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1

Arthroscopic Hip Labral Repair  

PubMed Central

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

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

2013-01-01

2

Arthroscopic Quadriceps Tendon Repair: Two Case Reports  

PubMed Central

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.

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

2015-01-01

3

Arthroscopic Capsulolabral Revision Repair for Recurrent Anterior Shoulder Instability  

Microsoft Academic Search

Background: Open capsulolabral repair is still considered the standard revision procedure for a failed anterior shoulder instability repair. To date, only a few studies have evaluated the outcome of arthroscopic revision instability repair.Purpose: This study was undertaken to assess the clinical outcome and postoperative sports activity level of arthroscopic revision stabilization using defined inclusion criteria and a standardized operative revision

Christoph Bartl; Katrin Schumann; Jochen Paul; Stephan Vogt; Andreas B. Imhoff

2011-01-01

4

Arthroscopic repair of the scapholunate interosseous ligament.  

PubMed

Scapholunate injuries are the most frequent of the intercarpal ligament injuries in the wrist. Current repair methods generally involve an open approach the dorsal capsule of the wrist. Arthroscopic repair of the dorsal portion of the scapholunate interosseus ligament would carry the advantages of less stiffness and would preserve the important dorsal capsular stabilizers. In the development of this technique, we first sought to determine the anatomic location and accessibility of the dorsal scapholunate ligament and the site in which a suture anchor would be placed. Ten fresh-frozen cadaver limbs were used. With the arthroscope in the 4 to 5 portal, the most dorsal portion of the SLIL was visualized in each specimen. K-wires were inserted through the 3 to 4 portal into the scaphoid adjacent to most distal portion of the dSLIL visualized. All limbs were dissected and the location of the wires relative to the prominence on the scaphoid directly adjacent to the central portion of the dSLIL was measured. The location of the prominence relative to the dSLIL was studied through magnified photography of a stained section of a cadaveric scaphoid. The mean distance of these wires distal to the center of the dSLIL is presented. Then the technique of arthroscopic repair of the dSLIL was developed using additional cadaveric wrist specimens. The technique is described. PMID:21107214

Stuffmann, Eric S; McAdams, Timothy R; Shah, Roshan P; Yao, Jeffrey

2010-12-01

5

Arthroscopic Rotator Cuff Repair: 4- to 10Year Results  

Microsoft Academic Search

Purpose: The purpose of this article is to report the 4- to 10-year results of arthroscopic repair of full- thickness rotator cuff tears. Type of Study: This is a retrospective study evaluating a series of arthroscopic rotator cuff repairs performed by a single surgeon from February 1990 to February 1996. Methods: Retrospective chart reviews and telephone interviews were performed to

Eugene M. Wolf; William T. Pennington; Vivek Agrawal

2004-01-01

6

Arthroscopic bankart repair in a high demand patient population  

Microsoft Academic Search

In this prospective study, 40 consecutive patients identified as high risk for recurrent instability were managed by an arthroscopic Bankart repair using nonabsorbable sutures and anchors. The technique employed is an arthroscopic modification of the capsulolabral repair described by Jobe. One-and-one-half to 3 years postoperatively (average 30 months), 37 of the 40 patients (93%) remained stable. The average Bankart score

Phillip Bacilla; L. D. Field; F. H. Savoie

1997-01-01

7

All-Inside Arthroscopic Meniscal Repair With Meniscal Cinch  

PubMed Central

The number of commercially available all-arthroscopic meniscal repair devices has increased in recent years. Although inside-out vertical mattress sutures have been considered the gold standard in the past, recent biomechanical studies have shown that some all-arthroscopic repair devices provide comparable strength. To successfully use these devices, surgeons must understand proper insertion technique. The purpose of this article is to demonstrate this technique for the Meniscal Cinch (Arthrex, Naples, FL). PMID:23875146

Goradia, Vipool K.

2013-01-01

8

Comparison of Open and Arthroscopically Assisted Rotator Cuff Repairs  

Microsoft Academic Search

Open rotator cuff repair has shown reliable results in terms of pain relief and improved shoulder function. Re cently, however, arthroscopically assisted rotator cuff repair has shown promising preliminary results. We compared the results of these two procedures with re gard to pain, function, range of motion, strength, patient satisfaction, and return to previous activity. Thirty-seven rotator cuff repairs were

Champ L. Baker; Stephen H. Liu

1995-01-01

9

Arthroscopic Technique for Patch Augmentation of Rotator Cuff Repairs  

Microsoft Academic Search

The patient is placed in the lateral position, and an arthroscopic cuff repair is performed according to standard techniques. The line of repair is usually in the shape of a “T” or an “L.” The repair is viewed through the lateral portal, with fluid inflow through the scope. Mattress sutures are placed in the anterior and posterior portions of the

Marc R. Labbé

2006-01-01

10

Arthroscopic Recognition and Repair of the Torn Subscapularis Tendon  

PubMed Central

Although the subscapularis has historically received less attention than posterosuperior rotator cuff tears, repair of a torn subscapularis tendon is critically important to restoring anatomy and achieving the best functional outcome possible. Arthroscopic repair begins with proper recognition of the tear. A systematic approach can then be used to arthroscopically repair all types of subscapularis tendon tears, from partial tears to full-thickness tears, as well as those which are retracted and have adhesions medially. Subscapularis footprint restoration can be accomplished with a variety of repair techniques that must be matched to the extent of the tear and mobility of the tendon. PMID:24400185

Denard, Patrick J.; Burkhart, Stephen S.

2013-01-01

11

Complications after arthroscopic labral repair for shoulder instability.  

PubMed

Arthroscopic labral repair is a widely performed and safe technique for anterior or posterior shoulder instability; however, complications have been reported in the literature. Postoperative injection of local anesthetic via an intra-articular pain pump should be avoided to prevent chondrolysis of the glenohumeral joint. Postoperative stiffness of the shoulder can be treated with physiotherapy, and a surgical treatment is indicated in shoulders that failed a conservative treatment. Although nerve injury is relatively rare, the axillary nerve should be given careful attention. Recurrent shoulder instability is the most common complication after labral repair, but most reported rates of recurrent instability after arthroscopic Bankart repair are less than 10 %. Augmentations, such as rotator interval closure and Hill-Sachs remplissage, have a potential to reduce the rate of recurrence. A better understanding of these possible complications, including their pathology and treatment, is essential for optimization of outcomes after arthroscopic labral repair. PMID:25532917

Matsuki, Keisuke; Sugaya, Hiroyuki

2015-03-01

12

Humeral head osteonecrosis following arthroscopic rotator cuff repair.  

PubMed

Humeral head chondrolysis and osteonecrosis of the glenoid have been reported; however, there is no report to date about humeral head osteonecrosis following arthroscopic shoulder procedure. We report a case of osteonecrosis of the humeral head following arthroscopic rotator cuff repair what we believe is probably secondary to disruption of its blood supply after placement of multiple metallic suture anchors. The surgical records were also reviewed in an attempt to identify the cause of the humeral head osteonecrosis. PMID:20033673

Beauthier, V; Sanghavi, S; Roulot, E; Hardy, P

2010-10-01

13

Biomechanical evaluation of arthroscopic all-inside meniscus repairs.  

PubMed

Viper is a new device for arthroscopically all-inside meniscal repairing. In previous studies about Viper device, procedures were not applied arthroscopically despite this device has been designed for arthroscopic application. In this study, we evaluated primary fixation strength of arthroscopically applied meniscal repair using Viper device to obtain better clinical relevance. Two centimeter in length meniscal tear 2-3 mm far from periferic edge of medial meniscus of 50 calves were created arthroscopically. The menisci were divided into five groups including 10 menisci in each. In group 1, tears were repaired by outside-in vertical loop suture technique with No: 0 PDS. Tears were fixed by all-inside vertical suture by using Viper device with No: 0 PDS in group 2. In meniscal implant groups, RapidLoc, H-Fix, and Clearfix were applied in groups 3,4, and 5, respectively. Primary fixation strength of repairing techniques were evaluated with bio-mechanical testing machine. Fixation strengths determined in groups 1 and 2 were detected as 145 +/- 13 and 136 +/- 33 N, respectively. There was no difference in pull-out strength between groups 1 and 2. Fixation strengths in these two groups were significantly higher compared to groups 3, 4, and 5. There was no significant difference between group 3 (33 +/- 6 N) and 5 (28 +/- 6 N) in terms of fixation strengths whereas fixation strengths of these two groups were significantly higher compared to group 4 (20 +/- 3 N) (P = 0.005, P = 0.018, respectively). All-inside vertical suture technique using Viper device revealed comparable primary fixation strength with outside-in vertical suture technique for meniscal repair. We suggest that the Viper device is safe and reliable for meniscal repair. PMID:19629442

Gunes, Taner; Bostan, Bora; Erdem, Mehmet; Asci, Murat; Sen, Cengiz; Kelestemur, Mehmet Halidun

2009-11-01

14

Arthroscopic Repair of Rotator Cuff Tears Using Extracellular Matrix Graft  

PubMed Central

Despite advances in surgical technology, as well as generally good outcomes, repairs of full-thickness rotator cuff tears show a retear rate of 25% to 57% and may fail to provide full return of function. The repairs tend to fail at the suture-tendon junction, which is due to several factors, including tension at the repair site, quality of the tendon, and defective tissue repair. One strategy to augment repair of large to massive rotator cuff tears is the development of biological scaffold materials, composed of extracellular matrix (ECM). The goal is to strengthen and evenly distribute the mechanical load across the repair site, thus minimizing the rupture risk of the native tendon while providing the biological elements needed for healing. The promising results of ECM-derived materials and their commercial availability have increased their popularity among shoulder surgeons. In contrast to a traditional open or arthroscopically assisted mini-open approach, this completely arthroscopic technique offers the full advantages warranted by the use of a minimally invasive approach. This technical guide describes arthroscopic rotator cuff repair using an ECM graft technique. PMID:25276607

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

2014-01-01

15

The Factors Affecting Pain Pattern after Arthroscopic Rotator Cuff Repair  

PubMed Central

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

Kim, Chang-Wan; Kim, Dong-Gyun

2014-01-01

16

Dual-camera technique for arthroscopic rotator cuff repair.  

PubMed

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

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

2014-12-01

17

Dual-Camera Technique for Arthroscopic Rotator Cuff Repair  

PubMed Central

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

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

2014-01-01

18

The Outcome and Repair Integrity of Completely Arthroscopically Repaired Large and Massive Rotator Cuff Tears  

Microsoft Academic Search

Background: The impact of a recurrent defect on the outcome after rotator cuff repair has been controversial. The purpose of this study was to evaluate the functional and anatomic results after arthroscopic repair of large and mas- sive rotator cuff tears with use of ultrasound as an imaging modality to determine the postoperative integrity of the repair. Methods: Eighteen patients

LEESA M. GALATZ; CRAIG M. BALL; SHARLENE A. TEEFEY; WILLIAM D. MIDDLETON; KEN YAMAGUCHI

19

Arthroscopic “Interval Slide” in the Repair of Large Rotator Cuff Tears  

Microsoft Academic Search

Summary: An arthroscopic technique for coracohumeral ligament release from a retracted supraspinatus tendon is presented. The procedure is technically simple and can greatly improve the mobility of retracted rotator cuff tears, thus expanding the application of arthroscopic repair to larger tears.Arthroscopy: The Journal of Arthroscopic and Related Surgery, Vol 15, No 5 (July-August), 1999: pp 527–530

Joseph C. Tauro

1999-01-01

20

Arthroscopic Single-Row Versus Double-Row Suture Anchor Rotator Cuff Repair  

Microsoft Academic Search

Background: Recurrent defects after open and arthroscopic rotator cuff repair are common. Double-row repair techniques may improve initial fixation and quality of rotator cuff repair.Purpose: To evaluate the load to failure, cyclic displacement, and anatomical footprint of 4 arthroscopic rotator cuff repair techniques.Hypothesis: Double-row suture anchor repair would have superior structural properties and would create a larger footprint compared to

Augustus D. Mazzocca; Peter J. Millett; Carlos A. Guanche; Stephen A. Santangelo; Robert A. Arciero

2005-01-01

21

Incidence and Treatment of Postoperative Stiffness Following Arthroscopic Rotator Cuff Repair  

Microsoft Academic Search

Purpose: The purpose of this study was to determine the incidence of clinically significant postoperative stiffness following arthroscopic rotator cuff repair. This study also sought to determine the clinical and surgical factors that were associated with higher rates of postoperative stiffness. Finally, we analyzed the result of arthroscopic lysis of adhesions and capsular release for treatment of patients who developed

David P. Huberty; John D. Schoolfield; Paul C. Brady; Antonio P. Vadala; Paolo Arrigoni; Stephen S. Burkhart

2009-01-01

22

Arthroscopic Rotator Interval Repair in Glenohumeral Instability: Description of an Operative Technique  

Microsoft Academic Search

Summary: Rotator interval tear is one of the lesions identified in patients with glenohumeral instability. We present our technique for arthroscopic repair that eliminates entry into the subacromial space and allows the surgeon to suture the rotator interval under direct intra-articular vision.Arthroscopy: The Journal of Arthroscopic and Related Surgery, Vol 15, No 3 (April), 1999: pp 330–332

Gary M. Gartsman; Ettore Taverna; Steven M. Hammerman

1999-01-01

23

Outcomes of arthroscopic Bankart repair in collision versus noncollision athletes.  

PubMed

The purpose of the study was to compare the recurrence rate of arthroscopic Bankart repair with suture anchors in collision vs noncollision athletes. Sixty-four patients who underwent arthroscopic shoulder stabilization using suture anchors for recurrent anterior dislocation were identified. Forty-three patients (22 collision and 21 noncollision) were evaluated at a minimum 24-month follow-up. The recurrence rate was reported, and functional outcomes (American Shoulder and Elbow Society, Western Ontario Shoulder Index, and Short Form 12) were evaluated. Statistical analysis was performed using chi-square test and Student's t test with a 95% confidence interval and a significance level set at a P value less than .05. The overall dislocation recurrence rate was 4.6% (2 of 43 patients); the dislocation recurrence rate in collision athletes was 9% (2 of 22 patients), and no redislocations occurred in noncollision athletes. No statistical differences existed in Western Ontario Shoulder Index score (73.5% in collision and 73.4% in noncollision athletes; P=.831), American Shoulder and Elbow Society score (91.2 in collision and 80.7 in noncollision athletes; P=.228), and Short Form 12 score (108.5 in collision and 101.2 in noncollision athletes; P=.083). Average external rotation loss was 6.8° in collision and 5.5° in noncollision athletes (P=.864). Ninety percent of collision athletes vs 95% of noncollision athletes were satisfied. Seventy-three percent of collision and 81% of noncollision athletes were able to return to sport at their preinjury levels. Collision athletes had higher recurrence rates after arthroscopic shoulder stabilization compared with noncollision athletes, but no statistical difference was found. Functional outcomes according to American Shoulder and Elbow Society, Western Ontario Shoulder Index, and Short Form 12 were similar. PMID:23672915

Petrera, Massimo; Dwyer, Tim; Tsuji, Matthew R S; Theodoropoulos, John S

2013-05-01

24

Arthroscopic repair of massive rotator cuff tears: A prospective cohort with 2- to 4-year follow-up  

Microsoft Academic Search

Purpose: The goal of this study is to report on the complete arthroscopic repair of massive rotator cuff tears. Type of Study: Prospective cohort study. Methods: Between 1997 and 1999, 37 patients underwent complete arthroscopic repair of massive rotator cuff tears. The preoperative and postoperative outcomes of these 37 patients were analyzed using the constant score, American Shoulder and Elbow

William F. Bennett

2003-01-01

25

Arthroscopic repair of massive, contracted, immobile rotator cuff tears using single and double interval slides: technique and preliminary results  

Microsoft Academic Search

Purpose: The purpose of this study is to describe the technique and review the preliminary results of arthroscopic repair of massive, contracted, immobile rotator cuff tears using an interval slide technique. Type of Study: Case series. Methods: From January 1999 to December 2000, the senior author (S.S.B.) performed arthroscopic rotator cuff repair on 94 massive rotator cuff tears. Of these,

Ian K. Y Lo; Stephen S Burkhart

2004-01-01

26

Efficacy of arthroscopically placed pain catheter adjacent to the suprascapular nerve (continuous arthroscopically assisted suprascapular nerve block) following arthroscopic rotator-cuff repair  

PubMed Central

Background Rotator-cuff surgery is well recognized to be a painful procedure. Objectives The purpose of this study was to examine the effectiveness of an arthroscopically placed perineural catheter at the scapular notch to provide a continuous block of the suprascapular nerve (continuous arthroscopically assisted suprascapular nerve block [ca-SSNB]) following arthroscopic rotator-cuff repair (ARCR). Materials and methods This level II, prospective, randomized, controlled trial without postoperative blinding included 40 patients, who had a 48-hour pain pump, with 0.2% ropivacaine infusion and a continuous rate of 3 mL/hour, placed via an arthroscopically placed catheter following ARCR with arthroscopic release of the superior transverse ligament: 21 patients had a ca-SSNB, and 19 patients had a continuous subacromial bursal block (SAB). The visual analog scale (at 6 hours and on the first, second, and third postoperative days) and the total number of additional pain-reduction attempts during the 3 postoperative days were calculated. Results The respective visual analog scale scores (mm) obtained from the ca-SSNB and SAB groups were 62.4 and 67.6 (P=0.73) before surgery, 9.1 and 19.4 (P=0.12) at 6 hours after surgery, 24.4 and 44.6 (P=0.019) on the first postoperative day, 19.4 and 40.4 (P=0.0060) on the second postoperative day, and 18.5 and 27.8 (P=0.21) on the third postoperative day. Total additional pain-reduction attempts recorded for the ca-SSNB and SAB groups during the 3 postoperative days were 0.3 times and 1.2 times (P=0.0020), respectively. Conclusion ca-SSNB was highly effective in controlling postoperative pain after ARCR. PMID:24982592

Yamakado, Kotaro

2014-01-01

27

Arthroscopic repair of large rotator cuff tears using the interval slide technique  

Microsoft Academic Search

Purpose: In some cases of larger and chronic rotator cuff tears, the supraspinatus tendon may be held in a retracted position by the contracted tissue of the rotator interval and the attached coracohumeral ligament. This study was performed to evaluate the utility and clinical effectiveness of an arthroscopic release of the rotator interval from the supraspinatus tendon combined with repair

Joseph C Tauro

2004-01-01

28

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

PubMed Central

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

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

2013-01-01

29

Functional evaluation of patient after arthroscopic repair of rotator cuff tear  

PubMed Central

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.

Kumar, Rohit; Jadhav, Umesh

2014-01-01

30

Arthroscopic Bankart Repair: Accessory Posterior Portal With Slotted Cannula for Lowest Capsulolabral Access  

PubMed Central

We present a novel technique for safe establishment of the accessory posterior portal using a slotted cannula. Arthroscopic Bankart repair is a common procedure. A variety of arthroscopic techniques have been described in the literature, commonly using the posterior portal for visualization and the anterior portal with a working cannula. The accessory posterior portal enables elegant access to the lower part of the capsulolabral junction, a firmer grasp and mobilization of the tissue, quick and easy tool exchange using a slotted cannula, and clearer suture placement because of the flat, direct working angle. The skin incision is made small without the need for an arthroscopic cannula, and the portal location is in a relatively safe zone. The use of the accessory posterior portal along with a slotted cannula shortens the duration of the operative procedure and improves safety and performance. PMID:25126512

Tsvieli, Oren; Atoun, Ehud; Amar, Eyal; Levy, Ofer; Rath, Ehud

2014-01-01

31

Glenoid damage from articular protrusion of metal suture anchor after arthroscopic rotator cuff repair.  

