Ultrasonography-Guided Muscle Hematoma Evacuation
Publication date: Available online 11 June 2019Source: Arthroscopy TechniquesAuthor(s): Pia Kareena Quiñones, Soichi Hattori, Shin Yamada, Yuki Kato, Hiroshi OhuchiAbstractMuscle injuries commonly occur in athletes, and in severe cases, they can result in hematoma formation, leading to pain and loss of function. A technique for minimally invasive ultrasound-guided evacuation of muscle hematoma is presented. A simple and quick outpatient procedure done under local anesthesia for faster muscle recovery provided immediate decompression of the muscle compartment, leading to early return to play. (Source: Arthroscopy Techniques)
Source: Arthroscopy Techniques - June 12, 2019 Category: Surgery Source Type: research

Arthroscopic Coracoacromial Ligament Transfer Augmented With Suspensory V-Shaped Fixation System for Chronic Acromioclavicular Joint Dislocation
We present an arthroscopic technique to transfer the coracoacromial ligament to the inferior surface of the lateral part of the clavicle in chronic ACJD, augmented with 2 clavicular buttons and a single coracoid button in a V-shaped configuration. The technique has various advantages including better stabilization, anatomic reconstruction, and a minimal risk of fracture of the coracoid and clavicle with small tunnels, using a vascularized graft with arthroscopic control of reduction. (Source: Arthroscopy Techniques)
Source: Arthroscopy Techniques - June 12, 2019 Category: Surgery Source Type: research

Osteochondral Autograft Transfer Procedure: Arthroscopic Technique and Technical Pearls
Publication date: Available online 11 June 2019Source: Arthroscopy TechniquesAuthor(s): Ryan Rowland, Michael Colello, Douglas J. WylandAbstractThe Osteochondral Autograft Transfer System (OATS; Arthrex, Naples, FL) is an excellent option for the treatment of articular cartilage lesions within the knee. Current literature suggests that at early-term to midterm follow-up, patients experience improved function, alleviation of pain, and good satisfaction with acceptable complication rates. Although long-term data are lacking, studies in athletes have shown that the OATS can provide an adequate rate of return to sports. The OA...
Source: Arthroscopy Techniques - June 12, 2019 Category: Surgery Source Type: research

Arthroscopic Repair of Proximal Posterior Cruciate Ligament Injuries in Pediatric Patients
Publication date: Available online 10 June 2019Source: Arthroscopy TechniquesAuthor(s): Gabriele Pisanu, João Luís Moura, Adnan Saithna, Bertrand Sonnery-CottetAbstractA renewed interest in arthroscopic knee ligament repair is emerging as a result of diagnostic and technical improvements. In pediatric patients with posterior cruciate ligament (PCL) injury, surgical reconstruction is rarely considered as an option because of the risk of iatrogenic physeal injury. In this Technical Note, we describe an arthroscopic surgical repair technique of PCL proximal avulsions in pediatric patients. The main reasons to co...
Source: Arthroscopy Techniques - June 12, 2019 Category: Surgery Source Type: research

Acute Triceps Tendon Repair: A Technique Utilizing 3 Curved Tunnels and Proximal Knots
Publication date: Available online 10 June 2019Source: Arthroscopy TechniquesAuthor(s): Alison K. Sarokhan, Nicky L. LeungAbstractAlthough triceps tendon tears are less common than other tendon tears, complete ruptures require surgical repair to restore the strength of the extensor mechanism of the elbow. There are several described techniques for repair using both transosseous tunnels and suture anchors. Current techniques often result in large suture knots over the dorsal ulna under thin subcutaneous tissue, which can be irritating for patients. Knotless techniques require costly suture anchors. In this technical note, w...
Source: Arthroscopy Techniques - June 12, 2019 Category: Surgery Source Type: research

Physeal-Sparing Transosseous-Equivalent Arthroscopic Rotator Cuff Repair
Publication date: Available online 6 June 2019Source: Arthroscopy TechniquesAuthor(s): Paul E. Caldwell, Adam J. Heisinger, Sara E. PearsonAbstractRotator cuff injuries in the skeletally immature population are uncommon, with most tears resulting from trauma or overuse in throwing athletes. Although the literature has referenced multiple repair methods in the pediatric population, an arthroscopic physeal-sparing technique has yet to be described. Given the proximity of the proximal humerus growth plate to the typical anchor placement during rotator cuff repair, we advocate a technique that avoids violation of the proximal ...
Source: Arthroscopy Techniques - June 7, 2019 Category: Surgery Source Type: research

