Arthroscopic scapholunate ligament repair and dorsal capsulodesis with suture anchor in acute scapholunate dissociation

Abstract

Abstract Purpose The objective of this study was to investigate the potential of arthroscopic scapholunate repair and dorsal capsulodesis with suture anchor as a treatment option for patients experiencing symptomatic acute scapholunate instability in the absence of wrist advanced degenerative changes. Methods From Jan. 2017 to Jan 2020, 19 wrists with acute tears of the SL ligament with symptomatic instability, were treated with arthroscopic SL repair and dorsal capsulodesis with suture anchor and scapholunate joint fixation with K-wires. All patients underwent wrist MRI and arthroscopy to confirm the diagnosis and exclude arthritis. The study included 16 men and 3 women with an average age of 24.5 years (range, 19 to 27 years). The average time from injury to operation was 8.8 weeks (range, 4 to 11 weeks). All patients underwent follow-up at our clinic regularly for an average of 26.5 months (range, 24 to 32 months). Results All 19 patients had rupture and dissociation of the SL ligament in the radiocarpal joint. Modified Mayo wrist scores revealed the following functionality: the total arc of wrist motion in the flexion-extension plane loss averaged 5.1° (P > .01). Grip force improved significantly, with 14.7% improvement of that on the normal side (P < .01). The Wilcoxon signed-rank test was used to compare the results: the postoperative scores were significantly better than the preoperative scores (P < .01). Sixteen patients (84.2%) were fully satisfied with the results and returned to their preinjury activity. Only one patient (5.3%) had mild laxity of the scapholunate ligament joint. Conclusions At a minimum of two years' follow-up, patients with acute symptomatic dissociation of scapholunate ligament instability who underwent arthroscopic scapholunate ligament repair and dorsal capsulodesis with suture anchor treatment had satisfactory results. Level of Evidence Level IV, case series.