Sample records for arthroscopic graftjacket repair

  1. Revision of Failed Arthroscopic Bankart Repairs

    Microsoft Academic Search

    Domenick J. Sisto

    2007-01-01

    Background: The results following open revision surgery following a failed arthroscopic Bankart procedure are not well documented.Purpose: To evaluate the results of patients with a failed arthroscopic Bankart repair treated with a traditional, open Bankart repair.Study Design: Case series; Level of evidence, 4.Methods: Thirty patients (28 male and 2 female) who had a mean age of 24 years (range 15-36)

  2. Arthroscopic quadriceps tendon repair: two case reports.

    PubMed

    Saito, Hidetomo; Shimada, Yoichi; Yamamura, Toshiaki; Yamada, Shin; Sato, Takahiro; Nozaka, Koji; Kijima, Hiroaki; Saito, Kimio

    2015-01-01

    Recently, although some studies of open repair of the tendon of the quadriceps femoris have been published, there have been no reports in the literature on primary arthroscopic repair. In our present study, we present two cases of quadriceps tendon injury arthroscopically repaired with excellent results. Case 1 involved a 68-year-old man who was injured while shifting his weight to prevent a fall. MRI showed complete rupture at the insertion of the patella of the quadriceps tendon. The rupture was arthroscopically repaired using both suture anchor and pull-out suture fixation methods via bone tunnels (hereafter, pull-out fixation). Two years after surgery, retearing was not observed on MRI and both Japan Orthopedic Association (JOA) Knee and Lysholm scores had recovered to 100. Case 2 involved a 50-year-old man who was also injured when shifting his weight to prevent a fall. MRI showed incomplete superficial rupture at the insertion of the patella of the quadriceps tendon. The rupture was arthroscopically repaired using pull-out fixation of six strand sutures. One year after surgery, MRI revealed a healed tendon and his JOA and Lysholm scores were 95 and 100, respectively. Thus, arthroscopic repair may be a useful surgical method for repairing quadriceps tendon injury. PMID:25815224

  3. Arthroscopic Quadriceps Tendon Repair: Two Case Reports

    PubMed Central

    Saito, Hidetomo; Shimada, Yoichi; Yamamura, Toshiaki; Yamada, Shin; Sato, Takahiro; Nozaka, Koji; Kijima, Hiroaki; Saito, Kimio

    2015-01-01

    Recently, although some studies of open repair of the tendon of the quadriceps femoris have been published, there have been no reports in the literature on primary arthroscopic repair. In our present study, we present two cases of quadriceps tendon injury arthroscopically repaired with excellent results. Case 1 involved a 68-year-old man who was injured while shifting his weight to prevent a fall. MRI showed complete rupture at the insertion of the patella of the quadriceps tendon. The rupture was arthroscopically repaired using both suture anchor and pull-out suture fixation methods via bone tunnels (hereafter, pull-out fixation). Two years after surgery, retearing was not observed on MRI and both Japan Orthopedic Association (JOA) Knee and Lysholm scores had recovered to 100. Case 2 involved a 50-year-old man who was also injured when shifting his weight to prevent a fall. MRI showed incomplete superficial rupture at the insertion of the patella of the quadriceps tendon. The rupture was arthroscopically repaired using pull-out fixation of six strand sutures. One year after surgery, MRI revealed a healed tendon and his JOA and Lysholm scores were 95 and 100, respectively. Thus, arthroscopic repair may be a useful surgical method for repairing quadriceps tendon injury. PMID:25815224

  4. Open versus Two Forms of Arthroscopic Rotator Cuff Repair

    PubMed Central

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

    2009-01-01

    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

  5. Complications associated with arthroscopic rotator cuff repair: a literature review.

    PubMed

    Randelli, P; Spennacchio, P; Ragone, V; Arrigoni, P; Casella, A; Cabitza, P

    2012-06-01

    The aim of this literature review was to report complications associated with arthroscopic rotator cuff repair (RCR). A computerized search of articles published between 200 and 2009 was performed using MEDLINE and PubMed. We included clinical studies (Level 1-4): (a) investigating patients with rotator cuff tears, managed by a completely arthroscopic RCR technique; (b) reported data about complications. Data about arthroscopic-assisted techniques were excluded. Articles that meet criteria inclusion were analytically examined. Complications were classified into general complications and specific complications related to arthroscopic RCR. We found 414 complications in 2,890 patients; most of them were specific complications related to arthroscopic RCR. Re-rupture was the most frequently encountered complication: re-tear rate ranged between 11.4 and 94%. Stiffness and hardware-related complications were observed in 74 and 12 patients, respectively. Eleven less common complications were also reported: 5 neurovascular, 3 septic, 2 thromboembolic events, and 1 anesthesiological complication. This review stated that arthroscopic RCR is a low-risk surgical procedure. Anatomical failure of the repair is the most common complication encountered in the literature. PMID:22205384

  6. Arthroscopic Repair of Rotator Cuff Tears Using Extracellular Matrix Graft

    PubMed Central

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

    2014-01-01

    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. PMID:25276607

  7. The Factors Affecting Pain Pattern after Arthroscopic Rotator Cuff Repair

    PubMed Central

    Kim, Chang-Wan; Kim, Dong-Gyun

    2014-01-01

    Background We evaluated the factors that affect pain pattern after arthroscopic rotator cuff repair. Methods From June 2009 to October 2010, 210 patients underwent arthroscopic rotator cuff repair operations. Of them, 84 patients were enrolled as subjects of the present study. The evaluation of postoperative pain was conducted by visual analog scale (VAS) scores during postoperative outpatient interviews at 6 weeks, 3 months, 6 months, and 12 months. The factors that were thought to affect postoperative pain were evaluated by dividing into three categories: preoperative, operative, and postoperative. Results Pain after arthroscopic rotator cuff repair surgery showed a strictly decreasing pain pattern. In single analysis and multiple regression tests for factors influencing the strictly decreasing pain pattern, initial VAS and pain onset were shown to be statistically significant factors (p = 0.012, 0.012, 0.044 and 0.028, respectively). With regard to the factors influencing lower than average intensity pain pattern for each period, the stiffness of internal rotation at 3 months postoperatively was shown to be a statistically significant factor in single and multiple regression tests (p = 0.017 and p = 0.004, respectively). Conclusions High initial VAS scores and the acute onset of pain affected the strictly decreasing postoperative pain pattern. Additionally, stiffness of internal rotation at postoperative 3 months affected the higher than average intensity pain pattern for each period after arthroscopic rotator cuff repair. PMID:25436062

  8. Arthroscopic transglenoid suture repair for initial anterior shoulder dislocation

    Microsoft Academic Search

    Harald Boszotta; Walther Helperstorfer

    2000-01-01

    Purpose: To evaluate the long-term results after arthroscopic transglenoid suture repair for initial anterior shoulder dislocation. Type of Study: Outcome study. Materials and Methods: Selection for surgery was based on the sporting ambitions of the patients and the documentation of instability. Evidence of instability included the sonographic documentation of ventral drawer compared with the unaffected opposite shoulder as well as

  9. Dual-camera technique for arthroscopic rotator cuff repair.

    PubMed

    Tuttle, John R; Ramos, Paul; DaSilva, Manuel F

    2014-12-01

    An all-arthroscopic rotator cuff repair demands a high level of technical skill and is associated with a steep learning curve. It is well accepted that small rotator cuff tears or partial tears can be more difficult than large or even massive tears to repair. Part of the reason is the difficulty in visualizing the tear, as well as important surrounding structures, during repair. To improve visibility during the repair process, we have introduced a second arthroscopic camera. Two cameras allow the surgeon to observe the rotator cuff from both the articular and bursal sides. We find this technique has merit in small or partial-thickness rotator cuff tears; however, there may be other applications. PMID:25685668

  10. Dual-Camera Technique for Arthroscopic Rotator Cuff Repair

    PubMed Central

    Tuttle, John R.; Ramos, Paul; DaSilva, Manuel F.

    2014-01-01

    An all-arthroscopic rotator cuff repair demands a high level of technical skill and is associated with a steep learning curve. It is well accepted that small rotator cuff tears or partial tears can be more difficult than large or even massive tears to repair. Part of the reason is the difficulty in visualizing the tear, as well as important surrounding structures, during repair. To improve visibility during the repair process, we have introduced a second arthroscopic camera. Two cameras allow the surgeon to observe the rotator cuff from both the articular and bursal sides. We find this technique has merit in small or partial-thickness rotator cuff tears; however, there may be other applications. PMID:25685668

  11. Arthroscopic Saucerization and Repair of Discoid Lateral Meniscal Tear

    PubMed Central

    Fields, Logan K.; Caldwell, Paul E.

    2015-01-01

    Meniscal tears are among the most commonly diagnosed knee injuries and often require surgical intervention. Understanding the types of meniscal tears and treatment options is paramount to caring for the young athlete. Sports medicine and arthroscopic physicians now recognize that meniscal preservation in the young athlete is essential to the long-term health and function of the knee. Although uncommon, the discoid lateral meniscus is more prone to injury because of its increased thickness and lack of blood supply. Because of the abnormal development, the peripheral attachments are frequently absent and instability often persists after a partial meniscectomy. If the instability is unrecognized during the initial treatment, a recurrence of pain and mechanical symptoms is likely and a subsequent subtotal meniscectomy may be the only treatment option. With increased awareness, arthroscopic saucerization accompanied by arthroscopically assisted inside-out meniscal repair is a preferable treatment option with an excellent outcome. PMID:26052498

  12. The frequency of subscapularis tears in arthroscopic rotator cuff repairs: A retrospective study comparing magnetic resonance imaging and arthroscopic findings

    PubMed Central

    Garavaglia, Guido; Ufenast, Henri; Taverna, Ettore

    2011-01-01

    Purpose: With the advent of arthroscopic shoulder surgery the comprehension and description of rotator cuff tears have strongly evolved. Subscapularis tears are difficult to recognize and are underestimated. Our purpose is to report our observations concerning the relative frequency of subscapularis tears in patients undergoing arthroscopic rotator cuff repair and to compare the arthroscopic observations with the magnetic resonance imaging (MRI) findings. Materials and Methods: Retrospective cohort study including all patients undergoing arthroscopic rotator cuff repair was performed between March 2006 and March 2009 at our institution. Preoperative MRI findings, intraoperative arthroscopic findings, and details of surgical intervention were collected using medical charts. Results: We reviewed the medical charts of a total of 348 consecutive arthroscopic rotator cuff repairs. There were 311 supraspinatus tears (89%), 48 infraspinatus tears (14%), and 129 subscapularis tears (37%). MRI sensitivity and specificity were respectively 0.25 and 0.98 for subscapularis tendon tears, 0.67 and 1.0 for supraspinatus tears and 0.5 and 0.99 for infraspinatus tears. Conclusion: Subscapularis tears are frequent lesions and usually appear concomitantly with supra or infraspinatus lesions. We propose a classification of subscapularis tendon tears, based on our observations of the pathoanatomy of the tears. While concordance with MRI results are good for the supraspinatus, MRI often fails to diagnose the presence of subscapularis tears and infraspinatus tears PMID:22223958

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

    Microsoft Academic Search

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

    2010-01-01

    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

  14. Open Bankart Repair Versus Arthroscopic Repair with Transglenoid Sutures or Bioabsorbable Tacks for Recurrent Anterior Instability of the ShoulderA Meta-analysis

    Microsoft Academic Search

    Kevin B. Freedman; Adam P. Smith; Anthony A. Romeo; Brian J. Cole; Bernard R. Bach

    2004-01-01

    Background: In published comparative studies, it remains unknown if arthroscopic techniques for performing Bankart repair for anterior shoulder instability equal the success of open repair.Hypothesis: The current literature supports a lower rate of recurrent instability after open Bankart repair compared to arthro-scopic repair with bioabsorbable tacks or transglenoid sutures.Study Design: Meta-analysis.Methods: A Medline search identified all randomized controlled trials or

  15. Quantification of active ROM after arthroscopic Bankart repair with rotator interval closure.

    PubMed

    Randelli, Pietro; Arrigoni, Paolo; Polli, Luca; Cabitza, Paolo; Denti, Matteo

    2009-06-01

    Several series report patients homogeneously treated using arthroscopic Bankart repair exclusively, or in some cases arthroscopic Bankart repair with rotator interval closure. Current international literature has few reports on arthroscopic Bankart repair with rotator interval closure procedures undertaken on a homogeneous series of patients. The purpose of this study was to evaluate the residual active range of motion (ROM) and clinical outcome in this patient population. Fourteen patients affected by recurrent anterior instability were consecutively treated. Rowe, Walch-Duplay, and UCLA scores, as well as differences in active ROM of both shoulders (treated and contralateral), were recorded. A significant reduction in active external rotation was noted along the side of the arm (P<.001) and at 90 degrees of abduction (P=.007). The average reduction was 12.14 degrees and 7.21 degrees, respectively, which represents 17.8% and 8% of the arc of motion of the opposite side in external rotation. No significant differences were found for flexion, abduction, and internal rotation. According to Walch-Duplay and Rowe scores, 71.4% and 85.7% of patients had excellent or good results. Arthroscopic Bankart repair with rotator interval closure results in a reduction of external rotation and provides satisfactory stability results. PMID:19634824

  16. The use of the supraclavicular fossa portal in arthroscopic rotator cuff repair

    Microsoft Academic Search

    William J. Ciccone; John W. Miles; Sang-Jin Cheon; Stephen Ash; James Esch; James Tasto

    2000-01-01

    Advances in arthroscopic technology allow rotator cuff repair through a minimally invasive approach. However, fixation of the rotator cuff tendon to suture anchors can be tedious and time consuming. The supraclavicular fossa portal allows improved access to the tear for passing suture. The authors describe the relevant anatomy, positioning, and surgical technique for use of the supraclavicular fossa portal to

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

    PubMed

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

    2013-01-01

    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

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

    PubMed Central

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

    2013-01-01

    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

  19. Functional evaluation of patient after arthroscopic repair of rotator cuff tear

    PubMed Central

    Kumar, Rohit; Jadhav, Umesh

    2014-01-01

    Background Rotator cuff tear is a common problem either after trauma or after degenerative tear in old age group. Arthroscopic repair is the current concept of rotator cuff repair. Here, we are trying to evaluate the functional outcome after arthroscopic repair of full thickness rotator cuff tear (single row) in Indian population. Materials and methods Twenty five patients (14 males and 11 females) who underwent arthroscopic repair of full thickness rotator cuff tear at a single institution were included in the study. Postoperatively patient's shoulder was rated according to UCLA score, pain was graded according to the visual analog score. The range of motion was analysed and documented. Results The mean age of the patients were 50.48 years. The preoperative VAS score mode was 7 and post operative VAS was 1 (p value <0.001). The UCLA grading was good in 80% (n = 20), fair in 12% (n = 3), excellent in 8% (n = 2) and poor results were seen in none of the patients. The mean UCLA improved from a score of 15.84 to 30.28 with a p value <0.001. Mean postoperative forward flexion was 161.6°, mean abduction was 147.6° and mean external rotation was 45.4°. Conclusion Arthroscopic repair is a good procedure for full thickness rotator cuff tear with minimal complications. The newer double row repair claims to be biomechanically superior with faster healing rates without functional advantages, hence we used a single row repair considering the Indian population and the cost effectiveness of the surgery with good to excellent results. PMID:25983476

  20. Subacromial pain pump use is safe after arthroscopic rotator cuff repair

    PubMed Central

    Busfield, Benjamin T.; Romero, Denise M.; Korshad, Daniel; Kharrazi, F. Daniel

    2014-01-01

    Background Intra-articular pain pumps with local anesthetics have been implicated as a potential cause of post-arthroscopic glenohumeral chondrolysis (PAGCL) of the shoulder. In short-term studies, subacromial pain pump use is effective and safe without association with PAGCL. Patients with full thickness rotator cuff tears may be at high risk of PAGCL given disruption of the tendinous integrity which may allow intra-articular infusion of local anesthetics. We hypothesized that subacromial pain pump use after arthroscopic rotator cuff repair would not result in PAGCL. Methods We analyzed a consecutive series of 34 patients treated with subacromial pain pump placement after arthroscopic rotator cuff repair and subacromial decompression for full thickness rotator cuff tears. Thirty patients met inclusion criteria of greater than 12-month follow-up with an average age of 51 (28–68). All patients had the subacromial pain pumps placed under arthroscopic visualization and infused 0.25% bupivacaine without epinephrine at 2 cc/h for 48 h. All patients had clinical examinations and radiographic studies performed more than 1 year after surgery. Results Patients had an average rotator cuff size of 1.6 cm and fixation was performed with bioabsorbable suture anchors. All patients had at least 150° of abduction and forward flexion at latest follow-up without palpable crepitus and no patients had any evidence of joint space narrowing on post-operative radiographs. Conclusion Subacromial pain pump use after arthroscopic rotator cuff repair is safe. Despite probable lack of a water-tight seal from repair, there were no cases of PAGCL. Level of evidence IV. PMID:25104887

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

    PubMed Central

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

    2009-01-01

    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

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

    PubMed

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

    2010-12-01

    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

  3. Arthroscopic Broström repair with Gould augmentation via an accessory anterolateral port for lateral instability of the ankle.

    PubMed

    Matsui, Kentaro; Takao, Masato; Miyamoto, Wataru; Innami, Ken; Matsushita, Takashi

    2014-10-01

    Although several arthroscopic surgical techniques for the treatment of lateral instability of the ankle have been introduced recently, some concern remains over their procedural complexity, complications, and unclear clinical outcomes. We have simplified the arthroscopic technique of Broström repair with Gould augmentation. This technique requires only two small skin incisions for two ports (medial midline and accessory anterolateral ports), without needing a percutaneous procedure or extension of the skin incisions. The anterior talofibular ligament is reattached to its anatomical footprint on the fibula with suture anchor, under arthroscopic view. The inferior extensor retinaculum is directly visualized through the accessory anterolateral port and is attached to the fibula with another suture anchor under arthroscopic view via the anterolateral port. The use of two small ports offers a procedure that is simple to perform and less morbid for patients. PMID:25015792

  4. Single-Versus Double-Row Arthroscopic Rotator Cuff Repair in Massive Tears

    PubMed Central

    Wang, EnZhi; Wang, Liang; Gao, Peng; Li, ZhongJi; Zhou, Xiao; Wang, SongGang

    2015-01-01

    Background It is a challenge for orthopaedic surgeons to treat massive rotator cuff tears. The optimal management of massive rotator cuff tears remains controversial. Therefore, the goal of this study was to compare arthroscopic single- versus double-row rotator cuff repair with a larger sample size. Material/Methods Of the subjects with massive rotator cuff tears, 146 were treated using single-row repair, and 102 were treated using double-row repair. Pre- and postoperative functional outcomes and radiographic images were collected. The clinical outcomes were evaluated for a minimum of 2 years. Results No significant differences were shown between the groups in terms of functional outcomes. Regarding the integrity of the tendon, a lower rate of post-treatment retear was observed in patients who underwent double-row repair compared with single-row repair. Conclusions The results suggest that double-row repair is relatively superior in shoulder ROM and the strength of tendon compared with single-row repair. Future studies involving more patients in better-designed randomized controlled trials will be required. PMID:26017641

  5. Clinical and Radiological Evaluation after Arthroscopic Rotator Cuff Repair Using Suture Bridge Technique

    PubMed Central

    Lee, Kwang Won; Bae, Kyoung Wan; Choy, Won Sik

    2013-01-01

    Background We retrospectively assessed the clinical outcomes and investigated risk factors influencing retear after arthroscopic suture bridge repair technique for rotator cuff tear through clinical assessment and magnetic resonance arthrography (MRA). Methods Between January 2008 and April 2011, sixty-two cases of full-thickness rotator cuff tear were treated with arthroscopic suture bridge repair technique and follow-up MRA were performed. The mean age was 56.1 years, and mean follow-up period was 27.4 months. Clinical and functional outcomes were assessed using range of motion, Korean shoulder score, Constant score, and UCLA score. Radiological outcome was evaluated with preoperative and follow-up MRA. Potential predictive factors that influenced cuff retear, such as age, gender, geometric patterns of tear, size of cuff tear, acromioplasty, fatty degeneration, atrophy of cuff muscle, retraction of supraspinatus, involved muscles of cuff and osteolysis around the suture anchor were evaluated. Results Thirty cases (48.4%) revealed retear on MRA. In univariable analysis, retear was significantly more frequent in over 60 years age group (62.5%) than under 60 years age group (39.5%; p = 0.043), and also in medium to large-sized tear than small-sized tear (p = 0.003). There was significant difference in geometric pattern of tear (p = 0.015). In multivariable analysis, only age (p = 0.036) and size of tear (p = 0.030) revealed a significant difference. The mean active range of motion for forward flexion, abduction, external rotation at the side and internal rotation at the side were significantly improved at follow-up (p < 0.05). The mean Korean shoulder score, Constant score, and UCLA score increased significantly at follow-up (p < 0.01). The range of motion, Korean shoulder score, Constant score, and UCLA score did not differ significantly between the groups with retear and intact repairs (p > 0.05). The locations of retear were insertion site in 10 cases (33.3%) and musculotendinous junction in 20 cases (66.7%; p = 0.006). Conclusions Suture bridge repair technique for rotator cuff tear showed improved clinical results. Cuff integrity after repair did not affect clinical results. Age of over 60 years and size of cuff tear larger than 1 cm were factors influencing rotator cuff retear after arthroscopic suture bridge repair technique. PMID:24340151

  6. Arthroscopic Meniscal Repair: “Modified Outside-In Technique”

    PubMed Central

    Keyhani, Sohrab; Abbasian, Mohammad Reza; Siatiri, Nasim; Sarvi, Ali; Kivi, Mohsen Mardani; Esmailiejah, Ali Akbar

    2015-01-01

    Background: Despite the introduction of different techniques for meniscal repair, no single procedure is superior in all situations. The new method for meniscal repair named “modified outside-in technique” aims to achieve higher primary fixation strength by an alternative suture technique as well as avoid disadvantages of outside-in, inside-out, and all-inside suture procedures. Additionally, the mid-term results of surgically treated patients with meniscal injuries by our new technique were evaluated. Methods: The current prospective study included 66 patients who underwent meniscal repair by the modified outside-in technique. The International Knee Documentation Committee (IKDC) Subjective Knee Evaluation Form was completed pre- and post-operatively. At final follow-up, Lysholm score was completed and patients were questioned about their return to previous sport activities. Clinical success was defined as lack of swelling and joint line tenderness, absence of locking, negative McMurray test and no need for meniscectomy. Patients’ satisfaction was evaluated using the visual analogue scale (VAS). Patients were followed for 26±1.7 months. Results: Clinical success was achieved in 61 patients (92.4%) and 5 candidates required meniscectomy (7.6%). IKDC Subjective Knee Evaluation Form score increased significantly from 54.2±12.7 preoperatively to 90.8±15.6 postoperatively (P<0.001). Lysholm score was excellent and good in 49 (80.3%) patients and fair in 12 (19.7%). Patients’ satisfaction averaged at 8.35±1 (6-10). Neurovascular injury, synovitis and other knot-related complications were not reported. Conclusions: The modified outside-in technique has satisfactory functional and clinical outcomes. We believe that this procedure is associated with better clinical and biomechanical results; however, complementary studies should be performed to draw a firm conclusion in this regard.

  7. Rehabilitation following arthroscopic rotator cuff repair: a review of current literature.

    PubMed

    Ross, David; Maerz, Tristan; Lynch, Jamie; Norris, Sarah; Baker, Kevin; Anderson, Kyle

    2014-01-01

    Physical rehabilitation following arthroscopic rotator cuff repair has conventionally involved a 4- to 6-week period of immobilization; there are two schools of thought regarding activity level during this period. Some authors encourage early, more aggressive rehabilitation along with the use of a continuous passive motion device; others propose later, more conservative rehabilitation. Although some studies report trends in improved early range of motion, pain relief, and outcomes scores with aggressive rehabilitation following rotator cuff repair, no definitive consensus exists supporting a clinical difference resulting from rehabilitation timing in the early stages of healing. Rehabilitation timing does not affect outcomes after 6 to 12 months postoperatively. Given the lack of information regarding which patient groups benefit from aggressive rehabilitation, individualized patient care is warranted. PMID:24382874

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

    PubMed Central

    Denard, Patrick J.; Burkhart, Stephen S.

    2012-01-01

    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

  9. Arthroscopic assessment for patellar injuries and novel suture repair of patellar fracture in a cat.

    PubMed

    Cusack, Lara; Johnson, Matthew

    2013-01-01

    A 4 yr old spayed female domestic shorthair was evaluated for an acute, nonweight-bearing, left hind limb lameness. Following 2 wk of conservative management without clinical improvement, the patient was referred for further examination. The stifle was palpably enlarged with suspected periarticular fibrosis. Radiographs showed a lateral longitudinal patellar fracture as well as a medial patellar luxation. Arthroscopic examination of the stifle and repair of the patellar fracture and luxation were performed with an excellent clinical outcome. Nine weeks postoperatively, the owners reported that the cat was using the leg normally inside, and re-examination revealed no pain or crepitus with manipulation of the limb. To the authors' knowledge, this is the first reported use of arthroscopy as a diagnostic tool and of suture reduction for fracture repair in the management of feline patellar injury. PMID:23690486

  10. REHABILITATION AFTER ARTHROSCOPIC ROTATOR CUFF REPAIR: CURRENT CONCEPTS REVIEW AND EVIDENCE-BASED GUIDELINES

    PubMed Central

    Westgard, Paul; Chandler, Zachary; Gaskill, Trevor R.; Kokmeyer, Dirk; Millett, Peter J.

    2012-01-01

    Purpose: To provide an overview of the characteristics and timing of rotator cuff healing and provide an update on treatments used in rehabilitation of rotator cuff repairs. The authors' protocol of choice, used within a large sports medicine rehabilitation center, is presented and the rationale behind its implementation is discussed. Background: If initial nonsurgical treatment of a rotator cuff tear fails, surgical repair is often the next line of treatment. It is evident that a successful outcome after surgical rotator cuff repair is as much dependent on surgical technique as it is on rehabilitation. To this end, rehabilitation protocols have proven challenging to both the orthopaedic surgeon and the involved physical therapist. Instead of being based on scientific rationale, traditionally most rehabilitation protocols are solely based on clinical experience and expert opinion. Methods: A review of currently available literature on rehabilitation after arthroscopic rotator cuff tear repair on PUBMED / MEDLINE and EMBASE databases was performed to illustrate the available evidence behind various postoperative treatment modalities. Results: There is little high-level scientific evidence available to support or contest current postoperative rotator cuff rehabilitation protocols. Most existing protocols are based on clinical experience with modest incorporation of scientific data. Conclusion: Little scientific evidence is available to guide the timing of postsurgical rotator cuff rehabilitation. To this end, expert opinion and clinical experience remains a large facet of rehabilitation protocols. This review describes a rotator cuff rehabilitation protocol that incorporates currently available scientific literature guiding rehabilitation. PMID:22530194

  11. Arthroscopic Posterior Shoulder Stabilization With an Iliac Bone Graft and Capsular Repair: A Novel Technique

    PubMed Central

    Smith, Tomas; Goede, Fabian; Struck, Melena; Wellmann, Mathias

    2012-01-01

    Several surgical approaches have been described for the treatment of recurrent posterior shoulder instability. Many authors have performed posterior bone block procedures with good results not only in the presence of glenoid bone loss or dysplasia but also in the case of capsular hyperlaxity and poor soft-tissue quality. Open techniques often require an extensive approach with the disadvantage of a poor cosmetic result and possible insufficiency of the deltoid muscle. Furthermore, the treatment of concomitant pathologies and the correct placement of the bone graft are difficult. Therefore we describe an all-arthroscopic posterior shoulder stabilization technique with an iliac bone graft and capsular repair that is intended to improve the pre-existing open procedure. The key steps of the operation are the precise placement and screw fixation of the bone block at the posterior glenoid under arthroscopic control and the subsequent posterior capsular refixation and plication using 2 suture anchors to create an extra-articular graft position. PMID:23766993

  12. Rare coexistence of gouty and septic arthritis after arthroscopic rotator cuff repair: a case report

    PubMed Central

    Ichiseki, Toru; Ueda, Shusuke; Matsumoto, Tadami

    2015-01-01

    Coexistence of septic arthritis and gouty arthritis is rare. In particular, no reports have described the development of both gouty and septic arthritis after arthroscopic shoulder surgery. The patient was an 83-year-old man who underwent arthroscopic rotator cuff repair. He had a history of diabetes mellitus (HbA1c: 7.4%), but not of gout, and the GFR was decreased (GFR=46). During the postoperative course fever suddenly developed and joint fluid retention was found. Uric acid crystals were detected when the joint fluid was aspirated, after which when the culture results became available sepsis due to methicillin sensitive Staphylococcus aureus (MSSA) was diagnosed. On the 2nd day after fever onset, lavage and debridement were performed under arthroscopy, with the subsequent course uneventful with no recurrence of the infection or gouty arthritis and no joint destruction. When uric acid crystals are found in aspirated joint fluid, gouty arthritis tends to be diagnosed, but like in the present case if infection also supervenes, joint destruction and a poor general state may result if appropriate intervention is not initiated swiftly. Accordingly, even if uric acid crystals are found, the possibility of coexistence of septic arthritis and gouty arthritis should be kept in mind.

  13. Application of Pain Quantitative Analysis Device for Assessment of Postoperative Pain after Arthroscopic Rotator Cuff Repair

    PubMed Central

    Mifune, Yutaka; Inui, Atsuyuki; Nagura, Issei; Sakata, Ryosuke; Muto, Tomoyuki; Harada, Yoshifumi; Takase, Fumiaki; Kurosaka, Masahiro; Kokubu, Takeshi

    2015-01-01

    Purpose : The PainVision™ system was recently developed for quantitative pain assessment. Here, we used this system to evaluate the effect of plexus brachialis block on postoperative pain after arthroscopic rotator cuff repair. Methods : Fifty-five patients who underwent arthroscopic rotator cuff repair were included in this study. First 26 cases received no plexus brachialis block (control group), and the next 29 cases received the plexus brachialis block before surgery (block group). Patients completed the visual analog scale at 4, 8, 16, and 24 hours after surgery, and the intensity of postoperative pain was assessed with PainVision™ at 16 hours. The postoperative use of non-steroidal anti-inflammatory agents was also recorded. Results : The pain intensity at 16 hours after surgery assessed by PainVision™ was significantly lower in the block group than in the control group (block, 252.0 ± 47.8, control, 489.0 ± 89.1, P < 0.05). However, there were no differences in the VAS values at 16 hours between the 2 groups (block, 4.3 ± 0.6, control, 5.7 ± 0.4, P = N.S.). The pain intensity and VAS at 16 hours after surgery were highly correlated (r = 0.59, P = 0.006 in the block group and r = 0.62, P = 0.003 in the control group). The effect size of the assessment by PainVision™ was bigger than that of VAS (r=0.31 in VAS and 0.51 in Pain vision). Conclusion : The PainVision™ system could be useful to evaluate postoperative pain because it enables the quantification and comparison of pain intensity independent of individual pain thresholds.

  14. Arthroscopic Repair of “Peel-Off” Lesion of the Posterior Cruciate Ligament at the Femoral Condyle

    PubMed Central

    Rosso, Federica; Bisicchia, Salvatore; Amendola, Annunziato

    2014-01-01

    Posterior cruciate ligament (PCL) injuries are uncommon, and most occur in association with other lesions. The treatment of PCL injuries remains controversial; in addition, PCL injuries have been documented to have a propensity to heal. In the literature several different patterns of PCL injury have been described including midsubstance tears/injuries, tibial bony avulsions, femoral bony avulsions, and femoral “peel-off” injuries. A peel-off injury is a complete or incomplete soft-tissue disruption of the PCL at its femoral attachment site without associated bony avulsion. In recent years arthroscopic repair of femoral avulsion and peel-off lesions of the PCL has been reported. In most of these articles, a transosseous repair with sutures passed through 2 bone tunnels into the medial femoral condyle has been described. We present a case of a femoral PCL avulsion in a 20-year-old collegiate football player with an associated medial collateral ligament injury, and we report about a novel technique for PCL repair using 2 No. 2 FiberWire sutures and two 2.9-mm PushLock anchors (Arthrex) to secure tensioning the ligament at its footprint. PMID:24749037

  15. The "Labral Bridge": A Novel Technique for Arthroscopic Anatomic Knotless Bankart Repair.

    PubMed

    Ostermann, Roman C; Hofbauer, Marcus; Platzer, Patrick; Moen, Todd C

    2015-04-01

    Arthroscopic Bankart repair with suture anchors is widely considered a mainstay for surgical treatment of anterior shoulder instability after recurrent anterior shoulder dislocations. Traditionally, the displaced capsulolabral complex is restored and firmly attached to the glenoid by placing multiple suture anchors individually from a 5- to 3-o'clock position. A variety of different techniques using different anchor designs and materials have been described. Knotless anchors are widely used nowadays for shoulder instability repair, providing a fast and secure way of labral fixation with favorable long-term outcomes. However, these techniques result in a concentrated point load of the reduced labrum to the glenoid at each suture anchor. We describe a technique, developed by the first author, using a 1.5-mm LabralTape (Arthrex, Naples, FL) in combination with knotless suture anchors (3.5-mm PEEK [polyether ether ketone] PushLock anchors; Arthrex), for hybrid fixation of the labrum. The LabralTape is used to secure the torn labrum to the glenoid between each suture anchor, thus potentially providing a more even pressure distribution. PMID:26052499

  16. The “Labral Bridge”: A Novel Technique for Arthroscopic Anatomic Knotless Bankart Repair

    PubMed Central

    Ostermann, Roman C.; Hofbauer, Marcus; Platzer, Patrick; Moen, Todd C.

    2015-01-01

    Arthroscopic Bankart repair with suture anchors is widely considered a mainstay for surgical treatment of anterior shoulder instability after recurrent anterior shoulder dislocations. Traditionally, the displaced capsulolabral complex is restored and firmly attached to the glenoid by placing multiple suture anchors individually from a 5- to 3-o'clock position. A variety of different techniques using different anchor designs and materials have been described. Knotless anchors are widely used nowadays for shoulder instability repair, providing a fast and secure way of labral fixation with favorable long-term outcomes. However, these techniques result in a concentrated point load of the reduced labrum to the glenoid at each suture anchor. We describe a technique, developed by the first author, using a 1.5-mm LabralTape (Arthrex, Naples, FL) in combination with knotless suture anchors (3.5-mm PEEK [polyether ether ketone] PushLock anchors; Arthrex), for hybrid fixation of the labrum. The LabralTape is used to secure the torn labrum to the glenoid between each suture anchor, thus potentially providing a more even pressure distribution.

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

    PubMed

    Wahegaonkar, Abhijeet L; Mathoulin, Christophe L

    2013-05-01

    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

  18. The results of arthroscopic versus mini-open repair for rotator cuff tears at mid-term follow-up

    PubMed Central

    Pearsall, Albert W; Ibrahim, Khalid A; Madanagopal, Sudhakar G

    2007-01-01

    Background To prospectively evaluate patients who underwent a "mini-open" repair versus a completely arthroscopic technique for small to large size rotator cuff tears. Methods Fifty-two patients underwent "mini-open" or all arthroscopic repair of a full thickness tear of the rotator cuff. Patients who complained of shoulder pain and/or weakness and who had failed a minimum of 6 weeks of physical therapy and had at least one sub-acromial injection were surgical candidates. Pre and post-operative clinical evaluations included the following: 1) demographics; 2) Simple Shoulder Test (SST); 3) University of California, Los Angeles (UCLA) rating scale; 4) visual analog pain assessment (VAS); and 5) pre-op SF12 assessment. Descriptive analysis was performed for patient demographics and for all variables. Pre and post outcome scores, range of motion and pain scale were compared using paired t-tests. Analysis of variance (ANOVA) was used to evaluate any effect between dependent and independent variables. Significance was set at p is less than or equal to 0.05. Results There were 31 females and 21 males. The average follow-up was 50.6 months (27 – 84 months). The average age was similar between the two groups [arthroscopic x = 55 years/mini-open x = 58 years, p = 0.7]. Twenty-seven patients underwent arthroscopic repair and 25 underwent repair with a mini-open incision. The average rotator cuff tear size was 3.1 cm (range: 1–5 centimeters). There was no significant difference in tear size between the two groups (arthroscopic group = 2.9 cm/mini-open group = 3.2 cm, p = 0.3). Overall, there was a significant improvement from pre-operative status in shoulder pain, shoulder function as measured on the Simple Shoulder test and UCLA Shoulder Form. Visual analog pain improved, on average, 4.4 points and the most recent Short Shoulder Form and UCLA scores were 8 and 26 respectively. Both active and passive glenohumeral joint range of motion improved significantly from pre-operatively. Conclusion Based upon the number available, we found no statistical difference in outcome between the two groups, indicating that either procedure is efficacious in the treatment of small and medium size rotator cuff tears. Level of Evidence Type III PMID:18053153

  19. All-Arthroscopic versus Mini-Open Repair of Small to Large Sized Rotator Cuff Tears: A Meta-Analysis of Clinical Outcomes

    PubMed Central

    Chen, Kai; Cai, Zhengdong; Li, Guodong

    2014-01-01

    Purpose The purpose of this study was to compare clinical outcomes of patients with full-thickness small to large sized tears undergoing all-arthroscopic versus mini-open rotator cuff repair. Method A literature search for electronic databases and references for eligible studies was conducted through Medline, Embase and Cochrane library between 1969 and 2013. Results A total of 12 comparative studies (n?=?770 patients) were included. Pooled results showed: there were no differences in function outcome, pain scores, retear rate or the incidence of adhesive capsulitis between all arthroscopic and mini-open repair groups. Conclusions There were no differences in outcomes between the arthroscopic and mini-open rotator cuff repair techniques, they should be considered alternative treatment options. Level of Evidence Level IV, Meta analysis. PMID:24728326

  20. Descriptive Report of Shoulder Range of Motion and Rotational Strength Six and 12 Weeks Following Arthroscopic Superior Labral Repair

    PubMed Central

    Sueyoshi, Tetsuro; Winters, Matthew; Zeman, David

    2008-01-01

    Objectives To measure short-term post surgery glenohumeral internal and external rotation strength, shoulder range of motion (ROM), and subjective self-report ratings following arthroscopic superior labral (SLAP) repair. Background Physical therapists provide rehabilitation for patients following arthroscopic repair of the superior labrum. Little research has been published regarding the short-term results of this procedure while the patient is typically under the direct care of the physical therapist. Methods Charts from 39 patients (7 females and 32 males) with a mean age of 43.4±14.9 years following SLAP repair were reviewed. All patients underwent rehabilitation by the same therapist using a standardized protocol and were operated on and referred by the same orthopaedic surgeon. Retrospective chart review was performed to obtain descriptive profiles of shoulder ROM at 6 and 12 weeks post surgery and isokinetically documented internal and external rotation strength 12 weeks post surgery. Results At 12 weeks post-surgery, involved shoulder flexion, abduction, and external rotation active ROM values were 2-6 degrees greater than the contralateral, non-involved extremity. Isokinetic internal and external rotation strength deficits of 7-11% were found as compared to the uninjured extremity. Patients completed the self-report section of the Modified American Shoulder Elbow Surgeons Rating Scale and scored a mean of 37/45 points. Conclusion The results of this study provide objective data for both glenohumeral joint ROM and rotator cuff strength following superior labral repair at time points during which the patient is under the direct care of the physical therapist. These results show a nearly complete return of active ROM and muscular strength following repair of the superior labrum and post-operative physical therapy. PMID:21509132

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

    PubMed Central

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

    2014-01-01

    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

  2. Synovial Fluid Lubricant Properties are Transiently Deficient after Arthroscopic Articular Cartilage Defect Repair with Platelet-Enriched Fibrin Alone and with Mesenchymal Stem Cells

    PubMed Central

    Grissom, Murray J.; Temple-Wong, Michele M.; Adams, Matthew S.; Tom, Matthew; Schumacher, Barbara L.; McIlwraith, C. Wayne; Goodrich, Laurie R; Chu, Constance R.; Sah, Robert L.

    2014-01-01

    Background Following various types of naturally-occurring traumatic injury to an articular joint, the lubricating ability of synovial fluid is impaired, with a correlated alteration in the concentration and/or structure of lubricant molecules, hyaluronan and proteoglycan-4. However, the effect of arthroscopic cartilage repair surgery on synovial fluid lubricant function and composition is unknown. Hypothesis Arthroscopic treatment of full-thickness chondral defects in horses with (1) platelet-enriched fibrin or (2) platelet-enriched fibrin+mesenchymal stem cells leads to equine synovial fluid with impaired lubricant function and hyaluronan and proteoglycan-4 composition. Study Design Controlled Laboratory Study. Methods Equine synovial fluid was aspirated from normal joints at a pre-injury state (0 days) and at 10 days and 3 months following fibrin or fibrin+mesenchymal stem cell repair of full thickness chondral defects. Equine synovial fluid samples were analyzed for friction-lowering boundary lubrication of normal articular cartilage (static and kinetic friction coefficients) and concentrations of hyaluronan and proteoglycan-4, as well as molecular weight distribution of hyaluronan. Experimental groups deficient in lubrication function were also tested for the ability of exogenous high-molecular weight hyaluronan to restore lubrication function. Results Lubrication and biochemical data varied with time after surgery but generally not between repair groups. Relative to pre-injury, kinetic friction was higher (+94%) at 10 days but returned to baseline levels at 3 months while static friction was not altered. Correspondingly, hyaluronan concentration was transiently lower (-64%) and shifted towards lower molecular weight forms, while proteoglycan-4 concentration was increased (+210%) in 10-day samples relative to pre-injury levels. Regression analysis revealed that kinetic friction decreased with increasing total and high molecular weight hyaluronan. Addition of high molecular weight hyaluronan to bring 10-day hyaluronan levels to 2.0mg/ml restored kinetic friction to pre-injury levels. Conclusion Following arthroscopic surgery for cartilage defect repair, synovial fluid lubrication function is transiently impaired, in association with decreased hyaluronan concentration. This functional deficiency in synovial fluid lubrication can be counteracted in vitro by addition of high molecular weight hyaluronan. Clinical Relevance Synovial fluid lubrication is deficient shortly following arthroscopic cartilage repair surgery, and supplementation with high molecular weight hyaluronan may be beneficial. PMID:25530978

  3. Platelet-Rich Plasma Augmentation for Arthroscopic Rotator Cuff RepairA Randomized Controlled Trial

    Microsoft Academic Search

    Roberto Castricini; Umile Giuseppe Longo; Massimo De Benedetto; Nicola Panfoli; Piergiorgio Pirani; Raul Zini; Nicola Maffulli; Vincenzo Denaro

    2011-01-01

    Background: After reinsertion on the humerus, the rotator cuff has limited ability to heal. Growth factor augmentation has been proposed to enhance healing in such procedure.Purpose: This study was conducted to assess the efficacy and safety of growth factor augmentation during rotator cuff repair.Study Design: Randomized controlled trial; Level of evidence, 1.Methods: Eighty-eight patients with a rotator cuff tear were

  4. Infusion Methods for Continuous Interscalene Brachial Plexus Block for Postoperative Pain Control after Arthroscopic Rotator Cuff Repair

    PubMed Central

    Byeon, Gyeong Jo; Yoon, Ji Uk; Kim, Eun Jung; Baek, Seung Hoon; Ri, Hyun Su

    2015-01-01

    Background Infusion methods during regional analgesia using perineural catheters may influence the quality of postoperative analgesia. This study was conducted to compare the effects of combined or bolus-only infusion of 0.2% ropivacaine on the postoperative analgesia in interscalene brachial plexus block (ISBPB) with perineural catheterization. Methods Patients scheduled for arthroscopic rotator cuff repair were divided into two groups, one that would receive a combined infusion (group C, n = 32), and one that would receive intermittent infusion (group I, n = 32). A perineural catheter was inserted into the interscalene brachial plexus (ISBP) using ultrasound (US) and nerve stimulation, and 10 ml of 0.2% ropivacaine was administered. After the operation, group C received a continuous infusion of 4 ml/h, and a 4 ml bolus with a lockout interval of 60 min. Group I received only a 4 ml bolus, and the lockout interval was 30 min. Postoperative pain by the numeric rating scale (NRS) and the forearm muscle tone by the manual muscle test (MMT) were checked and evaluated at the following timepoints: preoperative, and postoperative 1, 4, 12, 24, 36, and 48 h. Supplemental opioid requirements, total consumed dose of local anesthetic, and adverse effects were compared between the two groups. Results Sixty-four patients completed the study and the postoperative values such as operation time, time to discharge, and operation site were comparable. There were no differences in NRS scores and supplemental opioid requirements between the two groups. The MMT scores of group I at 4 and 12 h after surgery were significantly higher than those of group C (P < 0.05). The total consumed dose of local anesthetic was significantly lower in group I than in group C (P < 0.05). The adverse effects were not different between the groups. Conclusions The bolus-only administration of 0.2% ropivacaine provided a similar analgesic effect with a lower total volume of local anesthetic and decreased motor weakness compared to combined infusion. Therefore, bolus-only administration is an effective postoperative analgesic method in ISBPB with perineural catheterization after rotator cuff repair.

  5. All-arthroscopic versus mini-open repair of small or moderate-sized rotator cuff tears: A protocol for a randomized trial [NCT00128076

    PubMed Central

    MacDermid, Joy C; Holtby, Richard; Razmjou, Helen; Bryant, Dianne

    2006-01-01

    Background Rotator cuff tears are the most common source of shoulder pain and disability. Only poor quality studies have compared mini-open to arthroscopic repair, leaving surgeons with inadequate evidence to support optimal, minimally-invasive repair. Methods/Design This randomized, multi-centre, national trial will determine whether an arthroscopic or mini-open repair provides better quality of life for patients with small or moderate-sized rotator cuff tears. A national consensus meeting of investigators in the Joint Orthopaedic Initiative for National Trials of the Shoulder (JOINTS Canada) identified this question as the top priority for shoulder surgeons across Canada. The primary outcome measure is a valid quality-of-life scale (Western Ontario Rotator Cuff (WORC)) that addresses 5 domains of health affected by rotator cuff disease. Secondary outcomes will assess rotator cuff functionality (ROM, strength, Constant score), secondary dimensions of health (general health status (SF-12) and work limitations), and repair integrity (MRI). Outcomes are measured at baseline, at 6 weeks, 3, 6, 12, and 24 months post-operatively by blinded research assistants and musculoskeletal radiologists. Patients (n = 250) with small or medium-sized cuff tears identified by clinical examination and MRI who meet eligibility criteria will be recruited. This sample size will provide 80% power to statistically detect a clinically important difference of 20% in WORC scores between procedures after controlling for baseline WORC score (? = 0.05). A central methods centre will manage randomization, data management, and monitoring under supervision of experienced epidemiologists. Surgeons will participate in either conventional or expertise-based designs according to defined criteria to avoid biases from differential surgeon expertise. Mini-open or all-arthroscopic repair procedures will be performed according to a standardized protocol. Central Adjudication (of cases), Trial Oversight and Safety Committees will monitor trial conduct. We will use an analysis of covariance (ANCOVA), where the baseline WORC score is used as a covariate, to compare the quality of life (WORC score) at 2 years post-operatively. As a secondary analysis, we will conduct the same statistical test but will include age and tear size as covariates with the baseline score. Enrollment will require 2 years and follow-up an additional 2 years. The trial will commence when funding is in place. Discussion These results will have immediate impact on the practice behaviors of practicing surgeons and surgical trainees at JOINTS centres across Canada. JOINTS Canada is actively engaged in knowledge exchange and will publish and present findings internationally to facilitate wider application. This trial will establish definitive evidence on this question at an international level. PMID:16529658

  6. Fiber-optics couple arthroscope to TV

    NASA Technical Reports Server (NTRS)

    Franke, J. M.; Rhodes, D. B.

    1981-01-01

    Convenient, hand-held coupler images output of arthroscope onto coherent fiber bundle. Arthroscope allows surgeons to examine internal organs through any small opening in body. Coupler is also used for engine inspection, instrument repair, and around-corner visual inspection. Image from arthroscope travels along flexible bundle and appears at other cable end where it is recollimated by lens. Image is read from lens or projected on color TV camera.

  7. Arthroscopic reconstruction for acromioclavicular joint dislocation

    Microsoft Academic Search

    Eugene M Wolf; William T Pennington

    2001-01-01

    We describe an arthroscopic reconstruction technique for acromioclavicular joint dislocation. Subsequent to Baum’s first repair of the coracoclavicular complex in 1886, over 60 operative procedures have been described in the literature. This procedure is the first described arthroscopic approach used in reconstruction for acromioclavicular dislocation. It provides an anatomically correct and structurally sound reconstruction of the coracoclavicular ligament complex. This

  8. Arthroscopic Surgery.

    ERIC Educational Resources Information Center

    Connors, G. Patrick

    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.…

  9. Arthroscopic tennis elbow release.

    PubMed

    Savoie, Felix H; O'Brien, Michael J

    2015-01-01

    Lateral epicondylitis, originally referred to as tennis elbow, affects between 1% and 3% of the population and is usually found in patients aged 35 to 50 years. Although it was initially thought that lateral epicondylitis was caused by an inflammatory process, most microscopic studies of excised tissue demonstrate a failure of reparative response in the extensor carpi radialis brevis tendon and in any of the associated structures. Most cases of lateral epicondylitis respond to appropriate nonsurgical treatment protocols, which include medication, bracing, physical therapy, corticosteroid injections, shock wave therapy, platelet-rich plasma, and low-dose thermal or ultrasound ablation devices. However, when these protocols are unsuccessful, surgical measures may be appropriate and have a high rate of success. The results of arthroscopic surgical procedures have documented satisfactory results, with improvement rates reported between 91% and 97.7%. Recent advances in arthroscopic repair and plication of these lesions, along with recognizing the presence and repair of coexisting lesions, have allowed arthroscopic techniques to provide excellent results. PMID:25745908

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

    PubMed Central

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

    2013-01-01

    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

  11. Arthroscopic treatment for malunions of the proximal humeral greater tuberosity

    Microsoft Academic Search

    Angel Antonio Martinez; Angel Calvo; Javier Domingo; Jorge Cuenca; Antonio Herrera

    2010-01-01

    The purpose of this article was to report an arthroscopic treatment method for greater tuberosity malunion. Eight patients\\u000a with malunion of the greater tuberosity were treated by arthroscopic acromioplasty, detachment of rotator cuff, tuberoplasty\\u000a of the greater tuberosity and repair of the rotator cuff. On the basis of the UCLA rating scale, the overall score increased\\u000a from 11.1 (range 9–14)

  12. Superior labrum anterior to posterior lesions of the shoulder: Diagnosis and arthroscopic management

    PubMed Central

    Aydin, Nuri; Sirin, Evrim; Arya, Alp

    2014-01-01

    After the improvement in arthroscopic shoulder surgery, superior labrum anterior to posterior (SLAP) tears are increasingly recognized and treated in persons with excessive overhead activities like throwers. Several potential mechanisms for the pathophysiology of superior labral tears have been proposed. The diagnosis of this condition can be possible by history, physical examination and magnetic resonance imaging combination. The treatment of type 1 SLAP tears in many cases especially in older patients is non-operative but some cases need arthroscopic intervention. The arthroscopic management of type 2 lesions in older patients can be biceps tenodesis, but young and active patients like throwers will need an arthroscopic repair. The results of arthroscopic repair in older patients are not encouraging. The purpose of this study is to perform an overview of the diagnosis of the SLAP tears and to help decision making for the surgical management. PMID:25035838

  13. Arthroscopic lateral ankle stabilization.

    PubMed

    Kashuk, K B; Landsman, A S; Werd, M B; Hanft, J R; Roberts, M

    1994-07-01

    The indications for arthroscopic stabilization include those patients with isolated ruptures or strains of the ATF. The procedure is particularly convenient for patients with ankle joint pathology that is already most commonly treated arthroscopically, such as chronic instability, in which inflamed synovium or meniscoid bodies are to be excised. Although significant stability can be gained with this technique, injuries that result in damage to the calcaneofibular ligament may require additional open surgery, since this ligament cannot be visualized arthroscopically. However, the anchoring techniques described in this article can still be used when performing open surgery. PMID:7954209

  14. Anatomical reconstruction of the anterior talofibular and calcaneofibular ligaments with an all-arthroscopic surgical technique.

