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Arthroscopy Techniques

journal
https://www.readbyqxmd.com/read/29379710/laparoscopic-treatment-of-pubic-symphysis-instability-with-anchors-and-tape-suture
#1
Justin W Arner, Marcio Albers, Brian S Zuckerbraun, Craig S Mauro
Patients with pubic symphysis instability who had failed nonoperative treatments may benefit from surgical repair. This disease process is rare, most commonly seen in postpartum women and athletes, and its surgical treatment is invasive and nonphysiological. Currently described surgical interventions, although limited, include plating, which provides an overly rigid construct with the risk of failure and possibly poor long-term outcomes particularly in athletes, and treatments such as curettage, more commonly used in the treatment of osteitis pubis...
January 2018: Arthroscopy Techniques
https://www.readbyqxmd.com/read/29379709/diagnostic-evaluation-of-the-knee-in-the-office-setting-using-small-bore-needle-arthroscopy
#2
Karan A Patel, David E Hartigan, Justin L Makovicka, Donald L Dulle, Anikar Chhabra
Arthroscopy is currently the gold standard for diagnosing intra-articular knee pathology. Magnetic resonance imaging (MRI) can be a clinical adjunct for diagnosis; however, it is not without its shortcomings. Although highly accurate, even advanced imaging misdiagnoses the condition in 1 in 14 patients with regard to anterior cruciate ligament pathology. Previous studies have indicated that MRI fails to identify meniscal pathology when one exists in 1 of every 10 cases, and diagnoses pathology when pathology truly does not exist in 1 of every 5 patients...
January 2018: Arthroscopy Techniques
https://www.readbyqxmd.com/read/29379708/an-arthroscopic-knotless-technique-for-anatomical-restoration-of-the-rotator-cuff-and-superior-capsule-the-double-layer-cinch-bridge
#3
Philipp R Heuberer, Leo Pauzenberger, Daniel Smolen, Roman C Ostermann, Werner Anderl
Rotator cuff repairs are the most common procedures in shoulder surgery, but still show long-term retear rates of up to 70%. Nonanatomic reconstruction is one possible cause of repair failure. The rotator cuff histologically consists of 5 separate layers of which 2 are macroscopically identifiable: the superior or tendinous layer and the inferior or capsule-ligamentous layer. In case of rotator cuff tears, these layers are often retracted to different degrees. The intraoperative detectable prevalence of rotator cuff delamination reaches up to 85%...
January 2018: Arthroscopy Techniques
https://www.readbyqxmd.com/read/29379707/arthroscopic-coracohumeral-ligament-release-for-patients-with-frozen-shoulder
#4
Yoshihiro Hagiwara, Akira Ando, Kenji Kanazawa, Masashi Koide, Takuya Sekiguchi, Junichiro Hamada, Eiji Itoi
Arthroscopic pancapsular release has been recommended for recalcitrant frozen shoulder, but regaining range of motion has not been sufficient compared with the unaffected side. There is no consensus about the reasons for these remaining restrictions in range of motion, but residual capsular or connective tissue must be considered a candidate. A thickened coracohumeral ligament at the rotator interval has been reported as one of the most specific manifestations of frozen shoulder. It covers wider portions of the subscapularis tendon, supraspinatus tendon, and infraspinatus tendon than previously reported...
January 2018: Arthroscopy Techniques
https://www.readbyqxmd.com/read/29349034/arthroscopic-microfracture-of-hip-chondral-lesions
#5
H Atil Atilla, T David Luo, Allston J Stubbs
Microfracture of hip chondral lesions has been performed for more than a decade with modified treatment principles and techniques from knee arthroscopy. This note and accompanying video review the pertinent techniques, pearls, and pitfalls of the microfracture procedure in the treatment of hip chondral lesions. After debridement of damaged chondral tissue, the size of the lesion is approximated to determine the number of microfracture holes to create. The working portal may be adjusted based on the site of the lesion...
December 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/29349033/arthroscopic-reduction-and-fixation-of-tibial-spine-avulsion-fractures-by-a-stainless-steel-wiring-technique
#6
Mohamed M Abdelhamid, Maysara Abdelhalim Bayoumy, Hesham A Elkady, Ayman Farouk Abdelkawi
Several techniques of arthroscopic treatment of tibial spine avulsion fractures have been described in the literature. These techniques include the use of various fixation devices such as screws, K-wires, wiring, sutures, and suture anchors. In this study, we evaluate a new wiring technique for the treatment of these injuries. This technique involves fixation by stainless steel tension wires passed over the fractured spine and tied over a bone bridge. The advantages of this technique are that it aids in reduction, allows for compression of the tibial spine fragment anatomically in its fracture bed, provides stable fixation in difficult comminuted fractures, and allows for early mobilization and weight bearing because of the solid fixation...
