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Labrum repairs

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https://www.readbyqxmd.com/read/27909680/anatomic-labral-repair-in-the-hip-using-a-knotless-tensionable-suture-anchor
#1
Carlos Suarez-Ahedo, Timothy J Martin, John P Walsh, Sivashankar Chandrasekaran, Parth Lodhia, Benjamin G Domb
To perform a proper labral repair, most surgeons use anchors to secure the labrum to the acetabular bone. We aim to describe a technique for labral repair with a knotless tensionable suture anchor. This technique uses a looped suture configuration, allowing selective tensioning of the repair to maintain the anatomic suction seal of the hip. The use of this technique is easily reproducible and reduces the surgical time compared with previous techniques.
October 2016: Arthroscopy Techniques
https://www.readbyqxmd.com/read/27909661/the-oblique-mattress-lasso-loop-stitch-for-arthroscopic-capsulolabral-repair
#2
Nata Parnes, Maryellen Blevins, Monica Morman, Paul Carey
Arthroscopic capsulolabral repair during shoulder stabilization surgery requires the use of suture anchors. Several arthroscopic suturing techniques for capsulolabral repair have been described, and each carries very specific advantages and disadvantages with regard to risk, patient satisfaction, and functional outcomes. The purpose of this report is to describe the oblique mattress lasso-loop stitch. This stitch (1) provides strong initial fixation of the labrum, (2) establishes labral height and allows for larger capsular plication if needed, (3) prevents the suture from cutting through the radial fibers of the glenoid labrum, (4) prevents knot migration to the articular side and loosening of the knot, and (5) requires fewer implants and preserves glenoid bone stock by increasing the amount of labrum and capsule that can be reattached to the glenoid with a single-loaded suture anchor...
October 2016: Arthroscopy Techniques
https://www.readbyqxmd.com/read/27876489/morphologic-changes-and-outcomes-after-arthroscopic-acetabular-labral-repair-evaluated-using-postoperative-computed-tomography-arthrography
#3
Jun-Il Yoo, Yong-Chan Ha, Young-Kyun Lee, Guen-Young Lee, Moon-Jib Yoo, Kyung-Hoi Koo
PURPOSE: To investigate smaller sized labra after acetabular labral repair comparing preoperative and postoperative computed tomography arthrography (CTA) and to assess the correlation between the anatomic changes and clinical outcomes. METHODS: The design and protocol of this retrospective study were approved by the institutional review board of our hospital. The inclusion criteria included age older than 18 years and hip pain associated with mechanical symptoms...
November 19, 2016: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/27834459/histological-changes-of-the-acetabular-labrum-in-coxarthrosis-labral-degeneration-and-repair
#4
Marcin E Domzalski, Marek Synder, Anna Karauda, Wielislaw Papierz
INTRODUCTION: The current study was designed to describe types of histological changes within the acetabular labrum in the advanced stages of coxarthrosis, in patients requiring total hip arthroplasty (THA). METHODS: 77 consecutive patients without systemic disorders or prior hip surgery, scheduled for THA with 3 types of coxarthrosis: avascular necrosis (AVN), idiopathic, and dysplastic coxarthrosis were analysed. Patient's data: age, gender, side of the involvement, duration of the symptoms were recorded, and standard anteroposterior (AP) radiographic views of the pelvis were obtained...
November 9, 2016: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
https://www.readbyqxmd.com/read/27793805/superior-labrum-anterior-posterior-tears-in-the-national-football-league
#5
Caitlin C Chambers, T Sean Lynch, Daniel B Gibbs, Jason H Ghodasra, Shawn Sahota, Kristina Franke, Christina D Mack, Gordon W Nuber
BACKGROUND: Shoulder disorders are common in football players, with up to 50% of National Football League (NFL) recruits reporting a history of shoulder injuries. Superior labrum anterior-posterior (SLAP) tears are an entity with well-described detrimental effects on return to play in overhead-throwing athletes but with minimal data in contact athletes. PURPOSE: To identify the incidence, predisposing factors, and effect of SLAP tears in NFL athletes and prospects as well as the treatment patterns of NFL team physicians...
October 28, 2016: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/27765830/superior-labral-anterior-posterior-slap-tears-in-the-military-a-clinical-review-of-incidence-diagnosis-and-treatment-compared-with-the-civilian-population
#6
William Rossy, George Sanchez, Anthony Sanchez, Matthew T Provencher
CONTEXT: Given the notable physical demands placed on active members of the military, comprehension of recent trends in management and outcomes of superior labral anterior-posterior (SLAP) tears in this patient population is critical for successful treatment. EVIDENCE ACQUISITION: Electronic databases, including PubMed, MEDLINE, and Embase, were reviewed for the years 1985 through 2016. STUDY DESIGN: Database review. LEVEL OF EVIDENCE: Level 5...