    PubMed

    Guillo, S; Cordier, G; Sonnery-Cottet, B; Bauer, T

    2014-12-01

    Arthroscopy is becoming an essential tool for the treatment of chronic lateral ankle instability. It allows the surgeon to determine which ligaments are injured and choose the most appropriate surgical repair technique, and also to assess and treat any associated injuries. Several arthroscopic techniques for lateral ankle ligament repair have recently been developed. As a consequence, it may be possible to carry out complete lateral ligament reconstruction with an all-arthroscopic procedure. Such an arthroscopic lateral ankle ligament reconstruction technique is described in this article. PMID:25454336

  15. Arthroscopic release for lateral epicondylitis

    Microsoft Academic Search

    Brett D. Owens; Kevin P. Murphy; Timothy R. Kuklo

    2001-01-01

    Purpose: This study was performed to review the results of our early experience with recalcitrant lateral epicondylitis treated arthroscopically. Type of Study: This study is a case series consisting of consecutive patients with lateral epicondylitis treated arthroscopically by 1 surgeon. Methods: Patients failing a minimum of 6 months of conservative treatment underwent arthroscopic release of the extensor carpi radialis brevis

  16. Arthroscopic Repair of Anterior-Inferior Glenohumeral Instability Using a Portal at the 5:30-o’Clock PositionAnalysis of the Effects of Age, Fixation Method, and Concomitant Shoulder Injury on Surgical Outcomes

    Microsoft Academic Search

    Andreas B. Imhoff; Patrick Ansah; Thomas Tischer; Christoph Reiter; Christoph Bartl; Maximilian Hench; Jeffrey T. Spang; Stephan Vogt

    2010-01-01

    Background: Traumatic anterior-inferior shoulder joint dislocations are common injuries among the young athletic population. The aim of this study was to assess which factors, including concomitant injury (rotator cuff tears, superior labral anterior posterior [SLAP] lesions), patient age, and fixation methods, led to redislocation after arthroscopic stabilization.Hypothesis: There are several risk factors for the outcome after arthroscopic anterior-inferior glenohumeral stabilization.Study

  17. Arthroscopic ankle arthrodesis.

    PubMed

    Tasto, J P; Frey, C; Laimans, P; Morgan, C D; Mason, R J; Stone, J W

    2000-01-01

    The obvious socioeconomic advantages are quite dramatic, with early weight-bearing and AFO immobilization allowing patients an early return to work. Outpatient surgery is a cost-effective benefit. Patient satisfactions as well as comfort are greatly enhanced, requiring only oral pain medication. All patients have tolerated their postoperative regimen and same-day discharge. Arthroscopic subtalar arthrodesis is a technically demanding procedure that requires some rather advanced arthroscopic skills to perform. Joint access is tight, restricted, and requires small instrumentation. Deformities cannot be corrected; therefore, at this stage, a fusion in situ must be considered. The learning curve is certainly far steeper because of the smaller patient population available for enhancing surgical skills. Overall, this procedure has stood the test of time and follow-up. The results appear to be excellent in terms of patient satisfaction, fusion rate time until union, and postoperative morbidity. The recognition and enhancement of this technique as well as the development of more advanced technology will certainly allow this arthroscopic subtalar arthrodesis technique to mature even further over time. PMID:10829182

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

    PubMed Central

    Maiotti, Marco; Massoni, Carlo

    2013-01-01

    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

  19. Arthroscopic Bone Graft Procedure for Anterior Inferior Glenohumeral Instability

    PubMed Central

    Taverna, Ettore; D'Ambrosi, Riccardo; Perfetti, Carlo; Garavaglia, Guido

    2014-01-01

    There are many described surgical techniques for the treatment of recurrent anterior shoulder instability. Numerous authors have performed anterior bone block procedures with good results for the treatment of anterior shoulder instability with glenoid bone loss. The benefits of using arthroscopic procedures for surgical stabilization of the shoulder include smaller incisions with less soft-tissue dissection, better visualization of the joint, better repair accessibility, and the best possible outcome for external rotation. We describe an arthroscopic anteroinferior shoulder stabilization technique with an iliac crest tricortical bone graft and capsulolabral reconstruction. It is an all-arthroscopic technique with the advantage of not using fixation devices, such as screws, but instead using special buttons to fix the bone graft. The steps of the operation are as follows: precise placement of a specific posterior glenoid guide that allows the accurate positioning of the bone graft on the anterior glenoid neck; fixation of the graft flush with the anterior glenoid rim using specific buttons under arthroscopic control; and finally, subsequent capsular, labral, and ligament reconstruction on the glenoid rim using suture anchors and leaving the graft as an extra-articular structure. PMID:25685669

  20. Arthroscopic Ultrasound Assessment of Articular Cartilage in the Human Knee Joint

    PubMed Central

    Kaleva, Erna; Virén, Tuomas; Saarakkala, Simo; Sahlman, Janne; Sirola, Joonas; Puhakka, Jani; Paatela, Teemu; Kröger, Heikki; Kiviranta, Ilkka; Jurvelin, Jukka S.; Töyräs, Juha

    2011-01-01

    Objective: We tested whether an intra-articular ultrasound (IAUS) method could be used to evaluate cartilage status arthroscopically in human knee joints in vivo. Design: Seven patients undergoing arthroscopic surgery of the knee were enrolled in this study. An ultrasonic examination was conducted using the same portals as in the arthroscopic surgery. A high-frequency (40-MHz) ultrasound transducer (diameter = 1 mm) was directed to the desired location on the articular surface under arthroscopic control. In addition to ultrasound data, an IAUS video and optical video through the arthroscope were recorded. Classification of cartilage injuries according to International Cartilage Repair Society, as conducted by the orthopedic surgeon, provided reference data for comparison with the IAUS. Results: The IAUS method was successful in imaging different characteristics of the articular surfaces (e.g., intact surface, surface fibrillation, and lesions of varying depth). In some cases, also the subchondral bone and abnormal internal cartilage structure were visible in the IAUS images. Specifically, using the IAUS, a local cartilage lesion of 1 patient was found to be deeper than estimated arthroscopically. Conclusions: The IAUS method provided a novel arthroscopic method for quantitative imaging of articular cartilage lesions. The IAUS provided quantitative information about the cartilage integrity and thickness, which are not available in conventional arthroscopy. The present equipment is already approved by the Food and Drug Administration for intravascular use and might be transferred to intra-articular use. The invasiveness of the IAUS method might restrict its wider clinical use but combined with arthroscopy, ultrasonic assessment may enlarge the diagnostic potential of arthroscopic surgery. PMID:26069583

  1. Efficacy of Different Rotator Cuff Repair Techniques.

    PubMed

    Gurnani, Navin; van Deurzen, Derek Friedrich Petrus; Flipsen, Mark; Raven, Eric Ernest Joseph; van den Bekerom, Michel Pieter Jozef

    2015-05-01

    The purpose of this review article is to describe the currently used techniques for rotator cuff repair and after treatment. The literature was searched for the different surgical techniques and additional treatment including: [1] full arthroscopic and arthroscopic assisted rotator cuff repair, [2] acromioplasty as an additional treatment to rotator cuff repair, [3] the use of plasma rich platelets (PRP) after rotator cuff repair, [4] the single and double row fixation techniques, [5] long head of the biceps brachii tenotomy or tenodesis with rotator cuff repair, [6] scaffolds in rotator cuff surgery, and [7] early motion or immobilization after rotator cuff repair. The rationale, the results, and the scientific evidence were reported for the eligible procedures. PMID:26055023

  2. Arthroscopic laser in intra-articular knee cartilage disorders

    NASA Astrophysics Data System (ADS)

    Nosir, Hany R.; Siebert, Werner E.

    1996-12-01

    Different assemblies have endeavored to develop arthroscopic laser surgery. Various lasers have been tried in the treatment of orthopaedic problems, and the most useful has turned out to be the Hol-YAG laser 2.1 nm which is a near- contact laser. By using the laser as a powerful tool, and cutting back on the power level, one is able to better achieve the desired treatment effect. Clinical studies to evaluating the role of the laser in different arthroscopic knee procedures, comparing to conventional techniques, showed that the overall outcome attains a momentous confidence level which is shifted to the side of the laser versus the conventional for all maneuvers, barring meniscectomy where there is not perceiving disparity between laser versus the conventional. Meniscectomy continues to be one of the most commonly performed orthopaedic procedures. Laser provides a single tool which can ablate and debride meniscal rims with efficiency and safety. Chondroplasty can also be accomplished with ease using defocused laser energy. Both lateral release and soft tissue cermilization benefit from the cutting effect of laser along with its hemostatic effect. Synovial reduction with a defocused laser is also easily accomplished. By one gadget, one can cut, ablate, smooth, coagulate, congeal and with authentic tissue depth control The future of laser arthroscopic surgery lies in its ability to weld or repair tissues. Our research study has shown that laser activated photoactive dyes can produce a molecular bonding of collagen fibers, and therefore a repair 'weld' can be achieved with both meniscal tissues and with articular cartilage lesions.

  3. Augmented Virtuality for Arthroscopic Knee Surgery

    E-print Network

    Stewart, James

    Augmented Virtuality for Arthroscopic Knee Surgery John M. Li1 , Davide D. Bardana2 , A. James residents. 1 Introduction Arthroscopic knee surgery is a minimally invasive procedure in which the surgeon open surgery. However, navigating within the joint is challenging because the camera image

  4. Intra-articular analgesia for arthroscopic meniscectomy

    Microsoft Academic Search

    B. LYONS; D. LOHAN; C. G. FLYNN; G. P. JOSHI; T. M. O'BRIEN; M. MCCARROLL

    Summary Intra-articular morphine has been shown to provide prolonged analgesia after arthroscopic knee sur- gery; the addition of local anaesthetic agents has been reported to improve this analgesic effect. Pethidine possesses local anaesthetic properties, and therefore this study was designed to evaluate its analgesic efficacy after arthroscopic meniscectomy. Sixty patients were allocated randomly to receive intra-articular injections of pethidine 50

  5. How do massive immobile rotator cuff tears behave after arthroscopic interval slides? Comparison with mobile tears

    PubMed Central

    FOSSATI, CHIARA; ARRIGONI, PAOLO; RAGONE, VINCENZA; SPENNACCHIO, PIETRO; BANFI, GIUSEPPE; RANDELLI, FILIPPO; RANDELLI, PIETRO

    2014-01-01

    Purpose the aim of this study was to compare clinical outcomes of contracted immobile massive rotator cuff tears mobilised through an arthroscopic interval slide technique versus massive mobile cuff tears directly repaired without any mobilisation. Methods twenty-five patients who underwent arthroscopic repair for massive rotator cuff tears with a minimum of 18 months follow-up were included. The patients were retrospectively divided into two groups. In group 1, a single or double interval slide was performed to achieve adequate tendon mobilisation. In group 2 (control group), massive rotator cuff tears were arthroscopically repaired without any additional release. Patients were evaluated with validated outcomes scores: subjective and objective Constant score, a Visual Analogue Scale (VAS) for pain, and single Assessment Numeric Evaluation (SANE). Results the two groups were comparable in terms of age, gender and involvement of the dominant arm. The mean follow-up duration was 31 months in group 1 and 28 months in group 2 (p = 0.4). The two groups showed no significant differences in SANE and VAS results (group 1: SANE 77%, VAS 1.3; group 2: SANE 88%, VAS 1.6), or in total Constant score (group 1: 66.5 ± 11; group 2: 75 ± 14; p = 0.1) and subjective Constant score (Group 1: 31 ± 5; group 2: 30.8 ± 7; p = 0.9). A significant difference was found for the objective Constant score, which was higher in the control group (group 1: 35.5 ± 7; group 2: 44 ± 8; p = 0.009). Conclusions Subjective clinical outcomes of arthroscopic repair with or without interval slides did not differ and were satisfactory. Objectively, immobile cuff tears showed inferior results. The use of interval slides might be considered a first step or an alternative to more invasive procedures for low demanding patients. Level of evidence Level III, retrospective comparative study. PMID:25606545

  6. The Intracapsular Atraumatic Arthroscopic Technique for Closure of the Hip Capsule

    PubMed Central

    Asopa, Vipin; Singh, Parminder J.

    2014-01-01

    The hip joint capsule is a critical static stabilizer of the hip. During hip arthroscopy, the capsule is breached to gain exposure to treat femoroacetabular impingement lesions. There have been recent concerns regarding hip instability after hip arthroscopy, and relatively few techniques have been described for atraumatic arthroscopic closure of the hip capsule. We describe an atraumatic, inside-out, 2-portal technique to repair the capsule. PMID:24904769

  7. Direct Arthroscopic Distal Clavicle Resection

    PubMed Central

    Lervick, Gregory N

    2005-01-01

    Degenerative change involving the acromioclavicular (AC) is frequently seen as part of a normal aging process. Occasionally, this results in a painful clinical condition. Although AC joint symptoms commonly occur in conjunction with other shoulder pathology, they may occur in isolation. Treatment of isolated AC joint osteoarthritis is initially non-surgical. When such treatment fails to provide lasting relief, surgical treatment is warranted. Direct (superior) arthroscopic resection of the distal (lateral) end of the clavicle is a successful method of treating the condition, as well as other isolated conditions of the AC joint. The following article reviews appropriate patient evaluation, surgical indications and technique. PMID:16089089

  8. Application of optical coherence tomography enhances reproducibility of arthroscopic evaluation of equine joints

    PubMed Central

    2014-01-01

    Background Arthroscopy is widely used in various equine joints for diagnostic and surgical purposes. However, accuracy of defining the extent of cartilage lesions and reproducibility in grading of lesions are not optimal. Therefore, there is a need for new, more quantitative arthroscopic methods. Arthroscopic optical coherence tomography (OCT) imaging is a promising tool introduced for quantitative detection of cartilage degeneration and scoring of the severity of chondral lesions. The aim of this study was to evaluate the inter-investigator agreement and inter-method agreement in grading cartilage lesions by means of conventional arthroscopy and with OCT technique. For this aim, 41 cartilage lesions based on findings in conventional and OCT arthroscopy in 14 equine joints were imaged, blind coded and independently ICRS (International Cartilage Repair Society) scored by three surgeons and one PhD-student. Results The intra- and inter-investigator percentages of agreement by means of OCT (68.9% and 43.9%, respectively) were higher than those based on conventional arthroscopic imaging (56.7% and 31.7%, respectively). The intra-investigator Kappa coefficients were 0.709 and 0.565 for OCT and arthroscopy, respectively. Inter-investigator Kappa coefficients were 0.538 and 0.408 for OCT and arthroscopy, respectively. Conclusions OCT can enhance reproducibility of arthroscopic evaluation of equine joints. PMID:24410869

  9. Arthroscopically assisted acromioclavicular joint reconstruction.

    PubMed

    Baumgarten, Keith M; Altchek, David W; Cordasco, Frank A

    2006-02-01

    Arthroscopically assisted acromioclavicular joint reconstruction avoids the large incisions necessary with open reconstructions. This acromioclavicular joint reconstruction technique via the subacromial space does not violate the rotator interval or require screw removal. The patient is placed in a modified beach-chair position. The arthroscope is placed into the subacromial space, and a bursectomy is performed through a lateral subacromial portal. The coracoacromial ligament is released from the acromion with an electrocautery and an arthroscopic elevator. A nonabsorbable suture is passed through the coracoacromial ligament with a suture passer, and an arthroscopic suture grasper is used to deliver both ends of the suture out through the lateral portal. The coracoid is identified and isolated using a radiofrequency ablator placed through the anterior portal while visualizing through the lateral portal. A percutaneous shuttle device is passed through the skin superomedial to the coracoid. The shuttle is visualized entering superior to the coracoid and is passed just medial to the coracoid. Once the tip of the shuttle can be visualized in the recess inferior to the coracoid, the shuttle loop is advanced. A suture grasper is used to deliver both ends of the shuttle out through the anterior portal. A semitendinosus allograft is used to reconstruct the coracoclavicular ligament. A nonabsorbable suture is passed through both ends of the allograft. Three strands of nonabsorbable suture are braided together. The tendon and the braided suture are shuttled around the coracoid. At this point, both the braided suture and the allograft tendon enter the anterior portal, wrap around the coracoid base, and exit the anterior portal. A 3-cm incision is made over the distal clavicle. A hole is drilled through the clavicle with a 5-mm drill. A loop of 22-gauge wire is passed through the hole in the clavicle, and a looped suture is shuttled through the hole. A curved clamp is used to create a tunnel from the acromioclavicular joint, under the deltoid, to the anterior portal. The ends of the braided suture and the tendon sutures are grasped by the clamp and pulled out the acromioclavicular joint incision. The limbs of the braided suture and the tendon suture that pass medial to the coracoid are shuttled through the hole in the clavicle using the looped suture that was previously passed through the clavicle. The acromioclavicular joint is reduced by pushing down on the distal clavicle with a bone tamp while simultaneously lifting the acromion upward by superiorly loading the humerus at the elbow. Once the acromioclavicular joint is reduced or slightly over-reduced, the braided suture is tied down securely. The acromioclavicular joint should remain reduced even after the manual reduction maneuver is released. The semitendinosus allograft is tensioned around the distal end of the clavicle and sutured to itself with a nonabsorbable suture. The released coracoacromial ligament is retrieved from the clavicular incision and sutured to the distal clavicle and semitendinosus allograft. The incision is closed in standard fashion, and a sling is applied. PMID:16458813

  10. Arthroscopic Allograft Cartilage Transfer for Osteochondral Defects of the Talus

    PubMed Central

    Min, Kyong S.; Ryan, Paul M.

    2015-01-01

    Arthroscopic treatment of osteochondral defects is well established but has had mixed results in larger lesions and revision operations. Particulated allograft cartilage transfer may provide an arthroscopic option for lesions that would otherwise have been treated through open approaches or osteotomies. The procedure is performed under noninvasive distraction with standard arthroscopic portals. PMID:26052496

  11. Comparison of open and arthroscopic subacromial decompression.

    PubMed

    Lazarus, M D; Chansky, H A; Misra, S; Williams, G R; Iannotti, J P

    1994-01-01

    We retrospectively reviewed 68 patients (70 shoulders) who underwent either open or arthroscopic acromioplasty performed by a single surgeon (JPI) for chronic impingement syndrome in the presence of an intact rotator cuff. Group 1 consisted of 24 shoulders that had open acromioplasty and group 2 consisted of 46 shoulders that had arthroscopic acromioplasty. The minimum follow-up was 12 months for both groups. There was no statistical difference in mean postoperative shoulder scores between the operative groups. However, there were more excellent results in the open group as compared with the arthroscopic group (54.2% vs 41.9%, respectively). In addition, there was a higher percentage of poor results in group 2 as compared with group 1 (27.9% vs 16.6%, respectively). Arthroscopic acromioplasty was associated with shorter hospital stays and faster achievement of maximal pain relief as compared with open acromioplasty. Examination of postoperative radiographs often revealed subacromial calcifications. These calcifications were more frequent after arthroscopic acromioplasty and were associated with a worse result. PMID:22959606

  12. Arthroscopic landmarks of the equine carpus.

    PubMed

    Hurtig, M B; Fretz, P B

    1986-11-15

    The radiocarpal and middle carpal joints of 4 clinically normal horses and 24 necropsy specimens were examined with an arthroscope to describe the topographic anatomy of these joints. The carpal bones of the radiocarpal joint had congruent articular surfaces in extension, but carpal flexion resulted in a stairstep between the radial and intermediate carpal bones. The variable surface anatomy, as well as the restricted synovial space and the technical limitations of the arthroscope, contributed to the need for more than one arthroscopic approach to the radiocarpal joint to ensure a thorough examination. The middle carpal joint's hinge-like biomechanics resulted in a spacious synovial cavity that was more amenable to arthroscopic examination. Careful planning was necessary to ensure that areas of interest were distant from the arthroscope-insertion site to allow the best perspective possible. The lateral approach to the middle carpal joint provided the best viewing of both facets of the intermediate and third carpal bones as well as the dorsal rim of the radial carpal bone. The medial approach did not allow complete inspection of these areas. PMID:3793573

  13. Arthroscopic laser meniscectomy in a gas medium.

    PubMed

    Whipple, T L; Caspari, R B; Meyers, J F

    1985-01-01

    Laboratory investigations demonstrate the theoretical feasibility of utilizing CO2 laser energy for arthroscopic resection of the knee meniscus. Infrared light of 10.6 micron wavelength is sufficiently absorbed by fibrocartilage with byproducts of heat, water vapor, and a small residue of carbon ash. The remaining meniscus rim demonstrates viable chondrocytes in close proximity to the margin of resection, and gross collagen fiber architecture is preserved. The depth of penetration of the laser beam can be controlled by limiting the duration of exposure. Arthroscopic application of CO2 laser energy requires a gas medium. Carbon dioxide and nitrogen have proven to be satisfactory insufflation agents, with no lasting untoward effects noted in a clinical series of diagnostic arthroscopic procedures. The cost of laser generators and the lack of an ideal delivery system are limiting factors in clinical applications of this cutting mode for meniscectomy. PMID:3937537

  14. Augmented virtuality for arthroscopic knee surgery.

    PubMed

    Li, John M; Bardana, Davide D; Stewart, A James

    2011-01-01

    This paper describes a computer system to visualize the location and alignment of an arthroscope using augmented virtuality. A 3D computer model of the patient's joint (from CT) is shown, along with a model of the tracked arthroscopic probe and the projection of the camera image onto the virtual joint. A user study, using plastic bones instead of live patients, was made to determine the effectiveness of this navigated display; the study showed that the navigated display improves target localization in novice residents. PMID:22003616

  15. Revision Wrist Arthroscopy after Failed Primary Arthroscopic Treatment

    PubMed Central

    Jang, Eugene; Danoff, Jonathan R.; Rajfer, Rebecca A.; Rosenwasser, Melvin P.

    2014-01-01

    Background?The etiologies and outcomes of cases of failed therapeutic wrist arthroscopy have not been well-described to date. Purpose?The purposes of this study were to identify common preventable patterns of failure in wrist arthroscopy and to report outcomes of a series of revision arthroscopy cases. Patients and Methods?Retrospective review of 237 wrist arthroscopies revealed 21 patients with a prior arthroscopy for the same symptoms, of which 16 were assessed by questionnaires and physical exam for this study. Results?Six of sixteen patients (38%) had unrecognized dynamic ulnar impaction after débridement of triangular fibrocartilage complex (TFCC) tears, which resolved with arthroscopic wafer resection. Five (31%) had persistent distal radioulnar joint (DRUJ) instability after initial treatment of TFCC tears, requiring arthroscopic repair at revision. Four (25%) experienced diffuse dorsal wrist pain initially diagnosed as TFCC tears, but dynamic scapholunate ligament injuries were found and addressed with radiofrequency (RF) shrinkage at reoperation. Two (13%) required further resection of the radial styloid, after initial débridement was insufficient to correct radioscaphoid impingement. At a mean of 4.8 years after repeat arthroscopy (range, 1.5–13.4 years), this cohort had significant improvements in pain and satisfaction with outcomes after revision arthroscopy. Conclusions?The most common indications for repeat wrist arthroscopy were ligamentous instability (of the DRUJ or scapholunate ligament) and osteoarthritis (from dynamic ulnar impaction or radioscaphoid impingement). Although revision wrist arthroscopy may yield acceptable outcomes, careful assessment of stability and cartilage wear at index procedure is crucial. Level of Evidence:?Level IV Therapeutic. PMID:24533243

  16. Biomechanical investigations of different meniscal repair implants in comparison with horizontal sutures on human meniscus

    Microsoft Academic Search

    Roland Becker; Marlene Schröder; Christian Stärke; Dietmar Urbach; Wolfgang Nebelung

    2001-01-01

    Purpose: The use of biodegradable implants for arthroscopic repair of meniscal lesions is becoming increasingly popular. The aim of this study was to test the biomechanical stability and the mode of failure of these implants. Type of Study: Biomechanical testing study. Methods: Biomechanical investigations were performed on human menisci using 6 commonly used biodegradable implants for meniscal repair to compare

  17. Arthroscopic resection of the acromioclavicular joint

    Microsoft Academic Search

    Gary M. Gartsman

    1993-01-01

    Arthroscopic resection of the distal clavicle was used to treat 26 patients who had osteoarthritis of the acro mioclavicular joint. Twenty of these patients were avail able for review at a minimum followup of 2 years. The preoperative ratings for pain, activities of daily living, work, and sports improved markedly in 17 patients postoperatively. No intraoperative complications were noted. The

  18. Agreement in Arthroscopic and Arthrotomy Assessment of Full-Thickness Articular Cartilage Lesions of the Knee in a Clinical Setting in 33 Consecutive Patients

    PubMed Central

    Røtterud, Jan Harald; Sivertsen, Einar Andreas

    2013-01-01

    Objective To evaluate the accuracy of arthroscopic measurement of full-thickness (International Cartilage Repair Society grades 3-4) cartilage lesions of the knee. Design In 33 consecutive arthroscopically evaluated cartilage lesion knees the lesion size was routinely estimated. At the final treatment, a knee arthrotomy was performed, and the lesion was reestimated. The 2 estimates were then compared by paired t test and the area estimated by knee arthrotomy was used as the gold standard. Results. The mean area of the cartilage lesion estimated by arthroscopic surgery was 3.5 cm2 (standard deviation [SD] = 1.7) whereas in the open surgery the mean area was 3.2 cm2 (SD = 1.5). The mean difference was 0.3 cm2, indicating a tendency toward overestimation by the arthroscopic evaluation, but the difference was not significant (P = 0.09). Additional MRI assessment of the area demonstrated a mean area of 2.3 cm2 (SD = 1.6). This underestimated the size of the lesion by 1.2 cm2 (SD = 0.8; P = 0.015). Conclusion Knee arthroscopic examination estimated a cartilage full-thickness lesion with an error of less than 25 % in the majority of the patients.

  19. Arthroscopic Osteochondral Grafting for Radiocarpal Joint Defects

    PubMed Central

    Ho, Pak-cheong; Tse, Wing-Iim; Wong, Clar Wing-Yee; Chow, Esther Ching-San

    2013-01-01

    Background Focal chondral lesion is a common cause of chronic wrist pain. The best treatment remains unknown. We have developed a technique of arthroscopic transplantation of an osteochondral autograft from the knee joint to the distal radius with satisfactory clinical results. Materials and Methods Between December 2006 and December 2010, four patients (average age 31 years) with posttraumatic osteochondral lesions over the dorsal lunate fossa were treated with arthroscopic osteochondral grafting. Pre- and postoperative motion, grip strength, wrist functional performance score, pain score, and return to work status were charted. Postoperative computed tomography (CT) scan, magnetic resonance imaging (MRI), and second-look arthroscopy were performed to assess graft incorporation. Description of Technique With the arthroscope in the 3-4 portal, synovitis over the dorsal lunate fossa was débrided to uncover the underlying osteochondral lesion. We employed the 6-mm trephine of the Osteoarticular Transfer System (OATS) to remove the osteochondral defect. Osteochondral graft was harvested from the lateral femoral condyle and delivered into the wrist joint arthroscopically. Results In all cases, grafts incorporation was completed by 3-4 months postoperative. All patients showed improvement in the wrist performance score (preoperative 27.5, postoperative 39 out of 40) with no pain on final follow-up at average 48.5 months (range 24-68 months). Grip strength improved from 62.6 to 98.2% of the contralateral side. Motion improved from 115.5 to 131.3°. X-ray images showed preserved joint space. Patient satisfaction was high with no complication. Conclusion An arthroscopic-assisted transfer of an osteochondral graft is a viable treatment option for chondral defects of the distal radius. PMID:24436819

  20. Comprehensive Approach to Arthroscopic Rotator Cuff Repair: Options and Techniques

    MedlinePLUS Videos and Cool Tools

    ... portal that I use for visualization and for instrumentation, which is a direct lateral portal. I place ... put an anterior cannula in that allows me instrumentation and orients me because the largest blood vessels ...

  1. The Circumferential Compression Stitch for Meniscus Repair

    PubMed Central

    Saliman, Justin D.

    2013-01-01

    Over the past 30 years, many patients have benefited from arthroscopically assisted meniscus repair surgery and its ability to preserve a healthy knee. Although techniques have evolved, the basic premise of central-to-peripheral needle penetration across the tear with fixation into the capsular region immediately peripheral to the meniscus has remained. Suture repair techniques that involve encircling the tear have been discussed but have remained largely impractical because of the anatomic constraints of the arthroscopic knee. A suture-passing technology designed to function within these constraints was recently made available from Ceterix Orthopaedics (Menlo Park, CA). It allows surgeons to arthroscopically place circumferential sutures around meniscus tears to provide uniform, anatomic compression of the tear edges through an all-inside technique. This stitch is likely to improve healing rates and safety, as well as to enable repair of tears that were previously considered difficult or impossible to sew. The purposes of this note and accompanying video are to show the feasibility of placing all-inside circumferential compression stitches to treat tears of the knee meniscus and to discuss the potential benefits of such techniques. PMID:24265995

  2. Technique of CO2 laser arthroscopic surgery

    NASA Astrophysics Data System (ADS)

    Meller, Menachem M.; Sherk, Henry H.; Rhodes, Anthony L.; Sazy, John; Uppal, Gurvinder S.; Lane, Gregory J.

    1991-05-01

    The CO2 laser was selected for arthroscopic surgery due to its availability in the hospital high power output and excellent absorption by unpigmented tissues. During the course of this study 4 generations of laser instruments were tested. These include the focused beam delivered via a handpiece the (3 mm O.D.) macrowaveguide the (1.5 mm Q.D.) microwaveguide and the flexible waveguide. The latter two devices complement each other in that the microwaveguide will tolerate and retain up to a 30 degree(s) curve. The flexible waveguide will clear narrow joint tolerances without creating lesions in the articular surface. CO2 laser arthroscopic tissue ablation must be done under gaseous joint distention but this presents no undue difficulties. At the completion of the procedure saline irrigation must be done for char removal.

  3. Knee joint biomechanics following arthroscopic partial meniscectomy.

    PubMed

    Sturnieks, Daina L; Besier, Thor F; Mills, Peter M; Ackland, Tim R; Maguire, Ken F; Stachowiak, Gwidon W; Podsiadlo, Pawel; Lloyd, David G

    2008-08-01

    We investigated spatiotemporal data, joint kinematics, and joint kinetics during gait in a group of subjects who had recently undergone arthroscopic partial meniscectomy and compared the results to those of healthy controls. Gait analysis was performed on 105 pain-free meniscectomy patients and 47 controls, walking at a self-selected speed. The meniscectomy population was comparable to controls in spatiotemporal parameters and knee kinematics. However, they had reduced range of motion (ROM) and lower peak moments in the sagittal plane on the operated limb compared to the nonoperated limb. Compared to controls, the meniscectomy patients had significantly larger knee adduction moments over stance, even after accounting for their greater body weight. These differences likely increase articular loads on the medial compartment of the tibiofemoral joint and may contribute to the high risk of knee osteoarthritis following arthroscopic meniscal surgery. PMID:18327795

  4. Complications of arthroscopic surgery of the hip

    PubMed Central

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

    2012-01-01

    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

  5. The Arthroscopic Surgical Skill Evaluation Tool (ASSET)

    PubMed Central

    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

    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

  6. Does Platelet-Rich Plasma Accelerate Recovery After Rotator Cuff Repair? A Prospective Cohort Study

    Microsoft Academic Search

    Chris Hyunchul Jo; Ji Eun Kim; Kang Sup Yoon; Ji Ho Lee; Seung Baik Kang; Jae Hyup Lee; Hyuk Soo Han; Seung Hwan Rhee; Sue Shin

    2011-01-01

    Background: Platelet-rich plasma (PRP) has been recently used to enhance and accelerate the healing of musculoskeletal injuries and diseases, but evidence is still lacking, especially on its effects after rotator cuff repair.Hypothesis: Platelet-rich plasma accelerates recovery after arthroscopic rotator cuff repair in pain relief, functional outcome, overall satisfaction, and enhanced structural integrity of repaired tendon.Study Design: Cohort study; Level of

  7. Hip arthroscopic surgery: patient evaluation, current indications, and outcomes.

    PubMed

    Lynch, T Sean; Terry, Michael A; Bedi, Asheesh; Kelly, Bryan T

    2013-05-01

    Arthroscopic surgery in the hip joint has historically lagged behind its counterparts in the shoulder and knee. However, the management of hip injuries in the athletic population has rapidly evolved over the past decade with our improved understanding of mechanical hip pathology as well as the marked improvement in imaging modalities and arthroscopic techniques. Current indications for hip arthroscopic surgery may include symptomatic labral tears, femoroacetabular impingement (FAI), hip capsular laxity/instability, chondral lesions, disorders of the peritrochanteric or deep gluteal space, septic joint, loose bodies, and ligamentum teres injuries. Furthermore, hip arthroscopic surgery is developing an increasingly important role as an adjunct diagnostic and therapeutic tool in conjunction with open femoral and/or periacetabular osteotomy for complex hip deformities. Arthroscopic techniques have evolved to allow for effective and comprehensive treatment of various hip deformities. Techniques for extensile arthroscopic capsulotomies have allowed for improved central and peripheral compartment exposure and access for labral takedown, refixation, treatment of chondral injury, and osteochondroplasty of the femoral head-neck junction and acetabular rim. While favorable short-term and midterm clinical outcomes have been reported after arthroscopic treatment of prearthritic hip lesions, greater long-term follow-up is necessary to assess the efficacy of hip arthroscopic surgery in altering the natural history and progressive degenerative changes associated with FAI. PMID:23449836

  8. Arthroscopic resection of the common extensor origin: anatomic considerations

    Microsoft Academic Search

    Adam M Smith; Jason A Castle; David S Ruch

    2003-01-01

    This study examines the intra-articular anatomy and safe zones for arthroscopic resection of the common extensor origin for the treatment of lateral epicondylitis. The extensor complex was arthroscopically debrided in 7 cadaveric elbows to determine the percentage of each tendinous origin that was resectable. Elbow stability was assessed, and safe zones of resection were determined. The extensor carpi radialis brevis

  9. Arthroscopic Assessment and Treatment of Dancers' Knee Injuries.

    ERIC Educational Resources Information Center

    Silver, Daniel M.; Campbell, Pat

    1985-01-01

    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)

  10. Meningocele repair

    MedlinePLUS

    ... Myelodysplasia repair; Spinal dysraphism repair; Meningomyelocele repair; Neural tube defect repair; Spina bifida repair ... hydrocephalus, the doctor may put a shunt (plastic tube) in their brain to drain the extra fluid ...

  11. All arthroscopic stabilization of acute acromioclavicular joint dislocation with fiberwire and endobutton system

    PubMed Central

    Spoliti, Marco; De Cupis, Mauro; Via, Alessio Giai; Oliva, Francesco

    2014-01-01

    Summary Introduction: acromioclavicular (AC) joint dislocation is common in athletes and in contact sports and about 9% of shoulder injuries involves this joint. The majority of these AC lesions can be successfully treated conservatively but high grade dislocation and some cases of type III dislocation need a surgical treatment. Many different operative techniques have been described over the years. The purpose of this study is to evaluate the results of arthroscopic stabilization of AC joint dislocation with TightRope® system. Materials and methods: nineteen patients with acute AC dislocation were treated by arthroscopic fixation with TightRope® system. Any associated lesions were repaired. All patients were assessed before surgery (T0), at 3 months (T1), at 6 months (T2) and at 1 year after the surgery (T3) using a visual analogic scale (VAS) and Constant-Murley Score (CMS). All patients were evaluated with X-ray. Results: six AC-joint dislocations involved the right shoulder and thirteen the left shoulder. Ten were type III dislocation, three were type IV and six were type V dislocation. We found a statistically significant reduction of pain (p< 0.01) at T1 compared to the pretreatment scores. The CMS measures showed an improvement between T1, T2 and T3, but the difference was statistically significant only between T1 and T3 (p= 0.017). The postoperative X-Ray of the shoulder showed a good reduction of the AC joint dislocation. We had 1 case of recurrence and 2 cases of loss of intraoperative reduction. Conclusion: arthroscopic technique for acute AC joint dislocations with the use of the TightRope® device is minimally invasive and it allows an anatomic restoration of the joint. It is a safe and effective procedure ensuring stable AC joint reconstruction and good cosmetic results. PMID:25767774

  12. Arthroscopic optical coherence tomography provides detailed information on articular cartilage lesions in horses.

    PubMed

    te Moller, N C R; Brommer, H; Liukkonen, J; Virén, T; Timonen, M; Puhakka, P H; Jurvelin, J S; van Weeren, P R; Töyräs, J

    2013-09-01

    Arthroscopy enables direct inspection of the articular surface, but provides no information on deeper cartilage layers. Optical coherence tomography (OCT), based on measurement of reflection and backscattering of light, is a diagnostic technique used in cardiovascular surgery and ophthalmology. It provides cross-sectional images at resolutions comparable to that of low-power microscopy. The aim of this study was to determine if OCT is feasible for advanced clinical assessment of lesions in equine articular cartilage during diagnostic arthroscopy. Diagnostic arthroscopy of 36 metacarpophalangeal joints was carried out ex vivo. Of these, 18 joints with varying degrees of cartilage damage were selected, wherein OCT arthroscopy was conducted using an OCT catheter (diameter 0.9 mm) inserted through standard instrument portals. Five sites of interest, occasionally supplemented with other locations where defects were encountered, were arthroscopically graded according to the International Cartilage Repair Society (ICRS) classification system. The same sites were evaluated qualitatively (ICRS classification and morphological description of the lesions) and quantitatively (measurement of cartilage thickness) on OCT images. OCT provided high resolution images of cartilage enabling determination of cartilage thickness. Comparing ICRS grades determined by both arthroscopy and OCT revealed poor agreement. Furthermore, OCT visualised a spectrum of lesions, including cavitation, fibrillation, superficial and deep clefts, erosion, ulceration and fragmentation. In addition, with OCT the arthroscopically inaccessible area between the dorsal MC3 and P1 was reachable in some cases. Arthroscopically-guided OCT provided more detailed and quantitative information on the morphology of articular cartilage lesions than conventional arthroscopy. OCT could therefore improve the diagnostic value of arthroscopy in equine orthopaedic surgery. PMID:23810744

  13. Arthroscopic Delivery of Matrix-Induced Autologous Chondrocyte Implant

    PubMed Central

    Cortese, Fabrizio; McNicholas, Michael; Gillogly, Scott; Abelow, Stephen P.; Gigante, Antonio; Coletti, Nicolò

    2012-01-01

    Objective: To identify consensus recommendations for the arthroscopic delivery of the matrix-induced autologous chondrocyte implant. Design: An invited panel was assembled on November 20 and 21, 2009 as an international advisory board in Zurich, Switzerland, to discuss and identify best practices for the arthroscopic delivery of matrix-induced autologous chondrocyte implantation. Results: Arthroscopic matrix-induced autologous chondrocyte implantation is suitable for patients 18 to 55 years of age who have symptomatic, contained chondral lesions of the knee with normal or corrected alignment and stability. This technical note describes consensus recommendations of the international advisory board for the technique of arthroscopic delivery of the matrix-induced autologous chondrocyte implant. Conclusions: Matrix-induced autologous chondrocyte implantation can be further improved by arthroscopic delivery that does not require special instrumentation. In principle, arthroscopic versus open procedures of delivery of the matrix-induced autologous chondrocyte implant are less invasive and may potentially result in less postoperative pain, less surgical site morbidity, and faster surgical recovery. Long-term studies are needed to confirm these assumptions as well as the efficacy and safety of this arthroscopic approach.

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

    PubMed Central

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

    2014-01-01

    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

  15. Arthroscopic anatomic reconstruction of the lateral ligaments of the ankle with gracilis autograft.

    PubMed

    Guillo, Stéphane; Archbold, Pooler; Perera, Anthony; Bauer, Thomas; Sonnery-Cottet, Bertrand

    2014-10-01

    Lateral ankle sprains are common; if conservative treatment fails and chronic instability develops, stabilization surgery is indicated. Numerous surgical procedures have been described, but those that most closely reproduce normal ankle lateral ligament anatomy and kinematics have been shown to have the best outcomes. Arthroscopy is a common adjunct to open ligament surgery, but it is traditionally only used to improve the diagnosis and the management of any associated intra-articular lesions. The stabilization itself is performed open because standard anterior ankle arthroscopy provides only partial visualization of the anterior talofibular ligament from above and the calcaneofibular ligament attachments cannot be seen at all. However, lateral ankle endoscopy can provide a view of this area that is superior to open surgery. We have developed a technique of ankle endoscopy that enables anatomic positioning of the repair or fixation of the graft. In this article we describe a safe and reproducible arthroscopic anatomic reconstruction of the lateral ligaments of the ankle using a gracilis autograft. The aim of this procedure is to obtain a more physiological reconstruction while maintaining all the advantages of an arthroscopic approach. PMID:25473613

  16. A Reproducible Technique for Arthroscopic Acromioclavicular Joint Excision.

    PubMed

    Wheelton, Andrew; Kenyon, Peter; Ravenscroft, Matt

    2015-06-01

    Arthroscopic acromioclavicular joint excision is a commonly performed but technically demanding procedure. Incomplete excision can leave residual symptoms. We present a simple, reproducible technique ensuring satisfactory excision of the joint. PMID:26078510

  17. Experience-based virtual training system for knee arthroscopic inspection

    PubMed Central

    2013-01-01

    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

  18. Arthroscopic-Assisted Fixation of Ideberg Type III Glenoid Fractures.

    PubMed

    Tao, Matthew A; Garrigues, Grant E

    2015-04-01

    Operative treatment of scapular fractures with extension into the glenoid can be a challenging clinical scenario. Though traditionally addressed in an open fashion, the morbidity of this approach, complemented by advancements in arthroscopic technique and instrumentation, has led to increasing use of arthroscopic-assisted fixation. We describe our technique, including pearls and pitfalls, for minimally invasive fixation of Ideberg type III glenoid fractures. This approach minimizes morbidity, allows optimal visualization and reduction, and provides good functional results. PMID:26052487

  19. Discoid lateral meniscus: diagnosis and results of arthroscopic treatment

    Microsoft Academic Search

    Mehmet Asik; Cengiz Sen; Omer F. Taser; Aziz K. Alturfan; Yunus V. Sozen

    2003-01-01

    We evaluated the results of arthroscopic meniscectomy in patients with discoid lateral menisci of the knee. Discoid lateral menisci were detected in 308 patients, of whom 197 (124 males, 73 females; mean age 34.5 years, range 6-67) were clinically, radiologically, and arthroscopically found to be symptomatic and underwent partial meniscectomy. The average period between injury and operation was 13.2 months

  20. Nine cases of osteonecrosis in elderly patients following arthroscopic meniscectomy

    Microsoft Academic Search

    V. Pruès-Latour; J.-C. Bonvin; D. Fritschy

    1998-01-01

    We report nine cases of osteonecrosis of the knee after arthroscopic meniscectomy between 1992 and 1996. In five women and\\u000a four men aged between 58 and 82 years (mean 69 years), magnetic resonance imaging (MRI) demonstrated a meniscal tear for which\\u000a arthroscopic meniscectomy was performed. MRI was done between 3 days and 72 weeks after the onset of symptoms. Signs

  1. Arthroscopic-Assisted Fixation of Ideberg Type III Glenoid Fractures

    PubMed Central

    Tao, Matthew A.; Garrigues, Grant E.

    2015-01-01

    Operative treatment of scapular fractures with extension into the glenoid can be a challenging clinical scenario. Though traditionally addressed in an open fashion, the morbidity of this approach, complemented by advancements in arthroscopic technique and instrumentation, has led to increasing use of arthroscopic-assisted fixation. We describe our technique, including pearls and pitfalls, for minimally invasive fixation of Ideberg type III glenoid fractures. This approach minimizes morbidity, allows optimal visualization and reduction, and provides good functional results. PMID:26052487

  2. Arthroscopically Assisted Reconstruction of Acute Acromioclavicular Joint Dislocations: Anatomic AC Ligament Reconstruction With Protective Internal Bracing-The "AC-RecoBridge" Technique.

    PubMed

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

    2015-04-01

    An arthroscopically assisted technique for the treatment of acute acromioclavicular joint dislocations is presented. This pathology-based procedure aims to achieve anatomic healing of both the acromioclavicular ligament complex (ACLC) and the coracoclavicular ligaments. First, the acromioclavicular joint is reduced anatomically under macroscopic and radiologic control and temporarily transfixed with a K-wire. A single-channel technique using 2 suture tapes provides secure coracoclavicular stabilization. The key step of the procedure consists of the anatomic repair of the ACLC ("AC-Reco"). Basically, we have observed 4 patterns of injury: clavicular-sided, acromial-sided, oblique, and midportion tears. Direct and/or transosseous ACLC repair is performed accordingly. Then, an X-configured acromioclavicular suture tape cerclage ("AC-Bridge") is applied under arthroscopic assistance to limit horizontal clavicular translation to a physiological extent. The AC-Bridge follows the principle of internal bracing and protects healing of the ACLC repair. The AC-Bridge is tightened on top of the repair, creating an additional suture-bridge effect and promoting anatomic ACLC healing. We refer to this combined technique of anatomic ACLC repair and protective internal bracing as the "AC-RecoBridge." A detailed stepwise description of the surgical technique, including indications, technical pearls and pitfalls, and potential complications, is given. PMID:26052493

  3. Arthroscopically Assisted Reconstruction of Acute Acromioclavicular Joint Dislocations: Anatomic AC Ligament Reconstruction With Protective Internal Bracing—The “AC-RecoBridge” Technique

    PubMed Central

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

    2015-01-01

    An arthroscopically assisted technique for the treatment of acute acromioclavicular joint dislocations is presented. This pathology-based procedure aims to achieve anatomic healing of both the acromioclavicular ligament complex (ACLC) and the coracoclavicular ligaments. First, the acromioclavicular joint is reduced anatomically under macroscopic and radiologic control and temporarily transfixed with a K-wire. A single-channel technique using 2 suture tapes provides secure coracoclavicular stabilization. The key step of the procedure consists of the anatomic repair of the ACLC (“AC-Reco”). Basically, we have observed 4 patterns of injury: clavicular-sided, acromial-sided, oblique, and midportion tears. Direct and/or transosseous ACLC repair is performed accordingly. Then, an X-configured acromioclavicular suture tape cerclage (“AC-Bridge”) is applied under arthroscopic assistance to limit horizontal clavicular translation to a physiological extent. The AC-Bridge follows the principle of internal bracing and protects healing of the ACLC repair. The AC-Bridge is tightened on top of the repair, creating an additional suture-bridge effect and promoting anatomic ACLC healing. We refer to this combined technique of anatomic ACLC repair and protective internal bracing as the “AC-RecoBridge.” A detailed stepwise description of the surgical technique, including indications, technical pearls and pitfalls, and potential complications, is given.

  4. Arthroscopic microfracture may not be superior to arthroscopic debridement, but abrasion arthroplasty results are good, although not great.

    PubMed

    Lubowitz, James H

    2015-03-01

    Microfracture is nonanatomic because microfracture destroys the gross structure and the complex microscopic infrastructure of the subchondral plate, and may promote subchondral cyst formation. In consideration of the destruction of subchondral anatomy, it may be time to abandon the arthroscopic microfracture procedure. However, arthroscopic abrasion arthroplasty results in a positive outcome in 66% of patients, and may still merit consideration as a salvage procedure. PMID:25744323

  5. A simple method for identifying the acromioclavicular joint during arthroscopic procedures.

    PubMed

    Javed, Saqib; Heasley, Richard; Ravenscroft, Matt

    2014-06-01

    Arthroscopic acromioclavicular joint excision is performed via an anterior portal and is technically demanding. We present a simple method for identifying the acromioclavicular joint during arthroscopic procedures. PMID:24876686

  6. Effectiveness of arthroscopic versus open surgical stabilisation for the management of traumatic anterior glenohumeral instability.

    PubMed

    Ng, Choong; Bialocerkowski, Andrea; Hinman, Rana

    2007-06-01

    Background? Anterior instability is a frequent complication following a traumatic glenohumeral dislocation. Frequently the underlying pathology associated with recurrent instability is a Bankart lesion. Surgical correction of Bankart lesions and other associated pathology is the key to successful treatment. Open surgical glenohumeral stabilisation has been advocated as the gold standard because of consistently low postoperative recurrent instability rates. However, arthroscopic glenohumeral stabilisation could challenge open surgical repair as the gold standard treatment for traumatic anterior glenohumeral instability. Objectives? Primary evidence that compared the effectiveness of arthroscopic versus open surgical glenohumeral stabilisation was systematically collated regarding best-practice management for adults with traumatic anterior glenohumeral instability. Search strategy? A systematic search was performed using 14 databases: MEDLINE, Cumulative Index of Nursing and Allied Health (CINAHL), Allied and Complementary Medicine Database (AMED), ISI Web of Science, Expanded Academic ASAP, Proquest Medical Library, Evidence Based Medicine Reviews, Physiotherapy Evidence Database, TRIP Database, PubMed, ISI Current Contents Connect, Proquest Digital Dissertations, Open Archives Initiative Search Engine, Australian Digital Thesis Program. Studies published between January 1984 and December 2004 were included in this review. No language restrictions were applied. Selection criteria? Eligible studies were those that compared the effectiveness of arthroscopic versus open surgical stabilisation for the management of traumatic anterior glenohumeral instability, which had more than 2?years of follow up and used recurrent instability and a functional shoulder questionnaire as primary outcomes. Studies that used non-anatomical open repair techniques, patient groups that were specifically 40?years or older, or had multidirectional instability or other concomitant shoulder pathology were excluded. Data collection and analysis? Two independent reviewers assessed the eligibility of each study for inclusion into the review, the study design used and its methodological quality. Where any disagreement occurred, consensus was reached by discussion with an independent researcher. Studies were assessed for homogeneity by considering populations, interventions and outcomes. Where heterogeneity was present, synthesis was undertaken in a narrative format; otherwise a meta-analysis was conducted. Results? Eleven studies were included in the review. Two were randomised controlled trials. Evidence comparing arthroscopic and open surgical glenohumeral stabilisation was of poor to fair methodological quality. Hence, the results of primary studies should be interpreted with caution. Observed clinical heterogeneity in populations and outcomes was highlighted and should be considered when interpreting the meta-analysis. Authors also used variable definitions of recurrent instability and a variety of outcome measures, which made it difficult to synthesise results. When comparable data were pooled, there were no significant differences (P?>?0.05) between the arthroscopic and open groups with respect to recurrent instability rates, Rowe score, glenohumeral external rotation range and complication rates. Conclusions? Statistically, it appears that both surgical techniques are equally effective in managing traumatic anterior glenohumeral instability. In light of the methodological quality of the included studies, it is not possible to validate arthoscopic stabilisation to match open surgical stabilisation as the gold standard treatment. Further research using multicentred randomised controlled trials with sufficient power and instability-specific questionnaires with sound psychometric properties is recommended to build on current evidence. The choice of treatment should be based on multiple factors between the clinician and the patient. PMID:21631787

  7. Arthroscopic reconstruction of the acromioclavicular joint disruption: surgical technique and preliminary results

    Microsoft Academic Search

    Bancha Chernchujit; Thomas Tischer; Andreas B. Imhoff

    2006-01-01

    Introduction: Numerous operative procedures have been described for the reconstruction of acromioclavicular joint separation; however, the arthroscopic reconstruction has been rarely reported. Therefore, our objective was to propose a new technique of arthroscopic acromioclavicular joint surgery and to evaluate the preliminary results. Materials and methods: Thirteen patients with a mean follow-up of 18 months underwent the arthroscopic acromioclavicular joint reconstruction

  8. Subacromial Spacer Placement for Protection of Rotator Cuff Repair

    PubMed Central

    Szöllösy, Gregor; Rosso, Claudio; Fogerty, Simon; Petkin, Kalojan; Lafosse, Laurent

    2014-01-01

    Rotator cuff repairs have a high failure rate proportional to the tear size. Various techniques have been described to improve the repair strength and failure rate. The described surgical technique uses a biodegradable subacromial balloon-shaped spacer (InSpace; OrthoSpace, Caesarea, Israel) that is implanted arthroscopically to protect our tendon repair. We describe the introduction technique and suggest some hints and tricks. The spacer is placed under direct vision in the subacromial space after the rotator cuff repair is finished. Correct placement is verified by moving the arm freely. The subacromial spacer may help to protect the rotator cuff repair by centering the humeral head and reducing friction between suture knots and the acromion. It may also help to flatten dog-ear formations. PMID:25473615

  9. Arthroscopic management of tibial plateau fractures: special techniques.

    PubMed

    Perez Carro, L

    1997-04-01

    Arthroscopic assessment and treatment of tibial plateau fractures has gained popularity in recent years. This article describes some maneuvers to facilitate the management of these fractures with the arthroscope. We use a 14-mm rounded curved periosteal elevator to manipulate fragments within the joint instead of using a probe. To facilitate visualization of fractures, we describe the use of loop sutures around the meniscus to retract the meniscus when there is a tear in the meniscus. We suggest the use of the arthroscope for directly viewing the interosseous space to be sure that any internal fixation devices remain outside the articular space. The use of these tactics will allow a faster, more accurate reduction with less radiation exposure in patients with displaced tibial plateau fractures. PMID:9127091

  10. Pneumomediastinum after arthroscopic shoulder surgery -A case report-

    PubMed Central

    Kim, Hae-Kyoung; Ko, Eun-Sung; Kim, Jee-Young; Park, Jung-Min; Kim, Jae-Yun

    2013-01-01

    An 86-year-old female with a history of right rotator cuff injury was admitted for arthroscopic shoulder surgery under general anesthesia. There were no remarkable immediate postoperative complications. However, while recovering in the general ward, she developed dyspnea with hypoxia. She was immediately treated with oxygen, and antibiotics after pneumomediastinum was confirmed on both chest x-ray and chest computed tomography. Subcutaneous emphysema on either face or neck followed by arthroscopic shoulder surgery was common, but pneumomediastinum with hypoxia is a rare but extremely dangerous complication. Thus we would like to report our case and its pathology, the diagnosis, the treatment and prevention, with literature review. PMID:23646251

  11. Arthroscopic Glenohumeral Arthrodesis With O-Arm Navigation

    PubMed Central

    Lädermann, Alexandre; Denard, Patrick J.

