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Peritrochanteric Endoscopy Through Standard Hip Arthroscopy Portals: A Stepwise Approach for Diagnostic Evaluation 通过标准髋关节镜入口的转子周围内窥镜检查:一种诊断评估的逐步方法
IF 1.1 Q3 ORTHOPEDICS Pub Date : 2025-12-01 DOI: 10.1016/j.eats.2025.103979
Ady H. Kahana-Rojkind M.D. , Isabella A. Wallace B.A. , Talha Syed B.S. , Roger Quesada-Jimenez M.D. , Etan Sugarman M.D. , Benjamin G. Domb M.D.
Peritrochanteric endoscopy allows direct visualization of abductor tendons, the iliotibial band, and the trochanteric bursa, and it can be seamlessly performed at the conclusion of hip arthroscopy using the same portals. This Technical Note outlines a systematic approach to access and evaluate the peritrochanteric space endoscopically without repositioning or redraping. The technique emphasizes safe cannula placement using fluoroscopy, blunt dissection under the iliotibial band, and a methodical diagnostic survey of the gluteus medius, gluteus minimus, vastus lateralis, gluteus maximus insertion, and overlying structures. This approach facilitates early identification of pathology that may be missed on magnetic resonance imaging and guides decision-making for further treatment. Early diagnostic access may improve clinical outcomes by enabling timely identification and treatment of extra-articular pathology within the same surgical session.
转子周围内窥镜可以直接看到外展肌腱、髂胫束和转子滑囊,并且可以在髋关节镜检查结束时使用相同的入口无缝地进行。本技术说明概述了一种系统的方法,无需重新定位或重新覆盖,即可在内窥镜下进入和评估转子周围空间。该技术强调在透视下安全放置套管,在髂胫束下钝性剥离,并对臀中肌、臀小肌、股外侧肌、臀大肌止点和上覆结构进行系统的诊断检查。这种方法有助于早期识别磁共振成像可能遗漏的病理,并指导进一步治疗的决策。早期诊断可以通过在同一手术期间及时识别和治疗关节外病理来改善临床结果。
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引用次数: 0
Arthroscopic Autologous Iliac Crest Bone Grafting for Augmentation of Glenoid Bone Loss Using Suture Anchor Fixation Combined With the Remplissage Procedure 关节镜下自体髂骨植骨加缝合锚钉固定联合复位术治疗关节盂骨缺损
IF 1.1 Q3 ORTHOPEDICS Pub Date : 2025-12-01 DOI: 10.1016/j.eats.2025.103952
Zhimian Zhang M.D., Xiaobing Xiang M.D., Jianfa Chen M.D., Jie Li M.D., Yuanyuan Wang M.D.
For patients experiencing recurrent anterior shoulder dislocation with accompanying glenoid bone loss, glenoid reconstruction via bone grafting is crucial for restoring joint stability. Current fixation methods can be classified into rigid approaches, such as compression screws, and nonrigid alternatives, including suture button plates and suture anchors. While rigid fixation carries risks associated with stress shielding–induced graft resorption and potential screw impingement, nonrigid fixation techniques, such as suture button methods, present their own set of challenges, necessitating specialized instrumentation for precise bone tunnel preparation. This article describes an innovative modification of the Eden-Hybinette technique that employs anchor-based nonrigid fixation. Performed entirely through an intra-articular approach, this method offers dual advantages: it significantly simplifies the surgical procedure while mitigating the complications associated with the retention of permanent metallic hardware in the glenoid.
