Pub Date : 2025-11-01DOI: 10.1016/j.eats.2025.103861
Roman Steika M.D. , Joseph Choi M.D. , Abdullah Foad M.D., F.A.A.O.S., F.A.A.N.A.
Managing massive rotator cuff tears in patients with minimal arthropathy who maintain an active lifestyle remains a significant challenge for orthopaedic surgeons. There is still uncertainty regarding which joint-preserving surgical techniques offer the best clinical and functional outcomes while minimizing the risk of retears. For some time, superior capsular repair has been used to treat massive rotator cuff tears through the ability to restore glenohumeral stability and function, decrease superior capsular distance, and provide biologic augmentation. The use of the long head of the biceps tendon as augmentation for irreparable rotator cuff tears provides support while reducing concerns associated with allograft viability, rejection, infection, and costs. In this Technical Note, we present our preferred surgical technique for superior capsular repair with long head of the biceps tendon, with successful recovery of range of motion, strength, and function of the shoulder at a minimum of 2 years postoperatively.
{"title":"Superior Capsule Reconstruction Augmentation for Massive Rotator Cuff Repair Using the Long Head of the Biceps Tendon","authors":"Roman Steika M.D. , Joseph Choi M.D. , Abdullah Foad M.D., F.A.A.O.S., F.A.A.N.A.","doi":"10.1016/j.eats.2025.103861","DOIUrl":"10.1016/j.eats.2025.103861","url":null,"abstract":"<div><div>Managing massive rotator cuff tears in patients with minimal arthropathy who maintain an active lifestyle remains a significant challenge for orthopaedic surgeons. There is still uncertainty regarding which joint-preserving surgical techniques offer the best clinical and functional outcomes while minimizing the risk of retears. For some time, superior capsular repair has been used to treat massive rotator cuff tears through the ability to restore glenohumeral stability and function, decrease superior capsular distance, and provide biologic augmentation. The use of the long head of the biceps tendon as augmentation for irreparable rotator cuff tears provides support while reducing concerns associated with allograft viability, rejection, infection, and costs. In this Technical Note, we present our preferred surgical technique for superior capsular repair with long head of the biceps tendon, with successful recovery of range of motion, strength, and function of the shoulder at a minimum of 2 years postoperatively.</div></div>","PeriodicalId":47827,"journal":{"name":"Arthroscopy Techniques","volume":"14 11","pages":"Article 103861"},"PeriodicalIF":1.1,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145651736","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-01DOI: 10.1016/j.eats.2025.103865
Joaquim Rodeia M.D. , Rita Alçada M.D. , Francisco Baptista M.D. , Rodrigo Goes M.D.
Anterior cruciate ligament reconstruction is one of the most commonly performed procedures in knee surgery. Despite its frequency, numerous technical variations exist, and several aspects remain controversial. Hamstring tendons are among the most frequently used autografts, and there is growing interest in techniques that preserve the gracilis tendon. Additionally, preservation of the tibial insertion of the hamstrings has recognized biological and mechanical advantages. In this technical note, we describe a technique that aims to combine the advantages of both approaches: the benefits of using a short single semitendinosus graft, preserving the gracilis tendon, which is associated with lower donor-site morbidity and improved flexion strength compared with traditional 2-tendon harvests, and the advantages of maintaining the tibial attachment of the semitendinosus, which include improved graft vascularization and a secondary point of tibial fixation. This method uses a tibial-pedicled, quadrupled semitendinosus graft combined with a dual adjustable-loop cortical suspension device. The technique is reproducible, is cost-effective, and may offer both biological and mechanical benefits over conventional approaches.
