Knotless Arthroscopic Dorsal Scapholunate Capsulodesis: A Simplified Technique.

Partial dorsal tears of the scapholunate ligament are a common soft-tissue injury in the wrist. These injuries have been a challenging problem and have gone through evolutionary changes over time from different open to arthroscopic techniques.  This study describes a knotless arthroscopic dorsal scapholunate (SL) capsulodesis technique using both the radiocarpal and midcarpal joint portals, indicated for acute or chronic reducible scapholunate instability.  Using arthroscopy, we pierce the dorsal capsule on both sides of the dorsal torn remains of the SL ligament with two 18-gauge needles, one loaded with a 2-0 suture and the other with a nitinol wire loop. The 2-0 suture is weaved through the nitinol loop to create a knotless mattress stitch within the midcarpal joint and reduce the torn SL ligament.  In this article, we present the outcomes of a patient treated with this arthroscopic inside knotless technique in treating scapholunate instability.  This knotless arthroscopic scapholunate capsulodesis technique provides a simple method to performing an arthroscopic dorsal capsulodesis.