PubMed

Arthroscopic repair of rotator cuff tears has been shown to be effective and safe. The use of suture anchors has increased the ability to perform rotator cuff repairs arthroscopically. However, the use of suture anchors for any surgery around the shoulder can result in complications if the devices are not used and inserted properly. Complications that have been reported with the use of suture anchors for rotator cuff surgery include prominent anchors in the tuberosities, dislodged anchors secondary to pull-out or improper insertion, and osteolysis around the anchors. We report a case of articular cartilage damage secondary to a suture anchor protruding through the humeral head because of improper anchor insertion. Our patient's case reminds surgeons not only to be careful of the depth of insertion of suture anchors when performing rotator cuff surgery but also to obtain radiographs to evaluate the anchor position if patients continue to have symptoms after rotator cuff repair using these devices. PMID:25750956

Kim, Yang-Soo; Ok, Ji-Hoon; Garzon-Muvdi, Juan; McFarland, Edward G

2015-03-01

32

Arthroscopic Double-Row Anterior Stabilization and Bankart Repair for the “High-Risk” Athlete  

PubMed Central

In addition to operative intervention for the patient with recurrent shoulder instability, current literature suggests that younger athletic patients unwilling to modify their activities may benefit from an early surgical shoulder stabilization procedure. Although open shoulder stabilization clearly has a role to play in some cases, we believe that further optimization of arthroscopic fixation techniques may allow us to continue to refine the indications for open stabilization. In particular, when an arthroscopic approach is used for capsulolabral repair in relatively high-risk groups, it may be beneficial to use a double-row repair technique. We describe our technique for shoulder stabilization through double-row capsulolabral repair of a soft-tissue Bankart lesion in the high-risk patient with shoulder instability or the patient with a small osseous Bankart lesion. PMID:24749044

Moran, Cathal J.; Fabricant, Peter D.; Kang, Richard; Cordasco, Frank A.

2014-01-01

33

Arthroscopic versus mini-open salvage repair of the rotator cuff tear: outcome analysis at 2 to 6 years’ follow-up  

Microsoft Academic Search

Purpose: The purpose of this study was to compare the outcomes of arthroscopic repair of medium and large rotator cuff tears with the outcomes for mini-open repair of similar tears in which arthroscopic repair was technically unsuccessful. Type of Study: Retrospective case series. Methods: We evaluated 76 patients who were treated for full-thickness rotator cuff tears either by all-arthroscopic (42

Seung-Ho Kim; Kwon-Ick Ha; Jong-Hyuk Park; Jin-Seok Kang; Sung-Kyun Oh; Irvin Oh

2003-01-01

34

The Global Percutaneous Shuttling Technique Tip for Arthroscopic Rotator Cuff Repair  

PubMed Central

Most arthroscopic rotator cuff repairs utilize suture passing devices placed through arthroscopic cannulas. These devices are limited by the size of the passing device where the suture is passed through the tendon. An alternative technique has been used in the senior author’s practice for the past ten years, where sutures are placed through the rotator cuff tendon using percutaneous passing devices. This technique, dubbed the global percutaneous shuttling technique of rotator cuff repair, affords the placement of sutures from nearly any angle and location in the shoulder, and has the potential advantage of larger suture bites through the tendon edge. These advantages may increase the area of tendon available to compress to the rotator cuff footprint and improve tendon healing and outcomes. The aim of this study is to describe the global percutaneous shuttling (GPS) technique and report our results using this method. The GPS technique can be used for any full thickness rotator cuff tear and is particularly useful for massive cuff tears with poor tissue quality. We recently followed up 22 patients with an average follow up of 32 months to validate its usefulness. American Shoulder and Elbow Surgeons scores improved significantly from 37 preoperatively to 90 postoperatively (P<0.0001). This data supports the use of the GPS technique for arthroscopic rotator cuff repair. Further biomechanical studies are currently being performed to assess the improvements in tendon footprint area with this technique. PMID:25002932

Vopat, Bryan G.; Murali, Jothi; Gowda, Ashok L.; Kaback, Lee; Blaine, Theodore

2014-01-01

35

Analysis of the functional results of arthroscopic Bankart repair in posttraumatic recurrent anterior dislocations of shoulder  

PubMed Central

Background: The Bankart lesion represents the most common form of labro-ligamentous injury in patients with traumatic dislocations of the shoulder leading to shoulder instability. We report the clinical outcome of arthroscopic repair of Bankart lesion in 50 patients. Materials and Methods: Sixty five patients with posttraumatic anterior dislocation of shoulder were treated by arthroscopic repair from Jan 2005 to Nov 2008. Fifty patients, with an average age of 26.83 years (range 18-45 years), were reviewed in the study. The average followup period was 27 months (range 24-36 months). University of California Los Angeles shoulder rating scale was used to determine the outcome after surgery. The recurrence rates, range of motion, as well as postoperative function and return to sporting activities were evaluated. Results: Thirty six patients (72.0%) had excellent results, whereas seven patients (14.0%) had good results. The mean pre- and postoperative range of external rotation was 80.38° and 75.18°, respectively. Eighty-six percent patients had stability compared with the normal sided shoulder and were able to return to sports. There were no cases of redislocation observed in this study; however, three cases had mild laxity of the joint. Conclusion: Arthroscopic Bankart repair with the use of suture anchors is a reliable treatment method, with good clinical outcomes, excellent postoperative shoulder motion and low recurrence rates. PMID:23325970

Mishra, Amit; Sharma, Pulak; Chaudhary, Deepak

2012-01-01

36

Factors affecting healing after arthroscopic rotator cuff repair  

PubMed Central

Rotator cuff repair has been shown to have good long-term results. Unfortunately, a significant proportion of repairs still fail to heal. Many factors, both patient and surgeon related, can influence healing after repair. Older age, larger tear size, worse muscle quality, greater muscle-tendon unit retraction, smoking, osteoporosis, diabetes and hypercholesterolemia have all shown to negatively influence tendon healing. Surgeon related factors that can influence healing include repair construct-single vs double row, rehabilitation, and biologics including platelet rich plasma and mesenchymal stem cells. Double-row repairs are biomechanically stronger and have better healing rates compared with single-row repairs although clinical outcomes are equivalent between both constructs. Slower, less aggressive rehabilitation programs have demonstrated improved healing with no negative effect on final range of motion and are therefore recommended after repair of most full thickness tears. Additionally no definitive evidence supports the use of platelet rich plasma or mesenchymal stem cells regarding improvement of healing rates and clinical outcomes. Further research is needed to identify effective biologically directed augmentations that will improve healing rates and clinical outcomes after rotator cuff repair.

Abtahi, Amir M; Granger, Erin K; Tashjian, Robert Z

2015-01-01

37

Factors affecting healing after arthroscopic rotator cuff repair.  

PubMed

Rotator cuff repair has been shown to have good long-term results. Unfortunately, a significant proportion of repairs still fail to heal. Many factors, both patient and surgeon related, can influence healing after repair. Older age, larger tear size, worse muscle quality, greater muscle-tendon unit retraction, smoking, osteoporosis, diabetes and hypercholesterolemia have all shown to negatively influence tendon healing. Surgeon related factors that can influence healing include repair construct-single vs double row, rehabilitation, and biologics including platelet rich plasma and mesenchymal stem cells. Double-row repairs are biomechanically stronger and have better healing rates compared with single-row repairs although clinical outcomes are equivalent between both constructs. Slower, less aggressive rehabilitation programs have demonstrated improved healing with no negative effect on final range of motion and are therefore recommended after repair of most full thickness tears. Additionally no definitive evidence supports the use of platelet rich plasma or mesenchymal stem cells regarding improvement of healing rates and clinical outcomes. Further research is needed to identify effective biologically directed augmentations that will improve healing rates and clinical outcomes after rotator cuff repair. PMID:25793161

Abtahi, Amir M; Granger, Erin K; Tashjian, Robert Z

2015-03-18

38

An Augmentation Suture Technique for Arthroscopic Rotator Cuff Repair  

PubMed Central

The double-row suture technique and the suture-bridge technique have been used for rotator cuff repair to decrease the occurrence of retears. However, when only the degenerated tendon end is sutured, the risk of retear remains. The augmentation suture technique is a new procedure that connects the intact medial tendon to the lateral greater tuberosity, and this approach may protect the initial repair site. The procedures for this technique are as follows: 2 sutures are placed through the medial intact tendon, the cuff tear is repaired by the single-row technique, 2 sutures are pulled laterally over the single-row repair site, and 2 sutures are fixed at the lateral greater tuberosity with a push-in–type anchor. This technique is simple and easy and does not require special equipment. Moreover, this approach can augment the single-row repair technique without creating high tension at the cuff end. PMID:25126493

Omae, Hiromichi; Yamamoto, Susumu; Mochizuki, Yu; Ochi, Mitsuo

2014-01-01

39

Early outcome of arthroscopic Bankart's repair for recurrent traumatic anterior shoulder instability  

PubMed Central

Background/objectives Despite the improvements in the methods of arthroscopic stabilization of anterior shoulder instability, a recurrence rate of as high as 30% is reported in the literature. In this context, we report the outcome of arthroscopic Bankart repair in anterior shoulder instability, with the use of bio-absorbable suture anchors for patients that were followed up for at least two years from the date of surgery. The arthroscopic method offers a less invasive technique of Bankart repair for traumatic anterior shoulder instability. We would like to report the 2-year clinical outcomes of bio-absorbable suture anchors used in traumatic anterior dislocations of the shoulder. Methods Data from 79 shoulders in 74 patients were collected over 4 years (2005–2009). Each patient was followed up over a period of 2 years. The patients underwent arthroscopic Bankart repair using bio-absorbable suture anchors for their anterior shoulder instability. These surgeries were performed at a single institution by a single surgeon over the time period. The patients were assessed with two different outcome measurement tools. The University of California at Los Angeles (UCLA) shoulder rating scale and the Simple Shoulder Test (SST) score. The scores were calculated before surgery and at the 2-year follow-up. The recurrence rates, range of motion as well post-operative function and return to sporting activities were evaluated. Results SST results from the 12 domains showed a significant improvement from a mean of 6.1 ± 3.1 to 11.1 ± 1.8 taken at the 2-year follow-up (p < 0.0001). Data from the UCLA scale showed a pre and post-operative mean of 20.2 ± 5.0 and 32.4 ± 4.6 respectively (p < 0.0001). 34 had excellent post-operative scores, 35 had good scores, 1 had fair score and 3 had poor scores. 75% of the patients returned to sports while 7.6% developed a recurrence of shoulder dislocation or subluxation. Conclusion Arthroscopic Bankart repair with the use of suture anchors is a reliable treatment method, with good clinical outcomes, excellent post-operative shoulder motion and low recurrence rates.

Saccomanni, Bernardino

2013-01-01

40

Arthroscopic management of recalcitrant stiffness following rotator cuff repair: A retrospective analysis  

PubMed Central

Background: Rotator cuff repair surgery is one of the most commonly performed procedures in the world but limited literature exists for guidance of optimal management of post-operative arthrofibrosis following cuff repair. The purpose of this study is to report the results of arthroscopic capsular release, lysis of adhesions, manipulation under anesthesia, and aggressive physical therapy in patients with recalcitrant postoperative stiffness after rotator cuff repair. Materials and Methods: Twenty-nine patients who had recalcitrant arthrofibrosis following either an arthroscopic (62%), open (28%), or mini-open (10%) rotator cuff repair were included in study. The average age at the time of index cuff repair surgery was 49.8 years (range 24?70 years). Sixteen patients (55%) were involved in worker's compensation claims. The mean time from the date of index operation to lysis of adhesions was 9.7 months (range 4.2?36.2 months), and the mean time from lysis of adhesion to most recent follow-up 18.2 months (range 4.1?43.7 months). Post-operative evaluation was performed using American Shoulder and Elbow Surgeons Score (ASES), Visual Analog Score (VAS), Single Assessment Numeric Evaluation (SANE), and Simple Shoulder Test (SST) on 18 (62%), while range of motion (ROM), dynamometer strength testing, and Constant-Murley Scoring were performed on 13 (45%). Statistical analysis was performed using a Student's t-test. Results: Prior to arthroscopic lysis of adhesions, mean forward active elevation (FE) was 103.8°, (range 60-145° (SD 26.3) and external rotation at the side (ERS) was 25.3°, (range 5-70° SD 15.1°). Post-operatively, at the most recent follow-up, FE was significantly improved to 158.3°, (range 110?180° SD 22.3°), and ERS improved to 58.9°, (range 15?90° SD 18.6°) in both cases. Involvement in a worker's compensation claim resulted in a lower ASES, VAS, and SANE score, but there was no statistically significant difference in motion. Conclusion: Arthroscopic capsular release, lysis of adhesions, and manipulation under anesthesia is a safe, reliable method of treating persistent stiffness following rotator cuff repair. PMID:23682175

Bhatia, Sanjeev; Mather, Richard C; Hsu, Andrew R; Ferry, Amon T; Romeo, Anthony A; Nicholson, Gregory P; Cole, Brian J; Verma, Nikhil N

2013-01-01

41

Arthroscopic Lateral Meniscus Root Repair With Soft Suture Anchor Technique  

PubMed Central

Meniscus root tear leads to circumferential hoop tension loss and increases femorotibial contact force, which causes irreversible cartilage degeneration. Biomechanical studies have shown that meniscus root repair provides better femorotibial contact force than meniscectomy. Many techniques for meniscus root repair have been published in recent years. The soft suture anchor is widely used in the glenoid labral repair. It is a small low-profile soft anchor. This article presents a new and simple technique of lateral meniscus root repair using the small soft anchor, which results in an anatomic and more vertical anchor position. It avoids instrument-related complications, such as cartilage delamination, material reaction, metal retention, and hard suture anchor pullout. PMID:24892012

Prasathaporn, Niti; Kuptniratsaikul, Somsak; Kongrukgreatiyos, Kitiphong

2013-01-01

42

Transtendon, Double-Row, Transosseous-Equivalent Arthroscopic Repair of Partial-Thickness, Articular-Surface Rotator Cuff Tears  

PubMed Central

Arthroscopic transtendinous techniques for the arthroscopic repair of partial-thickness, articular-surface rotator cuff tears offer the advantage of minimizing the disruption of the patient's remaining rotator cuff tendon fibers. In addition, double-row fixation of full-thickness rotator cuff tears has shown biomechanical advantages. We present a novel method combining these 2 techniques for transtendon, double-row, transosseous-equivalent arthroscopic repair of partial-thickness, articular-surface rotator cuff tears. Direct visualization of the reduction of the retracted articular tendon layer to its insertion on the greater tuberosity is the key to the procedure. Linking the medial-row anchors and using a double-row construct provide a stable repair that allows early shoulder motion to minimize the risk of postoperative stiffness. PMID:25473606

Dilisio, Matthew F.; Miller, Lindsay R.; Higgins, Laurence D.

2014-01-01

43

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

PubMed

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

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

2014-10-01

44

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

PubMed

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

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

2014-01-01

45

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

PubMed Central

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

Denard, Patrick J.; Burkhart, Stephen S.

2012-01-01

46

Arthroscopic transtendinous repair of articular-sided pasta (partial articular supraspinatus tendon avulsion) injury  

PubMed Central

Objective: To evaluate clinical efficacy of arthroscopic transtendinous repair of partial articular-sided PASTA (partial articular supraspinatus tendon avulsion) injury. Methods: From February 2011 to July 2014, 12 cases of PASTA, aged 29 to 72 years with an average of 52.9 ± 13.3 years, were treated arthoscopically. To repair PASTA, articular-sided rotator cuff tear was explored, injury site was punctured and labeled with PDS absorbable monofilament suture (Ethicon, Somerville, NJ, USA) suture, subacromial bursa was cleaned up with acromioplasty, and integrity of bursa-side rotator cuff was assessed. Then with arthroscope in glenohumeral joint, footprint of the bursa-side supraspinatus tendon was preserved, rivets were introduced into the joint through supraspinatus tendon, joint-side partial tear was sutured, and anatomical reconstruction of the rotator cuff footprint was established. The patients were followed up post-operatively for 12-36 months, average 22 ± 7.3 months. The clinical outcomes were emulated with ASES (American Shoulder and Elbow Surgeons) Shoulder Score system and UCLA (University of California at Los Angeles) Shoulder rating scale. Results: The post-operative ASES score was 89.7 ± 5.6, higher than the pre-operative one 49.8 ± 9.8 (t = 12.25, P <0.0001). While UCLA scale increased from the pre-operative 17.3, ± 3.3 to the post-operative 30.4 ± 3.2 points (t = 9.87, P <0.0001), with a satisfaction rate of 11/12 (91.7%). Conclusion: Trans-tendon repair is ideal for PASTA with advantage of maximal preservation of the normal rotator cuff tissue, anatomical reconstruction of the rotator cuff footprint and stable fixation of tendon-bone interface. PMID:25784979

Wang, Yi; Lu, Liangyu; Lu, Zhe; Xiao, Lei; Kang, Yifan; Wang, Zimin

2015-01-01

47

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

PubMed Central

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

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

2012-01-01

48

Arthroscopic repair of medium to large full-thickness rotator cuff tears: Outcome at 2- to 6-year follow-up  

Microsoft Academic Search

Medium-term follow-up of arthroscopic rotator cuff repair was evaluated in 48 consecutive arthroscopic repairs of medium to large rotator cuff tears. Mean rotator cuff tear size was 2.4 cm (range, 2-4 cm), mean age at surgery was 57.6 years (range, 38-80 years), and mean follow-up was 39 months (range, 24-66 months). Mean University of California at Los Angeles End-Result Scores

Thomas F Murray; Georg Lajtai; Robert M Mileski; Stephen J Snyder

2002-01-01

49

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

PubMed

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

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

2014-01-01

50

All-Arthroscopic Knotless Suture Anchor Repair of Triangular Fibrocartilage Complex Fovea Tear by the 2-Portal Technique  

PubMed Central

After the importance of the deep fiber of the distal radioulnar ligament had been acknowledged, some repair techniques have been introduced. Because the knotless suture anchor does not cause any knot irritation and yields appropriate tension, it is a useful fixation material. All-arthroscopic knotless suture anchor repair of the triangular fibrocartilage complex fovea tear by a 2-portal technique is easier and less vulnerable to ulnar nerve injury than the original Geissler technique. Instead of the suture hook and accessory portal, this technique uses the always-sharp 18-gauge needle and percutaneous route. This change results in the repair of the complex fovea tear having the smallest possible remnant tissue. Repair of triangular fibrocartilage complex fovea tears combined type IB, ID, and IIC tears can reduce the chance of needing to perform distal radioulnar ligament reconstruction. PMID:25685672

Park, Yongcheol

2014-01-01

51

Arthroscopic Repair of Inferior Labrum From Anterior to Posterior Lesions Associated With Multidirectional Instability of the Shoulder  

PubMed Central

Multidirectional instability (MDI) of the shoulder may arise spontaneously; however, recent evidence suggests that traumatic events may play a role in this syndrome. Variable degrees of injury around the circumference of the glenoid have been reported, ranging from Bankart and Kim lesions to 270° of injury and even 360° of injury. Hyperabduction injury may cause inferior subluxation of the shoulder and result in traumatic isolated injury to the inferior labrum from anterior to posterior. This particular lesion spans approximately 180° of the inferior hemisphere and may lead to symptomatic MDI. In contrast to open or arthroscopic plication procedures for atraumatic MDI without labral injury, the goal in these cases is anatomic arthroscopic repair of the inferior labrum tear without the need for capsular plication, volume reduction, or rotator interval closure. PMID:25685683

Burt, David M.

