J Korean Soc Surg Hand.  2013 Jun;18(2):59-66. 10.12790/jkssh.2013.18.2.59.

The Short Term Results of All-inside Arthroscopic Repair of the Triangular Fibrocartilage Complex Type 1B Tear by Knotless Suture Anchor

• Park YC
• Kim MS
• Seo CY
• Kim JS
• Shin SG
• Lee JH

• KMID: 2194158
• DOI: http://doi.org/10.12790/jkssh.2013.18.2.59

Abstract

PURPOSE
We studied the short term results of the arthroscopic repair of 1B type triangular fibrocartilage complex (TFCC) tear using a knotless suture anchor.
METHODS
We evaluated 23 patients who underwent all-inside arthroscopic TFCC repair using a knotless suture anchor. The average follow-up duration was 6.6 months (range, 3-10 months). Mean duration of symptom was 10.9 months (range, 1 week-7 years). The arthroscopic finding documented 15 type 1B, 2 1B with 1D, and 6 1B with 2C lesions. All showed the positive hook test. The concomitant pathologies were 16 scapholunate injuries and 10 lunotriquetral injuries. TFCC tears were repaired by the knotless suture anchor. The Wafer procedure was done for 2C lesions.
RESULTS
According to Mayo modified wrist score, the result was excellent in 4, good in 14 and fair in 5. Nineteen patients (82.6%) could return to his job or hobby.
CONCLUSION
The all-inside arthroscopic repair using knotless suture anchor for TFCC 1B tear can provide good results. The appropriate management should be done for the concomitant pathologies for the better results.

Keyword

Triangular fibrocartilage complex 1B tear; Arthroscopic repair; Knotless suture anchor

MeSH Terms

Follow-Up Studies
Humans
Suture Anchors
Sutures
Triangular Fibrocartilage
Wrist

Figure

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  Fig. 1. Hook test. The triangular fibrocartilage complex is elevated by pulling with probe beneath.

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  Fig. 2. Mini PushLock anchor (Arthrex).

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  Fig. 3. Arthroscopic repair technique. (A) A needle loaded with thread penetrates the triangular fibrocartilage complex (TFCC) from outside. (B) After another penetration, horizontal mattress suture is made. (C) Knotless suture anchor is being inserted to the drilled bone hole. (D) After cutting the thread, the repair of TFCC is done.

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  Fig. 4. Arthroscopic scapholunate capsuloligament repair. (A) Palmar scapholunate repair. (B) Dorsal scapholunate repair.

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  Fig. 5. Forty-seven-year-old man. (A) The picture of the repair of triangular fibrocartilage complex IB tear. (B) Geissler grade 3 scapholunate injury from midcarpal viewing. (C) The K-wire fixation was performed. (D) After 1 year from operation, the clenched fist view documented the widening of scapholunate joint (arrowhead).

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