{"title":"Anterior Cruciate Ligament Reconstruction Using a Tibial-Pedicled Quadrupled Semitendinosus Autograft With Dual Adjustable-Loop Cortical Suspension","authors":"Joaquim Rodeia M.D. , Rita Alçada M.D. , Francisco Baptista M.D. , Rodrigo Goes M.D.","doi":"10.1016/j.eats.2025.103865","DOIUrl":"10.1016/j.eats.2025.103865","url":null,"abstract":"<div><div>Anterior cruciate ligament reconstruction is one of the most commonly performed procedures in knee surgery. Despite its frequency, numerous technical variations exist, and several aspects remain controversial. Hamstring tendons are among the most frequently used autografts, and there is growing interest in techniques that preserve the gracilis tendon. Additionally, preservation of the tibial insertion of the hamstrings has recognized biological and mechanical advantages. In this technical note, we describe a technique that aims to combine the advantages of both approaches: the benefits of using a short single semitendinosus graft, preserving the gracilis tendon, which is associated with lower donor-site morbidity and improved flexion strength compared with traditional 2-tendon harvests, and the advantages of maintaining the tibial attachment of the semitendinosus, which include improved graft vascularization and a secondary point of tibial fixation. This method uses a tibial-pedicled, quadrupled semitendinosus graft combined with a dual adjustable-loop cortical suspension device. The technique is reproducible, is cost-effective, and may offer both biological and mechanical benefits over conventional approaches.</div></div>","PeriodicalId":47827,"journal":{"name":"Arthroscopy Techniques","volume":"14 11","pages":"Article 103865"},"PeriodicalIF":1.1,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145651787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-01DOI: 10.1016/j.eats.2025.103881
Philippe Beauchamp-Chalifour M.D., M.Sc., F.R.C.S.C. , Anna-Lee Policicchio M.D. , Gareth Ryan M.D. , David Longino M.D., F.R.C.S.C. , C. Ryan Martin M.D., F.R.C.S.C.
Posterolateral corner injury is associated with cruciate ligament injury. Even when the lateral collateral fibular ligament is intact and provides adequate stability in the coronal plane, a posterolateral rotational instability may still be present due to popliteus insufficiency. In this clinical context, arthroscopic popliteus reconstruction may provide sufficient posterolateral stability, while being less invasive than open posterolateral reconstruction. We propose a modified arthroscopic popliteus reconstruction using anterolateral portals to increase the toolbox of the arthroscopic knee surgeon when faced with partial posterolateral corner injury.
{"title":"Arthroscopic Popliteus Reconstruction Using Anterolateral Portals","authors":"Philippe Beauchamp-Chalifour M.D., M.Sc., F.R.C.S.C. , Anna-Lee Policicchio M.D. , Gareth Ryan M.D. , David Longino M.D., F.R.C.S.C. , C. Ryan Martin M.D., F.R.C.S.C.","doi":"10.1016/j.eats.2025.103881","DOIUrl":"10.1016/j.eats.2025.103881","url":null,"abstract":"<div><div>Posterolateral corner injury is associated with cruciate ligament injury. Even when the lateral collateral fibular ligament is intact and provides adequate stability in the coronal plane, a posterolateral rotational instability may still be present due to popliteus insufficiency. In this clinical context, arthroscopic popliteus reconstruction may provide sufficient posterolateral stability, while being less invasive than open posterolateral reconstruction. We propose a modified arthroscopic popliteus reconstruction using anterolateral portals to increase the toolbox of the arthroscopic knee surgeon when faced with partial posterolateral corner injury.</div></div>","PeriodicalId":47827,"journal":{"name":"Arthroscopy Techniques","volume":"14 11","pages":"Article 103881"},"PeriodicalIF":1.1,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145651790","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-01DOI: 10.1016/j.eats.2025.103886
Avinesh Agarwalla M.D., Matthew Y. Siow M.D., M.B.A., Christos D. Photopoulos M.D.
Anterior cruciate ligament (ACL) injuries are a common pathology and one of the most heavily researched topics within orthopaedic surgery. ACL reconstruction is a successful procedure with high rates of return to sport, even among elite athletes. There are a multitude of variations in ACL reconstruction that are heavily researched in an attempt to improve outcomes after surgery. Improving the biomechanics of ACL reconstruction may improve the duration of return to sport and reduce the risk of reinjury. We describe a technique using an independent internal brace in the setting of ACL reconstruction.
{"title":"Arthroscopic Anterior Cruciate Ligament Reconstruction With Independently Tensioned Internal Brace Augmentation","authors":"Avinesh Agarwalla M.D., Matthew Y. Siow M.D., M.B.A., Christos D. Photopoulos M.D.","doi":"10.1016/j.eats.2025.103886","DOIUrl":"10.1016/j.eats.2025.103886","url":null,"abstract":"<div><div>Anterior cruciate ligament (ACL) injuries are a common pathology and one of the most heavily researched topics within orthopaedic surgery. ACL reconstruction is a successful procedure with high rates of return to sport, even among elite athletes. There are a multitude of variations in ACL reconstruction that are heavily researched in an attempt to improve outcomes after surgery. Improving the biomechanics of ACL reconstruction may improve the duration of return to sport and reduce the risk of reinjury. We describe a technique using an independent internal brace in the setting of ACL reconstruction.</div></div>","PeriodicalId":47827,"journal":{"name":"Arthroscopy Techniques","volume":"14 11","pages":"Article 103886"},"PeriodicalIF":1.1,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145651792","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-01DOI: 10.1016/j.eats.2025.103888
Parvind Grish Dev Sookun M.D. (Resident Orthopedic), Hemeshwaraj Jeetun M.D., Shouyu Wang M.D., Ph.D., Zhen Zhang M.D., Ph.D.
