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Arthroscopy Techniques

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https://www.readbyqxmd.com/read/29593980/anatomic-posterolateral-corner-reconstruction-with-autografts
#1
Carlos Eduardo Franciozi, Leonardo José Bernardes Albertoni, Guilherme Conforto Gracitelli, Fernando Cury Rezende, Luiz Felipe Ambra, Fábio Pacheco Ferreira, Marcelo Seiji Kubota, Sheila Jean McNeil Ingham, Marcus Vinícius Malheiros Luzo, Moisés Cohen, Rene Jorge Abdalla
Anatomic posterolateral corner reconstruction reproduces 3 main structures: the lateral collateral ligament, the popliteofibular ligament, and the popliteus tendon. The LaPrade technique reproduces all 3 main stabilizers. However, it requires a long graft, limiting its indication to clinical settings in which allograft tissue is available. We propose a surgical procedure that is a modification of the LaPrade technique using the same tunnel placement, hamstring autografts, and biceps augmentation when necessary...
February 2018: Arthroscopy Techniques
https://www.readbyqxmd.com/read/29552485/graft-retensioning-technique-using-an-adjustable-loop-fixation-device-in-arthroscopic-anterior-cruciate-ligament-reconstruction
#2
Joseph T Gamboa, Edward C Shin, Neil P Pathare, Patrick J McGahan, James L Chen
Anterior cruciate ligament (ACL) tears are an unfortunate and devastating injury in the athletic patient. Surgical reconstruction of the ACL with a taut graft construct is necessary to restore knee stability and help expedite the patient's return to an active lifestyle. Arthroscopy-assisted ACL reconstruction can be a technically involved procedure, where strong fixation limits graft motion to allow sufficient healing within the tibial and femoral tunnels at the bone-tendon interfaces. Loss of tension in a graft can cause symptomatic anterior or rotatory instability and potential retear of the ACL graft...
February 2018: Arthroscopy Techniques
https://www.readbyqxmd.com/read/29552484/anatomic-single-incision-repair-of-distal-biceps-tendon-ruptures-using-flexible-reamers
#3
Jimmy Tat, Adam Hart, Adam Cota, Khalid Alsheikh, Dominique Behrends, Paul A Martineau
Distal biceps tendon ruptures are treated operatively in active healthy individuals. Treatment consists of either single- or double-incision techniques, each with its own set of advantages and complications. The double incision was traditionally preferred for a more anatomic reattachment of the distal biceps tendon, but there has been renewed interest in the single-incision anterior approach given its lower risk for heterotopic ossification. However, current single-incision techniques cannot achieve anatomic reconstruction of the distal biceps because of a restricted operational angle with standard rigid instruments...
February 2018: Arthroscopy Techniques
https://www.readbyqxmd.com/read/29552483/a-percutaneous-knotless-technique-for-acute-achilles-tendon-ruptures
#4
Daniel J Liechti, Gilbert Moatshe, Jonathon D Backus, Daniel Cole Marchetti, Thomas O Clanton
Achilles tendon ruptures are a common tendon injury, usually occurring in middle-aged men during recreational sporting activities. Both nonoperative and operative management are employed to treat these injuries. Several operative treatments are described in the literature, including percutaneous Achilles repair, mini-open repair, and open repair. Open Achilles repair is associated with higher rates of impaired wound healing and infection, whereas minimally invasive techniques have been reported to have an increased risk of iatrogenic sural nerve injury...
February 2018: Arthroscopy Techniques
https://www.readbyqxmd.com/read/29552482/anatomical-arthroscopic-graft-reconstruction-of-the-anterior-tibiofibular-ligament-for-chronic-disruption-of-the-distal-syndesmosis
#5
Jesús Vilá-Rico, Enrique Sánchez-Morata, Elena Vacas-Sánchez, Cristina Ojeda-Thies
Injuries of the distal tibiofibular syndesmosis are commonly overlooked or mismanaged, and chronic instability is a debilitating condition leading to premature joint degeneration. Several methods of treatment have been described, mainly screw fixation, arthrodesis, or ligament reconstruction. Most clinical evidence is limited to case series, mainly screw fixation, and there is a general paucity of evidence regarding ligament reconstruction, which is considered to be more anatomic and to restore joint biomechanics...
