Search Results (66)

Background/Objectives: Female tubal factor infertility is a major clinical challenge. While surgical repair of the fallopian tubes remains the traditional standard, biological fibrin sealants have been proposed to reduce tissue trauma and improve reproductive outcomes. Methods: We conducted database searches of PubMed/MEDLINE, EMBASE and Google Scholar until 31 August 2025, using the keywords “tubal anastomosis”, “tubal reanastomosis,” “tubal reanastomosis”, “uterine horn anastomosis”, “fibrin glue”, “fibrin sealant”, “biological sealant”, “tissue adhesive”, “rabbit”, “rat” and “sterilization reversal.” Reference lists of retrieved articles have been examined to find studies which tested end-to-end tubal (or small-animal uterine horn) anastomosis through biological adhesives with or without additional components to evaluate patency success, fertility results and adhesion formation. Results: Thirteen studies met the inclusion criteria (eleven animal; two human). Rat and rabbit models demonstrated that fibrin sealants with intraluminal splints and one-to-two anchoring sutures produced results comparable to microsutures for patency (tubal patency rates of 75–100%) and pregnancy success (pregnancy rates of 60–83%) while reducing surgical time and decreasing peritubal adhesions. The success rates of the procedures depended on the anastomosis locations. Isthmic–isthmic anastomosis produced better results than ampullary repairs which tended to fail or develop stenosis. Fibrin sealant-only repairs without splinting were associated with lower patency (almost 60%) despite acceptable histologic healing. Human data showed similar pregnancy rates (intrauterine pregnancy in about 40–50% of women) and tubal patency but no consistent decrease in adhesions. Ectopic pregnancy rates ranged from 9 to 11%. Conclusions: Fibrin sealants are useful adjuncts to microsurgical tubal repair, but they should not replace the basic repair procedures. The effectiveness of this procedure is dependent on three critical factors: precise segment alignment, proper use of splints and stents, and selection of segments with comparable caliber. In a personalized-medicine framework, fibrin-assisted reanastomosis may offer a tailored option for selected women who desire natural pregnancy. Modern standardized research is required to define indications and analyze how the adaptation of fibrin sealants in minimally invasive procedures affect reproductive outcomes, ectopic pregnancy rates, and adhesion development. Full article

Background/Objectives: In two-stage flexor tendon reconstruction, a biomechanically strong connection between the tendon graft, the motor unit, and the distal phalanx of the finger is essential to enable active rehabilitation after surgery. However, the available literature contains few biomechanical studies concerning the strength of this connection. In this study, we tested a new model of this connection involving suturing the tendon graft to the phalanx using an anchor and to the flexor digitorum profundus stump with a three-level continuous suture (palmaris longus—flexor digitorum profundus—anchor (PL-FDP-A)). Methods: For this study, we used eight fingers from patients with injuries that were unsuitable for replantation, as well as eight palmaris longus tendons harvested from cadavers. Eight specimens simulating the PL-FDP-A connections were prepared and tested on a tensile testing machine. The elongation of the specimens under a 20 N load (the minimum for active loading) and the force at rupture were assessed. Results: The mean rupture strength was 44.53 N (SD 16.27, min. 16.50, max. 64.60), with elongation at 20 N of 4.28 mm (SD 2.65, min. 1.49, max. 9.14). Conclusions: Based on our findings, we recommend the PL-FDP-A connection for use in two-stage flexor tendon reconstruction due to (1) rupture values which significantly exceeded the force required for active rehabilitation, and (2) minimal elongation at 20 N, so that motion transmission was not impaired. Full article

Background/Objectives: Distal biceps tendon rupture is a disabling injury that compromises elbow flexion and forearm supination strength, particularly in high-performance athletes. Although several fixation techniques have been proposed, no single method has proven optimal in combining mechanical stability, anatomical restoration, and early functional recovery. This study aimed to evaluate the efficacy, safety, and reproducibility of a hybrid dual-fixation technique combining a Tightrope^® cortical button (Arthrex, Naples, FL, USA) with a PEEK interference screw for anatomic reinsertion of the distal biceps tendon in athletic individuals. Methods: A prospective observational study was conducted on 13 high-performance athletes who underwent distal biceps tendon repair using the hybrid Tightrope–PEEK construct between March 2024 and September 2025. Functional recovery, muscle strength, esthetic contour, and patient satisfaction were evaluated using the Visual Analog Scale (VAS), Mayo Elbow Performance Score (MEPS), Quick Disabilities of the Arm, Shoulder and Hand questionnaire (QuickDASH), and a 5-point Likert scale over a 12-month follow-up. Descriptive statistical analysis was performed using IBM SPSS Statistics, version 29.0. Results: All patients achieved secure fixation with no intraoperative or postoperative complications, loss of reduction, or hardware failure. Early controlled mobilization began within the first postoperative week. At 6 months, flexion and supination strength were fully restored, and at 12 months, all patients achieved full range of motion and optimal functional scores (mean MEPS 100; QuickDASH 0). No “Popeye” deformities or contour irregularities were observed, and mean patient satisfaction was 5/5. Conclusions: The hybrid Tightrope–PEEK dual-fixation technique provides excellent mechanical stability, allowing early mobilization and rapid functional recovery with minimal complications. Its reproducibility and cosmetic advantages suggest that it represents a safe and effective option for distal biceps tendon reinsertion in high-demand athletes. Full article

