Arthroscopic Superior Capsular Reconstruction by the Mini-Open Modified Keyhole Technique Using an Achilles Tendon–Bone Allograft

Publication date: Available online 24 January 2020Source: Arthroscopy TechniquesAuthor(s): Jeong Woo Kim, Dae Jin NamAbstractThe treatment of massive and irreparable rotator cuff tears remains a challenge for shoulder surgeons. When treating patients with chronic rotator cuff tears, especially those with severe fatty degeneration, severe tendon retraction, or muscle atrophy, the risk of re-tear and persistent severe pain persists. Therefore, surgeons can choose from numerous options. Superior capsular reconstruction (SCR) was introduced as a technique to maintain the stability of the upper shoulder and stabilize the muscles without repairing the supraspinatus and infraspinatus. Various autograft and allograft techniques have been developed. SCR performed using an autograft has the disadvantage of requiring harvesting the tensor fascia lata. Although allografts reduce harvest time, they also increase donor-site morbidity and the time required for healing. To solve the healing problem, we have introduced an SCR technique through grafting with the Achilles tendon–bone. Although this is an unproven technique for patients with chronic irreparable rotator cuff tears, our short-term outcomes seem promising. Further studies and follow-ups are needed to determine the success of this technique.
Source: Arthroscopy Techniques - Category: Surgery Source Type: research

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Publication date: Available online 25 November 2019Source: Arthroscopy TechniquesAuthor(s): Liam A. Peebles, Travis J. Dekker, Ramesses A. Akamefula, Petar Golijanin, W. Jeffrey Grantham, Matthew T. ProvencherAbstractAlthough chronic pain and dysfunction of the acromioclavicular (AC) joint can reliably be treated with distal clavicle excision, disruption of the local stabilizing ligamentous structures may result in iatrogenic instability of the joint. Iatrogenic AC joint instability is a rare condition caused by over resection of the distal clavicle with unintended injury to the stabilizing ligaments in the treatment of AC...
Source: Arthroscopy Techniques - Category: Surgery Source Type: research
Publication date: Available online 25 October 2019Source: Arthroscopy TechniquesAuthor(s): Cecilia Pascual-Garrido, Maria T. Schwabe, Jorge Chahla, Masahiko HanedaAbstractGreater trochanteric pain syndrome can be caused by gluteus medius and minimus tendinopathy/tears and chronic trochanteric bursitis. Specifically, moderate-to-severe abductor tendon tears can cause severe lateral hip pain, limp, and abnormal gait. A variety of open and endoscopic techniques to treat glut abductors hip tears have been described. The use of scaffolds, such as acellular human dermal allograft, to augment tendon repair, already has been succe...
Source: Arthroscopy Techniques - Category: Surgery Source Type: research
We describe a superior gluteal reconstruction technique that is suitable for cases with abductor tendon tear with severe tendon loss.
Source: Arthroscopy Techniques - Category: Surgery Source Type: research
ConclusionsUsing non-irradiated allografts for one-stage reconstructions of all the injured ligaments in MLKIs is effective and safe. Anteroposterior stability was difficult to restore, but patients returned to their daily activities and sometimes to their sports activity at the same preinjury level.Level of evidenceLevel IV, case series.
Source: Orthopaedics and Traumatology: Surgery and Research - Category: Orthopaedics Source Type: research
Publication date: Available online 2 June 2019Source: Arthroscopy TechniquesAuthor(s): Liam A. Peebles, Zachary S. Aman, Fletcher R. Preuss, Brian T. Samuelsen, Tyler J. Zajac, Ravi B. Patel, Matthew T. ProvencherAbstractChronic instability of the sternoclavicular (SC) joint is a challenging clinical problem, particularly in a patient population for which nonoperative forms of treatment prove ineffective. Patients present after experiencing recurrent subluxation events and subsequent pain, which commonly result in increasing functional limitation. Recurrent SC joint instability of this nature can lead to damage of the SC j...
Source: Arthroscopy Techniques - Category: Surgery Source Type: research
The objective of this Technical Note is to describe our preferred technique for the primary treatment of AC joint instability in the acute and chronic setting. Using 2 free tendon grafts in combination with a cortical button suspensory device combines the advantages of a nonrigid biologic and anatomic AC and coracoclavicular ligament reconstruction while benefiting from the strength of a cortical suspensory device in resisting displacement of the AC joint.
Source: Arthroscopy Techniques - Category: Surgery Source Type: research
Publication date: Available online 25 February 2019Source: Arthroscopy TechniquesAuthor(s): James Gwosdz, Alexander Rosinski, Moyukh Chakrabarti, Brittany M. Woodall, Nicholas Elena, Patrick J. McGahan, James L. ChenAbstractOsteochondritis dissecans (OCD) has been recognized for over 100 years yet still poses treatment challenges owing to both the avascular nature of articular cartilage and the inability to generate hyaline cartilage. The knee is most commonly involved, and without repair, patients have chronic knee pain, loose bodies, and early-onset osteoarthritis. There are a number of surgical techniques for repai...
Source: Arthroscopy Techniques - Category: Surgery Source Type: research
ConclusionsFair evidence (Grade B) was found in favour of the use of allografts in lateral ankle ligament reconstruction or treatment of intra-articular calcaneal fracture. Fair evidence (Grade B) was found against the use of allogeneic MSCs in tibiotalar fusions.Level of evidenceV.
Source: Knee Surgery, Sports Traumatology, Arthroscopy - Category: Orthopaedics Source Type: research
The objective of this Technical Note is to describe our preferred technique for the primary treatment of AC joint instability in the acute and chronic setting. Using 2 free tendon grafts in combination with a cortical button suspensory device combines the advantages of a nonrigid biologic and anatomic AC and coracoclavicular ligament reconstruction while benefiting from the strength of a cortical suspensory device in resisting displacement of the AC joint.
Source: Arthroscopy Techniques - Category: Surgery Source Type: research
Publication date: Available online 24 September 2018Source: Arthroscopy TechniquesAuthor(s): Mads Oksum, Per-Henrik RandsborgAbstractInjury to the proximal tibiofibular joint can lead to lateral knee pain and instability owing to chronic rupture of the posterior tibiofibular ligament. The condition is often missed, and the true incidence is unknown. A variety of surgical treatments have been proposed over the last decades. Methods such as arthrodesis and fibular head resection have largely been replaced with various reconstruction techniques using autografts. The purpose of this report is to describe our method for treatme...
Source: Arthroscopy Techniques - Category: Surgery Source Type: research
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