Mechanical and Structural Alterations after Surgical Treatment of Wrist Osteoarthritis

Wrist osteoarthritis (OA) is one of the most common conditions encountered by hand surgeons. There is no cure to OA. In severe cases, surgical treatment, such as proximal row carpectomy or four corner arthrodesis is performed to reduce pain and to improve mobility; yet, with varying success rates and controversy exists on which procedure is the optimal one. It is hypothesized that patient-specific differences in bone microstructure play a crucial role, such that optimal treatment in one patient may mean overcorrection in others. The aim of this project is to obtain an improved understanding on (i) the alterations in bone microstructure following surgery and on (ii) how these structural alterations are related to alterations in bone loading. Specifically, bone microstructure in patients with wrist OA will be measured using cone-beam CT and the alterations occurring within two years following surgical treatment will be monitored. Reverse engineering and the finite element method will be used to quantify the alterations in mechanical load following treatment. These data are highly needed to improve treatment planning of wrist osteoarthritis.