All-Inside Arthroscopic TFCC Repair: Capsular Repair Kits Versus Soft Anchor Fovea Repair

The triangular fibrocartilage complex (TFCC) is a crucial structure in the stability and function of the wrist, particularly in the distal radioulnar joint (DRUJ). Injuries to the TFCC are common, especially among athletes and individuals engaged in repetitive wrist activities, often requiring surgical intervention for optimal recovery. Arthroscopic techniques have advanced significantly, allowing for minimally invasive repairs with improved outcomes. This presentation compares two prominent methods for all-inside arthroscopic TFCC repair: capsular repair kits and soft anchor fovea repair. 

Capsular repair kits involve the use of suture-based systems designed to reattach the torn TFCC to the capsule, restoring stability and function. These kits typically offer a straightforward technique with reproducible results, particularly effective in peripheral tears. They allow for precise tensioning and placement of the suture, which is critical for the healing process. However, challenges remain in ensuring robust fixation in areas with compromised tissue quality. 

On the other hand, soft anchor fovea repair involves securing the TFCC directly to the fovea of the ulna using bioabsorbable anchors. This method aims to restore the native anatomy and biomechanical function of the TFCC by directly addressing the foveal detachment. The technique is particularly advantageous in cases of peripheral tears with remarkable DRUJ instability, as it provides a more anatomical reconstruction. Nonetheless, this method may involve a steeper learning curve and requires precise anchor placement to avoid complications such as chondral damage. 

In conclusion, both capsular repair kits and soft anchor fovea repair offer viable solutions for TFCC injuries, with the choice of technique largely dependent on the specific tear pattern, tissue quality, and surgeon expertise. Further comparative studies are necessary to establish long-term outcomes and refine surgical indications.