Capsulodesis

**Capsulodesis** is a surgical procedure that involves tightening or reinforcing the joint
capsule, which is the fibrous tissue surrounding a joint, to stabilize it. This procedure is often
used in the treatment of joint instability, particularly in the wrist, where it helps to restore proper
alignment and function to a joint that has become unstable due to injury or laxity in the
supporting ligaments.
### **Common Uses of Capsulodesis:**
1. **Scapholunate Instability:**
- One of the most common indications for capsulodesis is scapholunate instability, a condition
where the ligament connecting the scaphoid and lunate bones in the wrist is damaged or torn.
This can lead to abnormal movement between these bones, resulting in pain, weakness, and
eventually arthritis if left untreated.
- **Procedure:** In cases of scapholunate instability, a capsulodesis procedure might involve
using a portion of the joint capsule or a tendon graft to reinforce the damaged area, thereby
stabilizing the scapholunate joint.
2. **Lunotriquetral Instability:**
- Capsulodesis can also be used for lunotriquetral instability, which is another form of carpal
instability in the wrist where the ligament between the lunate and triquetrum bones is
compromised.
- **Procedure:** Similar to the scapholunate capsulodesis, this surgery aims to stabilize the
lunotriquetral joint by reinforcing the joint capsule or using a tendon graft.
3. **Thumb Carpometacarpal (CMC) Joint Instability:**

- Capsulodesis can be applied to stabilize the thumb’s carpometacarpal joint, particularly in
cases of ligament injuries or degenerative changes that have caused joint instability.
### **Types of Capsulodesis Procedures:**
1. **Dorsal Capsulodesis:**
- This approach involves tightening the dorsal (back) aspect of the joint capsule. It is
commonly used in the wrist to stabilize the scapholunate joint.
- **Brunelli Procedure:** A specific type of dorsal capsulodesis where a tendon, often the
flexor carpi radialis (FCR), is rerouted to support and stabilize the scapholunate joint.
2. **Volar Capsulodesis:**
- Involves tightening the volar (palm) aspect of the joint capsule. This may be used in cases
where anterior (palm-side) instability is present, such as in certain forms of thumb CMC joint
instability.
### **Procedure Overview:**
- **Incision:** The surgeon makes an incision over the affected joint to access the capsule and
surrounding structures.
- **Tissue Manipulation:** The joint capsule is either tightened or reinforced using sutures, a
tendon graft, or a portion of the patient’s own joint capsule. In some cases, a tendon from
elsewhere in the body may be used to add strength to the capsule.
- **Stabilization:** The goal is to restore stability to the joint, allowing for proper movement
and function while preventing abnormal motion that could lead to further damage.
- **Closure and Recovery:** The incision is closed, and the patient is typically placed in a splint
or cast to immobilize the joint during the initial healing phase.
### **Recovery and Rehabilitation:**
- **Immobilization:** After surgery, the joint is often immobilized in a cast or splint for several
weeks to allow the repaired tissues to heal properly.
- **Physical Therapy:** Once the initial healing period is complete, physical therapy is usually
recommended to restore range of motion, strength, and function to the joint.
- **Full Recovery:** Full recovery can take several months, depending on the extent of the
procedure and the joint involved.
### **Complications and Risks:**
- **Infection:** As with any surgical procedure, there is a risk of infection.
- **Stiffness:** There may be some loss of motion or stiffness in the joint post-surgery,
particularly if immobilization is prolonged.
- **Failure of the Procedure:** In some cases, the capsulodesis may not fully restore stability, or
the joint may become unstable again over time.
### **Conclusion:**
Capsulodesis is a valuable surgical technique for treating joint instability, particularly in the
wrist. It aims to restore stability to the affected joint, thereby reducing pain and improving
function. The specific approach and type of capsulodesis depend on the joint involved and the
nature of the instability. Proper postoperative care and rehabilitation are crucial for achieving the
best outcomes.

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Capsulodesis is a surgical procedure that involves tightening or reinforcing the joint

### Common Uses of Capsulodesis:

3. Thumb Carpometacarpal (CMC) Joint Instability:

### Types of Capsulodesis Procedures:

### Procedure Overview:

### Recovery and Rehabilitation:

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