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Arthroscopy portals

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https://www.readbyqxmd.com/read/28630760/treatment-of-hindfoot-and-ankle-pathologies-with-posterior-arthroscopic-techniques
#1
Tahir Ögüt, N Selcuk Yontar
The two-portal hindfoot arthroscopy is an effective procedure enabling direct visualisation of posterior ankle pathology with low invasiveness.An important stage of the hindfoot endoscopy is localisation of the flexor hallucis longus (FHL) tendon to protect the neurovascular bundle which is located just medial to it.Posterior ankle impingement syndrome and FHL tenosynovitis are common causes of posterior ankle pain and frequently occur together.Posteriorly localised talar osteochondral lesions, Achilles tendon disorders, osteoarthritis, talar bone cysts and talar fractures are among the other pathologies that can be treated with hindfoot arthroscopy...
May 2017: EFORT open reviews
https://www.readbyqxmd.com/read/28608150/-arthroscopy-of-the-proximal-interphalangeal-joint
#2
N Borisch
OBJECTIVE: Pain reduction in the affected proximal interphalangeal joint (PIP joint) by synovectomy, loose body extraction, dorsal arthrolysis. INDICATIONS: Therapy-resistant synovitis in rheumatoid arthritis (RA), early stage primary and secondary degenerative arthritis, loose bodies, capsular contracture. CONTRAINDICATIONS: Established biomechanic changes in RA (boutonniere and swanneck deformity). Large dorsal synovial cysts. Advanced radiologic changes in degenerative arthritis...
June 12, 2017: Operative Orthopädie und Traumatologie
https://www.readbyqxmd.com/read/28607785/pseudoaneurysm-of-the-anterior-tibial-artery-following-ankle-arthroscopy-in-a-soccer-player
#3
Ichiro Tonogai, Tetsuya Matsuura, Toshiyuki Iwame, Keizo Wada, Tomoya Takasago, Tomohiro Goto, Daisuke Hamada, Yohei Kawatani, Eiki Fujimoto, Tetsuya Kitagawa, Shyoichiro Takao, Seiji Iwamoto, Moriaki Yamanaka, Masafumi Harada, Koichi Sairyo
Ankle arthroscopy carries a lower risk of vascular complications when standard anterolateral and anteromedial portals are used. However, the thickness of the fat pad at the anterior ankle affords little protection for the thin-walled anterior tibial artery, rendering it susceptible to indirect damage during procedures performed on the anterior ankle joint. To our knowledge, only 11 cases of pseudoaneurysm involving the anterior tibial artery after ankle arthroscopy have been described in the literature. Here we reported a rare case of a 19-year-old soccer player who presented with pseudoaneurysm of the anterior tibial artery following ankle arthroscopy using an ankle distraction method and underwent anastomosis for the anterior tibial artery injury...
2017: Case Reports in Orthopedics
https://www.readbyqxmd.com/read/28596053/the-assessment-of-portal-tract-healing-after-knee-arthroscopy
#4
Nihat Acar, Ali Er, Mehmet Erduran
OBJECTIVE: The aim of this study was to analyse the pattern of portal-tract healing, to compare the healing time of anteromedial and anterolateral portal tracts and to assess the impact of portal-tract delayed healing on the post-operative sub-acute and chronic anterior knee tenderness. METHODS: The study included 104 patients (68 males and 36 females; mean age: 49 ± 3.16 years (range; 17-66)) who have undergone knee arthroscopy. Puncture wounds were divided into two groups, (1) anteromedial and (2) anterolateral groups...
June 5, 2017: Acta Orthopaedica et Traumatologica Turcica
https://www.readbyqxmd.com/read/28588661/quantification-of-the-articular-view-of-the-elbow-afforded-by-standard-portals-using-30%C3%A2-arthroscopy
#5
Robert Moverley, Henry B Colaco, Bran Rudran, Matthew Szarko, Magnus Arnander, Duncan Tennent
BACKGROUND: The present study quantifies the field of view (FOV) from standard arthroscopy portals and aims to identify anatomical regions where the FOV is limited. METHODS: Eleven cadaveric elbows were examined through standard anteromedial, anterolateral and posterior portals. The FOV was marked with dye using a spinal needle. The articular surfaces were then exposed and the percentage FOV seen was calculated. FOV percentage areas were compared using a Student's t-test (JMP, version 10, SAS Institute Inc...
July 2017: Shoulder & Elbow
https://www.readbyqxmd.com/read/28567341/technical-note-anterior-cruciate-ligament-reconstruction-in-the-presence-of-an-intramedullary-femoral-nail-using-anteromedial-drilling
#6
Matthew Lacey, Joseph Lamplot, Kempland C Walley, Joseph P DeAngelis, Arun J Ramappa
AIM: To describe an approach to anterior cruciate ligament (ACL) reconstruction using autologous hamstring by drilling via the anteromedial portal in the presence of an intramedullary (IM) femoral nail. METHODS: Once preoperative imagining has characterized the proposed location of the femoral tunnel preparations are made to remove all of the hardware (locking bolts and IM nail). A diagnostic arthroscopy is performed in the usual fashion addressing all intra-articular pathology...