2014-01-01

52

Effectiveness of Subacromial Anti-Adhesive Agent Injection after Arthroscopic Rotator Cuff Repair: Prospective Randomized Comparison Study  

PubMed Central

Background Arthroscopic rotator cuff repair generally has a good clinical outcome but shoulder stiffness after surgery due to subacromial adhesion is one of the most common and clinically important complications. Sodium hyaluronate (HA) has been reported to be an anti-adhesive agent in a range of surgical procedures. However, there are few reports of the outcomes of arthroscopic rotator cuff repair of the shoulder. This study examined whether a subacromial injection of HA/carboxymethylated cellulose (CMC) affected the postoperative shoulder stiffness and healing of rotator cuff repair, as well as the safety of an injection. Methods Between January 2008 and May 2008, 80 consecutive patients with arthroscopic rotator cuff repair were enrolled. The patients were assigned randomly to the HA/CMC injection group (n = 40) or control group (n = 40). All patients were evaluated using the visual analog scale (VAS) for pain, passive range of motion at 2, 6 weeks, 3, 6, 12 months after surgery, and the functional scores at 6, 12 months postoperatively. Cuff healing was also evaluated using CT arthrography or ultrasonography at 6 or 12 months after surgery. Results The HA/CMC injection group showed faster recovery of forward flexion at 2 weeks postoperatively than the control group but the difference was not statistically significant (p = 0.09). There were no significant difference in pain VAS, internal rotation, external rotation and functional scores between two groups at each follow-up period. The functional scores improved 6 months after surgery in both groups but there were no differences between the two groups. The incidence of unhealed rotator cuff was similar in the two groups. There were no complications related to an injection of anti-adhesive agents including wound problems or infections. Conclusions A subacromial injection of an anti-adhesive agent after arthroscopic rotator cuff repair tended to produce faster recovery in forward flexion with no adverse effects on cuff healing. However, its anti-adhesive effects after rotator cuff repair should be considered carefully with further studies. PMID:21369479

Oh, Chung Hee; Oh, Joo Han; Kim, Sae Hoon; Cho, Jae Hwan; Yoon, Jong Pil

2011-01-01

53

Do nonsteroidal anti-inflammatory drugs affect the outcome of arthroscopic Bankart repair?  

PubMed Central

To achieve pain control after arthroscopic shoulder surgery, nonsteroidal anti-inflammatory drugs (NSAIDs) are a complement to other analgesics. However, experimental studies have raised concerns that these drugs may have a detrimental effect on soft tissue-to-bone healing and, thus, have a negative effect on the outcome. We wanted to investigate if there are any differences in the clinical outcome after the arthroscopic Bankart procedure for patients who received NSAIDs prescription compared with those who did not. 477 patients with a primary arthroscopic Bankart procedure were identified in the Norwegian shoulder instability register and included in the study. 32.5% received prescription of NSAIDs post-operatively. 370 (78%) of the patients answered a follow-up questionnaire containing the Western Ontario Shoulder Instability index (WOSI). Mean follow-up was 21 months. WOSI at follow-up were 75% in the NSAID group and 74% in the control group. 12% of the patients in the NSAID group and 14% in the control group reported recurrence of instability. The reoperation rate was 5% in both groups. There were no statistically significant differences between the groups. Prescription of short-term post-operative NSAID treatment in the post-operative period did not influence on the functional outcome after arthroscopic Bankart procedures. PMID:24750379

Blomquist, J; Solheim, E; Liavaag, S; Baste, V; Havelin, L I

2014-01-01

54

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

PubMed Central

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

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

2014-01-01

55

A Novel Arthroscopic Inside-Out Repair Technique for PASTA Lesions  

PubMed Central

There is no current consensus in the literature on the optimal technique for surgical treatment of partial articular-sided supraspinatus tendon avulsion (PASTA) lesions, although most techniques described to date require takedown of the partially torn tendon or passage of an anchor through the already damaged tendon. We describe a novel inside-out repair technique for partial articular surface supraspinatus tears that does not require further disruption of the partially torn tendon by passage of an anchor. PMID:25473607

Caldwell, Lindsey S.; Cooper, Anna R.; Elfar, John C.

2014-01-01

56

Arthroscopic Repair of Chronic Bony Bankart Lesion Using a Low Anterior Portal  

PubMed Central

We describe the repair of a chronic bony Bankart lesion in a case with recurrent instability using standard techniques and equipment for addressing anteroinferior glenohumeral instability. A 25-year-old man with recurrent instability and a chronic bony Bankart lesion with a Hill-Sachs lesion was treated. The inferior 2 sutures and knotless anchors are placed through a low anterior portal, which improves the angle of approach to the inferior portion of the glenoid that is fractured. The knotless anchors are impacted through the low anterior portal, just superior to the level of the suture, as the fragment tends to retract medially and inferiorly, with the drill guide slightly on the face of the glenoid. The superior-anterior portal adjacent to the biceps tendon gives a better view of the glenoid articular cartilage position of the anchors required to restore the anatomic location of the fracture fragment. The low anterior portal improved and simplified the reduction of the fracture fragment to the glenoid neck by allowing access to the anterior-inferior bony Bankart lesion that was repairable with suture and knotless anchors using standardized techniques. PMID:23766999

Brand, Jefferson C.; Westerberg, Paul

2012-01-01

57

An arthroscopic stitch for massive rotator cuff tears: the mac stitch  

Microsoft Academic Search

Arthroscopic repair of rotator cuff tears has become popular with the advancement in technology and arthroscopic technique. As we attempt to arthroscopically repair larger rotator cuff tears, we are relying more on tissue fixation. The tendon–suture interface has been recognized as the weak link in rotator cuff repair. In this article, we propose the use of the Mac stitch—a simple

John D. MacGillivray; C. Benjamin Ma

2004-01-01

58

Arthroscopic Debridement and Acromioplasty Versus Mini-Open Repair in the Treatment of Significant Partial-Thickness Rotator Cuff Tears  

Microsoft Academic Search

Summary: Partial tears of the rotator cuff, especially of the articular side, have received attention only with the recent ability of magnetic resonance imaging (MRI) and arthroscopy to diagnose these lesions. Several early reports showed nearly 100% success in managing these lesions with arthroscopic debridement with or without acromioplasty. This series compares 32 patients with significant partial-thickness rotator cuff tears

Stephen C. Weber

1999-01-01

59

Comparison between open and arthroscopic-assisted foveal triangular fibrocartilage complex repair for post-traumatic distal radio-ulnar joint instability.  

PubMed

The aim of this study was to assess the objective and subjective functional outcomes after foveal reattachment of proximal or complete ulnar-sided triangular fibrocartilage complex lesions by two surgical procedures: an open technique or an arthroscopically assisted repair. The study was done prospectively on 49 wrists affected by post-traumatic distal radio-ulnar joint instability. Twenty-four patients were treated with the open technique (Group 1) and 25 by the arthroscopically assisted technique (Group 2). Magnetic resonance imaging demonstrated a clear foveal detachment of the triangular fibrocartilage complex in 67% of the cases. Arthroscopy showed a positive ulnar-sided detachment of the triangular fibrocartilage complex (positive hook test) in all cases. Distal radio-ulnar joint stability was obtained in all but five patients at a mean follow-up of 6 months. Both groups had improvement of all parameters with significant differences in wrist pain scores, Mayo wrist score, Disability of the Arm, Shoulder and Hand questionnaire and Patient-Rated Wrist/Hand Evaluation questionnaire scores. There were no significant post-operative differences between the two groups in the outcome parameters except for the Disability of the Arm Shoulder and Hand questionnaire score, which was significantly better in Group 2 (p < 0.001). PMID:23962870

Luchetti, R; Atzei, A; Cozzolino, R; Fairplay, T; Badur, N

2014-10-01

60

Evaluation of the Instability Severity Index Score and the Western Ontario Shoulder Instability Index as predictors of failure following arthroscopic Bankart repair.  

PubMed

In this study we evaluated whether the Instability Severity Index Score (ISIS) and the Western Ontario Shoulder Instability Index (WOSI) could detect those patients at risk of failure following arthroscopic Bankart repair. Between April 2008 and June 2010, the ISIS and WOSI were recorded pre-operatively in 110 patients (87 male, 79%) with a mean age of 25.1 years (16 to 61) who underwent this procedure for recurrent anterior glenohumeral instability. A telephone interview was performed two-years post-operatively to determine whether patients had experienced a recurrent dislocation and whether they had returned to pre-injury activity levels. In all, six (5%) patients had an ISIS > 6 points (0 to 9). Of 100 (91%) patients available two years post-operatively, six (6%) had a recurrent dislocation, and 28 (28%) did not return to pre-injury activity. No patient who dislocated had an ISIS > 6 (p = 1.0). There was no difference in the mean pre-operative WOSI in those who had a re-dislocation and those who did not (p = 0.99). The pre-operative WOSI was significantly lower (p = 0.02) in those who did not return to pre-injury activity, whereas the ISIS was not associated with return to pre-injury activity (p = 0.13). In conclusion, neither the pre-operative ISIS nor WOSI predicted recurrent dislocation within two years of arthroscopic Bankart repair. Patients with a lower pre-operative WOSI were less likely to return to pre-injury activity. PMID:25452374

Bouliane, M; Saliken, D; Beaupre, L A; Silveira, A; Saraswat, M K; Sheps, D M

2014-12-01

61

Arthroscopic tennis elbow release.  

PubMed

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

Savoie, Felix H; O'Brien, Michael J

2015-01-01

62

ORV Arthroscopic Reduction and Internal Fixation of Tibial Eminence Fractures  

PubMed Central

Tibial eminence fractures are an uncommon but well-described avulsion of the anterior cruciate ligament. Treatment principles are based on the amount and pattern of fracture displacement. Management has evolved from closed reduction and immobilization to arthroscopic reduction and internal fixation followed by early rehabilitation. Various fixation methods have evolved, ranging from arthroscopic reduction and percutaneous screw fixation to arthroscopic suture repair. We present a technique for arthroscopic reduction and internal fixation using a cannulated drill bit and high-strength suture. This technique facilitates anatomic reduction with uncomplicated tunnel placement and suture passing in an effort to allow strong fixation and early rehabilitation. PMID:24400179

Myer, Daniel M.; Purnell, Gregory J.; Caldwell, Paul E.; Pearson, Sara E.

2013-01-01

63

Arthroscopic Treatment of Calcific Tendonitis  

PubMed Central

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

Barber, F. Alan; Cowden, Courtney H.

2014-01-01

64

Arthroscopic Anterior Shoulder Stabilization of Collision and Contact Athletes  

Microsoft Academic Search

Background:Repair of the anterior labrum (Bankart lesion) with tightening of the ligaments (capsulorrhaphy) is the recommended treatment for recurrent anterior glenohumeral dislocations. Current evidence suggests that arthroscopic anterior stabilization methods yield similar failure rates for resubluxation and redislocation when compared to open techniques.Study Design:Case series; Level of evidence, 4Purpose:To examine the results of arthroscopic anterior shoulder stabilization of high-demand collision

Augustus D. Mazzocca; Fred M. Brown; Dominic S. Carreira; Jennifer Hayden; Anthony A. Romeo

2005-01-01

65

Arthroscopic removal of bullet fragments from the subacromial space of the shoulder  

Microsoft Academic Search

This article describes a case of arthroscopic removal of a bullet fragment from the subacromial space. The bullet tore the rotator cuff and imbedded itself on the inferior surface of the acromion, producing pain and impingement. The bullet was removed, and the rotator cuff repaired arthroscopically. The patient noted complete relief of pain and improved range of motion.

Fernando Otero; Esteban Cuartas

2004-01-01

66

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

PubMed Central

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

Aydin, Nuri; Sirin, Evrim; Arya, Alp

2014-01-01

67

Arthroscopic repair of meniscus tears extending into the avascular zone with or without anterior cruciate ligament reconstruction in patients 40 years of age and older  

Microsoft Academic Search

Purpose: The purpose of this study was to prospectively determine the outcome of meniscal repairs for tears that extended into the central one-third zone of the meniscus, or had a rim width of 4 mm or greater, in a case series of patients 40 years of age and older. Type of Study: Prospective case series. Materials and Methods: Thirty meniscal

Frank R. Noyes; Sue D. Barber-Westin

2000-01-01

68

Arthroscopic Decompression of the Suprascapular Nerve at the Spinoglenoid Notch and Suprascapular Notch Through the Subacromial Space  

Microsoft Academic Search

Suprascapular nerve entrapment can cause disabling shoulder pain. Suprascapular nerve release is often performed for compression neuropathy and to release pressure on the nerve associated with arthroscopic labral repair. This report describes a novel all-arthroscopic technique for decompression of the suprascapular nerve at the suprascapular notch or spinoglenoid notch through a subacromial approach. Through the subacromial space, spinoglenoid notch cysts

Neil Ghodadra; Shane J. Nho; Nikhil N. Verma; Stefanie Reiff; Dana P. Piasecki; Matthew T. Provencher; Anthony A. Romeo

2009-01-01

69

"V"ictory transosseous equivalent suture configuration for arthroscopic rotator cuff tear repairs of iatrogenically completed PASTA lesions and full-thickness "U"-shaped tears.  

PubMed

The cost of numerous anchors in rotator cuff surgery is high from both an economic standpoint as well as a physiologic one. More anchors means increased cost and increased surgical time; additionally, the greater number of anchors placed, the greater the expense on the native bone that they inevitably replace. It is therefore in the surgeon's and patient's best interest to use the appropriate number of anchors, no more and no less, with the appropriate number being that which allows for strong, stable fixation with minimal gap formation and maximal healing potential and recovery. The transosseous equivalent repair technique described herein uses a single double-loaded bioabsorbable suture anchor placed along the medial border of the rotator cuff foot print and the humeral head articular cartilage margin followed by 1 pushlock (Arthrex, Naples, Florida) anchor placed laterally on the vertical aspect of the greater tuberosity. It is designed for small to medium "U"-shaped tears and for iatrogenically completed partial articular supraspinatus tendon avulsions of moderate to large size, the so-called PASTA lesion. The use of selective knot placement allows for the conversion of a linear construct into a "V" configuration, optimizing repair strength and allowing for earlier rehabilitation while maximizing the healing biology seen with increased footprint contact dimensions and less repair gap formation. PMID:19824586

Lewicky, Yuri M

2009-10-01

70

Arthroscopic subacromial decompression  

Microsoft Academic Search

In this study, we analyzed the results of two series of patients treated for impingement syndrome by undergoing arthroscopic subacromial decompression (ASD). Patients had not responded to nonoperative treatment. Group 1 included 112 consecutive patients (average age, 41 years) with 96 (77%) patients available for 2-year follow-up. Group 2 (28 patients, 29 shoulders; average age, 43 years; range, 22 to

Richard J. Hawkins; Kevin D. Plancher; Stephen R. Saddemi; Leigh Scott Brezenoff; John T. Moor

2001-01-01

71

Arthroscopic biceps tenodesis  

Microsoft Academic Search

Arthroscopic biceps tenodesis is indicated for the treatment of severe biceps tendonopathy, partial- or full-thickness tendon tears, or biceps instability typically associated with rotator cuff tear, although there has been considerable debate on tenotomy versus tenodesis. We advocate tenodesis, for the following reasons: to re-establish the resting muscle length so as to avoid scaring and spasm, to allow biceps use

Anthony A Romeo; Augustus D Mazzocca; Joseph C Tauro

2004-01-01

72

Arthroscopic Absorbable Suture Fixation for Tibial Spine Fractures  

PubMed Central

The purpose of this technical note and accompanying video is to describe a modified arthroscopic suture fixation technique to treat tibial spine avulsion fractures. Twenty-one patients underwent arthroscopic treatment for tibial spine avulsion with our technique; they were clinically and biomechanically evaluated at 2 years' follow-up and showed optimal clinical and radiographic outcomes. Repair with this arthroscopic technique provides a significant advantage in the treatment of type III and IV fractures of the tibial eminence by obtaining arthroscopic fixation within the substance of the anterior cruciate ligament: suture methods based on the avulsed bone fragment are technically impossible, but sutures through the base of the ligament itself provide secure fixation, reducing the risks of comminution of the fracture fragment and eliminating the time for hardware removal. This arthroscopic technique restores the length and the integrity of the anterior cruciate ligament and provides a simplified, reproducible method of treating patients, including young patients, with low hardware costs in comparison to sutures using anchors or other hardware. PMID:24749022

Verdano, Michele Arcangelo; Pellegrini, Andrea; Lunini, Enricomaria; Tonino, Pietro; Ceccarelli, Francesco

2013-01-01

73

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

PubMed Central

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

Maiotti, Marco; Massoni, Carlo

2013-01-01

74

Arthroscopic Repair of Chronic Ankle Instability  

Microsoft Academic Search

\\u000a Lateral ankle ligament sprains are some of the most common injuries encountered in the orthopedic office, occurring in an\\u000a estimated 1\\/10,000 persons per day.1 These injuries can be seen in as many as 40% of all sports injuries.2 While the majority of acute ankle sprains heal reliably with activity modification and physical therapy\\/ankle rehabilitation,\\u000a approximately 29–42% of patients experience chronic

Peter B. Maurus; Gregory C. Berlet

75

2009 survey results: surgeon practice patterns regarding arthroscopic surgery.  

PubMed

A survey was conducted to collect information on the surgical management and practice preferences of the audience members at a recent continuing medical education conference. Participants were polled on a variety of surgical topics, and their responses were recorded using a wireless audience response system. The answers were tabulated and are presented in this report. The majority of respondents preferred an arthroscopic repair for rotator cuff tears (52%) and shoulder instability (71%). Most (50%) perform single-row repair; 33% perform double-row repair. For simple knee arthroscopy, most use preoperative antibiotics (85%), no tourniquet (53%), and no chemical anticoagulation or only compression boots (69%). For cruciate ligament reconstruction, the majority preferred only a preoperative antibiotic (67%), no chemical anticoagulation or only compression boots (56%), and single-bundle reconstruction (88%) using a transtibial femoral tunnel (78%). Most (47%) prefer an all inside suture-based meniscus repair device. PMID:19962073

Redfern, John; Burks, Robert

2009-12-01

76

Results of All-Inside Meniscal Repair With the FasT-Fix Meniscal Repair System  

Microsoft Academic Search

Purpose: The goal of this prospective study was to evaluate the results of arthroscopic meniscal repair using the FasT-Fix repair system. Type of Study: Prospective case series. Methods: Sixty-one meniscal repairs with the FasT-Fix meniscal repair system in 58 patients with a mean age of 32.6 years were performed between 2001 and 2002. Concurrent anterior cruciate ligament reconstruction was performed

Elias S. Kotsovolos; Michael E. Hantes; Dimitrios S. Mastrokalos; Olaf Lorbach; Hans H. Paessler

2006-01-01

77

Arthroscopic management of a chronic primary anterior shoulder dislocation.  

