Jnl Wrist Surg 2019; 08(03): 250-254
DOI: 10.1055/s-0038-1670682
Emerging Technologies and New Technological Concepts
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Scapholunate Ligament Internal Brace 360 Tenodesis (SLITT) Procedure: A Biomechanical Study

Sanjeev Kakar
1  Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota
,
Ryan M. Greene
1  Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota
,
Janet Denbeigh
1  Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota
,
Andre Van Wijnen
1  Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota
› Author Affiliations
Further Information

Publication History

20 March 2018

02 August 2018

Publication Date:
18 September 2018 (eFirst)

Abstract

Background Twelve paired fresh frozen cadaveric wrists were randomized to a 360-degree tenodesis repair group or the 360-degree tenodesis repair with an internal brace (suture tape) construct.

Case Description The specimens were preloaded to 5 N and subsequently biomechanically loaded to failure, at a rate of 0.1 mm/s on a jig that allowed for axial load. The maximum load and mode of failure were recorded. Load to failure in the 360 tenodesis group with internal brace was 283.47 ± 100.25 N, compared with the 360 tenodesis group only, whose yield strength was 143.61 ± 90.54 N. The mode of failure within the internal brace construct was either through knot slippage, graft disruption, or bone separation from strength testing construct. The 360 tenodesis group tended to fail via graft slippage or graft rupture.

Literature Review The management of scapholunate instability can be a difficult problem to treat. Traditionally, many of the surgical reconstructions have focused upon dorsal ligament reconstruction with Kirschner (K) wire fixation. This results in prolonged immobilization of the wrist with varied outcomes, in part due to the multiaxial instability that may persist due to concomitant volar ligament disruption. To address this instability, surgical techniques have been devised that address both the volar and dorsal ligament injuries.

Clinical Relevance Scapholunate reconstruction with a 360-degree tenodesis and internal brace augmentation (SLITT procedure) provided superior biomechanical stability than tenodesis alone.

Ethical Approval

This study was performed at Arthrex HQ in Naples, Florida and was conducted per their review board.