Revisional triangular fibrocartilage complex (TFCC) repair using arthroscopic one-tunnel transosseous suture: preliminar
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ORTHOPAEDIC SURGERY
Revisional triangular fibrocartilage complex (TFCC) repair using arthroscopic one‑tunnel transosseous suture: preliminary results Young Woo Kwon1 · Ji Hun Park2 · In Cheul Choi3 · Joon Suk Lee3 · Jong Woong Park3 Received: 14 June 2020 / Accepted: 30 September 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose The purpose of this study was to report the clinical outcome of revision arthroscopic triangular fibrocartilage complex (TFCC) foveal repair using a one-tunnel transosseous suture technique after failed primary TFCC repair. Methods Consecutive patients treated with arthroscopic TFCC foveal repair using the uniform one-tunnel transosseous suture technique after failed TFCC repair from 2014 to 2018 were retrospectively reviewed. The clinical outcome was evaluated using the Modified Mayo Wrist Score (MMWS) and the Quick Disabilities of the Arm, Shoulder, and Hand (Quick-DASH) score. The Visual Analog Scale (VAS) for pain, stability of the distal radioulnar joint (DRUJ), grip strength, and active range of motion (ROM) of the wrist joint also were assessed. Results This study cohort consisted of eight patients, and their mean time to revision after initial surgery was 15.1 months. Previous surgeries were performed using an arthroscopy-assisted mini-open TFCC repair in six cases, an arthroscopic allinside repair in one case, and an arthroscopic transosseous suture technique in the remaining case. After revisional TFCC foveal repair, all patients demonstrated improved pain and a stable DRUJ. Participants showed improvement in grip strength and mean active wrist ROM. There was improvement in MMWS (from 58.6 to 87.5) and Quick-DASH score (from 46.9 to 12.2) during the mean follow-up of 15.6 months (range: 8–36 months). Conclusion Based on the results of this study, remaining ulnar TFCC remnants may be appropriate for sufficient stable repair using an arthroscopic one-tunnel transosseous suture technique after failed primary repair. However, only a small number of patients was examined. A larger number has to be investigated to confirm the promising preliminary results. Level of evidence Level IV, therapeutic case series. Keywords Wrist · Triangular fibrocartilage complex · Revisional surgery · Arthroscopy · Transosseous one-tunnel suture repair
Introduction The triangular fibrocartilage complex (TFCC) is a critical component of wrist biomechanics and serves important functions in both load transmission and distal radioulnar joint (DRUJ) stability. TFCC injuries that affect foveal * Jong Woong Park [email protected] 1
Department of Orthopedic Surgery, Eulji Medical Center, Seoul, Korea
2
Department of Orthopedic Surgery, Korea University, College of Medicine, Guro Hospital, Seoul, Korea
3
Department of Orthopedic Surgery, Korea University, College of Medicine, Anam Hospital, 73, Koryeodae‑ro, Sungbuk‑gu, Seoul 02841, South Korea
attachment typically result in pain, instability, and secondary osteoarthritis of the DRUJ [13]. Conventional treat
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