Removal of dorsal ganglion cyst

In this key lecture, Dr. Slutsky provides a thorough presentation about the dorsal radiocarpal ligament.

In this authoritative lecture, Dr. Michel Levadoux goes over the arthroscopic partial scaphoid implant.

In this key lecture, Dr. Levadoux introduces the arthroscopic partial scaphoid implant.

An anatomical and biomechanical study has recently shown that detachment of the scapholunate (SL) ligament from the dorsal capsuloligamentous scapholunate septum (DCSS) and dorsal intercarpal ligament (DIC) worsens scapholunate dissociation. This knowledge has revolutionized the treatment of scapholunate dissociation and formed the basis of the arthroscopic repair of the scapholunate ligament complex. In some large dissociation, we can use a trick, catching a largest part of the dorsal capsule, proximally and distally, in order to help scapholunate reduction when the knot is tightened. Sometimes, the scapholunate ligament is avulsed from the dorsal proximal pole of the scaphoid, and it is necessary to put an anchor at the exact location of the scapholunate attachment into the dorsal scaphoid to allow a dorsal capsuloligamentous repair as for a classical scapholunate tear.

There is still controversy regarding the value of arthroscopic suture of triangular fibrocartilage complex (TFCC) peripheral tears compared with open transosseous repair because only the latter method restores foveal insertions of TFCC in case of distal radioulnar joint (DRUJ) instability. Five classes of TFCC peripheral tears are recognized in a treatment-oriented algorithm based on arthroscopic findings, and indications to proper treatment are set accordingly.

Treatment of 1st CMC arthritis is controversial. Many techniques have been described, and indications are related to the stage of osteoarthritis. When the only trapeziometacarpal joint is involved with preserved axes, we can propose to put a pyrocarbon implant arthroscopically.

The interest of wrist arthroscopy for the treatment of intra-articular fractures of the distal radius has been demonstrated in the literature for several years. This surgical technique requires specific instrumentation,
like a tower traction, small size optics and small tools. Once the stabilization of the wrist has been performed (using K-wires or plates), an arthroscopic control allows to appreciate the reduction of the fracture, and to diagnose and treat ligamentous injuries. Reduction of the fracture is
sometimes not sufficient and can be carried out under arthroscopic control using K-wires as a joystick. This surgical technique needs a learning curve to be able to treat difficult articular fractures of the distal radius. Using arthroscopy, the follow-up of operated articular fractures of the distal radius is easier for the surgeon and the patient.

In this key lecture, Dr. Zemirline covers wrist arthroscopy anatomy.

The understanding of TFCC lesions has dramatically changed in recent years. Interesting proposal from Palmer in 1981, i.e. 30 years from now, and thanks to wrist arthroscopy, we have improved our knowledge of this disco-ligamentous complex and its lesions. This presentation provides an update of what was known and our progress in the field.

In this key lecture, Dr. Muratore outlines wrist arthroscopic anatomy.