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Elbow arthroscopy

Patrick Barousse, Michael Saper, Karim Meijer, Charles Roth, James R Andrews
Elbow arthroscopy is a useful tool for managing diseases of the elbow, including valgus extension overload, when conservative treatments have failed. Arthroscopic access to the elbow in the supine-suspended position is simple and reproducible with the technique described in this report. Synovial tissue can be cleared, optimizing visualization of the anatomic structures in the elbow including the posterior ulnohumeral joint. This report describes, in detail, arthroscopy of the elbow in the supine-suspended position and basic principles for arthroscopic decompression of the posterior elbow for valgus extension overload...
August 2016: Arthroscopy Techniques
Eva Coppieters, Bernadette Van Ryssen, Henri van Bree, Geert Verhoeven, Bart Broeckx, Evelien de Bakker, Dieter Deforce, Ingrid Gielen
Medial compartment erosion is an advanced stage of medial coronoid disease, an important cause of elbow lameness in dogs, with treatment and the expected prognosis depending on the extent of the cartilage lesions. The identification of specific computed tomographic (CT) findings might facilitate the nonsurgical diagnosis and add to treatment decision making. Aims of this retrospective, analytical, method comparison study were to describe CT findings in elbows of dogs arthroscopically diagnosed with medial compartment erosion and to compare CT vs...
October 4, 2016: Veterinary Radiology & Ultrasound
M Hackl, T Leschinger, L P Müller, K Wegmann
BACKGROUND: Chronic ligamentous instability of the elbow is an important pathology as it is accompanied with pronounced dysfunction. Moreover, it represents an established risk factor for the development of osteoarthritis. Posterolateral rotatory instability (PLRI) caused by insufficiency of the lateral collateral ligament (LCL) is the most common type of chronic elbow instability and is usually a sequel of traumatic elbow dislocation. Chronic overload can lead to insufficiency of the ulnar collateral ligament (UCL) with subsequent valgus instability, especially in overhead athletes...
October 2016: Der Orthopäde
Mandeep S Virk, Richard L Manzo, Mark Cote, James K Ware, Augustus D Mazzocca, Carl W Nissen, Kevin P Shea, Robert A Arciero
BACKGROUND: The results of open and arthroscopic instability repairs have been shown to be equivalent in recent literature. PURPOSE: To compare the time to recurrence (TTR) of instability and disease-specific outcome measures in patients undergoing open and arthroscopic Bankart repair. STUDY DESIGN: Cohort study; Level of evidence, 3. METHODS: Patients with recurrent traumatic anterior shoulder instability and a Bankart lesion on diagnostic arthroscopy underwent either open Bankart repair (OB) or arthroscopic Bankart and suture capsulorrhaphy (ABSC) using suture anchors...
June 2016: Orthopaedic Journal of Sports Medicine
Brandon J Erickson, Peter N Chalmers, Gregory L Cvetanovich, Rachel M Frank, Anthony A Romeo, Joshua D Harris
The purpose of this article is to perform a systematic review and meta-analysis of elbow arthroscopy literature to answer the following questions: "Across the world, what demographic of patients are undergoing elbow arthroscopy, what are the most common indications for elbow arthroscopy, and how good is the evidence?" The authors hypothesized that patients who undergo elbow arthroscopy will be chiefly age <40 years, the most common indication for elbow arthroscopy will be a release/débridement, and the evidence regarding elbow arthroscopy will be poor...
July 2016: American Journal of Orthopedics
Kevin J DiSilvestro, Adam J Santoro, Fotios P Tjoumakaris, Eric A Levicoff, Kevin B Freedman
BACKGROUND: Patients often ask their doctors when they can safely return to driving after orthopaedic injuries and procedures, but the data regarding this topic are diverse and sometimes conflicting. Some studies provide observer-reported outcome measures, such as brake response time or simulators, to estimate when patients can safely resume driving after surgery, and patient survey data describing when patients report a return to driving, but they do not all agree. We performed a systematic review and quality appraisal for available data regarding when patients are safe to resume driving after common orthopaedic surgeries and injuries affecting the ability to drive...
August 4, 2016: Clinical Orthopaedics and related Research
M Beirer, G H Sandmann, A B Imhoff, S Buchmann
OBJECTIVE: To restore the physiologic anterior and posterior capsular volume to achieve an anatomic central contact point of the glenohumeral articulation and treatment of concomitant glenohumeral injuries due to posterosuperior impingement (PSI). INDICATIONS: Plateauing of clinical improvement despite adequate nonsurgical treatment (for at least 6-12 months). CONTRAINDICATIONS: General contraindications for elective arthroscopic surgery...