Medial meniscus posterior root tears (MMPRTs) are significant injuries that compromise the biomechanical function of the knee, leading to meniscus extrusion and rapid progression of osteoarthritis if left untreated. While various arthroscopic repair techniques exist, persistent meniscus extrusion after repair remains a challenge. Centralization of the extruded meniscus has shown promise in improving repair outcomes and reducing arthritic progression. This Technical Note describes a modified arthroscopic technique for the repair of MMPRT and concomitant centralization of the extruded medial meniscus using a double transtibial tunnel approach, notably without the need for accessory portals. This modified technique offers advantages by utilizing only 2 routine portals, reducing technical demands, and shortening operative time, while achieving precise anatomic repair of the posterior root and effective centralization of the extruded meniscus. This combined approach aims to restore the meniscus’s load-absorbing function, reduce stress on the root repair, potentially improve pain and functional scores, and reduce the risk of early osteoarthritis compared to root-only repairs. Early diagnosis and appropriate surgical management of MMPRT, particularly with concomitant centralization, are crucial for preserving knee joint health. This modified arthroscopic technique provides a streamlined and effective method for both posterior root repair and meniscus centralization, promoting optimal anatomic restoration and preventing osteoarthritic degeneration.
{"title":"Modified Arthroscopic Technique for Repair of Medial Meniscus Posterior Root Tear and Centralization of the Extruded Medial Meniscus Through a Double Transtibial Tunnel (Without Use of Accessory Ports)","authors":"Parvind Grish Dev Sookun M.D. (Resident Orthopedic), Hemeshwaraj Jeetun M.D., Shouyu Wang M.D., Ph.D., Zhen Zhang M.D., Ph.D.","doi":"10.1016/j.eats.2025.103888","DOIUrl":"10.1016/j.eats.2025.103888","url":null,"abstract":"<div><div>Medial meniscus posterior root tears (MMPRTs) are significant injuries that compromise the biomechanical function of the knee, leading to meniscus extrusion and rapid progression of osteoarthritis if left untreated. While various arthroscopic repair techniques exist, persistent meniscus extrusion after repair remains a challenge. Centralization of the extruded meniscus has shown promise in improving repair outcomes and reducing arthritic progression. This Technical Note describes a modified arthroscopic technique for the repair of MMPRT and concomitant centralization of the extruded medial meniscus using a double transtibial tunnel approach, notably without the need for accessory portals. This modified technique offers advantages by utilizing only 2 routine portals, reducing technical demands, and shortening operative time, while achieving precise anatomic repair of the posterior root and effective centralization of the extruded meniscus. This combined approach aims to restore the meniscus’s load-absorbing function, reduce stress on the root repair, potentially improve pain and functional scores, and reduce the risk of early osteoarthritis compared to root-only repairs. Early diagnosis and appropriate surgical management of MMPRT, particularly with concomitant centralization, are crucial for preserving knee joint health. This modified arthroscopic technique provides a streamlined and effective method for both posterior root repair and meniscus centralization, promoting optimal anatomic restoration and preventing osteoarthritic degeneration.</div></div>","PeriodicalId":47827,"journal":{"name":"Arthroscopy Techniques","volume":"14 11","pages":"Article 103888"},"PeriodicalIF":1.1,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145651793","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Elevated posterior tibial slope (PTS) has been identified as a risk factor for failure of primary and revision anterior cruciate ligament (ACL) reconstruction. Anterior closing-wedge slope-reducing high tibial osteotomy (ACW-SRO) has been shown to decrease PTS, decrease ACL graft strain, and decrease static anterior tibial translation. One approach is an infratubercle ACW-SRO, which preserves the tibial tubercle and extensor mechanism, allows for concurrent procedures, and reduces complications related to patellar height and/or tunnel placement. The purpose of this study is to present technical and planning tips that are critical to executing a successful infratubercle ACW-SRO. Preoperative planning, precise execution, and plate fixation are critical to avoid complications such as hinge fracture, neurovascular injury, and nonunion. This technique is a safe and effective option for patients with elevated PTS and failed ACL reconstruction, although further studies are needed to assess long-term outcomes.
