J Wrist Surg 2021; 10(06): 484-491
DOI: 10.1055/s-0041-1728802
Special Review: The Scapholunate Dilemma

Design Requirements for Scapholunate Interosseous Ligament Reconstruction

1   Department of Orthopedic Surgery, SUNY Upstate Medical University, Syracuse, New York
› Author Affiliations
Funding The study was supported by Department of Orthopedic Surgery, State University of New York, Upstate Medical University.


Background As numerous repairs, reconstructions, and replacements have been used following scapholunate interosseous ligament (SLIL) injury, there is a need to define the structural requirements for any reconstruction or replacement.

Methods Research has been conducted on the force needed to keep the scaphoid and lunate reduced following simulated injury, the failure force of the native SLIL and various replacements, the stiffness of the SLIL and replacements, and the torsional resistance of the scaphoid relative to the lunate.

Results Forces on the order of 50 N are needed to keep the scaphoid and lunate reduced during simple wrist motions in the chronically injured wrist. Even greater forces (up to 110 N) are needed to keep the bones reduced during strenuous activities, such as pushups. The failure force of the entire SLIL has been reported to be as high as 350 N and the failure force of just the dorsal component of the SLIL to be 270 N.

Conclusions The design requirements for a reconstruction or repair may vary depending upon the demands of the patient. In a high demand patient, a reconstruction needs to support the above-mentioned forces during cyclic loading (50 N), when performing strenuous activities (110 N), or during a fall (at least 350 N). Any artificial replacement must undergo careful biocompatibility testing.

Publication History

Received: 21 August 2020

Accepted: 04 March 2021

Article published online:
01 May 2021

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