    2014-01-01

    Glenohumeral arthrodesis is an end-stage salvage operation that has traditionally been performed in an open fashion. In recent years an arthroscopic approach has been described. The purpose of this report was to present an arthroscopic glenohumeral arthrodesis technique with the assistance of O-arm–based navigation. An illustrative case example is presented. This technique allows not only a minimally invasive glenohumeral arthrodesis but also precise screw fixation by navigation, which may be particularly useful in cases of limited bone stock and/or bony deformity. PMID:24904761

  12. Infection after arthroscopic anterior cruciate ligament reconstruction.

    PubMed

    Kim, Seung-Ju; Postigo, Ricardo; Koo, Sowon; Kim, Jong Hun

    2014-07-01

    Septic arthritis is a rare but potentially devastating complication of anterior cruciate ligament (ACL) reconstruction surgery. The purpose of this study was to provide an evidence-based summarization of the treatment and outcome of infection after ACL reconstruction with a pooled analysis of the reported cases. The authors conducted a systematic review of published studies that evaluated the outcome of septic arthritis after arthroscopic ACL reconstruction. A structured literature review of multiple databases referenced articles from 1950 to 2012. A total of 22,836 knees from 14 published studies were assessed. Postoperative septic arthritis occurred in 121 knees, with a pooled percentage of 0.5%. Mean duration of follow-up after ACL reconstruction was 53.6 months (range, 4-218 months). An average of 1.92 procedures (range, 1-5 procedures) were performed to eradicate the infection. The grafts were retained in 77% of cases. Postoperative intravenous antibiotics were used for at least 5 days (range, 5-90 days) after debridement. At final follow-up, mean postoperative Lysholm score was 80.2 (range, 23-100). No reinfection was observed in 121 patients. This study has helped to further elucidate the outcomes of infection after ACL reconstruction. Once an infection is encountered, culture-specific antibiotics and surgical joint irrigation with graft retention are recommended as initial treatment. Graft removal can be considered only for those infections resistant to initial treatment. PMID:24992054

  13. Release of growth factors after arthroscopic acromioplasty.

    PubMed

    Randelli, Pietro; Margheritini, Fabrizio; Cabitza, Paolo; Dogliotti, Giada; Corsi, Massimiliano M

    2009-01-01

    It has recently been postulated that a variety of growth factors may be released from cancellous bone after an acromioplasty. The aim of this study was to demonstrate the presence of growth factors in the subacromial space after acromioplasty. Between October 2006 and March 2007, 23 patients underwent arthroscopic acromioplasty. A sample of at least 3 ml of fluid from the shoulder was obtained 15 min after the end of the procedure. At the same time another sample of 3 ml of the patient's venous blood was obtained as a control. The concentrations of growth factors in the fluids collected were determined using enzyme-linked immunosorbent assay (ELISA). The growth factors assayed were platelet-derived growth factor-AB (PDGF-AB), basic fibroblast growth factor basic (bFGF) and transforming growth factor beta 1 (TGF-beta1). The concentrations of TGF-beta1 (p = 0.0001), PDGF-AB (p = 0.02), and bFGF (p < 0.0001) were significantly higher in the fluid from the subacromial space than in the blood sample. There are high concentrations of several growth factors in the subacromial space after acromioplasty. PMID:18974971

  14. Rupture of the quadriceps tendon after arthroscopic lateral meniscectomy

    Microsoft Academic Search

    Renato Viola; Nicola Marzano; Roberto Vianello

    2001-01-01

    We report a case of complete quadriceps tendon rupture that occured a few days after arthroscopic lateral meniscectomy. Complications following arthroscopy are rare; there have been many reports of quadriceps tendon rupture in the literature, but none by this kind of mechanism.

  15. Arthroscopic acromioclavicular joint resectionAn anatomical study

    Microsoft Academic Search

    Gary M. Gartsman; Andrew H. Combs; Pamela F. Davis; Hugh S. Tullos

    1991-01-01

    Distal clavicle resection has been an effective procedure for treatment of acromioclavicular arthritis. The conven tional open surgical technique involves deltoid detach ment and reattachment, which may cause postopera tive weakness and requires protection during the post operative period to allow for healing. Arthroscopic acromioclavicular joint resection has the theoretical ad vantages of no deltoid disruption and a shorter rehabil

  16. Incidence of Acromioclavicular Joint Complications After Arthroscopic Subacromial Decompression

    Microsoft Academic Search

    Brett W. Fischer; R. Michael Gross; Jack A. McCarthy; Julian S. Arroyo

    1999-01-01

    Summary: We performed a chart and radiograph review of 173 patients (183 shoulders) who underwent arthroscopic subacromial decompression between 1991 and 1994 and had preoperative and postoperative radiographs. The study focused on the presence of preoperative acromioclavicular joint pathology, intraoperative violation of the acromioclavicular joint, extent of distal clavicle excision, and subsequent development of acromioclavicular joint symptoms. The 183 surgical

  17. Arthroscopic Treatment of Acute and Chronic Acromioclavicular Joint Dislocation

    Microsoft Academic Search

    Laurent Lafosse; Gloria P. Baier; Jan Leuzinger

    2005-01-01

    This article presents an all-arthroscopic technique for coracoclavicular ligament reconstruction by ligamentoplasty after acute or chronic acromioclavicular joint dislocation. A coracoacromial ligament transfer is done to reconstruct the torn coracoclavicular ligaments, similar to open surgery. The coracoacromial ligament is dissected from the undersurface of the acromion and is reinserted on the inferior clavicle by transosseous suture fixation. Additional wire or

  18. Arthroscopic Subtalar Arthrodesis: The Posterior Approach in the Prone Position

    Microsoft Academic Search

    Luis Perez Carro; Pau Golanó; Jordi Vega

    2007-01-01

    Arthroscopic subtalar arthrodesis, as reported by Tasto, is done in the lateral decubitus position, and the portal sites are lateral. This report describes a new alternative method in which the patient is in the prone position and a posterior 2-portal approach is used, as described by van Dijk et al. The initial debridement and synovectomy are performed with 4- and

  19. Arthroscopic Treatment of Posttraumatic Elbow Pain and Stiffness

    Microsoft Academic Search

    Laura A. Timmerman; James R. Andrews

    1994-01-01

    Nineteen consecutive cases of posttraumatic arthrofi brosis of the elbow secondary to a fracture or fracture- dislocation and treated with arthroscopic debridement and manipulation were retrospectively reviewed. All of the patients had pain and stiffness in their elbows, and all had failed a conservative therapy program. All 19 patients were followed postoperatively for an average of 29 months (range, 12

  20. Improved Visualization of the 70° Arthroscope in the Treatment of Talar Osteochondral Defects

    PubMed Central

    Spennacchio, Pietro; Randelli, Pietro; Arrigoni, Paolo; van Dijk, Niek

    2013-01-01

    Osteochondral defects (OCDs) of the talus are a common cause of residual pain after ankle injuries. When conservative treatment fails, arthroscopic debridement combined with drilling/microfracturing of the lesion (bone marrow stimulation [BMS] procedures) has been shown to provide good to excellent outcomes. Not uncommonly, talar OCDs involve the borders of the talar dome. These uncontained lesions are sometimes difficult to visualize with the 30° arthroscope, with potential negative effect on the clinical outcome of an arthroscopic BMS procedure. The use of the 70° arthroscope has been described for a multitude of common knee, shoulder, elbow, and hip procedures. The purpose of this article is to show the usefulness of the 70° arthroscope in arthroscopic BMS procedures, pointing out which kinds of talar OCDs can benefit most from its use. PMID:23875138

  1. Improved visualization of the 70° arthroscope in the treatment of talar osteochondral defects.

    PubMed

    Spennacchio, Pietro; Randelli, Pietro; Arrigoni, Paolo; van Dijk, Niek

    2013-05-01

    Osteochondral defects (OCDs) of the talus are a common cause of residual pain after ankle injuries. When conservative treatment fails, arthroscopic debridement combined with drilling/microfracturing of the lesion (bone marrow stimulation [BMS] procedures) has been shown to provide good to excellent outcomes. Not uncommonly, talar OCDs involve the borders of the talar dome. These uncontained lesions are sometimes difficult to visualize with the 30° arthroscope, with potential negative effect on the clinical outcome of an arthroscopic BMS procedure. The use of the 70° arthroscope has been described for a multitude of common knee, shoulder, elbow, and hip procedures. The purpose of this article is to show the usefulness of the 70° arthroscope in arthroscopic BMS procedures, pointing out which kinds of talar OCDs can benefit most from its use. PMID:23875138

  2. A novel graphical user interface for ultrasound-guided shoulder arthroscopic surgery

    NASA Astrophysics Data System (ADS)

    Tyryshkin, K.; Mousavi, P.; Beek, M.; Pichora, D.; Abolmaesumi, P.

    2007-03-01

    This paper presents a novel graphical user interface developed for a navigation system for ultrasound-guided computer-assisted shoulder arthroscopic surgery. The envisioned purpose of the interface is to assist the surgeon in determining the position and orientation of the arthroscopic camera and other surgical tools within the anatomy of the patient. The user interface features real time position tracking of the arthroscopic instruments with an optical tracking system, and visualization of their graphical representations relative to a three-dimensional shoulder surface model of the patient, created from computed tomography images. In addition, the developed graphical interface facilitates fast and user-friendly intra-operative calibration of the arthroscope and the arthroscopic burr, capture and segmentation of ultrasound images, and intra-operative registration. A pilot study simulating the computer-aided shoulder arthroscopic procedure on a shoulder phantom demonstrated the speed, efficiency and ease-of-use of the system.

  3. Gastroschisis repair

    MedlinePLUS

    Abdominal wall defect repair ... back into the belly. The opening in the wall of the belly will be repaired, if possible. ... after surgery. Inflammation of tissues that line the wall of the abdomen and cover the abdominal organs ...

  4. Suture-bridge subscapularis tendon repair technique using low anterior portals.

    PubMed

    Park, Jin-Young; Park, Jun-Suk; Jung, Jae-Kyung; Kumar, Praveen; Oh, Kyung-Soo

    2011-02-01

    A suture-bridge technique has been introduced to facilitate fixation procedures and to achieve increased holding strength in posterosuperior rotator cuff. Based on biomechanical studies, this technique has been suggested as an effective method that could optimize rotator cuff tendon-footprint contact area and mean pressure, as well as holding strength. In this technique, the suture-bridge creation is adapted for arthroscopic subscapularis repair to attain the ideal cuff integrity and footprint restoration. To obtain enough working portals and space, two accessory portals were made on the anterior aspect of the shoulder and use an elevator to retract the conjoined tendons and deltoid muscle. This technique could be useful for the repair of subscapularis tears, which are not easily approached using other arthroscopic techniques. From a biomechanical point of view, the subscapularis tendon could be restored more ideally using the suture-bridge technique. PMID:20890701

  5. Arthroscopic reconstruction of the anterior cruciate ligament using allograft tendon.

    PubMed

    Wainer, R A; Clarke, T J; Poehling, G G

    1988-01-01

    Treatment of the anterior cruciate ligament (ACL)-deficient knee using an arthroscopic technique and freeze-dried allograft tendons in 23 patients was studied prospectively. Accurate placement of drill holes and anchoring positions for the allografts was effected through a standard arthroscopic approach combined with a 3 cm incision on the medial tibial flare. Candidates for reconstruction were those who were unable to tolerate brace therapy and who had no degenerative arthritis. The 23 patients were drawn from a group of 60 treated patients because their follow-up had been greater than or equal to 1 year. Their knees were assessed preoperatively and postoperatively with a Lysholm knee rating scale, Lachman test with KT-1000 arthrometric quantitation, pivot shift, Biodex test, and radiographs. Knee rating values improved in all knees, and only one patient had a significant deterioration in the KT-1000 reading. All patients with at least 20 months follow-up have resumed their preinjury activity levels. PMID:3166660

  6. Advantages of 70° arthroscope in management of ECRB tendinopathy.

    PubMed

    Arrigoni, P; Zottarelli, L; Spennacchio, P; Denti, M; Cabitza, P; Randelli, P

    2011-07-01

    Lateral epicondylitis requires a challenging therapeutic management even for expert surgeons. With the failure of conservative treatment, the physician should consider a surgical choice. The purpose of the surgical procedure is to excise the degenerated tissue of extensor carpi radialis brevis tendon. This article describes the arthroscopic release, performed under direct visualization with a 70° scope; the aim is to encourage the use of this type of lens, versus the traditional 30° one. The patient is positioned in a modified lateral decubitus. After joint distension, a diagnostic arthroscopy of the posterior compartment is performed as first step. Then, an anterior compartment arthroscopic evaluation, a subsequent antero-lateral capsulectomy, and extensor carpi radialis brevis tendon exposition are performed with a 30° view. At this point, the 70° lens is switched and the tendon release is performed under direct control. The 70° lens allows a safer procedure, but requires a dedicated learning curve. PMID:21484442

  7. Knee complaints in patients with normal arthroscopic findings.

    PubMed

    Grønlund, B; Andersen-Ranberg, F

    1990-01-01

    Clinical follow-up was obtained in 96 patients with knee complaints but normal arthroscopic findings (mean observation time, 10 months). About one-third had no symptoms at follow-up; in another third there was improvement; in the remaining third there were unchanged or worsened symptoms, and a clinical re-examination indicated that alterations in the soft tissues around the knee might explain the worsening. However, 10 patients in the last group had not only significant worsening of the knee symptoms but also severe complaints in other regions of the body and a psychosomatic factor was suspected. Most of the patients with symptoms at follow-up had significant wasting of the quadriceps muscles. Energetic exercises seem important even in patients with normal arthroscopic findings. PMID:2075813

  8. Advantages of 70° arthroscope in management of ECRB tendinopathy

    Microsoft Academic Search

    P. Arrigoni; L. Zottarelli; P. Spennacchio; M. Denti; P. Cabitza; P. Randelli

    2011-01-01

    Lateral epicondylitis requires a challenging therapeutic management even for expert surgeons. With the failure of conservative\\u000a treatment, the physician should consider a surgical choice. The purpose of the surgical procedure is to excise the degenerated\\u000a tissue of extensor carpi radialis brevis tendon. This article describes the arthroscopic release, performed under direct visualization\\u000a with a 70° scope; the aim is to

  9. Clinical Outcomes after Arthroscopic Release for Recalcitrant Frozen Shoulder

    PubMed Central

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

    2014-01-01

    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

  10. Arthroscopic approaches and intraarticular anatomy of the equine elbow.

    PubMed

    Nixon, A J

    1990-01-01

    Periarticular anatomy and techniques for arthroscopic access to the equine elbow were studied in six joints from cadavers. Caudomedial and craniolateral approaches were evaluated subsequently in 11 anesthetized horses. The caudomedial approach was made between the flexor carpi radialis and flexor carpi ulnaris muscle bellies. Most of the caudal articular surfaces of the humeral condyles, the caudal perimeter of the radius, and the trochlear notch and portions of the anconeal process of the ulna could be identified. The voluminous caudal joint capsule cul-de-sac proximal to the anconeal process was readily entered. A 70 degree arthroscope allowed examination of more of the joint recesses and articular surfaces of the olecranon fossa than a 25 degree arthroscope. A second portal for intraarticular instrument manipulation was made caudal and slightly proximal to the arthroscope entry. Entry more proximal than the level of the radiohumeral articulation carried significant risk of damage to the ulnar nerve and collateral ulnar artery and vein. For examination of the cranial regions of the elbow, a craniolateral portal was established cranial to the lateral collateral ligament. An instrument portal was made through the muscle bellies of the extensor carpi radialis or common digital extensor muscles. The cranial articular surfaces of the humeral condyles were readily exposed by extension of the elbow. The weight-bearing articular surface of the radius could not be seen. Eight horses were euthanatized without recovery from anesthesia and the elbows were dissected for examination. Three horses were allowed to recover from anesthesia and were euthanatized on days 3, 30, and 60.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:2333691

  11. The Effect of Arthroscopic Rotator Interval Closure on Glenohumeral Volume.

    PubMed

    Ponce, Brent A; Rosenzweig, Seth D; Sheppard, Evan D; Jennings, Jonathan K; Thompson, Kevin J

    2015-06-01

    The role of rotator interval in shoulder pathology and the effect of its closure are not well understood. In addition, the effect of rotator interval closure on intra-articular glenohumeral volume (GHV) remains unknown. We conducted a study to quantify the GHV reduction obtained with an arthroscopic rotator interval closure and to determine whether medial and lateral interval closures resulted in different degrees of volume reduction. We dissected 8 fresh-frozen cadaveric shoulders (mean age, 64.4 years) to the level of the rotator cuff. Volumetric measurements were taken before and after medial and lateral rotator interval closure incorporating the superior glenohumeral ligament and the upper portion of the subscapularis. Arthroscopic closure of the rotator interval with 2 sutures reduced GHV by a mean of 45%. More volume reduction resulted with use of a single lateral interval closure stitch than with use of a single medial stitch (35% vs 24%; P < .02). Arthroscopic rotator interval closure with 2 plication stitches is a powerful tool in reducing intracapsular volume of the shoulder and may be a useful adjunct in restoring glenohumeral stability. If a single plication stitch is preferred, a lateral stitch (vs a medial stitch) can be used for a significantly larger reduction in shoulder volume. PMID:26047004

  12. Arthroscopic treatment of osteochondral lesions of the talus with correlation of outcome scoring systems

    Microsoft Academic Search

    Stephen A. Hunt; Orrin Sherman

    2003-01-01

    Purpose: The goal of this study was to perform a retrospective review of arthroscopically treated osteochondral lesions of the talus (OCLTs) to determine their outcome and to analyze the correlation of 3 subjective outcome scoring systems for the ankle. Methods: Between 1985 and 1999, 37 arthroscopic debridement or subchondral drilling procedures were performed on 33 ankles to treat OCLTs. The

  13. Equine Models of Articular Cartilage Repair

    PubMed Central

    McIlwraith, C. Wayne; Fortier, Lisa A.; Frisbie, David D.; Nixon, Alan J.

    2011-01-01

    Articular cartilage injuries of the knee and ankle are common, and a number of different methods have been developed in an attempt to improve their repair. Clinically, there are 2 distinct aims of cartilage repair: 1) restoration of joint function and 2) prevention or at least delay of the onset of osteoarthritis. These goals can potentially be achieved through replacement of damaged or lost articular cartilage with tissue capable of functioning under normal physiological environments for an extended period, but limitations of the final repair product have long been recognized and still exist today. Screening of potential procedures for human clinical use is done by preclinical studies using animal models. This article reviews equine chondral defect models that have been recently recognized to have specific advantages for translation into human articular cartilage regeneration. Defect models in the femoropatellar, femorotibial, and tibiotalar joints have been developed. The horse provides the closest approximation to humans in terms of articular cartilage and subchondral bone thickness, and it is possible to selectively leave the entire calcified cartilage layer or completely remove it. The defect on the equine medial femoral condyle emulates medial femoral condylar lesions in humans. Other advantages of the equine model include an ability to use an arthroscope to create lesions and perform second-look arthroscopies, the large lesion size allowing for more tissue for evaluation, and the ability to have controlled exercise and test the ability of the repair to cope with athletic exercise as well as institute rehabilitation regimens. PMID:26069590

  14. Osteoarthritis Classification Scales: Interobserver Reliability and Arthroscopic Correlation

    PubMed Central

    Wright, Rick W.; Ross, James R.; Haas, Amanda K.; Huston, Laura J.; Garofoli, Elizabeth A.; Harris, David; Patel, Kushal; Pearson, David; Schutzman, Jake; Tarabichi, Majd; Ying, David; Albright, John P.; Allen, Christina R.; Amendola, Annunziato; Anderson, Allen F.; Andrish, Jack T.; Annunziata, Christopher C.; Arciero, Robert A.; Bach, Bernard R.; Baker, Champ L.; Bartolozzi, Arthur R.; Baumgarten, Keith M.; Bechler, Jeffery R.; Berg, Jeffrey H.; Bernas, Geoffrey A.; Brockmeier, Stephen F.; Brophy, Robert H.; Bush-Joseph, Charles A.; Butler V, J. Brad; Campbell, John D.; Carpenter, James E.; Cole, Brian J.; Cooper, Daniel E.; Cooper, Jonathan M.; Cox, Charles L.; Creighton, R. Alexander; Dahm, Diane L.; David, Tal S.; DeBerardino, Thomas M.; Dunn, Warren R.; Flanigan, David C.; Frederick, Robert W.; Ganley, Theodore J.; Gatt, Charles J.; Gecha, Steven R.; Giffin, James Robert; Hame, Sharon L.; Hannafin, Jo A.; Harner, Christopher D.; Harris, Norman Lindsay; Hechtman, Keith S.; Hershman, Elliott B.; Hoellrich, Rudolf G.; Hosea, Timothy M.; Johnson, David C.; Johnson, Timothy S.; Jones, Morgan H.; Kaeding, Christopher C.; Kamath, Ganesh V.; Klootwyk, Thomas E.; Lantz, Brett A.; Levy, Bruce A.; Ma, C. Benjamin; Maiers, G. Peter; Mann, Barton; Marx, Robert G.; Matava, Matthew J.; Mathien, Gregory M.; McAllister, David R.; McCarty, Eric C.; McCormack, Robert G.; Miller, Bruce S.; Nissen, Carl W.; O’Neill, Daniel F.; Owens, LTC Brett D.; Parker, Richard D.; Purnell, Mark L.; Ramappa, Arun J.; Rauh, Michael A.; Rettig, Arthur; Sekiya, Jon K.; Shea, Kevin G.; Sherman, Orrin H.; Slauterbeck, James R.; Smith, Matthew V.; Spang, Jeffrey T.; Spindler, Kurt P.; Stuart, Michael J.; Svoboda, LTC Steven J.; Taft, Timothy N.; Tenuta, COL Joachim J.; Tingstad, Edwin M.; Vidal, Armando F.; Viskontas, Darius G.; White, Richard A.; Williams, James S.; Wolcott, Michelle L.; Wolf, Brian R.; York, James J.; Carey, James L.

    2014-01-01

    Background: Osteoarthritis of the knee is commonly diagnosed and monitored with radiography. However, the reliability of radiographic classification systems for osteoarthritis and the correlation of these classifications with the actual degree of confirmed degeneration of the articular cartilage of the tibiofemoral joint have not been adequately studied. Methods: As the Multicenter ACL (anterior cruciate ligament) Revision Study (MARS) Group, we conducted a multicenter, prospective longitudinal cohort study of patients undergoing revision surgery after anterior cruciate ligament reconstruction. We followed 632 patients who underwent radiographic evaluation of the knee (an anteroposterior weight-bearing radiograph, a posteroanterior weight-bearing radiograph made with the knee in 45° of flexion [Rosenberg radiograph], or both) and arthroscopic evaluation of the articular surfaces. Three blinded examiners independently graded radiographic findings according to six commonly used systems—the Kellgren-Lawrence, International Knee Documentation Committee, Fairbank, Brandt et al., Ahlbäck, and Jäger-Wirth classifications. Interobserver reliability was assessed with use of the intraclass correlation coefficient. The association between radiographic classification and arthroscopic findings of tibiofemoral chondral disease was assessed with use of the Spearman correlation coefficient. Results: Overall, 45° posteroanterior flexion weight-bearing radiographs had higher interobserver reliability (intraclass correlation coefficient = 0.63; 95% confidence interval, 0.61 to 0.65) compared with anteroposterior radiographs (intraclass correlation coefficient = 0.55; 95% confidence interval, 0.53 to 0.56). Similarly, the 45° posteroanterior flexion weight-bearing radiographs had higher correlation with arthroscopic findings of chondral disease (Spearman rho = 0.36; 95% confidence interval, 0.32 to 0.39) compared with anteroposterior radiographs (Spearman rho = 0.29; 95% confidence interval, 0.26 to 0.32). With respect to standards for the magnitude of the reliability coefficient and correlation coefficient (Spearman rho), the International Knee Documentation Committee classification demonstrated the best combination of good interobserver reliability and medium correlation with arthroscopic findings. Conclusions: The overall estimates with the six radiographic classification systems demonstrated moderate (anteroposterior radiographs) to good (45° posteroanterior flexion weight-bearing radiographs) interobserver reliability and medium correlation with arthroscopic findings. The International Knee Documentation Committee classification assessed with use of 45° posteroanterior flexion weight-bearing radiographs had the most favorable combination of reliability and correlation. Level of Evidence: Diagnostic Level I. See Instructions for Authors for a complete description of levels of evidence. PMID:25031368

  15. Isolated and combined Type II SLAP repairs in a military population.

    PubMed

    Enad, Jerome G; Kurtz, Christopher A

    2007-11-01

    The study compares the clinical results of isolated arthroscopic repair of Type II SLAP tears with those of combined treatment for Type II SLAP and other associated shoulder conditions. The population was composed of 36 aged-matched active duty males with a mean age of 31.6 years (range 22-41 years); mean follow-up was 29.1 months (range 24-42 months). Eighteen subjects in Group I had isolated Type II SLAP tears. Eighteen subjects in Group II had Type II SLAP tear and concomitant ipsilateral shoulder conditions, including subacromial impingement in six patients, acromioclavicular arthrosis in three patients, subacromial impingement and acromioclavicular arthrosis in four patients, spinoglenoid cyst in four patients, and intra-articular loose bodies in one patient. Arthroscopic SLAP repair was performed with biodegradable suture anchors. Subacromial decompression and spinoglenoid cyst decompression were performed arthroscopically. Distal claviculectomy was performed in open fashion. Loose bodies were removed arthroscopically. At minimum 2-year follow-up, the mean UCLA score for Group I (30.2 +/- 3.0 points) was not significantly different from Group II (30.8 +/- 2.0 points) (P = 0.48). The mean post-operative ASES score for Group I (84.1 +/- 13.4 points) was significantly lower than for Group II (91.8 +/- 5.4 points) (P < 0.04). The mean VAS pain score for Group I (1.6 +/- 1.3 points) was significantly higher than for Group II (0.7 +/- 0.7 points) (P < 0.02). Seventeen of 18 patients (94%) in each group returned to full duty. In a population of active duty males, arthroscopic repair of isolated Type II SLAP had comparable results with a cohort of Type II SLAP repairs treated in combination with other shoulder conditions, with the combined treatment group having significantly better results in two of three parameters measured. Return to duty rates were identical. Therefore, concurrent treatment of other associated extra-articular shoulder conditions improves the overall success of SLAP repair and the presence of these other conditions should be recognized and treated along with the SLAP tears in order to maximize clinical results. PMID:17497133

  16. Subscapularis Tendon Repair Using Suture Bridge Technique

    PubMed Central

    Park, Yong Bok; Park, Young Eun; Koh, Kyoung Hwan; Lim, Tae Kang; Shon, Min Soo; Yoo, Jae Chul

    2015-01-01

    The subscapularis tendon plays an essential role in shoulder function. Although subscapularis tendon tears are less common than other rotator cuff tears, tears of the subscapularis tendon have increasingly been recognized with the advent of magnetic resonance imaging and arthroscopy. A suture bridge technique for the treatment of posterosuperior rotator cuff tears has provided the opportunity to improve the pressurized contact area and mean footprint pressure. However, suture bridge fixation of subscapularis tendon tears appears to be technically challenging. We describe an arthroscopic surgical technique for suture bridge repair of subscapularis tendon tears that obtains ideal cuff integrity and footprint restoration. Surgery using such a suture bridge technique is indicated for large tears, such as tears involving the entire first facet or more, tears with a disrupted lateral sling, and combined medium to large supraspinatus/infraspinatus tears. PMID:26052489

  17. Arthroscopic Lavage and Debridement for Osteoarthritis of the Knee

    PubMed Central

    2005-01-01

    Executive Summary Objective The purpose of this review was to determine the effectiveness and adverse effects of arthroscopic lavage and debridement, with or without lavage, in the treatment of symptoms of osteoarthritis (OA) of the knee, and to conduct an economic analysis if evidence for effectiveness can be established. Questions Asked Does arthroscopic lavage improve motor function and pain associated with OA of the knee? Does arthroscopic debridement improve motor function and pain associated with OA of the knee? If evidence for effectiveness can be established, what is the duration of effect? What are the adverse effects of these procedures? What are the economic considerations if evidence for effectiveness can be established? Clinical Need Osteoarthritis, the most common rheumatologic musculoskeletal disorder, affects about 10% of the Canadian adult population. Although the natural history of OA is not known, it is a degenerative condition that affects the bone cartilage in the joint. It can be diagnosed at earlier ages, particularly within the sports injuries population, though the prevalence of non-injury-related OA increases with increasing age and varies with gender, with women being twice as likely as men to be diagnosed with this condition. Thus, with an aging population, the impact of OA on the health care system is expected to be considerable. Treatments for OA of the knee include conservative or nonpharmacological therapy, like physiotherapy, weight management and exercise; and more generally, intra-articular injections, arthroscopic surgery and knee replacement surgery. Whereas knee replacement surgery is considered an end-of-line intervention, the less invasive surgical procedures of lavage or debridement may be recommended for earlier and more severe disease. Both arthroscopic lavage and debridement are generally indicated in patients with knee joint pain, with or without mechanical problems, that are refractory to medical therapy. The clinical utility of these procedures is unclear, hence, the assessment of their effectiveness in this review. Lavage and Debridement Arthroscopic lavage involves the visually guided introduction of saline solution into the knee joint and removal of fluid, with the intent of extracting any excess fluids and loose bodies that may be in the knee joint. Debridement, in comparison, may include the introduction of saline into the joint, in addition to the smoothening of bone surface without any further intervention (less invasive forms of debridement), or the addition of more invasive procedures such as abrasion, partial or full meniscectomy, synovectomy, or osteotomy (referred to as debridement in combination with meniscectomy or other procedures). The focus of this health technology assessment is on the effectiveness of lavage, and debridement (with or without meniscal tear resection). Review Strategy The Medical Advisory Secretariat followed its standard procedures and searched these electronic databases: Ovid MEDLINE, EMBASE, Ovid MEDLINE In-Process and Other Non-Indexed Citations, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews and The International Network of Agencies for Health Technology Assessment. The keywords searched were: arthroscopy, debridement, lavage, wound irrigation, or curettage; arthritis, rheumatoid, osteoarthritis; osteoarthritis, knee; knee or knee joint. Time frame: Only 2 previous health technology assessments were identified, one of which was an update of the other, and included 3 of 4 randomized controlled trials (RCTs) from the first report. Therefore, the search period for inclusion of studies in this assessment was January 1, 1995 to April 24, 2005. Excluded were: case reports, comments, editorials, and letters. Identified were 335 references, including previously published health technology assessments, and 5 articles located through a manual search of references from published articles and health technology assessments. These were examined against the criteria, as described below, which resulted in the in

  18. T2 RELAXOMETRY OF INFRAPATELLAR FAT PAD AFTER ARTHROSCOPIC SURGERY

    PubMed Central

    Torriani, Martin; Taneja, Atul K.; Hosseini, Ali; Gill, Thomas J.; Bredella, Miriam A.; Li, Guoan

    2014-01-01

    PURPOSE To investigate the T2 relaxation values of infrapatellar fat pad (IFP) after arthroscopic surgery. MATERIALS AND METHODS This study was approved by the institutional review board; all individuals signed informed consent. We performed MR imaging in sixteen knees from eight subjects. Prior to imaging, each subject had unilateral arthroscopic knee surgery and an asymptomatic non-operated contralateral knee. We used a 10-echo multiple-TE fast-spin echo pulse sequence for creation of T2 relaxation time maps. Two musculoskeletal radiologists independently placed regions of interest in the IFP, suprapatellar subcutaneous and deep intermuscular adipose tissue. Qualitative assessments were performed to assess fibrotic changes affecting patellar retinaculum and IFP. Statistical analyses of T2 values determined differences between groups, correlation with time after surgery, and cut-off values to differentiate groups. RESULTS The average time between arthroscopy and imaging was 3.5 ± 0.4 years. IFP of knees with prior surgery had significantly shorter mean T2 values (133 ± 14 ms) when compared to control knees (147 ± 8 ms, P = 0.03). There was no significant difference between operated and control knees regarding T2 values of suprapatellar subcutaneous (P = 0.3) or deep intermuscular adipose tissue (P = 0.2). There was no correlation between IFP T2 values and time after surgery (P > 0.2). IFP T2 values ? 139 ms had 75% sensitivity and 88% specificity to identify prior arthroscopy. CONCLUSION Shortening of T2 relaxation values is present in IFP chronically after arthroscopic surgery and may be an indicator of adipose tissue fibrosis. PMID:24343788

  19. Arthroscopic Assessment of Stifle Synovitis in Dogs with Cranial Cruciate Ligament Rupture

    PubMed Central

    Little, Jeffrey P.; Bleedorn, Jason A.; Sutherland, Brian J.; Sullivan, Ruth; Kalscheur, Vicki L.; Ramaker, Megan A.; Schaefer, Susan L.; Hao, Zhengling; Muir, Peter

    2014-01-01

    Cranial cruciate ligament rupture (CR) is a degenerative condition in dogs that typically has a non-contact mechanism. Subsequent contralateral rupture often develops in dogs with unilateral CR. Synovitis severity is an important factor that promotes ligament degradation. Consequently, we wished to evaluate the utility of arthroscopy for assessment of stifle synovitis in dogs with CR. Herein, we report results of a prospective study of 27 dogs with unilateral CR and bilateral radiographic osteoarthritis. Arthroscopic images and synovial biopsies from the lateral and medial joint pouches were obtained bilaterally and graded for synovial hypertrophy, vascularity, and synovitis. Synovial tartrate-resistant acid phosphatase-positive (TRAP+) macrophages, CD3+ T lymphocytes, Factor VIII+ blood vessels, and synovial intima thickness were quantified histologically and related to arthroscopic observations. Risk of subsequent contralateral CR was examined using survival analysis. We found that arthroscopic scores were increased in the index stifle, compared with the contralateral stifle (p<0.05). Numbers of CD3+ T lymphocytes (SR?=?0.50, p<0.05) and TRAP+ cells in joint pouches (SR?=?0.59, p<0.01) were correlated between joint pairs. Arthroscopic grading of vascularity and synovitis was correlated with number density of Factor VIII+ vessels (SR>0.34, p<0.05). Arthroscopic grading of villus hypertrophy correlated with numbers of CD3+ T lymphocytes (SR?=?0.34, p<0.05). Synovial intima thickness was correlated with arthroscopic hypertrophy, vascularity, and synovitis (SR>0.31, p<0.05). Strong intra-observer and moderate inter-observer agreement for arthroscopic scoring was found. Dog age and arthroscopic vascularity significantly influenced risk of contralateral CR over time. We conclude that arthroscopic grading of synovitis is a precise tool that correlates with histologic synovitis. Arthroscopy is useful for assessment of stifle synovitis in client-owned dogs, and could be used in longitudinal clinical trials to monitor synovial responses to disease-modifying therapy. PMID:24892866

  20. Ulnar Impaction Syndrome: Ulnar Shortening vs. Arthroscopic Wafer Procedure

    PubMed Central

    Smet, Luc De; Vandenberghe, Lore; Degreef, Ilse

    2014-01-01

    The outcome of ulnar shortenings was compared with that of arthroscopic wafer resections for ulnar impaction (or abutment) syndrome in patients with a positive ulnar variance. The outcome was measured by DASH score, visual analog scale for pain, and working incapacity. The mean DASH score in the ulnar shortening group was 26; in the wafer group it was 36. The VAS scores were respectively 4.4 and 4.6. The working incapacity was 7?months in the ulnar shortening group and 6.1 months in the wafer group. The differences between the two groups were not statistically significant. PMID:25032075

  1. Comparison of efficacy of intraarticular application of magnesium, levobupivacaine and lornoxicam with placebo in arthroscopic surgery

    Microsoft Academic Search

    Kemalettin KoltkaGul Koknel-Talu; Gul Koknel-Talu; Mehmet Asik; Suleyman Ozyalcin

    Purpose  Arthroscopic knee surgery is done in outpatient settings; however, postoperative pain is a major barrier for discharge and\\u000a limits early rehabilitation. The efficacy of intraarticular application of magnesium sulphate, levobupivacaine and lornoxicam,\\u000a with placebo on postoperative pain after arthroscopic meniscectomy was evaluated.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  One hundred and twenty ASA status I-II patients undergoing elective arthroscopic meniscectomy were included in this randomized,\\u000a single

  2. REHABILITATION AFTER HIP ARTHROSCOPY AND LABRAL REPAIR IN A HIGH SCHOOL FOOTBALL ATHLETE

    PubMed Central

    Kolber, Morey J.

    2012-01-01

    Study Design: Case Report Background: Femoral acetabular impingement (FAI) has been implicated in the etiology of acetabular labral tears. The rehabilitation of younger athletes following arthroscopic surgery for FAI and labral tears is often complex and multifactorial. A paucity of evidence exists to describe the rehabilitation of younger athletes who have undergone arthroscopic hip surgery. Case Presentation: This case report describes a four-phase rehabilitation program for a high school football player who underwent hip arthroscopy with a labral repair and chondroplasty. Outcomes: The player returned to training for football 16 weeks later and at the 4 month follow-up was pain free with no signs of FAI. Discussion: There is little evidence regarding the rehabilitation of younger athletes who undergo arthroscopic hip surgery. This case study described a four phase rehabilitation program for a high school football player who underwent hip arthroscopy and labral repair. The patient achieved positive outcomes with a full return to athletic activity and football. The overall success of these patients depends on the appropriate surgical procedure and rehabilitation program. Key Words: Femoral acetabular impingement (FAI), hip, hip impingement Level of evidence: 4-Case report PMID:22530192

  3. 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 ...

  4. Arthroscopic Identification of the Anterolateral Ligament of the Knee

    PubMed Central

    Sonnery-Cottet, Bertrand; Archbold, Pooler; Rezende, Fernando C.; Neto, Ayrton M.; Fayard, Jean-Marie; Thaunat, Mathieu

    2014-01-01

    Intense interest has focused on the recent description of the anterolateral ligament of the knee. Advancing knowledge of its anatomy and function is leading to a realization of its importance in the rotatory control of the tibia in anterior cruciate ligament injuries. Reconstruction of this structure will increasingly become an important goal during anterior cruciate ligament reconstruction. However, preoperative assessment of this ligament is difficult. Clinical assessment of rotatory laxity has poor reproducibility, and it is difficult to define using current imaging techniques. This article is the first to describe a safe and reproducible arthroscopic technique to allow identification and examination of the anterolateral ligament of the knee. With the knee at 90° of flexion, the arthroscope is introduced through the anterolateral portal to allow clear visualization of the lateral gutter. Under direct vision, an accessory portal is made over the inferior limit of the lateral gutter. A shaver is then introduced through this portal and used to debride this synovial recess and define the anterolateral ligament. This allows the surgeon to examine the integrity of the anterolateral ligament, in particular its femoral insertion. If required, this additional information can facilitate the performance of a more accurate and effective extra-articular reconstruction. PMID:25126509

  5. Arthroscopic treatment of bony loose bodies in the subacromial space

    PubMed Central

    Li, Wei; Xiao, De-Ming; Jiang, Chang-qing; Zhang, Wen-tao; Lei, Ming

    2015-01-01

    Introduction Multiple bony loose bodies in the subacromial space caused form cartilage or bone cells and continue to grow. Presentation of case A 58-year-old man with two-year history of swelling and pain of the right shoulder. He had no history of tuberculosis and rheumatoid arthritis. Magnetic resonance (MR) images showed some bony loose bodies in the subacromial space. The removal of loose bodies and bursa debridement were performed arthroscopically. Histological diagnosis of them was synovitis with fibrous bodies. Discussion Extra-articular loose bodies is extremely rare, especially in the subacromial space, which maybe originated in the proliferative synovial bursa. Most authors recommend open removal to relive the pain, but there were choice to apply arthroscopy to remove them. Conclusion The mechanism of formation of bony loose bodies is not clear, may be associated with synovial cartilage metaplasia. Arthroscopic removal of loose bodies and bursa debridement is a good option for treatment of the loose body in the subacromial space, which can receive good function. PMID:25958049

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

    PubMed

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

    2010-10-01

    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

  7. Intra-articular glucocorticoid, bupivacaine and morphine reduces pain, inflammatory response and convalescence after arthroscopic meniscectomy

    Microsoft Academic Search

    Sten Rasmussen; Allan S. Larsen; Søren T. Thomsen; Henrik Kehlet

    1998-01-01

    Convalescence after arthroscopic meniscectomy is dependent on pain and the inflammatory response. The aim of the study was therefore to investigate the effect of intra-articular bupivacaine+morphine+methylprednisolone versus bupivacaine+morphine or saline on post-meniscectomy pain, mobilisation and convalescence. In a double-blind randomized study 60 patients undergoing arthroscopic meniscectomy were allocated to intra-articular saline, intra-articular bupivacaine 150 mg+morphine 4 mg or the same

  8. Arthroscopic treatment of synovial disorders in the shoulder, elbow, and ankle.

    PubMed

    Bynum, C Kelly; Tasto, James

    2002-01-01

    A wide range of synovial conditions can affect patient function and often respond to conservative treatment. However, when symptoms do not respond, arthroscopic synovectomy is a useful tool for management. Pigmented villonodular synovitis, synovial chondromatosis, rheumatoid arthritis, adhesive capsulitis of the shoulder, and ankle impingement are the diseases that most often require synovectomy. Arthroscopic management offers the following advantages over open synovectomy: a more thorough evaluation of the joint and synovium, better access for surgical synovectomy, and decreased postoperative morbidity. PMID:11829337

  9. A New Technique for Patch Augmentation of Rotator Cuff Repairs

    PubMed Central

    Mihara, Shuzou; Ono, Teruyasu; Inoue, Hirofumi; Kisimoto, Tetsurou

    2014-01-01

    Massive rotator cuff tears defying primary repair have been treated with debridement, arthroscopic subacromial decompression, partial repair, muscle-tendon transfer, and joint prosthesis, among other techniques. However, the treatment results have not been satisfactory compared with those of small- to medium-sized rotator cuff tears; each procedure has its merits and demerits, and currently, there is no single established method. For massive rotator cuff tears defying primary repair, the arthroscopic patch graft procedure has been reported as an effective surgical procedure, and this procedure is chosen as the first-line treatment in our department. In this procedure, suture anchors are generally used to fix the patch graft to the footprint on the side of the greater tuberosity. However, tendon-to-bone healing is frequently difficult to achieve, and bone-to-bone healing seems more advantageous for the repair of the rotator cuff attachment site. To improve the results of treatment, a new patch graft procedure was developed, in which the iliotibial ligament with bone was collected at Gerdy's tubercle and the bone was anchored to the footprint on the side of the greater tuberosity. With this procedure, excellent results were obtained, although only short-term results are available at present. The technique and its results so far are reported. PMID:25126505

  10. Return to driving after arthroscopic rotator cuff repair: patient-reported safety and maneuverability.

    PubMed

    Gholson, J Joseph; Lin, Albert; McGlaston, Timothy; DeAngelis, Joseph; Ramappa, Arun

    2015-01-01

    This survey investigated patients' return to driving after rotator cuff surgery, to determine whether pain, weakness, sling use, and narcotics correlate with self-assessed safety and maneuvering. Fifty-four patients (80.6% of those eligible) were surveyed 4 months after surgery. Return to driving ranged widely from same day to 4 months, with two not driving at 4 months; 12% reported narcotics use and 33% reported sling use. Drivers reporting weakness were more likely to feel unsafe (p = .02) and more likely to report difficulty maneuvering (p <.01). Drivers reporting pain were more likely to feel unsafe (p < .01) and more likely to report difficulty maneuvering their vehicle (p < .01). Patient-reported return to driving does not correspond to perceived safety; pain and weakness correspond with feeling unsafe and difficulty maneuvering. Although subjective, clinicians may find these self-assessments predictive when counseling patients on return to driving. PMID:25988695

  11. Railroad Repair

    NSDL National Science Digital Library

    2013-12-04

    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.

  12. Snowmobile Repair.

    ERIC Educational Resources Information Center

    Helbling, Wayne

    This guide is designed to provide and/or improve instruction for occupational training in the area of snowmobile repair, and includes eight areas. Each area consists of one or more units of instruction, with each instructional unit including some or all of the following basic components: Performance objectives, suggested activities for teacher and…

  13. Motorcycle Repair.

    ERIC Educational Resources Information Center

    Hein, Jim; Bundy, Mike

    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…

  14. Arthroscopic capsule reconstruction in the hip using iliotibial band allograft.

    PubMed

    Trindade, Christiano A C; Sawyer, Gregory A; Fukui, Kiyokazu; Briggs, Karen K; Philippon, Marc J

    2015-02-01

    The hip capsule has been identified as an important static stabilizer of the hip joint. Despite the intrinsic bony stability of the hip socket, the capsule plays a key role in hip stability, particularly at the extremes of motion, and the iliofemoral ligament is the most important stabilizer in extension and external rotation. Patients who do not undergo capsular closure or plication may continue to complain of hip pain and dysfunction postoperatively, likely because of microinstability or muscle invagination into the capsular defect, and high-resolution magnetic resonance imaging or magnetic resonance arthrography will identify the capsular defect. Seen primarily in the revision setting, capsular defects can cause recurrent stress at the chondrolabral junction. An attempt at secondary closure can be challenging because of capsular limb adherence to the surrounding soft tissues. Therefore reconstruction may be the only possible surgical solution for this problem. We describe our new surgical technique for arthroscopic hip capsular reconstruction using iliotibial band allograft. PMID:25973378

  15. Arthroscopic Capsule Reconstruction in the Hip Using Iliotibial Band Allograft

    PubMed Central

    Trindade, Christiano A.C.; Sawyer, Gregory A.; Fukui, Kiyokazu; Briggs, Karen K.; Philippon, Marc J.

    2015-01-01

    The hip capsule has been identified as an important static stabilizer of the hip joint. Despite the intrinsic bony stability of the hip socket, the capsule plays a key role in hip stability, particularly at the extremes of motion, and the iliofemoral ligament is the most important stabilizer in extension and external rotation. Patients who do not undergo capsular closure or plication may continue to complain of hip pain and dysfunction postoperatively, likely because of microinstability or muscle invagination into the capsular defect, and high-resolution magnetic resonance imaging or magnetic resonance arthrography will identify the capsular defect. Seen primarily in the revision setting, capsular defects can cause recurrent stress at the chondrolabral junction. An attempt at secondary closure can be challenging because of capsular limb adherence to the surrounding soft tissues. Therefore reconstruction may be the only possible surgical solution for this problem. We describe our new surgical technique for arthroscopic hip capsular reconstruction using iliotibial band allograft. PMID:25973378

  16. Return to sport after arthroscopic meniscectomy on stable knees

    PubMed Central

    2013-01-01

    Background Athletes suffering from any injuries want to know when they will be able to return sports activity. The period of return-to-sport after the arthroscopic meniscectomy is still unknown. The aim of this study is to investigate the period of the return-to-sport from surgery and the clinical symptoms after the meniscectomy on stable knees. Methods Fifty-six athletes who underwent the arthroscopic meniscectomy were evaluated. The patients with an average age of 26.7 years (range, 13–67) comprised 45 men and 11 women, 16 medial meniscus and 40 lateral meniscus injuries. The average of the follow-up period was 9.2 months. The parameter examined were age, the injured side of meniscus (medial or lateral), articular cartilage status, amount of resection, and sports activity level. Results The mean period was 54 days in young group, and was 89 days in old group (p?=?0.0013). The period was 79 days in medial meniscus (MM) injured group, and was 61 days in lateral meniscus (LM) group (p?=?0.017). There was a significant difference among the groups in activity levels and in amount of resection. Pain and/or effusion in the knee after the return-to-sport were found 22% of the MM group and 53% in the LM group. Conclusions The period of the return-to-sport was shorter in young age, high activity and large amount of resection group. Although athletes in LM group can return to sports earlier than those in MM group, more than half of athletes have pain or effusion at the time of return-to sport. PMID:24257295

  17. Arthroscopy of the subtalar joint and arthroscopic subtalar arthrodesis.

    PubMed

    Tasto, James P

    2006-01-01

    Subtalar arthroscopy has become a valuable adjunct to the tools used in lower extremity surgery. For the past 25 years, ankle arthroscopy has been in vogue for treating a variety of conditions. Subtalar arthroscopy has more treatment limitations and is more technically difficult to perform than ankle arthroscopy because of the anatomic confines and structure of the subtalar joint. Most procedures are performed on the posterior aspect of the subtalar joint. The subtalar joint is composed of three articulations (posterior, middle, and anterior facets) and is surrounded by a variety of intra-articular and extra-articular ligaments, whose anatomy must be fully understood before attempting this procedure. Subtalar arthroscopy may be indicated for diagnostic purposes and for débridement of synovial impingement syndromes in the sinus tarsi. It may be used to examine loose bodies or osteochondral lesions, to address fractures of the lateral process of the talus, and to evaluate subtalar instability to determine appropriate stabilization methods. Arthroscopic subtalar arthrodesis also has gained credibility over the past 10 years as an acceptable surgical procedure. Arthroscopic evaluation of subtalar instability is useful in planning the appropriate stabilization. Subtalar arthroscopy is usually performed with the patient in the lateral decubitus position without traction. Anterior and posterior portals as well as an accessory anterior portal are usually necessary to perform all of the above procedures. Because of the limited confines of the joint, care must be taken to prevent any articular cartilage damage. When performing subtalar arthroscopy in conjunction with ankle arthroscopy, the subtalar arthroscopy should be performed first to avoid excessive extravasation from the ankle arthroscopy, which could obscure entry to the subtalar joint. Complications of subtalar arthroscopy are similar to those encountered in ankle arthroscopy, such as damage to the sural and superficial peroneal nerves. PMID:16958488

  18. Arthroscopic assessment of human cartilage stiffness of the femoral condyles and the patella with a new tactile sensor

    Microsoft Academic Search

    Y Uchio; M Ochi; N Adachi; K Kawasaki; J Iwasa

    2002-01-01

    We measured the stiffness of the cartilage of the human femoral condyles via an ultrasonic tactile sensor under arthroscopic control. The stiffness and the degeneration of articular cartilage were assessed in 105 knees in 74 patients (39 men, 35 women, age: 9–72 years) who underwent arthroscopic observation or surgery. Twenty-five knees suffered from traumatic cartilage injury, 14 from osteochondritis dissecans,

  19. Outbreak of serial knee joint sepsis after arthroscopic surgery: a case series with the guideline for treatment.

    PubMed

    Mirzatolooei, Fardin

    2014-01-01

    Knee infection after arthroscopic surgeries is rare but devastating complication. A serial knee joint infection occurred in our hospital after the contamination of arthroscopic equipments set with an unknown microorganism. Herein we describe the natural course of these patients and suggest a treatment protocol according to the experiment gained from management of these patients. PMID:24901863

  20. Preclinical Studies for Cartilage Repair

    PubMed Central

    Hurtig, Mark B.; Buschmann, Michael D.; Fortier, Lisa A.; Hoemann, Caroline D.; Hunziker, Ernst B.; Jurvelin, Jukka S.; Mainil-Varlet, Pierre; McIlwraith, C. Wayne; Sah, Robert L.; Whiteside, Robert A.

