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Treatment of Articular Cartilage Defects of the Knee With Microfracture and Enhanced Microfracture Techniques
Chondral injuries in the knee are a common source of pain and morbidity. Treatment of symptomatic chondral defects is challenging due to the limited healing capacity of articular cartilage. Microfracture is the most common surgical technique used to treat chondral defects in the knee and utilizes marrow stimulation to generate a fibrocartilage repair. Microfracture has demonstrated good short-term postoperative outcomes. Long-term outcomes following microfracture are variable, with loss of improvement attributed to the poor mechanical qualities of the fibrous repair tissue. Current research is focusing on ways to optimize ...
Source: Sports Medicine and Arthroscopy Review - May 4, 2016 Category: Sports Medicine Tags: Review Articles Source Type: research

Debridement of Articular Cartilage: The Natural Course
Chondral defects of the knee are quite common, affecting an estimated 10% to 12% of the population. Symptomatic chondral defects are thought to be persistent and possibly progressive. Less is known about the natural history of asymptomatic chondral lesions. Traditional treatment of chondral lesions has involved arthroscopic debridement with a mechanical shaver. Radiofrequency chondroplasty has been explored as a possible alternative or adjuvant to mechanical chondroplasty. The role of chondroplasty in the setting of knee osteoarthritis is more controversial. Early studies demonstrated promising results of arthroscopic debr...
Source: Sports Medicine and Arthroscopy Review - May 4, 2016 Category: Sports Medicine Tags: Review Articles Source Type: research

Diseases of Subchondral Bone 2
Osteonecrosis of the knee can be divided into the following 3 categories: primary or Spontaneous osteonecrosis of the knee (SONK), secondary osteonecrosis (ON), and postarthroscopic osteonecrosis. Patient characteristics as well as underlying risk factors can help categorize the type of osteonecrosis and guide treatment. SONK was first described by Ahlback et al in 1968. It is described as a disease of subchondral bone that leads to focal ischemia and bone marrow edema, necrosis, and possible subsequent structural collapse. SONK typically presents in the older women with frequent involvement of the medial femoral cond...
Source: Sports Medicine and Arthroscopy Review - May 4, 2016 Category: Sports Medicine Tags: Review Articles Source Type: research

Diseases of Subchondral Bone 1
The subchondral zone plays an important role in both the structural and biochemical maintenance of articular cartilage. Knowledge of the structure, function, and pathophysiology of the normal subchondral bone/articular surface interface is essential for an understanding of the pathogenesis of many of the disease entities that we will review in this chapter. (Source: Sports Medicine and Arthroscopy Review)
Source: Sports Medicine and Arthroscopy Review - May 4, 2016 Category: Sports Medicine Tags: Review Articles Source Type: research

Articular Cartilage Repair Techniques
No abstract available (Source: Sports Medicine and Arthroscopy Review)
Source: Sports Medicine and Arthroscopy Review - May 4, 2016 Category: Sports Medicine Tags: Editorial Source Type: research

Meniscal Allograft Transplantation: State of the Art
Meniscal allograft transplantation has evolved over the years to provide a state-of-the-art technique for the sports medicine surgeon to utilize in preserving contact mechanics and function of the knee in irreparable meniscal pathology. However, this procedure continues to spark considerable debate on proper tissue processing techniques, acceptable indications, methods of implantation, and potential long-term outcomes. (Source: Sports Medicine and Arthroscopy Review)
Source: Sports Medicine and Arthroscopy Review - May 4, 2016 Category: Sports Medicine Tags: Digital Exclusives Source Type: research

Malalignment: A Requirement for Cartilage and Organ Restoration
The treatment of combined knee pathology is a challenging problem that requires careful attention to all aspects of the underlying disease. This is true of the interplay among malalignment and meniscal or articular cartilage restoration in the knee. Optimal outcomes are contingent on a comprehensive preoperative evaluation of patient-specific factors (patient expectations, patient age, and activity level), as well as disease-specific factors of the knee. Surgical intervention for meniscal or chondral deficiencies without attention to malalignment will lead to inferior outcomes. The focus of this review is to highlight the ...
Source: Sports Medicine and Arthroscopy Review - May 4, 2016 Category: Sports Medicine Tags: Digital Exclusives Source Type: research

Endoscopic Flexor Hallucis Longus Tendon Transfer for Chronic Achilles Tendon Rupture
Chronic Achilles tendon rupture posed significant disability to the patients. Flexor hallucis longus (FHL) transfer can be used to restore the plantarflexion power of the ankle. Traditionally, a long medial incision with extensive soft tissue dissection is needed for FHL transfer. With the advance in flexor hallucis tendoscopy, endoscopic FHL tendon transfer can be performed without extensive soft tissue dissection. (Source: Sports Medicine and Arthroscopy Review)
Source: Sports Medicine and Arthroscopy Review - January 13, 2016 Category: Sports Medicine Tags: Review Articles Source Type: research

