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Arthroscopy Techniques

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https://www.readbyqxmd.com/read/28706849/all-intra-articular-arthroscopic-rotator-cuff-repair
#1
Pablo Ruben Rupenian
This Technical Note presents an arthroscopic technique to repair rotator cuff tears using a constant intra-articular (glenohumeral) portal for visualization. The smoothness of both the humeral head cartilage and the articular side of the rotator cuff offers a cleaner arthroscopic approach, while the absence of a subacromial bursa also reduces bleeding, turbidity, and the need for iterative soft tissue debridement. It also facilitates the recognition and repair of certain tear patterns. The intra-articular perspective allows the surgeon to visualize how stitches pierce the tissue in a desired and resistant area of the tendon...
June 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/28706848/bipolar-bone-loss-of-the-shoulder-joint-due-to-recurrent-instability-use-of-fresh-osteochondral-distal-tibia-and-humeral-head-allografts
#2
Daniel B Haber, Anthony Sanchez, George Sanchez, Marcio B Ferrari, Sami Ferdousian, Matthew T Provencher
With increasing shoulder instability events, the likelihood of a bony lesion of the glenoid and/or humeral head rises. Although bone loss of either the glenoid or humeral head may result in recurrent instability, bipolar lesions have been shown, in particular, to result in a negative and additive effect on glenohumeral stability. In the case of a bipolar lesion comprising severe glenoid bone loss and an engaging, "off-track" Hill-Sachs lesion, the bony foundation of the glenohumeral joint is compromised and bony augmentation is necessary...
June 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/28706847/endoscopic-synovectomy-of-peroneal-tendon-sheath
#3
Tun Hing Lui
Peroneal tenosynovitis usually responds to conservative therapy. Early diagnosis and management are imperative because improper or delayed diagnosis and treatment of peroneal tenosynovitis may lead to progression of the tenosynovitis to peroneal tendon rupture, ultimately limiting the benefit of nonoperative treatment. For refractory cases, endoscopic tenosynovectomy is indicated. The purpose of this Technical Note is to report a minimally invasive approach to perform a synovectomy of zones 1 and 2 of the peroneal tendon sheath...
June 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/28706846/arthroscopic-reduction-and-fixation-of-transverse-intra-articular-glenoid-fractures-with-scapular-extension
#4
Anastasios Papadonikolakis
The most common procedure to address transverse glenoid fractures that are characterized by intra-articular step-off or gapping is open reduction and internal fixation. Disadvantages of open surgery are delay in regaining full range of motion, increased approach morbidity, neurovascular complications, and the need for capsulotomy, which delays healing and increases the risk of stiffness. An arthroscopically assisted fracture fixation, as described in this article, is characterized by better visualization of the glenoid articular surface and reduction of the intra-articular fragments under direct vision, which diminishes the chances of residual step-off after fixation...
June 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/28706845/arthroscopic-triple-arthrodesis-in-management-of-chronic-flatfoot-deformity
#5
Tun Hing Lui
Triple arthrodesis has a significant role in the management of hindfoot osteoarthritis and deformity. Traditionally, it is an open procedure with extensive soft tissue dissection. Arthroscopic triple arthrodesis would appear to provide good visualization and preparation of the fusion surfaces while preserving the soft tissue envelope. The purpose of this Technical Note is to describe a minimally invasive approach of triple arthrodesis to correct chronic flatfoot deformity.
June 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/28706844/bankart-repair-using-modern-arthroscopic-technique
#6
Tariq Hendawi, Charles Milchteim, Roger Ostrander
As technology continues to improve, surgeons must regularly re-evaluate techniques to improve efficacy and outcomes. The Bankart repair for shoulder instability has evolved from open reconstruction to minimally invasive arthroscopic techniques, which have the benefit of less pain and morbidity. This technical description and video present a modern arthroscopic technique for Bankart repair used at our institution with high success in an athletic population.
June 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/28706843/a-modification-of-the-active-compression-test-for-the-shoulder-biceps-labrum-complex
#7
Ekaterina Urch, Samuel A Taylor, Helen Zitkovsky, Stephen J O'Brien, Joshua S Dines, David M Dines
The active compression test (O'Brien Sign) is widely used by physicians to aid in the diagnosis of biceps-labrum complex disease. This maneuver has been particularly criticized in the literature, however, with regard to interobserver reliability. Criticisms may in fact stem from inaccurate and inconsistent practice of the examination maneuver, stemming from both patient- and physician-related errors. In this Technical Note, we introduce an easy modification to the O'Brien Sign that limits such errors and improves test uniformity...
