What happens to the TFCC/fibrocartilage after it is debrided?

I am in my thirties and had a TFCC debridement + repair done several weeks ago, my arm has changed to a sugar tong brace now for another few weeks. Currently my wrists still feels weird/tender every now and then even in the brace. Can anyone share their recovery experience with TFCC repair + debridement? Thank you.

Also, what happens to the fibrocartilge after it is debrided? Does it regenerate? I am worried the disk will wear out in the near future with sports as the fibrocartilage is thinner after debridement? 

Hi. I'm not an MD, so can't speak to what actually happens in terms of cartilage growing back. My sense from a lot of ankle issues is that probably not, or not quickly. This said, I had a really good experience with TFCC debridement. Mine was done about 10 years ago, when I was 39 or 40. The dr. was not able to fix it entirely, but she shaved it it down to be less of an issue. It then was achy and wobbly but not too bad right after, except when I did stupid things like try to pull a gallon of milk from the fridge with that hand. That hurt. And didn't work. I did a TON of physical therapy to get the strength back. The physical therapists kept saying that a much lower strength level was fine, as I quickly reached "normal" strength, but I wanted it to match my other wrist and eventually got there. Went back to climbing a few months after surgery, maybe 2-3. Started really easy stuff, not too much pressure on wrist. Did some weights with that wrist (initially feared I'd reinjured with the weights, but it was ok with rest). I was more or less back to my pre-injury climbing capacity 3 months later. I did tape the wrist for a few years after that, because it felt wobbly somehow, though I couldn't quite say how and I occasionally had twinges of discomfort. But maybe 4-5 years ago, the twinges were gone and and I quit using the tape and it's been fine since (knock wood). Though I still avoid mantles if I possibly can.

AC One wrote: Also, what happens to the fibrocartilge after it is debrided? Does it regenerate? I am worried the disk will wear out in the near future with sports as the fibrocartilage is thinner after debridement? 

A debridement implies a technique used on an area of the fibrocartilage which has no blood supply. Cartilage is generally not vascularized by definition; however, it can and does get nutrients via synovial fluid using a mechanical means (i.e. as you move your joint, the fluid flows around the cartilage and delivers fresh nutrients to ensure its health). IIRC, the TFCC fibrocartilage disk is 75/25 avascular/vascular. Once they debride the avascular cartilage, it does not regenerate. They are simply trying to "smooth it out" so it doesn't hurt anymore when you use the joint. Cartilage should be low friction, but tears produce rough, irregular surfaces that increase friction and cause pain during movement (and sometimes eventually arthritis). There are some techniques surgeons might use to stimulate new cartilage to grow, but I think this is typically used in larger joints.

TFCC repairs indicate surgical work to the vascularized portion. Afaik, this means they may be suturing it, etc. This part of the fibrocartilage should regenerate due to available blood supply, but it also takes far, far longer to heal than debridement because tissue is regenerating.

The TFCC is weird because it is a hybrid structure of both cartilage as well as ligament. TFCs degenerate in everyone who lives long enough. Cadaver research has shown that by our fifth decade, TFCs are degenerating quite noticeably in most of the human population. However, most degenerated TFCs cause no pain (otherwise everyone would be walking around with wrist splints on all the time in older age).

You are right, debridement will make the disc thinner than before. But like I said, it also reduces frictional forces, and friction can be thought of as an excellent mechanism for that TFC to get even more fucked up over time. So, overall, debridement will be a good thing for a damaged fibrocartilage 7 or 8 times out of 10. (I think that statistic matches most of the post-op outcomes for TFCC surgery.)