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Michael Ryan, Thomas Youm, Jonathan Vigdorchik
Hip arthroscopy as we know it today developed over the last 15 to 20 years, yet its true beginning is far more dated. Initially developed as a means of removing loose bodies or as a means of lavage, hip arthroscopy was not utilized to treat femoroacetabular impingement (FAI) until much later. Its usefulness as a means of treating FAI did not arise until hip impingement was understood to be causal in the development of degenerative changes of the labrum and articular surfaces. As our understanding of FAI grew, the tools for treating it developed in tandem...
March 2018: Bulletin of the Hospital for Joint Diseases
Christopher Nacca, Joseph A Gil, Rohit Badida, Joseph J Crisco, Brett D Owens
BACKGROUND: There is currently no consensus regarding the amount of posterior glenoid bone loss that is considered critical. Critical bone loss is defined as the amount of bone loss that occurs in which an isolated labral repair will not sufficiently restore stability. PURPOSE: The purpose is to identify the critical size of the posterior defect. STUDY DESIGN: Controlled laboratory study. METHODS: Eleven cadaveric shoulders were tested...
March 1, 2018: American Journal of Sports Medicine
Saya Horiuchi, Taiki Nozaki, Atsushi Tasaki, Sachiko Ohde, Gautam A Deshpande, Jay Starkey, Takeshi Hara, Nobuto Kitamura, Hiroshi Yoshioka
OBJECTIVE: The aims of this study were to compare isotropic 3-dimensional fat-suppressed T2-weighted fast spin echo (FSE) imaging (T2FS) with 2-dimensional fat-suppressed proton-density-weighted FSE imaging (2D-PDFS) and evaluate feasibility of isotropic 3-dimensional FSE shoulder imaging at 3-T magnetic resonance imaging (MRI). METHODS: Seventy-eight patients who underwent shoulder MRI were evaluated. Three-dimensional T2FS and 2D-PDFS were qualitatively graded for delineation of anatomic structures...
February 27, 2018: Journal of Computer Assisted Tomography
Renato Locks, Ioanna K Bolia, Hajime Utsunomiya, Karen K Briggs, Marc J Philippon
PURPOSE: To determine the causes of revision hip arthroscopy in patients who underwent labral reconstruction and to compare outcomes of these patients with patients who did not require a revision following reconstruction. METHODS: Patients who underwent revision hip arthroscopy after previous labral reconstruction from 2006 to 2014 were included. Patients with less than 2-year follow-up, preoperative joint space of ≤2 mm, or who underwent other reconstructive procedures at the time of labral reconstruction were excluded...
February 15, 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
Eric J Cotter, Charles P Hannon, David Christian, Rachel M Frank, Bernard R Bach
CONTEXT: Shoulder pain and dysfunction are common, with patients presenting complaints to both primary and orthopaedic physicians. History and physical examination remain essential to creating a differential diagnosis, even as noninvasive imaging has improved. EVIDENCE ACQUISITION: Literature was obtained through keyword searches based on the pathology in question (eg, rotator cuff) and the keywords physical examination using PubMed from January 1, 1980, through September 20, 2017...
February 1, 2018: Sports Health
Ashley L Kapron, Stephen K Aoki, Jeffrey A Weiss, Aaron J Krych, Travis G Maak
PURPOSE: Develop a framework to quantify the size, location and severity of femoral and acetabular-sided cartilage and labral damage observed in patients undergoing hip arthroscopy, and generate a database of individual defect parameters to facilitate future research and treatment efforts. METHODS: The size, location, and severity of cartilage and labral damage were prospectively collected using a custom, standardized post-operative template for 100 consecutive patients with femoroacetabular impingement syndrome...
February 13, 2018: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Andrea M Spiker, Kate R Gumersell, Ernest L Sink, Bryan T Kelly
In the realm of hip preservation, hip arthroscopy is often used to address intra-articular impingement pathology, whereas periacetabular osteotomy (PAO) is used to address dysplasia and instability. Indications to combine these 2 procedures include hip dysplasia and symptomatic instability with a concomitant symptomatic labral tear or the other symptomatic intra-articular pathology (i.e., loose body, chondral flap). The arthroscopic portion of the procedure allows repair of the injured labrum and close inspection of the hip joint, and the PAO addresses undercoverage and/or inappropriate version of the acetabulum...
