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1

Arthroscopic Hip Labral Repair  

PubMed Central

Labral tears in the hip may cause painful clicking or locking of the hip, reduced range of motion, and disruption to sports and daily activities. The acetabular labrum aids stabilization of the hip joint, particularly during hip motion. The fibrocartilaginous structure extends the acetabular rim and provides a suction seal around the femoroacetabular interface. Treatment options for labral tears include debridement, repair, and reconstruction. Repair of the labrum has been shown to have better results than debridement. Labral refixation is achieved with sutures anchored into the acetabular rim. The acetabular rim is trimmed either to correct pincer impingement or to provide a bleeding bed to improve healing. Labral repair has shown excellent short-term to midterm outcomes and allows patients to return to activities and sports. Arthroscopic rim trimming and labral refixation comprise an effective treatment for labral tears with an underlying diagnosis of femoroacetabular impingement and are supported by the peer-reviewed literature. PMID:23875153

Philippon, Marc J.; Faucet, Scott C.; Briggs, Karen K.

2013-01-01

2

Arthroscopic Repairs of Triangular Fibrocartilage Complex Tears  

Microsoft Academic Search

Technical advancements in arthroscopic wrist procedures have improved our knowledge of normal and abnormal intraarticular wrist function. Triangular fibrocartilage complex (TFCC) tears from trauma injuries are a common source of ulnar-sided wrist pain. Fortunately, the TFCC is a structure that can be evaluated and treated arthroscopically with results that are comparable to open surgical procedures. Successful arthroscopic repairs of TFCC

Patricia Baehser-Griffith; John M. Bednar; A. Lee Osterman; Randall Culp

1997-01-01

3

Arthroscopic meniscus repair  

Microsoft Academic Search

From February 1982 through July 1987, the author studied 87 patients who had a total of 116 meniscus tears, 96 of which were repaired. Seventy patients (79 meniscus repairs) had postoperative followup ranging from 12 months to 5½ years (mean, 39 months). The patients' ages ranged from 14 to 51 years with a mean age of 22. The time from

Donald B. Miller

1988-01-01

4

All-arthroscopic rotator cuff repair.  

PubMed

All-arthroscopic rotator cuff repair has evolved into a viable surgical option, with outcome results equal to that of mini-open and open rotator cuff repair, with less perioperative morbidity and is driven by patient demand. The technique has required refinement of arthroscopic surgical techniques, and further advances from industry to provide alternative tools and techniques to make the procedure technically easier. This manuscript discusses all aspects of arthroscopic rotator cuff repair, and covers the evolution of the technique and provides a step-by-step technique to be used to accomplish a successful rotator cuff repair. PMID:18004220

Fouse, Matthew; Nottage, Wesley M

2007-12-01

5

Arthroscopic knots and strength sutures for rotator cuff repair.  

PubMed

Most arthroscopic rotator cuff reconstruction techniques require a method of securing the tendon to the bone to obtain a stable construct. The available options include knotless technology and suture welding, but the most common method uses suture anchors and knots. Tissue quality, surgical technique, repair material, and tension overload influence the stability of tissue repair. Arthroscopic knots are technically demanding because they are tied through cannulas with long-handled knot pushers. The strength of the repair is also influenced by the suture material used. In this study, we review the state-of-the-art of arthroscopic knots and suture materials being used for arthroscopic rotator cuff repair. PMID:21822109

Longo, Umile Giuseppe; Buchmann, Stefan; Berton, Alessandra; Maffulli, Nicola; Denaro, Vincenzo

2011-09-01

6

Open versus Two Forms of Arthroscopic Rotator Cuff Repair  

PubMed Central

There have been technologic advances in the methods for repairing torn rotator cuffs. We compared the clinical and structural outcomes of three different forms of rotator cuff repair with up to 24 months’ followup. We wished to assess how surgical technique affected clinical outcomes and see how these correlated to repair integrity. Three cohorts of patients had repair of a symptomatic rotator cuff tear using (1) an open technique (n = 49); (2) arthroscopic knotted (n = 53); or (3) arthroscopic knotless (n = 57) by one surgeon. Standardized patient- and examiner-determined outcomes were obtained preoperatively and at 6 weeks, 3 and 6 months, and 2 years postoperatively. Ultrasound studies were performed with a validated protocol at 6 months and 2 years postsurgery. Clinical outcomes were similar with the exception that the arthroscopic groups had, on average, 20% better American Shoulder and Elbow Surgeons scores than the open group at 6 months and 2 years. Retear correlated with tear size and operation time and occurred more frequently after open repair (39%) than after arthroscopic knotted (25%) and arthroscopic knotless (16%) repair. An intact cuff on ultrasound corresponded to better results for supraspinatus strength, patient outcomes, and rotator cuff functional ability. Level of Evidence: Level III, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence. PMID:19184264

Millar, Neal L.; Wu, Xiao; Tantau, Robyn; Silverstone, Elizabeth

2009-01-01

7

Arthroscopic Repair of Rotator Cuff Tears Using Extracellular Matrix Graft  

PubMed Central

Despite advances in surgical technology, as well as generally good outcomes, repairs of full-thickness rotator cuff tears show a retear rate of 25% to 57% and may fail to provide full return of function. The repairs tend to fail at the suture-tendon junction, which is due to several factors, including tension at the repair site, quality of the tendon, and defective tissue repair. One strategy to augment repair of large to massive rotator cuff tears is the development of biological scaffold materials, composed of extracellular matrix (ECM). The goal is to strengthen and evenly distribute the mechanical load across the repair site, thus minimizing the rupture risk of the native tendon while providing the biological elements needed for healing. The promising results of ECM-derived materials and their commercial availability have increased their popularity among shoulder surgeons. In contrast to a traditional open or arthroscopically assisted mini-open approach, this completely arthroscopic technique offers the full advantages warranted by the use of a minimally invasive approach. This technical guide describes arthroscopic rotator cuff repair using an ECM graft technique.

Gilot, Gregory J.; Attia, Ahmed K.; Alvarez, Andres M.

2014-01-01

8

Arthroscopic meniscus repair with bioabsorbable arrows  

Microsoft Academic Search

Purpose: The clinical results of a single surgeon’s experience with Meniscus Arrows (Bionx, Blue Bell, PA) for meniscal repair are reviewed and reported to determine the safety and efficacy of this device. Type of Study: Consecutive sample. Methods: Over a 3-year period, the senior author has used only Meniscus Arrows for all meniscal repairs. All patients who underwent meniscal repair

Timothy S. Petsche; Harlan Selesnick; Adam Rochman

2002-01-01

9

Arthroscopic isolated posterior labral repair in rugby players  

PubMed Central

Background The shoulder is the second most frequently injured joint after the knee in rugby players and labral tears appear to be common. There is limited data available in the literature regarding the mechanisms of posterior labral injury in rugby players and the management of these injuries. Objective The aim of this study is to report the clinical presentation, arthroscopic findings, surgical technique for repair, and the functional outcome in elite English rugby players with isolated posterior labral injuries. Study Design Case series (level IV evidence) Materials and Methods Over a 5-year period we surgically treated 142 elite rugby players, of whom 11 (7.8%) had isolated posterior labral injuries. All these 11 patients had significant contact injury. Only three (24%) patients had a true posterior shoulder dislocation. Pre- and postoperative assessment included Constant score, Oxford shoulder score, and Oxford instability score. We also assessed the time taken to return to preinjury level of fitness and the complications of surgery. Results Average follow-up was for 32 months (range 17–54 months). The mean Constant score improved from 66 to 99. The Oxford score indicated improvement, decreasing from 33 to 18; similarly, the Oxford instability score also decreased from 52.2 to 12.3. Return to playing rugby at peak level was at a mean of 4.3 months after arthroscopic repair. Conclusion Successful clinical results and rapid return to play can be achieved by appropriate early arthroscopic repair and supervised accelerated rehabilitation for posterior labral tears in elite rugby players. PMID:20616949

Badge, Ravi; Tambe, Amol; Funk, Lennard

2009-01-01

10

A Knotless Suture Anchor: Technique for use in arthroscopic Bankart repair.  

PubMed

Arthroscopic Bankart repair performed using suture anchors most closely mimics open repair techniques. One of the challenges with the arthroscopic technique is tying consistent, good-quality arthroscopic knots. The unique Knotless Suture Anchor (Mitek Products, Westwood, MA) and method of use for arthroscopic Bankart repair is described. The Knotless Suture Anchor has a short loop of suture secured to the tail end of the anchor. A channel is located at the tip of the anchor that functions to capture the loop of suture after it has been passed through the ligament. The ligament is tensioned as the anchor is inserted into bone to the appropriate depth. The doubled suture configuration that is created with the loop increases the suture strength in the Knotless Suture Anchor compared with standard suture anchors with the same size suture. To my knowledge, this article describes the first knotless suture anchor. A secure, low-profile repair can be created without arthroscopic knot tying. PMID:11172255

Thal, R

2001-02-01

11

Functional outcome after open and arthroscopic Bankart repair for traumatic shoulder instability  

PubMed Central

Purpose Both open and arthroscopic Bankart repair are established procedures in the treatment of anterior shoulder instability. While the open procedure is still considered as the "golden standard" functional outcome is supposed to be better in the arthroscopic procedure. The aim of this retrospective study was to compare the functional outcome between open and arthroscopic Bankart repair. Materials and methods In 199 patients a Bankart procedure with suture anchors was performed, either arthroscopically in presence of an detached, but not elongated capsulolabral complex (40) or open (159). After a median time of 31 months (12 to 67 months) 174 patients were contacted and agreed to follow-up, 135 after open and 39 after arthroscopic Bankart procedure. Results Re-dislocations occurred in 8% after open and 15% after arthroscopic Bankart procedure. After open surgery 4 of the 11 re-dislocations occurred after a new adequate trauma and 1 of the 6 re-dislocations after arthroscopic surgery. Re-dislocations after arthroscopic procedure occured earlier than after open Bankart repair. An external rotation lag of 20° or more was observed more often (16%) after open than after arthroscopic surgery (3%). The Rowe score demonstrated "good" or "excellent" functional results in 87% after open and in 80% patients after arthroscopic treatment. Conclusion In this retrospective investigation the open Bankart procedure demonstrated good functional results. The arthroscopic treatment without capsular shift resulted in a better range of motion, but showed a tendency towards more frequently and earlier recurrence of instability. Sensitive patient selection for arthroscopic Bankart repair is recommended especially in patients with more than five dislocations. PMID:19258206

2009-01-01

12

Modified technique for arthroscopic Bankart repair using anchor sutures.  

PubMed

Bankart repair, or one of its modifications, is currently the gold standard procedure for treatment of anterior traumatic shoulder instability. It is now possible to perform the operation arthroscopically with the introduction of suture anchors. As described by Eugene Wolf, arthroscopic shoulder stabilization using the Mitek (Mitek Surgical Products, Ethicon, Edinburgh, U.K.) anchors requires two anterior portals and intra-articular knot tying. However, sliding the anchor on the inside limb of a suture loop could be challenging because the other limb could get tangled in the nitinol arc of the anchor. We describe a modification of the original technique to prevent that possibility and avoid any tension on the repair tissue during anchor passage. The proposed modification involves the use of a cheap, readily available silastic feeding tube to isolate the outside limb of the suture loop and stabilize labral tissues while the anchor is being passed. This tube also serves as a stent for knot tying. By allowing the whole operation to be performed through one anterior portal, the modified technique reduces possible morbidity associated with a second portal and further reduces cost. PMID:15243444

Saweeres, Emad S B; Thomas, Andrew P

2004-07-01

13

Arthroscopic rotator cuff repair in elite rugby players  

PubMed Central

Background Rugby is an increasingly popular collision sport. A wide spectrum of injuries can be sustained during training and match play. Rotator cuff injury is uncommon in contact sports and there is little published literature on the treatment of rotator cuff tears in rugby players. Aims We therefore reviewed the results and functional outcomes of arthroscopic rotator cuff repair in elite rugby players. Materials and Methods Eleven professional rugby players underwent arthroscopic rotator cuff repair at our hospital over a 2-year period. We collected data on these patients from the operative records. The patients were recalled for outcome scoring and ultrasound scans. Results There were seven rugby league players and four rugby union players, including six internationals. Their mean age was 25.7 years. All had had a traumatic episode during match play and could not return to the game after the injury. The mean time to surgery was 5 weeks. The mean width of the cuff tear was 1.8 cm. All were full- thickness cuff tears. Associated injuries included two Bankart lesions, one bony Bankart lesion, one posterior labral tear, and two 360° labral tears. The biceps was involved in three cases. Two were debrided and a tenodesis was performed in one. Repair was with suture anchors. Following surgery, all patients underwent a supervised accelerated rehabilitation programme. The final follow-up was at 18 months (range: 6–31 months) post surgery. The Constant scores improved from 44 preoperatively to 99 at the last follow-up. The mean score at 3 months was 95. The Oxford shoulder score improved from 34 to 12, with the mean third month score being 18. The mean time taken to return to full match play at the preinjury level was 4.8 months. There were no complications in any of the patients and postoperative scans in nine patients confirmed that the repairs had healed. Conclusion We conclude that full-thickness rotator cuff tears in the contact athlete can be addressed successfully by arthroscopic repair, with a rapid return to preinjury status. PMID:20616950

Tambe, Amol; Badge, Ravi; Funk, Lennard

2009-01-01

14

Arthroscopic repair of delaminated acetabular articular cartilage in femoroacetabular impingement.  

PubMed

Lesions to articular cartilage can be difficult to treat and directly impact surgical outcome in hip arthroscopy. This article describes a direct cartilage suture repair technique for a young, active individual with full-thickness acetabular cartilage delamination. Lesions of this type are commonly seen with femoroacetabular impingement. A 17-year-old boy presented with bilateral hip pain greater in the right than left. Arthroscopic intervention for the right hip included direct cartilage repair for the cartilage lesion, osteoplasty for femoroacetabular impingement, repair for an anterior labral tear, capsular plication for iliofemoral ligament laxity, and psoas lengthening. Twelve weeks postoperatively, a standard capsular plication, osteoplasty, and chondroplasty were performed on the left hip. At follow-up, the patient reported feeling 95% normal. He noted that the right and left hips were essentially the same. Symptoms consisted of stiffness after prolonged sitting and mild pain following sports. The patient reported being pain free 90% of the time, with pain 2/10 at worst. He scored a 96 on the modified Harris Hip Score, 93 on the Hip Outcome Score Activities of Daily Living subscale, and 81 on the Hip Outcome Score Sports subscale. Overall, the patient was satisfied with the outcome. The direct cartilage repair, in addition to osteoplasty, anterior superior labral repair, iliofemoral capsular plication, and psoas lengthening, produced an excellent outcome in this young, active patient. PMID:19750994

Sekiya, Jon K; Martin, RobRoy L; Lesniak, Bryson P

2009-09-01

15

Arthroscopic Repair of Full-Thickness Tears of the Supraspinatus: Does the Tendon Really Heal?  

Microsoft Academic Search

Background: Good functional results have been reported for arthroscopic repair of rotator cuff tears, but the rate of tendon-to-bone healing is still unknown. Our hypothesis was that arthroscopic repair of full-thickness supraspinatus tears achieves a rate of complete tendon healing equivalent to those reported in the literature with open or mini-open techniques. Methods: Sixty-five consecutive shoulders with a chronic full-thickness

PASCAL BOILEAU; NICOLAS BRASSART; DUNCAN J. WATKINSON; MICHEL CARLES; ARMODIOS M. HATZIDAKIS; SUMANT G. KRISHNAN

16

When Do Rotator Cuff Repairs Fail? Serial Ultrasound Examination After Arthroscopic Repair of Large and Massive Rotator Cuff Tears  

Microsoft Academic Search

Background: Despite advances in arthroscopic repair of rotator cuff tears, recurrent tears after repair of large and massive tears remain a significant clinical problem. The primary objective of this study was to define the timing of structural failure of surgically repaired large and massive rotator cuff tears by serial imaging with ultrasound. The secondary objective of this study was to

Bruce S. Miller; Brian K. Downie; Robert B. Kohen; Theresa Kijek; Bryson Lesniak; Jon A. Jacobson; Richard E. Hughes; James E. Carpenter

2011-01-01

17

Arthroscopic all-inside meniscal repair—Does the meniscus heal?  

Microsoft Academic Search

Objective  The purpose of this study was to correlate clinical and radiological results using a 3-T MRI to verify meniscal healing after\\u000a arthroscopic all-inside meniscus repair.\\u000a \\u000a \\u000a \\u000a \\u000a Materials and methods  We selected 27 patients (14 men and 13 women) with an average age of 31?±?9 years and retrospective clinical examinations\\u000a and radiological assessments using a 3-T MRI after all-inside arthroscopic meniscal repair were conducted.

Thomas Hoffelner; Herbert Resch; Rosemarie Forstner; Mayer Michael; Bernd Minnich; Mark Tauber

2011-01-01

18

Arthroscopic vs mini-open rotator cuff repair. A quality of life impairment study  

Microsoft Academic Search

We compared the clinical and quality of life related outcome of rotator cuff repair performed using either a mini-open or\\u000a an arthroscopic technique for rotator cuff tears of less than 3 cm. The records of 64 patients who underwent rotator cuff\\u000a repair between September 2003 and September 2005 were evaluated. Thirty-two patients underwent a mini-open rotator cuff repair,\\u000a and 32 patients

Leonardo Osti; Rocco Papalia; Massimo Paganelli; Enzo Denaro; Nicola Maffulli

2010-01-01

19

Arthroscopic Repair of Combined Bankart and SLAP Lesions: Operative Techniques and Clinical Results  

PubMed Central

Background To evaluate the clinical results and operation technique of arthroscopic repair of combined Bankart and superior labrum anterior to posterior (SLAP) lesions, all of which had an anterior-inferior Bankart lesion that continued superiorly to include separation of the biceps anchor in the patients presenting recurrent shoulder dislocations. Methods From May 2003 to January 2006, we reviewed 15 cases with combined Bankart and SLAP lesions among 62 patients with recurrent shoulder dislocations who underwent arthroscopic repair. The average age at surgery was 24.2 years (range, 16 to 38 years), with an average follow-up period of 15 months (range, 13 to 28 months). During the operation, we repaired the unstable SLAP lesion first with absorbable suture anchors and then also repaired Bankart lesion from the inferior to superior fashion. We analyzed the preoperative and postoperative results by visual analogue scale (VAS) for pain, the range of motion, American Shoulder and Elbow Surgeon (ASES) and Rowe shoulder scoring systems. We compared the results with the isolated Bankart lesion. Results VAS for pain was decreased from preoperative 4.9 to postoperative 1.9. Mean ASES and Rowe shoulder scores were improved from preoperative 56.4 and 33.7 to postoperative 91.8 and 94.1, respectively. There were no specific complication and no significant limitation of motion more than 10 degree at final follow-up. We found the range of motions after the arthroscopic repair in combined lesions were gained more slowly than in patients with isolated Bankart lesions. Conclusions In recurrent dislocation of the shoulder with combined Bankart and SLAP lesion, arthroscopic repair using absorbable suture anchors produced favorable clinical results. Although it has technical difficulty, the concomitant unstable SLAP lesion should be repaired in a manner that stabilizes the glenohumeral joint, as the Bankart lesion can be repaired if the unstable SLAP lesion is repaired first. PMID:20191000

Cho, Hyung Lae; Lee, Choon Key; Hwang, Tae Hyok; Park, Jong Won

2010-01-01

20

Arthroscopic repair of peripheral triangular fibrocartilage complex tears with suture welding: a technical report.  

PubMed

This report presents a method of arthroscopic repair of the peripheral triangular fibrocartilage complex tears that replaces traditional suture knots with ultrasonic welding of sutures. This will help eliminate potential causes of ulnar-sided wrist discomfort during the postoperative period. PMID:17027791

Badia, Alejandro; Jiménez, Alexis

2006-10-01

21

Impingement syndrome of the shoulder following double row suture anchor technique for arthroscopic rotator cuff repair: a case report  

PubMed Central

Introduction Arthroscopic repair of the rotator cuff is a demanding surgery. Accurate placement of anchors is key to success. Case presentation A 38-year-old woman received arthroscopic repair of her rotator cuff using a double row suture anchor technique. Postoperatively, she developed impingement syndrome which resulted from vertical displacement of a suture anchor once the shoulder was mobilised. The anchor was removed eight weeks following initial surgery and the patient had an uneventful recovery. Conclusion Impingement syndrome following arthroscopic repair of the rotator cuffs using double row suture anchor has not been widely reported. This is the first such case where anchoring has resulted in impingement syndrome. PMID:19830217

2009-01-01

22

Arthroscopic repair of the subscapularis tendon: indications, limits and technical features  

PubMed Central

Summary The rationale to anatomically repair this tendon is to restore the functional biomechanics of the shoulder. Clinical and imaging assessment are required before undertaking arthroscopy. In this way, associated pathologies of the biceps and labrum may be successfully addressed. The arthroscopic repair of the tendon implies to use suture anchors and reinsert the tendon itself over the footprint. Results after arthroscopy are comparable to those observed after open procedures. PMID:24367783

Osti, Leonardo; Soldati, Francesco; Del Buono, Angelo; Buda, Matteo

2013-01-01

23

Arthroscopic repair of the subscapularis tendon: indications, limits and technical features.  

PubMed

The rationale to anatomically repair this tendon is to restore the functional biomechanics of the shoulder. Clinical and imaging assessment are required before undertaking arthroscopy. In this way, associated pathologies of the biceps and labrum may be successfully addressed. The arthroscopic repair of the tendon implies to use suture anchors and reinsert the tendon itself over the footprint. Results after arthroscopy are comparable to those observed after open procedures. PMID:24367783

Osti, Leonardo; Soldati, Francesco; Buono, Angelo Del; Buda, Matteo

2013-01-01

24

Arthroscopic vs mini-open rotator cuff repair. A quality of life impairment study  

PubMed Central

We compared the clinical and quality of life related outcome of rotator cuff repair performed using either a mini-open or an arthroscopic technique for rotator cuff tears of less than 3 cm. The records of 64 patients who underwent rotator cuff repair between September 2003 and September 2005 were evaluated. Thirty-two patients underwent a mini-open rotator cuff repair, and 32 patients underwent an arthroscopic rotator cuff repair. The mean follow-up period was 31 months in the mini-open group and 30.6 months in the arthroscopic group (P?>?0.05). The UCLA rating system, range of motion examination and the self-administered SF-36 used for postoperative evaluation showed a statistically significant improvement from the preoperative to the final score for both groups (P?repair techniques (P?> 0.05). This study suggests that there is no difference in terms of subjective and objective outcomes between the two surgical procedures studied if patients have rotator cuff tears of less than 3 cm. PMID:19424692

Osti, Leonardo; Papalia, Rocco; Paganelli, Massimo; Denaro, Enzo

2009-01-01

25

Arthroscopic vs mini-open rotator cuff repair. A quality of life impairment study.  

PubMed

We compared the clinical and quality of life related outcome of rotator cuff repair performed using either a mini-open or an arthroscopic technique for rotator cuff tears of less than 3 cm. The records of 64 patients who underwent rotator cuff repair between September 2003 and September 2005 were evaluated. Thirty-two patients underwent a mini-open rotator cuff repair, and 32 patients underwent an arthroscopic rotator cuff repair. The mean follow-up period was 31 months in the mini-open group and 30.6 months in the arthroscopic group (P > 0.05). The UCLA rating system, range of motion examination and the self-administered SF-36 used for postoperative evaluation showed a statistically significant improvement from the preoperative to the final score for both groups (P < 0.05). No statistically significant difference in the total UCLA scores was found when comparing the two repair techniques (P > 0.05). This study suggests that there is no difference in terms of subjective and objective outcomes between the two surgical procedures studied if patients have rotator cuff tears of less than 3 cm. PMID:19424692

Osti, Leonardo; Papalia, Rocco; Paganelli, Massimo; Denaro, Enzo; Maffulli, Nicola

2010-03-01

26

Comparison of arthroscopic rotator cuff repair in healthy patients over and under 65 years of age  

Microsoft Academic Search

We compared the outcomes of arthroscopically repaired rotator cuff tears in 28 patients older than 65 years (the over 65 group:\\u000a median age 70 years) with a control group of 28 patients younger than 65 years (the under 65 group: median age 57 years).\\u000a The groups were similar in regard to sex distribution, surgical technique, and post-operative rehabilitation programmes, but\\u000a different in age. After

Leonardo OstiRocco; Rocco Papalia; Angelo Del Buono; Vincenzo Denaro; Nicola Maffulli

2010-01-01

27

Comparison of arthroscopic rotator cuff repair in healthy patients over and under 65 years of age.  

PubMed

We compared the outcomes of arthroscopically repaired rotator cuff tears in 28 patients older than 65 years (the over 65 group: median age 70 years) with a control group of 28 patients younger than 65 years (the under 65 group: median age 57 years). The groups were similar in regard to sex distribution, surgical technique, and post-operative rehabilitation programmes, but different in age. After careful arthroscopic evaluation of the full-thickness rotator cuff tear, rotator cuff repair and biceps tenotomy were performed in all patients. Pre- and post-operatively, each patient was evaluated for range of motion, shoulder score (UCLA), and SF-36 self-administered questionnaire. Comparing pre- versus post-operative status at a minimum 24 months follow-up, forward elevation, internal and external rotation, modified UCLA rating system scores, and SF-36 scores improved significantly in both groups, with no significant difference between the groups. At the last follow-up, strength improved significantly in both groups, with non-significant intergroup difference. The Popeye sign was detected in 13/28 (46%) of the patients in the over 65 group and in 11/28 (39%) in the under 65 group (? = 0.29) with non-significant difference between the two groups. In selected active patients older than 65, arthroscopic rotator cuff repair associated with biceps tenotomy (when necessary) can yield clinical and related quality of life outcomes similar to those of patients younger than 65 years. PMID:20182868

Osti, Leonardo; Papalia, Rocco; Del Buono, Angelo; Denaro, Vincenzo; Maffulli, Nicola

2010-12-01

28

Influence of tendon healing after arthroscopic rotator cuff repair on clinical outcome using single-row Mason-Allen suture technique: a prospective, MRI controlled study  

Microsoft Academic Search

The reported functional results of rotator cuff repair performed arthroscopically have been good. Only little is known about the cuff integrity after arthroscopic repair and how it influences the outcome. The aim of the study is to set a baseline of what rate of healing response respectively re-tears to expect and how cuff integrity alters the outcome. Fifty-three consecutive patients

Sven Lichtenberg; Dennis Liem; Petra Magosch; Peter Habermeyer

2006-01-01

29

Arthroscopic meniscal repair: a comparative study between three different surgical techniques.  

PubMed

The purpose of this prospective study was to evaluate and compare the results of arthroscopic meniscal repair using three different techniques. Between January 2002 and March 2004, 57 patients who met the inclusion criteria underwent an arthroscopic meniscal repair. The outside-in technique was used in 17 patients (group A), the inside-out in 20 patients (group B), while the rest of the 20 patients (group C) were managed by the all-inside technique using the Mitek RapidLoc soft tissue anchor (Mitek Surgical Products, Westwood, MA, USA). Anterior cruciate ligament (ACL) reconstruction was performed in 29 patients (51%). The criteria for clinical success included absence of joint line tenderness, locking, swelling, and a negative McMurray test. The minimum follow-up was one year for all groups. The mean follow-up was 23 months for group A, 22 months for group B, and 22 months for group C. All meniscal repairs were considered healed according to our criteria in group A, while 19 out of 20 repairs (95%) healed in group B. Finally 7 of 20 repairs (35%) were considered failures in group C and this difference was statistically significant in comparison with other groups. The time required for meniscal repair averaged 38.5 min for group A, 18.1 min for group B, and 13.6 min for group C. Operation time for meniscal repair in group A was statistically longer in comparison with other groups. There were no significant differences among the three groups concerning complications. According to our results, arhtroscopic meniscal repair with the inside-out technique seems to be superior in comparison with the other methods because it offers a high rate of meniscus healing without prolonged operation time. PMID:16858558

Hantes, Michael E; Zachos, Vasilios C; Varitimidis, Sokratis E; Dailiana, Zoe H; Karachalios, Theophilos; Malizos, Konstantinos N

2006-12-01

30

Retrospective Analysis of Arthroscopic Superior Labrum Anterior to Posterior Repair: Prognostic Factors Associated with Failure  

PubMed Central

Background. The purpose of this study was to report on any prognostic factors that had a significant effect on clinical outcomes following arthroscopic Type II SLAP repairs. Methods. Consecutive patients who underwent arthroscopic Type II SLAP repair were retrospectively identified and invited to return for follow-up examination and questionnaire. Statistical analysis was performed to determine associations between potential prognostic factors and failure of SLAP repair as defined by ASES of less than 50 and/or revision surgery. Results. Sixty-two patients with an average age of 36 ± 13 years met the study criteria with a mean followup of 3.3 years. There were statistically significant improvements in mean ASES score, forward elevation, and external rotation among patients. Significant associations were identified between ASES score less than 50 and age greater than 40 years; alcohol/tobacco use; coexisting diabetes; pain in the bicipital groove on examination; positive O'Brien's, Speed's, and/or Yergason's tests; and high levels of lifting required at work. There was a significant improvement in ASES at final followup. Conclusions. Patients younger than 20 and overhead throwers had significant associations with cases requiring revision surgery. The results from this study may be used to assist in patient selection for SLAP surgery. PMID:23585969

Frank, Rachel M.; Nho, Shane J.; McGill, Kevin C.; Grumet, Robert C.; Cole, Brian J.; Verma, Nikhil N.; Romeo, Anthony A.

2013-01-01

31

Arthroscopic meniscus repair in the ACL-deficient knee  

Microsoft Academic Search

Between 1985 and 1995, 45 patients underwent closed meniscus repair. There were 30 men and 15 women with a mean age of 32.5 years. In 23 patients, the anterior cruciate ligament was intact (group 1) whereas it was deficient in 22 patients (group 2). All patients were managed with the same postoperative program of partial weight bearing, immediate motion and

F. Steenbrugge; W. Van Nieuwenhuyse; R. Verdonk; K. Verstraete

2005-01-01

32

Outcome and Structural Integrity After Arthroscopic Rotator Cuff Repair Using 2 Rows of FixationMinimum 2Year Follow-Up  

Microsoft Academic Search

Background: Although arthroscopic repairs of the rotator cuff are becoming increasingly popular, security of fixation remains a concern. Two-row repairs have been described, but clinical outcome reports have primarily involved open techniques.Hypothesis: An arthroscopic repair technique that uses 2 rows of fixation produces satisfactory outcome and structural integrity by ultrasonography.Study Design: Case series; Level of evidence, 4.Methods: Forty-eight patients (52

Kyle Anderson; Michael Boothby; Daniel Aschenbrener; Marnix Van Holsbeeck

2006-01-01

33

Arthroscopic versus mini-open rotator cuff repair: a prospective, randomized study with 24-month follow-up.  

PubMed

This prospective, randomized study was performed to evaluate the results of mini-open and arthroscopic rotator cuff repair in a comparative case series of patients followed for 24 months. A total of 125 patients were randomized to mini-open (Group I) or arthroscopic (Group II) rotator cuff repair at the time of surgical intervention. The University of California Los Angeles (UCLA) score, the American Shoulder and Elbow Surgeons (ASES) index, and muscle strength were measured to evaluate the clinical results, while magnetic resonance arthrography was used at 24-month follow-up to investigate the postoperative rotator cuff integrity. Fifty-three patients in Group I and 55 patients in Group II were available for evaluation at 24-month follow-up. At 24-month follow-up, the UCLA score, the ASES index, and muscle strength were statistically significantly increased in both groups postoperatively, while no significant difference was detected between the 2 groups. Intact rotator cuffs were investigated in 42 patients in Group I and 35 in Group II, and there was a significant difference in postoperative structural integrity between the two groups (P < 0.05). When analysis was limited to the patients with full-thickness tear, the muscle strength of the shoulder was significantly better in Group II, and the retearing rate was significantly higher in Group II. Based on the results obtained from this study, it can be indicated that arthroscopic and mini-open rotator cuff repair displayed substantially equal outcomes, except for higher retearing rate in the arthroscopic repair group. While for patients with full-thickness tear, arthroscopic rotator cuff repair displayed better shoulder strength and significantly higher retearing rate as compared to mini-open rotator cuff repair at 24-month follow-up. PMID:23812851

Zhang, Zhenxiang; Gu, Beibei; Zhu, Wei; Zhu, Lixian; Li, Qingsong

2014-08-01

34

A Load-Sharing Rip-Stop Fixation Construct for Arthroscopic Rotator Cuff Repair  

PubMed Central

Despite advancements in arthroscopic rotator cuff repair techniques, achieving tendon-to-bone healing can be difficult in the setting of poor-quality tendon. Moreover, medial tendon tears or tears with lateral tendon loss may preclude standard techniques. Rip-stop suture configurations have been shown to improve load to failure compared with simple or mattress stitch patterns and may be particularly valuable in these settings. The purpose of this report is to describe a technical modification of a rip-stop rotator cuff repair that combines the advantages of a rip-stop suture (by providing resistance to tissue cutout) and a double row of load-sharing suture anchors (minimizing the load per anchor and therefore the load per suture within each anchor). PMID:23766972

Denard, Patrick J.; Burkhart, Stephen S.

2012-01-01

35

Hip Arthroscopic Synovectomy and Labral Repair in a Patient With Rheumatoid Arthritis With a 2-Year Follow-up  

PubMed Central

The arthroscopic surgical procedures reported previously for a rheumatic hip joint have been primarily performed as diagnostic procedures. Only a few studies have reported the success of arthroscopic surgery in hip joint preservation. We encountered a special case in which joint remodeling was seen in a patient with rheumatoid arthritis treated with biological drugs after hip arthroscopic synovectomy and labral repair. We report the case of a 39-year-old woman with rheumatism, which was controlled with tocilizumab, prednisolone, and tacrolimus. The hip joint showed Larsen grade 3 destruction, and the Harris Hip Score was 55 points. Because of the patient's strong desire to undergo a hip preservation operation, we performed hip arthroscopic synovectomy and repair of a longitudinal labral tear. After 2.5 years, the joint space had undergone rebuilding with improvement to Larsen grade 2, and the Harris Hip Score had improved to 78 points; the patient was able to return to work with the use of 1 crutch. It is possible to perform hip arthroscopic surgery for rheumatoid arthritis with a hip preservation operation with biological drugs.

Watanabe, Nobuyuki; Iguchi, Hirotaka; Mitsui, Hiroto; Tawada, Kaneaki; Murakami, Satona; Otsuka, Takanobu

2014-01-01

36

Arthroscopic anterior and posterior labral repair after traumatic hip dislocation: case report and review of the literature.  

PubMed

With the improvements in flexible instrumentation, hip arthroscopy is being increasingly used to treat a variety of hip pathology, including labral tears. However, up to this point, there has not been a case report of an anterior and a posterior labral tear successfully repaired arthroscopically. We present a case report of a 27-year-old male firefighter who presented to our institution with an anterior and posterior labral tear, as well as a cam lesion and loose body, following a traumatic hip dislocation. The purpose of this case report is to illustrate that both anterior and posterior labral tears can be repaired using hip arthroscopy. Anterior and posterior labral tears can be caused by a traumatic hip dislocation, and both can be successfully repaired using arthroscopic techniques. PMID:21886540

Cross, Michael B; Shindle, Michael K; Kelly, Bryan T

2010-09-01

37

Glenoid fracture after arthroscopic bankart repair: case series and biomechanical analysis.  

PubMed

To examine whether anchors used in arthroscopic Bankart repair increased the risk of subsequent fracture, six intact polyurethane scapulae and six with three 3.0-mm suture anchors placed along the anteroinferior glenoid were compared. An axial load of 1 mm/s was applied to the anteroinferior glenohumeral joint with a prosthetic humeral head. Outcome measures were force needed for initial fracture and catastrophic failure, percent of anterior glenoid bone loss, and fracture length. With the numbers available, no significant differences could be detected between groups in yield load or maximum load. The anchor group had a significantly larger percentage of bone loss (p < .01) and fracture length (p < .01) compared to the intact group. In this study, anchors did not decrease force needed to fracture but did lead to significantly larger fractures of the anterior glenoid during a simulated dislocation event. Further study using various anchors and techniques is warranted. PMID:25153814

Farmer, Kevin W; Uribe, John W; Moser, Michael W; Conrad, Bryan C; Yagnik, Gautam P; Wright, Thomas W

2014-01-01

38

Suture welding for arthroscopic repair of peripheral triangular fibrocartilage complex tears.  

PubMed

This report presents a method of arthroscopic repair of the peripheral triangular fibrocartilage tears by using ultrasonic suture welding technique, thus avoiding the need for traditional suture knots. This technique eliminates the potential causes of ulnar-sided wrist discomfort especially during the postoperative period. Twenty-three patients (9 women and 14 men; mean age, 35 years; range, 18-52 years) were operated during a 1-year period in 2001 for Palmer grade 1B triangular fibrocartilage complex tear and followed up for 17 months. At the final follow-up, the average wrist arc of motion was as follows: extension, 65 degrees; flexion, 56 degrees; supination, 80 degrees; pronation, 78 degrees; radial deviation, 12 degrees; and ulnar deviation, 25 degrees. Grip strength measured with a dynamometer (Jamar) averaged 81% of the contralateral side at the final evaluation (range, 53%-105%). PMID:17536524

Badia, Alejandro; Khanchandani, Prakash

2007-03-01

39

Arthroscopic Posterior Labral Repair and Capsular Shift With a Lateralized Posterior Portal  

PubMed Central

Arthroscopic techniques for posterior shoulder subluxation with labral injuries in athletes have shown good results. The difficulty with the procedure is gaining appropriate access to the posteroinferior quadrant of the glenoid at a steep enough angle that allows for safe anchor placement. Various portals have been described that can be used as accessory portals for anchor placement. Although the use of additional portals to create appropriate access to the joint is always encouraged, preoperative planning can minimize the need for their use. The video shows a simple technique for posterior labral repair with capsular plications through a lateralized posterior portal in the lateral decubitus position. This technique allows the surgeon to address posterior labral tears and capsular laxity without the need for accessory portals. PMID:24400175

Ciccone, William J.

2013-01-01

40

Arthroscopic Dorsal Capsulo-Ligamentous Repair in the Treatment of Chronic Scapho-Lunate Ligament Tears  

PubMed Central

Introduction?Scapholunate ligament injuries usually result due to a fall on the outstretched hand leading to scapholunate instability. The natural history of untreated scapholunate instability remains controversial and usually results in late arthritic changes- the so-called “SLAC” wrist. The advent of wrist arthroscopy helps in early diagnosis and treatment of these serious injuries. In selected cases with reducible scapholunate instability (Garcia-Elias stages 2, 3 and 4) we propose a new “all arthroscopic dorsal capsulo- ligamentous repair” with the added advantage of early rehabilitation and prevention of post-operative stiffness. Material and Methods?We report the results of our series of 57 consecutive patients suffering from chronic wrist pain refractory to conservative measures. All patients underwent a thorough clinical examination in addition to a standard set of radiographs and MRI exam; and they were treated by an all-arthroscopic dorsal capsulo-ligamentous repair under loco-regional anesthesia on an ambulatory basis. All patients were available for follow-up at regular intervals during the post-operative period. At follow-up, the wrist ROM in all directions, the grip strength, DASH questionnaire and pain relief based on the VAS were recorded for both- the operated and contra-lateral sides. Results?There were 34 males & 23 females with a mean age of 38.72?±?11.33 years (range 17–63 years). The dominant side was involved in 52 cases. The mean time since injury was 9.42?±?6.33 months (range 3–24 months) and the mean follow-up was 30.74?±?7.05 months (range 18–43 months). The mean range of motion improved in all directions. The mean difference between the post- and pre-operative extension was 14.03° (SEM?=?1.27°; p?arthroscopic capsulo-ligamentous repair technique provides reliable results in addition to avoiding postoperative stiffness. The overall results at a mean follow-up period of more than 2 years in our series of young, active patients appear to be encouraging. PMID:24436807

Wahegaonkar, Abhijeet L.; Mathoulin, Christophe L.

2013-01-01

41

Arthroscopic dorsal capsulo-ligamentous repair in the treatment of chronic scapho-lunate ligament tears.  

PubMed

Introduction?Scapholunate ligament injuries usually result due to a fall on the outstretched hand leading to scapholunate instability. The natural history of untreated scapholunate instability remains controversial and usually results in late arthritic changes- the so-called "SLAC" wrist. The advent of wrist arthroscopy helps in early diagnosis and treatment of these serious injuries. In selected cases with reducible scapholunate instability (Garcia-Elias stages 2, 3 and 4) we propose a new "all arthroscopic dorsal capsulo- ligamentous repair" with the added advantage of early rehabilitation and prevention of post-operative stiffness. Material and Methods?We report the results of our series of 57 consecutive patients suffering from chronic wrist pain refractory to conservative measures. All patients underwent a thorough clinical examination in addition to a standard set of radiographs and MRI exam; and they were treated by an all-arthroscopic dorsal capsulo-ligamentous repair under loco-regional anesthesia on an ambulatory basis. All patients were available for follow-up at regular intervals during the post-operative period. At follow-up, the wrist ROM in all directions, the grip strength, DASH questionnaire and pain relief based on the VAS were recorded for both- the operated and contra-lateral sides. Results?There were 34 males & 23 females with a mean age of 38.72?±?11.33 years (range 17-63 years). The dominant side was involved in 52 cases. The mean time since injury was 9.42?±?6.33 months (range 3-24 months) and the mean follow-up was 30.74?±?7.05 months (range 18-43 months). The mean range of motion improved in all directions. The mean difference between the post- and pre-operative extension was 14.03° (SEM?=?1.27°; p?arthroscopic capsulo-ligamentous repair technique provides reliable results in addition to avoiding postoperative stiffness. The overall results at a mean follow-up period of more than 2 years in our series of young, active patients appear to be encouraging. PMID:24436807

Wahegaonkar, Abhijeet L; Mathoulin, Christophe L

2013-05-01

42

The Factors Affecting the Clinical Outcome and Integrity of Arthroscopically Repaired Rotator Cuff Tears of the Shoulder  

PubMed Central

Background The purpose of this study was to evaluate the functional and anatomic results of arthroscopic rotator cuff repair, and to analyze the factors affecting the integrity of arthroscopically repaired rotator cuff tears of the shoulder. Methods One hundred sixty-nine consecutive shoulders that underwent arthroscopic rotator cuff repair, had a postoperative MRI evaluation and were followed for at least two years were enrolled in this study. The mean age was 57.6 years (range, 38 to 74 years) and the mean follow-up period was 39 months (range, 24 to 83 months). Results The rotator cuff was completely healed in 131 (77.5%) out of 169 shoulders and recurrent tears occurred in 38 shoulders (22.5%). At the last follow-up visit, the mean score for pain during motion was 1.53 (range, 0 to 4) in the completely healed group and 1.59 (range, 0 to 4) in the group with recurrent tears (p = 0.092). The average elevation strength was 7.87 kg (range, 4.96 to 11.62 kg) and 5.25 kg (range, 4.15 to 8.13 kg) and the mean University of California at Los Angeles score was 30.96 (range, 26 to 35) and 30.64 (range, 23 to 34), respectively (p < 0.001, p = 0.798). The complete healing rate was 87.8% in the group less than 50 years of age (49 shoulders), 79.4% in the group over 51 years but less than 60 years of age (68 shoulders), and 65.4% in the group over 61 years of age (52 shoulders, p = 0.049); it was 96.7% in the group with small-sized tears (30 shoulders), 87.3% in the group with medium-sized tears (71 shoulders), and 58.8% in the group with large-sized or massive tears (68 shoulders, p = 0.009). All of the rotator cuffs with a global fatty degeneration index of greater than two preoperatively had recurrent tears. Conclusions Arthroscopic repair of full-thickness rotator cuff tears led to a relatively high rate of recurrent defects. However, the minimum two-year follow up demonstrated excellent pain relief and improvement in the ability to perform the activities of daily living, despite the structural failures. The factors affecting tendon healing were the patient's age, the size and extent of the tear, and the presence of fatty degeneration in the rotator cuff muscle. PMID:19885061

Cho, Nam Su

2009-01-01

43

Outcome of Arthroscopic Repair of Type II SLAP Lesions in Worker’s Compensation Patients  

Microsoft Academic Search

Purpose  Arthroscopic stabilization has become the accepted treatment for type II superior labral anterior and posterior (SLAP) lesions.\\u000a Short-term results using a variety of techniques were promising, but most reports focus on motivated athletes. The purpose\\u000a of our report is to evaluate the results of arthroscopic fixation of type II SLAP lesions in 21 patients who suffered a work-related\\u000a injury and

Nikhil N. Verma; Ralph Garretson; Anthony A. Romeo

2007-01-01

44

The arrow versus horizontal suture in arthroscopic meniscus repairA prospective randomized study with arthroscopic evaluation  

Microsoft Academic Search

In a prospectively randomized study including 68 patients, the results of inside-out horizontal meniscus suturing were compared\\u000a to meniscus repair using the meniscus arrow. 96% of the patients underwent re-arthroscopy after 3–4 months. Only lesions in\\u000a the red\\/red or red\\/white areas were included. Patients were treated with a hinged brace for 9 weeks. 30 patients had an isolated\\u000a bucket-handle lesion.

P. Albrecht-Olsen; G. Kristensen; P. Burgaard; U. Joergensen; C. Toerholm

1999-01-01

45

Arthroscopic repair of peripheral avulsions of the triangular fibrocartilage complex of the wrist: A multicenter study  

Microsoft Academic Search

A multicenter study to assess arthroscopic reconstruction of the peripheral attachment of the triangular fibrocartilage complex was undertaken. A total of 44 patients (45 wrists) from three institutions were reviewed. Twenty-seven of the 45 wrists had associated injuries, including distal radius fracture (4), partial or complete rupture of the scapholunate (7), lunotriquetral (9), ulnocarpal (2), or radiocarpal (2) ligaments. There

Salvatore J. Corso; Felix H. Savoie; William B. Geissler; Terry L. Whipple; Wayne Jiminez; Nan Jenkins

1997-01-01

46

Fatal pulmonary embolism after arthroscopic rotator cuff repair: a case series  

PubMed Central

Summary Background: pulmonary embolism (PE) is a rare and serious complication of arthroscopic orthopaedic surgery. Currently there is great paucity in the literature regarding PE events following arthroscopic rotator cuff (ARCR) surgery. The purpose of this case series was to (1) report our known incidence rate of symptomatic PE following ARCR for a single surgeon and (2) describe five cases of pulmonary embolism following ARCR, detailing patient medical history and potential perioperative risk factors. Methods: the number of PE events were queried retrospectively from the institutional database with the ICD-9 code 415.1 within a 10 year time frame (2003–2013). Cases of PE identified by ICD-9 query were reviewed for type of procedure, postoperative day of event, and surgeon. Only patients with a confirmed diagnosis by computed tomography (CT) scan or post-mortem exam, were included in this study. Patient medical records belonging to affected patients were ordered and reviewed by a single investigator. Pre, intra, and postoperative information was obtained and summarized. Results: 5 cases of PE were identified, two of which were fatal. All events occurred in the perioperative period following ARCR. The 10 year incidence rate for PE following ARCR was 0.89%. Medical record review revealed significant risk factors for these patients when compared to current VTE prophylactic guidelines. Conclusions: our ten year incidence rate of PE following arthroscopic shoulder surgery and ARCR was 0.25 and 0.89% respectively. These rates were found to be considerably higher than reported rates of PE in the general population and following arthroscopic shoulder surgery. In addition, our methods failed to detect subclinical PE events, resulting in the likelihood of this value to be an underestimate of the true incidence. Medical record review revealed risk factors which would qualify patients for chemoprophylaxis under certain guidelines, however, the validity of available risk stratification methods continue to be a topic of debate. Level of Evidence: Level IV; case series. PMID:25332941

Durant, Thomas J.S.; Cote, Mark P.; Arciero, Robert A.; Mazzocca, Augustus D.

2014-01-01

47

Modes of failure of knotted and knotless suture anchors in an arthroscopic bankart repair model with the capsulolabral tissues intact.  

