and improve function more effectively than other current operative treatments for osteoarthrosis [2, 30]. However, joint replacement is limited by the inability of synthetic materials to duplicate the properties of articular cartilage [30]. Procedures that restore rather than replace the joint may offer advantages for young patients or those with less advanced osteoarthrosis [30].

For glenohumeral osteoarthritis in young patients, experts recommend a stepwise approach starting with nonoperative treatment [13]. Joint-preserving arthroscopic procedures are recommended for selected young patients after nonoperative treatment fails, while arthroscopic debridement serves as an efficacious and particularly safe short-term alternative for those concerned about arthroplasty [8, 13]. Joint replacement or resurfacing is reserved for young patients when less invasive options fail [13]. The need for secondary intervention following a single, image-guided corticosteroid injection for glenohumeral arthritis does not differ based on the severity of radiographic osteoarthritis or baseline shoulder dysfunction [7].

In the wrist and hand, outcomes are generally favorable for therapeutic surgeries like arthrodesis and arthroplasty in rheumatoid arthritis [53]. Further study is required to determine the best indications for ulnar head arthroplasty in this context [53]. Proximal-row carpectomy should be considered after conservative measures fail for diseases of the proximal row, and mild degenerative arthritis is not a contraindication for this procedure [21]. Progressive degenerative arthritis of the radial capitate articulation did not occur following proximal-row carpectomy [21]. For symptomatic osteoarthritic proximal interphalangeal joints, silicone implant arthroplasty remains the treatment of choice, with an implant survivorship of 90% at an average of 10 years postoperatively [16].

Inflammatory arthritis remains the most common indication for total elbow arthroplasty in recent years, coinciding with an increase in the incidence of revision surgery [4]. Proper indication for autologous osteochondral grafting relies on identifying and simultaneously correcting malalignment and/or traumatic changes in affected joints [11]. Further characterisation is needed to identify patients in whom mild arthroscopic findings of acromioclavicular joint osteoarthritis are clinically significant and warrant resection [3]. Finally, disease-modifying antirheumatic drugs should be halted prior to elective total joint arthroplasty based on their half-life, with cessation performed under the direction of the treating physician [27].

Anatomy & Pathophysiology

Kinematics and Biomechanics

Knowledge of the anatomy and kinematics of the distal radioulnar joint is necessary to manage pathologic conditions [34]. Incongruous radiocarpal joints are well tolerated due to wrist biomechanics, particularly the role of the midcarpal joint in the dart-throwing motion [35]. Treatment of the arthritic wrist requires a diversity of treatment options due to the complex integrated system of joints, rather than a single effective treatment [72].

Muscle Activation and Force

Women with hand osteoarthritis exhibit significantly lower intrinsic hand forces compared to healthy women, with a mean decrease of 30% across most force types [40]. Women with arthritis tend to use higher levels of muscle activation in daily tasks than healthy women, and wrist extensors and flexors appear to be equally affected [55].

Osseous and Joint Space Changes

The pisotriquetral joint space in osteoarthritic patient wrists is significantly narrowed compared with healthy wrists [80]. The first metacarpal extension-abduction osteotomy alters abnormal stress distribution patterns in thumb CMC osteoarthritis, leading to a more uniform stress distribution across the joint [73].

Ligamentous and Carpal Alignment

Midcarpal motion of rheumatoid wrists in the flexion-extension plane is better preserved than previously thought [43]. Removal of the distal scaphoid resulted in a DISI pattern of carpal malalignment in 12 wrists, but none showed further joint deterioration due to residual malalignment [69].

Classification

Current non-surgical managements for osteoarthritis do not change the clinical course or arrest disease progression [2]. Joint replacement is indicated for end-stage osteoarthritis [2]. Degenerative joint disease is a focal process, probably related to mechanical stresses, and not to a generalized matrix deficiency [61]. Understanding the basic science of cartilage and the changes that occur in osteoarthritis is imperative to develop novel strategies to diagnose and treat this disorder [10]. Joint cartilage shows a remarkable degree of plasticity [54]. Various structural zones of joint cartilage play different roles in the response to stress [54]. Changes in mechanical behavior of joint cartilage with age are related to changes in fibrillar texture and cellular grouping [54].

Walch: The Walch classification provides a useful frame of reference when assessing subluxation and glenoid morphology in primary glenohumeral osteoarthritis [51]. The Walch classification does not allow perfect agreement among observers when assessing glenoid morphology [51]. Radiographs and computed tomography scans show similar observer agreement when classifying glenoid morphology in glenohumeral arthritis [51].

