Pub Date : 2025-12-01DOI: 10.1016/j.eats.2025.103961
Ayyappan V. Nair M.B.B.S., D.N.B. , Jetty Tejaswari M.B.B.S., M.S. , Prince Shanavas Khan M.S. , Kiran Veerendra M.S., M.R.C.S. , Aravind Rajan M.B.B.S., M.S., D.N.B. , Shakir Rashid M.B.B.S., M.S. , M. Priyamvada B.Tech, M.Tech
Glenoid articular cartilage lesions are a significant cause of persistent shoulder pain, particularly following trauma or previous surgical interventions, such as failed Bankart repairs. Current surgical approaches for addressing cartilage damage in the glenohumeral joint include microfracture, osteochondral autograft transfer, osteochondral allograft transplantation, and autologous chondrocyte implantation. However, the use of bone marrow aspiration concentrate (BMAC), which is rich in mesenchymal stem cells, has emerged as a promising minimally invasive single-step procedure that promotes cartilage regeneration. This study presents an arthroscopic technique for addressing cartilage defects in the glenoid using BMAC after failed Bankart repair in a patient. Although the evidence base for BMAC in glenoid defects is limited, early clinical results suggest effective cartilage healing, few complications, and satisfactory patient outcomes. This technique appears to be safe and offers the benefit of being a single-step process that utilizes autologous bone marrow mesenchymal cells to facilitate cartilage regeneration. Further research is needed to establish the long-term efficacy of this approach for treating glenoid cartilage lesions.
{"title":"An Arthroscopic Technique for Addressing Cartilage Defects in the Glenoid Using Bone Marrow Aspiration Concentrate After Failed Bankart Repair","authors":"Ayyappan V. Nair M.B.B.S., D.N.B. , Jetty Tejaswari M.B.B.S., M.S. , Prince Shanavas Khan M.S. , Kiran Veerendra M.S., M.R.C.S. , Aravind Rajan M.B.B.S., M.S., D.N.B. , Shakir Rashid M.B.B.S., M.S. , M. Priyamvada B.Tech, M.Tech","doi":"10.1016/j.eats.2025.103961","DOIUrl":"10.1016/j.eats.2025.103961","url":null,"abstract":"<div><div>Glenoid articular cartilage lesions are a significant cause of persistent shoulder pain, particularly following trauma or previous surgical interventions, such as failed Bankart repairs. Current surgical approaches for addressing cartilage damage in the glenohumeral joint include microfracture, osteochondral autograft transfer, osteochondral allograft transplantation, and autologous chondrocyte implantation. However, the use of bone marrow aspiration concentrate (BMAC), which is rich in mesenchymal stem cells, has emerged as a promising minimally invasive single-step procedure that promotes cartilage regeneration. This study presents an arthroscopic technique for addressing cartilage defects in the glenoid using BMAC after failed Bankart repair in a patient. Although the evidence base for BMAC in glenoid defects is limited, early clinical results suggest effective cartilage healing, few complications, and satisfactory patient outcomes. This technique appears to be safe and offers the benefit of being a single-step process that utilizes autologous bone marrow mesenchymal cells to facilitate cartilage regeneration. Further research is needed to establish the long-term efficacy of this approach for treating glenoid cartilage lesions.</div></div>","PeriodicalId":47827,"journal":{"name":"Arthroscopy Techniques","volume":"14 12","pages":"Article 103961"},"PeriodicalIF":1.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145814152","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 : 2025-12-01DOI: 10.1016/j.eats.2025.103990
Raahil Patel M.D., M.B.A. , Andrew Moore M.D. , Collin Chase M.D. , Michael Kucharik M.D. , Viki Sochor M.S. , Humberto Cardona B.S. , Christopher Baker M.D.
