Trends in wrist arthroscopic management of triangular fibrocartilage complex and ligament injuries: a South Korean nationwide study

Background: Wrist arthroscopy has been increasingly used to treat triangular fibrocartilage complex (TFCC) and wrist ligament injuries.This nationwide study investigated real-world treatment trends among patients diagnosed with traumatic wrist ligament injury (ICD-10 code S63.3), with a particular focus on TFCC injury, based on procedural codes and reimbursement criteria in South Korea.Methods: This study used the Korean National Health Insurance Service claims database.Patients aged ≥19 years who were newly diagnosed with ICD-10 code S63.3 between 2013 and 2021 were identified.Based on the reimbursement criteria for wrist arthroscopic procedures, patients who underwent arthroscopic joint excision/synovectomy or arthroscopic tendon/ligament repair or reconstruction within 2 years after diagnosis were included.Demographic characteristics, annual trends, procedure types, the interval from diagnosis to surgery, and subsequent ulnar shortening osteotomy performed within 1 year after the index arthroscopy were extracted and analyzed.Results: Among 211,627 screened patients, 8,814 adults (4.16%) underwent qualifying arthroscopic wrist surgery within 2 years of diagnosis.The mean age was 37.3 ± 13.1 years, and 62.6% were men.The annual number of arthroscopic procedures increased from 551 in 2013 to 1,517 in 2021.Patients in their 20s and 30s represented the largest age groups.During the study period, the predominant procedure shifted from excision/synovectomy to ligament repair/reconstruction.Most patients underwent surgery within 30 days of diagnosis, accounting for 66.5% of cases.Subsequent ulnar shortening osteotomy within 1 year after the index arthroscopy was performed in only 2.6% of patients.Conclusion: Patients who underwent wrist arthroscopy after a diagnosis of traumatic wrist ligament injury, including TFCC injury, were predominantly young male.The annual number of procedures increased steadily over the study period, accompanied by a growing proportion of repair-oriented procedures.Considering the continued upward trend, the demand for wrist arthroscopic treatment and the associated healthcare resources is expected to increase further.