    2011-01-01

    Investigational devices for articular cartilage repair or replacement are considered to be significant risk devices by regulatory bodies. Therefore animal models are needed to provide proof of efficacy and safety prior to clinical testing. The financial commitment and regulatory steps needed to bring a new technology to clinical use can be major obstacles, so the implementation of highly predictive animal models is a pressing issue. Until recently, a reductionist approach using acute chondral defects in immature laboratory species, particularly the rabbit, was considered adequate; however, if successful and timely translation from animal models to regulatory approval and clinical use is the goal, a step-wise development using laboratory animals for screening and early development work followed by larger species such as the goat, sheep and horse for late development and pivotal studies is recommended. Such animals must have fully organized and mature cartilage. Both acute and chronic chondral defects can be used but the later are more like the lesions found in patients and may be more predictive. Quantitative and qualitative outcome measures such as macroscopic appearance, histology, biochemistry, functional imaging, and biomechanical testing of cartilage, provide reliable data to support investment decisions and subsequent applications to regulatory bodies for clinical trials. No one model or species can be considered ideal for pivotal studies, but the larger animal species are recommended for pivotal studies. Larger species such as the horse, goat and pig also allow arthroscopic delivery, and press-fit or sutured implant fixation in thick cartilage as well as second look arthroscopies and biopsy procedures.

  1. Reactions of meniscal tissue after arthroscopic laser application: an in vivo study using five different laser systems.

    PubMed

    Bernard, M; Grothues-Spork, M; Hertel, P; Moazami-Goudarzi, Y

    1996-08-01

    In many clinical and in vitro studies, the effect of laser radiation on meniscal tissue was examined. Clinical studies referred to clinical criteria like swelling, effusion, and pain to evaluate laser effects. In vitro studies showed the laser effect in the moment of cutting the tissue. But the effect of laser radiation on biological tissue also depends on the vital reaction of the tissue. So, the real extent of tissue damage caused by laser irradiation can only be examined in long-term in vivo studies. This was the purpose of this study. Seventy-two knees of pigs underwent arthroscopic meniscal cuts in the anterior horn of the medial meniscus. The pigs were divided into 6 groups: The first 5 groups were operated with 5 different laser systems: Neodym: YAG 1,440-nm wavelength; Nd:YAG 1,064-nm wavelength, Excimer, Holmium:YAG, and CO2. The sixth group was operated with mechanical punches. From each group, the menisci of the pigs were examined macroscopically and by light-microscope after survival periods of 0, 2, 6, 12 weeks. Results were as follows. (1) All laser systems caused greater damage to the meniscal tissue than mechanical instruments. (2) This damage was a biological reaction of the tissue, characterized by a necrotic zone surrounding the meniscus cut. (3) This necrotic zone was not visible intraoperatively but only 2, 6 and 12 weeks after operation. The diameter of the necrotic zone ranged between 1.5 nm and 9 mm. (4) Meniscus cuts with mechanical instruments showed no necrotic zone in the surrounding tissue. (5) Laser cuts in the meniscus caused more extensive healing reaction than cuts with mechanical instruments. (6) The quality of this healing reaction varied with the different laser systems: the Nd:YAG 1,064-nm, Ho:YAG, and CO2 laser caused only an incomplete healing because the tissue repair showed by tissue growing from the synovial edge into the defect only. The Nd:YAG 1,440-nm wavelength and Excimer led to tissue growing from the synovial edge and to remodeling of original meniscal tissue, recognizable by reduction of the necrotic zone. Arthroscopic surgeons should be aware that the damage to meniscus tissue caused by a laser is much greater than can be seen intraoperatively and is much greater than the damage caused by mechanical punches. The healing reaction of the tissue is more extensive after laser application than after use of mechanical instruments. Results of in vitro studies on the tissue damage caused by lasers are insufficient to describe the whole extent of laser effects on living tissue. PMID:8864002

  2. Repairable posterior menisco-capsular disruption in anterior cruciate ligament injuries.

    PubMed

    Woods, G W; Chapman, D R

    1984-01-01

    Two hundred thirty-four consecutive patients with a positive Lachman test underwent examination under anesthesia and diagnostic arthroscopy to include complete evaluation of both posterior menisco-capsular attachments. Knees which had had previous arthrotomy were excluded. Complete repairable posterior menisco-capsular disruptions occurred in 31 of 112 (27.7%) acute cases and 36 of 122 (29.5%) knees in the chronic group. These lesions are not predictable by physical examination or by routine clinical grading of instability. Thorough arthroscopic examination to include direct visualization of the posterior menisco-capsular junction is necessary for complete diagnosis in anterior cruciate ligament injuries. PMID:6548611

  3. Isolated and combined Type II SLAP repairs in a military population

    Microsoft Academic Search

    Jerome G. Enad; Christopher A. Kurtz

    2007-01-01

    The study compares the clinical results of isolated arthroscopic repair of Type II SLAP tears with those of combined treatment\\u000a for Type II SLAP and other associated shoulder conditions. The population was composed of 36 aged-matched active duty males\\u000a with a mean age of 31.6 years (range 22–41 years); mean follow-up was 29.1 months (range 24–42 months). Eighteen subjects\\u000a in Group I had isolated

  4. Arthroscopic posterior cruciate ligament reconstruction with allograft versus autograft

    PubMed Central

    Sun, Xiujiang; Zhang, Jianfeng; Qu, Xiaoyi

    2015-01-01

    Introduction The aim of the study was to compare and analyze retrospectively the outcomes of arthroscopic posterior cruciate ligament reconstruction with autograft versus allograft. Material and methods Seventy-one patients who underwent arthroscopic posterior cruciate ligament reconstruction with an autograft or allograft met our inclusion criteria. There were 36 patients in the autograft group and 35 patients in the allograft group. All the patients were evaluated by physical examination and a functional ligament test. Comparative analysis was done in terms of operation time, incision length, fever time, postoperative infection rate, incidence of numbness and dysesthesia around the incision, as well as a routine blood test. Results The average follow-up of the autograft group was 3.2 ±0.2 years and that of the allograft group was 3.3 ±0.6 years; there was no significant difference (p > 0.05). No differences existed in knee range of motion, Lysholm scores, International Knee Documentation Committee standard evaluation form and Tegner activity score at final follow-up (p > 0.05), except that patients in the allograft group had a shorter operation time and incision length and a longer fever time (p < 0.05). We found a difference in posterior drawer test and KT-2000 arthrometer assessment (p < 0.05). The posterior tibia displacement averaged 3.8 ±1.5 mm in the autograft group and 4.8 ±1.7 mm in the allograft group (p < 0.05). The incidence of numbness and dysesthesia around the incision in the autograft group was higher than that in the allograft group (p < 0.05). There was no infection postoperatively. The white blood cells and neutrophils in the allograft group increased more than those in the autograft group postoperatively (p < 0.05). Conclusions Both groups of patients had satisfactory outcomes after the operation. However, in the instrumented posterior laxity test, the autograft gave better results than the allograft. No differences in functional scores were found. PMID:25995757

  5. Arthroscopic Technique of Capsular Plication for the Treatment of Hip Instability.

    PubMed

    Chandrasekaran, Sivashankar; Vemula, S Pavan; Martin, Timothy J; Suarez-Ahedo, Carlos; Lodhia, Parth; Domb, Benjamin G

    2015-04-01

    Atraumatic instability or microinstability of the hip is a recognized cause of groin pain and hip instability. Risk factors include female sex, ligamentous laxity, and borderline dysplasia. Arthroscopically, the joint may distract easily, and there may be associated ligamentum teres tears and laxity of the capsule on manual probing. The use of arthroscopic capsular plication in this cohort of patients has shown good to excellent results. Biomechanically, a capsular plication aims to create an imbrication and inferior shift of the capsule to augment the screw-home mechanism of the capsuloligamentous structures and thereby improve stability in extension and external rotation. The purpose of this article is to detail the step-by-step surgical technique of arthroscopic capsular plication, in addition to the indications, pearls, and pitfalls of the technique. PMID:26052494

  6. Arthroscopic Technique of Capsular Plication for the Treatment of Hip Instability

    PubMed Central

    Chandrasekaran, Sivashankar; Vemula, S. Pavan; Martin, Timothy J.; Suarez-Ahedo, Carlos; Lodhia, Parth; Domb, Benjamin G.

    2015-01-01

    Atraumatic instability or microinstability of the hip is a recognized cause of groin pain and hip instability. Risk factors include female sex, ligamentous laxity, and borderline dysplasia. Arthroscopically, the joint may distract easily, and there may be associated ligamentum teres tears and laxity of the capsule on manual probing. The use of arthroscopic capsular plication in this cohort of patients has shown good to excellent results. Biomechanically, a capsular plication aims to create an imbrication and inferior shift of the capsule to augment the screw-home mechanism of the capsuloligamentous structures and thereby improve stability in extension and external rotation. The purpose of this article is to detail the step-by-step surgical technique of arthroscopic capsular plication, in addition to the indications, pearls, and pitfalls of the technique.

  7. Bilateral Medial Tibial Plateau Fracture after Arthroscopic Anterior Cruciate Ligament Reconstruction

    PubMed Central

    Cho, Chul Hyun; Lee, Kyung Jae; Jeon, Jong Hyuk

    2015-01-01

    Tibial plateau fractures after arthroscopic anterior cruciate ligament (ACL) reconstruction are rare, and only isolated cases have been reported. The authors describe a case of bilateral medial tibial plateau fracture following a minor motorcycle accident in a patient who underwent arthroscopic ACL reconstruction in the past. Two years and four months before the accident, the patient underwent an arthroscopically assisted ACL reconstruction using double-bundle technique on his left knee at a hospital. He had the same surgery using single-bundle technique on his right knee about eight months ago at another hospital. The fractures in his both involved knees occurred through the tibial tunnel and required open reduction with internal fixation. At three weeks after fixation, a second-look arthroscopy revealed intact ACLs in both knees. At five months follow-up, he was able to walk without instability on physical examination. Follow-up radiographs of the patient showed callus formations with healed fractures. PMID:26060613

  8. Bilateral Medial Tibial Plateau Fracture after Arthroscopic Anterior Cruciate Ligament Reconstruction.

    PubMed

    Bae, Ki Cheor; Cho, Chul Hyun; Lee, Kyung Jae; Jeon, Jong Hyuk

    2015-06-01

    Tibial plateau fractures after arthroscopic anterior cruciate ligament (ACL) reconstruction are rare, and only isolated cases have been reported. The authors describe a case of bilateral medial tibial plateau fracture following a minor motorcycle accident in a patient who underwent arthroscopic ACL reconstruction in the past. Two years and four months before the accident, the patient underwent an arthroscopically assisted ACL reconstruction using double-bundle technique on his left knee at a hospital. He had the same surgery using single-bundle technique on his right knee about eight months ago at another hospital. The fractures in his both involved knees occurred through the tibial tunnel and required open reduction with internal fixation. At three weeks after fixation, a second-look arthroscopy revealed intact ACLs in both knees. At five months follow-up, he was able to walk without instability on physical examination. Follow-up radiographs of the patient showed callus formations with healed fractures. PMID:26060613

  9. Eye muscle repair - discharge

    MedlinePLUS

    ... Lazy eye repair - discharge; Strabismus repair - discharge; Extraocular muscle surgery - discharge ... You or your child had eye muscle repair surgery to correct eye muscle ... term for crossed eyes is strabismus. Children most often ...

  10. Arthroscopic treatment of an aneurysmal bone cyst of the patella: A case report

    PubMed Central

    Sandokji, Abdullah

    2015-01-01

    Aneurysmal bone cyst is a benign tumor-like bone lesion. This report concerns a 43 year-old male patient diagnosed with a primary aneurysmal bone cyst of his right patella. His main presentation was anterior knee pain. The patient was treated with arthroscopic excisional biopsy of the cyst and curettage, followed by filling the cavity with bone cement at a second stage. During the 5-year follow-up, the patient remained symptom free, with a normal range of motion. The arthroscopic approach is a less-invasive procedure with low morbidity and enabled us to determine which site should be going through. PMID:25901136

  11. Same day discharge following inter-scalene block administration for arthroscopic shoulder surgery: implementing a change in practice.

    PubMed

    Lane, Suzanne; Blundell, Clare; Mills, Simon; Charalambous, C P

    2014-10-01

    Patients who had arthroscopic shoulder surgery with the provision of an inter-scalene nerve block (ISB) at Blackpool Teaching Hospitals, were previously required to remain in hospital overnight. We introduced a new protocol that allowed same day discharge following arthroscopic shoulder surgery under general anaesthesia and ISB. The aim of this study was to review the outcome of this change in practice. Our results indicated that providing a discharge protocol for patients having arthroscopic shoulder surgery with the inclusion of ISB can avoid unnecessary overnight stay and enable significant cost savings, without detriment to patient safety or satisfaction. PMID:26016271

  12. Arthroscopic According Subacromial Decompression: Results to the Degree of Rotator Cuff Tear

    Microsoft Academic Search

    James C. Esch; Leonard R. Ozerkis; Norman Kane; Nancy Lilliott

    Summary: We evaluated the results of arthroscopic subacromial decompres- sion according to the degree of rotator cuff tear in 71 patients, available for follow-up for at least 1 year (average 19 months). Of the patients with stage II disease, 82% were satisfied regardless of whether they had no rotator cuff tear (nine of 11) or had a partial tear (28

  13. Arthroscopic Treatment of Popliteal Cyst and Associated Intra-articular Knee Disorders in Adults

    Microsoft Academic Search

    Valerio Sansone; Alessandro De Ponti

    1999-01-01

    Summary: We describe a surgical arthroscopic treatment for popliteal cyst in a series of 30 patients, with a mean follow-up of 32 months. The treatment consists of a cure for the intra-articular pathology of the knee associated with popliteal cysts, and the contemporaneous correction of the valvular mechanism responsible for the formation and reoccurrence of popliteal cyst. The popliteal cyst

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

    Microsoft Academic Search

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

    2000-01-01

    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

  15. A Multicenter Study of 210 Rotator Cuff Tears Treated by Arthroscopic Acromioplasty

    Microsoft Academic Search

    Jean-François Kempf; Pascal Gleyze; François Bonnomet; Gilles Walch; Daniel Mole; André Frank; Philippe Beaufils; Christophe Levigne; Bruno Rio; André Jaffe

    1999-01-01

    Summary: We followed 210 cases of rotator cuff tears treated in four French centers by arthroscopic acromioplasty in 195 cases and by a tenotomy of the Long Head of Biceps (LHB) in 15 cases. All patients were evaluated by means of the Constant score (CS) and radiographic imaging. The mean age was 61 years and the mean follow-up period was

  16. Unicameral bone cyst of the humeral head: arthroscopic curettage and bone grafting.

    PubMed

    Randelli, Pietro; Arrigoni, Paolo; Cabitza, Paolo; Denti, Matteo

    2009-01-01

    Arthroscopic surgery has improved greatly over the past decade. Treatment of various juxta-articular disorders around the shoulder have benefited from endoscopic approaches. Cystic lesions of the shoulder on the scapular side have been treated in this way. This article describes a case of a 29-year-old patient with a unicameral bone cyst on the posterior aspect of the humeral head. Arthroscopic visualization using an accessory posteroinferior portal localized the cyst through the bare area of the humeral head. A cannulated burr was used to create an opening through the cortical wall between the cyst and the joint, and a careful curettage was performed. The cavity was filled with a demineralized bone matrix enriched with autologous blood packed into an arthroscopic cannula and delivered through the accessory portal. The patient reported pain relief immediately postoperatively and at follow-up. This case demonstrates the feasibility of arthroscopic treatment of a simple bone cyst of the humeral head. We believe that the knowledge of the juxta-articular anatomy allows the applications of scope-assisted procedures to be expanded, maximizing the results of a technique that allows a shorter recovery and less painful rehabilitation. PMID:19226028

  17. A Review of Arthroscopic Bone Marrow Stimulation Techniques of the Talus

    PubMed Central

    Murawski, Christopher D.; Foo, Li Foong; Kennedy, John G.

    2010-01-01

    Osteochondral lesions of the talus are common injuries following acute and chronic ankle sprains. Numerous surgical treatment strategies have been employed for treating these lesions; arthroscopic bone marrow stimulation is recognized as the first-line technique to provide fibrocartilage infill of the defect site. While the short- and medium-term outcomes of this technique are good, the long-term outcomes are not yet known. An increasing number of studies, however, show a cause for concern in employing this technique, including declining outcome scores over time. The current authors have therefore developed a treatment strategy based on previously established guidelines in addition to morphological cartilage-sensitive fast spin echo techniques and quantitative T2 mapping magnetic resonance imaging (MRI). Accordingly, the authors advocate arthroscopic bone marrow stimulation in lesion sizes up to 8 mm in diameter and osteochondral autograft transplant (OATS) in lesion sizes greater than 8 mm in diameter. In the absence of long-term studies, confining the use of arthroscopic bone marrow stimulation to smaller lesions may support prolonged joint life by decreasing the rate at which the fibrocartilage ultimately degenerates over time. Employing the OATS procedure in larger lesions has the advantage of replacing “like with like.” The current review examines the role of arthroscopic bone marrow stimulation techniques of the talus. PMID:26069545

  18. Simulating arthroscopic knee surgery using volumetric object representations, real-time volume rendering and haptic feedback

    Microsoft Academic Search

    Sarah F. Frisken Gibson; Joe Samosky; Andrew B. Mor; Christina Fyock; W. Eric L. Grimson; Takeo Kanade; Ron Kikinis; Hugh C. Lauer; Neil Mckenzie; Shin Nakajima; Takahide Ohkami; Randy Osborne; Akira Sawada

    1997-01-01

    A system for simulating arthroscopic knee surgery that is based on volumetric object models derived from 3D Magnetic Resonance Imaging is presented. Feedback is provided to the user via real-time volume rendering and force feedback for haptic exploration. The system is the result of a unique collaboration between an industrial research laboratory, two major universities, and a leading research hospital.

  19. A novel technique of arthroscopic excision of a symptomatic os trigonum.

    PubMed

    Horibe, Shuji; Kita, Keisuke; Natsu-ume, Takashi; Hamada, Masayuki; Mae, Tatsuo; Shino, Konsei

    2008-01-01

    We describe a new arthroscopic excision technique for a symptomatic os trigonum. With the patient lying in a prone position, a posterolateral portal just lateral to the Achilles tendon, at the 5-mm level proximal to the tip of the fibula, is used for the arthroscope and an accessory posterolateral portal just posterior to the peroneal tendon at the same level is used for instruments. The synovial tissues are then debrided with a power shaver through the accessory posterolateral portal for better visualization. An elevator is used to release the fibrous tissue between the os trigonum and the talus. The os trigonum is completely excised with a grasper to visualize the flexor hallucis longus tendon. Radiographic control is helpful to check the position of the arthroscope if it happens to be inserted into the ankle joint as a result of the reduced subtalar joint space. Postoperatively, no immobilization is necessary, and full weight-bearing is allowed as tolerated. Three of us have performed 11 procedures with excellent results and no cases of complications. This arthroscopic excision technique for the symptomatic os trigonum is a safe and effective procedure. PMID:18182212

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

    PubMed Central

    Nichols, Sylvain; Anderson, David E.

    2014-01-01

    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

  1. Physical therapy in the postoperative management of temporomandibular joint arthroscopic surgery.

    PubMed

    Uriell, P; Bertolucci, L; Swaffer, C

    1989-01-01

    Arthroscopic surgery of the temporomandibular joint (TMJ) is now commonly employed for both diagnostic and therapeutic purposes. Literature regarding the rehabilitation of patients who have undergone therapeutic anthroscopy is essentially nonexistent. This article presents basic rehabilitation principles based on the authors' experience in the postoperative care of 100 TMJs treated anthroscopically over a two-year period. PMID:2611896

  2. The application of arthroscopic principles to bone grafting of delayed union of long bone fractures

    Microsoft Academic Search

    Lanny L. Johnson; Kenneth M. Morrison; David L. Wood

    2000-01-01

    The purpose of this study was to explore the potential of applying arthroscopic techniques to autogenous bone grafting of long bone fracture delayed union. There were 9 patients in this initial series, including 4 patients (average age, 37 years) with humeral lesions and 5 patients (average age, 25 years) with tibial fractures. There were 6 men and 3 women. Techniques

  3. Histology and Arthroscopic Anatomy of the Ulnar Collateral Ligament of the Elbow

    Microsoft Academic Search

    Laura A. Timmerman; James R. Andrews

    1994-01-01

    The histology and arthroscopic anatomy of the ulnar collateral ligament of the elbow were studied in cadav eric specimens. The capsule consists of two layers of collagen fibers, with two distinct ligamentous bundles corresponding to anterior and posterior portions of the ulnar collateral ligament. The posterior bundle consists of distinct collagen bundles within the layers of the cap sule ;

  4. Arthroscopic assessment of occult intra-articular injury in acute ankle fractures

    Microsoft Academic Search

    Gregory J. Loren; Richard D. Ferkel

    2002-01-01

    Purpose: To arthroscopically assess the pattern and extent of intra-articular damage associated with ankle fractures. Type of Study: Prospective case series. Methods: From 1989 to 1998, 48 consecutive patients with acute unstable ankle fractures underwent ankle arthroscopy followed by reduction and internal fixation. In addition, all injuries were categorized by specific osseous, ligamentous, and articular pathology, based on clinical and

  5. Prevention of arthrofibrosis after arthroscopic screw fixation of tibial spine fracture in children and adolescents.

    PubMed

    Parikh, Shital N; Myer, David; Eismann, Emily A

    2014-01-01

    Arthrofibrosis is a major complication of tibial spine fracture treatment in children, potentially resulting in knee pain, quadriceps weakness, altered gait, decreased function, inability to return to sports, and long-term osteoarthritis. Thus, prevention rather than treatment of arthrofibrosis is desirable. The purpose of this study was to evaluate an aggressive postoperative rehabilitation and early intervention approach to prevent permanent arthrofibrosis after tibial spine fracture treatment and to compare epiphyseal and transphyseal screws for fixation. A consecutive series of 24 patients younger than age 18 with displaced type II and III tibial spine fractures who underwent arthroscopic reduction and screw fixation between 2006 and 2011 were retrospectively reviewed. Final range of motion was compared between patients with epiphyseal (n=12) and transphyseal (n=9) screws. One-third (4 of 12) of patients with epiphyseal screws underwent arthroscopic debridement and screw removal approximately 3 months postoperatively; 3 patients lacked 5° to 15° of extension, 1 experienced pain with extension, and 1 had radiographic evidence of screw pullout, loss of reduction, and resultant malunion. In the transphyseal screw group, 3 patients had 10° loss of extension, and all corrected after arthroscopic debridement and screw removal. The two groups did not significantly differ in time to hardware removal or return to sports or final range of motion. No growth disturbances were identified in patients after transphyseal screw removal. An aggressive approach of postoperative rehabilitation and early intervention after arthroscopic reduction and screw fixation of tibial spine fractures in children was successful in preventing permanent arthrofibrosis. PMID:24683658

  6. Arthroscopic decompression of paralabral cyst around suprascapular notch causing suprascapular neuropathy.

    PubMed

    Gupta, Ravi; Kapoor, Love; Shagotar, Saurabh

    2015-09-01

    A case of 22 year old male gymnast, who suffered from suprascapular neuropathy due to compression of suprascapular nerve by paralabral cysts around suprascapular notch, leading to marked atrophy of supraspinatus and infraspinatus muscles. After arthroscopic decompression of paralabral cysts, weakness and atrophy of the supraspinatus and infraspinatus muscles improved. PMID:26155054

  7. Arthroscopic Evaluation of the Lateral Compartment of Knees With Grade 3 Posterolateral Knee Complex Injuries

    Microsoft Academic Search

    Robert F. LaPrade

    1997-01-01

    The purpose of this study was to evaluate prospec tively the arthroscopic findings in the lateral compart ment of knees with posterolateral knee complex inju ries, to help identify individual injured anatomic structures, and to assist in the clinical identification of these injuries. Thirty of 33 consecutive knees noted to have grade 3 posterolateral knee complex injuries on preoperative evaluations

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

    PubMed Central

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

    2012-01-01

    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

  9. Early and Late-Term Results of Arthroscopic Surgery on Patients with Gonarthrosis

    PubMed Central

    Yilar, Sinan; Yildirim, Omer Selim

    2014-01-01

    Objective: To provide guidance in the selection of the appropriate patient for arthroscopic debridement. Materials and Methods: Ninety patients who were diagnosed with gonarthrosis according to modified American College of Rheumatology (ACR) criteria and who underwent arthroscopic debridement and meniscectomy were evaluated. Functional assessment of patients was made based on preoperative as well as 1 month and 1 year postoperative results of the Lysholm Knee Score and the Visual Analog Scale (VAS). One year postoperatively, the Tapper-Hoover Scoring System was used to calculate long-term results. Analyses were conducted using SPSS 18 software. For this study ethics committee approval was received from the ethics committee of Ataturk University Medical Studies Department Head on 08.10.2010 at the 6th meeting with regards to the document written on 16.06.2010 with number 998. Results: Differences between preoperative and 1-month and 1-year postoperative values in the Western Otorino and McMaster Universities Osteoarthrosis (WOMAC) Index, Lysholm and VAS were found to be statistically significant (p<0.001) (Table 1). According to Tapper-Hoover results, 82.8% of patients benefited from arthroscopic debridement in the long term (Table 2). Among body mass index (BMI) groups, the WOMAC, Lysholm and VAS values of obese patients were worse than those of normal weight and underweight patients, and the difference was statistically significant (p<0.005). Late-term results of patients younger than 55 were superior to those over 55. Conclusion: In the treatment of patients with gonarthrosis, arthroscopic debridement is a good option. Patients who have a low BMI and are younger than 55 years old experience more benefit from arthroscopic debridement. PMID:25610307

  10. Frozen shoulder after simple arthroscopic shoulder procedures: What is the risk?

    PubMed

    Evans, J P; Guyver, P M; Smith, C D

    2015-07-01

    Frozen shoulder is a recognised complication following simple arthroscopic shoulder procedures, but its exact incidence has not been reported. Our aim was to analyse a single-surgeon series of patients undergoing arthroscopic subacromial decompression (ASD; group 1) or ASD in combination with arthroscopic acromioclavicular joint (ACJ) excision (group 2), to establish the incidence of frozen shoulder post-operatively. Our secondary aim was to identify associated risk factors and to compare this cohort with a group of patients with primary frozen shoulder. We undertook a retrospective analysis of 200 consecutive procedures performed between August 2011 and November 2013. Group 1 included 96 procedures and group 2 104 procedures. Frozen shoulder was diagnosed post-operatively using the British Elbow and Shoulder Society criteria. A comparative group from the same institution involved 136 patients undergoing arthroscopic capsular release for primary idiopathic frozen shoulder. The incidence of frozen shoulder was 5.21% in group 1 and 5.71% in group 2. Age between 46 and 60 years (p = 0.002) and a previous idiopathic contralateral frozen shoulder (p < 0.001) were statistically significant risk factors for the development of secondary frozen shoulder. Comparison of baseline characteristics against the comparator groups showed no statistically significant differences for age, gender, diabetes and previous contralateral frozen shoulder. These results suggest that the risk of frozen shoulder following simple arthroscopic procedures is just over 5%, with no increased risk if the ACJ is also excised. Patients aged between 46 and 60 years and a previous history of frozen shoulder increase the relative risk of secondary frozen shoulder by 7.8 (95% confidence interval (CI) 2.1 to 28.3)and 18.5 (95% CI 7.4 to 46.3) respectively. Cite this article: Bone Joint J 2015; 97-B:963-6. PMID:26130353

  11. Umbilical hernia repair

    MedlinePLUS

    Umbilical hernia repair is surgery to repair an umbilical hernia . An umbilical hernia is a sac (pouch) formed from the inner ... and pain-free) for this surgery. If your hernia is small, you may receive spinal or epidural ...

  12. Intelligent pothole repair vehicle 

    E-print Network

    Minocher Homji, Ruzbeh Adi

    2006-10-30

    This thesis presents an endeavor to design and construct a prototype of an automated road repair vehicle called the Intelligent Pothole Repair Vehicle (IPRV). The IPRV is capable of automatically detecting and filling ...

  13. Comparison of Three Methods to Quantify Repair Cartilage Collagen Orientation

    PubMed Central

    Ross, Keir A.; Williams, Rebecca M.; Schnabel, Lauren V.; Mohammed, Hussni O.; Potter, Hollis G.; Bradica, Gino; Castiglione, Emme; Pownder, Sarah L.; Satchell, Patrick W.; Saska, Ryan A.

    2013-01-01

    Objective: The aim of this study was to determine if the noninvasive or minimally invasive and nondestructive imaging techniques of quantitative T2-mapping or multiphoton microscopy (MPM) respectively, could detect differences in cartilage collagen orientation similar to polarized light microscopy (PLM). It was hypothesized that MRI, MPM, and PLM would all detect quantitative differences between repair and normal cartilage tissue. Methods: Osteochondral defects in the medial femoral condyle were created and repaired in 5 mature goats. Postmortem, MRI with T2-mapping and histology were performed. T2 maps were generated and a mean T2 value was calculated for each region of interest. Histologic slides were assessed using MPM with measurements of autocorrelation ellipticity, and by PLM with application of a validated scoring method. Collagen orientation using each of the 3 modalities (T2-mapping, MPM, and PLM) was measured in the center of the repair tissue and compared to remote, normal cartilage. Results: MRI, MPM, and PLM were able to detect a significant difference between repair and normal cartilage (n = 5). The average T2 value was longer for repair tissue (41.43 ± 9.81 ms) compared with normal cartilage (27.12 ± 14.22 ms; P = 0.04); MPM autocorrelation ellipticity was higher in fibrous tissue (3.75 ± 1.17) compared with normal cartilage (2.24 ± 0.51; P = 0.01); the average PLM score for repair tissue was lower (1.6 ± 1.02) than the score for remote normal cartilage (4.4 ± 0.42; P = 0.002). The strongest correlation among the methods was between MRI and PLM (r = ?0.76; P = 0.01), followed by MPM and PLM (r = ?0.58; P = 0.08), with the weakest correlation shown between MRI and MPM (r = 0.35; P = 0.31). Conclusion: All 3 imaging methods quantitatively measured differences in collagen orientation between repair and normal cartilage, but at very different levels of resolution. PLM is destructive to tissue and requires euthanasia, but because MPM can be used arthroscopically, both T2-mapping and MPM can be performed in vivo, offering nondestructive means to assess collagen orientation that could be used to obtain longitudinal data in cartilage repair studies.

  14. The contact neodymium-yttrium aluminum garnet laser. A new approach to arthroscopic laser surgery.

    PubMed

    O'Brien, S J; Miller, D V

    1990-03-01

    Arthroscopic treatment of meniscal lesions has been modified as technological advances have occurred. However, alternatives to conventional arthroscopic cutting tools, including electrocautery and CO2 lasers, have thus far met with limited success. The recent development of a sapphire tip has enabled the use of the neodymium-yttrium aluminum garnet (Nd-YAG) laser in a contact mode in a saline medium. This study compares the biology of the Nd-YAG laser to that of electrocautery and scalpel techniques with respect to its effects on articular cartilage and the meniscus. The contact Nd-YAG laser has advantages over both scalpel and electrocautery with regard to its effects on articular cartilage. It also has significant biologic advantages over electrocautery for meniscal lesions. Although in its infancy in the clinical setting, the contact Nd-YAG laser represents the possible beginning of a new era for application of laser energy in arthroscopy. PMID:2302897

  15. Arthroscopic distal metaphyseal ulnar shortening osteotomy for ulnar impaction syndrome: a different technique.

    PubMed

    Yin, Hua-Wei; Qiu, Yan-Qun; Shen, Yun-Dong; Xu, Jian-Guang; Gu, Yu-Dong; Xu, Wen-Dong

    2013-11-01

    Ulnar impaction syndrome generally occurs with positive ulnar variance. The solution to the problem is to unload the ulnocarpal joint. Effective surgical options include diaphyseal ulnar shortening osteotomy, open wafer osteotomy, and arthroscopic wafer osteotomy. Recently, Slade and Gillon described an open procedure of ulnar shortening in the osteochondral region of the ulnar head. The procedure minimizes the risk of hemarthrosis and does not require hardware removal, which are problems with other surgical options. This article introduces a new arthroscopic technique of distal metaphyseal ulnar shortening osteotomy for ulnar impaction syndrome. This technique offers the advantages of minimizing surgical injury to the dorsal capsule of the distal radoulnar joint and so protects its stability. PMID:24206993

  16. High recurrence of instability in adolescents playing contact sports after arthroscopic shoulder stabilization.

    PubMed

    Nixon, Matthew F; Keenan, Oisin; Funk, Lennard

    2015-05-01

    Sixty-one shoulders in 57 adolescents underwent primary arthroscopic shoulder stabilization for labral tears sustained during contact sports (all Stanmore type 1). Mean follow-up was 22 months, mean age 16.8 (13-18) years. Postoperatively, the median subjective improvement was 90%, median VAS pain was 0 and mean Oxford Instability Score was 26.8. Sixty-one per cent returned to preinjury sporting level. A higher than expected proportion reported recurrent dislocation, with 15% followed up for 1 year and 31% for 4 years. Of these 11 requiring further surgery, 90% of redislocations occurred while playing rugby. Sex, type of sport, hyperlaxity and tear morphology were not significantly related to recurrence. Adolescents are at high risk for recurrence following arthroscopic stabilization. Patients should be counselled for the higher recurrence rate and consideration should be made for other aetiological factors such as returning to contact sports and joint hyperlaxity. PMID:25569537

  17. Comparison of magnetic resonance contrast arthrography and arthroscopic anatomy of the equine palmar lateral outpouching of the middle carpal joint.

    PubMed

    Getman, Liberty M; McKnight, Alexia L; Richardson, Dean W

    2007-01-01

    The objective of this report was to provide an anatomic description of the equine palmar lateral outpouching of the middle carpal joint by comparing its arthroscopic and magnetic resonance (MR) contrast arthrography appearance and to define the structures within the palmar lateral outpouching of the middle carpal joint that can be assessed arthroscopically. MR contrast arthrography was performed on seven cadaveric limbs; images were compared with those obtained during arthroscopic exploration of the palmar lateral outpouching of the middle carpal joint. Gross dissection was performed to confirm identification of intra-articular structures. The MR images compared well with the arthroscopic and gross appearance of the palmar lateral outpouching of the middle carpal joint. Portions of the ulnar carpal bone, fourth carpal bone, fourth metacarpal bone, lateral palmar intercarpal ligament, and lateral collateral ligament of the carpus were identified within the palmar lateral outpouching of the middle carpal joint in all limbs. In addition, in three limbs areas of the third carpal bone and intermediate carpal bone could be seen. MR arthrography was a useful tool for helping to define the anatomy of the palmar lateral outpouching of the middle carpal joint. The arthroscopic approach to the palmar lateral outpouching of the middle carpal joint is technically easy, but the intra-articular anatomy can be confusing. Use of a motorized arthroscopic blade to remove excess synovial tissue is necessary to view all of the structures within the palmar lateral outpouching of the middle carpal joint. Arthroscopic removal of osteochondral fragments from this location may be facilitated by the information obtained from this study. PMID:18018719

  18. Efficacy of Osseous Abnormalities Correction with Arthroscopic Surgery in Femoroacetabular Impingement

    PubMed Central

    Alvarez, Daniel R. Camacho; Mardones, Rodrigo M.

    2010-01-01

    Femoroacetabular impingement (FAI) is a clinical syndrome characterized by subtle abnormal morphology of the proximal femur and/or the acetabulum that leads to abnormal contact between the femoral neck and the acetabular rim during the hip range of motion. Traditionally, FAI has been managed safely and effectively with surgical hip dislocation; less invasive arthroscopic techniques are now being used to an increasing extent, trying to emulate the results of the open technique. The purpose of this study was to evaluate the radiographic results of arthroscopic acetabular rim trimming and femoral osteochondroplasty in FAI. This was a retrospective analysis of preoperative and postoperative plain radiographs of 80 patients treated for FAI with arthroscopic surgery between April 2007 and December 2008. We evaluated 2 parameters: the Wiberg angle (center-edge angle) (normal, 25°-35°), and the anterior/posterior relation of femoral head-neck offset (normal, 0.8-1). Of 80 hips, 10 (12.5%) were pincer-type impingement, 17 (21.25%) were cam type, and 53 (66.25%) were mixed type. The preoperative Wiberg average was 39° (range, 25°-51°), and the postoperative Wiberg average was 32° (range, 25°-42°). The preoperative anterior/posterior femoral offset relation average was 0.42 (range, ?0.38 to 1), and the postoperative anterior/posterior femoral offset relation average was 0.94 (range, 0.61-1.2). Our results show that it is possible to obtain an anatomical correction of the osseous abnormalities with arthroscopic surgery in FAI. Level of evidence: level III.

  19. Management of intraoperative complications in arthroscopic primary anterior cruciate ligament reconstruction.

    PubMed

    Charalambous, Charalambos P; Alvi, Farhan; Sutton, Paul M

    2015-04-01

    Arthroscopic anterior cruciate ligament reconstruction is a commonly performed procedure which is technically demanding and involves multiple surgical steps with the potential for a wide range of intraoperative complications. In this article, we review these potential complications and give algorithms for dealing with them based on our experience and published evidence. We discuss the use of both bone-patellar tendon-bone and hamstring grafts and examine complications associated with suspensory button and interference screw fixation. PMID:24752920

  20. Arthroscopic double-bundled posterior cruciate ligament reconstruction with quadriceps tendon–patellar bone autograft

    Microsoft Academic Search

    Chih-Hwa Chen; Wen-Jer Chen; Chun-Hsiung Shih

    2000-01-01

    Summary: An arthroscopic technique for double-bundled reconstruction for posterior cruciate ligament with quadriceps tendon–patellar bone autograft is presented. Anterolateral and posteromedial tunnels were created to simulate and reproduce the double-bundle structure of the posterior cruciate ligament. The bone plug is situated at the tibial tunnel and fixed by a titanium interference screw. Each of the bundles of tendon graft is

  1. Arthroscopic posterior cruciate ligament reconstruction with quadriceps tendon-patellar bone autograft

    Microsoft Academic Search

    C.-H. Chen; W.-J. Chen; C.-H. Shih

    1999-01-01

    Surgical reconstruction of the posterior cruciate ligament (PCL) is indicated in the PCL-deficient knee with symptomatic\\u000a instability and multiple ligamentous injury. However, the choice of graft tissues continues to be controversial. We describe\\u000a an arthroscopic PCL reconstruction technique using the quadriceps tendon-patellar bone autograft. From March through September\\u000a 1996, this autograft was used in 12 patients with PCL injuries. After

  2. Arthroscopic fixation of superior labral lesions using a biodegradable implant: A preliminary report

    Microsoft Academic Search

    Michael J. Pagnani; Kevin P. Speer; David W. Altchek; Russell F. Warren; David M. Dines

    1995-01-01

    Twenty-two patients were treated for symptomatic lesions of the superior glenoid labrum in association with instability of the tendinous insertion of the long head of the biceps brachii. A biodegradable implant was used to fix the labrum to the bony glenoid using an arthroscopic technique. At 2-year average follow-up, satisfactory results were obtained in 86% of the patients. Two patients,

  3. Arthroscopic Treatment of Femoroacetabular Impingement of the Hip: A New Technique to Access the Joint

    Microsoft Academic Search

    Monika Horisberger; Alexander Brunner; Richard F. Herzog

    2010-01-01

    Femoroacetabular impingement has been established as an important cause of groin pain and limitation of range of motion in\\u000a young, active patients and a possible cause for early osteoarthritis of the hip. Open surgery is a well-recognized approach\\u000a for treatment and probably the standard for most surgeons, but recent reports regarding arthroscopic treatment procedures\\u000a suggest comparable results. We present a

  4. Laser repair of liver

    NASA Astrophysics Data System (ADS)

    Prahl, Scott A.; Denison, Tim; LaJoie, Elaine

    2001-05-01

    Laser repair of liver using albumin is a promising method for treating liver trauma. Concentrated human serum albumin is applied to a liver laceration and then denatured using a laser. These repairs were pulled with a material tester to measure the ultimate strength of the laser repair. We show that the ultimate strength of the liver repairs tends to increase with delivered laser energy, that the mode of delivery (pulsed versus continuous) does not matter, that the repair strength correlates with the area of denatured albumin, and that strong welds cause about 1.5 mm of thermal damage.

  5. Arthroscopic technique for the treatment of pigmented villonodular synovitis of the hip.

    PubMed

    Lee, Simon; Haro, Marc S; Riff, Andrew; Bush-Joseph, Charles A; Nho, Shane J

    2015-02-01

    Open synovectomy remains the treatment of choice for pigmented villonodular synovitis (PVNS) of the hip but has shown modest results compared with the treatment of other joints. Recent advances in hip arthroscopy permit a thorough evaluation of the joint surfaces, improved access, and decreased postoperative morbidity. We describe an arthroscopic synovectomy technique for PVNS of the hip. The use of additional arthroscopic portals and creation of a large capsulotomy enable successful visualization and extensive synovectomy of the entire synovial lining of the hip. The T-capsulotomy enables extensive soft-tissue retraction for complete exposure. The midanterior portal enables use of an arthroscopic grasper and shaver to directly access and excise the synovial lining of the peripheral compartment while avoiding damage to the medial and lateral retinacular vessels. Technical innovations in hip arthroscopy have enhanced visualization in the central and peripheral compartments, as well as instrument management and diagnostic evaluation of the capsule, therefore allowing enhanced management of PVNS of the hip. PMID:25973372

  6. Arthroscopic Sternoclavicular Joint Resection Arthroplasty: A Technical Note and Illustrated Case Report

    PubMed Central

    Warth, Ryan J.; Lee, Jared T.; Campbell, Kevin J.; Millett, Peter J.

    2014-01-01

    Open resection arthroplasty of the sternoclavicular (SC) joint has historically provided good long-term results in patients with symptomatic osteoarthritis of the SC joint. However, the procedure is rarely performed because of the risk of injury to vital mediastinal structures and concern regarding postoperative joint instability. Arthroscopic decompression of the SC joint has therefore emerged as a potential treatment option because of many recognized advantages including minimal tissue dissection, maintenance of joint stability, avoidance of posterior SC joint dissection, expeditious recovery, and improved cosmesis. There are, however, safety concerns given the proximity of neurovascular structures. In this article we demonstrate a technique for arthroscopic SC joint resection arthroplasty in a 26-year-old active man with bilateral, painful, idiopathic degenerative SC joint osteoarthritis. This case also highlights the pearls and pitfalls of arthroscopic resection arthroplasty for the SC joint. There were no perioperative complications. Four months postoperatively, the patient had returned to full activities, including weightlifting, without pain or evidence of SC joint instability. One year postoperatively, the patient showed substantial improvements in the American Shoulder and Elbow Surgeons score; Single Assessment Numeric Evaluation score; Quick Disabilities of the Arm, Shoulder and Hand score; and Short Form 12 Physical Component Summary score over preoperative baseline values. PMID:24749040

  7. Arthroscopic surgery for degenerative knee: systematic review and meta-analysis of benefits and harms

    PubMed Central

    Juhl, C B; Roos, E M; Lohmander, L S

    2015-01-01

    Objective To determine benefits and harms of arthroscopic knee surgery involving partial meniscectomy, debridement, or both for middle aged or older patients with knee pain and degenerative knee disease. Design Systematic review and meta-analysis. Main outcome measures Pain and physical function. Data sources Systematic searches for benefits and harms were carried out in Medline, Embase, CINAHL, Web of Science, and the Cochrane Central Register of Controlled Trials (CENTRAL) up to August 2014. Only studies published in 2000 or later were included for harms. Eligibility criteria for selecting studies Randomised controlled trials assessing benefit of arthroscopic surgery involving partial meniscectomy, debridement, or both for patients with or without radiographic signs of osteoarthritis were included. For harms, cohort studies, register based studies, and case series were also allowed. Results The search identified nine trials assessing the benefits of knee arthroscopic surgery in middle aged and older patients with knee pain and degenerative knee disease. The main analysis, combining the primary endpoints of the individual trials from three to 24 months postoperatively, showed a small difference in favour of interventions including arthroscopic surgery compared with control treatments for pain (effect size 0.14, 95% confidence interval 0.03 to 0.26). This difference corresponds to a benefit of 2.4 (95% confidence interval 0.4 to 4.3) mm on a 0-100 mm visual analogue scale. When analysed over time of follow-up, interventions including arthroscopy showed a small benefit of 3-5 mm for pain at three and six months but not later up to 24 months. No significant benefit on physical function was found (effect size 0.09, ?0.05 to 0.24). Nine studies reporting on harms were identified. Harms included symptomatic deep venous thrombosis (4.13 (95% confidence interval 1.78 to 9.60) events per 1000 procedures), pulmonary embolism, infection, and death. Conclusions The small inconsequential benefit seen from interventions that include arthroscopy for the degenerative knee is limited in time and absent at one to two years after surgery. Knee arthroscopy is associated with harms. Taken together, these findings do not support the practise of arthroscopic surgery for middle aged or older patients with knee pain with or without signs of osteoarthritis. Systematic review registration PROSPERO CRD42014009145. PMID:26080045

  8. Arthroscopic removal of an osteochondral fragment from the caudal pouch of the lateral femorotibial joint in a colt.

    PubMed

    Stick, J A; Borg, L A; Nickels, F A; Peloso, J G; Perau, D L

    1992-06-01

    An osteochondral fragment was removed from the caudal pouch of the lateral femorotibial joint in a 2-year-old Trakehner colt by use of arthroscopic surgery and a lateral approach. The approach to this aspect of the femorotibial joints was developed in another horse. The fragment was not attached and resembled an osteochondritis dissecans lesion. The intermittent lameness associated with the fragment resolved after surgical removal. A positive response to diagnostic anesthesia of the femorotibial joint in the absence of a confirmed diagnosis (following radiographic and arthroscopic evaluations of the other aspects of the stifle joint) is an indication for arthroscopic exploration of the caudal pouches of the femorotibial joints of stifles in horses. PMID:1624349

  9. Alternative Excision Repair Pathways

    PubMed Central

    Yasui, Akira

    2013-01-01

    Alternative excision repair (AER) is a category of excision repair initiated by a single nick, made by an endonuclease, near the site of DNA damage, and followed by excision of the damaged DNA, repair synthesis, and ligation. The ultraviolet (UV) damage endonuclease in fungi and bacteria introduces a nick immediately 5? to various types of UV damage and initiates its excision repair that is independent of nucleotide excision repair (NER). Endo IV-type apurinic/apyrimidinic (AP) endonucleases from Escherichia coli and yeast and human Exo III-type AP endonuclease APEX1 introduce a nick directly and immediately 5? to various types of oxidative base damage besides the AP site, initiating excision repair. Another endonuclease, endonuclease V from bacteria to humans, binds deaminated bases and cleaves the phosphodiester bond located 1 nucleotide 3? of the base, leading to excision repair. A single-strand break in DNA is one of the most frequent types of DNA damage within cells and is repaired efficiently. AER makes use of such repair capability of single-strand breaks, removes DNA damage, and has an important role in complementing BER and NER. PMID:23645854

  10. Fundamentals of Airframe Repair

    NSDL National Science Digital Library

    On this site, visitors will find introductory materials to airframes and airframe repair for helicopters and airplanes. The resource is divided into two parts; part one discusses the basic components and processes of airframes, and part two covers airframe damage repair. Additionally, each part is broken down into four lessons, including Aviation Hardware, Structural Repair, and Metal-Working Processes. The text of the material is supplemented with helpful labeled drawings to illustrate each part of the airframe. This resource is useful for students who are just beginning in the field of airframe maintenance and repair, or the more general fields of aeronautics or aeronautical engineering.

  11. Short-term result of arthroscopic synovial excision for dorsal wrist pain in hyperextension associated with synovial hypertrophy

    PubMed Central

    Jain, Kowshik; Singh, Raminder

    2014-01-01

    INTRODUCTION Arthroscopic excision of the hypertrophic dorsal synovium is performed on patients with dorsal wrist pain in hyperextension. Although dorsal wrist impingement has been described in cadaveric studies, to our knowledge, there is no published clinical data on its treatment with arthroscopic synovial excision. Herein, we present the results of arthroscopic management of this condition in our hospital. METHOD A total of 13 patients underwent arthroscopic excision of the hypertrophic dorsal impinging synovium. All patients presented with the cardinal symptom of dorsal-radial wrist pain in extreme extension. The diagnoses were made after excluding other causes and confirmed on wrist arthroscopy. Arthroscopy was offered after nonoperative measures failed. The mean postoperative follow-up period was 14 (range 6–31) months. RESULTS Mean pre-and postoperative quick Disabilities of the Arm, Shoulder and Hand scores were 49 (range 34–82) and 17 (range 0–48), respectively; paired t-test revealed a significant difference between the two (p < 0.001). Mean postoperative flexion-extension arc and radial-ulnar deviation arc were 120º and 46º, respectively. Postoperatively, one patient developed complex regional pain syndrome, with tethering of the dorsal branch of the ulnar nerve, which required surgical release, while another patient required revision arthroscopic excision of the impinging tissue. Both patients had good postoperative outcomes. CONCLUSION When treating patients with dorsal wrist pain, dorsal wrist impingement caused by synovial hypertrophy should be included in the differential diagnosis. Arthroscopic excision of the impinging synovium can achieve reliable pain relief with significant functional improvement in the short term, although further research on its long-term benefits is required. PMID:25631897

  12. 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 ...

  13. Effect of arthroscopic cartilage defect repair with bone marrow derived cells on the lubricant properties of synovial fluid :

    E-print Network

    Grissom, Murray J.

    2011-01-01

    parameters of hyaluronic acid in normal and arthritis humanparameters of hyaluronic acid in normal and arthritis humanhyaluronic acid plus phospholipid on synovial joint lubrication and prevention of articular cartilage degeneration in experimental osteoarthritis. Arthritis

  14. The antero-inferior (transmuscular) approach for arthroscopic repair of the bankart lesion: An anatomic and clinical study

    Microsoft Academic Search

    Herbert Resch; Heinz F. Wykypiel; Herbert Maurer; Markus Wambacher

    1996-01-01

    In order to find a direct approach to the antero-inferior third of the glenoid rim, an anatomic study was performed on a total of 89 shoulders (48 cadavers). To obtain defined reference points for the anterior inferior third of the glenoid cavity, it was compared with the hour markings on a clock face. The 4:30 position on the right shoulder

  15. Human DNA Repair Genes

    Microsoft Academic Search

    Richard D. Wood; Michael Mitchell; John Sgouros; Tomas Lindahl

    2001-01-01

    Cellular DNA is subjected to continual attack, both by reactive species inside cells and by environmental agents. Toxic and mutagenic consequences are minimized by distinct pathways of repair, and 130 known human DNA repair genes are described here. Notable features presently include four enzymes that can remove uracil from DNA, seven recombination genes related to RAD51, and many recently discovered

  16. Snowmobile Repair. Teacher Edition.

    ERIC Educational Resources Information Center

    Hennessy, Stephen S.; Conrad, Rex

    This teacher's guide contains 14 units on snowmobile repair: (1) introduction to snowmobile repair; (2) skis, front suspension, and steering; (3) drive clutch; (4) drive belts; (5) driven clutch; (6) chain drives; (7) jackshafts and axles; (8) rear suspension; (9) tracks; (10) shock absorbers; (11) brakes; (12) engines; (13) ignition and…

  17. A Comparison of Functional Outcomes After Metallic and Bioabsorbable Interference Screw Fixations in Arthroscopic ACL Reconstructions

    PubMed Central

    Rai, Deepak K; Kannampilly, Antony J

    2014-01-01

    Introduction: Anterior Cruciate Ligament (ACL) is as one of the most frequently injured ligaments in the modern contact sports scenario. Graft fixations can be achieved during anterior cruciate ligament (ACL) reconstructions by using either bioabsorbable screws or metal screws. The objective of this study was to compare the functional outcomes after bioabsorbable and metallic interference screw fixations in arthroscopic anterior cruciate ligament reconstructions done by using hamstring grafts. Materials and Methods: This was a prospective, randomized study. Patients in Group 1 received bioabsorbable interference screws and patients in Group 2 received metallic interference screws. Arthroscopic assisted, anterior cruciate ligament reconstructions with the use of hamstring grafts which were fixed proximally with endobuttons and distally with bioabsorbable or metallic interference screws, were undertaken. Progress in functional outcomes was assessed by using Mann Whitney U- test. Functional outcomes in the two groups were compared by using independent t-test. Observation and Results: In each group, there were statistically significant improvements in functional outcomes over successive follow-ups, which were seen on basis on Mann-Whitney U-test. The comparison of functional outcomes between the two groups, done by using independent t-test, showed no statistically significant differences between the two groups at 3 months, 6 months and 1 year of follow-up. p-value <0.05 was considered to be significant in our study. Conclusion: In our prospective study of comparison of functional outcomes between bioabsorbable and metallic interference screws in arthroscopic anterior cruciate ligament reconstuctions, which were evaluated by using Tegner activity scale and Lysholm knee scoring scale for a period of 1 year, no statistically significant difference was found. However, further authentication is required by doing long term studies. PMID:24959468

  18. Intra-articular injection of hyaluronic acid following arthroscopic partial meniscectomy of the knee.

    PubMed

    Thein, Rafael; Haviv, Barak; Kidron, Amos; Bronak, Shlomo

    2010-10-01

    The short-term recovery period post-arthroscopic meniscectomy is characterized by pain and impaired function most likely related to the irrigation of synovial fluid from the knee intraoperatively. Consequently, along with removal of harmful debris, the irrigation fluid dilutes the hyaluronic acid layer covering the joint tissues. Hyaluronic acid contributes to the homeostasis of the joint environment and is an important component of synovial fluid and cartilage matrix. Hence, the instillation of hyaluronic acid after the procedure may relieve symptoms. This prospective, single-blind, randomized, controlled study evaluated clinical outcome after hyaluronic acid injection to patients who underwent arthroscopic meniscectomy of the knee. Patients with ligamentous injuries or severe chondral damage were excluded. Fifty-six patients with a mean age of 34 years (range, 17-44 years) were injected with Viscoseal (TRB Chemedica International S.A., Geneva, Switzerland) or normal saline immediately post-arthroscopy and divided into the Viscoseal group or control group, respectively. Patients were evaluated for pain, swelling, and function at 1, 4, and 12 weeks postoperatively. Patients in the control group reported more pain at week 1, with a mean visual analog score (VAS) of 43, than did patients in the Viscoseal group, with a mean VAS of 28 (P=.006). At 4 weeks postoperatively, none of the Viscoseal patients had consumed analgesics, where 9 (of 28) in the control group reported acetaminophen intake (P=.039). No significant difference in knee function was found between groups. Intra-articular injection of Viscoseal after arthroscopic meniscectomy reduced pain in the short-term recovery period. PMID:20954664

  19. A Modified Outside-in Suture Technique for Repair of the Middle Segment of the Meniscus Using a Spinal Needle

    PubMed Central

    2014-01-01

    Introduction Several techniques have been used for arthroscopic repair of middle segment, posteromedial or posterolateral corner tears of the meniscus. One of the commonly used methods is the inside-out double arm needle technique. Surgical Technique We have developed a vertical mattress absorbable suture technique. It is easy to perform with a small sized skin incision for knot tying. This technique just necessitates 1 or 2 spinal needles for repair. Materials and Methods Between March 2010 and February 2012, 20 menisci were treated by this technique, a modified method of the outside-in vertical meniscal repair using a spinal needle and No. 2 PDS absorbable suture material. Evaluation of clinical results was done using the Lysholm score. Results The mean preoperative Lysholm score was 63.9 and the mean postoperative score was 97.3. A second look arthroscopy was performed in 13 knees (65%) and the repair sites were well healed. Conclusions We recommend this method as an alternative technique for repair of the middle segment, posteromedial or posterolateral corner of the meniscus. PMID:24639946

  20. Hypoxia and DNA Repair

    PubMed Central

    Glazer, Peter M.; Hegan, Denise C.; Lu, Yuhong; Czochor, Jennifer; Scanlon, Susan E.

