Outcome in TFCC repair using micro anchor and trans‑osseous technique

Area of Science:

• Orthopedic Surgery
• Hand and Wrist Surgery
• Sports Medicine

Background:

• The triangular fibrocartilage complex (TFCC) stabilizes the distal radioulnar joint (DRUJ), crucial for wrist movement and grip strength.
• TFCC tears are a common cause of ulnar-sided wrist pain, leading to decreased grip strength and function.
• Palmer classification categorizes TFCC tears into traumatic (Type 1) and degenerative (Type 2).

Purpose of the Study:

• To compare the clinical outcomes of open TFCC repair using micro suture anchors versus trans-osseous techniques.
• To evaluate the effectiveness of these surgical methods in restoring DRUJ stability and alleviating ulnar-sided wrist pain.
• To assess improvements in grip strength, range of motion, and patient-reported scores (DASH, MMWS) post-operatively.

Main Methods:

• A prospective study involving 51 patients with TFCC tears undergoing open repair between July 2017 and July 2020.
• Patients were divided into two groups: micro suture anchor repair (38 patients) and trans-osseous repair (13 patients).
• Clinical outcomes were assessed using the Disability of the Arm, Shoulder and Hand (DASH) score and Modified Mayo Wrist Score (MMWS) pre- and post-operatively, along with grip strength and DRUJ stability evaluations.

Main Results:

• Both micro suture anchor and trans-osseous TFCC repair techniques resulted in significant improvements in pain, range of motion, and grip strength at 6-48 months follow-up.
• Forty-five patients became pain-free with improved grip strength; six experienced decreased pain and improved grip strength.
• MMWS improved from 70% to 90% with suture anchors and 65% to 85% with trans-osseous repair. DASH scores improved from 70% to 15% and 60% to 15%, respectively.

Conclusions:

• Open repair of TFCC tears using either micro suture anchors or trans-osseous techniques leads to significant improvements in wrist function.
• Both methods achieve pain-free motion, enhanced grip strength, and stable DRUJ, with comparable clinical outcomes.
• No significant differences in clinical outcomes were observed between the micro suture anchor and trans-osseous TFCC repair techniques.