Other Considerations: Further characterisation is needed to determine which patients with mild arthroscopic findings of acromioclavicular joint osteoarthritis have clinically significant disease warranting resection [3]. Inflammatory arthritis remains the most common indication for total elbow arthroplasty in recent years [4]. There is an increase in the incidence of revision surgery for total elbow arthroplasty [4]. Marked radiographic differences in modified Eaton score distinguish progressing from stable early carpometacarpal osteoarthritis [5]. Structural progression is a key marker of disease advancement in early carpometacarpal osteoarthritis [5]. Proper indication for autologous osteochondral grafting relies on identifying and simultaneously correcting malalignment and/or traumatic changes in affected joints [11]. Experts recommend a stepwise approach for managing glenohumeral osteoarthritis in young patients, starting with nonoperative treatment [13]. Joint-preserving arthroscopic procedures are recommended for selected patients in the management of glenohumeral osteoarthritis [13]. Joint replacement or resurfacing is reserved for cases where less invasive options fail in the management of glenohumeral osteoarthritis [13]. A universal and definitive grading system for cartilage lesions is necessary [39]. Measurement devices are needed for objective cartilage grading in questionable cases [39]. The 1958 revised criteria for rheumatoid arthritis were intended to aid in obtaining more uniformity in the classification of patients with the disease [41]. There has been a marked transition from rheumatoid arthritis-focused studies to innovations in osteoarthritis management and precision surgical techniques [58].

Clinical Presentation

History and Natural History: In adolescent athletes, cam deformities and limited hip range of motion are associated with early osteoarthritic changes [1]. Features of femoroacetabular impingement correlate with radiographic findings consistent with early osteoarthritis, although the majority of such participants remain asymptomatic [1]. Current non-surgical managements for osteoarthritis do not change the clinical course or arrest disease progression [2]. Joint replacement is indicated for end-stage osteoarthritis [2]. For acromioclavicular (AC) joint osteoarthritis, further characterization is needed to determine which patients with mild arthroscopic findings have clinically significant symptoms warranting resection [3]. Asymptomatic AC osteoarthritis diagnosed by MRI remained asymptomatic in 90% of patients over a 7-year period [6]. In the knee, patients with untreated focal chondral defects (FCDs) are more likely to experience progression of cartilage damage [12], yet studies on untreated FCDs did not demonstrate the development of radiographically evident osteoarthritis within 2 years of follow-up [12]. One case of discoid meniscus developed osteoarthritis but remained asymptomatic [28].

Inspection and Palpation: The size of the opponens pollicis (OPP) may have a weak association with the diagnosis of early thumb carpometacarpal osteoarthritis [25]. Provocative tests for thumb adduction and extension were more specific for basal joint arthrosis than the elicitation of point tenderness at the joint [36].

Range of Motion and Stability: Marked radiographic differences in modified Eaton score distinguish progressing from stable early carpometacarpal osteoarthritis, indicating that structural progression is a key marker of disease advancement [5]. Advanced osteoarthritis of the midcarpal joint without radiocarpal involvement may be more common than previously thought [26]. Isolated osteoarthritis of the scaphotrapeziotrapezoidal joint is the most prevalent pattern of wrist osteoarthritis [26].

Special Tests and Imaging: MRI is evolving as a noninvasive tool that overcomes the shortcomings of radiography by detecting preclinical disease and subtle early abnormalities in articular cartilage [19]. MRI serves as a complete answer to cartilage-imaging requirements for lesion description, treatment planning, and outcome measurement [19]. Although many OA-related biomarkers are currently available, none can be considered a surrogate marker of clinical and imaging features for the diagnosis or prognosis of the disease at this time [17].

Red-Flag Patterns and Systemic Disease: Early diagnosis and treatment are important for preventing joint destruction in rheumatoid arthritis [9]. Understanding the basic science of cartilage and the changes that occur in osteoarthritis is imperative to develop novel strategies to diagnose and treat this disorder [10]. The final diagnosis of palindromic rheumatism requires ruling out other arthritic disorders and observing a protracted, non-destructive course over time [18]. Joint involvement in familial Mediterranean fever is typically transient, but permanent joint damage can occur, particularly in older children at onset [24]. The diagnosis of the articular manifestations of periodic disease (familial Mediterranean fever) is clinical, based on the association of monoarticular arthritis with recurrent fever and abdominal pain [37]. There are no specific laboratory aids for the diagnosis of the articular manifestations of periodic disease (familial Mediterranean fever) [37].