July 28, 2016: Operative Orthopädie und Traumatologie
Renée Keijsers, Michel P J van den Bekerom, Koen L M Koenraadt, Ronald L A W Bleys, C Niek van Dijk, Denise Eygendaal
PURPOSE: Different injection therapies are used in the treatment of lateral epicondylitis (LE). Usually, the extensor carpi radialis brevis (ECRB) tendon is affected. Therefore, an injection should be aimed at the origin of this tendon. This study demonstrates the accuracy of manual injections in the treatment of LE. METHODS: Ten surgeons have injected a cadaver elbow with acrylic paint, using the same injection technique (i.e. number of perforations, amount of injected fluid) that they in daily practice would use in the treatment of LE...
July 2, 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Femke M A P Claessen, Amir R Kachooei, Gregory P Kolovich, Geert A Buijze, Luke S Oh, Michel P J van den Bekerom, Job N Doornberg
PURPOSE: In this anatomical cadaver study, the distance between major nerves and ligaments at risk for injury and portal sites created by trainees was measured. Trainees, inexperienced in elbow arthroscopy, have received a didactic lecture and cadaver instruction prior to portal placement. The incidence of iatrogenic injury from novice portal placement was also determined. METHODS: Anterolateral, direct lateral, and anteromedial arthroscopic portals were created in ten cadavers by ten inexperienced trainees in elbow arthroscopy...
June 28, 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Brandon J Erickson, Bernard R Bach, Charles A Bush-Joseph, Nikhil N Verma, Anthony A Romeo
The ulnar collateral ligament (UCL) is a vital structure to the overhead athlete, especially the baseball pitcher. For reasons not completely understood, UCL injuries have become increasingly more common in major league baseball (MLB) pitchers over the past 10 years. UCL reconstruction (UCLR) is the current gold standard of treatment for these injuries in MLB pitchers who wish to return to sport (RTS) at a high level and who have failed a course of non-operative treatment. Results following UCLR in MLB pitchers have been encouraging, with multiple RTS rates now cited at greater than 80%...
June 18, 2016: World Journal of Orthopedics
Termphong Phorkhar, Cholawish Chanlalit
BACKGROUND: Modern surgery as elbow arthroscopic surgery is an accepted operation due to benefit in precise intra-articular lesion detection and minimally invasive surgery. OBJECTIVE: To report the functional results when using arthroscopic surgery to treat chronic lateral elbow pain. MATERIAL AND METHOD: The data was collected from 25 patients with chronic lateral elbow pain that failed in non-operative treatment and treated with elbow arthroscopic surgery...
November 2015: Journal of the Medical Association of Thailand, Chotmaihet Thangphaet
Thitinut Dilokhuttakam, Termphong Phorkhar
BACKGROUND: An elbow arthroscopic surgery is a minimally invasive surgery. There were several international publications report neurovascular complications in elbow arthroscopic surgery. But there was no study which was conducted in Thailand OBJECTIVE: To report the result of elbow arthroscopic surgery which focus on the neurovascular complications. MATERIAL AND METHOD: A retrospective review of elbow arthroscopic surgery between April 2011 to May 2014 at HRH Princess Maha Chakri Sirindhorn Medical Center Srinakharinwirot University in Nakhon Nayok province was performed...
November 2015: Journal of the Medical Association of Thailand, Chotmaihet Thangphaet
Eric C Hans, W Brian Saunders, Brian S Beale, Don A Hulse
Fragmentation of the medial coronoid process (FCP) is an uncommon cause of thoracic limb lameness in toy and small breed dogs. Arthroscopic findings and treatment remains poorly described. The objective of this study was to describe the arthroscopic findings and short-term outcome following arthroscopic treatment in toy and small breed dogs with FCP. Medical records were retrospectively reviewed. Arthroscopic findings were available from 13 elbows (12 dogs). Outcome data ≥4 wk postoperatively were available for nine elbows...
July 2016: Journal of the American Animal Hospital Association
Bogdan A Matache, Randa Berdusco, Franco Momoli, Peter L C Lapner, J W Pollock
BACKGROUND: Tennis elbow is a common elbow pathology typically affecting middle-aged individuals that can lead to significant disability. Most cases resolve within 2 years of symptom onset, but a subset of patients will develop persistent symptoms despite appropriate conservative management. There are several surgical approaches used to treat chronic tennis elbow, with arthroscopic surgery becoming an increasingly popular approach to address this pathology in North America. This procedure involves the arthroscopic release of the extensor carpi radialis brevis tendon (ECRB) origin at the elbow...
