SLAC Wrist Arthritis

What is SLAC Wrist Arthritis?

SLAC stands for “scapho-lunate advanced collapse." It is a painful condition of the wrist. The scaphoid and lunate are two small bones in the wrist held tightly together by a band of tissue called the scapholunate ligament. An injury to this ligament destabilizes the wrist bones, causing them to gradually develop painful arthritis over months and years. Adults commonly experience this condition, but younger people with severe wrist injuries may also develop it. When left untreated, SLAC wrist leads to severe wrist osteoarthritis, which causes pain and limits function.

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Overview

Symptoms

Causes

Most cases of SLAC wrist start with a significant wrist sprain or fracture, but occasionally no history of injury is recalled. Some cases of scapholunate ligament injury may be due to repetitive heavy loading of the wrist as seen with obesity, or inflammatory conditions of the wrist that damage the ligament.

Diagnosis

Your symptoms and medical history as well as an examination of your hand and wrist can help to diagnose SLAC wrist. X-rays can usually confirm, although sometimes we recommend an MRI or wrist arthroscopy to evaluate the scapholunate ligament and joint surfaces in early cases.

Model showing the ligament of the hand and wrist

Why treatment matters

Treatment for SLAC wrist arthritis depends largely on how advanced the arthritis is. Important considerations include age and activity level. There are many different options, and your surgeon will recommend which is best for you.

Nonoperative treatment

Activity modifications
NSAIDs
Splinting
Steroid injections

Operative treatment

Wrist arthroscopic debridement: Small camera and instruments in the wrist clean out damaged tissues
Partial wrist denervation: Surgically snip the nerve endings in the arthritic wrist that sense pain
Proximal row carpectomy: Remove the arthritic bones of the wrist, but the wrist is not fused
Wrist fusion: Remove the arthritis and fuse the wrist bones together (wrist no longer moves with the goal of reducing pain)

A man's hand and wrist in a wrist brace.

Take the next step

Our board-certified specialists are here to help you heal. They can often diagnose the problem in one visit and get you started with a personalized treatment plan. We offer a wide variety of treatment options.