The Arthroscopic “Montgolfier Double-Row Knotless” Rotator Cuff Repair Technique
We describe an effective and easily reproducible technique: the arthroscopic “Montgolfier double-row” repair technique. This knotless construct has an evenly distributed, load-sharing, radially oriented suture limb configuration much like the envelope cables of a Montgolfier hot-air balloon, its namesake. Other advantages include the ability to apply manual, progressive and calculated tension on each suture limb and easy intraoperative modification depending on tear size, shape, and delamination, as well as tissue tension and quality. Future studies are needed to validate the biomechanics and clinical outcomes ...
Source: Arthroscopy Techniques - June 7, 2019 Category: Surgery Source Type: research

Endoscopic Repair of Proximal Hamstring Tear With Double-Row Suture Bridge Construct
We describe our technique for endoscopic proximal hamstring repair, which uses a double-row suture bridge construct to reattach the tendons to the ischial tuberosity. (Source: Arthroscopy Techniques)
Source: Arthroscopy Techniques - June 7, 2019 Category: Surgery Source Type: research

Minimally Invasive Ultrasound-Guided Anterolateral Ligament Reconstruction With Autologous 2-Strand Gracilis Graft
We describe an ultrasound-guided anterolateral ligament (ALL) reconstruction technique that uses the gracilis tendon and can be added to any anterior cruciate ligament reconstruction technique. Preoperative ultrasound imaging is used to view the ruptured ALL and confirm the location of bony landmarks. Two minimally invasive incisions are made: one posterior to the lateral epicondyle and one posterior to the Gerdy tubercle. After anterior cruciate ligament graft fixation, the 2-strand gracilis tendon is introduced from the tibial incision, under the fascia lata, toward the femoral incision. The ALL graft is secured to the f...
Source: Arthroscopy Techniques - June 6, 2019 Category: Surgery Source Type: research

Patellar Tendon Reconstruction Using Hamstring Tendon and Adjustable Suspensory Cortical Fixation
We describe safe, reproducible anatomic reconstruction of the patellar tendon using hamstring tendon and adjustable suspensory fixation. After harvesting of the hamstrings, the graft is prepared with 2 adjustable suspensory fixation devices. Then, a complete tibial tunnel and a patellar tunnel with a socket are drilled with the appropriate diameter, and the graft is pulled through the tunnels. Finally, the suspensory fixation devices on the tibial and patellar sides are tensioned. The aim of this procedure is to obtain complete mobility of the knee, using a procedure similar to anterior cruciate ligament reconstruction in ...
Source: Arthroscopy Techniques - June 6, 2019 Category: Surgery Source Type: research

Arthroscopic Knotless, Tensionable All-Suture Anchor Bankart Repair
Publication date: Available online 2 June 2019Source: Arthroscopy TechniquesAuthor(s): Lucca Lacheta, Travis J. Dekker, Nicole Anderson, Brandon Goldenberg, Peter J. MillettAbstractSurgical management for glenohumeral instability has advanced to provide stronger fixation and to be less invasive. Arthroscopic suture anchor repair has been the gold standard for isolated capsulolabral tears over the years. Despite the ability of the solid suture anchors to handle physiologic load, they can present challenges such as chondral damage due to anchor size and imperfect angulation, osteolysis, anchor breakage, revision drilling, di...
Source: Arthroscopy Techniques - June 3, 2019 Category: Surgery Source Type: research

Figure-of-4 Cruciate Remnant Objective Assessment Test Reducibility of Anterior Cruciate Ligament Stump for Feasibility of Arthroscopic Primary Anterior Cruciate Ligament Repair
We describe a test called the Figure-of-4 Cruciate Remnant Objective Assessment test that objectively interprets the reducibility of the ACL remnant for arthroscopic primary ACL repair. (Source: Arthroscopy Techniques)
Source: Arthroscopy Techniques - June 3, 2019 Category: Surgery Source Type: research

