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Arthroscopy portals

Mikel Aramberri, Giovanni Tiso, David L Haeni
Synovial chondromatosis of the shoulder is a rare disorder characterized by metaplastic synovial proliferation, causing multiple loose bodies usually localized intra-articularly. Surgical treatment with open techniques through a deltopectoral approach has been commonly used. The evolution of arthroscopy has allowed a complete joint assessment and the extraction of intra-articular loose bodies with less morbidity than open techniques. Nevertheless, this pathology occurs less frequently in the subcoracoid bursa...
March 2018: Arthroscopy Techniques
Hiroyuki Kan, Yuji Arai, Shuji Nakagawa, Hiroaki Inoue, Yuta Fujii, Hiroyoshi Fujiwara, Toshikazu Kubo
Although the outside-in method has been used to treat injuries to the anterior segment of the meniscus, this method has drawbacks including the need to make a skin incision and portals for arthroscopy, pain caused by strangulation of the subcutaneous tissue and joint capsule, and protrusion of the knots. To resolve these problems, we present an all-inside method that enables simple suture of injuries to the anterior segment of the meniscus through arthroscopic portals placed only on the anteromedial and lateral sides without using a specific instrument...
March 2018: Arthroscopy Techniques
Jae-Sung Yoo, Seong-Jun Kim, Jae-Uk Jung, Joong-Bae Seo
We sought to evaluate proper elbow arthroscopy portal placement in pediatric and adolescent patients. Overall, 109 pediatric and adolescent patients who underwent elbow arthrography were included. Condylar width was measured and the proximal anterior joint capsule location was determined using the ulna-capsular distance. Condylar width and Bone mass index(BMI) also had a high positive correlation coefficient with the proximal joint capsule location. Proximal ulnar border is recommended new bony landmark in pediatric and adolescent patients who undergo elbow arthroscopy...
June 2018: Journal of Orthopaedics
Ju-Eun Kim, Dae-Jung Choi
Background context: Lumbar foraminal stenosis or extraforaminal stenosis is a common cause of spinal cord radiculopathy. Recently, several authors have introduced an endoscopy-based spinal surgery technique. Purpose: The study aimed to introduce far lateral approach of biportal arthroscopic technique using 30° arthroscopy for foraminal decompression of L5-S1. Study design: Technical note. Patient sample: 12 consecutive patients...
June 2018: Journal of Orthopaedics
Brittany M Woodall, Nicholas Elena, Asher B Mirvish, Edward C Shin, Neil P Pathare, Patrick J McGahan, James L Chen
Horizontal cleavage tears of the medial and lateral meniscus can be difficult to treat using the standard anteromedial or anterolateral arthroscopy portals. In this Technical Note, we present a new surgical technique to better manage the inferior leaflet of horizontal cleavage tears of the medial and lateral meniscus and their associated parameniscal cysts.
May 2018: Arthroscopy Techniques
Nicholas Elena, Brittany M Woodall, Sohyun Ahn, Patrick J McGahan, Neil P Pathare, Edward C Shin, James L Chen
Open Bankart repair was the standard technique used in the past, but the request for less invasiveness, always pursued by every surgeon, pushed the development of the arthroscopic procedure. Nowadays the stabilization of the anteroinferior labrum is usually performed with an arthroscopic technique that uses the classic posterior portal and 2 anterior working portals. Because arthroscopy is progressing steadily under every aspect, there is now the chance to use only one working portal with the aid of a suture passer...
May 2018: Arthroscopy Techniques
Anna Jeon, Chang Min Seo, Je-Hun Lee, Seung-Ho Han
Introduction: The aim of this study was to investigate entry points for anterior ankle arthroscopy that would minimize the risk of neurovascular injury. Methods: Thirty-eight specimens from 21 Korean cadavers (age range from 43 to 92 years, mean age of 62.3 years) were used for the study. For the measurements, the most prominent points of the lateral malleolus (LM) and the medial malleolus (MM) were identified before dissection. A line connecting the LM and MM, known as the intermalleolar line, was used as a reference line...
