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Arthroscopy Techniques

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https://www.readbyqxmd.com/read/27909681/double-bundle-all-inside-posterior-cruciate-ligament-reconstruction-a-technique-using-2%C3%A2-separate-autologous-grafts
#1
Roy A G Hoogeslag, Bart W Oudelaar, Rianne Huis In't Veld, Reinoud W Brouwer
In a double-bundle posterior cruciate ligament reconstruction, several surgical techniques are available. Compared with other techniques, the advantages of the all-inside technique and cortical suspension devices with variable loop length are that shorter grafts can be used, tendons can be quadrupled, and a double-bundle posterior cruciate ligament reconstruction can be performed with autologous grafts. Furthermore, the all-inside technique provides independent outside-in socket reaming and is soft tissue, cortex, and bone sparing because no full diameter tunnels but sockets are created with a small diameter guide pin, which can transform into a retrograde drill...
October 2016: Arthroscopy Techniques
https://www.readbyqxmd.com/read/27909680/anatomic-labral-repair-in-the-hip-using-a-knotless-tensionable-suture-anchor
#2
Carlos Suarez-Ahedo, Timothy J Martin, John P Walsh, Sivashankar Chandrasekaran, Parth Lodhia, Benjamin G Domb
To perform a proper labral repair, most surgeons use anchors to secure the labrum to the acetabular bone. We aim to describe a technique for labral repair with a knotless tensionable suture anchor. This technique uses a looped suture configuration, allowing selective tensioning of the repair to maintain the anatomic suction seal of the hip. The use of this technique is easily reproducible and reduces the surgical time compared with previous techniques.
October 2016: Arthroscopy Techniques
https://www.readbyqxmd.com/read/27909679/arthroscopic-treatment-of-patellar-tendinopathy-use-of-70%C3%A2-arthroscope-and-superolateral-portal
#3
Orestis Karargyris, Vipul Mandalia
Surgical treatment of recalcitrant patellar tendinopathy includes both the open surgical approach and minimally invasive arthroscopic debridement. A variety of arthroscopic techniques have been described that involve the use of a standard 30° arthroscope and standard anterolateral and anteromedial portals. As a result, visualization of the infrapatellar region can be variable, and it may be necessary to create additional portals. A 70° arthroscope provides the advantage of a wider field of view to the surgeon...
October 2016: Arthroscopy Techniques
https://www.readbyqxmd.com/read/27909678/bridge-tenodesis-a-secure-fixation-technique-for-biceps-long-head-tendinopathy-during-arthroscopic-rotator-cuff-repair-using-a-suture-bridge-technique
#4
Jin-Young Park, Jae-Hyung Lee, Kyung-Soo Oh, Seok-Won Chung, Jin-Young Bang, Young-Min Noh
Tendinopathy of the long head of the biceps is often found as an intra-articular pathology in the glenohumeral joint. Because long head of the biceps lesions are common, surgical intervention to properly manage the long head of the biceps has become an important issue. Both tenodesis and tenotomy have been shown to provide benefits in biceps long head tendinopathy. But because of concerns about muscle power reduction, cramping, and "Popeye's deformity," which may result from biceps tenotomy, biceps tenodesis is a good option for treating biceps lesions...
October 2016: Arthroscopy Techniques
https://www.readbyqxmd.com/read/27909677/basic-shoulder-arthroscopy-lateral-decubitus-patient-positioning
#5
Alexander H Jinnah, Sandeep Mannava, Johannes F Plate, Austin V Stone, Michael T Freehill
Shoulder arthroscopy offers a minimally invasive surgical approach to treat a variety of shoulder pathologies. The patient can be positioned in either the lateral decubitus or the beach chair position. This note and accompanying video describe the operating room setup for shoulder arthroscopy in the lateral decubitus position, including positioning of the arms, head, and sterile preparation and draping. Appropriate lateral decubitus positioning for shoulder arthroscopy with careful attention to detail will promote ease of surgical intervention and minimize complications...