June 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/28706842/single-bundle-augmentation-for-a-partial-tear-of-the-anterior-cruciate-ligament
#8
Allison J Rao, Gregory L Cvetanovich, William A Zuke, Beatrice Go, Brian Forsythe
Given the prevalence of anterior cruciate ligament (ACL) tears in young athletes, it is essential to elucidate and illustrate surgical interventions that return the most favorable outcomes. Although most ACL injuries are full-thickness tears, occasionally either the anteromedial (AM) or posterolateral (PL) bundle is torn in isolation, allowing consideration of an ACL reconstruction or augmentation. Because the ACL-deficient knee has been shown to exhibit less proprioceptive feedback, the preservation of the intact bundle may offer an inherent component of stability...
June 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/28706841/technique-for-transtibial-knotless-repair-of-lateral-meniscus-root-avulsion
#9
Emily Harnden, Timothy Lin, Adam Wilson, John B Reid
Tear of the meniscal root results in loss of circumferential hoop tension in the meniscus and increased tibiofemoral contact pressure, leading to cartilage wear. Repair of the meniscal root can restore function of the meniscus. Many techniques for root repair have recently been described. We present a technique for root repair using a transtibial socket and knotless suture technique that can be performed through standard arthroscopy portals.
June 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/28706840/arthroscopic-excision-of-osteoid-osteoma-of-the-talus
#10
Iftach Hetsroni, Meir Nyska, Evgeny Edelshtein, Gideon Mann, Ezequiel Palmanovich
Osteoid osteoma is a benign tumor that can cause significant pain and disability. Excision of the tumor can be accomplished with open surgery or, as advocated in recent years, with computed tomography (CT)-guided radiofrequency ablation. In this article, a unique arthroscopic approach to excise an osteoid osteoma of the talus is presented. This was possible by relying on a clear intra-articular prominent osteophyte, which was used as a landmark to indicate tumor location in accordance with preoperative CT views...
June 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/28706839/suspensory-fixation-device-for-use-with-bone-patellar-tendon-bone-grafts
#11
Philippe Colombet, Nicolas Bouguennec
Good to excellent results at long-term follow-up have been published for bone-patellar tendon-bone (BTB) graft anterior cruciate ligament reconstruction. Fixation using screws historically has been the most common choice for femoral and tibial bone blocks, but screws present several disadvantages, which include the risk of blowout (for which prevention implies having to shift the position of the tunnel anteriorly), as well as lesions of the bone blocks and tendons. This article describes a technique using Pullup BTB adjustable-loop length suspensory fixation (SBM, Lourdes, France) on the femoral and tibial sides...
June 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/28706838/endoscopic-decompression-of-a-gouty-tophus-at-the-hand-dorsum
#12
Tun Hing Lui
Medical treatment including lifestyle and dietary modifications and drug therapy remains the mainstay of treatment for gouty arthritis of the hand and wrist. Without proper and timely treatment, tophi develop approximately 10 years after the onset of the disease. Open surgery for tophaceous gout is associated with a relatively high rate of complications particularly related to the surgical wound and overlying skin necrosis. Intralesional shaving of the tophi through small incisions has been reported and has the advantage of fewer wound complications...
June 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/28706837/intraosseous-infiltration-of-platelet-rich-plasma-for-severe-hip-osteoarthritis
#13
Nicolás Fiz, Juan Carlos Pérez, Jorge Guadilla, Ane Garate, Pello Sánchez, Sabino Padilla, Diego Delgado, Mikel Sánchez
This work describes a technique of platelet-rich plasma (PRP) infiltration for the treatment of severe hip osteoarthritis (OA). Although the results achieved with intra-articular infiltrations of PRP are promising, they may be insufficient in the long-term for severe hip OA. The technique consists of a combined intra-articular and intraosseous infiltration of PRP to reach all joint tissues, especially the subchondral bone, and hence facilitate a greater distribution of PRP. Diagnosis is based on clinical and radiographic findings, and patients with grade III OA according to the Tönnis scale, as well as patients who have not responded to conventional treatment, are considered candidates for this technique...
June 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/28706836/arthroscopic-treatment-of-capitellum-osteochondritis-dissecans-with-micronized-allogeneic-cartilage-scaffold
#14
Paul E Caldwell, Brett Auerbach, Sara E Pearson
Osteochondritis dissecans (OCD) of the capitellum is a common disorder that causes pain and functional limitation in the adolescent elbow. Although conservative management is the first line of treatment, surgical intervention is usually recommended for patients with persistent mechanical symptoms, loose bodies, or unstable lesions. Elbow arthroscopy has become the gold standard to evaluate and treat symptomatic OCD lesions. Arthroscopic debridement and bone marrow stimulation have been shown to yield good short-term results...