PubMed

Chronic anterior dislocation of the glenohumeral joint often leads to functional impairment and pain. Duration of dislocation is correlated with complications, and this injury is traditionally treated with an open procedure. A right-hand - dominant woman in her late 70s presented with traumatic chronic anterior dislocation of the glenohumeral joint. Her physical exam and imaging studies were consistent with anterior shoulder dislocation, a large Hill-Sachs deformity, and rotator cuff and anterior labral tears. A shoulder reduction under anesthesia was performed followed by an arthroscopic double-row rotator cuff repair. In addition, a labral repair was performed via percutaneously inserted suture anchors. Following this treatment, stability was restored to the glenohumeral joint. The patient progressed well with physical therapy and, at 1-year follow-up, the patient had returned to all routine activities pain-free. Arthroscopic repair of chronic primary traumatic anterior shoulder dislocations requiring surgical treatment is a valuable alternative to open procedures and should be considered in higher-functioning elderly patients. Percutaneous suture anchor placement minimizes trauma to an already pathologic rotator cuff and joint capsule. PMID:20844774

Galano, Gregory J; Dieter, Alexis A; Moradi, Natan E; Ahmad, Christopher S

2010-07-01

78

Arthroscopic proficiency: methods in evaluating competency  

PubMed Central

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

2013-01-01

79

Arthroscopic managementof miscellaneous elbow disorders  

Microsoft Academic Search

Surgical arthroscopy is indicated primarily in the treatment of radiocapitellar disorders and soft tissue disorders, or bony ankylosis of the elbow joint. However, there are other elbow conditions in which the arthroscope is beneficial, particularly by the treatment of lateral epicondylitis and olecranon bursitis. Chronic lateral epicondylitis can result in damage to the common origin of the extensor carpi radialis

Champ L. Baker; P. Dean Cummings

1998-01-01

80

Arthroscopic surgery of the knee  

Microsoft Academic Search

In the first 1000 arthroscopic operations performed by one surgeon 136 patients had two or more procedures, making a total of 1168 during the 1000 operations. The indications for operation were internal mechanical derangements in 565 patients, anterior knee pain in 246, disorders of the synovium in 77, ligament injuries in 63, and degenerative joint disease in 49. Complications included

D J Dandy; P F OCarroll

1982-01-01

81

21 CFR 888.1100 - Arthroscope.  

Code of Federal Regulations, 2010 CFR

...Class I for the following manual arthroscopic instruments: cannulas, currettes, drill guides, forceps, gouges, graspers, knives, obturators, osteotomes, probes, punches, rasps, retractors, rongeurs, suture passers, suture knotpushers,...

2010-04-01

82

Antibiotic prophylaxis for arthroscopic surgery.  

PubMed

Because the incidence of infection in arthroscopic surgery is very low, one can argue both for and against the use of prophylactic antibiotics. Administering antibiotics adds expense and introduces the potential for both exposure to allergic reactions and selection of resistant organisms. Antibiotics are given to prevent deep infection; such treatment may require further surgery, prolonged use of intravenous antibiotics, high costs, and outcomes that may be less than satisfactory. An answer to this controversial issue would require a study that includes large numbers of patients to make it adequately statistically powered because the incidence of infection is so low. No such research has yet been performed, and the American Academy of Orthopaedic Surgeons (AAOS) has not produced an advisory statement addressing this issue. It is the opinion of this author that antibiotic prophylaxis is indicated for arthroscopic surgery. Despite surgical team best practices, mistakes can occur. This has led the AAOS to issue an advisory statement to prevent wrong-site surgery. Similarly, complacency with repetition may produce breaks in sterility that may occasionally go undetected. Antibiotic usage may help to reduce infection in such circumstances. Arthroscopic procedures are not always performed in healthy patients. The risk of infection in "high-risk" patients, such as those with diabetes, immune problems, and skin disorders, may be reduced by prophylactic antibiotics. How one defines a case as arthroscopic can be debated. If small incisions are made, or if the scope is used for only a portion of the procedure, many would still consider the case to be arthroscopic. Surgeries are becoming more complex, which adds to their duration. Some cases also involve the use of implants such as interference screws and suture anchors. It is my opinion that antibiotics should be used in these situations. The potential exists for litigation in cases of infection. Medicolegally, it is easier to argue that all measures were taken to prevent infection if prophylactic antibiotics were given, although patient care issues supersede defensive medicine. Risk of infection in arthroscopic surgery is multifactorial, and antibiotic prophylaxis is only one facet of the issue. Although it is my opinion that antibiotics are recommended, others could be justified in supporting the opposite opinion, pending appropriately designed and adequately powered future investigations. PMID:16581459

Kurzweil, Peter R

2006-04-01

83

Arthroscopic Centralization of an Extruded Lateral Meniscus  

PubMed Central

Extrusion of the lateral meniscus has been reported after posterior root tear or radial tear, partial meniscectomy, and meniscoplasty of discoid meniscus. It has also been shown to be associated with the development of osteoarthritis. This technical note describes a new arthroscopic technique to centralize and stabilize the mid body of the lateral meniscus to restore and maintain the lateral meniscus function by repairing/preventing extrusion of the meniscus. A JuggerKnot Soft Anchor (Biomet, Warsaw, IN), loaded with a MaxBraid suture (Biomet), was placed on the lateral edge of the lateral tibial plateau, just anterior to the popliteal hiatus, through a midlateral portal. A Micro Suture Lasso Small Curve with Nitinol Wire Loop (Arthrex, Naples, FL) was used to pass 2 limbs of the MaxBraid suture through the meniscus at the margin between the meniscus and the capsule. Another anchor was inserted on the lateral edge of the lateral tibial plateau, 1 cm anterior to the first anchor, and the same procedure was repeated. The sutures were then tied by use of a self-locking sliding knot, achieving centralization and secure stabilization of the lateral meniscus. PMID:23766997

Koga, Hideyuki; Muneta, Takeshi; Yagishita, Kazuyoshi; Watanabe, Toshifumi; Mochizuki, Tomoyuki; Horie, Masafumi; Nakamura, Tomomasa; Okawa, Atsushi; Sekiya, Ichiro

2012-01-01

84

Arthroscopic centralization of an extruded lateral meniscus.  

PubMed

Extrusion of the lateral meniscus has been reported after posterior root tear or radial tear, partial meniscectomy, and meniscoplasty of discoid meniscus. It has also been shown to be associated with the development of osteoarthritis. This technical note describes a new arthroscopic technique to centralize and stabilize the mid body of the lateral meniscus to restore and maintain the lateral meniscus function by repairing/preventing extrusion of the meniscus. A JuggerKnot Soft Anchor (Biomet, Warsaw, IN), loaded with a MaxBraid suture (Biomet), was placed on the lateral edge of the lateral tibial plateau, just anterior to the popliteal hiatus, through a midlateral portal. A Micro Suture Lasso Small Curve with Nitinol Wire Loop (Arthrex, Naples, FL) was used to pass 2 limbs of the MaxBraid suture through the meniscus at the margin between the meniscus and the capsule. Another anchor was inserted on the lateral edge of the lateral tibial plateau, 1 cm anterior to the first anchor, and the same procedure was repeated. The sutures were then tied by use of a self-locking sliding knot, achieving centralization and secure stabilization of the lateral meniscus. PMID:23766997

Koga, Hideyuki; Muneta, Takeshi; Yagishita, Kazuyoshi; Watanabe, Toshifumi; Mochizuki, Tomoyuki; Horie, Masafumi; Nakamura, Tomomasa; Okawa, Atsushi; Sekiya, Ichiro

2012-12-01

85

Ease of tying arthroscopic knots.  

PubMed

To date, there is no comprehensive study that determines which arthroscopic knots are easiest to learn to tie. In this study, 23 surgeons in training graded 10 arthroscopic knots with regard to ease of learning and tying using a 10-cm visual analog scale for No. 2 Ethibond and No. 1 polydioxanone (PDS) II suture. Statistical analysis was performed with analysis of variance and the Tukey Studentized range (HSD) test for post hoc analysis with a significant value of P < .05. The Tennessee slider, Duncan loop, Revo knot, and Nicky's knot were the easiest knots to tie by use of both Ethibond and PDS suture. The Field knot and double-twist knot were consistently the hardest knots to tie. Knots tied with Ethibond were easier to tie than knots tied with PDS. Novice surgeons should consider using the Revo knot when developing their arthroscopic knot-tying skills. Once they have mastered this knot, they can consider adding more difficult knots to their repertoire. PMID:17507243

Baumgarten, Keith M; Wright, Rick W

2007-01-01

86

Intra-articular analgesia for arthroscopic meniscectomy  

Microsoft Academic Search

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

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

87

Augmented Virtuality for Arthroscopic Knee Surgery  

E-print Network

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

Stewart, James

88

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

PubMed Central

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

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

2013-01-01

89

Arthroscopic treatment of pigmented villonodular synovitis involving bilateral shoulders.  

PubMed

Pigmented villonodular synovitis (PVNS) is a lesion of benign proliferative synovium that invades joint, tendon sheath, and bursa. It mainly occurs in 1 joint, the knee joint or hand, and multi-joint invasion is reported to be <1%. Rare cases have been reported of PVNS occurring in the shoulder joint. Generally, total synovectomy is a standard treatment of PVNS. However, complete synovectomy is sometimes impossible because of difficulty of visualization and access to the whole joint and subacromial space. Therefore, recurrence of the disease is always of concern. This article presents a case of 64-year-old patient with pain and swelling of bilateral shoulder joints of 4 months' duration. Physical examination showed atrophy of the deltoid and infraspinatus and a mass-like protrusion on the anterior portion of left shoulder. Active forward elevation was limited to 30 degrees on the right and 90 degrees on the left. Overall synovial hyperplasia and nodular mass was observed on magnetic resonance imaging. Massive rotator cuff tear and invasion of the lesion toward the subacromial space and deltoid muscle was noted as well. Arthroscopic examination revealed a typical finding of PVNS: yellowish brown pigmentation over the overall joint capsule and subacromial space. Arthroscopic total synovectomy without rotator cuff repair was performed for both shoulders. Clinical outcomes showed good pain relief and no recurrence of the disease, although range of motion and muscle strength was not significantly improved, possibly due to accompanied massive rotator cuff tear. Arthroscopic total synovectomy in the treatment of PVNS of the shoulder joint is a minimally invasive and effective method, which makes it possible to access the whole joint space and subacromial space. PMID:20806759

Koh, Kyoung Hwan; Lim, Kyung Sub; Yoo, Jae Chul

2010-06-01

90

Thromboembolic complications in arthroscopic surgery.  

PubMed

Venous thromboembolism (VTE) is a relatively rare complication of arthroscopic surgery but has the potential to cause significant morbidity and even mortality. VTE has been reported after shoulder and knee arthroscopy prompting controversial guidelines to be proposed. More limited studies are available regarding hip and ankle arthroscopy and 1 case of deep venous thrombosis in the contralateral leg status after hip arthroscopy exists. No reports have been published regarding VTE after elbow or wrist arthroscopy to these authors' knowledge. In this article, a systematic review of the literature was conducted to analyze the incidence, treatment, and prevention of thromboembolic complications in arthroscopy. PMID:23649153

Greene, Joseph W; Deshmukh, Ajit J; Cushner, Fred D

2013-06-01

91

Direct Arthroscopic Distal Clavicle Resection  

PubMed Central

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

Lervick, Gregory N

2005-01-01

92

Arthroscopic Labral Reconstruction With Gracilis Autograft  

PubMed Central

Despite growing interest in hip arthroscopy and labral preservation, some patients have severely damaged, degenerative, or deficient labrums and may be candidates for arthroscopic labral reconstruction. The ligamentum teres has been used as a graft source for open hip labral grafting, and the iliotibial band has been used in the arthroscopic setting. We present an alternative method of hip labral reconstruction using the gracilis autograft, which does not require post-harvest manipulation. Arthroscopic techniques for graft tensioning and labrum-graft overlap are introduced that may facilitate restoration of labral function in patients with otherwise non-salvageable labrums. PMID:23766969

Matsuda, Dean K.

2012-01-01

93

Functional outcome of arthroscopic assisted fixation of distal radius fractures  

PubMed Central

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

Khanchandani, Prakash; Badia, Alejandro

2013-01-01

94

Single row rotator cuff repair with modified technique.  

PubMed

Rotator cuff tear is a common medical condition. We introduce various suture methods that can be used for arthroscopic rotator cuff repair, review the single row rotator cuff repair method with modified technique, and introduce the Ulsan-University (UU) stich. We compare the UU stitch with the modified Mason-Allen (MA) suture method. The UU stitch configuration is a simple alternative to the modified MA suture configuration for rotator cuff repair. PMID:23362463

Ko, Sang-Hun; Shin, Seung-Myeong

2012-12-18

95

Multirater Agreement of Arthroscopic Meniscal Lesions  

Microsoft Academic Search

Background: Establishing the validity of classification schemes is a crucial preparatory step that should precede multicenter studies. There are no studies investigating the reproducibility of arthroscopic classification of meniscal pathology among multiple surgeons at different institutions.Hypothesis: Arthroscopic classification of meniscal pathology is reliable and reproducible and suitable for multicenter studies that involve multiple surgeons.Study Design: Multirater agreement study.Methods: Seven surgeons

Warren R. Dunn; Brian R. Wolf; Annunziato Amendola; Jack T. Andrish; Christopher Kaeding; Robert G. Marx; Eric C. McCarty; Richard D. Parker; Rick W. Wright; Kurt P. Spindler

2004-01-01

96

Arthroscopic Technique for Treatment of Femoroacetabular Impingement  

PubMed Central

With an increasing understanding of femoroacetabular impingement (FAI) and advancement of the surgical treatment in patients with FAI, various techniques have been published. Successful outcome after arthroscopic hip surgery depends on appropriately reshaping the bony architecture to allow for improved range of motion before impingement symptoms occur, with special attention to preserve the labrum and restore its function. We present our surgical technique for the arthroscopic treatment of FAI. PMID:23767009

Jackson, Timothy J.; Stake, Christine E.; Trenga, Anthony P.; Morgan, Julie; Domb, Benjamin G.

2013-01-01

97

Arthroscopic Treatment of Stiff Elbow  

PubMed Central

Contracture of the elbow represents a disabling condition that can impair a person's quality of life. Regardless of the event that causes an elbow contracture, the conservative or surgical treatment is usually considered technically difficult and associated with complications. When the conservative treatment fails to restore an acceptable range of motion in the elbow, open techniques have been shown to be successful options. More recently the use of arthroscopy has become more popular for several reasons. These reasons include better visualization of intra-articular structures, less tissue trauma from open incisions, and potentially the ability to begin early postoperative motion. The purpose of this paper is to review the indications, complications, and results of arthroscopic management of a stiff elbow. PMID:22084755

Blonna, Davide; Bellato, Enrico; Marini, Eleonora; Scelsi, Michele; Castoldi, Filippo

2011-01-01

98

Arthroscopic lysis in knee arthrofibrosis.  

PubMed

Arthrofibrosis continues to be a difficult complication in articular surgery on the knee. We present our experience in 21 cases of arthroscopic lysis as an alternative to mobilization under anesthesia. The technique begins with the liberation of the adhesions of the suprapatellar pouch, continues down both gutters, and ends with a cleaning of the notch where necessary. When a restriction of patellar mobility persists, we make a retinacular release. The results obtained are very satisfactory, with an average increase in the arc of mobility of 68 degrees. The average gain in mobility at 6 months is significantly greater than that achieved in the immediate postoperative period. Longer follow-up showed no improvement in range of motion after 6 months. PMID:8305107

Vaquero, J; Vidal, C; Medina, E; Baena, J

1993-01-01

99

Reversed arthroscopic subacromial decompression for massive rotator cuff tears  

Microsoft Academic Search

This prospective study evaluates the results of a procedure for massive rotator cuff tears that we term reversed arthroscopic subacromial decompression (ASD). The procedure includes an arthroscopic debridement of the subacromial space and glenohumeral joint, an arthroscopic tuberoplasty, and depending on the pathologic condition of the long head of the biceps, a biceps tendon tenotomy. Reversed ASD avoids a classic

Markus Scheibel; Sven Lichtenberg; Peter Habermeyer

2004-01-01

100

Arthroscopic findings associated with the unstable ankle.  

PubMed

Before lateral ankle stabilization, arthroscopic surgery was performed on 54 patients (55 ankles) with chronic ankle instability. All patient charts, x-rays, operative reports, and surgical videotapes were reviewed. A detailed questionnaire was answered by all patients. The study population included 31 males and 23 females, with a mean age of 31 years (range, 14-64 years). The right ankle was involved in 64% of cases. Average follow-up was 9.6 months. Arthroscopic surgery was performed using small joint instrumentation including 30 degrees and 70 degrees 2.7-mm arthroscopes and a 30 degrees 1.9-mm arthroscope. At surgery, 51 ankles (93%) had intra-articular abnormalities including loose bodies (12), synovitis (38), osteochondral lesions of the talus (9), ossicles (14), osteophytes (6), adhesions (8), and chondromalacia (12). The most common arthroscopic procedures were synovectomy, removal of loose bodies and ossicles, excision and drilling of osteochondral lesions, debridement of the lateral gutter, excision of osteophytes, and removal of adhesions and scar tissue. There was a 25% incidence of chondral injuries, which differs considerably from the results of Taga et al., who found chondral injuries in 95% of ankles with lateral instability. Overall, there were excellent or good results in 96% of ankles. The incidence of excellent results was lower in the worker's compensation patients because of a greater incidence of complaints of pain with activity. There was no correlation between the presence of osteochondral lesions or amount of talar tilt and results. PMID:10582846

Komenda, G A; Ferkel, R D

1999-11-01

101

Arthroscopic reduction and internal fixation of acetabular fractures.  