December 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/29349032/revision-acromioclavicular-coracoclavicular-reconstruction-use-of-precontoured-button-and-2-allografts
#7
Daniel B Haber, Robert C Spang, George Sanchez, Anthony Sanchez, Márcio B Ferrari, Matthew T Provencher
Injuries to the acromioclavicular (AC) joint are common, particularly in the young and active population. Approximately 9% of all shoulder girdle injuries involve the AC joint, and AC joint dislocations represent approximately 8% of all joint dislocations throughout the body. AC joint injuries are graded as type I through type VI according to the Rockwood classification. Type I and II injuries are typically treated nonoperatively, whereas type IV, V, and VI injuries are most often treated surgically. A variety of surgical techniques have been described, including anatomic and nonanatomic reconstruction...
December 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/29349031/modified-elmslie-trillat-procedure-for-distal-realignment-of-patella-tendon
#8
Ricardo Bastos Filho, Alberto Monteiro, Renato Andrade, M J S Fredrick Michael, Nuno Sevivas, Bruno Pereira, André Sarmento, João Espregueira-Mendes
Patellofemoral dysfunction, due to either a patellofemoral malalignment or patellar instability, is a complex and debilitating condition that significantly decreases the knee function. Conservative management may yield significant clinical outcomes; however, when morphologic anomalies are identified, the surgical approach should be employed. Hence, several surgical procedures have been described in the scientific literature aiming the correction of underlying extensor mechanism malalignments. Still, the rate of complications is higher than desirable...
December 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/29349030/augmentation-of-patellar-tendon-repair-with-autologous-semitendinosus-graft-porto-technique
#9
João Espregueira-Mendes, Renato Andrade, M J S Fredrick Michael, André Sarmento, Nuno Sevivas, Rui Rocha, Ricardo Bastos Filho
Patellar tendon ruptures can lead to significant functional deficiency of the extensor mechanism of the knee. These injuries, because of their inherent nature and associated complications, may require a complex treatment and remains a challenge for orthopaedic surgeons. Current surgical techniques present significant complications, including patellar fracture, damage to patellar articular cartilage, and abnormal patella height. This note describes a surgical technique to provide an additional reinforcement to the patellar tendon repair with a semitendinous autograft, without the necessity to perform any transosseous tunnels at the patella bone...
December 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/29349029/puncture-capsulotomy-during-hip-arthroscopy-for-femoroacetabular-impingement-preserving-anatomy-and-biomechanics
#10
William K Conaway, Scott D Martin
We describe an arthroscopic technique for the treatment of labral pathology and femoroacetabular impingement that provides excellent access to the central and peripheral compartments while preserving the biomechanically crucial components of hip joint stability. The hip capsule and the ligaments within it have been shown to be integral to hip biomechanical stability. Other popular techniques such as interportal and T-capsulotomy inherently damage the capsuloligamentous complex of the hip and can be associated with postoperative gross instability, micro-instability, heterotopic ossification, and seroma...
December 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/29349028/knotless-suture-bridge-technique-in-high-grade-bursal-sided-rotator-cuff-tears-is-this-the-way-forward
#11
Bancha Chernchujit, Mohd Azrin Shahul Hamid, Sittan Aimprasittichai
We present our technique in managing high-grade bursal-sided rotator cuff tears. In this technique, the remaining intact cuff tissue is not sacrificed. The suture bridge technique is used to uniformly tension the torn tissue to the rotator cuff footprint. No knots are tied on the rotator cuff to minimize the tension on the cuff. The sutures are then anchored on the lateral cortex of the humerus. This technique allows repair with minimum tension while preserving the original length of the rotator cuff.
December 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/29349027/arthroscopic-repair-of-massive-subscapularis-and-supraspinatus-tear-by-double-row-knotless-technique
#12
Bancha Chernchujit, Pankaj N Sharma
Subscapularis is the most powerful muscle in the rotator cuff. A steep learning curve and constrained space anteriorly make the repair difficult. In massive tears of the rotator cuff, repair of the subscapularis initially makes the massive supraspinatus tear repairable. We present our technique to repair subscapularis and supraspinatus tear by double-row anchors in a knotless and tension-free manner. This technique can be done in partial or full-thickness tears of the upper subscapularis.
December 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/29349026/arthroscopic-management-of-posterior-instability-due-to-floating-posterior-inferior-glenohumeral-ligament-lesions
#13
Lawrence O'Malley, Eric D Field, Larry D Field
The "floating" posterior inferior glenohumeral ligament (floating PIGHL) is an uncommon cause of posterior shoulder instability. This pathologic lesion, defined as detachment of both the origin of the PIGHL (posterior Bankart lesion) and insertion of the of the PIGHL from its humeral head insertion site, often results in significant and persistent shoulder instability symptoms. An effective surgical technique for arthroscopic repair of a floating PIGHL lesion is described and demonstrated.
