Episode 17: Managing DRUJ Arthritis from Sauvé-Kapandji to Total Joint Replacement with Marc Richard, MD

In this episode of the ASSH Handthology Podcast, host Sanjeev Kakar, MD, is joined by Mark Richard, MD, of Duke University, to continue their discussion on the surgical management of distal radioulnar joint (DRUJ) arthritis. Dr. Richard shares his technical pearls for the Sauvé-Kapandji procedure across both inflammatory and post-traumatic arthritis patients, including resection sizing, fixation technique, and strategies for preventing bony regrowth and stump instability.The conversation covers his stepwise approach to higher-demand patients with primary DRUJ osteoarthritis, including ulna shortening osteotomy, the Bowers hemi-resection interposition, and interposition arthroplasty. Dr. Kakar also discusses the Calamari procedure and the evolution toward meniscal allograft interposition.The episode closes with a nuanced discussion on constrained total DRUJ prostheses — including key technical pearls for radial component placement — and management of proximal stump instability using the Sateriano interposition allograft technique.The ASSH Handthology Podcast is a curated podcast for physicians and health care providers interested in hand surgery. Each episode will cover key topics related to the field of hand surgery including surgical techniques and treatment options, non-surgical treatment techniques and options, different hand, wrist, shoulder, and upper extremity conditions, and more.Learn more about Handthology, your go-to resource for comprehensive knowledge on hand, wrist, shoulder, and upper extremity surgery, by the ASSH: https://handthology.assh.org/Listen to other Handthology Podcast episodes: https://www.assh.org/hande/s/handthology-podcastLearn more about the American Society for Surgery of the Hand (ASSH): https://www.assh.org/s/