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Open Versus Arthroscopic Repair of 1B Ulnar-Sided Triangular Fibrocartilage Complex Tears: A Systematic Review

Robba, Vanessa; Fowler, Andrew; Karantana, Alexia; Grindlay, Douglas; Lindau, Tommy

Open Versus Arthroscopic Repair of 1B Ulnar-Sided Triangular Fibrocartilage Complex Tears: A Systematic Review Thumbnail


Authors

Vanessa Robba

Andrew Fowler

ALEXIA KARANTANA ALEXIA.KARANTANA@NOTTINGHAM.AC.UK
Clinical Associate Professor in Hand Surgery

Douglas Grindlay

Tommy Lindau



Abstract

Background: Peripheral 1B tears of the triangular fibrocartilage complex (TFCC) can result in distal radioulnar joint (DRUJ) instability. In the context of associated DRUJ instability, combined evidence supports successful outcomes for peripheral tear repair.
Methods: The aim of this systematic review (SR) was to compare the surgical treatment of 1B TFCC tears via arthroscopic versus open methods of repair. The primary outcome measure was restored DRUJ stability. The secondary outcome measures included patient-reported outcomes and clinical outcome measures. An electronic database search of Ovid Embase, PubMed, and the Cochrane Central Register of Controlled Trials was performed to cover a 20-year period. Two authors independently screened records for eligibility and extracted data.
Results: Only 3 studies met the strict inclusion criteria, highlighting the poor evidence base for TFCC 1B repairs. Hence, a “secondary analysis” group was developed with modified inclusion criteria which included a further 7 studies for analysis. Pooled data from the primary and secondary analysis groups demonstrated that postoperative DRUJ stability was achieved following open repair in 84% (76/90) of cases and following arthroscopic repair in 86% (129/150) of cases. Conclusions: This SR demonstrates a current lack of high-quality evidence required to draw firm conclusions on the merits of arthroscopic versus open repair of 1B TFCC tears. There is no scientific evidence to suggest superiority of one technique over the other, albeit some surgeons and authors may express a strong personal view.

Journal Article Type Article
Acceptance Date Oct 12, 2018
Online Publication Date Jan 22, 2019
Publication Date Jul 1, 2020
Deposit Date Nov 5, 2018
Publicly Available Date Jan 11, 2019
Journal HAND
Print ISSN 1558-9447
Electronic ISSN 1558-9455
Publisher SAGE Publications
Peer Reviewed Peer Reviewed
Volume 15
Issue 4
Pages 456-464
DOI https://doi.org/10.1177/1558944718815244
Public URL https://nottingham-repository.worktribe.com/output/1224526
Publisher URL https://journals.sagepub.com/doi/10.1177/1558944718815244

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