Arthroscopy Techniques最新文献

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Computer-Assisted Hip Arthroscopic Surgery for Secondary Femoroacetabular Impingement After Rotational Acetabular Osteotomy Using Capsular Takedown Techniques

IF 1.2 Q3 ORTHOPEDICS

Arthroscopy Techniques

Pub Date : 2025-02-01 DOI: 10.1016/j.eats.2024.103193

Shota Higashihira M.D., Ph.D. , Yohei Yukizawa M.D., Ph.D. , Ayahiro Kadowaki M.D. , Shu Takagawa MD., Ph.D. , Hyonmin Choe M.D., Ph.D. , Yutaka Inaba M.D., Ph.D. , Naomi Kobayashi M.D., Ph.D.

Secondary femoroacetabular impingement (FAI) is a severe complication observed after acetabular osteotomy; however, the diagnostic and treatment strategies of FAI have not been well established, especially with respect to arthroscopic techniques. We here describe hip arthroscopic osteochondroplasty for secondary FAI using computer-assisted techniques. The main features and tips of our technique are preoperative computed tomography (CT)-based surgical planning and the intraoperative capsule takedown method. Computer modeling produces a patient-specific 3-dimensional CT bone model. Subsequently, we identify the impingement point between the acetabulum and the femoral neck using dynamic simulation. The excess bony bumps are resected through computer surgical simulation, and pre- and postoperative 3-dimensional CT bone models are combined to identify the appropriate resection area. For the surgical technique, it is important to detach the capsule to visualize the acetabulum bony excess. Once the resection area has been sufficiently visualized, the bone resection is performed. Finally, the capsule is reattached to the excavated acetabulum, and the delaminated labrum is sewn up with the capsule in a round bale shape.

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引用次数: 0

Combined Open-Anterolateral Ligament and Anterior Cruciate Ligament Reconstruction of the Knee: The “Open-ALL”

IF 1.2 Q3 ORTHOPEDICS

Arthroscopy Techniques

Pub Date : 2025-02-01 DOI: 10.1016/j.eats.2024.103189

Felipe Galvão Abreu M.D. , Julien Chamoux M.D. , Marc Barrera Uso M.D. , Silvia Cardarelli M.D. , Anahita Borojeni M.D. , Louis Kluyskens M.D. , Thais Dutra Vieira M.D. , Bertrand Sonnery-Cottet M.D, Ph.D.

The addition of an extra-articular reinforcement, such as the anterolateral ligament (ALL) or a Lemaire’s procedure, in anterior cruciate ligament reconstructions has shown good clinical results, with greater graft protection and a lower rerupture rate. Despite being a reproducible procedure, its application in cases of large, muscled knees or in obese patients can be challenging. This Technical Note describes the “Open-ALL” technique, using a mini-open approach for a combined anterior cruciate ligament and ALL reconstruction.

引用次数: 0

Fascia Lata Allograft Medial Patellofemoral Ligament Reconstruction—Restore the Nature as Close as Possible

IF 1.2 Q3 ORTHOPEDICS

Arthroscopy Techniques

Pub Date : 2025-02-01 DOI: 10.1016/j.eats.2024.103194

Marcin Mostowy M.D. , Michalina Bawor , Krzysztof Bujak , Przemysław A. Pękala M.D., Ph.D. , Robert F. LaPrade M.D., Ph.D. , Konrad Malinowski M.D., Ph.D.

Various surgical techniques for medial patellofemoral ligament (MPFL) reconstruction have been described, commonly using hamstring auto- or allografts. Despite their widespread use, these techniques have limitations due to the tubular structure of the hamstring tendons, which does not match the flat, sail-like anatomy of the MPFL. Furthermore, over- or undertensioning of the graft due to tunnel misplacement remains a significant risk, even if anatomic and radiologic landmarks are used. To address these issues, a fascia lata allograft MPFL reconstruction with assessment of angular anisometry is presented. This technique allows for reconstruction of the MPFL as close as possible to its nature with a flat and wide patellar attachment and a gradual transition of maximal tension across the graft fibers, depending on the knee flexion angle. Precise intraoperative control of predefined graft angular anisometry allows for achievement of the desired amount of tension at specific flexion angles. This mitigates the risk of under- or overtensioning and subsequently ensures proper medial-lateral mobility of the patella.

