Arthroscopic assisted tendon reconstruction for triangular fibrocartilage complex irreparable tears

Area of Science:

• Orthopedic Surgery
• Hand and Wrist Surgery
• Sports Medicine

Background:

• Chronic distal radio-ulnar joint (DRUJ) instability often results from irreparable triangular fibrocartilage complex (TFCC) injuries.
• Surgical reconstruction is a treatment option for persistent DRUJ instability when conservative methods fail.

Purpose of the Study:

• To evaluate the 11-year experience with arthroscopically assisted TFCC reconstruction for chronic DRUJ instability.
• To assess the safety, efficacy, and patient outcomes of this minimally invasive technique.

Main Methods:

• Eleven patients with irreparable TFCC injuries underwent arthroscopically assisted TFCC reconstruction.
• A tendon graft was used to reconstruct the dorsal and palmar radio-ulnar ligaments via radial and ulna tunnels.
• Procedures were guided by fluoroscopy and arthroscopy.

Main Results:

• At a mean follow-up of 68 months, 10 out of 11 patients achieved a stable DRUJ.
• Significant improvements were observed in pain, grip strength, Mayo wrist score, DASH, and PRWHE scores.
• Forearm rotation range remained largely unchanged, with some complications noted.

Conclusions:

• Arthroscopically assisted TFCC reconstruction is a safe and effective treatment for chronic DRUJ instability due to irreparable TFCC tears.
• The outcomes are comparable to traditional open surgical techniques.
• This approach offers a viable minimally invasive option for TFCC reconstruction.