Ankle Microinstability

Ankle sprains are one of the most common injuries in foot and ankle, and the superior fascicle of the anterior talofibular ligament (ATFL) frequently is injured as a consequence. Patients with isolated rupture of ATFL’s superior fascicle can sustain a subtle ankle instability or ankle microinstability. Patients with symptomatic ankle microinstability may describe a subjective feeling of ankle instability, recurrent symptomatic ankle sprains, chronic anterolateral pain or a combination of any of them. When conservative management fails, anatomic all-inside ATFL’s superior fascicle repair under direct arthroscopic visualization is the preferred surgical technique.
Source: Techniques in Foot and Ankle Surgery - Category: Orthopaedics Tags: Special Focus: Innovations in Foot and Ankle Sports Injury Treatment Source Type: research

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This article presents an overview of management of patients with symptomatic, large, retracted, chronic tears of the abductor tendons. The highlighted repair is a “double-row” repair with biological patch augmentation.
Source: Arthroscopy Techniques - Category: Surgery Source Type: research
r H Abstract OBJECTIVE: Repair of the lateral ligament complex of the ankle joint; identification and treatment of intra-articular pathologies. INDICATIONS: Symptomatic chronic lateral ankle instability. Treatment of osteochondral lesions associated with lateral ankle instability. CONTRAINDICATIONS: Osteoarthritis of the ankle joint, risk factors such as peripheral occlusive disease, diabetic foot syndrome, complex regional pain syndrome. SURGICAL TECHNIQUE: Diagnostic arthroscopy of the ankle joint utilizing anterolateral and -medial portals; identification and treatment of intra-articular patholog...
Source: Operative Orthopadie und Traumatologie - Category: Orthopaedics Authors: Tags: Oper Orthop Traumatol Source Type: research
CONCLUSIONS: Perioperative intravenous ketamine probably reduces postoperative analgesic consumption and pain intensity. Results were consistent in different operation types or timing of ketamine administration, with larger and smaller studies, and by higher and lower pain intensity. CNS adverse events were little different with ketamine or control. Perioperative intravenous ketamine probably reduces postoperative nausea and vomiting by a small extent, of arguable clinical relevance. PMID: 30570761 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - Category: General Medicine Authors: Tags: Cochrane Database Syst Rev Source Type: research
ConclusionsBoth the surgical treatments, SLAP repair and the biceps tenodesis, are efficacious in pain alleviation and recovery of shoulder function. But, compared with SLAP repair, biceps tenodesis showed higher rate of patient satisfaction and return to preinjury sports participation.The translational potential of this articleImpart better understanding regarding discrepancies in the outcomes between biceps tenodesis and SLAP repair in treating patients with isolated Type II SLAP lesions.
Source: Journal of Orthopaedic Translation - Category: Orthopaedics Source Type: research
ConclusionsBoth the surgical treatments, SLAP repair and the biceps tenodesis, are efficacious in pain alleviation and recovery of shoulder function. But, compared with SLAP repair, biceps tenodesis showed higher rate of patient satisfaction and return to preinjury sports participation.The translational potential of this articleImpart better understanding regarding discrepancies in the outcomes between biceps tenodesis and SLAP repair in treating patients with isolated Type II SLAP lesions.
Source: Journal of Orthopaedic Translation - Category: Orthopaedics Source Type: research
Publication date: Available online 7 September 2018Source: PM&RAuthor(s): Paul S. Chirichella, Steven Jow, Stephen Iacono, Hannah E. Wey, Gerard A. MalangaAbstractThe meniscal tear treatment paradigm traditionally begins with conservative measures such as physical therapy with referral for operative management for persistent or mechanical symptoms. As a result, the partial meniscectomy is performed more than any other orthopedic procedure in the United States. This treatment paradigm has shifted as recent literature supports the attempt to preserve or repair the meniscus whenever possible given its importance for the struc...
Source: PMandR - Category: Rehabilitation Source Type: research
Publication date: Available online 21 May 2018Source: Arthroscopy TechniquesAuthor(s): Mitsunori Kaya, Masashi Fujii, Yosuke Iwamoto, Itsuki NagahataAbstractGroin pain is a common problem that is known to be a complex issue. The wide variety of possible pathologies in numerous anatomical structures contributes to this complexity. For patients who have anterior hip pain in Patrick's test and tenderness at Scarpa's triangle, we perform periarticular debridement based on the hypothesis that rectus femoris tendinosis, subacute/chronic fibrosis of the anterior inferior iliac spine fat pad, and gluteal muscle adhesion are respon...
Source: Arthroscopy Techniques - Category: Surgery Source Type: research
Abstract OBJECTIVE: Reconstruction of tendon integrity to maintain glenohumeral joint centration and hence to restore shoulder functional range of motion and to reduce pain. INDICATIONS: Isolated or combined full-thickness subscapularis tendon tears (≥upper two-thirds of the tendon) without both substantial soft tissue degeneration and cranialization of the humeral head. CONTRAINDICATIONS: Chronic tears of the subscapularis tendon with higher grade muscle atrophy, fatty infiltration, and static decentration of the humeral head. SURGICAL TECHNIQUE: After arthroscopic three-sided subscapularis tend...
Source: Operative Orthopadie und Traumatologie - Category: Orthopaedics Authors: Tags: Oper Orthop Traumatol Source Type: research
To determine specific patient characteristics that might be predictive of pain and narcotic use after primary arthroscopic rotator cuff repair, repairs performed by a single surgeon over a 4-year period were identified. Patient-specific preoperative factors investigated included tobacco use, narcotic use, chronic pain syndromes, disability claims, mood disorders (depression/anxiety), workers’ compensation claims, and obesity. Outcome measures included visual analog pain scores and narcotic usage. For the 65 repairs in the study, significant predictors of increased pain scores at 12 weeks were preoperative narcotic us...
Source: Techniques in Shoulder and Elbow Surgery - Category: Orthopaedics Tags: Research Article Source Type: research
CONCLUSIONS: Despite identifying 60 eligible trials, only one trial compared a combination of manual therapy and exercise reflective of common current practice to placebo. We judged it to be of high quality and found no clinically important differences between groups in any outcome. Effects of manual therapy and exercise may be similar to those of glucocorticoid injection and arthroscopic subacromial decompression, but this is based on low quality evidence. Adverse events associated with manual therapy and exercise are relatively more frequent than placebo but mild in nature. Novel combinations of manual therapy and exerci...
Source: Cochrane Database of Systematic Reviews - Category: Journals (General) Authors: Tags: Cochrane Database Syst Rev Source Type: research
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