PubMed

Arthroscopic reduction and screw fixation of acetabular fractures have not been reported. In this case report, arthroscopic treatment for acetabular fracture is reported for two patients. A 49-year-old man diagnosed with acetabular posterior wall fracture was treated by arthroscopic reduction and fixation using two screws. A 20-year-old woman who diagnosed with anterior column fracture was fixed using a screw using the arthroscopic technique prior to open reduction and internal fixation in the iliac bone fracture. Arthroscopic reduction and fixation in some case of acetabular fracture could be good indication with additional advantages of joint debridement and loose body removal. PMID:24306124

Kim, Hyangkyoung; Baek, Ji-Hoon; Park, Sang-Min; Ha, Yong-Chan

2014-04-01

102

Arthroscopic Treatment of Iliotibial Band Syndrome  

PubMed Central

Lateral knee pain in athletes is commonly seen in the sports medicine clinic, and the diagnosis of iliotibial band (ITB) syndrome is frequently made. Although conservative management including rest from activity, equipment modification, oral nonsteroidal anti-inflammatory drug use, and physical therapy is the mainstay of treatment initially, refractory cases do exist. Multiple surgical techniques have been described including an arthroscopic technique. Arthroscopic release of the ITB attachment to the lateral femoral epicondyle and resection of the lateral synovial recess for recalcitrant ITB syndrome comprise a valid option that can have a good outcome. This option avoids the complications associated with open surgery and allows for a complete arthroscopic knee examination. Division or lengthening of the ITB band itself is not a necessary step in this technique. PMID:24843846

Cowden, Courtney H.; Barber, F. Alan

2013-01-01

103

Arthroscopic bullet removal from the acetabulum  

Microsoft Academic Search

Hip arthroscopy has been shown to offer minimally invasive access to the hip joint compared with standard open arthrotomy. The use of arthroscopy for diagnosing and treating disorders about the hip continues to evolve. The authors describe an arthroscopically assisted technique for the removal of a bullet lodged in the acetabulum of a patient who sustained a gunshot wound that

Steven B. Singleton; Atul Joshi; Mark A. Schwartz; Cory A. Collinge

2005-01-01

104

Comprehensive Approach to Arthroscopic Rotator Cuff Repair: Options and Techniques  

MedlinePLUS Videos and Cool Tools

... we're going to entertain questions from four locations. These locations are Atlanta, Minneapolis, Philadelphia, and as far away ... marked out here, and then you see the location of the B portal. The D and the ...

105

Current biomechanical concepts for rotator cuff repair.  

PubMed

For the past few decades, the repair of rotator cuff tears has evolved significantly with advances in arthroscopy techniques, suture anchors and instrumentation. From the biomechanical perspective, the focus in arthroscopic repair has been on increasing fixation strength and restoration of the footprint contact characteristics to provide early rehabilitation and improve healing. To accomplish these objectives, various repair strategies and construct configurations have been developed for rotator cuff repair with the understanding that many factors contribute to the structural integrity of the repaired construct. These include repaired rotator cuff tendon-footprint motion, increased tendon-footprint contact area and pressure, and tissue quality of tendon and bone. In addition, the healing response may be compromised by intrinsic factors such as decreased vascularity, hypoxia, and fibrocartilaginous changes or aforementioned extrinsic compression factors. Furthermore, it is well documented that torn rotator cuff muscles have a tendency to atrophy and become subject to fatty infiltration which may affect the longevity of the repair. Despite all the aforementioned factors, initial fixation strength is an essential consideration in optimizing rotator cuff repair. Therefore, numerous biomechanical studies have focused on elucidating the strongest devices, knots, and repair configurations to improve contact characteristics for rotator cuff repair. In this review, the biomechanical concepts behind current rotator cuff repair techniques will be reviewed and discussed. PMID:23730471

Lee, Thay Q

2013-06-01

106

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

PubMed

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

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

2014-11-01

107

Release of growth factors after arthroscopic acromioplasty  

Microsoft Academic Search

It has recently been postulated that a variety of growth factors may be released from cancellous bone after an acromioplasty.\\u000a The aim of this study was to demonstrate the presence of growth factors in the subacromial space after acromioplasty. Between\\u000a October 2006 and March 2007, 23 patients underwent arthroscopic acromioplasty. A sample of at least 3 ml of fluid from the

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

2009-01-01

108

Arthroscopic Treatment of Subscapularis Calcific Tendonitis  

PubMed Central

Rotator cuff tendonitis is a very common diagnosis of the shoulder that usually responds to conservative management. However, calcific tendonitis occurs less frequently and often necessitates surgical intervention. The etiology and treatment options for this disorder remain controversial among orthopaedic shoulder specialists. Calcific tendonitis frequently presents within the supraspinatus tendon and rarely appears within the subscapularis tendon. We present a case and accompanying video technique of arthroscopic treatment of subscapularis calcific tendonitis. PMID:25473608

Fields, Logan K.; Muxlow, Chad J.; Caldwell, Paul E.

2014-01-01

109

Complications of arthroscopic surgery of the hip  

PubMed Central

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

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

2012-01-01

110

Arthroscopic latarjet procedure: safety evaluation in cadavers  

PubMed Central

OBJECTIVE: To evaluate the safety of arthroscopic Latarjet procedure in cadavers. METHODS : Twelve cadaveric shoulders underwent arthroscopic Latarjet procedure in our laboratory for arthroscopy, by four different surgeons. Following surgery, the specimens were subjected to radiographic examination and evaluated by an independent examiner. Nineteen parameters were evaluated, including the coracoid graft fixation, positioning and angulation of the screws, neurological damage and integrity of tendons. RESULTS : Four procedures were considered to be satisfactory, with no difference among the surgeons. The mean angulation of the screws was 27.2°. The subscapularis splitting was, on average, 17.8mm from the upper edge. The coracoid graft was properly positioned relative to equator of the glenoid in 11 cases. There was no injury to the axillary or musculocutaneous nerves. The main complications were: interposition of soft tissue, suprascapular nerve injury, articular deviation of the graft, diastasis and conjoined tendon injury. CONCLUSION : The arthroscopic Latarjet procedure is a complex technique in which each step must be precise to reduce the risk of complications. Our study showed a high risk of failure of the procedure. Level of Evidence IV, Case Series. PMID:24453657

Gracitelli, Mauro Emilio Conforto; Ferreira, Arnaldo Amado; Benegas, Eduardo; Malavolta, Eduardo Angeli; Sunada, Edwin Eiji; Assunēćo, Jorge Henrique

2013-01-01

111

Return to work after arthroscopic subacromial decompression.  

PubMed

The incidence of arthroscopic subacromial decompression has been increasing over the last few years. Little is known about the duration of sick leave after such a procedure. The aim of this study was to determine the time till return to full duty and to explore the various influencing factors. We retrospectively evaluated a group of 166 patients who consecutively underwent arthroscopic subacromial decompression for subacromial impingement syndrome. One hundred patients were professionally active at the time of surgery; the mean duration till return to full duty was 11.1 weeks. Self-employed workers had the shortest sick leave period (median time of 1 week). No statistically significant difference was seen between the group with a financial compensation from the national health insurance system (median time of 12 weeks) and the group with income replacement by a private insurance company (median time of 8 weeks). Patients performing manual labour typically had a longer period of sick leave than other employees (12 versus 8 weeks). A longer absence from work was also observed in individuals who underwent a concomitant arthroscopic AC resection and patients with a higher BMI. PMID:22308617

Luyckx, Lucas; Luyckx, Thomas; Donceel, Peter; Debeer, Philippe

2011-12-01

112

Early arthroscopic release in stiff shoulder  

PubMed Central

Purpose: To evaluate the results of early arthroscopic release in the patients of stiff shoulder Methods: Twenty patients of stiff shoulder, who had symptoms for at least three months and failed to improve with steroid injections and physical therapy of 6 weeks duration, underwent arthroscopic release. The average time between onset of symptoms and the time of surgery was 4 months and 2 weeks. The functional outcome was evaluated using ASES and Constant and Murley scoring systems. Results: All the patients showed significant improvement in the range of motion and relief of pain by end of three months following the procedure. At 12 months, mean improvement in ASES score is 38 points and Constant and Murley score is 4O.5 points. All patients returned to work by 3-5 months (average -4.5 months). Conclusion: Early arthroscopic release showed promising results with reliable increase in range of motion, early relief of symptoms and consequent early return to work. So it is highly recommended in properly selected patients. Level of evidence: Level IV PMID:20300309

Sabat, Dhananjaya; Kumar, Vinod

2008-01-01

113

Arthroscopic wafer procedure for ulnar impaction syndrome.  

PubMed

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

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

2014-02-01

114

Arthroscopic treatment in split depression-type tibial pilon fracture.  

PubMed

Treatment of tibial pilon fractures is complicated and often very invasive. Partial fractures with a depressed component raise the question of the choice of surgical technique. Minimally invasive surgical reduction under arthroscopic guidance appears to be a promising alternative in this type of fracture. We describe a technique for arthroscopically assisted treatment of a split depression tibial pilon fracture. PMID:24898416

Lonjon, Guillaume; Delgrande, Damien; Solignac, Nicolas; Faivre, Bruno; Hardy, Philippe; Bauer, Thomas

2015-02-01

115

Rationale of arthroscopic surgery of the temporomandibular joint  

PubMed Central

Arthroscopic surgery has been widely used for treatment of temporomandibular joint (TMJ) internal derangements and diseases for the last 40 years. Although 626 articles have been hit by Pubmed search in terms of “TMJ arthroscopic surgery”, this review article is described based on distinguished publishing works and on my experiences with TMJ arthroscopic surgery and related research with an aim to analyse the rationale of arthroscopic surgeries of the temporomandibular joint. With arthrocentesis emerging as an alternative, less invasive, treatment for internal derangement with closed lock, the primary indication of arthroscopic surgery seems to be somewhat limited. However, the value of endoscopic inspection and surgery has its position for both patient and physician with its long-term reliable results. PMID:25737901

Murakami, KenIchiro

2013-01-01

116

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

PubMed Central

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.

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

2014-01-01

117

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

PubMed

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

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

1999-09-01

118

Arthroscopic treatment options for irreparable rotator cuff tears of the shoulder  

PubMed Central

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

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

2014-01-01

119

Arthroscopic Anatomic Reconstruction of the Lateral Ligaments of the Ankle With Gracilis Autograft  

PubMed Central

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

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

2014-01-01

120

Arthroscopic anatomy and surgical techniques for peritrochanteric space disorders in the hip.  

PubMed

Disorders of the lateral or peritrochanteric space (often grouped into the greater trochanteric pain syndrome), such as recalcitrant trochanteric bursitis, external snapping iliotibial band, and gluteus medius and minimus tears, are now being treated endoscopically. We outline the endoscopic anatomy of the peritrochanteric space of the hip and describe surgical techniques for the treatment of these entities. Proper portal placement is key in understanding the peritrochanteric space and should be first oriented at the gluteus maximus insertion into the linea aspera, as well as the vastus lateralis. When tears of the gluteus medius and minimus are encountered, suture anchors can be placed into the footprint of the abductor tendons in a standard arthroscopic fashion. Our initial experience indicates that recalcitrant trochanteric bursitis, external coxa saltans, and focal, isolated tears of the gluteus medius and minimus tendon may be successfully treated with arthroscopic bursectomy, iliotibial band release, and decompression of the peritrochanteric space and suture anchor tendon repair to the greater trochanter, respectively. PMID:17986418

Voos, James E; Rudzki, Jonas R; Shindle, Michael K; Martin, Hal; Kelly, Bryan T

2007-11-01

121

Comparison of the Clinical Outcomes of Single and Double-row Repairs in Rotator Cuff Tears  

Microsoft Academic Search

Background: Although research has demonstrated the superiority of double-row rotator cuff repair over single-row methods from a biological and mechanical point of view, few studies have compared clinical outcome of the 2 methods, and no articles have been published describing the superiority of double-row methods in clinical aspects.Hypothesis: Arthroscopic double-row repair of a rotator cuff tear has superior clinical outcome

Jin-Young Park; Sang-Hoon Lhee; Jin-Hyung Choi; Hong-Keun Park; Je-Wook Yu; Joong-Bae Seo

2008-01-01

122

Arthroscopic assessment of full-thickness rotator cuff tears  

Microsoft Academic Search

To evaluate the reliability of the arthroscopic assessment of full-thickness rotator cuff tears, 117 cases were prospectively investigated by imaging, arthroscopy, and open surgery. The confidence of the surgeon, his accuracy, and the surgeon-dependent character of arthroscopic assessment were evaluated in terms of the description of the main anatomic parameters. The surgeons were confident and accurate in diagnosing a full-thickness

Hervé Thomazeau; Pascal Gleyze; Laurent Lafosse; Gilles Walch; Franēois Kelbérine; Henri Coudane

2000-01-01

123

Experience-based virtual training system for knee arthroscopic inspection  

PubMed Central

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

2013-01-01

124

Discoid lateral meniscus: diagnosis and results of arthroscopic treatment  

Microsoft Academic Search

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

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

2003-01-01

125

First validation of the PASSPORT training environment for arthroscopic skills  

Microsoft Academic Search

The demand for high quality care is in contrast to reduced training time for residents to develop arthroscopic skills. Thereto,\\u000a simulators are introduced to train skills away from the operating room. In our clinic, a physical simulation environment to\\u000a Practice Arthroscopic Surgical Skills for Perfect Operative Real-life Treatment (PASSPORT) is being developed. The PASSPORT\\u000a concept consists of maintaining the normal

Gabriėlle J. M. Tuijthof; Maayke N. van Sterkenburg; Inger N. Sierevelt; Jakob van Oldenrijk; C. Niek Van Dijk; Gino M. M. J. Kerkhoffs

2010-01-01

126

Hernia Repair  

MedlinePLUS

... through an opening that is several inches long. Laparoscopic hernia repair - In this less-invasive procedure, the surgeon ... slightly increase the possibility of scarring or infection. Laparoscopic hernia repair - In a laparoscopic repair, a harmless gas ...

127

Arthroscopic Double-Locked Stitch: A New Technique for Suturing Rotator Cuff Tears  

PubMed Central

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

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

2014-01-01

128

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

PubMed

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

Ng, Choong; Bialocerkowski, Andrea; Hinman, Rana

2007-06-01

129

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

PubMed

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

Lubowitz, James H

2015-03-01

130

Arthroscopic treatment of femoral nerve paresthesia caused by an acetabular paralabral cyst.  

PubMed

This report describes a rare case of femoral nerve paresthesia caused by an acetabular paralabral cyst of the hip joint. A 68-year-old woman presented with a 6-month history of right hip pain and paresthesia along the anterior thigh and radiating down to the anterior aspect of the knee. Radiography showed osteoarthritis with a narrowed joint space in the right hip joint. Magnetic resonance imaging showed a cyst with low T1- and high T2-weighted signal intensity arising from a labral tear at the anterior aspect of the acetabulum. The cyst was connected to the joint space and displaced the femoral nerve to the anteromedial side. The lesion was diagnosed as an acetabular paralabral cyst causing femoral neuropathy. Because the main symptom was femoral nerve paresthesia and the patient desired a less invasive procedure, arthroscopic labral repair was performed to stop synovial fluid flow to the paralabral cyst that was causing the femoral nerve paresthesia. After surgery, the cyst and femoral nerve paresthesia disappeared. At the 18-month follow-up, the patient had no recurrence. There have been several reports of neurovascular compression caused by the cyst around the hip joint. To the authors' knowledge, only 3 cases of acetabular paralabral cysts causing sciatica have been reported. The current patient appears to represent a rare case of an acetabular paralabral cyst causing femoral nerve paresthesia. The authors suggest that arthroscopic labral repair for an acetabular paralabral cyst causing neuropathy can be an option for patients who desire a less invasive procedure. PMID:24810828

Kanauchi, Taira; Suganuma, Jun; Mochizuki, Ryuta; Uchikawa, Shinichi

2014-05-01

131

Subacromial Spacer Placement for Protection of Rotator Cuff Repair  

PubMed Central

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

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

2014-01-01

132

Subacromial spacer placement for protection of rotator cuff repair.  

PubMed

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

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

2014-10-01

133

The behaviour of knots and sutures during the first 12 hours following a Bankart repair.  

PubMed

It has been reported that the effectiveness of arthroscopic procedures in terms of preventing recurrent dislocation has not matched that from open techniques. Also little is known about how these knots behave when exposed to physiological loading following repair. This study presents the development of a practical tool to allow surgeons to test the quality of their arthroscopic knots and allow them to make choices with regard to knot configuration and suture material. This study uses an apparatus to model the repair of a Bankart lesion. Ten examples of the Duncan loop and SMC knots were tied using PDS, Ethibond, Panacryl and Fibrewire. An arthroscopic knotting technique was used. Reverse slippage occurring during the tying process was recorded. Each knot was then left for 12 hours under loads equivalent to a Bankart repair and the subsequent reverse slippage was recorded. After initial passing of the Duncan loop and after passing of locking hitches the sutures were ranked inversely to size of suture loop (resistance to slippage). Only Fibrewire showed a significant difference (5.7 +/- 1.03 mm to 5.66 +/- 0.5 mm; p <0.05). After 12 hrs, some evidence of reverse slippage was noted, especially with Fibrewire (5.66 +/- 0.5 mm--significant p <0.05). The SMC knot showed generally inferior results. In this study using arthroscopic techniques, Fibrewire performed less well than other materials. PMID:19058691

Hughes, Peter J; Kerin, Cronan; Hagan, Richard P; Fisher, Anthony C; Frostick, Simon P

2008-10-01

134

Comma Sign–Directed Repair of Anterosuperior Rotator Cuff Tears  

PubMed Central

The comma sign was described as an arthroscopic landmark to identify the torn subscapularis stump to mobilize and repair the tendon in anterosuperior rotator cuff tears. It was hypothesized that it is composed of the humeral attachments of the superior glenohumeral and coracohumeral ligaments. This arthroscopic finding has since become accepted orthopaedic nomenclature pathognomonic for subscapularis tears and a key component of subscapularis tear classification. We propose an alternative theory of the pathoanatomy of the comma sign in anterosuperior rotator cuff tears and present the technique of comma sign–directed repairs of combined subscapularis and supraspinatus lesions. After appropriate releases, tendon-to-tendon repair of the distal-superior aspect of the comma sign to the upper border of the remnant subscapularis results in anatomic re-creation of the intra-articular portion of the torn subscapularis with concomitant reduction of the anterior leading edge of the supraspinatus and reconstitution of the rotator cable complex. A tension-free, single-anchor subscapularis repair is then performed to secure the tendon to the lesser tuberosity. After subscapularis repair, the supraspinatus that was previously retracted to the glenoid rim takes the appearance of a crescent-type tear that is easily approximated to its anatomic insertion. PMID:25685676

Dilisio, Matthew F.; Neyton, Lionel

2014-01-01

135

Arthroscopic ankle arthrodesis with intra-articular distraction.  

PubMed

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

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

2014-01-01

136

Arthroscopic Resection of Wrist Ganglion Arising from the Lunotriquetral Joint  

PubMed Central

The dorsal wrist ganglion is the most common wrist mass, and previous studies have shown that it arises from the scapholunate interval in the vast majority of cases. Treatment has traditionally been open excision, and more recently arthroscopic resection has been established as an effective and less invasive treatment method. However, application of this technique to ganglia in atypical locations has not been reported, where open excision is the usual practice. This report describes two cases of atypical dorsal wrist ganglia that arose from the lunotriquetral (LT) joint, demonstrated by arthroscopic visualization and wrist arthrogram in one of them. Arthroscopic resection was performed, and the application of this technique to a dorsal wrist ganglion with an atypical origin and location is described. PMID:24436842

Mak, Michael C. K.; Ho, Pak-cheong; Tse, W. L.; Wong, Clara W. Y.

