Triangular Fibrocartilage Complex (TFCC) injury is an increasingly recognized problem that can significantly affect wrist function, even for activities of daily living. Diagnosis and treatment of ulnar-sided wrist pain has improved with advances in technology in imaging and arthroscopy. Several techniques have been described for arthroscopic repair of the TFCC. Arthrex provides solutions for capsular repair of the superficial TFCC as well as superficial and deep tears back to bone.

Hand and Wrist

Procedure

Using standard wrist arthroscopy portals and setup, type 1B tears of the TFCC are repaired back to their anatomic insertion on the bone. Using a specialized Micro SutureLasso™ suture passer, a 2-0 FiberWire® suture is passed through the TFCC and a mattress stitch is created. The TFCC kit is then used to place a knotless 2.5 mm PushLock anchor into the base of the ulna. The sutures are tightened, bringing both the superficial and deep fibers of the TFCC back to their insertion site on the bone. The knotless anchor is inserted and final fixation of the TFCC back to the bone is achieved.

Arthroscopic Knotless TFCC Repair Using the PushLock® Anchor

Arthroscopic Knotless TFCCRepair back to bone

Human

Arthrex introduces an all-arthroscopic, knotless technique to repair peripheral ulnar tears of the articular disk. The advantage of this technique is that it repairs both superficial and deep layers (ligamentum subcrunetum) of the articular disk back-to-bone at their anatomic insertion. In addition, using a knotless technique decreases potential soft tissue irritation from suture knots. The use of FiberWire suture allows for permanent suture fixation of the articular disk as compared to absorbable suture. The featured TFCC Instrument Kit significantly simplifies the arthroscopic procedure.

Arthroscopic Knotless TFCC Repair Back to Bone

Secondary (C)

Using standard arthroscopic portals, the Micro SutureLasso™ are directed through the TFCC tissue adjacent to the tear. The Micro SutureLasso can be inserted using either the outside-in or inside-out techniques. A specialized 2-0 FiberStick allows direct passage of 2-0 FiberWire suture through the Micro SutureLasso and TFCC tissue. Using either technique a mattress stitch is created over the tear. The sutures are then tied to the capsule to complete the repair.

Arthroscopic TFCC Repair using the Micro SutureLasso™ (Inside out / Outside in)


Arthroscopic TFCC Repair

The Arthrex Micro SutureLassos were designed to facilitate repair of the TFCC, whether the dorsal or palmar capsular ligament portion is torn. Each Micro SutureLasso has a 20-gauge tip designed to be less traumatic to the TFCC and surrounding ligament during passing. Both inside/out and outside/in techniques can be used, as well as a double needle technique. Use of the Micro SutureLassos will facilitate the repair by increasing the control and speed with which the suture can be passed when compared with previously described techniques. For detailed information about the Arthroscopic TFCC Repair Technique, visit our resources section.

The Ulnar Head Wafer procedure is used to eliminate further impingement of the distal ulna against the lunate. This impingement is commonly associated with central TFCC tears. Arthrex has developed extremely efficient, small size burrs (round and oval) to resect the few millimeters needed from the ulnar head.

TFCC Tears

Arthroscopic Knotless TFCC Repair Back to Bone

Arthroscopic TFCC Repair

Ulnar Head Wafer Excision