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Revision Rates Following Scapholunate Ligament Repair and Reconstruction: A Multi-Institutional Database Study and
Matthew V Abola1, Billy I Kim1, Troy B Amen1
1Department of Hand and Upper Extremity, Hospital for Special Surgery, New York, New York, United States.
Purpose:
Scapholunate (SL) ligament tears represent a significant challenge in hand surgery, with implications for wrist stability, function, and the prevention of arthritis. Despite various SL ligament repair and reconstructive techniques, there is a lack of consensus on the overall revision rate. The following study was undertaken to identify revision rates following SL repair or reconstruction utilizing a multi-institutional database with long-term follow-up (greater than 5 years).
Materials And Methods:
This study utilized the PearlDiver Mariner 161 Database. Patients who had undergone SL repair with a diagnosis of SL ligament tear prior to or on the same day of surgery were identified using Current Procedural Terminology (CPT) and International Classification of Diseases (ICD-9 and ICD-10) codes. There were 1,320 patients identified, of which 1,228 patients had a minimum active period of 90 days after surgery and were included in the study.
Results:
Out of 1,228 patients, 110 (9.0%) patients underwent any secondary procedure after their index surgery. The most common secondary procedure was revision SL ligament repair/reconstruction ( n = 48, 3.9%), followed by proximal row carpectomy (PRC; n = 29, 2.4%), and partial wrist arthrodesis ( n = 22, 1.8%). About 54 (4.4%) patients underwent secondary salvage procedures (PRC, partial and complete wrist fusions) after their index surgery. Additionally, review of revision rates reported in the current literature ranged from 2% to 20% when evaluating reoperations following repair or reconstruction of the SL ligament.
Conclusion:
In this large multi-institutional database study, the revision rate following SL ligament repair or reconstruction to a secondary salvage procedure was 4.4%. Despite several different reconstruction and repair methods for the SL ligament, there is a relatively low revision rate reported in our multi-institutional database study.
Clinical Relevance:
This study was undertaken to identify revision rates following SL repair/reconstruction, which helps evaluate the long-term success of these procedures.