Purpose
To biomechanically compare the stability between open repair and arthroscopic transosseous
repair technique for reattachment of the foveal triangular fibrocartilage complex
(TFCC). We also evaluated the feasibility of a new aiming device for the creation
of 2 bone tunnels simultaneously during the arthroscopic technique.
Methods
Six matched pairs of fresh-frozen forearm cadaver specimens were prepared for testing.
Group I specimens were treated by open repair with suture anchor. Group II specimens
were treated by arthroscopic transosseous suture with a new aiming device. Before
and after disruption of the TFCC fovea and after its repair, dorsal and palmar translation
of the ulna was measured in both groups in response to a load (3 kg) applied in the
palmar and then in the dorsal direction. The total translation of the ulna was calculated
as the sum of the mean dorsal and palmar translations.
Results
The mean total ulnar translation before and after TFCC disruption, and after TFCC
repair was 5.94 ± 2.16 mm, 9.08 ± 2.64 mm, and 6.04 ± 2.18 mm, respectively. The specimens
demonstrated a significant increase in the total translation of the ulna after disruption
of the ulnar attachment of TFCC (P = .003), whereas a significant decrease was observed after TFCC foveal repair (P = .003). The median percentage of eliminated translation after TFCC repair was 64%
and 172%, respectively, in groups I and II (P = .043).
Conclusions
The athroscopic transosseous suture technique demonstrated superior repair efficacy
to the open repair technique in terms of biomechanical strength. This cadaveric study
also demonstrated the feasibility of a new aiming device.
Clinical Relevance
When making decisions about TFCC foveal repair, arthroscopic transosseous suture technique
may provide better biomechanical strength than the open repair technique.
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Article Info
Publication History
Published online: December 26, 2016
Accepted:
October 26,
2016
Received:
April 14,
2016
Footnotes
The authors report the following potential conflicts of interest or sources of funding: The Ministry of Science and Technology (MOST 103-2320-B-650-003; MOST 104-2221-E-650-002) and E-Da Hospital (EDPJ103059; EDPJ1040553) provided grants.
Identification
Copyright
© 2016 by the Arthroscopy Association of North America
ScienceDirect
Access this article on ScienceDirectLinked Article
- Regarding “Biomechanical Comparison of Open and Arthroscopic Transosseous Repair of Triangular Fibrocartilage Complex Foveal Tears: A Cadaveric Study”ArthroscopyVol. 33Issue 5
- PreviewIt was with great interest that we read the article “Biomechanical Comparison of Open And Arthroscopic Transosseous Repair of Triangular Fibrocartilage Complex Foveal Tears: A Cadaveric Study” by Ma et al.1 Instability of the distal radioulnar joint is an extremely relevant pathology and, unfortunately, is often difficult to detect clinically. Therefore, it is important to conduct studies concerning the distal radioulnar joint. In this context we thank the authors for their contributions.
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