Arthroscopic Midcarpal Tendon Interposition: A New Technique for Capitolunate Constraints

Area of Science:

• Orthopedic Surgery
• Hand Surgery
• Arthroscopy

Background:

• Capitolunate conflicts cause midcarpal pain via friction, stemming from conditions like avascular necrosis of the capitate (AVNC) or midcarpal instability (PMCI).
• These issues can also be part of broader osteoarthritis, including scaphoid pseudarthrosis (SNAC) or scapholunate ligament lesions (SLAC).
• Current treatments like capitolunar arthrodesis lead to stiffness, while other methods show variable results.

Purpose of the Study:

• To present a conservative arthroscopic management technique for capitolunate conflicts.
• To describe the arthroscopic midcarpal tendon interposition (AMTI) procedure.
• To offer an alternative to arthrodesis that preserves wrist motion.

Main Methods:

• Development and description of the arthroscopic midcarpal tendon interposition (AMTI) technique.
• Focus on conservative management of capitolunate friction-related midcarpal pain.
• Utilizing tendon interposition within the capitolunate joint via arthroscopy.

Main Results:

• The proposed AMTI technique aims to alleviate midcarpal pain caused by capitolunate conflicts.
• This arthroscopic approach avoids the joint stiffness typically resulting from capitolunar arthrodesis.
• Successful implementation requires significant wrist arthroscopy expertise.

Conclusions:

• Arthroscopic midcarpal tendon interposition (AMTI) offers a motion-preserving alternative for treating capitolunate conflicts.
• This technique addresses midcarpal pain without the functional limitations of fusion.
• Further clinical evaluation may be warranted, emphasizing the need for surgical skill.