2018: BioMed Research International
T Pillukat, M Mühldorfer-Fodor, J Windolf, J van Schoonhoven
OBJECTIVE: The aim of the procedure is to visualize the proximal pouch of the DRUJ, the joint surfaces of the sigmoid notch and the ulnar head, the convexity of the ulnar head and the proximal ulnar side surface of the triangular fibrocartilage complex (TFCC). INDICATIONS: Arthroscopy of the distal radioulnar joint is applied for the evaluation of joint pathologies in ulnar-sided wrist pain, especially in cases without diagnostic findings in standard X‑rays and MRIs and arthroscopically assisted procedures...
May 24, 2018: Der Orthopäde
Nicos Papaloucas
There have been many innovations in the field of ACL-reconstruction over the years, including the FlipCutter® and TightRope® system (both from Arthrex Inc.). The FlipCutter® is a combined guide pin and reamer that allows minimally invasive socket-creation from the inside out, especially in difficult-to-reach areas. The TightRope® is a further development of the well-known Endobutton™ (Smith & Nephew plc) that consists of a four-point knotless locking system. Its main advantage is its adjustability, which makes it possible to fill the entire bone socket with the graft without any empty space...
June 1, 2018: Surgical Technology International
Giles Heilpern, Jo Stephen, Simon Ball, Andrew Amis, Andy Williams
PURPOSE: Recently, it has been recognized that meniscocapsular ('ramp') lesions of the posterior one-third of the medial meniscus frequently occur during injuries causing ACL rupture, and that these lesions are easily missed at arthroscopy. Furthermore, it is clear that these lesions are biomechanically significant, adding to the deficits caused by ACL rupture, and that their repair can reverse this. The efficacy of an all inside repair technique has been questioned by some authors and by those who advocate a suture shuttle technique via an accessory posteromedial portal...
May 12, 2018: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
M Sawa, T Nakasa, Y Ikuta, M Yoshikawa, Y Tsuyuguchi, M Kanemitsu, Y Ota, N Adachi
Aims The aim of this study was to evaluate antegrade autologous bone grafting with the preservation of articular cartilage in the treatment of symptomatic osteochondral lesions of the talus with subchondral cysts. Patients and Methods The study involved seven men and five women; their mean age was 35.9 years (14 to 70). All lesions included full-thickness articular cartilage extending through subchondral bone and were associated with subchondral cysts. Medial lesions were exposed through an oblique medial malleolar osteotomy, and one lateral lesion was exposed by expanding an anterolateral arthroscopic portal...
May 1, 2018: Bone & Joint Journal
Kaissar Yammine, Chahine Assi
Neurovascular and tendon structures are considered at risk when performing ankle arthroscopy. Injury rate and distance from portals to such structures varied in the literature. The aim of this meta-analysis is to evaluate the injury risk of these structures in terms of proximity and injury prevalence. Thirteen studies including 184 cadaveric ankle arthroscopy procedures met the inclusion criteria. The antero-central portal exhibited the highest frequencies of nerve/vessel proximity and nerve/vessel missed injuries...
May 2018: Surgical and Radiologic Anatomy: SRA
Haijiao Mao, Linger Wang, Wenwei Dong, Zhenxin Liu, Weigang Yin, Dachuan Xu, Keith L Wapner
PURPOSE: The aim of this study was to evaluate the occurrence of anatomical variations of the musculotendinous junction of the flexor hallucis longus (FHL) muscle, the relationship between FHL tendon or muscle and the tibial neurovascular bundle at the level of the posterior ankle joint in human cadavers. METHODS: Seventy embalmed feet from 20 male and 15 female cadavers, the cadavers' mean age was 65.4 (range from 14 to 82) years, were dissected and anatomically classified to observe FHL muscle morphology define the relationship between FHL tendon or muscle and the tibial neurovascular bundle...
April 16, 2018: Surgical and Radiologic Anatomy: SRA
Paolo Arrigoni, Davide Cucchi, Enrico Guerra, Francesco Luceri, Simone Nicoletti, Alessandra Menon, Pietro Randelli
PURPOSE: Arthroscopic reduction and internal fixation for coronoid process fractures has been proposed to overcome limitations of open approaches. Currently, arthroscopy is most frequently used to assist insertion of a retrograde guide wire for a retrograde cannulated screw. The present anatomical study presents an innovative arthroscopic technique to introduce an antegrade guide wire from an accessory anteromedial portal and evaluates its safety and reproducibility. METHODS: Six fresh-frozen cadaver specimens were obtained and prepared to mimic an arthroscopic setting...