    2013-01-01

    Hypoxia is a characteristic feature of solid tumors and occurs very early in neoplastic development. Hypoxia transforms cell physiology in multiple ways, with profound changes in cell metabolism, cell growth, susceptibility to apoptosis, induction of angiogenesis, and increased motility. Over the past 20 years, our lab has determined that hypoxia also induces genetic instability. We have conducted a large series of experiments revealing that this instability occurs through the alteration of DNA repair pathways, including nucleotide excision repair, DNA mismatch repair, and homology dependent repair. Our work suggests that hypoxia, as a key component of solid tumors, can drive cancer progression through its impact on genomic integrity. However, the acquired changes in DNA repair that are induced by hypoxia may also render hypoxic cancer cells vulnerable to tailored strategies designed to exploit these changes. PMID:24348208

  1. Arthroscopic debridement and biological resurfacing of the glenoid in glenohumeral arthritis.

    PubMed

    de Beer, Joe F; Bhatia, Deepak N; van Rooyen, Karin S; Du Toit, Donald F

    2010-12-01

    The purpose of this study was to analyse the intermediate-term results of an arthroscopic procedure to debride and resurface the arthritic glenoid, in a middle-aged population, using an acellular human dermal scaffold. Between 2003 and 2005, thirty-two consecutive patients underwent an arthroscopic debridement and biological glenoid resurfacing for glenohumeral arthritis. The diagnoses included primary osteoarthrosis (28 patients), arthritis after arthroscopic reconstruction for anterior instability (1 patient) and inflammatory arthritis (3 patients). All shoulders were assessed clinically using the Constant and Murley score, and results graded according to Neer's criteria. Statistical analysis was performed to determine significant parameters and associations. A significant improvement (P < 0.0001) in each parameter of the subjective evaluation component (severity of pain, limitation in daily living and recreational activities) of the Constant score was observed. The Constant and Murley score increased significantly (P < 0.0001) from a median of 40 points (range 26-63) pre-operatively to 64.5 (range 19-84) at the final assessment. Overall, the procedure was considered as "successful outcome" in 23 patients (72%) and as a "failure" in 9 patients (28%). According to Neer's criteria, the result was categorized as excellent in 9 (28%), satisfactory in 14 (44%) and unsatisfactory in 9 (28%). Within the unsatisfactory group, there were five conversions to prosthetic arthroplasty. A standard magnetic resonance imaging was performed on 22 patients in the successful outcome group; glenoid cartilage was identified in 12 (thick in 5, intermediate in 1, thin in 6) and could not be identified in 10 patients (complete/incomplete loss in 5, technical difficulties in 5). Overall, five complications included transient axillary nerve paresis, foreign-body reaction to biological material, inter-layer dissociation, mild chronic non-specific synovitis and post-traumatic contusion. Dominance of affected extremity and generalized disease (diabetes, rheumatoid arthritis, generalized osteoarthritis) was associated with an unsatisfactory outcome (P < 0.05). Arthroscopic debridement and biological resurfacing of the glenoid is a minimally invasive therapeutic option for pain relief, functional improvement and patient satisfaction, in glenohumeral osteoarthritis, in the intermediate-term. PMID:20480357

  2. In Situ Pinning With Arthroscopic Osteoplasty for Mild SCFE: A Preliminary Technical Report

    Microsoft Academic Search

    Michael Leunig; Kevin Horowitz; Hannes Manner; Reinhold Ganz

    2010-01-01

    Background  There is emerging evidence that even mild slipped capital femoral epiphysis leads to early articular damage. Therefore, we\\u000a have begun treating patients with mild slips and signs of impingement with in situ pinning and immediate arthroscopic osteoplasty.\\u000a \\u000a \\u000a \\u000a \\u000a Description of Techniques  Surgery was performed using the fracture table. After in situ pinning and diagnostic arthroscopy, peripheral compartment access\\u000a was obtained and head-neck

  3. Automotive Repair Shops Case Study ME 4171 Automotive Repair Shops

    E-print Network

    Automotive Repair Shops Case Study ­ ME 4171 ­ 1 ­ Automotive Repair Shops In the following, you. Question: #12;Automotive Repair Shops Case Study ­ ME 4171 ­ 2 ­ 1) Do you anticipate hazardous wastes generated through welding? To repair both minor and major auto body damage, hydraulic equipment and hand

  4. INTERNAL REPAIR OF PIPELINES

    SciTech Connect

    Robin Gordon; Bill Bruce; Ian Harris; Dennis Harwig; George Ritter; Bill Mohr; Matt Boring; Nancy Porter; Mike Sullivan; Chris Neary

    2004-08-17

    The two broad categories of fiber-reinforced composite liner repair and deposited weld metal repair technologies were reviewed and evaluated 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. Principal conclusions from a survey of natural gas transmission industry pipeline operators can be summarized in terms of the following performance requirements for internal repair: (1) Use of internal repair is most attractive for river crossings, under other bodies of water, in difficult soil conditions, under highways, under congested intersections, and under railway. (2) Internal pipe repair offers a strong potential advantage to the high cost of horizontal direct drilling when a new bore must be created to solve a leak or other problem. (3) Typical travel distances can be divided into three distinct groups: up to 305 m (1,000 ft.); between 305 m and 610 m (1,000 ft. and 2,000 ft.); and beyond 914 m (3,000 ft.). All three groups require pig-based systems. A despooled umbilical system would suffice for the first two groups which represents 81% of survey respondents. The third group would require an onboard self-contained power unit for propulsion and welding/liner repair energy needs. (4) The most common size range for 80% to 90% of operators surveyed is 508 mm (20 in.) to 762 mm (30 in.), with 95% using 558.8 mm (22 in.) pipe. Evaluation trials were conducted on pipe sections with simulated corrosion damage repaired with glass fiber-reinforced composite liners, carbon fiber-reinforced composite liners, and weld deposition. Additional un-repaired pipe sections were evaluated in the virgin condition and with simulated damage. Hydrostatic failure pressures for pipe sections repaired with glass fiber-reinforced composite liner were only marginally greater than that of pipe sections without liners, indicating that this type of liner is only marginally effective at restoring the pressure containing capabilities of pipelines. Failure pressures for larger diameter pipe repaired with a semi-circular patch of carbon fiber-reinforced composite lines were also marginally greater than that of a pipe section with un-repaired simulated damage without a liner. These results indicate that fiber reinforced composite liners have the potential to increase the burst pressure of pipe sections with external damage Carbon fiber based liners are viewed as more promising than glass fiber based liners because of the potential for more closely matching the mechanical properties of steel. Pipe repaired with weld deposition failed at pressures lower than that of un-repaired pipe in both the virgin and damaged conditions, indicating that this repair technology is less effective at restoring the pressure containing capability of pipe than a carbon fiber-reinforced liner repair. Physical testing indicates that carbon fiber-reinforced liner repair is the most promising technology evaluated to-date. Development of a comprehensive test plan for this process is recommended for use in the field trial portion of this program.

  5. A systematic review of intra-articular local anesthesia for postoperative pain relief after arthroscopic knee surgery

    Microsoft Academic Search

    Steen Møiniche; Søren Mikkelsen; Jørn Wetterslev; Jørgen Berg Dahl

    1999-01-01

    Background and Objectives. In a systematic review, we have evaluated double-blind, randomized, controlled trials of intra-articular local anesthesia compared with placebo or no treatment in the control of postoperative pain after arthroscopic knee surgery. Methods. Outcome measures were pain scores, supplementary analgesics, and time to first analgesic request. Efficacy was estimated by significant difference (P < .05) as reported in

  6. [Combined anterior cruciate ligament and posterior cruciate ligament injury--technique and results of simultaneous arthroscopic reconstruction].

    PubMed

    Martinek, V; Imhoff, A B

    1998-01-01

    Simultaneous ACL and PCL ruptures are rare but serious injuries resulting in distinct instability of the knee joint followed by an early degenerative arthritis. This combined trauma, which is often accompanied by additional ligament lesions, originates from a knee dislocation. While the conservative treatment of this complex instability is abandoned, the operative procedures are not yet standardised. The timing of the cruciate ligament reconstruction depends on the additional injuries, but generally the postprimary treatment is performed. Autografts and allografts, which can be also combined, are available for the reconstruction of the cruciate ligaments. The arthroscopic assisted operation starts with the drilling of all tibial and femoral tunnels using standard ACL and PCL arthroscopic instruments. The PCL is positioned after the graft has been transported into the joint through an anterolateral port, the ACL graft is positioned through the tibial drill hole and both are anchored first on the femoral and then on the tibial site i.e. with interference screws. In the postoperative rehabilitation neither immobilisation nor brace are used and progressive range of motion is allowed. The arthroscopic assisted reconstructions of the ACL and increasingly of the PCL are becoming standard procedures, but the technically difficult combined ACL/PCL reconstruction is restricted to a small number of arthroscopists. The first clinical results demonstrate, that the arthroscopic operation is comparable to the open reconstruction. PMID:9816662

  7. Divergent diagnosis from arthroscopic findings and identification of CPII and C2C for detection of cartilage degradation in horses.

    PubMed

    Lettry, Vivien; Sumie, Yasuharu; Mitsuda, Kenta; Tagami, Masaaki; Hosoya, Kenji; Takagi, Satoshi; Okumura, Masahiro

    2010-02-01

    The objective of this study was to investigate the changes in synovial fluid concentration of collagen type II cleavage site (C2C) and procollagen II C-propeptide (CPII), markers of joint cartilage degeneration and synthesis, respectively, in horses with intraarticular fracture or osteochondrosis dissecans (OCD), and to examine the relationship between arthroscopic findings and these biomarker levels. Synovial fluid was collected from 36 joints in 18 horses (6 fractures and 12 OCDs). Samples from contralateral normal joints, when available, served as controls (n = 12). Concentrations of C2C and CPII were measured using enzyme-linked immunosorbant assays. Moreover, the severity of the cartilage degradation was graded arthroscopically in 16 horses, and the correlation between the C2C and CPII levels and the arthroscopic scores were investigated. Compared to the control, the concentration of C2C was increased in OCD joints but not in fracture joints, whereas the concentration of CPII was increased in fracture joints but not in OCD joints. Within each disease group there was no correlation between biomarker levels and arthroscopic findings. Therefore, although C2C and CPII have diagnostic potential further knowledge is required to provide accurate analysis. PMID:20364792

  8. Salvage hypospadias repairs

    PubMed Central

    Sripathi, V.; Satheesh, M.; Shubha, K.

    2008-01-01

    Aim: Review of our experience and to develop an algorithm for salvage procedures in the management of hypospadias cripples and treatment of urethral strictures following hypospadias repair. Methods: This is a retrospective review of hypospadias surgeries over a 41-month period. Out of a total 168 surgeries, 20 were salvage/re-operative repairs. In three children a Duplay repair was feasible, while in four others a variety of single-stage repairs could be done. The repair was staged in seven children – buccal mucosal grafts (BMGs) in five, buccal mucosal tube in one, and skin graft in one. Five children with dense strictures were managed by dorsal BMG inlay grafting in one, vascularized tunical onlay grafting on the ventrum in one, and a free tunical patch in one. Three children were treated by internal urethrotomy and stenting for four weeks with a poor outcome. Results: The age of children ranged from 1.5–15 years (mean 4.5). Follow-up ranged from 3 months to 3.5 years. Excellent results were obtained in 10 children (50%) with a well-surfaced erect penis and a slit-like meatus. Glans closure could not be achieved and meatus was coronal in three. Two children developed fistulae following a Duplay repair and following a staged BMG. Three repairs failed completely – a composite repair broke down, a BMG tube stenosed with a proximal leak, and a stricture recurred with loss of a ventral free tunical graft. Conclusions: In salvage procedures performed on hypospadias cripples, a staged repair with buccal mucosa as an inlay in the first stage followed by tubularization 4–6 months later provides good results. A simple algorithm to plan corrective surgery in failed hypospadias cases and obtain satisfactory results is devised. PMID:20011495

  9. Rapid road repair vehicle

    DOEpatents

    Mara, Leo M. (Livermore, CA)

    1999-01-01

    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.

  10. Arthroscopic Removal of a Polyethylene Glenoid Component in Total Shoulder Arthroplasty

    PubMed Central

    Venjakob, Arne J.; Reichwein, Frank; Nebelung, Wolfgang

    2015-01-01

    We present a technique for arthroscopic glenoid removal in a case of glenoid loosening after total shoulder arthroplasty (TSA). The presented technique is technically feasible and may be useful if 1-stage surgery with glenoid reimplantation is not indicated. To exclude low-grade infection, the presented technique allows for an intraoperative infection workup such as intraoperative cultures. However, glenoid loosening in TSA is a well-known problem and has been described before. The advantages of the presented technique include minimally invasive surgery, decreased pain, preservation of the subscapularis tendon, and assurance of exclusion of low-grade infection before reimplantation of a new glenoid implant. In this case a 73-year-old patient was treated with a TSA for severe osteoarthritis of the right shoulder in April 2014. Because of persistent anterior shoulder pain postoperatively, radiographic evaluation was performed and showed signs of glenoid loosening 6 months after surgery without any clinical signs of infection. To exclude low-grade infection, arthroscopy of the right shoulder was performed. Arthroscopy showed a totally loosened glenoid component leading to arthroscopic glenoid removal by use of a special forceps. PMID:26052492

  11. Fungal osteomyelitis after arthroscopic anterior cruciate ligament reconstruction: a case report with review of the literature.

    PubMed

    Sun, Lei; Zhang, Lei; Wang, Kai; Wang, Wei; Tian, Min

    2012-10-01

    Fungal osteomyelitis is a very rare complication after anterior cruciate ligament (ACL) reconstruction associated with catastrophic consequences. Herein, we present a case of such disastrous complication after ACL reconstruction. A 23-year-old man developed fever, swelling and pain of the affected knee from 18 days after arthroscopic ACL reconstruction. Therefore, he underwent arthroscopic debridement, removal of the graft and internal fixators, irrigation and suction drainage, successively. Negative results for serial bacterial cultures and smear examinations are obtained. However, computer tomography and X-ray examination showed massive bone destruction at 48 days after ACL reconstruction. As the first open debridement was performed at 50 days after ACL reconstruction, fungal infection was diagnosed based on finding Aspergillus hyphae in pathologic examination of the debrided bone sample. After the final debridement, a 12-cm bone loss in the distal femur was treated by Ilizarov's bone transport. The patient got solid arthrodesis of the affected knee without clinical infection at a year after the initial operation. In addition, a review of the literature regarding case reports of fungal osteomyelitis after ACL reconstruction is presented. PMID:22209694

  12. Heterotopic ossifications after arthroscopic management of femoroacetabular impingement: the role of NSAID prophylaxis

    PubMed Central

    Randelli, Filippo; Pierannunzii, Luca; Ragone, Vincenza; Aliprandi, Alberto; Buly, Robert

    2010-01-01

    Background Open hip surgery is known to be a risk for heterotopic ossification (HO), and nonsteroidal anti-inflammatory drugs (NSAIDs) have been widely recognized as an effective prevention. Hip arthroscopy is gaining popularity thanks to the possibility of treating femoroacetabular impingement (FAI) with a minimally invasive technique, however little is known about its rate of postoperative HO. The aim of the present study is to evaluate HO prevalence after hip arthroscopy for FAI and its relationship with NSAID prophylaxis. Materials and methods We retrospectively reviewed 300 FAI cases who have been managed with hip arthroscopy in two different hospitals from April 2006 to May 2009. All medical records and indications at discharge were analyzed, focusing on administration of NSAIDs, as well as follow-up roentgenograms with regard to presence of HO around the hip joint. The patients were divided into two groups: a treatment group of 285 hips which received NSAID prophylaxis and a control group of 15 hips which did not. Results Five hips presented HO, with overall prevalence of 1.6%. All five patients with HO belonged to the control group. No HO was observed in the treatment group. Thus, HO rate turned out to be significantly higher (P < 0.001) in patients who did not receive NSAIDs after surgery. Conclusion Arthroscopic treatment of FAI is not exempt from potential development of HO. NSAIDs after arthroscopic FAI treatment seem to be an effective prevention. PMID:21116673

  13. Arthroscopic approach and intra-articular anatomy of the plantar pouch of the equine tarsocrural joint.

    PubMed

    Zamos, D T; Honnas, C M; Hoffman, A G

    1994-01-01

    Arthroscopic examination of structures within the plantar pouch of the tarsocrural joint was accomplished via portals in both the plantaromedial and plantarolateral aspects of the joint. Flexion and extension of the tarsus while examining the joint through either portal allowed observation of the proximal and plantar aspects of the lateral and medial trochlear ridges, the trochlear groove, the caudal aspect of the distal tibia, and the deep digital flexor tendon (DDFT) in its sheath. From a plantarolateral portal, the plantar talocalcaneal ligament and the plantar aspect of the lateral malleolus could be observed. The caudal aspect of the medial malleolus could not be observed with flexion or extension of the joint from a plantaromedial portal, but in some horses, the caudal aspect of the lateral malleolus could be observed. The dorsolateral and dorsomedial aspects of the plantar pouch were best examined from a portal on the ipsilateral side of the joint. An instrument portal opposite either arthroscope portal allowed access to most regions of the joint except the abaxial surface of the trochlear ridge opposite the instrument. PMID:8066979

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

    PubMed Central

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

    2014-01-01

    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

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

    PubMed Central

    Kostov, Hristijan; Stojmenski, Slavcho; Kostova, Elena

    2014-01-01

    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

  16. Large increase in arthroscopic meniscus surgery in the middle-aged and older population in Denmark from 2000 to 2011

    PubMed Central

    Thorlund, Jonas B; Hare, Kristoffer B; Lohmander, L Stefan

    2014-01-01

    Background Arthroscopic meniscal surgery is the most common orthopedic procedure, and the incidence has increased in Denmark over the last 10 years. Concomitantly, several randomized controlled trials have shown no benefit of arthroscopic procedures including arthroscopic partial meniscectomy in middle-aged and older individuals suffering from knee pain with or without knee osteoarthritis. We examined the annual incidence of meniscal procedures together with age, sex, and diagnosis for patients who underwent meniscal procedures in the period 2000–2011 in Denmark. Methods Data on age, sex, diagnosis, and surgical procedures were extracted from the Danish National Patient Register for the years 2000–2011, for all records containing meniscal surgery as a primary or secondary procedure. Results The overall annual incidence of meniscal procedures per 100,000 persons in Denmark doubled from 164 in 2000 to 312 in 2011 (i.e. 8,750 procedures to 17,368 procedures). A 2-fold increase was found for patients aged between 35 and 55, and a 3-fold increase was found for those older than 55. Middle-aged and older patients accounted for 75% of all 151,228 meniscal procedures carried out between 2000 and 2011. Interpretation The incidence of meniscal procedures performed in Denmark doubled from 2000 to 2011, with the largest increase in middle-aged and older patients. This increase contrasts with the mounting evidence showing no added benefit of arthroscopic partial meniscectomy over non-surgical treatments. Our observations illustrate the long delay in the dissemination, acceptance, and implementation of research evidence into the practice of arthroscopic surgery. PMID:24800623

  17. The FasT-Fix Repair Technique for Ramp Lesion of the Medial Meniscus

    PubMed Central

    Li, Wei-ping; Song, Bin; Yang, Rui; Tan, Weiquan

    2015-01-01

    Introduction This technical note describes a new arthroscopic technique to repair the peripheral attachment lesion of the posterior horn of the medial meniscus. The operation was performed under arthroscopy using a standard anterior portal. Surgical Technique A FasT-Fix needle was inserted obliquely close to the tibial plateau and the first implant was inserted into the joint capsule depending on its bending angle underneath the meniscus. The second implant was inserted through 1/3 periphery of the meniscus into the meniscocapsular area. The pre-tied self-sliding knot was tensioned to achieve secure fixation of the posterior meniscal peripheral attachment at the original attachment point. Materials and Methods From August 2011 to February 2014, 23 knees were diagnosed as ramp lesion, underwent meniscal repair using FasT-Fix technique. Results All patients were followed up for average 14 months. The Lysholm score improved from preoperative 64.4±4.52 to postoperative 91.2±4.60. Conclusions We believe that the FasT-Fix technique via the standard anterior portal can be a more convenient and less traumatic alternative for repair of the peripheral attachment lesion of the posterior horn of the medial meniscus in the anterior cruciate ligament deficient knee. PMID:25750895

  18. Patent urachus repair

    MedlinePLUS

    Patent urachal tube repair ... belly. Next, the surgeon will find the urachal tube and remove it. The bladder opening will be ... surgeon uses the tools to remove the urachal tube and close off the bladder and area where ...

  19. Intestinal obstruction repair

    MedlinePLUS

    ... contents of the intestines cannot pass through and exit the body. A complete obstruction is a surgical ... your bowel will be repaired or removed. This procedure is called bowel resection . If a section is ...

  20. Repairing Thermal Tiles

    NASA Technical Reports Server (NTRS)

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

    1984-01-01

    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.

  1. Easily repairable networks

    NASA Astrophysics Data System (ADS)

    Fink, Thomas

    2015-03-01

    We introduce a simple class of distribution networks which 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. We acknowledge support from the Defense Threat Reduction Agency, BCG and EU FP7 (Growthcom).

  2. INTERNAL REPAIR OF PIPELINES

    SciTech Connect

    Robin Gordon; Bill Bruce; Ian Harris; Dennis Harwig; Nancy Porter; Mike Sullivan; Chris Neary

    2004-04-12

    The two broad categories of deposited weld metal repair and fiber-reinforced composite liner 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 repair and for fiber-reinforced composite liner repair. Evaluation trials have been conducted using a modified fiber-reinforced composite liner provided by RolaTube and pipe sections without liners. All pipe section specimens failed in areas of simulated damage. Pipe sections containing fiber-reinforced composite liners failed at pressures marginally greater than the pipe sections without liners. The next step is to evaluate a liner material with a modulus of elasticity approximately 95% of the modulus of elasticity for steel. Preliminary welding parameters were developed for deposited weld metal repair in preparation of the receipt of Pacific Gas & Electric's internal pipeline welding repair system (that was designed specifically for 559 mm (22 in.) diameter pipe) and the receipt of 559 mm (22 in.) pipe sections from Panhandle Eastern. The next steps are to transfer welding parameters to the PG&E system and to pressure test repaired pipe sections to failure. A survey of pipeline operators was conducted to better understand the needs and performance requirements of the natural gas transmission industry regarding internal repair. Completed surveys contained the following principal conclusions: (1) Use of internal weld repair is most attractive for river crossings, under other bodies of water, in difficult soil conditions, under highways, under congested intersections, and under railway crossings. (2) Internal pipe repair offers a strong potential advantage to the high cost of horizontal direct drilling (HDD) when a new bore must be created to solve a leak or other problem. (3) Typical travel distances can be divided into three distinct groups: up to 305 m (1,000 ft.); between 305 m and 610 m (1,000 ft. and 2,000 ft.); and beyond 914 m (3,000 ft.). All three groups require pig-based systems. A despooled umbilical system would suffice for the first two groups which represents 81% of survey respondents. The third group would require an onboard self-contained power unit for propulsion and welding/liner repair energy needs. (4) Pipe diameter sizes range from 50.8 mm (2 in.) through 1,219.2 mm (48 in.). The most common size range for 80% to 90% of operators surveyed is 508 mm to 762 mm (20 in. to 30 in.), with 95% using 558.8 mm (22 in.) pipe. An evaluation of potential repair methods clearly indicates that the project should continue to focus on the development of a repair process involving the use of GMAW welding and on the development of a repair process involving the use of fiber-reinforced composite liners.

  3. A Simple Book Repair Manual

    NSDL National Science Digital Library

    Created by the Dartmouth College Library Preservation Services, this handy and straightforward site should appeal to book lovers and collectors. The site is basically an electronic version of the print publication, supplemented by illustrative photos and a Quicktime movie. The manual discusses guiding principles to book repair, tools, practical guidelines, as well as guiding users through nine common repairs. These include torn pages, hinge repair, hinge tightening, corner repair, and spine repair, among others. A glossary and bibliography are also included.

  4. Repairing Foam Insulation

    NASA Technical Reports Server (NTRS)

    Corbin, J.; Buras, D.

    1986-01-01

    Large holes in polyurethane foam insulation repaired reliably by simple method. Little skill needed to apply method, used for overhead repairs as well as for those in other orientations. Plug positioned in hole to be filled and held in place with mounting fixture. Fresh liquid foam injected through plug to bond it in place. As foam cures and expands, it displaces plug outward. Protrusion later removed.

  5. Laparoscopic Paraesophageal Hernia Repair

    PubMed Central

    Medina, Laura; Peetz, Michael; Ratzer, Erick

    1998-01-01

    Background and Objective: Paraesophageal hernias are uncommon yet potentially lethal conditions. Their repair has now been facilitated by laparoscopic technology. We present a series of 20 patients with paraesophageal hernias repaired laparoscopically. Methods: Twenty patients with paraesophageal hernias had laparoscopic repairs. Eighteen patients had primary repair of their hiatal defect. Two required mesh reinforcement. Fifteen patients had a fundoplication procedure performed concomitantly. Results: Long-term follow-up is available on 17 patients. There was no in-hospital morbidity or mortality. Average length of stay was 2.3 days. One patient recurred in the immediate postoperative period. There were no other recurrences. The only death in the series occurred in the oldest patient 18 days postoperatively. He had been discharged from the hospital and died of cardiac failure. No patients have had complications from a paraesophageal hernia postoperatively. Conclusion: Laparoscopic repair of paraesophageal hernias is possible. Preoperative work-up should include motility evaluation to assess esophageal peristalsis as the majority of these will need a concomitant anti-reflux procedure. This data helps the surgeon to determine whether or not a complete or partial wrap should be done. Repair of the diaphragmatic defect can be accomplished in the majority of patients without the use of prosthetic material with excellent results. PMID:9876752

  6. Pulsed electromagnetic fields after rotator cuff repair: a randomized, controlled study.

    PubMed

    Osti, Leonardo; Buono, Angelo Del; Maffulli, Nicola

    2015-03-01

    The current study tested the hypothesis that the use of pulsed electromagnetic fields after rotator cuff repair is effective in the short term as an adjuvant treatment to reduce local inflammation, postoperative joint swelling, and recovery time, as well as to induce pain relief. Sixty-six patients who underwent shoulder arthroscopy for repair of small to medium rotator cuff tears were randomly divided into 2 groups with a block randomization procedure. Thirty-two patients underwent arthroscopic rotator cuff repair and application of pulsed electromagnetic fields postoperatively; 34 patients underwent rotator cuff repair and placebo treatment (placebo group). All patients had the same postoperative rehabilitation protocol. At 3 months from the index procedure, visual analog scale, range of motion, and University of California at Los Angeles and Constant scores were significantly better in the pulsed electromagnetic fields group than in the placebo group (P<.05). Three patients in the pulsed electromagnetic fields group and 7 patients in the placebo group had mild to moderate capsulitis (P=.2). Severe capsulitis occurred in 1 patient in the pulsed electromagnetic fields group and 2 patients in the placebo group (P=.6). At the last follow-up (minimum, 2 years), clinical and functional outcomes were further improved in both groups, with no significant intergroup differences. Application of pulsed electromagnetic fields after rotator cuff repair is safe and reduces postoperative pain, analgesic use, and stiffness in the short term. At 2 years, no difference was seen in outcomes in patients who did or did not undergo treatment with pulsed electromagnetic fields. PMID:25760511

  7. A Comparison of Conventional Ultrasonography and Arthrosonography in the Assessment of Cuff Integrity after Rotator Cuff Repair

    PubMed Central

    Lee, Kwang Won; Chun, Tong Jin; Bae, Kyoung Wan; Choy, Won Sik; Park, Hyeon Jong

    2014-01-01

    Background This study was designed to perform conventional ultrasonography, magnetic resonance arthrography (MRA) and arthrosonography exams after rotator cuff repair to compare the results of conventional ultrasonography and arthrosonography with those of MRA as the gold standard. Methods We prospectively studied 42 consecutive patients (14 males, 28 females; average age, 59.4 years) who received arthroscopic rotator cuff repair due to full-thickness tears of the supraspinatus tendon from 2008 to 2010. The integrity assessment of the repaired rotator cuff was performed 6 months postoperatively using conventional ultrasonography, MRA, and arthrosonography. Results The diagnostic accuracy of the conventional ultrasonography compared to MRA was 78.6% and the McNemar test results were 0.016 in full-thickness tear and 0.077 in partial-thickness tear. The diagnostic accuracy of arthrosonography compared to MRA was 92.9% and the McNemar test results were 0.998 in full-thickness tear and 0.875 in partial-thickness tear. Conclusions It was found that the integrity assessment of the repaired rotator cuff by ultrasonography must be guarded against and that arthrosonography is an effective alternative method in the postoperative integrity assessment. Also, an arthrosonography seems to be a suitable modality to replace the conventional ultrasonography. PMID:25177461

  8. Outcome of arthroscopic drainage and debridement with continuous suction irrigation technique in acute septic arthritis

    PubMed Central

    Shukla, Ajay; Beniwal, Sandeep K.; Sinha, Skand

    2014-01-01

    Purpose The purpose of this study was to determine the clinical course and functional outcome of acute septic arthritis treated by arthroscopic drainage and debridement with continuous suction irrigation. Methods Eighteen subsequent cases of acute septic arthritis of hip and knee were included in this study. Complete hemogram, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), blood sugar, liver and kidney function test was done. Plain radiographs and ultrasound of affected joints were done. Joint aspirate was analyzed for gram staining, AFB staining, culture/sensitivity, biochemistry and cytology. Quantitative CRP was repeated every third day till normal CRP level was noted. Intravenous cloxacillin 25–50 mg/kg was started according to WHO protocol and was later changed to specific antibiotics after culture reports. Arthroscopic drainage and debridement of joints was done through standard portals and two tubes were placed in each joint for continuous suction and irrigation. Continuous suction irrigation was used till the effluent saline from the joint was clear. Functional outcome was documented as per Harris hip score for hips and Lysholm score for knee joint. Scoring was done before surgery, at one month and at three months. The duration of intravenous antibiotics and hospitalization was recorded. Results Out of eighteen cases 83.33% were males and 14.67% females. The mean age was 22 years (±12.01). The mean duration of symptoms was 4.33 days (±1.41). According to Gachter classification 88.88% of cases were stage 2 infection and 11.12% cases in stage 1 at the time of arthroscopy. The mean duration of hospital stay was 14.61 days (±4.01). Intravenous antibiotics were given for a mean period of 9.33 days (±2.16). The mean pre-operative Harris score was 13.6 (±2.07) which improved to 98 (±1.87) at 3 months and all the cases had painless normal range of movements. Mean pre-operative Lysholm score was 38.38 (±4.29) and it improved to 98.84 (±2.19) at 3 months. There were no sequelae of septic arthritis in any case. Conclusion Early arthroscopic decompression and debridement of septic arthritis with continuous suction irrigation can eradicate the infection. The duration of intravenous antibiotics and the hospital stay required is shorter. The functional outcome of joints is satisfactory. PMID:25983462

  9. Comparison of ultrasound and optical coherence tomography techniques for evaluation of integrity of spontaneously repaired horse cartilage.

    PubMed

    Virén, T; Huang, Y P; Saarakkala, S; Pulkkinen, H; Tiitu, V; Linjama, A; Kiviranta, I; Lammi, M J; Brünott, A; Brommer, H; Van Weeren, R; Brama, P A J; Zheng, Y P; Jurvelin, J S; Töyräs, J

    2012-04-01

    The aim of this study was to compare sensitivity of ultrasound and optical coherence tomography (OCT) techniques for the evaluation of the integrity of spontaneously repaired horse cartilage. Articular surfaces of horse intercarpal joints, featuring both intact tissue and spontaneously healed chondral or osteochondral defects, were imaged ex vivo with arthroscopic ultrasound and laboratory OCT devices. Quantitative ultrasound (integrated reflection coefficient (IRC), apparent integrated backscattering coefficient (AIB) and ultrasound roughness index (URI)) and optical parameters (optical reflection coefficient (ORC), optical roughness index (ORI) and optical backscattering (OBS)) were determined and compared with histological integrity and mechanical properties of the tissue. Spontaneously healed tissue could be quantitatively discerned from the intact tissue with ultrasound and OCT techniques. Furthermore, several significant correlations (p?arthroscopic evaluation of the integrity of articular cartilage. PMID:22439802

  10. Arthroscopic double-bundle anterior cruciate ligament reconstruction: an anatomic approach.

    PubMed

    Cha, Peter S; Brucker, Peter U; West, Robin V; Zelle, Boris A; Yagi, Masayoshi; Kurosaka, Masahiro; Fu, Freddie H

    2005-10-01

    The anterior cruciate ligament consists of 2 functional bundles, the anteromedial and the posterolateral bundle. Anterior cruciate ligament reconstruction has traditionally focused on recreating the anteromedial bundle, while the reconstruction of the posteromedial bundle has not routinely been addressed. The authors, from 2 academic centers, present a technique of arthroscopic anterior cruciate ligament reconstruction that restores both the anteromedial and the posterolateral bundle using either semitendinosus and gracilis autografts or tibialis anterior allografts. This technique represents a novel approach to restore the anteromedial and the posterolateral bundle at their anatomic insertion sites on both the tibia and the femur through separate bone tunnels. We believe that our double-bundle anatomic anterior cruciate ligament reconstruction closely reapproximates the native insertion sites of the anterior cruciate ligament on the tibia and the femur while more closely recreating the biomechanical function of the native ligament. PMID:16226666

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

    PubMed Central

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

    2014-01-01

    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

  12. Arthroscopic Excision of Acetabular Osteoid Osteoma: Computer Tomography–Guided Approach

    PubMed Central

    Tamam, Cüneyt; Howse, Elizabeth A.; Tamam, Muge; Barnes, Ryan H.; Kelsey, Thomas J.; Perry, Brad; Stubbs, Allston J.

    2015-01-01

    Osteoid osteoma is a benign osteoblastic tumor that occurs in the subcortical shaft and metaphysis of the long bones of the lower extremities; however, intra-articular lesions are also possible. Intra-articular osteoid osteomas are rare, and clinical symptoms are often less specific and, thereby, may lead to misdiagnosis. The definitive treatment for osteoid osteoma is the excision of the nidus. We present the case of a 23-year-old man with a 4-year history of right anterior hip pain, subsequently diagnosed with a subarticular osteoid osteoma located in the right anterior acetabulum. Hip arthroscopic excision of the juxta-articular osteoid osteoma is presented as an effective treatment, with the advantage of less potential damage to normal bone and cartilage, as well as the additional benefits available with hip arthroscopy.

  13. Arthroscopic treatment of bilateral snapping scapula syndrome: a case report and review of the literature.

    PubMed

    Freche, Sven; Juch, Franziska; Nusselt, Thomas; Delank, Karl Stefan; Hagel, Alexander

    2015-01-01

    Snapping scapula syndrome represents a rare entity in shoulder surgery. Clinically, it presents as shoulder pain and loud crepitus during shoulder movement. Moreover, glenohumeral bursitis can cause additional pain. Snapping scapula syndrome is caused by an increased angulation of the superomedial part of the scapula combined with bursitis. Other common causes such as subscapular osteochondroma or rib fracture non-unions were excluded. We report a 24-year-old female patient with persisting shoulder pain and disturbing crepitus during movement of the left shoulder. Radiographic examination revealed increased angulation of the superomedial scapula on both sides and MRI, bursitis of the left shoulder. The patient was successfully treated with minimally invasive arthroscopic trimming of the prominent osseous formation at the left scapula combined with bursectomy. Additionally, specific pain-adapted physiotherapeutic exercises of both shoulders were performed. The patient had a pain-free shoulder movement without crepitus on both sides at the 6th month follow-up. PMID:25803260

  14. Arthroscopic Excision of Acetabular Osteoid Osteoma: Computer Tomography-Guided Approach.

    PubMed

    Tamam, Cüneyt; Howse, Elizabeth A; Tamam, Muge; Barnes, Ryan H; Kelsey, Thomas J; Perry, Brad; Stubbs, Allston J

    2015-04-01

    Osteoid osteoma is a benign osteoblastic tumor that occurs in the subcortical shaft and metaphysis of the long bones of the lower extremities; however, intra-articular lesions are also possible. Intra-articular osteoid osteomas are rare, and clinical symptoms are often less specific and, thereby, may lead to misdiagnosis. The definitive treatment for osteoid osteoma is the excision of the nidus. We present the case of a 23-year-old man with a 4-year history of right anterior hip pain, subsequently diagnosed with a subarticular osteoid osteoma located in the right anterior acetabulum. Hip arthroscopic excision of the juxta-articular osteoid osteoma is presented as an effective treatment, with the advantage of less potential damage to normal bone and cartilage, as well as the additional benefits available with hip arthroscopy. PMID:26052484

  15. [Complications of hypospadias repairs].

    PubMed

    Soave, A; Riechardt, S; Engel, O; Rink, M; Fisch, M

    2014-07-01

    Hypospadias is the most common congenital abnormality of the lower urinary tract affecting one of 300 male newborns. More than 300 different surgical hypospadias repair techniques have been described. Currently, tubularized incised plate and meatal advancement and glansplasty integrated repair are the preferred techniques for distal hypospadias, whereas two-staged procedures are most frequently used in proximal forms. Success rates are high in the hands of dedicated surgeons, although studies on long-term results are sparse. The most frequent complications of hypospadias repairs include urethrocutaneous fistulas, meatal stenosis, and urethral strictures. Urological follow-up into puberty is warranted, as well as further studies with standardized reporting of long-term results and complications. PMID:25023236

  16. Articular Cartilage Repair

    PubMed Central

    Schwartz, John A.; Brandel, Eric; Chahine, Nadeen O.; Sgaglione, Nicholas

    2013-01-01

    This review traces the genealogy of the field of articular cartilage repair from its earliest attempts to its present day vast proliferation of research advances. Prior to the 1980s there was only sporadic efforts to regenerate articular cartilage as it was considered to be incapable of regeneration based on historical dogma. The first flurry of reports documented the use of various cell types ultimately leading to the first successful demonstration of autologous chondrocyte transplantation which was later translated to clinical use and has resulted in the revised axiom that cartilage regeneration is possible. The current field of cartilage repair is multifaceted and some of the 1980s’ vintage concepts have been revisited with state of the art technology now available. The future of the field is now poised to undertake the repair of whole cartilage surfaces beyond focal defects and an appreciation for integrated whole joint health to restore cartilage homeostasis.

  17. Arthroscopic laser extirpation of metacarpophalangeal synovial pad proliferation in eleven horses.

    PubMed

    Murphy, D J; Nixon, A J

    2001-05-01

    A new surgical technique for treatment of chronic metacarpophalangeal synovial pad proliferation in the horse and the findings and long-term follow-up from 11 clinical cases are described. The medical records of all equine lameness cases attributed to metacarpophalangeal synovial pad proliferation admitted to the College of Veterinary Medicine at Cornell University (1991-1996) were reviewed and all those treated surgically by laser extirpation were included in this study. Retrieved data included subject details, preoperative lameness, ultrasonography, radiography and synovial fluid evaluations and lesion histopathology. Lesions were ablated using a CO2 or a Nd:YAG laser intra-articularly with arthroscopic guidance. Long-term follow-up was provided by telephone conversation with owners or trainers. All horses had fetlock joint effusion and were lame at presentation. Mean synovial pad thickness measured ultrasonographically was 9.0 mm (range 6-15 mm). Seven horses (64%) had radiographic evidence of remodelling of the dorsal cortex of distal McIII and 3 horses (27%) had concurrent dorsal proximal P1 fractures. No postoperative complications were noted. All 11 horses returned to training within 90 days of surgery without recurrence of the lesion(s). Laser extirpation of metacarpophalangeal synovial pad proliferation using arthroscopic guidance provided a rapid, safe and efficient method for surgical removal of such lesions without complications or recurrence. This surgical technique provides a suitable alternative to more conventional treatments for chronic metacarpophalangeal synovial pad proliferation in horses, particularly for removal of very large, fibrotic masses. PMID:11352353

  18. 46 CFR Sec. 19 - Ship Repair Summaries.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ...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...

  19. 46 CFR Sec. 19 - Ship Repair Summaries.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 8 2012-10-01 2012-10-01 false Ship Repair Summaries. Sec. 19 Section 19 Shipping...SUM REPAIR CONTRACT-NSA-LUMPSUMREP Sec. 19 Ship Repair Summaries. (a) Ship Repair Summaries shall be prepared on Form...

  20. 46 CFR Sec. 19 - Ship Repair Summaries.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 8 2011-10-01 2011-10-01 false Ship Repair Summaries. Sec. 19 Section 19 Shipping...SUM REPAIR CONTRACT-NSA-LUMPSUMREP Sec. 19 Ship Repair Summaries. (a) Ship Repair Summaries shall be prepared on Form...

  1. 46 CFR Sec. 19 - Ship Repair Summaries.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 8 2014-10-01 2014-10-01 false Ship Repair Summaries. Sec. 19 Section 19 Shipping...SUM REPAIR CONTRACT-NSA-LUMPSUMREP Sec. 19 Ship Repair Summaries. (a) Ship Repair Summaries shall be prepared on Form...

  2. 46 CFR Sec. 19 - Ship Repair Summaries.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 8 2010-10-01 2010-10-01 false Ship Repair Summaries. Sec. 19 Section 19 Shipping...SUM REPAIR CONTRACT-NSA-LUMPSUMREP Sec. 19 Ship Repair Summaries. (a) Ship Repair Summaries shall be prepared on Form...

  3. Rescheduling with iterative repair

    NASA Technical Reports Server (NTRS)

    Zweben, Monte; Davis, Eugene; Daun, Brian; Deale, Michael

    1992-01-01

    This paper presents a new approach to rescheduling called constraint-based iterative repair. This approach gives our system the ability to satisfy domain constraints, address optimization concerns, minimize perturbation to the original schedule, produce modified schedules, quickly, and exhibits 'anytime' behavior. The system begins with an initial, flawed schedule and then iteratively repairs constraint violations until a conflict-free schedule is produced. In an empirical demonstration, we vary the importance of minimizing perturbation and report how fast the system is able to resolve conflicts in a given time bound. We also show the anytime characteristics of the system. These experiments were performed within the domain of Space Shuttle ground processing.

  4. 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.

  5. Electric motor model repair specifications

    SciTech Connect

    NONE

    1995-08-01

    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.

  6. Arthroscopic surgery of the knee on the U.S. Naval Hospital Ships during Operation Desert Shield.

    PubMed

    Buckley, S L; Jones, A A; Bosse, M J; Holmes, C A; Culp, R W; Smallman, T; McLaughlin, C M

    1992-09-01

    Between September 1990 and January 1991, while deployed to the Persian Gulf for Operation Desert Shield, 118 patients underwent arthroscopic surgery of the knee on the U.S. Naval Hospital Ships USNS Mercy and USNS Comfort. There were 113 men and 5 women, with an average age of 28 years (range, 19-59 years). The most common findings at the time of arthroscopy were meniscus tears (53%), anterior cruciate ligament tears (29%), and normal arthroscopic examinations (9%). There were three complications, two hemarthroses and one superficial portal site infection. Seventy patients (59%) were able to be returned to duty at an average of 6 days post-operatively, obviating the need to evacuate these patients out of the Middle East theater to Europe or the United States, thus avoiding additional delay, expense, and loss of the service member to his military unit. PMID:1454189

  7. Anatomy and pathophysiology of the popliteal tendon area in the lateral meniscus: 1. Arthroscopic and anatomical investigation.

    PubMed

    Kimura, M; Shirakura, K; Hasegawa, A; Kobayashi, Y; Udagawa, E

    1992-01-01

    An arthroscopic and anatomical investigation was performed to define the abnormal conditions of the popliteal tendon area in a lateral meniscus. Arthroscopic findings for 100 patients and anatomical observations of 10 amputated knees were analyzed. Five of the 10 dissected menisci were also examined histologically. Menisco-tibial coronary ligaments were classified into two types, as follows: type I--a coronary ligament covering an entire popliteal tendon beneath the meniscus; type II--a popliteal tendon visible beneath the meniscus through defects of the coronary ligament. Twenty-one of 100 cases were classified as type I, and 79 were classified as type II. Three of the 10 anatomical dissections were type I, and the remaining 7 were type II. Menisci in which the type I coronary ligaments were thought to be torn and menisci with type II coronary ligaments showed a rather marked mobility, but no conclusion could be reached. PMID:1466698

  8. Arthroscopic-Assisted Broström-Gould for Chronic Ankle Instability: A Long-Term Follow-up

    Microsoft Academic Search

    Caio Nery; Fernando Raduan; Angelo Del Buono; Inacio Diogo Asaumi; Moises Cohen; Nicola Maffulli

    2011-01-01

    Background: Lateral ankle sprains account for 85% of ankle lesions.Hypothesis: Combined open and arthroscopic procedures could improve the diagnosis and management of intra-articular lesions and allow surgeons to perform minimally invasive anatomic reconstruction of the lateral ligament complex.Study Design: Case series; Level of evidence, 4.Methods: Forty consecutive patients underwent ankle arthroscopy for recurrent (2 or more episodes) lateral ankle instability

  9. Arthroscopic Treatment of Acute Tibial Avulsion Fracture of the Posterior Cruciate Ligament Using the TightRope Fixation Device

    PubMed Central

    Gwinner, Clemens; Kopf, Sebastian; Hoburg, Arnd; Haas, Norbert P.; Jung, Tobias M.

    2014-01-01

    Avulsion fracture of the posterior cruciate ligament from its tibial insertion is a rare condition. Early surgical treatment has been regarded as necessary, but the optimal surgical technique remains unclear. The purpose of this technical note is to present a novel all-inside arthroscopic reconstruction technique for bony tibial avulsion fractures of the posterior cruciate ligament using the TightRope device (Arthrex, Naples, FL). PMID:25126507

  10. Arthroscopic debridement of the osteoarthritic knee combined with hyaluronic acid (Orthovisc®) treatment: A case series and review of the literature

    PubMed Central

    Li, Xinning; Shah, Agam; Franklin, Patricia; Merolli, Renee; Bradley, Jill; Busconi, Brian

    2008-01-01

    Objective An evaluation of safety and efficacy of high molecular weight hyaluronan (HA) delivered at the time of arthroscopic debridement of the osteoarthritic knee. Methods Thirty consecutive patients who met inclusion and exclusion criteria underwent arthroscopic debridement by a single surgeon and concomitant delivery of 6 ml/90 mg HA (Orthovisc®). These patients were evaluated preoperatively, at 6 weeks, 3 and 6 months post-operatively. Evaluations consisted of WOMAC pain score, SF-36 Physical Component Summary (PCS) score and complications. Results No complications occurred during this study. Pre-op average WOMAC pain score was 6.8 +/- 3.5 (n = 30) with a reduction to 3.4 +/- 3.1 at 6 weeks (n = 27). Final average WOMAC pain score improved to 3.2 +/- 3.8 at six months (n = 23). No patients had deterioration of the WOMAC pain score. Mean pre-operative SF-36 PCS score was 39.0 +/- 10.4 with SF-36 PCS score of the bottom 25th percentile at 29.9 (n = 30). Post procedure and HA delivery, mean PCS score at 6 weeks improved to 43.7 +/- 8.0 with the bottom 25th percentile at 37.5 (n = 27). At 6 months, mean PCS score was 48.0 +/- 9.8 with the bottom 25th percentile improved to 45.8 (n = 23). Conclusion The results show that concomitant delivery of high molecular weight hyaluronan (Orthovisc® – 6 ml/90 mg) is safe when given at the time of arthroscopic debridement of the osteoarthritic knee. By delivering HA (Orthovisc®) at the time of the arthroscopic debridement, there may be a decreased risk of joint infection and/or injection site pain. Furthermore, the combination of both procedures show efficacy in reducing WOMAC pain scores and improving SF-36 PCS scores over a six month period. PMID:18798990

  11. Self-repairing of composites

    Microsoft Academic Search

    Carolyn M. Dry

    2003-01-01

    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

  12. Automotive Engine Maintenance and Repair.

    ERIC Educational Resources Information Center

    Marine Corps Inst., Washington, DC.

    This correspondence course, originally developed for the Marine Corps, is designed to provide students with an understanding of automotive engine maintenance and repair. The course contains six study units covering automotive engine maintenance and repair; design classification; engine malfunction, diagnosis, and repair; engine disassembly; engine…

  13. Lawn and Garden Equipment Repair.

    ERIC Educational Resources Information Center

    Hardway, Jack; And Others

    This publication is designed to supplement the Comprehensive Small Engine Rapair guide by covering in detail all aspects of lawn and garden equipment repair not included in general engine repair or the repair of other small engines. It consists of instructional materials for both teachers and students, written in terms of student performance using…

  14. Arthroscopic-Assisted Treatment of a Reversed Hill-Sachs Lesion: Description of a New Technique Using Cerament

    PubMed Central

    Bark, S.; Renken, F.; Schulz, A. P.; Paech, A.; Gille, J.