对于复发性肩关节前脱位伴肩关节盂骨丢失的患者,通过植骨重建肩关节盂是恢复关节稳定性的关键。目前的固定方法可分为刚性方法,如加压螺钉和非刚性方法,包括缝合扣板和缝合锚钉。虽然刚性固定存在应力屏蔽诱导的移植物吸收和潜在的螺钉撞击的风险,但非刚性固定技术,如缝线扣方法,存在其自身的一系列挑战,需要专门的器械来精确地准备骨隧道。本文描述了Eden-Hybinette技术的创新改进,采用锚定非刚性固定。该方法完全通过关节内入路进行,具有双重优势:它显著简化了手术过程,同时减轻了与关节盂内永久金属内固定相关的并发症。
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引用次数: 0
Continuous Bone–Quadriceps Tendon–Rectus Femoris Autograft for Revision Anterior Cruciate Ligament and Anterolateral Ligament Reconstructions 连续骨-股四头肌肌腱-股直肌自体移植物修复前交叉韧带和前外侧韧带重建
IF 1.1 Q3 ORTHOPEDICS Pub Date : 2025-12-01 DOI: 10.1016/j.eats.2025.103985
Vincent Morin M.D. , Guillaume Veyrat M.D. , Enora Pennec R.N. , Benoit Gaulin M.D., M.Sc. , Pierre Girard M.D. , Matthieu Ollivier M.D., Ph.D. , Clément Horteur M.D., M.Sc.
Revision anterior cruciate ligament (ACL) reconstruction is a frequent procedure due to the significant incidence of rupture following primary reconstruction. Achieving strong graft fixation alongside favorable biological conditions is essential for optimal graft healing, which can present challenges in the context of revision surgery. Additionally, the addition of anterolateral ligament reconstruction is recommended during revision procedures, necessitating adequate graft length or the use of a secondary harvest site. Consequently, the selection of an appropriate autograft for revision ACL reconstruction is critical to satisfy these requirements. Recently, the rectus femoris tendon and its aponeurosis have been proposed as viable autograft options for ACL reconstruction. Herein, we describe the surgical technique for combined ACL and anterolateral ligament reconstruction using a continuous autograft composed of a patellar bone block, partial-thickness quadriceps tendon, and the rectus femoris tendon and aponeurosis.
前交叉韧带(ACL)重建是一种常见的手术,因为在初次重建后会发生严重的断裂。在良好的生物条件下实现强大的移植物固定对于最佳的移植物愈合是必不可少的,这在翻修手术的背景下可能会带来挑战。此外,建议在翻修过程中增加前外侧韧带重建,需要足够的移植物长度或使用二次收获部位。因此,选择合适的自体移植物进行ACL重建是满足这些要求的关键。最近,股直肌腱及其腱膜被认为是ACL重建的可行自体移植物。在此,我们描述了联合前交叉韧带和前外侧韧带重建的手术技术,使用由髌骨块、部分厚度的股四头肌肌腱、股直肌肌腱和腱膜组成的连续自体移植物。
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引用次数: 0
Isolated Osteochondral Autograft Mosaicplasty for In Situ Fixation of Unstable Osteochondritis Dissecans in Skeletally Mature Patients 离体自体骨软骨镶嵌成形术原位固定成熟骨不稳定夹层性骨软骨炎
IF 1.1 Q3 ORTHOPEDICS Pub Date : 2025-12-01 DOI: 10.1016/j.eats.2025.103972
Stephanie O’Brien M.B. B.Ch. B.A.O. , Peter S.E. Davies M.B.ChB., F.R.C.S. (Tr&Orth), P.G. Cert. Med. Ed. (Surgery), M.F.S.T.Ed. , Rebecca Rogers M.B. B.Ch. B.A.O. , Alistair I.W. Mayne M.B.ChB. (Hons), M.Sc., F.R.C.S. (Tr&Orth) , Peter Edwards Ph.D. , Jay Ebert Ph.D. , Peter A. D’Alessandro M.B.B.S. (Hons), F.R.A.C.S., F.A.OrthA.
Osteochondritis dissecans of the adult knee may result in unstable lesions that cause pain and mechanical symptoms. These often require surgery due to the failure of conservative management. Surgical techniques aim to retain the fragment where possible. Mosaicplasty for in situ fixation provides mechanical stability and a biological stimulus without the need for additional hardware. This all-arthroscopic technique uses osteochondral autograft plugs harvested from a nonweightbearing part of the knee to bridge through the lesion into the subchondral bone. Graft diameter and length can be tailored to the lesion and patient. Postoperatively, patients commence early range-of-motion exercises and follow a graduated weightbearing protocol.