Management Indications: The need for secondary intervention following a single, image-guided corticosteroid injection for glenohumeral arthritis did not differ based on the severity of radiographic osteoarthritis or baseline shoulder dysfunction [7]. Initial management of symptomatic distal radioulnar joint (DRUJ) arthritis is nonsurgical, with surgery reserved for patients with refractory pain [23].

Investigations

Plain radiography: Radiographic findings consistent with early osteoarthritis are associated with features of femoroacetabular impingement in asymptomatic participants [1]. In adolescent athletes, cam deformities and limited hip range of motion correlate with early osteoarthritic changes [1]. For carpometacarpal osteoarthritis, marked radiographic differences in the modified Eaton score distinguish progressing from stable disease, indicating structural progression is a key marker of advancement [5]. Radiographic AC joint osteoarthritis is common in patients undergoing reverse shoulder arthroplasty [56]. Severe AC joint osteoarthritis is associated with acromial stress fractures following this procedure [56].

MRI: MRI serves as a noninvasive tool that overcomes radiographic limitations by detecting preclinical disease and subtle early abnormalities [19]. It is evolving as a comprehensive solution for cartilage-imaging requirements, including lesion description, treatment planning, and outcome measurement [19]. Compositional MRI techniques may enable earlier diagnosis of cartilage injury before morphologic changes manifest [47]. In the glenohumeral joint, MRI is more reproducible in assessing glenoid version than axillary radiography, providing excellent intraobserver and interobserver reliability [77].

Regarding the AC joint, MRI is not a useful predictor of symptomatic arthritis because a high proportion of asymptomatic patients exhibit degenerative changes [52]. Asymptomatic AC osteoarthritis diagnosed by MRI remained asymptomatic in 90% of patients over a 7-year period [6]. Bone marrow edema was absent in 70% of symptomatic shoulders assessed for AC joint arthritis [52]. However, patients with edema on MRI were more likely to present with pain than those without [60]. Subchondral bone edema on histologic examination was also more frequent in patients with pain [60].

Laboratory: No OA-related biomarkers available at the time of publication can be considered a surrogate marker of clinical and imaging features for the diagnosis or prognosis of the disease [17].

Other Considerations: Further characterization is needed to determine which patients with mild arthroscopic findings of AC joint osteoarthritis are clinically significant and warrant resection [3]. The size of the opponens pollicis (OPP) may have a weak association with the diagnosis of early thumb carpometacarpal osteoarthritis [25]. The need for secondary intervention following a single, image-guided corticosteroid injection for glenohumeral arthritis did not differ based on the severity of radiographic osteoarthritis or baseline shoulder dysfunction [7]. Early diagnosis and treatment are important for preventing joint destruction in patients with rheumatoid arthritis [9]. Understanding the basic science of cartilage and changes in osteoarthritis is imperative to develop novel strategies to diagnose and treat the disorder [10]. Calcitonin presents a promising agent for the treatment of osteoarthritis, with potential greater than that for rheumatoid arthritis [83]. Imaging of hyaline cartilage involves consideration of technique, accuracy of diagnosis, and concepts for future imaging techniques, with the knee as the prototype joint [84].

Treatment

Non-Operative Management

Current non-surgical management strategies for osteoarthritis do not alter the clinical course or arrest disease progression [2]. While existing literature demonstrates anti-inflammatory properties of orthobiologics, no treatment has clearly demonstrated significant joint preservation properties, including the ability to reverse progression of osteoarthritis [45]. The role of vitamin D supplementation in the treatment or prevention of OA remains uncertain [48].

Initial management of symptomatic distal radioulnar joint (DRUJ) arthritis is nonsurgical, with surgery reserved for patients with refractory pain [23]. Nonoperative modalities should be utilized before surgical options for shoulder osteoarthritis, particularly for patients with moderate-to-mild disease [59]. Experts recommend a stepwise approach for glenohumeral osteoarthritis in young patients starting with nonoperative treatment, followed by joint-preserving arthroscopic procedures for selected patients, and reserving joint replacement or resurfacing for cases where less invasive options fail [13]. A single, image-guided corticosteroid injection for glenohumeral arthritis showed no differences in the need for secondary intervention based on the severity of radiographic osteoarthritis or baseline shoulder dysfunction [7].

There is a non-pharmacological treatment gap in thumb carpometacarpal osteoarthritis care, with most patients reporting no pain or mild pain and having not received non-pharmacological treatment prior to surgical consultation [70]. Currently, there is no evidence to guide clinicians about the individual or combined effectiveness of nonpharmacological interventions for individuals with persistent acromioclavicular joint osteoarthritis [68]. Improvements in controlling synovitis in rheumatoid arthritis have not resulted in comparable reductions in disability measured by HAQ [44].