2013-01-01

137

Chronic Osteomyelitis in the Femoral Midshaft Following Arthroscopic ACL Reconstruction  

PubMed Central

A 25 year-old man presented with pain, swelling, and intermittent drainage from distal lateral aspect of his left knee three months after undergoing isolated ACL reconstruction with arthroscopic hamstring autograft and endobottom technique. His surgeon at that time tried to eliminate the pathology through arthroscopic wash out in two attempts. However, the pain, edema, and discharge recurred after a year of being symptom free. The patient underwent imaging assessment and anteroposterior and lateral radiographs demonstrated a sclerotic area beneath the femoral condoyle in femoral tunnel and a fusiform sclerotic area in the lateral aspect of femoral midshaft. Magnetic Resonance Imaging revealed necrotic tissue with bone edema consistent with the sclerotic area in radiographs indicating micro abscesses and osteomyelitis. A diagnosis of femoral chronic osteomyelitis was made and the patient underwent arthroscopic drainage and washout, followed by open surgery for diaphysial femoral osteomyelitis. Rehabilitation was started and after six months the patient returned to his work. PMID:25692173

Ebrahimzadeh, Mohammad H; Moradi, Ali; Khalesi, Mohammad K; Choghadeh, Maysam Fathi

2015-01-01

138

Success of Meniscal Repair at ACL Reconstruction  

PubMed Central

Background Meniscal repair is performed in an attempt to prevent posttraumatic arthritis resulting from meniscal dysfunction after meniscal tears. The socioeconomic implications of premature arthritis are significant in the young patient population. Investigations and techniques focusing on meniscus preservation and healing are now at the forefront of orthopaedic sports medicine. Hypothesis Concomitant meniscal repair with ACL reconstruction is a durable and successful procedure at two year follow-up. Study Design Case Series; Level of evidence, 4. Methods All unilateral primary ACL reconstructions entered in 2002 in a prospective cohort who had meniscal repair at the time of ACLR were evaluated. Validated patient oriented outcome instruments were completed preoperatively and then again at the two-year postoperative time point. Reoperation after the index procedure was also documented and confirmed by operative reports. Results 437 unilateral primary ACL reconstructions were performed with 86 concomitant meniscal repairs (57 medial, 29 lateral) in 84 patients during the study period. Patient follow-up was obtained on 94% (81/86) of the meniscal repairs, allowing confirmation of meniscal repair success (defined as no repeat arthroscopic procedure) or failure. The overall success rate for meniscal repairs was 96% (76/79 patients) at two-year follow-up. Conclusions Meniscal repair is a successful procedure in conjunction with ACL reconstruction. When confronted with a “repairable” meniscal tear at the time of ACL reconstruction, orthopaedic surgeons can expect an estimated >90% clinical success rate at two-year follow-up using a variety of methods as shown in our study. PMID:19465734

Toman, Charles; Spindler, Kurt P.; Dunn, Warren R.; Amendola, Annunziata; Andrish, Jack T.; Bergfeld, John A.; Flanigan, David; Jones, Morgan; Kaeding, Christopher C.; Marx, Robert G.; Matava, Matthew J.; McCarty, Eric C.; Parker, Richard D.; Wolcott, Michelle; Vidal, Armando; Wolf, Brian R.; Huston, Laura J.; Harrell, Frank E.; Wright, Rick W.

2013-01-01

139

CO2 laser arthroscopy-through the arthroscope  

NASA Astrophysics Data System (ADS)

Orthopedists have been among the last of the specialists to utilize lasers in surgery. Even today, laser usage in orthopedics is almost exclusively limited to arthroscopy procedures. Although other types of lasers have been approved for use in orthopedics, nearly all laser-assisted arthroscopic procedures have involved the carbon dioxide laser in the knee. These techniques involve skills and problems not previously encountered. In an attempt to simplify the usage and circumvent some of the problems, we describe a means of laser energy delivery through the arthroscope.

Garrick, James G.

1990-06-01

140

Arthroscopic Medial Retinacular Plication With a Needle-Hole Technique  

PubMed Central

Patellar instability is a common problem resulting in anterior knee pain. The medial patellofemoral ligament, which is part of the medial retinaculum, is often injured, and this damaged structure can affect normal patellar movement. Medial retinacular plication can correct this main pathology of patellar instability. Many studies have shown good to excellent results with medial retinacular plication with or without lateral retinacular release. This medial retinacular plication technique can also be performed arthroscopically. Arthroscopic medial reticular plication with a needle-hole technique is a treatment that uses the less invasive technique of arthroscopy, does not require tissue grafts, and has a greater cosmetic advantage than open procedures. PMID:25264510

Prasathaporn, Niti; Kuptniratsaikul, Somsak; Kongrukgreatiyos, Kitiphong

2014-01-01

141

Arthroscopic Labral Reconstruction of the Hip Using Local Capsular Autograft  

PubMed Central

Labral reconstruction is becoming an important treatment modality for hips with nonsalvageable labra. Nonsalvageable labra can be present in cases of intrasubstance damage, revision surgery after debridement, labral calcification, and hypoplasia. Previous methods of reconstruction have been performed in an open manner and arthroscopically using ligamentum teres, iliotibial band, and gracilis autograft. We present an alternate method of arthroscopic labral reconstruction using capsular autograft. The technique uses readily available capsular tissue during arthroscopy with no donor-site morbidity. This technique may be valuable in appropriately selected patients with labral deficiency. PMID:25126503

Domb, Benjamin G.; Gupta, Asheesh; Stake, Christine E.; Hammarstedt, Jon E.; Redmond, John M.

2014-01-01

142

Arthroscopic medial retinacular plication with a needle-hole technique.  

PubMed

Patellar instability is a common problem resulting in anterior knee pain. The medial patellofemoral ligament, which is part of the medial retinaculum, is often injured, and this damaged structure can affect normal patellar movement. Medial retinacular plication can correct this main pathology of patellar instability. Many studies have shown good to excellent results with medial retinacular plication with or without lateral retinacular release. This medial retinacular plication technique can also be performed arthroscopically. Arthroscopic medial reticular plication with a needle-hole technique is a treatment that uses the less invasive technique of arthroscopy, does not require tissue grafts, and has a greater cosmetic advantage than open procedures. PMID:25264510

Prasathaporn, Niti; Kuptniratsaikul, Somsak; Kongrukgreatiyos, Kitiphong

2014-08-01

143

Arthroscopic bullet removal from the acetabulum.  

PubMed

Hip arthroscopy has been shown to offer minimally invasive access to the hip joint compared with standard open arthrotomy. The use of arthroscopy for diagnosing and treating disorders about the hip continues to evolve. The authors describe an arthroscopically assisted technique for the removal of a bullet lodged in the acetabulum of a patient who sustained a gunshot wound that entered the abdomen and traversed the rectum before ending up in the weight-bearing dome of the acetabulum. A number of issues led to the decision to use both arthroscopy and this specific technique. Most importantly was our desire to limit the amount of surrounding articular cartilage and local bone damage on removal. Minimizing the soft tissue dissection needed to access the bullet and keeping down our operative time also played a role in deciding to use this technique. We considered the risks of potential bullet fragmentation and migration, as well as a possible abdominal compartment syndrome before proceeding. This surgical technique afforded a very satisfactory outcome for this patient and serves as a model for others when encountering a similar injury pattern in a trauma patient. It is a procedure that can be performed safely, quickly, and with minimal complications for surgeons who have experience with arthroscopy of the hip joint. PMID:15756192

Singleton, Steven B; Joshi, Atul; Schwartz, Mark A; Collinge, Cory A

2005-03-01

144

Simulation of arthroscopic surgery using MRI data  

NASA Technical Reports Server (NTRS)

With the availability of Magnetic Resonance Imaging (MRI) technology in the medical field and the development of powerful graphics engines in the computer world the possibility now exists for the simulation of surgery using data obtained from an actual patient. This paper describes a surgical simulation system which will allow a physician or a medical student to practice surgery on a patient without ever entering an operating room. This could substantially lower the cost of medial training by providing an alternative to the use of cadavers. This project involves the use of volume data acquired by MRI which are converted to polygonal form using a corrected marching cubes algorithm. The data are then colored and a simulation of surface response based on springy structures is performed in real time. Control for the system is obtained through the use of an attached analog-to-digital unit. A remote electronic device is described which simulates an imaginary tool having features in common with both arthroscope and laparoscope.

Heller, Geoffrey; Genetti, Jon

1994-01-01

145

Arthroscopic debridement for ankle haemophilic arthropathy.  

PubMed

The purpose of this study is to describe the results of arthroscopic ankle debridement (AAD) with the aim of determining whether it is possible to avoid or delay ankle fusion or total ankle replacement for advanced haemophilic arthropathy of the ankle in young patients. In a 12-year period (2000-2011), 24 AADs (one bilateral in two stages) were performed for advanced haemophilic arthropathy of the ankle in 23 patients (22 had haemophilia A, 1 haemophilia B, 0 with inhibitors against the deficient factor). Their average age at operation was 25.3 years (range 21-36). Inclusion criteria were: more than 50% of ankle motion, good axial alignment of the ankle (increased varus or valgus angulation was a contraindication for AAD) and pain greater than 6 points on a visual analogue scale (0-no pain to 10 points). Follow-up was for an average of 5.4 years (range 2-14 years). The results were evaluated retrospectively by the American Orthopaedic Foot and Ankle Society Ankle-Hindfoot scale. The clinical results were excellent in 13 (54.2%), good in nine (37.5%) and fair in two (8.3%). There were two (8.3%) postoperative complications (haemarthroses resolved by join aspiration). Three patients (12.5%) required an ankle fusion. AAD should be considered in the young haemophiliac to delay ankle fusion or total ankle replacement. The operation may give the patient years of life without intense pain. PMID:25402194

Rodriguez-Merchan, E Carlos; Gomez-Cardero, Primitivo; Martinez-Lloreda, Įngel; De La Corte-Rodriguez, Hortensia; Jimenez-Yuste, Victor

2015-04-01

146

Multirater Agreement of Arthroscopic Grading of Knee Articular Cartilage  

Microsoft Academic Search

Background: Acute and chronic cartilage injury of the knee has an important impact on prognosis. The validity of the classification of such injuries is critical for prospective multicenter studies. The agreement among multiple surgeons at different institutions for articular cartilage lesions has not been established.Hypothesis: Arthroscopic classification of articular cartilage lesions is reliable and reproducible and can be used for

Robert G. Marx; Jason Connor; Stephen Lyman; Annunziato Amendola; Jack T. Andrish; Christopher Kaeding; Eric C. McCarty; Richard D. Parker; Rick W. Wright; Kurt P. Spindler

2005-01-01

147

Fluid temperatures during arthroscopic subacromial decompression using a radiofrequency probe  

Microsoft Academic Search

Our aim was to investigate the temperatures reached in the subacromial space during radiofrequency ablation of the subacromial bursa, in order to see if the probes generate sufficiently high temperatures to cause chondrolysis of the articular surfaces in the glenohumeral joint. We recorded the maximum temperatures in the subacromial space during arthroscopic subacromial decompression on 30 con - secutive patients

Howard DAVIES; Henry WYNN; Thomas DESMET; Shameem SAMPATH; Bury St Edmunds

2009-01-01

148

Can the impingement test predict outcome after arthroscopic subacromial decompression?  

Microsoft Academic Search

The impingement test, placement of local anesthetic in the subacromial space, is considered a useful tool in diagnosing impingement syndrome. The purpose of this study was to examine the predictive value of the impingement test with respect to outcome after arthroscopic subacromial decompression. Fifty-five patients who had a preoperative impingement test were evaluated at 3 and 12 months postoperatively. We

Scott D Mair; Randall W Viola; Thomas J Gill; Karen K Briggs; Richard J Hawkins

2004-01-01

149

Arthroscopic treatment of labral tears in femoroacetabular impingement: a comparative study of refixation and resection with a minimum two-year follow-up.  

PubMed

Labral tears are commonly associated with femoroacetabular impingement. We reviewed 151 patients (156 hips) with femoroacetabular impingement and labral tears who had been treated arthroscopically. These were subdivided into those who had undergone a labral repair (group 1) and those who had undergone resection of the labrum (group 2). In order to ensure the groups were suitably matched for comparison of treatment effects, patients with advanced degenerative changes (Tönnis grade > 2, lateral sourcil height < 2 mm and Outerbridge grade 4 changes in the weight-bearing area of the femoral head) were excluded, leaving 96 patients (101 hips) in the study. At a mean follow-up of 2.44 years (2 to 4), the mean modified Harris hip score in the labral repair group (group 1, 69 hips) improved from 60.2 (24 to 85) pre-operatively to 93.6 (55 to 100), and in the labral resection group (group 2, 32 hips) from 62.8 (29 to 96) pre-operatively to 88.8 (35 to 100). The mean modified Harris hip score in the labral repair group was 7.3 points greater than in the resection group (p = 0.036, 95% confidence interval 0.51 to 14.09). Labral detachments were found more frequently in the labral repair group and labral flap tears in the resection group. No patient in our study group required a subsequent hip replacement during the period of follow-up. This study shows that patients without advanced degenerative changes in the hip can achieve significant improvement in their symptoms after arthroscopic treatment of femoroacetabular impingement. Where appropriate, labral repair provides a superior result to labral resection. PMID:21768624

Schilders, E; Dimitrakopoulou, A; Bismil, Q; Marchant, P; Cooke, C

2011-08-01

150

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

PubMed Central

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

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

2014-01-01

151

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

PubMed

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

Hwang, Yong Gil; Kwoh, C Kent

2014-04-01

152

The Use of Double-Loaded Suture Anchors for Labral Repair and Capsular Repair During Hip Arthroscopy  

PubMed Central

With the development of hip joint preservation procedures, the use of hip arthroscopy has grown dramatically over the past decade. However, recent articles have reported cases of hip instability after hip arthroscopy. Little is known about the role of static and dynamic stabilizers on hip joint stability, but there are concerns that an extensile capsulotomy or capsulectomy, osteoplasty of the acetabulum and proximal femur, and labral detachment or debridement during hip arthroscopy could potentially compromise hip stability. The safety parameters for arthroscopic hip surgery have not yet been fully established, and techniques are being developed for labral refixation and capsular repair after arthroscopic treatment of femoroacetabular impingement in an attempt to decrease the chance of iatrogenic hip instability or microinstability. The surgical technique presented in this article may provide anatomic repair of both the labrum and capsule using a double-loaded suture anchor technique. We believe that this technique increases both operative efficiency and the strength of the overall repair, which may minimize the risk of iatrogenic hip instability after hip arthroscopy. PMID:23766998

Slikker, William; Van Thiel, Geoffrey S.; Chahal, Jaskarndip; Nho, Shane J.

2012-01-01

153

Arthroscopic removal of giant loose bodies in the glenohumeral joint  

PubMed Central

INTRODUCTION Loose bodies within the joint because of any cause have the potential for continued growth. PRESENTATION OF CASE A 41-year-old man had suffered multiple recurrent dislocations of his left shoulder, accompanied with pain. His anterior apprehension and relocation tests were positive, but no other sign was noted on physical examination. On magnetic resonance imaging and at arthroscopy, two giant loose bodies were seen. They were in the axillary recess and were removed arthroscopically. DISCUSSION Most authors recommend surgical removal of the cartilaginous loose bodies to ameliorate the symptoms. Furthermore, the majority of authors recommend a synovectomy to decrease the risk of recurrence. Depending on the size of the chondral loose bodies, removal can be performed via an arthrotomy, arthroscopy with mini-open arthrotomy, or arthroscopy. CONCLUSION The source of the loose body should be determined carefully. Other lesions may be associated with the loose body. Arthroscopic treatment is a good option for removing the loose body. PMID:24973527

Yucel, Bulent; Mutlu, Serhat; Komur, Baran; Mutlu, Harun

2014-01-01

154

Hemophilic synovitis of the knee: radiosynovectomy or arthroscopic synovectomy?  

PubMed

Radiosynovectomy (RS) is the best choice for patients with persistent synovitis of the knee unresponsive to a 3-month trial of prophylactic factor replacement. If three consecutive RSs with 6-month intervals have been ineffective, an arthroscopic synovectomy should be indicated in patients older than 12 years of age (adolescents). In children younger than 12 years of age, adequate prophylaxis should be maintained, with arthroscopic synovectomy always being the last resort. In the knee, we recommend Yttrium-90 at a dose of 90 mBq in children and 185 mBq in adults. Although the dose of radiation of RS is minimal and neither articular nor systemic neoplastic changes related to RS have been reported so far, all patients must be given the opportunity to consider the risk/benefit ratios. Our current recommendation is to use knee RS in hemophilia patients older than 12 years of age (adolescents). PMID:24957567

Rodriguez-Merchan, Emerito Carlos

2014-08-01

155

Arthroscopic assisted bone grafting for early stages of Kienböck's disease.  

PubMed

Kienböck's disease is known for its difficulty in being diagnosed and treated at early stages; option treatments are few and most of them quite aggressive. The author describes his experience with arthroscopic assisted lunate bone grafting. Three patients with diagnosis of stage I avascular necrosis of the lunate (average age: 45 years), were treated. Before surgical procedure, the patients underwent to a conservative treatment. After harvesting the bone graft from the volar surface of the radius, arthroscopic bone grafting was performed. At an average follow-up of 13.5 months (9-15), all the patients show a normal density of the lunate and no arthritic changes in radiographs. The MRI confirmed the lunate vascularity. The number of patients is definitely small, due also to the rarity of the disease and the difficulty in diagnosis, but, despite the very high learning curve, could be the proper first choice of treatment. PMID:21548146

Pegoli, L; Ghezzi, A; Cavalli, E; Luchetti, R; Pajardi, G

2011-01-01

156

Clinical Outcomes after Arthroscopic Release for Recalcitrant Frozen Shoulder  

PubMed Central

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

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

2014-01-01

157

Arthroscopic cartilage regeneration facilitating procedure for osteoarthritic knee  

PubMed Central

Background The effectiveness of arthroscopic treatment for osteoarthritic knee is a controversy. This study presents the technique of a novel concept of arthroscopic procedure and investigates its clinical outcome. Method An arthroscopic procedure targeted on elimination of focal abrasion phenomenon and regaining soft tissue balance around patello-femoral joint was applied to treat osteoarthritis knees. Five hundred and seventy-one knees of 367 patients with osteoarthritis received this procedure. There were 70 (19%) male and 297 (81%) female and the mean age was 60 years (SD 10). The Knee Society score (KSS) and the knee injury and osteoarthritis outcome score (KOOS) were used for subjective outcome study. The roentgenographic changes of femoral-tibial angle and joint space width were evaluated for objective outcomes. The mean follow-up period was 38 months (SD 3). Results There were 505 knees in 326 patients available with more than 3 years follow-up and the mean follow-up period was 38 months (SD 3). The subjective satisfactory rate for the whole series was 85.5%. For 134 knees with comprehensive follow-up evaluation, the KSS and all subscales of the KOOS improved statistically. The femoral-tibial angle improved from 1.57 degrees (SD 3.92) to 1.93 degrees (SD 4.12) (mean difference: 0.35, SD 0.17). The joint space width increased from 2.02 millimeters (SD 1.24) to 2.17 millimeters (SD 1.17) (mean difference: 0.13, SD 0.05). The degeneration process of the medial compartment was found being reversed in 82.1% of these knees by radiographic evaluation. Conclusions Based on these observations arthroscopic cartilage regeneration facilitating procedure is an effective treatment for osteoarthritis of the knee joint and can be expected to satisfy the majority of patients and reverse the degenerative process of their knees. PMID:23171074

2012-01-01

158

Arthroscopic treatment of antirior synovitis of the ankle in athletes  

Microsoft Academic Search

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

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

1994-01-01

159

Advantages of 70° arthroscope in management of ECRB tendinopathy  

Microsoft Academic Search

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

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

2011-01-01

160

Symptomatic first metatarsocuneiform nonunion revised by arthroscopic lapidus arthrodesis.  

