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Superior capsule reconstruction

Roberto Castricini, Olimpio Galasso, Daria Anna Riccelli, Filippo Familiari, Massimo De Benedetto, Nicola Orlando, Giorgio Gasparini
Several treatment options for chronic, massive rotator cuff tears exist, and they include debridement with possible biceps tenotomy or tenodesis, open or arthroscopic partial repair, muscle or tendon transfer, superior capsule reconstruction, synthetic patch augmentation, and reverse total shoulder arthroplasty. The aim of this technique article is to describe our preferred surgical option for irreparable, massive rotator cuff tears with an irreparable supraspinatus, a reparable infraspinatus, and an intact or reparable subscapularis tendon...
February 2017: Arthroscopy Techniques
Takaaki Hattori, Kenji Ito, Chika Nakazawa, Yoshiyuki Numasawa, Mayumi Watanabe, Shigeki Aoki, Hidehiro Mizusawa, Sumio Ishiai, Takanori Yokota
Left hemispatial neglect (neglect) is an impaired state of spatial attention. We aimed to reconstruct structural connectivity in the spatial attention network and to identify disconnection patterns underlying neglect. We enrolled 59 right-handed patients who had their first-ever infarction in the right hemisphere and classified them into neglect group (34 patients with neglect) and control group (25 patients without neglect). The neglect group was further subcategorized into 6 subgroups based on infarcted vascular territories...
March 13, 2017: Brain Imaging and Behavior
Jason M Schon, J Christoph Katthagen, Cameron N Dupre, Justin J Mitchell, Travis Lee Turnbull, Christopher R Adams, Patrick J Denard, Peter J Millett
PURPOSE: To investigate glenoid fixation for superior capsule reconstruction (SCR) and evaluate anchor positions, intraosseous trajectories, and proximity to the suprascapular nerve (SSN) and glenoid fossa. The secondary purpose was to provide technical pearls and pitfalls for anchor insertion on the superior glenoid during SCR. METHODS: Three beath pins were arthroscopically inserted into 12 (n = 12) nonpaired human cadaveric shoulders through Neviaser, anterior, and posterior portals to simulate anchor placement on the superior glenoid during SCR...
December 31, 2016: Arthroscopy: the Journal of Arthroscopic & related Surgery
Takashi Kurabayashi, Hirotaka Asato, Yasutoshi Suzuki, Nobuyuki Kaji, Yoko Mitoma
BACKGROUND: In two-stage procedures for reconstruction of microtia, an axial flap of temporoparietal fascia is widely used to cover the costal cartilage blocks placed behind the framework. Although a temporoparietal fascia flap is undoubtedly reliable, use of the flap is associated with some morbidity and comes at the expense of the option for salvage surgery. METHODS: The authors devised a simplified procedure for covering the cartilage blocks by creating a pocket in the postauricular temporoparietal fascia...
April 2017: Plastic and Reconstructive Surgery
Xinning Li, Antonio Cusano, Josef Eichinger
Shoulder dislocations are a common injury, with anterior shoulder dislocation among male patients being the most common presentation. A patient with recurrent shoulder instability, anterior-superior escape, and chronic subscapularis tendon rupture following multiple shoulder stabilization surgeries presents the surgeon with a complex and challenging case. This report describes a 40-year-old man with an extensive left shoulder history that included a failed Latarjet procedure, an irreparable, chronic subscapularis tear with grade 4 Goutallier fatty infiltration, and associated anterior-superior escape...
October 13, 2016: Orthopedics
Yupeng Wu, Dandan Sun, Yong Wang, Yibao Wang
The definitive structure and functional role of the inferior fronto-occipital fasciculus (IFOF) are still controversial. In this study, we aimed to investigate the connectivity, asymmetry, and segmentation patterns of this bundle. High angular diffusion spectrum imaging (DSI) analysis was performed on 10 healthy adults and a 90-subject DSI template (NTU-90 Atlas). In addition, a new tractography approach based on the anatomic subregions and two regions of interest (ROI) was evaluated for the fiber reconstructions...
2016: Frontiers in Neuroanatomy
M Petri, J A Greenspoon, S G Moulton, P J Millett
BACKGROUND: Massive rotator cuff tears in active patients with minimal glenohumeral arthritis remain a particular challenge for the treating surgeon. METHODS: A selective literature search was performed and personal surgical experiences are reported. RESULTS: For patients with irreparable rotator cuff tears, a reverse shoulder arthroplasty or a tendon transfer are often performed. However, both procedures have rather high complication rates and debatable long-term results, particularly in younger patients...
