Capitate Resurfacing Using Metal Implant Hemiarthroplasty: A Motion-Sparing Approach for Wrist Arthritis

Abstract Proximal row carpectomy (PRC) is limited when the capitate head or lunate fossa is degenerated. Resurfacing the capitate with a metallic hemiarthroplasty aims to extend PRC indications while preserving motion. Metal capitate resurfacing hemiarthroplasty provides pain relief and functional improvement for scapholunate advanced collapse (SLAC)/scaphoid nonunion advanced collapse (SNAC), Kienböck disease, and primary midcarpal arthritis, with low complication rates. A retrospective series of 16 consecutive wrists treated with metal capitate hemiarthroplasty between August 2020 and December 2022. Data included demographics, diagnosis, additional procedures, immobilization/rehabilitation, QuickDASH (pre/post), Mayo Wrist Score, ROM, grip strength, and complications; follow-up averaged 32 months. Mean age 56 years; 60% male. Indications: SNAC (n = 7), SLAC (n = 5), Kienböck (n = 2), primary midcarpal arthritis (n = 2); selected cases had adjunct procedures (partial radial styloidectomy, n = 1; interposition to scaphoid/lunate fossae using tendon or fascia lata autograft, n = 2). QuickDASH improved from 42.9 preoperative to 5.8 postoperative; mean Mayo score 92.5; mean extension 44.7 degrees (72% of contralateral wrist), flexion 47.8 degrees (67.5%), grip strength 24.7 kg (74%). One patient developed Quervain tenosynovitis, with no other reported complications. Metal capitate resurfacing hemiarthroplasty yielded substantial symptom relief and function with very low early complication rates, offering a motion-sparing alternative to fusion in midcarpal-involved arthritis. Outcomes compare favorably with the published pyrocarbon RCPI series.