成人膝关节夹层性骨软骨炎可导致不稳定病变,引起疼痛和机械症状。这些通常需要手术治疗,因为保守治疗失败。手术技术的目的是尽可能保留碎片。原位固定的镶嵌成形术提供了机械稳定性和生物刺激,而不需要额外的硬件。这种全关节镜技术使用从膝关节非承重部位获得的自体骨软骨移植桥塞,通过病变进入软骨下骨。移植物的直径和长度可以根据病变和患者量身定制。术后,患者开始早期活动范围练习,并遵循分级负重方案。
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引用次数: 0
Combined Trochleaplasty, Lateral Retinacular Lengthening, and Medial Patellofemoral Ligament Reconstruction Using Quadriceps Tendon 用股四头肌肌腱联合滑车成形术、外侧支持带延长和内侧髌股韧带重建
IF 1.1 Q3 ORTHOPEDICS Pub Date : 2025-12-01 DOI: 10.1016/j.eats.2025.103977
Julian Mehl M.D., Sebastian Siebenlist M.D., Lukas Willinger M.D.
Chronic and recurrent patellar instability frequently is associated with trochlear dysplasia, lateral retinacular tightness, and medial patellofemoral ligament (MPFL) insufficiency. Combined surgical correction addressing all pathologic factors is critical to restoring patellar stability. This Technical Note presents a detailed and reproducible surgical technique combining deepening trochleaplasty, lateral retinacular lengthening, and MPFL reconstruction using a quadriceps tendon autograft. Trochleaplasty is performed using a thin-flap technique to create a new, stable trochlear groove. Lateral retinacular lengthening is carried out via a stepwise Z-plasty, and an anatomic MPFL reconstruction is accomplished with a partial-thickness quadriceps tendon graft without patellar bone tunnels. This comprehensive approach aims to restore patellar tracking, reduce pain, and prevent recurrent dislocations. The described technique offers a systematic strategy for treating complex patellar instability while preserving joint congruency and minimizing complications.
慢性和复发性髌骨不稳定常与滑车发育不良、外侧支持带紧、内侧髌股韧带(MPFL)不全有关。针对所有病理因素的联合手术矫正对恢复髌骨稳定性至关重要。本技术报告介绍了一种详细且可重复的手术技术,结合了滑车加深成形术、外侧支持带延长术和使用自体股四头肌腱重建MPFL。滑车成形术采用薄瓣技术来创造一个新的、稳定的滑车沟。通过渐进式z形成形术进行外侧支持带延长,并通过不带髌骨隧道的部分厚度股四头肌腱移植完成解剖性MPFL重建。这种综合方法旨在恢复髌骨追踪,减轻疼痛并防止复发性脱位。所描述的技术提供了一种系统的策略来治疗复杂的髌骨不稳,同时保持关节一致性并尽量减少并发症。
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引用次数: 0
An Arthroscopic Upper Superior Capsule Reconstruction Using a U-Fold Long Head of the Biceps Tendon Autograft for the Treatment of Irreparable Massive Rotator Cuff Tears 关节镜下使用u型长头自体肱二头肌腱重建上囊治疗不可修复的大面积肩袖撕裂
IF 1.1 Q3 ORTHOPEDICS Pub Date : 2025-12-01 DOI: 10.1016/j.eats.2025.103950
Yang Chen M.D., Haijun Zhang M.D., Bo Zhang M.D., Pengzhen Gu M.D., Qiaojie Chen M.D.
We describe an arthroscopic technique utilizing the long head of the biceps tendon (LHBT) for U-fold reconstruction of the upper articular capsule in treating irreparable massive rotator cuff tears. For patients with irreparable massive rotator cuff tears but intact LHBT, the U-fold LHBT is further sutured to the retracted rotator cuff tissues to achieve bridging. This technique aims to reinforce the superior capsular constraint and facilitate integration with the remaining rotator cuff tissue. It emphasizes graft preparation and fixation without the need for additional biomaterials, offering a potential alternative in the surgical treatment of irreparable massive rotator cuff defects.