October 2017: Arthroscopy Techniques
Patrick Finton Carton, David Filan
Arthroscopic labral 'takedown' and refixation is utilized to permit adequate visualization and resection of the acetabular rim deformity, in patients with pincer or mixed femoroacetabular impingement. Deficiencies exist in present techniques, which include disruption of vital anatomical support and vascular structures to the labrum and chondrolabral junction, drill or anchor articular penetration risk, bunching, elevation and instability of the labrum. A new operative technique is described which preserves the important chondrolabral interface, accurately restoring the 'flap seal' of the acetabular labrum while minimizing vascular disruption and reducing the risk of drill and anchor penetration...
January 2018: Journal of Hip Preservation Surgery
Renato Locks, Jorge Chahla, Ioanna K Bolia, Karen K Briggs, Marc J Philippon
The purpose of this study was to determine the outcomes following segmental labral reconstruction (labral defects measuring <1 cm) using a segment of capsular tissue or a segment of the indirect head of rectus femoris tendon. Eleven patients (five females and six males) underwent segmental labral reconstruction using a segment of capsule (eight patients) or indirect head of rectus tendon (three patients) by a single surgeon from March 2005 to October 2012. The average age of the patients was 35 years old (range, 20-51 years)...
January 2018: Journal of Hip Preservation Surgery
Jan Weidner, Michael Wyatt, Martin Beck
Preservation of an intact labrum and reconstruction of a deficient or worn acetabular labrum are accepted techniques in modern hip surgery. If the remaining labrum is very thin, its intact tip can be preserved and its volume restored with a ligamentum teres graft. Technique and preliminary results of this augmentation technique are presented. Labral augmentation was performed in 16 hips (11 rights) in 16 patients (7 males, mean age 29 years) during surgical dislocation for treatment of femoroacetabular impingement...
January 2018: Journal of Hip Preservation Surgery
Joseph W Galvin, Josef K Eichinger, Eric J Cotter, Alyssa R Greenhouse, Stephen A Parada, Brian R Waterman
Purpose: The purpose of this study is to evaluate the trends in surgical management for anterior shoulder instability in the U.S. Military. Methods: A retrospective analysis of military service members undergoing arthroscopic or open shoulder stabilization from 2012 to 2015 within the U.S. Military Health System was conducted. Demographic and surgical variables were extracted from the medical record. Chi-square and linear regression analysis were performed to identify temporal trends by surgical procedures and concomitant surgery...
February 6, 2018: Military Medicine
Travis Labrum
Despite the high comorbidity of psychiatric and substance use disorders, extremely little research has examined the experience of caregiving for relatives with co-occurring psychiatric and substance use disorders (COD). The primary objective of the present article is to identify characteristics pertaining to care recipients, family caregivers, and the experience of providing caregiving associated with care recipients having COD vs. only having psychiatric disorders (PD). A U.S. community recruited sample of 1394 family caregivers of persons with COD or PD was employed...
February 8, 2018: Psychiatric Quarterly
Dennis Zhaowen Ng, Bernard Puang Huh Lau, Bryan Hsi Ming Tan, V Prem Kumar
Arthroscopic Bankart repair is widely accepted as the method of choice in restoring the labrum to the glenoid rim. It has been shown to have comparable outcomes with open stabilization. This usually involves the use of 2 portals anteriorly: one anterosuperior accessory portal and another anteroinferior working portal. The aim of this Technical Note is to present a simple and reproducible technique for Bankart repair using a single working portal anteriorly without an accessory portal.
October 2017: Arthroscopy Techniques
Nathan W Skelley, William K Conaway, Scott D Martin
The prevalence of hip arthroscopy has increased exponentially with the advent of arthroscopic labral repair techniques for femoroacetabular impingement. The goal of arthroscopic labral repair is to re-create the anatomic suction seal of the labrum against the femoral head. This important anatomic relationship has been demonstrated in several biomechanical studies. Performing the acetabular recession and evaluating the congruity of labral repairs during surgery is difficult with the application of traction distracting the femoral head from the chondrolabral junction...