Endoscopic-assisted Repair of Neglected Rupture or Rerupture After Primary Repair of Extensor Hallucis Longus Tendon
Rerupture of the extensor hallucis longus tendon after primary repair and neglected rupture of the tendon poses surgical challenges to orthopedic surgeons. Open exploration and repair of the tendon ends usually requires large incision and extensive dissection. This may induce scarring and adhesion around the repaired tendon. Endoscopic-assisted repair has the advantage of minimally invasive surgery including less soft tissue trauma and scar formation and better cosmetic result. The use of Krackow locking suture and preservation of the extensor retinacula allow early mobilization of the great toe. (Source: Sports Medicine a...
Source: Sports Medicine and Arthroscopy Review - January 13, 2016 Category: Sports Medicine Tags: Review Articles Source Type: research

Extra-Articular Endoscopy
With the advent of endoscopy in the last 2 decades, a number of procedures, and modifications to them, have been developed and have advanced exponentially. The list of indications was extended over time because of several reasons: better understanding of the pathophysiology, better diagnostics, and advances in endoscopic technology. In this review article, we summarize the most frequently performed extra-articular endoscopic procedures on the extremities. As there are several methods, some have been described briefly, whereas others have been described in greater detail, such as suprascapular nerve entrapment syndrome and ...
Source: Sports Medicine and Arthroscopy Review - January 13, 2016 Category: Sports Medicine Tags: Review Articles Source Type: research

Endoscopy of the Posterior Aspect of the Ankle: Double Posteromedial Portals
We describe a 2 posteromedial ankle portals procedure, which allows to reach both the posterior side of the ankle joint and the hindfoot extra-articular compartments keeping the patient supine throughout the procedure. After treatment of anterior compartment disorders using standard anterior portals, 2 posteromedial entry portals permit to visualize and treat pathologies of the posterior ankle and of the hindfoot, without prolonging surgery. (Source: Sports Medicine and Arthroscopy Review)
Source: Sports Medicine and Arthroscopy Review - January 13, 2016 Category: Sports Medicine Tags: Review Articles Source Type: research

Endoscopic-assisted Release of Lower Leg Chronic Exertional Compartment Syndromes: Results of a Systematic Literature Review
Endoscopic treatment of recalcitrant chronic exertional compartment syndromes (CECS) of the lower leg is rarely reported. Until now, endoscopic release of CECS of the lower leg is described in only 3 papers addressing 48 interventions in 30 patients. A systematic literature analysis was performed comparing endoscopic and minimally invasive lower leg CECS releases. No statistically relevant difference was found between the results of endoscopic (unweighted mean success rate=86.3%) and minimally invasive (unweighted mean success rate=80.0%) CECS release. However, the methodological quality of the analyzed studies is not suff...
Source: Sports Medicine and Arthroscopy Review - January 13, 2016 Category: Sports Medicine Tags: Review Articles Source Type: research

Endoscopic Management of Gluteus Medius Tendon Tears
Tears in the gluteus medius and minimus tendons have been recognized as an important cause of recalcitrant greater trochanteric pain syndrome. Because of the frequency of partial-thickness undersurface tears, this relatively unknown pathology is often misdiagnosed and left untreated. Surgery is indicated in case of 4 associated conditions: (i) Failure of conservative treatment with duration of symptoms >6 months; (ii) magnetic resonance imaging showing a tendon tear; (iii) positive ultrasound-guided infiltration test; and (iv) the absence of an evolved fatty degeneration or atrophy of the gluteus medius and minimus muscle....
Source: Sports Medicine and Arthroscopy Review - January 13, 2016 Category: Sports Medicine Tags: Review Articles Source Type: research

Endoscopic Resection of the Bicipitoradial Bursa
The bicipitoradial bursa lies at the insertion of the biceps tendon on the radial tuberosity. It is an unusual site for chronic bursitis. It can be treated conservatively with aspiration and steroid injection. Surgical excision of the bursa is indicated in case of infection cause, failed conservative treatment with recurrence of the enlarged bursa and pain after aspiration, the presence of nerve compression with neurological impairment, mechanical limitation to flexion and extension of the elbow or biceps tendon degeneration, and/or functional impairment. Open resection through the anterior approach requires extensive diss...
Source: Sports Medicine and Arthroscopy Review - January 13, 2016 Category: Sports Medicine Tags: Review Articles Source Type: research

Endoscopic Transnasal Odontoidectomy
Transoral microscopic odontoidectomy followed by posterior fixation has been accepted as a standard procedure to treat nonreducible basilar invagination during the half past century. In recent years, the development of endoscopic techniques has raised challenges regarding the traditional treatment algorithm. The endoscopic transnasal odontoidectomy is a feasible and effective method in the treatment of irreducible ventral cervicomedullary junction compression, which has several advantages over the transoral approach. The endoscopic odontoidectomy includes transnasal, transoral, and transcervical approaches. The 3 different...
Source: Sports Medicine and Arthroscopy Review - January 13, 2016 Category: Sports Medicine Tags: Review Articles Source Type: research