Background: Cuff reconstructions vary due to different technical approaches by suture anchor manufacturers, as well as different suture construct configurations. Objectives: The main aim of this study is to primarily compare clinical outcomes and secondarily observe cost-effectiveness by assessing suture construct configurations in arthroscopic rotator cuff repair (ARCR). Methods: Using a retrospective local registry, we included patients undergoing arthroscopic rotator cuff repair who had been implanted with different anchor configurations and different anchor manufacturers. Data analysis was conducted via multiple linear regression, primarily evaluating the relationship between clinical scores (OSS; SSV) and suture construct configurations, to analyze, monitor, and compare the postoperative clinical development. Total surgical costs were also obtained from the clinical billing department for analysis of various factors, including Adjusted Life Years (ALYs) and Incremental Cost-Effectiveness Ratio (ICER), while controlling for sex, tear severity, and age. Results: A total of 317 patients were included in the final analysis, with a mean age at surgery of 60.1 ± 10.8 years, with 58% of patients being male. According to the Gerber tear severity classification, 23% of patients had a partial tear, 59% had at least one full-thickness tear, and the remaining 18% had a massive tear. Using linear regression models, the analysis of changes in Quality-Adjusted Life Years (QALYs) as the dependent variable did not yield statistically significant results. The postoperative development of the measured clinical scores (SSV; OSS) did not show a significant difference comparing the two manufacturers (p = 0.11, p = 0.85). However, the model evaluating costs identified significant effects related to the type of anchor configuration and manufacturer. Regarding anchor configurations, utilizing anchor configuration 1 or 2 resulted in lower costs by up to CHF 254.51 compared to the reference anchor configuration 4 (p < 0.05), after controlling for age, sex, tear severity, and anchor configuration. Conclusions: The primary findings of this study indicate that although clinical outcomes are generally consistent across various rotator cuff reconstruction scenarios, while secondarily the cost implications can differ significantly and are mainly attributed to the differing numbers of anchors required for each configuration and price setting of the manufacturer. The study underscores the importance of suture construct configuration and manufacturer selection in controlling healthcare costs while maintaining quality patient care. Full article

Background: It is known that meniscus root tears affect the biomechanics of the knee in a way that is equivalent to a total meniscectomy. Therefore, repair is increasingly favored for meniscal root tears. In our study, we aimed to investigate the clinical and radiological outcomes of meniscal root repairs with suture anchors. Materials and Methods: Patients who had undergone surgery for medial meniscus posterior root tear (MMPRT) using suture-anchors between 2018 and 2023 were retrospectively analyzed. Patients were excluded if they had a previous infection, a fracture and an operation on the same knee, or osteoarthritis and a follow-up period under one year. The MMPRTs were classified according to the LaPrade classification system. For the functional classification, the range of motion (ROM), the Visual Analog Scale (VAS), the Lysholm Knee Score (LKS), and the International Knee Documentation Committee (IKDC) Subjective Knee Form were used for the postoperative functional assessments. The radiological assessment was performed by measuring the medial meniscus extrusion (MME) and evaluating the signal changes in the magnetic resonance imaging (MRI) of the knee, which was recorded during the last follow-up examination. Results: Thirty-two patients (6M/26F) were included in the study. The mean age was 49.9 ± 5.4 years old, and the follow-up period was 29.6 ± 24.1 months. The LKS improved from 53.7 ± 6.9 to 83.6 ± 5.2 and the IKDC improved from 46.1 ± 6.9 to 83.0 ± 5.5 at the final follow-up control (p < 0.001 and p < 0.001). The VAS score decreased from 8.4 ± 0.5 to 2.5 ± 0.9 (p < 0.001). The MRI scan of the knee performed at the last follow-up examination showed no improvement in only one patient. While the MME before surgery was 5.0 ± 2.1 mm, it was 4.6 ± 2.1 mm at the last follow-up examination (p = 0.178). An increase in the Kellgren–Lawrence stage was observed in 4 of our patients (from stage 1 to stage 2 in one patient, from stage 0 to stage 1 in 3 patients). Conclusions: The results of this study suggest that repairing MMPRTs using suture-anchors is a valid solution for treatment and prevention in patients with poor prognoses in order to achieve positive results in reducing pain, restoring mobility, improving functional outcomes and avoiding a significant increase in progression to arthrosis. Full article