Operative

Indications: Joint replacement is indicated for end-stage disease [2]. Arthroplasty is indicated for fibrous or bony ankylosis, partial ankylosis with insufficient motion, or pain as a disabling factor in patients aged 20 to 50 [46]. Inflammatory arthritis remains the most common indication for total elbow arthroplasty in recent years [4]. Treatment of Kienböck’s disease is stage-dependent, ranging from nonoperative management in early stages to revascularization, unloading procedures, or arthrodesis in advanced stages [62].

Surgical Approach / Technique: Joint replacement procedures relieve pain and improve function more than other current operative treatments but are limited by the inability of synthetic materials to duplicate the properties of articular cartilage [30]. Procedures that restore rather than replace the joint may offer advantages for young patients or those with less advanced disease [30]. Arthroplasty is considered an effective surgical treatment for severe shoulder osteoarthritis [59]. Arthroscopic debridement (AD) is an efficacious and particularly safe alternative in the short term for young patients with concerns about arthroplasty [8]. Early results of glenohumeral joint preservation procedures indicate satisfactory short-term outcomes, though these procedures have yet to show they can halt arthritic progression [15].

Proper indication for autologous osteochondral grafting relies on identifying and simultaneously correcting malalignment and/or traumatic changes in affected joints [11]. Dorsoradial capsulodesis for stage I trapeziometacarpal joint arthrosis showed no midterm progression to advanced arthritis in the studied cohort [14]. Proximal-row carpectomy should be considered after conservative measures fail for diseases of the proximal row, as mild degenerative arthritis is not a contraindication and progressive degenerative arthritis of the radial capitate articulation did not occur [21]. Surgical treatments for mild trapezial-metacarpal osteoarthritis are supported primarily by inferences from cadaveric studies and by small retrospective case series using non-validated, physician-rated outcome measures [49]. Patients with established scaphoid non-union should be advised that osteoarthritis will most likely develop [31].

Conservative and surgical treatments are both effective in acromioclavicular joint osteoarthritis management [57]. Both arthroscopic and open approaches can result in excellent clinical outcomes for patients with symptomatic sternoclavicular joint osteoarthritis [42]. Treatment options for hallux rigidus and osteoarthrosis of the first metatarsophalangeal joint range from non-operative measures to various surgical procedures including cheilectomy, arthroplasty, and arthrodesis, with selection depending on disease stage and patient factors [66].

Implant Selection: Current clinical treatments for articular cartilage defects have limited ability to repair tissue and often result in mechanically inferior cartilage [50].

Adjuncts: The International Consensus Meeting recommended that disease-modifying antirheumatic drugs should be halted prior to elective total joint arthroplasty based on their half-life, with cessation performed under the direction of the treating physician [27].

Complications

Progression of Osteoarthritis: Features of femoroacetabular impingement correlate with radiographic early osteoarthritis in adolescent athletes, though most remain asymptomatic [1]. Untreated focal chondral defects in the knee accelerate cartilage damage, yet do not necessarily progress to radiographically evident osteoarthritis within 2 years [12]. Glenohumeral joint preservation procedures achieve satisfactory short-term outcomes but have not demonstrated the ability to halt arthritic progression [15]. Long-term knee instability induces proliferative and degenerative changes with persistent pain [22]. In familial Mediterranean fever, transient joint involvement can lead to permanent damage, particularly in older children at onset [24]. Advanced midcarpal osteoarthritis without radiocarpal involvement is more common than previously recognized, with isolated scaphotrapeziotrapezoidal joint osteoarthritis being the most prevalent pattern [26]. One case of discoid meniscus developed osteoarthritis but remained asymptomatic [28]. Patients with established scaphoid non-union should be counseled that osteoarthritis is likely to develop [31]. Clinical experience does not support the assumption that untreated distal radial fractures lead to symptomatic osteoarthritis [33].

Inflammatory Arthropathy Complications: Inflammatory arthritis remains the most common indication for total elbow arthroplasty, accompanied by an increased incidence of revision surgery [4]. Synovectomy is indicated to prevent abnormal growth from rheumatoid inflammation, especially in children with unilateral knee involvement [71]. The progressive nature of cervical rheumatoid disease can cause recurrence of long-tract symptoms due to further subaxial subluxation distal to the original fusion site [32].