June 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/28706835/surgical-technique-for-open-reduction-internal-fixation-of-an-unstable-displaced-3-part-proximal-humeral-fracture-using-a-proximal-humeral-locking%C3%A2-plate
#15
Wichan Kanchanatawan, Sunikom Suppauksorn, Thanapon Chobpenthai, Worawit Densiri-Aksorn, Warongporn Pongpinyopap, Gem Dorjiee
The proximal humeral locking plate (PHLP) is a recently developed fixed-angle implant that is an option for open reduction-internal fixation of an unstable displaced proximal humeral fracture. Various articles have reported successful outcomes using the PHLP when compared with other implant designs. However, many complications still occur with use of the PHLP, such as avascular necrosis of the humeral articular fragment, malreduction (particularly varus malalignment), and screw penetration. These complications are related to the difficulty in fixation of this particular type of fracture, as well as ineffective surgical technique...
June 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/28706834/screw-fixation-of-os-acetabuli-an-arthroscopic-technique
#16
Adrián Cuéllar, Xabier Albillos, Asier Cuéllar, Ricardo Cuéllar
An os acetabuli (OA) increases the contact area and surface area of the acetabulum and is important to maintain congruity of the hip joint. Thus preservation of this ossicle is important to prevent loss of contact area and ensure containment of the femoral head. We describe an all-arthroscopic approach to the fixation of OA with a compression screw. Initially, the fibrous tissue is debrided between the acetabular rim and the OA, a guidewire is placed through the OA up to the acetabular rim, and a screw is inserted over the wire...
June 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/28706833/latarjet-technique-for-treatment-of-anterior-shoulder-instability-with-glenoid-bone-loss
#17
Kevin J McHale, George Sanchez, Kyle P Lavery, William H Rossy, Anthony Sanchez, Marcio B Ferrari, Matthew T Provencher
Anterior glenohumeral instability is a common clinical entity, particularly among young athletic patient populations. Nonoperative management and arthroscopic treatment of glenohumeral instability have been associated with high rates of recurrence, particularly in the setting of glenohumeral osseous defects. Coracoid transfer, particularly the Latarjet procedure, has become the treatment of choice for recurrent anterior glenohumeral instability in the setting of osseous deficiencies greater than 20% to 30% of the glenoid surface area and may also be considered for the primary treatment of recurrent instability in the high-risk contact athlete, even in the setting of limited osseous deficiency...
June 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/28706832/iliotibial-band-lengthening-an-arthroscopic-surgical-technique
#18
Todd P Pierce, Samuel J Mease, Kimona Issa, Anthony Festa, Vincent K McInerney, Anthony J Scillia
Iliotibial (IT) band syndrome is a common cause of lateral knee pain in runners and cyclists. Many can be treated nonoperatively; however, some may require surgical lengthening of their IT band to achieve optimal pain relief and a return to preinjury level of activity. Several studies have been published detailing surgical lengthening procedures and satisfactory outcomes after these procedures. However, it is important to continue to improve on and optimize outcomes. We present our arthroscopic IT band-lengthening procedure...
June 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/28706831/arthroscopic-treatment-of-greater-tuberosity-avulsion-fractures
#19
Jonathan A Godin, J Christoph Katthagen, Erik M Fritz, Jonas Pogorzelski, Peter J Millett
Isolated fractures of the greater tuberosity of the humerus are an uncommon and frequently missed diagnosis. Mistreated and unrecognized, these fractures can cause chronic pain and diminished shoulder range of motion and function. Operative treatment options include open reduction and internal fixation, as well as arthroscopic-assisted reduction and internal fixation. The purpose of this Technical Note is to describe a bridging arthroscopic technique for the treatment of bony avulsions of the supraspinatus tendon...
June 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/28706830/a-single-tunnel-technique-for-coracoclavicular-and-acromioclavicular-ligament-reconstruction
#20
Michael B Banffy, Carola F van Eck, Michael Stanton, Neal S ElAttrache
Acromioclavicular (AC) joint separation is a common injury seen in the young adult athletic population. Both the indications for surgical management and the best operative technique remain controversial. One of the most popular reconstruction techniques is the anatomic double-tunnel coracoclavicular (CC) ligament reconstruction. However, there have been several case reports of clavicle fractures with this technique. This article presents a single-tunnel reconstruction technique that aims to restore both the CC and AC ligament function, while minimizing fracture risk...
June 2017: Arthroscopy Techniques
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