October 2016: Arthroscopy Techniques
https://www.readbyqxmd.com/read/27909676/anatomic-double-bundle-anterior-cruciate-ligament-reconstruction-with-a-free-quadriceps-tendon-autograft
#6
Sergiu Caterev, Dan Viorel Nistor, Adrian Todor
Anatomic double-bundle anterior cruciate ligament (ACL) reconstruction aims to restore the 2 functional bundles of the ACL in an attempt to better reproduce the native biomechanics of the injured knee and promote long-term knee health. However, this concept is not fully accepted and is not performed on a standard basis. In addition, the superiority of this technique over the conventional single-bundle technique has been questioned, especially the long-term clinical results. One of the down sides of the double-bundle reconstruction is the complexity of the procedure, with increased risks, operative time, and costs compared with the single-bundle procedure...
October 2016: Arthroscopy Techniques
https://www.readbyqxmd.com/read/27909675/arthroscopic-primary-repair-of-proximal-anterior-cruciate-ligament-tears
#7
Gregory S DiFelice, Jelle P van der List
In a select group of patients with proximal anterior cruciate ligament (ACL) tears, primary repair can be a useful technique. Preservation of the native ACL may be advantageous for proprioceptive function and is thought to restore normal knee joint kinematics. The procedure is a less morbid and more conservative surgical approach to restore knee stability. Primary repair is preferably performed in the acute setting because of better healing capacity and tissue quality. We present the surgical technique of arthroscopic primary ACL repair with suture anchors in patients with proximal tears and excellent tissue quality...
October 2016: Arthroscopy Techniques
https://www.readbyqxmd.com/read/27909674/minimally-invasive-quadriceps-tendon-harvest-and-graft-preparation-for-all-inside-anterior-cruciate-ligament-reconstruction
#8
Harris S Slone, William B Ashford, John W Xerogeanes
The quadriceps tendon is an infrequently used graft option for anterior cruciate ligament reconstruction despite favorable clinical results in the literature with low donor site morbidity. It is a versatile graft that can be harvested with bone or as a soft tissue graft alone. In addition, it can be used for anatomic, double-bundle, transtibial, and all-inside reconstructions. The unique characteristics of the quadriceps tendon allow for the ability to harvest a single-bundle large-diameter graft and minimize disruption of normal anatomy, which makes the quadriceps tendon an excellent choice for all-inside techniques...
October 2016: Arthroscopy Techniques
https://www.readbyqxmd.com/read/27909673/how-to-build-your-simple-and-cost-effective-arthroscopic-skills-simulator
#9
Georgios Arealis, James Holton, Joana Bento Rodrigues, Maria Sagkrioti, Martyn Snow, Mark Hamlet, Ofer Levy
Acquisition of arthroscopic skills is not always easy and can be time-consuming. Simulation in arthroscopy improves surgical skills and can bridge the gap between reduced surgical exposure and training time and the need to reach a required level of competency. We propose a method to create a simple and cost-effective arthroscopic skills simulator using readily available materials and a low-cost Web camera available from online shops. This arthroscopic simulation device can be used to improve skills of all levels of trainees at home, in a bioskills laboratory, or in the theater...
October 2016: Arthroscopy Techniques
https://www.readbyqxmd.com/read/27909672/arthroscopic-360%C3%A2-capsular-release-for-adhesive-capsulitis-in-the-lateral-decubitus-position
#10
Gregory L Cvetanovich, Timothy Leroux, Jason T Hamamoto, John D Higgins, Anthony A Romeo, Nikhil N Verma
Idiopathic adhesive capsulitis of the shoulder is a relatively common condition that results in pain and loss of motion due to capsular thickening and fibrosis. Most cases are successfully treated with conservative management including physical therapy and intra-articular steroid injections. If conservative management fails, arthroscopic capsular release allows precise release of thickened capsular tissue with a lower risk of complications and less soft-tissue trauma than manipulation under anesthesia alone...