我们描述了一种关节镜技术,利用二头肌肌腱长头(LHBT)进行u型重建上关节囊,以治疗不可修复的大面积肩袖撕裂。对于无法修复的大量肩袖撕裂但LHBT完好的患者,进一步将u型LHBT缝合到缩回的肩袖组织以实现桥接。这项技术的目的是加强上囊约束,促进与剩余的肩袖组织的融合。它强调移植物的准备和固定,而不需要额外的生物材料,为外科治疗不可修复的大面积肩袖缺损提供了潜在的选择。
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引用次数: 0
Acellular Dermal Graft Augmentation Technique for Arthroscopic Rotator Cuff Repair 脱细胞真皮增强技术用于关节镜下肩袖修复
IF 1.1 Q3 ORTHOPEDICS Pub Date : 2025-12-01 DOI: 10.1016/j.eats.2025.103878
Maria Victoria Pomenta M.D., Albert Arman M.D., Lluis Peidro M.D., Ph.D., Leticia Torres M.D., Raquel Garcia M.D., Sergi Sastre M.D., Ph.D.
The arthroscopic reconstruction of the rotator cuff is currently regarded as the gold standard when a complete tendon rupture occurs. However, many studies have shown different failure rates after repair. We present a technique for a full-thickness acellular dermal matrix augmentation for arthroscopic rotator cuff repair. Augmentation with allografts has been shown to improve the initial strength of the reconstruction and support the healing and remodeling, which in turn reduces the risk of failure. This technique could potentially benefit patients functionally.
关节镜下肩袖重建目前被认为是发生完全性肌腱断裂时的金标准。然而,许多研究显示修复后的故障率不同。我们提出一种全层脱细胞真皮基质增强技术用于关节镜下肩袖修复。同种异体移植物的增强已被证明可以提高重建的初始强度,支持愈合和重塑,从而降低失败的风险。这项技术可能在功能上对患者有益。
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引用次数: 0
Arthroscopically-Assisted Medial Collateral Ligament Repair of Proximal Tears with Inside-out Suture Technique 关节镜辅助下内侧副韧带近端撕裂的内外侧缝合修复
IF 1.1 Q3 ORTHOPEDICS Pub Date : 2025-12-01 DOI: 10.1016/j.eats.2025.103951
Chun-Lin Tao B.S. , Wei-Lin Chang M.D. , Kun-Hui Chen M.D. , En-Rung Chiang M.D., Ph.D. , Hsuan-Hsiao Ma M.D.
Medial collateral ligament (MCL) injuries are among the most common ligamentous injuries of the knee. Although most MCL injuries have favorable outcomes with conservative treatment, surgical intervention may be considered in cases of chronic instability or in conjunction with injuries to other knee structures, such as the anterior cruciate ligament or meniscus. In this Technical Note, we describe a minimally invasive arthroscopic-assisted technique for femoral-sided MCL repair using an inside-out suture method with suture anchor fixation and internal bracing using FiberTape. This technique offers biomechanical support, proprioceptive preservation, and reduced soft-tissue trauma. Although early results are promising, further long-term studies are warranted to assess durability, clinical outcomes, and potential complications.
内侧副韧带(MCL)损伤是膝关节最常见的韧带损伤。尽管大多数MCL损伤保守治疗效果良好,但在慢性不稳定或合并其他膝关节结构损伤(如前交叉韧带或半月板)的情况下,可以考虑手术干预。在这篇技术笔记中,我们描述了一种微创关节镜辅助技术,用于股骨侧MCL的修复,采用由内到外缝合方法,缝合锚固定和使用FiberTape的内支具。该技术提供生物力学支持、本体感觉保存和减少软组织创伤。虽然早期的结果很有希望,但需要进一步的长期研究来评估其耐久性、临床结果和潜在的并发症。
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引用次数: 0
All-Suture Cortical Button Fixation in All-Inside Anterior Cruciate Ligament Reconstruction With Quadriceps Tendon Autograft 自体股四头肌肌腱全内前交叉韧带重建的全缝合皮质扣固定
IF 1.1 Q3 ORTHOPEDICS Pub Date : 2025-12-01 DOI: 10.1016/j.eats.2025.103956
Evan H. Richman M.D. , Jack C. Hop M.D. , Beau M. McGinley M.D. , Jeremy M. Burnham M.D. , Justin J. Mitchell M.D. , Aaron J. Krych M.D. , Rachel M. Frank M.D.