PubMed

The purpose of this study was to assess failure modes of knotless and knotted anchors in a Bankart repair model with the capsulolabral soft tissues intact. Previous reports used a model stripped of soft tissues. In 8 matched pairs of cadaver shoulders, a Bankart lesion was repaired arthroscopically using either 2 Bio-SutureTak anchors (Arthrex, Naples, Florida) or 2 Bioknotless anchors (Mitek, Westwood, Massachusetts). The shoulders were mounted with the repaired capsulolabral tissues attached to a custom sinusoidal clamp, and were tested in cyclic loading (20-80 N, 100 cycles, 0.5 mm/s) and then load to failure (1.25 mm/s). Cut-through at the suture-tissue interface (23/32 anchors) was more common than pullout at the anchor-bone interface (9/32) as a mode of failure (P = .02). Failure at the suture-tissue interface occurred in 10/16 knotted and 13/16 knotless anchors. Mean (SD) ultimate load of knotted vs knotless anchors was 125.3 (67.4) N and 96.9 (95.1) N, respectively. Mean (SD) stiffness of knotted vs knotless anchors was 20.9 (6.4) N/mm and 19.8 (8.6)N/mm, respectively. We concluded that both knotted and knotless anchors fail most often at the suture-tissue interface. The tested model with the capsulolabral tissues intact is distinct from previous models, which tested the anchor-bone interface only. PMID:21720601

Ranawat, Anil S; Golish, S Raymond; Miller, Mark D; Caldwell, Paul E; Singanamala, Naveen; Treme, Gehron; Costic, Ryan; Hart, Joseph M; Sekiya, Jon K

2011-03-01

48

Arthroscopic, histological and MRI analyses of cartilage repair after a minimally invasive method of transplantation of allogeneic synovial mesenchymal stromal cells into cartilage defects in pigs  

PubMed Central

Background aims Transplantation of synovial mesenchymal stromal cells (MSCs) may induce repair of cartilage defects. We transplanted synovial MSCs into cartilage defects using a simple method and investigated its usefulness and repair process in a pig model. Methods The chondrogenic potential of the porcine MSCs was compared in vitro. Cartilage defects were created in both knees of seven pigs, and divided into MSCs treated and non-treated control knees. Synovial MSCs were injected into the defect, and the knee was kept immobilized for 10 min before wound closure. To visualize the actual delivery and adhesion of the cells, fluorescence-labeled synovial MSCs from transgenic green fluorescent protein (GFP) pig were injected into the defect in a subgroup of two pigs. In these two animals, the wounds were closed before MSCs were injected and observed for 10 min under arthroscopic control. The defects were analyzed sequentially arthroscopically, histologically and by magnetic resonance imaging (MRI) for 3 months. Results Synovial MSCs had a higher chondrogenic potential in vitro than the other MSCs examined. Arthroscopic observations showed adhesion of synovial MSCs and membrane formation on the cartilage defects before cartilage repair. Quantification analyses for arthroscopy, histology and MRI revealed a better outcome in the MSC-treated knees than in the non-treated control knees. Conclusions Leaving a synovial MSC suspension in cartilage defects for 10 min made it possible for cells to adhere in the defect in a porcine cartilage defect model. The cartilage defect was first covered with membrane, then the cartilage matrix emerged after transplantation of synovial MSCs. PMID:22309371

Nakamura, Tomomasa; Sekiya, Ichiro; Muneta, Takeshi; Hatsushika, Daisuke; Horie, Masafumi; Tsuji, Kunikazu; Kawarasaki, Tatsuo; Watanabe, Atsuya; Hishikawa, Shuji; Fujimoto, Yasuhiro; Tanaka, Hozumi; Kobayashi, Eiji

2012-01-01

49

Arthroscopic pubic symphysis debridement and adductor enthesis repair in athletes with athletic pubalgia: technical note and video illustration.  

PubMed

We elaborately describe our novel arthroscopic technique of the symphysis pubis in athletes with osteitis pubis and concomitant adductor enthesopathy who fail to conservative treatment modalities. The symphysis pubis is debrided arthroscopically and the degenerated origin of adductor tendon (enthesis) is excised and reattached. With our surgical procedure the stability of the symphysis pubis is successfully preserved and the adductor longus enthesopathy simultaneously addressed in the same setting. PMID:25055756

Hopp, Sascha; Tumin, Masjudin; Wilhelm, Peter; Pohlemann, Tim; Kelm, Jens

2014-11-01

50

Arthroscopic Intratendinous Repair of the Delaminated Partial-Thickness Rotator Cuff Tear in Overhead Athletes  

Microsoft Academic Search

A distinct type of partial-thickness rotator cuff tear has been observed in overhead athletes, characterized by partial failure of the undersurface of the posterior supraspinatus and anterior infraspinatus tendons with intratendinous delamination. We present a technique of percutaneous intratendinous repair using nonabsorbable mattress sutures designed for the management of articular-side delaminated partial-thickness tears. After tear evaluation and preparation, the torn

Stephen F. Brockmeier; Christopher C. Dodson; Seth C. Gamradt; Struan H. Coleman; David W. Altchek

2008-01-01

51

Arthroscopic assisted rotator cuff repair: Results using a mini-open deltoid splitting approach  

Microsoft Academic Search

Out of 78 patients identified who underwent mini-open cuff repair, 64 were interviewed and returned a detailed questionnaire and 47 returned for a physical examination. Their average age was 64 years (31 to 85 years); and the average follow-up was 29.2 months (image, 12 to 65 months). The average tear size was 8 cm2. Preoperatively, all patients complained of pain

Field T. Blevins; Russell F. Warren; Charles Cavo; David W. Altchek; David Dines; George Palletta; Thomas L. Wickiewicz

1996-01-01

52

Arthroscopic all-inside meniscus repair using a new refixation device  

Microsoft Academic Search

Purpose: To evaluate complications and clinical results after meniscus refixation using a new all-inside technique. Type of Study: Prospective clinical study. Methods: This study reports clinical results of 37 patients after refixation of an unstable bucket-handle meniscus tear using a new all-inside technique (Mitek Meniscal Repair System; Mitek, Ethicon, Norderstedt, Germany). Twenty tears were located in the peripheral third (red

Heinz Laprell; Volker Stein; Wolf Petersen

2002-01-01

53

Arthroscopic evaluation of meniscal repairs after anterior cruciate ligament reconstruction and immediate motion  

Microsoft Academic Search

Sixty-six patients who had meniscal repair at the same time as an ACL reconstruction were followed-up with arthroscopy at an average of 12 months postopera tively. All patients underwent immediate postoperative range of motion from 20° to 90° and began partial weightbearing between the 1 st and 3rd postoperative weeks. The rate of meniscal healing was classified as complete, partial,

Mark S. Buseck; Frank R. Noyes

1991-01-01

54

Arthroscopic intratendinous repair of the delaminated partial-thickness rotator cuff tear in overhead athletes.  

PubMed

A distinct type of partial-thickness rotator cuff tear has been observed in overhead athletes, characterized by partial failure of the undersurface of the posterior supraspinatus and anterior infraspinatus tendons with intratendinous delamination. We present a technique of percutaneous intratendinous repair using nonabsorbable mattress sutures designed for the management of articular-side delaminated partial-thickness tears. After tear evaluation and preparation, the torn rotator cuff undersurface is held in a reduced position with a grasper through an anterolateral rotator interval portal while viewing intra-articularly. Two spinal needles are then placed percutaneously through the full thickness of the torn and intact rotator cuff. A polydioxanone suture is passed through each needle, retrieved out the anterior portal, and used to shuttle a single nonabsorbable No. 2 suture through the tissue, creating a mattress suture. Multiple mattress sutures can be placed as dictated by tear size and morphology, with suture retrieval and knot securing then proceeding in the subacromial space. We have adopted this approach with the goals of anatomically re-establishing the rotator cuff insertion and sealing the area of intratendinous delamination while preventing significant alteration to the anatomy of the rotator cuff insertion, which could lead to motion deficits, internal impingement, and potential tear recurrence. PMID:18657747

Brockmeier, Stephen F; Dodson, Christopher C; Gamradt, Seth C; Coleman, Struan H; Altchek, David W

2008-08-01

55

Arthroscopic Surgery.  

ERIC Educational Resources Information Center

Arthroscopic surgery (or microsurgery) is a significant breakthrough in treating knee injuries. Its applications range from basic diagnosis to arthroscopic menisectomy, although its use in some procedures is still highly controversial. Many surgeons perform the diagnostic procedure, but follow this with the conventional surgical approach.…

Connors, G. Patrick

56

Longitudinal evaluation of cartilage repair tissue after microfracture using T2-mapping: a case report with arthroscopic and MRI correlation  

Microsoft Academic Search

A man sustained a left knee injury which led to full-thickness chondral defects of the trochlear groove and lateral femoral\\u000a condyle. Both areas were treated with microfractures and evaluated at 5 months and 2 years with standard MRI scans, T2 relaxation\\u000a maps, and arthroscopy. At 5-months post-microfracture repair, the patient complained of recurrent anterior knee pain. While\\u000a standard MRI imaging was inconclusive

José M. Mejía Oneto; Jutta Ellermann; Robert F. LaPrade

2010-01-01

57

Are Platelet-Rich Products Necessary during the Arthroscopic Repair of Full-Thickness Rotator Cuff Tears: A Meta-Analysis  

PubMed Central

Background Platelet-rich products (PRP) are widely used for rotator cuff tears. However, whether platelet-rich products produce superior clinical or radiological outcomes is controversial. This study aims to use meta-analysis to compare clinical and radiological outcomes between groups with or without platelet-rich products. Methods The Pubmed, Embase, and Cochrane library databases were searched for relevant studies published before April 20, 2013. Studies were selected that clearly reported a comparison between the use or not of platelet-rich products. The Constant, ASES, UCLA, and SST scale systems and the rotator cuff retear rate were evaluated. The weighted mean differences and relative risks were calculated using a fixed-effects model. Results Seven studies were enrolled in this meta-analysis. No significant differences were found for the Constant scale (0.73, 95% CI, ?1.82 to 3.27, P?=?0.58), ASES scale (?2.89, 95% CI, ?6.31 to 0.53, P?=?0.1), UCLA scale (?0.79, 95% CI, ?2.20 to 0.63, P?=?0.28), SST scale (0.34, 95% CI, ?0.01 to 0.69, P?=?0.05), and the overall rotator cuff retear rate (0.71, 95% CI, 0.48 to 1.05, P?=?0.08). Subgroup analysis according to the initial tear size showed a lower retear rate in small- and medium-sized tears (0.33, 95% CI, 0.12 to 0.91, P?=?0.03) after platelet-rich product application but no difference for large- and massive-sized tears (0.86, 95% CI, 0.60 to 1.23, P?=?0.42). Conclusion In conclusion, the meta-analysis suggests that the platelet-rich products have no benefits on the overall clinical outcomes and retear rate for the arthroscopic repair of full-thickness rotator cuff tears. However, a decrease occurred in the rate of retears among patients treated with PRP for small- and medium-sized rotator cuff tears but not for large- and massive-sized tears. Level of Evidence Level II PMID:23874991

Zhang, Qiang; Ge, Heng'an; Zhou, Jiaojiao; Cheng, Biao

2013-01-01

58

Arthroscopic treatment of calcific tendonitis.  

PubMed

Calcific tendonitis, or calcifying tendonitis, is a common disorder characterized by the multifocal accumulation of basic calcium phosphate crystals within the rotator cuff tendons. In most cases, the multifocal calcifications are located 1 to 2 cm from the insertion of the supraspinatus tendon on the greater tuberosity. The initial treatment should be nonoperative including oral anti-inflammatory medication and physical therapy. If this is unsuccessful, arthroscopic debridement of the deposit is effective. The technique used is an arthroscopic localization and debridement without associated subacromial decompression. The rotator cuff should be evaluated for partial- and full-thickness tears before and after the debridement of calcifications. If a partial- or full-thickness rotator cuff tendon tear is identified, it should be treated in a fashion consistent with those without associated calcium deposits. In our hands, tears 5 mm or greater in depth are repaired using a tendon-to-tendon or tendon-to-bone technique. Tears with less depth are debrided and then left alone. Arthroscopic debridement of calcific tendonitis can yield excellent functional results and high patient satisfaction. PMID:24904767

Barber, F Alan; Cowden, Courtney H

2014-04-01

59

Arthroscopic stabilization of posterior shoulder instability.  

PubMed

Posterior shoulder instability is a rare and challenging condition with a complex patho-anatomy. The role of arthroscopic repair in the treatment remains poorly defined. The purpose of this study is to evaluate the result of arthroscopic stabilization procedures in patients with posterior shoulder instability. In this case series, we treated eighteen patients (19 shoulders) with posterior shoulder instability with either arthroscopic thermal capsular shrinkage (9 patients), capsulorrhaphy (3) or labral refixation (7). There were eight male and ten female patients with a mean age of 26 years. The study group included unidirectional (6 patients; PI), bi-directional (8; PII) and multidirectional posterior instability (5; MDI). The Rowe-score and DASH-score as well as subjective and objective evaluations of the patients function, range of motion, pain and instability were used as clinical outcome measurements. At a mean follow-up of 50 months, the Rowe-score improved significantly from 46 to 74 (P = 0.005). Four patients (21%) had recurrent instability after arthroscopic treatment (2 with generalized ligamentous laxity; 3 after thermal shrinkage). Analysis of postoperative DASH-scores showed a tendency toward inferior outcomes after thermal shrinkage and in patients with an a-traumatic origin of shoulder instability. We conclude that arthroscopic shoulder stabilization by either labral refixation or capsulorrhaphy is a safe and effective treatment for posterior shoulder instability. Thermal capsular shrinkage however showed poor results and should be abandoned for this indication. PMID:20411378

Engelsma, Y; Willems, W J

2010-12-01

60

Arthroscopic treatment of glenohumeral instability in soccer goalkeepers.  

PubMed

The aim of this study was to report epidemiologic data and results of arthroscopic treatment of glenohumeral instability in soccer goalkeepers. We included 12 soccer goalkeepers with a mean age of 28.9 years (range 18-45 years) with acute or recurrent traumatic anterior instability who underwent an arthroscopic anatomic capsulolabral repair with bone anchors. Patients who underwent surgery within 4 weeks of the first episode of dislocation were classified as acute instability. The results were evaluated using the Rowe Scale and analyzed according to stability, range of motion and function. The mean follow-up was 3.8 years. The most common mechanism of injury (90% of the cases) was abduction, external rotation and extension. Associated injuries were present in 57.2% of recurrent cases and 20% of acute cases (p<0.293). Excellent or good results were observed in 80% of the cases of acute instability and in 57.2% of cases in the group with recurrent instability (p<0.586). From a total of 12 soccer goalkeepers who underwent the arthroscopic capsulolabral repair, good or excellent results were obtained in 66.6% of cases of glenohumeral instability. Surgical arthroscopic repair was possible in all cases of acute or recurrent instability based on well-established inclusion criteria, i. e., with well-defined exclusion criteria, such as HAGL lesion and significant glenohumeral bone loss, the arthroscopic capsulolabral repair can be carried out in soccer goalkeepers. PMID:23143699

Terra, B B; Ejnisman, B; Figueiredo, E A; Andreoli, C V; Pochini, A C; Cohen, C; Arliani, G G; Cohen, M

2013-06-01

61

Arthroscopic versus open treatment of anterior shoulder instability.  

PubMed

Open repair is the accepted mainstay of treatment for anterior shoulder instability, and consistently good clinical results have been reported in the literature. With the development of newer arthroscopic imbrication techniques, however, arthroscopy may eventually provide equivalent long-term efficacy. PMID:15116644

Armstrong, April; Boyer, Dory; Ditsios, Konstantinos; Yamaguchi, Ken

2004-01-01

62

Arthroscopic-assisted biceps tenodesis for ruptures of the long head of biceps brachii: the cobra procedure  

Microsoft Academic Search

A number of open procedures have been presented in the literature that described the repair of the ruptured long head of biceps brachii (LHBB). Although arthroscopic biceps tenodesis techniques have been used to address partial tears or subluxation of the biceps, no arthroscopic technique to assist in the treatment of complete retracted ruptures of the LHBB has been described. This

David P Richards; Stephen S Burkhart

2004-01-01

63

Rotator cuff repair should be done open: seein’ is believin’!—in opposition  

Microsoft Academic Search

As arthroscopic techniques continue to evolve and become widespread, the repair of rotator cuff tears without an open incision will likely become both commonplace and the new “gold” standard. Similar to the evolution that occurred two decades ago with arthroscopic knee surgery, arthroscopic rotator cuff surgery will allow surgeons and patients to reduce the morbidity of this procedure while still

Sumant G Krishnan; Wayne Z Burkhead

2004-01-01

64

Arthroscopic Treatment of Knee Fractures  

Microsoft Academic Search

Tibial plateau fractures can be a challenging injury to manage for orthopaedic surgeons. Management of these fractures has\\u000a evolved from immobilization, skeletal traction, open reduction, and internal fixation to (all) arthroscopic reduction and\\u000a internal fixation for some fracture types. Although not all fractures are amenable to arthroscopic reduction and fixation\\u000a techniques, the arthroscope is still an important instrument for intraarticular

S. L. Mortimer; Robert Hunter

65

All-arthroscopic patch augmentation of a massive rotator cuff tear: surgical technique.  

PubMed

Surgical management of massive rotator cuff tears remains challenging, with failure rates ranging from 20% to 90%. Multiple different arthroscopic and open techniques have been described, but there is no current gold standard. Failure after rotator cuff repair is typically multifactorial; however, failure of tendon-footprint healing is often implicated. Patch augmentation has been described as a possible technique to augment the biology of rotator cuff repair in situations of compromised tendon quality and has shown promising short-term results. The purpose of this article is to describe our preferred surgical technique for arthroscopic rotator cuff repair with patch augmentation. PMID:24400198

Chalmers, Peter N; Frank, Rachel M; Gupta, Anil K; Yanke, Adam B; Trenhaile, Scott W; Romeo, Anthony A; Bach, Bernard R; Verma, Nikhil N

2013-01-01

66

All-Arthroscopic Patch Augmentation of a Massive Rotator Cuff Tear: Surgical Technique  

PubMed Central

Surgical management of massive rotator cuff tears remains challenging, with failure rates ranging from 20% to 90%. Multiple different arthroscopic and open techniques have been described, but there is no current gold standard. Failure after rotator cuff repair is typically multifactorial; however, failure of tendon-footprint healing is often implicated. Patch augmentation has been described as a possible technique to augment the biology of rotator cuff repair in situations of compromised tendon quality and has shown promising short-term results. The purpose of this article is to describe our preferred surgical technique for arthroscopic rotator cuff repair with patch augmentation. PMID:24400198

Chalmers, Peter N.; Frank, Rachel M.; Gupta, Anil K.; Yanke, Adam B.; Trenhaile, Scott W.; Romeo, Anthony A.; Bach, Bernard R.; Verma, Nikhil N.

2013-01-01

67

Postoperative aneurysm of the popliteal artery after arthroscopic meniscectomy.  

PubMed

We report a case of a 14-year-old girl who underwent arthroscopic subtotal meniscectomy after a bucket-handle tear of the lateral meniscus followed by a pseudoaneurysm of the popliteal artery. A revision surgery and reconstruction of the artery with a saphena magna patch was necessary to repair the defect. At 1-year follow-up, excellent range of motion, function of the knee, and a normal quality of life was achieved. PMID:11172252

Kiss, H; Drekonja, T; Grethen, C; Dorn, U

2001-02-01

68

Arthroscopic Augmentation With Subscapularis Tendon in Anterior Shoulder Instability With Capsulolabral Deficiency  

PubMed Central

The treatment of chronic shoulder instability with poor quality of the anterior capsulolabral tissue is still controversial. In these cases the Latarjet procedure is certainly more effective in preventing recurrence than an arthroscopic capsular repair. However, several studies have reported a variety of severe complications related to the Latarjet procedure because of the use of bone augmentation and hardware implantation; moreover, the arthroscopic version of the Latarjet procedure is technically difficult and potentially dangerous because of the proximity of neurovascular structures. The aim of this report is to describe an innovative arthroscopic technique consisting of an augmentation of the anterior capsulolabral tissue using the articular portion of the subscapularis tendon and knotless suture anchors paired with high-strength tape for its fixation to the anterior glenoid edge. In the absence of severe bone deficiency of the anterior glenoid edge, this procedure can minimize arthroscopic technique failures, restoring the anterior capsulolabral wall without any significant reduction of shoulder functionality. PMID:24266004

Maiotti, Marco; Massoni, Carlo

2013-01-01

69

Arthroscopic proficiency: methods in evaluating competency  

PubMed Central

Background The current paradigm of arthroscopic training lacks objective evaluation of technical ability and its adequacy is concerning given the accelerating complexity of the field. To combat insufficiencies, emphasis is shifting towards skill acquisition outside the operating room and sophisticated assessment tools. We reviewed (1) the validity of cadaver and surgical simulation in arthroscopic training, (2) the role of psychomotor analysis and arthroscopic technical ability, (3) what validated assessment tools are available to evaluate technical competency, and (4) the quantification of arthroscopic proficiency. Methods The Medline and Embase databases were searched for published articles in the English literature pertaining to arthroscopic competence, arthroscopic assessment and evaluation and objective measures of arthroscopic technical skill. Abstracts were independently evaluated and exclusion criteria included articles outside the scope of knee and shoulder arthroscopy as well as original articles about specific therapies, outcomes and diagnoses leaving 52 articles citied in this review. Results Simulated arthroscopic environments exhibit high levels of internal validity and consistency for simple arthroscopic tasks, however the ability to transfer complex skills to the operating room has not yet been established. Instrument and force trajectory data can discriminate between technical ability for basic arthroscopic parameters and may serve as useful adjuncts to more comprehensive techniques. There is a need for arthroscopic assessment tools for standardized evaluation and objective feedback of technical skills, yet few comprehensive instruments exist, especially for the shoulder. Opinion on the required arthroscopic experience to obtain proficiency remains guarded and few governing bodies specify absolute quantities. Conclusions Further validation is required to demonstrate the transfer of complex arthroscopic skills from simulated environments to the operating room and provide objective parameters to base evaluation. There is a deficiency of validated assessment tools for technical competencies and little consensus of what constitutes a sufficient case volume within the arthroscopy community. PMID:23631421

2013-01-01

70

Arthroscopic management of shoulder instabilities: anterior, posterior, and multidirectional.  

PubMed

Arthroscopy is considered a relatively new technique for the surgical repair of an unstable shoulder. Shoulder arthroscopy has grown in popularity and is considered the gold standard for treating carefully selected patients. Despite its increasing popularity, the procedure has a significant learning curve and has resulted in early higher recurrence rates when compared with patients treated with open techniques. With the addition of newer instrumentation, the refinement of techniques, and additional capsular plication and tensioning, outcomes for patients treated with shoulder arthroscopy should continue to improve. A major distinguishing feature in selecting appropriate candidates for shoulder arthroscopy is whether there have been significant bone changes resulting from dislocation recurrence. Recurrent anterior dislocation may create an anterior glenoid rim fracture, erosion loss from multiple recurrences, and an impression defect on the posterior aspect of the humeral head. The loss of contact area between the "ball and cup" may compromise the results of techniques that restore the anatomic restraints of soft tissues. Early intervention is becoming recognized as an important factor in patient selection for arthroscopic treatment. Imaging studies after traumatic injuries include radiographs, CT scans, possible articular contrast studies, and MRIs. These studies can identify and quantify rim fractures and the remaining articular contact in patients with recurrent subluxations, allowing for earlier appropriate intervention. Patients with significant bone loss may be best treated with an open procedure that allows grafting of the deficiency. Arthroscopic techniques to repair fractures or graft deficiencies continue to evolve. Rim fractures can be anatomically repaired with a suture anchor technique when recognized early. Rim erosion from chronic recurrent dislocations may require a combination of soft-tissue reattachment and coracoid grafting. Humeral head defects may require either soft-tissue or bone grafting to avoid engagement with the anterior edge of the glenoid. These techniques require arthroscopic skill and experience and are currently being performed as open procedures. In the future, it is likely that arthroscopy will be involved in the entire spectrum of treatment for shoulder instability. PMID:20415377

Abrams, Jeffrey S; Bradley, James P; Angelo, Richard L; Burks, Robert

2010-01-01

71

A practical algorithm forcartilage repair  

Microsoft Academic Search

Symptomatic chondral defects may be repaired by arthroscopic lavage and debridement, marrow stimulation,osteochondral graft transfer, autologous chondrocyte implantation, or osteoarticular allograft transplantation. The procedural selection may be made easier by a knowledge of the factors influencing prognosis. These factors include defect size, patient age, acuteness of injury, and activity level. Predisposing causes for chondral injuries such as instability, axial or

Tom Minas

2000-01-01

72

Arthroscopic debridement for dialysis shoulders  

Microsoft Academic Search

Purpose: To arthroscopically treat “dialysis shoulder,” severe shoulder pain in patients on long-term hemodialysis. This pain occurs only at rest such as during hemodialysis or while sleeping and is temporarily alleviated by assuming the sitting position or moving the shoulder joint. Limitations in range of motion and pain with overhead activity or the arm in the forward flexed position are

Koji Midorikawa; Masafumi Hara; Gen Emoto; Yozo Shibata; Masatoshi Naito

2001-01-01

73

Augmented Virtuality for Arthroscopic Knee Surgery  

E-print Network

Augmented Virtuality for Arthroscopic Knee Surgery John M. Li1 , Davide D. Bardana2 , A. James. A user study, using plastic bones instead of live patients, was made to determine the effectiveness residents. 1 Introduction Arthroscopic knee surgery is a minimally invasive procedure in which the surgeon

Stewart, James

74

Complications associated with arthroscopic shoulder surgery  

Microsoft Academic Search

We review the literature on complication of arthroscopic shoulder surgery and their management. Computer data based searches were used to identify articles regarding complications of shoulder arthroscopy, as well as hand searches of Arthroscopy and Journal of Shoulder and Elbow Surgery over the last decade. Arthroscopic shoulder surgery has become a popular therapeutic and diagnostic procedure during the past two

Stephen C. Weber; Jeffrey S. Abrams; Wesley M. Nottage

2002-01-01

75

Arthroscopic Posterior Bone Block Procedure: A New Technique Using Suture Anchor Fixation  

PubMed Central

We present a novel all-arthroscopic technique of posterior shoulder stabilization that uses suture anchors for both bone block fixation and capsulolabral repair. The bone graft, introduced inside the glenohumeral joint through a cannula, is fixed with 2 suture anchors. The associated posteroinferior capsulolabral repair places the bone block in an extra-articular position. In this article we present the detailed arthroscopic technique performed in a consecutive series of 15 patients and report the early results. We also report the positioning, healing, and remodeling of the bone block using postoperative 3-dimensional computed tomography. The benefits of this new technique are as follows: (1) it is all arthroscopic, preserving the posterior deltoid and posterior rotator cuff muscles; (2) it is accurate, resulting in appropriate bone block positioning; (3) it is efficient, allowing for consistent bone graft healing; (4) it is anatomic, both restoring the glenoid bone stock and repairing the injured posterior labrum; and (5) it is safe, limiting hardware-related complications and eliminating the risk of injury to vital structures associated with drilling or screw insertion from posterior to anterior. We believe that this technique is advantageous because it does not use screws for fixation and may be safer for the patient. PMID:24892011

Boileau, Pascal; Hardy, Marie-Beatrice; McClelland, Walter B.; Thelu, Charles-Edouard; Schwartz, Daniel G.

2013-01-01

76

Arthroscopic surgery of the knee.  

PubMed Central

In the first 1000 arthroscopic operations performed by one surgeon 136 patients had two or more procedures, making a total of 1168 during the 1000 operations. The indications for operation were internal mechanical derangements in 565 patients, anterior knee pain in 246, disorders of the synovium in 77, ligament injuries in 63, and degenerative joint disease in 49. Complications included fracture of instruments in the knee in five patients, haemarthrosis in 10, deep vein thrombosis in three, and synovial fistula in one. In no patient was the wound infected. A total of 26 different operations was performed. PMID:6812832

Dandy, D J; O'Carroll, P F

1982-01-01

77

Meniscus repair in the anterior cruciate deficient knee  

Microsoft Academic Search

From 1979 to 1986, isolated repair of a peripheral vascular zone meniscal tear was performed in 22 pa tients (23 menisci) who had ACL insufficiency. For various reasons none of these patients underwent re pair or reconstruction of their ACL. The meniscus repair was done by open arthrotomy in 12 cases and by arthroscopic techniques in 11 cases. The purpose

Gregory A. Hanks; Trenton M. Gause; John A. Handal; Alexander Kalenak

1990-01-01

78

Functional outcome of arthroscopic assisted fixation of distal radius fractures  

PubMed Central

Background: Many studies in literature have supported the role of wrist arthroscopy as an adjunct to the stable fixation of unstable intraarticular distal radial fractures. This article focuses on the surgical technique, indications, advantages, and results using wrist arthroscopy to assess articular reduction and evaluates the treatment of carpal ligament injuries and triangular fibrocartilage complex (TFCC) injuries in conjunction with the stable fixation of distal radial fractures. Materials and Methods: We retrospectively evaluated 27 patients (16 males and 11 females), who underwent stable fixation of intraarticular distal radial fractures with arthroscopic evaluation of the articular reduction and repair of associated carpal injuries. As per the AO classification, they were 9 C 1, 12 C2, 2 C3, 3 B 1, and 1 B2 fractures. The final results were evaluated by modified Mayo wrist scoring system. The average age was 41 years (range: 18-68 years). The average followup was of 26 months (range 24-52 months). Results: Five patients needed modification of the reduction and fixation after arthroscopic joint evaluation. Associated ligament lesions found during the wrist arthroscopy were TFCC tears (n=17), scapholunate ligament injury (n=8), and luno-triquetral ligament injury (n=1). Five patients had combined injuries i.e. included TFCC tear, scapholunate and/or lunotriquetral ligament tear. There were 20 excellent, 3 good, and 4 fair results using this score. Conclusion: The radiocarpal and mid carpal arthroscopy is a useful adjunct to stable fixation of distal radial fractures. PMID:23798761

Khanchandani, Prakash; Badia, Alejandro

2013-01-01

79

Behavior of arthroscopic irrigation systems.  

PubMed

In the literature, no consensus exists about optimal irrigation of joints during arthroscopic operations. The goal of this paper is to study the behavior of irrigation systems resulting in the proposal of guidelines for optimal irrigation. To this end, optimal irrigation is defined as the steady state of irrigation of a joint in which a sufficient positive intra-articular pressure and a sufficient flow are maintained. A model of the complete irrigation system was created to schematically elucidate the behavior of pump systems. Additionally, clinical experiments were performed during arthroscopic knee operations in which the pressure at different locations and the irrigation flow were measured. The combination of model prediction and clinical results could well be used to derive guidelines, since the clinical results, which showed considerable variation, were used to verify the model, and the model could be used to explain the typical trends. The main findings are twofold the set pressure is always higher than the intra-articular pressure, and the scope-sheath combination has a significant influence on irrigation control, because of its large restriction. Based on the results, we advice to increase the set pressure during active suction, and to include the sheath-scope combination in the control loop. PMID:15630604

Tuijthof, G J M; Dusée, L; Herder, J L; van Dijk, C N; Pistecky, P V

2005-04-01

80

Arthroscopic surgery of the ankle.  

PubMed

Ankle arthroscopy is a useful technique, especially for intra-articular problems and osteocartilagenous lesions. Indications for this diagnostic and therapeutic technique include: ankle sprain unresponsive to the usual course of treatment, complaints of intermittent locking, pain and clicking, limitation of motion, and painful conditions with no obvious etiology (especially in a worker's compensation beneficiary). A review of arthroscopic, radiographic, and clinical data of all patients undergoing ankle arthroscopy at our center provided the following diagnoses: talar dome osteochondral fractures, loose bodies, accessory ossicles, talar dome cyst with loose bodies, and chronic synovitis. The anatomy of ankle arthroscopy is demanding; while the technique incorporates the same instrumentation as is used for knee arthroscopy, awareness of the neurovascular structures is essential to avoid complications. Although infrequent, complications can include sinus tract formation, sensory nerve damage, synovitis, infection, instrument breakage, and calf compartment syndromes due to extravasation of irrigation fluid. PMID:3050810

Barber, F A; Britt, B T; Ratliff, H W; Sutker, A N

1988-05-01

81

Arthroscopic Treatment of Synovial Chondromatosis of the Hip  

Microsoft Academic Search

Background: Recently, arthroscopic loose body removal and synovectomy have been performed as treatments for synovial chondromatosis of the hip joint. However, to date, no reports have been published on the outcomes of arthroscopic treatments.Hypothesis: Arthroscopic treatment is effective for synovial chondromatosis of the hip joint and has advantages such as low recurrence rates, faster return to activities of daily life,

Jung-Bum Lee; Chan Kang; Chang-Hwan Lee; Pil-Sung Kim; Deuk-Soo Hwang

2012-01-01

82

Unplanned overnight admissions in day-case arthroscopic shoulder surgery  

Microsoft Academic Search

The majority of arthroscopic shoulder procedures can be safely performed as day-case surgery. However, despite better pain control and preoperative assessment; some patients end with unplanned overnight admission. The aim of this study was to investigate the reasons behind unplanned admissions of patients undergoing day-case arthroscopic shoulder surgery.A retrospective review of 242 consecutive cases of arthroscopic shoulder surgery performed by

J. Sultan; K. Z. Marflow; B. Roy

83

Comprehensive Approach to Arthroscopic Rotator Cuff Repair: Options and Techniques  

MedlinePLUS

... one. That was more for grabbing the anterior aspect just to -- for later preparation. 00:38:!6 ... try and bring the cuff from the posterior aspect to the anterior aspect on the tuberosity. 00: ...

84

Arthroscopic transosseous suture anchor technique for rotator cuff repairs.  

PubMed

The skin is incised 1 to 2 cm distal to the lateral portal. A transosseous tunnel is created through the greater tuberosity by a sharp penetrator, entering 1.5 to 2 cm distal to the top of the greater tuberosity. The penetrator exits medially, between the tip of the greater tuberosity and the articular surface of the humeral head, in the middle of the footprint. The first anchor, a 5-mm Spiralok (DePuy Mitek, Norwood, MA) is placed at the penetrator's exit site on the footprint. Using a specially designed suture leader, the lateral limb of the suture in the anchor, which passes through the previously created transosseous tunnel, is taken from the anchor and pulled out. The other suture end is passed through the supraspinatus tendon. The second suture, placed superficially in the anchor, is passed from the anchor through the supraspinatus tendon, as a mattress suture. If more anchors are required, the procedure should be repeated. The transosseous suture limb and the suture limb that is passed through the supraspinatus tendon are tied through the lateral portal. The knot tying is then performed with a sliding Delimar knot. The mattress suture, passing through the supraspinatus tendon, is tied through the anterior lateral portal. The knot tying procedure is repeated depending on the number of anchors. PMID:16651169

Cicak, Nikola; Klobucar, Hrvoje; Bicanic, Goran; Trsek, Denis

2006-05-01

85

A two-year clinical outcomes study of 400 patients, comparing open surgery and arthroscopy for rotator cuff repair  

PubMed Central

Objectives The aim of this study was to determine whether there is any significant difference in temporal measurements of pain, function and rates of re-tear for arthroscopic rotator cuff repair (RCR) patients compared with those patients undergoing open RCR. Methods This study compared questionnaire- and clinical examination-based outcomes over two years or longer for two series of patients who met the inclusion criteria: 200 open RCR and 200 arthroscopic RCR patients. All surgery was performed by a single surgeon. Results Most pain measurements were similar for both groups. However, the arthroscopic RCR group reported less night pain severity at six months, less extreme pain and greater satisfaction with their overall shoulder condition than the open RCR group. The arthroscopic RCR patients also had earlier recovery of strength and range of motion, achieving near maximal recovery by six months post-operatively whereas the open RCR patients took longer to reach the same recovery level. The median operative times were 40 minutes (20 to 90) for arthroscopic RCR and 60 minutes (35 to 120) for open RCR. Arthroscopic RCR had a 29% re-tear rate compared with 52% for the open RCR group (p < 0.001). Conclusions Arthroscopic RCR involved less extreme pain than open RCR, earlier functional recovery, a shorter operative time and better repair integrity. PMID:23610693

Walton, J. R.; Murrell, G. A. C.

2012-01-01

86

[Arthroscopic surgery of the trapeziometacarpal joint].  

PubMed

Treatments of 1st CMC joint arthritis are numerous. Arthroscopic surgery allows distal trapezium resection in early stage of CMC arthritis, avoiding more extensive classical open surgery. The distal trapezium resection is performed under arthroscopic control, associated to tendinous interposition. Between 2000 and 2005 we treated 32 patients. There were 26 women and 6 men. The average age was 56 years old (range 48-78). In 4 cases we had to transform the procedure in open surgery with trapezectomy. Postoperative pain were usual and long. We had technical fault with foreign bodies in one case, insufficient resection in 2 cases. One case presented a secondary joint collapses with necessity of other operation. PMID:17361898

Da Rin, F

2006-11-01

87

[Arthroscopic surgery of the trapeziometacarpal joint.  

PubMed

Treatments of 1st CMC joint arthritis are numerous. Arthroscopic surgery allows distal trapezium resection in early stage of CMC arthritis, avoiding more extensive classical open surgery. The distal trapezium resection is performed under arthroscopic control, associated to tendinous interposition. Between 2000 and 2005 we treated 32 patients. There were 26 women and 6 men. The average age was 56 years old (range 48-78). In 4 cases we had to transform the procedure in open surgery with trapezectomy. Postoperative pain were usual and long. We had technical fault with foreign bodies in one case, insufficient resection in 2 cases. One case presented a secondary joint collapses with necessity of other operation. PMID:17349404

Da Rin, F

2006-11-01

88

Complications of arthroscopic surgery of the hip  

PubMed Central

Over recent years hip arthroscopic surgery has evolved into one of the most rapidly expanding fields in orthopaedic surgery. Complications are largely transient and incidences between 0.5% and 6.4% have been reported. However, major complications can and do occur. This article analyses the reported complications and makes recommendations based on the literature review and personal experience on how to minimise them. PMID:23610683

Papavasiliou, A. V.; Bardakos, N. V.

2012-01-01

89

The Arthroscopic Surgical Skill Evaluation Tool (ASSET)  

PubMed Central

Background Surgeries employing arthroscopic techniques are among the most commonly performed in orthopaedic clinical practice however, valid and reliable methods of assessing the arthroscopic skill of orthopaedic surgeons are lacking. Hypothesis The Arthroscopic Surgery Skill Evaluation Tool (ASSET) will demonstrate content validity, concurrent criterion-oriented validity, and reliability, when used to assess the technical ability of surgeons performing diagnostic knee arthroscopy on cadaveric specimens. Study Design Cross-sectional study; Level of evidence, 3 Methods Content validity was determined by a group of seven experts using a Delphi process. Intra-articular performance of a right and left diagnostic knee arthroscopy was recorded for twenty-eight residents and two sports medicine fellowship trained attending surgeons. Subject performance was assessed by two blinded raters using the ASSET. Concurrent criterion-oriented validity, inter-rater reliability, and test-retest reliability were evaluated. Results Content validity: The content development group identified 8 arthroscopic skill domains to evaluate using the ASSET. Concurrent criterion-oriented validity: Significant differences in total ASSET score (p<0.05) between novice, intermediate, and advanced experience groups were identified. Inter-rater reliability: The ASSET scores assigned by each rater were strongly correlated (r=0.91, p <0.01) and the intra-class correlation coefficient between raters for the total ASSET score was 0.90. Test-retest reliability: there was a significant correlation between ASSET scores for both procedures attempted by each individual (r = 0.79, p<0.01). Conclusion The ASSET appears to be a useful, valid, and reliable method for assessing surgeon performance of diagnostic knee arthroscopy in cadaveric specimens. Studies are ongoing to determine its generalizability to other procedures as well as to the live OR and other simulated environments. PMID:23548808

Koehler, Ryan J.; Amsdell, Simon; Arendt, Elizabeth A; Bisson, Leslie J; Braman, Jonathan P; Butler, Aaron; Cosgarea, Andrew J; Harner, Christopher D; Garrett, William E; Olson, Tyson; Warme, Winston J.; Nicandri, Gregg T.

2014-01-01

90

Arthroscopic Wafer Procedure for Ulnar Impaction Syndrome  

PubMed Central

Ulnar impaction syndrome is abutment of the ulna on the lunate and triquetrum that increases stress and load, causing ulnar-sided wrist pain. Typically, ulnar-positive or -neutral variance is seen on a posteroanterior radiograph of the wrist. The management of ulnar impaction syndrome varies from conservative, symptomatic treatment to open procedures to shorten the ulna. Arthroscopic management has become increasingly popular for management of ulnar impaction with ulnar-positive variance of less than 3 mm and concomitant central triangular fibrocartilage complex tears. This method avoids complications associated with open procedures, such as nonunion and symptomatic hardware. The arthroscopic wafer procedure involves debridement of the central triangular fibrocartilage complex tear, along with debridement of the distal pole of the ulna causing the impaction. Debridement of the ulna arthroscopically is taken down to a level at which the patient is ulnar neutral or slightly ulnar negative. Previous studies have shown good results with relief of patient symptoms while avoiding complications seen with open procedures. PMID:24749031

Colantoni, Julie; Chadderdon, Christopher; Gaston, R. Glenn

2014-01-01

91

ARTHROSCOPIC INTERPOSITION ARTHROPLASTY OF THE FIRST CARPOMETACARPAL JOINT  

Microsoft Academic Search

First carpometacarpal joint arthritis is a common condition encountered by hand surgeons. Traditionally, surgical approaches have included arthrodesis, trapeziectomy or reconstructive arthroplasty techniques. Previously, we described a technique for arthroscopic debridement and interposition arthroplasty of the first carpometacarpal joint. Patients with Eaton stages II and III symptomatic first carpometacarpal joint arthritis recalcitrant to >6 months of non-operative therapy underwent arthroscopic

J. E. ADAMS; S. M. MERTEN; S. P. STEINMANN

2007-01-01

92

Arthroscopic Assessment and Treatment of Dancers' Knee Injuries.  

ERIC Educational Resources Information Center

Arthroscopic examination of 16 dancers with dance-related knee injuries which defied conservative treatment showed 15 meniscal tears and 4 cases of chondromalacia patellae. Partial arthroscopic meniscectomy was used to treat the tears. The results were excellent, with 13 of the 16 returning to preoperative levels of dance activity. (MT)

Silver, Daniel M.; Campbell, Pat

1985-01-01

93

Visualization and reduction of a mensical capsular junction tear in the knee: an arthroscopic surgical technique.  

PubMed

Meniscal injuries commonly occur concomitantly with anterior cruciate ligament (ACL) injuries. Although many types of meniscal injuries have been described in the literature, there has not been much focus on meniscal capsular junction (MCJ) tears. This lack of attention is concerning given that, in a survey of 67 orthopedic surgeons, 88% indicated that MCJ tears could be a source of chronic pain. In addition, we reviewed 781 ACL reconstructions at our clinic and found a 12.3% incidence of MCJ tear with primary ACL injury and a 23.6% incidence of MCJ tear with revision ACL reconstruction. In this article, we describe an arthroscopic repair technique for MCJ tears at the posterior aspect of the medial meniscus root. The repair uses an accessory posterior medial portal. The technique can also be used for significant posterior medial capsular tears. PMID:25379745

Plymale, Mickey; Fleisig, Glenn S; Kocaj, Stephen M; Cooney, William P; Evans, Timothy J; Cain, E Lyle; Dugas, Jeffrey R

2014-11-01

94

Elbow arthroscopic surgery update for sports medicine conditions.  

PubMed

Elbow arthroscopic surgery can now effectively treat a variety of conditions that affect athletes. Advances in instrumentation, increased surgeon familiarity, and expanded indications have led to significant growth in elbow arthroscopic surgery in the past few decades. While positioning, portal placement, and specific instruments may vary among surgeons, anatomic considerations guide surgical approaches to minimize neurovascular compromise. Arthroscopic procedures vary in difficulty, and surgeons should follow stepwise advancement with experience. Removal of loose bodies, debridement of synovial plicae, and debridement of the extensor carpi radialis brevis for lateral epicondylitis are considered simple procedures for novice elbow arthroscopic surgeons. More advanced procedures include management of osteochondritis dissecans, valgus extension overload in the throwing athlete, and capsular release. With proper technique, a variety of athletic elbow conditions can be treated arthroscopically with predictable results and minimal morbidity. PMID:23572098

Byram, Ian R; Kim, H Mike; Levine, William N; Ahmad, Christopher S

2013-09-01

95

Ulnar shortening after TFCC suture repair of Palmer type 1B lesions  

Microsoft Academic Search

Purpose  The objective of this study was to determine functional and subjective outcomes of an ulnar shortening procedure elected by\\u000a patients who experienced persistent ulno-carpal symptoms following arthroscopic suture repair of a Palmer type 1B lesion.\\u000a All patients had a dynamic ulna positive variance.\\u000a \\u000a \\u000a \\u000a Methods  Five patients (3 males and 2 females) with arthroscopic repair of Palmer type 1B tears who subsequently

Maya B. Wolf; Markus W. Kroeber; Andreas Reiter; Susanne B. Thomas; Peter Hahn; Raymund E. Horch; Frank Unglaub

2010-01-01

96

Arthroscopic surgery in a reticulated giraffe (Giraffa camelopardalis reticulata).  

PubMed

An 8-mo-old captive male reticulated giraffe (Giraffa camelopardalis reticulata) developed an acute lameness (grade IV/V) of the right forelimb, with swelling of the metacarpophalangeal joint. A traumatic injury was suspected based on clinical, radiographic, and arthroscopic evaluation. Several abnormalities were identified arthroscopically, including synovitis, cartilage damage, and an osteochondral fragment. Medial collateral ligament damage was also suspected based on radiographic evaluation. Arthroscopy provided a means of diagnosis and treatment of the abnormalities identified. The lameness in this giraffe resolved within 6 wk following arthroscopic surgery. PMID:10572867

Radcliffe, R M; Turner, T A; Radcliffe, C H; Radcliffe, R W

1999-09-01

97

Arthroscopic treatment options for irreparable rotator cuff tears of the shoulder.  

PubMed

The management of patients with irreparable rotator cuff tears remains a challenge for orthopaedic surgeons with the final treatment option in many algorithms being either a reverse shoulder arthroplasty or a tendon transfer. The long term results of these procedures are however still widely debated, especially in younger patients. A variety of arthroscopic treatment options have been proposed for patients with an irreparable rotator cuff tear without the presence of arthritis of the glenohumeral joint. These include a simple debridement with or without a biceps tenotomy, partial rotator cuff repair with or without an interval slide, tuberplasty, graft interposition of the rotator cuff, suprascapular nerve ablation, superior capsule reconstruction and insertion of a biodegradable spacer (Inspace) to depress the humeral head. These options should be considered as part of the treatment algorithm in patients with an irreparable rotator cuff and could be used as either as an interim procedure, delaying the need for more invasive surgery in the physiologically young and active, or as potential definitive procedures in the medically unfit. The aim of this review is to highlight and summarise arthroscopic procedures and the results thereof currently utilised in the management of these challenging patients. PMID:25405083

Anley, Cameron M; Chan, Samuel Kl; Snow, Martyn

2014-11-18

98

Arthroscopic treatment options for irreparable rotator cuff tears of the shoulder  

PubMed Central

The management of patients with irreparable rotator cuff tears remains a challenge for orthopaedic surgeons with the final treatment option in many algorithms being either a reverse shoulder arthroplasty or a tendon transfer. The long term results of these procedures are however still widely debated, especially in younger patients. A variety of arthroscopic treatment options have been proposed for patients with an irreparable rotator cuff tear without the presence of arthritis of the glenohumeral joint. These include a simple debridement with or without a biceps tenotomy, partial rotator cuff repair with or without an interval slide, tuberplasty, graft interposition of the rotator cuff, suprascapular nerve ablation, superior capsule reconstruction and insertion of a biodegradable spacer (Inspace) to depress the humeral head. These options should be considered as part of the treatment algorithm in patients with an irreparable rotator cuff and could be used as either as an interim procedure, delaying the need for more invasive surgery in the physiologically young and active, or as potential definitive procedures in the medically unfit. The aim of this review is to highlight and summarise arthroscopic procedures and the results thereof currently utilised in the management of these challenging patients.

Anley, Cameron M; Chan, Samuel KL; Snow, Martyn

2014-01-01

99

Single versus double-row repair of the rotator cuff  

Microsoft Academic Search

Purpose  Several techniques for arthroscopic repair of rotator cuff defects have been introduced over the past years. Besides established\\u000a techniques such as single-row repairs, new techniques such as double-row reconstructions have gained increasing interest.\\u000a The present article therefore provides an overview of the currently available literature on both repair techniques with respect\\u000a to several anatomical, biomechanical, clinical and structural endpoints.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  Systematic

Stephan Pauly; Christian Gerhardt; Jianhai Chen; Markus Scheibel

2010-01-01

100

Arthroscopic debridement and grafting of an intraosseous talar ganglion.  

PubMed

We report the case of a 41-year-old man with right ankle pain and swelling who had an intraosseous talar ganglion in the medial part of talar dome. A surgical procedure was performed using the 3-portal arthroscopic approach. The softened chondral surface was removed and the content of the cyst was discharged arthroscopically. The sclerotic rim was abraded until the bleeding spongious layer was seen. A grafting procedure was also performed arthroscopically. A trocar was introduced into the defect from the superomedial portal. Autografts were impacted using a cylindrical rod through the trocar into the defect. The clinical and radiologic results at the 1-year follow-up were satisfactory. We encountered no complications postoperatively. We conclude that arthroscopic debridement and grafting of an intraosseous ganglion adjacent to the articular surface may be a better option compared with open surgery. PMID:16226660

Uysal, Mustafa; Akpinar, Sercan; Ozalay, Metin; Ozkoç, Gurkan; Cesur, Necip; Hersekli, Murat A; Tandogan, Reha N

2005-10-01

101

Experience-based virtual training system for knee arthroscopic inspection  

PubMed Central

Background Arthroscopic surgical training is inherently difficult due to limited visibility, reduced motion freedom and non-intuitive hand-eye coordination. Traditional training methods as well as virtual reality approach lack the direct guidance of an experienced physician. Methods This paper presents an experience-based arthroscopic training simulator that integrates motion tracking with a haptic device to record and reproduce the complex trajectory of an arthroscopic inspection procedure. Optimal arthroscopic operations depend on much practice because the knee joint space is narrow and the anatomic structures are complex. The trajectory of the arthroscope from the experienced surgeon can be captured during the clinical treatment. Then a haptic device is used to guide the trainees in the virtual environment to follow the trajectory. Results In this paper, an experiment for the eight subjects’ performance of arthroscopic inspection on the same simulator was done with and without the force guidance. The experiment reveals that most subjects’ performances are better after they repeated the same inspection five times. Furthermore, most subjects’ performances with the force guidance are better than those without the force guidance. In the experiment, the average error with the force guidance is 33.01% lower than that without the force guidance. The operation time with the force guidance is 14.95% less than that without the force guidance. Conclusions We develop a novel virtual knee arthroscopic training system with virtual and haptic guidance. Compared to traditional VR training system that only has a single play-script based on a virtual model, the proposed system can track and reproduce real-life arthroscopic procedures and create a useful training database. From our experiment, the force guidance can efficiently shorten the learning curve of novice trainees. Through such system, novice trainees can efficiently develop required surgical skills by the virtual and haptic guidance from an experienced surgeon. PMID:23826988

2013-01-01

102

Hernia Repair  

MedlinePLUS

... navel. There are two kinds of hernia repair: Traditional (open) hernia repair - The surgeon cuts open the ... less than one or two hours to complete. Traditional hernia repair - In a traditional repair, the surgeon ...