Rotator cuff tears continue to have a high incidence of retear rates despite improvements in implants and repair techniques. The management of rotator cuff tears remains challenging because of the variability in both patient and tear pathology, without any universally accepted treatment to improve repair outcomes. Biologic patch augmentation has gained interest to enhance tendon healing, reduce retear rates, and restore the rotator cuff footprint. This Technical Note aims to describe a surgical technique using a hyaluronic acid-based biocompatible implant for both partial- and full-thickness rotator cuff tears. For partial-thickness tears, an onlay technique is used, placing the implant directly on the bursal surface of the tendon without formal suture repair. In full-thickness tears, the implant is applied over a completed standard rotator cuff repair construct to augment tendon-to-bone healing. This technique offers an alternative to currently utilized rotator cuff repair augmentation options.
{"title":"Hyaluronic Acid-Biocompatible Implant System for Rotator Cuff Augmentation","authors":"Raahil Patel M.D., M.B.A. , Andrew Moore M.D. , Collin Chase M.D. , Michael Kucharik M.D. , Viki Sochor M.S. , Humberto Cardona B.S. , Christopher Baker M.D.","doi":"10.1016/j.eats.2025.103990","DOIUrl":"10.1016/j.eats.2025.103990","url":null,"abstract":"<div><div>Rotator cuff tears continue to have a high incidence of retear rates despite improvements in implants and repair techniques. The management of rotator cuff tears remains challenging because of the variability in both patient and tear pathology, without any universally accepted treatment to improve repair outcomes. Biologic patch augmentation has gained interest to enhance tendon healing, reduce retear rates, and restore the rotator cuff footprint. This Technical Note aims to describe a surgical technique using a hyaluronic acid-based biocompatible implant for both partial- and full-thickness rotator cuff tears. For partial-thickness tears, an onlay technique is used, placing the implant directly on the bursal surface of the tendon without formal suture repair. In full-thickness tears, the implant is applied over a completed standard rotator cuff repair construct to augment tendon-to-bone healing. This technique offers an alternative to currently utilized rotator cuff repair augmentation options.</div></div>","PeriodicalId":47827,"journal":{"name":"Arthroscopy Techniques","volume":"14 12","pages":"Article 103990"},"PeriodicalIF":1.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145814216","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 : 2025-12-01DOI: 10.1016/j.eats.2025.103928
Christian L. Blough M.D., Michael B. Banffy M.D.
Proximal hamstring tears can significantly affect patient quality of life. Recently, endoscopy has been used to address these tears when conservative management fails. The results of endoscopic proximal hamstring repair are promising, but retears do occur. Revision endoscopic repair is an option. We present a technique, using suture staples, which can be used in partial or undersurface proximal hamstring tears.
{"title":"Revision Endoscopic Proximal Hamstring Repair with Suture Staples","authors":"Christian L. Blough M.D., Michael B. Banffy M.D.","doi":"10.1016/j.eats.2025.103928","DOIUrl":"10.1016/j.eats.2025.103928","url":null,"abstract":"<div><div>Proximal hamstring tears can significantly affect patient quality of life. Recently, endoscopy has been used to address these tears when conservative management fails. The results of endoscopic proximal hamstring repair are promising, but retears do occur. Revision endoscopic repair is an option. We present a technique, using suture staples, which can be used in partial or undersurface proximal hamstring tears.</div></div>","PeriodicalId":47827,"journal":{"name":"Arthroscopy Techniques","volume":"14 12","pages":"Article 103928"},"PeriodicalIF":1.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145814229","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 : 2025-12-01DOI: 10.1016/j.eats.2025.103867
Christopher R. Orear B.S. , Kyle S. Jamar B.S. , Jessica H. Lee M.D. , James W. Genuario M.D. , Jacob L. Segil Ph.D. , Omer Mei-Dan M.D.
Joint access is crucial for hip arthroscopy success, yet current techniques—with or without the use of a cannula—fail to achieve optimal joint access. Current commercially available cannula options have many drawbacks, including limited range of movement of instruments, slow instrument changes, limited joint visualization, fluid outflow blockage, and potential for unintentional cartilage damage. In this article, we present a cannula concept for hip arthroscopy that addresses these limitations. The cannula’s unique design includes slotted geometry and fixation deep to the capsule and superficially to the skin using a single capsular stay suture, allowing better control of instruments, improved visualization of the joint, faster instrument changes, a constant fluid outflow track, and a lower potential for cartilage damage.