PubMed

Lapidus arthrodesis is indicated for painful, advanced hallux valgus and symptomatic first ray hypermobility with or without arthrosis of the joint. Nonunion of the first metatarsocuneiform joint fusion is the most frequent complication of attempted lapidus arthrodesis. We present a case of painful first metatarsocuneiform nonunion that was successfully treated using arthroscopic revision lapidus arthrodesis to describe this unusual approach to a known postoperative complication. PMID:22819003

Lui, Tun Hing

2012-01-01

161

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

PubMed

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

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

2012-05-01

162

Current concept for the use of PRP in arthroscopic surgery.  

PubMed

PRP is commonly used in sports medicine and because it is supposed to increase healing capacities of damaged tissues, it is expected to be increase efficiency or god clinical outcomes when added to arthroscopic surgical procedure. The current review of literature explores the evidence-based medicine supporting the use of PRP in three arthroscopic related disorders. Regarding cartilage lesions of the knee, many studies are exploring several aspect of cartilage lesion treatment. It appears that PRP, in some protocols with specific concentration, should be more efficient than current therapies in the treatment of early stages of knee OA, but only in the field of rheumatology or sport medicine, not when used during surgery. PRP have been used in ACL reconstruction, no benefit has been reported in any study regarding clinical or radiological outcomes. In shoulder cuff disorder, to date, no clinical benefit nor increased healing rate have been clearly reported. Thus, in 2013, it is clear that there is no evidence base medicine data supporting the use of PRP in arthroscopic surgery. PMID:24239107

Nourissat, G; Mainard, D; Kelberine, F

2013-12-01

163

Arthroscopic cystectomy for popliteal cysts through the posteromedial cystic portal.  

PubMed

In the treatment of patients with popliteal cysts (Baker's cysts), we generally need to address the intra-articular pathologies, most commonly, medial meniscal tears and concomitant connecting valvular mechanisms responsible for the formation and recurrence of the cyst. We introduce here an arthroscopic technique that can treat the associated intra-articular pathology and correct the valvular mechanism of the capsular fold. The most important step is to locate the opening connection between the joint cavity and the popliteal cyst at the posteromedial compartment. The opening is found at the posteromedial side of the medial head of the gastrocnemius after inferior displacement of the capsular fold, which overlies the opening. It is helpful to rotate the bevel of the arthroscope upward to the 11-, 12-, and 1-o'clock positions for most effective visualization of the capsular fold. After the opening connection of the cyst is found, the capsular fold is resected with basket forceps and a shaver inserted through the posteromedial portal to correct the valvular mechanism. Furthermore, we have developed an additional "posteromedial cystic portal," which is located directly above the popliteal cyst and can be effectively used in cystectomy, especially in treatment of cysts that consist of septa and nodules. Arthroscopic popliteal cyst removal with use of an additional posteromedial cystic portal can be effective in treating a cyst with multiple fibrous septa or membranes. PMID:17478291

Ahn, Jin Hwan; Yoo, Jae Chul; Lee, Sang Hak; Lee, Yong Seuk

2007-05-01

164

The use of arthroscopic thermal capsulorrhaphy to treat internal impingement in baseball players  

Microsoft Academic Search

Purpose: To determine if reducing glenohumeral translation by arthroscopic thermal shrinkage would improve the results of arthroscopic treatment of internal impingement in baseball players. Type of Study: Retrospective review. Introduction: Traditional treatment of internal impingement does not address the pathophysiology. Baseball players’ shoulders routinely have glenohumeral laxity. Addressing this laxity by thermal capsulorrhaphy may improve the results in the treatment

Craig L. Levitz; Jeffrey Dugas; James R. Andrews

2001-01-01

165

Ultrasonography-Assisted Arthroscopic Proximal Iliotibial Band Release and Trochanteric Bursectomy  

PubMed Central

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

Weinrauch, Patrick; Kermeci, Sharon

2013-01-01

166

Arthroscopic washout of the ankle for septic arthritis in a three-month-old boy  

PubMed Central

There is no report of athroscopic treatment for septic arthritis of the ankle in infants. We report a case of successful management of septic arthritis of the ankle in a three-month-old boy by arthroscopic washout. Arthroscopic washout may be a useful treatment for septic arthritis in young infants when performed early after onset. PMID:21961455

2011-01-01

167

Arthroscopic surgery for treatment of anterior displacement of the disc without reduction of the temporomandibular joint  

Microsoft Academic Search

The aim of this study was to investigate the clinical results and efficacy of an arthroscopic approach to correct anterior displacement of the disc without reduction of the temporomandibular joint (TMJ) with limitation of mouth opening. We studied 28 joints with internal derangement in 23 patients, all of whom had had arthroscopic surgery (lavage, lysis of adhesions in the superior

Yaomin Zhu; Cangshang Zheng; Yongqiang Deng; Yang Wang

168

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

PubMed Central

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

Kolber, Morey J.

2012-01-01

169

Anatomical Considerations of the Suprascapular Nerve in Rotator Cuff Repairs  

PubMed Central

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

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

2014-01-01

170

The Thrower's Elbow: Arthroscopic Treatment of Valgus Extension Overload Syndrome  

PubMed Central

Injury to the medial collateral ligament of the elbow (MCL) can be a career-threatening injury for an overhead athlete without appropriate diagnosis and treatment. It has been considered separately from other athletic injuries due to the unique constellation of pathology that results from repetitive overhead throwing. The past decade has witnessed tremendous gains in understanding of the complex interplay between the dynamic and static stabilizers of the athlete's elbow. Likewise, the necessity to treat these problems in a minimally invasive manner has driven the development of sophisticated techniques and instrumentation for elbow arthroscopy. MCL injuries, ulnar neuritis, valgus extension overload with osteophyte formation and posteromedial impingement, flexor pronator strain, medial epicondyle pathology, and osteochondritis dissecans (OCD) of the capitellum have all been described as sequelae of the overhead throwing motion. In addition, loose body formation, bony spur formation, and capsular contracture can all be present in conjunction with these problems or as isolated entities. Not all pathology in the thrower's elbow is amenable to arthroscopic treatment; however, the clinician must be familiar with all of these problems in order to form a comprehensive differential diagnosis for an athlete presenting with elbow pain, and he or she must be comfortable with the variety of open and arthroscopic treatments available to best serve the patient. An understanding of the anatomy and biomechanics of the thrower's elbow is critical to the care of this population. The preoperative evaluation should focus on a thorough history and physical examination, as wellas on specific diagnostic imaging modalities. Arthroscopic setup, including anesthesia, patient positioning, and portal choices will be discussed. Operative techniques in the anterior and posterior compartments will bereviewed, as well as postoperative rehabilitationandsurgical results. Lastly, complications will be reviewed. PMID:18751853

Altchek, David W.

2006-01-01

171

Arthroscopic Lateral Epicondylitis Release Using the “Bayonet” Technique  

PubMed Central

Most patients diagnosed with lateral epicondylitis respond well to conservative management. For patients who do not respond to nonoperative modalities, surgical treatment represents a viable option for long-term symptomatic relief. The arthroscopic surgical technique described in this article has been consistently used by the senior author for the treatment of recalcitrant lateral epicondylitis for more than 5 years (198 patients) without the occurrence of any major complications and appears to be a safe, reliable, and efficacious surgical intervention for the management of lateral epicondylitis. PMID:24749034

Stiefel, Eric C.; Field, Larry D.

2014-01-01

172

Arthroscopic Tenoplasty in Congenital Split Biceps Long Head  

PubMed Central

The long head of the biceps brachii tendon arises mainly from the superior glenoid labrum and supraglenoid tubercle. Biceps brachii display anatomic variations, but these are rarely encountered. We report, for the first time, a technique called arthroscopic intra-articular biceps tenoplasty describing restoration of the long head of the biceps tendon using the superior capsule in a case of anomalous congenital split biceps tendon encountered incidentally during diagnostic glenohumeral arthroscopy in a patient who was treated for shoulder instability and SLAP tear. PMID:24904759

Yoo, Yon-Sik; Kim, Hyung-Jin; Arora, Manish

2014-01-01

173

Snowmobile Repair.  

ERIC Educational Resources Information Center

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…

Helbling, Wayne

174

Motorcycle Repair.  

ERIC Educational Resources Information Center

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

Hein, Jim; Bundy, Mike

175

Craniosynostosis repair  

MedlinePLUS

... operating room under general anesthesia. This means your child will be asleep and will not feel pain. Traditional surgery is called open repair. It includes these steps: The most common place for a surgical cut to be made is over the ...

176

Railroad Repair  

NSDL National Science Digital Library

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

2013-12-04

177

Railroad Repair  

NSDL National Science Digital Library

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

2008-01-01

178

A New Technique for Patch Augmentation of Rotator Cuff Repairs  

PubMed Central

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

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

2014-01-01

179

Development of Atomic Force Microscope for Arthroscopic Knee Cartilage Inspection  

NASA Astrophysics Data System (ADS)

A recent study, based on ex vivo unconfined compression testing of normal, diseased, and enzymatically altered cartilage, revealed that a scanning force microscope (SFM), used as a nano-intender, is sensitive enough to enable measurement of alterations in the biomechanical properties of cartilage. Based on these ex vivo measurements, we have designed a quantitative diagnosis tool, the scanning force arthroscope (SFA), able to perform in vivo measurements during a standard arthroscopic procedure. For stabilizing and positioning the instrument relative to the surface under investigation, a pneumatic system has been developed. A segmented piezoelectric tube was used to perform the indentation displacement, and a pyramidal nanometer-scale silicon tip mounted on a cantilever with an integrated deflection sensor measured the biomechanical properties of cartilage. Mechanical means were designed to protect the fragile cantilever during the insertion of the instrument into the knee joint. The stability of the pneumatic stage was checked with a prototype SFA. In a series of tests, load-displacement curves were recorded in a knee phantom and, more recently, in a pig’s leg.

Imer, Raphaėl; Akiyama, Terunobu; de Rooij, Nicolaas F.; Stolz, Martin; Aebi, Ueli; Friederich, Niklaus F.; Koenig, Uwe; Wirz, Dieter; Daniels, A. U.; Staufer, Urs

2006-03-01

180

A minimally invasive medial patellofemoral ligament arthroscopic reconstruction.  

PubMed

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

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

2014-02-01

181

Arthroscopic treatment of rotator cuff tear and greater tuberosity fracture nonunion  

Microsoft Academic Search

The association of full-thickness rotator cuff tear combined with a nonunion of the greater tuberosity is uncommon. We present one case, describing management of both lesions using arthroscopic technique

Gary M. Gartsman; Ettore Taverna

1996-01-01

182

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

PubMed Central

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

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

2014-01-01

183

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

PubMed

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

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

2010-10-01

184

Arthroscopic Transtendinous Modified Double-Row Suture Bridge Repair of a Bony PASTA Lesion.  

PubMed

Surgical and conservative management of partial tears of the rotator cuff has long been a controversial topic for many generations of shoulder surgeons. These tears frequently occur on both the articular and bursal surfaces and within the intrasubstance of the rotator cuff. The term "PASTA lesion" describes the partial articular supraspinatus tendon avulsion-type injury. A less common variant of this injury is the bony PASTA lesion or partial articular bony avulsion of the supraspinatus tendon (PABAST). PMID:25264507

Johnson, Jeffrey S; Caldwell, Paul E; Pearson, Sara E

2014-08-01

185

Arthroscopic Transtendinous Modified Double-Row Suture Bridge Repair of a Bony PASTA Lesion  

PubMed Central

Surgical and conservative management of partial tears of the rotator cuff has long been a controversial topic for many generations of shoulder surgeons. These tears frequently occur on both the articular and bursal surfaces and within the intrasubstance of the rotator cuff. The term “PASTA lesion” describes the partial articular supraspinatus tendon avulsion–type injury. A less common variant of this injury is the bony PASTA lesion or partial articular bony avulsion of the supraspinatus tendon (PABAST). PMID:25264507

Johnson, Jeffrey S.; Caldwell, Paul E.; Pearson, Sara E.

2014-01-01

186

All-Arthroscopic Repair of Arcuate Avulsion Fracture With Suture Anchor  

Microsoft Academic Search

Arcuate avulsion fractures are very rare but present pathologic posterolateral rotation instability. Untreated instability may lead to overload of the reconstructed posterior cruciate ligament (PCL) graft. Surgical treatment and clinical results have not yet been reported to our knowledge. This study presents the case of a 45-year-old man with PCL injury and an arcuate avulsion fracture of the fibular head.

Hui Zhang; Lei Hong; Xue-Song Wang; Jin Zhang; Xin Liu; Hua Feng

2011-01-01

187

Isolated subscapularis repair for massive rotator cuff tear.  

PubMed

The best surgical treatment for an irreparable rotator cuff tear is controversial. In such cases, partial rotator cuff repair, primarily involving the posterior cuff in most reports, has been shown to be beneficial. The authors retrospectively investigated 41 patients who underwent arthroscopic subscapularis-only repair and greater tuberoplasty between April 2003 and August 2009 for massive 3-tendon cuff tears with irreparable supraspinatus and infraspinatus tendons after 3 months of conservative management was unsuccessful. Twenty-five patients (61%) underwent biceps tenotomy, and the remaining 39% had preexisting biceps tenotomy or rupture. The patients were assessed with American Shoulder and Elbow Surgeons (ASES) and Single Assessment Numeric Evaluation (SANE) scores. Of the 41 patients, 34 (83%) were available for a follow-up telephone questionnaire after a minimum of 12 months (mean, 35 months; range, 12-84 months). Mean ASES and SANE scores were 76% and 63%, respectively. Mean postoperative passive range of motion was 156° of forward flexion and 39° of external rotation. Of the patients queried, 74% (25 of 34) were able to actively raise their arms above shoulder level. For those with a positive belly-press test result preoperatively, 22 of 27 patients had a negative test result postoperatively. A total of 3 complications (7.3%) occurred. Workers' compensation claim was a strong predictor of lower shoulder scores. Arthroscopic subscapularis-only repair and greater tuberoplasty may offer a promising and safe method for treating massive rotator cuff tears when the supra-spinatus and infraspinatus tendons are irreparable. Workers' compensation claim may predict lower outcome scores. PMID:25361371

Austin, Luke; Chang, Edward S; Zmistowski, Benjamin; Nydick, Jason; Lazarus, Mark

2014-11-01

188

Arthroscopic management of tibial plateau fractures: surgical technique.  

PubMed

Tibial plateau fractures are serious articular fractures that are challenging to treat. Arthroscopy-assisted percutaneous fixation is the treatment of choice in Schatzker types 1, 2, 3, and 4 fractures, as it ensures optimal reduction and stable fixation consistent with early mobilisation. The most reliable fixation method seems to be percutaneous cannulated screw fixation, which is less invasive than open plate fixation. In complex proximal tibial fractures, arthroscopy may allow an evaluation of articular fracture reduction, thereby obviating the need for extensive arthrotomy. Complementary stable fixation is crucial and should allow early mobilisation to reap the benefits of the arthroscopic assistance. This article aims to review the technical points that are useful to the successful video-assisted management of tibial plateau fractures. PMID:23347755

Burdin, G

2013-02-01

189

The pathoanatomy and arthroscopic management of femoroacetabular impingement  

PubMed Central

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

Tibor, L. M.; Leunig, M.

2012-01-01

190

Arthroscopic reduction of complex dorsal metacarpophalangeal dislocation of index finger.  

PubMed

Complex dorsal dislocation of the metacarpophalangeal joint is an uncommon injury, typically caused by entrapment of the volar plate within the joint space. Closed reduction of the dislocation is not effective; instead, open reduction is necessary to release the soft tissues interposed between the metacarpal head and the proximal phalanx. However, an operative risk of digital nerve injury exists because of intricate displacement of the normal anatomy. We successfully reduced a dislocation by arthroscopic release of the entrapped volar plate. The case involved an 11-year-old boy with a complex dorsal dislocation of the metacarpophalangeal joint of the right index finger that had failed closed reduction. This technique allowed for reliable joint reduction, enabling observation of the structures obstructing the reduction; was less invasive; and avoided the risk of neurovascular injury. It is a reasonable method to use when the volar plate prevents reduction of the dislocation. PMID:24904773

Kodama, Akira; Itotani, Yuji; Mizuseki, Takaya

2014-04-01

191

Arthroscopic Reduction of Complex Dorsal Metacarpophalangeal Dislocation of Index Finger  

PubMed Central

Complex dorsal dislocation of the metacarpophalangeal joint is an uncommon injury, typically caused by entrapment of the volar plate within the joint space. Closed reduction of the dislocation is not effective; instead, open reduction is necessary to release the soft tissues interposed between the metacarpal head and the proximal phalanx. However, an operative risk of digital nerve injury exists because of intricate displacement of the normal anatomy. We successfully reduced a dislocation by arthroscopic release of the entrapped volar plate. The case involved an 11-year-old boy with a complex dorsal dislocation of the metacarpophalangeal joint of the right index finger that had failed closed reduction. This technique allowed for reliable joint reduction, enabling observation of the structures obstructing the reduction; was less invasive; and avoided the risk of neurovascular injury. It is a reasonable method to use when the volar plate prevents reduction of the dislocation. PMID:24904773

Kodama, Akira; Itotani, Yuji; Mizuseki, Takaya

2014-01-01

192

Open and Arthroscopic Surgical Anatomy of the Ankle  

PubMed Central

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

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

2013-01-01

193

Arthroscopic Gluteal Muscle Contracture Release With Radiofrequency Energy  

PubMed Central

Gluteal muscle contracture is common after repeated intramuscular injections and sometimes is sufficiently debilitating to require open surgery. We asked whether arthroscopic release of gluteal muscle contracture using radiofrequency energy would decrease complications with clinically acceptable results. We retrospectively reviewed 108 patients with bilateral gluteal muscle contractures (57 males, 51 females; mean age, 23.7 years). We used inferior, anterosuperior, and posterosuperior portals. With the patient lying laterally, we developed and enlarged a potential space between the gluteal muscle group and the subcutaneous fat using blunt dissection. Under arthroscopic guidance through the inferior portal, we débrided and removed fatty tissue overlying the contractile band of the gluteal muscle group using a motorized shaver introduced through the superior portal. Radiofrequency then was introduced through the superior portal to gradually excise the contracted bands from superior to inferior. Finally, hemostasis was ensured using radiofrequency. Patients were followed a minimum of 7 months (mean, 17.4 months; range, 7–42 months). At last followup, the adduction and flexion ranges of the hip were 45.3° ± 8.7° and 110.2° ± 11.9°, compared with 10.4° ± 7.2° and 44.8° ± 14.1° before surgery. No hip abductor contracture recurred and no patient had residual hip pain or gluteal muscle wasting. We found gluteal muscle contracture could be released effectively with radiofrequency energy. Level of Evidence: Level IV, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence. Electronic supplementary material The online version of this article (doi:10.1007/s11999-008-0595-7) contains supplementary material, which is available to authorized users. PMID:18975040

Liu, Yu-Jie; Wang, Yan; Xue, Jing; Lui, Pauline Po-Yee

2008-01-01

194

Interactive stereotaxic teleassistance of remote experts during arthroscopic procedures.  