Chronic Instability and Pain of the Sternoclavicular Joint: Treatment With Semitendinosus Allograft to Restore Joint Stability
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 - June 3, 2019 Category: Surgery Source Type: research

Distal Tibial Tuberosity Arc Osteotomy in Open-Wedge Proximal Tibial Osteotomy to Prevent Patella Infra
Publication date: Available online 2 June 2019Source: Arthroscopy TechniquesAuthor(s): Takenori Akiyama, Kei Osano, Hideki Mizu-Uchi, Norimasa Nakamura, Ken Okazaki, Hiroshi Nakayama, Ryohei TakeuchiAbstractOpen-wedge high tibial osteotomy is considered to be an effective surgical intervention for medial compartmental knee osteoarthritis. However, patella infra, which has been reported to be a result of tuberosity distalization after open-wedge high tibial osteotomy, changes the native patellofemoral biomechanics. This could raise abnormal patellofemoral contact stresses, which might be the trigger of patellofemoral arthro...
Source: Arthroscopy Techniques - June 3, 2019 Category: Surgery Source Type: research

Arthroscopic Treatment of Pigmented Villonodular Synovitis of the Hip Using Puncture Capsulotomy
Publication date: Available online 2 June 2019Source: Arthroscopy TechniquesAuthor(s): Mark R. Nazal, Ali Parsa, Scott D. MartinAbstractPigmented villonodular synovitis (PVNS) is a monoarticular, benign tumor arising from the synovium. Although classically treated with open synovectomy, arthroscopic treatment has demonstrated good clinical outcomes. The arthroscopic management of hip PVNS has been described as technically challenging due to difficulty obtaining the appropriate exposure. The purpose of this technical report is to describe a novel technique that allows for sound excision of PVNS during hip arthroscopy using ...
Source: Arthroscopy Techniques - June 3, 2019 Category: Surgery Source Type: research

Arthroscopic Coracoclavicular and Acromioclavicular Stabilization of Acute Acromioclavicular Joint Dislocation By Suspensory Fixation System
We present an arthroscopic technique to stabilize acute acromioclavicular joint dislocations in both the vertical and horizontal planes, with better results than conventional coracoclavicular suspension techniques. (Source: Arthroscopy Techniques)
Source: Arthroscopy Techniques - May 23, 2019 Category: Surgery Source Type: research

Anatomic Acromioclavicular Ligament Reconstruction Using Semitendinosus Autograft With Suture Augmentation: Surgical Technique
Publication date: Available online 23 May 2019Source: Arthroscopy TechniquesAuthor(s): Benjamin Sherman, Michael French, Wade FaerberAbstractAcromioclavicular (AC) joint separations are common injuries and account for 3.2% of shoulder injuries. These injuries typically occur among adolescent and young adult athletes during contact sports, such as hockey, wrestling, and rugby. Low-grade AC joint separations (Rockwood grade I-II) are often successfully treated nonoperatively. High-grade AC joint separations (Rockwood grade IV-VI) have the potential to alter scapular kinematics, causing painful and restricted motion, and are ...
Source: Arthroscopy Techniques - May 23, 2019 Category: Surgery Source Type: research

Distal Adductor Longus Avulsion: A Technique for Successful Repair
Publication date: Available online 23 May 2019Source: Arthroscopy TechniquesAuthor(s): K. Linnea Welton, Mary K. Jesse, James Genuario, Omer Mei-DanAbstractStrains of the adductor muscle are common among athletes, but avulsion at its insertion is rare. Likewise, the diagnosis and management of distal ruptures of the adductors are infrequently reported in the literature. Presented here are the common presenting clinical findings of chronic distal adductor longus tendon ruptures and a description of how these can be successfully treated with a previously undescribed surgical technique. Preoperative and postoperative magnetic...
Source: Arthroscopy Techniques - May 23, 2019 Category: Surgery Source Type: research

Hill-Sachs Remplissage Procedure Based on Posterosuperior Capsulomuscular Anatomy
We describe a remplissage technique using 2 posterior working portals that respects the anatomy of the posterior-superior area of the glenohumeral joint without compromising the vascularization. (Source: Arthroscopy Techniques)
Source: Arthroscopy Techniques - May 23, 2019 Category: Surgery Source Type: research

