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Arthroscopy Techniques

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https://www.readbyqxmd.com/read/28149744/arthroscopic-psoas-management-techniques-for-psoas-preservation-and-psoas-tenotomy
#1
Andrea M Spiker, Ryan M Degen, Christopher L Camp, Struan H Coleman
The iliopsoas tendon is an important dynamic stabilizer of the hip joint, and it should be carefully identified and preserved during routine hip arthroscopy. However, it may also be a source of hip pain manifesting as iliopsoas tendinitis or a snapping hip or contributing to the development of labral pathology caused by psoas impingement. In the appropriately indicated, refractory cases of iliopsoas-related hip pain, surgical intervention in the form of an iliopsoas tenotomy at the level of the labrum can result in reliable pain relief...
December 2016: Arthroscopy Techniques
https://www.readbyqxmd.com/read/28149743/a-surgical-technique-for-posterolateral-placement-of%C3%A2-interference-screw-accurately-in-tibial-tunnel-in%C3%A2-single-bundle-anterior-cruciate-ligament%C3%A2-reconstruction
#2
Prashant Parate, Bancha Chernchujit
Anatomic orientation of the graft in anatomic anterior cruciate ligament reconstruction is the key to improved knee stability, restoration of normal knee kinematics, and the prevention of long-term joint degeneration. The graft position and orientation in the joint depend on the position of the tibial and femoral tunnels. Graft displacement in the tibial tunnel due to the position of the interference screw when the screw has proximal fixation also has an effect on the orientation of the graft. We have developed a technique for adjusting guidewire placement for the interference screw posterolaterally in the tibial tunnel in anatomic single-bundle anterior cruciate ligament reconstruction...
December 2016: Arthroscopy Techniques
https://www.readbyqxmd.com/read/28149742/endoscopic-calcaneoplasty-and-achilles-tendoscopy-with-the-patient-in-supine-position
#3
Tun Hing Lui
Insertional and non-insertional Achilles tendinopathy is usually treated conservatively. Surgery is indicated if conservative treatment fails to relieve the pain. Endoscopic surgery has the advantages of less morbidity, a shorter operating time, reduced postoperative pain, and a lower rate of wound and soft-tissue healing problems. Patients will have a short recovery time and quickly resume work and sports because of less soft-tissue disruption. Moreover, the pathology can be better differentiated and precisely treated...
December 2016: Arthroscopy Techniques
https://www.readbyqxmd.com/read/28149741/arthroscopic-release-of-lateral-half-of-the-talocalcaneonavicular-joint
#4
Tun Hing Lui
Arthrofibrosis of the talocalcaneonavicular joint can follow trauma or surgery of the joint. Arthroscopic release of the lateral half of the talocalcaneonavicular joint is indicated if the painful restriction of hindfoot inversion together with tenderness of the lateral side of the joint that is not controlled with conservative treatment. This procedure is contraindicated in other causes of painful stiffness including post-traumatic arthritis, osteonecrosis, and malunion. This technique includes arthroscopic release of the lateral side of the anterior subtalar joint and the talonavicular joint...
December 2016: Arthroscopy Techniques
https://www.readbyqxmd.com/read/28149740/surgical-technique-jumper-s-knee-arthroscopic-treatment-of-chronic-tendinosis-of-the-patellar-tendon
#5
Matthias Brockmeyer, Alexander Haupert, Dieter Kohn, Olaf Lorbach
Chronic patellar tendinosis (jumper's knee) is a common problem among athletes. Conservative treatment is successful in most of the cases including, among others, the use of nonsteroidal anti-inflammatory drugs, local cryotherapy, eccentric muscle training, limitation of sports activity, and local infiltration. In approximately 10% of conservatively treated patients, conservative treatment fails and surgery is required. Different open and arthroscopic surgical techniques have been described in the literature...
December 2016: Arthroscopy Techniques
https://www.readbyqxmd.com/read/28149739/arthroscopic-superior-capsular-reconstruction-for-massive-irreparable-rotator-cuff-repair
#6
Stephen S Burkhart, Patrick J Denard, Christopher R Adams, Paul C Brady, Robert U Hartzler
We have been performing arthroscopic superior capsular reconstruction (SCR) with acellular dermal allograft for almost 2 years. Our techniques are based on Mihata's original concept for SCR, in which he used fascia lata autograft. In this report, we describe our standard arthroscopic technique as well as 2 variations of a "zip-line" technique, which we have found particularly useful for large dermal allografts (grafts that are ≥40 mm in any dimension).
December 2016: Arthroscopy Techniques
https://www.readbyqxmd.com/read/28149738/frontal-tendon-lengthening-plasty-for-treatment-of-structural-patella-baja
#7
Valentino F Bruhin, Stefan Preiss, Gian M Salzmann, Laurent P Harder
Patella baja is a severe complication seen after trauma, prolonged immobilization and surgery. Several surgical methods have been described to proximalize the patella without a change in the patella tendon length. Yet, patella tendon shortening and thickening can be regarded as the hallmark pathology. As such, we describe a technique for the lengthening of the patellar tendon to pathoconformly address underlying patella baja. The technique is reproducible and gives the possibility of an early postoperative mobilization to prevent re-baja-a typical complication after patella baja surgery...