2016: Open Orthopaedics Journal
Hussan Mohammed, Matthew R Skalski, Dakshesh B Patel, Anderanik Tomasian, Aaron J Schein, Eric A White, George F Rick Hatch, George R Matcuk
The coracoid process is a hook-shaped bone structure projecting anterolaterally from the superior aspect of the scapular neck. Surgeons often refer to the coracoid process as the "lighthouse of the shoulder" given its proximity to major neurovascular structures such as the brachial plexus and the axillary artery and vein, its role in guiding surgical approaches, and its utility as a landmark for other important structures in the shoulder. The coracoid also serves as a critical anchor for many tendinous and ligamentous attachments...
November 2016: Radiographics: a Review Publication of the Radiological Society of North America, Inc
Joseph Liu, Alexander S McLawhorn, Alexander B Christ, Peteris Dzenis, John H Healey
BACKGROUND: The posterolateral approach is one of the most common approaches used during hip arthroplasty. A posterior soft tissue repair is necessary to limit the risk of postoperative dislocation. For a trapezoidal capsulotomy, the proximal limb divides the superior band of the iliofemoral ligament (Bigelow's ligament). A transosseous repair frequently leaves a defect in this region, which may elevate the risk for dislocation. The purpose of this article is to describe a simple, rational technique for reinforcing the posterior capsular repair...
July 2016: HSS Journal: the Musculoskeletal Journal of Hospital for Special Surgery
Jason Capo, Daniel J Kaplan, David J Fralinger, Ronald S Adler, Kirk A Campbell, Laith M Jazrawi, Michael J Alaia
PURPOSE: Injury to the anterolateral ligament (ALL) of the knee has recently received attention as a potential risk factor for failure of anterior cruciate ligament reconstruction. However, evaluation of the anterolateral ligament is currently difficult, and radiologic data are sparse with regard to the normal appearance of this ligament. The purpose of the present study was to determine whether the ALL could be identified and visualized using ultrasonography. METHODS: Ten non-paired, fresh-frozen cadaveric knees underwent ultrasound by an experienced musculoskeletal radiologist using a Siemens S2000 Acuson Ultrasound machine with a 14-MHz linear transducer...
June 25, 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Joshua A Greenspoon, Maximilian Petri, Peter J Millett
The management of massive rotator cuff tears remains a challenge for physicians, with failure rates being higher when compared with smaller tears. Many surgical treatment options exist including debridement with biceps tenodesis, complete repair, partial repair, repair with augmentation devices, superior capsule reconstruction, tendon transfer, and reverse total shoulder arthroplasty. The purpose of this article is to describe our preferred surgical technique for a complete arthroscopic repair using an extended linked, knotless, double-row construct...
February 2016: Arthroscopy Techniques
John M Tokish, Clint Beicker
Chronic, massive, irreparable rotator cuff tears remain one of the most challenging pathologies in shoulder surgery to treat. Because of this, many treatment options exist for the management of chronic retracted rotator cuff tears. Superior capsule reconstruction is one option that provides the potential to restore and rebalance the force couples necessary for dynamic shoulder function. We describe an all-arthroscopic technique using an acellular dermal allograft for superior capsule reconstruction indicated for patients with a deficient superior rotator cuff...
December 2015: Arthroscopy Techniques
Maximilian Petri, Joshua A Greenspoon, Peter J Millett
Massive irreparable rotator cuff tears in young patients are a particular challenge for the orthopaedic surgeon. Surgical treatment options include debridement, partial rotator cuff repair, patch-augmented rotator cuff repair, bridging rotator cuff reconstruction with graft interposition, tendon transfer, and reverse total shoulder arthroplasty. Recently, reconstruction of the superior glenohumeral capsule using a fascia lata autograft has been suggested to reduce superior glenohumeral translation and restore superior stability...
December 2015: Arthroscopy Techniques
Yasuo Itami, Teruhisa Mihata, Koji Shibano, Kazuomi Sugamoto, Masashi Neo
BACKGROUND: Humeral retroversion in baseball players is greater in the dominant shoulder than in the nondominant shoulder. However, the site and severity of the humeral rotational deformity remain unclear. PURPOSE: To evaluate the site of side-to-side differences in humeral retroversion in baseball players and the severity of these changes through 3-dimensional computed tomographic (3D CT) bone models. STUDY DESIGN: Cross-sectional study; Level of evidence, 3...
