Scapholunate ligament reconstruction poses a significant challenge in hand surgery, particularly in chronic cases or following failed previous treatments. Arthroscopic techniques have gained popularity as they offer reduced morbidity and faster recovery times. This video introduces a novel transosseous arthroscopic approach using a flexor carpi radialis tendon graft for scapholunate ligament reconstruction.

An arthroscopic reconstruction of the scapholunate ligament was performed using a flexor carpi radialis tendon graft. The graft was passed through transosseous tunnels in the scaphoid and lunate, with fixation to the radius. The technique involved the use of a suture anchor with FiberWire, a metallic screw with a washer, and a Kirschner wire. Surgical time, functional outcomes, and the overall cost of the procedure were compared to established techniques.

Surgical time was approximately 25% longer compared to established techniques. However, functional outcomes, as measured by the QuickDASH score, were comparable to traditional methods. Additionally, the total cost of the procedure was 31% lower than that of established techniques, without compromising treatment efficacy.

The described transosseous arthroscopic technique offers a viable alternative for scapholunate ligament reconstruction, with functional results comparable to established techniques. The increased surgical time can be attributed to the learning curve associated with the arthroscopic approach and graft manipulation. Nonetheless, the significant cost reduction presents a notable advantage, particularly in healthcare systems with limited resources.

Transosseous arthroscopic reconstruction of the scapholunate ligament using a flexor carpi radialis tendon graft is an effective technique, yielding functional outcomes similar to established methods while significantly reducing costs. This surgical video demonstrates the feasibility of the technique and may serve as an appealing option for surgeons seeking less invasive and more cost-effective alternatives for scapholunate ligament reconstruction.