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The following is a summary of “Arthroscopically assisted repair of foveal triangular fibrocartilage complex tear using modified “double loop suture” – a retrospective cohort study,” published in the February 2025 issue of the BMC Surgery by Zheng et al.

The triangular fibrocartilage complex (TFCC) is a critical stabilizing structure of the distal radioulnar joint (DRUJ) and is commonly subjected to traumatic or degenerative injuries that may lead to pain, functional impairment, and joint instability. When conservative management fails to provide symptom relief, surgical intervention is often warranted. This study aimed to evaluate the clinical efficacy of arthroscopic-assisted modified “double loop suture” transosseous repair for TFCC foveal tears in restoring DRUJ stability and improving functional outcomes. 

A retrospective review was conducted on 14 patients who underwent this procedure between January 2021 and 2023. During surgery, an osseous tunnel was created, and two nickel-based alloy loops along with a 2–0 polydioxanone II (PDS II) suture were used to achieve anatomic repair. Postoperatively, all patients underwent structured rehabilitation exercises under supervision. Patients were followed for an average of 15 months, and multiple clinical outcome measures were assessed, including pain levels, grip strength, wrist range of motion, and functional disability scores. The visual analog scale (VAS) score for pain significantly decreased from a preoperative mean of 5 (95% CI 4–6) to 2 (95% CI 1–3) at the final follow-up (p < 0.05). Grip strength improved from a baseline of 17 kg (95% CI 13–22) to 21 kg (95% CI 16–25) postoperatively (p < 0.05). 

Functional disability, assessed by the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire, showed a significant reduction in scores from 35 (95% CI 26–44) preoperatively to 16 (95% CI 9–22) at the final follow-up (p < 0.05). The Patient-Rated Wrist Evaluation score also demonstrated a notable decline from a median of 28 (IQR 21–48) before surgery to 10 (IQR 6–15) at the final assessment. Wrist flexion-extension range improved from a mean of 111° (95% CI 100–122) preoperatively to 116° (95% CI 106–126) after surgery (p < 0.05), while forearm pronation-supination increased from 125° (95% CI 110–140) to 135° (95% CI 121–149) (p < 0.05). None of the patients exhibited residual DRUJ instability, as determined by the ballottement test, and no surgical complications such as postoperative infection, dorsal ulnar nerve injury, or iatrogenic ulnar styloid fracture were observed. These findings suggest that arthroscopic-assisted modified “double loop suture” transosseous repair provides a reliable and effective means of restoring DRUJ stability, reducing pain, and improving wrist function in patients with TFCC foveal tears. 

This technique may serve as a preferred surgical approach for TFCC reconstruction due to its favorable clinical outcomes, low complication rate, and ability to achieve anatomical restoration. Further studies with larger sample sizes and long-term follow-up are recommended to validate these findings and optimize surgical protocols for TFCC repair.

Source: bmcsurg.biomedcentral.com/articles/10.1186/s12893-025-02806-y