2016: BMC Musculoskeletal Disorders
Mark S Hsiao, Nicholas Kusnezov, Ryan N Sieg, Brett D Owens, Joshua P Herzog
Since its inception, arthroscopic surgery has become widely adopted among orthopedic surgeons. It is therefore important to have an understanding of the basic principles of arthroscopy. Compared with open techniques, arthroscopic procedures are associated with smaller incisions, less structural damage, improved intra-articular visualization, less pain in the immediate postoperative period, and faster recovery for patients. Pump systems used for arthroscopic surgery have evolved over the years to provide improved intraoperative visualization...
May 1, 2016: Orthopedics
Desmond K Tan, Sherman O Canapp, Christopher S Leasure, David L Dycus, Erica O'Donnell
OBJECTIVE: To describe traumatic fracture of the medial coronoid process in dogs as a clinically distinct disease unrelated to congenital elbow dysplasia. METHODS: Clinical records of dogs with acute, traumatic, unilateral lameness attributable to medial coronoid process disease were reviewed retrospectively. Clinical interpretation included findings on physical examination, orthopaedic examination, and subjective gait analysis. Radiographs of the affected and contralateral elbows were obtained and reviewed for pathology...
July 19, 2016: Veterinary and Comparative Orthopaedics and Traumatology: V.C.O.T
Bradley Schoch, Jean-David Werthel, Robert Cofield, Joaquin Sanchez-Sotelo, John W Sperling
BACKGROUND: Chondrolysis is a rare complication after shoulder arthroscopy leading to early joint destruction. Shoulder arthroplasty may be considered for end-stage chondrolysis, but concerns exist about implant survivorship, given the younger age of this population. This study aimed to assess pain relief, function, and survivorship of shoulder arthroplasty for chondrolysis and to assess risk factors for failure. METHODS: Between January 2000 and January 2013, 26 consecutive shoulders with chondrolysis were treated at our institution with shoulder arthroplasty...
September 2016: Journal of Shoulder and Elbow Surgery
Brandon J Erickson, Joshua D Harris, Yale A Fillingham, Gregory L Cvetanovich, Charles A Bush-Joseph, Bernard R Bach, Anthony A Romeo, Nikhil N Verma
PURPOSE: To determine practice patterns of Major League Baseball (MLB) team orthopaedic surgeons in addressing the controversial topics of ulnar collateral ligament (UCL) tears, type II SLAP tears, and partial-thickness rotator cuff tear. METHODS: Seventy-four MLB team orthopaedic surgeons were surveyed via an online survey system. A 14-question survey was used to assess surgeon experience, technique, and graft choice for UCL reconstruction (UCLR), treatment of type II SLAP tears, and other common pathologic conditions...
July 2016: Arthroscopy: the Journal of Arthroscopic & related Surgery
Joseph A Gil, Gregory R Waryasz, Brett D Owens, Alan H Daniels
PURPOSE: To examine orthopaedic surgery case logs for arthroscopy case volume during residency training and to evaluate trends in case volume and variability over time. METHODS: Publicly available Accreditation Council for Graduate Medical Education surgical case logs from 2007 to 2013 for orthopaedic surgery residency were assessed for variability and case volume trends in shoulder, elbow, wrist, hip, knee, and ankle arthroscopy. The national average number of procedures performed in each arthroscopy category reported was directly compared from 2009 to 2013...
May 2016: Arthroscopy: the Journal of Arthroscopic & related Surgery
Sang-Eun Park, Daniel R Bachman, Shawn W O'Driscoll
PURPOSE: To report the safety of using the proximal anteromedial portal, using a simplified ulnar nerve management strategy derived from an earlier study, in a series of patients with previously transposed ulnar nerves. METHODS: A retrospective review of all elbow arthroscopies performed by a single surgeon from 2009 to 2014 was performed. The following techniques were used if, by palpation, localization of the ulnar nerve was considered to be certain (group 1) or uncertain (group 2): In group 1 (certain) the proximal anteromedial portal was established in the normal antegrade fashion...
March 9, 2016: Arthroscopy: the Journal of Arthroscopic & related Surgery
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