May 18, 2017: World Journal of Orthopedics
https://www.readbyqxmd.com/read/28560134/basics-of-elbow-arthroscopy-part-i-surface-anatomy-portals-and-structures-at-risk
#7
Christopher L Camp, Ryan M Degen, Joaquin Sanchez-Sotelo, David W Altchek, Joshua S Dines
As our knowledge and technology advance, the indications for elbow arthroscopy continue to grow rapidly. During this expansion, a number of new portals have been described and reported using variable nomenclature and location descriptions. Accordingly, a comprehensive review of these portals is warranted. Given the concern for potential iatrogenic injury to surrounding neurovascular structures, a discussion of these critical nerves and vessels is also timely. In this work, we review pertinent surface anatomy; portal nomenclature, locations, and utility; and review distances to the nearest structures at risk...
December 2016: Arthroscopy Techniques
https://www.readbyqxmd.com/read/28488163/historical-review-of-arthroscopic-surgery-of-the-hip
#8
REVIEW
Abigail C L Magrill, Naoki Nakano, Vikas Khanduja
BACKGROUND & PURPOSE: Increasing our appreciation of the historical foundations of hip arthroscopy offers greater insight and understanding of the field's current and future applications. This article offers a broad history of the progress of hip arthroscopy. METHODS: Hip arthroscopy's development from the early technologies of endoscopy to the present day is described through a review of the available literature. RESULTS: Endoscopic science begins with the Lichtleiter, developed by Phillip Bozzini (1779-1809) in 1806, but endoscopes were not applied to joints until 1912, as presented by Severin Nordentoft (1866-1922)...
May 9, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28479255/benzoyl-peroxide-and-clindamycin-topical-skin-preparation-decreases-propionibacterium-acnes-colonization-in-shoulder-arthroscopy
#9
Hailey H Dizay, Diana G Lau, Wesley M Nottage
BACKGROUND: Propionibacterium acnes is a gram-positive anaerobe that can lead to devastating postoperative shoulder infections. The objective of this study was to investigate whether a benzoyl peroxide and clindamycin preoperative skin preparation reduces the incidence of P. acnes colonization during shoulder arthroscopy. METHODS: Sixty-five shoulder arthroscopy patients were prospectively enrolled. A skin culture specimen was taken at the preoperative visit from standard arthroscopic portal sites...
May 4, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28451620/generalized-joint-hypermobility-is-predictive-of-hip-capsular-thickness
#10
Brian M Devitt, Bjorn N Smith, Robert Stapf, Mark Tacey, John M O'Donnell
BACKGROUND: The pathomechanics of hip microinstability are not clearly defined but are thought to involve anatomical abnormalities, repetitive forces across the hip, and ligamentous laxity. PURPOSE/HYPOTHESIS: The purpose of this study was to explore the relationship between generalized joint hypermobility (GJH) and hip capsular thickness. The hypothesis was that GJH would be predictive of a thin hip capsule. STUDY DESIGN: Cross-sectional study; Level of evidence, 3...
April 2017: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/28428918/the-safety-of-the-thenar-portal-an-anatomical-study-of-the-thumb-carpometacarpal-arthroscopy
#11
Yong-Wei Pan, Leung-Kim Hung
Purpose To define the localization of the distal course of the motor branches of median nerve (MBMN) and its arborization and its quantitative relationships to the thenar portal of the carpometacarpal (CMC) joint in the hope of evaluating the safety of this portal. Method In 16 embalmed cadaveric upper extremities, the localization of the course of the MBMN and its arborization were defined. In 14 fresh-frozen cadaver upper extremities, the CMC arthroscopic portals, 1-U, 1-R, and a thenar portal, were established, after which the limbs were dissected...
May 2017: Journal of Wrist Surgery
https://www.readbyqxmd.com/read/28409096/ankle-arthroscopy-with-microfracture-for-osteochondral-defects-of-the-talus
#12
Suman Medda, Ian M Al'Khafaji, Aaron T Scott
Therapeutic arthroscopy with microfracture leads to fibrocartilaginous repair and is an effective treatment of osteochondral lesions of the talus. A full diagnostic arthroscopy is performed, and then attention is turned to the osteochondral defect. We describe in detail patient positioning, ankle distraction, portal placement, steps of the diagnostic arthroscopy, and the technique of microfracture. We then discuss the special considerations to be taken regarding the use of a distractor, protection of neurovascular structures, and the indications for microfracture...
February 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/28343808/an-anatomic-evaluation-of-arthroscopic-access-to-the-radial-head
#13
Jonathan D Hodax, Travis D Blood, Dominic T Kleinhenz, Megan Gorman, Alison Biercevicz, Manuel DaSilva
PURPOSE: To determine the area of the radial head accessible for visualization and screw placement from the standard anteromedial and anterolateral portals used in elbow arthroscopy. METHODS: Five cadaveric elbows were arthroscopically evaluated using standard anteromedial and anterolateral portals. Markers (pins) were placed into the accessible portions of the radial head at maximal pronation and supination. Specimens were then evaluated by computed tomography, and the arc of the radial head accessible from each portal was determined...