December 2016: Arthroscopy Techniques
https://www.readbyqxmd.com/read/28149737/endoscopic-subtotal-fasciectomy-of-the-foot
#8
Tun Hing Lui
Plantar fibromatosis is a rare benign but often locally aggressive tumor of the plantar aponeurosis. Nonsurgical treatment is the first line of treatment for symptomatic lesions. Because of the high recurrence rate associated with surgical treatment, operation is indicated only when the lesions are highly symptomatic and conservative measures fail or the diagnosis is in question. The purpose of this technical note is to report the details of endoscopic subtotal fasciectomy. This may reduce the risks of skin necrosis and dehiscence, infection, and formation of painful hypertrophic scars...
December 2016: Arthroscopy Techniques
https://www.readbyqxmd.com/read/28149736/arthroscopic-debridement-of-the-thrower-s-shoulder-less-is-more
#9
Paul E Caldwell, Dustin C Dyer, Sara E Pearson
The thrower's shoulder has long been a topic of debate among shoulder specialists. The tremendous forces produced during the throwing motion coupled with the compilation of the pathology encountered in the thrower's shoulder have generated a complex treatment algorithm. Simplifying management options has been challenging and recommendations continue to evolve. Treatment of injuries to the thrower's shoulder most commonly involves addressing partial articular-sided rotator cuff tears. These can be isolated or more commonly associated with tearing of the posterior superior labrum...
December 2016: Arthroscopy Techniques
https://www.readbyqxmd.com/read/28149735/dynamic-hip-examination-for-assessment-of-impingement-during-hip-arthroscopy
#10
Renato Locks, Jorge Chahla, Justin J Mitchell, Eduardo Soares, Marc J Philippon
Arthroscopic procedures for treatment of hip pathology are growing exponentially as a result of continued improvements in the understanding of intra- and extra-articular hip anatomy and technological advancements in instrumentation. Nevertheless, it has been reported that the main cause of revision hip arthroscopy is related to a suboptimal intrasurgical management of the abnormal morphology in femoroacetabular impingement (FAI). Under-resection, over-resection, and in some cases combined under-resection and over-resection at different locations of the cam lesion at the femoral head-neck junction may lead to poor outcomes as a result of residual impingement or the iatrogenic creation of structural instability...
December 2016: Arthroscopy Techniques
https://www.readbyqxmd.com/read/28149734/medial-closing-wedge-distal-femoral-osteotomy-for-genu-valgum-with-lateral-compartment-disease
#11
James D Wylie, Travis G Maak
Lateral compartment disease combined with valgus alignment can lead to progressive knee joint degeneration. In the symptomatic patient with isolated lateral compartment disease, a varus-producing distal femoral osteotomy can unload the diseased lateral compartment. This osteotomy may be combined with other cartilage or meniscal restorative techniques to optimize knee joint preservation and pain relief. The osteotomy can be performed with a medial closing-wedge or lateral opening-wedge technique. Both techniques have been reported to improve knee-related quality of life in patients with lateral compartment disease...
December 2016: Arthroscopy Techniques
https://www.readbyqxmd.com/read/28149733/arthroscopic-interpositional-arthroplasty-of-the-second-metatarsophalangeal-joint
#12
Tun Hing Lui
Painful degenerative diseases of the second metatarsophalangeal joint are frequently progressive and difficult to treat. Surgical options for the degenerated second metatarsophalangeal joint include joint debridement and synovectomy, drilling and microfracture, core decompression, dorsal closing-wedge metatarsal osteotomies, joint arthroplasty (implant or interpositional), elevation of the depressed articular fragment and bone graft, distraction arthroplasty, osteochondral plug transplantation, osteochondral distal metatarsal allograft reconstruction, and resection arthroplasty (phalangeal base or metatarsal head)...
December 2016: Arthroscopy Techniques
https://www.readbyqxmd.com/read/28149732/arthroscopic-reduction-and-balloon-humeroplasty-in-the-treatment-of-acute-hill-sachs-lesions
#13
Drew Ratner, Jeffrey Backes, John M Tokish
Shoulder instability is often associated with an impaction fracture of the humeral head, commonly referred to as a "Hill-Sachs lesion." This lesion is present in both anterior and posterior instability. Forty percent to 90% of anterior shoulder dislocations have associated Hill-Sachs lesions, whereas 29% to 86% of posterior shoulder dislocations have reverse Hill-Sachs lesions. Both of these lesions can contribute to recurrent instability of the shoulder and require surgery to be treated. Currently, the most common procedures to address Hill-Sachs lesions are the remplissage procedure (transfer of the infraspinatus into the posterior humeral head defect), capsular shift, disimpaction technique, humeral head resurfacing, bone block transfer, or shoulder arthroplasty...
