A new arthroscopic repair technique for triangular fibrocartilage complex using an intracapsular suture: an outside-in transfer, all-inside repair

Abstract

Background Arthroscopic repair is a promising, minimally invasive surgical technique for patients with Palmer type 1B peripheral triangular fibrocartilage complex (TFCC) tears. Although several arthroscopic techniques are effective for repairing Palmer type 1B TFCC tears, some shortcomings remain; thus, better methods are necessary. Methods We performed an arthroscopic intracapsular suture using an outside-in transfer, all-inside repair technique, which is a modified method of the outside-in and all-inside technique using the needle of a 10-mL sterile syringe, for Palmer type 1B TFCC tears. A No. 2 polydioxanone suture was threaded through the needle and entered the wrist joint. Next, the needle was withdrawn carefully along the suture to the proximal tear ulnar surface of the TFCC and penetrated the TFCC, exiting the articular cavity surface of the ulnar side of the torn TFCC. Finally, arthroscopic knotting was performed. Results This new technique was used to treat 17 patients with Palmer type 1B Atzei class 1 TFCC tears. The treatment was as effective as the previously described arthroscopic techniques and had advantages of no additional incision and decreased risk of operation-related complications. Conclusions The outside-in transfer, all-inside repair is a simple, safe, minimally invasive, and economical procedure that confers a lower risk of complications for Palmer type 1B TFCC tears. We recommend this technique as a useful alternative to the conventional methods of repairing Palmer type 1B TFCC tears.