March 23, 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/28259751/cadaver-study-of-anatomic-landmark-identification-for-placing-ankle-arthroscopy-portals
#14
B Scheibling, G Koch, P Clavert
BACKGROUND: Arthroscopy-assisted surgery is now widely used at the ankle for osteochondral lesions of the talus, anterior and posterior impingement syndromes, talocrural or subtalar fusion, foreign body removal, and ankle instability. Injuries to the vessels and nerves may occur during these procedures. OBJECTIVE: To determine whether ultrasound topographic identification of vulnerable structures decreased the risk of iatrogenic injuries to vessels, nerves, and tendons and influenced the distance separating vulnerable structures from the arthroscope introduced through four different portals...
May 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28237081/incidence-of-posterior-interosseous-nerve-trauma-during-creation-of-the-3-4-wrist-arthroscopy-portal-in-cadavers
#15
Andre Eu-Jin Cheah, Wei Le, Jeffrey Yao
PURPOSE: To describe histologic evidence of nerve trauma during the creation and use of the 3-4 portal. METHODS: Fourteen fresh-frozen cadaveric wrists were mounted on a custom-built frame that simulated a wrist arthroscopy traction tower. After the 3-4 portal was created in the usual manner, the skin was dissected off to identify possible trauma to the posterior interosseous nerve (PIN). Specimens were categorized into those where there was clearly no trauma to the PIN and those where trauma was possible...
February 22, 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/28224065/the-supine-position-for-shoulder-arthroscopy
#16
Chonlathan Iamsumang, Bancha Chernchujit
Shoulder arthroscopy is traditionally performed with the patient in either the beach chair position or the lateral decubitus position. Each position has its advantages and disadvantages. The main topics for consideration include ease of surgery, view into the surgical field, risks to the patient, and economics of the setup. In the lateral decubitus position, it is inconvenient to work through the anterior portal and it is difficult to convert to an open procedure. In the beach chair position, it is difficult to manage the airway and cerebral oxygenation and the patient's head and the beach chair frame obstruct the insertion of a scope into the superior and posterior portals...
October 2016: Arthroscopy Techniques
https://www.readbyqxmd.com/read/28164043/pneumothorax-after-shoulder-arthroscopy-a-rare-but-life-threatening-complication
#17
Sven Bamps, Daan Renson, Stefaan Nijs, Sermon
INTRODUCTION: Arthroscopy has become a major diagnostic tool and treatment option for shoulder pathology. However rare, respiratory complications such as a pneumothorax have been reported in patients undergoing shoulder arthroscopy. Surgery - as well as anesthesiology-related factors and respiratory comorbidity have been hypothesized to intervene in the onset of respiratory complications. CASE REPORT: We report the case of a 42-year-old male patient who underwent an arthroscopy of the left shoulder...
September 2016: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/28149744/arthroscopic-psoas-management-techniques-for-psoas-preservation-and-psoas-tenotomy
#18
Andrea M Spiker, Ryan M Degen, Christopher L Camp, Struan H Coleman
The iliopsoas tendon is an important dynamic stabilizer of the hip joint, and it should be carefully identified and preserved during routine hip arthroscopy. However, it may also be a source of hip pain manifesting as iliopsoas tendinitis or a snapping hip or contributing to the development of labral pathology caused by psoas impingement. In the appropriately indicated, refractory cases of iliopsoas-related hip pain, surgical intervention in the form of an iliopsoas tenotomy at the level of the labrum can result in reliable pain relief...
December 2016: Arthroscopy Techniques
https://www.readbyqxmd.com/read/28142348/arthroscopic-fixation-of-the-clavicle-shaft-fracture
#19
Yang-Soo Kim, Hyo-Jin Lee, Jong-Ick Kim, Hyo Yang, Hong-Ki Jin, Hiren Kirtibhai Patel, Jong-Ho Kim, In Park
This article describes an arthroscopic technique for the fixation of clavicle shaft fractures. A viewing portal is made 2 cm anterior to the fracture site, and a working portal is made 2 cm lateral to the fracture site. The guide wire for a 4.0-mm cannulated screw is inserted through the fracture site to the medial fracture fragment under arthroscopic guidance. Through the medial fragment, the guide wire is delivered through the skin anteriorly. The fracture is reduced, and then, the guide wire is drilled back across the fracture site to the lateral fracture fragment...
January 2017: Journal of Orthopaedic Surgery
https://www.readbyqxmd.com/read/28081575/what-arthroscopic-skills-need-to-be-trained-before-continuing-safe-training-in-the-operating-room
#20
Gabrielle Tuijthof, Federico Cabitza, Vincenza Ragone, Riccardo Compagnoni, Pietro Randelli
The purpose of this study was to generate consensus among experienced surgeons on "what skills a resident should possess before continuing safe training in the operating room (OR)." An online survey of 65 questions was developed and distributed to surgeons in the European community. A total of 216 responded. The survey included 15 questions regarding generic and specific skills; 16 on patient and tissue manipulation, 11 on knowledge of pathology and 6 on inspection of e-anatomical structures; 5 methods to prepare residents; and 12 on specific skills exercises...
January 12, 2017: Journal of Knee Surgery
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