December 2016: Arthroscopy Techniques
https://www.readbyqxmd.com/read/28149731/modified-jobe-approach-with-docking-technique-for%C3%A2-ulnar-collateral-ligament-reconstruction
#14
Daniel J Kaplan, Sergio A Glait, William E Ryan, Laith M Jazrawi
The ulnar collateral ligament (UCL) of the elbow acts as the primary restraint to valgus force experienced in the late cocking and early acceleration phases of overhead throwing. If the UCL or dynamic flexor-pronator musculature is incompetent, elbow extension and valgus torque, as seen in throwing, can result in posteromedial impingement with subsequent chondromalacia and osteophyte formation. Before the first UCL reconstruction, performed by Frank Jobe in 1974, this injury was considered career ending in overhead athletes...
December 2016: Arthroscopy Techniques
https://www.readbyqxmd.com/read/28149730/quadruple-bundle-semitendinosus-gracilis-graft-technique-for-all-inside-anterior-cruciate-ligament-reconstruction
#15
Michael Kern, David Love, Eric J Cotter, William Postma
Hamstring tendon autograft has been shown to be an excellent option for anterior cruciate ligament (ACL) reconstruction. Adequate graft size can usually be achieved through either a double-bundle technique of semitendinosus and gracilis tendons or a quadruple-bundle technique using a single tendon. To minimize failure rates that result from graft insufficiency, a minimum graft thickness of 8 mm is recommended for reconstruction. However, certain patients possess small native hamstring tendons that do not allow for recommended graft thickness using either of these traditional techniques...
December 2016: Arthroscopy Techniques
https://www.readbyqxmd.com/read/28149729/arthroscopic-rotator-cuff-repair-double-row-transosseous-equivalent-suture-bridge-technique
#16
Mina Abdelshahed, Siddharth A Mahure, Daniel J Kaplan, Brent Mollon, Joseph D Zuckerman, Young W Kwon, Andrew S Rokito
Following a failed course of conservative management, arthroscopic rotator cuff repair (ARCR) has become the gold standard treatment for patients presenting with symptomatic rotator cuff (RC) tears. Traditionally, the single-row repair technique was used. Although most patients enjoy good to excellent clinical outcomes, structural healing to bone remains problematic. As a result, orthopaedic surgeons have sought to improve outcomes with various technological and technical advancements. One such possible advancement is the double-row technique...
December 2016: Arthroscopy Techniques
https://www.readbyqxmd.com/read/28149728/arthroscopic-interphalangeal-arthrodesis-of-the-thumb
#17
Tun Hing Lui
Arthrodesis of the interphalangeal joint of the thumb is an effective treatment for pain, deformity, or instability at the joint. Arthroscopic interphalangeal arthrodesis of the thumb is a minimally invasive surgery and has better cosmetic results and less surgical trauma as compared with the open approaches. The purpose of this technical note is to report the details of the arthroscopic interphalangeal arthrodesis with oblique placement of the headless screw. No traction device is used for this technique. It is indicated in recalcitrant painful arthritis of the interphalangeal joint of the thumb...
December 2016: Arthroscopy Techniques
https://www.readbyqxmd.com/read/28149727/arthroscopic-taloplasty-for-an-anterolateral-snapping-ankle
#18
Tun Hing Lui
Anterior ankle snapping syndrome is rare. Snapping of the extensor digitorum longus due to attenuated inferior extensor retinaculum and snapping due to hypertrophied or low-lying peroneal tertius muscle have been reported. We reported a new mechanism of anterolateral snapping due to a hypertrophied talar head. Anterolateral snapping ankle can be revealed by active dorsiflexion and plantarflexion of the ankle with the foot inverted. Foot inversion will tension the inferior extensor retinaculum and uncover the dorsolateral prominence of the talar head...
December 2016: Arthroscopy Techniques
https://www.readbyqxmd.com/read/28149726/arthroscopic-capsular-release-of-the-ankle-joint
#19
Tun Hing Lui
Adhesive capsulitis of the ankle is also known as frozen ankle and results in marked fibrosis and contracture of the ankle capsule. Arthroscopic capsular release is indicated for symptomatic frozen ankle that is resistant to conservative treatment. It is contraindicated for ankle stiffness due to degenerative joint disease, intra-articular malunion, or adhesion of the extensors of the ankle. The procedure consists of endoscopic posterior ankle capsulectomy and arthroscopic anterior ankle capsulotomy. It has the advantages of being minimally invasive surgery and allowing early postoperative vigorous mobilization of the ankle joint...
December 2016: Arthroscopy Techniques
https://www.readbyqxmd.com/read/28149725/correction-of-crossover-toe-deformity-by-arthroscopically-assisted-plantar-plate-tenodesis
#20
Tun Hing Lui
Plantar plate deficiency is the major pathology causing metatarsophalangeal joint instability. As the joint subluxates dorsally, the lumbrical is tethered at the medial side of the joint by the deep metatarsal ligament and becomes a deforming force for the development of crossover toe deformity. Plantar plate repair or reconstruction is a logical surgical treatment option. This can be performed through a dorsal or plantar approach. The purpose of this technical note is to report a minimally invasive technique of crossover toe deformity correction by suturing the plantar plate to the extensor tendon...
December 2016: Arthroscopy Techniques
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