Arthroscopy Techniques最新文献

Injuries to articular cartilage caused by a variety of factors are common clinically and can impair quality of life and lead to long-term dysfunction in a manner similar to osteoarthritis, which has led to the development of various repair techniques for articular cartilage injury. Although each technique has its own limitations and advantages, matrix-induced autologous chondrocyte implantation has been widely used and achieved good clinical results. We present a technique for fixing biofilms with absorbable nails with a “Roman column structure” as the main structure. The described technique allows stable immobilization of the biofilm while ensuring that subsequent cartilage damage repair can proceed smoothly.

Distal iliotibial band (ITB) syndrome is the most common cause of lateral knee pain in runners. If the ITB is too tight, the repetitive knee flexion associated with sports may lead to compression of the vascularized fat pad in the sub-ITB space or development of sub-ITB adventitious bursitis as the band crosses over the lateral femoral epicondyle and the ITB itself is normal. Distal ITB syndrome usually responds to conservative treatment. The presence of any underlying causes, for example, exostosis at the sub-ITB space, should be explored in recalcitrant cases of distal ITB syndrome. Although open surgical excision is the treatment of choice for extra-articular exostosis, the surgical risk and complication rates have been reported as high as 13%. Endoscopic resection of extra-articular exostosis has been proposed to reduce the complication rates. The purpose of this technical note is to describe the details of arthroscopic management of endoscopic resection of distal femoral exostosis that causes distal ITB syndrome.

Residual pain in the early postoperative phase after hallux valgus surgery is common, but persistent plantar pain of the first metatarsophalangeal joint after surgery is rare. This can be due to intra- or extra-articular causes. Metatarsosesamoid arthroscopy is effective for the management of intra-articular causes of plantar pain. The purpose of this technical note is to describe the details of metatarsosesamoid arthroscopy for the management of plantar pain of the first metatarsophalangeal joint after surgical correction of hallux valgus deformity.

Physical examination of knee ligament injuries often is considered subjective and imprecise as the result of various factors affecting its reliability. Magnetic resonance imaging is widely used but lacks information on ligament function and is costly. Stress radiography is commonly employed, but alternatives are sought because of radiation exposure and the need for a physician’s presence during the procedure. Ultrasonography represents a noninvasive, rapid, and cost-effective method for assessing knee injuries. This Technical Note presents stress ultrasonography protocols for evaluating medial and lateral tibiofemoral openings in patients with posteromedial corner and/or posterolateral corner injuries. The ultrasonography examination parameters are detailed for both the medial collateral ligament and lateral collateral ligament evaluation. Studies have associated certain degrees of tibiofemoral opening with knee ligament injuries, aiding surgeons in surgical decision-making. Examination with stress ultrasonography offers a dynamic and reproducible method without adverse effects for patients, potentially expediting the diagnosis and treatment of multiligament knee injuries.

Medial meniscus posterior root tear (MMPRT) is a common medial meniscus injury among elderly patients and often necessitates repair. Although the clinical outcomes of MMPRT repair have demonstrated improvements, subsequent second-look arthroscopy shows poor healing postrepair. Consequently, numerous repair techniques have been reported. Herein, we introduce a simple locking-suture method, the “delta-grip” stitch, for MMPRT repair. This technique exhibited sufficient pullout strength compared with conventional suturing methods, offering promising prospects for enhancing the outcomes of MMPRT repair.

Tibial spine avulsion injuries, including fractures, are a variant of anterior cruciate ligament injuries. Treatment historically consisted of open reduction and internal fixation of the avulsion fracture, with anterior cruciate ligament reconstruction considered in cases of failed open reduction and internal fixation or residual laxity. However, improved instrumentation has led to the advancement of various arthroscopic techniques for addressing these injuries. The emergence of newer implants designed for all-suture fixation has also overcome the limitations associated with screw fixation, such as hardware-related complications, challenges in treating comminuted fractures, and potential physeal injury. The purpose of this article is to describe a technique consisting of arthroscopic-assisted reduction and internal fixation of a tibial spine avulsion fracture with a re-tensionable all-suture–based construct using multiple looped cinch stitches and a cortical suspensory suture button device.