October 7, 2016: Sports Health
https://www.readbyqxmd.com/read/27726742/postoperative-shoulder-imaging-rotator-cuff-labrum-and-biceps-tendon
#7
Jennifer L Pierce, Nicholas C Nacey, Stephen Jones, Davis Rierson, Brian Etier, Stephen Brockmeier, Mark W Anderson
Imaging interpretation of the postoperative shoulder is a challenging and difficult task for both the radiologist and the orthopedic surgeon. The increasing number of shoulder rotator cuff, labrum, and biceps tendon repairs performed in the United States also makes this task a frequent occurrence. Whether treatment is surgical or conservative, imaging plays a crucial role in patient care. Many imaging findings can be used to predict prognosis and functional outcomes, ultimately affecting treatment. In addition, evolving surgical techniques alter the normal anatomy and imaging appearance of the shoulder such that accepted findings proved to be pathologic in the preoperative setting cannot be as readily described as pathologic after surgery...
October 2016: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/27709050/arthroscopic-repair-of-posterior-glenohumeral-capsular-rupture-with-concomitant-anterior-and-posterior-labrum-detachment
#8
Robert A Duerr, John J Christoforetti
Posterior glenohumeral capsular rupture is a rare cause of posterior glenohumeral instability. With advances in imaging and arthroscopic techniques, diagnosis and treatment of posterior glenohumeral instability are becoming more common in practice. We present a technique for arthroscopic repair of a posterior glenohumeral capsular rupture with concomitant anterior and posterior labrum detachment. Arthroscopic fixation was facilitated by use of a 70° arthroscope through an anterior viewing portal to allow accurate placement of the posterior portal in preparation for knot tying...
August 2016: Arthroscopy Techniques
https://www.readbyqxmd.com/read/27709046/arthroscopic-double-row-suture-anchor-repair-of-acute-posterior-bony-bankart-lesion
#9
Justin A Ly, Erin M Coleman, Eric J Kropf
The treatment of anterior shoulder instability is well described with various techniques, including arthroscopic double-row repair, an alternative to open stabilization procedures in high-risk groups. The surgical management of posterior instability in high-risk and athletic populations is a less-explored entity. We describe our technique for an all arthroscopic double-row suture anchor repair of a large posterior bony Bankart lesion. We prefer this technique over percutaneous cannulated screw fixation because the double-row suture technique allows for incorporation of capsular plication with bony fixation in an effort to better restore normal anatomy for capsulolabral complex...
August 2016: Arthroscopy Techniques
https://www.readbyqxmd.com/read/27709022/arthroscopic-repair-of-inferior-labrum-anterior-to-posterior-lesions-of-the-shoulder-using-a-combined-double-pulley-simple-knot-technique
#10
Nata Parnes, Maryellen Blevins, Brian Carr, Paul Carey
Inferior labrum anterior to posterior lesions as an isolated injury or as part of an extensive traumatic labral tear are uncommon and may present as multidirectional instability of the shoulder. These lesions are hard to visualize radiographically and many times are diagnosed only during surgery. Arthroscopic repair of these lesions requires advanced arthroscopic skills and is required for restoration of glenohumeral stability. We report a combined double-pulley simple knot technique that anatomically reconstructs the inferior labrum while overcoming the typical technical challenges, providing a large footprint for healing along the inferior glenoid rim and minimizing the amount of suture material in direct contact with the articular cartilage and the risk of knot migration...
August 2016: Arthroscopy Techniques
https://www.readbyqxmd.com/read/27703928/infected-shoulder-joint-with-loose-suture-anchor-in-the-joint-after-bankart-s-repair-a-case-report
#11
Mukesh Kumar, Jai Thilak
INTRODUCTION: The glenoid labrum is frequently torn in traumatic glenohumeral dislocation; arthroscopic repair is the standard method of treatment. The complications associated with this repair are pulling out of metal suture anchors, chondrolysis and joint infection. The infection of joint after arthroscopy is less than 1%. Staphylococcus is most common organism and rarely followed by Pseudomonas aeruginosa. We report a case of infected shoulder with chondrolysis of the joint and pulled out metal suture anchor lying inside the joint after Bankart's repair...
April 2016: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/27697179/editorial-commentary-the-not-so-benign-nature-of-an-isolated-slap-repair
#12
Matthew T Provencher
Although superior labrum anterior posterior (SLAP) repairs have a relatively high success rate, emerging evidence suggests that this is not always the case. The authors of "Subsequent Shoulder Surgery Following Isolated Arthroscopic SLAP Repair" reveal that 1 in 10 people needed additional surgery within 3 years after SLAP repair-mainly for disorders of the rotator cuff, biceps, and distal clavicle. This underscores the fact that SLAP tears rarely occur in isolation and that the initial diagnosis and management may require more than just SLAP work...
October 2016: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/27581790/hip-labral-repair-options-and-outcomes
#13
REVIEW
Joshua D Harris
The importance of the acetabular labrum has been increasingly recognized, playing a critical role in both normal anatomy and abnormal pathology of the hip joint. The labrum increases acetabular surface area and volume, providing a stable and durable articulation. The fibrocartilaginous composition affords a tissue capable of a lifetime of normal function in the absence of significant osseous pathology. In the setting of femoroacetabular impingement (FAI) or dysplasia, bony biomechanics may cause labral injury, which may translate to patient symptoms...