    2015-01-01

    Purpose. Impaction fractures of the anterior aspect of the humeral head, the reversed Hill-Sachs lesion, are common in posterior shoulder dislocation. We present a new technique to address these lesions arthroscopic-assisted with the use of a bone substitute. Methods. We report the case of a 45-year-old male with a reversed Hill-Sachs lesion after posterior shoulder dislocation. Initially a glenohumeral arthroscopy is performed to address concomitant intra-articular injuries. Guided by the k-wire a cannulated sizer was inserted for reduction of the fracture under arthroscopic visualization. For reduction of the impacted part of the humeral head the subcortical defect was filled with an injectable bone substitute (Cerament) to prevent secondary dislocation. Results. X-ray at follow-up 6 months after the index procedure documents the bony remodeling of the bone substitute. At that time the patient was pain-free (VAS 0) and satisfied with the outcome (Constant score: 78, Rand-36 score: 84, Rowe score: 81) with a good ROM. Conclusions. In conclusion, arthroscopic-assisted reconstruction of reversed Hill-Sachs lesions with an injectable bone substitute is feasible and may provide patients with all the benefits of an anatomic reconstruction with decreased risks related to open surgery. PMID:25688315

  15. Arthroscopic surgery for osteochondral fractures of the proximal phalanx of the metacarpophalangeal and metatarsophalangeal (fetlock) joints in horses.

    PubMed

    Yovich, J V; McIlwraith, C W

    1986-02-01

    Arthroscopic surgery for osteochondral fractures of the proximal phalanx was performed on 74 fetlock joints of 63 horses for a total of 87 fractures during a 2-year period. The medial dorsal proximal aspect of the proximal phalanx of the forelimbs was most commonly involved (59 fractures), followed by the lateral aspect (26 fractures), and 2 fractures occurred in the fetlock joint of the right hindlimb. At surgery, 82 fragments were removed and 5 fragments that had healed or were embedded in the joint capsule were not removed. Of the fragments removed, 15 were fixed firmly to the proximal phalanx, 63 were easily movable by arthroscopic instruments (but had soft tissue attachments to the proximal phalanx), and 4 were floating free within the joint. Arthroscopic surgery allowed excellent visualization and appreciation of the attachments of fragments and their stage of healing. Horses returned to full race training at an average of 11 1/2 weeks (range, 6 to 24 weeks). Thirty eight of 46 horses (82.6%) with adequate postoperative follow-up returned to athletic performance at least equal to that before fetlock injury. PMID:2869018

  16. Clinical Results of Contralateral Arthroscopic Meniscectomy Performed with Unilateral Total Knee Arthroplasty: Minimum 3-year Follow-up

    PubMed Central

    Lee, Sang Jin; Lee, Bum-Sik; Kim, Jong-Min

    2015-01-01

    Purpose We assessed the clinical outcome of contralateral arthroscopic meniscectomy performed with unilateral total knee arthroplasty (TKA). Materials and Methods From May 1999 to June 2006, 23 patients underwent unilateral total knee arthroplasty and contralateral arthroscopic meniscectomy at the same time. All patients were women and followed for at least 36 months, except 2 patients who died. For clinical assessment, range of motion of the knee joint, Hospital for Special Surgery (HSS) knee score and the Lysholm knee score were evaluated preoperatively and at the last follow-up. At arthroscopy, meniscal pathology and cartilage changes were recorded and classified according to the Outerbridge scale. Progression of osteoarthritis in the contralateral knee to subsequent TKA was also assessed. Results The mean age of the 21 patients was 67.1 years and the mean follow-up period was 5.7 years. All of the patients were diagnosed with osteoarthritis and had Outerbridge grade 3 or 4 cartilage changes. Eight of the 21 patients had subsequent TKA at an average of 3.1 years after the index operation. The other 13 patients had no further surgery and clinical results including the HSS knee score and the Lysholm score were improved from 74.5 and 60.6 preoperatively to 90.8 and 82.4 postoperatively, respectively (p<0.001). Conclusions Contralateral arthroscopic meniscectomy performed simultaneously with unilateral TKA produces relatively good results regardless of the presence of cartilage degeneration. PMID:26060605

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

    PubMed Central

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

    2014-01-01

    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

  18. Hypospadias repair - discharge

    MedlinePLUS

    Your child had hypospadias repair to fix a birth defect in which the urethra does not end at the tip of the penis. ... Snodgrass WT. Hypospadias. In: Wein AJ, ed. Campbell-Walsh Urology . 10th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 130.

  19. Basic Book Repair Methods.

    ERIC Educational Resources Information Center

    Schechter, Abraham A.

    This book addresses some common preservation techniques that invariably become necessary in library and archival collections of any size. The procedures are described in chronological sequence, and photographs show the techniques from the viewpoint of the person actually doing the work. The recommended repair methods can be accomplished using…

  20. Repairing CAD models

    Microsoft Academic Search

    Gill Barequet; Subodh Kumar

    1997-01-01

    We describe an algorithm for repairing polyhedral CAD models that have errors in their B-REP. Errors like cracks, degeneracie s, du- plication, holes and overlaps are usually introduced in sol id mod- els due to imprecise arithmetic, model transformations, de signer's fault, programming bugs, etc. Such errors often hamper furt her pro- cessing like finite element analysis, radiosity computatio n

  1. Automotive Body Repair Competencies.

    ERIC Educational Resources Information Center

    D'Armond, Jack; And Others

    Designed to provide a model curriculum and guidelines, this manual presents tasks that were identified by employers, employees, and teachers as important in a postsecondary auto body repair curriculum. The tasks are divided into ten major component areas of instruction: metalworking and fiberglass, painting, frame and suspension, glass and trim,…

  2. Gene Therapy for Cartilage Repair

    PubMed Central

    Madry, Henning; Orth, Patrick; Cucchiarini, Magali

    2011-01-01

    The concept of using gene transfer strategies for cartilage repair originates from the idea of transferring genes encoding therapeutic factors into the repair tissue, resulting in a temporarily and spatially defined delivery of therapeutic molecules to sites of cartilage damage. This review focuses on the potential benefits of using gene therapy approaches for the repair of articular cartilage and meniscal fibrocartilage, including articular cartilage defects resulting from acute trauma, osteochondritis dissecans, osteonecrosis, and osteoarthritis. Possible applications for meniscal repair comprise meniscal lesions, meniscal sutures, and meniscal transplantation. Recent studies in both small and large animal models have demonstrated the applicability of gene-based approaches for cartilage repair. Chondrogenic pathways were stimulated in the repair tissue and in osteoarthritic cartilage using genes for polypeptide growth factors and transcription factors. Although encouraging data have been generated, a successful translation of gene therapy for cartilage repair will require an ongoing combined effort of orthopedic surgeons and of basic scientists.

  3. Endorectal repair of rectocele

    Microsoft Academic Search

    Indru T. Khubchandani; James A. Sheets; John J. Stasik; Ayman R. Hakki

    1983-01-01

    A modification of Sullivan's procedure for endorectal repair of “low” rectocele was completed in 59 patients with local anesthesia.\\u000a Associated anorectal pathology was corrected in all patients. The technique is described. At follow-up, the results were as\\u000a follows: 37 excellent (62.7 per cent), 10 good (16.9 per cent), eight fair (13.6 per cent), and four poor (6.7 per cent).

  4. Laparoscopic repair of Morgagni hernia

    Microsoft Academic Search

    E. Durak; S. Gur; A. Cokmez; K. Atahan; E. Zahtz; E. Tarcan

    2007-01-01

    Background  Foramen of Morgagni hernias are rare diaphragmatic hernias. They account for 3–5% of all diaphragmatic hernias and the majority\\u000a of the cases are asymptomatic. They are caused by trauma, obesity or pregnancy. With the advancements of laparoscopic surgery,\\u000a laparoscopic repair has become an excellent alternative to open repair for Morgagni hernias. We report five cases of Morgagni\\u000a hernia repaired with

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

    PubMed Central

    Wechalekar, Mihir D; Smith, Malcolm D

    2014-01-01

    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

  6. Arthroscopic treatment of a large lateral femoral notch in acute anterior cruciate ligament tear.

    PubMed

    Tauber, Mark; Fox, Michael; Koller, Heiko; Klampfer, Helmut; Resch, Herbert

    2008-11-01

    A 24-year-old professional soccer player suffered an acute anterior cruciate ligament tear associated with a radiologically evident impression fracture of the lateral femoral condyle, the so-called "lateral femoral notch sign". Following MRI validation of the injury with detection of an additional lateral meniscus tear, arthroscopy was carried out 3 days after the injury. Due to the extended impression of about 5 mm, arthroscopically assisted closed reduction of the depression fracture was performed. A 3.2 mm tunnel was drilled at the lateral femoral condyle in a supero-inferior direction using an ACL tibial guide and the depressed area could be restored using an elevator. The resulting subchondral bone defect in the femoral condyle was filled with freeze-dried human cancellous bone allograft. As a one-stage procedure ACL reconstruction was carried out using a hamstring tendon technique. At 1-year follow up the patient has returned to full sporting function, including playing soccer with a radiographically reduced lateral femoral notch sign. PMID:18060552

  7. Quantitative evaluation after arthroscopic anterior cruciate ligament reconstruction. Allograft versus autograft.

    PubMed

    Shino, K; Nakata, K; Horibe, S; Inoue, M; Nakagawa, S

    1993-01-01

    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 third of the ipsilateral patellar tendon (N = 45). Instrumented drawer tests in the Lachman position were performed to measure anterior tibial displacement at 200 N (anterior laxity). Thigh muscle power was isokinetically measured with a Cybex II dynamometer. Significantly more anterior laxity was found in the reconstructed knees than in the contralateral normal knees regardless of graft material (paired t-test, P < 0.01), except for the male allograft patients. Although the mean anterior laxity difference between sides for the allograft patients was less than that for the autogenous ones, analysis of variance failed to demonstrate a statistically significant difference between the 2 groups if the comparison was strictly made within the same sex. Thigh muscle tests revealed that extension torque in the reconstructed knees was significantly less than that in the contralateral knees and analysis of variance showed that knee extension torque at 60 deg/sec for the allograft patients was significantly better than that of the autograft ones (P < 0.05). We concluded that the allograft procedure is advantageous over the patellar tendon autograft in terms of better restoration of anterior stability. PMID:8368425

  8. Posterolateral sling reconstruction of the popliteus tendon: an all-arthroscopic technique.

    PubMed

    Feng, Hua; Hong, Lei; Geng, Xiang-su; Zhang, Hui; Wang, Xue-song; Zhang, Jin

    2009-07-01

    Injuries to the posterolateral corner of the knee present with variable injury patterns that have produced a number of reconstructive procedures in the literature. We present an all-arthroscopic technique that reconstructs the popliteus tendon using either a semitendinosus autograft or an anterior tibialis allograft. After exposure of the posterior tibia by use of the posteromedial and trans-septal portals for visualization and posterolateral portal as a working portal, the popliteus musculotendinous junction is identified. In preparation for tibial tunnel drilling, a Kirschner wire is passed from the Gerdy tubercle to the popliteus musculotendinous junction on the posterior tibia, which is localized by use of an anterior cruciate ligament tibial tunnel guide brought in through the posterolateral portal. The 6-mm tibial tunnel is then created. The femoral insertion site is identified by use of the anterolateral portals for visualization and by use of the accessory superolateral portal for debriding the synovial fold at the insertion of the popliteus tendon. A K-wire is inserted, and a socket is established. The selected graft is then implanted by passing the graft through the tibial tunnel from anterior to posterior with a passing suture and pulling it up anteriorly and superiorly to the femoral socket. The graft is tensioned with the knee in 90 degrees of flexion and in neutral rotation before fixation of both ends of the graft with bio-interference screws. PMID:19560646

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

    PubMed

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

    2014-05-01

    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

  10. Arthroscopic posterior-inferior capsular release in the treatment of overhead athletes.

    PubMed

    Codding, Jason; Dahm, Diane L; McCarty, L Pearce; May, Jedediah H; Tucker, Lanning H; Buss, Daniel D

    2015-05-01

    In this article, we present our technique for arthroscopic posterior-inferior capsular release and report the results of applying this technique in a population of athletes with symptomatic glenohumeral internal rotation deficit (GIRD) that was unresponsive to nonoperative treatment and was preventing them from returning to sport. Fifteen overhead athletes met the inclusion criteria. Two were lost to follow-up. Of the 13 remaining, 6 underwent isolated posterior-inferior capsular releases, and 7 had concomitant procedures. Before and after surgery, patients completed an activity questionnaire, which included the American Shoulder and Elbow Surgeons (ASES) Standardized Shoulder Assessment Form. Passive internal rotation in the scapular plane was measured with a bubble goniometer. Mean age was 21 years (range, 16-33 years). Mean follow-up was 31.1 months (range, 24-59 months). Mean ASES score improved significantly (P < .01) from before surgery (71.5) to after surgery (86.9). Mean GIRD improved from 43.1° to 9.7° (P < .05). Three athletes (23%) did not return to their preoperative level of play; the other 10 (77%) returned to their same level of play or a higher level. PMID:25950537

  11. A canine hybrid double-bundle model for study of arthroscopic ACL reconstruction.

    PubMed

    Cook, James L; Smith, Patrick A; Stannard, James P; Pfeiffer, Ferris M; Kuroki, Keiichi; Bozynski, Chantelle C; Cook, Cristi R

    2015-08-01

    Development and validation of a large animal model for pre-clinical studies of intra-articular anterior cruciate ligament (ACL) reconstruction that addresses current limitations is highly desirable. The objective of the present study was to investigate a translational canine model for ACL reconstruction. With institutional approval, adult research hounds underwent arthroscopic debridement of the anteromedial bundle (AMB) of the ACL, and then either received a tendon autograft for "hybrid double-bundle" ACL reconstruction (n?=?12) or no graft to remain ACL/AMB-deficient (n?=?6). Contralateral knees were used as non-operated controls (n?=?18) and matched canine cadaveric knees were used as biomechanical controls (n?=?6). Dogs were assessed using functional, diagnostic imaging, gross, biomechanical, and histologic outcome measures required for pre-clinical animal models. The data suggest that this canine model was able to overcome the major limitations of large animal models used for translational research in ACL reconstruction and closely follow clinical aspects of human ACL reconstruction. The "hybrid double-bundle" ACL reconstruction allowed for sustained knee function without the development of osteoarthritis and for significantly improved functional, diagnostic imaging, gross, biomechanical, and histologic outcomes in grafted knees compared to ACL/AMB-deficient knees. © 2015 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 33:1171-1179, 2015. PMID:25763560

  12. Umbilical hernia repair - series (image)

    MedlinePLUS

    ... In most cases, by age 3 the umbilical hernia shrinks and closes without treatment. The indications for umbilical hernia repair include: incarcerated (strangulated) umbilical hernia defects not ...

  13. 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 ...

  14. DNA repair in cultured keratinocytes

    SciTech Connect

    Liu, S.C.; Parsons, S.; Hanawalt, P.C.

    1983-07-01

    Most of our understanding of DNA repair mechanisms in human cells has come from the study of these processes in cultured fibroblasts. The unique properties of keratinocytes and their pattern of terminal differentiation led us to a comparative examination of their DNA repair properties. The relative repair capabilities of the basal cells and the differentiated epidermal keratinocytes as well as possible correlations of DNA repair capacity with respect to age of the donor have been examined. In addition, since portions of human skin are chronically exposed to sunlight, the repair response to ultraviolet (UV) irradiation (254 nm) when the cells are conditioned by chronic low-level UV irradiation has been assessed. The comparative studies of DNA repair in keratinocytes from infant and aged donors have revealed no significant age-related differences for repair of UV-induced damage to DNA. Sublethal UV conditioning of cells from infant skin had no appreciable effect on either the repair or normal replication response to higher, challenge doses of UVL. However, such conditioning resulted in attenuated repair in keratinocytes from adult skin after UV doses above 25 J/m2. In addition, a surprising enhancement in replication was seen in conditioned cells from adult following challenge UV doses.

  15. Endovascular abdominal aortic aneurysm repair

    PubMed Central

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

    2007-01-01

    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

  16. DNA replication, repair, and repair tests. [Rat; human leukocytes

    SciTech Connect

    Lambert, B.

    1980-09-01

    The rate of inhibition and recovery of DNA synthesis can be used in a rapid assay system to detect genotoxic potentials of chemicals. Also, the observation that an agent stimulates DNA repair in a test system indicates its ability to cause damage in DNA. Different experimental approaches to the study of repair synthesis are discussed.

  17. Matrix metalloproteases MMP-2 and MMP-9: are they early biomarkers of bone remodelling and healing after arthroscopic acromioplasty?

    PubMed

    Galliera, E; Randelli, P; Dogliotti, G; Dozio, E; Colombini, A; Lombardi, G; Cabitza, P; Corsi, M M

    2010-11-01

    Arthroscopic acromioplasty, one of the most frequent procedures in shoulder surgery, can promote tissue healing process by the release of growth/angiogenic factors from the acromion. Matrix metalloproteinases MMP-2 and MMP-9 are involved in such process. The purpose of this study was to measure MMP-2 and MMP-9 levels in the articular fluid and in the peripheral blood of patients undergoing arthroscopic acromioplasty in order to better understand the local involvement of such factors in the healing process after surgical procedures. Concentrations of MMP-2 and MMP-9 in the subacromial space and peripheral blood collected shortly after surgery were determined by ELISA. MMP-2 and MMP-9 concentrations were measured in the subacromial fluid of 23 patients. In subacromial fluid, the levels between MMP-2 and MMP-9 did not reach statistical significance (127.15±45.56 vs 149.41±53.61 pg/ml, respectively, p>0.05). Peripheral blood levels of MMP-2 (130.75±47.48 pg/ml) were comparable to the subacromial fluid ones (127.15±45.56 pg/ml) whereas MMP-9 level was higher in the subacromial space (149.41±53.61 pg/ml) than in the peripheral blood (67.61±12.62 pg/ml, p<0.001). This work suggests that the measurement of bone specific MMPs (MMP-2 and MMP-9) can be an useful tool to be monitored in parallel with growth factor levels and other bone turnover markers in order to evaluate the bone remodelling and tissue healing processes. This study suggests that the measurement of bone specific MMPs levels, in particular MMP-9, may evaluate the bone remodelling and healing after arthroscopic shoulder acromioplasty. PMID:20950805

  18. Industrial motor repair in the United States

    SciTech Connect

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

    1994-09-01

    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.

  19. Biologics for tendon repair.

    PubMed

    Docheva, Denitsa; Müller, Sebastian A; Majewski, Martin; Evans, Christopher H

    2015-04-01

    Tendon injuries are common and present a clinical challenge to orthopedic surgery mainly because these injuries often respond poorly to treatment and require prolonged rehabilitation. Therapeutic options used to repair ruptured tendons have consisted of suture, autografts, allografts, and synthetic prostheses. To date, none of these alternatives has provided a successful long-term solution, and often the restored tendons do not recover their complete strength and functionality. Unfortunately, our understanding of tendon biology lags far behind that of other musculoskeletal tissues, thus impeding the development of new treatment options for tendon conditions. Hence, in this review, after introducing the clinical significance of tendon diseases and the present understanding of tendon biology, we describe and critically assess the current strategies for enhancing tendon repair by biological means. These consist mainly of applying growth factors, stem cells, natural biomaterials and genes, alone or in combination, to the site of tendon damage. A deeper understanding of how tendon tissue and cells operate, combined with practical applications of modern molecular and cellular tools could provide the long awaited breakthrough in designing effective tendon-specific therapeutics and overall improvement of tendon disease management. PMID:25446135

  20. Pipe inspection and repair system

    NASA Technical Reports Server (NTRS)

    Schempf, Hagen (Inventor); Mutschler, Edward (Inventor); Chemel, Brian (Inventor); Boehmke, Scott (Inventor); Crowley, William (Inventor)

    2004-01-01

    A multi-module pipe inspection and repair device. The device includes a base module, a camera module, a sensor module, an MFL module, a brush module, a patch set/test module, and a marker module. Each of the modules may be interconnected to construct one of an inspection device, a preparation device, a marking device, and a repair device.

  1. Major Appliance Repair. Teacher Edition.

    ERIC Educational Resources Information Center

    Smreker, Eugene; Calvert, King

    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…

  2. Instructional Guide for Autobody Repair.

    ERIC Educational Resources Information Center

    Virginia Polytechnic Inst. and State Univ., Blacksburg. Dept. of Education.

    The curriculum guide was developed to serve as a statewide model for Virginia auto body repair programs. The guide is designed to 1,080 hours of instruction in eleven blocks: orientation, introduction, welding and cutting, techniques of shaping metal, body filler and fiberglass repairs, body and frame, removing and replacing damaged parts, basic…

  3. 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.

  4. Arthroscopic assistance does not improve the functional or radiographic outcome of unstable intra-articular distal radial fractures treated with a volar locking plate: a randomised controlled trial.

    PubMed

    Yamazaki, H; Uchiyama, S; Komatsu, M; Hashimoto, S; Kobayashi, Y; Sakurai, T; Kato, H

    2015-07-01

    There is no consensus on the benefit of arthroscopically assisted reduction of the articular surface combined with fixation using a volar locking plate for the treatment of intra-articular distal radial fractures. In this study we compared the functional and radiographic outcomes of fluoroscopically and arthroscopically guided reduction of these fractures. Between February 2009 and May 2013, 74 patients with unilateral unstable intra-articular distal radial fractures were randomised equally into the two groups for treatment. The mean age of these 74 patients was 64 years (24 to 92). We compared functional outcomes including active range of movement of the wrist, grip strength and Disabilities of the Arm, Shoulder, and Hand scores at six and 48 weeks; and radiographic outcomes that included gap, step, radial inclination, volar angulation and ulnar variance. There were no significant differences between the techniques with regard to functional outcomes or radiographic parameters. The mean gap and step in the fluoroscopic and arthroscopic groups were comparable at 0.9 mm (standard deviation (sd) 0.7) and 0.7 mm (sd 0.7) and 0.6 mm (sd 0.6) and 0.4 mm (sd 0.5), respectively; p = 0.18 and p = 0.35). Arthroscopic reduction conferred no advantage over conventional fluoroscopic guidance in achieving anatomical reduction of intra-articular distal radial fractures when using a volar locking plate. Cite this article: Bone Joint J 2015; 97-B:957-62. PMID:26130352

  5. Arthroscopic stabilisation of an acute acromioclavicular dislocation grade III in a patient with ectopic insertion of the pectoralis minor: technical considerations.

    PubMed

    Minuesa-Asensio, Alvaro; Barrio-Asensio, Carmen; González-Gómez, Ignacio; Murillo-González, Jorge

    2014-12-01

    The different approaches used in arthroscopic stabilisation of the acromioclavicular joint are well known. However, and despite a great incidence of ectopic pectoralis minor insertion, an alternative choice for the use of arthroscopic portal has not being sufficiently described. Here, we describe a case of acute acromioclavicular dislocation grade III. The arthroscopic stabilisation was achieved using the TightRope (Arthrex, Naples, USA) implant. Through this technique, the approach to the articular portion of the coracoid process can be made intra-articularly or from the subacromial space. We accessed intra-articularly, by opening the rotator interval to reach the coracoid process from the joint cavity. After opening the rotator interval, an ectopic insertion of the pectoralis minor was observed. The choice of approach of the coracoid process from the subacromial space would have complicated the intervention, making it necessary to sever the ectopic tendon to complete the technique, lengthening the surgical time and increasing the chance of complications. For this reason, the use of a standard posterior portal providing intra-articular arthroscopic access through the rotator interval is recommended since the aforementioned anatomical variation is not infrequent. Level of evidence Therapeutic studies-investigating the results of treatment, Level V. PMID:25448140

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

    PubMed Central

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

    2014-01-01

    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

  7. Effects of Viscoseal, a synovial fluid substitute, on recovery after arthroscopic partial meniscectomy and joint lavage.

    PubMed

    Mathies, B

    2006-01-01

    This was a pilot, single blind, randomised, controlled study in patients requiring partial meniscectomy. The aim was to assess whether replacing the synovial fluid lost during arthroscopy with a hyaluronic acid-containing synovial fluid substitute (Viscoseal) would reduce the severity and duration of post-operative symptoms during the 4 weeks post-surgery, in comparison to the standard arthroscopy procedure alone. Fifty patients were randomly assigned to either undergo arthroscopic partial meniscectomy alone (control group: n=25) or to receive 10 ml Viscoseal into the joint at the end of the procedure (Viscoseal group: n=25). Forty patients (20 per group) completed the study. Despite the small patient population in this pilot study, some interesting results were obtained. On Day 1 after surgery, the mean values for pain at rest (VAS) increased in both groups but this increase was lower in the Viscoseal group (8.9+/-23.1 mm) than in the standard therapy group (20.0+/-25.9 mm) (Mann-Whitney statistic MW-S: P=0.0525) and remained in favour of Viscoseal for the first 3 days after surgery. Joint swelling decreased to a greater extent in the Viscoseal group with an observed superiority at Day 7 (MW-S: P=0.1187) and a proven superiority at Days 12 (MW-S: P=0.015) and 28 (MW-S: P=0.0072). Diclofenac intake was lower in the Viscoseal group from Day 3 to Day 28 with a proven superiority (LB-CI > 0.5) in favour of Viscoseal on Days 3 (MW-S: P = 0.0093), 4 (MW-S: P= 0.0075), and 7 (MW-S: P = 0.0195) indicating that the product had an NSAID-sparing effect. Viscoseal was safe and well-tolerated and no adverse reactions occurred during the study. These findings indicate that Viscoseal may be useful as a synovial fluid substitute after arthroscopy. PMID:15918064

  8. Knot security, loop security, and elongation of braided polyblend sutures used for arthroscopic knots.

    PubMed

    Livermore, Ryan W; Chong, Alexander C M; Prohaska, Daniel J; Cooke, Francis W; Jones, Teresa L

    2010-12-01

    In the study described here, we evaluated load to failure and cyclic loading elongation of different braided polyblend sutures under different sliding knot configurations. Four braided polyblend sutures (FiberWire, Herculine, Orthocord, Ultrabraid) were tied with 5 sliding arthroscopic knots (Static surgeon, Weston, Roeder, Nicky, Tennessee slider) with a series of 3 reversing half-hitches on alternating posts (RHAPs). Each knot was tied around a 30-mm circumference post to ensure a consistent loop circumference. Loop security was measured as load to failure (load at 3-mm cross-head displacement or suture breakage) and loop elongation at a frequency of 1 Hz from 6 N to 30 N for 1000 cycles. Twenty knots were tied for each possible combination of knots and sutures, 10 for load to failure and 10 for cyclic loading test. For any given knot type, tying with Ultrabraid suture material resulted in maximum performance in the maximum load-to-failure test. Conversely, tying with Orthocord resulted in a significantly lower maximum load to failure, with the exception of the Surgeon knot. The Weston knot with 3 RHAPs using Ultrabraid provided the highest load to failure(mean, 346 N; SD, 24 N). All knots elongated less than 0.45 mm at the 1000th cycle and experienced higher suture slippage at initial cyclic loading (50th cycles). At higher cycles, FiberWire and Orthocord demonstrated less than half of the suture slippage of Herculine and Ultrabraid (5x10(-5) vs 11x10(-5) mm/cycle). Different braided polyblend sutures provide different knot and loop security for a given type of sliding knot. All knots in this study appear to be durable with respect to resistance to loosening under cyclic loading conditions. The Weston knot with 3 RHAPs using Ultrabraid provided the best loop and knot security. Our study results help further our understanding of the biomechanics of knot and loop security differences for different braided polyblend sutures. PMID:21720573

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

    PubMed

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

    2014-08-01

    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

  10. Effects of adding butorphanol to a balanced anaesthesia protocol during arthroscopic surgery in horses.

    PubMed

    Caure, S; Cousty, M; Tricaud, C

    2010-03-13

    Three groups of horses scheduled for arthroscopic surgery were premedicated with 0.025 mg/kg acepromazine, 88 microg/kg romifidine and 25 mg/kg guaifenesin, and anaesthesia was induced with 2.2 mg/kg ketamine. In group 1 (14 horses), anaesthesia was maintained by halothane vaporised in oxygen, with supplementary doses of 20 microg/kg romifidine and 0.5 mg/kg ketamine every 20 minutes. The 17 horses in group 2 were maintained as for group 1; however, an additional dose of 0.05 mg/kg butorphanol was administered before the first incision. The 14 horses in group 3 were maintained as for group 2, except that the dose of romifidine was halved to 10 microg/kg. The mean (sd) dose of vaporised halothane (6.5 [1.1], 4.8 [1.3] and 4.8 [1.3] microl/kg/minute, for groups 1, 2 and 3, respectively), vaporiser dial setting (2.3 [0.2],1.6 [0.4] and 1.3 [0.1] per cent) and dose of dobutamine administered to correct episodes of hypotension (0.16 [0.08], 0.07 [0.09] and 0.0 [0.0] microg/kg/minute) were all significantly lower in groups 2 and 3 than in group 1. Mean arterial blood pressure was significantly higher in groups 2 and 3 than in group 1 (71 [3], 74 [5] and 80 [5] mmHg, for groups 1, 2 and 3, respectively). PMID:20228366

  11. Anatomical Description of the Dorsal Capsulo-Scapholunate Septum (DCSS)—Arthroscopic Staging of Scapholunate Instability after DCSS Sectioning

    PubMed Central

    Overstraeten, Luc Van; Camus, Emmanuel J.; Wahegaonkar, Abhijeet; Messina, Jane; Tandara, Andrea A.; Binder, Adeline Cambon; Mathoulin, Christophe L.

    2013-01-01

    Background The dorsal capsuloligamentous scapholunate septum (DCSS) is a confluence of the dorsal capsule, the dorsal intercarpal ligament (DIC), and the scapholunate interosseous ligament (SLIOL). It appears to play a role in the stability of the scapholunate articulation. The purpose of this study was to describe the anatomical basis for this structure and to investigate its role in scapholunate instability through sectioning of this structure followed by an arthroscopic and fluoroscopic analysis. Material and Methods?In the anatomical part of the study we dissected 3 fresh cadaver wrists to examine the anatomy of the DCSS. In the arthroscopic part of the study we assessed the EWAS grade of SL instability before and after sectioning the DCSS and measured the scapholunate and radiolunate angles fluoroscopically. Results?Sectioning the DCSS increased the EWAS grade of SL instability but did not affect the scapholunate gap, the scapholunate angle or radiolunate angle. Conclusion?We have demonstrated that there is a distinct structure that is separate from the dorsal capsule, which we have labeled the Dorsal Capsuloligamentous Scapholunate Septum. We believe that the DCSS is a previously unreported secondary stabilizer of the SL joint which may have therapeutic and prognostic implications. PMID:24436808

  12. Racing performance in standardbred trotters with chronic synovitis after partial arthroscopic synovectomy in the metacarpophalangeal, metatarsophalangeal and intercarpal (midcarpal) joints.

    PubMed

    Roneus, B; Andersson, A M; Ekman, S

    1997-01-01

    Chronic synovitis may cause recurring lameness in competing race horses. Forty-five standardbred horses with recurring lameness secondary to chronic synovitis were studied. Arthroscopic synovectomy was performed in 32 metacarpo-/metatarsophalangeal joints and in 28 intercarpal joints of horses that had previously been treated unsuccessfully with commonly used intraarticular medication The outcome of the synovectomy was evaluated by comparing racing performance before and after surgery. The synovial membrane was microscopically characterized as chronic synovitis of varying severity. Racing performance was expressed by racing results including average earnings/race, place 1-3, best time and racing index. Fourteen of 19 horses with chronic synovitis of the intercarpal joint performed at an equal or higher racing level after synovectomy. Twenty-one of 26 horses with lameness secondary to chronic synovitis in the fetlock joint had an equal or higher racing capacity after synovectomy. The results of this study indicates that arthroscopic synovectomy in combination with rest is an effective method in the treatment of chronic synovitis when conventional intraarticular medication has failed. PMID:9129350

  13. In vitro and in situ characterization of arthroscopic loop security and knot security of braided polyblend sutures: a biomechanical study.

    PubMed

    Armstrong, Lucas C; Chong, Alexander; Livermore, Ryan W; Prohaska, Daniel J; Doyon, Amanda N; Wooley, Paul H

    2015-04-01

    We conducted a study to evaluate biomechanical performance during destructive testing of several different suture materials in various arthroscopic knot configurations under both in vitro and in situ conditions. Surgeons of different levels of experience tied the knots. Three different arthroscopic knots (static surgeon's, Weston, Tennessee slider) with 3 reverse half-hitches on alternating posts were tested using Fiberwire, ForceFiber, Orthocord, and Ultrabraid suture materials under both in vitro and in situ (blood plasma at 37°C) conditions. Three surgeons of different experience levels tied the knots on a post 30 mm in circumference. A single load-to-failure test was performed. There were no significant in vitro-in situ differences for Ultrabraid in the different knot configurations or with the different experience levels. Surgeon B (intermediate experience) showed no significant differences between test conditions for any knot configuration or suture material. With Tennessee slider knots, surgeon C (least experience) showed significantly lower clinical failure load under both test conditions and had a higher percentage of complete knot slippage. Surgeon B had no knot slippage with use of Fiberwire. Both the aqueous environment and the surgeon's familiarity with certain knots have an effect on knot security. PMID:25844588

  14. Pain relief after arthroscopic shoulder surgery: a comparison of intraarticular analgesia, suprascapular nerve block, and interscalene brachial plexus block.

    PubMed

    Singelyn, François J; Lhotel, Laurence; Fabre, Bertrand

    2004-08-01

    In this prospective, randomized, blinded study, we assessed the analgesic efficacy of interscalene brachial plexus block (ISB), suprascapular nerve block (SSB), and intraarticular local anesthetic (IA) after arthroscopic acromioplasty. One-hundred-twenty patients were divided into 4 groups of 30. In Group SSB, the block was performed with 10 mL of 0.25% bupivacaine. In Group IA, 20 mL of 0.25% bupivacaine was administered intraarticularly at the end of surgery. In Group ISB, the block was performed with 20 mL of 0.25% bupivacaine. A control group was included for comparison. General anesthesia was administered to all patients. Patients were observed during the first 24 h. Pain scores, supplemental analgesia, satisfaction scores, and side effects were recorded at 4 and 24 h. No significant difference was observed between the IA and control groups. When compared with these groups, Groups SSB and ISB had significantly lower pain scores. At 4-h follow-up, better pain relief on movement was noted in Group ISB than in Group SSB. When compared with controls, a significant reduction in morphine consumption and a better satisfaction score were noted only in Group ISB. We conclude that ISB is the most efficient analgesic technique after arthroscopic acromioplasty. SSN block would be a clinically appropriate alternative. PMID:15271745

  15. 40 CFR 798.5500 - Differential growth inhibition of repair proficient and repair deficient bacteria: “Bacterial DNA...

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ...and repair deficient bacteria: âBacterial DNA damage or repair tests.â 798.5500 ...and repair deficient bacteria: “Bacterial DNA damage or repair tests.” (a) Purpose. Bacterial DNA damage or repair tests measure DNA...

  16. 40 CFR 798.5500 - Differential growth inhibition of repair proficient and repair deficient bacteria: “Bacterial DNA...

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ...and repair deficient bacteria: âBacterial DNA damage or repair tests.â 798.5500 ...and repair deficient bacteria: “Bacterial DNA damage or repair tests.” (a) Purpose. Bacterial DNA damage or repair tests measure DNA...

  17. 40 CFR 798.5500 - Differential growth inhibition of repair proficient and repair deficient bacteria: “Bacterial DNA...

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ...and repair deficient bacteria: âBacterial DNA damage or repair tests.â 798.5500 ...and repair deficient bacteria: “Bacterial DNA damage or repair tests.” (a) Purpose. Bacterial DNA damage or repair tests measure DNA...

  18. DNA Repair Deficiency in Neurodegeneration

    PubMed Central

    Jeppesen, Dennis Kjølhede; Bohr, Vilhelm A.; Stevnsner, Tinna

    2011-01-01

    Deficiency in repair of nuclear and mitochondrial DNA damage has been linked to several neurodegenerative disorders. Many recent experimental results indicate that the post-mitotic neurons are particularly prone to accumulation of unrepaired DNA lesions potentially leading to progressive neurodegeneration. Nucleotide excision repair is the cellular pathway responsible for removing helix-distorting DNA damage and deficiency in such repair is found in a number of diseases with neurodegenerative phenotypes, including Xeroderma Pigmentosum and Cockayne syndrome. The main pathway for repairing oxidative base lesions is base excision repair, and such repair is crucial for neurons given their high rates of oxygen metabolism. Mismatch repair corrects base mispairs generated during replication and evidence indicates that oxidative DNA damage can cause this pathway to expand trinucleotide repeats, thereby causing Huntington’s disease. Single-strand breaks are common DNA lesions and are associated with the neurodegenerative diseases, ataxia-oculomotor apraxia-1 and spinocerebellar ataxia with axonal neuropathy-1. DNA double-strand breaks are toxic lesions and two main pathways exist for their repair: homologous recombination and non-homologous end-joining. Ataxia telangiectasia and related disorders with defects in these pathways illustrate that such defects can lead to early childhood neurodegeneration. Aging is a risk factor for neurodegeneration and accumulation of oxidative mitochondrial DNA damage may be linked with the age-associated neurodegenerative disorders Alzheimer’s disease, Parkinson’s disease and amyotrophic lateral sclerosis. Mutation in the WRN protein leads to the premature aging disease Werner syndrome, a disorder that features neurodegeneration. In this article we review the evidence linking deficiencies in the DNA repair pathways with neurodegeneration. PMID:21550379

  19. Implantation of rAAV5-IGF-I transduced autologous chondrocytes improves cartilage repair in full-thickness defects in the equine model.

    PubMed

    Ortved, Kyla F; Begum, Laila; Mohammed, Hussni O; Nixon, Alan J

    2015-02-01

    Cartilage injury often precipitates osteoarthritis which has driven research to bolster repair in cartilage impact damage. Autologous chondrocytes transduced with rAAV5-IGF-I were evaluated in chondral defects in a well-established large animal model. Cartilage was harvested from the talus of 24 horses; chondrocytes were isolated and stored frozen. Twenty million cells were cultured and transduced with 10(5) AAV vg/cell prior to implantation. Chondrocytes from eight horses were transduced with rAAV5-IGF-I, chondrocytes from eight horses with rAAV5-GFP, and chondrocytes from eight horses were not transduced. A 15?mm full-thickness chondral defect was created arthroscopically in the lateral trochlear ridge of the femur in both femoropatellar joints. Treated defects were filled with naive or gene-enhanced chondrocytes, in fibrin vehicle. Control defects in the opposite limb received fibrin alone. rAAV5-IGF-I transduced chondrocytes resulted in significantly better healing at 8 week arthroscopy and 8 month necropsy examination when compared to controls. At 8 months, defects implanted with cells expressing IGF-I had better histological scores compared to control defects and defects repaired with naive chondrocytes. This included increased chondrocyte predominance and collagen type II, both features of hyaline-like repair tissue. The equine model closely approximates human cartilage healing, indicating AAV-mediated genetic modification of chondrocytes may be clinically beneficial to humans. PMID:25311491

  20. 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 ...

  1. Cleft lip repair - series (image)

    MedlinePLUS

    ... palate repair, tissue from the back of the mouth (pharynx) may be taken to add tissue to the deficient soft palate (this is called a pharyngeal flap). Occasionally more than one surgery is required for complete palate closure.

  2. DNA repair and synthetic lethality

    PubMed Central

    Guo, Gong-she; Zhang, Feng-mei; Gao, Rui-jie; Delsite, Robert; Feng, Zhi-hui; Powell, Simon N

    2011-01-01

    Tumors often have DNA repair defects, suggesting additional inhibition of other DNA repair pathways in tumors may lead to synthetic lethality. Accumulating data demonstrate that DNA repair-defective tumors, in particular homologous recombination (HR), are highly sensitive to DNA-damaging agents. Thus, HR-defective tumors exhibit potential vulnerability to the synthetic lethality approach, which may lead to new therapeutic strategies. It is well known that poly (adenosine diphosphate (ADP)-ribose) polymerase (PARP) inhibitors show the synthetically lethal effect in tumors defective in BRCA1 or BRCA2 genes encoded proteins that are required for efficient HR. In this review, we summarize the strategies of targeting DNA repair pathways and other DNA metabolic functions to cause synthetic lethality in HR-defective tumor cells. PMID:22010575

  3. What's new in cavitation repair

    SciTech Connect

    Fulton, E.

    1993-10-01

    Repairing pits and cracks on a hydroturbine runner in place is, perhaps, the most difficult maintenance task at many plants. Over the years, hydro operations and maintenance staff have created new techniques and tools for making the job easier. Responses to an informal survey of O M staff at a sampling of North American hydro plants suggests that the move to all stainless steel runners and the virtually universal use of stainless steel welding alloys in repairs has had a significant positive effect. Specifically, the interval between repairs has widened dramatically, often giving crews the opportunity to repair cavitation damage during routine maintenance of the entire turbine rather than being forced to shut down the unit for emergency work only on the runner.

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

    PubMed Central

    Rupp, W. Dean

    2013-01-01

    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

  5. Self-Repairing Mechanical Systems

    Microsoft Academic Search

    Satoshi Murata; Eiichi Yoshida; Haruhisa Kurokawa; Kohji Tomita; Shigeru Kokaji

    2001-01-01

    This paper reviews several types of self-repairing systems developed in the Mechanical Engineering Laboratory. We have developed a modular system capable of “self-assembly” and “self-repair.” The former means a set of units can form a given shape of the system without outside help; the latter means the system restores the original shape if an arbitrary part of the system is

  6. Model Repair via SAT Solvers

    E-print Network

    Attie, Paul

    2007-01-01

    We consider the following \\emph{model repair problem}: given a finite Kripke structure $M$ and a specification formula $\\phi$ in some modal or temporal logic, determine if $M$ contains a substructure $M'$ (with the same initial state) that satisfies $\\phi$. Thus, $M$ can be ``repaired'' to satisfy the specification $\\phi$ by deleting some transitions. Model repair can be used for automated debugging of finite-state shared memory concurrent programs. Given a program $P$, generate its transition graph $M$, repair $M$ with respect to the specification, and then extract a correct concurrent program $P'$ from the repaired model $M'$ by using the method of \\cite{AE96,AE01} to extract atomic read/write shared memory concurrent programs from Kripke structures. We show that model repair is NP-complete for CTL, and for any logic for which: (1) the model checking problem is in polynomial time, and (2) there is a polynomial time reduction from CTL to the logic. A notable example of such a logic is Alternating-Time Tempor...

  7. Angiomyogenesis for Myocardial Repair

    PubMed Central

    Akbar, Syed Ali; Ashraf, Muhammad

    2009-01-01

    Abstract The conventional therapeutic modalities for myocardial infarction have limited success in preventing the progression of left ventricular remodeling and congestive heart failure. The heart cell therapy and therapeutic angiogenesis are two promising strategies for the treatment of ischemic heart disease. After extensive assessment of safety and effectiveness in vitro and in experimental animal studies, both of these approaches have accomplished the stage of clinical utility, albeit with limited success due to the inherent limitations and problems of each approach. Neomyogenesis without restoration of regional blood flow may be less meaningful. A combined stem-cell and gene-therapy approach of angiomyogenesis is expected to yield better results as compared with either of the approaches as a monotherapy. The combined therapy approach will help to restore the mechanical contractile function of the weakened myocardium and alleviate ischemic condition by restoration of regional blood flow. In providing an overview of both stem cell therapy and gene therapy, this article is an in-depth and critical appreciation of combined cell and gene therapy approach for myocardial repair. Antioxid. Redox Signal. 11, 1929–1944. PMID:19361254

  8. Pseudogout in the temporomandibular joint with imaging, arthroscopic, operative, and pathologic findings. Report of an unusual case.

    PubMed

    Laviv, Amir; Sadow, Peter M; Keith, David A

    2015-06-01

    The authors present a case of a 60-year-old woman with a destructive painful condition in the right temporomandibular joint (TMJ) that proved to be calcium pyrophosphate crystal deposits at subsequent biopsy examination. The patient presented with the chief complaints of pain and limitation that had not resolved with splint therapy, medications, and habit control. Magnetic resonance imaging studies showed internal derangement without reduction. Right TMJ arthroscopy with manipulation of the jaw under anesthesia showed unique findings of fronds of synovial tissue in the posterior joint space and areas of white matter. Because there was no long-term improvement in her clinical symptoms, she subsequently underwent arthroplasty of the right joint, with the white material clearly seen at surgery, and the biopsy examination confirmed the clinical and arthroscopic impression of pseudogout. The presentation, diagnosis, pathology, and treatment of pseudogout of the TMJ are discussed. PMID:25843817

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

    PubMed

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

    2007-02-01

    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

  10. Arthroscopic approach and intra-articular anatomy of the palmaroproximal or plantaroproximal aspect of distal interphalangeal joints.

    PubMed

    Vacek, J R; Welch, R D; Honnas, C M

    1992-01-01

    An arthroscopic approach to the palmaroproximal or plantaroproximal pouch of the distal interphalangeal joint was developed in six cadaver limbs and seven limbs of three clinically normal horses. The dorsal aspect of the proximal border and the proximal articular margin of the distal sesamoid (navicular) bone, the palmar aspect of the distal articular margin of the middle phalanx, the collateral sesamoidean ligaments of the distal sesamoid bone, and the joint capsule attachments were readily accessible. Distending the joints with fluid gave access to portions of the articular surface between the distal sesamoid bone and the middle phalanx in all joints, and to a small portion of the distal phalanx in two hind distal interphalangeal joints. Two horses allowed to recover from anesthesia were not lame on days 30 and 37, respectively. Problems encountered initially were difficulty entering the joint, hemarthrosis, and minimal iatrogenic cartilage damage. PMID:1455632

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

    PubMed Central

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

    2014-01-01

    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. PMID:25419349

  12. Radiographic and Arthroscopic Assessment of DRUJ Instability Due to Foveal Avulsion of the Radioulnar Ligament in Distal Radius Fractures.

    PubMed

    Nakamura, Toshiyasu; Iwamoto, Takuji; Matsumura, Noboru; Sato, Kazuki; Toyama, Yoshiaki

    2014-02-01

    Background?As the triangular fibrocartilage complex (TFCC) anchors the distal radius to the ulna via the radioulnar ligament (RUL), a severely displaced distal fragment of the radius may be associated with a foveal avulsion of the TFCC. The purpose of this retrospective study was to assess, radiographically and arthroscopically, the relationship between displacement of the radius, the ulnar styloid, and avulsion of the RUL resulting in distal radioulnar joint (DRUJ) instability. Materials and Methods?Twenty-nine wrists of 29 patients with intra- and extra-articular distal radius fractures/malunion who underwent reduction or a corrective osteotomy of the displaced/malunited fracture, and/or wrist arthroscopy, were assessed radiographically and arthroscopically. Radial translation, radial inclination, radial shortening, volar or dorsal tilt, and the presence of an ulnar styloid fracture with more than 4?mm of displacement were measured from the initial films. Radiocarpal arthroscopy was used to assess peripheral lesions of the TFCC, while DRUJ arthroscopy was used to assess the foveal attachment. The relationship between displacement of the distal radius or the ulnar styloid fracture and the TFCC injury, including avulsion of the RUL, was recorded. Results?Univariate analysis revealed that increased radial translation, decreased radial inclination, increased radial shortening, and an ulnar styloid fragment radially displaced by more than 4?mm were significant predictors of RUL avulsion at the fovea. Volar or dorsal tilt of the radius and ulnar variance did not correlate with RUL avulsion or TFCC injuries. Multiple logistic regression analysis revealed that radial translation was an independent risk factor of foveal avulsion of the RUL. Conclusions?Increased radial translation and radial shortening and decreased radial inclination of the distal fragment can be associated with a foveal avulsion of the RUL. Radial translation can be an independent risk factor of foveal avulsion of the RUL. PMID:24533240

  13. Radiographic and Arthroscopic Assessment of DRUJ Instability Due to Foveal Avulsion of the Radioulnar Ligament in Distal Radius Fractures

    PubMed Central

    Nakamura, Toshiyasu; Iwamoto, Takuji; Matsumura, Noboru; Sato, Kazuki; Toyama, Yoshiaki

    2014-01-01

    Background?As the triangular fibrocartilage complex (TFCC) anchors the distal radius to the ulna via the radioulnar ligament (RUL), a severely displaced distal fragment of the radius may be associated with a foveal avulsion of the TFCC. The purpose of this retrospective study was to assess, radiographically and arthroscopically, the relationship between displacement of the radius, the ulnar styloid, and avulsion of the RUL resulting in distal radioulnar joint (DRUJ) instability. Materials and Methods?Twenty-nine wrists of 29 patients with intra- and extra-articular distal radius fractures/malunion who underwent reduction or a corrective osteotomy of the displaced/malunited fracture, and/or wrist arthroscopy, were assessed radiographically and arthroscopically. Radial translation, radial inclination, radial shortening, volar or dorsal tilt, and the presence of an ulnar styloid fracture with more than 4?mm of displacement were measured from the initial films. Radiocarpal arthroscopy was used to assess peripheral lesions of the TFCC, while DRUJ arthroscopy was used to assess the foveal attachment. The relationship between displacement of the distal radius or the ulnar styloid fracture and the TFCC injury, including avulsion of the RUL, was recorded. Results?Univariate analysis revealed that increased radial translation, decreased radial inclination, increased radial shortening, and an ulnar styloid fragment radially displaced by more than 4?mm were significant predictors of RUL avulsion at the fovea. Volar or dorsal tilt of the radius and ulnar variance did not correlate with RUL avulsion or TFCC injuries. Multiple logistic regression analysis revealed that radial translation was an independent risk factor of foveal avulsion of the RUL. Conclusions?Increased radial translation and radial shortening and decreased radial inclination of the distal fragment can be associated with a foveal avulsion of the RUL. Radial translation can be an independent risk factor of foveal avulsion of the RUL. PMID:24533240

  14. Imaging of cartilage repair procedures.

    PubMed

    Sanghvi, Darshana; Munshi, Mihir; Pardiwala, Dinshaw

    2014-07-01

    The rationale for cartilage repair is to prevent precocious osteoarthritis in untreated focal cartilage injuries in the young and middle-aged population. The gamut of surgical techniques, normal postoperative radiological appearances, and possible complications have been described. An objective method of recording the quality of repair tissue is with the magnetic resonance observation of cartilage repair tissue (MOCART) score. This scoring system evaluates nine parameters that include the extent of defect filling, border zone integration, signal intensity, quality of structure and surface, subchondral bone, subchondral lamina, and records presence or absence of synovitis and adhesions. The five common techniques of cartilage repair currently offered include bone marrow stimulation (microfracture or drilling), mosaicplasty, synthetic resorbable scaffold grafts, osteochondral allograft transplants, and autologous chondrocyte implantation (ACI). Complications of cartilage repair procedures that may be demonstrated on magnetic resonance imaging (MRI) include plug loosening, graft protuberance, graft depression, and collapse in mosaicplasty, graft hypertrophy in ACI, and immune response leading to graft rejection, which is more common with synthetic grafts and cadaveric allografts. PMID:25114387

  15. Imaging of cartilage repair procedures

    PubMed Central

    Sanghvi, Darshana; Munshi, Mihir; Pardiwala, Dinshaw

    2014-01-01

    The rationale for cartilage repair is to prevent precocious osteoarthritis in untreated focal cartilage injuries in the young and middle-aged population. The gamut of surgical techniques, normal postoperative radiological appearances, and possible complications have been described. An objective method of recording the quality of repair tissue is with the magnetic resonance observation of cartilage repair tissue (MOCART) score. This scoring system evaluates nine parameters that include the extent of defect filling, border zone integration, signal intensity, quality of structure and surface, subchondral bone, subchondral lamina, and records presence or absence of synovitis and adhesions. The five common techniques of cartilage repair currently offered include bone marrow stimulation (microfracture or drilling), mosaicplasty, synthetic resorbable scaffold grafts, osteochondral allograft transplants, and autologous chondrocyte implantation (ACI). Complications of cartilage repair procedures that may be demonstrated on magnetic resonance imaging (MRI) include plug loosening, graft protuberance, graft depression, and collapse in mosaicplasty, graft hypertrophy in ACI, and immune response leading to graft rejection, which is more common with synthetic grafts and cadaveric allografts. PMID:25114387

  16. Reprogramming Cells for Brain Repair

    PubMed Central

    Guarino, Alyx T.; McKinnon, Randall D.