103

Arthroscopic double-locked stitch: a new technique for suturing rotator cuff tears.  

PubMed

There are a number of reasons for failed rotator cuff tear repair. In such cases the suture-tendon interface seems to be the most vulnerable area, especially when tendon degeneration is present. We describe a new technique, the arthroscopic double-locked suture, that increases the tendon fixation and has the added benefit of being placed parallel to the blood vessels, therefore avoiding damage to the tendon vascularization. The suture may be achieved by use of knots or knotless anchors and suture passers, without the need for any additional instrumentation. The new technique is especially helpful in cases in which the tendon is retracted and degeneration is present, impeding the use of the double-row technique or its transosseous equivalents. PMID:24904764

Miyazaki, Alberto N; Zanella, Luiz A Z; La Salvia, João C; Fregoneze, Marcelo; Santos, Pedro D; da Silva, Luciana A; Sella, Guilherme do Vall; Checchia, Sergio L

2014-04-01

104

An arthroscopic analysis of lateral meniscal variants and a comparison with MRI findings  

Microsoft Academic Search

We reviewed 164 consecutive cases (158 patients) of arthroscopic examinations for lateral meniscal variants during the last 10 years. We classified lateral meniscal variants into four types by arthroscopic appearance, into six tear patterns by modifying OConnors classification, and compared magnetic resonance images (MRI) with arthroscopic findings. Regarding the four types, 131 cases were complete, 25 cases were incomplete, 4 cases

Yong-Goo Kim; Joo-Chul Ihn; Seong-Ki Park; Hee-Soo Kyung

2006-01-01

105

Subscapularis Repair With the Suture Shuttle Loop Technique  

PubMed Central

Successful techniques for arthroscopic repair of subscapularis tendon tears have been previously described in the literature. Recommendations regarding portal placement, tissue mobilization, and suture passage have been published. We present a novel technique that uses a shuttle suture passed with the Viper suture passer (Arthrex, Naples, FL) through a standard anterior arthroscopy portal. The described technique easily passes a suture through the subscapularis tendon while the surgeon visualizes suture placement from the posterior portal. PMID:23767007

Nystrom, Stephen; Fagan, Paul; Vedder, Kristin; Heming, James

2013-01-01

106

Arthroscopic ankle arthrodesis with intra-articular distraction.  

PubMed

Arthroscopic ankle arthrodesis has shown high rates of union comparable to those with open arthrodesis but with substantially less postoperative morbidity, shorter operative times, less blood loss, and shorter hospital stays. To easily perform arthroscopic resection of the articular cartilage, sufficient distraction of the joint is necessary to insert the arthroscope and instruments. However, sometimes, standard noninvasive ankle distraction will not be sufficient in post-traumatic ankle arthritis, with the development of arthrofibrosis and joint contracture after severe ankle trauma. In the present report, we describe a technique to distract the ankle joint by inserting a 4.6-mm stainless steel cannula with a blunt trocar inside the joint. The cannula allowed sufficient intra-articular distraction, and, at the same time, a 4.0-mm arthroscope can be inserted through the cannula to view the joint. Screws can be inserted to fix the joint under fluoroscopic guidance without changing the patient's position or removing the noninvasive distraction device and leg holder, which are often necessary during standard arthroscopic arthrodesis with noninvasive distraction. PMID:24717518

Kim, Hyong Nyun; Jeon, June Young; Noh, Kyu Cheol; Kim, Hong Kyun; Dong, Quanyu; Park, Yong Wook

2014-01-01

107

Outcomes of Open Subacromial Decompression after Failed Arthroscopic Acromioplasty  

PubMed Central

Aim. To prospectively assess the effectiveness of revision with open subacromial decompression in patients who had a previous unsatisfactory outcome with the arthroscopic procedure. Methods. 11 patients were identified for the study, who did not demonstrate expected improvement in symptoms after arthroscopic acromioplasty. All patients underwent structured rehabilitation. Functional evaluation was conducted using the Hospital for Special Surgery, New York, shoulder rating questionnaire. Results. M?:?F was 7?:?4. The mean age was 57?years. The average shoulder score improved from 49.6 preoperatively to 56 postoperatively at an average followup of 16 months. Two patients showed deterioration in their shoulder scores after revision while the rest showed only marginal improvement. All except one patient stated that they would opt for surgery again if given a second chance. Conclusion. In the group of patients that fail to benefit from the arthroscopic decompression, only a marginal improvement was noted after revision with open decompression. PMID:22649740

Pillai, Anand; Eranki, Vivek; Malal, Joby; Nimon, Gavin

2012-01-01

108

Image-driven haptic simulation of arthroscopic surgery.  

PubMed

Virtual haptic simulation of minimally invasive arthroscopic surgery becomes an extremely important training tool that allows the medical students to acquire necessary motor skills before they can approach actual patients. Normally, 3D simulation of the interior of a joint requires significant efforts from the software developers but yet remains not always photo realistic. In this paper, we propose a pioneering approach of using augmented real arthroscopic images for realistic and immersive image-driven visualization and haptic interaction within the surgical field as if it were actual three-dimensional scene where body parts displayed in the image act and feel as real 3D objects rather than their images. PMID:23400181

Rasool, Shahzad; Sourin, Alexei; Kagda, Fareed

2013-01-01

109

Arthroscopic treatment of post-traumatic cysts of the talus.  

PubMed

We report on 9 patients with persistent ankle pain and radiographic evidence of a cystic lesion on the talus. All had a history of an inversion-type of ankle injury. Radiographs were initially negative, but a cyst developed about 6 months after the injury. Arthroscopic debridement revealed extrusion of viscid gelatinous material from the cyst. The cavity was arthroscopically abraded to bleeding base. Follow-up of these patients at an average of 26 months showed statistically significant improvement in terms of pain, swelling, stiffness, limp, and activity level. Bone grafting may not be necessary in the treatment of post-traumatic cysts. PMID:10705333

Ogilvie-Harris, D J; Sarrosa, E A

2000-03-01

110

Arthroscopic Medial Retinacular Plication With a Needle-Hole Technique  

PubMed Central

Patellar instability is a common problem resulting in anterior knee pain. The medial patellofemoral ligament, which is part of the medial retinaculum, is often injured, and this damaged structure can affect normal patellar movement. Medial retinacular plication can correct this main pathology of patellar instability. Many studies have shown good to excellent results with medial retinacular plication with or without lateral retinacular release. This medial retinacular plication technique can also be performed arthroscopically. Arthroscopic medial reticular plication with a needle-hole technique is a treatment that uses the less invasive technique of arthroscopy, does not require tissue grafts, and has a greater cosmetic advantage than open procedures.

Prasathaporn, Niti; Kuptniratsaikul, Somsak; Kongrukgreatiyos, Kitiphong

2014-01-01

111

The results of arthroscopic anterior stabilisation of the shoulder using the bioknotless anchor system  

PubMed Central

Background Shoulder instability is a common condition, particularly affecting a young, active population. Open capsulolabral repair is effective in the majority of cases, however arthroscopic techniques, particularly using suture anchors, are being used with increasing success. Methods 15 patients with shoulder instability were operated on by a single surgeon (VK) using BioKnotless anchors (DePuy Mitek, Raynham, MA). The average length of follow-up was 21 months (17 to 31) with none lost to follow-up. Constant scores in both arms, patient satisfaction, activity levels and recurrence of instability was recorded. Results 80% of patients were satisfied with their surgery. 1 patient suffered a further dislocation and another had recurrent symptomatic instability. The average constant score returned to 84% of that measured in the opposite (unaffected) shoulder. There were no specific post-operative complications encountered. Conclusion In terms of recurrence of symptoms, our results show success rates comparable to other methods of shoulder stabilisation. This technique is safe and surgeons familiar with shoulder arthroscopy will not encounter a steep learning curve. Shoulder function at approximately 2 years post repair was good or excellent in the majority of patients and it was observed that patient satisfaction was correlated more with return to usual activities than recurrence of symptoms. PMID:19284697

Cooke, Stephen J; Starks, Ian; Kathuria, Vinod

2009-01-01

112

Patient outcomes following T-Fix meniscal repair and a modifiable, progressive rehabilitation program, a retrospective study  

Microsoft Academic Search

Introduction This retrospective study presents clinical patient outcomes following meniscal repair using T-Fix devices and a modifiable, progressive rehabilitation program. Materials and methods Fifty-two patients (35 males and 17 females) with a mean age of 26.7 years (range 13–50 years) representing all of the patients who underwent arthroscopic meniscal repair (43 medial meniscus, 12 lateral meniscus) over a 3-year period by the

Yavuz Kocabey; John Nyland; William M. Isbell; David N. M. Caborn

2004-01-01

113

Arthroscopic Treatment of Slipped Capital Femoral Epiphysis Screw Impingement and Concomitant Hip Pathology  

PubMed Central

Impingement caused by screws used for stabilization of slipped capital femoral epiphysis can be treated arthroscopically. Although troublesome screws have traditionally been removed by open techniques, arthroscopic removal can successfully be achieved. In addition to affording the patient the benefits of minimally invasive surgery, surgeons also have the ability to arthroscopically address any concomitant hip pathology responsible for pain, including femoroacetabular impingement and labral tears. PMID:25264513

Howse, Elizabeth A.; Wooster, Benjamin M.; Mannava, Sandeep; Perry, Brad; Stubbs, Allston J.

2014-01-01

114

Arthroscopic management of anterior shoulder instability with glenoid bone defects.  

PubMed

Bony deficiency of the anterior glenoid rim may significantly contribute to recurrent shoulder instability. Today, based on clinical and biomechanical data, a bony reconstruction is recommended in patients with bone loss of greater than 20-25 % of the glenoid surface area. Recent advances in arthroscopic instruments and techniques presently allow minimally invasive and arthroscopic reconstruction of glenoid bone defects and osteosynthesis of glenoid fractures. This article underlines the role of glenoid bone deficiency in recurrent shoulder instability, provides an update on the current management regarding this pathology and highlights the modern techniques for surgical treatment. Therefore, it can help orthopaedic surgeons in the treatment and decision-making when dealing with these difficult to treat patients in daily clinical practice. PMID:22976501

Martetschläger, Frank; Kraus, Tobias M; Hardy, Philippe; Millett, Peter J

2013-12-01

115

Arthroscopic hip preservation surgery: current concepts and perspective.  

PubMed

The technical advances in arthroscopic surgery of the hip, including the improved ability to manage the capsule and gain extensile exposure, have been paralleled by a growth in the number of conditions that can be addressed. This expanding list includes symptomatic labral tears, chondral lesions, injuries of the ligamentum teres, femoroacetabular impingement (FAI), capsular laxity and instability, and various extra-articular disorders, including snapping hip syndromes. With a careful diagnostic evaluation and technical execution of well-indicated procedures, arthroscopic surgery of the hip can achieve successful clinical outcomes, with predictable improvements in function and pre-injury levels of physical activity for many patients.This paper reviews the current position in relation to the use of arthroscopy in the treatment of disorders of the hip. PMID:23307667

Bedi, A; Kelly, B T; Khanduja, V

2013-01-01

116

Arthroscopic Gluteal Muscle Contracture Release With Radiofrequency Energy  

Microsoft Academic Search

Gluteal muscle contracture is common after repeated intramuscular injections and sometimes is sufficiently debilitating to\\u000a require open surgery. We asked whether arthroscopic release of gluteal muscle contracture using radiofrequency energy would\\u000a decrease complications with clinically acceptable results. We retrospectively reviewed 108 patients with bilateral gluteal\\u000a muscle contractures (57 males, 51 females; mean age, 23.7 years). We used inferior, anterosuperior, and posterosuperior

Yu-Jie Liu; Yan Wang; Jing Xue; Pauline Po-Yee Lui; Kai-Ming Chan

2009-01-01

117

Clinical Outcomes after Arthroscopic Release for Recalcitrant Frozen Shoulder  

PubMed Central

Background: To explain the role of arthroscopic release in intractable frozen shoulders. We used different questionnaires and measuring tools to understand whether arthroscopic release is the superior modality to treat patients with intractable frozen shoulders. Methods: Between 2007 and 2013, in a prospective study, we enrolled 80 patients (52 females and 28 males) with recalcitrant frozen shoulder, who underwent arthroscopic release at Ghaem Hospital, a tertiary referral center, in Mashhad, Iran. Before operation, all patients filled out the Disability of Arm, Shoulder and Hand (DASH), Constant, University of California Los Angeles (UCLA), ROWE and Visual Analogue Scale (VAS) for pain questionnaires. We measured the difference in range of motion between both the normal and the frozen shoulders in each patient. Results: The average age of the patients was 50.8±7.1 years. In 49 patients, the right shoulder was affected and in the remaining 31 the left side was affected. Before surgery, the patients were suffering from this disease on average for 11.7±10.3 months. The average time to follow-up was 47.2±6.8 months (14 to 60 months). Diabetes mellitus (38%) and history of shoulder trauma (23%) were the most common comorbidities in our patients. We did not find any significant differences between baseline characteristics of diabetics patients with non-diabetics ones. After surgery, the average time to achieve maximum pain improvement and range of motion were 3.6±2.1 and 3.6±2 months, respectively. The VAS score, constant shoulder score, Rowe score, UCLA shoulder score, and DASH score showed significant improvement in shoulder function after surgery, and shoulder range of motion improved in all directions compared to pre-operation range of motion. Conclusions: According to our results, arthroscopic release of recalcitrant frozen shoulder is a valuable modality in treating this disease. This method could decrease pain and improve both subjective and objective mid-term outcomes. PMID:25386586

Ebrahimzadeh, Mohammad H; Moradi, Ali; Pour, Mostafa Khalili; Moghadam, Mohammad Hallaj; Kachooei, Amir Reza

2014-01-01

118

Arthroscopic Bony Bankart Fixation Using a Modified Sugaya Technique  

PubMed Central

Arthroscopic fixation of bony Bankart lesions in the setting of anterior shoulder instability has had successful long-term results. Key factors such as patient positioning, portal placement, visualization, mobilization of bony/soft tissues, and anatomic reduction and fixation are crucial to yield such results. We present a modified Sugaya technique that is reproducible and based on such key principles. This technique facilitates ease of anchor and suture placement to allow for anatomic reduction and fixation. PMID:24265994

Gupta, Anil K.; McCormick, Frank M.; Abrams, Geoffrey D.; Harris, Joshua D.; Bach, Bernard R.; Romeo, Anthony A.; Verma, Nikhil N.

2013-01-01

119

Arthroscopic treatment of antirior synovitis of the ankle in athletes  

Microsoft Academic Search

In a retrospective study we analysed the results of arthroscopic treatment of anterior synovitis of the ankle in 35 athletes. Five athletes additionally suffered from anterior osteophytes, and three presented with an anterolateral plica. Their average age was 25 years (SD 8.3), and the follow-up interval was 32.4 months (SD 19.4). Eight patients suffered from additional hyperlaxity of the ankle

J. Jerosch; J. Steinbeck; M. Schröder; H. Halm

1994-01-01

120

Arthroscopic coracoclavicular ligament reconstruction using biologic and suture fixation.  

PubMed

Presented in this report is a modified arthroscopic approach to acromioclavicular joint reconstruction via suture and allograft fixation. An arthroscopic approach is used to expose the base of the coracoid by use of electrocautery. After an open distal clavicle excision is performed, clavicular and coracoid tunnels are created under arthroscopic visualization as previously described by Wolf and Pennington. The myotendinous end of a semitendinosus allograft is sutured to a Spider plate (Kinetikos Medical, San Diego, CA). The tendinous end of the graft is prepared with a running baseball stitch. A Nitinol wire with a loop end (Arthrex, Naples, FL) is used to pass 2 free FiberTape sutures (Arthrex) and the leading sutures from the tendinous end of the graft through the clavicular and coracoid tunnels, exiting out the anterior portal. One of the FiberTape sutures is retrieved with a grasper and passed over the anterior aspect of the distal clavicle. The second FiberTape suture and the allograft are passed over the distal end of the resected clavicle. While the acromioclavicular joint is held reduced, the FiberTape sutures are tied to the plate and the allograft is tensioned medially until the plate is embedded against the superior surface of the clavicle. The tendinous end of the graft is secured to the superior surface of the clavicle with a Bio-tenodesis screw (Arthrex) medial to the clavicular tunnel. PMID:17637416

Pennington, William T; Hergan, David J; Bartz, Brian A

2007-07-01

121

The incidence of reoperation after temporomandibular joint arthroscopic surgery: A retrospective study of 450 consecutive joints  

Microsoft Academic Search

Purpose. The purpose of this study was to investigate the incidence of reoperation after temporomandibular joint arthroscopic surgery in 315 consecutive patients (488 joints). Study Design. The clinical data and operative reports of all patients who underwent arthroscopic procedures from 1995 to 2000 were reviewed retrospectively. Patients had a preoperative clinical and panoramic radiographic evaluation. Most of the patients had

Hani Abd-Ul-Salam; Simon Weinberg; Bohdan Kryshtalskyj

2002-01-01

122

Ultrasonography-Assisted Arthroscopic Proximal Iliotibial Band Release and Trochanteric Bursectomy  

PubMed Central

We describe arthroscopic iliotibial band release and trochanteric bursectomy assisted by intraoperative ultrasonography for accurate placement of arthroscopic portals and to ensure adequate decompression of the peritrochanteric space. We have found ultrasonography for endoscopic iliotibial band release a useful tool to assist with localizing the site and length of decompression. PMID:24400195

Weinrauch, Patrick; Kermeci, Sharon

2013-01-01

123

Pectus excavatum repair  

MedlinePLUS

Funnel chest repair; Chest deformity repair; Sunken chest repair; Cobbler's chest repair; Nuss repair ... The most common reason for pectus excavatum repair is to improve ... very self-conscious about the sunken look of their chest wall. ...

124

Artrhoscopic rotator cuff repair with augmentation: the V-sled technique.  

PubMed

Numerous techniques have been described for patch positioning in rotator cuff shoulder arthroscopic surgery. These techniques seem to be difficult challenges for the majority of arthroscopic surgeons, and because of that they are called "highly demanding" techniques. Without the use of dedicated instruments and cannulas, the authors propose a V-sled technique that seems to be more reproducible, quicker and less difficult to perform for arthroscopic shoulder surgeons. The patient is placed in the lateral position. All arthroscopic procedures are performed without the use of cannulas. The standard posterior portal is used for the glenohumeral (GH) joint arthroscopy with fluid inflowing through the scope. After an accurate evaluation of the GH space, the scope is then introduced into the subacromial space. With the use of a spinal needle, a lateral portal is performed. The great tuberosity is prepared with a bur to place two 5.5 mm triple-loaded radiolucent anchors. In addition, two free high strength sutures are passed through the muscle, respectively. The repair is performed using two high strength sutures from each anchor. The third wire from each anchor is retrieved out of the accessories portals used for the insertion of the anchors. In addition, two free high strength sutures are passed through the muscle, and the patch sizing is done using a measuring probe introduced through the lateral portal. Next, the patch is then prepared and is introduced into the subacromial space, and then the patch is stabilized, and the free sutures are tied. PMID:22615157

Chillemi, Claudio; El Boustany, Stefano; Giudici, Luca Dei; Ippolito, Giorgio

2012-05-01

125

The METEOR trial: no rush to repair a torn meniscus.  

PubMed

It is uncertain whether arthroscopic partial meniscectomy is better than physical therapy in patients who have a symptomatic torn meniscus on top of osteoarthritis of the knee. The Meniscal Repair in Osteoarthritis Research (METEOR) trial concluded that physical therapy is acceptable at first, and that surgery is not routinely needed. In patients assigned to physical therapy who eventually needed surgery, the delay resulting from a trial of conservative management did not impair outcomes at 12 months from the initial presentation. Here, we analyze the background, design, findings, and clinical implications of the METEOR trial. PMID:24692441

Hwang, Yong Gil; Kwoh, C Kent

2014-04-01

126

Sex Differences in Factors Influencing Recovery from Arthroscopic Knee Surgery  

Microsoft Academic Search

Background  Many factors affect recovery from arthroscopic partial meniscectomy, including patient sex. However, sex differences in time\\u000a to maximal recovery of knee function and factors influencing differential rates of recovery are unknown.\\u000a \\u000a \\u000a \\u000a \\u000a Questions\\/purposes  We determined (1) preoperative sex differences, (2) sex differences in rate and extent of recovery through 1 year postoperatively,\\u000a and (3) clinical and fitness variables that could explain potential sex

Patricia H. Rosenberger; Firdaus S. Dhabhar; Elissa Epel; Peter Jokl; Jeannette R. Ickovics

2010-01-01

127

Reossification and fusion across the acromioclavicular joint after arthroscopic acromioplasty and distal clavicle resection.  

PubMed

Arthroscopic acromioplasty and distal clavicle resection has now become an accepted method of treatment for acromioclavicular (AC) joint arthritis. Complications following arthroscopic acromioplasty are relatively uncommon and include instrument breakage, hematoma, traction neuropathy, infection, acromial fracture, reflex sympathetic dystrophy, and recurrence of symptoms. Although heterotopic ossification within the soft tissues has also been reported, complete reossification of the resected clavicle has not. We report a case of reossification of the clavicle and fusion across the AC joint following arthroscopic acromioplasty and distal clavicle resection. PMID:11694940

Tytherleigh-Strong, G; Gill, J; Sforza, G; Copeland, S; Levy, O

2001-01-01

128

Arthroscopic thermal capsular shrinkage for palmar midcarpal instability.  

PubMed

Background?Arthroscopic capsular shrinkage has been previously used to stabilize major joints. This is the first series of its use in the wrist for palmar midcarpal instability (PMCI). Materials and Methods?This is a medium-term retrospective review of 13 patients (15 wrists) at an average follow-up of 48 months postoperative. All patients were assessed with a functional questionnaire for instability and a Disabilities of the Arm, Shoulder, and Hand (DASH) score, as well as clinical examination. Description of Technique?Arthroscopic capsular shrinkage was performed to the palmar and dorsal capsules of the radiocarpal and midcarpal joints using a bipolar thermal probe. All wrists were immobilized for 6 weeks post operation. Results?100% follow-up was achieved . All cases had an improvement in the frequency and severity of instability symptoms. The average DASH score was significantly reduced. There were no complications. The average loss of movement following the procedure was 15%. Conclusions?The medium-term results show that wrist instability due to PMCI can be improved significantly by thermal capsular shrinkage with only a minimal amount of secondary stiffness. PMID:25097808

Hargreaves, David G

2014-08-01

129

A minimally invasive medial patellofemoral ligament arthroscopic reconstruction.  

PubMed

The medial patellofemoral ligament reconstruction is recognized as a good choice for patients with recurrent patellar dislocation. Most techniques of the medial patellofemoral ligament reconstruction are open surgeries. Recently, we present a minimally invasive medial patellofemoral ligament arthroscopic reconstruction technique as a possible alternative method for recurrent patellar dislocation. The aim of the study was to describe a safe and effective technique to perform medial patellofemoral ligament reconstruction. The graft was prepared in shape to "Y." Two 5-mm incisions were made in the skin above the medial edge of the patella. Two docking bone tunnels were drilled from medial edge to the center of the patella, mimicking the wide patellar insertion of the medial patellofemoral ligament, and a bone tunnel was made at the femoral insertion site. Two free ends of the graft were fixed into the patellar tunnels by lateral cortical suspension, and the folded end was fixed into the femoral tunnel by bioabsorbable interference screw. Average patellar tilt and the congruence angle were 30.7° ± 7.5° and 52.7° ± 7.3° and were reduced to 12.8° ± 0.9° and 2.3° ± 11.5° after treatment. The Kujala score was increased from 63.0 ± 9.0 to 91.0 ± 7.0. The minimally invasive medial patellofemoral ligament arthroscopic reconstruction in this paper seems to be helpful to increase safe of operation and treatment effect and reduce complications. PMID:23412307

Zhou, Jian-Wei; Wang, Cheng-Hai; Ji, Gang; Ma, Long-Fei; Wang, Juan; Zhang, Feng; Dong, Jiang-Tao; Wang, Fei

2014-02-01

130

Hydrocele repair  

MedlinePLUS

... Sometimes they form when there is also a hernia (an abnormal bulging of tissue) present. Hydroceles are ... muscle wall with stitches. This is called a hernia repair. Sometimes the surgeon uses a laparoscope to ...

131

Craniosynostosis repair  

MedlinePLUS

... Infection, including in the lungs and urinary tract Blood loss (children having an open repair may need a transfusion) Reactions to medicines Possible risks of having this surgery are: Infection in the brain Bones connect together again, and ...

132

Anatomical Considerations of the Suprascapular Nerve in Rotator Cuff Repairs  

PubMed Central

Introduction. When using the double interval slide technique for arthroscopic repair of chronic large or massive rotator cuff tears, the posterior interval release is directed toward the scapular spine until the fat pad that protects the suprascapular nerve is reached. Injury to the suprascapular nerve can occur due to the nerve's proximity to the operative field. This study aimed to identify safe margins for avoiding injury to the suprascapular nerve. Materials and Methods. For 20 shoulders in ten cadavers, the distance was measured from the suprascapular notch to the glenoid rim, the articular margin of the rotator cuff footprint, and the lateral border of the acromion. Results. From the suprascapular notch, the suprascapular nerve coursed an average of 3.42?cm to the glenoid rim, 5.34?cm to the articular margin of the rotator cuff footprint, and 6.09?cm to the lateral border of the acromion. Conclusions. The results of this study define a safe zone, using anatomic landmarks, to help surgeons avoid iatrogenic injury to the suprascapular nerve when employing the double interval slide technique in arthroscopic repair of the rotator cuff. PMID:24724030

Tom, James A.; Shah, Mitesh P.; Lee, Dan J.; Cerynik, Douglas L.; Amin, Nirav H.

2014-01-01

133

A comparison of radiographic, arthroscopic and histological measures of articular pathology in the canine elbow joint.  

PubMed

Validation of radiographic and arthroscopic scoring of joint pathology requires their comparison with histological measures of disease from the same joint. Fragmentation of the medial coronoid process (FMCP) is a naturally occurring disease of the canine elbow joint that results in osteoarthritis, and the objectives of this study were to compare the severity of histopathological changes in the medial coronoid process (MCP) and medial articular synovial membrane with gross radiographic scoring of elbow joint osteophytosis and the arthroscopic assessment of the MCP articular cartilage surface. Radiographic scoring of osteophytosis and the arthroscopic scoring of visual cartilage pathology of the MCP correlated moderately well with the histopathological evaluation of cartilage damage on the MCP and synovial inflammation in the medial part of the joint, but not with bone pathology in the MCP. Marked cartilage pathology on the MCP was identified in joints with either no radiographic evidence of osteophytosis or with mild cartilage damage that was evident arthroscopically. PMID:19716324

Goldhammer, Marc A; Smith, Sionagh H; Fitzpatrick, Noel; Clements, Dylan N

2010-10-01

134

Can arthroscopic revision surgery for shoulder instability be a fair option?  

PubMed Central

Summary Background: the aim of this study was to evaluate the role of arthroscopic capsuloplasty in the treatment of failed primary arthroscopic treatment of glenohumeral instability. Methods: we retrospectively examined at a minimum of 3-years follow-up 22 patients who underwent arthroscopic treatment between 1999 and 2007 who had recurrent anterior shoulder instability with a post-surgical failure. A statistical analysis was performed to evaluate which variable could influence the definitive result and clinical outcomes at final follow-up. A p value of less than 0.05 was considered significant. Results: we observed after revision surgery an overall failure rate of 8/22 (36.4%) including frank dislocations, subluxations and also apprehension that seriously inhibit the patient's quality of life. No significant differences were observed in the examined parameters. Conclusions: according to our outcomes we generally do not recommend an arthroscopic revision procedure for failed instability surgery. PMID:25332940

De Giorgi, Silvana; Garofalo, Raffaele; Tafuri, Silvio; Cesari, Eugenio; Rose, Giacomo Delle; Castagna, Alessandro

2014-01-01

135

[Arthroscopic reconstruction of the anterior cruciate ligament using double anteromedial and posterolateral bundles].  

PubMed

We propose a method for repairing the anterior cruciate ligament which takes advantage of the multifascular nature of the ligament to achieve better physiological anteroposterior and rotational stability compared with conventional methods. Arthroscopic reconstruction of the anteromedial and posterolateral bundles of the ligament closely reproduces normal anatomy. We have used this technique in 92 patients with anterior cruciate ligament laxity and present here the mid-term results. The hamstring tendons (gracilis and semitendinosus) are harvested carefully to obtain good quality grafts. Arthroscopic preparation of the notch allows careful cleaning of the axial aspect of the lateral condyle; it is crucial to well visualize the region over the top and delimit the 9 h-12 h zone for the right knee or the 12-15 h zone for the left knee. The femoral end of the anteromedial tunnel lies close to the floor of the intercondylar notch, 5 to 10 mm in front of the posterior border of the lateral condyle, at 13 h for the left knee and 11 h for the right knee. The femoral end of the posterolateral tunnel lies more anteriorly, at 14 h for the left knee and 10 h for the right knee. The tibial end of the posterolateral tunnel faces the anterolateral spike of the tibia. The tibial end of the anteromedial tunnel lies in front of the apex of the two tibial spikes half way between the anteromedial spike and the anterolateral spike, 8 mm in front of the protrusion of the posteriolateral pin. The posterolateral graft is run through the femoral and tibial tunnels first. A cortical fixation is used for the femoral end. The femoral end of the anteromedial graft is then fixed in the same way. The tibial fixation begins with the posterolateral graft with the knee close to full extension. The anteromedial graft is fixed with the knee in 90 degrees flexion. Thirty patients were reviewed at least six months after the procedure. Mean age was 28.2 years. Mean overall IKDC score was 86% (36% A and 50% B). Gain in laxity was significant: 6.53 preoperatively and 2.1 postoperatively. Most of the patients (86.6%) were able to resume their former occupation 2 months after the procedure. The different components of the anterior cruciate ligament and their respective functions have been the object of several studies. The anteromedial bundle maintains joint stability during extension and anteroposterior stability during flexion. The posterolateral bundle contributes to the action of the anteromedial bundle with an additional effect due to its position: rotational stability during flexion. In light of the multifascicular nature of the anterior cruciate ligament and the residual rotational laxity observed after conventional repair, our proposed method provides a more anatomic reconstruction which achieves better correction of anteroposterior and rotational stability. This technique should be validated with comparative trials against currently employed methods. PMID:12457115

Franceschi, J P; Sbihi, A; Champsaur, P

2002-11-01

136

Arthroscopic fixation for a malunited greater tuberosity fracture using the suture-bridge technique: technical report and literature review.  

PubMed

Greater tuberosity of the humerus malunion is relatively uncommon, and open techniques are the treatment of choice in most cases. Recent advances in arthroscopic techniques for treatment of greater tuberosity fractures have produced promising results. The use of arthroscopic techniques for the treatment of proximal humerus malunion, however, has been reported only rarely in the literature. This case report describes the malunited greater tuberosity fracture treated arthroscopically using the suture-bridge technique. PMID:19399480

Ji, Jong-Hun; Moon, Chang-Yun; Kim, Young-Yul; Shafi, Mohamed

2009-12-01

137

Adult tibial eminence fracture fixation: arthroscopic procedure using K-wire folded fixation  

Microsoft Academic Search

The purpose of this article is to describe a new and simple technique for arthroscopic fixation of tibial intercondylar eminence\\u000a avulsion fractures using folded surgical pin. This technique allows reduction and fixation of the bone fragment without using\\u000a special equipment. After standard arthroscopic procedure to explore the knee and to remove fracture debris and blood clot,\\u000a the bone block is

Nicolas Bonin; Laurent Jeunet; Laurent Obert; David Dejour

2007-01-01

138

An arthroscopic bone graft procedure for treating anterior–inferior glenohumeral instability  

Microsoft Academic Search

The purpose of this study is twofold: to present an arthroscopic method for treating anterior–inferior glenohumeral instability,\\u000a and to evaluate its feasibility in a cadaveric model. This arthroscopic technique was performed in ten fresh frozen cadaver\\u000a shoulder specimens. Quality of the results following the procedure were evaluated subjectively by assessing how the bone block\\u000a graft was placed respect glenoid rim.

E. Taverna; P. Golanò; V. Pascale; F. Battistella

2008-01-01

139

The resident's ridge as an arthroscopic landmark for anatomical femoral tunnel drilling in ACL reconstruction.  

PubMed

The purposes of this study were to establish the technique to arthroscopically identify the resident's ridge without bony notchplasty even in patients with chronic ACL insufficiency and to elucidate if the ridge could be used as a landmark for anatomical femoral tunnel for ACL graft. There were 50 consecutive patients undergoing arthroscopic ACL reconstruction. With the thigh kept horizontal using a leg holder, a meticulous effort was made to find out a linear ridge running proximo-distal in a posterior one-third of the lateral notch wall, after removal of superficial soft tissue with radiofrequency energy. If the ridge was found, a socket with a rectangular aperture of 5 x 10 mm was created just behind the ridge. At 3-4-weeks post surgery, three-dimensional computed tomography (3-D CT) was performed to geographically identify the location of the ridge using the socket as a reference. Arthroscopically, a linear ridge running from superior-anterior to inferior-posterior on the lateral notch wall was consistently observed 7-10 mm anterior to the posterior articular cartilage margin of the lateral femoral condyle in all of the patients. The 3-D CT pictures proved the arthroscopically identified ridge to be the resident's ridge. The resident's ridge is arthroscopically identifiable after non-mechanical removal of the soft tissues without bony notchplasty. The ridge is a useful landmark for anatomical femoral tunnel drilling in arthroscopic ACL reconstruction. PMID:19915823

Shino, Konsei; Suzuki, Tomoyuki; Iwahashi, Takehiko; Mae, Tatsuo; Nakamura, Norimasa; Nakata, Ken; Nakagawa, Shigeto

2010-09-01

140

Meniscal repair.  

PubMed

The meniscus plays an important role in preventing osteoarthritis of the knee. Repair of a meniscal lesion should be strongly considered if the tear is peripheral and longitudinal, with concurrent anterior cruciate ligament reconstruction, and in younger patients. The probability of healing is decreased in complex or degenerative tears, central tears, and tears in unstable knees. Age or extension of the tear into the avascular area are not exclusion criteria. Numerous repair techniques are available, and suture repair seems to provide superior biomechanical stability. However, the clinical success rate does not correlate well with the mechanical strength of the repair technique. Biologic factors might be of greater importance to the success of meniscal repair than the surgical technique. Therefore, the decision on the most appropriate repair technique should not rely on biomechanical parameters alone. Contemporary all-inside repair systems have decreased the operating time and the level of surgical skill required. Despite the ease of use, there is a potential for complications because of the close proximity of vessels, nerves, and tendons, of which the surgeon should be aware. There is no clear consensus on postoperative rehabilitation. Weight bearing in extension would most likely not be crucial in typical longitudinal lesions. However, higher degrees of flexion, particularly with weight bearing, give rise to large excursions of the menisci and to shear motions, and should therefore be advised carefully. Long-term studies show a decline in success rates with time. Further studies are needed to clarify the factors relevant to the healing of the menisci. Tissue engineering techniques to enhance the healing in situ are promising but have not yet evolved to a practicable level. PMID:19732643

Stärke, Christian; Kopf, Sebastian; Petersen, Wolf; Becker, Roland

2009-09-01

141

Arthroscopic Avulsion Repair of a Pediatric ACL with an Anomalous Primary Insertion into the Lateral Meniscus  

Microsoft Academic Search

Background  Injury to the anterior cruciate ligament (ACL) in the pediatric population is becoming more common, with the majority of ruptures\\u000a occurring at the tibial insertion site. However, to our knowledge, there are no reports of avulsion in which the primary ACL\\u000a insertion site is the anterior lateral meniscal root.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  We report a rare case of a pediatric ACL\\/anterior horn of

Jason O. Toy; Brian T. Feeley; Lawrence V. Gulotta; Russell F. Warren

142

The pathoanatomy and arthroscopic management of femoroacetabular impingement  

PubMed Central

Femoroacetabular impingement (FAI) causes pain and chondrolabral damage via mechanical overload during movement of the hip. It is caused by many different types of pathoanatomy, including the cam ‘bump’, decreased head–neck offset, acetabular retroversion, global acetabular overcoverage, prominent anterior–inferior iliac spine, slipped capital femoral epiphysis, and the sequelae of childhood Perthes’ disease. Both evolutionary and developmental factors may cause FAI. Prevalence studies show that anatomic variations that cause FAI are common in the asymptomatic population. Young athletes may be predisposed to FAI because of the stress on the physis during development. Other factors, including the soft tissues, may also influence symptoms and chondrolabral damage. FAI and the resultant chondrolabral pathology are often treated arthroscopically. Although the results are favourable, morphologies can be complex, patient expectations are high and the surgery is challenging. The long-term outcomes of hip arthroscopy are still forthcoming and it is unknown if treatment of FAI will prevent arthrosis. PMID:23610655

Tibor, L. M.; Leunig, M.

2012-01-01

143

Open and Arthroscopic Surgical Anatomy of the Ankle  

PubMed Central

Ankle-related complaints are among the most commonly encountered problems for musculoskeletal clinicians. Ankle pathology is widely variable, including, but not limited to, fractures, deformity, infection, oncologic diseases, neuromuscular conditions, and arthritis. While nonoperative management with activity modification, bracing and/or shoe modifications, and medications is usually indicated as first line of treatment, surgical intervention may become necessary. A thorough understanding of the complex anatomy and biomechanics of the ankle, and in particular, the potential neurovascular structures that may be encountered, is important to reduce complications and obtain good surgical outcomes. The purpose of this review is to discuss the most common open and arthroscopic exposures to the ankle with a focus on surgically relevant anatomy for each approach. PMID:24288614

Frank, Rachel M.; Hsu, Andrew R.; Gross, Christopher E.; Walton, David M.

2013-01-01

144

Arthroscopic treatment of ruptures of the rotator cuff.  

PubMed

566 patients with shoulder disease were treated at the Clinic of Orthopaedics at the University Hospital Olomouc. Of these, 181 were operated for ruptures of the rotator cuff (RC). They were categorised according to the Gschwend classification, age and gender(1). Laterality of the operated limb was also evaluated. Patients with ruptures larger than 4 cm were treated by open operation. 84 shoulders with ruptures classified as Gschwend I, II and IIIa -52 males and 32 females-were treated arthroscopically. The age of the operated patients ranged from 40-60 years. In both genders, the right shoulder was more often affected. Two operating techniques were used: 1) Transosseal refixation of the RC muscle tendons, using RC MITEK anchor implants, 2) "End to end" sutures, without implants(2-4). Operating time was reduced to 30-40 min. The operating results were evaluated according to the UCLA criteria- University of California Shoulder Rating Score(2). 45 patients achieved excellent results (53 %), 35 patients had good results (42 %), and 4 patients (5 %) obtained satisfactory results. None of the patients obtained poor results- a score of less than 20 was poor. Patients felt comfortable following the operation and none had any post-operational complications. The author is convinced, along with others, that arthroscopic suturing of RC ruptures classified I-IIIa allows for rupture treatment that in the past had to be treated by open technique(2-5). The deltoid muscle is not affected by arthroscopy. There is normalisation of the patient's movement, pain, force, and rotational stability is comparable to the healthy limb. Treatment time is reduced to a minimum and the patient may soon return to normal daily life. PMID:16601771

Holibka, Radomír; Kalina, Radim; Pach, Miroslav; R?zicková, Katherine

2005-12-01

145

Railroad Repair  

NSDL National Science Digital Library

In this online math game from Cyberchase, sneaky Hacker has removed some of the tracks on the Trans-Cyberspace Railroad. Learners must repair the tracks so the Cybertrain can get back to Central Station. Learners add decimals and drag spare tracks to fill the missing spaces.

Wnet

2011-01-01

146

Railroad Repair  

NSDL National Science Digital Library

The sneaky Hacker has removed some of the tracks on the trans-cyberspace railroad. It's up to you to repair the tracks so the cybertrain can get back to Central Station. Youâll need to drag spare tracks to fill the missing spaces. To successfully fill the missing spaces you must add decimals together. Good luck!

2008-01-01

147

Outboard Repair.  

ERIC Educational Resources Information Center

This consortium-developed instructor's manual for small engine repair (with focus on outboard motors) consists of the following nine instructional units: electrical remote control assembly, mechanical remote control assembly, tilt assemblies, exhaust housing, propeller and trim tabs, cooling system, mechanical gearcase, electrical gearcase, and…

Hardway, Jack

148

Motorcycle Repair.  

ERIC Educational Resources Information Center

This motorcycle repair curriculum guide contains the following ten areas of study: brake systems, clutches, constant mesh transmissions, final drives, suspension, mechanical starting mechanisms, electrical systems, fuel systems, lubrication systems, and overhead camshafts. Each area consists of one or more units of instruction. Each instructional…

Hein, Jim; Bundy, Mike

149

DNA excision repair pathways  

Microsoft Academic Search

The major DNA excision repair pathways of base excision repair for endogenous DNA lesions and nucleotide excision repair for DNA damage inflicted by ultraviolet light have been reconstructed with purified mammalian proteins and details of these repair mechanisms are emerging. Similar data are becoming available with regard to mismatch repair for correction of replication errors. Deletion of individual DNA repair

Tomas Lindahl; Peter Karran; Richard D Wood

1997-01-01

150

ARTROSKOPSKO ZDRAVLJENJE ANTERIORNE UTESNITVE V ZGORNJEM SKO?NEM SKLEPU ARTHROSCOPIC TREATMENT OF ANTERIOR IMPINGEMENT IN THE ANKLE  

Microsoft Academic Search

Background. Anterior soft tissue impingement is a common cause of chronic pain in the ankle. The preferred method of operative treatment is an arthroscopic excision of hypertrophic fibrous and synovial tissue in the anterior part of the ankle joint. Methods. We present the results of arthroscopic treatment of anterior ankle impingement in group of 14 patients. Results. Subjective improvement after

Martin Mikek; Mohsen Hussein

151

Preoperative ultrasonographic mapping of calcium deposits facilitates localization during arthroscopic surgery for calcifying tendinitis of the rotator cuff  

Microsoft Academic Search

Calcifying tendinitis is a relatively common disorder of the rotator cuff. For symptomatic patients, excision of the calcium deposits offers reliable pain relief. The arthroscopic technique is demanding. Arthroscopic localization of the deposit is frequently demanding. The technique described in this article facilitates the localization of calcium deposits based on preoperative ultrasonography. Knowing the exact topography of the deposit relative

S Rupp; R Seil; D Kohn

1998-01-01

152

Results of infected total knee arthroplasty treated with arthroscopic debridement and continuous antibiotic irrigation system  

PubMed Central

Background: Arthroscopic debridement with continuous irrigation system was used with success in treating infective arthritis. We evaluated the effectiveness of arthroscopic debridement coupled with antibiotic continuous irrigation system in acute presentation of late infected total knee arthroplasty. Materials and Methods: We performed a retrospective review of medical record of patients with acute presentation of late infected total knee arthroplasty who were treated by arthroscopic debridement coupled with continuous postoperative antibiotic irrigation system. Results: Seventeen patients were included in our study. 15 (88%) patients preserved their total knee prosthesis at mean of followup of 27.5 months (range, 14-28 months). Two (12%) patients failed arthroscopic protocol and finally needed two stages revision. Our study showed an 88% prosthesis retention rate in patients with acute presentation of late prosthetic knee infection. No complication was associated with use of antibiotic irrigation system. Conclusion: Arthroscopic debridement combined with continuous antibiotic irrigation and suction is an effective treatment for patients with acute presentation of late infected total knee arthroplasty. PMID:23533105

Liu, Che-Wei; Kuo, Chun-Lin; Chuang, Shih-Youeng; Chang, Jen-Huei; Wu, Chia-Chun; Tsai, Tsung-Ying; Lin, Leou-Chyr

2013-01-01

153

A detached arthroscopic lens within the shoulder joint: a case report.  

PubMed

Shoulder arthroscopy has become a common procedure in today's orthopedic practice. The safety of this procedure has been well established, but there are some complications associated with every surgical procedure both minor and major. In the present era, with advanced arthroscopic instruments, it is rare to encounter the problem of instrument breakage during arthroscopic surgery. Here, we report an unusual case in which we found a detached arthroscopic lens within the shoulder joint. A 58-year-old male patient who was previously operated for shoulder arthroscopy for the treatment of impingement syndrome combined with shoulder stiffness. We performed shoulder arthroscopy again and removed the detached lens arthroscopically. This case warrants the need for the surgeon and the operating room staff to be well acquainted with the arthroscopic instruments and to check the instruments properly before and after the completion of the procedure. If the operating room staff would have identified the damage to the scope, encountered during the primary operation, we could have avoided the second procedure to remove the lens. PMID:24861465

Ji, Jong-Hun; Jeong, Jae-Jung; Panchal, Karnav; Park, Yong

2014-08-01

154

A novel technique of rotator cuff repair using spinal needle and suture loop  

PubMed Central

Background We present a simple technique of arthroscopic rotator cuff repair using a spinal needle and suture loop. Methods With the arthroscope laterally, a spinal needle looped with PDS is inserted percutaneously into the shoulder posteriorly and penetrated through the healthy posterior cuff tear margin. Anteriorly, another spinal needle loaded with PDS is inserted percutaneously to engage the healthy tissue at the anterior tear margin. The suture in the anterior needle is then delivered into the suture loop of the posterior needle using a suture retriever. The posterior needle and loop are then pulled out carrying the anterior suture with it. The two limbs of this suture are then retrieved through a cannula for knotting. The same procedure is then repeated for additional suturing. Suture anchors placed over the greater tuberosity are used to complete the repair. Conclusion This is an easy method of rotator cuff repair using simple instruments and lesser time, hence can be employed at centers with less equipment and at reduced cost to the patient. PMID:21062442

2010-01-01

155

Arthroscopic Particulated Juvenile Cartilage Allograft Transplantation for the Treatment of Osteochondral Lesions of the Talus.  

PubMed

Several options exist for the treatment of osteochondral lesions of the talus. Particulated juvenile cartilage allograft transplantation (PJCAT) has become a viable treatment modality for osteochondral lesions of the talus that are not amenable to microfracture or for which microfracture has failed. Arthroscopic placement of this type of graft obviates the need for osteotomy or plafondplasty and does not prevent additional procedures from being performed through an anterior approach. Special instrumentation and setup are not required to perform this procedure. Our arthroscopic technique for placement of particulated juvenile cartilage into osteochondral lesions of the talus is described. Case series and outcomes after arthroscopic ankle PJCAT are currently not reported within the literature; however, it is believed that the outcomes are at least similar to those of open ankle PJCAT. PMID:25264516

Adams, Samuel B; Demetracopoulos, Constantine A; Parekh, Selene G; Easley, Mark E; Robbins, Justin

2014-08-01

156

Arthroscopic Particulated Juvenile Cartilage Allograft Transplantation for the Treatment of Osteochondral Lesions of the Talus  

PubMed Central

Several options exist for the treatment of osteochondral lesions of the talus. Particulated juvenile cartilage allograft transplantation (PJCAT) has become a viable treatment modality for osteochondral lesions of the talus that are not amenable to microfracture or for which microfracture has failed. Arthroscopic placement of this type of graft obviates the need for osteotomy or plafondplasty and does not prevent additional procedures from being performed through an anterior approach. Special instrumentation and setup are not required to perform this procedure. Our arthroscopic technique for placement of particulated juvenile cartilage into osteochondral lesions of the talus is described. Case series and outcomes after arthroscopic ankle PJCAT are currently not reported within the literature; however, it is believed that the outcomes are at least similar to those of open ankle PJCAT.

Adams, Samuel B.; Demetracopoulos, Constantine A.; Parekh, Selene G.; Easley, Mark E.; Robbins, Justin

2014-01-01

157

Sonography-Assisted Arthroscopic Resection of Volar Wrist Ganglia: A New Technique  

PubMed Central

Although satisfactory arthroscopic resection of volar wrist ganglia has been reported recently, the risk of damage to arteries, nerves, and tendons remains. Furthermore, ganglia and their stalks cannot be visualized arthroscopically in many cases, and surgeons must perform a blind resection of the joint capsule until ganglion cysts or their stalks appear. Sonography has limited resolution, but recent improvements in hardware and software have made it an excellent noninvasive and dynamic imaging technique for assessing the musculoskeletal system. Ganglia, tendons, nerves, and vessels around the lesion can be clearly observed by sonography. Furthermore, the cyclic motion of the arthroscopic shaver tip makes identification by sonography easy and assists in guiding the surgeon to the lesion. PMID:23766971

Yamamoto, Michiro; Kurimoto, Shigeru; Okui, Nobuyuki; Tatebe, Masahiro; Shinohara, Takaaki; Hirata, Hitoshi

2012-01-01

158

Hybrid Repair of Large Crescent Rotator Cuff Tears Using a Modified SpeedBridge and Double-Pulley Technique.  