Arthroscopic Rotator Cuff Repair With Allograft Augmentation: Making It Simple
Publication date: Available online 22 May 2019Source: Arthroscopy TechniquesAuthor(s): Jovan Laskovski, Jeffrey Abrams, Anastasia Bogdanovska, Neal Taliwal, Mathew Taylor, Michael FisherAbstractRotator cuff tears are increasing in frequency in the aging population and are a common issue seen by orthopaedic surgeons. In patients with large, multi-tendon rotator cuff tears or retears, treatment can be challenging. Failure rates of up to 90% have been reported for rotator cuff repair (RCR) of large, multi-tendon tears. Biological augmentation has been an area of interest because of the distinctly different biology of the repa...
Source: Arthroscopy Techniques - May 22, 2019 Category: Surgery Source Type: research

Forget the Greater Trochanter! Hip Joint Access With the 12 O’clock Portal in Hip Arthroscopy
Publication date: Available online 17 May 2019Source: Arthroscopy TechniquesAuthor(s): David R. Maldonado, Jeffrey W. Chen, Rafael Walker-Santiago, Philip J. Rosinsky, Jacob Shapira, Ajay C. Lall, Benjamin G. DombAbstractMost surgeons rely on the greater trochanter as the reference point to establish the anterolateral portal. Nevertheless, we believe that the anterosuperior iliac spine is a more reliable landmark. Unlike the greater trochanter, it is unaffected by leg rotation and is more easily identified by palpation. Abiding by the central tenet of medicine to “do no harm,” the technique described herein pre...
Source: Arthroscopy Techniques - May 19, 2019 Category: Surgery Source Type: research

All-Arthroscopic Treatment of Schatzker Type III Lateral Tibial Plateau Fracture Without Fluoroscopy
We present an all-arthroscopic procedure for Schatzker type III lateral tibial plateau fractures with using a trans-septal portal for visualization, which does not demand fluoroscopy. (Source: Arthroscopy Techniques)
Source: Arthroscopy Techniques - May 19, 2019 Category: Surgery Source Type: research

Open Gluteus Medius and Minimus Repair With Double-Row Technique and Bioinductive Implant Augmentation
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)
Source: Arthroscopy Techniques - May 19, 2019 Category: Surgery Source Type: research

Treatment of Cartilage Defects With the Matrix-Induced Autologous Chondrocyte Implantation Cookie Cutter Technique
We present a technique for the facile implantation of MACI membranes using cookie cutter instrumentation to aid in defect debridement and graft preparation. The technique described allows for efficient operative workflow while ensuring the creation of vertical, stable defect edges and a form-fitting MACI membrane in a readily implemented fashion. (Source: Arthroscopy Techniques)
Source: Arthroscopy Techniques - May 17, 2019 Category: Surgery Source Type: research

Coracohumeral Ligament Reconstruction for Patients With Multidirectional Shoulder Instability
Publication date: Available online 16 May 2019Source: Arthroscopy TechniquesAuthor(s): Zachary S. Aman, Liam A. Peebles, Daniel Shubert, Petar Golijanin, Travis J. Dekker, Matthew T. ProvencherAbstractCoracohumeral ligament pathology arises from acute trauma, capsular thickening, or congenital connective tissue disorders within the glenohumeral joint. Recent studies have highlighted the significance of this pathology in multidirectional shoulder instability because insufficiency of the rotator interval has become increasingly recognized and attributed to failed shoulder stabilization procedures. The diagnosis and subsequen...
Source: Arthroscopy Techniques - May 17, 2019 Category: Surgery Source Type: research

The Fertilized Anterior Cruciate Ligament: An All-Inside Anterior Cruciate Ligament Reconstruction Augmented With Amnion, Bone Marrow Concentrate, and a Suture Tape
Publication date: Available online 6 May 2019Source: Arthroscopy TechniquesAuthor(s): Chad Lavender, Charles BishopAbstractThere is increasing research and interest surrounding biologics and sports medicine. Amnion has the potential to decrease adhesions and possibly protect anterior cruciate ligament (ACL) grafts along with increasing vascularization by acting as a scaffold. Bone marrow concentrate containing mesenchymal stem cells combined with Allosync Pure (Arthrex, Naples, FL) injected into ACL tunnels has the potential to increase the speed and quality of graft bone incorporation, especially when used in the setting ...
Source: Arthroscopy Techniques - May 7, 2019 Category: Surgery Source Type: research