July 2016: American Journal of Sports Medicine
Teruhisa Mihata, Michelle H McGarry, Timothy Kahn, Iliya Goldberg, Masashi Neo, Thay Q Lee
BACKGROUND: Patients with irreparable rotator cuff tears have a defect of the superior capsule, which creates discontinuity of the shoulder capsule in the transverse direction (anterior-posterior direction). This effect is one of the causes underlying shoulder instability after rotator cuff tears. PURPOSE/HYPOTHESIS: The purpose of this study was to assess the effects of anterior and posterior continuity on shoulder biomechanics after superior capsule reconstruction (SCR)...
June 2016: American Journal of Sports Medicine
Alan M Hirahara, Christopher R Adams
Massive irreparable rotator cuff tears have been troublesome entities to treat, especially in younger patients. Few good options exist, leaving most patients in recent years receiving a reverse total shoulder arthroplasty. Reverse shoulder arthroplasty carries serious risks, a limited lifespan, and no other viable options should it fail. Recent biomechanical studies have shown that the superior capsule is critical to containing the glenohumeral joint reduced, allowing the larger muscles like the deltoid and pectoralis major to function properly...
December 2015: Arthroscopy Techniques
Marc J Philippon, Max P Michalski, Kevin J Campbell, Mary T Goldsmith, Brian M Devitt, Coen A Wijdicks, Robert F LaPrade
BACKGROUND: Hip endoscopy facilitates the treatment of extra-articular disorders of the proximal femur. Unfortunately, current knowledge of proximal femur anatomy is limited to qualitative descriptions and lacks surgically relevant landmarks. PURPOSE: To provide a quantitative and qualitative analysis of proximal femur anatomy in reference to surgically relevant bony landmarks. STUDY DESIGN: Descriptive laboratory study. METHODS: Fourteen cadaveric hemipelvises were dissected...
June 2014: Orthopaedic Journal of Sports Medicine
Teruhisa Mihata, Michelle H McGarry, Timothy Kahn, Iliya Goldberg, Masashi Neo, Thay Q Lee
PURPOSE: To investigate the effects of graft length and thickness on shoulder biomechanics after superior capsule reconstruction. METHODS: Subacromial peak contact pressure and glenohumeral superior translation were measured at 0°, 30°, and 60° of glenohumeral abduction in 8 fresh-frozen cadaveric shoulders under 5 conditions: (1) intact shoulder; (2) irreparable supraspinatus tendon tear, (3) superior capsule reconstruction with a fascia lata allograft 4-mm thick and 15 mm longer than the distance from the superior glenoid to the lateral edge of the greater tuberosity, as determined during placement at 30° of glenohumeral abduction; (4) superior capsule reconstruction with a fascia lata allograft 8-mm thick and with the same 15 mm relative length determined at 10° of glenohumeral abduction, and (5) superior capsule reconstruction with a fascia lata allograft 8-mm thick and with the 15-mm relative length determined at 30° of glenohumeral abduction...
March 2016: Arthroscopy: the Journal of Arthroscopic & related Surgery
Teruhisa Mihata, Michelle H McGarry, Timothy Kahn, Iliya Goldberg, Masashi Neo, Thay Q Lee
BACKGROUND: Acromioplasty is increasingly being performed for both reparable and irreparable rotator cuff tears. However, acromioplasty may destroy the coracoacromial arch, including the coracoacromial ligament, consequently causing a deterioration in superior stability even after superior capsule reconstruction. PURPOSE/HYPOTHESIS: The purpose of this study was to investigate the effects of acromioplasty on shoulder biomechanics after superior capsule reconstruction for irreparable supraspinatus tendon tears...
January 2016: American Journal of Sports Medicine
M Nelitz, S R M Williams
OBJECTIVE: Combined anatomical reconstruction of the MPFL and deepening trochleoplasty to improve the stability of the patellofemoral joint in patients with severe trochlear dysplasia. INDICATIONS: Confirmed patellofemoral instability with recurrent dislocations and high-grade trochlear dysplasia. CONTRAINDICATIONS: Open distal femoral physis, degenerative changes of the patellofemoral joint grade ICRS III-IV. SURGICAL TECHNIQUE: Diagnostic arthroscopy, exposure of the femoral trochlea through a lateral parapatellar arthrotomy and preparation of an osteochondral flake were carried out...
December 2015: Operative Orthopädie und Traumatologie
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