Implant or Reconstruction? Imaging, Artificial Intelligence and Decision-Making in Hand and Wrist Surgery

Dear Colleagues,

Degenerative and post-traumatic disease of the thumb base and wrist can be managed either through joint replacement or reconstructive procedures that preserve, redistribute or sacrifice motion. Both strategies continue to evolve—through dual-mobility and metal-on-metal implants, bioresorbable interposition scaffolds, tendon suspension techniques and low-profile fixation systems—yet head-to-head comparative evidence remains fragmented, single-centre and predominantly short-term. Surgical decision-making, therefore, still largely rests on individual experience, rather than quantifiable predictors.

This Topic invites original clinical series, comparative and registry studies, Systematic Reviews, and biomechanical or imaging work that addresses the choice between implant arthroplasty and reconstructive alternatives in the hand and wrist, with emphasis on implant survivorship, revision burden, patient-reported outcomes and criteria for patient selection.

Alongside clinical comparisons, the Topic welcomes work in which imaging is used quantitatively rather than descriptively: radiomic and texture analysis of the bone–implant interface; automated measurement of component position and migration; machine learning models that predict loosening, revision or functional outcome; and studies that assess the reliability and generalisability of such models across centres. Contributions addressing methodological quality, reporting standards and clinical readiness of AI tools in small-joint surgery are equally encouraged.

Dr. Rafał Obuchowicz
Dr. Wojciech Glinkowski
Topic Editors