Arthroscopically Assisted Transosseous Triangular Fibrocartilage Complex Foveal Tear Repair in the United States Military

Abstract

PurposeTo compare subjective and objective midterm functional clinical outcomes of knotless arthroscopic assisted transosseous (AAT) triangular fibrocartilage complex (TFCC) repairs specifically in a cohort of military service members.MethodsPatient charts were reviewed to identify all cases of TFCC repair by a single surgeon from 2012 to 2016. Primary outcome variables were the Quick–Disabilities of the Arm, Shoulder, and Hand score and return to full military duty. Secondary outcome variables were visual analog scale for pain, Mayo Modified Wrist Score, Single-Assessment Numeric Evaluation, and the number of push-ups in 2 minutes during a record physical fitness test. Inclusion criteria were adult active duty service members who underwent AAT TFCC repair with a minimum of 2 years’ follow-up. Terminal follow-up was determined by a telephone interview. Exclusion criteria were distal radioulnar joint instability, revision procedures, cases involving other ligamentous repair procedures, and those with an incomplete medical record or who could not be reached for the survey.ResultsFifteen patients, average age 21 years (range, 18–29 years), met inclusion and exclusion criteria with mean follow-up of 3.8 years (range, 2–5.9 years). Average Quick–Disabilities of the Arm, Shoulder, and Hand score was 9.7 (range, 0–29.5) and 93% were able to remain on active duty. Average secondary outcomes scores were: visual analog scale = 1.3 (range, 0–4); Single-Assessment Numeric Evaluation = 87.3 (range, 30–100); Mayo Modified Wrist Score = 84.3 (range, 55–100); and push-ups = 72 (range, 42–90) in 2 minutes. One patient required a secondary surgery.ConclusionsKnotless AAT TFCC repair may be a safe and effective procedure that may return military service members to a preinjury level of activity.Type of study/level of evidenceTherapeutic IV. To compare subjective and objective midterm functional clinical outcomes of knotless arthroscopic assisted transosseous (AAT) triangular fibrocartilage complex (TFCC) repairs specifically in a cohort of military service members. Patient charts were reviewed to identify all cases of TFCC repair by a single surgeon from 2012 to 2016. Primary outcome variables were the Quick–Disabilities of the Arm, Shoulder, and Hand score and return to full military duty. Secondary outcome variables were visual analog scale for pain, Mayo Modified Wrist Score, Single-Assessment Numeric Evaluation, and the number of push-ups in 2 minutes during a record physical fitness test. Inclusion criteria were adult active duty service members who underwent AAT TFCC repair with a minimum of 2 years’ follow-up. Terminal follow-up was determined by a telephone interview. Exclusion criteria were distal radioulnar joint instability, revision procedures, cases involving other ligamentous repair procedures, and those with an incomplete medical record or who could not be reached for the survey. Fifteen patients, average age 21 years (range, 18–29 years), met inclusion and exclusion criteria with mean follow-up of 3.8 years (range, 2–5.9 years). Average Quick–Disabilities of the Arm, Shoulder, and Hand score was 9.7 (range, 0–29.5) and 93% were able to remain on active duty. Average secondary outcomes scores were: visual analog scale = 1.3 (range, 0–4); Single-Assessment Numeric Evaluation = 87.3 (range, 30–100); Mayo Modified Wrist Score = 84.3 (range, 55–100); and push-ups = 72 (range, 42–90) in 2 minutes. One patient required a secondary surgery. Knotless AAT TFCC repair may be a safe and effective procedure that may return military service members to a preinjury level of activity.