Chondrocalcinosis may reach simultaneously or successively several joints in the hand and the wrist. There is still no causal therapy to stop the development of this disease. When conservative treatment is no longer efficient, surgery must be considered and it may be useful to treat every symptomatic joint in the same procedure. But the surgical program should also be as conservative as possible without jeopardizing further procedure that may be needed when nearby joints are affected by the condition with time.

Eight patients (three dominant and 5 non-dominant sides, mean age 66.3A2.3 years) were operated on from 2010 to 2013 by the same surgeon and retrospectively reviewed by a neutral observer (range of follow-up – 6–36 months). Five patients (group 1, mean age 64.8A3.5 years) had a combined STT arthropathy (1 stage II, 4 stages III according to Crosby's classification) and TM (4 stages II, 1 stage IV according to Dell's classification), and three (group 2, mean age 68.7A1.4 years) had a combined arthropathy of the wrist (2 SCAC II, 1 SCAC III according to Romano's classification) and TM (1 stage II, 1 stage III, 1 stage IV according to Dell). All patients had disabling pain in spite of medical treatment. The procedure consisted of: group 1 (STT+TM): an interposition arthroplasty with a pyrocarbon implant (Pyrocardan y) for STT joint and TM prosthesis (Maia y): group 2 (SCAC wrist+TM): a four-bone fusion using the Watson's technique and TM prosthesis (Maia y). Objective clinical parameters and subjective (VAS, Quick-DASH, PRWE) were analyzed as well as X-rays. The nonparametric Wilcoxon test was used (alpha=0.05).

There was not any complication (especially no CRPS). In the two groups, ROM, grip and key-pinch strengths were preserved. The average Quick-DASH was respectively 18.18A2.3 100 in group 1 and 21.97A11.3 100 in group 2. The average PRWE was 19.75A3.8 100 in group 1 and 14 A 5.2 100 in group 2. The improvement for pain was significant. All implants were in place without any problem of integration and all fusions were achieved. All patients recommended the procedure.

Same time surgery avoids repeated procedures with several anaesthesias and several recoveries. Even trapeziectomy is still the gold standard for peritrapezial arthritis, its sustainability in uncertain as chondrocalcinosis may also affects the SL ligament and Watson's four bone fusion would not be possible anymore. Our strategy is based on the preservation of the trapezium as the integrity of the second row of carpal bones to allow further surgical procedure in case of extension of this disease.