Midterm Outcome of Bone-Ligament-Bone Graft and Dorsal Capsulodesis for Chronic Scapholunate Instability

Gray, Anne; Cuénod, Philippe; Papaloïzos, Michaël

doi:10.1016/j.jhsa.2015.04.034

Cited by 10 publications

(10 citation statements)

References 29 publications

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“…Gray et al 55 also reported their experience. In their study, 23 scapholunate ligaments were reconstructed with trapezoid to second metacarpal grafts, two with capitohamate joint grafts, and one with a composite graft harvested from 1289e the second-third metacarpal area.…”

Section: Discussionmentioning

confidence: 92%

Long-Term Outcomes of Arthroscopic-Assisted Bone-Ligament-Bone Reconstruction for non-static Scapholunate Ligament Injury.

Rosa

Bertozzi

Annoscia

et al. 2022

Plastic &Amp; Reconstructive Surgery

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Background: Scapholunate ligament injury is the most common cause of carpal instability. This retrospective case series aimed to assess the effectiveness and the maintenance of the results obtained by reconstructing the scapholunate ligament with a bone–ligament–bone autograft through an arthroscope-assisted minimally invasive approach. Methods: Thirty-six patients were enrolled initially but only 31 constituted the final population study (23 male, eight female; median age, 38 years; age range, 18 to 55 years). Radiographic (posteroanterior and true lateral radiographs to assess the scapholunate gap, radiolunate, and capitolunate angles; computed tomographic scan; magnetic resonance images), functional [grip strength (Jamar test and pinch test), active range of motion], and subjective (patient-rated wrist evaluation test) outcome measurements were collected. Minimum follow-up was 50 months. Results: Grip strength and wrist mobility were significantly improved from the preoperative values and improved over time. No scapholunate synostosis or carpal bone necrosis was observed. No wrist showed any sign of arthrosis or progression towards wrist instability. Only four patients had scapholunate gap greater than 3 mm. Conclusions: The proposed technique for scapholunate reconstruction, providing a biologic reconstruction of both the volar and dorsal portion of the scapholunate ligament and avoiding extensive capsulotomy, obtained significant functional outcomes improvement that was maintained over time and prevented degenerative changes to the articular surfaces. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.

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Section: Discussionmentioning

confidence: 92%

Long-Term Outcomes of Arthroscopic-Assisted Bone-Ligament-Bone Reconstruction for non-static Scapholunate Ligament Injury.

Rosa

Bertozzi

Annoscia

et al. 2022

Plastic &Amp; Reconstructive Surgery

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“…We emailed 13 authors, of whom 6 responded: 3 responses indicated that individual patient data could not be provided for subgroup analysis, [30][31][32] 1 response caused exclusion of the study owing to inadequate follow-up, 33 1 response allowed inclusion of the study after removal of data for 2 patients with concomitant injuries, 34 and 1 response provided individual patient metadata, allowing inclusion of patients into subgroup analysis. 35 Data were collected on 805 procedures from a total of 35 papers 25,[28][29][30][31][32] (Table 3). The review included 43 patients from 4 studies involving intentional fibrous nonunion type procedures, 32,41,48,61 391 patients from 14 groups involving capsulodesis, [29][30][31]39,43,47,51,52,54,55,59,60,62,63 319 patients from 12 groups involving tenodesis techniques 25,30,34,36,37,40,[44][45][46]50,53,58 and 51 patients from 4 groups using bone-tissue-bone techniques.…”

Section: Resultsmentioning

confidence: 99%

“…The review included 43 patients from 4 studies involving intentional fibrous nonunion type procedures, 32,41,48,61 391 patients from 14 groups involving capsulodesis, [29][30][31]39,43,47,51,52,54,55,59,60,62,63 319 patients from 12 groups involving tenodesis techniques 25,30,34,36,37,40,[44][45][46]50,53,58 and 51 patients from 4 groups using bone-tissue-bone techniques. 35,42,57,64 Overall, 68% of patients were male, and the patients' average age was 39 years (Table 4). In patients with identifiable traumatic events, the average time from injury to surgery was 19 months.…”

Section: Resultsmentioning

confidence: 99%

Surgical outcomes of chronic isolated scapholunate interosseous ligament injuries: a systematic review of 805 wrists

