Operative Techniques in Orthopaedics最新文献

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Operative Techniques in Orthopaedic Surgery: Meniscal Tears 骨科手术技术：半月板撕裂

IF 0.2 Q4 ORTHOPEDICS

Operative Techniques in Orthopaedics

Pub Date : 2025-06-01 DOI: 10.1053/j.oto.2025.101179

Andrew J. Sheean

引用次数: 0

Editorial Board (pick up from previous issue w/updates) 编辑委员会（选自上一期，并有更新）

IF 0.2 Q4 ORTHOPEDICS

Operative Techniques in Orthopaedics

Pub Date : 2025-06-01 DOI: 10.1053/S1048-6666(25)00036-9

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Meniscus Root Injuries: Modern Techniques and Clinical Outcomes 半月板根损伤：现代技术和临床结果

IF 0.2 Q4 ORTHOPEDICS

Operative Techniques in Orthopaedics

Pub Date : 2025-06-01 DOI: 10.1016/j.oto.2025.101184

Brandon C. Cabarcas, Jason Ina, Gavin H. Ward, Mario Hevesi, Aaron J. Krych

Meniscus root tears have gathered increased recent attention in the orthopaedic literature with substantial implications for sustained patient knee function and longevity. A growing body of evidence supports surgical repair over nonoperative treatment or partial meniscectomy in the setting of medial or lateral meniscus root tears with overall preserved articular cartilage. Decreased risk of osteoarthritic degeneration, conversion to total knee arthroplasty, and reliable improvements in validated clinical outcome scores have all been demonstrated by multiple biomechanical and clinical investigations. Centralization of an extruded meniscus with a root tear has emerged as a promising surgical technique to help restore native meniscus function and normal knee kinematics. This review outlines the historical background, diagnostic evaluation, and clinical management of meniscus root tears, including modern surgical advancements and latest clinical outcomes.

最近，在骨科文献中，半月板根撕裂引起了越来越多的关注，对患者的持续膝关节功能和寿命有重大影响。越来越多的证据支持手术修复优于非手术治疗或半月板部分切除术治疗内侧或外侧半月板根撕裂，关节软骨整体保留。多项生物力学和临床研究都证明了骨关节炎退行性变的风险降低、转向全膝关节置换术以及有效的临床结果评分的可靠改善。突出的半月板根部撕裂的集中化已成为一种有前途的手术技术，以帮助恢复原始半月板功能和正常的膝关节运动学。本文综述了半月板根撕裂的历史背景、诊断评价和临床处理，包括现代外科进展和最新的临床结果。

引用次数: 0

Nerve Healing and Future Directions 神经愈合和未来方向

IF 0.2 Q4 ORTHOPEDICS

Operative Techniques in Orthopaedics

Pub Date : 2025-03-28 DOI: 10.1016/j.oto.2025.101178

Christopher Jou , Anisha Sonti , Austin Kennemer , Rafael Ramos , Megan M. Jack , Grzegorz Kwiecien , Dennis Kao

Peripheral nerve injuries are potentially devastating injuries that can lead to profound functional deficits and pain. As peripheral nerves retain the ability to regenerate, understanding the mechanism and physiology of nerve regeneration is critical to improving patient outcomes. Here, we review the physiology of nerve regeneration, as well as review surgical management and new treatment modalities for these injuries.

周围神经损伤是潜在的破坏性损伤，可导致严重的功能缺陷和疼痛。由于周围神经保留再生能力，了解神经再生的机制和生理学对改善患者预后至关重要。在这里，我们回顾了神经再生的生理学，以及这些损伤的外科治疗和新的治疗方式。

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Nerve Transfers for Brachial Plexus and Upper Extremity Nerve Injuries 臂丛神经及上肢神经损伤的神经转移治疗

IF 0.2 Q4 ORTHOPEDICS

Operative Techniques in Orthopaedics

Pub Date : 2025-03-01 DOI: 10.1016/j.oto.2025.101175

Paul J. Hannon, Joseph F. Styron

Nerve transfer in the setting of both brachial plexus injury (BPI) and peripheral nerve injury (PNI) has become a valuable tool in the armamentarium of the hand and upper extremity surgeon. Depending on the level of injury, numerous donor nerves exist which can be utilized to re-animate deficient motor functions and/or restore sensation. Commonly after BPI, the patient is left with deficiencies in shoulder abduction, external rotation and/or elbow flexion/extension for which there are a host of available nerve transfer options. Unfortunately, we do not yet have many successful techniques to restore intrinsic hand function after complete BPI, however there are numerous techniques to improve hand function in the setting of PNI. Multiple donors are often available, and the decision for which to harvest is at the discretion of the surgeon, taking into consideration the presence of concomitant injury, regenerative distance and deficits which may result from donor harvest. For the best chance at an optimal outcome after nerve transfer, progressive rehabilitation programs for both motor and sensory re-education are critical. Multiple techniques for restoration of motor and sensory function after BPI and PNI are described below, as well as a description of typical rehabilitation protocol after nerve transfer.

