Short-term evaluation of arthroscopic outside-in repair of ulnar side TFCC tear with vertical mattress suture

Bayoumy, Maysara Abdelhalim; Elkady, Hesham A.; Said, Hatem G.; El‐Sayed, Amr; Saleh, Waleed Riad

doi:10.1016/j.jor.2015.10.013

Cited by 18 publications

(34 citation statements)

References 11 publications

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“…8 Regarding arthroscopic treatment of peripheral tears, PRWE scores ranging from 19 to 33 with a follow-up range of 11.5 to 17.5 months have been reported. 11,21 These PRWE scores described are comparable to our median PRWE of 19.5, concluding that arthroscopic treatment of TFCC lesions leads to acceptable functional outcomes.…”

Section: Discussionsupporting

confidence: 76%

Patient-Reported Outcomes following Arthroscopic Triangular Fibrocartilage Complex Repair

2019

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Background Triangular fibrocartilage complex (TFCC) injury is a common cause of ulnar-sided wrist pain, which may lead to serious physical impairments. Arthroscopic repair has benefits such as less soft tissue damage, greater surgical accuracy, and may lead to faster recovery than open repair. Objective The purpose of this study was to determine the functional outcome of patients with symptomatic TFCC injuries treated with arthroscopic debridement or repair. Patients and Methods A retrospective study of all consecutive patients with a TFCC injury treated arthroscopically was conducted. The primary outcome was the patient-rated wrist evaluation (PRWE) score. Secondary outcomes were, pain, operative findings, complications, and additional treatment. Results A total of 51 patients with a median follow-up of 16.5 months (interquartile range [IQR]: 13–25) were included. Injuries were treated with TFCC debridement (n = 25), TFCC ligament to capsule suturing (n = 10), TFCC debridement and ligament to capsule suturing (n = 7), TFCC debridement and synovectomy (n = 5), and TFCC foveal reinsertion with a suture anchor (n = 4). The median PRWE was 19.5 (IQR: 6–49). Complications occurred in three patients and in nine patients additional surgery was performed. Conclusion Arthroscopic treatment of TFCC lesions leads to satisfactory functional outcomes. Level of Evidence This is a Level IV study.

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Section: Discussionsupporting

confidence: 76%

Patient-Reported Outcomes following Arthroscopic Triangular Fibrocartilage Complex Repair

2019

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“…11,14,15,[26][27][28][29][30] Arthroscopic-assisted techniques have shown good results at follow-up ranging from 11 months to 4.8 years with pain reduction by VAS, grip strength returning to a mean of 71 to 95% of the contralateral hand, near full wrist and forearm motion, and improved outcome scores with mean DASH, PRWE, and MMW scores of 9 to 22, 33, and 71 to 91, respectively. 11,14,15,[26][27][28][29][31][32][33][34][35][36] All-arthroscopic techniques are performed solely through the arthroscopic portals and knots are placed intra-articularly. 30 Few studies have reported on outcomes following allarthroscopic repair of Palmer 1B peripheral TFCC tears.…”

Section: Discussionmentioning

confidence: 99%

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

2019

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Background A pre-tied suture device has been utilized for all-arthroscopic peripheral triangular fibrocartilage complex (TFCC) repairs with promising early clinical results. Purpose The purpose of this study was to evaluate long-term functional outcomes of these repairs. Patients and Methods A retrospective review of patients undergoing arthroscopic TFCC repair was performed. Inclusion criteria were the Palmer type 1B TFCC tears diagnosed on arthroscopy and repaired using the all-arthroscopic pre-tied suture device. Patients with any evidence of concomitant wrist injury at the time of surgery, history of prior wrist surgery, or nonrepairable and nonperipheral TFCC tears were excluded. Postoperative complications, range of motion, grip strength, and outcome assessments were recorded for each patient. Results Eleven patients (mean age, 36 years; range, 20–64 years) satisfied our inclusion criteria and comprised the study cohort. The mean follow-up period was 7.0 years (range, 4.3–10.9 years). Mean range of motion of the wrist revealed flexion of 76 ± 11 degrees and extension of 73 ± 12 degrees. Mean grip strength was 98 ± 15% of the nonsurgical extremity. QuickDASH, modified Mayo, and patient-rated wrist evaluation (PRWE) average scores were 9 ± 8, 80 ± 6, and 12 ± 12, respectively. No surgical complications were observed and no patient required any further surgical intervention. Conclusions Our cohort of patients following all-arthroscopic pre-tied suture device repair of isolated Palmer type 1B TFCC tears demonstrated excellent clinical function at a mean follow-up of 7 years. These findings indicate that the pre-tied suture device is a reliable, safe, effective, and most importantly, durable treatment option for repair of peripheral TFCC tears. Level of Evidence This is a Level IV, therapeutic study.

