gms | German Medical Science

Objectives/Interrogation: To report the anatomical study and preliminary clinical experience with an arthroscopic adaptation of the ECRL antipronation spiral tenodesis for Scapholunate and Radiolunate ligaments deficiency.

Methods: After an anatomical cadaveric study, 5 patients were operated using this technique. The following extended portals were used: 1-2; 4-5 and volar-radial. A 8cm distally based strip of the ERCL was passed within the STT joint and through a tunnel on the scaphoid, where it is blocked using a 3x8 mm interference screw. Then, it was retrieved in the dorsal radio-carpal joint, fixed on the dorsal ridge of the lunate with a bone anchor, and introduced in a tunnel through the triquetum, to exit on the volar aspect of the radio-carpal joint. Subsequently, the tendon graft is deployed through the volar-radial portal and fixed on the radial styloid using a fork tipped interference screw.

The visual analog scale of pain (VAS), SL instability (as assessed using the Watson test to dislocate the proximal scaphoid over the dorsal rim of the radius), ability to return to work, range of motion (ROM), grip strength were used for evaluation at minimum follow-up of 12 months.

Results and Conclusions: No intra-operative complications were recorded. One patient developed significant post-operative osteopenia, without obvious signs of CRPS.

Pain under load decreased from 7.5 to 2, all Sl were stable (Watson test cannot dorsally dislocate the scaphoid). All patients returned to previous work. ROM was reduced of 27% compared to pre-op values. Grip strength increased fo 33%.

Arthroscopic spiral tenodesis reconstruction is feasible and safe, producing comparable results as the standard technique.