title: Biomechanical Comparison of Open and Arthroscopic Transosseous Repair of Triangular Fibrocartilage Complex Foveal Tears: A Cadaveric Study.
abstract: OBJECTIVE
  To biomechanically compare the stability between open repair and arthroscopic transosseous repair technique for reattachment of the foveal triangular fibrocartilage complex (TFCC). We also evaluated the feasibility of a new aiming device for the creation of 2 bone tunnels simultaneously during the arthroscopic technique.
  
  
  METHODS
  Six matched pairs of fresh-frozen forearm cadaver specimens were prepared for testing. Group I specimens were treated by open repair with suture anchor. Group II specimens were treated by arthroscopic transosseous suture with a new aiming device. Before and after disruption of the TFCC fovea and after its repair, dorsal and palmar translation of the ulna was measured in both groups in response to a load (3 kg) applied in the palmar and then in the dorsal direction. The total translation of the ulna was calculated as the sum of the mean dorsal and palmar translations.
  
  
  RESULTS
  The mean total ulnar translation before and after TFCC disruption, and after TFCC repair was 5.94 ± 2.16 mm, 9.08 ± 2.64 mm, and 6.04 ± 2.18 mm, respectively. The specimens demonstrated a significant increase in the total translation of the ulna after disruption of the ulnar attachment of TFCC (P = .003), whereas a significant decrease was observed after TFCC foveal repair (P = .003). The median percentage of eliminated translation after TFCC repair was 64% and 172%, respectively, in groups I and II (P = .043).
  
  
  CONCLUSIONS
  The athroscopic transosseous suture technique demonstrated superior repair efficacy to the open repair technique in terms of biomechanical strength. This cadaveric study also demonstrated the feasibility of a new aiming device.
  
  
  CONCLUSIONS
  When making decisions about TFCC foveal repair, arthroscopic transosseous suture technique may provide better biomechanical strength than the open repair technique.
authors.affiliation: Department of Orthopedics, E-Da Hospital/I-Shou University, Kaohsiung, Taiwan.
authors.forename: Ching-Hou
authors.initials: CH
authors.lastname: Ma
authors.affiliation: Department of Biomedical Engineering, I-Shou University, Kaohsiung, Taiwan.
authors.forename: Ting-Sheng
authors.initials: TS
authors.lastname: Lin
authors.affiliation: Department of Orthopedics, E-Da Hospital/I-Shou University, Kaohsiung, Taiwan. Electronic address: wuchinhsien@icloud.com.
authors.forename: Chin-Hsien
authors.initials: CH
authors.lastname: Wu
authors.affiliation: Department of Biomedical Engineering, I-Shou University, Kaohsiung, Taiwan.
authors.forename: Dong-Yi
authors.initials: DY
authors.lastname: Li
authors.affiliation: Department of Orthopedics, E-Da Hospital/I-Shou University, Kaohsiung, Taiwan.
authors.forename: Shih-Chieh
authors.initials: SC
authors.lastname: Yang
authors.affiliation: Department of Orthopedics, E-Da Hospital/I-Shou University, Kaohsiung, Taiwan.
authors.forename: Yuan-Kun
authors.initials: YK
authors.lastname: Tu
mesh_terms: D000368:Aged; D001182:Arthroscopy; D001696:Biomechanical Phenomena; D002102:Cadaver; D005260:Female; D006801:Humans; D007593:Joint Instability / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D053441:Suture Anchors; D013536:Suture Techniques; D051478:Triangular Fibrocartilage / Q000601:surgery*; D014955:Wrist Joint / Q000601:surgery*