Background/Objectives: Anterior disc displacement (ADD) is a common temporomandibular joint (TMJ) disorder and may progress to internal derangements. Although arthroscopic discopexy (minimally invasive disc repositioning with fixation) has been adopted, suggested techniques and pooled outcomes have not been comprehensively synthesized. The aim of the present study was to summarize the effectiveness of arthroscopic discopexy in treating patients with disc-related TMJ disorders. Methods: This systematic review and meta-analysis followed Cochrane guidance and PRISMA 2020 protocol. Four databases were searched through 1 September 2025. A total of 26 studies were included in this review. Nine studies met the eligibility criteria for meta-analysis and were pooled. The remaining 17 studies were narratively described, focusing on surgical characteristics. Continuous outcomes (MIO, pain score (VAS 0–10)) were pooled as mean differences (MD) with 95% confidence intervals (CIs), and joint sounds were synthesized as dichotomous outcomes. Analyses and heterogeneity were performed in RevMan 5.4. Certainty was graded with GRADE. (PROSPERO: CRD420251145229). Results: 1086 TMJs were analyzed. Arthroscopic discopexy significantly improved MIO, pain, and joint sounds at all time points. The MD of MIO was 10.58 mm (95% CI: 4.46 to 16.70; p ≤ 0.001), 9.83 mm (95% CI: 4.09 to 15.57; p ≤ 0.001), and 13.06 mm (95% CI: 4.40 to 21.72; p ≤ 0.001), respectively. The MD of the pain score was −4.36 (95% CI: −6.89 to −1.82; p ≤ 0.001), −3.91 (95% CI: −6.23 to −1.59; p ≤ 0.001), and −4.56 (95% CI: −7.81 to −1.31; p < 0.01), respectively. At 12 months, joint sounds were less frequent than preoperatively (OR = 0.07; 95% CI: 0.01 to 0.37; p < 0.01). Overall, the certainty of evidence according to the GRADE approach was rated as low. Therefore, the results should be interpreted with caution, as high heterogeneity was observed across the three follow-up time points and the included studies were observational. Conclusions: These findings underscore the significance of arthroscopic discopexy in enhancing TMJ function and alleviating symptoms. Current evidence, characterized by a low risk of bias and low certainty, supports the advantage of arthroscopic discopexy. Due to the observational evidence base and heterogeneity, high-quality randomized trials conducted under standardized treatment protocols and with longer follow-up are needed. Full article

Arthroscopic shoulder surgery has undergone significant evolution over the past decades, particularly in the materials used for suture anchors. The transition from metallic to bioabsorbable polymer anchors has revolutionized soft tissue-to-bone repair procedures, offering distinct advantages in terms of biocompatibility, imaging compatibility, and reduced complications. This comprehensive review examines the current state-of-the-art in anchor polymers used in arthroscopic shoulder surgery and their biocomposite formulations. Additionally, we explore the role of biostable polymers and emerging technologies in anchor design. The review synthesizes clinical outcomes, degradation kinetics, biocompatibility profiles, and mechanical properties of various anchor polymer systems. We also discuss the challenges associated with each material type, including osteolysis, cyst formation, premature degradation, and osseointegration. Recent advances in biocomposite anchors demonstrate promising solutions to address these limitations, offering controlled degradation rates and enhanced osteoconductivity. This review provides clinicians and researchers with a comprehensive understanding of anchor polymer technologies, their clinical applications, and future directions in arthroscopic shoulder surgery. Nevertheless, potential publication bias and heterogeneity among studies should be considered when interpreting comparative data. Full article