臂丛神经损伤（BPI）和周围神经损伤（PNI）的神经移植已成为手肢和上肢外科医生的重要工具。根据损伤程度的不同，存在大量的供体神经，可用于恢复缺乏的运动功能和/或恢复感觉。通常在BPI术后，患者在肩部外展、外旋和/或肘关节屈伸方面存在缺陷，因此有许多可用的神经转移选择。不幸的是，我们还没有很多成功的技术来恢复完全BPI后的固有手功能，但是有许多技术可以改善PNI设置下的手功能。通常有多个供体可供选择，选择哪个供体是由外科医生决定的，要考虑到是否存在伴随损伤、再生距离和供体切除可能导致的缺陷。为了在神经移植后获得最佳结果的最佳机会，运动和感觉再教育的渐进式康复计划至关重要。下面将介绍BPI和PNI术后运动和感觉功能恢复的多种技术，以及神经移植后典型康复方案的描述。

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Upper Extremity Targeted Muscle Reinnervation 上肢定向肌肉再神经支配

IF 0.2 Q4 ORTHOPEDICS

Operative Techniques in Orthopaedics

Pub Date : 2025-03-01 DOI: 10.1016/j.oto.2025.101174

Khusboo Desai, Erin Weber

Residual limb and phantom limb pain can affect as many as 80% of individuals after amputation and can drastically affect a patient's quality of life and ability to wear a prosthetic device. Targeted muscle reinnervation (TMR) is a novel nerve transfer technique developed to increase the number of available electromyography (EMG) signals available for myoelectric prosthetic control. This initial indication has been expanded as later studies have also shown a reduction in opioid usage and increased prosthetic wear, even in highly comorbid patients, secondary to reduced phantom and residual limb pain. In this article we review the relevant anatomy and discuss TMR nerve transfer options available for patients with amputations at varying levels including partial hand, trans-radial, trans-humeral and shoulder disarticulation.

残肢和幻肢疼痛可影响多达80%的截肢后个体，并可能严重影响患者的生活质量和佩戴假肢装置的能力。靶向肌肉神经移植（TMR）是一种新型的神经移植技术，旨在增加肌电假肢控制的肌电信号数量。这一最初适应症已经扩大，因为后来的研究也表明，阿片类药物的使用减少，假体磨损增加，甚至在高度合并症的患者中，继发于减少幻肢和残肢疼痛。在这篇文章中，我们回顾了相关的解剖学，并讨论了TMR神经移植可用于不同程度截肢的患者，包括部分手部、经桡骨、经肱骨和肩部脱臼。

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Contributors (pick up from previous issue w/updates) 贡献者（从以前的问题和更新中挑选）

IF 0.2 Q4 ORTHOPEDICS

Operative Techniques in Orthopaedics

Pub Date : 2025-03-01 DOI: 10.1053/S1048-6666(25)00028-X

引用次数: 0

Table of Contents (pick up from previous issue w/updates) 目录（选自上一期的内容和更新）

IF 0.2 Q4 ORTHOPEDICS

Operative Techniques in Orthopaedics

Pub Date : 2025-03-01 DOI: 10.1053/S1048-6666(25)00027-8

引用次数: 0

Nerve Transfers for Tetraplegia 神经移植治疗四肢瘫痪

IF 0.2 Q4 ORTHOPEDICS

Operative Techniques in Orthopaedics

Pub Date : 2025-03-01 DOI: 10.1016/j.oto.2025.101177

Christopher Jou , Kyle J. Chepla

Cervical spinal cord injury can result in loss of upper extremity function including elbow extension, hand opening and closing. Together, these losses can severely limit independence, negatively impact quality of life, and the ability to perform activities of daily living without assistance from family or caregivers. Thus, restoration of hand and upper extremity function is critical and often a top priority for patients with tetraplegia. While reconstructive surgical techniques such as tendon transfer, tenodesis and arthrodesis have been long used to accomplish this, nerve transfers have recently demonstrated excellent outcomes and are now being incorporated into treatment algorithms for these patients either alone or in conjunction with tendon transfer. Here, we review the pathophysiology of spinal cord injury, commonly performed nerve transfers, complications and expected outcomes.

颈脊髓损伤可导致肘关节伸直、手开合等上肢功能丧失。总之，这些损失会严重限制独立性，对生活质量产生负面影响，并在没有家人或照顾者帮助的情况下进行日常生活活动的能力。因此，手部和上肢功能的恢复是至关重要的，并且通常是四肢瘫痪患者的重中之重。虽然重建手术技术，如肌腱转移、肌腱固定术和关节融合术长期以来一直用于实现这一目标，但神经转移最近显示出良好的效果，现在正被纳入这些患者单独或联合肌腱转移的治疗算法中。在这里，我们回顾脊髓损伤的病理生理学，常见的神经转移，并发症和预期结果。

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Evaluation and Grading of Peripheral Nerve Injuries 周围神经损伤的评价与分级

IF 0.2 Q4 ORTHOPEDICS

Operative Techniques in Orthopaedics

Pub Date : 2025-03-01 DOI: 10.1016/j.oto.2025.101170

Austin Kennemer , Anisha Sonti , Eric Z. Herring , Grzegorz Kwiecien , Dennis Kao , Megan M. Jack

Peripheral nerve injury can be caused by many etiologies including ischemic, mechanical, chemical, thermal and inflammatory insults and affects sensory, motor and autonomic function. In this article we will review the classification of nerve injury, examination of a patient with a suspected nerve injury and useful supplementary diagnostic tools including electromyography, ultrasound and magnetic resonance neurography. The aforementioned are all critical parts in determining whether spontaneous recovery is possible or if, and when, surgical intervention including neurolysis, direct repair, grafting or nerve transfer should be considered.

周围神经损伤可由多种病因引起，包括缺血性、机械性、化学性、热和炎症性损伤，并影响感觉、运动和自主神经功能。在本文中，我们将回顾神经损伤的分类、疑似神经损伤患者的检查以及有用的辅助诊断工具，包括肌电图、超声和磁共振神经成像。上述都是决定自发恢复是否可能的关键部分，或者是否以及何时应考虑手术干预，包括神经松解术、直接修复、移植或神经转移。

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