{"title":"Tibial Infratubercle Anterior Closing-Wedge Slope-Reducing Osteotomy With Combined Revision Anterior Cruciate Ligament Reconstruction","authors":"Ricardo Abreu M.D. , Alexis Aboulafia B.S. , Jorg Dickschas M.D. , Matthieu Ollivier M.D., Ph.D. , Alfred Mansour M.D.","doi":"10.1016/j.eats.2025.103890","DOIUrl":"10.1016/j.eats.2025.103890","url":null,"abstract":"<div><div>Elevated posterior tibial slope (PTS) has been identified as a risk factor for failure of primary and revision anterior cruciate ligament (ACL) reconstruction. Anterior closing-wedge slope-reducing high tibial osteotomy (ACW-SRO) has been shown to decrease PTS, decrease ACL graft strain, and decrease static anterior tibial translation. One approach is an infratubercle ACW-SRO, which preserves the tibial tubercle and extensor mechanism, allows for concurrent procedures, and reduces complications related to patellar height and/or tunnel placement. The purpose of this study is to present technical and planning tips that are critical to executing a successful infratubercle ACW-SRO. Preoperative planning, precise execution, and plate fixation are critical to avoid complications such as hinge fracture, neurovascular injury, and nonunion. This technique is a safe and effective option for patients with elevated PTS and failed ACL reconstruction, although further studies are needed to assess long-term outcomes.</div></div>","PeriodicalId":47827,"journal":{"name":"Arthroscopy Techniques","volume":"14 11","pages":"Article 103890"},"PeriodicalIF":1.1,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145651795","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Type B and C musculotendinous junction tears present unique surgical challenges because of poor tissue integrity. We describe an arthroscopic technique—the supraspinatus tendon reinforcement reconstruction technique—that combines autologous fascia lata grafting with remnant tendon augmentation. This biologically optimized approach achieves anatomic restoration through 3 key principles: intramuscular fascia lata passage to enhance medial integration, lateral bridging reinforcement fixation to improve load distribution, and scapular spine anchoring for structural stability. By preserving native kinematics while augmenting repair integrity, this reproducible method may reduce retear rates in type B and C musculotendinous junction tears, offering a viable alternative to traditional reconstructions.
{"title":"Arthroscopic Supraspinatus Tendon Reconstruction Using Fascia Lata Autograft Augmentation for Type B and C Musculotendinous Junction Tears","authors":"Xueyan Zhao M.D. , Xiaoli Gou M.D. , Guo Zheng M.D. , Binghua Zhou M.D., Ph.D.","doi":"10.1016/j.eats.2025.103895","DOIUrl":"10.1016/j.eats.2025.103895","url":null,"abstract":"<div><div>Type B and C musculotendinous junction tears present unique surgical challenges because of poor tissue integrity. We describe an arthroscopic technique—the supraspinatus tendon reinforcement reconstruction technique—that combines autologous fascia lata grafting with remnant tendon augmentation. This biologically optimized approach achieves anatomic restoration through 3 key principles: intramuscular fascia lata passage to enhance medial integration, lateral bridging reinforcement fixation to improve load distribution, and scapular spine anchoring for structural stability. By preserving native kinematics while augmenting repair integrity, this reproducible method may reduce retear rates in type B and C musculotendinous junction tears, offering a viable alternative to traditional reconstructions.</div></div>","PeriodicalId":47827,"journal":{"name":"Arthroscopy Techniques","volume":"14 11","pages":"Article 103895"},"PeriodicalIF":1.1,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145652114","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-01DOI: 10.1016/j.eats.2025.103754
Lawrence Miller M.D. , Betina B. Hinckel M.D., Ph.D. , Leonardo M. Cavinatto M.D., Ph.D.
