Long-term outcomes of arthroscopic radial styloidectomy for the treatment of radioscaphoid impingement, including SLAC and SNAC wrists

This study aimed to evaluate the patient-reported outcomes following arthroscopic radial styloidectomy (ARS) in patients with symptomatic radioscaphoid impingement (RSI). All arthroscopically treated patients with symptomatic RSI were retrospectively included. Arthroscopy was performed using four portals (3-4, 6 R, MC-U and MC-R) and the radial styloid was removed with a burr. Primary outcome was wrist function measured with the Patient-Rated Wrist Evaluation (PRWE) score with a minimal follow-up of two years. Secondary outcomes were Numeric Rating Scale (NRS) for pain, complications, secondary surgery, patients satisfaction and lost workdays. Seventeen RSI patients were included with a median age of 47 years: four with scapholunate advanced collapse, six with scaphoid nonunion advanced collapse, four with a healed scaphoid fracture and three with a radial styloid fracture nonunion. Follow-up assessments were performed at 22 months and 59 months. The median PRWE score was 8 and the median NRS was 0, which both showed continuous improvement until the final follow-up. Among the two complications were hypertrophic scar tissue and a septic arthritis which was treated with arthroscopic drainage and antibiotics. Four patients required secondary surgery, which included repeated ARS, open radial styloidectomy, posterior interosseous nerve neurectomy and wrist arthroplasty. Out of the 17 patients, 15 reported satisfaction with the treatment. The median number of lost workdays was eight. We conclude that ARS results in good long-term patient-reported outcomes with an acceptable risk of complications and need for secondary surgery. ARS should be considered before opting for more invasive procedures. IV therapeutic.