Arthroscopic "S"-shaped Ligamentoplasty for Floating Lunate

Area of Science:

• Orthopedic Surgery
• Wrist Biomechanics
• Arthroscopic Techniques

Background:

• Combined scapholunate (SL) and lunotriquetral (LT) ligament tears, termed "floating lunate" instability, present a significant challenge in wrist surgery.
• Existing arthroscopic treatments primarily address SL instability, leaving a gap in minimally invasive options for combined SL-LT injuries.
• Open surgical approaches for "floating lunate" instability carry risks and may necessitate prolonged recovery.

Purpose of the Study:

• To present a novel arthroscopic technique for reconstructing combined SL and LT ligament tears.
• To describe the "S"-shaped ligamentoplasty, a modified arthroscopic procedure for "floating lunate" instability.
• To evaluate the feasibility of reconstructing both major wrist ligaments arthroscopically without open joint exposure.

Main Methods:

• Development and description of a novel arthroscopic "S"-shaped ligamentoplasty technique.
• Utilizing a graft that traverses the scaphoid, lunate, and triquetrum to reconstruct both SL and LT ligaments.
• Application of the same early postoperative mobilization protocol as previously established for SL ligament reconstruction.

Main Results:

• The described "S"-shaped ligamentoplasty allows for arthroscopic reconstruction of the strongest portions of both the SL and LT ligaments.
• This technique avoids the need for open joint surgery, reducing surgical invasiveness.
• The procedure enables simultaneous repair of the "floating lunate" condition, restoring wrist stability.

Conclusions:

• The arthroscopic "S"-shaped ligamentoplasty is a viable minimally invasive option for treating combined SL and LT ligament tears.
• This technique effectively addresses "floating lunate" instability by reconstructing both critical wrist ligaments arthroscopically.
• The procedure facilitates early postoperative mobilization, potentially improving patient outcomes and recovery times.