title: Biomechanical comparison of 3 methods of scapholunate ligament reconstruction.
abstract: OBJECTIVE
  To compare the biomechanical characteristics of 3 methods of scapholunate (SL) ligament reconstruction, including 1 that provides a biological central axis tether.
  
  
  METHODS
  Twelve fresh-frozen cadaver limbs were mounted on a jig that allowed for wrist and finger motion by tendon loading. The specimens were randomized to receive the SL axis method (SLAM) reconstruction, the Blatt capsulodesis (BC), or the modified Brunelli tenodesis (MBT). Fluoroscopic images were taken to measure the SL interval and SL angle in various positions. The specimens were evaluated in 4 states: intact, with the SL and radioscaphocapitate ligaments cut, after reconstruction, and after reconstruction followed by 100 cycles of simulated motion.
  
  
  RESULTS
  After cycling, the MBT and the SLAM reconstructions performed significantly better than the BC in recreating the intact SL interval in a clenched fist posture. The SLAM SL interval trended to be closer to the intact state than the MBT SL interval. The SLAM reconstruction also trended toward greater restoration of the native SL angle in the clenched fist posture than either the MBT or the BC.
  
  
  CONCLUSIONS
  The SL ligament reconstruction that uses a 2-tailed tendon autograft placed along the axis of rotation of the SL joint and secured both at the scaphoid and the lunate minimized creep and reconstructed the critical dorsal SL ligament. The SLAM achieved improved the SL interval and SL angle correction compared with conventional techniques of SL ligament reconstruction.
  
  
  CONCLUSIONS
  The SLAM method may be a useful alternative for SL ligament reconstruction.
authors.affiliation: Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, NY; Department of Orthopaedic Surgery, Stanford University School of Medicine, Stanford, CA; Department of Orthopaedic Surgery, Philadelphia Shriners Hospital for Children, Philadelphia, PA; Department of Orthopaedic Surgery, NYU Hospital for Joint Diseases, New York, NY. Electronic address: steve.kichul.lee@gmail.com.
authors.forename: Steve K
authors.initials: SK
authors.lastname: Lee
authors.affiliation: Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, NY; Department of Orthopaedic Surgery, Stanford University School of Medicine, Stanford, CA; Department of Orthopaedic Surgery, Philadelphia Shriners Hospital for Children, Philadelphia, PA; Department of Orthopaedic Surgery, NYU Hospital for Joint Diseases, New York, NY.
authors.forename: Dan A
authors.initials: DA
authors.lastname: Zlotolow
authors.affiliation: Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, NY; Department of Orthopaedic Surgery, Stanford University School of Medicine, Stanford, CA; Department of Orthopaedic Surgery, Philadelphia Shriners Hospital for Children, Philadelphia, PA; Department of Orthopaedic Surgery, NYU Hospital for Joint Diseases, New York, NY.
authors.forename: Anthony
authors.initials: A
authors.lastname: Sapienza
authors.affiliation: Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, NY; Department of Orthopaedic Surgery, Stanford University School of Medicine, Stanford, CA; Department of Orthopaedic Surgery, Philadelphia Shriners Hospital for Children, Philadelphia, PA; Department of Orthopaedic Surgery, NYU Hospital for Joint Diseases, New York, NY.
authors.forename: Raj
authors.initials: R
authors.lastname: Karia
authors.affiliation: Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, NY; Department of Orthopaedic Surgery, Stanford University School of Medicine, Stanford, CA; Department of Orthopaedic Surgery, Philadelphia Shriners Hospital for Children, Philadelphia, PA; Department of Orthopaedic Surgery, NYU Hospital for Joint Diseases, New York, NY.
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Yao
mesh_terms: D000368:Aged; D001696:Biomechanical Phenomena; D005260:Female; D006801:Humans; D008023:Ligaments, Articular / Q000000981:diagnostic imaging / Q000601:surgery*; D012667:Lunate Bone; D008297:Male; D019637:Orthopedic Procedures / Q000379:methods*; D011859:Radiography; D019651:Plastic Surgery Procedures / Q000379:methods*; D021361:Scaphoid Bone; D014954:Wrist Injuries / Q000000981:diagnostic imaging / Q000601:surgery; D014955:Wrist Joint / Q000601:surgery
keywords: Carpal; instability; ligament; scapholunate; wrist