Articular-sided, partial-thickness rotator cuff tears often lead to shoulder pain and dysfunction. Surgical options include debridement, apposition of resorbable bioinductive collagen implants, tear completion followed by repair, and arthroscopic in situ transtendinous repair. Traditional in situ transtendinous repair, using a single camera, limits visualization of the intra-articular and subacromial spaces, risking tension mismatch and tendon buckling. In this article, we present our technique, which uses two cameras simultaneously, one in the intra-articular space and one in the subacromial space, to enhance visibility and prevent suboptimal suture placement, thereby improving repair quality and footprint coverage.
{"title":"Simultaneous Dual-Camera Technique for Partial-Thickness, Articular-Sided, In Situ Transtendinous Rotator Cuff Repair","authors":"Lawrence Miller M.D. , Betina B. Hinckel M.D., Ph.D. , Leonardo M. Cavinatto M.D., Ph.D.","doi":"10.1016/j.eats.2025.103754","DOIUrl":"10.1016/j.eats.2025.103754","url":null,"abstract":"<div><div>Articular-sided, partial-thickness rotator cuff tears often lead to shoulder pain and dysfunction. Surgical options include debridement, apposition of resorbable bioinductive collagen implants, tear completion followed by repair, and arthroscopic in situ transtendinous repair. Traditional in situ transtendinous repair, using a single camera, limits visualization of the intra-articular and subacromial spaces, risking tension mismatch and tendon buckling. In this article, we present our technique, which uses two cameras simultaneously, one in the intra-articular space and one in the subacromial space, to enhance visibility and prevent suboptimal suture placement, thereby improving repair quality and footprint coverage.</div></div>","PeriodicalId":47827,"journal":{"name":"Arthroscopy Techniques","volume":"14 11","pages":"Article 103754"},"PeriodicalIF":1.1,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145652116","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-01DOI: 10.1016/j.eats.2025.103850
James G. Jefferies M.B.Ch.B., FRCSEd (Tr.&Orth.) , Julian A. Feller M.B.B.S., F.R.A.C.S., F.A.Orth.A. , Dirk van Bavel M.B.B.S., F.R.A.C.S., F.A.Orth.A, M.ClinRes. , Andrew W.W. Tang M.B.B.S., F.R.A.C.S., F.A.Orth.A. , Lachlan M. Batty M.B.B.S. (Hons), B.Med.Sc. (Hons), F.R.A.C.S., F.A.Orth.A.
Increased posterior tibial slope is a risk factor for anterior cruciate ligament reconstruction graft failure. In revision anterior cruciate ligament surgery, anterior closing-wedge high-tibial osteotomy (ACW-HTO) addresses increased tibial slope. ACW-HTO is technically challenging in accurately executing the desired bony cuts and degree of correction. Risks include posterior neurovascular injury, hinge fractures, coronal-plane alterations, and over/under alignment correction. We present a technique leveraging the accuracy of a computed tomography−based robotic knee arthroplasty system to plan and execute precise bone cuts for ACW-HTO. We carried out 3 ACW-HTO scenarios on a Sawbones model; supratubercle, infratubercle, and combined coronal plane osteotomy. After Sawbones computed tomography scanning the software was used to plan osteotomy trajectories. The tibial baseplate cut for knee arthroplasty was adapted to perform 2 angulated ACW-HTO bone cuts, rotated and positioned upon the desired posterior hinge point. Bone cuts were successfully executed using a robotically assisted saw, registering cuts to a high accuracy. Bony registration is permitted through the surgical approach for an ACW-HTO referencing only the anterior tibial cortex with 0.2-mm accuracy. This delivered excellent precision, matching planned corrections. Robotic haptic boundaries ensured safe limits posteriorly, hinge-point maintenance and coronal-plane control.