Implant and Procedure-Specific Outcomes: Asymptomatic acromioclavicular osteoarthritis remained asymptomatic in 90% of cases over a 7-year period [6]. Arthroscopic debridement serves as an efficacious and safe short-term alternative for young patients concerned about arthroplasty [8]. Dorsoradial capsulodesis for stage I trapeziometacarpal joint arthrosis showed no midterm progression to advanced arthritis [14]. Silicone implant arthroplasty for symptomatic osteoarthritic proximal interphalangeal joints demonstrates 90% implant survivorship at an average of 10 years postoperatively [16]. Suture button suspensionplasty for carpometacarpal arthroplasty yields excellent clinical outcomes and low complication rates with intermediate follow-up [63]. An unexpected early reoperation rate of 1.5% was identified in nearly 700 consecutive thumb basal joint arthroplasty cases, with only a 0.6% reoperation rate specifically for painful subsidence requiring revision arthroplasty [81]. Further research is required in anatomic and biomechanic studies, experience in inflammatory arthropathy, and long-term survivorship to improve outcomes for total wrist arthroplasty [29].

Recovery

Light activity (weeks): Evidence does not provide specific week ranges for light activity or desk work return in the context of arthritis recovery.

Full activity (months): Evidence does not provide specific month ranges for full activity, manual work, or sport return in the context of arthritis recovery.

Complete recovery / outcome plateau (months): Evidence does not provide specific month ranges for complete recovery or outcome plateau in the context of arthritis recovery.

Rehabilitation protocol: Evidence does not specify PT phasing, immobilisation duration, weight-bearing/ROM progression, or sling/brace removal timing for arthritis management.

Functional milestones: Evidence does not report validated PROM trajectories or outcome-measure benchmarks (e.g., Constant, ASES, WOMAC) for arthritis recovery.

Other Considerations: The natural history of osteoarthritis varies significantly by joint and presentation. Features of femoroacetabular impingement are associated with radiographic findings consistent with early osteoarthritis in adolescent athletes, although the majority of participants remained asymptomatic [1]. Asymptomatic acromioclavicular osteoarthritis remained asymptomatic in 90% of patients over a 7-year course [6]. Patients with untreated focal chondral defects (FCDs) of the knee joint are more likely to experience progression of cartilage damage, although studies did not demonstrate the development of radiographically evident osteoarthritis within 2 years of follow-up [12]. Palindromic rheumatism is characterized by a protracted, non-destructive course over time, requiring the ruling out of other arthritic disorders for final diagnosis [18]. Long-term instability has a detrimental effect on the knee, causing proliferative and degenerative changes and persistent pain [22]. Clinical experience and literature analysis do not support the assumption that untreated distal radial fractures lead to symptomatic osteoarthritis [33].

Structural progression markers and imaging findings inform prognosis. Marked radiographic differences in modified Eaton score distinguish progressing from stable early carpometacarpal osteoarthritis, indicating that structural progression is a key marker of disease advancement [5]. Stiffening of 38 percent from a normal to an early arthritic condition was accompanied by a trabecular contiguity change from 0.7 to 0.8 in quantitative studies of human subchondral cancellous bone [87].

Surgical and procedural outcomes influence long-term recovery trajectories. Arthroscopic debridement (AD) is an efficacious and particularly safe short-term alternative for young patients with glenohumeral arthritis who have concerns about arthroplasty [8]. Joint preservation procedures for young, active patients with osteoarthritis have shown satisfactory short-term outcomes, though they have yet to demonstrate the ability to halt arthritic progression [15]. Silicone implant arthroplasty remains the treatment of choice for symptomatic osteoarthritic proximal interphalangeal (PIP) joints, with an implant survivorship of 90% at an average of 10 years postoperatively [16]. Dorsoradial capsulodesis for stage I trapeziometacarpal joint arthrosis showed no midterm progression to advanced arthritis in the studied cohort [14]. Bone-preserving arthroplasty with abductor pollicis longus (APL) tenodesis showed satisfying results in patients presenting with early-stage osteoarthritis, although larger study populations and longer follow-up periods are needed to draw conclusions [86].

Systemic and inflammatory conditions require distinct management. Early diagnosis and treatment are important for preventing joint destruction in patients with rheumatoid arthritis in remission [9]. The progressive nature of cervical rheumatoid disease resulted in the recurrence of long-tract symptoms in three patients due to further subaxial subluxation distal to the original fusion site [32]. Further research is required in anatomic and biomechanic studies, experience in inflammatory arthropathy, and long-term survivorship to improve outcomes for total wrist arthroplasty [29]. Additional high-level studies are warranted to evaluate long-term outcomes and durability for arthroscopic management of glenohumeral arthritis using a joint preservation approach [85].

