Equivalent Clinical Outcomes Following Favored Treatments of Chronic Scapholunate Ligament Tear

Abstract

This systematic review failed to demonstrate any significant difference in outcomes from capsulodesis or reconstruction for treatment of chronic scapholunate instability. However, the retrospective studies examined were notably heterogeneous in design with high estimates of variance. Further prospective trials are necessary to determine an ideal treatment strategy.

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

“…We were unable to detect any statistically significant differences in outcomes between surgical procedure categories. This is consistent with the conclusions of a recent systematic review by Wang and colleagues, 66 who compared capsulodesis procedures to scapholunate ligament reconstructions. This is not to say no differences exist; however, given the heterogeneity of the diagnostic methods, surgical techniques, outcome measures and length of follow-up, it is not possible to determine the most appropriate approach to treatment at this stage.…”

Management of chronic scapholunate ligament injury

“…This finding was also supported by a systematic review by Wang et al comparing capsulodesis procedure to scapholunate ligament reconstructions. 32 Although the thickest and strongest portion of the SLIL is the dorsal limb, both dorsal and volar SLIL integrity is essential for normal carpal mechanics, and their reconstruction would provide multiaxial stability. Many open reconstruction methods do not address the volar portion of SLIL; therefore, there is higher risk of failure to reduce the SL interval.…”

“…The above results are further supported by similar findings in a recent systematic review by Wang et al who compared capsulodesis to scapholunate ligament reconstructions. 32 Their sample size was 11 studies that comprised of 308 patients. Their analysis of wrist flexion after ligament reconstruction and after capsulodesis identified an average of 40.9 and 45.6 respectively.…”

“…Average SLA was 56.5 for ligament reconstruction group, and 60.3 in the capsulotomy group at follow up. 32 A most recent systematic review published by Daly et al, in 2020, compared preoperative and postoperative Radiographic, Clinical and Functional outcomes of tenodesis and capsulodesis as a surgical treatment for chronic scapholunate interosseous ligament (SLIL) disruption. Their review identified 40 studies (978 wrists), of which 23 assessed tenodesis, 14 assessed capsulodesis and 3 assessed both capsulodesis and tenodesis.…”

Minimum 5-Year Outcomes of Dorsal Intercarpal Ligament Capsulodesis With Scapholunate Interosseous Ligament Repair for Subacute and Chronic Static Scapholunate Instability: A Clinical Series of 5 Patients

“…among the treatments. 17,18 However, it was pointed out that many of the reports had low evidence levels and that long-term comparative studies were required. 19,20 Scapholunate instability can be classified as acute, subacute, or chronic and as dynamic or static.…”