Arthroscopic Repair of Double Radial Tears of the Lateral Meniscus
We describe our technique for repairing a lateral meniscus body radial tear and concomitant posterior root tear, via inside-out suture repair and transtibial suture repair, respectively. This investigation was performed at Mayo Clinic. (Source: Arthroscopy Techniques)
Source: Arthroscopy Techniques - May 7, 2019 Category: Surgery Source Type: research

Superficial and Deep Medial Collateral Ligament Reconstruction for Chronic Medial Instability of the Knee
We describe sMCL and dMCL reconstruction with semitendinosus and gracilis autografts using adjustable-length loop suspensory fixation devices for tibial fixation. By use of our technique, it is possible to provide good stability and satisfactory results for medial instability of the knee. (Source: Arthroscopy Techniques)
Source: Arthroscopy Techniques - May 7, 2019 Category: Surgery Source Type: research

Using a Web-Based Data Collection Platform to Implement an Effective Electronic Patient-Reported Outcome Registry
Publication date: Available online 6 May 2019Source: Arthroscopy TechniquesAuthor(s): Vincent A. Lizzio, Caleb M. Gulledge, Fabien Meta, Sreten Franovic, Eric C. MakhniAbstractModern health care places significant emphasis on patient-centered care. As a result, many orthopaedic providers are incorporating routine patient-reported outcome measure (PROM) collection into their practice. However, routine PROM collection often disrupts clinical workflow and can place a burden on both the patient and the provider. Electronic PROM collection systems, if implemented deliberately to maximize convenience and efficiency, have the pot...
Source: Arthroscopy Techniques - May 7, 2019 Category: Surgery Source Type: research

Arthroscopic Double-Pulley Remplissage Using a 2-Portal Technique for Hill-Sachs Lesions in Recurrent Anterior Shoulder Instability
Publication date: Available online 6 May 2019Source: Arthroscopy TechniquesAuthor(s): Moyukh O. Chakrabarti, James Gwosdz, Alexander Rosinski, Alvarho J. Guzman, Patrick J. McGahan, James L. ChenAbstractHill-Sachs lesions of the humeral head are associated with recurrent anterior shoulder instability. Arthroscopic double-pulley remplissage has emerged as the leading alternative to the open Latarjet procedure to address recurrent shoulder instability with comparable recurrence rates and favorable complication rates. This technical note describes our adaptation of the double-pulley remplissage technique by using 2 portals, w...
Source: Arthroscopy Techniques - May 7, 2019 Category: Surgery Source Type: research

The Arthroscopic Loop Tenodesis Procedure: An Implant-Free Technique to Treat Long Biceps Tendon Pathologies
This article describes the arthroscopic loop tenodesis procedure. The technique is based on an enlargement of the proximal tenotomized tendon by creating a tendon loop, which subsequently blocks itself at the entrance to the bicipital groove and prevents distalization of the biceps muscle. This procedure can be performed arthroscopically, resulting in a stable fixed tendon without an anchor or other foreign materials, and might be suitable for young and old patients with biceps tendon pathologies. (Source: Arthroscopy Techniques)
Source: Arthroscopy Techniques - April 28, 2019 Category: Surgery Source Type: research

Arthroscopic All-Inside Medial Meniscus Extrusion Reduction
Publication date: Available online 26 April 2019Source: Arthroscopy TechniquesAuthor(s): Bancha Chernchujit, Sumit AgrawalAbstractMedial meniscus extrusion is commonly seen in patients who have medial meniscus posterior root tear. Extruded meniscus results in faster progression of knee arthrosis. Thus, it is important to reduce the extrusion as well as treat the cause of extrusion. This Technical Note describes an all-inside arthroscopic technique to reduce the meniscus extrusion. An additional medial portal has to be made along with the standard anteromedial and anterolateral portals. A double-loaded suture anchor is used...
Source: Arthroscopy Techniques - April 28, 2019 Category: Surgery Source Type: research

