Lee Shin Woo, Hong Jung Jun, Sung Seung-Yong, Park Tae-Hoon, Kim Ji-Sup
Department of Orthopaedic Surgery, College of Medicine, Ewha Womans University Seoul Hospital, Seoul 07804, Republic of Korea.
Department of Orthopaedic Surgery, Yonsei Wa Hospital, Incheon 21557, Republic of Korea.
J Clin Med. 2024 May 8;13(10):2766. doi: 10.3390/jcm13102766.
This study compared clinical outcomes between arthroscopic and open repair of triangular fibrocartilage complex (TFCC) foveal tears in chronic distal radioulnar joint (DRUJ) instability patients. A total of 79 patients who had gone through foveal repair of TFCC using arthroscopic technique (n = 35) or open technique (n = 44) between 2016 and 2020 were retrospectively analyzed. The visual analog scale (VAS) score for pain, active range of motion (ROM), grip strength, Mayo Modified Wrist Score (MMWS), Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire score, and Patient-Rated Wrist Evaluation (PRWE) score at 2-4-6-12-24 months postoperatively were compared between two groups. Two years after the operation, clinical parameters (VAS, MMWS, DASH, and PRWE), grip strength, and ROM showed significant advancement in the two groups in comparison to their values measured preoperatively ( < 0.001). Nonetheless, we could not identify any statistically significant differences in the above clinical factors between the two groups. The arthroscopic group showed a better flexion-extension arc at 2 months and supination-pronation arc at 2 and 4 months than the open group ( < 0.001). There were no significant differences between the two groups at 2 years postoperatively. Ten patients (12.6%) had recurrent instability (three in the arthroscopic group and seven in the open group, = 0.499). Similarly, both groups showed no significant difference in the return to work period. Arthroscopic foveal repair of TFCC provided similarly favorable outcomes and early recovery of pain and ROM compared to open repair.
本研究比较了慢性下尺桡关节(DRUJ)不稳定患者三角纤维软骨复合体(TFCC)中央凹撕裂的关节镜修复与切开修复的临床疗效。回顾性分析了2016年至2020年间共79例采用关节镜技术(n = 35)或切开技术(n = 44)进行TFCC中央凹修复的患者。比较了两组术后2、4、6、12、24个月时的视觉模拟量表(VAS)疼痛评分、主动活动范围(ROM)、握力、梅奥改良腕关节评分(MMWS)、上肢、肩部和手部功能障碍(DASH)问卷评分以及患者自评腕关节评估(PRWE)评分。术后两年,与术前测量值相比,两组的临床参数(VAS、MMWS、DASH和PRWE)、握力和ROM均有显著改善(P < 0.001)。然而,我们未能发现两组在上述临床因素上有任何统计学显著差异。关节镜组在术后2个月时的屈伸弧以及术后2个月和4个月时的旋前旋后弧均优于切开组(P < 0.001)。术后两年两组之间无显著差异。10例患者(12.6%)出现复发性不稳定(关节镜组3例,切开组7例,P = 0.499)。同样,两组在重返工作岗位的时间上也无显著差异。与切开修复相比,关节镜下TFCC中央凹修复提供了相似的良好疗效以及疼痛和ROM的早期恢复。