Arthroscopically assisted repair of triangular fibrocartilage complex foveal tear using modified “double loop suture” – a retrospective cohort study

Abstract

Background The triangular fibrocartilage complex (TFCC) plays an important role in the distal radioulnar joint (DRUJ)stabilization, and is frequently torn. Especially when conservative treatment fails, surgical treatment is required. Methods Fourteen individuals with TFCC foveal tear and DRUJ instability were admitted to the department and treated with arthroscopic-assisted modified “double loop suture” transosseous repair between January 2021 and 2023. During the surgery, an osseous tunnel was established, and two nickel-based alloy loops and a polydioxanone II (PDS II) suture were used to achieve the anatomic repair of the tear. All patients received supervised rehabilitation exercises after surgery. Results The patients were followed up for an average of 15.3 months. The mean Visual Analog Scale (VAS) score, grip strength, and Disabilities of the Arm, Shoulder, and Hand (DASH) score before surgery were 4.7 points, 17.3 kg, and 35.2 points, respectively, compared with 1.9 points, 20.7 kg, and 15.5 points at the final follow-up, with significant differences. The median Patient-Rated Wrist Evaluation (PRWE) score was 27.50 before surgery, which then decreased to 10.00 at the final follow-up, with significant differences. The mean flexion-extension range of the wrist and pronation-supination range of the forearm, respectively, increased from 111 degrees and 125 degrees before surgery to 116 degrees and 135 degrees at the final follow-upassessment. None of the assessed individuals exhibited DRUJ instability or developed surgery-related complications. Conclusion Arthroscopic-assisted modified “double loop suture” is a secure and efficient approachfor achieving anatomic repair of TFCC foveal tears, with satisfactory functional improvement and restoration of DRUJ stability.