Arthroscopically Assisted Reduction of Sagittal-Plane Disruption of Distal Tibiofibular Syndesmosis
Publication date: Available online 26 April 2019Source: Arthroscopy TechniquesAuthor(s): Yiu Ho Sin, Tun Hing LuiAbstractInjuries to the distal tibiofibular syndesmosis can occur in conjunction with ankle fractures. Sagittal instability of the syndesmosis is more critical than coronal instability and must be taken into account when considering reduction and fixation of the syndesmosis. The purpose of this Technical Note is to report the technique of arthroscopically assisted reduction of sagittal-plane disruption of the distal tibiofibular syndesmosis. This ensures a comprehensive assessment of the pattern of syndesmotic d...
Source: Arthroscopy Techniques - April 28, 2019 Category: Surgery Source Type: research

Double-Bundle Medial Patellofemoral Ligament Reconstruction With Allograft
This article describes our technique for double-bundle MPFL reconstruction with an allograft while highlighting certain aspects of the procedure that are critical for achieving favorable outcomes. The main advantages of the technique include strong patellar fixation with suture anchors and anatomic graft placement at the origin and insertion of the native MPFL. In our experience, this method of reconstruction has been safe, reproducible, and effective in the treatment of patients with patellar instability. (Source: Arthroscopy Techniques)
Source: Arthroscopy Techniques - April 28, 2019 Category: Surgery Source Type: research

Acute Achilles Tendon Rupture: Ultrasonography and Endoscopy-Assisted Percutaneous Repair
Publication date: Available online 26 April 2019Source: Arthroscopy TechniquesAuthor(s): Mathieu Severyns, Tsiry Andriamananaivo, Marie-Eva Rollet, Charles Kajetanek, Ronny Lopes, Guillaume Renard, Thibaut Noailles, Guillaume A. Odri, Jean-Louis RouvillainAbstractTo date, there is no consensus concerning the treatment of acute Achilles tendon ruptures. Although surgical treatment decreases the risk of a recurrent rupture, it is not without complications. In particular, percutaneous sutures may cause a lesion of the sural nerve. The purpose of this Technical Note is to describe a reliable and reproducible surgical procedure...
Source: Arthroscopy Techniques - April 28, 2019 Category: Surgery Source Type: research

Labral Repair Augmentation by Labroplasty and Simultaneous Trans-Subscapular Transposition of the Long Head of the Biceps
We describe an alternative technique that provides triple mechanisms of stabilization like the Latarjet procedure. In our procedure, the long head of the biceps tendon is used for a sling effect, dynamic stabilization is achieved by trans-subscapular tenodesis with simultaneous plasty of the anterior segment of the labrum, and subsequent resuspension of the glenohumeral ligaments is performed using the same anchors. In patients without substantial bone loss, this procedure has numerous advantages over the arthroscopic Latarjet procedure. By creating triple mechanisms of stability like the Latarjet procedure (the bumper eff...
Source: Arthroscopy Techniques - April 28, 2019 Category: Surgery Source Type: research

All-Inside Partial Epiphyseal Anterior Cruciate Ligament Reconstruction Plus an Associated Modified Lemaire Procedure Sutured to the Femoral Button
We describe a partial epiphyseal ACLR to be done in skeletally immature patients involved in highly demanding sport activities. This technique is performed with an extraphyseal femoral tunnel drilled retrograde, a transphyseal tibial tunnel, and a retrograde tibial drilling without trespassing the tibial physis. We added a modified Lemaire procedure to improve rotational instability to the previously performed ACLR. (Source: Arthroscopy Techniques)
Source: Arthroscopy Techniques - April 19, 2019 Category: Surgery Source Type: research

Superior Capsular Reconstruction With Arthroscopic Rotator Cuff Repair in a “Functional Biologic Augmentation” Technique to Treat Massive Atrophic Rotator Cuff Tears
This article presents our technique of functional rotator cuff augmentation, which is concomitant superior capsular reconstruction with arthroscopic rotator cuff repair, to treat massive, atrophic rotator cuff tears. This technique is used in patients with massive rotator cuff tears and superior capsular insufficiency. (Source: Arthroscopy Techniques)
Source: Arthroscopy Techniques - April 19, 2019 Category: Surgery Source Type: research