Biodegradable zinc-based alloys have recently emerged as promising candidates for temporary biomedical implants due to their favorable biocompatibility, appropriate degradation rate, and relatively simple processing. In this study, the Zn-0.1Mg alloy was investigated after being processed by means of a two-step equal-channel angular pressing (ECAP) route, consisting of the first pass at 150 °C followed by a second pass at room temperature. The mechanical properties were evaluated using uniaxial tensile tests at different strain rates, while the microstructure and phase composition were analyzed using synchrotron hard X-ray diffraction and transmission electron microscopy (TEM). The processed alloy exhibited a remarkable enhancement in both strength and ductility compared to the annealed state. At the lowest applied strain rate, a fracture elongation of up to 240% was achieved at room temperature, representing a unique manifestation of superplasticity under ambient conditions. Diffraction analysis confirmed the stability of the supersaturated Zn matrix with minor Mg₂Zn₁₁ intermetallic phase. TEM observations revealed an ultrafine-grained microstructure and activation of non-basal slip systems, which enabled efficient plastic flow. These findings demonstrate that controlled severe plastic deformation provides an effective pathway for tailoring Zn-Mg alloys, opening opportunities for their use in the next generation of bioresorbable low-to-moderate load orthopedic fixation devices, e.g., plates, screws, suture anchors and craniofacial miniplates. Full article

Suture anchors are widely used for tendon and ligament repair, but their fixation strength is compromised in osteoporotic bone and limited bone volume such as the coracoid process. Existing designs are prone to penetration and insufficient cortical engagement under such conditions. In this study, we developed a novel short expandable-wing (SEW) suture anchor (Ti6Al4V) designed to enhance pull-out resistance through a deployable wing mechanism that locks directly against the cortical bone. Finite element analysis based on CT-derived bone material properties demonstrated reduced intra-bone displacement and improved load transfer with the SEW compared to conventional anchors. Mechanical testing using matched artificial bone surrogates (N = 3 per group) demonstrated significantly higher static pull-out strength in both normal (581 N) and osteoporotic bone (377 N) relative to controls (p < 0.05). Although the sample size was limited, results were consistent and statistically significant. After cyclic loading, SEW anchor fixation strength increased by 25–56%. In a 3D-printed anatomical coracoclavicular ligament reconstruction model, the SEW anchor provided nearly double the fixation strength of the hook plate, underscoring its superior stability under high-demand clinical conditions. This straightforward implantation protocol—requiring only a 5 mm drill hole without tapping, followed by direct insertion and knob-driven wing deployment—facilitates seamless integration into existing surgical workflows. Overall, the SEW anchor addresses key limitations of existing anchor designs in small bone volume and osteoporotic environments, demonstrating strong potential for clinical translation. Full article

Background: For high-grade dislocation of the acromioclavicular (AC) joint, surgical treatment is widely recommended. This study aimed to evaluate the clinical and radiological outcomes after arthroscopic-assisted stabilization of acute high-grade AC joint dislocations using a low-profile suture button (LPSB) combined with percutaneous AC cerclage fixation. A secondary objective was to quantify clavicular tunnel widening (cTW) and explore its correlation with clinical and radiological outcomes. Methods: This retrospective study included 45 patients with acute Rockwood type V injuries treated with the LPSB technique and additional AC cerclage. Clinical outcomes were the Constant Score (CS), Subjective Shoulder Value (SSV), Taft Score (TF), AC Joint Instability Score (ACJI), and VAS for pain upon palpation. Radiological assessment included coracoclavicular (CC) distance and percentage deviations compared to the contralateral side, reclassified according to Rockwood, dynamic posterior translation (DPT), cTW measurements, and assessment of ossifications and AC joint osteoarthritis. Results: After 35.3 months, significant improvements were observed in CC distance and percentage deviation. A total of 27.3% were reclassified as Rockwood type III and 2.3% as type V. Initial overreduction persisted in 18.2%. DPT was observed in 34.1% of cases. The mean CS was 89.64, the SSV was 91.1, and the VAS was 0.8. cTW occurred only below the superior button and increased significantly over time, showing a negative correlation with the SSV but no correlation with any radiological outcome parameter. No implant-related revision surgery was reported. Conclusions: Arthroscopic-assisted stabilization of acute high-grade AC joint dislocations using the LPSB technique with AC cerclage fixation provides excellent clinical outcomes and high patient satisfaction, with minimal implant-related complications and no need for revision surgery due to implant issues. Although cTW occurs, its clinical impact appears limited within this procedure. Full article

