Arthroscopic all-inside repair of Palmer type 1B triangular fibrocartilage complex tears: a technical note

Abstract

Arthroscopic repair of peripheral dorso-ulnar triangular fibrocartilage complex (TFCC) lesions is now a preferred method. Both outside-in and inside-out techniques are commonly performed for repairing Palmer type 1B TFCC tear. But these techniques have disadvantages of making an additional skin incision to tie knots subcutaneously over the capsule. We performed an arthroscopic all-inside repair technique of Palmer type 1B TFCC tears, which is a modified method of the outside-in technique using a spinal needle. This all-inside technique is as simple as previously described arthroscopic techniques and also has advantages of vertical mattress suture and no additional incision. We recommend this technique as a useful alternative to the others for repairing Palmer type 1B TFCC tear.

Management of Peripheral Triangular Fibrocartilage Complex Tears in the Ulnar Positive Patient: Arthroscopic Repair Versus Ulnar Shortening Osteotomy

“…16,22,29 Although this is one viable option for repair, other techniques such as the all-inside arthroscopic technique can be used. 48,49 This might be relevant based on Yao's belief that all-inside sutures are superior due to less residual ulnar pain from subcutaneous knots when compared with other suture techniques. 50 Therefore, the results of our study comparing arthroscopic repair to USO have to be taken in perspective considering that different surgical techniques exist in the surgical treatment of TFCC tears.…”

Long-Term Outcomes of All-Arthroscopic Pre-Tied Suture Device Triangular Fibrocartilage Complex Repair

“…37 Other prior studies have demonstrated methods to pass suture through the TFCC and capsule all-arthroscopically with the knot tied intra-articularly with various cannulated passing devices. 16,[38][39][40] Millants et al reported a technique using intra-articular knots on two pieces of suture used to tether the peripheral TFCC, which was secured to the ulnar wrist capsule with a third knot tied subcutaneously in the 6U portal. They reported mean DASH scores of 15 at 4.8 years of follow-up with 46% of patients still reporting some limitation on their activities due to their wrist.…”

An update on the triangular fibrocartilage complex

“…Lee et al 15 described an all-inside repair using a 20-guage spinal needle, arthroscopic retriever, and suture material. Preliminary results of four patients at 7 month follow-up demonstrated no ulnar joint line tenderness and negative grind test.…”