Open versus arthroscopic repair of the triangular fibrocartilage complex: a systematic review

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Hand Surgery

Background:

• Triangular fibrocartilage complex (TFCC) injuries are common wrist ailments.
• Surgical repair aims to restore wrist stability and function.
• Both open and arthroscopic techniques are utilized for TFCC repair.

Purpose of the Study:

• To systematically review and compare the outcomes of open versus arthroscopic repair for TFCC injuries.
• To evaluate the effectiveness of each surgical approach regarding joint stability, range of motion, and functional recovery.

Main Methods:

• A comprehensive literature search was conducted across major databases (PubMed, Embase, Cochrane Library) from 1985 to 2017.
• Studies comparing open and arthroscopic TFCC repair with over one year follow-up were included.
• Risk of bias assessment and data extraction followed PRISMA guidelines, focusing on DRUJ re-instability, ROM, grip strength, and functional scores.

Main Results:

• Only two studies met the inclusion criteria, both exhibiting risks of bias.
• No significant differences were found in distal radioulnar joint (DRUJ) re-instability between open and arthroscopic TFCC repair.
• Functional outcomes, including range of motion and grip strength, were comparable, with one study favoring arthroscopic surgery based on DASH scores.

Conclusions:

• Current evidence suggests comparable clinical outcomes between open and arthroscopic TFCC repair regarding DRUJ re-instability and functional scores.
• There is a lack of high-quality comparative studies, making it difficult to recommend one surgical technique over the other.
• Further research with robust methodologies is needed to guide clinical practice for TFCC injuries.