Supercapsuloplasty Using an Anchor for Scapholunate Ligament Injury: A Technical Note

Abstract Scapholunate ligament (SLL) injuries are the most common source of carpal instability and may progress to degenerative changes when not properly treated. Arthroscopic Supercapsuloplasty has become a valuable minimally invasive option for mild to moderate scapholunate instability; however, the technique relies on the integrity of the dorsal intercarpal ligament (DICL). Because DICL avulsion is frequently associated with SLL tears, the conventional approach may be limited in combined lesions. This study presents a modified arthroscopic technique incorporating DICL reinsertion using an anchor to expand the indications of Supercapsuloplasty. The technique is performed through standard radiocarpal and midcarpal portals. After diagnostic arthroscopy, debridement, and bone scarification, a 2.2–2.7 mm anchor is inserted into the scaphoid through an accessory radial midcarpal portal to reattach the DICL. Two anchor-based suture loops are created—one toward the scaphoid and one toward the triquetrum. Supercapsuloplasty sutures are then passed through the dorsal capsule near the 3–4 portal, retrieved through the midcarpal portals, and shuttled across the scapholunate joint using the anchor-based loops. Final double-to-double knot-tying tensions the DICL and capsule, reproducing a labrum-like dorsal stabilizing effect. A preliminary series of five patients treated with the combined technique demonstrated reduced pain, improved grip strength, and maintenance of range of motion at early follow-up. Patients tolerated early physiotherapy well and reported functional improvement during low-load activities in the acute postoperative period. Anchor-assisted arthroscopic supercapsuloplasty effectively addresses combined SLL and DICL injuries, providing a minimally invasive and technically efficient solution for reducible scapholunate instability. By reestablishing dorsal capsule-ligamentous support, the technique expands traditional indications and offers encouraging early outcomes. Larger studies with long-term follow-up are warranted to confirm durability and broader applicability. Level IV (case series).