April 2, 2018: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Jesús Vilá-Rico, Enrique Sánchez-Morata, Elena Vacas-Sánchez, Cristina Ojeda-Thies
Injuries of the distal tibiofibular syndesmosis are commonly overlooked or mismanaged, and chronic instability is a debilitating condition leading to premature joint degeneration. Several methods of treatment have been described, mainly screw fixation, arthrodesis, or ligament reconstruction. Most clinical evidence is limited to case series, mainly screw fixation, and there is a general paucity of evidence regarding ligament reconstruction, which is considered to be more anatomic and to restore joint biomechanics...
February 2018: Arthroscopy Techniques
Yusuke Tsuyuguchi, Tomoyuki Nakasa, Masakazu Ishikawa, Yasunari Ikuta, Mikiya Sawa, Masahiro Yoshikawa, Nobuo Adachi
Ankle arthroscopy is a minimally invasive technique for ankle joint treatment. However, injury to the intermediate dorsal cutaneous nerve (IDCN) and the medial dorsal cutaneous nerve (MDCN) is a common complication during anterior portal placement. To prevent injuries, methods such as palpating the nerves topographically and marking the nerves by transilluminating the skin with an arthroscope have been proposed. Easier and more definitive methods of identifying the IDCN and MDCN should result in a reduction of complications...
February 2018: Arthroscopy Techniques
Ichiro Tonogai, Fumio Hayashi, Yoshihiro Tsuruo, Koichi Sairyo
Arthroscopy is an important and minimally invasive diagnostic and therapeutic tool. However, the risk of injury to the neurovascular structures around the portals exists during arthroscopy of the ankle. In the present study, we measured the distance between each portal and the adjacent neurovascular structures with the foot in plantarflexion and dorsiflexion in the Japanese population. Standard anterolateral (AL), anteromedial, posterolateral (PL), and posteromedial portal positions were identified in 6 fresh adult cadaveric feet...
May 2018: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Francisco Del Piñal, Eduardo Moraleda, Jaime S Rúas, Ana Rodriguez-Vega, Alexis Studer
PURPOSE: To present a new arthroscopic method for treating supination losses. METHODS: Six patients (15-71 y) were eligible for this study. All had a history of trauma to the wrist more than 6 months previously. Five of them had sustained a distal radius fracture: 3 had been treated with a volar plate (1 of them for an extra-articular malunion), 1 with an external fixator and K-wires, and 1 had been treated in a cast. One of these patients underwent a further operation for correcting an intra-articular malunion...
March 6, 2018: Journal of Hand Surgery
Jonathan D Bartlett, John E Lawrence, Vikas Khanduja
PURPOSE: To determine: (1) What is the proximity of the lateral femoral cutaneous nerve (LFCN) to the anterior portal (AP) used in supine hip arthroscopy? (2) What is the proximity of the LCFN to the incision in the minimally invasive anterior approach (MIAA) for total hip arthroplasty? (3) What effect does lateralizing the AP have on the likelihood of nerve injury? (4) What branching patterns are observable in the LFCN? METHODS: Forty-five hemipelves were dissected...
February 23, 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
Burcu Erçakmak, Ceren Günenç Beşer, M. Hakan Özsoy, M. Deniz Demiryürek, Alp Bayramoğlu, K. Mutlu Hayran
Background/aim: The localization of the standard posterior portal of shoulder arthroscopy and landmarks mentioned in the literature are unclear. The purpose of this prospective cadaveric study was to determine the localization of the standard posterior portal and its distance to the neural structures. Materials and methods: One fresh frozen and 10 formalin-fixed adult cadaveric shoulders were dissected. In the beach chair position, a 5-mm trocar was placed anteroposteriorly from the superior edge of the subscapularis muscle, superior to the tip of the coracoid process and tangent to the glenoid...
February 23, 2018: Turkish Journal of Medical Sciences
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