Patient-Reported Outcomes following Arthroscopic Triangular Fibrocartilage Complex Repair

Abstract

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.

Arthroscopic Treatment Results of Triangular Fibrocartilage Complex Tears in Adolescents: A Systematic Review

“…In comparison with the current literature on adult cases, the presented results in children and adolescents may be considered similar overall [43][44][45]. However, as in the analyzed adolescent cohort, many different techniques and approaches have been reported in adults so far.…”

Post-operative septic arthritis after arthroscopy: modern diagnostic and therapeutic concepts

“…Most of the data presented are referred to atraumatic septic arthritis with 2–5 infections per 100,000 in the general population and up to 38 per 100,000 individuals with rheumatoid arthritis [ 62 ]. The infection rate after arthroscopy can only be estimated from case series and is reported to be between 0 and 0.6% [ 8 , 36 , 67 , 68 , 83 ]. One study investigating the complications after wrist arthroscopy of 10,107 patients reported an incidence rate of 0.04% [ 45 ].…”

Ulnar fractures and ligament injuries of the wrist

“…When comparing studies it is important to know the characteristics of the populations investigated; acute or delayed repair, concomitant injuries, type of tear and type of repair used. Other studies on TFCC repair have shown PRWE scores of between 5 and 19.5 (Selles, d'Ailly et al 2020, Thalhammer, Haider et al 2021, where better results were achieved in a population with very strict exclusion criteria and with no reoperations (Thalhammer, Haider et al 2021). After trauma, duration of symptoms before surgery probably has an impact on outcome.…”