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引用次数: 0

Modified MacIntosh (Over-the-Top Iliotibial Band Autograft) Technique for Pediatric Anterior Cruciate Ligament Reconstruction Using Knotless All-Suture Anchor Fixation

IF 1.2 Q3 ORTHOPEDICS

Arthroscopy Techniques

Pub Date : 2025-02-01 DOI: 10.1016/j.eats.2024.103204

Jarod A. Richards M.D., Logan M. Mays B.S., David R. Woodard M.D., Steven F. DeFroda M.D., Clayton W. Nuelle M.D.

Anterior cruciate ligament (ACL) injury is a significant cause of injury among pediatric patients with an increasing incidence. ACL insufficiency can lead to lifelong disability as further joint deterioration occurs in the form of meniscal and subsequently chondral pathology. Techniques for pediatric ACL reconstruction can broadly be classified as physeal-sparing and non–physeal-sparing. Bone age is frequently used when deciding which technique to employ. Patients are candidates for physeal-sparing, over-the-top iliotibial band reconstruction (i.e., modified MacIntosh II) when they have >4 years remaining before skeletal maturity. The modified Macintosh procedure provides both intra- and extra-articular rotational and translational constraint. This Technical Note describes the senior author’s modified MacIntosh technique using knotless all-suture anchor fixation in a suture staple technique to mitigate risk of physeal damage.

引用次数: 0

Three-Point Contact Repair Technique for Partial Subscapularis Tears Using U-Stitch and Cow Hitch Knot Loaded on a Single Knotless Anchor: Simple, Reliable and Quick Method

IF 1.2 Q3 ORTHOPEDICS

Arthroscopy Techniques

Pub Date : 2025-02-01 DOI: 10.1016/j.eats.2024.103239

Mehmet Chodza M.D. , Ozgur Koyuncu M.D. , Olgar Birsel M.D. , Ilker Eren M.D. , Mehmet Demirhan M.D.

The importance of repairing the subscapularis tendon to facilitate restoration of the rotator cuff force couple is obvious. However, identifying and repairing subscapularis tears can be challenging for surgeons. In this technical note, we present our preferred surgical method for Lafosse type 1, 2, and 3 and Yoo and Rhee type 1-2A and 2B subscapularis tears, providing a 3-point suture contact achieved with FiberTape (Arthrex) and knotless anchors. In this technique, fiber suture is placed into the superolateral edge of the subscapularis tendon as a traction stitch (cow hitch knot). Second, the FiberTape is passed through the medial upper and lower parts of the tendon, just perpendicular to the fibers, using a suture passer. The FiberTape’s free ends remain on the tendon’s anterior side, shaping a U form. The U-shaped FiberTape and traction suture are loaded to a knotless anchor and placed on the footprint area. This creates a 3-point contact between the FiberTape U-suture and the cow hitch knot on the area. We believe that this technique provides fast and reliable fixation due to its 3-point contact application and simplicity.

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引用次数: 0

Arthroscopic Patch Bridging Using Fascia Lata for Irreparable Rotator Cuff Tears

IF 1.2 Q3 ORTHOPEDICS

Arthroscopy Techniques

Pub Date : 2025-02-01 DOI: 10.1016/j.eats.2024.103000

Youqiang Sun M.D., Jianfa Chen M.D., Yuanyuan Wang M.D., Xiaobing Xiang M.D.

We describe an arthroscopic technique for irreparable rotator cuff tears using patch bridging reconstruction with fascia lata autograft. Compared with conventional rotator cuff repair, this technique reconstitutes the rotator cuff as a dynamic structure, preserves the rotator cuff remnant, reduces excessive tension of the rotator cuff, and preserves the shoulder joint. The fascia lata patch itself is low cost and avoids risks of transmission of blood-borne infectious diseases and rejection. Although the bridging reconstruction is a complex operation with a long learning curve, we believe patch bridging using fascia lata is a highly effective and reproducible surgical protocol for appropriate irreparable rotator cuff tear patients.

引用次数: 0

Minimally Invasive 2-Incision Patellar Tendon Autograft Anterior Cruciate Ligament Reconstruction Using Retrograde Reamer Guide to Prevent Graft-Construct Mismatch

IF 1.2 Q3 ORTHOPEDICS

Arthroscopy Techniques

Pub Date : 2025-02-01 DOI: 10.1016/j.eats.2024.103230

Dylan S. Koolmees M.D., Joseph D. Lamplot M.D., Andrew D. Nahr M.D., Tori J. Coble D.O., Frederick M. Azar M.D., David L. Bernholt M.D.

