Can Scapholunate Dissociation Lead to Arthritis in The Wrist?

The wrist is a complex and finely tuned joint made up of eight small bones that work together to provide strength and flexibility. Two of these bones, the scaphoid and the lunate, are connected by the scapholunate ligament, which helps keep the wrist stable.

When this ligament is stretched or torn, often because of an injury, the smooth movement between the bones is disrupted. This condition is called scapholunate dissociation. Let’s discuss whether scapholunate dissociation can lead to arthritis in the wrist.

How Scapholunate Dissociation Can Cause Wrist Arthritis?

Scapholunate dissociation changes how the wrist works because the ligament between the scaphoid and lunate bones is torn or damaged. This injury causes the two bones to move abnormally and become unstable.

If a bad tear isn’t treated, many patients develop Scapholunate Advanced Collapse or SLAC wrist arthritis. It usually starts near the radial styloid, then involves the whole radioscaphoid joint, then the capitolunate joint. The joint between the radius and lunate often stays healthy until late. Some doctors describe a later Stage IV when wear reaches most of the wrist.

The development of arthritis in the wrist happens in stages:

• Stage 1: Arthritis starts at the radial styloid (a small part of the wrist bone)
• Stage 2: The damage spreads to the entire radioscaphoid joint
• Stage 3: Wear reaches the capitolunate joint (where the capitate meets the lunate)

Treatment Options to Lower Arthritis Risk and Protect the Wrist

Getting timely and proper treatment helps in protecting the wrist and lowering the risk of developing arthritis after a scapholunate ligament injury. Some common treatment options include:

Non-Surgical Treatments

In mild cases, non-surgical options can help relieve symptoms and stabilize the wrist. Braces, activity changes, medicines and injections can ease pain and swelling and protect the wrist. They don’t “fix” a fully torn ligament or make the wrist completely stable. They’re best for symptom control or partial/low-grade injuries.

Physical therapy focuses on gentle exercises to restore movement and strengthen surrounding muscles while protecting the injured ligament.

Pain relief methods, such as medications and ice packs, can help reduce swelling and discomfort. While these treatments ease symptoms and improve stability, they usually can’t fully repair a torn ligament.

Surgical Repair

Surgery is recommended when the ligament is severely damaged or when non-surgical care isn’t enough. The goal is to repair or reconstruct the torn ligament and realign the wrist bones.

If the torn ligament can’t be stitched back together, surgeons often reconstruct the ligament using a strip of your own tendon to help hold the wrist bones in better position (for example, the modified Brunelli/‘three-ligament’ tenodesis).

If arthritis has already developed, there are surgeries that can reduce pain while keeping some wrist movement. These include removing a few small wrist bones (proximal row carpectomy) or fusing certain wrist bones together (four-corner fusion) to improve comfort and function.

Both surgeries usually reduce pain and keep useful motion. Most people keep about half to two-thirds of normal wrist bend and roughly two-thirds to three-quarters of grip strength compared to the other side.

Even after successful surgery, the wrist won’t be perfect. Expect improved pain and function, but some limits in motion and strength compared to a healthy wrist.

Rehabilitation and Long-Term Care

After treatment, physical therapy is recommended to rebuild strength, flexibility, and proper movement. Regular follow-up visits help track healing and adjust the recovery plan as needed.

Long-term care includes protecting the wrist from new injuries and maintaining overall joint health through proper exercises and good wrist habits.

Key Takeaways

Understanding how scapholunate dissociation can lead to arthritis is important for keeping your wrist healthy. Getting your wrist checked soon after an injury helps doctors find the problem early and start treatment before it gets worse.

Consult a board-certified orthopedic surgeon at Randy Y. Luo, MD, MBA, for wrist injuries. Call us today to book an appointment.