December 2016: Current Reviews in Musculoskeletal Medicine
https://www.readbyqxmd.com/read/27497788/variable-reporting-of-functional-outcomes-and-return-to-play-in-superior-labrum-anterior-and-posterior-tear
#14
Michael E Steinhaus, Eric C Makhni, Adam C Lieber, Cynthia A Kahlenberg, Lawrence V Gulotta, Anthony A Romeo, Nikhil N Verma
BACKGROUND: Outcomes assessments after superior labrum anterior and posterior (SLAP) tear/repair are highly varied, making it difficult to draw comparisons across the literature. This study examined the inconsistency in outcomes reporting in the SLAP tear literature. We hypothesize that there is significant variability in outcomes reporting and that although most studies may report return to play, time to return reporting will be highly variable. METHODS: The PubMed, Medline, Scopus, and Embase databases were systematically reviewed for studies from January 2000 to December 2014 reporting outcomes after SLAP tear/repair...
November 2016: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/27469476/-surgical-treatment-of-posterosuperior-impingement-psi
#15
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...
December 2016: Operative Orthopädie und Traumatologie
https://www.readbyqxmd.com/read/27416990/patient-characteristics-and-early-functional-outcomes-of-combined-arthroscopic-labral-refixation-and-periacetabular-osteotomy-for-symptomatic-acetabular-dysplasia
#16
Benjamin F Ricciardi, Stephanie W Mayer, Kara G Fields, Catherine Wentzel, Bryan T Kelly, Ernest L Sink
BACKGROUND: Symptomatic labral tears are common in patients with acetabular dysplasia; however, optimal treatment of the labrum remains controversial. PURPOSE: To present patient characteristics and early functional outcomes associated with combined arthroscopic labral refixation and Bernese periacetabular osteotomy (PAO) for symptomatic acetabular dysplasia with a displaced labral tear from the acetabular rim. STUDY DESIGN: Cohort study; Level of evidence, 3...
October 2016: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/27354952/arthroscopic-knotless-repair-of-the-posterior-labrum-using-labraltape
#17
Paul E Caldwell, Sara E Pearson, Mark S D'Angelo
Operative management of symptomatic labral tears of the shoulder has traditionally been the preferred treatment. Arthroscopic techniques and equipment continue to be refined and subsequent new recommendations for treatment are being developed. Contemporary techniques for arthroscopic knotless repair offer possible advantages over traditional arthroscopically tied knots. Although knotless repair of labral tears is well recognized, advancements continue to progress toward stronger fixation with reduced risks of cutting through the labrum and chondral abrasion...
April 2016: Arthroscopy Techniques
https://www.readbyqxmd.com/read/27343389/management-of-the-acetabular-labrum
#18
REVIEW
Andrew B Wolff, Jamie Grossman
The options for labral treatment are debridement, repair, and reconstruction. Debridement of labral tissue is indicated when there is peripheral tearing of the labrum that does not compromise the functionality of the labrum at its base or if the labrum is not playing an important role in the patient's pathology. Labral repair is performed when the base of the labrum is unstable at its attachment at the acetabular rim and the tissue is of otherwise good quality. Labral reconstruction is an option for labral tissue compromised beyond repair, segmental labral defect, or previous failed repair...
July 2016: Clinics in Sports Medicine
https://www.readbyqxmd.com/read/27284508/simplified-knotless-mattress-repair-of-type-ii-slap-lesions
#19
Marcus Robert Chia, Cameron Hatrick
Arthroscopic repair of lesions of the superior labrum and biceps anchor has been shown to provide good to excellent results. We describe a simplified arthroscopic surgical technique using a single knotless anchor with a mattress suture configuration. This technique provides an effective and reproducible method to reattach and re-create the normal appearance of the superior labrum and biceps anchor in a time-efficient manner without the need for knot tying.
December 2015: Arthroscopy Techniques
https://www.readbyqxmd.com/read/27262413/tobacco-use-is-associated-with-increased-rates-of-infection-and-revision-surgery-after-primary-superior-labrum-anterior-and-posterior-repair
#20
Jourdan M Cancienne, Stephen F Brockmeier, Brian C Werner
BACKGROUND: Although the general health consequences of tobacco use have been well defined, the effects of perioperative tobacco use on arthroscopic shoulder procedures remain largely unknown. The purpose of this study is to use a national database to investigate the relationship between tobacco use and rates of superior labrum anterior and posterior (SLAP) repair failure and postoperative infection after primary SLAP repair compared with matched controls. METHODS: A national private-payer insurance database was queried for patients who underwent arthroscopic primary SLAP from 2005-2012...
June 1, 2016: Journal of Shoulder and Elbow Surgery
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