{"title":"The Dual-Fixed Slotted Cannula for Hip Arthroscopy: Surgical Technique","authors":"Christopher R. Orear B.S. , Kyle S. Jamar B.S. , Jessica H. Lee M.D. , James W. Genuario M.D. , Jacob L. Segil Ph.D. , Omer Mei-Dan M.D.","doi":"10.1016/j.eats.2025.103867","DOIUrl":"10.1016/j.eats.2025.103867","url":null,"abstract":"<div><div>Joint access is crucial for hip arthroscopy success, yet current techniques—with or without the use of a cannula—fail to achieve optimal joint access. Current commercially available cannula options have many drawbacks, including limited range of movement of instruments, slow instrument changes, limited joint visualization, fluid outflow blockage, and potential for unintentional cartilage damage. In this article, we present a cannula concept for hip arthroscopy that addresses these limitations. The cannula’s unique design includes slotted geometry and fixation deep to the capsule and superficially to the skin using a single capsular stay suture, allowing better control of instruments, improved visualization of the joint, faster instrument changes, a constant fluid outflow track, and a lower potential for cartilage damage.</div></div>","PeriodicalId":47827,"journal":{"name":"Arthroscopy Techniques","volume":"14 12","pages":"Article 103867"},"PeriodicalIF":1.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145814233","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 : 2025-12-01DOI: 10.1016/j.eats.2025.103948
Kaitlyn H. Smith B.S. , Nicholas K. Retzer B.S. , Benjiman J. Wilebski M.D., A.T.C. , Luke V. Tollefson B.S. , Matthew T. Rasmussen M.D. , Dustin R. Lee M.D. , Robert F. LaPrade M.D., Ph.D.
The primary role of the posterior cruciate ligament (PCL) is to prevent posterior tibial translation (PTT). PCL graft forces increase as the posterior tibial slope decreases. Therefore, in the setting of a failed PCL reconstruction, the posterior tibial slope should be evaluated as a potential factor to offload the PCL graft. Patients with a failed PCL reconstruction or chronic PCL instability have an additional risk of meniscal tear and osteoarthritis (OA) development. PCL reconstruction failures may be associated with a decreased tibial slope and varus malalignment, which further increases the risk of subsequent meniscal and cartilage injuries. A slope increasing medial opening-wedge proximal tibial osteotomy (MOWPTO) has been shown to slow progression of medial knee OA, decrease the amount of PTT in the PCL-deficient knee, protect PCL reconstructions, and postpone the need for a total knee arthroplasty. A revision second-stage PCL reconstruction may be indicated to address ligament instability after the slope increasing MOWPTO heals, if the patient has symptomatic residual PTT. This Technical Note outlines the technique for a slope increasing MOWPTO to offload the PCL and to correct varus malalignment that may accelerate degenerative effects on the medial compartment in the setting of a failed PCL reconstruction and medial compartment OA.