    2013-01-01

    At present there are no clinical therapies that can repair traumatic brain injury, spinal cord injury or degenerative brain disease. While redundancy and rewiring of surviving circuits can recover some lost function, the brain and spinal column lack sufficient endogenous stem cells to replace lost neurons or their supporting glia. In contrast, pre-clinical studies have demonstrated that exogenous transplants can have remarkable efficacy for brain repair in animal models. Mesenchymal stromal cells (MSCs) can provide paracrine factors that repair damage caused by ischemic injury, and oligodendrocyte progenitor cell (OPC) grafts give dramatic functional recovery from spinal cord injury. These studies have progressed to clinical trials, including human embryonic stem cell (hESC)-derived OPCs for spinal cord repair. However, ESC-derived allografts are less than optimal, and we need to identify a more appropriate donor graft population. The cell reprogramming field has developed the ability to trans-differentiate somatic cells into distinct cell types, a technology that has the potential to generate autologous neurons and glia which address the histocompatibility concerns of allografts and the tumorigenicity concerns of ESC-derived grafts. Further clarifying how cell reprogramming works may lead to more efficient direct reprogram approaches, and possibly in vivo reprogramming, in order to promote brain and spinal cord repair. PMID:24961526

  17. Arthroscopically assisted anterior cruciate ligament reconstruction with the pes anserine tendonsComparison of results in acute and chronic ligament deficiency

    Microsoft Academic Search

    Nicholas A. Sgaglione; Wilson Del Pizzo; James M. Fox; Mark J. Friedman

    1993-01-01

    Fifty anterior cruciate ligament-deficient knees treated consecutively with arthroscopically assisted recon struction using a pes anserine tendon autograft were retrospectively studied. The mean followup was 36.7 months (range, 26 to 58). All patients had reconstruc tion with a double-stranded graft. The mean injury to surgery interval was 9.6 days in 22 patients (acute group) and 22.5 months in 28 patients

  18. The Analgesic Effects of Morphine and Tramadol Added to Intra-articular Levobupivacaine-Tenoxicam Combination for Arthroscopic Knee Surgery on Postoperative Pain; a Randomized Clinical Trial

    PubMed Central

    Oral, Ebru Gelici; Hanci, Ayse; Ulufer Sivrikaya, Gulcihan; Dobrucali, Hale; Turkoglu Kilinc, Leyla

    2015-01-01

    Background: Arthroscopic knee surgery is commonly performed as an outpatient procedure and is often associated with postoperative pain. Objectives: We aimed to compare the effects of intra-articular levobupivacaine-tenoxicam-tramadol and levobupivacaine-tenoxicam-morphine combinations on postoperative pain in patients undergoing elective arthroscopic knee surgery. Materials and Methods: A total of 90 ASA I-II patients undergoing elective arthroscopic meniscectomy under general anesthesia were enrolled. The participants were randomly allocated to three groups to receive the following intra-articular medications after completion of the surgery and before deflation of the tourniquet: Group S, 20 mL of saline; Group T, 35 mg of levobupivacaine, 20 mg of tenoxicam, and 100 mg of tramadol in 20 mL saline; and Group M, 35 mg of levobupivacaine, 20 mg of tenoxicam, and 4 mg of morphine in 20 mL saline. Visual analogue scale values at rest (VASr) and at active flexion of knee (VASa) at postoperation hours 1, 2, 4, 8, 12, and 24, duration of analgesia, total analgesic consumption, and number of rescue analgesia at 24 hours were evaluated. Results: VASr and VASa were significantly higher in group S in comparison to other groups (P < 0.05). Duration of analgesia was significantly longer in Group T and Group M than in Group S (P < 0.05). The difference between group T and group M was also significant (P < 0.05). Number of rescue analgesia and total analgesic consumption at postoperative hour 24 was significantly fewer in group M compared with other groups (P < 0.05). Conclusions: Intra-articular levobupivacaine-tenoxicam-morphine combination provides effective pain relief, longer analgesic duration, and less analgesic requirement when compared with intra-articular levobupivacaine-tenoxicam-tramadol combination and saline after knee arthroscopic surgery. PMID:26161321

  19. Arthroscopic removal of fractures of the lateral malleolus of the tibia in the tarsocrural joint: a retrospective study of 13 cases.

    PubMed

    O'Neill, H D; Bladon, B M

    2010-09-01

    There is limited information on the treatment of lateral malleolus (LM) fractures in the horse, with no previously published case series for the outcome following arthroscopic removal of such fractures. This report reviews and evaluates findings of a retrospective study of 13 horses admitted to a private equine referral hospital over a 10 year period (1999-2009) that underwent arthroscopic removal of fractures of the LM. Hospital records were reviewed and details including patient history, aetiology of the fracture and limb affected, results of all diagnostic tests and surgical reports were documented. Performance information concerning Thoroughbred horses that went onto race post operatively was collected using an online database. Owners and trainers were contacted regarding the return to performance for non-Thoroughbred cases or those that did not go onto race post operatively. Of the 13 horses presented, 12 were Thoroughbreds, 9 of which were National Hunt racehorses and 3 were Flat racehorses. The other horse in the study was used for general purpose riding. All cases presented with an acute unilateral fracture. Eleven of the 13 had >6 months post operative follow-up and all were nonlame. Of the 12 Thoroughbreds, 10 have raced again, a total of 104 times (median 5 times). The median time from surgery to return to racing was 241 days (180-366 days). It is concluded that horses with fractures of the LM have an excellent prognosis for return to full athletic performance following arthroscopic debridement; and that arthroscopic fragment removal is an appropriate treatment method for fractures of the LM. PMID:20716198

  20. All-Arthroscopic Reconstruction of the Acetabular Labrum by Capsular Augmentation

    PubMed Central

    Nwachukwu, Benedict U.; Alpaugh, Kyle; McCormick, Frank; Martin, Scott D.

    2015-01-01

    The acetabular labrum plays an important role in hip joint stability and articular cartilage maintenance. As such, reconstitution of the labral complex is ideal. In cases in which the labrum is too degenerative to allow adequate reconstruction with current repair techniques, a capsular augmentation is a novel technique that can be used to restore the labral structure. Use of capsular augmentation enables preservation of the donor-tissue blood supply with local tissue transfer, without adding significant complexity to the procedure or significant donor-site morbidity. PMID:26052488

  1. Techniques in Endovascular Aneurysm Repair

    PubMed Central

    Phade, Sachin V.; Garcia-Toca, Manuel; Kibbe, Melina R.

    2011-01-01

    Endovascular repair of infrarenal abdominal aortic aneurysms (EVARs) has revolutionized the treatment of aortic aneurysms, with over half of elective abdominal aortic aneurysm repairs performed endoluminally each year. Since the first endografts were placed two decades ago, many changes have been made in graft design, operative technique, and management of complications. This paper summarizes modern endovascular grafts, considerations in preoperative planning, and EVAR techniques. Specific areas that are addressed include endograft selection, arterial access, sheath delivery, aortic branch management, graft deployment, intravascular ultrasonography, pressure sensors, management of endoleaks and compressed limbs, and exit strategies. PMID:22121487

  2. Thrombotic popliteal block following simultaneous bi-cruciate single-stage arthroscopic reconstruction in a neglected multiligamentous knee injury in a smoker.

    PubMed

    Panigrahi, Ranajit; Mahapatra, Amita Kumari; Palo, Nishit; Priyadarshi, Ashok

    2015-01-01

    We report a case of neglected multiligamentous injury that developed a complete thrombotic popliteal artery block following arthroscopic surgery. A 56-year-old man, a farmer, presented with an 8-month history of instability of the right knee. Examination revealed ipsilateral anterior (ACL)/posterior cruciate ligament (PCL) injuries. MRI and diagnostic arthroscopy confirmed complete ACL/PCL tear. Single-stage arthroscopic ACL/PCL reconstruction was performed. Postsurgery, the operated limb appeared swollen, firm and cold, without sensation or toe movement. Angiogram revealed complete thrombotic block of left popliteal artery. Fogarty's catheterism was performed and distal vascularity re-established. At 28?months, the patient was back at work with good functional outcome. We failed to examine the patient preoperatively in spite of his advanced age, history of beedi smoking and tobacco use, and presence of feeble vascular pulsations with thickened skin over leg and foot. Thus, in multiligamentous injuries, patient selection and thorough detailed clinical examination are the keys to successful arthroscopic procedures. PMID:26150635

  3. Arthroscopic Excision of Bone Fragments in a Neglected Fracture of the Lateral Process of the Talus in a Junior Soccer Player

    PubMed Central

    Funasaki, Hiroki; Kato, Soki; Hayashi, Hiroteru; Marumo, Keishi

    2014-01-01

    Fractures of the lateral process of the talus are uncommon and often overlooked. Typically, they are found in adult snowboarders. We report the case of an 11-year-old male soccer player who complained of lateral ankle pain after an inversion injury 6 months earlier. He did not respond to conservative treatment and thus underwent arthroscopic excision of fragments of the talar lateral process. The ankle was approached through standard medial and anterolateral portals. A 2.7-mm-diameter 30° arthroscope was used. Soft tissues around the talus were cleared with a motorized shaver, and the lateral aspect of the talar process was then visualized. The lateral process presented as an osseous overgrowth, and a loose body was impinged between the talus and the calcaneus. The osseous overgrowth was resected piece by piece with a punch, and the loose body was removed en block. The patient returned to soccer 5 weeks after the operation. This case exemplifies 2 important points: (1) This type of fracture can develop even in children and not only in snowboarders. (2) Arthroscopic excision of talar lateral process fragments can be accomplished easily, and return to sports can be achieved in a relatively short time. PMID:25126497

  4. Mountain Plains Learning Experience Guide: Automotive Repair. Course: Engine Repair.

    ERIC Educational Resources Information Center

    Schramm, C.; Osland, Walt

    One of twelve individualized courses included in an automotive repair curriculum, this course covers theory and construction, inspection diagnoses, and service and overhaul of automotive engines. The course is comprised of five units: (1) Fundamentals of Four-Cycle Engines, (2) Engine Construction, (3) Valve Train, (4) Lubricating Systems, and (5)…

  5. Outsourcing Prioritized Warranty Repairs Peter S. Buczkowski

    E-print Network

    Kulkarni, Vidyadhar G.

    Outsourcing Prioritized Warranty Repairs Peter S. Buczkowski University of North Carolina at Chapel Carolina at Chapel Hill Department of Statistics and Operations Research Keywords Warranty, Outsourcing, Network, Resource Allocation Abstract We consider the problem of outsourcing warranty repairs to outside

  6. Reducing Your Leak Rate Without Repairing Leaks 

    E-print Network

    Beals, C.

    2005-01-01

    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...

  7. Sanitizing private data for repair systems

    E-print Network

    Fang, Katherine Jien-Yin

    2014-01-01

    The SOLAR system helps restore interconnected system integrity after security attacks with a focus of minimizing the exposure of sensitive data in the repair logs. It builds upon Warp, a repair system for Django web ...

  8. Final report [DNA Repair and Mutagenesis - 1999

    SciTech Connect

    Walker, Graham C.

    2001-05-30

    The meeting, titled ''DNA Repair and Mutagenesis: Mechanism, Control, and Biological Consequences'', was designed to bring together the various sub-disciplines that collectively comprise the field of DNA Repair and Mutagenesis. The keynote address was titled ''Mutability Doth Play Her Cruel Sports to Many Men's Decay: Variations on the Theme of Translesion Synthesis.'' Sessions were held on the following themes: Excision repair of DNA damage; Transcription and DNA excision repair; UmuC/DinB/Rev1/Rad30 superfamily of DNA polymerases; Cellular responses to DNA damage, checkpoints, and damage tolerance; Repair of mismatched bases, mutation; Genome-instability, and hypermutation; Repair of strand breaks; Replicational fidelity, and Late-breaking developments; Repair and mutation in challenging environments; and Defects in DNA repair: consequences for human disease and aging.

  9. Arthroscopic Lamina-Specific Double-Row Fixation for Large Delaminated Rotator Cuff Tears

    PubMed Central

    Mori, Daisuke; Funakoshi, Noboru; Yamashita, Fumiharu

    2014-01-01

    Delamination is a commonly observed finding at the time of rotator cuff repair, but few studies have described the surgical techniques used for delaminated rotator cuff tears (RCTs) or their clinical outcomes. We developed a technique using a combination of a double row and an additional row, which we call lamina-specific double-row fixation, for large delaminated RCTs. The lamina-specific double-row technique is performed using an additional row (lamina-specific lateral row) of suture anchors placed between the typical medial and lateral rows of suture anchors. The technique is performed as follows: (1) medial-row sutures are passed through the inferior (articular-side) and superior (bursal-side) layers in a mattress fashion; (2) lamina-specific lateral-row simple sutures are passed through the inferior layer; and (3) lateral-row simple sutures are passed through the superior layer. We believe that this technique offers the following advantages: (1) creation of a larger area of contact between the inferior layer and the footprint, (2) higher initial fixation strength of the articular-side components of the repaired rotator cuff tendon, and (3) an adaptation between the superficial and inferior layers. This technique represents an alternative option in the operative treatment of large delaminated RCTs. PMID:25685671

  10. Standardized Curriculum for Automotive Body Repair.

    ERIC Educational Resources Information Center

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

    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…

  11. Self-repairing composites for airplane components

    Microsoft Academic Search

    Carolyn Dry

    2008-01-01

    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

  12. Welding/brazing for Space Station repair

    NASA Astrophysics Data System (ADS)

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

    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.

  13. Welding/brazing for Space Station repair

    NASA Technical Reports Server (NTRS)

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

    1990-01-01

    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.

  14. Current Challenges in Automatic Software Repair

    E-print Network

    Fernandez, Thomas

    repairs (e.g., AutoFix-E [10], Axis [11], AFix [12], or Gopinath et al. [13]); or using evolutionary computation (EC) (e.g., by co- evolving test cases and repairs [14, 15], or via language-specific operators in this area is exciting. Auto- matic repair work has been evaluated by DARPA red teams [8] and won awards

  15. Endoscopic repair of cerebrospinal fluid rhinorrhea

    Microsoft Academic Search

    VIVIAN H. MAO; WILLIAM M. KEANE; JOSEPH P. ATKINS; JOSEPH R. SPIEGEL; THOMAS O. WILLCOX; MARC R. ROSEN; DAVID REWS; DAVID ZWILLENBERG

    2000-01-01

    Endoscopic repair of cerebrospinal fluid rhinorrhea is a promising alternative to traditional repair techniques. This article reports our experience with 21 cases (10 spontaneous, 8 iatrogenic, and 3 traumatic). Various diagnostic radiographic modalities were used, including computer-aided techniques. Most repairs were accomplished with a free fascial graft positioned in the epidural space. Postoperative lumbar drainage was used in 15 cases.

  16. New allocation methods for repairable systems

    Microsoft Academic Search

    Suprasad V. Amari; Vaishali Hegde

    2006-01-01

    Allocations are used to translate the reliability and availability goals of a system into reliability and availability goals for the subsystems. There are very few allocation methods available for repairable systems, even though most systems are repairable. The most popular allocation method for repairable systems assigns equal availabilities to subsystems to meet the desired system level availability. This method assumes

  17. Totally extraperitoneal laparoendoscopic repair of lumbar hernia

    Microsoft Academic Search

    A. K. Meinke

    2003-01-01

    Background: The repair of congenital and acquired lumbar hernias has remained a significant surgical challenge for over three centuries. Transperitoneal laparoendoscopic techniques have been reported that have achieved success in repairing these difficult hernias using a variety of synthetic mesh. Careful review of the surgical literature addressing the repair of lumbar hernia reveals that only fourteen successful cases have been

  18. Contribution of Stem Cells to Kidney Repair

    Microsoft Academic Search

    Benedetta Bussolati; Peter Viktor Hauser; Raquel Carvalhosa; Giovanni Camussi

    2009-01-01

    A current explanation for development of chronic renal injury is the imbalance between injurious mechanism and regenerative repair. The possibility that stem cells contribute to the repair of glomerular and tubular damage is of great interest for basic and translational research. Endogenous bone marrow-derived stem cells have been implicated in the repair of renal tissue, although the lineage of stem

  19. Analysis of residual stresses at weld repairs

    Microsoft Academic Search

    P. Dong; J. K. Hong; P. J. Bouchard

    2005-01-01

    In contrast to initial fabrication welds, residual stresses associated with finite length weld repairs tend to exhibit some important invariant features, regardless of actual component configurations, materials, and to some degree, welding procedures. Such invariant features are associated with the severe restraint conditions present in typical repair welding situations. In this paper, residual stress results from several weld repair case

  20. Simple repair of a giant inguinoscrotal hernia

    PubMed Central

    Coetzee, E.; Price, C.; Boutall, A.

    2010-01-01

    We present a case of a giant inguinoscrotal hernia that extended almost to the patient's knees. Operative repair was through a standard transverse inguinal incision. No debulking or abdominal enlargement procedure had to be performed. The repair was done with a tension-free, onlay, prosthetic mesh repair. PMID:22096682

  1. Anodization As A Repair Technique

    NASA Technical Reports Server (NTRS)

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

    1988-01-01

    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.

  2. Computer Equipment Repair Curriculum Guide.

    ERIC Educational Resources Information Center

    Reneau, Fred; And Others

    This guide is intended for use in a course to train students to repair computer equipment and perform related administrative and customer service tasks. Addressed in the individual units are the following topics (with selected subtopics in brackets): performing administrative functions (preparing service bills, maintaining accounts and labor…

  3. Verification of Motor Repair Quality 

    E-print Network

    Butler, K.

    1998-01-01

    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...

  4. Repair of recurrent rectovaginal fistulas

    Microsoft Academic Search

    Amy L. Halverson; Tracy L. Hull; Victor W. Fazio; James Church; Jeffery Hammel; Crina Floruta

    2001-01-01

    Background. Recurrent rectovaginal fistulas (RRVFs) pose a challenging problem, which can be treated by different surgical procedures. We performed this study to determine the ultimate success rate of various repair techniques. Methods. Using a standard data collection form, we retrospectively reviewed charts of patients treated for RRVF. Results. Between 1991 and 2000, 57 procedures were performed in 35 women who

  5. Airframe Repair Specialist (AFSC 53153).

    ERIC Educational Resources Information Center

    Air Univ., Gunter AFS, Ala. Extension Course Inst.

    This airframe repairman course comprises the self-study portion of an on-the-job training program. It deals with the job-related knowledge requirements for airframe repairs that are required to progress from the 3 to 5 skill level of the career field. It contains five volumes. Volume 1 (27 hours) covers the general subjects related to the…

  6. Photoimmunology, DNA repair and photocarcinogenesis

    Microsoft Academic Search

    Mark Berneburg; Jean Krutmann

    2000-01-01

    In recent years major progress has been made in identifying the molecular mechanisms by which UV radiation modulates the immune system of the skin. From these studies it appears that the generation of DNA damage and the subsequent activation of DNA repair enzymes play a critical role in the generation of UV-B-induced immunosuppression. These studies have made use of cells

  7. Endovascular repair of popliteal aneurysms.

    PubMed

    Cina, Claudio S

    2010-04-01

    Endovascular repair is an established modality of treatment for abdominal aortic aneurysms. It is therefore reasonable to expect its application to other less common aneurysmal conditions, including isolated iliac and popliteal artery aneurysms (PAA). There are, however, essential differences between aortic aneurysms and peripheral aneurysms: smaller arterial caliber, mobility of the arterial segment, associated occlusive disease, and devices that have not been specifically designed for peripheral applications. Due to these differences, results obtained in abdominal aortic aneurysms cannot be extrapolated to peripheral aneurysms. The attraction of the endovascular repair for PAA is its minimally invasive nature. The literature, however, provides only case reports, case series and small cohorts, and one small randomized, controlled trial. A cumulative summary of these studies provides the clinician with information upon which to base the choice of treatment on a specific patient. Endovascular repair for PAA with suitable anatomy and good run-off can be considered safe, and medium term results appear comparable with those of open repair. PMID:20045613

  8. Pulpal Progenitors and Dentin Repair

    Microsoft Academic Search

    Y. Harichane; A. Hirata; S. Dimitrova-Nakov; I. Granja; A. Goldberg; O. Kellermann; A. Poliard

    2011-01-01

    Mesenchymal stem cells are present in the dental pulp. They have been shown to contribute to dentin-like tissue formation in vitro and to participate in bone repair after a mandibular lesion. However, their capacity to contribute efficiently to reparative dentin formation after pulp lesion has never been explored. After pulp exposure, we have identified proliferative cells within 3 zones. In

  9. DNA repair in Bacillus subtilis: excision repair capacity of competent cells. [uv radiation

    Microsoft Academic Search

    R. E. Yasbin; J. D. Fernwalt; P. I. Fields

    1979-01-01

    Competent Bacillus subtilis were investigated for their ability to support the repair of uv-irradiated bacteriophage and bacteriophage DNA. uv-irradiated bacteriophage DNA cannot be repaired to the same level as uv-irradiated bacteriophage, suggesting a deficiency in the ability of competent cells to repair uv damage. However, competent cells were as repair proficient as noncompetent cells in their ability to repair irradiated

  10. Homology-directed repair is a major double-strand break repair pathway in mammalian cells.

    PubMed

    Liang, F; Han, M; Romanienko, P J; Jasin, M

    1998-04-28

    Mammalian cells have been presumed to repair potentially lethal chromosomal double-strand breaks (DSBs) in large part by processes that do not require homology to the break site. This contrasts with Saccharomyces cerevisiae where the major DSB repair pathway is homologous recombination. Recently, it has been determined that DSBs in genomic DNA in mammalian cells can stimulate homologous recombination as much as 3 or 4 orders of magnitude, suggesting that homology-directed repair may play an important role in the repair of chromosomal breaks. To determine whether mammalian cells use recombinational repair at a significant level, we have analyzed the spectrum of repair events at a defined chromosomal break by using direct physical analysis of repair products. When an endonuclease-generated DSB is introduced into one of two direct repeats, homologous repair is found to account for 30-50% of observed repair events. Both noncrossover and deletional homologous repair products are detected, at approximately a 1:3 ratio. These results demonstrate the importance of homologous recombination in the repair of DSBs in mammalian cells. In the remaining observed repair events, DSBs are repaired by nonhomologous processes. The nonhomologous repair events generally result in small deletions or insertions at the break site, although a small fraction of events result in larger chromosomal rearrangements. Interestingly, in two insertions, GT repeats were integrated at one of the broken chromosome ends, suggesting that DSB repair can contribute to the spread of microsatellite sequences in mammalian genomes. PMID:9560248

  11. Laparoscopic fascial suture repair of parastomal hernia

    PubMed Central

    Zia, Khawaja; McGowan, David Ross; Moore, Etienne

    2013-01-01

    Parastomal hernia is a recognised complication following stoma formation, representing a challenging problem to surgeons. At least three approaches for parastomal hernia repair have been described: fascial suture repair, relocation of stoma and local repair with use of mesh. In simple fascial suture repair only open techniques have been described. Relocation of stoma can be complicated with another parastomal hernia at the new site and risk of incisional hernia at the site of previous stoma. Mesh repair can be either open or laparoscopic. The recurrence rate and complications of parastomal hernia repair remain very high. We have invented a simple fascial suture laparoscopic repair of parastomal hernia with the use of the Crochet hook needle (EndoClose). This new technique may result in reduced pain, earlier discharge from hospital and reduced risk of infection as there is no mesh used as well as reduced risk of seroma formation. PMID:23780775

  12. Closing the gap for EUV mask repair

    NASA Astrophysics Data System (ADS)

    Bret, T.; Jonckheere, R.; Van den Heuvel, D.; Baur, C.; Waiblinger, M.; Baralia, G.

    2012-03-01

    The EUV-photomask is used as mirror and no longer as transmissive device. In order to yield defect-free reticles, repair capability is required for defects in the absorber and for defects in the mirror. Defects can propagate between the EUV mask layers, which makes the detection and the repair complex or impossible if conventional methods are used. In this paper we give an overview of the different defect types. We discuss the EUV repair requirements including SEMinvisible multilayer defects, and demonstrate e-beam repair performance. The repairs are qualified by SEM, AFM and through-focus wafer prints. Furthermore a new repair strategy involving in-situ AFM is introduced. Successful repair is demonstrated on real defects.

  13. The door opener for EUV mask repair

    NASA Astrophysics Data System (ADS)

    Waiblinger, M.; Jonckheere, R.; Bret, Tristan; Van den Heuvel, D.; Baur, C.; Baralia, G.

    2012-06-01

    The EUV-photomask is used as mirror and no longer as transmissive device. In order to yield defect-free reticles, repair capability is required for defects in the absorber and for defects in the mirror. Defects can propagate between the EUV mask layers, which makes the detection and the repair complex or impossible if conventional methods are used. In this paper we give an overview of the different defect types. We discuss the EUV repair requirements including SEMinvisible multilayer defects and blank defects, and demonstrate e-beam repair performance. The repairs are qualified by SEM, AFM and through-focus wafer prints. Furthermore a new repair strategy involving in-situ AFM is introduced. We will apply this new strategy on real defects and verify the repair quality using state of the art EUV wafer printing technology.

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

    NASA Astrophysics Data System (ADS)

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

    2013-09-01

    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.

  15. Perineal hernia repair in dogs.

    PubMed

    Robertson, J J

    1984-05-01

    Old male Collies, Pekingese , Boxers and Boston Terriers are predisposed to perineal hernia. Recurrence is often related to poor surgical technic in the initial repair. With the anesthetized dog in sternal recumbency and the tail tied forward, a curvilinear skin incision is made over the hernia, from the tail base to the midline, ventral to the anus. The hernial sac is opened and its contents reduced. Five stainless-steel sutures are preplaced in the muscles and ligaments of the perineal diaphragm and tied from top to bottom. In cases of failure of the ventral aspect of the repair, the internal obturator muscle can be elevated from the ischial table and used to cover the ventral aspect of the hernia. Postoperative complications are related to infection, self-trauma and straining. PMID:6738509

  16. Wnt Signaling and Injury Repair

    PubMed Central

    Whyte, Jemima L.; Smith, Andrew A.; Helms, Jill A.

    2012-01-01

    Wnt signaling is activated by wounding and participates in every subsequent stage of the healing process from the control of inflammation and programmed cell death, to the mobilization of stem cell reservoirs within the wound site. In this review we summarize recent data elucidating the roles that the Wnt pathway plays in the injury repair process. These data provide a foundation for potential Wnt-based therapeutic strategies aimed at stimulating tissue regeneration. PMID:22723493

  17. Metallic Biomaterials in Skeletal Repair

    Microsoft Academic Search

    Karl-Heinz Frosch; Klaus Michael Stürmer

    2006-01-01

    Metallic biomaterials are becoming increasingly important in skeletal repair. The goal of this review article is to present\\u000a an overview of metallic implant materials currently used in trauma and orthopedic surgery. Further, new research trends and\\u000a future clinical concepts are described and discussed. Titanium, titanium alloys, stainless steels and CoCr alloys are used\\u000a as bone implants in orthopedic and trauma

  18. Animal models of cartilage repair

    PubMed Central

    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

    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

  19. Venous thromboembolism following arthroscopic knee surgery: a current concepts review of incidence, prophylaxis, and preoperative risk assessment.

    PubMed

    Graham, William C; Flanigan, David C

    2014-03-01

    The purpose of this review was to compile existing knowledge regarding venous thromboembolism (VTE) after arthroscopic knee surgery (AKS). We reviewed the reported incidence, published prophylaxis guidelines, randomized controlled trials (RCT) of prophylaxis, and current prophylaxis practice patterns. In this context we then considered the most appropriate VTE risk assessment model for patients undergoing knee arthroscopy. The existing body of literature regarding VTE and AKS reports a wide range of incidence, often utilizing primary outcome measures with unclear clinical significance: asymptomatic and distal deep vein thrombosis (DVT). Published prophylaxis guidelines provide limited practical guidance and it is unclear how to translate the results of RCTs to clinical practice, as many of the VTE prevented by routine prophylaxis are asymptomatic or distal DVT. Literature regarding actual implementation of pharmacologic prophylaxis following AKS suggests that no consensus exists. Patients undergoing knee arthroscopy would be best managed with the individual model of VTE risk assessment rather than the group model that is applied to hip and knee arthroplasty patients. PMID:24190733

  20. Arthroscopic Treatment of Popliteal Cyst: A Direct Posterior Portal by Inside-Out Technique for Intracystic Debridement

    PubMed Central

    Kongmalai, Pinkawas; Chernchujit, Bancha

    2015-01-01

    Popliteal cysts are characterized by enlargement of the gastrocnemius-semimembranosus bursa. The pathogenesis includes a valvular opening between the knee joint and the bursa, and associated intra-articular pathology may give rise to knee effusion. The mainstay of treatment is conservative. If popliteal cysts are symptomatic, analgesia, aspiration, and steroid injection therapy may be considered, but most recur rapidly. In the past, open excision was an option if they remained symptomatic, but the associated recurrence rate was high. One important reason was that the intra-articular pathology causing the knee effusion was not treated. We present an alternative minimally invasive arthroscopic treatment using dye (methylene blue) directly injected into the cyst, which will leak from the cyst into the joint, to identify the valvular opening. The thickened valve is opened using a basket forceps and then enlarged using a motorized shaver to disrupt the 1-way mechanism between the joint and bursa, as well as to establish an unobstructed freeway connection between them. We also present a safe technique to create a direct posterior portal. Intracystic debridement of the fibrous membrane, nodules, and septa through this portal will decrease the recurrence rate of the popliteal cyst. PMID:26052491

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

    PubMed Central

    Sum, Jonathan

    2011-01-01

    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

  2. Arthroscopic removal of osteochondral fragments of the palmar/plantar aspect of the metacarpo/metatarsophalangeal joints.

    PubMed

    Houttu, J

    1991-05-01

    This paper presents the results of arthroscopic surgery in 42 Standardbred trotters and three Finnish horses. Forty-five horses were operated on. The age range was one to seven years; 73 per cent of the horses were three years old or younger. Horses showed a variety of clinical signs ranging from moderate to severe lameness at slow speeds, to obscure lameness manifesting only at high speeds. Synovial effusion of the fetlock joint was rare. In this series, 44 horses that had Type I fragments and one horse that had Type III fragments were operated on. Of the 45 horses operated on, 23 (51 per cent) returned to speed training in three months and 41 (91 per cent) returned to speed training in six months. Three of 45 (6 per cent) were lame three months after the surgery when the trainer attempted to start speed training. One of those was sound six months after the operation. The remaining two (4 per cent) stayed lame due to a lesion in the affected joint. Two of 45 (4 per cent) discontinued training for other reasons. The horse with Type III fragments returned to speed training in three months. PMID:1884695

  3. Midterm results of arthroscopic treatment of scapholunate ligament lesions associated with intra-articular distal radius fractures.

    PubMed

    Peicha, G; Seibert, F; Fellinger, M; Grechenig, W

    1999-01-01

    Since 1993, we have treated 30 patients with acute intra-articular distal radius fractures using arthroscopic assistance. Concomitant lesions of the intrinsic scapholunate (SL) ligaments were diagnosed in 12 patients (40%). Using the grading system of Geissler et al. [13], the identified lesions included a single grade I tear, three grade II, six grade III, and two grade IV. The grade III and IV lesions were accompanied by intraoperative findings of marked instability. Therefore operative stabilization was performed by temporary scapholunate and scaphocapitate arthrodesis. Seven patients in this group (87.5%) were followed up clinically and radiologically for an average of 3 years postoperatively. Clinical examination included range of motion and a subjective questionnaire concerning pain and ability to work. Objective grip strength was measured using a Jamar-tester and compared to the contralateral wrist. Radiological evaluation consisted of posteroanterior and lateral views and of stress views in radial and ulnar deviation. Data were evaluated by the scoring systems of Jakim et al. [21], Cooney et al. [5] and by the demerit point system of Gartland and Werley [12], as modified by Sarmiento et al. [36]. An excellent result was present in 100% of our patients by the Gartland and Werley system, in 86% by that of Jakim et al., and in 60% by that of Cooney et al. Based on a subjective questionnaire, all of the patients had an excellent or good result. PMID:10525704

  4. Outcome of pediatric hypospadias repair in adulthood

    PubMed Central

    Chertin, Boris; Prat, Dan; Shenfeld, Ofer Z

    2010-01-01

    Purpose To review the evolution of the technique of hypospadias repair. Methods A search of Pubmed, Medline and the Journal of Pediatric Urology was performed, and papers dealing with surgical techniques for hypospadias repair were critally reviewed. Special emphasis was given to papers on the effects in the long term of hypospadias repair on voiding and sexual dysfunction. Results The techniques for hypospadias repair have evolved over the years. The most popular technique now is tubularized incised plate urethroplasty. Long-term results with the use of the new techniques of the hypospadias repair in terms of voiding and sexual problems should be addressed. Conclusion There is a need for valid studies on the outcomes of hypospadias repair in adults that were performed in childhood in terms of cosmetic appearance, voiding and sexual performance. PMID:24198614

  5. 46 CFR 282.22 - Maintenance (upkeep) and repairs.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ...repairs, machinery repairs, hull and deck repairs, electrical repairs, exterior...and combined into a standard set of specifications based on a particular type of vessel... 33,004 36,193 Hull and Deck Repairs 16,729 20,853...

  6. 46 CFR 252.32 - Maintenance (upkeep) and repairs.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ...repairs, machinery repairs, hull and deck repairs, electrical repairs...and combined into a standard set of specifications based on a particular type of vessel... 22,505 108,165 Hull and Deck Repairs 33,500 99,370...

  7. Repair and maintenance: answering the challenge

    SciTech Connect

    Cowan, S.I.

    1980-01-01

    Innovative equipment and repair techniques should increase power-plant availability and reliability during the 1980s. Among the new repair procedures to reduce downtime are on-site machining made possible by smaller and lighter tools and essential for immovable reactor feedwater nozzles; ultrasonic and computer techniques for diagnosing and repairing rotor overbore; flame spray coating for areas subject to abrasion, erosion, and fretting; plasma sprayed coatings; and flame spraying boiler tubes. (DCK)

  8. Repairing sealing surfaces on aluminum castings

    NASA Technical Reports Server (NTRS)

    Hanna, T. L.

    1980-01-01

    Approach using stylus nickel plating instead of copper and cadmium plating has simplified repair procedure. Damaged sealing surfaces are stylus nickelplated in one step. Superficial scratches and porous areas are removed more easily from repaired surface by simply lapping sealing areas to required finish. Although method is aimed for aerospace components, it may be easily incorporated into conventional aluminumcasting technology. One-step repair can be considered for cast-aluminum automobile and aircraft engines to reduce time and costs.

  9. 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

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

    2014-01-01

    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

  10. Laparoscopic ventral hernia repair: a systematic review

    Microsoft Academic Search

    Clarabelle T. Pham; Caryn L. Perera; D. Scott Watkin; Guy J. Maddern

    2009-01-01

    Background  Laparoscopic ventral hernia repair may be an alternative to open mesh repair as it avoids a large abdominal incision, and\\u000a thus potentially reduces pain and hospital stay. This review aimed to assess the safety and efficacy of laparoscopic ventral\\u000a hernia repair in comparison with open ventral hernia repair.\\u000a \\u000a \\u000a \\u000a Method  A systematic review was conducted, with comprehensive searches identifying six randomised controlled

  11. Snodgrass Hypospadias Repair with Vascularized Dartos Flap: The Perfect Repair for Virgin Cases of Hypospadias?

    Microsoft Academic Search

    Earl Y. Cheng; Sreenivas N. Vemulapalli; Bradley P. Kropp; John C. Pope; Peter D. Furness; William E. Kaplan; D. Preston Smith

    2002-01-01

    PurposeSince its introduction, the Snodgrass hypospadias repair has been applied to virtually all forms of hypospadias repair. However, fistula rates have still been reported to be as high as 5% from large center, multiple surgeon studies and 16% from smaller center studies. We report on the use of the Snodgrass repair in conjunction with routine use of a vascularized dartos

  12. Comparative biomechanical analysis of a new circumferential flexor tendon repair and a modified Kessler repair

    Microsoft Academic Search

    L. E. Ion; P. J. Sykes; O. C. S. Cassell; D. M. O'Doherty; A. M. Roberts

    1997-01-01

    We present the technical details and the results of a biomechanical analysis of a new type of circumferential flexor tendon repair, designed with the more stringent requirements of zone II injuries in mind. Apart from good initial strength we aimed for a design with little bulk at the repair site and good control of the tendon edges.The new repair is

  13. Two-Echelon Repairable Item Inventory System with Limited Repair Capacity under Nonstationary Demands

    Microsoft Academic Search

    Hoong Chuin Lau; Huawei Song

    2004-01-01

    We study a repairable item inventory system under limited repair capacity and nonstationary Poisson demands, motivated by corrective maintenance of military equipment. Our goal is to minimize the cost of both spare and repair resource allocation. We propose an efficient analytical model that combines optimization modeling and queuing theory.

  14. Endovascular repair of abdominal aortic aneurysms: Eligibility rate and impact on the rate of open repair

    Microsoft Academic Search

    Yehuda G. Wolf; Thomas J. Fogarty; Cornelius Olcott; Bradley B. Hill; E. John Harris; R. Scott Mitchell; D. Craig Miller; Ronald L. Dalman; Christopher K. Zarins

    2000-01-01

    Objective: The purpose of this study was to determine the rate of eligibility among patients with abdominal aortic aneurysms (AAAs) considered for endovascular repair and to examine the effect of an endovascular program on the institutional pattern of AAA repair. Methods: All patients evaluated for endovascular AAA repair since the inception of an endovascular program were reviewed for determination of

  15. Endovascular repair of abdominal aortic aneurysms: Eligibility rate and impact on the rate of open repair

    Microsoft Academic Search

    Yehuda G. Wolf; Thomas J. Fogarty; Cornelius Olcott IV; Bradley B. Hill; E. John Harris; R. Scott Mitchell; D. Craig Miller; Ronald L. Dalman; Christopher K. Zarins; Calif Stanford

    Objective: The purpose of this study was to determine the rate of eligibility among patients with abdominal aortic aneurysms (AAAs) considered for endovascular repair and to examine the effect of an endovascular program on the institutional pattern of AAA repair. Methods: All patients evaluated for endovascular AAA repair since the inception of an endovascular program were reviewed for determination of

  16. Initiating Repair and Beyond: The Use of Two Repeat-Formatted Repair Initiations in Mandarin Conversation

    ERIC Educational Resources Information Center

    Wu, Ruey-Jiuan Regina

    2006-01-01

    As part of a growing effort to understand the organization of repair across languages, this study examines 2 repeat-formatted other-initiated repair practices in Mandarin conversation. Using the methodology of conversation analysis as a central framework, this study shows that the 2 Mandarin repair initiations under examination, like…

  17. 49 CFR 192.311 - Repair of plastic pipe.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ...2013-10-01 false Repair of plastic pipe. 192.311 Section 192...and Mains § 192.311 Repair of plastic pipe. Each imperfection or damage...would impair the serviceability of plastic pipe must be repaired or...

  18. 49 CFR 192.311 - Repair of plastic pipe.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ...2012-10-01 false Repair of plastic pipe. 192.311 Section 192...and Mains § 192.311 Repair of plastic pipe. Each imperfection or damage...would impair the serviceability of plastic pipe must be repaired or...

  19. 49 CFR 192.311 - Repair of plastic pipe.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ...2014-10-01 false Repair of plastic pipe. 192.311 Section 192...and Mains § 192.311 Repair of plastic pipe. Each imperfection or damage...would impair the serviceability of plastic pipe must be repaired or...

  20. AUTOMOTIVE REPAIR SHOP, SLIDING DOOR LEADING TO BOILER ROOM ON ...

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

    AUTOMOTIVE REPAIR SHOP, SLIDING DOOR LEADING TO BOILER ROOM ON SOUTH SIDE OF SOUTH WING, WITH SCALE. - Cedar City Automotive Repair Shop, Automotive Repair Shop, 820 North Main Street, Cedar City, Iron County, UT

  1. AUTOMOTIVE REPAIR SHOP, DETAIL OF MILLS COAL BOILER WITH SCREWFEED ...

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

    AUTOMOTIVE REPAIR SHOP, DETAIL OF MILLS COAL BOILER WITH SCREW-FEED COAL HOPPER ON RIGHT SIDE, WITH SCALE. - Cedar City Automotive Repair Shop, Automotive Repair Shop, 820 North Main Street, Cedar City, Iron County, UT

  2. AUTOMOTIVE REPAIR SHOP, SLIDING DOOR LEADING TO BOILER ROOM ON ...

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

    AUTOMOTIVE REPAIR SHOP, SLIDING DOOR LEADING TO BOILER ROOM ON SOUTH SIDE OF SOUTH WING. - Cedar City Automotive Repair Shop, Automotive Repair Shop, 820 North Main Street, Cedar City, Iron County, UT

  3. 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

  4. AUTOMOTIVE REPAIR SHOP, DETAIL OF BUILDING CORNER (MAIN WING) SHOWING ...

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

    AUTOMOTIVE REPAIR SHOP, DETAIL OF BUILDING CORNER (MAIN WING) SHOWING WOOD EAVE AND STUCCO RAKEBOARD ON GABLE END. - Cedar City Automotive Repair Shop, Automotive Repair Shop, 820 North Main Street, Cedar City, Iron County, UT

  5. AUTOMOTIVE REPAIR SHOP, DETAIL OF MILLS COAL BOILER WITH SCREWFEED ...

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

    AUTOMOTIVE REPAIR SHOP, DETAIL OF MILLS COAL BOILER WITH SCREW-FEED COAL HOPPER ON RIGHT SIDE. - Cedar City Automotive Repair Shop, Automotive Repair Shop, 820 North Main Street, Cedar City, Iron County, UT

  6. 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

  7. AUTOMOTIVE REPAIR SHOP, DETAIL OF FABRICATING PRESS IN EAST END ...

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

    AUTOMOTIVE REPAIR SHOP, DETAIL OF FABRICATING PRESS IN EAST END OF MAIN WING, WITH SCALE. - Cedar City Automotive Repair Shop, Automotive Repair Shop, 820 North Main Street, Cedar City, Iron County, UT

  8. Lube rack of Automotive and Tractor Repair Shops with Warehousefield ...

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

    Lube rack of Automotive and Tractor Repair Shops with Warehouse-field Equipment Repair Shop Building's wall to the right, looking from the south - Kekaha Sugar Company, Automotive and Tractor Repair Shops, 8315 Kekaha Road, Kekaha, Kauai County, HI

  9. AUTOMOTIVE REPAIR SHOP, DETAIL OF BUILDING CORNER (MAIN WING) SHOWING ...

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

    AUTOMOTIVE REPAIR SHOP, DETAIL OF BUILDING CORNER (MAIN WING) SHOWING WOOD EAVE AND STUCCO RAKEBOARD ON GABLE END, WITH SCALE. - Cedar City Automotive Repair Shop, Automotive Repair Shop, 820 North Main Street, Cedar City, Iron County, UT

  10. Automotive Repair by Number Theory Bart Snapp and Chris Snapp

    E-print Network

    Snapp, Bart

    Automotive Repair by Number Theory Bart Snapp and Chris Snapp While repairing the ignition switch on a 1981 Fiat Spider, we discovered the following connection between number theory and automotive repair

  11. 46 CFR 282.22 - Maintenance (upkeep) and repairs.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ...and deck repairs, electrical repairs, exterior painting and interior painting, etc. The jobs shall be described fully...Electrical Repairs 11,868 11,117 Exterior Painting 5,456 7,974 Interior Painting 681...

  12. 21 CFR 870.1350 - Catheter balloon repair kit.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ...2010-04-01 2010-04-01 false Catheter balloon repair kit. 870.1350 Section...Cardiovascular Diagnostic Devices § 870.1350 Catheter balloon repair kit. (a) Identification. A catheter balloon repair kit is a device used...

  13. 49 CFR 192.311 - Repair of plastic pipe.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ...2011-10-01 false Repair of plastic pipe. 192.311 Section 192...and Mains § 192.311 Repair of plastic pipe. Each imperfection or damage...would impair the serviceability of plastic pipe must be repaired or...

  14. 49 CFR 192.311 - Repair of plastic pipe.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ...2010-10-01 false Repair of plastic pipe. 192.311 Section 192...and Mains § 192.311 Repair of plastic pipe. Each imperfection or damage...would impair the serviceability of plastic pipe must be repaired or...

  15. 30 CFR 75.510 - Energized trolley wires; repair.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ...2011-07-01 2011-07-01 false Energized trolley wires; repair. 75.510 Section...Equipment-General § 75.510 Energized trolley wires; repair. [Statutory Provisions] Energized trolley wires may be repaired only by a...

  16. 30 CFR 75.510 - Energized trolley wires; repair.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...2010-07-01 2010-07-01 false Energized trolley wires; repair. 75.510 Section...Equipment-General § 75.510 Energized trolley wires; repair. [Statutory Provisions] Energized trolley wires may be repaired only by a...

  17. 40 CFR 51.369 - Improving repair effectiveness.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ...retest. Performance monitoring shall include statistics on the number of vehicles submitted for a retest after repair by the repair...close-loop vehicles; (2) The application of emission control theory and diagnostic data to the diagnosis and repair of...

  18. Dynamics of DNA Mismatch Repair

    NASA Astrophysics Data System (ADS)

    Coats, Julie; Lin, Yuyen; Rasnik, Ivan

    2009-11-01

    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.

  19. Endoluminal Abdominal Aortic Aneurysm Repair

    PubMed Central

    Ghouri, Maaz; Krajcer, Zvonimir

    2010-01-01

    Endovascular abdominal aortic aneurysm repair (EVAR) is an attractive alternative to open surgical repair. Distal endograft migration and type 1 endoleak are recognized to be the 2 main complications of EVAR. First-generation endografts had a stronger propensity for distal migration, modular component separation, thrombosis, and loss of structural integrity. Substantial progress has been made in recent years with 2nd- and 3rd-generation devices to prevent these complications. Some of the most common predictors of endograft failure are angulated and short infrarenal necks, large-diameter necks, and thrombus in the aneurysmal sac. The purpose of this study is to describe and review our experience in using innovative techniques and a newer generation of endografts to prevent distal migration and type 1 endoleak in patients with challenging infrarenal neck anatomy. The use of these innovative EVAR techniques and the new generation of endografts in patients with challenging infrarenal neck anatomy has yielded encouraging procedural and intermediate-term results. PMID:20200623

  20. Repair of overheating linear accelerator

    SciTech Connect

    Barkley, Walter; Baldwin, William; Bennett, Gloria; Bitteker, Leo; Borden, Michael; Casados, Jeff; Fitzgerald, Daniel; Gorman, Fred; Johnson, Kenneth; Kurennoy, Sergey; Martinez, Alberto; O’Hara, James; Perez, Edward; Roller, Brandon; Rybarcyk, Lawrence; Stark, Peter; Stockton, Jerry

    2004-01-01

    Los Alamos Neutron Science Center (LANSCE) is a proton accelerator that produces high energy particle beams for experiments. These beams include neutrons and protons for diverse uses including radiography, isotope production, small feature study, lattice vibrations and material science. The Drift Tube Linear Accelerator (DTL) is the first portion of a half mile long linear section of accelerator that raises the beam energy from 750 keV to 100 MeV. In its 31st year of operation (2003), the DTL experienced serious issues. The first problem was the inability to maintain resonant frequency at full power. The second problem was increased occurrences of over-temperature failure of cooling hoses. These shortcomings led to an investigation during the 2003 yearly preventative maintenance shutdown that showed evidence of excessive heating: discolored interior tank walls and coper oxide deposition in the cooling circuits. Since overheating was suspected to be caused by compromised heat transfer, improving that was the focus of the repair effort. Investigations revealed copper oxide flow inhibition and iron oxide scale build up. Acid cleaning was implemented with careful attention to protection of the base metal, selection of components to clean and minimization of exposure times. The effort has been very successful in bringing the accelerator through a complete eight month run cycle allowing an incredible array of scientific experiments to be completed this year (2003-2004). This paper will describe the systems, investigation analysis, repair, return to production and conclusion.

  1. 40 CFR 63.1005 - Leak repair.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...monitoring. The leak identification on a connector in gas/vapor or light liquid service... (3) Delay of repair for valves, connectors, and agitators is also allowed if the...shutdown. (d) Unsafe-to-repair connectors. Any connector that is...

  2. 40 CFR 63.1005 - Leak repair.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ...monitoring. The leak identification on a connector in gas/vapor or light liquid service... (3) Delay of repair for valves, connectors, and agitators is also allowed if the...shutdown. (d) Unsafe-to-repair connectors. Any connector that is...

  3. Outsourcing Warranty Repairs: Dynamic Allocation Michelle Opp

    E-print Network

    Kulkarni, Vidyadhar G.

    Outsourcing Warranty Repairs: Dynamic Allocation Michelle Opp Kevin Glazebrook Vidyadhar G In this paper we consider the problem of minimizing the costs of outsourcing warranty repairs when failed items study. Key words: Optimal allocation, Warranty outsourcing, Index policies, Dynamic routing, Restless

  4. Repair of natural EUV reticle defects

    NASA Astrophysics Data System (ADS)

    Jonckheere, R.; Bret, T.; Van den Heuvel, D.; Magana, J.; Gao, W.; Waiblinger, M.

    2011-11-01

    Defects of the multi-layer (ML) mirror on a EUV reticle, so-called ML-defects, are a prime aspect why EUV mask defectivity is considered a challenge before EUV lithography can be used for the production of future node integrated circuits. The present paper addresses the possibility to mitigate the printability of these defects by repair. Repair of natural EUV mask defects is performed using the electron beam based Carl Zeiss MeRiT® repair technology and is evaluated by wafer printing on the ASML EUV Alpha Demo Tool (ADT) installed at IMEC. Both absorber defects and ML-defects are included. The success of absorber defect repair (both opaque and clear type) is illustrated. For compensation repair of ML-defects experimental proof of the technique is reported, with very encouraging results both for natural pits and bumps. In addition, simulation is used to investigate the limitations of such compensation repair, inspired by the residual printability found experimentally. As an example it was identified that alignment of the compensation repair shape with the ML-defect position requires sub-20nm accuracy. The integration of an Atomic Force Microscope (AFM) into the repair tool has been an important asset to cope with this.

  5. Chemical Fume Hood Maintenance, Repair and Certification

    E-print Network

    Jia, Songtao

    Chemical Fume Hood Maintenance, Repair and Certification Procedure: 6.03 Created: 6/20/2013 Version of chemical fume hoods (CFH) at Columbia University. This includes performance testing, reporting and users on status of hood repair. 3. CFH Users/Lab Staff a. For details see Chemical Fume Hoods Use

  6. Adult stem cells and tissue repair

    Microsoft Academic Search

    M Körbling; Z Estrov; R Champlin

    2003-01-01

    Recently, adult stem cells originating from bone marrow or peripheral blood have been suggested to contribute to repair and genesis of cells specific for liver, cardiac and skeletal muscle, gut, and brain tissue. The mechanism involved has been termed transdifferentiation, although other explanations including cell fusion have been postulated. Using adult stem cells to generate or repair solid organ tissue

  7. Modulation of Wnt Signaling Influences Fracture Repair

    PubMed Central

    Komatsu, David E.; Mary, Michelle N.; Schroeder, Robert Jason; Robling, Alex G.; Turner, Charles H.; Warden, Stuart J.

    2011-01-01

    While the importance of Wnt signaling in skeletal development and homeostasis is well documented, little is known regarding its function in fracture repair. We hypothesized that activation and inactivation of Wnt signaling would enhance and impair fracture repair, respectively. Femoral fractures were generated in Lrp5 knockout mice (Lrp5?/?) and wild-type littermates (Lrp5+/+), as well as C57BL/6 mice. Lrp5?/? and Lrp5+/+mice were untreated, while C57BL/6 mice were treated 2×/week with vehicle or anti-Dkk1 antibodies (Dkk1 Ab) initiated immediately postoperatively (Day 0) or 4 days postoperatively (Day 4). Fractures were radiographed weekly until sacrifice at day 28, followed by DXA, pQCT, and biomechanical analyses. Lrp5?/? mice showed impaired repair compared to Lrp5+/+ mice, as evidenced by reduced callus area, BMC, BMD, and biomechanical properties. The effects of Dkk1 Ab treatment depended on the timing of initiation. Day 0 initiation enhanced repair, with significant gains seen for callus area, BMC, BMD, and biomechanical properties, whereas Day 4 initiation had no effect. These results validated our hypothesis that Wnt signaling influences fracture repair, with prompt activation enhancing repair and inactivation impairing it. Furthermore, these data suggest that activation of Wnt signaling during fracture repair may have clinical utility in facilitating fracture repair. PMID:20063381

  8. Repairing high-temperature glazed tiles

    NASA Technical Reports Server (NTRS)

    Ecord, G. M.; Schomburg, C.

    1981-01-01

    Tetraethyl orthosilicate (TEOS) mixture fills chips and cracks in glazed tile surface. Filler is made by mixing hydrolyzed TEOS, silicon tetraboride powder, and pulverized tile material. Repaired tiles survived testing by intense acoustic emissions, arc jets, and intense heat radiation. Repair is reliable and rapid, performed in 1-1 1/2 hours with tile in any or orientation.

  9. [Wound repair in plant tissues (Review)].

