J Wrist Surg
DOI: 10.1055/s-0044-1791501
Scientific Article

Arthroscopic Suture Anchor Scapholunate Capsulodesis

1   Hand and Reconstructive Microsurgery, Singapore General Hospital, Singapore
,
Vicente Carratalá
2   Hand Surgery Department, Hospital Quiron, Valencia, Spain
,
3   Hand Surgery and Microsurgery Department, Hospital Universitario HM Monteprincipe, Boadilla del Monte, Madrid, Spain
,
4   Arthrex Inc., Naples, Florida
,
5   Department of Orthopedic Surgery, Mayo Clinic, 200 First Street S.W., Rochester, Minnesota
› Institutsangaben
Funding This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

Abstract

Background: A retrospective review was performed of 15 adult patients who underwent arthroscopic suture anchor scapholunate capsuloligamentous repair between 2021 and 2023.

Patient/Methods/Results: There were 12 male and 3 female patients, with a mean age of 44.9 years. Eight patients had European Wrist Arthroscopy Society (EWAS) II (Geissler II), four patients had EWAS IIIC (Geissler III), and three patients had EWAS IV (Geissler IV). After a follow-up of 12 months (12–26), the mean grip strength significantly improved by 131% compared with presurgery. There was a significant improvement in the visual analog scale score from 6 to 1.2, the Mayo Wrist Score from 43.5 to 86.5, and the Quick Disabilities of the Arm, Shoulder, and Hand questionnaire score from 65.9 to 6.5. Two EWAS IV patients had recurrent symptomatic scapholunate diastasis requiring scapholunate ligamentoplasty.

Conclusion: The arthroscopic dorsal scapholunate capsuloligamentous repair with suture anchors is a reliable and safe technique with minimal complications. It is recommended for reducible acute or chronic injury to the scapholunate ligament complex with suspected avulsion injury.

Level Of Evidence: Level IV

Ethical Approval

This study was approved by the Ethics Committee of the Hospital Quironsalud Valencia.


Contributorship

All authors were actively involved in the planning, enactment, and writing up of the study.


Trial Registration

Not applicable.


Informed Consent

Informed consent was obtained for this study.