{"title":"Slope Increasing Medial Opening Wedge Proximal Tibial Osteotomy for Preventive Offloading of the Posterior Cruciate Ligament and to Correct Varus Malalignment in the Setting of a Failed Posterior Cruciate Ligament Reconstruction","authors":"Kaitlyn H. Smith B.S. , Nicholas K. Retzer B.S. , Benjiman J. Wilebski M.D., A.T.C. , Luke V. Tollefson B.S. , Matthew T. Rasmussen M.D. , Dustin R. Lee M.D. , Robert F. LaPrade M.D., Ph.D.","doi":"10.1016/j.eats.2025.103948","DOIUrl":"10.1016/j.eats.2025.103948","url":null,"abstract":"<div><div>The primary role of the posterior cruciate ligament (PCL) is to prevent posterior tibial translation (PTT). PCL graft forces increase as the posterior tibial slope decreases. Therefore, in the setting of a failed PCL reconstruction, the posterior tibial slope should be evaluated as a potential factor to offload the PCL graft. Patients with a failed PCL reconstruction or chronic PCL instability have an additional risk of meniscal tear and osteoarthritis (OA) development. PCL reconstruction failures may be associated with a decreased tibial slope and varus malalignment, which further increases the risk of subsequent meniscal and cartilage injuries. A slope increasing medial opening-wedge proximal tibial osteotomy (MOWPTO) has been shown to slow progression of medial knee OA, decrease the amount of PTT in the PCL-deficient knee, protect PCL reconstructions, and postpone the need for a total knee arthroplasty. A revision second-stage PCL reconstruction may be indicated to address ligament instability after the slope increasing MOWPTO heals, if the patient has symptomatic residual PTT. This Technical Note outlines the technique for a slope increasing MOWPTO to offload the PCL and to correct varus malalignment that may accelerate degenerative effects on the medial compartment in the setting of a failed PCL reconstruction and medial compartment OA.</div></div>","PeriodicalId":47827,"journal":{"name":"Arthroscopy Techniques","volume":"14 12","pages":"Article 103948"},"PeriodicalIF":1.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145814256","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 : 2025-12-01DOI: 10.1016/j.eats.2025.103986
Misty Suri M.D., M.S. , Manik Dham , Cameron King M.D. , Brenton Hill , Christopher Adams
Massive irreparable rotator cuff tears present a significant challenge in shoulder pathology, particularly for patients who are not suitable candidates for arthroplasty. Such tears disrupt the mechanical function of the shoulder joint, leading to progressive deterioration of the glenohumeral joint cartilage and the eventual development of rotator cuff arthropathy. Patients typically exhibit pain and a decline in functional capacity, subsequently facing the difficult task of selecting from a multitude of available treatment options. Among these options, arthroscopic biologic tuberoplasty has shown satisfactory clinical outcomes alongside a low rate of reoperation. In addition, the rotator cuff cable, a critical anatomical structure within the shoulder, has been identified as a significant contributor to glenohumeral joint stability. The preservation of the rotator cuff cable's integrity is vital for maintaining function and alleviating strain on the remaining rotator cuff tissue. Consequently, we propose an enhancement to our previous technique of biologic tuberoplasty, which now encompasses anterior/posterior medial cable reconstruction.
{"title":"Arthroscopic Biologic Tuberoplasty With Cable Reconstruction: A Technique for Massive Irreparable Rotator Cuff Tears","authors":"Misty Suri M.D., M.S. , Manik Dham , Cameron King M.D. , Brenton Hill , Christopher Adams","doi":"10.1016/j.eats.2025.103986","DOIUrl":"10.1016/j.eats.2025.103986","url":null,"abstract":"<div><div>Massive irreparable rotator cuff tears present a significant challenge in shoulder pathology, particularly for patients who are not suitable candidates for arthroplasty. Such tears disrupt the mechanical function of the shoulder joint, leading to progressive deterioration of the glenohumeral joint cartilage and the eventual development of rotator cuff arthropathy. Patients typically exhibit pain and a decline in functional capacity, subsequently facing the difficult task of selecting from a multitude of available treatment options. Among these options, arthroscopic biologic tuberoplasty has shown satisfactory clinical outcomes alongside a low rate of reoperation. In addition, the rotator cuff cable, a critical anatomical structure within the shoulder, has been identified as a significant contributor to glenohumeral joint stability. The preservation of the rotator cuff cable's integrity is vital for maintaining function and alleviating strain on the remaining rotator cuff tissue. Consequently, we propose an enhancement to our previous technique of biologic tuberoplasty, which now encompasses anterior/posterior medial cable reconstruction.</div></div>","PeriodicalId":47827,"journal":{"name":"Arthroscopy Techniques","volume":"14 12","pages":"Article 103986"},"PeriodicalIF":1.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145814378","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}
