Results of the Knotless Arthroscopic Foveal Anchorage of the Triangular Fibrocartilage Complex in Atzei 2/3 Lesions
Abstract
Objective: To retrospectively evaluate the functional and objective outcomes in patients with foveal lesions of the triangular fibrocartilage complex treated with arthroscopic knotless bone anchors. Materials and Methods: We retrospectively evaluated 12 patients with Atzei 2/3 foveal lesions of the triangular fibrocartilage complex with an average follow-up of 18 months. All the lesions were repaired arthroscopically using a fibrocartilage guide and knotless bone anchors. The ranges of motion and grip strength were assessed with the Mayo Clinic wrist scale and the DASH questionnaire. Results: Improvements were obtained in the pain and strength test; the average range of motion was 70° in extension, 85° in flexion, 20° in radial deviation, and 30° in ulnar deviation. The outcomes according to the Mayo Clinic wrist scale were excellent in 83% of the cases and good in 17%; there were no poor outcomes. The average DASH score was 56 preoperatively and 8 postoperatively. The average contralateral comparative strength was 70%. Conclusion: The arthroscopic repair of Atzei 2/3 lesions with knotless bone anchors achieves good outcomes,improves ranges of motion, and restores stability and total or partial strength in all cases.Downloads
References
Atzei A, Luchetti R, Braidotti F. Arthroscopic foveal repair of the triangular fibrocartilage complex. J Wrist Surg
;4:22-30. https://doi.org/10.1055/s-0035-1544226
Trehan SK, Wall LB, Calfee RP, Shen TS, Dy CJ, Yannascoli SM, et al. Arthroscopic diagnosis of the triangular
fibrocartilage complex foveal tear: a cadaver assessment. J Hand Surg Am 2018;43(7):680.e1-680.e5.
https://doi.org/10.1016/j.jhsa.2017.12.017
Ma CH, Lin TS, Wu CH, Li DY, Yang SC, Tu YK. Biomechanical comparison of open and arthroscopic transosseous repair of triangular fibrocartilage complex foveal tears: a cadaveric study. Arthroscopy 2017;33(2):297-304. https://doi.org/10.1016/j.arthro.2016.10.027
Hong Li, Yujie Zhao, Yinghui Hua, Qianru Li, Hongyun Li, Shiyi Chen. Knotless anchor repair produced similar
favourable outcomes as knot anchor repair for anterior talofibular ligament repair. Knee Surg Sports Traumatol
Arthosc 2020;28(12):3987-93. https://doi.org/10.1007/s00167-020-05998-3
Lacheta L, Dekker TJ, Anderson N, Goldenberg B, Millett PJ. Arthroscopic knotless, tensionable all-suture anchor Bankart repair. Arthrosc Technic 2019;8(6):e647-e653. https://doi.org/10.1016/j.eats.2019.02.010
Palmer AK. Triangular fibrocartilage complex lesions: a classification. Hand Surg Am1989;14(4):594-606.
https://doi.org/10.1016/0363-5023(89)90174-3
Shinohara T, Tatebe M, Okui N, Yamamoto M, Kurimoto S, Hirata H. Arthroscopically assisted repair of triangular fibrocartilage complex foveal tears. J Hand Surg Am 2013;38(2):271-7. https://doi.org/10.1016/j.hsa.2012.11.008
Jung HS, Song KS, Jung HS, Yoon BI, Lee JS, Park MJ. Clinical outcomes and factors influencing these outcome
measures resulting in success after arthroscopic transosseous triangular fibrocartilage complex foveal repair.
Arthroscopy 2019;35(8):2322-30. https://doi.org/10.1016/j.arthro.2019.03.060
Park JH, Kim D, Park JW. Arthroscopic one-tunnel transosseous foveal repair for triangular fibrocartilage complex (TFCC) peripheral tear. Arch Orthop Trauma Surg 2018;138(1):131-8. https://doi.org/10.1007/s00402-017-2835-3
Geissler WB. Management of scapholunate instability. En: Geissler WB (ed). Wrist arthroscopy. New York:
Springer; 2005:86-93.
De Smet L. The DASH questionnaire and score in the evaluation of hand and wrist disorders. Acta Orthop Belg 2008;74(5):575-81. PMID: 19058688
Cáceres-Palou E, López-Prats F, Mesa-Ramos M, et al. Valoración de resultados en Cirugía Ortopédica y
Traumatología. Rev Esp Cir Ortop Traumatol 2005;49(S1):119-42. Disponible en: https://www.elsevier.es/enrevista-revista-espanola-cirugia-ortopedica-traumatologia-129-articulo-valoracion-resultados-cirugia-ortopedicatraumatologia-X1888441505011090
DaSilva MF, Goodman AD, Gil JA, Akelman EJ. Evaluation of ulnar-sided wrist pain. Am Acad Orthop Surg
;25(8):e150-e156. https://doi.org/10.5435/JAAOS-D-16-00407
Matsumoto T, Tang P, Fujio K, Strauch RJ, Rosenwasser MP. The optimal suture placement and bone tunnels for TFCC repair: a cadaveric study. J Wrist Surg 2018;7(5):375-81. https://doi.org/10.1055/s-0038-1661361
Chen WJ. Arthroscopically assisted transosseous foveal repair of triangular fibrocartilage complex. Arthrosc Tech 2017;6(1):e57-e64. https://doi.org/10.1016/j.eats.2016.09.004
Manuscript acceptance by the Journal implies the simultaneous non-submission to any other journal or publishing house. The RAAOT is under the Licencia Creative Commnos Atribución-NoComercial-Compartir Obras Derivadas Igual 4.0 Internacional (CC-BY-NC.SA 4.0) (http://creativecommons.org/licences/by-nc-sa/4.0/deed.es). Articles can be shared, copied, distributed, modified, altered, transformed into a derivative work, executed and publicly communicated, provided a) the authors and the original publication (Journal, Publisher and URL) are mentioned, b) they are not used for commercial purposes, c) the same terms of the license are maintained.
In the event that the manuscript is approved for its next publication, the authors retain the copyright and will assign to the journal the rights of publication, edition, reproduction, distribution, exhibition and communication at a national and international level in the different databases. data, repositories and portals.
It is hereby stated that the mentioned manuscript has not been published and that it is not being printed in any other national or foreign journal.
The authors hereby accept the necessary modifications, suggested by the reviewers, in order to adapt the manuscript to the style and publication rules of this Journal.