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“…9 Tang et al, 10 Kim et al, 11 Sarkissian et al, 12 and Iwasaki et al 13 all moved to surgery after 3 months with Iwasaki et al using a removal wrist brace for immobilization. Ruch and Papadonikolakis 14 and Infanger and Grimm 15 proceeded after at least 4 months of conservative management and Papapetropoulos et al, 16 Bayoumy et al, 17 and Millants et al 18 utilized 6 months of conservative management with splinting and anti-inflammatories prior to surgical intervention.…”

Section: Nonoperative Treatmentmentioning

confidence: 99%

“…In our review, 16 articles were found focusing specifically on outcomes of arthroscopically repaired 1B lesions with a total of 409 patients undergoing repair. [11][12][13][16][17][18][38][39][40][41][42][43][44][45][46][47] For the 16 articles, four different scoring metrics were reported (Disabilities of the Arm, Shoulder, and Hand [DASH], Mayo, visual analog scale, and personal scoring system) and not every article reported pre-and postoperative values. Additionally, not all reported range of motion (ROM), pain, or return to work status.…”

Section: Repairmentioning

confidence: 99%

“…DASH score was the most reported with an overall average improvement from 40.2 to 14.8 in 10 articles. 12,13,17,18,40,42,[44][45][46][47] Return to work was the second most common outcome discussed in eight of the articles, 13,18,[39][40][41][42][43]46 showing that in this group with an average age of 33, only 68% were able to return to work. Six articles specifically addressed pain 13,18,38,41,42,45 of the patients, persistent pain was noted in 52 (40.9%), though an additional 34 were noted to have a "reduction in pain" which was not specified regarding full resolution.…”

Section: Repairmentioning

confidence: 99%

See 1 more Smart Citation

A Systematic Review and Analysis of Palmer Type I Triangular Fibrocartilage Complex Injuries: Outcomes of Treatment

McNamara

Colakoğlu

Iorio

2020

Journal of Hand and Microsurgery

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Triangular fibrocartilage complex (TFCC) injuries can present incidentally as an asymptomatic lesion or can cause acute and chronic pain. This study compared different treatment approaches for symptomatic Palmer Type 1 TFCC injuries and rates of improvement using a systematic review of the literature. Two hundred thirty-one articles were identified, 43 met criteria and were included. Two of these articles indicated conservative therapy may be adequate. Patients who underwent debridement for any Type 1 Palmer class returned to work at a rate of 92% (n = 182), but only 44% (n = 38) were free of pain. For 1B lesions that underwent repair, 68.3% (n = 226) were able to return to work and 41% (n = 52) had persistent pain. 1D lesions were treated with both repair and debridement with similar results. Data for Types 1A and 1C were limited as no authors solely addressed these lesions. For 1A lesions, those treated with traditional treatment of debridement still had high rates of being unable to return to work. The literature remains insufficient, making comparison between studies and techniques difficult. For asymptomatic injuries, there is no need for treatment. For patients with recalcitrant symptoms, surgery improves pain, grip strength, and increases return to work and activity. The level of evidence is IV.

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Short-term evaluation of arthroscopic outside-in repair of ulnar side TFCC tear with vertical mattress suture

Cited by 18 publications

References 11 publications

Patient-Reported Outcomes following Arthroscopic Triangular Fibrocartilage Complex Repair

Patient-Reported Outcomes following Arthroscopic Triangular Fibrocartilage Complex Repair

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

A Systematic Review and Analysis of Palmer Type I Triangular Fibrocartilage Complex Injuries: Outcomes of Treatment

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