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Knee Joint

Knee Joint

The knee joint is the most complicated joint in the body. It consists of three articulations– two tibiofemoral and one patellofemoral. As is characteristic of synovial joints, the knee joint has a thin articular capsule that partially surrounds this joint cavity. Additionally, several ligaments, muscles, and cartilaginous structures support the movement of the knee.
A total of seven ligaments support the knee joint. The patellar ligament, which is also attached to the quadriceps femoris...

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Arthroscopic Capsular Repair for Triangular Fibrocartilage Complex Tears.

Takehiko Takagi¹, Toshiyasu Nakamura², Masatoshi Fukuoka³

¹Department of Surgical Specialties, Division of Orthopaedic Surgery, National Center for Child Health and Development, Tokyo, Japan.

Journal of Wrist Surgery

|June 10, 2021

Summary

Arthroscopic outside-in repair of triangular fibrocartilage complex (TFCC) tears shows excellent outcomes for peripheral detachments. Best results were seen in patients with less than 15 months of symptoms and no severe distal radioulnar joint instability.

Keywords:

capsular repair technique peripheral tear triangular fibrocartilage complex

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Area of Science:

Orthopedic Surgery
Sports Medicine
Hand and Wrist Surgery

Background:

Triangular fibrocartilage complex (TFCC) lesions are a common cause of ulnar wrist pain after injury.
Ulnar wrist pain often results from impact and loading injuries affecting the TFCC.

Purpose of the Study:

To evaluate clinical outcomes of TFCC lesion repair using the arthroscopic outside-in technique.
To assess the efficacy of the arthroscopic outside-in technique for TFCC tears.

Main Methods:

Arthroscopic capsular repair was performed on 21 wrists.
The outside-in technique involved percutaneous sutures with a 21-gauge needle and 4-0 nylon loops.
Postoperative evaluation included pain relief, forearm rotation, and distal radioulnar joint (DRUJ) stability assessments.

Main Results:

Ten wrists had simple ulnar avulsion (Palmer 1B, Atzei Class 1).
Five wrists had combined 1B tears with horizontal TFCC tears.
Six wrists had dorsal TFCC avulsion, including complete detachment.
Significantly better outcomes were observed in patients with preoperative periods of 15 months or less.

Conclusions:

The arthroscopic outside-in TFCC repair technique yields excellent clinical results for peripheral TFC detachments.
Optimal outcomes are associated with cases lacking severe DRUJ instability and with symptom duration under 15 months.