Combined Soft Tissue Reconstruction of the Medial Patellofemoral Ligament and Medial Quadriceps Tendon–Femoral Ligament
Publication date: Available online 17 April 2019Source: Arthroscopy TechniquesAuthor(s): João Espregueira-Mendes, Renato Andrade, Ricardo Bastos, Sheeba Joseph, John P. Fulkerson, Luís Duarte SilvaAbstractPatellar dislocation is a major orthopaedic concern in pediatric and adult populations, with both conservative and surgical options available. Several surgical techniques of the combined or isolated reconstruction of the medial patellofemoral ligament are described in the literature using different grafts, locations, and types of fixations, providing different advantages and disadvantages. New recent develop...
Source: Arthroscopy Techniques - April 19, 2019 Category: Surgery Source Type: research

Arthroscopic Repair of Rare Transtendinous Rotator Cuff Tear: Utilizing Established Portals and a Posterior Superior Accessory Portal
Publication date: Available online 11 April 2019Source: Arthroscopy TechniquesAuthor(s): Shane Anderson, Scott TrenhaileAbstractThere is a high incidence of rotator cuff injuries in the adult population, and there are well-described techniques for the most common types. Full-thickness transtendon rotator cuff tears are an uncommon injury, and there is limited literature on the appropriate treatment. These rare injuries are important to recognize due to the risk of repair failure using traditional techniques. Simply anchoring the medial portion of the tendon to the anatomic footprint after debriding the lateral tendon risks...
Source: Arthroscopy Techniques - April 13, 2019 Category: Surgery Source Type: research

Anterior Closing Wedge Proximal Tibial Osteotomy for Slope Correction in Failed ACL Reconstructions
Publication date: Available online 11 April 2019Source: Arthroscopy TechniquesAuthor(s): Nicholas N. DePhillipo, Mitchell I. Kennedy, Travis J. Dekker, Zachary S. Aman, W. Jeffrey Grantham, Robert F. LaPradeAbstractIncreased sagittal plane posterior tibial slope has been identified as a risk factor for primary anterior cruciate ligament reconstruction (ACLR) failure. Although ACLR failure is multifactorial, correction of sagittal plane posterior tibial slope should be evaluated in patients with an ACLR graft rupture. There are limited technical descriptions of proposed decreasing tibial slope osteotomy procedures; therefor...
Source: Arthroscopy Techniques - April 13, 2019 Category: Surgery Source Type: research

Multidirectional Shoulder Instability With Bone Loss and Prior Failed Latarjet Procedure: Treatment With Fresh Distal Tibial Allograft and Modified T-Plasty Open Capsular Shift
Publication date: Available online 11 April 2019Source: Arthroscopy TechniquesAuthor(s): Liam A. Peebles, Zachary S. Aman, Fletcher R. Preuss, Brian T. Samuelsen, Tyler J. Zajac, Mitchell I. Kennedy, Matthew T. ProvencherAbstractRecurrent multidirectional shoulder instability (MDI) is a challenging clinical problem, particularly in the setting of connective tissue diseases, and there is a distinct lack of literature discussing strategies for operative management of this unique patient group. These patients frequently present with significant glenoid bone loss, patulous and abnormal capsulolabral structures, and a history o...
Source: Arthroscopy Techniques - April 13, 2019 Category: Surgery Source Type: research

Arthroscopic Lysis of Adhesions and Anterior Interval Release With Manipulation Under Anesthesia for Severe Post-traumatic Knee Stiffness: A Simple and Reproducible Step-by-Step Guide
We describe our arthroscopic technique of lysis of adhesions with anterior interval release and intraoperative MUA, which has been shown to provide sustainable range-of-motion improvement in a subset of patients with severe knee arthrofibrosis. Although technically demanding, this technique benefits from being minimally invasive, allows for direct visualization of intra-articular structures, and allows all-round arthroscopic release of adhesions to improve patellar mobility and decrease the risk of fracture prior to MUA. A rigorous postoperative formal physical therapy protocol and patient compliance are imperative to achi...
Source: Arthroscopy Techniques - April 13, 2019 Category: Surgery Source Type: research