    PubMed

    Vasiukova, N I; Chalenko, G I; Gerasimova, N G; Ozeretskovskaia, O L

    2011-01-01

    Signaling systems responsible for repair processes in plants and manifestation of defensive effects in plant tissues were analyzed. Special attention was given to jasmonic acid, a mobile systemic repair signal, as well as to jasmonate biosynthesis and signal transport to the areas where protective responses of plants are induced. The main defense responses of potato tubers induced by wounding were considered. PMID:21790022

  10. Robot Service and Repair. Teacher's Guide.

    ERIC Educational Resources Information Center

    Pittsburg State Univ., KS. Kansas Vocational Curriculum Dissemination Center.

    This document is a teacher's guide for teaching a course on robot service and repair. The guide is organized in four units covering the following topics: introduction to robots, power supply, robot control systems, and service and repair. Each unit contains several lesson plans on the unit topic. Lesson plans consist of objectives, tools and…

  11. Robot Service and Repair. Student Guide.

    ERIC Educational Resources Information Center

    Pittsburg State Univ., KS. Kansas Vocational Curriculum Dissemination Center.

    This document is a student guide for a course on robot service and repair. It is organized in four units covering the following topics: introduction to robots, power supply, robot control systems, and service and repair. Each unit contains several lesson plans on the unit topic. Lesson plans consist of lesson objectives, lists of teaching aids and…

  12. Repair Negotiation by English L2 Learners

    ERIC Educational Resources Information Center

    Choi, Yujeong

    2012-01-01

    It is widely accepted that L2 learners often face communication problems due to lack of competency in the target language and familiarity with its culture of origin. One way to resolve miscommunication problems is to seek clarification of the utterance; this process is called "repair negotiation" (Nakahama et al. 2001). Repair

  13. Phase clocks for transient fault repair

    Microsoft Academic Search

    Ted Herman

    2000-01-01

    Phase clocks are synchronization tools that implement a form of logical time in distributed systems. For systems tolerating transient faults by self-repair of damaged data, phase clocks can enable reasoning about the progress of distributed repair procedures. This paper presents a phase clock algorithm suited to the model of transient memory faults in asynchronous systems with read\\/write registers. The algorithm

  14. Mechanisms of wound repair in crayfish

    Microsoft Academic Search

    X Vafopoulou

    2009-01-01

    This review describes the complexity of events involved with repair to integumentary wounds and their regulation using the crayfish as a model system. Injuries to integument precipitate a cascade of cellular events that lead to rapid healing of the wound, regeneration of damaged tissues and repair of the integument. The first step in this cascade is hemolymph clotting and subsequent

  15. 30 CFR 57.14104 - Tire repairs.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 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...

  16. 30 CFR 56.14104 - Tire repairs.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 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...

  17. 30 CFR 57.14104 - Tire repairs.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 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...

  18. 30 CFR 56.14104 - Tire repairs.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 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...

  19. Analysis of clinical factors related to the efficacy of shoulder arthroscopic synovectomy plus capsular release in patients with rheumatoid arthritis.

    PubMed

    Kanbe, Katsuaki; Chiba, Junji; Inoue, Yasuo; Taguchi, Masashi; Iwamatsu, Akiko

    2015-04-01

    Shoulder synovectomy is a well-known surgical treatment for rheumatoid arthritis. However, synovectomy alone is insufficient for improving range of motion clinically. We investigated the clinical factors related to the efficacy of shoulder synovectomy performed with capsular release in patients with rheumatoid arthritis. Fifty-four shoulders of 54 patients (12 males, 42 females; mean age 53.3 years) with rheumatoid arthritis were treated by synovectomy plus capsular release. The patients had a mean disease duration of 8.33 years, a mean follow-up period of 5.02 years, and 66.7% received biological treatment. The disease activity score 28 using C-reactive protein, range of motion of the shoulder, and Japanese Orthopaedic Association (JOA) score assessment were used to investigate clinical factors, analyzed by multiple regression analysis, associated with improved outcome. The average disease activity score 28 using C-reactive protein and JOA score improved significantly from 4.29 and 36.7 to 3.11 and 84.6, respectively, with the restoration of range of motion. Multiple regression analysis showed that disease duration and prednisolone were significantly associated with flexion degree and JOA score. Larsen grade and JOA score were not correlated significantly. There was no significant difference in the JOA score between the groups with or without biological medicinal treatment. Shoulder arthroscopic synovectomy performed with capsular release with or without biological treatment effectively improved function. Short disease duration and low prednisolone dose in rheumatoid arthritis were important for prediction of efficacy. PMID:25537932

  20. 49 CFR 180.513 - Repairs, alterations, conversions, and modifications.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 2010-10-01 false Repairs, alterations, conversions...MATERIALS REGULATIONS CONTINUING QUALIFICATION AND MAINTENANCE OF PACKAGINGS Qualification and Maintenance of Tank Cars § 180.513 Repairs, alterations,...

  1. Effect of acrylamide on hepatocellular DNA repair

    SciTech Connect

    Miller, M.J.; McQueen, C.A.

    1986-01-01

    Acrylamide has recently been reported to induce tumors in laboratory animals. The effect of acrylamide on unscheduled DNA synthesis using the hepatocyte primary culture (HPC)/DNA repair test was examined. Isolated hepatocytes were exposed to acrylamide and (3H)thymidine ( (3H)TdR) for 18 hr. Incorporation of (3H)TdR into DNA was determined by autoradiography. No DNA repair was observed at acrylamide concentrations up to 10(-2) M. These findings were confirmed using density gradients. Acrylamide concentrations exceeding 10(-2) M were cytotoxic to hepatocytes. Because both autoradiography and density gradients measure DNA repair as an endpoint, the ability of acrylamide to inhibit these repair processes was also determined. Acrylamide had no effect on the repair of UV-damaged DNA. These results show that acrylamide is not genotoxic in isolated hepatocytes.

  2. DNA triplet repeat expansion and mismatch repair.

    PubMed

    Iyer, Ravi R; Pluciennik, Anna; Napierala, Marek; Wells, Robert D

    2015-06-01

    DNA mismatch repair is a conserved antimutagenic pathway that maintains genomic stability through rectification of DNA replication errors and attenuation of chromosomal rearrangements. Paradoxically, mutagenic action of mismatch repair has been implicated as a cause of triplet repeat expansions that cause neurological diseases such as Huntington disease and myotonic dystrophy. This mutagenic process requires the mismatch recognition factor MutS? and the MutL? (and/or possibly MutL?) endonuclease, and is thought to be triggered by the transient formation of unusual DNA structures within the expanded triplet repeat element. This review summarizes the current knowledge of DNA mismatch repair involvement in triplet repeat expansion, which encompasses in vitro biochemical findings, cellular studies, and various in vivo transgenic animal model experiments. We present current mechanistic hypotheses regarding mismatch repair protein function in mediating triplet repeat expansions and discuss potential therapeutic approaches targeting the mismatch repair pathway. PMID:25580529

  3. INTERNAL REPAIR OF PIPELINES REVIEW & EVALUATION OF INTERNAL PIPELINE REPAIR TRIALS REPORT

    SciTech Connect

    Robin Gordon; Bill Bruce; Ian Harris; Dennis Harwig; George Ritter; Bill Mohr; Matt Boring; Nancy Porter; Mike Sullivan; Chris Neary

    2004-09-01

    The two broad categories of fiber-reinforced composite liner repair and deposited weld metal repair technologies were reviewed and evaluated 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. Evaluation trials were conducted on pipe sections with simulated corrosion damage repaired with glass fiber-reinforced composite liners, carbon fiber-reinforced composite liners, and weld deposition. Additional un-repaired pipe sections were evaluated in the virgin condition and with simulated damage. Hydrostatic failure pressures for pipe sections repaired with glass fiber-reinforced composite liner were only marginally greater than that of pipe sections without liners, indicating that this type of liner is generally ineffective at restoring the pressure containing capabilities of pipelines. Failure pressure for pipe repaired with carbon fiber-reinforced composite liner was greater than that of the un-repaired pipe section with damage, indicating that this type of liner is effective at restoring the pressure containing capability of pipe. Pipe repaired with weld deposition failed at pressures lower than that of un-repaired pipe in both the virgin and damaged conditions, indicating that this repair technology is less effective at restoring the pressure containing capability of pipe than a carbon fiber-reinforced liner repair. Physical testing indicates that carbon fiber-reinforced liner repair is the most promising technology evaluated to-date. Development of a comprehensive test plan for this process is recommended for use in the next phase of this project.

  4. Changes in synovial fluid biomarker concentrations following arthroscopic surgery in horses with osteochondritis dissecans of the distal intermediate ridge of the tibia.

    PubMed

    Brink, Palle; Smith, Roger K W; Tverdal, Aage; Dolvik, Nils I

    2015-07-01

    OBJECTIVE To quantify concentrations of cartilage oligomeric matrix protein (COMP) and fibromodulin in synovial fluid from the tarsocrural joints (TCJs) of horses with osteochondritis dissecans (OCD) of the distal intermediate ridge of the tibia and determine whether concentrations would change following arthroscopic removal of osteochondral fragments. ANIMALS 115 client-owned horses with OCD of the TCJ and 29 control horses euthanized for unrelated reasons. PROCEDURES COMP and fibromodulin concentrations were measured in synovial fluid from the TCJs of the affected horses before and after osteochondral fragments were removed arthroscopically and in synovial fluid from the TCJs of the control horses after euthanasia. Synovial biopsy specimens from the TCJs of affected and control horses were examined histologically for evidence of inflammation. RESULTS Synovial fluid COMP and fibromodulin concentrations prior to surgery in horses with OCD were not significantly different from concentrations in control horses. Fibromodulin, but not COMP, concentration in horses with OCD was significantly decreased after surgery, compared with the concentration before surgery. Fibromodulin concentration was significantly correlated with joint effusion score but not with lameness score or results of a flexion test and was correlated with histologic score for number of synoviocytes on the surface of the synovium but not with score for degree of infiltration of inflammatory cells in the synovium. Synovial fluid COMP concentration was not significantly correlated with clinical or histologic findings. CONCLUSIONS AND CLINICAL RELEVANCE Results suggested that fibromodulin, but not COMP, could potentially be a biomarker of joint inflammation in horses with OCD of the TCJ. PMID:26111089

  5. A new arthroscopic-assisted drilling method through the radius in a distal-to-proximal direction for osteochondritis dissecans of the elbow.

    PubMed

    Arai, Yuji; Hara, Kunio; Fujiwara, Hiroyoshi; Minami, Ginjiro; Nakagawa, Shuji; Kubo, Toshikazu

    2008-02-01

    We developed a new arthroscopic-assisted drilling method through the radius in a distal-to-proximal direction for osteochondritis dissecans (OCD) of the elbow. Only 1 drill hole is created in the radius by use of a single 1.8-mm K-wire inserted from the shaft of the radius approximately 3 cm distal to the humeroradial joint into the joint, which allows drilling of the entire OCD lesion. The forearm is supinated so that the tip of the K-wire is at the lateral side of the lesion in the humeral capitellum, and drilling is performed at 30 degrees elbow flexion. The flexion angle is changed from 30 degrees to 60 degrees to 90 degrees to 120 degrees while maintaining supination, to drill in 4 sites (1 site for each angle of flexion) of the lateral side of the OCD lesion. Next, we move the forearm from supination to pronation so that the tip of the K-wire is placed in the medial side of the lesion in the humeral capitellum, and as with the lateral side, drilling is performed in 4 sites. With this technique, the entire OCD lesion can be vertically drilled under arthroscopic guidance. This method is minimally invasive, and an early return to sports could be possible. PMID:18237711

  6. [Isokinetic evaluation of external rotators and abductors of the shoulder before and after arthroscopic decompression of suprascapular nerve due to its neuropathy--preliminary report].

    PubMed

    Fabi?, Jaros?aw

    2007-01-01

    The paper presents results of objective isokinetic evaluation of shoulder abductors and external rotators peak torque in 4 cases (2 women and 2 men) suffering from suprascapular nerve neuropathy (SNN). The mean age of patients was 25 years. The clinical diagnosis of SSN involvement was confirmed by electromyographic study in all cases. The radiological, sonographic and additionally magnetic resonas (2 cases operated on) examinations proved the absence of bone and soft tissues pathologies (ganglion and rotator cuff). The arthroscopic decompression of SSN was done in 2 cases. Isokinetic evaluation (180 degrees/s) disclosed weakness of shoulder abductors and external rotators in all cases and decrease of side to side difference of their peak torque 6 months after surgery. The patients operated on refused control EMG evaluation since they experience complete pain relief and improvement of function. There were no complications. Arthroscopic suprascapular nerve decompression can be done safely and effectively in properly selected cases. The isokinetics offers objective pre and postoperative evaluation of muscles involved by SNN. PMID:18078284

  7. Near-infrared (NIR) spectroscopy. A new method for arthroscopic evaluation of low grade degenerated cartilage lesions. Results of a pilot study

    PubMed Central

    Spahn, Gunter; Plettenberg, Holger; Kahl, Enrico; Klinger, Hans M; Mückley, Thomas; Hofmann, Gunther O

    2007-01-01

    Background Arthroscopy is a highly sensitive method of evaluating high-grade cartilage lesions but the detection of low-grade lesions is often is unreliable. Objective measurements are required. A novel NIRS (near-infrared-spectroscopy) device for detection of low-grade cartilage defects was evaluated in a preliminary clinical study. Methods In 12 patients who had undergone arthroscopy, the cartilage lesions within the medial knee compartment were classified according to the ICRS protocol. With a NIR spectrometer system and an optical probe, similar in design to a hook used for routine arthroscopy, the optical properties of cartilage were measured during arthroscopy. Results The mean ratio of 2 NIR absorption bands of intact cartilage 3.8 (range 2.3 to 8.7).was significantly lower than that of cartilage with grade 1 lesions (12.8, range 4.8 to 19.6) and grade 2 lesions (13.4, range 10.4 to 15.4). No differences were observed between grade 1 and grade 2 lesions. Conclusion NIRS can be used to distinguish between ICRS grade 1 lesions and healthy cartilage during arthroscopic surgeries. The results of this clinical study demonstrate the potential of NIRS to objectify classical arthroscopic grading systems. PMID:17535439

  8. Systems Maintenance Automated Repair Tasks (SMART)

    NASA Technical Reports Server (NTRS)

    Schuh, Joseph; Mitchell, Brent; Locklear, Louis; Belson, Martin A.; Al-Shihabi, Mary Jo Y.; King, Nadean; Norena, Elkin; Hardin, Derek

    2010-01-01

    SMART is a uniform automated discrepancy analysis and repair-authoring platform that improves technical accuracy and timely delivery of repair procedures for a given discrepancy (see figure a). SMART will minimize data errors, create uniform repair processes, and enhance the existing knowledge base of engineering repair processes. This innovation is the first tool developed that links the hardware specification requirements with the actual repair methods, sequences, and required equipment. SMART is flexibly designed to be useable by multiple engineering groups requiring decision analysis, and by any work authorization and disposition platform (see figure b). The organizational logic creates the link between specification requirements of the hardware, and specific procedures required to repair discrepancies. The first segment in the SMART process uses a decision analysis tree to define all the permutations between component/ subcomponent/discrepancy/repair on the hardware. The second segment uses a repair matrix to define what the steps and sequences are for any repair defined in the decision tree. This segment also allows for the selection of specific steps from multivariable steps. SMART will also be able to interface with outside databases and to store information from them to be inserted into the repair-procedure document. Some of the steps will be identified as optional, and would only be used based on the location and the current configuration of the hardware. The output from this analysis would be sent to a work authoring system in the form of a predefined sequence of steps containing required actions, tools, parts, materials, certifications, and specific requirements controlling quality, functional requirements, and limitations.

  9. Shuttle Repair Tools Automate Vehicle Maintenance

    NASA Technical Reports Server (NTRS)

    2013-01-01

    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.

  10. Surgical repair of pectus carinatum.

    PubMed

    Saxena, A K; Willital, G H

    1999-01-01

    Pectus carinatum represents a variety of protrusion deformities of the anterior chest wall. Although various non-operative methods of treatment have been employed, surgery has been widely accepted as the only effective method for the correction of pectus carinatum. We evaluate our 14 year single center experience of pectus carinatum correction on 111 patients using a uniform technique of internal stabilization employing stainless steel struts. Operative correction required double bilateral chondrotomy parasternally and at points of transition to normal ribs, followed by detorsion of the sternum, retrosternal mobilization and correction of the everted sternum as well as of the everted and inverted ribs. The mobilized sternum after incomplete wedge osteotomy was finally stabilized by one transternal and two bilateral parasternal metal struts. The corrections were completed with successful repair in 109 patients (98.2%). Major recurrences in 2 patients (1.8%) were corrected while mild recurrence were observed in 3 patients (2.7%). PMID:10667812

  11. Abdominoplasty repair for abdominal wall hernias.

    PubMed

    Robertson, J Douglas; de la Torre, Jorge I; Gardner, Paul M; Grant, John H; Fix, R Jobe; Vásconez, Luis O

    2003-07-01

    The objectives of abdominal hernial repair are to reconstruct the structural integrity of the abdominal wall while minimizing morbidity. Current techniques include primary closure, staged repair, and the use of prosthetic materials. Techniques for abdominoplasty include the use of the transverse lower abdominal incision and the resection of excess skin. By incorporating these aspects into hernial repairs, the procedures are made safer and the results are improved. The medical records were reviewed of 123 consecutive patients who underwent hernial repair. Seventy-six of these patients underwent a total of 82 herniorrhaphies using an abdominoplasty approach. This included using a transverse lower abdominal incision with or without extending it into an inverted-T incision. The hernial defect was then identified and isolated. Repair was obtained with primary fascial closure and plication, primary fascial approximation and reinforcement with absorbable Vicryl mesh, or placement of permanent mesh with or without fascial approximation. Overall, 8 of 82 hernias recurred. Most complications were minor and could be managed with local wound care only. Major complications included one enterocutaneous fistula, one occurrence of skin flap necrosis requiring operative debridement and skin grafting, and one delayed permanent mesh extrusion 2 years after repair. The abdominoplasty approach isolates the incision from the hernial defect and repair. This technique is safe with a low risk of complications and a low rate of recurrence. It is particularly helpful in obese patients, in patients with multiple hernias, and in those patients with recurrent hernias. PMID:12838119

  12. Diverless pipeline repair clamp: Phase 1

    SciTech Connect

    Miller, J.E.; Knott, B. (Stress Engineering Services, Inc., Houston, TX (United States))

    1991-12-01

    Offshore oil and gas developments are underway for water depths beyond which divers can function. The economic lifelines of these projects are the pipelines which will transport the products to shore. In preparation for the day when one of these pipelines will require repair because of a leak, the Pipeline Research Committee of the American Gas Association is funding research directed at developing diverless pipeline repair capabilities. Several types of damage are possible, ranging from latent weld defects on one end of the spectrum to damage resulting in parting of the pipe at the other end. This study is specifically directed toward laying the groundwork for development of a diverless pipeline repair clamp for use in repair of leaks resulting from minor pipe defects. The incentive for a clamp type repair is costs. When compared to replacing a section of pipe, either by welding or by mechanical means, the clamp type repair requires much less disturbance of the pipe, less time, fewer operations and less equipment. This report summarizes (1) capabilities of remotely operated vehicles (ROV's) and associated systems, (2) highlights areas for further research and development, (3) describes the required capabilities of the diverless repairclamp, (4) investigates some alternatives to the diverless clamp, (5) overviews the state of the art in leak repair clamps, and (6) critiques several possible generic clamp concepts.

  13. Magnetic Resonance Imaging of Cartilage Repair

    PubMed Central

    Trattnig, Siegfried; Winalski, Carl S.; Marlovits, Stephan; Jurvelin, Jukka S.; Welsch, Goetz H.; Potter, Hollis G.

    2011-01-01

    Articular cartilage lesions are a common pathology of the knee joint, and many patients may benefit from cartilage repair surgeries that offer the chance to avoid the development of osteoarthritis or delay its progression. Cartilage repair surgery, no matter the technique, requires a noninvasive, standardized, and high-quality longitudinal method to assess the structure of the repair tissue. This goal is best fulfilled by magnetic resonance imaging (MRI). The present article provides an overview of the current state of the art of MRI of cartilage repair. In the first 2 sections, preclinical and clinical MRI of cartilage repair tissue are described with a focus on morphological depiction of cartilage and the use of functional (biochemical) MR methodologies for the visualization of the ultrastructure of cartilage repair. In the third section, a short overview is provided on the regulatory issues of the United States Food and Drug Administration (FDA) and the European Medicines Agency (EMEA) regarding MR follow-up studies of patients after cartilage repair surgeries.

  14. Leakage test during mitral valve repair.

    PubMed

    Watanabe, Taiju; Arai, Hirokuni

    2014-11-01

    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

  15. Autonomous Repair Fault Tolerant Dynamic Reconfigurable Device

    NASA Astrophysics Data System (ADS)

    Nakahara, Kentaro; Kouyama, Shin'ichi; Izumi, Tomonori; Ochi, Hiroyuki; Nakamura, Yukihiro

    Recently, reconfigurable devices are widely used in the fields of small amount production and trial production. They are also expected to be utilized in such mission-critical fields as space development, because system update and pseudo-repair can be achieved remotely by reconfiguring. However, in the case of conventional reconfigurable devices, configuration memory upsets caused by radiation and alpha particles reconfigure the device unpredictably, resulting in fatal system failures. Therefore, a reconfigurable device with high fault-tolerance against configuration upsets is required. In this paper, we propose an architecture of a fault-tolerant reconfigurable device that autonomously repairs configuration upsets by itself without interrupting system operations. The device consists of a 2D array of “Autonomous-Repair Cells” each of which repairs its upsets autonomously. The architecture has a scalability in fault tolerance; a finer-grained Autonomous-Repair Cell provides higher fault-tolerance. To determine the architecture, we analyze four autonomous repair techniques of the cell experimentally. Then, two autonomous repair techniques, simple multiplexing (S.M.) and memory multiplexing (M.M.), are applied; the former to programmable logics and the latter to cell-to-cell routing resources. Through evaluation, we show that proposed device achieves more than 10 years average lifetime against configuration upsets even in a severe situation such as a satellite orbit.

  16. Weld Repair of Thin Aluminum Sheet

    NASA Technical Reports Server (NTRS)

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

    1986-01-01

    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.

  17. Designing Hydrogel Adhesives for Corneal Wound Repair

    PubMed Central

    Grinstaff, Mark W.

    2013-01-01

    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

  18. Repair of Electronics for Long Duration Spaceflight

    NASA Technical Reports Server (NTRS)

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

    2007-01-01

    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.

  19. DNA Repair Pathways in Trypanosomatids: from DNA Repair to Drug Resistance

    PubMed Central

    Genois, Marie-Michelle; Paquet, Eric R.; Laffitte, Marie-Claude N.; Maity, Ranjan; Rodrigue, Amélie

    2014-01-01

    SUMMARY All living organisms are continuously faced with endogenous or exogenous stress conditions affecting genome stability. DNA repair pathways act as a defense mechanism, which is essential to maintain DNA integrity. There is much to learn about the regulation and functions of these mechanisms, not only in human cells but also equally in divergent organisms. In trypanosomatids, DNA repair pathways protect the genome against mutations but also act as an adaptive mechanism to promote drug resistance. In this review, we scrutinize the molecular mechanisms and DNA repair pathways which are conserved in trypanosomatids. The recent advances made by the genome consortiums reveal the complete genomic sequences of several pathogens. Therefore, using bioinformatics and genomic sequences, we analyze the conservation of DNA repair proteins and their key protein motifs in trypanosomatids. We thus present a comprehensive view of DNA repair processes in trypanosomatids at the crossroads of DNA repair and drug resistance. PMID:24600040

  20. Small Engines Care, Operation, Maintenance and Repair. Volume II.

    ERIC Educational Resources Information Center

    Turner, J. Howard

    Developed by teacher educators and agricultural engineers, this teacher and student reference is for use in a course in small engine operation and maintenance. Content includes: (1) Principles of Good Workmanship, (2) Repairing Starters, (3) Maintaining and Repairing Ignition Systems, (4) Repairing Fuel Systems, (5) Repairing Governors, (6)…

  1. DNA repair pathways as targets for cancer therapy

    Microsoft Academic Search

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

    2008-01-01

    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

  2. A repair technology program at NASA on composite materials

    NASA Technical Reports Server (NTRS)

    Deaton, J. W.

    1982-01-01

    Repair techniques for graphite/epoxy and graphite/polyimide composite structures are discussed. Tension and compression test results for several basic repair processes that were applied to damaged specimens are shown to approach the strength of undamaged specimens. Other repair configurations currently under investigation are illustrated, and plans in the repair technology program are presented.

  3. Design Methodology for Scarf Repairs to Composite Structures

    Microsoft Academic Search

    C. H. Wang; A. Gunnion

    Scarf repairs are the preferred method of repairing thick composite structures, especially when externally bonded patches can no longer meet the stiffness, strength, and flushness requirements. Present designs of scarf repairs are based on two-dimensional analyses of scarf joints, assuming a uniform stress distribution along the scarf. This report presents an improve design methodology for designing scarf repairs to composite

  4. High-resolution repair of photomasks using a deep-UV-laser-based defect repair system

    Microsoft Academic Search

    John W. Herman; Yung-Ho Chuang; Baorui Yang; Minchuan Wang; Stephen Palese

    1995-01-01

    A laser-based defect repair system developed at Excel\\/Quantronix is designed to repair photomasks with submicron resolution. The laser of the repair unit consists of a gain-switched Ti:Sapphire system configured to operate at 248 nm. The deep-UV light is obtained by frequency tripling the fundamental Ti:Sapphire wavelength. The Ti:Sapphire laser system generates pulses with temporal duration of approximately 12 ns and

  5. Complications and surgical conversion after total aortic repair using endovascular repair in patients with Marfan syndrome.

    PubMed

    Numata, Satoshi; Tsutsumi, Yasushi; Ohashi, Hirokazu

    2015-04-01

    We report a case of a Marfan syndrome patient who developed a complicated clinical course after total aortic repair using a hybrid technique. After hybrid total aortic repair, this patient was required to undergo open thoracic and thoracoabdominal aortic repair due to impending rupture of the aorta. Moreover, the abdominal aortic graft was rereplaced due to debranching graft occlusion of the coeliac artery and the left renal artery. PMID:25575789

  6. Interscalene brachial plexus block for shoulder arthroscopic surgery: Prospective randomised controlled study of effects of 0.5% ropivacaine and 0.5% ropivacaine with dexamethasone

    PubMed Central

    Jadon, Ashok; Dixit, Shreya; Kedia, Sunil Kr; Chakraborty, Swastika; Agrawal, Amit; Sinha, Neelam

    2015-01-01

    Background and Aims: Various adjuvants have been used to prolong the duration of local anaesthetic action after peripheral and regional nerve blocks. We evaluated the effect of dexamethasone on the duration of pain relief in shoulder arthroscopic surgeries performed under interscalene brachial plexus using ropivacaine as local anaesthetic. Methods: After Ethical Committee approval and informed consent from patients we performed a prospective, randomised, comparative study on patients scheduled for arthroscopic shoulder surgery under interscalene block (ISB). Patients in ropivacaine group (Group R) received 30 ml of 0.5% ropivacaine plus 2 ml normal saline (n = 50) and dexamethasone-ropivacaine (Group RD) received 0.5% ropivacaine 30 ml plus 8 mg dexamethasone (4 mg/ml) (n = 50). Duration of analgesia, onset of sensory and motor block, success and failure of block, and complications were recorded and compared. Computer software SPSS version-16 (SPSS Inc., Chicago, Illinois, USA) was used for statistical analysis. Chi-square test and Student's t-test were used and P < 0.05 was considered as significant. Results: The mean duration of analgesia in Group RD was 1103.72 ± 296.027 min and in Group R it was 551.54 ± 166.92 min (P = 0.0001). Onset of sensory block in Group RD was 12.24 ± 1.88 min and in Group R was 13.48 ± 1.81 min (P = 0.5170). Onset of motor block in Group RD was 16.24 ± 2.04 min and in Group R was 17.76 ± 2.21 min (P = 0.2244). Onset of surgical anaesthesia in Group RD was19.46 ± 1.86 min and in Group R was 20.84 ± 1.71 min (P = 0.0859). Conclusion: Dexamethasone significantly prolonged duration of analgesia of ropivacaine during ISB used for arthroscopic surgeries of shoulder. Dexamethasone when mixed with ropivacaine had no effect on the onset of sensory and motor effects of ISB with ropivacaine. PMID:25838589

  7. MANAGEMENT OF URETHRAL STRICTURES AFTER HYPOSPADIAS REPAIR

    Microsoft Academic Search

    BARRY P. DUEL; JULIA SPENCER BARTHOLD; RICARDO GONZALEZ

    1998-01-01

    PurposeWe conducted a retrospective study of patients with strictures after hypospadias repair to identify factors contributing to the development of strictures and to attempt to define an optimal strategy for management.

  8. 49 CFR 195.422 - Pipeline repairs.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ...2012-10-01 2012-10-01 false Pipeline repairs. 195.422 Section 195...Relating to Transportation (Continued) PIPELINE AND HAZARDOUS MATERIALS SAFETY ADMINISTRATION...DEPARTMENT OF TRANSPORTATION (CONTINUED) PIPELINE SAFETY TRANSPORTATION OF...

  9. 49 CFR 195.422 - Pipeline repairs.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ...2010-10-01 2010-10-01 false Pipeline repairs. 195.422 Section 195...Relating to Transportation (Continued) PIPELINE AND HAZARDOUS MATERIALS SAFETY ADMINISTRATION...DEPARTMENT OF TRANSPORTATION (CONTINUED) PIPELINE SAFETY TRANSPORTATION OF...

  10. 49 CFR 195.422 - Pipeline repairs.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ...2011-10-01 2011-10-01 false Pipeline repairs. 195.422 Section 195...Relating to Transportation (Continued) PIPELINE AND HAZARDOUS MATERIALS SAFETY ADMINISTRATION...DEPARTMENT OF TRANSPORTATION (CONTINUED) PIPELINE SAFETY TRANSPORTATION OF...

  11. 49 CFR 195.422 - Pipeline repairs.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ...2014-10-01 2014-10-01 false Pipeline repairs. 195.422 Section 195...Relating to Transportation (Continued) PIPELINE AND HAZARDOUS MATERIALS SAFETY ADMINISTRATION...DEPARTMENT OF TRANSPORTATION (CONTINUED) PIPELINE SAFETY TRANSPORTATION OF...

  12. The biomechanics of cruciate ligament repair

    E-print Network

    Ferry, Katheryn Irene

    2013-02-22

    Reconstruction in the Dog. Veterinary and Comparative Orthopaedics and Traumatology, 9, 166-71. Lewis, J. L. , Lew, W. D. , Engebretson, L. et al. (1990). Factors Affecting Graft Force in 20 The Btomecttanics of Cruciate Ligament Repair Surgical...

  13. Recombination and DNA Repair in Helicobacter pylori

    PubMed Central

    Dorer, Marion S.; Sessler, Tate H.; Salama, Nina R.

    2013-01-01

    All organisms have pathways that repair the genome, ensuring their survival and that of their progeny. But these pathways also serve to diversify the genome, causing changes on the level of nucleotide, whole gene, and genome structure. Sequencing of bacteria has revealed wide allelic diversity and differences in gene content within the same species, highlighting the importance of understanding pathways of recombination and DNA repair. The human stomach pathogen Helicobacter pylori is an excellent model system for studying these pathways. H. pylori harbors major recombination and repair pathways and is naturally competent, facilitating its ability to diversify its genome. Elucidation of DNA recombination, repair, and diversification programs in this pathogen will reveal connections between these pathways and their importance to infection. PMID:21682641

  14. SURGICAL REPAIR OF URETHRAL CIRCUMCISION INJURIES

    Microsoft Academic Search

    Laurence S. Baskin; Douglas A. Canning; Howard M. Snyder; John W. Duckett

    1997-01-01

    PurposeThe 2 types of urethral injury that can occur during circumcision are urethrocutaneous fistula and urethral distortion secondary to partial glans amputation. We report the surgical repair of these rare injuries.

  15. Targeting homologous recombination repair defects in cancer.

    PubMed

    Evers, Bastiaan; Helleday, Thomas; Jonkers, Jos

    2010-08-01

    DNA repair is essential for cells to maintain genome stability in an environment that constantly produces DNA damage. There is a growing appreciation that defects in homologous recombination repair underlie hereditary and sporadic tumourigenesis, and that deficiency in this pathway may dictate the sensitivity of tumours to certain DNA-damaging agents. Homologous recombination deficiency (HRD) may therefore prove to be a diagnostic criterion per se if appropriate biomarkers become available to identify these tumours. In addition, homologous recombination-deficient tumours are more sensitive to inhibition of other DNA repair pathways through so-called 'synthetic lethal interactions', a principle that is currently being tested in clinical trials. Finally, homologous recombination repair-deficient cells may have an increased dependency on certain cell-cycle checkpoints, which can be therapeutically exploited. Here we describe recent advances in strategies to identify and target HRD tumours, approaches to overcome resistance, and combinatory strategies to optimize treatment outcome. PMID:20598756

  16. 49 CFR 195.422 - Pipeline repairs.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ...2013-10-01 2013-10-01 false Pipeline repairs. 195.422 Section 195...Relating to Transportation (Continued) PIPELINE AND HAZARDOUS MATERIALS SAFETY ADMINISTRATION...DEPARTMENT OF TRANSPORTATION (CONTINUED) PIPELINE SAFETY TRANSPORTATION OF...

  17. Encirclement sleeves reduce pipeline repair costs

    SciTech Connect

    NONE

    1996-01-01

    Welded sleeve, or replacement of line repair methods have been used successfully for many years in the pipeline industry but can lead to other difficulties for a pipeline operator. Clock Spring`s composite sleeves have been used in over ten thousand pipeline repairs with pipe sizes ranging from 6- to 56-inches in diameter, all without costly shutdown, welding or purging. Repairs can be completed while the pipeline is fully operational and require only six inches of clearance under the pipe for wrapping the eight thicknesses of the coil. This minimizes costly digging and backfilling over long runs of pipe and necessary shoring for personnel safety. Also it provides a more cost-effective alterative to conventional pipeline repair since special handling, lifting, or installation equipment is not needed. This paper reviews the installation and performance of these sleeves.

  18. Conceptual approaches to lung injury and repair.

    PubMed

    Zemans, Rachel L; Henson, Peter M; Henson, Jan E; Janssen, William J

    2015-03-01

    Lung injury and repair is a broad topic that includes many cell types and is relevant to the pathogenesis of most lung diseases. Here, we focus on injury and repair of the alveolus, the principal function of which is to achieve gas exchange. The many cell types and structures present in the alveolus are discussed, with emphasis on their interactions in both health and disease. We define injury as damage resulting in impaired gas exchange; physiologic repair, then, requires restoration of normal alveolar architecture and function. The role of inflammation in both injury and repair of structural alveolar cells, particularly epithelial cells, as well as mechanisms of resolution of inflammation will be addressed. Finally, emphasis is placed on the importance of addressing quantitatively the dynamic and complex multidirectional interactions between the many alveolar cell types and structures in three dimensions over time and in relating such mechanistic studies to physiologic outcomes and human disease. PMID:25830855

  19. The Low Anterior Five-O'clock Portal During Arthroscopic Shoulder Surgery Performed in the Beach-Chair Position

    Microsoft Academic Search

    Albert W. Pearsall; Tom F. Holovacs; Kevin P. Speer

    1999-01-01

    We evaluated the difficulty, accuracy, and safety of establishing a low anterior 5-o'clock portal for anterior capsulolabral repair in patients positioned in the beach-chair position during shoulder arthroscopy. An initial 5-o'clock portal was created using an inside-out technique as described by Davidson and Tibone. During establishment of the portal, significant force was required to lever the humeral head laterally, and

  20. DNA Transcription and Repair: A Confluence*

    PubMed Central

    Moses, Robb E.; O'Malley, Bert W.

    2012-01-01

    DNA repair and transcription process complex nucleic acid structures. The mammalian cell can cross-utilize select components of either pathway to respond to general or special situations arising in either path. These functions comprise activity networks capable of addressing unique requirements for each process. Here, we discuss examples of such networks that are tailored to respond to the demands of both DNA repair and transcription. PMID:22605334

  1. Contribution of Stem Cells to Kidney Repair

    Microsoft Academic Search

    Benedetta Bussolati; Ciro Tetta; Giovanni Camussi

    2008-01-01

    The potential role of stem cells in the repair of glomerular and tubular injury is under intensive investigation. Several studies have addressed the role of endogenous bone-marrow (BM)-derived stem cells (SC) in the repair of renal injury. Some reports indicate that BM-derived SC are capable of engraftment into damaged nephrons, although the lineage of SC recruited has not been established.

  2. Topological Repairing of 3D Digital Images

    Microsoft Academic Search

    Marcelo Siqueira; Longin Jan Latecki; Nicholas J. Tustison; Jean H. Gallier; James C. Gee

    2008-01-01

    We present here a new randomized algorithm for repairing the topology of objects represented by 3D binary digital images.\\u000a By “repairing the topology”, we mean a systematic way of modifying a given binary image in order to produce a similar binary\\u000a image which is guaranteed to be well-composed. A 3D binary digital image is said to be well-composed if, and only

  3. Regulation of DNA repair by ubiquitylation

    Microsoft Academic Search

    Tony T. Huang; Alan D. D'Andrea

    2006-01-01

    The process of ubiquitylation is best known for its role in targeting proteins for degradation by the proteasome. However, recent studies of DNA-repair and DNA-damage-response pathways have significantly broadened the scope of the role of ubiquitylation to include non-proteolytic functions of ubiquitin. These pathways involve the monoubiquitylation of key DNA-repair proteins that have regulatory functions in homologous recombination and translesion

  4. Repairing and recovering broken peritoneal catheters.

    PubMed

    Moreiras-Plaza, Mercedes; Blanco-García, Raquel; Beato-Coo, Laura; Martín-Baez, Isabel; Fernández-Fleming, Francisco

    2014-11-17

    Breakage of peritoneal catheters is an emergency of the technique that is uncommon but which requires immediate action when there is leakage of the dialysate and risk of infection. Early and adequate intervention can save broken catheters without interrupting peritoneal dialysis. We report our experience repairing damaged catheters using the Quinton® Peri-Patch repair kit (Quinton Instrument Co., Tyco Healthcare Group LP. Mansfield, MA., U.S.A.). PMID:25415572

  5. Early Evolution of DNA Repair Mechanisms

    Microsoft Academic Search

    Jocelyne DiRuggiero; Frank T. Robb

    DNA repair is critical for the maintenance of genome integrity and replication fidelity in all cells, and therefore was arguably\\u000a of major importance in the Last Universal Cellular Ancestor (LUCA) as well. Archaea, and hyperthermophiles in particular,\\u000a are well suited for studying early DNA repair mechanisms from two perspectives. First, these prokaryotes embody a mix of bacterial\\u000a and eukaryal molecular

  6. Laparoscopic repair of postoperative perineal hernia

    Microsoft Academic Search

    J.-L. Dulucq; P. Wintringer; A. Mahajna

    2006-01-01

    Background  Perineal hernia is an uncommon complication following abdominoperineal resection of the rectum. There are only a few reports\\u000a concerning the management of this unusual problem. Various methods of repair have been described, but none of them is well\\u000a established. The purpose of our study is to present our experience and to discuss the pathogenesis and the different surgical\\u000a repair techniques

  7. Phase Clocks for Transient Fault Repair

    Microsoft Academic Search

    Ted Herman

    2000-01-01

    Abstract Phase clocks are synchronization tools that implement,a form of logical time in distributed systems. For systems tolerating transient faults by self-repair of damaged data, phase clocks can enable reasoning about the progress of distributed repair procedures. This paper presents a phase clock algorithm suited to the model of transient memory,faults in asynchronous systems with read\\/write registers. The algorithm is

  8. Hybrid Repair of Proximal Subclavian Artery Aneurysm

    PubMed Central

    Morimoto, Kazuki; Fukuda, Tetsuya; Iba, Hiroshi; Tanaka, Hiroshi; Sasaki, Hiroaki; Minatoya, Kenji; Kobayashi, Junjiro

    2015-01-01

    Objective: Conventional open repair for proximal subclavian artery aneurysms (SCAAs) requires cardiopulmonary bypass. However, patients with proximal SCAA can be treated with hybrid repair. Methods: Between 2007 and 2012, we performed hybrid repair to treat six consecutive patients with proximal SCAA (three left SCAAs, one right aberrant SCAA, two right SCAAs). Their median age was 73.5 [70–87] years, and the size of their aneurysm was 33.5 [30–45] mm. Thoracic endovascular aneurysm repair (TEVAR) only was used for one patient with left SCAA, TEVAR and supra-aortic bypass for two with left SCAA and one with right aberrant SCAA, and endovascular repair with reconstruction of the vertebral artery using the saphenous vein graft (SVG) for two with right SCAA. Results: The follow-up duration was 3.7 [0.2–6.8] years. There was no 30-day mortality and only one early complication consisting of a minor stroke after TEVAR for shaggy aorta. Two late deaths occurred, one caused by cerebral infarction due to occlusion of SVG to the dominant vertebral artery 2 months after the operation and the other by aortic dissection 5 years postoperatively. Conclusions: Hybrid repair can be a less-invasive alternative for proximal SCAA. Revascularization of neck vessels and TEVAR should be performed very carefully to prevent neurologic complications.

  9. Subsidence resistant repair of a block basement

    SciTech Connect

    Mahar, J.W. [Geotechnical Consultants, Inc., Savoy, IL (United States); Marino, G.G. [Marino Engineering Associates, Inc., Urbana, IL (United States); Murphy, E.; Farnetti, J. [Illinois Mine Subsidence Insurance Fund, Chicago, IL (United States)

    1998-12-31

    A one story house was damaged by mine subsidence movement. The house is located in a small subsidence sag and is experiencing differential settlement and compressive ground strains. Instead of waiting for the ground movements to eventually stop, The Illinois Mine Subsidence Insurance Fund developed a permanent repair scheme that was implemented at the same time damaging mine subsidence movement was affecting the structure. This repair provided a significant structural resistance against the anticipated residual mine subsidence movement and was aesthetically acceptable to the homeowners. The repair consisted of epoxying vertical and horizontal steel straps and then applying a cover coat of fiber-cement on the unreinforced concrete block basement walls. The repair scheme was relatively untried, but had been successfully researched. This paper provides information on the mine subsidence movement/damage, the design concepts of steel strap/fiber-cement repair, construction details, performance and costs. Other applications of the use of the steel strap repair method are also discussed for releveling of a building and/or correcting subsidence damage to structures located in the tension zone.

  10. Regulatory Challenges for Cartilage Repair Technologies

    PubMed Central

    Stiegman, Glenn

    2013-01-01

    In the United States, few Food and Drug Administration (FDA)–approved options exist for the treatment of focal cartilage and osteochondral lesions. Developers of products for cartilage repair face many challenges to obtain marketing approval from the FDA. The objective of this review is to discuss the necessary steps for FDA application and approval for a new cartilage repair product. FDA Guidance Documents, FDA Panel Meetings, scientific organization recommendations, and clinicaltrials.gov were reviewed to demonstrate the current thinking of FDA and the scientific community on the regulatory process for cartilage repair therapies. Cartilage repair therapies can receive market approval from FDA as medical devices, drugs, or biologics, and the specific classification of product can affect the nonclinical, clinical, and regulatory strategy to bring the product to market. Recent FDA guidance gives an outline of the required elements to bring a cartilage repair product to market, although these standards are often very general. As a result, companies have to carefully craft their study patient population, comparator group, and clinical endpoint to best showcase their product’s attributes. In addition, regulatory strategy and manufacturing process validation need to be considered early in the clinical study process to allow for timely product approval following the completion of clinical study. Although the path to regulatory approval for a cartilage repair therapy is challenging and time-consuming, proper clinical trial planning and attention to the details can eventually save companies time and money by bringing a product to the market in the most expeditious process possible.

  11. Application of composite repair for pipeline anomalies

    SciTech Connect

    Stephens, D.R. [Battelle, Columbus, OH (United States); Lindholm, U.S. [Southwest Research Inst., San Antonio, TX (United States); Hill, V.L. [Gas Research Inst., Chicago, IL (United States); Block, N. [Clock Spring Co., Houston, TX (United States)

    1996-09-01

    The cost of maintaining the structural integrity of the 650,000 kilometer high-pressure gas gathering and transmission pipeline network is a significant part of the operating budget of the US pipeline industry. To help in controlling thee costs, the Gas Research institute (GRI) has supported research resulting in the development of Clock Spring{reg_sign}, a low-cost fiberglass composite alternative to conventional steel sleeves for transmission line pipe reinforcement and repair. Investigation and development of engineering guidelines have been completed. Field validation of laboratory research on application of Clock Spring as a repair for corrosion and mechanical damage defects is in progress. This paper presents an overview of composite repair technology for pipeline corrosion and mechanical damage defects. It summarizes the results and conclusions of modeling and experiments on reinforcement and repair of both corrosion and mechanical damage (i.e., dent and gouge) pipeline defects. These investigations provide quantitative results on the operating envelope of composite reinforcements and installation requirements that ensure sound and reliable repair of pipeline defects. The paper further summarizes the work to date on field installation in verification of composite repair performance.

  12. Biomaterials for orbital fractures repair

    PubMed Central

    Totir, M; Ciuluvica, R; Dinu, I; Careba, I; Gradinaru, S

    2015-01-01

    The unique and complex anatomy of the orbit requires significant contouring of the implants to restore the proper anatomy. Fractures of the orbital region have an incidence of 10-25% from the total facial fractures and the most common age group was the third decade of life. The majority of cases required reconstruction of the orbital floor to support the globe position and restore the shape of the orbit. The reason for this was that the bony walls were comminuted and/ or bone fragments were missing. Therefore, the reconstruction of the missing bone was important rather than reducing the bone fragments. This could be accomplished by using various materials. There is hardly any anatomic region in the human body that is so controversial in terms of appropriate material used for fracture repair: non resorbable versus resorbable, autogenous/ allogeneic/ xenogenous versus alloplastic material, non-prebent versus preformed (anatomical) plates, standard versus custom-made plates, nonporous versus porous material, non-coated versus coated plates. Thus, the importance of the material used for reconstruction becomes more challenging for the ophthalmologist and the oral and maxillofacial surgeon. PMID:25914737

  13. Pulpal progenitors and dentin repair.

    PubMed

    Harichane, Y; Hirata, A; Dimitrova-Nakov, S; Granja, I; Goldberg, A; Kellermann, O; Poliard, A

    2011-07-01

    Mesenchymal stem cells are present in the dental pulp. They have been shown to contribute to dentin-like tissue formation in vitro and to participate in bone repair after a mandibular lesion. However, their capacity to contribute efficiently to reparative dentin formation after pulp lesion has never been explored. After pulp exposure, we have identified proliferative cells within 3 zones. In the crown, zone I is near the cavity, and zone II corresponds to the isthmus between the mesial and central pulp. In the root, zone III, near the apex, at a distance from the inflammatory site, contains mitotic stromal cells which may represent a source of progenitor cells. Stem-cell-based strategies are promising treatments for tissue injury in dentistry. Our experiments focused on (1) location of stem cells induced to leave their quiescent state early after pulp injury and (2) implantation of pulp progenitors, a substitute for classic endodontic treatments, paving the way for pulp stem-cell-based therapies. PMID:21677084

  14. Single-dose intra-articular bupivacaine plus morphine after knee arthroscopic surgery: a meta-analysis of randomised placebo-controlled studies

    PubMed Central

    Wang, Yi-lun; Zeng, Chao; Xie, Dong-xing; Yang, Ye; Wei, Jie; Yang, Tuo; Li, Hui; Lei, Guang-hua

    2015-01-01

    Objectives To evaluate the efficacy and safety of single-dose intra-articular bupivacaine plus morphine after knee arthroscopic surgery. Design Meta-analysis. Data sources and study eligibility criteria A comprehensive literature search, using Medline (1966–2014), the Cochrane Central Register of Controlled Trials and Embase databases, was conducted to identify randomised placebo-controlled trials that used a combination of single-dose intra-articular bupivacaine and morphine for postoperative pain relief. Results 12 articles were included in this meta-analysis. The mean visual analogue scale (VAS) scores of the bupivacaine plus morphine group were significantly lower than those of the placebo group (weighted mean difference (WMD) ?1.75; 95% CI ?2.16 to ?1.33; p<0.001). The VAS scores at the last follow-up time point (last VAS scores) of the bupivacaine plus morphine group were also significantly lower than those of the placebo group (WMD ?1.46; 95% CI ?1.63 to ?1.29; p<0.001). The number of patients requiring supplementary analgesia was also significantly reduced (RR 0.60; 95% CI 0.39 to 0.93; p=0.02), while there was no significant difference in the time to first analgesic request (WMD 3.46; 95% CI ?1.81 to 8.72; p=0.20) or short-term side effects (RR 1.67; 95% CI 0.65 to 4.26; p=0.29). Conclusions The administration of single-dose intra-articular bupivacaine plus morphine after knee arthroscopic surgery is effective for pain relief, and its short-term side effects remain similar to saline placebo. PMID:26078306

  15. Modelling maintenance and repair costs using stochastic point processes for life cycle costing of repairable systems

    Microsoft Academic Search

    Laxman Y. Waghmode; Anil D. Sahasrabudhe

    2011-01-01

    The objective of this article is to present a methodology based on reliability and maintainability (R & M) parameters for effective implementation of life cycle costing in design and procurement of repairable systems. For this purpose, a number of life cycle cost models developed over the years have been reviewed, the important life cycle stages for repairable systems are identified

  16. Modelling maintenance and repair costs using stochastic point processes for life cycle costing of repairable systems

    Microsoft Academic Search

    Laxman Y. Waghmode; Anil D. Sahasrabudhe

    2012-01-01

    The objective of this article is to present a methodology based on reliability and maintainability (R & M) parameters for effective implementation of life cycle costing in design and procurement of repairable systems. For this purpose, a number of life cycle cost models developed over the years have been reviewed, the important life cycle stages for repairable systems are identified

  17. Bilingual Skills Training Program. Auto Body Repair. Module 3.0: Basic Metal Repair.

    ERIC Educational Resources Information Center

    Northern New Mexico Community Coll., El Rito.

    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…

  18. Fault tree analysis of phased mission systems with repairable and non-repairable components

    Microsoft Academic Search

    J. K. Vaurio

    2001-01-01

    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

  19. Mesh repair of vaginal wall prolapse

    PubMed Central

    Kapur, Krishan; Dalal, Vinod

    2014-01-01

    Background Over the last decade, mesh augmented surgical repair is being increasingly used in pelvic organ prolapse. Perigee and Apogee are comprehensive, single-use needle suspension kits that provide a standardized delivery method for mesh or graft-augmented repairs. This study has been carried out to study the safety and efficacy of the Perigee and Apogee mesh repair systems. Methods 10 cases of posterior vaginal wall prolapse with or without Apical prolapse underwent Apogee mesh repair surgery and 10 cases of anterior vaginal wall prolapse underwent Perigee mesh repair surgery. Depending on the findings either Apogee or Perigee or both were used. Patients were followed up for complications of the surgery if any, and for the relief of the symptoms related to prolapse and associated symptoms of bowel/bladder dysfunction. Objective cure rate was prolapse < stage 1 as per the POPQ system. Data collected was statistically analyzed. Results The objective and subjective cure rates were 100%. Postoperative complications were minor. No patient developed de novo urinary urge symptoms, stress urinary incontinence or UTI postoperatively. There were no operative complications like bladder injuries, hematoma and rectal injuries. The mean blood loss was 180 ml and the mean duration of surgery during the Apogee and Perigee mesh repair was 51.5 ± 2.99 min and 60.9 ± 4.65 min respectively. Conclusion In the present study there was a significant improvement in the degree of prolapse after the mesh repair surgeries and the results were consistent even at 12 months follow up. PMID:24843196

  20. AIMS-fab SPEC for defect repair and better repair profile

    NASA Astrophysics Data System (ADS)

    Lu, Colbert; Chou, William Y.; Cheng, Andy; Wu, J. K.

    2004-12-01

    For current mask defect repair, depending only on an inspection metrology tool (KLA-SLF77) to judge wafer printability is not enough. Many mask makers and users are turning to simulation-based photomask qualification to reduce unnecessary repairs and confirm defect repair. Using programmed defects of known size, phase, and location, we fabricated binary and Att PSM test masks to perform the repair. Utilizing Carl Zeiss" Aerial Image Measurement System (AIMS-fab), we compared reticle simulation results to actual wafer image prints and then established a criteria SPEC as the core judgment rule. The investigation shows for binary L/S layout, the better repair profile received a wider ED-window for the wafer process. For Att PSM contact layout, the proper depth of quartz etching for smaller miss-contact was also demonstrated.