{"title":"Robotically Assisted Anterior Closing Wedge High Tibial Osteotomy: A Surgical Technique Proof of Concept","authors":"James G. Jefferies M.B.Ch.B., FRCSEd (Tr.&Orth.) , Julian A. Feller M.B.B.S., F.R.A.C.S., F.A.Orth.A. , Dirk van Bavel M.B.B.S., F.R.A.C.S., F.A.Orth.A, M.ClinRes. , Andrew W.W. Tang M.B.B.S., F.R.A.C.S., F.A.Orth.A. , Lachlan M. Batty M.B.B.S. (Hons), B.Med.Sc. (Hons), F.R.A.C.S., F.A.Orth.A.","doi":"10.1016/j.eats.2025.103850","DOIUrl":"10.1016/j.eats.2025.103850","url":null,"abstract":"<div><div>Increased posterior tibial slope is a risk factor for anterior cruciate ligament reconstruction graft failure. In revision anterior cruciate ligament surgery, anterior closing-wedge high-tibial osteotomy (ACW-HTO) addresses increased tibial slope. ACW-HTO is technically challenging in accurately executing the desired bony cuts and degree of correction. Risks include posterior neurovascular injury, hinge fractures, coronal-plane alterations, and over/under alignment correction. We present a technique leveraging the accuracy of a computed tomography−based robotic knee arthroplasty system to plan and execute precise bone cuts for ACW-HTO. We carried out 3 ACW-HTO scenarios on a Sawbones model; supratubercle, infratubercle, and combined coronal plane osteotomy. After Sawbones computed tomography scanning the software was used to plan osteotomy trajectories. The tibial baseplate cut for knee arthroplasty was adapted to perform 2 angulated ACW-HTO bone cuts, rotated and positioned upon the desired posterior hinge point. Bone cuts were successfully executed using a robotically assisted saw, registering cuts to a high accuracy. Bony registration is permitted through the surgical approach for an ACW-HTO referencing only the anterior tibial cortex with 0.2-mm accuracy. This delivered excellent precision, matching planned corrections. Robotic haptic boundaries ensured safe limits posteriorly, hinge-point maintenance and coronal-plane control.</div></div>","PeriodicalId":47827,"journal":{"name":"Arthroscopy Techniques","volume":"14 11","pages":"Article 103850"},"PeriodicalIF":1.1,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145651729","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-01DOI: 10.1016/j.eats.2025.103854
Jorge Chahla M.D., Ph.D. , Jacob T. Morgan B.A. , Napatpong Thamrongskulsiri M.D. , Jose F. Vega M.D. , Gabriel Octavio Pérez Lloveras M.D. , Felipe Casanova M.D. , Robert F. LaPrade M.D., Ph.D.
Lateral femoral condyle (LFC) impaction fractures are an increasingly recognized pathology occurring concomitantly with anterior cruciate ligament (ACL) rupture. These lesions are important to identify and treat because of the impact they have on knee instability, meniscal degeneration, a faster rate of progression to osteoarthritis, and increased chance of ACL graft rerupture. The technique presented is intended for use in large and deep LFC impaction fractures in conjunction with ACL reconstruction with bone−patellar tendon−bone autograft. It uses an open anterolateral arthrotomy and a subchondral cortical window to place autologous bone graft into the LFC from the bone−patellar tendon−bone tibial harvest site and tibial tunnel bone chips. This is performed to mitigate the risk of posttraumatic complications and to restore the native joint anatomy in a biologically sound, cost-effective manner.
{"title":"Open Reduction of Lateral Femoral Condyle Impaction Fracture Using Autologous Bone Graft in the Setting of Anterior Cruciate Ligament Reconstruction With Bone−Patellar Tendon−Bone Autograft","authors":"Jorge Chahla M.D., Ph.D. , Jacob T. Morgan B.A. , Napatpong Thamrongskulsiri M.D. , Jose F. Vega M.D. , Gabriel Octavio Pérez Lloveras M.D. , Felipe Casanova M.D. , Robert F. LaPrade M.D., Ph.D.","doi":"10.1016/j.eats.2025.103854","DOIUrl":"10.1016/j.eats.2025.103854","url":null,"abstract":"<div><div>Lateral femoral condyle (LFC) impaction fractures are an increasingly recognized pathology occurring concomitantly with anterior cruciate ligament (ACL) rupture. These lesions are important to identify and treat because of the impact they have on knee instability, meniscal degeneration, a faster rate of progression to osteoarthritis, and increased chance of ACL graft rerupture. The technique presented is intended for use in large and deep LFC impaction fractures in conjunction with ACL reconstruction with bone−patellar tendon−bone autograft. It uses an open anterolateral arthrotomy and a subchondral cortical window to place autologous bone graft into the LFC from the bone−patellar tendon−bone tibial harvest site and tibial tunnel bone chips. This is performed to mitigate the risk of posttraumatic complications and to restore the native joint anatomy in a biologically sound, cost-effective manner.</div></div>","PeriodicalId":47827,"journal":{"name":"Arthroscopy Techniques","volume":"14 11","pages":"Article 103854"},"PeriodicalIF":1.1,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145651732","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
扫码关注我们
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号