Publikationsverlauf

Eingereicht: 02. Juli 2024

Angenommen: 30. August 2024

Artikel online veröffentlicht:
03. Oktober 2024

© 2024. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 
  • References

  • 1 Watson HK, Ballet FL. The SLAC wrist: scapholunate advanced collapse pattern of degenerative arthritis. J Hand Surg Am 1984; 9 (03) 358-365
  • 2 Garcia-Elias M, Lluch AL, Stanley JK. Three-ligament tenodesis for the treatment of scapholunate dissociation: indications and surgical technique. J Hand Surg Am 2006; 31 (01) 125-134
  • 3 Geissler WB, Freeland AE, Savoie FH, McIntyre LW, Whipple TL. Intracarpal soft-tissue lesions associated with an intra-articular fracture of the distal end of the radius. J Bone Joint Surg Am 1996; 78 (03) 357-365
  • 4 Messina JC, Van Overstraeten L, Luchetti R, Fairplay T, Mathoulin CL. The EWAS classification of scapholunate tears: an anatomical arthroscopic study. J Wrist Surg 2013; 2 (02) 105-109
  • 5 Wolfe SW, Kakar S. Carpal instability. In: Green's Operative Hand Surgery. 8th ed. Philadelphia, PA: Elsevier/Churchill Livingstone; 2021
  • 6 Whipple TL. The role of arthroscopy in the treatment of scapholunate instability. Hand Clin 1995; 11 (01) 37-40
  • 7 Beredjiklian PK, Dugas J, Gerwin M. Primary repair of the scapholunate ligament. Tech Hand Up Extrem Surg 1998; 2 (04) 269-273
  • 8 Blatt G. Capsulodesis in reconstructive hand surgery. Dorsal capsulodesis for the unstable scaphoid and volar capsulodesis following excision of the distal ulna. Hand Clin 1987; 3 (01) 81-102
  • 9 Lavernia CJ, Cohen MS, Taleisnik J. Treatment of scapholunate dissociation by ligamentous repair and capsulodesis. J Hand Surg Am 1992; 17 (02) 354-359
  • 10 Lui H, Kakar S. Arthroscopic-assisted volar scapholunate capsulodesis: a new technique. J Hand Surg Am 2022; 47 (11) 1124.e1-1124.e6
  • 11 Mathoulin C, Dauphin N, Sallen V. Arthroscopic dorsal capsuloplasty in chronic scapholunate ligament tears: a new procedure; preliminary report. Chir Main 2011; 30 (03) 188-197
  • 12 Baczkowski B, Lorczyński A, Kabuła J, Camilleri R. Scapholunate ligament repair using suture anchors. Ortop Traumatol Rehabil 2006; 8 (02) 129-133
  • 13 Rosati M, Parchi P, Cacianti M, Poggetti A, Lisanti M. Treatment of acute scapholunate ligament injuries with bone anchor. Musculoskelet Surg 2010; 94 (01) 25-32
  • 14 Szabo RM. Scapholunate ligament repair with capsulodesis reinforcement. J Hand Surg Am 2008; 33 (09) 1645-1654
  • 15 Dubey PP, Chauhan NK, Siddiqui MS, Verma AK. Study of vascular supply of lunate and consideration applied to Kienböck disease. Hand Surg 2011; 16 (01) 9-13
  • 16 Hagert E, Persson JK. Desensitizing the posterior interosseous nerve alters wrist proprioceptive reflexes. J Hand Surg Am 2010; 35 (07) 1059-1066
  • 17 Carratalá V, Lucas FJ, Miranda I, Sánchez Alepuz E, González Jofré C. Arthroscopic scapholunate capsuloligamentous repair: suture with dorsal capsular reinforcement for scapholunate ligament lesion. Arthrosc Tech 2017; 6 (01) e113-e120
  • 18 Carratalá V, Lucas FJ, Miranda I, Prada A, Guisasola E, Miranda FJ. Arthroscopic reinsertion of acute injuries of the scapholunate ligament technique and results. J Wrist Surg 2020; 9 (04) 328-337
  • 19 Cooney WP, Bussey R, Dobyns JH, Linscheid RL. Difficult wrist fractures. perilunate fracture-dislocations of the wrist. Clin Orthop Relat Res 1987; (214) 136-147
  • 20 Beaton DE, Wright JG, Katz JN. Upper Extremity Collaborative Group. Development of the QuickDASH: comparison of three item-reduction approaches. J Bone Joint Surg Am 2005; 87 (05) 1038-1046
  • 21 Larsen CF, Mathiesen FK, Lindequist S. Measurements of carpal bone angles on lateral wrist radiographs. J Hand Surg Am 1991; 16 (05) 888-893
  • 22 del Piñal F. Dry arthroscopy and its applications. Hand Clin 2011; 27 (03) 335-345
  • 23 Kakar S, Kalapos R. Knotless arthroscopic dorsal scapholunate capsulodesis: a simplified technique. J Wrist Surg 2023; DOI: 10.1055/s-0043-1768134.
  • 24 Del Piñal F. Arthroscopic volar capsuloligamentous repair. J Wrist Surg 2013; 2 (02) 126-128
  • 25 Carratalá V, Lucas FJ, Alepuz ES, Guisasola E, Calero R. Arthroscopically assisted ligamentoplasty for axial and dorsal reconstruction of the scapholunate ligament. Arthrosc Tech 2016; 5 (02) e353-e359
  • 26 Sandow MJ, Fisher TJ, Howard CQ, Papas S. Unifying model of carpal mechanics based on computationally derived isometric constraints and rules-based motion - the stable central column theory. J Hand Surg Eur Vol 2014; 39 (04) 353-363
  • 27 Short WH, Werner FW, Green JK, Sutton LG, Brutus JP. Biomechanical evaluation of the ligamentous stabilizers of the scaphoid and lunate: part III. J Hand Surg Am 2007; 32 (03) 297-309
  • 28 Berger RA, Imeada T, Berglund L, An KN. Constraint and material properties of the subregions of the scapholunate interosseous ligament. J Hand Surg Am 1999; 24 (05) 953-962
  • 29 Conyers DJ. Scapholunate interosseous reconstruction and imbrication of palmar ligaments. J Hand Surg Am 1990; 15 (05) 690-700
  • 30 Logan SE, Nowak MD, Gould PL, Weeks PM. Biomechanical behavior of the scapholunate ligament. Biomed Sci Instrum 1986; 22: 81-85
  • 31 Nikolopoulos FV, Apergis EP, Poulilios AD, Papagelopoulos PJ, Zoubos AV, Kefalas VA. Biomechanical properties of the scapholunate ligament and the importance of its portions in the capitate intrusion injury. Clin Biomech (Bristol, Avon) 2011; 26 (08) 819-823
  • 32 Merlini L, Mathoulin C. Arthroscopic repair of the dorsal intercarpal ligament detachment from the scaphoid. J Wrist Surg 2021; 10 (06) 539-542
  • 33 Overstraeten LV, Camus EJ, Wahegaonkar A. et al. Anatomical description of the dorsal capsulo-scapholunate septum (DCSS)-arthroscopic staging of scapholunate instability after DCSS sectioning. J Wrist Surg 2013; 2 (02) 149-154
  • 34 Cohen MS, Taleisnik J. Direct ligamentous repair of scapholunate dissociation with capsulodesis augmentation. Tech Hand Up Extrem Surg 1998; 2 (01) 18-24
  • 35 Andersson JK, Garcia-Elias M. Dorsal scapholunate ligament injury: a classification of clinical forms. J Hand Surg Eur Vol 2013; 38 (02) 165-169
  • 36 Melone Jr CP, Polatsch DB, Flink G, Horak B, Beldner S. Scapholunate interosseous ligament disruption in professional basketball players: treatment by direct repair and dorsal ligamentoplasty. Hand Clin 2012; 28 (03) 253-260 , vii
  • 37 Wessel LE, Kim J, Morse KW. et al. The dorsal ligament complex: a cadaveric, histology, and imaging study. J Hand Surg Am 2022; 47 (05) 480.e1-480.e9