Diagnostic Shoulder Arthroscopy: Surgical Technique
Publication date: Available online 11 April 2019Source: Arthroscopy TechniquesAuthor(s): Ian M. Crimmins, Mary K. Mulcahey, Michael J. O'BrienAbstractShoulder arthroscopy is the second most common orthopaedic procedure. Diagnostic arthroscopy of the shoulder requires an efficient and reproducible technique. In this Technical Note, we describe a step-wise approach to diagnostic arthroscopy of the shoulder. This technique is performed using a posterior viewing portal. It can be performed from the beach chair or the lateral decubitus position. This technique uses a 2-circle approach: the surgeon first evaluates the glenoid as...
Source: Arthroscopy Techniques - April 13, 2019 Category: Surgery Source Type: research

Arthroscopic Coracoclavicular Fixation Technique Using Multiple All-Suture Anchors
Publication date: Available online 11 April 2019Source: Arthroscopy TechniquesAuthor(s): Jeung Yeol Jeong, Yon-Sik Yoo, Seung-Jin Lee, Wooyoung ImAbstractAcromioclavicular (AC) joint dislocation is a common injury, particularly among active young individuals. Numerous surgical procedures for treating acute, high-grade AC joint dislocation have been reported. However, no standard surgical procedure that restores the normal kinematics of the AC joint is available. Among the available coracoclavicular (CC) fixation techniques, cortical button fixation was recently introduced, and it has had successful outcomes. Moreover, it i...
Source: Arthroscopy Techniques - April 13, 2019 Category: Surgery Source Type: research

Fluoroscopy-Guided Suture Anchor Placement for Acetabular Labrum Repair
We describe a technique using intraoperative fluoroscopy to guide suture anchor placement into the anterior and superior acetabular rim, which may reduce the risk of iatrogenic injury during arthroscopic acetabular labrum repair. (Source: Arthroscopy Techniques)
Source: Arthroscopy Techniques - April 10, 2019 Category: Surgery Source Type: research

Arthroscopic Treatment of Medial Femoral Knee Osteochondral Defect Using Subchondroplasty and Chitosan-Based Scaffold
Publication date: Available online 9 April 2019Source: Arthroscopy TechniquesAuthor(s): Kelsey Holt, Mark Sorhaindo, Catherine Coady, Ivan Ho-Bun WongAbstractOsteochondral defects of the knee are highly common, cause significant pain, and reduce function. Standard articular cartilage repair treatments include microfracture alone or in conjunction with subchondroplasty or CarGel (chitosan-based scaffold) application (Piramal Life Sciences). Combining such cartilage regenerative techniques with microfracture yields better long-term outcomes than microfracture alone. The purpose of this Technical Note was to describe the surg...
Source: Arthroscopy Techniques - April 10, 2019 Category: Surgery Source Type: research

Erratum
Publication date: March 2019Source: Arthroscopy Techniques, Volume 8, Issue 3Author(s): (Source: Arthroscopy Techniques)
Source: Arthroscopy Techniques - April 3, 2019 Category: Surgery Source Type: research

Isolated Complete Rupture of the Biceps Femoris Insertion: A Surgical Repair Technique Manuscript
We describe a knotless suture anchor fixation technique for this tear pattern. At surgery, the retracted biceps tendon and insertion site is debrided to healthy tissue, FiberTape suture (Arthrex) is passed in a Kracków fashion through the tendon, and the 2 ends of the suture are brought down to a SwiveLock anchor (Arthrex) at the anatomic insertion. FiberWire sutures (Arthrex) from the anchor are brought over the remnant stump, completing the repair. (Source: Arthroscopy Techniques)
Source: Arthroscopy Techniques - March 30, 2019 Category: Surgery Source Type: research

Primary Repair of the Medial Collateral Ligament with a Double Row Suture Technique and Suture Tape Augmentation for Acute Tibial-Sided Injuries
Publication date: Available online 25 March 2019Source: Arthroscopy TechniquesAuthor(s): Thomas Golden, Alex M.B. Friedman, Reza Jazayeri, Brent Sanderson, Ezra LevyAbstractThe management of medial collateral ligament (MCL) injuries has evolved during the past 30 years. Most heal reliably with conservative management. The treatment of MCL sprains with concomitant other ligamentous injuries continues to be controversial. Surgical management of chronic laxity of the medial structures can be quite difficult, and therefore anatomic repair of the medial support structures in the acute setting is preferred when indicated. C...
Source: Arthroscopy Techniques - March 27, 2019 Category: Surgery Source Type: research