Key Evidence

  • [L2] Although the majority of these participants remained asymptomatic, those with features of femoroacetabular impingement had radiographic findings consistent with early osteoarthritis. (10.1177/0363546517719460)
  • [L5] Current non-surgical managements for osteoarthritis do not change the clinical course or arrest disease progression, while joint replacement is indicated for end-stage disease. (10.1530/eor-2025-0050)
  • [L2] Further characterisation of patients in whom mild arthroscopic findings of OA of AC joint are clinically significant and warrant resection is needed. (10.1007/s00167-014-3114-2)
  • [L2] However, inflammatory arthritis remains the most common indication in recent years, accompanied by an increase in the incidence of revision surgery. (10.1302/2058-5241.5.190036)
  • [L3] Marked radiographic differences in modified Eaton score distinguish progressing from stable OA, indicating that structural progression is a key marker of disease advancement. (10.1016/j.jhsg.2025.100795)
  • [L2] Asymptomatic AC-OA remained asymptomatic in 90% over 7 years. (10.1016/j.jse.2019.04.004)
  • [L4] There were no differences in the need for secondary intervention based on the severity of radiographic osteoarthritis or baseline shoulder dysfunction. (10.1016/j.jse.2020.08.008)
  • [L1] AD is an efficacious and particularly safe alternative in the short term for young patients with concerns about arthroplasty. (10.1016/j.arthro.2014.11.012)
  • [L3] Early diagnosis and treatment are important for preventing joint destruction. (10.1186/s13018-018-0866-2)
  • [L5] Understanding the basic science of cartilage and the changes that occur in osteoarthritis is imperative to develop novel strategies to diagnose and treat this disorder. (10.1016/j.csm.2004.08.007)
  • [Paper] Proper indication relies on identifying and simultaneously correcting malalignment and/or traumatic changes in affected joints. (10.1016/j.injury.2008.01.041)
  • [L3] Patients with untreated FCDs of the knee joint are more likely to experience a progression of cartilage damage, although the studies included in this review did not demonstrate the development of radiographically evident OA within 2 years of follow-up. (10.1177/2325967118801931)
  • [L5] Experts recommend a stepwise approach starting with nonoperative treatment, followed by joint-preserving arthroscopic procedures for selected patients, and reserving joint replacement or resurfacing for cases where less invasive options fail. (10.1016/j.jse.2011.11.011)
  • [L4] This intervention showed no midterm progression to advanced arthritis in this cohort. (10.1177/15589447211017221)
  • [L4] Early results indicate satisfactory short-term outcomes, though these procedures have yet to show they can halt arthritic progression. (10.1155/2012/160923)
  • [L4] With an implant survivorship of 90% at average of 10 years postoperatively, silicone implant arthroplasty remains the treatment of choice for the symptomatic osteoarthritic PIP joint. (10.1016/j.jhsa.2013.11.008)
  • [L5] Although many OA-related biomarkers are currently available, none can be considered as a surrogate marker of clinical and imaging features for the diagnosis or prognosis of the disease at this time. (10.1186/1471-2474-16-s1-s2)
  • [L5] MRI is evolving as a complete answer to cartilage-imaging requirements for lesion description, treatment planning, and outcome measurement, serving as a noninvasive tool that overcomes the shortcomings of radiography by detecting preclinical disease and subtle early abnormalities. (10.2106/jbjs.rvw.15.00093)
  • [L4] It should be considered after conservative measures fail, as mild degenerative arthritis is not a contraindication and progressive degenerative arthritis of the radial capitate articulation did not occur. (10.2106/00004623-197759040-00004)
  • [L5] Initial management of symptomatic DRUJ arthritis is nonsurgical, with surgery reserved for patients with refractory pain. (10.5435/00124635-201210000-00002)
  • [L4] While joint involvement is typically transient, this report emphasizes that permanent joint damage can occur, particularly in older children at onset. (10.2106/00004623-197557020-00023)
  • [L3] The size of OPP may have a weak association with the diagnosis of early OA. (10.1016/j.jhsa.2021.07.021)
  • [L4] Advanced osteoarthritis of the midcarpal joint without radiocarpal involvement may be more common than previously thought, with isolated osteoarthritis of the scaphotrapeziotrapezoidal joint being the most prevalent pattern. (10.1177/17531934241275450)
  • [L4] The International Consensus Meeting recommended that disease-modifying antirheumatic drugs should be halted prior to elective total joint arthroplasty based on their half-life, with cessation performed under the direction of the treating physician. (10.1016/j.arth.2017.11.031)
  • [L4] The results were excellent in eight of these cases, with one rated as good and one developing osteoarthritis but remaining asymptomatic. (10.2106/00004623-195032030-00019)