PubMed

An ideal rotator cuff repair maximizes the tendon-bone interface and has adequate biomechanical strength that can withstand a high level of demand. Arthroscopic transosseous-equivalent rotator cuff repairs have become popular and have been shown to be superior to many other methods of fixation. We present an alternative method of repair for large crescent rotator cuff tears that combines 2 well-known methods of fixation: modified SpeedBridge (Arthrex, Naples, FL) and double-pulley techniques. These 2 repair constructs were combined to provide the greatest amount of compression across the footprint while also providing rigid fixation. Ultimately, this can provide an optimal environment for healing in otherwise significant injuries. PMID:25126513

Chauhan, Aakash; Regal, Steven; Frank, Darren A

2014-06-01

159

Metal markers for radiographic visualization of rotator cuff margins: A new technique for radiographic assessment of cuff repair integrity.  

PubMed

Surgically repaired rotator cuff repairs may re-tear in the post-operative follow-up phase, and periodic imaging is useful for early detection. The authors describe a simple surgical technique that provides a visible clue to the tendon edge on an anteroposterior radiograph of the shoulder. The technique involves arthroscopic or mini-open radio-opaque tagging of the tendon edge using a metal marker, and followed by a double-row rotator cuff repair using suture anchors. Serial post-operative radiographs may then be used to monitor the position of the marker. Progressive or marked displacement of the marker suggests a failure of cuff repair integrity and should be evaluated further. PMID:23858295

Bhatia, Deepak N; De Beer, Joe F

2013-01-01

160

Arthroscopic Posterior Stabilization of the Shoulder Using a Percutaneous Knotless Mattress Suture Technique.  

PubMed

Posterior shoulder instability is far less common than anterior instability, and its arthroscopic treatment can be technically demanding. We describe a percutaneous arthroscopic technique for posterior shoulder stabilization using mattress sutures and knotless anchors. Spinal needles are used to pass the sutures percutaneously in a mattress fashion. Knotless anchors are used to secure the sutures under the labrum. These anchors can be used without cannulas, giving easier access to the posterior glenoid. This procedure is simple, cost-effective, and safe, avoiding the presence of both knots and suture strands in contact with the humeral head. PMID:24749039

Tennent, Duncan; Concina, Chiara; Pearse, Eyiyemi

2014-02-01

161

Arthroscopic treatment of piriformis syndrome by perineural cyst on the sciatic nerve: a case report.  

PubMed

This is a case report of an arthroscopic treatment performed on a patient with piriformis syndrome due to perineural cyst on piriformis muscle and sciatic nerve. Confirmation, incision, and drainage of benign cystic lesion on the sciatic nerve below the piriformis muscle were performed following the release of the piriformis tendon through the posterior and posteroinferior arthroscopic portal. Recurrence of the symptoms has not been observed since postoperative period of 20 months. Nor did the MRI taken after the procedure reveal any such recurrence. PMID:20062971

Hwang, Deuk-Soo; Kang, Chan; Lee, Jung-Bum; Cha, Soo-Min; Yeon, Kyu-Woong

2010-05-01

162

Hip Arthroscopic Portal Bridge Retraction Technique for Improved Peripheral Compartment Visualization  

PubMed Central

Hip arthroscopy has been shown to be an effective technique in managing an increasingly widening set of indications for hip pathology. In any arthroscopic procedure, obtaining good visualization is one of the most critical components to performing a successful operation. Whereas other authors have described various techniques for improving visualization, we describe an additional simple but effective technique in this report. We describe the use of a retracting suture bridge between portal sites that allows for improved visualization of the peripheral compartment in hip arthroscopy, as well as other arthroscopic procedures. PMID:25264511

McGrath, Brian E.; Kuechle, Joseph B.

2014-01-01

163

[Arthroscopic subacromial decompression--indications in os acromiale?].  

PubMed

A total of 122 patients with subacromial pathology without tears in the rotator cuff underwent arthroscopic subacromial decompression (ASD) and were re-examined 1-3 years after the operation. All patients' data were recorded before and after operation with reference to a 100-point shoulder score. The group included 12 patients who proved to have an os acromiale on X-ray. Postoperatively scores wee significantly higher (p < 0.05). Patients with os acromiale had a slightly but not significantly worse outcome than the others. Results were excellent in 43% of all patients, good in 17%, and fair in 25%, while 15% were considered failures. Again patients with an os acromiale had a slightly, but not significantly, worse result. Patients with a preoperative pain history of more than 1 year had a significantly worse result than those with a preoperative course of less than 1 year (p < 0.05). This was true for both groups without any differences between them. Older patients also scored worse in both groups. Other factors, e.g. sex, preoperative range of motion, and muscle atrophy, did not significantly influence the result. Our results after ASD in patients with subacromial pathology without rupture of the rotator cuff and with os acromiale are encouraging. Therefore, this minimally invasive procedure seems to be a reasonable alternative to other complex procedures with ORIF in selected cases. PMID:8153644

Jerosch, J; Steinbeck, J; Strauss, J M; Schneider, T

1994-02-01

164

Aortic aneurysm repair - endovascular  

MedlinePLUS

EVAR; Endovascular aneurysm repair - aorta; AAA repair - endovascular; Repair - aortic aneurysm - endovascular ... leaking or bleeding. You may have an abdominal aortic aneurysm that is not causing any symptoms or problems. ...

165

INTERNAL REPAIR OF PIPELINES  

SciTech Connect

The two broad categories of deposited weld metal repair and fiber-reinforced composite repair technologies were reviewed for potential application for internal repair of gas transmission pipelines. Both are used to some extent for other applications and could be further developed for internal, local, structural repair of gas transmission pipelines. Preliminary test programs were developed for both deposited weld metal repairs and for fiber-reinforced composite repair. To date, all of the experimental work pertaining to the evaluation of potential repair methods has focused on fiber-reinforced composite repairs. Hydrostatic testing was also conducted on four pipeline sections with simulated corrosion damage: two with composite liners and two without.

Robin Gordon; Bill Bruce; Nancy Porter; Mike Sullivan; Chris Neary

2003-05-01

166

Case report: correction of neglected club foot deformity by arthroscopic assisted triple arthrodesis.  

PubMed

Neglected club foot deformity at the adulthood is difficult to correct. It is usually a rigid deformity associated with arthritic change of the hindfoot joint. Combined bone and soft tissue procedure is necessary to correct the deformity. We present a case of neglected club foot in adulthood who was successfully corrected with arthroscopic triple arthrodesis. PMID:20213451

Lui, Tun Hing

2010-08-01

167

Determination of the normal arthroscopic anatomy of the femoropatellar and cranial femorotibial joints of cattle  

PubMed Central

The arthroscopic approach and anatomy of the bovine femoropatellar and femorotibial joints are described. A 4-mm diameter, 15-cm long arthroscope with a 30° forward angle view was used. The structures viewed were recorded according to the position of the arthroscope within the joint. The femoropatellar joint was best accessed via a lateral approach, between the middle and lateral patellar ligaments. The axial portion of the medial femorotibial joint was viewed from a medial approach between the middle and medial patellar ligaments and the abaxial portion was viewed from a lateral approach between the middle and the lateral patellar ligaments. The axial portion of the lateral femorotibial joint was viewed from a lateral approach between the middle and the lateral patellar ligaments and the abaxial portion was viewed from a medial approach between the middle and medial patellar ligaments. The results of this study provide guidelines regarding the location of arthroscopic portals to evaluate precisely different areas of the stifle in cattle. PMID:24587506

Nichols, Sylvain; Anderson, David E.

2014-01-01

168

Quantitative evaluation after arthroscopic anterior cruciate ligament reconstructionAllograft versus autograft  

Microsoft Academic Search

We measured the anteroposterior ligamentous laxity and thigh muscle power in 92 subjects who were rated as successes after they had undergone arthroscopic anterior cruciate ligament reconstruction for unilateral anterior cruciate ligament insufficiency 18 to 36 months previously. The subjects were divided into 2 groups according to the type of graft: fresh-frozen allogenic tendon (N = 47) or central one

Konsei Shino; Ken Nakata; Shuji Horibe; Masahiro Inoue; Shigeto Nakagawa

1993-01-01

169

Arthroscopic studies of variants of the anterior horn of the medial meniscus  

Microsoft Academic Search

The objective of this study was to arthroscopically analyse the morphology and dynamics of variants of the anterior horn of the medial meniscus of the knee (VAMM) and to then consider the pathological significance of these variants. VAMM was defined as knees in which the anterior horn of the medial meniscus is not attached to the tibia. Between April 1992

Yasumitsu Ohkoshi; Tatsuto Takeuchi; Chiharu Inoue; Tomoyuki Hashimoto; Keiichi Shigenobu; Shigeru Yamane

1997-01-01

170

Clinical results and motion analysis following arthroscopic anterior stabilization of the shoulder using bioknotless anchors  

PubMed Central

Purpose: Traumatic anterior dislocation of the shoulder is a common occurrence increasingly being treated arthroscopically. This study aims to determine the outcome of arthroscopic anterior stabilization using bioknotless anchors and analyze the motion in a subset of these patients. Materials and Methods: The outcome of 20 patients who underwent arthroscopic anterior stabilization using the bioknotless system was studied (average follow-up 26 months). Four of these patients underwent motion analysis of their shoulder pre- and post-operatively. Results: 15% were dissatisfied following surgery and the recurrence of instability was also 15%. Those who were dissatisfied or suffered recurrent symptoms had statistically significant lower constant scores at the final follow up. Pre-operative motion analysis showed a disordered rhythm of shoulder rotation which was corrected following surgery with minimal loss of range of motion. Conclusions: Our success rate was comparable to similar arthroscopic techniques and results published in the literature. Patient satisfaction depended more on return to usual activities than recurrence of symptoms. There was very little reduction in range of movement following surgery and the rhythm of shoulder motion, particularly external rotation in abduction was improved. Level of Evidence: Four retrospective series. PMID:21072146

Cooke, Stephen; Ennis, Owain; Majeed, Haroon; Rahmatalla, Aziz; Kathuria, Vinod; Wade, Roger

2010-01-01

171

Arthroscopic extraarticular reconstruction of the medial patellofemoral ligament with gracilis tendon autograft - surgical technique.  

PubMed

The standard approach to reconstruct the medial patellofemoral ligament (MPFL) is by mini-open incision at its patellar insertion and femoral origin. At the medial patella rim, the MPFL insertion may be visualized in most cases by dissection during surgery. On the femur, it is more difficult to localize the MPFL remnants by a mini-open incision due to soft tissue covering the anatomical origin. Therefore, the femoral MPFL origin is usually identified by intraoperative lateral fluoroscopy. However, the insertion and origin of the MPFL at the patella and femur might be directly visualized using an arthroscopic extraarticular approach from the knee joint through a window of the synovial layer. This is especially helpful on the femoral side but also at the patella to find the individual anatomical MPFL footprints. Arthroscopic extraarticular reconstruction may then be performed using one additional medial mid-parapatellar portal. The major advantages of this technique are an individualized anatomical procedure, which is minimal invasive and cosmetically appealing. The aim of this study was to describe the arthroscopic extraarticular approach to the MPFL insertion at the patella and origin at the femur through synovial windows and to explain the procedure of arthroscopic MPFL reconstruction with a gracilis tendon autograft. Level of evidence Expert opinion, surgical technique, Level V. PMID:22484369

Siebold, Rainer; Borbon, Carlo Angelo V

2012-07-01

172

Intra-articular adhesions of the temporomandibular joint: Relation between arthroscopic findings and clinical symptoms  

Microsoft Academic Search

BACKGROUND: Intra-articular adhesion (IA) is one of the important pathologic signs of intracapsular temporomandibular joint (TMJ) diseases, but this factor has been rarely described with respect to its arthroscopic characteristics and histology. The purpose of this study was to describe the incidence and distribution of IA in patients with internal derangement (ID) and to investigate the correlation between adhesions and

ShanYong Zhang; XiuMing Li u; Chi Yang; XieYi Cai; MinJie Chen; Majd S Haddad; Bai Yun; ZhuoZhi Chen

2009-01-01

173

A simple modified arthroscopic procedure for fixation of displaced tibial eminence fractures  

Microsoft Academic Search

Avulsion fractures of the tibial eminence have been well described in children and adults with an increased in incidence resulting from road traffic and athletic accidents. According to the literature, only surgical treatment is advocated because of the high incidence of the nonunion and instability following conservative treatment. Open reduction can cause some morbidity and, therefore, arthroscopic techniques have been

Leonardo Osti; Franco Merlo; Stephen H. Liu; Luigi Bocchi

2000-01-01

174

Fifteen-year follow-up of arthroscopic partial meniscectomy.  

PubMed

From an original pool of 283 patients, 146 patients who had undergone arthroscopic partial meniscectomy an average of 14.7 years before were followed-up. Lysholm score, Tegner activity level, satisfaction index on a scale of 1 to 10, and standing anteroposterior and flexion weight-bearing radiographs of both knees, were obtained. A physical examination was performed on each knee emphasizing motion, swelling, and ligament evaluation. Radiographs were graded for degenerative changes for each knee. Each knee joint space was also measured in millimeters and compared, operative knee with unoperated knee. The unoperated knee had no injuries or surgeries and was used as a control. Patients were 83% male and 17% female; 78% had undergone medial meniscectomies, 19% lateral, and 3% both. There were 88% good and excellent results in anterior cruciate ligament-stable knees. The radiographic grade side-to-side difference showed the operative knee to be only a 0.23 grade worse than the nonoperative knee. Age at the time of meniscectomy was not found to be a factor. Male patients had better radiographic results than female patients, but not better functional scores. Medial meniscus and lateral meniscus results were not significantly different. Knees with a femoral-tibial anatomic alignment of > 0 degree valgus compared with < or = 0 degree and that had undergone medial meniscectomy had significantly better radiographic results. Patients with anterior cruciate ligament tears and meniscectomy did significantly poorer than stable knees with meniscectomy in regards to radiographic grade change, Lysholm, satisfaction index, Tegner level, and medial joint space narrowing. PMID:9442319

Burks, R T; Metcalf, M H; Metcalf, R W

1997-12-01

175

Arthroscopic surgery for degenerative tears of the meniscus: a systematic review and meta-analysis  

PubMed Central

Background: Arthroscopic surgery for degenerative meniscal tears is a commonly performed procedure, yet the role of conservative treatment for these patients is unclear. This systematic review and meta-analysis evaluates the efficacy of arthroscopic meniscal débridement in patients with knee pain in the setting of mild or no concurrent osteoarthritis of the knee in comparison with nonoperative or sham treatments. Methods: We searched MEDLINE, Embase and the Cochrane databases for randomized controlled trials (RCTs) published from 1946 to Jan. 20, 2014. Two reviewers independently screened all titles and abstracts for eligibility. We assessed risk of bias for all included studies and pooled outcomes using a random-effects model. Outcomes (i.e., function and pain relief) were dichotomized to short-term (< 6 mo) and long-term (< 2 yr) data. Results: Seven RCTs (n = 805 patients) were included in this review. The pooled treatment effect of arthroscopic surgery did not show a significant or minimally important difference (MID) between treatment arms for long-term functional outcomes (standardized mean difference [SMD] 0.07, 95% confidence interval [CI] ?0.10 to 0.23). Short-term functional outcomes between groups were significant but did not exceed the threshold for MID (SMD 0.25, 95% CI 0.02 to 0.48). Arthroscopic surgery did not result in a significant improvement in pain scores in the short term (mean difference [MD] 0.20, 95% CI ?0.67 to 0.26) or in the long term (MD ?0.06, 95% CI ?0.28 to 0.15). Statistical heterogeneity was low to moderate for the outcomes. Interpretation: There is moderate evidence to suggest that there is no benefit to arthroscopic meniscal débridement for degenerative meniscal tears in comparison with nonoperative or sham treatments in middle-aged patients with mild or no concomitant osteoarthritis. A trial of nonoperative management should be the first-line treatment for such patients. PMID:25157057

Khan, Moin; Evaniew, Nathan; Bedi, Asheesh; Ayeni, Olufemi R.; Bhandari, Mohit

2014-01-01

176

The resident’s ridge as an arthroscopic landmark for anatomical femoral tunnel drilling in ACL reconstruction  

Microsoft Academic Search

The purposes of this study were to establish the technique to arthroscopically identify the resident’s ridge without bony\\u000a notchplasty even in patients with chronic ACL insufficiency and to elucidate if the ridge could be used as a landmark for\\u000a anatomical femoral tunnel for ACL graft. There were 50 consecutive patients undergoing arthroscopic ACL reconstruction. With\\u000a the thigh kept horizontal using

Konsei Shino; Tomoyuki Suzuki; Takehiko Iwahashi; Tatsuo Mae; Norimasa Nakamura; Ken Nakata; Shigeto Nakagawa

2010-01-01

177

Tissue Engineering for Rotator Cuff Repair: An Evidence-Based Systematic Review  

PubMed Central

The purpose of this systematic review was to address the treatment of rotator cuff tears by applying tissue engineering approaches to improve tendon healing, specifically platelet rich plasma (PRP) augmentation, stem cells, and scaffolds. Our systematic search was performed using the combination of the following terms: “rotator cuff”, “shoulder”, “PRP”, “platelet rich plasma”, “stemcells”, “scaffold”, “growth factors”, and “tissue engineering”. No level I or II studies were found on the use of scaffolds and stem cells for rotator cuff repair. Three studies compared rotator cuff repair with or without PRP augmentation. All authors performed arthroscopic rotator cuff repair with different techniques of suture anchor fixation and different PRP augmentation. The three studies found no difference in clinical rating scales and functional outcomes between PRP and control groups. Only one study showed clinical statistically significant difference between the two groups at the 3-month follow up. Any statistically significant difference in the rates of tendon rerupture between the control group and the PRP group was found using the magnetic resonance imaging. The current literature on tissue engineering application for rotator cuff repair is scanty. Comparative studies included in this review suggest that PRP augmented repair of a rotator cuff does not yield improved functional and clinical outcome compared with non-augmented repair at a medium and long-term followup. PMID:25098365

Maffulli, Nicola; Longo, Umile Giuseppe; Loppini, Mattia; Berton, Alessandra; Spiezia, Filippo; Denaro, Vincenzo

2012-01-01

178

Neuronal repair  

PubMed Central

The potential of the central nervous system (CNS) to regenerate is regulated by a complex interaction of neuronal intrinsic and extrinsic factors that remain poorly understood. Significant research has been dedicated to identifying these factors to facilitate design of therapies that will treat the functional impairment associated with CNS injuries. Over the last decade, the development of in vivo laser severing of single axons in C. elegans has established an invaluable model for the genetic identification of novel regeneration factors. In a recent study we report the unexpected identification of the core apoptotic proteins CED-4/Apaf-1 and the executioner caspase CED-3 as important factors that promote early events in regeneration in C. elegans. Other upstream regulators of apoptosis do not influence regeneration, indicating the existence of a novel mechanism for activation of CED-4 and CED-3 in neuronal repair. CED-4 and CED-3 function downstream of injury-induced calcium transients and appear to act through the conserved DLK-1 pathway to promote regeneration. We propose a working model for calcium-dependent localized activation of CED-4 and CED-3 caspase and discuss questions raised including mechanisms for spatially regulating activated CED-3 and the possible substrates that it might cleave to initiate regeneration. PMID:24058867

Reina, Christopher P.; Driscoll, Monica; Gabel, Christopher V.

2013-01-01

179

Rapid road repair vehicle  

DOEpatents

Disclosed is a rapid road repair vehicle capable of moving over a surface to be repaired at near normal posted traffic speeds to scan for and find an the high rate of speed, imperfections in the pavement surface, prepare the surface imperfection for repair by air pressure and vacuum cleaning, applying a correct amount of the correct patching material to effect the repair, smooth the resulting repaired surface, and catalog the location and quality of the repairs for maintenance records of the road surface. The rapid road repair vehicle can repair surface imperfections at lower cost, improved quality, at a higher rate of speed than was was heretofor possible, with significantly reduced exposure to safety and health hazards associated with this kind of road repair activities in the past.

Mara, Leo M. (Livermore, CA)

1998-01-01

180

Rapid road repair vehicle  

DOEpatents

Disclosed is a rapid road repair vehicle capable of moving over a surface to be repaired at near normal posted traffic speeds to scan for and find at the high rate of speed, imperfections in the pavement surface, prepare the surface imperfection for repair by air pressure and vacuum cleaning, applying a correct amount of the correct patching material to effect the repair, smooth the resulting repaired surface, and catalog the location and quality of the repairs for maintenance records of the road surface. The rapid road repair vehicle can repair surface imperfections at lower cost, improved quality, at a higher rate of speed than was not heretofor possible, with significantly reduced exposure to safety and health hazards associated with this kind of road repair activities in the past. 2 figs.

Mara, L.M.

1998-05-05

181

Osteochondritis dissecans of the talus and knee: prospective comparison of MR and arthroscopic classifications.  

PubMed

The primary objective of this study was to determine if magnetic resonance (MR) could accurately predict the arthroscopic stage of osteochondritis dissecans lesions of the knee and ankle. Twelve patients, who were indicated for arthroscopy on either clinical or radiographic findings, underwent an MR examination prior to arthroscopy. All scans were performed on a 0.35 T magnet using the same spin echo sequence: repetition time 1,000 ms and echo time 40 ms. Magnetic resonance scans were interpreted prospectively (D.W.N.) and retrospectively (J.S.) by the radiologists without knowledge of the arthroscopic findings. Both radiologists predicted the exact grade in 11 of 12 patients. A single Grade 2 lesion was called Grade 3 by both radiologists. An MR staging classification has been developed that allows accurate preoperative staging of osteochondritis dissecans lesions of the talus and knee. PMID:2398165

Nelson, D W; DiPaola, J; Colville, M; Schmidgall, J

1990-01-01

182

A technique for arthroscopic fasciotomy for the chronic exertional tibialis anterior compartment syndrome.  

PubMed

Chronic exertional anterior compartment syndrome (CECS) is a condition that causes pain over the front of the shin bone that usually occurs in physically active people, especially runners. It may require sometimes an immediate fasciotomy. A longitudinal incision just over the fibula has used as surgical treatment bad cosmetic appearance. Although nowadays mini surgical incisions are preferred. The aim of this study to evaluate a simple fasciotomy technique with a minimal incision by using arthroscope. Nine legs of six patients that diagnosed as CECS has underwent fasciotomy operation with a 1 cm incision. Complaints had disappeared after operation. The mean follow-up time is 2 years. The results were good all of the patients and they never experienced exertional pain episodes. The arthroscopic assisted mini incisional fasciotomy technique has advantage such as early rehabilitation and good cosmetic appearance. PMID:18043906

Sebik, Ahmet; Do?an, Ali

2008-05-01

183

Arthroscopic treatment of chronically painful calcific tendinitis of the rectus femoris  

PubMed Central

Background Relatively large calcific tendinitis with persistent symptoms after extended periods of conservative treatment is an indication for operative therapy. Arthroscopy, as a treatment for calcific tendinitis of the hip abductors and calcinosis circumscripta, has been described previously; however, to our knowledge, the clinical and radiological response to arthroscopic removal of calcific tendinitis of the rectus femoris tendon has not. Methods We present arthroscopic treatment of unusual calcific tendonitis of the origin of the rectus femoris and associated intra-articular lesions in 3 patients with chronic coxa pain. Results Our cases show that hip arthroscopy is an effective therapeutic modality for calcific tendinitis of the hip joint with satisfactory short-term outcomes. Conclusions Calcific tendinitis, although an uncommon clinical entity, should be a part of the differential diagnosis of acute or chronic hip pain. PMID:24266900

2013-01-01

184

Distal clavicle fracture as a complication of arthroscopic distal clavicle resection.  

PubMed

Arthroscopic resection of the distal clavicle has been advocated as a surgical treatment option for acromioclavicular (AC) joint pathology. To our knowledge, iatrogenic fracture of the distal clavicle during distal clavicle resection has never been reported. This report describes distal clavicle fracture as a complication of misidentification of the AC joint and subsequent aggressive burring of the distal clavicle during shoulder arthroscopy. This case is further complicated by the development of symptomatic delayed union and adhesive capsulitis. Ultimately, a revision distal clavicle resection was performed, underscoring the fact that special care must be taken to properly identify the AC joint and rule out pre-existing distal clavicle stress fracture or osteolysis before performing the arthroscopic Mumford procedure. PMID:19664514

Ghodadra, Neil; Lee, Gregory H; Kung, Peter; Busfield, Benjamin T; Kharazzi, F Daniel

2009-08-01

185

Anatomic Anterior Cruciate Ligament Reconstruction With a Flexible Reamer System and 70? Arthroscope  

PubMed Central

Anterior cruciate ligament (ACL) reconstruction techniques continue to evolve as surgeons seek to improve surgical process and outcome measures. On the basis of published data showing improved biomechanics, many surgeons now attempt to better re-create native ACL anatomy in reconstruction. Use of flexible reamer technology and a 70° arthroscope allows for excellent visualization of the native ACL anatomy, as well as precise and independent drilling of the tibial and femoral reconstruction tunnels, while offering several surgical and technical advantages compared with other drilling techniques. This technical note with accompanying video describes our use of the Smith & Nephew Clancy anatomic cruciate guide/flexible drill system (Smith & Nephew, London, England) with a 70° arthroscope. PMID:24400174

Rasmussen, Jeffrey F.; Lavery, Kyle P.; Dhawan, Aman

2013-01-01

186

A Case of Rhabdomyolysis Associated with Use of a Pneumatic Tourniquet during Arthroscopic Knee Surgery  

PubMed Central

The common causes of rhabdomyolysis include trauma, hypoxia, drugs, toxins, infections and hyperthermia. Operative insults, including direct trauma and ischemia, have the potential to cause the development of rhabdomyolysis. Pneumatic tourniquets used during arthroscopic knee surgery to prevent blood loss have led to many complications such as nerve paralysis and vascular injuries. Rhabdomyolysis can also be caused by prolonged pneumatic tourniquet application without a midapplication release, and also from an increased application pressure, but the actual incidence of this is low. In order to prevent rhabdomyolysis, the clinicians must be aware of such risks and follow strict guidelines for the application time, the midapplication release and also the inflation pressure. Vigorous hydration and postoperative patient surveillance are helpful to prevent rhabdomyolysis. We have recently experienced a case of rhabdomyolysis after the arthroscopic knee surgery, and the rhabdomyolysis could have been associated with the use of a pneumatic tourniquet. PMID:20195412

Lee, Yong Gu; Park, Woong; Kim, Sang Hoon; Yun, Sang Pil; Jeong, Hun; Kim, Hyung Jong

2010-01-01

187

Arthroscopically assisted percutaneous fixation of displaced midclavicular fracture using a Knowles pin.  

PubMed

Clavicle fractures are common traumatic injuries of the shoulder girdle, with surgery being the recommended treatment for some displaced midshaft fractures. Open surgery is widely used; however, the primary concerns of this procedure include cosmetic problems and incisional complications, such as wound dehiscence, infection, numbness, and sensitivity. A new arthroscopically assisted technique was developed, in which the Knowles pin was used for percutaneous fixation to treat the displaced midclavicular fracture. This technique is an attractive alternative treatment option for midclavicular fractures. PMID:23179454

Lin, Cheng-Li; Jou, I-Ming; Huang, Ming-Tung; Lin, Chii-Jeng; Su, Wei-Ren

2014-02-01

188

Airway obstruction involving a laryngeal mask airway during arthroscopic shoulder surgery  

Microsoft Academic Search

Several earlier reports have described life-threatening airway obstruction during arthroscopic shoulder surgery performed under regional anesthesia, caused by the leakage of irrigation fluid out of the shoulder joint space into the surrounding soft tissues and then the neck and the pharynx. Here, we present a case of airway obstruction that occurred in a patient under general anesthesia. A 77-year-old woman

Eriko Yoshimura; Toshiyuki Yano; Keisuke Ichinose; Kazuo Ushijima

2005-01-01

189

Foot and ankle injuries in sport: imaging correlation with arthroscopic and surgical findings.  

PubMed

Foot and ankle injuries are common in sport. Although many available imaging techniques can be useful in identifying and classifying injuries, magnetic resonance imaging (MRI) provides high levels of sensitivity and specificity for articular and soft-tissue injuries. Arthroscopic and minimally invasive treatment techniques for foot and ankle injuries are rapidly evolving, minimizing morbidity and improving postoperative rehabilitation and return to play. Correlation between MRI and surgical findings can aid in both accessing and treating pathologic processes and structures. PMID:23773880

Hunt, Kenneth J; Githens, Michael; Riley, Geoffrey M; Kim, Michael; Gold, Garry E

2013-07-01

190

A comparison of clinical and radiological parameters with two arthroscopic techniques for anterior cruciate ligament reconstruction  

Microsoft Academic Search

We performed a comparative study of two series of 25 patellar tendon arthroscopic reconstructions of isolated chronic anterior cruciate ligament injuries, alternating between a double-incision (using a rear-entry guide) or single-incision technique (using a transtibial approach). The patients were reviewed to assess the clinical, KT-2000 and radiological differences at an average follow-up of 14 months (range 8–18 months). For the

P. Aglietti; G. Zaccherotti; P. P. M. Menchetti; P. De Biase

1995-01-01

191

A new technique for arthroscopic meniscus transplant using soft tissue fixation and anatomical meniscal root reinsertion  

Microsoft Academic Search

Allograft meniscus transplant is considered as a treatment option for meniscus-deficient patients to provide pain relief and\\u000a decrease contact stress. This procedure is now considered as safe and reliable for the treatment for knee pain after total\\u000a menisectomy. This is a new technique that has been developed for arthroscopic meniscus transplant with no bone blocks. It\\u000a anatomically recreates the meniscus–tibial

Yee Han Dave Lee; David N. M. Caborn

192

Rehabilitation after arthroscopic meniscectomy: a critical review of the clinical trials  

Microsoft Academic Search

We reviewed the literature on patient management following arthroscopic meniscal surgery. A critical appraisal of the literature produced 8 randomized controlled trials evaluating the use of non-steroidal anti-inflammatory drugs or various forms of physiotherapy and pain control. Different treatments and outcome measures precluded meta-analysis. The limited evidence suggests that this is a relatively pain-free procedure with rapid recovery, and that

F. Goodyear-Smith; B. Arroll

2001-01-01

193

Arthroscopic posterior cruciate ligament reconstruction with bone-tendon-bone patellar graft  

Microsoft Academic Search

We present a retrospective study of 24 patients with chronic injury of the posterior cruciate ligament (PCL) treated by arthroscopically\\u000a assisted reconstruction with bone-tendon-bone patellar autograft. At a mean follow-up of 26.5 months (range 24–53 months)\\u000a the International Knee Documentation Committee (IKDC) evaluation form, Lysholm and Tegner rating systems were used to evaluate\\u000a symptoms, functional limitations during sports and daily

P. P. Mariani; E. Adriani; N. Santori; G. Maresca

1997-01-01

194

Arthroscopic treatment of chronic patellar tendinopathy in high-level athletes  

PubMed Central

Summary To present the results of arthroscopic treatment of patellar tendinopathy in high-level competition athletes. Eleven high-level athletes presented chronic patellar tendinopathy which did not respond to long term conservative treatment. Average age of the patients was 24.8 ±3.4 years old. All patients received an arthroscopic procedure with osteoplasty of the distal patellar pole, debridement of the underlying Hoffa fat pad and of the degenerated areas of the proximal posterior patella tendon and cauterization of the visible neo-vessels. Mean duration of follow-up was 17.4±4 months. Patients showed a major improvement in the Lysholm score from 49.9±5.2 to 92.5±7 and in the VISA P score from 41.2±5.2 to 86.8±14.9 on tenth post-operative week. All patients had returned to sports activities by the twelfth postoperative week. Arthroscopic treatment of chronic patellar tendinopathy found to be a minimal invasive and safe technique which produced satisfactory results. PMID:23738308

Alaseirlis, Dimosthenis Artemis; Konstantinidis, George Athanasios; Malliaropoulos, Nikolaos; Nakou, Lamprini Stefanos; Korompilias, Anastasios; Maffulli, Nicola

2012-01-01

195

Arthroscopic treatment of chronic patellar tendinopathy in high-level athletes.  

PubMed

To present the results of arthroscopic treatment of patellar tendinopathy in high-level competition athletes. Eleven high-level athletes presented chronic patellar tendinopathy which did not respond to long term conservative treatment. Average age of the patients was 24.8 ±3.4 years old. All patients received an arthroscopic procedure with osteoplasty of the distal patellar pole, debridement of the underlying Hoffa fat pad and of the degenerated areas of the proximal posterior patella tendon and cauterization of the visible neo-vessels. Mean duration of follow-up was 17.4±4 months. Patients showed a major improvement in the Lysholm score from 49.9±5.2 to 92.5±7 and in the VISA P score from 41.2±5.2 to 86.8±14.9 on tenth post-operative week. All patients had returned to sports activities by the twelfth postoperative week. Arthroscopic treatment of chronic patellar tendinopathy found to be a minimal invasive and safe technique which produced satisfactory results. PMID:23738308

Alaseirlis, Dimosthenis Artemis; Konstantinidis, George Athanasios; Malliaropoulos, Nikolaos; Nakou, Lamprini Stefanos; Korompilias, Anastasios; Maffulli, Nicola

2012-10-01

196

Biceps Tenoscopy in Arthroscopic Treatment of Primary Synovial Chondromatosis of the Shoulder  

PubMed Central

Primary synovial chondromatosis (PSC) of the shoulder is a rare condition and usually necessitates operative therapy. Arthroscopic partial synovectomy with removal of loose osteochondromas may be regarded as the current surgical treatment of choice. However, involvement of the biceps tendon sheath (BTS) occurs in almost half of the patients and required additional open surgery in all previously reported cases. We successfully performed tenoscopy of the BTS and long head of the biceps tendon during arthroscopic treatment of PSC in a 26-year-old male competitive wrestler. Biceps tenoscopy enabled minimally invasive partial (teno)synovectomy and removal of all osteochondromas within the BTS. The symptoms of PSC fully subsided within 2 postoperative weeks. There were no functional restrictions at the 3-month follow-up examination. These preliminary results support the feasibility, safety, and efficacy of biceps tenoscopy as a complement in arthroscopic treatment of PSC of the shoulder, dispensing with the need for additional open surgery. The spectrum of indications for biceps tenoscopy has still to be defined. Conceivable indications are proposed. This first report of a diagnostic and interventional biceps tenoscopy entails a detailed step-by-step description of the surgical technique. PMID:25264517

Maier, Dirk; Izadpanah, Kaywan; Jaeger, Martin; Ogon, Peter; Sudkamp, Norbert P.

2014-01-01

197

Arthroscopic evaluation for omalgia patients undergoing the clavicular hook plate fixation of distal clavicle fractures  

PubMed Central

Background The aim of this study is to investigate the anatomic changes in the shoulder joints responsible for omalgia after the clavicular hook plate fixation under arthroscope. Methods Arthroscopic examination was carried out for 12 omalgia patients who underwent clavicular hook plate fixation due to distal clavicle fractures. Functional outcome of shoulder was measured by the Japanese Orthopaedic Association (JOA) score before and after the withdrawal of the fixation plate. Results The rotator cuff compression by the clavicular hook was arthroscopically observed in 11 of the 12 cases. The JOA scores of the shoulder were significantly improved at 1 month after the withdrawal of the fixation plate (pain, 28?±?2.4 vs. 15?±?5.2; function, 19.2?±?1.0 vs. 11.7?±?1.9; range of movements, 26.8?±?2.6 vs. 14.8?±?3.4) compared with before. Conclusions The impingement of the hook to the rotator cuff may be the main cause for the omalgia. The appropriate hook and plate that fit to the curve of the clavicle as well as the acromion are necessary to decrease the severity of omalgia. PMID:24917508

2014-01-01

198

Airway obstruction involving a laryngeal mask airway during arthroscopic shoulder surgery.  

PubMed

Several earlier reports have described life-threatening airway obstruction during arthroscopic shoulder surgery performed under regional anesthesia, caused by the leakage of irrigation fluid out of the shoulder joint space into the surrounding soft tissues and then the neck and the pharynx. Here, we present a case of airway obstruction that occurred in a patient under general anesthesia. A 77-year-old woman with a rotator cuff rupture who was to undergo right-shoulder arthroscopic surgery was anesthetized with fentanyl and propofol. Her airway was secured with a flexible laryngeal mask airway (LMA). During surgery, the compliance of her breathing bag became gradually poorer, and finally we were not able to ventilate her at an airway pressure of 60 cmH2O. We found that her chest wall, neck, and face were swollen and tense. Laryngoscopy revealed massive swelling of the pharyngeal soft tissues. The vocal cords were not visible. Her trachea was intubated blindly, and adequate ventilation was re-established. She was placed in the Fowler position and furosemide was given intravenously. Her neck and chest swelling were reduced over the next 2 h and she was extubated without any problem. We recommend that physicians should periodically examine the neck of any patient undergoing arthroscopic shoulder surgery, especially when general anesthesia is used, because anesthetized patients cannot complain of breathing difficulty and the airway swelling may progress until it becomes life-threatening. PMID:16261473

Yoshimura, Eriko; Yano, Toshiyuki; Ichinose, Keisuke; Ushijima, Kazuo

2005-01-01

199

Arthroscopic ligamentoplasty of the dorsal and volar portions of the scapholunate ligament.  

PubMed

Classical arthroscopic techniques for scapholunate instability consist of debridement, thermal shrinkage, and percutaneous pinning. Good results are obtained in acute lesions or in chronic partial tears, but they are less predictable when the lesion is complete, because of the poor healing capacity of the scapholunate ligament and because it is not possible to perform an anatomic ligamentous reconstruction with these techniques. Open techniques are thus required for reconstruction, but they damage the soft tissues. We recently published a description and cadaver study of an arthroscopic ligamentoplasty, trying to combine the advantages of arthroscopic techniques (minimally invasive surgery) and open techniques (reconstruction of the ligament). With this approach, it is possible to reconstruct the dorsal scapholunate ligament and the secondary stabilizers while causing minimal damage to the soft tissues and avoiding injury to the posterior interosseous nerve and detachment of the dorsal intercarpal ligament. The current report describes an additional step to this technique with which it is possible to reconstruct the volar portion of the scapholunate ligament. We also describe an early mobilization postoperative protocol that we believe is equally important. PMID:24275054

Corella, Fernando; Del Cerro, Miguel; Ocampos, Montserrat; Larrainzar-Garijo, Ricardo

2013-12-01

200

Repairing Broken Bones  

NSDL National Science Digital Library

Students learn about how biomedical engineers aid doctors in repairing severely broken bones. They learn about using pins, plates, rods and screws to repair fractures. They do this by designing, creating and testing their own prototype devices to repair broken turkey bones.

Integrated Teaching and Learning Program, College of Engineering,

201

Glenohumeral joint motion after subscapularis tendon repair: an analysis of cadaver shoulder models  

PubMed Central

Background As for the surgical treatment of the rotator cuff tears, the subscapularis tendon tears have recently received much attention for the mini-open or arthroscopic repair. The results of surgical repair for the subscapularis tendon tear are satisfactory, but the range of external rotation is reported to be restricted after the repair. The purpose of this study was to evaluate the range of glenohumeral joint motion after repairs of various sizes of subscapularis tendon tears. Methods Using eight fresh frozen human cadaveric shoulders (mean age at death, 81.5 years), three sizes of subscapularis tendon tear (small, medium, and large) were made and then repaired. With the scapula fixed to the wooden jig, the end-range of glenohumeral motion was measured with passive movement applied through 1.0-Nm torque in the directions of scapular elevation, flexion, abduction, extension, horizontal abduction, and horizontal adduction. The passive end-ranges of external and internal rotation in various positions with rotational torque of 1.0 Nm were also measured. Differences in the ranges among the three type tears were analyzed. Results As tear size increased, range of glenohumeral motion in horizontal abduction after repair decreased gradually and was significantly decreased with the large size tear (P?repair of large size tear at 30° to 60° of scapular elevation and abduction. Conclusions As the size of the subscapularis tendon tear increased, the passive ranges of horizontal abduction and external rotation of the glenohumeral joint after repair decreased significantly. In shoulders with a subscapularis tendon tear, it is necessary to consider the reduction of external rotation depending on tear size. PMID:24885276

2014-01-01

202

Arthroscopic synovectomy, irrigation, and debridement for treatment of septic ankle arthrosis: a systematic review and case series.  

PubMed

Septic arthrosis of the ankle is a rare, often devastating, infection, with a high potential for morbidity and mortality. Delay in treatment can lead to cartilage erosion, painful synovitis, and osteomyelitis. Septic ankle arthrosis deserves prompt recognition and intervention. However, quality, sound, protocol-directed arthroscopic treatment of septic ankle arthrosis of the ankle has not yet been reported. We performed a systematic review of the electronic databases and other relevant peer-reviewed sources to determine the outcomes and treatment protocols associated with septic ankle arthrosis treated with arthroscopic synovectomy, irrigation, and debridement. Nine studies, involving a total of 15 ankles, met our inclusion criteria. In addition, we present the short-term outcomes of a protocol-driven arthroscopic synovial biopsy, deep culture procurement, synovectomy, irrigation, and debridement approach for 8 ankles (8 patients). To our knowledge, this would be the largest individual case series specific to arthroscopic treatment of septic ankle arthrosis. The most common infectious organism reported in the systematic review and in our case series was methicillin-sensitive Staphylococcus aureus. Arthroscopic synovectomy, irrigation, and debridement represents an acceptable treatment method for septic ankle arthrosis and demonstrated outcomes similar to the more traditional open approach, with fewer complications. Additional, appropriately weighted, randomized controlled studies with long-term follow-up are warranted. PMID:24345707

Mankovecky, Michael R; Roukis, Thomas S

2014-01-01

203

A comparison of intra-articular magnesium and\\/or morphine with bupivacaine for postoperative analgesia after arthroscopic knee surgery  

Microsoft Academic Search

Purpose  Both magnesium and morphine provide enhanced patient analgesia after arthroscopic knee surgery when administered separately\\u000a via the intra-articular route. Magnesium sulfate amplifies the analgesic effect of morphine. This study was designed to compare\\u000a the analgesic effects of intra-articular magnesium and morphine, with bupivacaine, when used separately and in combination.\\u000a \\u000a \\u000a \\u000a Methods  Eighty patients undergoing arthroscopic menisectomy were randomized blindly into four intra-articular

Sherif Farouk; Ansam Aly

2009-01-01

204

Morphologic and histologic changes in canine temporomandibular joint tissues following arthroscopic guided neodymium:YAG laser exposure  

SciTech Connect

A neodymium:yttrium aluminum garnet (Nd:YAG) laser beam was introduced by a quartz fiber passed arthroscopically into the superior joint space of the temporomandibular joints (TMJ) of five mongrel dogs, with one joint serving as a control without laser wounds. Immediate postoperative death and examination of the disc grossly and histologically revealed different patterns for contact and noncontact burn wounds. The wounds exhibited signs of thermal coagulation necrosis similar to those reported in other tissues. The potential implications of the adaptation of the Nd:YAG laser to TMJ arthroscopic surgery are discussed.

Bradrick, J.P.; Eckhauser, M.L.; Indresano, A.T. (Case Western Reserve Univ. College of Medicine, OH (USA))

1989-11-01

205

Biomechanical testing of a new knotless suture anchor compared with established anchors for rotator cuff repair.  

PubMed

Various suture anchors are available for rotator cuff repair. For arthroscopic application, a knotless anchor was developed to simplify the intra-operative handling. We compared the new knotless anchor (BIOKNOTLESStrade mark RC; DePuy Mitek, Raynham, MA) with established absorbable and titanium suture anchors (UltraSorbtrade mark and Super Revo 5mmtrade mark; ConMed Linvatec, Utica, NY). Each anchor was tested on 6 human cadaveric shoulders. The anchors were inserted into the greater tuberosity. An incremental cyclic loading was performed. Ultimate failure loads, anchor displacement, and mode of failure were recorded. The anchor displacement of the BIOKNOTLESStrade mark RC (15.3 +/- 5.3 mm) after the first cycle with 75 N was significantly higher than with the two other anchors (Super Revo 2.1 +/- 1.6 mm, UltraSorb: 2.7 +/- 1.1 mm). There was no significant difference in the ultimate failure loads of the 3 anchors. Although the Bioknotlesstrade mark RC indicated comparable maximal pullout strength, it bares the risk of losing contact between the tendon-bone-interface due to a significantly higher system displacement. Therefore, gap formation between the bone and the soft tissue fixation jeopardizes the repair. Bioknotlesstrade mark RC should be used in the lateral row only when a double row technique for rotator cuff repair is performed, and is not appropriate for rotator cuff repair if used on its own. PMID:18396417

Pietschmann, Matthias F; Froehlich, Valerie; Ficklscherer, Andreas; Wegener, Bernd; Jansson, Volkmar; Müller, Peter E

2008-01-01

206

A RANDOMIZED TRIAL OF ISOKINETIC VERSUS ISOTONIC REHABILITATION PROGRAM AFTER ARTHROSCOPIC MENISCECTOMY  

PubMed Central

Background: Although both isotonic and isokinetic exercises are commonly used in the rehabilitation of patients after arthroscopic meniscectomy no studies have compared their effect on strength recovery and functional outcomes. Purpose: The purpose of this study was to investigate the effects of two rehabilitation programs (isotonic and isokinetic) on muscle strength and functional performance after partial knee meniscectomy. A secondary purpose was to assess the correlation between isokinetic strength deficits and hop test performance deficits. Methods: Twenty male patients who underwent arthroscopic partial meniscectomy volunteered for the study. Both isotonic and isokinetic training were performed with the same equipment thereby blinding subjects to the mode of exercise. Main outcome measures were collected on the 14th and 33rd postoperative days and included isokinetic strength of the knee extensors and flexors, functional performance (single, triple, and vertical hopping) and the Lysholm questionnaire. Multivariate and univariate analyses of variance were used to assess the effects of the independent variables on the isokinetic variables, functional tests, and Lysholm score. Pearson's correlation was used to assess the relationship between isokinetic strength deficits and functional performance deficits. Results: Isokinetic measures, functional tests, and the Lysholm score all increased between initial and final assessment (p?0.003). However, there were no group or group*time effects on any of the outcome variables (p?0.33). Functional tests were better predictors of isokinetic deficits in the 14th compared to the 33rd postoperative day. Conclusion: No differences were found in the outcomes of patients treated using an isokinetic and an isotonic protocol for rehabilitation after arthroscopic meniscectomy. More than half of patients did not meet the 90% criterion in the hop tests for safe return to sports five weeks after meniscectomy. There were correlations between the hop tests and isokinetic deficits two weeks after meniscectomy but not at the fifth week. Level of evidence: 1b PMID:22319678

Koutras, Georgios; Letsi, Magdalini; Papadopoulos, Pericles; Gigis, Ioannis

2012-01-01

207

Comparative outcome of arthroscopic release for frozen shoulder in patients with and without diabetes.  

PubMed

Our aim was to compare the outcome of arthroscopic release for frozen shoulder in patients with and without diabetes. We prospectively compared the outcome in 21 patients with and 21 patients without diabetes, two years post-operatively. The modified Constant score was used as the outcome measure. The mean age of the patients was 54.5 years (48 to 65; male:female ratio: 18:24), the mean pre-operative duration of symptoms was 8.3 months (6 to 13) and the mean pre-operative modified Constant scores were 36.6 (standard deviation (sd) 4.6) and 38.4 (sd 5.7) in the diabetic and non-diabetic groups, respectively. The mean modified Constant scores at six weeks, six months and two years post-operatively in the diabetics were 55. 6 (sd 4.7), 67. 4 (sd 5.6) and 84. 4 (sd 6.8), respectively; and in the non-diabetics 66.8 (sd 4.5), 79.6 (sd 3.8) and 88.6 (sd 4.2), respectively. A total of 15 (71%) of diabetic patients recovered a full range of movement as opposed to 19 (90%) in the non-diabetics. There was significant improvement (p < 0.01) in the modified Constant scores following arthroscopic release for frozen shoulder in both groups. The results in diabetics were significantly worse than those in non-diabetics six months post-operatively (p < 0.01) with a tendency towards persistent limitation of movement two years after operation. These results may be used when counselling diabetic patients for the outcome after arthroscopic treatment of frozen shoulder. Cite this article: Bone Joint J 2014;96-B:1355-8. PMID:25274921

Mehta, S S; Singh, H P; Pandey, R

2014-10-01

208

Does Perception of Usefulness of Arthroscopic Simulators Differ with Levels of Experience?  

