Outcomes After Wrist Arthroscopy for the Treatment of Scapholunate Predynamic Instability in the Young Active Patient

Abstract

Purpose: Predynamic instability in scapholunate (SL) ligament tears is a source of wrist pain. Despite this, identifying the proper treatment remains elusive. The purpose of this study was to evaluate return to activity after wrist arthroscopic electrothermal shrinkage for treatment of SL predynamic instability. Methods: Patients enrolled in an ongoing quality assurance project of wrist arthroscopic electrothermal shrinkage surgery for treatment of SL predynamic instability in an active duty military patient cohort were included in this retrospective review. Primary outcomes at a 2-year minimum follow-up were the rate of return to full duty and the rate of return to push-up activities. Results: This study identified 14 active duty patients who met inclusion criteria, mean age 29 years. Six were male and 9 of 14 had concomitant arthroscopic occult dorsal ganglion cyst removal at the time of the index surgery. The severity of SL instability was staged using the Geissler classification; the cohort distribution for stages I, II, and III was 3 patients, 10 patients, and 1 patient, respectively. At 2-year follow-up, the return to duty rate was 12 out of 14 and the return to push-ups activity rate was 11 out of 14. Pain with activities by visual analog scale was reduced from 7.1 to 1.4. Conclusions: Prior studies demonstrated SL ligament electrothermal shrinkage as a useful modality for pain relief. Our study suggests that this treatment may also aid in return to duty and push-up activities for young active patients. Type of study/level of evidence: Therapeutic IV. Key words: predynamic instability, scapholunate, thermal shrinkage, wrist arthroscopy