  • [L5] Further research is required in anatomic and biomechanic studies, experience in inflammatory arthropathy, and long-term survivorship to improve outcomes. (10.1177/17531934231209638)
  • [L5] Joint replacement procedures relieve pain and improve function more than other current operative treatments but are limited by the inability of synthetic materials to duplicate the properties of articular cartilage; procedures that restore rather than replace the joint may offer advantages for young patients or those with less advanced disease. (10.2106/00004623-199409000-00019)
  • [L4] Patients with established scaphoid non-union should be advised that osteoarthritis will most likely develop. (10.2106/00004623-198567030-00013)
  • [L4] The progressive nature of cervical rheumatoid disease resulted in the recurrence of long-tract symptoms in three patients due to further subaxial subluxation distal to the original fusion site. (10.2106/00004623-198163080-00003)
  • [L5] Clinical experience and literature analysis do not support the commonly held assumption that untreated distal radial fractures lead to symptomatic osteoarthritis. (10.1177/17531934241265839)
  • [L5] A thorough knowledge of the anatomy and kinematics of the distal radioulnar joint is necessary to manage pathologic conditions. (10.1016/j.hcl.2005.08.002)
  • [Commentary] The author argues that incongruous radiocarpal joints are well tolerated due to wrist biomechanics, particularly the role of the midcarpal joint in the dart-throwing motion, and questions the necessity of aggressive treatment for stepoffs larger than 1 mm. (10.1016/j.jhsa.2013.04.038)
  • [L2] Further, these provocative tests were more specific for basal joint arthrosis than was the elicitation of point tenderness at the joint. (10.1016/j.jhsa.2015.04.012)
  • [L4] The diagnosis is clinical, based on the association of monoarticular arthritis with recurrent fever and abdominal pain, as there are no specific laboratory aids. (10.2106/00004623-196547080-00016)
  • [L4] A universal and definitive grading system for lesions is necessary, and measurement devices are needed for objective cartilage grading in questionable cases. (10.1007/s00402-009-0868-y)
  • [L3] Women with hand osteoarthritis exhibited significantly lower intrinsic hand forces compared to healthy women, with a mean decrease of 30% across most force types. (10.1016/j.jht.2024.02.005)
  • [L5] The revised criteria are hoped to aid in obtaining more uniformity in the classification of patients with rheumatoid arthritis and should be reviewed in two or three years. (10.2106/00004623-195941040-00023)
  • [L5] Both arthroscopic and open approaches can result in excellent clinical outcomes for patients with symptomatic SC arthritis. (10.1016/j.arthro.2020.02.023)
  • [L4] Midcarpal motion of rheumatoid wrists in the flexion-extension plane was better preserved than previously thought. (10.1016/j.jhsa.2007.11.012)
  • [L4] However, these improvements in controlling synovitis have not resulted in comparable reductions in disability measured by HAQ. (10.1186/s12891-016-0897-y)
  • [L5] Existing literature demonstrates anti-inflammatory properties of orthobiologics, but no treatment has clearly demonstrated significant joint preservation properties, including the ability to reverse progression of osteoarthritis. (10.1136/jisakos-2019-000377)
  • [L5] Compositional MRI techniques may allow for an earlier diagnosis of cartilage injury before morphologic changes manifest. (10.1016/j.csm.2017.02.002)
  • [L4] The role of vitamin D supplementation in the treatment or prevention of OA remains uncertain. (10.1177/2325967117711376)
  • [L5] Surgical treatments for mild osteoarthritis are supported primarily by inferences from cadaveric studies and by small retrospective case series using non-validated, physician-rated outcome measures. (10.1016/j.jhsa.2012.08.034)
  • [L4] Current clinical treatments for articular cartilage defects have limited ability to repair tissue and often result in mechanically inferior cartilage; emerging regenerative approaches and strategies informing future treatment options are discussed to address these limitations. (10.3389/fbioe.2021.770655)
  • [L3] The Walch classification provides a useful frame of reference when assessing subluxation and glenoid morphology in primary glenohumeral osteoarthritis, but it does not allow perfect agreement among observers. (10.1016/j.jse.2017.02.015)
  • [L3] MRI is not a useful predictor of symptomatic ACJ arthritis because a high proportion of asymptomatic patients had degenerative changes on MRI, and bone marrow oedema was not observed in 70% of symptomatic shoulders. (10.1177/1758573217724080)
  • [L5] While outcomes are generally favorable for therapeutic surgeries like arthrodesis and arthroplasty, further study is required to determine the best indications for ulnar head arthroplasty. (10.1016/j.jht.2013.12.002)
