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Seven patients with chronic scapholunate instability (Geissler grade 2-4) were treated by percutaneous placement of screws across the scapholunate joint after arthroscopic debridement of the remnants of the scapholunate ligament. In all seven cases, the screw caused partial destruction of the lunate and/or scaphoid requiring screw removal within 6 months. We no longer perform this procedure.

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Intraosseous ganglion cysts are rare causes of wrist pain. Surgical treatment of this pathologic condition yields good results and a low recurrence rate. The main complications are joint stiffness and vascular disturbances of the lunate bone. Wrist arthroscopy is a surgical technique that reduces the intra-articular operative area and therefore minimizes postoperative stiffness. This article describes an arthroscopic technique used for lunate intraosseous cyst resection associated with an autologous bone graft in a series of cases to prevent joint stiffness while respecting the scapholunate ligament. This study was based on a series of 4 patients, all of whom had wrist pain because of intraosseous ganglion cysts. Arthrosynovial cyst resection, ganglion curettage, and bone grafting were performed arthroscopically. Pain had totally disappeared within 2 months after the operation in 100% of patients. The average hand grip strength was estimated at 100% compared with the opposite side, and articular ranges of motion were the same on both sides in 100% of cases. No complications were reported after surgery. On the basis of these results, arthroscopic treatment of intraosseous synovial ganglion cysts seems to be more efficient and helpful in overcoming the limitations of classic open surgery in terms of complications.W rist intraosseous ganglion cysts are rare tumors in adults, and they are asymptomatic and idiopathic most of the time; however, but they represent one of the few causes of wrist pain.1 Classic cases include lytic bone tumors found through radiologic diagnosis, with a scapholunate ligament origin. Diagnoses of symptomatic cystic lesions of the lunate bone (Kienböck disease, trauma, scaphoid pseudarthrosis) must be eliminated before stating that the wrist pain is due to an intraosseous bone ganglion cyst.Surgical treatment of this pathologic condition yields good results and a low recurrence rate. Wrist arthroscopy is a recent, up-and-coming surgical technique, usually performed with the patient under local or regional anesthesia and performed either with saline irrigation or as a dry procedure. The wrist arthroscopy setup includes a small fiberoptic camera with a diameter of 2.4 or 2.7 mm, a shaver without a suction pump and with or without an electrocautery, and basic arthroscopy instruments (palpation rod, basket forceps). There are more and more wrist arthroscopy indications, including scapholunate ligament repair, treatment of fractures of the distal radius, intercarpal arthrodesis, and intra-articular cyst resection, but the use of wrist arthroscopy in such cases needs to be qualified. The main advantage of this technique is that it reduces the intra-articular operative area and therefore minimizes postoperative joint stiffness. However, it is a difficult technique with a significant learning process.This article describes an arthroscopic technique used for lunate intraosseous cyst resection associated with an autologous bone graft in a series of cases to prevent joint stiffness while res...