October 2017: Arthroscopy Techniques
Anne Helene S Tandberg, Wim Vader
Amphilochus manudens and Amphilochopsis hamatus are redescribed based on specimens from the BioIce, Mareano, and IceAGE programmes. The new species Amphilochus anoculussp. n. is described based on material from the IceAGE programme and the preceding BioIce programme; it is separated from the closely related Amphilochus manudens by the absence of eyes, a symmetrically bilobed labrum, four setae on the maxilla 2 outer plate, a rounded corner of epimeral plate 3, and a robust seta at the tip of the telson. There are also clear differences in depth and temperature ranges...
2018: ZooKeys
Allison J Rao, Nikhil N Verma, Scott W Trenhaile
Surgical repair of a Bankart lesion requires thorough recognition of the capsulolabral attachment and adequate visualization for suture anchor repair. The glenoid labrum usually detaches from its capsule and bony attachment anteriorly and inferiorly; however, the labral and capsule detachment can sometimes extend beyond this zone of injury. Identification and repair may require additional viewing and working portals to allow for ease of suture passage and anchor placement. This technique guide describes a case scenario of a Bankart lesion with anterior extension of the capsular tear, repaired with use of 2 anterior working portals...
October 2017: Arthroscopy Techniques
B Finke, W Petersen
OBJECTIVE: The aim of a tenotomy of the long biceps tendon is to remedy a painful pathology in the proximal region of the tendon. Tenodesis of the tendon can restore the motor and cosmetic function of the biceps brachii muscle. INDICATIONS: Partial rupture or tendopathy of the long biceps tendon, injuries of the anchor of the long biceps tendon (SLAP lesions; SLAP: superior labrum anterior posterior), lesions of the pulley system. CONTRAINDICATIONS: Infections or tumors, loss of the long head biceps tendon from the intertubercular groove...
February 2018: Operative Orthopädie und Traumatologie
Adam Hines, Jay B Cook, James S Shaha, Kevin Krul, Steve H Shaha, John Johnson, Craig R Bottoni, Douglas J Rowles, John M Tokish
BACKGROUND: Glenoid bone loss is a well-accepted risk factor for failure after arthroscopic stabilization of anterior glenohumeral instability. Glenoid bone loss in posterior instability has been noted relative to its existence in posterior instability surgery. Its effect on outcomes after arthroscopic stabilization has not been specifically evaluated and reported. PURPOSE: The purpose was to evaluate the presence of posterior glenoid bone loss in a series of patients who had undergone arthroscopic isolated stabilization of the posterior labrum...
January 1, 2018: American Journal of Sports Medicine
Anne Le Bouthillier, Kawan S Rakhra, Etienne L Belzile, Ryan C B Foster, Paul E Beaulé
BACKGROUND: Clinically, understanding how the soft tissue envelope adapts to various forms of hip dysfunction could enhance both surgical and nonsurgical management. Very few studies have looked at soft tissue structures as preoperative discriminators between varying underlying etiologies of hip conditions. PURPOSE: To demonstrate that the magnetic resonance arthrography assessment of soft tissue structures of the hip will preoperatively differ in patients with different underlying hip joint diseases...
February 2018: Journal of Orthopaedic Trauma
Itay Perets, Edwin O Chaharbakhshi, David E Hartigan, Victor Ortiz-Declet, Brian Mu, Benjamin G Domb
PURPOSE: To evaluate a delayed gadolinium-enhanced magnetic resonance imaging of cartilage (dGEMRIC) index designed to predict focal acetabular articular cartilage damage in patients with femoroacetabular impingement (FAI). METHODS: The inclusion criteria were patients who underwent dGEMRIC and hip arthroscopy between April 2010 and August 2015 for FAI syndrome. The exclusion criteria were previous hip conditions, a Tönnis grade greater than 1, and a delay between magnetic resonance imaging and surgery greater than 180 days...
January 17, 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
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