December 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/29349025/anterior-capsule-reconstruction-for-irreparable-subscapularis-tears
#14
Jason P Rogers, Adam Kwapisz, John M Tokish
A subscapularis complete tear presents its own challenges in management. The glenohumeral biomechanics and force couple are reliant on a competent and functioning subscapularis muscle. An irreparable subscapularis makes those same challenges even more difficult to address. Traditionally, this problem has been addressed with tendon transfers, including pectoralis major or latissimus dorsi. These techniques can alter the ideal biomechanics of the shoulder and have high rates or failure. Iliotibial autograft or tibialis anterior have also been wrought with high failure rates...
December 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/29349024/the-crossing-internal-suture-augmentation-technique-to-protect-the-all-inside-anterior-cruciate-ligament-reconstruction-graft
#15
Mohamed Aboalata, Ashraf Elazab, Abdelsamie Halawa, Moheib S Ahmed, Andreas B Imhoff, Yehia Bassiouny
The crossing internal suture augmentation technique is an all-inside technique of anterior cruciate ligament reconstruction with augmentation of the hamstring tendon autograft with a braided ultrahigh-molecular-weight polyester-polyethylene suture tape resting on the adjustable cortical buttons on both the femoral and tibial sides. The internal suture augmentation acts as a backbone supporting and protecting the graft until the process of healing and ligamentization of the graft is completed. The ends of the suture tape are tied on the tibial button and additionally fixed to the tibia with a knotless anchor as a backup fixation with the knee in full extension...
December 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/29349023/bipolar-acromioclavicular-joint-resection
#16
Julien Gaillard, Michel Calò, Geoffroy Nourissat
Acromioclavicular (AC) joint arthropathy remains one of the most common causes of shoulder pain. In the case of AC joint arthropathy resistant to conservative treatment, most authors have recognized distal clavicle resection as the gold-standard treatment. However, some challenges remain to be solved. One is the difficulty in visualization of the superior and posterior part of the distal clavicle from the midlateral portal, causing an incomplete resection of the distal clavicle. This could potentially lead to unresolved pain and therefore surgical failure...
December 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/29349022/arthroscopic-delivery-of-injectable-bone-graft-for-staged-revision-anterior-cruciate-ligament-reconstruction
#17
Kent T Yamaguchi, Gina M Mosich, Kristofer J Jones
Bone defects caused by femoral and tibial tunnel enlargement can pose a significant technical challenge when planning to perform revision anterior cruciate ligament reconstruction. A number of options have been described for managing osseous deficiencies, including the use of large autograft or allograft bone dowels to provide sufficient tunnel fill and subsequent structural support for revision surgery. These techniques can be time-consuming and technically demanding to ensure proper tunnel fill and press-fit stability of the bone graft...
December 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/29349021/arthroscopic-repair-of-medial-transtendinous-rotator-cuff-tears
#18
Brian J Kelly, Larry D Field
Rotator cuff tears are extremely common in the adult population, and medial transtendinous rotator cuff tears, although rare, have recently been reported in the literature. These tears are almost always traumatic, which is a common indication for surgical management. It is necessary to consider these tears as a distinct subset when planning for rotator cuff repair because traditional repair techniques would overtension the tendon, increasing the risk for failure of the repair. The objective of this Technical Note is to describe an arthroscopic repair technique for these tears that avoids overtensioning the rotator cuff while still using repair techniques that are familiar to the arthroscopic shoulder surgeon...
December 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/29349020/an-arthroscopic-humeral-medializing-repair-of-the-supraspinatus
#19
Amir Ghazanfari, Daniel J H Henderson, Geoffroy Nourissat
Posterosuperior repair of the rotator cuff is one of the most frequently performed surgical procedures in the shoulder. Its aim is to fix the tendon back to the bone to restore anatomy, improve shoulder function, and prevent progression of cuff tear arthropathy and attendant muscle degeneration. Despite technical advances in this procedure, in some cases, the tendon cannot be fixed back to the footprint without excessive tension on the repair. In young patients or in patients with low-grade muscle atrophy and fatty degeneration (Goutallier grade 1 or 2), it is mandatory to attempt fixation of the tendon to restore functional anatomy and prevent further muscle degeneration...
December 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/29349019/arthroscopic-decompression-of-greater-trochanteric-sciatic-nerve-impingement
#20
Shane Tipton, Ian Alkhafaji, Rebecca Senehi, Allston Stubbs
Therapeutic extra-articular hip endoscopy is an effective treatment of greater trochanteric sciatic nerve impingement. We describe in detail technical pearls of the procedure including positioning, portal placement, and steps to obtaining adequate decompression while avoiding iatrogenic nerve injury.
December 2017: Arthroscopy Techniques
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