Microsoft Academic Search

Background  Some commercial simulators are available for training basic arthroscopic skills. However, it is unclear if these simulators\\u000a allow training for their intended purposes and whether the perception of usefulness relates to level of experience.\\u000a \\u000a \\u000a \\u000a \\u000a Questions\\/purposes  We addressed the following questions: (1) Do commercial simulators have construct (times to perform tasks) and face validity\\u000a (realism), and (2) is the perception of usefulness

Gabriëlle J. M. Tuijthof; P. Visser; Inger N. Sierevelt; C. Niek Van Dijk; Gino M. M. J. Kerkhoffs

2011-01-01

209

Arthroscopic-Assisted Core Decompression for Osteonecrosis of the Femoral Head  

PubMed Central

The management of pre-collapse osteonecrosis of the femoral head is controversial. Core decompression is a technique that theoretically decreases the intraosseous pressure of the femoral head, resulting in a local vascularized healing response. Its efficacy has been shown in delaying early subchondral collapse. We describe the technique of arthroscopic-assisted core decompression of the femoral head for osteonecrosis. The advantages of this technique include evaluation of the presence or absence of articular cartilage injury, subchondral collapse, and guidance during reaming and curettage. It also allows the ability to address any concomitant soft-tissue or bony pathology associated with or in addition to the osteonecrotic lesion. PMID:24749025

Gupta, Anil K.; Frank, Rachel M.; Harris, Joshua D.; McCormick, Frank; Mather, Richard C.; Nho, Shane J.

2013-01-01

210

Hiatal hernia repair - series (image)  

MedlinePLUS

... backflows from the stomach into the esophagus. Hiatal hernia repair is surgery to repair a bulging of ... abdomen and chest (diaphragm) into the chest (hiatal hernia). Hiatal hernia repair may be recommended when the ...

211

Simultaneous arthroscopic implantation of autologous chondrocytes and high tibial osteotomy for tibial chondral defects in the varus knee  

Microsoft Academic Search

There is no consensus on the ideal management of patients with chondral defects of the medial tibial plateau and varus malalignment of the knee. We performed a cohort study to evaluate the outcome of patients affected by these conditions, who underwent arthroscopic implantation of autologous chondrocytes and a medial opening wedge high tibial osteotomy. Eight patients (four men and four

Francesco Franceschi; Umile Giuseppe Longo; Laura Ruzzini; Andrea Marinozzi; Nicola Maffulli; Vincenzo Denaro

2008-01-01

212

Arthroscopic distal clavicular autograft for treating shoulder instability with glenoid bone loss.  

PubMed

Glenoid bone loss is a significant risk factor for failure after arthroscopic shoulder stabilization. Multiple options are available to reconstruct this bone loss, including coracoid transfer, iliac crest bone graft, and osteoarticular allograft. Each technique has strengths and weaknesses. Coracoid grafts are limited to anterior augmentation and, along with iliac crest, do not provide an osteochondral reconstruction. Osteochondral allografts do provide a cartilage source but are challenged by the potential for graft rejection, infection, cost, and availability. We describe the use of a distal clavicular osteochondral autograft for bony augmentation in cases of glenohumeral instability with significant bone loss. This graft has the advantages of being readily available and cost-effective, it provides an autologous osteochondral transplant with minimal donor-site morbidity, and it can be used in both anterior and posterior bone loss cases. The rationale and technical aspects of arthroscopic performance will be discussed. Clinical studies are warranted to determine the outcomes of the use of the distal clavicle as a graft in shoulder instability. PMID:25264509

Tokish, John M; Fitzpatrick, Kelly; Cook, Jay B; Mallon, William J

2014-08-01

213

Arthroscopic Distal Clavicular Autograft for Treating Shoulder Instability With Glenoid Bone Loss  

PubMed Central

Glenoid bone loss is a significant risk factor for failure after arthroscopic shoulder stabilization. Multiple options are available to reconstruct this bone loss, including coracoid transfer, iliac crest bone graft, and osteoarticular allograft. Each technique has strengths and weaknesses. Coracoid grafts are limited to anterior augmentation and, along with iliac crest, do not provide an osteochondral reconstruction. Osteochondral allografts do provide a cartilage source but are challenged by the potential for graft rejection, infection, cost, and availability. We describe the use of a distal clavicular osteochondral autograft for bony augmentation in cases of glenohumeral instability with significant bone loss. This graft has the advantages of being readily available and cost-effective, it provides an autologous osteochondral transplant with minimal donor-site morbidity, and it can be used in both anterior and posterior bone loss cases. The rationale and technical aspects of arthroscopic performance will be discussed. Clinical studies are warranted to determine the outcomes of the use of the distal clavicle as a graft in shoulder instability.

Tokish, John M.; Fitzpatrick, Kelly; Cook, Jay B.; Mallon, William J.

2014-01-01

214

Efficacy of intraarticular dexamethasone for postoperative analgesia after arthroscopic knee surgery  

PubMed Central

Background and Aims: In an attempt to improve the recovery and early rehabilitation after arthroscopic knee surgery, various medications have been administered via intra-articular route to prolong the duration and improve the quality of postoperative analgesia. Among the potentially effective substances, steroids like dexamethasone could be of particular interest. Materials and Methods: Fifty patients undergoing elective knee arthroscopy were randomly assigned to one of the following groups containing 25 patients each. Group D patients received 8 mg (2 mL) of dexamethasone added to 18 mL of 0.25% levobupivacaine intra-articularly, (total volume 20 mL). Group L patients received 18 mL of 0.25% levobupivacaine and 2 mL of isotonic saline (20 mL in total) intra-articularly. Analgesic effect was evaluated by measuring pain intensity visual analogue scale score and duration of analgesia. Results: A longer delay was observed between intra-articular injection of study medication and first requirement of supplementary analgesic in Group D (10.24 ± 2.8 hours) compared with Group L (5.48 ± 1.6 h). Total consumption of diclofenac sodium in first 24 h in postoperative period was significantly less in Group D. No significant side effects were noted. Conclusion: Dexamethasone, used as adjunct to levobupivacaine in patients undergoing arthroscopic knee surgery, improves the quality and prolongs the duration of postoperative analgesia. PMID:25190949

Bhattacharjee, Dhurjoti Prosad; Biswas, Chaitali; Haldar, Purba; Ghosh, Sujata; Piplai, Gautam; Rudra, Jati Sankar

2014-01-01

215

Arthroscopic delivery of cancellous tibial autograft for unstable osteochondral lesions in the adolescent knee.  

PubMed

The appropriate surgical technique for the treatment of unstable osteochondral lesions of the knee remains unclear and had been traditionally described with an open arthrotomy. Administration of bone grafting material in the knee may be performed for a variety of pathologic conditions, including unstable osteochondritis dissecans, traumatic osteochondral defects, or subchondral fracture nonunion, or for preparation of residual tunnels during revision anterior cruciate ligament reconstruction. Although various grafting materials have been described in the literature, cancellous autograft remains the gold standard for treatment safety and efficacy. We describe a successful technique for arthroscopic delivery of autogenous bone graft during fixation of unstable osteochondral lesions of the knee. When the indication for grafting is established, cancellous autograft is harvested from the proximal tibia, undergoes morcellation, and is soaked in bone marrow aspirate obtained through the harvest window. The bone graft is then packed into a modified tuberculin syringe. After arthroscopic preparation of the unstable osteochondral fragment and the respective donor surface, the tuberculin syringe is placed through a standard arthroscopy portal and the bone graft is introduced into the defect under direct visualization, followed by an appropriate osteochondral fixation technique. PMID:25126499

Espinoza, Chris; Ellis, Henry B; Wilson, Philip

2014-06-01

216

Posttraumatic soft tissue impingement of the ankle: arthroscopic findings and surgical outcomes.  

PubMed

(Full text is available at http://www.manu.edu.mk/prilozi). Painful conditions and limited dorsal flexion of the ankle, which are the result of the friction of joint tissues and also the cause and the effect of altered joint biomechanics, are called ankle impingement syndromes. Post-traumatic ankle injures, like an ankle sprains or ankle fractures, are the main causes of impingement lesions, which result in chronic ankle pain. Purpose: To evaluate the results for patients treated arthroscopically for anterolateral soft tissue impingement after ankle injury. Methods: Twelve patients underwent operative arthroscopy for anterolateral impingement between 2010 and 2012, A retrospective study with a mean follow up of 1 year. There were 7 females and 5 males, average age 44.1 years. Results: Preoperative American ankle and foot score was average, 68 (63-71) points and after the operation 92 (87-95) points. Conclusion: Soft tissue impingement of the talocrural joint shows painful and limited dorsal flexion and plantar extension, effusion and joint line tenderness especially in the anterolateral gutter. Arthrofibrosis following ankle fractures causes an unfavorable surgical outcome, and arthroscopic debridement of fibrous tissue is an effective means of improving articular function. Key words: Ankle arthroscopy, soft tissue impingement, AAF score. PMID:24802201

Mitev, K; Mladenovski, S; Kaftandziev, I

2014-01-01

217

Massive Bone Loss from Fungal Infection after Anterior Cruciate Ligament Arthroscopic Reconstruction  

PubMed Central

Although there are numerous reports of septic pyogenic arthritis after arthroscopic anterior cruciate ligament (ACL) reconstruction, there is limited information regarding the outcomes of fungal infection. We determined the outcomes of six patients with mycotic infection after regular ACL reconstruction. There were four males and two females with a mean age of 33 years. We determined the number of procedures performed, bone loss originating to control infection, and final reconstruction in these patients. An average of five arthroscopic lavage procedures had been performed at the referring centers. Fungal infection was diagnosed based on pathologic samples; five infections were the result of mucormycosis and one was Candida. After final débridement, the mean segmental bone loss was 12.8 cm. All patients were treated with intravenous antifungal coverage and cement spacers before final reconstruction. At final followup, all patients were free of clinical infection. Three had reconstruction with an allograft-prosthesis composite, two with hemicylindrical allografts, and one with an intercalary allograft arthrodesis. Despite the extremely unusual presentation of this complication, surgeons should be aware of potential and catastrophic consequences of this severe complication after ACL reconstruction. Level of Evidence: Level IV, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence. Electronic supplementary material The online version of this article (doi:10.1007/s11999-009-0714-0) contains supplementary material, which is available to authorized users. PMID:19190972

Carbo, Lisandro; Aponte-Tinao, Luis A.; Ayerza, Miguel A.; Makino, Arturo

2009-01-01

218

Reliability Assessment of Arthroscopic Findings Versus MRI in ACL Injuries of the Knee  

PubMed Central

Introduction: This study was conducted to analyze the reliability of clinical diagnosis in ACL tear injuries. Material and methods: All patients attending our clinic with knee pain from 2009 to 2013 underwent systematic and thorough clinical assessment. From one hundred and three patients with knee problems in 73 were arhroscopicaly diagnosed ACL tears. All these patients underwent therapeutic arthroscopic knee surgery. The clinical diagnosis was confirmed during this procedure. The accuracy, sensitivity and specificity were calculated based on these arthroscopic findings. Results: The accuracy of clinical diagnosis in our study was 82.5% for ACL tears. Our study revealed high sensitivity and specificity and almost high accuracy for ACL injuries of knee joint in comparison to arthroscopy. MRI is an appropriate screening tool for therapeutic arthroscopy, making diagnostic arthroscopy unnecessary in most patients. Conclusion: Magnetic resonance imaging is accurate and non invasive modality for the assessment of ligamentous injuries. It can be used as a first line investigation in patients with soft tissue trauma to knee. PMID:24825936

Kostov, Hristijan; Stojmenski, Slavcho; Kostova, Elena

2014-01-01

219

Automotive Repair Shops Case Study ME 4171 Automotive Repair Shops  

E-print Network

generated through welding? To repair both minor and major auto body damage, hydraulic equipment and handAutomotive Repair Shops Case Study ­ ME 4171 ­ 1 ­ Automotive Repair Shops In the following, you generated by automotive repair shops in California. A lot of you will have had experience with automotive

220

Rapid road repair vehicle  

DOEpatents

Disclosed are improvments to a rapid road repair vehicle comprising an improved cleaning device arrangement, two dispensing arrays for filling defects more rapidly and efficiently, an array of pre-heaters to heat the road way surface in order to help the repair material better bond to the repaired surface, a means for detecting, measuring, and computing the number, location and volume of each of the detected surface imperfection, and a computer means schema for controlling the operation of the plurality of vehicle subsystems. The improved vehicle is, therefore, better able to perform its intended function of filling surface imperfections while moving over those surfaces at near normal traffic speeds.

Mara, Leo M. (Livermore, CA)

1999-01-01

221

Arthroscopic-assisted Locking Compression Plate clavicular hook fixation for unstable fractures of the lateral end of the clavicle: a prospective study  

Microsoft Academic Search

The aim of this prospective study was to assess the clinical outcomes of an unstable fracture of the lateral end of the clavicle\\u000a treated with an arthroscopic-assisted locking compressive plate (LCP) clavicular hook plate. Twenty-three patients underwent\\u000a arthroscopic assisted LCP clavicular hook plate fixation for these fractures. All patients achieved clinical and radiological\\u000a union over a mean of 4.2 months (range,

Kwang Won Lee; Sang Ki Lee; Kap Jung Kim; Yong In Kim; Won Cho Kwon; Won Sik Choy

2010-01-01

222

Thumb carpometacarpal ligaments inside and out: a comparative study of arthroscopic and gross anatomy from the robert a. Chase hand and upper limb center at stanford university.  

PubMed

Purpose?We propose to identify and correlate arthroscopic internal ligaments with external ligaments, providing an accurate roadmap for arthroscopic ligament and joint anatomy. Ligamentous laxity is considered an important risk factor in developing the common basilar arthritis of the thumb. Controversy exists as to the precise ligamentous anatomy of the thumb carpometacarpal (CMC) joint (CMC-I); description of the internal arthroscopic anatomy is limited. Methods?We performed CMC-I joint arthroscopy using the 1-Ulnar (1U) and thenar portals in five cadavers, seeking to identify the following seven ligaments arthroscopically: the superficial anterior oblique ligament (sAOL), deep anterior oblique ligament (dAOL), ulnar collateral ligament (UCL), dorsal trapeziometacarpal ligament (DTM-1), posterior oblique ligament (POL), dorsal central ligament (DCL), and dorsal radial ligament (DRL). After grading articular changes of the trapezium, we passed Kirschner wires (K-wires) (0.028) outside-in to mark the arthroscopic insertion of each ligament on the trapezium. Gross dissection was performed to confirm the wire placement; the anatomic identity and position of joint stabilizing ligaments, and the location of frequently used portals. Results?The volar ligaments-the sAOL, dAOL, and UCL-were highly variable in their arthroscopic appearance and precise location. The sAOL is a thin veil of membranous tissue that variably drapes across the anterior joint capsule. The reported dAOL and UCL, in our study, correlated to a thickened portion of this veil around the volar beak and was not consistently identified with gross dissection. In contrast, the arthroscopic appearance and location of the dorsal ligaments-DTM-I, POL, DCL, and DRL-were consistent in all specimens. Conclusion?Our study further defines and correlates the arthroscopic and external ligamentous anatomy of the CMC-I joint. PMID:24436790

Zhang, Andrew Y; Van Nortwick, Sarah; Hagert, Elisabet; Ladd, Amy L

2013-02-01

223

Detecting and Correcting Speech Repairs  

Microsoft Academic Search

Interactive spoken dialog provides many new challenges for spoken language systems. One of the most critical is the prevalence of speech repairs. This paper presents an al- gorithm that detects and corrects speech repairs based on finding the repair pattern. The repair pattern is built by find- ing word matches and word replacements, and identifying fragments and editing terms. Rather

Peter Heeman; James Allen

1993-01-01

224

Repairing Thermal Tiles  

NASA Technical Reports Server (NTRS)

Small chips and depression in surfaces of surface insulation tiles repaired using Ludox colloidal silica solution and silica powder. No waiting time necessary between mixing filler and using it. Patch cures quickly without heat being applied.

Mccain, C. R., Jr.; Feiler, C. W.

1984-01-01

225

Femur fracture repair - discharge  

MedlinePLUS

You had a fracture (break) in the femur, also called the thigh bone, in your leg. You may have needed surgery to repair ... surgeon will make a cut to open your fracture. Your surgeon will then use special metal devices ...

226

Timpani Repair and Maintenance.  

ERIC Educational Resources Information Center

Rather than focusing on specific brands of timpani, these guidelines for repair cover mechanical problems of a general nature: pedals, dents, unclear tone, and squeaking. Preventive maintenance is discussed. (Author/SJL)

Combs, F. Michael

1980-01-01

227

Structural Repair Project  

NSDL National Science Digital Library

These two diagrams from SpaceTEC National Aerospace Technical Education Center show how to create a PVC foam core sandwich and perform structural scarf repair. The diagrams show the materials to use and the dimensions of each.

2011-07-25

228

Planning Maintenance and Repairs.  

ERIC Educational Resources Information Center

Discusses the use of school facility design as an aid to efficiently repairing and maintaining facility systems. Also presents details on facility design's influence in properly maintaining mechanical and electrical systems. (GR)

Fitzemeyer, Ted

2001-01-01

229

Hypospadias repair - series (image)  

MedlinePLUS

... penis. Hypospadias is usually associated with an abnormal curvature of the penis, called "chordee". Hypospadias is one ... of the surgery are to repair the abnormal curvature of the penis, and to create a new ...

230

Rotator Cuff Repair  

MedlinePLUS Videos and Cool Tools

... Dr. Uribe's going to go up into this space. It's called the subacromial space, and that is where the rotator cuff repair ... flap of tissue, gets caught in that subacromial space Dr. Zvijac was talking about and that produces ...

231

When repair meets chromatin  

PubMed Central

In eukaryotic cells, the inheritance of both the DNA sequence and its organization into chromatin is critical to maintain genome stability. This maintenance is challenged by DNA damage. To fully understand how the cell can tolerate genotoxic stress, it is necessary to integrate knowledge of the nature of DNA damage, its detection and its repair within the chromatin environment of a eukaryotic nucleus. The multiplicity of the DNA damage and repair processes, as well as the complex nature of chromatin, have made this issue difficult to tackle. Recent progress in each of these areas enables us to address, both at a molecular and a cellular level, the importance of inter-relationships between them. In this review we revisit the ‘access, repair, restore’ model, which was proposed to explain how the conserved process of nucleotide excision repair operates within chromatin. Recent studies have identified factors potentially involved in this process and permit refinement of the basic model. Drawing on this model, the chromatin alterations likely to be required during other processes of DNA damage repair, particularly double-strand break repair, are discussed and recently identified candidates that might perform such alterations are highlighted. PMID:11799057

Green, Catherine M.; Almouzni, Genevieve

2002-01-01

232

Random Fuzzy Variable Modeling on Repairable System  

Microsoft Academic Search

Repairable system analysis is in nature an evaluation of repair effects. Recent tendency in reliability engineering literature was imposing repair regimes and estimate system repair effects or linking repair to certain covariate to extract repair impacts. Hinted by engineering tune up exercises, we propose a repair model in terms of random variable distribution with a fuzzy parameter because fuzziness reflects

R. Guo; R. Q. Zhao; D. Guo; T. Dunne

233

Hypotensive bradycardic events during shoulder arthroscopic surgery under interscalene brachial plexus blocks  

PubMed Central

Sudden, profound hypotensive and bradycardic events (HBEs) have been reported in more than 20% of patients undergoing shoulder arthroscopy in the sitting position. Although HBEs may be associated with the adverse effects of interscalene brachial plexus block (ISBPB) in the sitting position, the underlying mechanisms responsible for HBEs during the course of shoulder surgery are not well understood. The basic mechanisms of HBEs may be associated with the underlying mechanisms responsible for vasovagal syncope, carotid sinus hypersensitivity or orthostatic syncope. In this review, we discussed the possible mechanisms of HBEs during shoulder arthroscopic surgery, in the sitting position, under ISBPB. In particular, we focused on the relationship between HBEs and various types of syncopal reactions, the relationship between HBEs and the Bezold-Jarisch reflex, and the new contributing factors for the occurrence of HBEs, such as stellate ganglion block or the intraoperative administration of intravenous fentanyl. PMID:22474545

Song, Seok Young

2012-01-01

234

Arthroscopic distal tibial allograft augmentation for posterior shoulder instability with glenoid bone loss.  

PubMed

Glenoid bone loss is commonly associated with recurrent shoulder instability. Failure to recognize and appropriately address it can lead to poor outcomes. Numerous studies have found anterior-inferior glenoid bone loss in the setting of recurrent anterior instability. Though much less common, posterior shoulder instability can be seen in the setting of acute trauma, epilepsy, electrocution, and alcoholism. Heightened awareness has led to recognition in collision athletes as well. Posterior glenoid bone loss must be addressed in a similar fashion to anterior glenoid bone loss to prevent recurrent instability. Open bone augmentation procedures have been described with successful results. In this technical note, we describe an arthroscopic technique using fresh distal tibial allograft for posterior glenoid augmentation. In addition, a current review regarding the diagnosis and management of recurrent posterior shoulder instability is provided. PMID:24400190

Gupta, Anil K; Chalmers, Peter N; Klosterman, Emma; Harris, Joshua D; Provencher, Matthew T; Romeo, Anthony A

2013-01-01

235

Effect of beach chair position on bispectral index values during arthroscopic shoulder surgery  

PubMed Central

Background Bispectral index (BIS) monitoring reduces the cases of intraoperative awareness. Several factors can alter BIS readings without affecting the depth of anesthesia. We conducted a study to assess the impact of beach chair position (sitting position) on BIS readings. Methods General anesthesia was administered to 30 patients undergoing arthroscopic shoulder surgery. Patients were kept in neutral position (supine) for 10 minutes and BIS readings, mean arterial blood pressure, heart rate, end-tidal carbon dioxide, and end-tidal sevoflurane were recorded. Patients were then shifted to beach chair position. After 15 minutes, data were recorded. Results A significant decrease in BIS values (P < 0.01) associated with a position change from neutral position to beach chair position was evident. Conclusions BIS values are significantly decreased in the beach chair position compared with the neutral position and might affect interpretation of the depth of anesthesia. PMID:25368780

Lee, Sang Wook; Choi, Soo Eun; Han, Jin Hee; Kang, Wha Ja; Choi, Young Kyoo

2014-01-01

236

Arthroscopic Ankle Arthrodesis for Treating Osteoarthritis in a Patient with Kashin-Beck Disease  

PubMed Central

Kashin-Beck disease (KBD) is an endemic degenerative osteoarthritis. Death of cartilage and growth plate is the pathologic feature; therefore, KBD involves skeletal deformity and often results in osteoarthritis. Deficiency of selenium, high humic acid levels in water, and fungi on storage gains are considered the cause of KBD. The most frequently involved joints are ankles, knees, wrists, and elbows and symptoms are pain and limited motions of those joints. The main treatments for KBD are rehabilitation and osteotomy to correct the deformities because preventive treatment has not been established. In this report, we present a case of ankle osteoarthritis due to KBD and first describe arthroscopic ankle arthrodesis for treating osteoarthritis of KBD. PMID:25349619

Iwasa, Kenjiro; Kanzaki, Noriyuki; Fujishiro, Takaaki; Hayashi, Shinya; Hashimoto, Shingo; Kuroda, Ryosuke; Kurosaka, Masahiro

2014-01-01

237

Arthroscopic surgical tools: A source of metal particles and possible joint damage  

PubMed Central

Purpose Our goals were (1) to characterize metal micro-particles created by standard arthroscopic instruments, and (2) to examine the in-vitro cellular responses induced by those particles, including possible synergistic effects with local anesthetic. Methods We applied standard surgical tools to 16 foam bone blocks immersed in saline (plus 3 non-instrumented controls). Eight specimens had four minutes of exposure to a 4.0 mm full radius shaver rotating forward at 6,000 RPM. In the other blocks, four holes were created with a 3.0 mm drill via a sleeve. Particles were isolated onto silicon wafers by density gradient ultra-centrifugation, and SEM analyzed a minimum of 1000 particles per wafer. Metal particles were then isolated and purified. Aliquots of sterilized micro-particles were applied to cultured bovine chondrocytes (+/- local anesthetic) and to cultured human or bovine synoviocytes. Chondrocyte viability was assessed with live/dead cell assay by flow cytometry. Synoviocyte responses were assessed with qPCR. Results Stainless steel or aluminum particles were found in each sample (same composition as surgical instruments). Average particle size was 1 to 2 ?m (range 50 nm to 20 ?m). Chondrocyte exposure (1 hour) to metal debris induced a small but statistically significant increase in cell death, without any synergistic effect of local anesthetic. Proinflammatory chemokines were consistently upregulated in both human and bovine synoviocytes exposed to metallic micro-particles for 3, 24, and 48 hours. Conclusions The current study demonstrates that metallic microdebris is liberated by common arthroscopic instruments, at scales much smaller than previously recognized. These particles are bioactive as demonstrated by the in-vitro synoviocyte responses initiated by metallic micro-particles. Clinical Relevance Our findings suggest that metallic micro-particles could induce intra-articular damage via a synoviocyte-mediated cytokine response if their concentrations reach clinically significant levels. PMID:23910000

Pedowitz, Robert A.; Billi, Fabrizio; Kavanaugh, Aaron; Colbert, Andrew; Liu, Sen; Savoie, Felix H.; You, Zongbing

2013-01-01

238

Feasibility of Arthroscopic Placement of Autologous Matrix-Induced Chondrogenesis Grafts in the Cadaver Hip Joint  

PubMed Central

An assortment of clinical trials have been done presenting the effectiveness of autologous matrix-induced chondrogenesis (AMIC) for the regeneration of chondral leasions. The purpose of the study was to underline the accessability of the acetabulum and the femoral head through the known portals and prove i) the feasibility of placing the AMIC in the different zones of the hip joint and ii) check for dislocation after joint movement. Six human cadavers underwent hip arthroscopy on both hips. Two chondral lesions were set on each femoral head and two in the acetabulum to evaluate a total of 48 defects. After microfracturing an autologous matrix-induced chondrogenesis graft was placed on these lesions arthroscopically. After repeated joint movement the dislocation of the graft was checked. It was possible to place the AMIC graft in all 48 chondral lesions. The time needed for placing the graft was 8±2.9 minutes. A trend of time reduction could be detected throughout this study as the surgeon gained more experience. For the femoral head, after twenty cycles of joint movement 18/24 spots showed no displacement, 4/24 showed minor displacement (<3 mm) and 2/24 showed major displacement (>3 mm). None showed total displacement. For the acetabulum 22/24 spots showed no displacement and 2/24 showed minor displacement. A combined microfracturing and placing of an AMIC graft of focal chondral lesions of the hip joint can be done arthroscopically. Prospective randomized in vivo studies should compare the results of arthroscopilally placed AMIC grafts with microfracturing and microfracturing alone. PMID:24191186

Thorey, Fritz; Budde, Stefan; Ezechieli, Marco; Albrecht, Urs Vito; Ettinger, Max

2013-01-01

239

Perioperative Rehabilitation Using a Knee Extension Device and Arthroscopic Debridement in the Treatment of Arthrofibrosis  

PubMed Central

Background: Arthrofibrosis is a postoperative complication of intra-articular knee surgery that can be difficult to treat. Evidence suggests that maximizing knee range of motion may improve outcomes in patients with arthrofibrosis who undergo arthroscopic debridement. Hypothesis: Patients who achieve greater knee range of motion will have better subjective scores. Study Design: Retrospective case series analysis. Methods: A review of records was performed for 33 patients with arthrofibrosis who underwent knee arthroscopy and scar resection coupled with perioperative rehabilitation to maximize knee range of motion. Patient demographics and preoperative and postoperative range of motion measurements were extracted from the records. The International Knee Documentation Committee (IKDC) Subjective Knee Form was administered to assess pain, activity, and knee function. Patients performed a preoperative and postoperative rehabilitation program utilizing a knee extension device to maximize knee extension. Results: According to the IKDC range of motion criteria, 27 of 33 patients achieved normal knee extension, and 14 of 33 achieved normal knee flexion at a mean of 8.6 months after surgery. Patients with normal knee motion had a mean IKDC Subjective Knee Form score of 72.6 ± 13.6, which was significantly higher than patients who did not achieve normal motion (P = .04). Overall, mean IKDC Subjective Knee Form scores improved from 45.3 ± 16.7 preoperatively to 67.1 ± 18.0 postoperatively (P < .01) at a mean of 14.7 months after surgery. Conclusions: Perioperative rehabilitation that emphasizes restoration of normal knee range of motion appears to improve outcomes in patients with arthrofibrosis who undergo arthroscopic scar resection. In support of our hypothesis, patients who achieved greater knee range of motion had better subjective knee scores. PMID:23015970

Biggs-Kinzer, Angie; Murphy, Brian; Shelbourne, K. Donald; Urch, Scott

2010-01-01

240

Extra articular arthroscopic release in post-traumatic stiff knees: a prospective study of endoscopic quadriceps and patellar release.  

PubMed

Knee stiffness due to mismanaged trauma is still common in underdeveloped countries. Many patients with distal femoral fractures, patellar injuries or other local trauma present with intra-articular and extra-articular adhesions between the quadriceps and anterior femur. Nineteen knees with post trauma stiffness due to combined intra- and extra- articular aetiology were taken up for arthroscopic aided release after failing an aggressive physiotherapy protocol. Ultrasound was used to identify the extra-articular adhesions. The intra-articular part of the release was done by a standard protocol involving the release of all infrapatellar, suprapatellar and gutter adhesions, and then the extra-articular proximal adhesions were released by using special long periosteal elevators and arthroscopic scissors. We were able to release the adhesions as high as 9 inches above the patella, and in one case bony ankylosis between the patella and the femur was arthroscopically osteotomised (after 11 years of stiffness). Delay before surgery averaged 2.7 years (6 months-11.3 years). Mean active flexion at one year follow-up improved from 27.3 degrees to 119.3 degrees (average increase: 92 degrees). Mean preoperative extension lag reduced from 6 degrees to 1 degrees postoperatively. No CPM machine was available, and patients had to undergo daily manual and assisted therapy, with appropriate analgesia. Overall patient satisfaction was excellent; one patient developed a supracondylar fracture (infected old fracture with bone loss and severe contracture) and was retrospectively a wrong case selection. Arthroscopic aided quadriceps adhesion release is a good option in cases of neglected trauma; results are excellent even without sophisticated CPM machines, and the periosteal elevators needed are cheap and indigenous. PMID:16152854

Dhillon, Mandeep S; Panday, Awadesh K; Aggarwal, Sameer; Nagi, Onkar N

2005-04-01

241

Arthroscopic and open shoulder stabilization using absorbable implantsA clinical and radiographic comparison of two methods  

Microsoft Academic Search

The aim of this study was to compare the clinical and radiographic results in patients with recurrent unidirectional, post-traumatic\\u000a shoulder instability (dislocations\\/subluxations). All the patients had a Bankart lesion and underwent reconstruction using\\u000a either an open or an arthroscopic technique and absorbable implants. Thirty-three consecutive patients (36 shoulders) were\\u000a operated on by one surgeon. Group A comprised 18 shoulders which

Jüri Kartus; Lars Ejerhed; Eduard Funck; Kristina Köhler; Ninni Sernert; Jon Karlsson

1998-01-01

242

Appliance Repair, Tips & Help  

NSDL National Science Digital Library

On this site, visitors can find information about common household appliance parts and repair - categorized by type - including kitchen appliances, laundry equipment, and refrigerators. By clicking on the images of the individual machines, visitors can find more information including parts, how they work, common problems, and maintenance tips. There are also helpfully labeled images for particular brands and models of each appliance, which indicate the different features and parts of those particular machines. While some of the site is commercial (such as the links to appliance accessories), there is plenty of free and handy information for students working toward a career in appliance installation and repair.

2007-02-15

243

Satellite Repair Program  

NASA Technical Reports Server (NTRS)

NASA-Goddard's Satellite Repair Program counts among its major achievements the successful use of welding in servicing equipment employed in the Flight Support System (FSS) structures addressed by the the Solar Maximum Repair Mission of 1984. The FSS berthing and positioning ring will again be employed with the Space Shuttle for the anticipated upgrading of the Hubble Space Telescope; the Explorer Platform (EP) mission will also use the FSS during the planned on-orbit exchange of the EUV Explorer payload for an X-ray Timing Explorer payload. The EP, to which attention is presently given, is the first spacecraft designed to be entirely serviceable by intravehicular activity or EVA.

Davis, Robert E.

1991-01-01

244

A Comparative Study between Use of Arthroscopic Lavage and Arthrocentesis of Temporomandibular Joint Based on Computational Fluid Dynamics Analysis  

PubMed Central

Arthroscopic lavage and arthrocentesis, performed with different inner-diameter lavage needles, are the current minimally invasive techniques used in temporomandibular joint disc displacement (TMJ-DD) for pain reduction and functional improvement. In the current study, we aimed to explore the biomechanical influence and explain the diverse clinical outcomes of these two approaches with computational fluid dynamics. Data was retrospectively analyzed from 78 cases that had undergone arthroscopic lavage or arthrocentesis for TMJ-DD from 2002 to 2010. Four types of finite volume models, featuring irrigation needles of different diameters, were constructed based on computed tomography images. We investigated the flow pattern and pressure distribution of lavage fluid secondary to caliber-varying needles. Our results demonstrated that the size of outflow portal was the critical factor in determining irrigated flow rate, with a larger inflow portal and a smaller outflow portal leading to higher intra-articular pressure. This was consistent with clinical data suggesting that increasing the mouth opening and maximal contra-lateral movement led to better outcomes following arthroscopic lavage. The findings of this study could be useful for choosing the lavage apparatus according to the main complaint of pain, or limited mouth opening, and examination of joint movements. PMID:24223868

Zhu, Ping; Zhou, Wenyan; Han, Yi; Zheng, Youhua; Zhang, Zhiguang

2013-01-01

245

Acromioclavicular joint acceleration-deceleration injury as a cause of persistent shoulder pain: Outcome after arthroscopic resection  

PubMed Central

Background: Shoulder pain in general and acromioclavicular joint (ACJ) pain specifically is common after acceleration-deceleration injury following road traffic accident (RTA). The outcome of surgical treatment in this condition is not described in the literature. The aim of the present study was to report the outcome of arthroscopic resection of the ACJ in these cases Materials and Methods: Nine patients with localized ACJ pain, resistant to nonoperative treatment were referred on an average 18 months after the injury. There were 3 male and 6 females. The right shoulder was involved in seven patients and the left in two. The average age was 38.9 years (range 29-46 years). All presented with normal X-rays but with torn acromioclavicular joint disc and effusion on magnetic resonance imaging (MRI). Arthroscopic ACJ excision arthroplasty was performed in all patients. Results: At a mean followup of 18 month, all patients had marked improvement. The Constant score improved from 36 to 81, the pain score from 3/15 to 10/15 and the patient satisfaction improved from 3.5/10 to 9.3/10. Conclusion: Arthroscopic ACJ excision arthroplasty, gives good outcomes in patients not responding to conservative management in ACJ acceleration-deceleration injury. PMID:24741142

Atoun, Ehud; Bano, Artan-Athanasios; Tongel, Alexander Van; Narvani, Ali; Sforza, Giuseppe; Levy, Ofer

2014-01-01

246

Electric motor model repair specifications  

SciTech Connect

These model repair specifications list the minimum requirements for repair and overhaul of polyphase AC squireel cage induction motors. All power ranges, voltages, and speeds of squirrel cage motors are covered.

NONE

1995-08-01

247

Pectus excavatum repair - series (image)  

MedlinePLUS

Pectus excavatum is a deformity of the front of the chest wall with depression of the breastbone (sternum) ... Repair of pectus excavatum may be recommended for: improved appearance (cosmetic repair) improved breathing (respiratory function)

248

46 CFR Sec. 19 - Ship Repair Summaries.  

Code of Federal Regulations, 2013 CFR

...AUTHORITY PROCEDURE FOR ACCOMPLISHMENT OF VESSEL REPAIRS UNDER NATIONAL SHIPPING AUTHORITY MASTER LUMP SUM REPAIR CONTRACT-NSA-LUMPSUMREP Sec. 19 Ship Repair Summaries. (a) Ship Repair Summaries shall be prepared on Form...

2013-10-01

249

Results of rectocele repair  

Microsoft Academic Search

PURPOSE: This study was designed to evaluate the results of rectocele repair and parameters that might be useful in selecting patients for this operation. METHODS: Twentyfive patients with symptom-giving rectoceles were prospectively evaluated with a standardized questionnaire, physical examination, defecography, colon transit studies, anorectal manometry, and electrophysiology. Patients underwent posterior colporrhaphy and perineorrhaphy. They were followed postoperatively (mean, 1.0 year)

Anders Mellgren; Bo Anzén; Bengt-Yngve Nilsson; Claes Johansson; Anders Dolk; Peter Gillgren; Staffan Bremmer; Bo Holmström

1995-01-01

250

Comprehensive Small Engine Repair.  

ERIC Educational Resources Information Center

This curriculum guide contains the basic information needed to repair all two- and four-stroke cycle engines. The curriculum covers four areas, each consisting of one or more units of instruction that include performance objectives, suggested activities for teacher and students, information sheets, assignment sheets, job sheets, visual aids,…

Hires, Bill; And Others

251

Hallucinations after hypospadias repair.  

PubMed

The authors report a case of a 4-year-old child who developed hallucinations after hypospadias repair. He was brought to the emergency department the morning after outpatient surgery where the diagnosis of central anticholinergic syndrome was made. We review oxybutynin overdose and the importance of providing clear instruction to parents and caregivers about the administration of medications. PMID:16516613

Swana, Hubert S; Youmans, Sharon L; Kogan, Barry A; Bogetz, Martin S

2006-03-01

252

Recombinational DNA Repair in Bacteria  

E-print Network

Recombinational DNA Repair in Bacteria: Postreplication Kevin P Rice,University of Wisconsin Recombinational DNA repair represents the primary function for homologous DNA recombination in bacteria. Most of this repair occurs at replication forks that are stalled at sites of DNA damage. Introduction Deoxyribonucleic

Cox, Michael M.

253

Self-repairing of composites  

NASA Astrophysics Data System (ADS)

If the most important problem restraining polymer usage is damage and the inability to control it, predict, detect it it, then the solution is self repair of the composites. In order to be self -repairing, a healing chemical is stored in hollow fiber or vessels embedded in the polymer matrix. When the composite cracks, the crack progresses cracking the repair fiber, or bead. The healing chemical flows into the crack and the crack faces are rebonded. Also the fiber can be rebonded to the matrix or delaminations repaired with the adhesive. This research focuses on factors affecting repair so that it will be reliable and not as unpredictable as the polymer matrix itself.

Dry, Carolyn M.

2003-07-01

254

Meniscus repair and transplantation techniques.  

PubMed

Modern meniscal repair incorporates multiple techniques and adjunctive measures. The classic inside-out repair remains the gold standard and is most appropriate for a bucket-handle type tear of the medial or lateral meniscus. The all-inside technique has gained in popularity recently and has outcomes that approach those of the inside-out repair with decreased morbidity but increased cost. The choice of this technique is most appropriate for small tears requiring few sutures to repair. Outside-in repair can also be employed and is preferred for anterior horn tears. Surgeons may use a hybrid technique that incorporates all techniques in some challenging cases. Meniscal debridement is used for degenerative tears that are not amenable to repair. Meniscal transplantation is an option for symptomatic meniscal deficiency in young, active patients. This article discusses the technical considerations for meniscal debridement, repair, and transplantation. PMID:21980876

Burns, Travis C; Giuliani, Jeffrey R; Svoboda, Steven J; Owens, Brett D

2011-09-01

255

Minimally Invasive Spigelian Hernia Repair  

PubMed Central

Introduction: Spigelian hernia is an uncommon ventral hernia characterized by a defect in the linea semilunaris. Repair of spigelian hernia has traditionally been accomplished via an open transverse incision and primary repair. The purpose of this article is to present 2 case reports of incarcerated spigelian hernia that were successfully repaired laparoscopically using Gortex mesh and to present a review of the literature regarding laparoscopic repair of spigelian hernias. Methods: Retrospective chart review and Medline literature search. Results: Two patients underwent laparoscopic mesh repair of incarcerated spigelian hernias. Both were started on a regular diet on postoperative day 1 and discharged on postoperative days 2 and 3. One patient developed a seroma that resolved without intervention. There was complete resolution of preoperative symptoms at the 12-month follow-up. Conclusion: Minimally invasive repair of spigelian hernias is an alternative to the traditional open surgical technique. Further studies are needed to directly compare the open and the laparoscopic repair. PMID:19660230

Baucom, Catherine; Nguyen, Quan D.; Hidalgo, Marco

2009-01-01

256

Repair of a chondral defect using a cell free scaffold in a young patient - a case report of successful scaffold transformation and colonisation  

PubMed Central

Background Chondral defects of the articular surface are a common condition that can lead to osteoarthritis if not treated. Therapy of this condition is a topic of constant debate and a variety of chondral repair strategies are currently used. One strategy involves implantation of a cell-free matrix of type I collagen (COL1), to provide a scaffold for chondrocyte migration and proliferation and extracellular matrix production. Although several studies have suggested that chondrocytes can move, to the best of our knowledge there is still no proof of chondrocyte occurrence in a former cell-free scaffold for articular cartilage repair in humans. Case presentation An 18-year-old male patient underwent arthroscopic surgery of the knee for patellar instability and a chondral defect of the femoral condyle. Clinical outcome scores were recorded pre-operatively, after 6?weeks and after 6, 12, 24 and 36?months. MRI was recorded after 6?weeks and after 6, 12, 24 and 36?months postoperatively. At 42?months after implantation of a cell-free type I collagen matrix and reconstruction of the medial patellofemoral ligament, the patient was again treated arthroscopically for a tear of the medial meniscus of the same knee. A biopsy of the previous chondral defect was taken during arthroscopy for histological examination. Conclusion In addition to good clinical and radiological results reported for cell-free scaffolds for cartilage repair in several other studies, transformation of the scaffold could be observed during re-arthroscopy for the meniscal tear. Histological examination of the specimen revealed articular cartilage with vital chondrocytes and a strong staining reaction for type II collagen (COL II), but no reaction for type I collagen staining. This might indicate a complete transformation of the scaffold and supports the theory that cell free scaffolds could support cell migration. Although the cell source remains unclear, migrating chondrocytes from the periphery remain a possibility. PMID:23590134

2013-01-01

257

Prokaryotic Nucleotide Excision Repair  

PubMed Central

Nucleotide excision repair (NER) has allowed bacteria to flourish in many different niches around the globe that inflict harsh environmental damage to their genetic material. NER is remarkable because of its diverse substrate repertoire, which differs greatly in chemical composition and structure. Recent advances in structural biology and single-molecule studies have given great insight into the structure and function of NER components. This ensemble of proteins orchestrates faithful removal of toxic DNA lesions through a multistep process. The damaged nucleotide is recognized by dynamic probing of the DNA structure that is then verified and marked for dual incisions followed by excision of the damage and surrounding nucleotides. The opposite DNA strand serves as a template for repair, which is completed after resynthesis and ligation. PMID:23457260

Kisker, Caroline; Kuper, Jochen; Van Houten, Bennett

2014-01-01

258

Glandular hypospadias repair.  

PubMed

Glandular hypospadias represents approximately 15% of the hypospadias variants seen. This article will examine common surgical approaches applicable to the child with glandular hypospadias. Hypospadias repairs discussed in this article will include urethromeatoplasty, MAGPI, the GAP procedure, MIV glans plasty, urethral advancement procedure, and parameatal based flap variants, including the Mathieu and Barcat procedures. Because these anomalies are cosmetically less aberrant than more proximal variants, only those surgical techniques which assure a normal-appearing penis should be undertaken. PMID:12371221

Zaontz, Mark R; Dean, Gregory E

2002-05-01

259

Arthroscopic Acetabular Microfracture With the Use of Flexible Drills: A Technique Guide  

PubMed Central

Chondral injuries of the hip joint are often symptomatic and affect patient activity level. Several procedures are available for addressing chondral injuries, including microfracture. Microfracture is a marrow-stimulating procedure, which creates subchondral perforation in the bone, allowing pluripotent mesenchymal stem cells to migrate from the marrow into the chondral defect and form fibrocartilaginous tissue. In the knee, microfracture has been shown to relieve pain symptoms. In the hip, microfracture has been studied to a lesser extent, but published studies have shown promising clinical outcomes. The depth, joint congruity, and geometry of the hip joint make microfracture technically challenging. The most common technique uses hip-specific microfracture awls, but the trajectory of impaction is not perpendicular to the subchondral plate. Consequently, the parallel direction of impaction creates poorly defined channels. We describe an arthroscopic microfracture technique for the hip using a flexible microfracture drill. The drill and angled guides simplify access to the chondral defect. The microfracture drill creates clear osseous channels, avoiding compaction of the surrounding bone and obstruction of the channels. Furthermore, this technique allows for better control of the angle and depth of the drill holes, which enhances reproducibility and may yield improved clinical outcomes. PMID:25276604

Haughom, Bryan D.; Erickson, Brandon J.; Rybalko, Danil; Hellman, Michael; Nho, Shane J.

2014-01-01

260

Arthroscopic Acetabular Microfracture With the Use of Flexible Drills: A Technique Guide.  

PubMed

Chondral injuries of the hip joint are often symptomatic and affect patient activity level. Several procedures are available for addressing chondral injuries, including microfracture. Microfracture is a marrow-stimulating procedure, which creates subchondral perforation in the bone, allowing pluripotent mesenchymal stem cells to migrate from the marrow into the chondral defect and form fibrocartilaginous tissue. In the knee, microfracture has been shown to relieve pain symptoms. In the hip, microfracture has been studied to a lesser extent, but published studies have shown promising clinical outcomes. The depth, joint congruity, and geometry of the hip joint make microfracture technically challenging. The most common technique uses hip-specific microfracture awls, but the trajectory of impaction is not perpendicular to the subchondral plate. Consequently, the parallel direction of impaction creates poorly defined channels. We describe an arthroscopic microfracture technique for the hip using a flexible microfracture drill. The drill and angled guides simplify access to the chondral defect. The microfracture drill creates clear osseous channels, avoiding compaction of the surrounding bone and obstruction of the channels. Furthermore, this technique allows for better control of the angle and depth of the drill holes, which enhances reproducibility and may yield improved clinical outcomes. PMID:25276604

Haughom, Bryan D; Erickson, Brandon J; Rybalko, Danil; Hellman, Michael; Nho, Shane J

2014-08-01

261

Functional Outcome in Athletes at Five Years of Arthroscopic Anterior Cruciate Ligament Reconstruction  

PubMed Central

Introduction. The purpose of this study was to analyze the functional outcome in competitive level athletes at 5 years after ACL reconstruction with regard to return to sports and the factors or reasons in those who either stopped sports or showed a fall in their sporting levels. Methods. 48 competitive athletes who had undergone arthroscopic assisted ACL reconstruction with a minimum follow up of at least 5 years were successfully recalled and were analyzed. Results. 22 patients had returned to the preinjury levels of sports and 18 showed a decrease in their sporting levels. Of the 18 patients, 12 referred to fear of reinjuring the same or contra-lateral knee as the prime reason for the same while 6 patients reported persisting knee pain and instability as reasons for a fall in their sporting abilities. The difference in the scores of these groups was statistically significant. 8 patients out of the 48 had left sports completely due to reasons other than sports, even though they had good knee outcome scores. Conclusion. Fear of reinjury and psychosocial issues that are relevant to the social milieu of the athlete are very important and affect the overall results of the surgery with respect to return to sports. PMID:24977065

Devgan, Ashish; Magu, N. K.; Siwach, R. C.; Rohilla, Rajesh; Sangwan, S. S.

2011-01-01

262

Arthroscopic posterior cruciate ligament reconstruction in a skeletally immature patient: a new technique with case report.  

PubMed

Pediatric intrasubstance posterior cruciate ligament (PCL) injuries are rare but present a significant treatment challenge. Untreated instability may lead to further knee injury, including meniscal or chondral damage. Surgical intervention risks damage to the physis, growth arrest, and angular deformity. We present the case of a skeletally immature 11-year-old boy with a high-grade intrasubstance PCL injury reconstructed using an all-arthroscopic tibial inlay technique modified to minimize risk of physeal injury. The femoral tunnels were placed entirely within the epiphysis, and the tibial physis was minimally crossed with a small drill hole and suture material. At 17 months' follow up, the patient had returned to full activity, including sports. He had a grade 1 posterior drawer and no posterior sag. Radiographs showed no degenerative changes. Both the proximal tibial and distal femoral physes were widely patent with no angular deformity. The patient had a 1-cm leg length discrepancy, with the operative limb being longer. This technical note with a case report describes a novel physeal-sparing reconstruction of the PCL in a pediatric patient with open physes. PMID:20362839

Bovid, Karen M; Salata, Michael J; Vander Have, Kelly L; Sekiya, Jon K

2010-04-01

263

Osteochondritis dissecans of the knee; long-term clinical outcome following arthroscopic debridement.  

