title: Biomechanical Analysis of Scapholunate Ligament Repair Techniques.
abstract: OBJECTIVE
  To evaluate the biomechanical properties of 3 scapholunate repair techniques.
  
  
  METHODS
  In 51 cadavers, the scapholunate ligament was exposed through a dorsal approach, incised at its scaphoid insertion, and repaired using 1 of 3 techniques: 2 single-loaded suture anchors, 2 double-loaded suture anchors, or 2 transosseous sutures. Twenty-four repaired specimens underwent load to failure (LTF) testing using tensile distraction on a servo-hydraulic machine. Twenty-seven specimens underwent cyclical testing to measure gap formation at the scapholunate joint.
  
  
  RESULTS
  The mode of failure was suture pullout through the substance of the ligament in 22 specimens, failure at the bone suture interface in 1, and anchor pullout in 1. Double-loaded anchor repairs demonstrated a significantly higher mean ultimate LTF compared with single-loaded anchor (91 N vs 35 N) and transosseous (91 N vs 60 N) repairs. Transosseous repairs demonstrated a higher mean ultimate LTF compared with single-loaded suture repairs (60 N vs 35 N). After 300 cycles, the average gap for the transosseous repair group was double that for the single- and double-loaded repairs, although not statistically significant.
  
  
  CONCLUSIONS
  Primary scapholunate ligament repairs using double-loaded suture anchors demonstrated significantly higher strength compared with single-loaded anchors and transosseous repairs. On cyclic loading, transosseous repairs demonstrated the greatest gap formation with no measurable difference between single- and double-loaded repairs.
  
  
  CONCLUSIONS
  In a cadaveric model for primary repairs, double-loaded suture anchors demonstrated the highest LTF and offer a similar but unproven performance in vivo.
authors.affiliation: Division of Hand and Upper Extremity Surgery and the Department of Biomechanics, Hospital for Special Surgery, New York, NY.
authors.forename: Lana
authors.initials: L
authors.lastname: Kang
authors.affiliation: Division of Hand and Upper Extremity Surgery and the Department of Biomechanics, Hospital for Special Surgery, New York, NY.
authors.forename: Eugene T
authors.initials: ET
authors.lastname: Ek
authors.affiliation: Division of Hand and Upper Extremity Surgery and the Department of Biomechanics, Hospital for Special Surgery, New York, NY.
authors.forename: Mike T
authors.initials: MT
authors.lastname: Wei
authors.affiliation: Division of Hand and Upper Extremity Surgery and the Department of Biomechanics, Hospital for Special Surgery, New York, NY.
authors.forename: Kathleen N
authors.initials: KN
authors.lastname: Meyers
authors.affiliation: Division of Hand and Upper Extremity Surgery and the Department of Biomechanics, Hospital for Special Surgery, New York, NY.
authors.forename: Krystle A
authors.initials: KA
authors.lastname: Hearns
authors.affiliation: Division of Hand and Upper Extremity Surgery and the Department of Biomechanics, Hospital for Special Surgery, New York, NY. Electronic address: carlsonm@hss.edu.
authors.forename: Michelle G
authors.initials: MG
authors.lastname: Carlson
mesh_terms: D002102:Cadaver; D050824:Carpal Joints / Q000293:injuries* / Q000503:physiopathology / Q000601:surgery; D006801:Humans; D008023:Ligaments, Articular / Q000293:injuries* / Q000601:surgery*; D012667:Lunate Bone; D021361:Scaphoid Bone; D053441:Suture Anchors; D013536:Suture Techniques; D013718:Tensile Strength
keywords: SLIL; Scapholunate ligament; ligament; repair; wrist