Introduction: Pediatric lower-lip dog bite injuries are challenging due to contamination, tissue loss, and the need to maintain function, appearance, and psychological well-being. This single case describes immediate definitive closure using sharp debridement with adjunct polyhexanide (PHMB), a full-thickness skin graft (FTSG), and a polyurethane (PU) compression foam bolster. Methods: A 10-year-old boy with a severe contaminated lower-lip defect underwent debridement and 0.04% PHMB irrigation. An upper-arm FTSG was inset and compressed with a suture-anchored PU dressing. Topical PHMB gel was used perioperatively and for seven days after bolster removal. Oral antibiotics were given for five days. The patient was discharged eight days after the injury with detailed wound care instructions. Results: Immediate definitive closure was achieved with complete graft survival and no infection, necrosis, unplanned early dressing changes, or reoperations. At 12 months, oral competence, speech, lip mobility, and contour were preserved. However, mild residual esthetic differences remained (dyschromia, shallow border indentation, vellus hairs on the graft). Conclusion: In this single descriptive case, primary closure of a lower-lip injury with the combined intervention was associated with an uncomplicated functional course and manageable esthetic trade-offs at 12 months. These observations are descriptive; comparative studies with standardized functional, esthetic, and psychosocial measures are needed. Full article

Background/Objectives: The aim was to provide a comprehensive, systematic review on the Lateral Extra-articular Tenodesis (LET) methods used in anterior cruciate ligament (ACL) reconstruction in the light of recent data. Methods: To identify all of the essential studies that reported relevant data concerning primary outcomes: indications for surgery, surgical technique, graft type, fixation method, and tibial fixation location, an extensive search of the major and significant electronic databases (PubMed, Cochrane Central, ScienceDirect, Web of Science, Embase) was performed by three independent authors. A systematic investigation was conducted in November 2023, with no limits regarding the year of publication. After the database search, three independent reviewers screened all the papers, which followed strictly the inclusion and exclusion criteria, identifying a title, abstract, and full text concerning LET, surgical technique, femoral attachment, tibial attachment, graft type, fixation method, knee angle during fixation, and graft tension at fixation in ACL reconstruction. A systematic review of the collected literature was carried out according to the guidelines of Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Study quality was assessed using the Cochrane Risk of Bias Tool. Results: Of the 35 papers reviewed, seven surgical techniques of LET differing in the way the procedure was performed were separated. The majority of papers were from Italy (n = 11), USA (n = 3), France (n = 3), and Canada (n = 3). The number of total participants across all studies was 6253. The majority of studies (17 papers) used the Lemaire modified procedure, and 10 papers used the MacIntosh technique modified by the Coker–Arnold approach. Most of the papers mentioned fixation location on the lateral distal part of the femur including six articles referring directly to lateral femoral epicondyle. Most authors (25 papers) defined tibial attachment as Gerdy’s tubercle. The most common graft was the iliotibial band and fixation method was sutures. The types of fixation in the surgical techniques of the collected papers were Sutures, Staples, Anchor, Interference screw, K-wire, Bioabsorbable Screw and Titanium Screw with a serrated polyethylene washer. Conclusions: Despite variability in technique, the Lemaire-modified procedure emerged as the preferred approach for Lateral Extra-articular Tenodesis, suggesting a general consensus around its reliability and reproducibility in clinical practice. The frequent use of the iliotibial band as graft material reflects its accessibility and suitability for reinforcing anterolateral stability. Similarly, the consistent use of sutures and fixation at Gerdy’s tubercle may indicate a favorable balance between technical ease and biomechanical strength. The variability in femoral fixation points—either at the lateral femoral condyle or epicondyle—highlights the ongoing debate or surgeon preference, underscoring the need for further comparative studies to establish optimal fixation strategy. Collectively, these patterns may help guide surgical decision-making, particularly when tailoring procedures to individual patient anatomy or surgical expertise. Full article