PubMed

We reviewed 32 knees in 26 patients who had previously undergone arthroscopic debridement for symptomatic osteochondritis dissecans (OCD) of the knee. The patients were followed up at a minimum of 11 years following surgery and were evaluated clinically using the American Knee Society Clinical Rating Score. Additional evaluation was performed using the Hughston Scale to include radiographic assessment. The mean American Knee Society Score was 179 (out of 200), indicating good clinical function. Radiographically, however, only 29% scored excellent or good on the Hughston Scale. Younger patients with a small, stable (and therefore preserved), medial femoral condyle lesion had the best prognosis. Whilst more novel and complex options such as chondrocyte implantation are being assessed for the treatment of OCD, it is clear that within this study group careful debridement with removal of loose tissue can achieve good clinical results in the long term. There was however radiographic evidence of early degenerative joint disease in 17/24 (71%) of patients reviewed. Patients undergoing excision of OCD fragments did worse than those in whom the fragment was preserved, however the risk of further surgery is raised if a fragment is left in situ at initial surgery. PMID:17222556

Murray, J R D; Chitnavis, J; Dixon, P; Hogan, N A; Parker, G; Parish, E N; Cross, M J

2007-03-01

264

Utility of arthroscopic guided synovial biopsy in understanding synovial tissue pathology in health and disease states  

PubMed Central

The synovium is the soft tissue lining diarthrodial joints, tendon sheaths and bursae and is composed of intimal and subintimal layers. The intimal layer is composed of type A cells (macrophages) and type B cells (fibroblasts); in health, the subintima has few inflammatory cells. The synovium performs several homeostatic functions and is the primary target in several inflammatory arthritides. Inflammatory states are characterised by thickening of the synovial lining, macrophage recruitment and fibroblast proliferation, and an influx of inflammatory cells including lymphocytes, monocytes and plasma cells. Of the various methods employed to perform synovial biopsies arthroscopic techniques are considered the “gold standard”, and have an established safety record. Synovial biopsy has been of critical importance in understanding disease pathogenesis and has provided insight into mechanisms of action of targeted therapies by way of direct evidence about events in the synovial tissue in various arthritides. It has been very useful as a research tool for proof of concept studies to assess efficacy and mechanisms of new therapies, provide tissue for in vitro studies, proteomics and microarrays and allow evaluation for biomarkers that may help predict response to therapy and identify new targets for drug development. It also has diagnostic value in the evaluation of neoplastic or granulomatous disease or infection when synovial fluid analysis is non-contributory.

Wechalekar, Mihir D; Smith, Malcolm D

2014-01-01

265

Utility of arthroscopic guided synovial biopsy in understanding synovial tissue pathology in health and disease states.  

PubMed

The synovium is the soft tissue lining diarthrodial joints, tendon sheaths and bursae and is composed of intimal and subintimal layers. The intimal layer is composed of type A cells (macrophages) and type B cells (fibroblasts); in health, the subintima has few inflammatory cells. The synovium performs several homeostatic functions and is the primary target in several inflammatory arthritides. Inflammatory states are characterised by thickening of the synovial lining, macrophage recruitment and fibroblast proliferation, and an influx of inflammatory cells including lymphocytes, monocytes and plasma cells. Of the various methods employed to perform synovial biopsies arthroscopic techniques are considered the "gold standard", and have an established safety record. Synovial biopsy has been of critical importance in understanding disease pathogenesis and has provided insight into mechanisms of action of targeted therapies by way of direct evidence about events in the synovial tissue in various arthritides. It has been very useful as a research tool for proof of concept studies to assess efficacy and mechanisms of new therapies, provide tissue for in vitro studies, proteomics and microarrays and allow evaluation for biomarkers that may help predict response to therapy and identify new targets for drug development. It also has diagnostic value in the evaluation of neoplastic or granulomatous disease or infection when synovial fluid analysis is non-contributory. PMID:25405084

Wechalekar, Mihir D; Smith, Malcolm D

2014-11-18

266

Arthrometric stability of horizontal versus vertical single-bundle arthroscopic anterior cruciate ligament reconstruction.  

PubMed

The anteroposterior (AP) stability of standard anterior cruciate ligament (ACL) reconstruction, referred to as "vertical," was compared with that of a modified femoral position, referred to as "horizontal," which is lower than and anterior to an operative knee at 90° flexion. Two consecutive series of 50 patients underwent vertical and horizontal arthroscopic single-bundle ACL reconstruction, respectively. For vertical reconstruction, the clock position was chosen, placing the graft at 10:30 in right knees and 1:30 in left knees, 1 to 2 mm anterior to the posterior femoral cortical cortex and at the back of the resident ridge. In the horizontal reconstruction, the transplant replaced the original ligament insertion at approximately the 9:30 o'clock position in right knees and the 2:30 o'clock position in left knees, approximately 2 mm in front of the posterior femoral cortical cortex. One year after surgery, the results of stabilometric evaluation revealed good performance after horizontal transplant. The mean clinical results changed from 1.0 (±1.3) mm for vertical to 0.7 (±1.3) mm for horizontal reconstruction. PMID:24810813

Denti, Matteo; Arrigoni, Paolo; Volpi, Piero; Bait, Corrado; Sedran, Jean Claude; Randelli, Pietro

2014-05-01

267

All-Inside Meniscal Repair  

PubMed Central

All-inside meniscal repair has gained widespread popularity over recent years. The devices and techniques have rapidly evolved, resulting in increased ease of use and reduced surgical times and risk to the neurovascular structures. Despite these advances, inside-out suture repairs remain the current gold standard, with proven long-term results. All-inside techniques must continue to be compared to inside-out meniscal repair. PMID:23015905

Turman, Kimberly A.; Diduch, David R.; Miller, Mark D.

2009-01-01

268

Diaphragmatic hernia repair - series (image)  

MedlinePLUS

... life-threatening situation. The indications for a diaphragmatic hernia repair include: chest X-rays showing diaphragmatic hernia severe breathing difficulty (respiratory distress) shortly after birth ...

269

Endovascular abdominal aortic aneurysm repair  

PubMed Central

The operative mortality following conventional abdominal aortic aneurysm (AAA) repair has not fallen significantly over the past two decades. Since its inception in 1991, endovascular aneurysm repair (EVAR) has provided an alternative to open AAA repair and perhaps an opportunity to improve operative mortality. Two recent large randomised trials have demonstrated the short and medium term benefit of EVAR over open AAA repair, although data on the long term efficacy of the technique are still lacking. This review aimed at providing an overview of EVAR and a discussion of the potential benefits and current limitations of the technique. PMID:17267674

Norwood, M G A; Lloyd, G M; Bown, M J; Fishwick, G; London, N J; Sayers, R D

2007-01-01

270

Epineurial vs. perineurial repair.  

PubMed

Previous work concerning the efficacy of different types of nerve repair has been reviewed. We describe a model in which epineurial and perineurial suture techniques were studied by quantitative ultramicroscopy and electrophysiology. In this model, we believe suture of the perineurium was shown to have a slight advantage over suture of the epineurium. Microscopic control and fascicular alignment are advocated to increase the percentage of axons growing into the distal stump and the periphery. The model described should lend itself to the study of other traumatic peripheral neuropathies. PMID:20607943

Orgel, M G; Terzis, J K

1977-07-01

271

Advances in nerve repair.  

PubMed

Patients with peripheral nerve injuries face unpredictable and often suboptimal functional outcome, even following standard microsurgical nerve repair. The challenge of improving such outcomes following nerve surgical procedures has interested many research teams, in both clinical and fundamental fields. Some innovative treatments are presently being applied to a widening range of patients, whereas others will require further development before translation to human subjects. This article presents several recent advances in emerging therapies at various stages of clinical application. Nerve transfers have been successfully used in clinical settings, but new indications are being described, enlarging the range of patients who might benefit from them. Brief direct nerve electrical stimulation has been shown to improve nerve regeneration and outcome in animal models and in a small cohort of patients. Further clinical trials are warranted to prove the efficacy of this exciting and easily applicable approach. Animal studies also suggest a tremendous potential for stem and precursor cell therapy. Further studies will lead to a better understanding of their mechanisms of action in nerve repair and potential applications for human patients. PMID:23250767

Khuong, Helene T; Midha, Rajiv

2013-01-01

272

Arthroscopically assisted quadriceps double-bundle tibial inlay posterior cruciate ligament reconstruction: an analysis of techniques and a safe operative approach to the popliteal fossa  

Microsoft Academic Search

The arthroscopically assisted posterior cruciate ligament tibial inlay technique, frequently used in athletic individuals and in revision cases, requires a thorough and comprehensive understanding of posterior knee anatomy. Importantly, variations in the posterior vascular anatomy may be encountered. A safe and methodical posteromedial approach in a layered fashion to achieve proper and safe tibial inlay graft placement and fixation is

Frank R Noyes; Michael J Medvecky; Manoj Bhargava

2003-01-01

273

Industrial motor repair in the United States  

SciTech Connect

This report characterizes the motor repair industry in the United States; summarizes current motor repair and testing practice; and identifies barriers to energy motor repair practice and recommends strategies for overcoming those barriers.

Schueler, V.; Leistner, P.; Douglass, J.

1994-09-01

274

Endoscopic Proximal Hamstring Repair and Ischial Bursectomy  

PubMed Central

With the significant increase in use of the arthroscope around the hip have come several less invasive techniques to manage pathologies around this joint. This technical note with a video details one such technique that allows for the endoscopic management of proximal hamstring tears and chronic ischial bursitis, which until now have been managed exclusively with much larger open approaches. This procedure allows for complete exposure of the posterior aspect of the hip in a safe, minimally invasive fashion. PMID:23766996

Dierckman, Brian D.; Guanche, Carlos A.

2012-01-01

275

Optical design and evaluation of a 4 mm cost-effective ultra-high-definition arthroscope.  

PubMed

High definition and magnification rigid endoscope plays an important role in modern minimally invasive medical surgery and diagnosis. In this paper, we present the design and evaluation methods of a high definition rigid endoscope, specifically an arthroscope, with a large depth of field (DOF). The incident heights and exit angles of the sampled rays on the relay lens are controlled during the optimization process to ensure an effective field view (70°) and a normal ray path within the limited lens diameter of 2.7 mm. The lens is set up as a multi-configuration system with two extreme and one middle object distances to cover a large DOF. As a result, an entrance pupil of 0.3 mm is achieved for the first time, to bring the theoretical resolution to 23.1 lps/mm in the object space at a working distance of 20 mm, with the wavelength of 0.532 um. The modulation transfer function (MTF) curves approach diffraction limit, and the values are all higher than 0.3 at 160 line pairs/mm (lps/mm) in the image space. Meanwhile, stray light caused by total internal reflection on the inner wall of the rod lenses and the objective lens is eliminated. The measured resolution in the object space at a 20 mm working distance is 22.3 lps/mm, and test results show that other performance characteristics also fulfill design requirements. The relay lenses are designed with only one type of the spacer and two types of lenses to greatly reduce the fabrication and assembly cost. The design method has important research and application values for lens systems used in modern minimally invasive medical surgery and industrial non-destructive testing area. PMID:25136495

Cheng, Dewen; Wang, Yongtian; Yu, Lu; Liu, Xiaohua

2014-08-01

276

Optical design and evaluation of a 4 mm cost-effective ultra-high-definition arthroscope  

PubMed Central

High definition and magnification rigid endoscope plays an important role in modern minimally invasive medical surgery and diagnosis. In this paper, we present the design and evaluation methods of a high definition rigid endoscope, specifically an arthroscope, with a large depth of field (DOF). The incident heights and exit angles of the sampled rays on the relay lens are controlled during the optimization process to ensure an effective field view (70°) and a normal ray path within the limited lens diameter of 2.7 mm. The lens is set up as a multi-configuration system with two extreme and one middle object distances to cover a large DOF. As a result, an entrance pupil of 0.3 mm is achieved for the first time, to bring the theoretical resolution to 23.1 lps/mm in the object space at a working distance of 20 mm, with the wavelength of 0.532 um. The modulation transfer function (MTF) curves approach diffraction limit, and the values are all higher than 0.3 at 160 line pairs/mm (lps/mm) in the image space. Meanwhile, stray light caused by total internal reflection on the inner wall of the rod lenses and the objective lens is eliminated. The measured resolution in the object space at a 20 mm working distance is 22.3 lps/mm, and test results show that other performance characteristics also fulfill design requirements. The relay lenses are designed with only one type of the spacer and two types of lenses to greatly reduce the fabrication and assembly cost. The design method has important research and application values for lens systems used in modern minimally invasive medical surgery and industrial non-destructive testing area. PMID:25136495

Cheng, Dewen; Wang, Yongtian; Yu, Lu; Liu, Xiaohua

2014-01-01

277

Left atrial isomerism: biventricular repair  

Microsoft Academic Search

Objective: Biventricular repair of hearts with left atrial isomerism often necessitates complex atrial and ventricular baffle procedures. We analysed our experience with an accent on baffle techniques. Methods: From 1997 until 2008, 12 patients (four male) with left atrial isomerism received biventricular repair. Their median age at surgery was 9 (range: 1–24) months. Four patients had dextrocardia. Nine patients presented

Janez Vodiskar; Sally-Ann Clur; Jarda Hruda; Regina Bokenkamp; Mark Gerard Hazekamp

2010-01-01

278

Laparoscopic repair for groin hernias  

Microsoft Academic Search

Laparoscopic inguinal herniorrhaphy was first described by Ger, Schultz, Corbitt, and Filipi in the early 1990s (1-4) and burst upon the surgical scene just after laparoscopic cholecystectomy. It rapidly became popular, and many different techniques for repair were developed. Over the last decade much good work has been done to find which type of laparoscopic repair is best, to determine

Chad J. Davis; Maurice E. Arregui

279

The base excision repair pathway  

Microsoft Academic Search

The base excision repair pathway has evolved to protect cells from the deleterious effects of endogenous DNA damage induced by hydrolysis, reactive oxygen species and other intracellular metabolites that modify DNA base structure. However, base excision repair is also important to resist lesions produced by ionizing radiation and strong alkylating agents, which are similar to those induced by endogenous factors.

Erling Seeberg; Lars Eide; Magnar Bjørås

1995-01-01

280

Pregnancy and ventral hernia repair  

Microsoft Academic Search

Summary Reluctance to repair anterior abdominal wall hernias in women of childbearing age is probably unjustified. A unique series is described of 27 women who gave birth to 41 full-term babies following repair of an anterior abdominal wall hernia with no recurrence of the hernia. Nineteen had primary and recurrent umbilical hernias and an incisional hernia in a low transverse

J. Abrahamson; J. Gorman

2000-01-01

281

Drug resistance and DNA repair  

Microsoft Academic Search

DNA repair confers resistance to anticancer drugs which kill cells by reacting with DNA. A review of our current information on the topic will be presented here. Our understanding of the molecular biology of repair of 06-alkylguanine adducts in DNA has advanced as a result of the molecular cloning of the E. coli ada gene but the precise role of

Margaret Fox; John J. Roberts

1987-01-01

282

Outpatient Adult Inguinal Hernia Repair  

PubMed Central

Repair of adult inguinal hernia has been done on an outpatient basis at our surgical facility for the past six years. In 616 consecutive repairs, complications have been remarkably few: one patient was electively admitted to hospital, two hernias have recurred and one patient needed to be catheterized. Patient acceptance has been enthusiastic. PMID:6741121

Lee, R. Hewlett; Marzoni, Francis A.; Cannon, Walter B.; Trollope, Michael L.

1984-01-01

283

Major Appliance Repair. Teacher Edition.  

ERIC Educational Resources Information Center

This module is a comprehensive text on basic appliance repair, designed to prepare students for entry-level jobs in this growing field. Ensuring a firm grounding in electrical knowledge, the module contains 13 instructional units that cover the following topics: (1) major appliance repair orientation; (2) safety and first aid; (3) fundamentals of…

Smreker, Eugene; Calvert, King

284

Cost reduction during maintenance & repair  

Microsoft Academic Search

Low-technology equipment test and repair is typically composed of numerous manual actions performed in a series of predetermined steps. This paper describes a recently deployed rework\\/production system that eliminates all of the superfluous 'process control and tracking' effort required during operational system test and maintenance, and allows support personnel to focus on their primary task of testing and repairing operational

H. Smith

2003-01-01

285

Laparoscopic repair of recurrent hernias.  

PubMed

The purpose of this study was to evaluate the results of a laparoscopic approach to recurrent inguinal hernia repair which dissected the entire inguinal floor and repaired all potential areas of recurrence without producing tension. Both a transabdominal preperitoneal and a totally extraperitoneal laparoscopic approach were utilized. Ninety recurrent hernias were repaired in 81 patients. The patients had 26 indirect, 36 direct, and 26 pantaloon recurrent hernias of which eight had a femoral component. In all but one patient the primary operations were open anterior repairs. The median follow-up was 14 months, ranging from 1 to 28 months. Patients returned to normal activities in an average of 1 week. The only recurrence observed was in the one patient whose primary repair was laparoscopic. When the entire inguinal floor of the recurrent hernia was redissected and buttressed with mesh, early recurrence was eliminated and recovery was shortened. PMID:7597580

Felix, E L; Michas, C A; McKnight, R L

1995-02-01

286

Autosite.com Repairs - Maintenance  

NSDL National Science Digital Library

A subsection of Autosite.com, a for-profit (from ads, the content is free) information source for auto buyers, the maintenance and repair area offers free and detailed information on auto care and repair that is accessible but not simplistic. In the maintenance section, users will find a preventative maintenance checklist, illustrated guides to fluids and exterior systems, a discussion on tires, and FAQs. The Repair section features troubleshooting tips, an illustrated repair guide, a fairly deep Auto Repair Encyclopedia, and several related links. Whether you are a die-hard do-it-yourselfer or just prefer to be forearmed before taking your car to the mechanics, this site can help.

287

TPS Inspection and Repair  

NASA Technical Reports Server (NTRS)

Dr. Scott Parazynski provided a retrospective on the EVA tools and procedures efforts NASA went through in the aftermath of Columbia for the Shuttle Thermal Protection System (TPS) inspection and repair. He describes his role as the lead astronaut on this effort, and covered all of the Neutral Buoyancy Lab (NBL), KC 135 (reduced gravity aircraft), Precision Air Bearing Floor (PABF), vacuum chamber and 1 G testing that was done in order to develop the tools and techniques that were flown. Parazynski also discusses how the EVA community worked together to resolve a huge safety issue, and how his work in the spacesuit was critical to overcoming a design limitation of the Space Shuttle.

Parazynski, Scott

2012-01-01

288

Fix-It Careers: Jobs in Repair  

ERIC Educational Resources Information Center

From auto mechanic to HVAC technicians, many occupations require repair skills. For jobseekers with the right skills, there are many advantages to a repair career. Repair work provides millions of jobs throughout the United States. Wages are often higher than average. And in many occupations, the employment outlook is bright. Plus, most repair

Torpey, Elka Maria

2010-01-01

289

Enzymology of mitochondrial base excision repair  

Microsoft Academic Search

A number of laboratories have shown that those types of DNA damage that are generally reparable by base excision repair are efficiently repaired in mtDNA. In contrast, most types of damage that require other sorts of repair machinery, are not effectively repaired in mtDNA. We have shown that a set of highly purified mitochondria) proteins, including AP endonuclease (APE), DNA

Daniel F Bogenhagen; Kevin G Pinz; Romina M Perez-Jannotti

2001-01-01

290

Taking control of cavitation repair  

SciTech Connect

Eliminating surprises and emergencies is the key of mastering cavitation-erosion repair. Innovations in runner design, new welding techniques and materials, and integrated maintenance scheduling add to that mastery.

Fulton, E. [Hydro Review, Kansas City, MO (United States)

1994-05-01

291

Inguinal hernia repair - series (image)  

MedlinePLUS

A hernia occurs when part of an organ protrudes through a weak point or tear in the thin muscular ... Hernia repair may be recommended for: large bulges through a small hole (increased risk of incarceration and ...

292

Precision Instrument and Equipment Repairers.  

ERIC Educational Resources Information Center

Explains the job of precision instrument and equipment repairers, who work on cameras, medical equipment, musical instruments, watches and clocks, and industrial measuring devices. Discusses duties, working conditions, employment and earnings, job outlook, and skills and training. (JOW)

Wyatt, Ian

2001-01-01

293

Aircraft Metal Skin Repair and Honeycomb Structure Repair; Sheet Metal Work 3: 9857.02.  

ERIC Educational Resources Information Center

The course helps students determine types of repairs, compute repair sizes, and complete the repair through surface protection. Course content includes goals, specific objectives, protection of metals, repairs to metal skin, and honeycomb structure repair. A bibliography and post-test are appended. A prerequisite for this course is mastery of the…

Dade County Public Schools, Miami, FL.

294

Early Days of DNA Repair: Discovery of Nucleotide Excision Repair and Homology-Dependent Recombinational Repair  

PubMed Central

The discovery of nucleotide excision repair in 1964 showed that DNA could be repaired by a mechanism that removed the damaged section of a strand and replaced it accurately by using the remaining intact strand as the template. This result showed that DNA could be actively metabolized in a process that had no precedent. In 1968, experiments describing postreplication repair, a process dependent on homologous recombination, were reported. The authors of these papers were either at Yale University or had prior Yale connections. Here we recount some of the events leading to these discoveries and consider the impact on further research at Yale and elsewhere. PMID:24348214

Rupp, W. Dean

2013-01-01

295

Septic arthritis of the temporomandibular joint successfully treated with arthroscopic lysis and lavage: case report and review of the literature.  

PubMed

Septic arthritis of the temporomandibular joint (TMJ) is infrequently reported. We present a case of septic arthritis of the TMJ following the extraction of the left upper second molar that occurred 1 week before beginning of symptoms. No evident predisposing factors were detected. Arthroscopic diagnosis of septic arthritis, lysis and lavage, and capsular stretch were performed. Cultures taken from the TMJ space grew Streptococcus sp. After 1 month of antimicrobial therapy the patient was asymptomatic and mandibular function was normal. Literature related to septic arthritis of TMJ and its treatment was reviewed. Different surgical procedures are available to treat this condition. Arthroscopy should be preferred as initial treatment on account of the possibility of drainage and accurate lavage under direct visualization of joint space, at the same time allowing confirmation of diagnostic hypotheses. Improving joint mobility with lysis of adhesions and capsular stretch in an early stage of disease may be helpful in stopping the fibrosis process. PMID:17095265

Sembronio, Salvatore; Albiero, Alberto Maria; Robiony, Massimo; Costa, Fabio; Toro, Corrado; Politi, Massimo

2007-02-01

296

Comparison of the operation of arthroscopic tibial inlay and traditional tibial inlay for posterior cruciate ligament reconstruction  

PubMed Central

Objective: To perform dual-bundle reconstruction of posterior cruciate ligament using full arthroscopic tibial inlay technology with self-designed tibia tunnel drilling system and to compare the effect of arthroscopic tibial inlay versus traditional technique for posterior cruciate ligament reconstruction. Material and methods: 32 patients were randomly divided into experiment group (improved tibial inlay, n = 17) and control group (traditional tibial inlay, n = 15). Self-designed tibia tunnel drill system was used to produce intraoperative deep-limited bone tunnel. During follow-up, the location of the bone block and the healing situation were checked by knee X-ray and spiral CT scan. Blood loss, operation time and nerve vascular injuries were evaluated. Results: Mean intraoperative blood loss was 123.53 ± 74.05 ml in the improved tibial inlay group compared with 332 ± 114.26 ml in the traditional tibial inlay group (t = 6.12, P < 0.05). Mean operation time was 235.27 ± 58.88 min in the improved tibial inlay group compared with 346.37 ± 59.67 min in the traditional tibial inlay group (t = 5.19, P < 0.05). Posterior drawer test were negative in 15 cases, slight positive in 2 with improved tibial inlay technique compared with 14 negative cases and 2 positive cases of traditional tibial Inlay technique. The X-ray and spiral CT scan showed the location of the bone block were perfect and healed well with the patent who received improved tibial inlay technology after 12 weeks postoperatively. Conclusion: Accurate depth-limited bone tunnel can be produced by the tibia tunnel drill system with minor trauma, less bleeding and reducing of nerves or vessels and the recent clinical effects of PCL reconstruction were pretty good.

Lu, Daifeng; Xiao, Mochao; Lian, Yongyun; Zhou, Yong; Liu, Xuefeng

2014-01-01

297

Repairing Solar Max: The Solar Maximum Repair Mission  

NASA Technical Reports Server (NTRS)

Technology and procedures designed for replacing a faulty attitude control module and scientific instruments on the only orbiting solar observatory are described. The rationale for the repair mission is given and the operations of the flight support system within the cargo bay of the space shuttle are discussed. The use of the manned maneuvering unit in capturing the satellite and of the remote manipulator arm in berthing it are discussed, as well as the space tools to be used for repair operations. The space crew and their responsibilities are identified.

Mcmahan, T.; Neal, V.

1984-01-01

298

Does Intravenous Ketamine Enhance Analgesia after Arthroscopic Shoulder Surgery with Ultrasound Guided Single-Injection Interscalene Block?: A Randomized, Prospective, Double-Blind Trial  

PubMed Central

Ketamine has anti-inflammatory, analgesic and antihyperalgesic effect and prevents pain associated with wind-up. We investigated whether low doses of ketamine infusion during general anesthesia combined with single-shot interscalene nerve block (SSISB) would potentiate analgesic effect of SSISB. Forty adult patients scheduled for elective arthroscopic shoulder surgery were enrolled and randomized to either the control group or the ketamine group. All patients underwent SSISB and followed by general anesthesia. During an operation, intravenous ketamine was infused to the patients of ketamine group continuously. In control group, patients received normal saline in volumes equivalent to ketamine infusions. Pain score by numeric rating scale was similar between groups at 1, 6, 12, 24, 36, and 48 hr following surgery, which was maintained lower than 3 in both groups. The time to first analgesic request after admission on post-anesthesia care unit was also not significantly different between groups. Intraoperative low dose ketamine did not decrease acute postoperative pain after arthroscopic shoulder surgery with a preincisional ultrasound guided SSISB. The preventive analgesic effect of ketamine could be mitigated by SSISB, which remains one of the most effective methods of pain relief after arthroscopic shoulder surgery. Graphical Abstract PMID:25045235

2014-01-01

299

All-Arthroscopic Suprapectoral Long Head of Biceps Tendon Tenodesis With Interference Screw-Like Tendon Fixation After Modified Lasso-Loop Stitch Tendon Securing  

PubMed Central

Arthroscopic suprapectoral techniques for tenodesis of the long head of the biceps tendon (LHB) are appropriate for the treatment of proximal biceps lesions. Several types of techniques and fixation devices have been described and evaluated in biomechanical studies regarding primary stability. In this technical note, we describe an all-arthroscopic suprapectoral technique using the 6.25-mm Bio-SwiveLock device (Arthrex, Naples, FL) for an interference screw–like bony fixation after having armed the tendon with a lasso-loop stitch. Both the interference screw fixation and securing of the lasso-loop tendon have been well described and approved in biomechanical tests concerning the primary stability. One advantage of this technique performed from the glenohumeral space, in addition to the strong and secure fixation with ingrowth of the tendon in a bony canal, is the avoidance of touching the soft tissue above the bicipital groove, which results in a smooth fitting of the tendon into its natural canal and therefore avoids mechanical irritation of the stump at the rotator interval. In conclusion, the all-arthroscopic suprapectoral LHB tenodesis performed from the glenohumeral space with the modified lasso-loop stitch for securing of the tendon and the 6.25-mm Bio-SwiveLock suture anchor for interference screw–like bony tendon fixation is an appropriate technique for the treatment of LHB-associated lesions. PMID:23766976

Patzer, Thilo; Kircher, Jorn; Krauspe, Ruediger

2012-01-01

300

DNA repair systems in rhabdomyosarcoma.  

PubMed

Rhabdomyosarcoma (RMS) represents the most common soft tissue sarcoma in children and adolescent population. There are two major histological subtypes, embryonal (ERMS) and alveolar (ARMS), differing in cytogenetic and morphological features. RMS pathogenesis remains controversial and several cellular mechanisms and pathways have been implicated. Application of intense chemo- and radio-therapy improves survival rates for RMS patients, but significant efficacy has not been proved as DNA damage induced-resistance frequently occurs. The present review is aimed at summarizing the current evidence on DNA repair systems, implications in RMS development, focusing on gene expression alterations and point mutations of genes encoding for DNA repair enzymes. Understanding of DNA repair systems involvement in RMS pathogenesis could diversify RMS patients and provide novel individualized therapeutic targets. PMID:23516236

Tsioli, Panagiota G; Patsouris, Efstratios S; Giaginis, Constantinos; Theocharis, Stamatios E

2013-08-01

301

Robotic equipment for pipeline repair  

SciTech Connect

Hyperbaric welding provides the most reliable method for connection or repair of subsea oil and gas pipelines. Research on hyperbaric arc welding processes indicates that it should be possible to achieve stable welding conditions with Gas Tungsten Arc (GTA) to approximately 600m, and with Gas Metal Arc (GMA) and Plasma Arc to at least 1,000m. These depths are well beyond the limits of manned saturation diving. At the present time the limitation on the maximum depth to which these processes can be applied, in practice, is the requirement for completely diverless operation deeper than approximately 350m. Fully diverless hyperbaric welding is not presently available to the industry but several diverless pipeline repair systems which utilize mechanical connectors have been developed. This paper reviews the present status of mechanized hyperbaric welding systems currently being used in the North Sea and discusses some of the work being done to achieve fully diverless robotic pipeline repair with both welding and connectors.

Gibson, D.E.; Barratt, K.; Paterson, J. [National Hyperbaric Centre, Aberdeen (United Kingdom)

1995-12-31

302

Weld repair of irradiated materials  

SciTech Connect

Maintenance of an accelerator for production of tritium will require replacement or modification of components that have been exposed to neutron irradiation. A primary repair option is welding, but conventional repair welding processes produced severe cracking in irradiated stainless steel. Optical metallography, scanning electron microscopy, and transmission electron microscopy have shown that the cracks are: intergranular, primarily in the weld heat-affected zone, characterized by a dimple structure on the crack surface, and associated with helium bubbles that grow during welding. A model has been developed that qualitatively shows the interaction of three primary and three secondary variables producing helium embrittlement cracking. A shallow penetration overlay technique was successfully demonstrated to minimize cracking in irradiated 304 stainless steel that contained 10 appm helium. The overlay technique provides a potential method for repair or modification of accelerator materials exposed to irradiation.

Kanne, W.R. Jr.; Louthan, M.R. Jr.; Rankin, D.T.; Tosten, M.H.

1999-09-01

303

Weld Repair of Irradiated Materials  

SciTech Connect

Maintenance of an accelerator for production of tritium will require replacement or modification of components that have been exposed to neutron irradiation. A primary repair option is welding, but conventional repair welding processes produced severe cracking in irradiated stainless steel. Optical metallography, scanning electron microscopy, and transmission electron microscopy have shown that the cracks are: intergranular, primarily in the weld heat-affected zone, characterized by a dimple structure on the crack surface, and associated with helium bubbles which grow during welding. A model has been developed which qualitatively shows the interaction of three primary and three secondary variables producing helium embrittlement cracking. A shallow penetration overlay technique was successfully demonstrated to minimize cracking in irradiated 304 stainless steel that contained 10 appm helium. The overlay technique provides a potential method for repair or modification of accelerator materials exposed to irradiation.

Kanne, W.R. Jr.

1999-02-24

304

Optimal repair for repairable components during phaseout an aircraft fleet  

Microsoft Academic Search

The successive removal of units from a group of systems during phasing out leads to a variable requirement for stock level of spare parts. Repairable units from phased out systems can be reused for the remaining functional systems in the group. Hence, the stock level of spare parts increases and the demand for spare parts decreases. This can lead to

Jan Block; Tommy Tyrberg; Yuan Fuquing

2010-01-01

305

Summary of Repair Techniques for Aluminum Bridging.  

National Technical Information Service (NTIS)

This report provides the results of an investigation designed to recommend joining processes which could be used in the field to repair aluminum bridging. A literature search was conducted to identify the various aluminum repair processes available. The m...

D. Brockman, R. A. Weber

1982-01-01

306

Abdominal aortic aneurysm repair - open - discharge  

MedlinePLUS

AAA - open - discharge; Repair - aortic aneurysm - open - discharge ... You had open aortic aneurysm surgery to repair an aneurysm (a widened part) in your aorta, the large artery that carries blood to your ...

307

Reducing Your Leak Rate Without Repairing Leaks  

E-print Network

As plant personnel know, repairing compressed air leaks can be an expensive, labor intensive and never-ending process. This article discusses ways plant personnel can reduce and maintain their leak rate at a lower level without repairing leaks...

Beals, C.

2005-01-01

308

Five repair pathways in one context: chromatin modification during DNA repair  

Microsoft Academic Search

The eukaryotic cell is faced with more than 10 000 various kinds of DNA lesions per day. Failure to repair such lesions can lead to mutations, genomic instability, or cell death. Therefore, cells have developed 5 major repair path- ways in which different kinds of DNA damage can be detected and repaired: homologous recombination, nonhomologous end joining, nucleotide excision repair,

Yeganeh Ataian; Jocelyn E. Krebs

2006-01-01

309

Multi-Echelon Repairable Item Inventory System with Limited Repair Capacity under Nonstationary Demands  

Microsoft Academic Search

Classical multi-echelon repairable item inventory models are based either on steady-state analysis or infinite repair capacity, which may not work well in situations when the demand is nonstationary, or repair capacity is limited. In this paper, we propose an analytical model for evaluating system performance that works well under limited repair capacity and nonstationary demands. Following the METRIC methodology, we

Hoong Chuin LAU; Huawei Song

2008-01-01

310

How the Brain Repairs Stuttering  

ERIC Educational Resources Information Center

Stuttering is a neurodevelopmental disorder associated with left inferior frontal structural anomalies. While children often recover, stuttering may also spontaneously disappear much later after years of dysfluency. These rare cases of unassisted recovery in adulthood provide a model of optimal brain repair outside the classical windows of…

Kell, Christian A.; Neumann, Katrin; von Kriegstein, Katharina; Posenenske, Claudia; von Gudenberg, Alexander W.; Euler, Harald; Giraud, Anne-Lise

2009-01-01

311

Microwave Oven Repair. Teacher Edition.  

ERIC Educational Resources Information Center

This competency-based curriculum guide for teachers addresses the skills a technician will need to service microwave ovens and to provide customer relations to help retain the customer's confidence in the product and trust in the service company that performs the repair. The guide begins with a task analysis, listing 20 cognitive tasks and 5…

Smreker, Eugene

312

Small Engine Repair Course Outline.  

ERIC Educational Resources Information Center

Small engines as referred to here are engines used on lawn mowers, chain saws, power plants, outboards, and cycles. It does not include engines used on automobiles. The course outlined is intended to show how small two-cycle and four-cycle gas engines are constructed, how they operate, what goes wrong, and how to service and repair them. It is…

DeClouet, Fred

313

DNA damage repair and transcription  

Microsoft Academic Search

During the course of DNA damage a complex repertoire of molecular signals, chromatin determinants and specific transcription factors are set in motion for repair. In many instances, the response pathway can be characterized by profound changes in molecular remodeling and is intimately linked with DNA replication and gene transcription. Our understanding of the molecular pathways has come from scientific developments

A. El-Osta

2004-01-01

314

Verification of Motor Repair Quality  

E-print Network

Motor testing at Advanced Energy has shown that a motor that has not suffered irreparable damage as a result of failure can be repaired to perform as well as before the failure. But the only way to achieve the performance level of an energy...

Butler, K.

315

Anodization As A Repair Technique  

NASA Technical Reports Server (NTRS)

Thin, hard oxide layer added to aluminum part. Surfaces on aluminum part worn out of tolerance by no more than 0.004 in. often repaired by anodizing to build up aluminum oxide layers. Oxide layers very hard and grounded to desired final dimensions.

Groff, Roy E.; Maloney, Robert D.; Reeser, Robert W.

1988-01-01

316

GDR: a system for guided data repair  

Microsoft Academic Search

Improving data quality is a time-consuming, labor-intensive and often domain specific operation. Existing data repair approaches are either fully automated or not efficient in interactively involving the users. We present a demo of GDR, a Guided Data Repair system that uses a novel approach to efficiently involve the user alongside automatic data repair techniques to reach better data quality as

Mohamed Yakout; Ahmed K. Elmagarmid; Jennifer Neville; Mourad Ouzzani

2010-01-01

317

Auto Body Repair and Repainting: Instructional Units.  

ERIC Educational Resources Information Center

The guide contains 11 sections, each consisting of one or more units of instruction designed to provide students with entry-level skills in auto body repair. The sections deal with: introductory and related information; body and frame construction; tools; welding; basic metal repair; hardware, glass, and trim; major metal repair; refinishing;…

Manuel, Edward F.; Penner, Wayman R.

318

Standardized Curriculum for Automotive Body Repair.  

ERIC Educational Resources Information Center

Standardized curricula are provided for two courses for the secondary vocational education program in Mississippi: automotive body repair I and II. The nine units in automotive body repair I are as follows: introduction; related information; basic tool usage and safety; body and frame construction; basic sheet metal repair; preparing for…

Mississippi State Dept. of Education, Jackson. Office of Vocational, Technical and Adult Education.

319

Interactions between DNA damage, repair, and transcription  

Microsoft Academic Search

This review addresses a variety of mechanisms by which DNA repair interacts with transcription and vice versa. Blocking of transcriptional elongation is the best studied of these mechanisms. Transcription recovery after damage therefore has often been used as a surrogate marker of DNA repair in cells. However, it has become evident that relationships between DNA damage, repair, and transcription are

Andriy Khobta; Bernd Epe

320

Aircraft battle damage repair - A force multiplier  

Microsoft Academic Search

An aircraft battle-damage repair (BDR) program is described that provides for the assessment and repair of battle damage and the return of badly damaged aircraft to their home bases. The program methodology is based on the use of time-saving temporary repairs and associated training and materials provision. BDR is shown to require knowledge of damage mechanisms and specifications for the

Hess

1992-01-01

321

Scheduling and rescheduling with iterative repair  

Microsoft Academic Search

The GERRY scheduling and rescheduling system being applied to coordinate Space Shuttle ground processing is described. The system uses constraint-based iterative repair, a technique that starts with a complete but possibly flawed schedule and iteratively improves it by using constraint knowledge within repair heuristics. The tradeoff between the informedness and the computational cost of several repair heuristics is explored. It

Monte Zweben; Eugene Davis; Brian Daun; Michael J. Deale

1993-01-01

322

Welding/brazing for Space Station repair  

NASA Technical Reports Server (NTRS)

Viewgraphs on welding/brazing for space station repair are presented. Topics covered include: fabrication and repair candidates; debris penetration of module panel; welded repair patch; mechanical assembly of utility fluid line; space station utility systems; Soviet aerospace fabrication - an overview; and processes under consideration.

Dickinson, David W.; Babel, H. W.; Conaway, H. R.; Hooper, W. H.

1990-01-01

323

Utility guidelines for controlled deposition repair welding  

SciTech Connect

This paper reviews experimental results from the EQI work performed to develop controlled deposition repairs for Cr-Mo steels without postweld heat treatment (PWHT) which are pertinent to electric utility applications, gives recommended guidelines for evaluating if controlled deposition welding is appropriate for a particular repair, and provides a listing of potential applications for controlled deposition repair welding.

Neary, C.M. [Pacific Gas and Electric Co., San Ramon, CA (United States)

1996-06-01

324

Repairing Hurtful Messages in Marital Relationships  

Microsoft Academic Search

The effects of hurtful messages and accompanying repair strategies in interpersonal relationships have been noted individually; however, research has not investigated the relation of these two constructs in tandem. This study uses an attributional framework to examine use and the effectiveness of repair strategies with varying hurtful messages. Responses from 237 married adults indicated the justification repair strategy was used

Katie Neary Dunleavy; Alan K. Goodboy; Melanie Booth-Butterfield; Robert J. Sidelinger; Sara Banfield

2009-01-01

325

Endovascular Repair of Thoracic Aortic Aneurysms  

PubMed Central

Degenerative aneurysms of the thoracic aorta are increasing in prevalence; open repair of descending thoracic aortic aneurysms is associated with high rates of morbidity and mortality. Repair of isolated descending thoracic aortic aneurysms using stent grafts was introduced in 1995, and in an anatomically suitable subgroup of patients with thoracic aortic aneurysm, repair with endovascular stent graft provides favorable outcomes, with decreased perioperative morbidity and mortality relative to open repair. The cornerstones of successful thoracic endovascular aneurysm repair are appropriate patient selection, thorough preprocedural planning, and cautious procedural execution, the elements of which are discussed here. PMID:22379281

Findeiss, Laura K.; Cody, Michael E.

2011-01-01

326

The Effects of Spinal, Inhalation, and Total Intravenous Anesthetic Techniques on Ischemia-Reperfusion Injury in Arthroscopic Knee Surgery  

PubMed Central

Purpose. To compare the effects of different anesthesia techniques on tourniquet-related ischemia-reperfusion by measuring the levels of malondialdehyde (MDA), ischemia-modified albumin (IMA) and neuromuscular side effects. Methods. Sixty ASAI-II patients undergoing arthroscopic knee surgery were randomised to three groups. In Group S, intrathecal anesthesia was administered using levobupivacaine. Anesthesia was induced and maintained with sevoflurane in Group I and TIVA with propofol in Group T. Blood samples were obtained before the induction of anesthesia (t1), 30?min after tourniquet inflation (t2), immediately before (t3), and 5?min (t4), 15?min (t5), 30?min (t6), 1?h (t7), 2?h (t8), and 6?h (t9) after tourniquet release. Results. MDA and IMA levels increased significantly compared with baseline values in Group S at t2–t9 and t2–t7. MDA levels in Group T and Group I were significantly lower than those in Group S at t2–t8 and t2–t9. IMA levels in Group T were significantly lower than those in Group S at t2–t7. Postoperatively, a temporary 1/5 loss of strength in dorsiflexion of the ankle was observed in 3 patients in Group S and 1 in Group I. Conclusions. TIVA with propofol can make a positive contribution in tourniquet-related ischemia-reperfusion. PMID:24701585

Kosucu, Muge; Coskun, Ilker; Eroglu, Ahmet; Kutanis, Dilek; Mentese, Ahmet; Karahan, S. Caner; Baki, Emre; Kerimoglu, Servet; Topbas, Murat

2014-01-01

327

PHYSICAL THERAPY INTERVENTION FOR A FORMER POWER LIFTER AFTER ARTHROSCOPIC MICROFRACTURE PROCEDURE FOR GRADE IV GLENOHUMERAL CHONDRAL DEFECTS  

PubMed Central

Background: Power lifting places the shoulder complex at risk for injury. Microfracture is a relatively new procedure for chondral defects of the glenohumeral joint and is not well described in the literature. Objectives: The purpose of this case report is to describe the post-operative rehabilitation used with a power lifter who underwent a microfracture procedure to address glenoid and humeral chondral defects, debridement of type I superior labral anterior-posterior lesion, and a subacromial decompression. Case Description: The patient was a 46 year-old male who was evaluated nine weeks status-post arthroscopic microfracture procedure for glenoid and humeral chondral defects, debridement of superior labral anterior-posterior (SLAP) lesion, and subacromial decompression. Rehabilitation consisted of postural education, manual therapy, rotator cuff and scapular strengthening, dynamic stabilization, weightbearing exercises, and weight training over nine weeks (24 sessions). Lifting modifications were addressed. Outcomes: Results of the QuickDASH indicate that activities of daily living (ADLs), work, and sports modules all improved significantly, and the patient was able to return to recreational power lifting with limited discomfort or restrictions. Discussion: A structured post-operative physical therapy treatment program allowed this patient to return to recreational power lifting while restoring independent function for work-related activities and ADLs. PMID:21655454

Sum, Jonathan

2011-01-01

328

Is there an association between chronicity of patellar instability and patellofemoral cartilage lesions? An arthroscopic assessment of chondral injury.  

PubMed

The purpose of this study was to investigate the association between chronicity of patellar instability on the prevalence, grade, and location of chondral lesions in patients with recurrent patellar instability. Patellofemoral chondral status was documented and graded according to the Outerbridge classification in 38 patients who underwent arthroscopic examination at the time of a medial patellofemoral ligament reconstruction procedure. Chondral lesions of any location were observed in 63.2% of patients. Patellar and trochlear lesions were observed in 57.9 and 13.2% of patients, respectively. There was a significantly higher duration of patellar instability in patients with a trochlear lesion versus those without a trochlear lesion (p < 0.01), and in patients with combined patellar and trochlear lesions versus those without both patellar and trochlear lesions (p < 0.01). There was a significant correlation between chronicity of patellar instability and Outerbridge grade of trochlear chondral injury (p = 0.01). Chi-squared analysis revealed that chronicity of patellar instability greater than 5 years was significantly associated with the likelihood of trochlear lesions (p < 0.05). We conclude that patients with increasing chronicity of patellar instability may have a higher likelihood of and higher grade of patellofemoral chondral injuries, specifically for trochlear lesions. PMID:23150352

Franzone, Jeanne M; Vitale, Mark A; Shubin Stein, Beth E; Ahmad, Christopher S

2012-11-01

329

A novel method for utilizing AIMS to evaluate mask repair and quantify over-repair or under-repair condition  

NASA Astrophysics Data System (ADS)

The ZEISS AIMS™ platform is well established as the industry standard for qualifying the printability of mask features based on the aerial image. Typically the critical dimension (CD) and intensity at a certain through-focus range are the parameters which are monitored in order to verify printability or to ensure a successful repair. This information is essential in determining if a feature will pass printability, but in the case that the feature does fail, other metrology is often required in order to isolate the reason why the failure occurred, e.g., quartz level deviates from nominal. Photronics-nanoFab, in collaboration with Carl Zeiss, demonstrate the ability to use AIMSTM to provide quantitative feedback on a given repair process; beyond simple pass/fail of the repair. This technique is used in lieu of Atomic Force Microscopy (AFM) to determine if failing post-repair regions are "under-repaired" (too little material removed) or "over-repaired" (too much material removed). Using the ZEISS MeRiT E-beam repair tool as the test platform, the AIMSTM technique is used to characterize a series of opaque repairs with differing repair times for each. The AIMSTM technique provides a means to determine the etch depth based on through-focus response of the Bossung plot and further to predict the amount of MeRiT® recipe change required in order to bring out of spec repairs to a passing state.

Uzzel, Doug; Garetto, Anthony; Magnusson, Krister; Tabbone, Gilles

2013-09-01

330

The effect of initial local anesthetic dose with continuous interscalene analgesia on postoperative pain and diaphragmatic function in patients undergoing arthroscopic shoulder surgery: a double-blind, randomized controlled trial  

PubMed Central

Background Interscalene block (ISB) is commonly performed using 20-40 mL of local anesthetic. Spread to adjacent structures and consequent adverse effects including paralysis of the ipsilateral hemidiaphragm are frequent. Pain ratings, analgesic requirements, adverse events, satisfaction, function and diaphragmatic excursion were compared following interscalene block (ISB) with reduced initial bolus volumes. Methods Subjects undergoing arthroscopic rotator cuff repair were randomized to receive 5, 10, or 20 mL ropivacaine 0.75% for ISB in a double-blind fashion (N = 36). Continuous infusion with ropivacaine 0.2% was maintained for 48 h. Pain and diaphragmatic excursion were assessed before block and in the recovery unit. Results Pain ratings in the recovery room were generally less than 4 (0-10 NRS) for all treatment groups, but a statistically significant difference was noted between the 5 and 20 mL groups (NRS: 2.67 vs. 0.62 respectively; p = 0.04). Pain ratings and supplemental analgesic use were similar among the groups at 24 h, 48 h and 12 weeks. There were no differences in the quality of block for surgical anesthesia. Dyspnea was significantly greater in the 20 mL group (p = 0.041). Subjects with dyspnea had significant diaphragmatic impairment more frequently (Relative risk: 2.5; 95%CI: 1.3-4.8; p = 0.042). Increased contralateral diaphragmatic motion was measured in 29 of the 36 subjects. Physical shoulder function at 12 weeks improved over baseline in all groups (baseline mean SST: 6.3, SEM: 0.6; 95%CI: 5.1-7.5; 12 week mean SST: 8.2, SEM: 0.46; 95%CI: 7.3-9.2; p = 0.0035). Conclusions ISB provided reliable surgical analgesia with 5 mL, 10 mL or 20 mL ropivacaine (0.75%). The 20 mL volume was associated with increased complaints of dyspnea. The 5 mL volume was associated with statistically higher pain scores in the immediate postoperative period. Lower volumes resulted in a reduced incidence of dyspnea compared to 20 mL, however diaphragmatic impairment was not eliminated. Compensatory increases in contralateral diaphragmatic movement may explain tolerance for ipsilateral paresis. Trial Registration clinicaltrials.gov. identifier: NCT00672100 PMID:22443231

2012-01-01

331

Posterior wall prolapse and repair.  

PubMed

Most posterior wall defects occur in combination with other pelvic support disorders. Some patients with rectoceles, the most common posterior wall defect, are asymptomatic, whereas others experience a range of symptoms from a sensation of lower pelvic fullness to defecatory and/or sexual dysfunction. If patients are symptomatic, rectoceles can be treated conservatively with pelvic floor physiotherapy, behavioral therapy, or pessaries. Surgically, the most common rectocele repair is a traditional posterior colporrhaphy which provides excellent cure rates of up to 95%. The studies published to date do not support the use of biologic or synthetic absorbable grafts in reconstructive surgical procedures of the posterior compartment as these repairs have not improved anatomic or functional outcomes over traditional posterior colporrhaphy. PMID:20142644

Kudish, Bela I; Iglesia, Cheryl B

2010-03-01

332

Laparoscopic hernia repair in 2000  

Microsoft Academic Search

The 1994 meeting of the European Association for Endoscopic Surgery (E.A.E.S.) in Madrid highlighted a consensus-developing conference on the then new laparoscopic procedure for hernia repair. The conference was chaired by A. Paul from Cologne, Germany, and A. Fingerhut, from Poissy, France. The other members of the jury were B. Millat (France), L. Nyhus (USA), J. Himpens (Belgium), J.-L. Dulucq

A. Fingerhut; B. Millat; N. Bataille; E. Yachouchi; C. Dziri; M.-J. Boudet; A. Paul

2001-01-01

333

Repair of inflammatory tracheoesophageal fistula.  