Graft-tunnel mismatch (GTM) is a known technical challenge that can occur with anterior cruciate ligament reconstruction when using a patellar tendon autograft. Two-incision anterior cruciate ligament reconstruction is a well-established technique with excellent outcomes and can serve as an excellent tool to prevent GTM. Traditionally, 2-incision femoral tunnel drilling has been performed using an over-the-top guide through a lateral incision, but more modern retrograde reamer guides can allow this to be done percutaneously. We detail how a minimally invasive 2-incision femoral tunnel drilling technique can be used in patients with patellar tendon lengths that are longer than average to avoid GTM.

引用次数: 0

Arthroscopic Dorsal Cheilectomy, Plantar Capsular Release, Flexor Hallucis Brevis Release, and Sesamoid Cheilectomy for Management of Early Stages of Hallux Rigidus

IF 1.2 Q3 ORTHOPEDICS

Arthroscopy Techniques

Pub Date : 2025-02-01 DOI: 10.1016/j.eats.2024.103198

Tun Hing Lui M.B.B.S.(HK), F.R.C.S.(Edin), F.H.K.A.M., F.H.K.C.O.S. , Amanda Mun Yee Slocum M.B.B.S.(HK) , Charles Churk Hang Li M.B.Ch.B., F.H.K.C.O.S., F.H.K.A.M. , Wataru Kumamoto M.B.Ch.B.

In hallux rigidus, limitation of the dorsiflexion of the first metatarsophalangeal joint can be a result of dorsal impingement and plantar contracture of the joint. The purpose of this Technical Note is to describe the details of arthroscopic dorsal cheilectomy, plantar capsular release, flexor hallucis brevis release, and sesamoid cheilectomy for the management of early stages of hallux rigidus. This minimally invasive technique can deal with both dorsal and plantar pathologies of the first metatarsophalangeal joint.

引用次数: 0

“Zip” Lesion of the Lateral Meniscus Repair Technique Using All-Inside Meniscus Repair Device 使用全内半月板修复装置的外侧半月板 "拉链 "损伤修复技术

IF 1.2 Q3 ORTHOPEDICS

Arthroscopy Techniques

Pub Date : 2025-02-01 DOI: 10.1016/j.eats.2024.103030

Milind V. Pimprikar M.S., D. Orthopaedics, P.G. Dip. Sports and Exercise Medicine (UK), Hitendra G. Patil M.B.B.S., D.N.B.

Ramp lesion of the medial meniscus is an established clinical entity and is one of the causes of the positive pivot-shift test with anterior cruciate ligament (ACL) injury. A similar lesion in the region of the posterior horn of the lateral meniscus extending to the posterior meniscocapsular junction posterior to the popliteal hiatus along with ACL injury is called a “zip lesion.” These patients do exhibit a positive pivot shift under anesthesia. We have encountered different injury patterns to the lateral meniscocapsular junction, which can cause altered knee kinematics, and they should be looked for while performing an ACL reconstruction. Failure to identify and repair these lesions will have a deleterious effect on the knee kinematics. If untreated, these lesions may lead to compromised results of the ACL reconstruction. This Technical Note proposes a repair technique for the zip lesion.

引用次数: 0

Concomitant Medial and Lateral Meniscus Posterior Horn Root Repair With Anterior Cruciate Ligament Reconstruction Using Triangular Configuration of Transtibial Tunnel Technique 利用三角配置经胫骨隧道技术，同时进行内侧和外侧半月板后角根修复术和前十字韧带重建术

IF 1.2 Q3 ORTHOPEDICS

Arthroscopy Techniques

Pub Date : 2025-02-01 DOI: 10.1016/j.eats.2024.103227

Mukesh S. Laddha D.N.B., D.Ortho, Abhilash P. Sangtani M.S.Ortho, Lakshya Bhardwaj D.N.B., D.Ortho

The simultaneous presence of posterior horn root tears in both the medial and lateral menisci along with an anterior cruciate ligament (ACL) rupture is uncommon. Literature is scarce that addresses the concurrent repair of medial and lateral meniscus root tears alongside ACL reconstruction. We discuss the management of concomitant medial meniscus posterior horn root tear, lateral meniscus posterior horn root tear, and ACL tear. Challenges may arise, including difficulty in accessing the medial meniscal root tear, confusion regarding the sequence of repair, and the risk of tunnel coalition within the tibial bone during each procedure. In response, we offer a detailed, step-by-step arthroscopic technique aimed at efficiently addressing these obstacles while saving time.

引用次数: 0

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