Objectives: Tibial anterior cruciate ligament avulsion fractures (TAFs) are avulsions of the anterior cruciate ligament (ACL) from its insertion at the tibial intercondylar eminence that share the same trauma mechanism as ACL tears. TAFs were initially considered to be a pediatric equivalent to adult ACL ruptures due to the weaker insertion of the ACL on the immature tibial spine. Recent literature suggests that adult TAFs may be more common than previously thought. The incidence, possible concomitant injuries, and other differences between pediatric and adult TAFs remain a topic of ongoing debate in the literature. This systematic review provides a descriptive synthesis of the symptoms, biomechanics, and treatment outcomes of TAFs in pediatric and adult populations. This study highlights notable trends but avoids formal comparisons or meta-analysis due to heterogeneity in the literature. Methods: A systematic review was conducted on human-related studies involving tibial anterior cruciate ligament avulsion fractures, identified in PubMed^®® and EMBASE^®® databases between 2000 and 2024. Studies in English or German were included, while editorials, reviews, experimental studies, and papers with insufficient data were excluded. Data were extracted on patient demographics, trauma mechanisms, fracture classification, diagnostic modalities, treatment approaches, and clinical outcomes. Specific outcome parameters included: incidence and type of postoperative complications, return to sport rate, revision surgeries, hardware removal rates, and duration of follow-up. Due to heterogeneity in reporting, a descriptive synthesis approach was used rather than a meta-analysis. Results: The systematic search identified 3938 publications, with 2707 articles screened after duplicate removal. A total of 56 studies met the inclusion criteria. A total of 677 tibial avulsion fractures (TAF) were analyzed, with 208 (30.4%) pediatric and 469 (69.6%) adult patients. Type III fractures were most common in both groups (pediatric: 63.9%, adult: 63.4%). Concomitant injuries were more frequent in adults (35.6%) than children (8.2%). Arthroscopic surgery was the predominant technique (pediatric: 79.1%, adult: 87.8%). Fixation methods differed: pediatric cases more often used screws (40.5%) and sutures (38.2%), while adults favored sutures (49.7%) and suture anchors (23.1%). Complications were more frequent in pediatric patients (35.1% vs. 17.1%). Conclusions: TAFs show age-related differences in injury patterns and outcomes. Pediatric cases are mostly sports-related, while adult cases are commonly due to road traffic accidents. Concomitant injuries are more frequent in adults, whereas pediatric patients experience higher rates of arthrofibrosis and instability. Adults are more prone to malunion and non-union. These findings support the need for age-specific diagnostic and treatment strategies. Full article

This study aimed to assess, using finite element analysis (FEA), the mechanical effects of cortical bone thickness and cancellous bone density on the pull-out strength of suture anchors. A PEEK anchor was modeled and embedded in synthetic bone blocks with cortical thicknesses ranging from 1 to 5 mm and cancellous densities of 10 PCF, 20 PCF, and 30 PCF. Axial tensile loading simulations were conducted for all combinations, and selected cases were validated through experimental pull-out tests using commercial synthetic bone, demonstrating agreement within ±6%. Both cortical thickness and cancellous density were found to enhance pull-out resistance, though the magnitude and pattern varied with density. At 10 PCF, pull-out strength increased linearly with cortical thickness. At 20 PCF, substantial gains were observed between 2 and 4 mm, followed by a plateau. At 30 PCF, most of the increase was confined between 2 and 3 mm, with minimal improvement thereafter. These findings suggest that fixation strategies should be adapted on the basis of bone quality and provide biomechanical insights to inform patient-specific implant design and surgical planning. Full article

Introduction: The scapholunate interosseus ligament (SLIL) is critical for wrist stability, with injuries causing carpal instability and potential scapholunate advanced collapse (SLAC). This technical note presents a novel ligament-sparing surgical technique for treating SLIL tears ranging from grade 2 to 4 of the Garcia-Elias classification. Materials and Methods: A retrospective study was performed on ten patients treated with this novel technique. The technique involves a dorsal approach to the wrist through a 5–7 cm incision ulnar to Lister’s tubercle. After exposing the scapholunate joint, reduction is performed using Kirschner wires (K-wires) as joysticks, followed by stabilisation with three K-wires through the scapholunate, scapho-capitate, and radio-lunate joints. Two 2.3 mm suture anchors with double sutures are placed where the reduction K-wires were removed. One pair of sutures connects the anchors and any remaining SLIL tissue, while the second pair create a shoelace-like capsulodesis. Post-operative care includes staged K-wire removal at one and two months, with progressive rehabilitation before returning to weight-bearing activities at six months. Results: All patients improved in pain and function. The technique addresses SLIL injuries by restoring both coronal alignment through ligament repair and sagittal alignment via dorsal capsulodesis. The use of suture anchors and direct repair preserves the native tissue while reinforcing the dorsal capsule–scapholunate septum complex, avoiding the need for tendon grafts or extensive bone tunnelling. Conclusions: This ligament-sparing technique offers several advantages, including absence of donor site morbidity, minimal damage to carpal cartilage and vascularity, and preservation of surgical options should revision be necessary. The procedure effectively addresses both components of scapholunate instability while maintaining a relatively straightforward surgical approach. Full article