PubMed

Benign acquired tracheoesophageal fistula is uncommon. Erosin of the membranous wall of the trachea and the anterior esophageal wall by the high-pressure cuff on a tracheostomy tube, often against the anvil of a nasogastric tube, may produce such fistulas. Techniques for closure have included patching the tracheal defect with muscle and, often, multiple staged procedures, planned or unplanned. Since any cuff lesion severe enough to cause a fistula necessarily damages the trachea circumferentially at the same level, definitive correction must include circumferential tracheal resection as well as closure of the fitstula. Five patients with tracheoesophageal fistula due to cuff perforation had repair by such a single-stage procedure. Through an anterior approach the involved trachea was resected, primary anastomosis was done, and the esophagus was closed in layers. In 3 of these 5 patients muscle was interposed for added security. One patient had undergone a prior attempt at repair elsewhere. One required a second resection of trachea for subsequent stomal stenosis. Repair in 2 additional patients with fistulas of complex origin related to direct trauma, sepsis, and foreign body involved adaptation of the basic technique to the special problem; 1 of these procedures was necessarily staged. Results in all 7 patients have been good. PMID:973760

Grillo, H C; Moncure, A C; McEnany, M T

1976-08-01

334

Animal models of cartilage repair  

PubMed Central

Cartilage repair in terms of replacement, or regeneration of damaged or diseased articular cartilage with functional tissue, is the ‘holy grail’ of joint surgery. A wide spectrum of strategies for cartilage repair currently exists and several of these techniques have been reported to be associated with successful clinical outcomes for appropriately selected indications. However, based on respective advantages, disadvantages, and limitations, no single strategy, or even combination of strategies, provides surgeons with viable options for attaining successful long-term outcomes in the majority of patients. As such, development of novel techniques and optimisation of current techniques need to be, and are, the focus of a great deal of research from the basic science level to clinical trials. Translational research that bridges scientific discoveries to clinical application involves the use of animal models in order to assess safety and efficacy for regulatory approval for human use. This review article provides an overview of animal models for cartilage repair. Cite this article: Bone Joint Res 2014;4:89–94. PMID:24695750

Cook, J. L.; Hung, C. T.; Kuroki, K.; Stoker, A. M.; Cook, C. R.; Pfeiffer, F. M.; Sherman, S. L.; Stannard, J. P.

2014-01-01

335

Laparoscopic Repair of Incidentally Found Spigelian Hernia  

PubMed Central

Background and Objectives: A Spigelian hernia is a rare type of hernia that occurs through a defect in the anterior abdominal wall adjacent to the linea semilunaris. Estimation of its incidence has been reported as 0.12% of all abdominal wall hernias. Traditionally, the method of repair has been an open approach. Herein, we discuss a series of laparoscopic repairs. Methods: Case series and review of the literature. Cases: Three patients are presented. All were evaluated and taken to surgery initially for a different disease process, and all were incidentally found to have a spigelian hernia. These patients underwent laparoscopic repair of their hernias; 2 were repaired intraperitoneally and one was repaired totally extraperitoneally. Two patients initially underwent a mesh repair, while the third had an attempted primary repair. Conclusions: There is evidence that supports the use of laparoscopy for both diagnosis and repair of spigelian hernias. There are also reports of successful repairs both primarily and with mesh. In our experience with the preceding 3 patients, we found that laparoscopic repair of incidentally discovered spigelian hernias is a viable option, and we also found that implantation of mesh, when possible, resulted in satisfactory results and no recurrence. PMID:21902949

Nickloes, Todd; Mancini, Greg; Solla, Julio A.

2011-01-01

336

Pain relief in day care arthroscopic knee surgery: A comparison between intra-articular ropivacaine and levobupivacaine: A prospective, double-blinded, randomized controlled study  

PubMed Central

Background: Post-operative pain frequently hampers implementation of day care arthroscopic knee surgery in spite of so many analgesic, local anesthetic drugs and routes of administration. Aims: The aim of the present study was carried out to compare the efficacy of ropivacaine and levobupivacaine when administered through intra-articular route in controlling pain after day care arthroscopic knee surgery. Setting and Design: It was a prospective, double-blinded and randomized controlled study. Materials and Methods: April 2008-December 2008, 60 patients of both sex, of American Society of Anesthesiologists physical status I and II, undergoing day care arthroscopic knee surgery were randomly assigned into two groups (R, L). Group R received 10 ml of 0.75% ropivacaine, whereas group L received 10 ml of 0.50% levobupivacaine through intra-articular route at the end of the procedure. Pain assessed using visual analog scale (VAS) and diclofenac sodium given as rescue analgesia when VAS >3. Time of first analgesic request and total rescue analgesic were calculated. Statistical Analysis and Results: based on comparable demographic profiles; time for the requirement of first post-operative rescue analgesia (242.16 ± 23.86 vs. 366.62 ± 24.42) min and total mean rescue analgesic requirement was (104.35 ± 18.96 vs. 76.82 ± 14.28) mg in group R and L respectively. Group R had higher mean VAS score throughout the study period. No side effects found among the groups. These two results were clinically and statistically significant (P < 0.05). Conclusion: Hence, it was evident that intra-articular levobupivacaine give better post-operative pain relief, with an increase in time of first analgesic request and decreased need of total post-operative analgesia compared with ropivacaine. PMID:25191189

Das, Anjan; Majumdar, Saikat; Kundu, Ratul; Mitra, Tapobrata; Mukherjee, Anindya; Hajra, Bimal Kumar; Dutta, Soumyadip; Chattopadhyay, Sandip

2014-01-01

337

DNA repair pathways in human multiple myeloma  

PubMed Central

Every day, cells are faced with thousands of DNA lesions, which have to be repaired to preserve cell survival and function. DNA repair is more or less accurate and could result in genomic instability and cancer. We review here the current knowledge of the links between molecular features, treatment, and DNA repair in multiple myeloma (MM), a disease characterized by the accumulation of malignant plasma cells producing a monoclonal immunoglobulin. Genetic instability and abnormalities are two hallmarks of MM cells and aberrant DNA repair pathways are involved in disease onset, primary translocations in MM cells, and MM progression. Two major drugs currently used to treat MM, the alkylating agent Melphalan and the proteasome inhibitor Bortezomib act directly on DNA repair pathways, which are involved in response to treatment and resistance. A better knowledge of DNA repair pathways in MM could help to target them, thus improving disease treatment. PMID:23966156

Gourzones-Dmitriev, Claire; Kassambara, Alboukadel; Sahota, Surinder; Rème, Thierry; Moreaux, Jérôme; Bourquard, Pascal; Hose, Dirk; Pasero, Philippe; Constantinou, Angelos; Klein, Bernard

2013-01-01

338

Cellular repair/misrepair track model  

NASA Technical Reports Server (NTRS)

A repair/misrepair cell kinetics model is superimposed onto the track structure model of Katz to provide for a repair mechanism. The model is tested on the repair-dependent data of Yang et al. and provides an adequate description of that data. The misrepair rate determines the maximum relative biological effectiveness (RBE), but similar results could arise from indirect X-ray lethality not include in the present model.

Wilson, John W.; Cucinotta, Francis A.

1991-01-01

339

Current strategies and approaches to meniscal repair.  

PubMed

Repair of symptomatic meniscal tears in the appropriate patient has demonstrated successful mid and long-term results with a variety of different repair techniques. These techniques have undergone much evolution and innovation, from the initial open repairs to a variety of inside-out, outside-in, and all-inside techniques and devices. This article focuses on patient presentation, selection, current treatments, and surgical techniques including pearls and pitfalls, and discusses the most recent published outcomes and complications. PMID:25068846

Goodwillie, Andrew D; Myers, Kevin; Sgaglione, Nicholas A

2014-12-01

340

Thermal protection system repair kit program  

NASA Technical Reports Server (NTRS)

The feasibility and conceptual design aspects of repair materials and procedures for in orbit repair of the space shuttle orbiter TPS tiles are investigated. Material studies to investigate cure in place materials are described including catalyst and cure studies, ablation tests and evaluations, and support mixing and applicator design. The feasibility of the repair procedures, the storage of the TPS, dispensing, and cure problems are addressed.

1979-01-01

341

Easily Repairable Networks: Reconnecting Nodes after Damage  

NASA Astrophysics Data System (ADS)

We introduce a simple class of distribution networks that withstand damage by being repairable instead of redundant. Instead of asking how hard it is to disconnect nodes through damage, we ask how easy it is to reconnect nodes after damage. We prove that optimal networks on regular lattices have an expected cost of reconnection proportional to the lattice length, and that such networks have exactly three levels of structural hierarchy. We extend our results to networks subject to repeated attacks, in which the repairs themselves must be repairable. We find that, in exchange for a modest increase in repair cost, such networks are able to withstand any number of attacks.

Farr, Robert S.; Harer, John L.; Fink, Thomas M. A.

2014-09-01

342

Models for multi-echelon repairable item inventory systems with limited repair capacity  

Microsoft Academic Search

The dominant models for inventory control of repairable items, both in the literature and in practical applications, are based on the assumption of ample repair capacity. This assumption can introduce a serious underestimation of the spare parts requirements in systems with high repair facility utilization, as is typical in industry. In this paper, we introduce approximations that can deal with

Angel Diaz; Michael C. Fu

343

DNA damage recognition and repair pathway coordination revealed by the structural biochemistry of DNA repair enzymes  

Microsoft Academic Search

Cells have evolved distinct mechanisms for both preventing and removing mutagenic and lethal DNA damage. Structural and biochemical characterization of key enzymes that function in DNA repair pathways are illuminating the biological and chemical mechanisms that govern initial lesion detection, recognition, and excision repair of damaged DNA. These results are beginning to reveal a higher level of DNA repair coordination

David J Hosfield; Douglas S Daniels; Clifford D Mol; Christopher D Putnam; Sudip S Parikh; John A Tainer

2001-01-01

344

Macrophages: supportive cells for tissue repair and regeneration Short title: Macrophages in tissue repair and regeneration  

E-print Network

1 Macrophages: supportive cells for tissue repair and regeneration Short title: Macrophages in tissue repair and regeneration Bénédicte Chazaud Institut Cochin, INSERM U1016, Paris, France; CNRS 8104 cells ­ Regeneration ­ Repair ­ Resolution of inflammation Abbreviations 2-acetylaminofluorene (2-AAF

Paris-Sud XI, Université de

345

Long-term functional results and isokinetic strength evaluation after arthroscopic tenotomy of the long head of biceps tendon  

PubMed Central

Introduction: The objective of this study is to evaluate the biomechanical function of the upper arm after arthroscopic long head of biceps (LHB) tenotomy at long-term follow-up. Materials and Methods: Twenty-five male subjects ranging from 30 to 63 years old were evaluated at a mean follow-up of 7.0 years after tenotomy. Bilateral isokinetic testing was performed to obtain peak torque values, as well as total work done throughout the full range of elbow flexion and supination. Results: Magnetic resonance imaging scans revealed nine unrecognized LHB ruptures in the contralateral arm, leaving 16 subjects to complete the testing protocol. The mean quickDASH score was 8.1 (standard error [SE] 2.5). The mean oxford elbow score was 97.9 (SE 1.6). The tenotomy arm recorded a decrease in peak flexion torque of 7.0% (confidence interval [CI] 1.2-12.8), and a decrease in the peak supination torque of 9.1% (CI 1.8-16.4) relative to the contralateral arm. The total work carried out through the full range of joint motion was reduced in elbow flexion by 5.1% (CI ?1.3-11.4) and in forearm supination by 5.7% (CI-2.4-13.9). Discussion: Maximum strength in elbow flexion and forearm supination is significantly reduced compared with the contralateral arm. However, this impairment is partially compensated for by relatively greater strength sustained through the latter stages of joint motion. This results in comparable total work measurements between the tenotomised and contralateral side, potentially accounting for ongoing high levels of patient satisfaction and clinical function in the long term after LHB tenotomy. Level of Evidence IV: Case series without comparison group.

The, Bertram; Brutty, Mike; Wang, Allan; Campbell, Peter T.; Halliday, Michael J. C.; Ackland, Timothy R.

2014-01-01

346

Osteochondritis dissecans of the elbow: excellent mid-term follow-up results in teenage athletes treated by arthroscopic debridement and microfracture  

PubMed Central

Aim To extend the microfracture procedure, which has been proven successful on osteochondritis dissecans (OCD) lesions in the knee and ankle, to OCD lesions in the elbow. Methods Nine young patients were treated by arthroscopic debridement and microfracture by a single surgeon. The average age at operation was 15.0 years (median 15; range 12-19). The average length of the follow-up was 5.3 years (median 5; range 2-9). The follow-up included physical examination and patient interview with elbow function scoring. Success of treatment was determined according to pre-operative and follow-up Mayo Elbow Performance Index scores and the patients’ return to sports. Results Eight patients scored excellent results on the follow-up and 1 scored a good result. Four out of 9 patients were able to increase their training intensity, 2 returned to the same level of activity, 2 changed sports (due to reasons unrelated to the health of their elbow), and 1 left professional sports and started training only recreationally. No patients stopped participating in sports altogether. Conclusions We advocate arthroscopic microfracturing, followed by a strict rehabilitation regime, as a highly effective treatment for OCD of the humeral capitellum. PMID:22351577

Bojanic, Ivan; Smoljanovic, Tomislav; Dokuzovic, Stjepan

2012-01-01

347

New technique for inguinal hernia repair.  

PubMed

We compared a new fascia transversalis based hernioplasty with mesh repair techniques which leave the fascia transversalis intact. We prospectively randomized 180 consecutive patients with inguinal hernia to undergo one of the three hernia repair techniques. Hernias were repaired either by using the new fascia transversalis repair-Coskun's hernia repair (FTR), based on the plication of fascia using continuous sutures and followed by a second layer of interrupted or continuous sutures between inguinal ligament and conjoint tendon to distribute the tension, or one of the two mesh repair techniques: anterior (Lichtenstein) or posterior (preperitoneal) repair. Parameters such as age, sex, hernia cause, operation time, type of anesthesia, surgeon's seniority, complications, hospital stay and follow-up were evaluated. Recurrence rates were determined through clinical examination. Effect of prostatism, co-morbid disease, operation time, complications and Nyhus type of hernia on recurrences were also analysed. Most patients in each group were operated on under general anesthesia (78% vs. 80% vs. 85% for FTR, Lichtenstein, and preperitoneal repair, respectively) and by surgeons in training (average 78%). Patients were followed up for a median of 36 months. FTR had less complications and an acceptable time for operation whereas preperitoneal repairs needed more seniority, longer operation time, and caused more complications. There were only 3 (1.6%) recurrences, none in the FTR group and two the in Lichtenstein group during first postoperative year. There was no recurrence in preperitoneal repair group. All patients with recurrences had an operation time longer than 60 min and were operated on by surgeons in training. Two patients with recurrences had prostatism symptoms and chronic cough. We conclude that the new FTR is as effective as mesh repair (either anterior or posterior) with an acceptable rate of recurrences, fewer complications, and that it can be performed by the surgeons in training. PMID:15611838

Coskun, F; Ozmen, M M; Moran, M; Ozozan, O

2005-03-01

348

Dynamics of DNA Mismatch Repair  

NASA Astrophysics Data System (ADS)

DNA mismatch repair protects the genome from spontaneous mutations by recognizing errors, excising damage, and re-synthesizing DNA in a pathway that is highly conserved. Mismatch recognition is accomplished by the MutS family of proteins which are weak ATPases that bind specifically to damaged DNA, but the specific molecular mechanisms by which these proteins recognize damage and initiate excision are not known. Previous structural investigations have implied that protein-induced conformational changes are central to mismatch recognition. Because damage detection is a highly dynamic process in which conformational changes of the protein-DNA complexes occur on a time scale of a few seconds, it is difficult to obtain meaningful kinetic information with traditional ensemble techniques. In this work, we use single molecule fluorescence resonance energy transfer (smFRET) to study the conformational dynamics of fluorescently labeled DNA substrates in the presence of the mismatch repair protein MutS from E. coli and its human homolog MSH2/MSH6. Our studies allow us to obtain quantitative kinetic information about the rates of binding and dissociation and to determine the conformational states for each protein-DNA complex.

Coats, Julie; Lin, Yuyen; Rasnik, Ivan

2009-11-01

349

Simplified preperitoneal Marlex hernia repair.  

PubMed

The routine use of mesh for repair of inguinal hernia has been popularized by Lichtenstein and others. Although preperitoneal placement is more appealing than the onlay technique, the classical approach by Nyhus and Condon is difficult under local anesthesia and denervates the inguinal muscles to some degree. Preperitoneal mesh may become the standard for inguinal hernia as the laparoscopic approach becomes more popular. This report describes the author's first 100 hernia repairs done using a simplified preperitoneal approach under local anesthesia. The preperitoneal space is entered directly through the posterior floor, but a complete covering of the direct, indirect, and femoral spaces is accomplished similar to an open technique. After placement of the mesh, a truly "tension-free" closure of the posterior floor can be accomplished. Patients are discharged home in 1 to 2 hours. Because a standard approach and block are used, the learning curve for this operation should be brief compared with that of the laparoscopic method. The follow-up of this series is short (average: 15 months), but there have been no recurrences or infections. One patient returned to the operating room within 4 hours due to an arterial bleeder in Scarpa's fascia but was discharged that day and had no subsequent problems. Another patient has a postoperative neuralgia probably unrelated to the mesh. Otherwise, there has no complications with the placement of the Marlex mesh. Patients are allowed to return to full activity and work at their discretion. PMID:8488944

Horton, M D; Florence, M G

1993-05-01

350

International congress on DNA damage and repair: Book of abstracts  

SciTech Connect

This document contains the abstracts of 105 papers presented at the Congress. Topics covered include the Escherichia coli nucleotide excision repair system, DNA repair in malignant transformations, defective DNA repair, and gene regulation. (TEM)

Not Available

1987-01-01

351

21 CFR 870.1350 - Catheter balloon repair kit.  

...balloon repair kit is a device used to repair or replace the balloon of a balloon catheter. The kit contains the materials, such as glue and balloons, necessary to effect the repair or replacement. (b) Classification. Class III (premarket...

2014-04-01

352

5. EXTERIOR VIEW OF THE NORTH REPAIR BAY OF THE ...  

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

5. EXTERIOR VIEW OF THE NORTH REPAIR BAY OF THE MOTOR REPAIR SHOP, BUILDING 104, LOOKING WEST. - Mill Valley Air Force Station, Motor Repair & Auto Hobby Shop, East Ridgecrest Boulevard, Mount Tamalpais, Mill Valley, Marin County, CA

353

AUTOMOTIVE REPAIR SHOP, INTERIOR VIEW TO SOUTHEAST, DOORWAYS TO SHOP ...  

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

AUTOMOTIVE REPAIR SHOP, INTERIOR VIEW TO SOUTHEAST, DOORWAYS TO SHOP OFFICE AND SOUTH WING, WITH SCALE. - Cedar City Automotive Repair Shop, Automotive Repair Shop, 820 North Main Street, Cedar City, Iron County, UT

354

AUTOMOTIVE REPAIR SHOP, INTERIOR VIEW TO SOUTHEAST, DOORWAYS TO SHOP ...  

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

AUTOMOTIVE REPAIR SHOP, INTERIOR VIEW TO SOUTHEAST, DOORWAYS TO SHOP OFFICE AND SOUTH WING. - Cedar City Automotive Repair Shop, Automotive Repair Shop, 820 North Main Street, Cedar City, Iron County, UT

355

49 CFR 230.29 - Inspection and repair.  

Code of Federal Regulations, 2011 CFR

...or operator shall inspect and repair all steam locomotive...to other defects. (b) Repair standards. (1) All...suitable for service. (2) Any welding to unstayed portions of the...national standard for boiler repairs. The steam locomotive...

2011-10-01

356

49 CFR 230.29 - Inspection and repair.  

Code of Federal Regulations, 2013 CFR

...or operator shall inspect and repair all steam locomotive...to other defects. (b) Repair standards. (1) All...suitable for service. (2) Any welding to unstayed portions of the...national standard for boiler repairs. The steam locomotive...

2013-10-01

357

49 CFR 230.29 - Inspection and repair.  

Code of Federal Regulations, 2012 CFR

...or operator shall inspect and repair all steam locomotive...to other defects. (b) Repair standards. (1) All...suitable for service. (2) Any welding to unstayed portions of the...national standard for boiler repairs. The steam locomotive...

2012-10-01

358

49 CFR 230.29 - Inspection and repair.  

Code of Federal Regulations, 2010 CFR

...or operator shall inspect and repair all steam locomotive...to other defects. (b) Repair standards. (1) All...suitable for service. (2) Any welding to unstayed portions of the...national standard for boiler repairs. The steam locomotive...

2010-10-01

359

29 CFR 1926.30 - Shipbuilding and ship repairing.  

... 2014-07-01 false Shipbuilding and ship repairing. 1926.30 Section 1926.30...Provisions § 1926.30 Shipbuilding and ship repairing. (a) General. Shipbuilding, ship repairing, alterations, and maintenance...

2014-07-01

360

30 CFR 57.14105 - Procedures during repairs or maintenance.  

Code of Federal Regulations, 2010 CFR

...false Procedures during repairs or maintenance. 57.14105 Section 57.14105...and Equipment Safety Devices and Maintenance Requirements § 57.14105 Procedures during repairs or maintenance. Repairs or maintenance on...

2010-07-01

361

32 CFR 174.14 - Maintenance and repair.  

Code of Federal Regulations, 2010 CFR

...2010-07-01 2010-07-01 false Maintenance and repair. 174.14 Section 174.14...COMMUNITIES AND ADDRESSING IMPACTS OF REALIGNMENT Maintenance and Repair § 174.14 Maintenance and repair. (a) Facilities and...

2010-07-01

362

46 CFR 272.24 - Subsidy repair summaries.  

Code of Federal Regulations, 2010 CFR

...FOR CONDUCTING CONDITION SURVEYS AND ADMINISTERING MAINTENANCE AND REPAIR SUBSIDY...and belief, and based on recorded entries...statement of repair and maintenance expenditures for...the repair and maintenance items...

2010-10-01

363

Recent developments in flexor tendon repair techniques and factors influencing strength of the tendon repair.  

PubMed

Over the last decade, both basic researchers and surgeons have sought to identify the most appropriate techniques to be applied in flexor tendon repairs. Recent developments in experimental tendon repairs and clinical outcomes of newer repair techniques have been reviewed in an attempt to comprehensively summarize the most critical mechanical factors affecting the performance of tendon repairs and the surgical factors influencing clinical outcomes. Among them, attention to annular pulleys, the purchase and tension of the core suture, and the direction and curvature of the path of tendon motion have been found to be determining factors in the results of tendon repair. PMID:23792441

Wu, Y F; Tang, J B

2014-01-01

364

Self-repairing composites for airplane components  

NASA Astrophysics Data System (ADS)

Durability and damage tolerance criteria drives the design of most composite structures. Those criteria could be altered by developing structure that repairs itself from impact damage. This is a technology for increasing damage tolerance for impact damage. Repaired damage would enable continued function and prevent further degradation to catastrophic failure in the case of an aircraft application. Further, repaired damage would enable applications to be utilized without reduction in performance due to impacts. Self repairing structures are designed to incorporate hollow fibers, which will release a repairing agent when the structure is impacted, so that the repairing agent will fill delaminations, voids and cracks in les than one minute, thus healing matrix voids. The intent is to modify the durability and damage tolerance criteria by incorporation of self-healing technologies to reduce overall weight: The structure will actually remain lighter than current conventional design procedures allow. Research objective(s) were: Prove that damage can be repaired to within 80-90% of original flexural strength in less than one minute, in laminates that are processed at 300-350F typical for aircraft composites. These were successfully met. The main focus was on testing of elements in compression after impact and a larger component in shear at Natural Process Design, Inc. Based on these results the advantages purposes are assessed. The results show potential; with self repairing composites, compressive strength is maintained sufficiently so that less material can be used as per durability and damage tolerance, yielding a lighter structure.

Dry, Carolyn

2008-03-01

365

Repairers must relabel instruments, court rules.  

PubMed

A federal appeals court decided that repair companies must be sure that endoscopic instruments they have worked on, especially those they have drastically altered, must be clearly identified as such. In some cases, that could mean that the original manufacturer's name must be removed, or the repairer's name added to the device's label. PMID:12232895

2002-08-01

366

33 CFR 127.1405 - Repairs.  

Code of Federal Regulations, 2010 CFR

...2010-07-01 2010-07-01 false Repairs. 127.1405 Section 127.1405 ...Hazardous Gas Maintenance § 127.1405 Repairs. Each operator of a waterfront facility...Safety is not compromised; and (b) Welding and cutting meet NFPA...

2010-07-01

367

33 CFR 127.1405 - Repairs.  

Code of Federal Regulations, 2013 CFR

...2013-07-01 2013-07-01 false Repairs. 127.1405 Section 127.1405 ...Hazardous Gas Maintenance § 127.1405 Repairs. Each operator of a waterfront facility...Safety is not compromised; and (b) Welding and cutting meet NFPA...

2013-07-01

368

33 CFR 127.1405 - Repairs.  

Code of Federal Regulations, 2012 CFR

...2012-07-01 2012-07-01 false Repairs. 127.1405 Section 127.1405 ...Hazardous Gas Maintenance § 127.1405 Repairs. Each operator of a waterfront facility...Safety is not compromised; and (b) Welding and cutting meet NFPA...

2012-07-01

369

33 CFR 127.1405 - Repairs.  

Code of Federal Regulations, 2011 CFR

...2011-07-01 2011-07-01 false Repairs. 127.1405 Section 127.1405 ...Hazardous Gas Maintenance § 127.1405 Repairs. Each operator of a waterfront facility...Safety is not compromised; and (b) Welding and cutting meet NFPA...

2011-07-01

370

Human DNA repair and recombination genes  

SciTech Connect

Several genes involved in mammalian DNA repair pathways were identified by complementation analysis and chromosomal mapping based on hybrid cells. Eight complementation groups of rodent mutants defective in the repair of uv radiation damage are now identified. At least seven of these genes are probably essential for repair and at least six of them control the incision step. The many genes required for repair of DNA cross-linking damage show overlap with those involved in the repair of uv damage, but some of these genes appear to be unique for cross-link repair. Two genes residing on human chromosome 19 were cloned from genomic transformants using a cosmid vector, and near full-length cDNA clones of each gene were isolated and sequenced. Gene ERCC2 efficiently corrects the defect in CHO UV5, a nucleotide excision repair mutant. Gene XRCC1 normalizes repair of strand breaks and the excessive sister chromatid exchange in CHO mutant EM9. ERCC2 shows a remarkable /approximately/52% overall homology at both the amino acid and nucleotide levels with the yeast RAD3 gene. Evidence based on mutation induction frequencies suggests that ERCC2, like RAD3, might also be an essential gene for viability. 100 refs., 4 tabs.

Thompson, L.H.; Weber, C.A.; Jones, N.J.

1988-09-01

371

Nucleotide excision repair “a legacy of creativity”  

Microsoft Academic Search

The first half of the 20th century has seen an enormous growth in our knowledge of DNA repair, in no small part due to the work of Dirk Bootsma, Philip Hanawalt and Bryn Bridges; those honored by this issue. For the new millennium, we have asked three general questions: (A) Do we know all possible strategies of nucleotide excision repair

J. E. Cleaver; K. Karplus; M. Kashani-Sabet; C. L. Limoli

2001-01-01

372

30 CFR 56.14104 - Tire repairs.  

Code of Federal Regulations, 2013 CFR

... 1 2013-07-01 2013-07-01 false Tire repairs. 56.14104 Section 56.14104 Mineral...Devices and Maintenance Requirements § 56.14104 Tire repairs. (a) Before a tire is removed from a vehicle for tire...

2013-07-01

373

30 CFR 56.14104 - Tire repairs.  

Code of Federal Regulations, 2011 CFR

... 1 2011-07-01 2011-07-01 false Tire repairs. 56.14104 Section 56.14104 Mineral...Devices and Maintenance Requirements § 56.14104 Tire repairs. (a) Before a tire is removed from a vehicle for tire...

2011-07-01

374

30 CFR 57.14104 - Tire repairs.  

... 1 2014-07-01 2014-07-01 false Tire repairs. 57.14104 Section 57.14104 Mineral...Devices and Maintenance Requirements § 57.14104 Tire repairs. (a) Before a tire is removed from a vehicle for tire...

2014-07-01

375

30 CFR 56.14104 - Tire repairs.  

... 1 2014-07-01 2014-07-01 false Tire repairs. 56.14104 Section 56.14104 Mineral...Devices and Maintenance Requirements § 56.14104 Tire repairs. (a) Before a tire is removed from a vehicle for tire...

2014-07-01

376

30 CFR 56.14104 - Tire repairs.  

Code of Federal Regulations, 2010 CFR

... 1 2010-07-01 2010-07-01 false Tire repairs. 56.14104 Section 56.14104 Mineral...Devices and Maintenance Requirements § 56.14104 Tire repairs. (a) Before a tire is removed from a vehicle for tire...

2010-07-01

377

30 CFR 57.14104 - Tire repairs.  

Code of Federal Regulations, 2010 CFR

... 1 2010-07-01 2010-07-01 false Tire repairs. 57.14104 Section 57.14104 Mineral...Devices and Maintenance Requirements § 57.14104 Tire repairs. (a) Before a tire is removed from a vehicle for tire...

2010-07-01

378

30 CFR 57.14104 - Tire repairs.  

Code of Federal Regulations, 2011 CFR

... 1 2011-07-01 2011-07-01 false Tire repairs. 57.14104 Section 57.14104 Mineral...Devices and Maintenance Requirements § 57.14104 Tire repairs. (a) Before a tire is removed from a vehicle for tire...

2011-07-01

379

30 CFR 57.14104 - Tire repairs.  

Code of Federal Regulations, 2012 CFR

... 1 2012-07-01 2012-07-01 false Tire repairs. 57.14104 Section 57.14104 Mineral...Devices and Maintenance Requirements § 57.14104 Tire repairs. (a) Before a tire is removed from a vehicle for tire...

2012-07-01

380

30 CFR 57.14104 - Tire repairs.  

Code of Federal Regulations, 2013 CFR

... 1 2013-07-01 2013-07-01 false Tire repairs. 57.14104 Section 57.14104 Mineral...Devices and Maintenance Requirements § 57.14104 Tire repairs. (a) Before a tire is removed from a vehicle for tire...

2013-07-01

381

30 CFR 56.14104 - Tire repairs.  

Code of Federal Regulations, 2012 CFR

... 1 2012-07-01 2012-07-01 false Tire repairs. 56.14104 Section 56.14104 Mineral...Devices and Maintenance Requirements § 56.14104 Tire repairs. (a) Before a tire is removed from a vehicle for tire...

2012-07-01

382

Mechanisms of human DNA repair: an update.  

PubMed

The human genome, comprising three billion base pairs coding for 30000-40000 genes, is constantly attacked by endogenous reactive metabolites, therapeutic drugs and a plethora of environmental mutagens that impact its integrity. Thus it is obvious that the stability of the genome must be under continuous surveillance. This is accomplished by DNA repair mechanisms, which have evolved to remove or to tolerate pre-cytotoxic, pre-mutagenic and pre-clastogenic DNA lesions in an error-free, or in some cases, error-prone way. Defects in DNA repair give rise to hypersensitivity to DNA-damaging agents, accumulation of mutations in the genome and finally to the development of cancer and various metabolic disorders. The importance of DNA repair is illustrated by DNA repair deficiency and genomic instability syndromes, which are characterised by increased cancer incidence and multiple metabolic alterations. Up to 130 genes have been identified in humans that are associated with DNA repair. This review is aimed at updating our current knowledge of the various repair pathways by providing an overview of DNA-repair genes and the corresponding proteins, participating either directly in DNA repair, or in checkpoint control and signaling of DNA damage. PMID:14599765

Christmann, Markus; Tomicic, Maja T; Roos, Wynand P; Kaina, Bernd

2003-11-15

383

Pathologies o Bone Fracture and Bone Repair  

E-print Network

(Bone Cancer) o Paget's Disease o Overuse Damage (Stress Fractures) o Considerations for Bioengineers1 Bone Pathologies o Bone Fracture and Bone Repair o Degenerative Changes Associated with Aging o TOPICS 1 Bone Fracture and Bone Repair A radiograph of a torsional bone fracture from a skiing accident

Gefen, Amit

384

Control rod housing alignment and repair apparatus  

Microsoft Academic Search

This patent describes a welding a repair device for precisely locating and welding the position of the top of a control rod drive housing attached from a stub tube from a corresponding aperture and alignment pin in a core plate within a boiling water nuclear reactor, the welding and repair device. It comprises: a shaft, the shaft extending from the

R. C. Dixon; G. A. Deaver; J. R. Punches; G. E. Singleton; J. G. Erbes; H. P. Offer

1991-01-01

385

Anti-inflammatory strategies in cartilage repair.  

PubMed

Cartilage defects are normally concomitant with posttraumatic inflammation and pose a major challenge in cartilage repair. Due to the avascular nature of cartilage and its inability to surmount an inflammatory response, the cartilage is easily attacked by proinflammatory factors and oxidative stress; if left untreated, osteoarthritis may develop. Suppression of inflammation has always been a crux for cartilage repair. Pharmacological drugs have been successfully applied in cartilage repair; however, they cannot optimally work alone. This review article will summarize current pharmacological drugs and their application in cartilage repair. The development of extracellular matrix-based scaffolds and preconditioned tissue-specific stem cells will be emphasized because both of these tissue engineering components could contribute to an enhanced ability not only for cartilage regeneration but also for anti-inflammation. These strategies could be combined to boost cartilage repair under inflammatory conditions. PMID:24846478

Zhang, Ying; Pizzute, Tyler; Pei, Ming

2014-12-01

386

Phenotypic Transitions of Macrophages Orchestrate Tissue Repair  

PubMed Central

Macrophages are essential for the efficient healing of numerous tissues, and they contribute to impaired healing and fibrosis. Tissue repair proceeds through overlapping phases of inflammation, proliferation, and remodeling, and macrophages are present throughout this progression. Macrophages exhibit transitions in phenotype and function as tissue repair progresses, although the precise factors regulating these transitions remain poorly defined. In efficiently healing injuries, macrophages present during a given stage of repair appear to orchestrate transition into the next phase and, in turn, can promote debridement of the injury site, cell proliferation and angiogenesis, collagen deposition, and matrix remodeling. However, dysregulated macrophage function can contribute to failure to heal or fibrosis in several pathological situations. This review will address current knowledge of the origins and functions of macrophages during the progression of tissue repair, with emphasis on skin and skeletal muscle. Dysregulation of macrophages in disease states and therapies targeting macrophage activation to promote tissue repair are also discussed. PMID:24091222

Novak, Margaret L.; Koh, Timothy J.

2014-01-01

387

Shuttle Repair Tools Automate Vehicle Maintenance  

NASA Technical Reports Server (NTRS)

Successfully building, flying, and maintaining the space shuttles was an immensely complex job that required a high level of detailed, precise engineering. After each shuttle landed, it entered a maintenance, repair, and overhaul (MRO) phase. Each system was thoroughly checked and tested, and worn or damaged parts replaced, before the shuttle was rolled out for its next mission. During the MRO period, workers needed to record exactly what needed replacing and why, as well as follow precise guidelines and procedures in making their repairs. That meant traceability, and with it lots of paperwork. In 2007, the number of reports generated during electrical system repairs was getting out of hand-placing among the top three systems in terms of paperwork volume. Repair specialists at Kennedy Space Center were unhappy spending so much time at a desk and so little time actually working on the shuttle. "Engineers weren't spending their time doing technical work," says Joseph Schuh, an electrical engineer at Kennedy. "Instead, they were busy with repetitive, time-consuming processes that, while important in their own right, provided a low return on time invested." The strain of such inefficiency was bad enough that slow electrical repairs jeopardized rollout on several occasions. Knowing there had to be a way to streamline operations, Kennedy asked Martin Belson, a project manager with 30 years experience as an aerospace contractor, to co-lead a team in developing software that would reduce the effort required to document shuttle repairs. The result was System Maintenance Automated Repair Tasks (SMART) software. SMART is a tool for aggregating and applying information on every aspect of repairs, from procedures and instructions to a vehicle s troubleshooting history. Drawing on that data, SMART largely automates the processes of generating repair instructions and post-repair paperwork. In the case of the space shuttle, this meant that SMART had 30 years worth of operations that it could apply to ongoing maintenance work. According to Schuh, "SMART standardized and streamlined many shuttle repair processes, saving time and money while increasing safety and the quality of repairs." Maintenance technicians and engineers now had a tool that kept them in the field, and because SMART is capable of continually evolving, each time an engineer put it to use, it would enrich the Agency-wide knowledge base. "If an engineer sees something in the work environment that they could improve, a repair process or a procedure, SMART can incorporate that data for use in future operations," says Belson.

2013-01-01

388

Laparoscopic total extraperitoneal repair versus anterior preperitoneal repair for inguinal hernia.  

PubMed

Laparoscopic inguinal hernia repair is still not the gold standard for repair although mesh implantation is unequivocally accepted as an integral part of any groin hernia repair. The aim of the study was to compare the results of anterior preperitoneal (APP) mesh repair with totally extra peritoneal (TEP) repair for inguinal hernias. The prospective study was conducted on 241 patients with 247 hernias (from January 2000 to June 2004). Anterior preperitoneal repair was done in 121 patients and 120 patients were subjected to TEP repair. Repair in both groups was done by using Prolene mesh of size 6x4 in. or 6x6 in. intraoperative and postoperative parameters and complications were recorded and the patients were followed up to 1 year post-surgery. For both unilateral and bilateral inguinal hernias, mean operative time was significantly more in patients of TEP repair as compared to APP repair (P<0.001) and significantly more patients had peritoneal tears in the TEP group (P<0.001). Patients undergoing TEP repair, however, had significantly less postoperative pain (P<0.05) and postoperative hospital stay (P<0.05) and return to work was significantly earlier is this group (P<0.01 and P<0.001). There was no difference in the recurrence rate between the two groups. Patients with inguinal hernias undergoing laparoscopic repair recover more rapidly, and have less incidence of postoperative pain. But it takes significantly more time to perform than APP repair and also the incidence of peritoneal tear is higher. PMID:16479362

Sinha, R; Sharma, N; Dhobal, D; Joshi, M

2006-04-01

389

Leakage test during mitral valve repair.  

PubMed

Mitral valve repair is the preferred surgical treatment for mitral regurgitation. Cardiac surgeons must increasingly pursue high-quality mitral valve repair, which ensures excellent long-term outcomes. Intraoperative assessment of a competency of the repaired mitral valve before closure of the atrium is an important step in accomplishing successful mitral valve repair. Saline test is the most simple and popular method to evaluate the repaired valve. In addition, an "Ink test" can provide confirmation of the surface of coaptation, which is often insufficient in the assessment of saline test. There are sometimes differences between the findings of the leakage test in an arrested heart and the echocardiographic findings after surgery. Assessment of the mitral valve in an arrested heart may not accurately reflect its function in a contractile heart. Assessment of the valve on the beating heart induced by antegrade or retrograde coronary artery perfusion can provide a more physiological assessment of the repaired valve. Perfusion techniques during beating heart surgery mainly include antegrade coronary artery perfusion without aortic cross-clamping, and retrograde coronary artery perfusion via the coronary sinus with aortic cross-clamping. It is the most important point for the former approach to avoid air embolism with such precaution as CO2 insufflation, left ventricular venting, and transesophageal echocardiography, and for the latter approach to maintain high perfusion flow rate of coronary sinus and adequate venting. Leakage test during mitral valve repair increasingly takes an important role in successful mitral valve reconstruction. PMID:25156036

Watanabe, Taiju; Arai, Hirokuni

2014-11-01

390

DNA repair mechanisms in Huntington's disease.  

PubMed

The human genome is under continuous attack by a plethora of harmful agents. Without the development of several dedicated DNA repair pathways, the genome would have been destroyed and cell death, inevitable. However, while DNA repair enzymes generally maintain the integrity of the whole genome by properly repairing mutagenic and cytotoxic intermediates, there are cases in which the DNA repair machinery is implicated in causing disease rather than protecting against it. One case is the instability of gene-specific trinucleotides, the causative mutations of numerous disorders including Huntington's disease. The DNA repair proteins induce mutations that are different from the genome-wide mutations that arise in the absence of repair enzymes; they occur at definite loci, they occur in specific tissues during development, and they are age-dependent. These latter characteristics make pluripotent stem cells a suitable model system for triplet repeat expansion disorders. Pluripotent stem cells can be kept in culture for a prolonged period of time and can easily be differentiated into any tissue, e.g., cells along the neural lineage. Here, we review the role of DNA repair proteins in the process of triplet repeat instability in Huntington's disease and also the potential use of pluripotent stem cells to investigate neurodegenerative disorders. PMID:23361256

Jonson, Ida; Ougland, Rune; Larsen, Elisabeth

2013-06-01

391

Paraumbilical hernia repair during cesarean delivery  

PubMed Central

BACKGROUND AND OBJECTIVES: Pregnant women with paraumbilical hernia usually postpone hernia repair until after delivery, but some patients request that it be done during cesarean delivery. Therefore, we evaluated the outcome of combined cesarean delivery and paraumbilical hernia repair in a prospective study at a tertiary referral university hospital. PATIENTS AND METHODS: In a prospective study, we compared the outcome of 48 patients undergoing cesarean delivery combined with paraumbilical hernia repair versus 100 low-risk patients undergoing cesarean delivery alone. The main outcome measures were operation time, blood loss, severity of pain, peripartum complications, hospital stay, hernia recurrence, and patient satisfaction. RESULTS: The combined procedure took significantly longer than cesarean delivery alone (75.2 minutes versus 60.5 minutes, P<.001)). There were no major complications. Wound infection occurred in 6 patients (4.1%). Hospital stay did not differ significantly from those of controls. Pain at the hernia site repair occurred in two patients, and one hernia recurred in the hernia repair group during a mean follow-up period of 22 months (range, 6-36 months). All hernia patients reported that they preferred the combined operation. CONCLUSIONS: Combined cesarean delivery and paraumbilical hernia repair had the advantage of a single incision, single anesthesia, and a single hospital stay while avoiding re-hospitalization for a separate hernia repair. Our results indicate that the combination approach is safe, effective, and well accepted. PMID:19318752

Ghnnam, Wagih M.; Helal, Adel S.; Fawzy, Muhammad; Ragab, Ahmed; Shalaby, Hend; Elrefaay, Ehsan

2009-01-01

392

Efficacy of a physiotherapy rehabilitation program for individuals undergoing arthroscopic management of femoroacetabular impingement - the FAIR trial: a randomised controlled trial protocol  

PubMed Central

Background Femoroacetabular impingement is a common cause of hip/groin symptoms and impaired functional performance in younger sporting populations and results from morphological abnormalities of the hip in which the proximal femur abuts against the acetabular rim. Many people with symptomatic femoroacetabular impingement undergo arthroscopic hip surgery to correct the bony abnormalities. While many case series over the past decade have reported favourable surgical outcomes, it is not known whether formal rehabilitation is needed as part of the management of patients undergoing this surgical procedure. This randomised controlled trial will investigate the efficacy of a progressive physiotherapist-supervised rehabilitation program (Takla-O’Donnell Protocol) in improving health-related quality of life, physical function and symptoms in individuals undergoing arthroscopic management of femoroacetabular impingement. Methods/design 100 people aged 16–35 years undergoing hip arthroscopy for symptomatic femoroacetabular impingement will be recruited from surgical practices in Melbourne, Australia and randomly allocated to either a physiotherapy or control group. Both groups will receive written information and one standardised post-operative physiotherapy visit whilst in hospital as per usual care. Those in the physiotherapy group will also receive seven individual 30-minute physiotherapy sessions, including one pre-operative visit (within 2 weeks of surgery) and six post-operative visits at fortnightly intervals (commencing two weeks after surgery). The physiotherapy intervention will incorporate education and advice, manual techniques and prescription of a progressive rehabilitation program including home, aquatic and gym exercises. The control group will not receive additional physiotherapy management. Measurements will be taken at baseline (2 weeks pre-operatively) and at 14 and 24 weeks post-surgery. Primary outcomes are the International Hip Outcome Tool and the sports subscale of the Hip Outcome Score at 14 weeks post-surgery. Secondary outcomes include the Copenhagen Hip and Groin Outcome Score, the activities of daily living subscale of the Hip Outcome Score, the Heidelberg Sports Activity Score, a modified Tegner Activity Scale and participant-perceived overall change. Discussion The findings from this randomised controlled trial will provide evidence for the efficacy of a specific physiotherapist-supervised rehabilitation program in improving outcomes following arthroscopic management of symptomatic femoroacetabular impingement. Trial registration Australian New Zealand Clinical Trials Registry reference number: ACTRN12613000282785. PMID:24571824

2014-01-01

393

Evolution of mesh fixation for hernia repair.  

PubMed

Hernia repair remains one of the most common surgical procedures performed around the world. Over the past several decades, in response to various mesh-related complications and coinciding with the influx of laparoscopy into the field of general surgery, numerous advancements have been made in regards to the technology of mesh products being used in hernia repair today. Along these same lines, devices used for mesh fixation have evolved at a similar pace. The goal of this chapter is to review the various materials and methods of mesh fixation being utilized in both ventral and inguinal hernia repair today. PMID:25398127

Webb, David; Stoikes, Nathaniel; Voeller, Guy

2014-11-01

394

Repair of Electronics for Long Duration Spaceflight  

NASA Technical Reports Server (NTRS)

To reduce mission risk, long duration spaceflight and exploration activities will require greater degrees of self-sufficiency with regards to repair capability than have ever been employed before in space exploration. The current repair paradigm of replacing Orbital Replacement Units (ORUs) of malfunctioning avionics and electronic hardware will be impractical, since carrying all of the spares that could possibly be needed for a long duration mission would require upmass and volume at unprecedented and unacceptable levels. A strategy of component-level repair for electronics, however, could significantly reduce the mass and volume necessary for spares and enhance mission safety via a generic contingency capability. This approach is already used to varying degrees by the U.S. Navy, where vessels at sea experience some similar constraints such as the need for self sufficiency for moderately long time periods, and restrictions on volume of repair spares and infrastructure. The concept of conducting component-level repairs of electronics in spacecraft requires the development of design guidelines for future avionics (to enable repair), development of diagnostic techniques to allow an astronaut to pinpoint the faulty component aboard a vastly complex vehicle, and development of tools and methodologies for dealing with the physical processes of replacing the component. This physical process includes tasks such as conformal coating removal and replacement, component removal, replacement, and alignment--all in the difficulty of a reduced gravity environment. Further, the gravitational effects on the soldering process must be characterized and accounted for to ensure reliability of the newly repaired components. The Component-Level Electronics-Assembly Repair (CLEAR) project under the NASA Supportability program was established to develop and demonstrate the practicality of this repair approach. CLEAR involves collaborative efforts between NASA s Glenn Research Center, Langley Research Center, Johnson Space Center, the National Center for Space Exploration Research, and the U.S. Navy. The project goals are 1) develop and demonstrate a manually-operated electronics repair capability to be conducted in a spacecraft environment; and 2) develop guidelines for designs of electronics that facilitates component-level repair for future space exploration efforts. This multi-faceted program utilizes a cross-disciplinary approach to examine pre- and post-repair diagnostics, conformal coating removal and replacement, component soldering, and electronics design for supportability. These areas are investigated by a combination of trade studies, ground based testing, reduced gravity aircraft testing, and actual spaceflight testing on the International Space Station (ISS) in multiple experiments. This paper details the efforts of this program, with emphasis on early trade study results, ground-based efforts, and two upcoming ISS experiments.

Pettegrew, Richard D.; Easton, John; Struk, Peter

2007-01-01

395

Aircraft battle damage repair - A force multiplier  

SciTech Connect

An aircraft battle-damage repair (BDR) program is described that provides for the assessment and repair of battle damage and the return of badly damaged aircraft to their home bases. The program methodology is based on the use of time-saving temporary repairs and associated training and materials provision. BDR is shown to require knowledge of damage mechanisms and specifications for the minimum effective requirements for BDR support, and the method can facilitate the return of 50 percent of damaged aircraft within 24 hours.

Hess, J.W. (USAF, Wright Laboratory, Wright-Patterson AFB, OH (United States))

1992-08-01

396

Posterior-compartment repair: a urology perspective.  

PubMed

The prevalence of posterior-compartment prolapse (rectocele) is not known. The authors have found that operative repair symptomatically improved a majority of patients with impaired defecation associated with a large rectocele, but this improvement was likely related at least in part to factors other than the size of the rectocele. Multiple surgical techniques are available for rectocele repair, and the literature is not clear regarding indications for each type of surgical intervention. This article reviews the literature regarding various types of posterior-compartment repair, and draws conclusions regarding their absolute efficacy and relative efficacy in comparison with one another. PMID:22877720

Gomelsky, Alex; Dmochowski, Roger R

2012-08-01

397

Designing Hydrogel Adhesives for Corneal Wound Repair  

PubMed Central

Today, corneal wounds are repaired using nylon sutures. Yet there are a number of complications associated with suturing the cornea, and thus there is interest in an adhesive to replace or supplement sutures in the repair of corneal wounds. We are designing and evaluating corneal adhesives prepared from dendrimers – single molecular weight, highly branched polymers. We have explored two strategies to form these ocular adhesives. The first involves a photocrosslinking reaction and the second uses a peptide ligation reactions to couple the individual dendrimers together to from the adhesive. These adhesives were successfully used to repair corneal perforations, close the flap produced in a LASIK procedure, and secure a corneal transplant. PMID:17889330

Grinstaff, Mark W.