October 2016: Arthroscopy Techniques
https://www.readbyqxmd.com/read/27909671/endoscopic-resection-of-the-tibialis-anterior-tendon-bursa
#11
Tun Hing Lui
The tibialis anterior tendon bursa is located between the tibialis anterior tendon and the medial cuneiform bone and close to the tendon insertion. Bursitis can occur as a result of excessive local friction, infection, arthritides, or direct trauma. Endoscopic resection of the bursa is indicated in case of symptomatic bursitis that is not responding to conservative treatment or infection is suspected. It is contraindicated if there is skin infection at the portal sites. The purpose of this technical note is to describe a minimally invasive approach of endoscopic resection of the tibialis anterior tendon bursa through anterior tibial tendoscopy...
October 2016: Arthroscopy Techniques
https://www.readbyqxmd.com/read/27909670/treating-rotator-cuff-tears-through-a-coracoacromial-mini-open-approach
#12
Wolfram Thomas, Tom Sascha Thomas, Luca Tafuro, Sebastian Walter
The purpose of this study is to present a "smart," open, minimally invasive surgical technique for rotator cuff repair of the shoulder. On the basis of an anatomic study by Tichy, we use a coracoacromial mobile window: We split-not detach-the deltoid muscle by respecting its fibers' orientation and resect the coracoacromial ligament before repairing the torn rotator cuff tendons with anchors. The described approach is fast, is technically uncomplicated, and can be carried out with a standard set of instruments...
October 2016: Arthroscopy Techniques
https://www.readbyqxmd.com/read/27909669/reconstruction-of-massive-posterior-nonrepairable-acetabular-labral-tears-with-peroneus-brevis-tendon-allograft-arthroscopy-assisted-mini-open-approach
#13
Esther Moya, Luis Gerardo Natera, Carlomagno Cardenas, Emanuele Astarita, Vittorio Bellotti, Manel Ribas
Many of the described labral-reconstruction procedures are purely arthroscopic. This approach only allows segmentary reconstructions. For more extensive reconstructions, surgical dislocation of the hip still represents the more suitable approach. We present an arthroscopy-assisted procedure combined with an anterior mini-open approach, which could be considered for reconstruction of nonrepairable labral lesions located in the posterior aspect of the acetabulum and massive reconstructions in cases of global-pincer femoroacetabular impingement and protrusio acetabuli...
October 2016: Arthroscopy Techniques
https://www.readbyqxmd.com/read/27909668/triple-row-modification-of-the-suture-bridge-technique-for-arthroscopic-rotator-cuff-repair
#14
Roger V Ostrander, Jarrod Smith, Michael Saper
Recent advances to improve outcomes in rotator cuff repair include using arthroscopic double-row suture-bridge techniques in an effort to reconstruct the rotator cuff footprint and improve fixation. However, when using this technique for larger tears, it can be difficult to get the lateral portion of the rotator cuff into an anatomic position. This report describes a triple-row modification of the suture-bridge technique that results in significantly more footprint contact area and contact pressure compared with the double-row and standard suture-bridge techniques...
October 2016: Arthroscopy Techniques
https://www.readbyqxmd.com/read/27909667/arthroscopic-capsular-reconstruction-of-the-hip-with-acellular-dermal-extracellular-matrix-surgical-technique
#15
Itay Perets, David E Hartigan, John P Walsh, Edwin Chaharbakhshi, Mary R Close, Benjamin G Domb
Atraumatic instability of the hip has become an increasingly studied occurrence in recent years. There are several established surgical techniques that help restore stability of the native hip joint. In some cases, these procedures are not an option. As the phenomenon has become recognized more frequently, a greater number of revision surgeries are warranted in patients with ligamentous laxity. A durable solution for irreparable microinstability needs to be formulated to address this vulnerable patient demographic...