February 2018: Arthroscopy Techniques
https://www.readbyqxmd.com/read/29552481/surgical-management-of-the-multiple-ligament-knee-injury
#6
Kadir Buyukdogan, Michael S Laidlaw, Mark D Miller
The management of multiligament knee injury is a complex process starting with the adequate identification of the injury. A detailed physical and radiographic examination with a thorough understanding of knee anatomy is crucial to assess all damaged structures: anterior cruciate ligament, posterior cruciate ligament, posteromedial corner including the medial collateral ligament, and posterolateral corner including the lateral collateral ligament. Several surgical techniques have been developed throughout the years to adequately address these ligament insufficiencies...
February 2018: Arthroscopy Techniques
https://www.readbyqxmd.com/read/29552480/primary-anterior-cruciate-ligament-repair-with-augmentation
#7
Sachin Ramchandra Tapasvi, Anshu Shekhar, Shantanu Sudhakar Patil
Anterior cruciate ligament (ACL) tears are usually managed by reconstruction with autograft or allograft, but primary repair in carefully selected patients is a reasonable option. Proximal avulsions presenting early with excellent tissue quality are amenable to repair and healing. Restoration of native ACL preserves its proprioceptive and kinematic functions. A repair is less invasive and avoids graft-related problems, and faster rehabilitation is possible. Protection for the repair in the early stages will allow better healing...
February 2018: Arthroscopy Techniques
https://www.readbyqxmd.com/read/29552479/articulated-bone-block-for-posterior-cruciate-ligament-reconstruction-using-bone-patellar-tendon-bone-autograft-surgical-technique-to-facilitate-graft-passage
#8
Ramón Cugat, Eduard Alentorn-Geli, Xavier Cuscó, Jordi Navarro, Gilbert Steinbacher, Pedro Álvarez-Díaz, Roberto Seijas, David Barastegui, Montse García-Balletbó
Posterior cruciate ligament reconstruction using the transtibial technique provides successful clinical outcomes. However, a bone-patellar tendon-bone (BTB) autograft with the transtibial technique has not been used by some surgeons because of concerns with graft passage from the tibial to the femoral tunnels (sharp turn) that can damage graft fibers. In the present surgical technique, an arthroscopic, transtibial, single-bundle technique for posterior cruciate ligament reconstruction using the BTB autograft with an easy and effective technical tip to facilitate graft passage is presented...
February 2018: Arthroscopy Techniques
https://www.readbyqxmd.com/read/29552478/a-technique-for-the-reduction-of-complications-associated-with-anterior-portal-placement-during-ankle-arthroscopy-using-a-peripheral-vein-illumination-device
#9
Yusuke Tsuyuguchi, Tomoyuki Nakasa, Masakazu Ishikawa, Yasunari Ikuta, Mikiya Sawa, Masahiro Yoshikawa, Nobuo Adachi
Ankle arthroscopy is a minimally invasive technique for ankle joint treatment. However, injury to the intermediate dorsal cutaneous nerve (IDCN) and the medial dorsal cutaneous nerve (MDCN) is a common complication during anterior portal placement. To prevent injuries, methods such as palpating the nerves topographically and marking the nerves by transilluminating the skin with an arthroscope have been proposed. Easier and more definitive methods of identifying the IDCN and MDCN should result in a reduction of complications...
February 2018: Arthroscopy Techniques
https://www.readbyqxmd.com/read/29552477/sulcus-deepening-trochleoplasty-and-medial-patellofemoral-ligament-reconstruction-for-recurrent-patellar-instability
#10
Michael S Laidlaw, Scott M Feeley, Jeffrey R Ruland, David R Diduch
There are multiple etiologies for recurrent patellar instability. While patella alta, an elevated tibial tubercle trochlear groove distance, and prior lateral patellar dislocations with medial patellofemoral ligament (MPFL) insufficiency have been shown to be risk factors for recurrent patellar instability, trochlear dysplasia can result in a significant impediment to normal patellar tracking. With the adequate identification of risk factors, appropriate surgical treatments can be individually tailored to the patient...