Anatomic anterior cruciate ligament reconstruction (ACLR) aims to replicate the native 3-dimensional architecture of the anterior cruciate ligament (ACL), including its fiber orientation and insertion site, to restore normal knee biomechanics. The anatomic rectangular tunnel ACLR technique, pioneered by Shino et al., creates rectangular tunnels that better replicate the native ACL's fiber alignment compared with conventional round tunnels. Recently, the quadriceps tendon−bone autograft has gained attention because of its large cross-sectional area, strong tensile properties, and lower incidence of anterior knee pain compared with bone−patellar tendon−bone grafts. This technical note describes a layered quadriceps tendon−bone harvesting technique that preserves the third tendon layer while harvesting a sufficient graft with a rectangular bone block. The method uses minimal instruments and relies on anatomical landmarks to ensure reproducibility and graft quality. Benefits of this technique include anatomical reconstruction of the ACL, decreased graft-tunnel mismatch, potential for reduced tunnel widening, and favorable healing as the result of bone-to-bone integration. Limitations include the technical complexity of tendon harvesting, risk of patellar fracture, and a steep learning curve. With appropriate anatomical knowledge and surgical experience, this approach can be a reliable and effective option for anatomic ACLR.
{"title":"A Simple, Anatomical, and Reproducible Technique for Harvesting a Partial-Thickness Layered Rectangular Quadriceps Tendon–Bone Autograft: Using Standard Surgical Instruments","authors":"Yasukazu Yonetani M.D., Ph.D. , Kazunori Shimomura M.D., Ph.D. , Akira Tsujii M.D., Ph.D. , Ayaka Tanaka M.D. , Ryo Miyazaki M.D. , Hidekazu Suzuki M.D. , Masayuki Hamada M.D., Ph.D.","doi":"10.1016/j.eats.2025.103918","DOIUrl":"10.1016/j.eats.2025.103918","url":null,"abstract":"<div><div>Anatomic anterior cruciate ligament reconstruction (ACLR) aims to replicate the native 3-dimensional architecture of the anterior cruciate ligament (ACL), including its fiber orientation and insertion site, to restore normal knee biomechanics. The anatomic rectangular tunnel ACLR technique, pioneered by Shino et al., creates rectangular tunnels that better replicate the native ACL's fiber alignment compared with conventional round tunnels. Recently, the quadriceps tendon−bone autograft has gained attention because of its large cross-sectional area, strong tensile properties, and lower incidence of anterior knee pain compared with bone−patellar tendon−bone grafts. This technical note describes a layered quadriceps tendon−bone harvesting technique that preserves the third tendon layer while harvesting a sufficient graft with a rectangular bone block. The method uses minimal instruments and relies on anatomical landmarks to ensure reproducibility and graft quality. Benefits of this technique include anatomical reconstruction of the ACL, decreased graft-tunnel mismatch, potential for reduced tunnel widening, and favorable healing as the result of bone-to-bone integration. Limitations include the technical complexity of tendon harvesting, risk of patellar fracture, and a steep learning curve. With appropriate anatomical knowledge and surgical experience, this approach can be a reliable and effective option for anatomic ACLR.</div></div>","PeriodicalId":47827,"journal":{"name":"Arthroscopy Techniques","volume":"14 12","pages":"Article 103918"},"PeriodicalIF":1.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145814381","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 : 2025-12-01DOI: 10.1016/j.eats.2025.103965
Dustin J. Kress M.A., Patrick Waldron D.O., Amber N. Lopez B.S., Anderson Lee M.D., Lucas Voyvodic M.D., Nicolas A. Artz M.S.C., Kyle Cantave B.A., Patrick McGahan M.D., Ajith Malige M.D., James L. Chen M.D., M.P.H.
