Bone Inflammation Flags Pain Post-TFCC Surgery
A retrospective cohort study of patients who underwent triangular fibrocartilage complex (TFCC) repair surgery found that bone marrow oedema on postoperative MRI was associated with persistent wrist pain, whereas scarring and effusions at the TFCC were not.
METHODOLOGY:
Researchers retrospectively enrolled patients with TFCC lesions treated using arthroscopy-assisted, mini-open TFCC outside-in repair between 2012 and 2016.
A total of 17 patients older than 16 years (mean age at the time of surgery, 35 years; 41% men) were included.
Postoperative MRI scans were performed within 24 months after arthroscopy, with a mean follow-up duration of 22 months.
The pain level was assessed with patient-reported outcome measurements using the Munich Wrist Questionnaire. Clinical examination was conducted, and MRI scans were evaluated.
TAKEAWAY:
Postoperative MRI scans revealed scar tissue at the TFCC in 59% of patients and effusion in the ulnar recess in 53% of patients, with neither finding showing a consistent association with pain.
Bone marrow oedema was observed in the lunate of 29% of patients (three with and two without pain) and in the distal radioulnar joint (DRUJ) of 6% of patients with pain. Bone oedema was associated with pain.
Degenerative changes, including radioulnar arthrosis and DRUJ cartilage thinning, defects, or cysts, were not associated with pain.
IN PRACTICE:
"This present study is the first study correlating postoperative MRI findings after arthroscopic assisted TFCC surgery with both pain and function. Bone edema seems to be associated with pain, whereas scarring at the TFCC is visible on MRI but is not necessarily associated with pain," the authors wrote.
SOURCE:
This study was led by Francesca von Matthey, Klinikum Rechts der Isar, Technische Universität München, Munich, Germany. It was published online on May 26, 2025, in the Journal of Clinical Medicine .
LIMITATIONS:
This study included a small number of patients who underwent arthroscopic-assisted, mini-open TFCC outside-in repair, limiting the statistical power and generalisability of the findings.
DISCLOSURES:
This study did not receive any external funding. The authors reported having no conflicts of interest.
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