February 2018: Arthroscopy Techniques
https://www.readbyqxmd.com/read/29552476/latissimus-dorsi-tendon-transfer-with-acromial-osteotomy-for-massive-irreparable-rotator-cuff-tear
#11
Nicholas R Pagani, Antonio Cusano, Xinning Li
Latissimus dorsi tendon transfer is an effective option for young and active patients with massive irreparable posterosuperior rotator cuff tears and intact subscapularis tendon. This approach has been shown to relieve pain and improve shoulder function in both the short and long term. We describe a surgical technique using an acromial osteotomy to better expose the greater tuberosity for the tendon transfer without disrupting the deltoid muscle. The latissimus dorsi tendon is reinforced with a human dermal collagen matrix (GraftJacket; Wright Medical Group) for additional augmentation of the muscle to gain more excursion for the tendon transfer to the greater tuberosity...
February 2018: Arthroscopy Techniques
https://www.readbyqxmd.com/read/29552475/arthroscopic-in-situ-superior-capsular-reconstruction-using-the-long-head-of-the-biceps-tendon
#12
Yang-Soo Kim, Hyo-Jin Lee, In Park, Gwang Young Sung, Dong-Jin Kim, Jong-Ho Kim
Large to massive rotator cuff tears are challenging to repair, although there are several options for dealing with them. Among them, superior capsular reconstruction was recently introduced as an effective procedure for retaining the static stability of the shoulder joint and preventing the progression to cuff tear arthropathy. The purpose of this technique-based article is to describe a surgical option, called arthroscopic in situ superior capsular reconstruction, for large to massive rotator cuff tears using the long head of the biceps tendon...
February 2018: Arthroscopy Techniques
https://www.readbyqxmd.com/read/29552474/all-extra-articular-repair-of-anterosuperior-rotator-cuff-tears
#13
Malte Holschen, Kai-Axel Witt, Jörn Steinbeck
Anterosuperior rotator cuff tears involve the subscapularis tendon, supraspinatus tendon, and rotator interval. The long head of the biceps is usually affected and unstable in these complex lesions. Arthroscopic repair of anterosuperior rotator cuff tears often consists of 2 different procedures. Whereas the subscapularis tendon is reconstructed under intra-articular visualization, the supraspinatus tendon is reconstructed under extra-articular visualization. The rotator interval is often sacrificed to improve visualization and instrumentation...
February 2018: Arthroscopy Techniques
https://www.readbyqxmd.com/read/29552473/arthroscopic-repair-of-the-lateral-ulnar-collateral-ligament-of-the-elbow-using-a-knotless-suture-anchor
#14
Eugene T Ek, Kemble K Wang
The lateral collateral ligament (LCL) complex of the elbow plays a crucial role in the stability of the elbow joint, especially to varus loads. Deficiency of particularly the lateral ulnar collateral component of the LCL can lead to chronic posterolateral rotatory instability, which can be functionally debilitating and can lead to a rapid onset of early degenerative arthritis. Commonly, in the setting of acute rupture of the LCL, the ligament is repaired using an open technique with suture anchor fixation to the lateral epicondyle insertion point...
February 2018: Arthroscopy Techniques
https://www.readbyqxmd.com/read/29552472/endoscopic-management-of-calcaneofibular-impingement-and-posterior-ankle-impingement-syndrome-caused-by-malunion-of-joint-depressed-type-calcaneal-fracture
#15
Tun Hing Lui, Yuk Chuen Siu, Wai Kit Ngai
Identification of the correct source of symptoms is the key in formulating the correct treatment plan for heel pain after calcaneal malunion. Calcaneofibular and posterior ankle impingements can occur due to malunion of a joint depressed-type calcaneal fracture. The purpose of this Technical Note is to report the technical details of posterior and lateral decompression through the posteromedial and posterolateral portals using posterior ankle endoscopy.
