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We conducted a study to determine if a minimally invasive posteromedial reconstruction technique would return medial knee stability to its intact state. Ten cadaveric knees were tested under 3 state conditions: intact, sectioned, and reconstructed. The medial compartment opening was measured on valgus stress radiographs at full extension and at 20° of flexion with a 10-N valgus load (applied with dynamometer) to assess valgus stability in the intact, sectioned, and reconstructed states. After posteromedial sectioning, mean medial gap was statistically significantly larger (P = .0002) at full extension (11 mm vs 3.3 mm) and at 20° of flexion (12.6 mm vs 3.7 mm). There was no statistically significant difference between the value of the intact state and the value after minimally invasive reconstruction at 0° (P = .56) or 20° (P = .102) of flexion. Interobserver reliability for the measurements was almost perfect (κ = 0.86). Minimally invasive medial knee reconstruction returns medial knee stability almost to normal at full extension and at 20° of flexion. Development of minimally invasive techniques will allow medial ligament reconstruction with minimal disruption of the surrounding tissue, potentially leading to less scarring and easier restoration of knee motion after surgery., Competing Interests: Authors’ Disclosure Statement: The authors report no actual or potential conflict of interest in relation to this article.

Background  Scapholunate advanced collapse and scaphoid nonunion advanced collapse result in high morbidity and pose significant challenges for active patients. Multiple treatment options have been proposed to yield satisfactory results; however, restoration of physiological wrist motion remains an issue. Questions/Purposes  The objective of this study was to compare wrist mobility after four different treatment methods for grade III wrist collapse: (1) no treatment, (2) scaphoidectomy and lunate-capitate arthrodesis, (3) scaphoidectomy, lunate-capitate arthrodesis, and triquetrum-hamate arthrodesis, and (4) scaphoidectomy, lunate-capitate arthrodesis, and triquetrum excision. Methods  Four paired ( n  = 8) fresh-frozen human cadaveric upper limbs were used in this controlled laboratory study. Computed tomography scans were collected at all testing states and measurements were made to evaluate midcarpal joint mobility and alignment. Results  A significant decrease in wrist extension was observed for all treatments. Middle column and two-column arthrodesis demonstrated no significant differences for carpal alignment and mobility. No significant differences were observed for triquetrum-hamate mobility or wrist extension between the partial and two-column arthrodesis. Triquetrum excision significantly improved ulnar deviation. Conclusion  The most important finding of this study was that the one-column arthrodesis has comparable carpal alignment and range of motion to that of bi-column arthrodesis. Clinical Relevance  The results of this study suggest that a stage III advanced wrist collapse can be treated by isolated lunate-capitate arthrodesis with scaphoidectomy. Fusion between the remaining carpal bones may not be necessary because the carpal alignment and range of motion of the remaining joints were not significantly different in the present study.