Prevalence of Triangular Fibrocartilage Complex Abnormalities Regardless of Symptoms Rise With Age: Systematic Review and Pooled Analysis

Abstract

Background Triangular fibrocartilage complex abnormalities seem to be more common with age, but the degree to which this is so, and the degree to which the presence of an abnormality is associated with symptoms, are topics of controversy. Questions/purposes We wished to perform a systematic review to determine the prevalence of triangular fibrocartilage complex abnormalities, and to determine if the prevalence of abnormalities are greater with increasing age. In addition, we stratified age groups based on symptoms. Methods We searched MEDLINE, EMBASE, and the Cochrane Library through August 15, 2013. Studies that reported triangular fibrocartilage complex abnormalities by age were included. Fifteen studies including 977 wrists met our criteria and reported a total of 368 (38%) triangular fibrocartilage complex abnormalities. Eight studies included symptomatic patients; the remainder studied cadavers (six studies) or asymptomatic volunteers (one study). Patients were divided into four age groups (\30, 30-49, 50-69, and 70 years and older) for pooled analysis, comparing the proportions of patients with and without abnormalities between groups using chi-square analysis. We also evaluated the proportions after stratifying each age group by symptoms. Results Overall, the prevalence of triangular fibrocartilage complex abnormalities increased with age, from 27% (80/301) in patients younger than 30 years to 49% (130/ 265) in patients 70 years and older (p \ 0.001), odds ratio (OR), 2.7, 95% CI, 1.9-3.8 (p \ 0.001). In asymptomatic patients, triangular fibrocartilage complex prevalence abnormality increased from 15% (24/159) to 49% (129/ 263) in the same age groups (p \ 0.001), OR, 5.4, 95% CI, 3.3-8.9 (p \ 0.001). For symptomatic patients prevalence ranged from 39% (56/142) to 70% (14/20) in patients between 50 and 69 years old (p\0.034), OR, 3.6, 95% CI, 1.3-9.9 (p \ 0.014). Conclusion Triangular fibrocartilage complex abnormalities are common in symptomatic and asymptomatic wrists, and they are increasingly common with age. As in all situations where abnormalities are so common that they may be incidental, we need (1) a reliable and accurate method for determining whether these abnormalities are the cause of symptoms; and (2) evidence that treatment of these abnormalities improves symptoms better than placebo.

A Systematic Review of Outcomes after Arthroscopic Débridement for Triangular Fibrocartilage Complex Tear

“…Seventy percent of symptomatic patients and 38% of asymptomatic patients had TFCC injury in the age group 50–69 years. 1 In addition to wrist pain, TFCC injuries result in decreased grip strength and impaired hand function. 2 TFCC injuries are managed non-operatively initially.…”

Prevalence of Triangular Fibrocartilage Complex Abnormalities among Asymptomatic Young Individuals Using Magnetic Resonance Imaging in A Tertiary Center in Saudi Arabia: A Cross-Sectional Study

“…These findings persuades that the occurrence of incidental fibrocartilage complex abnormalities commonly occur independent of the symptoms and probability of their prevalence increases with age. It is also not clear whether the interventions used for addressing triangular fibrocartilage complex variations are better as compared to the natural history because of varying surgical outcomes they provide [21][22][23].…”

Who introduced the "quadrangular-construct" modification of the Sauvé Kapandji procedure first? Case presentation and brief overview of literature with regard to general, specific and practicable aspects to primary trauma-related surgical treatment including possible salvage options at the distal radioulnar joint

“…Case presentation and brief overview of literature with regard to general, specific and practicable aspects to primary trauma-related surgical treatment including possible salvage options at the distal radioulnar joint Longstanding UPV is generally associated with secondary degenerative lesions of the triangular fibrocartilage due to it compression, and additionally, primary degenerative lesions of the triangular fibrocartilage with or without UPV and in the absence of any clinical symptoms are also well known but it mostly occur in elderly patients aged 60 years and older [43][44][45][46][47]. Hence, it cannot always be concluded that a lesion of the triangular cartilage, assessed by MRI and wrist arthroscopy, in a young patient with evident acute traumatic UPV in which the triangular cartilage is generally detached or disrupted could mainly be caused by a pre-existing non-traumatic degenerative lesion, or that a chronic ulnar-sided wrist pain in an elderly patient with evident longstanding UPV longer than 2 mm (Figures 4 and 5) is based on a lesion of the triangular cartilage that consequently would requires MRI and wrist arthroscopy.…”