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J Hand Surg Am. 2015 Aug;40(8):1534-9. doi: 10.1016/j.jhsa.2015.03.031. Epub 2015 May 16.

Biomechanical Analysis of Scapholunate Ligament Repair Techniques.

Author information

1
Division of Hand and Upper Extremity Surgery and the Department of Biomechanics, Hospital for Special Surgery, New York, NY.
2
Division of Hand and Upper Extremity Surgery and the Department of Biomechanics, Hospital for Special Surgery, New York, NY. Electronic address: carlsonm@hss.edu.

Abstract

PURPOSE:

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.

CLINICAL RELEVANCE:

In a cadaveric model for primary repairs, double-loaded suture anchors demonstrated the highest LTF and offer a similar but unproven performance in vivo.

KEYWORDS:

SLIL; Scapholunate ligament; ligament; repair; wrist

PMID:
25986650
DOI:
10.1016/j.jhsa.2015.03.031
[Indexed for MEDLINE]

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