Montgomery

Rollick

Kubik

et al. 2019

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Background: Management of chronic isolated scapholunate interosseous ligament (SLIL) injuries has generated a substantial volume of low-quality literature with descriptions of multiple new surgical techniques, and the impact of instability pattern and the optimal surgical technique remain unclear. The primary goal of this review was to compare clinical, radiographic and patient-rated outcomes between current surgical techniques. Methods: We performed a systematic literature search using multiple databases. We analyzed clinical, radiographic and patient-reported outcomes. We used a fixedeffects model weighted by sample size with combined outcomes estimated via least squares means with 95% confidence intervals. We also performed a subgroup analysis of static versus dynamic instability. Results: We assessed 805 procedures from 37 study groups, with 429 procedures used in subgroup analysis. There were no statistically significant differences in outcomes between surgical techniques or in subgroup analysis. Overall, postoperative wrist flexion and pain scores decreased, and grip strength and patient-rated outcomes improved. Conclusion: Compared to overall preoperative values, modest improvements in pain score, grip strength and functional outcome scores were obtained from a range of reconstructive procedures performed for chronic isolated SLIL injuries. No significant differences could be ascertained between surgical techniques, potentially owing to the low quality of evidence and procedure heterogeneity. This study provides accurate preoperative reference values for future studies, highlights the controversial clinical impact of instability classification, and the need for higher-quality multicentre or collaborative trials to improve our understanding and management of this common injury. Contexte : La prise en charge des blessures chroniques du ligament interosseux scapho-lunaire (LISL) a généré un volume substantiel d'articles de faible qualité où sont décrites plusieurs nouvelles techniques chirurgicales, mais l'impact du modèle d'instabilité et la technique chirurgicale optimale restent à clarifier. Le principal objectif de cette revue était de comparer les résultats cliniques, radiographiques et autodéclarés par les patients entre les diverses techniques chirurgicales actuelles. Méthodes : Nous avons procédé à une interrogation systématique de la littérature dans plusieurs bases de données. Nous avons analysé les résultats cliniques, radiographiques et autodéclarés par les patients. Nous avons utilisé un modèle à effets fixes pondéré par la taille de l'échantillon, avec paramètres mixtes estimés par les moyennes des moindres carrés et des intervalles de confiance à 95 %. Nous avons aussi effectué une analyse de sous-groupes (instabilité radiographique dynamique c. statique). Résultats : Nous avons évalué 805 interventions dans 37 groupes étudiés, et 429 interventions ont été utilisées dans les analyses de sous-groupes. On n'a noté aucune différence statistiquement significative pour ce qui est des résultats entre...

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“…The rate of failure and continued pain in our cohort is similar to rates reported by others. 14,29,30…”

Section: Discussionmentioning

confidence: 99%

“…Of the four patients who had grade IV changes (scapholunate, n = 3; lunotriquetral, n = 1), two were back to work full time, with minimal pain at 1 year after The rate of failure and continued pain in our cohort is similar to rates reported by others. 14,29,30 Limitations of this study include the retrospective nature, heterogeneity, lack of patientreported clinical outcomes, and limited follow-up in some individuals. We believe that additional outcome measures and longer observation would only reinforce our conclusions, as signs of dissatisfaction with the procedure were already becoming evident.…”

Section: Discussionmentioning

confidence: 99%

Outcomes after Bone-Ligament-Bone Intercarpal Ligament Reconstruction

Ross

Gundlach

Yue

et al. 2022

Plastic &Amp; Reconstructive Surgery

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Background: Numerous surgical reconstructive techniques have been described for chronic scapholunate and lunotriquetral interosseous ligament instability. Methods: The authors retrospectively reviewed 16 consecutive patients who underwent bone-ligament-bone reconstruction for scapholunate or lunotriquetral intraosseous ligament predynamic and dynamic instability at a single tertiary care institution from 2013 to 2019. Clinical and radiographic outcomes, and complications, were recorded. Results: Eleven patients had bone-ligament-bone reconstruction for scapholunate ligament injuries and five for lunotriquetral instability. Fourteen patients (87.5 percent) underwent diagnostic arthroscopy before bone-ligament-bone reconstruction, with nine of 14 having grade 3 and four of 14 having grade 4 injury. Capitohamate bone-ligament-bone grafts were used in nine patients (56 percent) and the graft was taken from Lister tubercle in seven (44 percent). The average age at surgery was 37 years. The average follow-up was 60.6 weeks. There were no significant differences between preoperative and postoperative radiographic parameters. Median postoperative wrist flexion was 45 degrees, and mean postoperative wrist extension was 53 degrees, which were significantly less than contralateral flexion (85 degrees; p < 0.0001) and extension (78 degrees; p < 0.0001). Thirty-eight percent of patients complained of persistent pain at final follow-up, and two patients (13 percent) underwent salvage procedures, both at approximately 6.5 months after the index reconstruction. Conclusion: Short-term outcomes of bone-ligament-bone reconstruction for early-stage scapholunate and lunotriquetral ligament injuries reveal many patients with residual postoperative wrist pain and disability, and almost uniform limitations in flexion-extension motion. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.

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Midterm Outcome of Bone-Ligament-Bone Graft and Dorsal Capsulodesis for Chronic Scapholunate Instability

Cited by 10 publications

References 29 publications

Long-Term Outcomes of Arthroscopic-Assisted Bone-Ligament-Bone Reconstruction for non-static Scapholunate Ligament Injury.

Long-Term Outcomes of Arthroscopic-Assisted Bone-Ligament-Bone Reconstruction for non-static Scapholunate Ligament Injury.

Surgical outcomes of chronic isolated scapholunate interosseous ligament injuries: a systematic review of 805 wrists

Outcomes after Bone-Ligament-Bone Intercarpal Ligament Reconstruction

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