The all-inside anterior cruciate ligament reconstruction technique has gained popularity because of its ability to preserve bone stock, accommodate shorter graft lengths, and reduce postoperative pain. Traditionally, this technique uses metallic cortical suspensory buttons for graft fixation, which are reliable but may cause soft-tissue irritation and hardware prominence. A recent modification to traditional all-inside suspensory fixation uses all-suture cortical buttons, eliminating the need for metallic or screw-based implants while maintaining secure fixation. This Technical Note describes an all-inside anterior cruciate ligament reconstruction technique that uses an all–soft tissue quadriceps tendon autograft, secured with only suture-based buttons (no metal, no plastic) on both the femoral and tibial sides.
全内交叉韧带重建技术因其保留骨储备、适应较短的移植物长度和减少术后疼痛的能力而受到欢迎。传统上,该技术使用金属皮质悬吊按钮进行移植物固定,该方法可靠,但可能引起软组织刺激和硬件突出。最近对传统全内悬吊固定的改进使用全缝线皮质按钮,在保持固定安全的同时消除了金属或螺钉植入物的需要。本技术说明描述了一种全内部前交叉韧带重建技术,该技术使用全软组织股四头肌腱自体移植物,仅在股骨和胫骨两侧使用基于缝合线的按钮(无金属,无塑料)进行固定。
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引用次数: 0
An All-Inside All-Suture Technique for Meniscal Allograft Transplantation: The Chinese Way 半月板同种异体移植全内全缝合技术:中国方法
IF 1.1 Q3 ORTHOPEDICS Pub Date : 2025-12-01 DOI: 10.1016/j.eats.2025.103778
Hao Qin M.M. , Chengjie Lian M.D. , Wenlong Yan M.D. , Hao Tan M.M. , Zihang Xie M.M. , Aiguo Zhou M.D. , Hua Zhang M.D.
Current suturing techniques used in meniscal allograft transplantation pose risks of damaging blood vessels and nerves, and they conflict with patients’ esthetic needs, impacting the prognosis of the graft and patient satisfaction. This article introduces an all-inside all-suture technique for suturing and securing grafts during meniscal allograft transplantation procedures. This technique offers a more physiological alignment and fixation for the graft and joint capsule, ensuring graft stability while significantly reducing the risk of vascular and neural injuries in the knee joint and postoperative complications. Additionally, it eliminates the need for extra safety incisions, improving postoperative esthetics and patient satisfaction.
目前用于同种异体半月板移植的缝合技术存在破坏血管和神经的风险,并且与患者的审美需求相冲突,影响移植物的预后和患者的满意度。本文介绍了一种全内全缝合技术,用于半月板同种异体移植手术中缝合和固定移植物。该技术为移植物和关节囊提供了更生理的对准和固定,确保移植物的稳定性,同时显著降低膝关节血管和神经损伤的风险以及术后并发症。此外,它消除了额外的安全切口的需要,提高了术后美观和患者满意度。
{"title":"An All-Inside All-Suture Technique for Meniscal Allograft Transplantation: The Chinese Way","authors":"Hao Qin M.M. ,&nbsp;Chengjie Lian M.D. ,&nbsp;Wenlong Yan M.D. ,&nbsp;Hao Tan M.M. ,&nbsp;Zihang Xie M.M. ,&nbsp;Aiguo Zhou M.D. ,&nbsp;Hua Zhang M.D.","doi":"10.1016/j.eats.2025.103778","DOIUrl":"10.1016/j.eats.2025.103778","url":null,"abstract":"<div><div>Current suturing techniques used in meniscal allograft transplantation pose risks of damaging blood vessels and nerves, and they conflict with patients’ esthetic needs, impacting the prognosis of the graft and patient satisfaction. This article introduces an all-inside all-suture technique for suturing and securing grafts during meniscal allograft transplantation procedures. This technique offers a more physiological alignment and fixation for the graft and joint capsule, ensuring graft stability while significantly reducing the risk of vascular and neural injuries in the knee joint and postoperative complications. Additionally, it eliminates the need for extra safety incisions, improving postoperative esthetics and patient satisfaction.</div></div>","PeriodicalId":47827,"journal":{"name":"Arthroscopy Techniques","volume":"14 12","pages":"Article 103778"},"PeriodicalIF":1.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145814088","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}
引用次数: 0
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Arthroscopy Techniques
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