February 2018: Arthroscopy Techniques
https://www.readbyqxmd.com/read/29552471/a-technique-for-arthroscopic-assisted-ligamentum-teres-augmentation-using-a-suture-tape-augmentation
#16
Julie A Neumann, Renee S Greene, Michael B Banffy
Ligamentum teres (LT) tears are a pathologic condition being identified at increasing frequency because of growing use of hip arthroscopy. The exact role of the LT is not well understood, but it has been shown in recent biomechanical studies to contribute to hip stability. Patients with hip pain, instability, and/or mechanical symptoms with advanced imaging findings showing LT pathology may benefit from an LT augmentation. We present an arthroscopic-assisted LT augmentation technique, which can be performed as an isolated procedure or in conjunction with an arthroscopic labral repair and/or debridement, chondroplasty, and femoroplasty...
January 2018: Arthroscopy Techniques
https://www.readbyqxmd.com/read/29552470/cartilage-repair-in-the-knee-using-umbilical-cord-wharton-s-jelly-derived-mesenchymal-stem-cells-embedded-onto-collagen-scaffolding-and-implanted-under-dry-arthroscopy
#17
Boguslaw Sadlik, Grzegorz Jaroslawski, Mariusz Puszkarz, Adrian Blasiak, Tomasz Oldak, Dominika Gladysz, Graeme P Whyte
Cell-based cartilage repair procedures are becoming more widely available and have shown promising potential to treat a wide range of cartilage lesion types and sizes, particularly in the knee joint. More recently, techniques have evolved from 2-step techniques that use autologous chondrocyte expansion to 1-step techniques that make use of mesenchymal stem cells (MSCs) embedded onto biocompatible scaffolding. Our 1-step technique has been further developed to provide cell-based cartilage repair using MSCs that have the potential to be used in an off-the-shelf manner, without the need for autologous tissue harvest...
January 2018: Arthroscopy Techniques
https://www.readbyqxmd.com/read/29552469/ulnar-collateral-ligament-repair-with-suture-augmentation
#18
David P Trofa, Joseph M Lombardi, Manish S Noticewala, Christopher S Ahmad
Reconstruction of the ulnar collateral ligament (UCL) remains the gold standard for treating overhead throwing athletes with valgus instability secondary to UCL pathology. Although surgical techniques for reconstruction have evolved over time, current methods allow 90% of patients to return to their preinjury level of activity. Despite encouraging results with reconstruction, UCL repair remains a valuable treatment option for patients with UCL pathology fitting specific criteria. There are a number of advantages associated with a direct repair, and further, the development of collagen-coated sutures for ligament repair augmentation makes this procedure an attractive surgical option under the correct circumstances...
January 2018: Arthroscopy Techniques
https://www.readbyqxmd.com/read/29552468/endoscopic-superior-peroneal-retinaculum-reconstruction
#19
Wilson Wai Shun Hau, Tun Hing Lui, Wai Kit Ngai
Post-traumatic peroneal tendon subluxation or dislocation is most commonly due to injury to the superior peroneal retinaculum. Acute repair of the retinaculum is an option for active athletes who desire quick return of sport activity. In general, conventional open surgeries require extensive exposure of the injured superficial peroneal retinaculum and have potential risks of scar formation, sural nerve injury, limited range of movement, peroneal tendon re-subluxation, and tendon irritation. The purpose of this Technical Note is to describe the details of endoscopic superior peroneal retinaculum reconstruction...
January 2018: Arthroscopy Techniques
https://www.readbyqxmd.com/read/29552467/dynamic-anterior-stabilization-using-the-long-head-of-the-biceps-for-anteroinferior-glenohumeral-instability
#20
Philippe Collin, Alexandre Lädermann
Anteroinferior glenohumeral instability can be treated by variants of the Bankart repair, remplissage , and the Latarjet procedure, although all options remain associated with complications, including recurrence, stiffness, persistent pain, apprehension, and dislocation arthropathy. The authors therefore thought of a concept of dynamic anterior stabilization to treat anteroinferior glenohumeral instability by transferring the long head of the biceps within a subscapularis split to the anterior glenoid margin, thereby creating a "sling effect" by using a conservative technique...
January 2018: Arthroscopy Techniques
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