October 2016: Arthroscopy Techniques
https://www.readbyqxmd.com/read/27909666/arthroscopic-reduction-and-internal-fixation-for-pipkin-type-i-femoral-head-fracture-technical-note
#16
Aditya Kekatpure, Taesoo Ahn, Soong Joon Lee, Mi Youn Jeong, Jae Suk Chang, Pil Whan Yoon
Femoral head fractures after posterior dislocation of the hip are uncommon and are conventionally treated by an open method. Hip arthroscopy can be a valuable treatment option for the management of femoral head fractures. Arthroscopy allows for a less invasive option when compared with arthrotomy and can allow faster recovery with minimal soft-tissue injury. We describe the arthroscopic reduction and internal fixation of Pipkin type I femoral head fractures with a detailed stepwise description of the surgical technique, including technical pearls and pitfalls, potential complications, and advantages and disadvantages...
October 2016: Arthroscopy Techniques
https://www.readbyqxmd.com/read/27909665/autologous-osteophyte-grafting-for-open-wedge-high-tibial-osteotomy
#17
Takenori Akiyama, Ken Okazaki, Taro Mawatari, Satoshi Ikemura, Shunsuke Nakamura
Osteophytes are physiological bony outgrowths that develop at the margins of the articular surfaces during the progression of osteoarthritis; they are associated with active endochondral bone formation processes and expressions of various growth factors. We believe they could be a source of bone grafts as a result of a potentially strong osteoinductive effect. Moreover, osteophytes can be easily harvested by arthroscopy in patients undergoing open-wedge high tibial osteotomy (OW-HTO) for medial unicompartmental knee osteoarthritis...
October 2016: Arthroscopy Techniques
https://www.readbyqxmd.com/read/27909664/arthroscopic-assisted-lower-trapezius-tendon-transfer-for-massive-irreparable-posterior-superior-rotator-cuff-tears-surgical-technique
#18
Bassem T Elhassan, Eduard Alentorn-Geli, Andrew T Assenmacher, Eric R Wagner
Tendon transfer options to reconstruct a massive irreparable posterior-superior rotator cuff tear include latissimus dorsi, teres major, or lower trapezius transfer. We previously described the lower trapezius transfer using a 2-incision approach, which includes a medial incision to harvest the lower trapezius and lateral transacromial incision to expose the rotator cuff and then perform the transfer through a deep tunnel connecting these 2 sites. In this report, we describe an arthroscopic-assisted technique of lower trapezius transfer augmented with an Achilles tendon allograft to reconstruct an irreparable posterior-superior rotator cuff tear...
October 2016: Arthroscopy Techniques
https://www.readbyqxmd.com/read/27909663/the-quebec-city-slider-a-technique-for-capsular-closure-and-plication-in-hip-arthroscopy
#19
Travis J Menge, Jorge Chahla, Eduardo Soares, Justin J Mitchell, Marc J Philippon
Biomechanical and clinical studies have shown that the hip joint capsule plays an important role in maintaining stability and hip mechanics, including rotation and translation. The recent literature has shown that capsule closure after hip arthroscopy helps to restore stability. Without restoration of the native anatomy, the hip joint may translate when patients engage in activities that place force across the hip, leading to either microinstability or frank dislocation. The purpose of this note is to describe our preferred technique of capsular closure or plication during hip arthroscopy...
October 2016: Arthroscopy Techniques
https://www.readbyqxmd.com/read/27909662/osteochondral-autograft-transfer-technique-for-glenoid-osteochondral-defect
#20
Douglas J Wyland, Clint Beicker
Glenoid osteochondral defects can be a significant source of pain and disability in an active population. Many treatments are available, but most joint-preserving procedures are limited to debridement, abrasion chondroplasty, or marrow-stimulation techniques, all of which depend on healthy underlying bone and none of which address underlying bony pathology. Osteochondral autograft transfer has been a successful form of treatment for lesions in the knee, elbow, and ankle, especially when subchondral bone is involved...
October 2016: Arthroscopy Techniques
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