2013-01-01

398

Weld Repair of Thin Aluminum Sheet  

NASA Technical Reports Server (NTRS)

Weld repairing of thin aluminum sheets now possible, using niobium shield and copper heat sinks. Refractory niobium shield protects aluminum adjacent to hole, while copper heat sinks help conduct heat away from repair site. Technique limits tungsten/inert-gas (TIG) welding bombardment zone to melt area, leaving surrounding areas around weld unaffected. Used successfully to repair aluminum cold plates on Space Shuttle, Commercial applications, especially in sealing fractures, dents, and holes in thin aluminum face sheets or clad brazing sheet in cold plates, heat exchangers, coolers, and Solar panels. While particularly suited to thin aluminum sheet, this process also used in thicker aluminum material to prevent surface damage near weld area.

Beuyukian, C. S.; Mitchell, M. J.

1986-01-01

399

Fanconi-like crosslink repair in yeast  

PubMed Central

Interstrand crosslinks covalently link complementary DNA strands, block replication and transcription, and can trigger cell death. In eukaryotic systems several pathways, including the Fanconi Anemia pathway, are involved in repairing interstrand crosslinks, but their precise mechanisms remain enigmatic. The lack of functional homologs in simpler model organisms has significantly hampered progress in this field. Two recent studies have finally identified a Fanconi-like interstrand crosslink repair pathway in yeast. Future studies in this simplistic model organism promise to greatly improve our basic understanding of complex interstrand crosslink repair pathways like the Fanconi pathway. PMID:23062727

2012-01-01

400

Laparoscopic total extraperitoneal repair of lumbar hernia  

PubMed Central

Lumbar hernia is a rare surgical entity without a standard method of repair. With advancements in laparoscopic techniques, successful lumbar herniorrhaphy can be achieved by the creation of a completely extraperitoneal working space and secure fixation of a wide posterior mesh. We present a total extraperitoneal laparoendoscopic repair of lumbar hernia, which allowed for minimal invasiveness while providing excellent anatomical identification, easy mobilization of contents and wide secure mesh fixation. A total extraperitoneal method of lumbar hernia repair by laparoscopic approach is feasible and may be an ideal option. PMID:22111086

Lim, Man Sup; Lee, Hae Wan; Yu, Chang Hee

2011-01-01

401

DNA repair pathways as targets for cancer therapy  

Microsoft Academic Search

DNA repair pathways can enable tumour cells to survive DNA damage that is induced by chemotherapeutic treatments; therefore, inhibitors of specific DNA repair pathways might prove efficacious when used in combination with DNA-damaging chemotherapeutic drugs. In addition, alterations in DNA repair pathways that arise during tumour development can make some cancer cells reliant on a reduced set of DNA repair

Eva Petermann; Cecilia Lundin; Ben Hodgson; Ricky A. Sharma; Thomas Helleday

2008-01-01

402

The fission yeast UVDR DNA repair pathway is inducible  

Microsoft Academic Search

In addition to nucleotide excision repair (NER), the fission yeast Schizosaccharomyces pombe pos- sesses a UV damage endonuclease (UVDE) for the excision of cyclobutane pyrimidine dimers and 6-4 pyrimidine pyrimidones. We have previously de- scribed UVDE as part of an alternative excision repair pathway, UVDR, for UV damage repair. The existence of two excision repair processes has long been postulated

Scott Davey; Monica L. Nass; Jasmine V. Ferrer; Khalifah Sidik; Andrew Eisenberger; David L. Mitchell; Greg A. Freyer

1997-01-01

403

Project to evaluate the integrity of repaired welds  

Microsoft Academic Search

The preliminary stage of a multi-stage project has been carried out aimed at providing general guidance on welding repairs in terms of when such repairs may or may not be beneficial. The work has been centred on detailed finite element modelling of a matrix of relevant un-repaired and repaired weld configurations. Development and validation of the finite element models have

J. K. Sharples; L. Gardner; S. K. Bate; M. R. Goldthorpe; J. R. Yates; H. Bainbridge

2005-01-01

404

Maintenance and repair welding in power plants 5: Proceedings  

SciTech Connect

The papers in this book are divided into the following areas: material considerations in weld repair; advances in welding processes, equipment and inspection; recent repair cases/experiences tubes and piping; recent repair cases/experiences -- vessel components; and recent repair cases/experiences -- vessels, valves and turbines. Separate abstracts were prepared for 27 papers in this book.

NONE

1995-12-31

405

The modified Koyanagi hypospadias repair for the one-stage repair of proximal hypospadias  

PubMed Central

Perineal and penoscrotal hypospadias were often managed by two-stage urethroplasty with variable results and significant number of these may need third surgery. Though modified Koyanagi one-stage repair has a learning curve, it has all the advantages of two-stage repair. The aim was to review the results of modified Koyonagi repair from the literature and our own centre experience. PMID:19468399

Jayanthi, Venkata R.

2008-01-01

406

Role of nucleotide excision repair proteins in oxidative DNA damage repair: an updating  

Microsoft Academic Search

DNA repair is a crucial factor in maintaining a low steady-state level of oxidative DNA damage. Base excision repair (BER)\\u000a has an important role in preventing the deleterious effects of oxidative DNA damage, but recent evidence points to the involvement\\u000a of several repair pathways in this process. Oxidative damage may arise from endogenous and exogenous sources and may target\\u000a nuclear

B. Pascucci; M. D’Errico; E. Parlanti; S. Giovannini; E. Dogliotti

2011-01-01

407

Enhancement of lysine acetylation accelerates wound repair  

PubMed Central

In physiopathological conditions, such as diabetes, wound healing is significantly compromised and chronic complications, including ulcers, may occur. In a mouse model of skin repair, we recently reported that wound treatment with Sirtuin activators and class I HDAC inhibitors induced keratinocyte proliferation and enhanced healing via a nitric oxide (NO) dependent mechanism. We observed an increase in total protein acetylation in the wound area, as determined by acetylation of ?-tubulin and histone H3 Lysine 9. We reasoned that this process activated cell function as well as regulated gene expression to foster tissue repair. We report here that the direct activation of P300/CBP-associated factor (PCAF) by the histone acetylase activator pentadecylidenemalonate 1b (SPV-106) induced Lysine acetylation in the wound area. This intervention was sufficient to enhance repair process by a NO-independent mechanism. Hence, an impairment of PCAF and/or other GCN5 family acetylases may delay skin repair in physiopathological conditions. PMID:24265859

Spallotta, Francesco; Cencioni, Chiara; Straino, Stefania; Sbardella, Gianluca; Castellano, Sabrina; Capogrossi, Maurizio C; Martelli, Fabio; Gaetano, Carlo

2013-01-01

408

Augmented Reality for Maintenance and Repair (ARMAR).  

National Technical Information Service (NTIS)

The purpose of this research, Augmented Reality for Maintenance and Repair (ARMAR), was to research the design and development of experimental augmented reality systems for maintenance job aiding. The goal was to explore and evaluate the feasibility of de...

S. J. Henderson, S. K. Feiner

2007-01-01

409

Anesthesia For In Utero Repair of Myelomeningocele  

PubMed Central

Recently published results suggest that prenatal repair of fetal myelomeningocele is a potentially preferable alternative when compared to postnatal repair. In this article, the pathology of myelomeningocele, unique physiologic considerations, perioperative anesthetic management, and ethical considerations of open fetal surgery for prenatal myelomeningocele repair are discussed. Open fetal surgeries have many unique anesthetic issues such as inducing profound uterine relaxation, vigilance for maternal or fetal blood loss, fetal monitoring, and possible fetal resuscitation. Postoperative management, including the requirement for postoperative tocolysis and maternal analgesia are also reviewed. The success of intrauterine myelomeningocele repair relies on a well-coordinated multidisciplinary approach. Fetal surgery is an important topic for anesthesiologists to understand, as the number of fetal procedures is likely to increase as new fetal treatment centers are opened across the United States. PMID:23508219

Ferschl, Marla; Ball, Robert; Lee, Hanmin; Rollins, Mark D.

2013-01-01

410

33 CFR 115.40 - Bridge repairs.  

Code of Federal Regulations, 2012 CFR

...Waters 1 2012-07-01 2012-07-01 false Bridge repairs. 115.40 Section 115.40 Navigation...Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY BRIDGES BRIDGE LOCATIONS AND CLEARANCES; ADMINISTRATIVE...

2012-07-01

411

33 CFR 115.40 - Bridge repairs.  

Code of Federal Regulations, 2010 CFR

...Waters 1 2010-07-01 2010-07-01 false Bridge repairs. 115.40 Section 115.40 Navigation...Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY BRIDGES BRIDGE LOCATIONS AND CLEARANCES; ADMINISTRATIVE...

2010-07-01

412

33 CFR 115.40 - Bridge repairs.  

Code of Federal Regulations, 2013 CFR

...Waters 1 2013-07-01 2013-07-01 false Bridge repairs. 115.40 Section 115.40 Navigation...Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY BRIDGES BRIDGE LOCATIONS AND CLEARANCES; ADMINISTRATIVE...

2013-07-01

413

33 CFR 115.40 - Bridge repairs.  

Code of Federal Regulations, 2011 CFR

...Waters 1 2011-07-01 2011-07-01 false Bridge repairs. 115.40 Section 115.40 Navigation...Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY BRIDGES BRIDGE LOCATIONS AND CLEARANCES; ADMINISTRATIVE...

2011-07-01

414

Aerospace Curriculum: Composites Inspection and Repair Workshop  

NSDL National Science Digital Library

This lesson from SpaceTEC National Aerospace Technical Education Center presents a technician skills workshop on composites inspection and repair. Composites are two or more materials working together, each contributing its own structural properties yet retaining its unique identity. The PDF document includes 84 slides with graphics and text illustrating what composites are, their characteristics, advantages and disadvantages, related materials, shop safety and composite damage, inspection and repair.

Kane, Steve

2011-09-22

415

Laparoscopic extraperitoneal repair of inguinofemoral herniation.  

PubMed

This report describes my group's experience with repairing 100 direct and indirect inguinal hernias using a solely extraperitoneal, laparoscopic prosthetic procedure. No unusual complications were noted and all patients were discharged on the day of or the day following surgery and resumed normal activities within one week. The surgical technique is outlined, with attention given to general guidelines performing this minimally invasive repair procedure. PMID:8050020

McKernan, J B

1993-08-01

416

Mitral valve repair in heart failure  

Microsoft Academic Search

Mitral regurgitation MR is a frequent complication of end-stage heart failure. Historically, these patients were either managed medically or with mitral valve replacement, both associated with poor outcomes. Mitral valve repair via an 'undersized' annuloplasty repair is safe and effectively corrects MR in heart-failure patients. All of the observed changes contribute to reverse remodeling and restoration of the normal left-ventricular

Iva A. Smolens; Francis D. Pagani; Steven F. BollingU

2000-01-01

417

Mould steels repaired by laser welding  

Microsoft Academic Search

Laser-deposit welding, by using Nd-YAG, is a mould repairing process, which has the advantages relatively to the traditional methods of achieving a less change of the metal composition around the repaired zone and permitting a very accurate deposition of a small volume of the filler material in the area chosen at the work-piece surface. This paper presents a fatigue study

L. P. Borrego; J. T. B. Pires; J. M. Costa; J. M. Ferreira

2009-01-01

418

Fletcher Explains Methods to Repair Skylab I  

NASA Technical Reports Server (NTRS)

On May 23, 1973, Dr. James Fletcher Administrator for NASA, appeared before the United States Senate Committee on Aeronautical and Space Sciences. Dr. Fletcher explained to the committee what methods would be attempted to repair the damaged Skylab I. He stated that if the planned repairs were successful, that it would be possible to accomplish most of the activities scheduled for the two subsequent Skylab missions, each lasting 56 days.

1973-01-01

419

AIRCRAFT GAS TURBINE BLADE AND VANE REPAIR  

Microsoft Academic Search

The high replacement costs of aircraft gas turbine blades and vanes have created a fast-growing, highly-specialized segment of the aircraft repair industry. The economic rationale for repair in lieu of replacement is prima facie. The metallurgical rationale is less certain, but satisfactory flight performance over the past twenty-five years at least attests to the technical adequacy of blade and vane

K. C. Antony; G. W. Goward

420

Laparoscopic ventral hernia repair during pregnancy  

Microsoft Academic Search

Background  Laparoscopic ventral hernia repair in comparison to open herniorrhaphy results in reduced length of stay, less post-operative\\u000a pain, earlier return to work, and reduced complications for the repair of complex ventral hernias. The laparoscopic approach\\u000a has been the standard of care for complex or large ventral hernias for non-pregnant patients over the past decade. Despite\\u000a evidence that demonstrates that laparoscopy

P. Y. Wai; J. A. Ruby; K. A. Davis; A. C. Roberts; K. E. Roberts

2009-01-01

421

Repair of radiation damage in mammalian cells  

SciTech Connect

The responses, such as survival, mutation, and carcinogenesis, of mammalian cells and tissues to radiation are dependent not only on the magnitude of the damage to macromolecular structures - DNA, RNA, protein, and membranes - but on the rates of macromolecular syntheses of cells relative to the half-lives of the damages. Cells possess a number of mechanisms for repairing damage to DNA. If the repair systems are rapid and error free, cells can tolerate much larger doses than if repair is slow or error prone. It is important to understand the effects of radiation and the repair of radiation damage because there exist reasonable amounts of epidemiological data that permits the construction of dose-response curves for humans. The shapes of such curves or the magnitude of the response will depend on repair. Radiation damage is emphasized because: (a) radiation dosimetry, with all its uncertainties for populations, is excellent compared to chemical dosimetry; (b) a number of cancer-prone diseases are known in which there are defects in DNA repair and radiation results in more chromosomal damage in cells from such individuals than in cells from normal individuals; (c) in some cases, specific radiation products in DNA have been correlated with biological effects, and (d) many chemical effects seem to mimic radiation effects. A further reason for emphasizing damage to DNA is the wealth of experimental evidence indicating that damages to DNA can be initiating events in carcinogenesis.

Setlow, R.B.

1981-01-01

422

Achilles Tendon Repair, A Modified Technique  

PubMed Central

Background: Wound complications following open repair for acute Achilles tendon ruptures (AATR) remain the subject of significant debate. The aim of this study is to investigate the effects of covering repaired AATR using well-nourished connective tissues (paratenon and deep fascia) to avoid complications after open repair. Methods: In this case series study, open repair was performed for 32 active young patients with AATR. After the tendon was repaired, the deep fascia and paratenon was used to cover the Achilles tendon. Patients were followed for two years and any wound complication was recorded. During the last visit, the American Orthopedic Foot and Ankle Society (AOFAS) ankle-hind foot score was completed for all patients. Calf circumference and ankle range of motion were measured and compared with the contralateral side. Patients were asked about returning to previous sports activities and limitations with footwear. Results: Only, one patient developed deep wound infection (3%). None of the patients had any discomfort around the operation area, limitation with footwear, sural nerve injury, re-rupture, and skin adhesion. The AOFAS score averaged 92.5±6. Two patients (7%) were unable to return to previous sports activities because of moderate pain in heavy physical exercises. The calf circumference and ankle ROM were similar between healthy and operated sides. Conclusion: The present study showed that fascial envelope for full covering of the repaired Achilles tendon may help to prevent the occurrence of wound complications. PMID:25207295

Keyhani, Sohrab; Mardani-Kivi, Mohsen; Abbasian, Mohammadreza; Emami-Moghaddam Tehrani, Mohammad; Lahiji, Farivar Abdollahzadeh

2013-01-01

423

Concepts in Gene Therapy for Cartilage Repair  

PubMed Central

Summary Once articular cartilage is injured, it has a very limited capacity for self-repair. Although current surgical therapeutic procedures to cartilage repair are clinically useful, they cannot restore a normal articular surface. Current research offers a growing number of bioactive reagents, including proteins and nucleic acids, that may be used to augment different aspects of the repair process. As these agents are difficult to administer effectively, gene transfer approaches are being developed to provide their sustained synthesis at sites of repair. To augment regeneration of articular cartilage, therapeutic genes can be delivered to the synovium, or directly to the cartilage lesion. Gene delivery to the cells of the synovial lining is generally considered more suitable for chondroprotective approaches, based on the expression of anti-inflammatory mediators. Gene transfer targeted to cartilage defects can be achieved by either direct vector administration to cells located at or surrounding the defects, or by transplantation of genetically modified chondrogenic cells into the defect. Several studies have shown that exogenous cDNAs encoding growth factors can be delivered locally to sites of cartilage damage, where they are expressed at therapeutically relevant levels. Furthermore, data is beginning to emerge indicating, that efficient delivery and expression of these genes is capable of influencing a repair response toward the synthesis of a more hyaline cartilage repair tissue in vivo. This review presents the current status of gene therapy for cartilage healing and highlights some of the remaining challenges. PMID:18313477

Steinert, Andre F.; Noth, Ulrich; Tuan, Rocky S.

2009-01-01

424

Nuclear position dictates DNA repair pathway choice  

PubMed Central

Faithful DNA repair is essential to avoid chromosomal rearrangements and promote genome integrity. Nuclear organization has emerged as a key parameter in the formation of chromosomal translocations, yet little is known as to whether DNA repair can efficiently occur throughout the nucleus and whether it is affected by the location of the lesion. Here, we induce DNA double-strand breaks (DSBs) at different nuclear compartments and follow their fate. We demonstrate that DSBs induced at the nuclear membrane (but not at nuclear pores or nuclear interior) fail to rapidly activate the DNA damage response (DDR) and repair by homologous recombination (HR). Real-time and superresolution imaging reveal that DNA DSBs within lamina-associated domains do not migrate to more permissive environments for HR, like the nuclear pores or the nuclear interior, but instead are repaired in situ by alternative end-joining. Our results are consistent with a model in which nuclear position dictates the choice of DNA repair pathway, thus revealing a new level of regulation in DSB repair controlled by spatial organization of DNA within the nucleus. PMID:25366693

Lemaitre, Charlene; Grabarz, Anastazja; Tsouroula, Katerina; Andronov, Leonid; Furst, Audrey; Pankotai, Tibor; Heyer, Vincent; Rogier, Melanie; Attwood, Kathleen M.; Kessler, Pascal; Dellaire, Graham; Klaholz, Bruno; Reina-San-Martin, Bernardo; Soutoglou, Evi

2014-01-01

425

Intestinal Obstruction After Totally Extraperitoneal Laparoscopic Inguinal Hernia Repair  

PubMed Central

Laparoscopic hernia repair is a frequently performed operation. Although it has many advantages over open inguinal hernia repair, laparoscopic surgery is not without complications. Small bowel obstruction is a complication unique to laparoscopic repair of inguinal hernias. It is reported following transabdominal preperitoneal repairs. We present a case of small bowel incarceration through a peritoneal defect after a totally extraperitoneal inguinal hernia repair. Techniques to avoid this complication are presented. The literature is reviewed. PMID:14974673

Rink, Joanne

2004-01-01

426

Energy and Technology Review: Unlocking the mysteries of DNA repair  

SciTech Connect

DNA, the genetic blueprint, has the remarkable property of encoding its own repair following diverse types of structural damage induced by external agents or normal metabolism. We are studying the interplay of DNA damaging agents, repair genes, and their protein products to decipher the complex biochemical pathways that mediate such repair. Our research focuses on repair processes that correct DNA damage produced by chemical mutagens and radiation, both ionizing and ultraviolet. The most important type of DNA repair in human cells is called excision repair. This multistep process removes damaged or inappropriate pieces of DNA -- often as a string of 29 nucleotides containing the damage -- and replaces them with intact ones. We have isolated, cloned, and mapped several human repair genes associated with the nucleotide excision repair pathway and involved in the repair of DNA damage after exposure to ultraviolet light or mutagens in cooked food. We have shown that a defect in one of these repair genes, ERCC2, is responsible for the repair deficiency in one of the groups of patients with the recessive genetic disorder xeroderma pigmentosum (XP group D). We are exploring ways to purify sufficient quantities (milligrams) of the protein products of these and other repair genes so that we can understand their functions. Our long-term goals are to link defective repair proteins to human DNA repair disorders that predispose to cancer, and to produce DNA-repair-deficient mice that can serve as models for the human disorders.

Quirk, W.A.

1993-04-01

427

Lack of involvement of nucleotide excision repair gene polymorphisms in colorectal cancer  

Microsoft Academic Search

DNA repair has an essential role in protecting the genome from damage by endogenous and environmental agents. Polymorphisms in DNA repair genes and differences in repair capacity between individuals have been widely documented. For colorectal cancer, the loss of mismatch repair gene activity is a key genetic determinant. Nucleotide excision repair (NER), recombination repair (RR) and base excision repair (BER)

R Mort; L Mo; C McEwan; D W Melton

2003-01-01

428

Bilingual Skills Training Program. Auto Body Repair. Module 3.0: Basic Metal Repair.  

ERIC Educational Resources Information Center

This module on basic metal repair is the third of four (CE 028 303-306) in the auto body repair course of a bilingual vocational training program. The course is designed to furnish theoretical and laboratory experience in welding, metal straightening, metal finishing, painting, and use of power and hand tools. Module objectives are for students to…

Northern New Mexico Community Coll., El Rito.

429

Mammalian DNA base excision repair proteins: their interactions and role in repair of oxidative DNA damage  

Microsoft Academic Search

The DNA base excision repair (BER) is a ubiquitous mechanism for removing damage from the genome induced by spontaneous chemical reaction, reactive oxygen species (ROS) and also DNA damage induced by a variety of environmental genotoxicants. DNA repair is essential for maintaining genomic integrity. As we learn more about BER, a more complex mechanism emerges which supersedes the classical, simple

Tadahide Izumi; Lee R. Wiederhold; Gargi Roy; Rabindra Roy; Arun Jaiswal; Kishor K. Bhakat; Sankar Mitra; Tapas K. Hazra

2003-01-01

430

Fault tree analysis of phased mission systems with repairable and non-repairable components  

Microsoft Academic Search

Methods are developed for correct modeling and quantification of phased mission systems in which the system logic changes during a mission. No manual elimination of minimal cut sets is needed when using common fault tree codes and techniques in this refined reliability analysis with non-repairable components. Another major contribution is the fault tree technique for systems with repairable components. Exact

J. K. Vaurio

2001-01-01

431

General Mechanical Repair. Minor Automotive Maintenance, Small Engine [Repair, and] Welding: Curriculum Guide and Lesson Plans.  

ERIC Educational Resources Information Center

This document contains a curriculum guide and lesson plans for a general mechanical repair course with three sections: minor automotive maintenance, small engine repair, and welding. The curriculum guide begins with a matrix that relates the lesson plans to essential elements of math, science, language arts, and social studies and to Texas…

Hamlin, Larry

432

General Mechanical Repair. Minor Automotive Maintenance, Small Engine [Repair, and] Welding: Student Manual.  

ERIC Educational Resources Information Center

This document is a student manual for a general mechanical repair course. Following a list of common essential elements of trade and industrial education, the manual is divided into three sections. The first section, on minor automotive maintenance, contains 13 units: automotive shop safety; engine principles; fuel system operation and repair;…

Hamlin, Larry

433

[Jatene procedure with arch repair; usefulness of rapid two-stage repair].  

PubMed

Four cases of Jatene procedure with arch repair were performed since 2000 in our department. Two-stage repair was used in all cases and the extended end-to-end anastomosis and pulmonary artery banding (PAB) were performed in 3 cases as the initial repair. In a recent case of TGA type I with coarctation of the aorta (CoA), only subclavian flap aortoplasty was performed when he was 6-day-old and patent ductus arteriosus (PDA) was preserved and rapid two-stage Jatene procedure was performed when he was 8-day-old. There was no hospital or late death, or reoperation. The results of the two-stage Jatene procedure with arch repair was good and safe. Rapid two-stage repair was thought to be a useful choice especially for TGA type I with arch anomaly. PMID:16359010

Hiramatsu, Takeshi; Okamura, Y; Komori, S; Nishimura, Y; Mori, H; Hayashi, H; Suzuki, H; Takeuchi, T

2005-12-01

434

Targeting abnormal DNA double strand break repair in cancer  

PubMed Central

A major challenge in cancer treatment is the development of therapies that target cancer cells with little or no toxicity to normal tissues and cells. Alterations in DNA double strand break (DSB) repair in cancer cells include both elevated and reduced levels of key repair proteins and changes in the relative contributions of the various DSB repair pathways. These differences can result in increased sensitivity to DSB-inducing agents and increased genomic instability. The development of agents that selectively inhibit the DSB repair pathways that cancer cells are more dependent upon will facilitate the design of therapeutic strategies that exploit the differences in DSB repair between normal and cancer cells. Here, we discuss the pathways of DSB repair, alterations in DSB repair in cancer, inhibitors of DSB repair and future directions for cancer therapies that target DSB repair. PMID:20697770

Rassool, Feyruz V.

2010-01-01

435

DNA repair responses in human skin cells  

SciTech Connect

Sunlight and some environmental chemical agents produce lesions in the DNA of human skin cells that if unrepaired may interfere with normal functioning of these cells. The most serious outcome of such interactions may be malignancy. It is therefore important to develop an understanding of mechanisms by which the lesions may be repaired or tolerated without deleterious consequences. Our models for the molecular processing of damaged DNA have been derived largely from the study of bacterial systems. Some similarities but significant differences are revealed when human cell responses are tested against these models. It is also of importance to learn DNA repair responses of epidermal keratinocytes for comparison with the more extensive studies that have been carried out with dermal fibroblasts. Our experimental results thus far indicate similarities for the excision-repair of ultraviolet-induced pyrimidine dimers in human keratinocytes and fibroblasts. Both the monoadducts and the interstrand crosslinks produced in DNA by photoactivated 8-methoxypsoralen (PUVA) can be repaired in normal human fibroblasts but not in those from xeroderma pigmentosum patients. The monoadducts, like pyrimidine dimers, are probably the more mutagenic/carcinogenic lesions while the crosslinks are less easily repaired and probably result in more effective blocking of DNA function. It is suggested that a split-dose protocol that maximizes the production of crosslinks while minimizing the yield of monoadducts may be more effective and potentially less carcinogenic than the single ultraviolet exposure regimen in PUVA therapy for psoriasis.

Hanawalt, P.C.; Liu, S.C.; Parsons, C.S.

1981-07-01

436

Mask repair induced defect study and characterization  

NASA Astrophysics Data System (ADS)

Mask defect repair is a key part of manufacturing high quality masks. Issues such as low-level transmission defect have not been solved. A series of experiments was conducted to review the effects of gallium staining generated by older generation (FIB) focused ion beam repair tool. Deposition and chemical etching with a FIB tool is done in order to correct the defective areas. Dispersion of chemicals in a molecular beam to the area of interest with a well-defined amount of molecules and monolayers will ensure correct amount of material is removed. This repair technique-using FIB, results in other problems that impacts light transmission. This effect of transmission becomes an issue at extremes of focus exposure matrix. Gallium implantation defect resulting from focusing gallium ion beams to repair is not a killer Deep UV (DUV) defect since it is considered to be an invisible transmission type. We will discuss how an attempt to repair chrome extension defect on contact-hole mask lead to edge placement problems. This is due to defects can be invisible to blue lasers in mask inspection systems, and can still be printed on wafer. A detailed study on how to characterize these problems using different methods and tools will be discussed.

Ismail, Noor Azlina; Ibrahim, Kader; Sundharam, S. Mogana

2005-11-01

437

Repair of mismatched basepairs in mammalian DNA  

SciTech Connect

We have concentrated on three specific areas of our research plan. Our greatest emphasis is on the role of single strand nicks in influencing template strand selection in mismatch repair. We have found, that the ability of a nick in one strand to influence which strand is repaired is not a simple function of distance from the mismatched site but rather that an hot spot where a nick is more likely to have an influence can exist. The second line was production of single-genotype heteroduplexes in order to examine independently the repair of T/G and A/C mispairs within the same sequence context as in our mixed mispair preparations. We have shown preparations of supercoiled heteroduplex can be prepared that were exclusively T/G or exclusively A/C at the mispair site. The third effort has been to understand the difference in repair bias of different cell lines or different transfection conditions as it may relate to different repair systems in the cell. We have identified some of the sources of variation, including cell cycle position. We hope to continue this work to more precisely identify the phase of the cell cycle.

Taylor, J.H.; Hare, J.T.

1991-08-01

438

DNA Repair and Personalized Breast Cancer Therapy  

PubMed Central

Personalized cancer therapy is likely to be one of the next big advances in our search for a cure for cancer. To be able to treat people in an individualized manner, researchers need to know a great deal about their genetic constitution and the DNA repair status of their tumors. Specific knowledge is required regarding the polymorphisms individuals carry and how these polymorphisms influence responses to therapy. Researchers are actively engaged in biomarker discovery and validation for this purpose. In addition, the design of clinical trials must be reassessed to include new information on biomarkers and drug responses. In this review, we focus on personalized breast cancer therapy. The hypothesis we focus upon in this review is that there is connection between the DNA repair profile of individuals, their breast tumor subtypes, and their responses to cancer therapy. We first briefly review cellular DNA repair pathways that are likely to be impacted by breast cancer therapies. Next, we review the phenotypes of breast tumor subtypes with an emphasis on how a DNA repair deficiency might result in tumorigenesis itself and lead to the chemotherapeutic responses that are observed. Specific examples of breast tumor subtypes and their responses to cancer therapy are given, and we discuss possible DNA repair mechanisms that underlie the responses of tumors to various chemotherapeutic agents. Much is known about breast cancer subtypes and the way each of these subtypes responds to chemotherapy. In addition, we discuss novel design of clinical trials that incorporates rapidly emerging information on biomarkers. PMID:20872853

Li, Shu-Xia; Sjolund, Ashley; Harris, Lyndsay; Sweasy, Joann B.

2010-01-01

439

Repair to the Huygens probe  

NASA Technical Reports Server (NTRS)

Jet Propulsion Laboratory (JPL) workers examine the Huygens probe after removal from the Cassini spacecraft in the Payload Hazardous Servicing Facility (PHSF) at KSC. The spacecraft was returned to the PHSF after damage to the thermal insulation was discovered inside Huygens from an abnormally high flow of conditioned air. The damage required technicians to inspect the inside of the probe, repair the insulation, and clean the instruments. After returning from the PHSF to Launch Pad 40 at Cape Canaveral Air Station, Cassini/Huygens launched successfully in October 1997, and reached Saturn in July of 2004. Scientific instruments carried aboard the Cassini orbiter will study Saturn's atmosphere, magnetic field, rings, and several moons, while the Huygens probe will separate and land on the surface of Titan, Saturn's largest moon. The Cassini-Huygens mission owes its name to the Dutch astronomer Christiaan Huygens and Italian astronomer Giovanni Domenico Cassini. Both had spectacular careers as observers of the heavens, which included important discoveries about Saturn and its satellites. Huygens (1629-1695) discovered Saturn's largest moon, Titan, in 1655 and in 1656 described the shape and phase changes of Saturn's rings. Cassini (1625-1712) was the first to observe four of Saturn's moons, Iapetus, Rhea, Tethys, and Dione, in the 1670s and 1680s. He also, in 1675, discovered the gap in Saturn's rings, now called the Cassini Division, and proposed that the rings were formed from many tiny particles. Cassini-Huygens is a joint mission of NASA, the European Space Agency (ESA), and the Italian Space Agency, Agenzia Spaziale Italiana (ASI). JPL is managing the Cassini project for NASA. The mission was proposed in November 1982 by a group of European and American scientists from the European Science Foundation and the National Academy of Sciences. The Solar System Exploration Committee of the NASA Advisory Council endorsed the idea in April 1983, and NASA and ESA began a joint assessment study in 1984. ESA officially adopted the project in November 1988, and Congress approved funding for NASA's portion of the mission in FY 89.

1997-01-01

440

Cellular Encapsulation Enhances Cardiac Repair  

PubMed Central

Background Stem cells for cardiac repair have shown promise in preclinical trials, but lower than expected retention, viability, and efficacy. Encapsulation is one potential strategy to increase viable cell retention while facilitating paracrine effects. Methods and Results Human mesenchymal stem cells (hMSC) were encapsulated in alginate and attached to the heart with a hydrogel patch in a rat myocardial infarction (MI) model. Cells were tracked using bioluminescence (BLI) and cardiac function measured by transthoracic echocardiography (TTE) and cardiac magnetic resonance imaging (CMR). Microvasculature was quantified using von Willebrand factor staining and scar measured by Masson's Trichrome. Post?MI ejection fraction by CMR was greatly improved in encapsulated hMSC?treated animals (MI: 34±3%, MI+Gel: 35±3%, MI+Gel+hMSC: 39±2%, MI+Gel+encapsulated hMSC: 56±1%; n=4 per group; P<0.01). Data represent mean±SEM. By TTE, encapsulated hMSC?treated animals had improved fractional shortening. Longitudinal BLI showed greatest hMSC retention when the cells were encapsulated (P<0.05). Scar size at 28 days was significantly reduced in encapsulated hMSC?treated animals (MI: 12±1%, n=8; MI+Gel: 14±2%, n=7; MI+Gel+hMSC: 14±1%, n=7; MI+Gel+encapsulated hMSC: 7±1%, n=6; P<0.05). There was a large increase in microvascular density in the peri?infarct area (MI: 121±10, n=7; MI+Gel: 153±26, n=5; MI+Gel+hMSC: 198±18, n=7; MI+Gel+encapsulated hMSC: 828±56 vessels/mm2, n=6; P<0.01). Conclusions Alginate encapsulation improved retention of hMSCs and facilitated paracrine effects such as increased peri?infarct microvasculature and decreased scar. Encapsulation of MSCs improved cardiac function post?MI and represents a new, translatable strategy for optimization of regenerative therapies for cardiovascular diseases. PMID:24113327

Levit, Rebecca D.; Landazuri, Natalia; Phelps, Edward A.; Brown, Milton E.; Garcia, Andres J.; Davis, Michael E.; Joseph, Giji; Long, Robert; Safley, Susan A.; Suever, Jonathan D.; Lyle, Alicia N.; Weber, Collin J.; Taylor, W. Robert

2013-01-01

441

Current options in inguinal hernia repair in adult patients.  

PubMed

Inguinal hernia is a very common problem. Surgical repair is the current approach, whereas asymptomatic or minimally symptomatic hernias may be good candidate for watchful waiting. Prophylactic antibiotics can be used in centers with high rate of wound infection. Local anesthesia is a suitable and economic option for open repairs, and should be popularized in day-case setting. Numerous repair methods have been described to date. Mesh repairs are superior to "nonmesh" tissue-suture repairs. Lichtenstein repair and endoscopic/laparoscopic techniques have similar efficacy. Standard polypropylene mesh is still the choice, whereas use of partially absorbable lightweight meshes seems to have some advantages. PMID:22435019

Kulacoglu, H

2011-07-01

442

Current options in inguinal hernia repair in adult patients  

PubMed Central

Inguinal hernia is a very common problem. Surgical repair is the current approach, whereas asymptomatic or minimally symptomatic hernias may be good candidate for watchful waiting. Prophylactic antibiotics can be used in centers with high rate of wound infection. Local anesthesia is a suitable and economic option for open repairs, and should be popularized in day-case setting. Numerous repair methods have been described to date. Mesh repairs are superior to "nonmesh" tissue-suture repairs. Lichtenstein repair and endoscopic/laparoscopic techniques have similar efficacy. Standard polypropylene mesh is still the choice, whereas use of partially absorbable lightweight meshes seems to have some advantages. PMID:22435019

Kulacoglu, H

2011-01-01

443

Chromatin Remodeling, DNA Damage Repair and Aging  

PubMed Central

Cells are constantly exposed to a variety of environmental and endogenous conditions causing DNA damage, which is detected and repaired by conserved DNA repair pathways to maintain genomic integrity. Chromatin remodeling is critical in this process, as the organization of eukaryotic DNA into compact chromatin presents a natural barrier to all DNA-related events. Studies on human premature aging syndromes together with normal aging have suggested that accumulated damages might lead to exhaustion of resources that are required for physiological functions and thus accelerate aging. In this manuscript, combining the present understandings and latest findings, we focus mainly on discussing the role of chromatin remodeling in the repair of DNA double-strand breaks (DSBs) and regulation of aging. PMID:23633913

Liu, Baohua; Yip, Raymond KH; Zhou, Zhongjun

2012-01-01

444

Thoracic endovascular aortic repair: the basics.  

PubMed

Endografting for the treatment of thoracic aortic pathology continues to gain popularity; in some countries, numbers of endovascular aortic repairs now exceed those of open surgical cases. The skills and understanding of open surgical teams are not always translated into endovascular intervention teams, which may be led by cardiologists or vascular surgeons with little knowledge of thoracic pathology. Our experience with more than 400 thoracic interventional cases leads us to believe that that the cardiovascular surgeon is crucial to the success of any thoracic endovascular aortic repair program. Experienced surgeons should be involved in preoperative planning of cases, assessment of access vessels, creation of landing zones with revascularization procedures, passage of stents through the thoracic aorta, and protection of the spinal cord. In addition, surgeons should be familiar with the most common complications of thoracic endovascular aortic repair and be able to use both open surgical and endovascular strategies for complication management. PMID:23410772

Cheshire, Nick; Bicknell, Colin

2013-03-01

445

Learning to improve iterative repair scheduling  

NASA Technical Reports Server (NTRS)

This paper presents a general learning method for dynamically selecting between repair heuristics in an iterative repair scheduling system. The system employs a version of explanation-based learning called Plausible Explanation-Based Learning (PEBL) that uses multiple examples to confirm conjectured explanations. The basic approach is to conjecture contradictions between a heuristic and statistics that measure the quality of the heuristic. When these contradictions are confirmed, a different heuristic is selected. To motivate the utility of this approach we present an empirical evaluation of the performance of a scheduling system with respect to two different repair strategies. We show that the scheduler that learns to choose between the heuristics outperforms the same scheduler with any one of two heuristics alone.

Zweben, Monte; Davis, Eugene

1992-01-01

446

Richter's hernia after an intraperitoneal mesh repair.  

PubMed

For ventral hernia repair, laparoscopic surgery offers various advantages, including the application of a large mesh using the intraperitoneal approach. However, improper closure of the port site may lead to serious complications. Port-site hernia is a rare outcome of inadequate repair of the fascial or peritoneal layer, and Richter's hernia in a high risk patient, in the presence of an intraperitoneal mesh, is a particularly challenging scenario. Herein, we present a 58-year-old woman who, after a ventral hernia repair, was diagnosed with a small bowel hernia through a 10-mm port site. The patient complained of pain and mild swelling at the port site in the postoperative period, and her symptoms indicated intestinal obstruction. Clinical evaluation and abdominal X-ray confirmed the diagnosis, and early laparoscopic re-exploration and management were the key to a favorable outcome. PMID:25354381

Pandey, Anshuman; Masood, Shakeel; Goel, Vijay Kumar; Gupta, Amit Kumar

2014-11-01

447

Alkylation damage repair in mammalian genomes  

SciTech Connect

The repair of O{sup 6} -alkylguanine in DNA involves only O{sup 6} -methyltransferase (MGMT) while the repair of N-alkylpurines requires multiple proteins including N-methylpurine-DNA glycosylase (MPG). While the biochemical properties human and mouse MGMTs are very similar, the mouse MPG removes 7-methylguanine more efficiently than the human protein. An increased level of MGMT, without a change in the level of MPG associated with gene amplification, was observed in a mouse cell line resistant to 2-chloroethyl-N-nitrosourea. In contrast, no correlation was observed between MPG level and resistance to methyl methanesulfonate in Chinese hamster ovary (CHO) cells. This result suggests a protein other than MPG limits the repair rate of N-alkylpurine in CHO cells.

Mitra, S.; Roy, R.; Kim, N.K. [Texas Univ. Medical Branch, Galveston, TX (United States). Sealy Center for Molecular Science]|[Oak Ridge National Lab., TN (United States); Tano, K. [Banyu Pharmaceutical Co. Research Inst., Tsukuba (Japan)]|[Oak Ridge National Lab., TN (United States); Ibeanu, G.C. [NIEHS, Research Triangle, NC (United States)]|[Oak Ridge National Lab., TN (United States); Dunn, W.C. [Oak Ridge National Lab., TN (United States); Natarajan, A.T. [Leiden Univ. (Netherlands). Sylvius Labs.; Hartenstein, B.; Kaina, B. [Kernforschungszentrum Karlsruhe GmbH (Germany). Inst. fuer Genetik und Toxikologie

1992-11-01

448

Alkylation damage repair in mammalian genomes  

SciTech Connect

The repair of O{sup 6} -alkylguanine in DNA involves only O{sup 6} -methyltransferase (MGMT) while the repair of N-alkylpurines requires multiple proteins including N-methylpurine-DNA glycosylase (MPG). While the biochemical properties human and mouse MGMTs are very similar, the mouse MPG removes 7-methylguanine more efficiently than the human protein. An increased level of MGMT, without a change in the level of MPG associated with gene amplification, was observed in a mouse cell line resistant to 2-chloroethyl-N-nitrosourea. In contrast, no correlation was observed between MPG level and resistance to methyl methanesulfonate in Chinese hamster ovary (CHO) cells. This result suggests a protein other than MPG limits the repair rate of N-alkylpurine in CHO cells.

Mitra, S.; Roy, R.; Kim, N.K. (Texas Univ. Medical Branch, Galveston, TX (United States). Sealy Center for Molecular Science Oak Ridge National Lab., TN (United States)); Tano, K. (Banyu Pharmaceutical Co. Research Inst., Tsukuba (Japan) Oak Ridge National Lab., TN (United States)); Ibeanu, G.C. (NIEHS, Research Triangle, NC (United States) Oak Ridge National Lab., TN (United States)); Dunn, W.C. (

1992-01-01

449

The tether inspection and repair experiment (TIRE)  

NASA Technical Reports Server (NTRS)

The successful development and deployment of reusable tethers for space applications will require methods for detecting, locating, and repairing damage to the tether. This requirement becomes especially important whenever the safety of the STS or the Space Station may be diminished or when critical supplies or systems would be lost in the event of a tether failure. A joint NASA/PSN study endeavor has recently been initiated to evaluate and address the problems to be solved for such an undertaking. The objectives of the Tether Inspection and Repair Experiment (TIRE) are to develop instrumentation and repair technology for specific classes of tethers defined as standards, and to demonstrate the technologies in ground-based and in-flight testing on the STS.

Wood, George M.; Loria, Alberto; Harrison, James K.

1988-01-01

450

Results of open thoracoabdominal aortic aneurysm repair  

PubMed Central

Background Open surgical repair of thoracoabdominal aortic aneurysms (TAAAs) enables the effective replacement of the diseased aortic segment and reliably prevents aneurysm rupture. However, these operations also carry substantial risk of perioperative morbidity and mortality, principally caused by the associated ischemic insult involving the spinal cord, kidneys, and other abdominal viscera. Here, we describe the early outcomes of a contemporary series of open TAAA repairs. Methods We reviewed the outcomes of 823 open TAAA repairs performed between January 2005 and May 2012. Of these, 209 (25.4%) were Crawford extent I repairs, 264 (32.1%) were extent II, 157 (19.1%) were extent III, and 193 (23.5%) were extent IV. Aortic dissection was present in 350 (42.5%) cases, and aneurysm rupture was present in 37 (4.5%). Adjuncts used during the procedures included cerebrospinal fluid drainage in 639 (77.6%) cases, left heart bypass in 430 (52.2%), and cold renal perfusion in 674 (81.9%). Results The composite endpoint, adverse outcome—defined as operative death, renal failure that necessitated dialysis at discharge, stroke, or permanent paraplegia or paraparesis—occurred after 131 (15.9%) procedures. There were 69 (8.4%) operative deaths. Permanent paraplegia or paraparesis occurred after 42 (5.1%) cases, stroke occurred after 27 (3.3%), and renal failure necessitating permanent dialysis occurred after 45 (5.5%). Conclusions Although open surgical repair of the thoracoabdominal aorta can be life-saving to patients at risk for fatal aneurysm rupture, these operations remain challenging and are associated with substantial risk of early death and major complications. Additional improvements are needed to further reduce the risks associated with TAAA repair, particularly as increasing numbers of patients with advanced age and multiple or severe comorbidities present for treatment. PMID:23977510

Price, Matt D.; Green, Susan Y.; Zarda, Samantha; Coselli, Joseph S.

2012-01-01

451

Mini-mesh repair for femoral hernia  

PubMed Central

INTRODUCTION Femoral hernia consists only 4% of all primary groin hernias. It is described as “the Bête Noire of Hernias” because of its nature and anatomy which is difficult to understand for the surgeons and tendency to recurrence. Although there is some large series of femoral hernia in the literature, few studies prospectively comparing repair techniques especially for this type of hernia has been published. A new technique named mini-mesh repair is described here. PRESENTATION OF CASE After hernia sac is dissected completely and sent back into the preperitoneal space, femoral canal is exposed. A round or oval shaped patch is prepared in 1.5–2.5 cm in diameter according to the size of the femoral canal. Mesh is secured to the Cooper's ligament with 2/0 polypropylene suture. Eight femoral hernias in 8 patients were repaired with this new technique. Patient satisfaction is very good. One seroma and one limited ecchymosis were recorded. No recurrence was observed in a mean follow-up of 22.4 months. No chronic pain was recorded. DISCUSSION Many techniques for femoral hernia repair have been described to date with a variety of clinical outcomes. Each technique has its own advantages and disadvantages. Mesh repairs without tension seems to be better choices. When the transversalis fascia is healthy and strong in a patient with femoral hernia a large piece of mesh may be unnecessary. The simple technique described in this paper can be a good alternative. It is totally problem-oriented, and the burden of prosthetic material is very limited. CONCLUSION Mini mesh repair may be a good solution for selected patients with femoral hernia. PMID:25105770

Kulacoglu, Hakan

2014-01-01

452

Single Incision Laparoscopic Ventral Hernia Repair  

PubMed Central

Background and Objectives: Laparoscopic ventral hernia repair (LVH) requires several skin incisions for trocar placement. We have developed a single incision approach to LVH repair. The technique was introduced in clinical practice to any consenting patients who were candidates for a standard multi-port laparoscopic hernia repair. A consecutive series of patients was then followed to evaluate feasibility. Methods: Over an 8-month period, 14 patients (9 females, 5 males) underwent LVH repair by an academic surgeon. One of 2 access methods was used in each patient through a single 1.5-cm to 2-cm skin incision. One technique utilized two 5-mm ports with a temporarily placed 11-mm port for mesh insertion. The second technique utilized the SILS port (Covidien, Norwalk, CT). Standard or roticulating laparoscopic instruments were used with both techniques. Results: Range (mean) BMI: 23 to 59 (38), Age: 26 to 73 years (53), Duration: 37 to 87 minutes (57), Defect size: 1cm to 8cm (2), 3 with Swiss-cheese defect hernias. The procedure was successfully performed in all patients. No conversions to a multiple-port approach or to an open procedure were necessary. There were no mortalities, major complications, or recurrences during the mean follow-up period of 4 weeks. Conclusion: Single incision ventral hernia repair is technically feasible, effective, and reproducible. The technique is easy to master, and safe for any patient who is a candidate for laparoscopic ventral hernia repair. Further data collection with long-term follow-up will be needed to ensure equivalent outcomes. There will be demand for this approach by patients for cosmetic reasons, and it may serve as a bridge to natural orifice techniques. PMID:21902968

Love, Katie M.

2011-01-01

453

Laparoscopic hernia repair: a preliminary report.  

PubMed

Advances in laparoscopic technique have provided the opportunity to perform preperitoneal herniorrhaphy and potentially avoid the morbidity associated with open techniques. From January 1991 to May 1992, two primary surgeons repaired 63 inguinal hernias (42 indirect, 20 direct, 1 femoral) on 48 patients using a standardized laparoscopic technique. The hernia defect was visualized laparoscopically, and the peritoneum anterior to the defect was incised. The hernia sac was dissected from the inguinal canal. The hernia defect was then loosely packed with rolled 1 x 6-inch polypropylene mesh (average number of rolls used was 3.4). A sheet of polypropylene mesh (average 5 x 8 cm) was then placed over the mesh rolls and the hernia defect and anchored with an endostapler. The peritoneum was closed over the mesh sheet with standard laparoscopic clips. There were 44 males and 4 females in the study group. The mean age was 55 years (range, 17-89 years). The mean follow-up was 5.8 months (range, 1-12 months). Thirty-three patients underwent unilateral hernia repair, and 15 patients underwent bilateral hernia repair. Clinically unsuspected contralateral hernias were identified at the time of laparoscopy in seven patients. The mean duration of surgery was 118 minutes (range, 80-165 minutes) for bilateral hernia repair, and 70 minutes (range, 45-100 minutes) for unilateral hernia repair. All patients with laparoscopic hernia repairs were treated on a same-day or less-than-24-hour in-hospital stay. Complications were designated as minor, moderate, or severe. There were 14 minor complications, which included subcutaneous hematomas at the trocar site, scrotal ecchymosis, groin swelling emphysema, and testicular asymmetry.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:8476147

Sailors, D M; Layman, T S; Burns, R P; Chandler, K E; Russell, W L

1993-02-01

454

Treatment of unfavourable results of flexor tendon surgery: Ruptured repairs, tethered repairs and pulley incompetence  

PubMed Central

As primary repair of divided flexor tendons becomes more common, secondary tendon surgery becomes largely that of the complications of primary repair, namely ruptured and adherent repairs. These occur with an incidence of each in most reported series world-wide of around 5%, with these problems having changed little in the last two decades, despite strengthening our suture