Snapping biceps femoris tendon represents a rare but clinically significant cause of lateral knee pain in young athletes. Anomalous tendon insertions can create pathologic subluxation across the fibular head during knee motion, resulting in mechanical symptoms resistant to conservative treatment. We describe a surgical technique for managing this condition. A 20-year-old male athlete presented with lateral knee snapping caused by accessory biceps femoris insertion on the anterosuperior fibular head. The surgical technique involves release of the accessory tendon band from its aberrant insertion and tenodesis to the native biceps femoris insertion on the posterior fibular head using figure-of-8 suture configuration. This approach preserves tendon function while eliminating pathologic snapping through anatomic restoration of the tendon vector. Biceps femoris accessory tendon tenodesis offers an effective treatment option that maintains biomechanical function while addressing the underlying pathology.
{"title":"Accessory Biceps Femoris Tenotomy and Tenodesis to Biceps Femoris Tendon for Symptomatic Lateral Knee Snapping in Athletes","authors":"Dustin J. Kress M.A., Patrick Waldron D.O., Amber N. Lopez B.S., Anderson Lee M.D., Lucas Voyvodic M.D., Nicolas A. Artz M.S.C., Kyle Cantave B.A., Patrick McGahan M.D., Ajith Malige M.D., James L. Chen M.D., M.P.H.","doi":"10.1016/j.eats.2025.103965","DOIUrl":"10.1016/j.eats.2025.103965","url":null,"abstract":"<div><div>Snapping biceps femoris tendon represents a rare but clinically significant cause of lateral knee pain in young athletes. Anomalous tendon insertions can create pathologic subluxation across the fibular head during knee motion, resulting in mechanical symptoms resistant to conservative treatment. We describe a surgical technique for managing this condition. A 20-year-old male athlete presented with lateral knee snapping caused by accessory biceps femoris insertion on the anterosuperior fibular head. The surgical technique involves release of the accessory tendon band from its aberrant insertion and tenodesis to the native biceps femoris insertion on the posterior fibular head using figure-of-8 suture configuration. This approach preserves tendon function while eliminating pathologic snapping through anatomic restoration of the tendon vector. Biceps femoris accessory tendon tenodesis offers an effective treatment option that maintains biomechanical function while addressing the underlying pathology.</div></div>","PeriodicalId":47827,"journal":{"name":"Arthroscopy Techniques","volume":"14 12","pages":"Article 103965"},"PeriodicalIF":1.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145814436","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}
Many techniques have been described for the reconstruction of the medial patellofemoral ligament (MPFL) in patients with acute or recurrent instability. Most commonly, an MPFL hamstring tendon auto- or allograft is used, attached to the patella and medial femoral condyle using bone tunnels and various fixation implants to ensure stable fixation and graft healing. We describe a surgical technique in which an MPFL semitendinosus graft is inserted in a partial-width transverse patellar bone tunnel (typically 6-6.5 mm in diameter and 15-20 mm in length) and stabilized using adjustable loop cortical button fixation. In the femur, a tunnel is drilled in an oblique superolateral direction (typically 6-6.5 mm in diameter and 30 mm in length), and the graft is inserted and stabilized using an absorbable interference screw. The graft is tightened at 60° of knee flexion and retensioned after knee cycling as necessary, with the adjustable loop button. The described technique affords sufficient initial graft fixation strength, thereby eliminating the need for postoperative immobilization.