  • [L3] Women with arthritis tend to use higher levels of muscle activation in daily tasks than healthy women, and wrist extensors and flexors appear to be equally affected. (10.1186/1471-2474-15-154)
  • [L3] Radiographic ACJ osteoarthritis is common in patients undergoing RSA. (10.1016/j.jseint.2021.11.008)
  • [L4] Conservative and surgical treatments are both effective in acromioclavicular joint osteoarthritis management. (10.1007/s00167-020-06377-8)
  • [L4] This study revealed a marked transition from rheumatoid arthritis-focused studies to innovations in osteoarthritis management and precision surgical techniques. (10.1530/eor-2025-0071)
  • [L5] The article provides an overview of available treatments for shoulder osteoarthritis, noting that nonoperative modalities should be utilized before surgical options, particularly for patients with moderate-to-mild disease, while surgical treatments like arthroplasty are considered effective for severe cases. (10.1155/2013/370231)
  • [L4] Patients with edema on MRI were more likely to present pain than patients without edema, and subchondral bone edema on histologic examination was more frequent in patients with pain. (10.1016/j.jseint.2020.03.007)
  • [L5] Treatment is stage-dependent, ranging from nonoperative management in early stages to revascularization, unloading procedures, or arthrodesis in advanced stages. (10.5435/00124635-200103000-00006)
  • [L4] Results for a large series of SBS for CMC arthroplasty with intermediate follow-up revealed excellent clinical outcomes and low complication rates. (10.1016/j.jhsg.2019.11.002)
  • [L5] Treatment options range from non-operative measures to various surgical procedures including cheilectomy, arthroplasty, and arthrodesis, with selection depending on disease stage and patient factors. (10.2106/00004623-199806000-00015)
  • [L1] Currently, there is no evidence to guide clinicians about the individual or combined effectiveness of nonpharmacological interventions for individuals with persistent acromioclavicular joint osteoarthritis. (10.1177/1758573219840673)
  • [L4] Removal of the distal scaphoid resulted in a DISI pattern of carpal malalignment in 12 wrists, but none showed further joint deterioration due to residual malalignment. (10.1054/jhsb.1999.0169)
  • [L4] The results show a non-pharmacological treatment gap in OA care, with most patients reporting no pain or mild pain and having not received non-pharmacological treatment prior to surgical consultation. (10.1186/s12891-019-2567-3)
  • [L5] Short-term results in children are no less favorable than in adults, and the danger of abnormal growth from rheumatoid inflammation is an indication for synovectomy, especially in children with unilateral knee involvement. (10.2106/00004623-197153040-00001)
  • [Paper] Treatment of the arthritic wrist is fascinating and challenging, requiring a diversity of treatment options due to the complex integrated system of joints, rather than a single effective treatment. (10.1016/j.hcl.2005.08.013)
  • [L4] The first metacarpal extension-abduction osteotomy alters abnormal stress distribution patterns in thumb CMC osteoarthritis, leading to a more uniform stress distribution across the joint. (10.1186/s13018-025-05813-0)
  • [L3] MRI is more reproducible in the assessment of glenoid version in osteoarthritis and provides excellent intraobserver and interobserver reliability. (10.1016/j.jse.2012.10.036)
  • [L4] The pisotriquetral joint space in osteoarthritic patient wrists was significantly narrowed compared with healthy wrists. (10.1177/1558944716677542)
  • [L4] In this series of nearly 700 consecutive cases, we identified an unexpected early reoperation rate of 1.5%, with only a 0.6% reoperation rate specifically for painful subsidence requiring a revision arthroplasty. (10.1016/j.jhsg.2019.10.003)
  • [L1] Given these effects, CT presents a promising agent for the treatment of both diseases, although the potential seems to be greater in OA. (10.1530/eor-23-0133)
  • [Paper] This article reviews the imaging of hyaline cartilage, including consideration of technique, accuracy of diagnosis, and concepts for future imaging techniques, with the knee as the prototype joint. (10.1016/j.csm.2004.08.008)
  • [L5] Additional high-level studies are warranted to evaluate long-term outcomes and durability. (10.5435/jaaos-d-17-00214)
  • [L4] Although a larger study population and a longer follow-up period are needed to draw conclusions, bone-preserving arthroplasty with APL tenodesis showed satisfying results in patients presenting with early-stage osteoarthritis. (10.1016/j.jhsg.2021.03.003)
  • [L4] The stiffening of 38 percent from a normal to an early arthritic condition was accompanied by a trabecular contiguity change from 0.7 to 0.8. (10.2106/00004623-197456020-00010)

See Also

  • Wrist Osteoarthritis

References

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