{"title":"Single-Bundle Medial Patellofemoral Ligament Reconstruction Using Adjustable-Length Loop Cortical Button Patella Fixation and Interference Screw Femoral Fixation","authors":"Christos K. Yiannakopoulos M.D., Ph.D. , Georgios Kalinterakis M.D. , Apostolos Champipis M.D.","doi":"10.1016/j.eats.2025.103968","DOIUrl":"10.1016/j.eats.2025.103968","url":null,"abstract":"<div><div>Many techniques have been described for the reconstruction of the medial patellofemoral ligament (MPFL) in patients with acute or recurrent instability. Most commonly, an MPFL hamstring tendon auto- or allograft is used, attached to the patella and medial femoral condyle using bone tunnels and various fixation implants to ensure stable fixation and graft healing. We describe a surgical technique in which an MPFL semitendinosus graft is inserted in a partial-width transverse patellar bone tunnel (typically 6-6.5 mm in diameter and 15-20 mm in length) and stabilized using adjustable loop cortical button fixation. In the femur, a tunnel is drilled in an oblique superolateral direction (typically 6-6.5 mm in diameter and 30 mm in length), and the graft is inserted and stabilized using an absorbable interference screw. The graft is tightened at 60° of knee flexion and retensioned after knee cycling as necessary, with the adjustable loop button. The described technique affords sufficient initial graft fixation strength, thereby eliminating the need for postoperative immobilization.</div></div>","PeriodicalId":47827,"journal":{"name":"Arthroscopy Techniques","volume":"14 12","pages":"Article 103968"},"PeriodicalIF":1.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145814438","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 : 2025-12-01DOI: 10.1016/j.eats.2025.103840
Sergio Augusto Campolina de Azeredo M.D. , Maria Mascarenhas , Rodrigo de Paula Mascarenhas Vaz M.D. , Camila Cohen Kaleka M.D., Ph.D. , Pedro Debieux M.D., Ph.D.
The integration of extra-articular procedures in anterior cruciate ligament (ACL) reconstruction is crucial, especially in the context of the high incidence of ACL injuries, which are a leading cause of knee instability and potential progression to post-traumatic osteoarthritis. Injuries to the anterolateral ligament (ALL) and knee capsule are present in nearly 90% of ACL ruptures and are associated with significant rotational instability and grade 3 pivot-shift displacement. This study outlines a technique using the internal brace, a biocompatible device made of ultra-high-molecular-weight polyethylene fibers, not only to augment the ACL reconstruction but also to reinforce the ALL repair. Historically used across various ligament reconstructions, the internal brace aims to enhance postsurgical stability of the knee without increasing morbidity. This approach combines primary ACL reconstruction through arthroscopy with percutaneous reinforcement of the ALL. The method is designed to improve knee function and stability after reconstruction, thereby reducing the risk of ACL rerupture, protecting meniscal repairs, and increasing the rate of return to preinjury athletic performance.
{"title":"Reconstruction of the Anterior Cruciate Ligament and Anterolateral Ligament Using Internal Brace","authors":"Sergio Augusto Campolina de Azeredo M.D. , Maria Mascarenhas , Rodrigo de Paula Mascarenhas Vaz M.D. , Camila Cohen Kaleka M.D., Ph.D. , Pedro Debieux M.D., Ph.D.","doi":"10.1016/j.eats.2025.103840","DOIUrl":"10.1016/j.eats.2025.103840","url":null,"abstract":"<div><div>The integration of extra-articular procedures in anterior cruciate ligament (ACL) reconstruction is crucial, especially in the context of the high incidence of ACL injuries, which are a leading cause of knee instability and potential progression to post-traumatic osteoarthritis. Injuries to the anterolateral ligament (ALL) and knee capsule are present in nearly 90% of ACL ruptures and are associated with significant rotational instability and grade 3 pivot-shift displacement. This study outlines a technique using the internal brace, a biocompatible device made of ultra-high-molecular-weight polyethylene fibers, not only to augment the ACL reconstruction but also to reinforce the ALL repair. Historically used across various ligament reconstructions, the internal brace aims to enhance postsurgical stability of the knee without increasing morbidity. This approach combines primary ACL reconstruction through arthroscopy with percutaneous reinforcement of the ALL. The method is designed to improve knee function and stability after reconstruction, thereby reducing the risk of ACL rerupture, protecting meniscal repairs, and increasing the rate of return to preinjury athletic performance.</div></div>","PeriodicalId":47827,"journal":{"name":"Arthroscopy Techniques","volume":"14 12","pages":"Article 103840"},"PeriodicalIF":1.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145814090","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}
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