PubMed

This article describes the technical setup for stereotaxic telesurgical assistance for arthroscopic procedures. It also outlines the current state, limitations, and feasibility of this technical development. Teleassistance or teleconsultation implemented in endoscopic or arthroscopic procedures have not yet been reported. In this study, 7 computer-assisted arthroscopies of the temporomandibular joint were supported by extramural experts via interactive stereotaxic teleconsultation from distant locations. The external experts were supplied with close to real-time video, audio, and stereotaxic navigation data directly from the operation site. This setup allows the surgeons and external experts to interactively determine portals, target structures, and instrument positions relative to the patient's anatomy and to discuss any step of the procedures. Optoelectronic tracking interfaced to computer- based navigation technology allowed precise positioning of instruments for single or multiple temporomandibular joint punctures. The average error of digitizing probe measurements was 1.3 mm (range, 0.0 to 2.5 mm) and the average standard deviation was 0.7 mm (range, 0.4 to 0.9 mm). Evaluation of the reliability and accuracy of this technique suggests that it is sufficient for controlled navigation, even inside the small temporomandibular joint, a fact that encourages further applications for arthroscopy in general. The minimum requirement for high-quality video transmission for teleassisted procedures are integrated services digital network (ISDN) connections. Conventional ISDN-based videoconferencing can be combined with computer-aided intraoperative navigation. Transmission control protocol/internet protocol (TCP/IP)-based stereotaxic teleassistance data transmission via ATM or satellite seem to be promising techniques to considerably improve the field of arthroscopy. PMID:12426549

Wagner, Arne; Undt, Gerhard; Schicho, Kurt; Wanschitz, Felix; Watzinger, Franz; Murakami, Kenichiro; Czerny, Christian; Ewers, Rolf

2002-01-01

195

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 ...

196

Brain aneurysm repair  

MedlinePLUS

... aneurysm repair; Dissecting aneurysm repair; Endovascular aneurysm repair - brain; Subarachnoid hemorrhage - aneurysm ... Your scalp, skull, and the coverings of the brain are opened up. A metal clip is placed ...

197

Aortic aneurysm repair - endovascular  

MedlinePLUS

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

198

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

PubMed Central

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

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

2014-01-01

199

Clinical Results of Direct Arthroscopic Excision of Popliteal Cyst Using a Posteromedial Portal  

PubMed Central

Purpose To evaluate the efficacy of the direct arthroscopic excision of a popliteal cyst without additional skin incision using a posteromedial portal based on minimum 2 year follow-up clinical results. Materials and Methods From January 2003 to January 2010, 105 patients (111 cases) with popliteal cyst have been treated by a direct arthroscopic excision. Direct arthroscopic excision using a 70 degree arthroscopy and posteromedial portal can correct the valvular mechanism of capsular fold and reduce the complications with no additional skin incision at the popliteal area. In all cases, preoperative magnetic resonance imaging (MRI) was performed to detect combined intraarticular pathology. At 2 years postoperatively, a follow-up ultrasonography or MRI was performed to detect the recurrence of cysts. We used Rauschning and Lindgren criteria for clinical evaluation. Results All cases had neither recurrence nor complaints of pain, swelling, or functional impairment more than 2 years after the surgery. At ultrasonography or MRI, no recurrence was found, and 5 complications were 1 skin lesion and 4 hematoma. Postoperatively, Rauschning and Lindgren criteria were more than grade 1. Conclusions Direct arthroscopic excision using 70 degree arthroscope and posteromedial portal is an effective method for the treatment of popliteal cyst. PMID:23269962

2012-01-01

200

Time and cost savings in arthroscopic subacromial decompression: the use of bipolar versus monopolar radiofrequency  

PubMed Central

There is currently an increased interest in the use of electro surgery in arthroscopy. Since the introduction of the bipolar arthroscopic radiofrequency (RF) wand, it has started to replace the classic Bovie monopolar probe on the assumption that the new technology provides multifunctional devices, combining both tissue removal and haemostasis into one instrument. The more efficient tissue ablation and precise haemostasis achieved with these instruments should result in a significant reduction in the operative time and cost. We ran a prospective comparative randomised study to test this hypothesis. Forty patients underwent arthroscopic subacromial decompression, randomised into two groups. The group treated with bipolar RF was associated with an average operative time saving of 8 min (P?arthroscopic shoulder surgery, as it saves time and money. PMID:18414860

Fernandez, G. N.; Elsorafy, Kareem

2008-01-01

201

Acupuncture for postoperative pain in day surgery patients undergoing arthroscopic shoulder surgery.  

PubMed

The purpose of this quasi-experimental study was to examine the effect of acupuncture on postoperative pain in day surgery patients undergoing arthroscopic shoulder surgery. Twenty-two participants scheduled to undergo arthroscopic shoulder surgery were included. The results showed that on postoperative day one pain decreased (-1.1) in patients receiving acupuncture compared to the control group in which pain increased (2.0), p=.014. Sleep quality was also significantly higher in the acupuncture group compared to the control group, p=.042. In conclusions, acupuncture seems to have a reducing effect on postoperative pain as well as increase sleep quality in day surgery patients undergoing arthroscopic shoulder surgery. In regards to application, nurses should be encouraged to use additional nonpharmacologic approaches like acupuncture in postoperative pain management, as this can be a part of the multimodal analgesic regimes to improve patients care. PMID:22843248

Ward, Ulla; Nilsson, Ulrica G

2013-02-01

202

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

PubMed Central

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

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

2014-01-01

203

Neuronal repair  

PubMed Central

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

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

2013-01-01

204

Outcomes are favorable after arthroscopic treatment of osteochondritis dissecans of the talus.  

PubMed

Arthroscopic treatment of osteochondritis dissecans (OCD) of the talus has resulted in outcomes as good as, or better than, those after arthrotomy. We noted a lack of prospective studies investigating the outcomes of arthroscopic treatment. As such, we conducted a prospective study investigating the functional outcomes, pain scores, patient satisfaction, and expectation scores of patients undergoing arthroscopic treatment of OCD of the talus, hypothesizing that these patients would have good outcomes and satisfaction. A total of 61 patients underwent arthroscopic chondroplasty, removal of loose bodies, and microfracture for OCD of the talus and completed ?1 year of follow-up. We evaluated patients pre- and postoperatively at 6 and 12 months using the Ankle-Hindfoot score, visual analog scale for pain, and Medical Outcomes Study short-form 36 questionnaires. We also evaluated the patients' expectations and satisfaction. The mean Ankle-Hindfoot score improved significantly from 53.0 ± 14.3 points preoperatively to 77.8 ± 19.1 at 6 months and 83.1 ± 18.3 at 12 months after arthroscopic treatment (p < .001). The overall scores at the final follow-up visit were excellent for 30 (49%), good for 6 (10%), fair for 18 (30%), and poor for 7 (11%). The patients also experienced significant improvement in the visual analog scale score and physical component score of the short-form 36 questionnaire (p < .001). Of the 61 patients, 67% had their expectations fulfilled and 74% were satisfied with their surgery at 12 months of follow-up. Arthroscopic treatment of OCD of the talus continues to be a successful procedure to alleviate pain and loss of function. It is also associated with improvements to quality of life and good patient satisfaction. PMID:25441271

Goh, Graham Seow Hng; Bin Abd Razak, Hamid Rahmatullah; Mitra, Amit Kanta

2015-01-01

205

The modified racking hitch(MRH) knot: a new sliding knot for arthroscopic surgery.  

PubMed

Sliding knots are commonly used in arthroscopic surgery and can be problematic in terms of strength and loop security. A new sliding knot for arthroscopic surgery, a modified racking hitch (MRH) knot, is described. The knot is essentially a modified cow's hitch knot that includes two self-locking loops. By tensioning the loop strands, a snug knot is created without backward sliding and provides excellent knot and loop security. In laboratory testing, the MRH knot provided comparable strength and security to other sliding knots. Experience gained from approximately 5 years of clinical use has added to the promise of the useful application of the MRH knot in arthroscopy. PMID:18081550

Chokshi, Biren V; Ishak, Charbel; Iesaka, Kazuho; Jazrawi, Laith M; Kummer, Frederic J; Rosen, Jeffrey E

2007-01-01

206

Hip Arthroscopic Portal Bridge Retraction Technique for Improved Peripheral Compartment Visualization  

PubMed Central

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

McGrath, Brian E.; Kuechle, Joseph B.

2014-01-01

207

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

PubMed Central

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.

Sandokji, Abdullah

2015-01-01

208

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

PubMed

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

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

2010-05-01

209

The golf ball sign: arthroscopic localization of an osteochondritis dissecans lesion of the knee.  

PubMed

We report on the arthroscopic treatment of a 12-year-old boy diagnosed with an osteochondral defect of the medial femoral condyle. He underwent arthroscopic fixation of the defect, and during the surgery, a blunt trocar was used to localize the lesion. The trocar created a transient dimpling effect on the cartilage overlying the osteochondral defect that resembled the surface of a golf ball. This "golf ball sign" then served as a visual guide during placement of a chondral dart. When present, it is believed that this sign can benefit arthroscopists by helping to improve intraoperative localization of an osteochondral defect. PMID:25126500

Piposar, Jonathan; Sutton, Karen

2014-06-01

210

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

PubMed Central

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

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

2012-01-01

211

Rapid road repair vehicle  

DOEpatents

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

Mara, Leo M. (Livermore, CA)

1998-01-01

212

Rapid road repair vehicle  

DOEpatents

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

Mara, L.M.

1998-05-05

213

Direct Repair vs. Overlapping Sphincter Repair  

Microsoft Academic Search

PURPOSE: The aim of this study was to compare the results of two surgical techniques (direct end-to-end vs. overlapping) of delayed repair of a localized anterior defect of external anal sphincter after an obstetric trauma. METHODS: During a five-year period, 23 patients were randomly assigned to direct end-to-end repair (n = 12) or overlapping sphincter repair (n = 11), using

J. J. Tjandra; W. R. Han; J. Goh; M. Carey; P. Dwyer

2003-01-01

214

Twelve years' experience of the mini-Bankart repair for recurrent anterior dislocation of the shoulder  

PubMed Central

Stabilization for recurrent anterior shoulder dislocation can be achieved through either an open or arthroscopic approach. The former tends to have a lower recurrence rate but longer rehabilitation.The technique of mini-Bankart repair has been used at this establishment since 1996. We retrospectively reviewed the patients that had undergone this procedure. We describe our experience of the mini-Bankart procedure and the results in 24 patients with a mean follow-up of 56 months (range, 12-144 months). The technique is a direct mini-approach to the shoulder joint, preserving the inferior portion of subscapularis. Where present, a Bankart lesion is repaired with two GII Mitek anchors (Ethicon) and the capsule reefed. There were no incidences of repeat anterior dislocation, and the average time period taken to return to work was 8.8 weeks. We recommend this technique due to its low recurrence rate and satisfactory return to normal function. PMID:20661401

Cooney, Alan; Sinha, Satyajit; Campbell, Alexander Craig

2009-01-01

215

Rotator cuff repair  

MedlinePLUS

... Three common techniques are used to repair a rotator cuff tear: During open repair, surgical incision is made and ... when: You have a large or a complete rotator cuff tear. A tear was caused by a recent injury. ...

216

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

Microsoft Academic Search

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

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

1999-01-01

217

Arthroscopic Treatment of Partial Rotator Cuff Tears in Young AthletesA Preliminary Report  

Microsoft Academic Search

Forty-three athletes under age 40, more than half of which were collegiate or professional, with partial rota tor cuff tears were treated arthroscopically and ob served for a minimum of 24 months. By history and mechanism of injury, two main groups were identified. Group A had 14 patients with acute, traumatic injuries. All 14 had inflamed subacromial bursas, but increased

Loel Z. Payne; David W. Altchek; Edward V. Craig; Russell F. Warren

1997-01-01

218

Arthroscopic treatment of osteochondritis dissecans of the capitellum: Report of 5 female athletes  

Microsoft Academic Search

The management of osteochondritis dissecans of the capitellum of the adolescent elbow is still controversial. We report on 5 cases of female high-level athletes aged from 10 to 19 years (4 gymnasts, 1 waterpolo player). All these athletes had a symptomatic osteochondritis dissecans of the capitellum, which was treated arthroscopically in all cases. Follow-up time averaged 5 months (1 to

Matthijs R. Krijnen; Liesbeth Lim; W. Jaap Willems

2003-01-01

219

Saphenous neuralgia after arthroscopically assisted anterior cruciate ligament reconstruction with a semitendinosus and gracilis tendon graft  

Microsoft Academic Search

Summary: A case report of saphenous neuralgia following arthroscopically assisted anterior cruciate ligament reconstruction with hamstring tendons is presented. The patient complained of paresthesia in the anteromedial region of the lower leg and tenderness at the medial side of the knee without motor or reflex abnormalities. Because saphenous neuralgia can mimic disorders of the knee, peripheral vascular disease, and lumbar

Christoph Bertram; Matthias Porsch; Matthias H. Hackenbroch; Ditmar Terhaag

2000-01-01

220

Analgesic efficacy of intra-articular morphine after arthroscopic knee surgery in sport injury patients  

PubMed Central

Abstract: Background: Anterior Cruciate Ligament (ACL) tearing is a common injury among football players. The present study aims to determine the best single-dose of intra-articular morphine for pain relief after arthroscopic knee surgery that, in addition to adequate and long-term analgesia, leads to fewer systemic side effects. Methods: This clinical trial was conducted on 40 ASA-I athletes. After surgery, all participants received an injection of 20cc of 0.5% intra-articular bupivacaine. In addition, the first control group received a saline injection and 5, 10 and 15 mg of morphine were respectively injected into the joints of the second, third and fourth groups by use of Arthroscopic equipment before the Arthroscopic removal. The amount of pain based on VAS at 1, 2, 4, 6 and 24 hours after surgery, duration of analgesia and the consumption of narcotic drugs were recorded. Results: The VAS scores in the fourth, sixth and twenty-fourth hours after surgery showed a significant difference between the study groups. The average time to the first analgesic request from the bupivacaine plus 15 mg morphine group was significantly longer than other groups and total analgesic requests were significantly lower than other groups. No drowsiness complications were observed in any of the groups in the first 24 hours after injection. Conclusions: Application of 15 mg intra-articular morphine after Arthroscopic knee surgery increases the analgesia level as well as its duration (IRCT138902172946N3). PMID:23281420

Yari, Mitra; Saeb, Morteza; Golfam, Parisa; Makhloogh, Zahra

2013-01-01

221

Arthroscopic lysis of adhesions for the stiff total knee: results after failed manipulation.  

PubMed

Arthrofibrosis after total knee arthroplasty (TKA) is a potentially devastating complication, resulting in loss of motion and function and residual pain. For patients in whom aggressive physical therapy and manipulation under anesthesia fail, lysis of adhesions may be the only option to rescue the stiff TKA. The purpose of this study is to report the results of arthroscopic lysis of adhesions after failed manipulation for a stiff, cruciate-substituting TKA. This retrospective study evaluated patients who had undergone arthroscopic lysis of adhesions for arthrofibrosis after TKA between 2007 and 2011. Minimum follow-up was 12 months (average, 31 months). Average total range of motion of patients in this series was 62.3°. Average preoperative flexion contracture was 16° and average flexion was 78.6°. Statistical analysis was performed using Student's t test. Pre- to postoperative increase in range of motion was significant (P<.001) (average, 62° preoperatively to 98° postoperatively). Average preoperative extension deficit was 16°, which was reduced to 4° at final follow-up. This value was also found to be statistically significant (P<.0001). With regard to ultimate flexion attained, average preoperative flexion was 79°, which was improved to 103° at final follow-up. This improvement in flexion was statistically significant (P<.0001). Patients can reliably expect an improvement after arthroscopic lysis of adhesions for a stiff TKA using a standardized arthroscopic approach; however, patients achieved approximately half of the improvement that was obtained at the time of surgery. PMID:24810826

Tjoumakaris, Fotios Paul; Tucker, Bradfords Chofield; Post, Zachary; Pepe, Matthew David; Orozco, Fabio; Ong, Alvin C

2014-05-01

222

Arthroscopic release of shoulder internal rotation contracture in children with brachial plexus birth palsy.  

PubMed

In children with brachial plexus birth palsy, the unopposed contraction of the shoulder internal rotators and adductors, secondary to weakness of the external rotators and abductors, leads to internal rotation contracture of the shoulder joint. Latissimus dorsi and/or teres major tendon transfers combined with open musculotendinous lengthening can improve shoulder function. Arthroscopic release of the anterior glenohumeral ligaments, capsule and upper intra-articular subscapularis tendon, with or without tendon transfer(s), can also be performed in young children to restore external rotation and abduction of the shoulder. Joint alignment, thus obtained, may provide improvement of glenohumeral joint morphology in the long term, although the extent of glenoid remodeling has not been well defined. The authors review and discuss the recent literature on arthroscopic release, with or without tendon transfers, for reduction of the glenohumeral joint subluxation and for restoration of external rotation. Both pathologies respond well to these procedures. According to the literature, arthroscopic release "alone" may be sufficient in children up to 3 years. This minimally invasive procedure restores function successfully, and leads to a centered glenohumeral joint and to glenoid remodeling. A successful arthroscopic release of the shoulder in a 2.5-year-old child is described. PMID:24205762

Kokkalis, Zinon T; Ballas, Efstathios G; Mavrogenis, Andreas F

2013-08-01

223

Patella fracture and proximal patellar tendon rupture following arthroscopic anterior cruciate ligament reconstruction.  

PubMed

The central one-third bone-patella tendon-bone graft is a popular choice for arthroscopic anterior cruciate ligament reconstruction. Complications following graft harvesting are unusual, but several reports have been published. We report an unusual case involving a simultaneous patella fracture and patellar tendon rupture that occurred 6 weeks postoperatively. PMID:10495182

Miller, M D; Nichols, T; Butler, C A

1999-09-01

224

The relationship between subacromial space pressure, blood pressure, and visual clarity during arthroscopic subacromial decompression  

Microsoft Academic Search

Twenty-two consecutive patients with subacromial impingement syndrome underwent arthroscopic subacromial decompression. Measurements of the subacromial space pressure and the blood pressure were recorded along with the clarity of the visual field. The clarity of the visual field was objectively determined based on the pressure at which bleeding was observed from trabecular bone or the soft tissue capillaries. A direct correlation

David S. Morrison; Randall K. Schaefer; Robert L. Friedman

1995-01-01

225

Arthroscopic-assisted allograft anterior cruciate ligament reconstruction in patients with symptomatic arthrosis  

Microsoft Academic Search

We reviewed the results of arthroscopic-assisted anterior cruciate ligament (ACL) allograft reconstructions in 40 patients who had advanced articular cartilage deterioration documented by arthroscopy during the reconstruction. A mean of 7 years had elapsed between the original injury and the reconstruction, and 102 prior operative procedures had been done in 34 of the 40 patients. A total of 64 articular

Frank R. Noyes; Sue D. Barber-Westin

1997-01-01

226

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

Microsoft Academic Search

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

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

1997-01-01

227

Arthroscopic resection of the calcaneonavicular coalition or the "too long" anterior process of the calcaneus.  

PubMed

Calcaneonavicular coalition and the "too long" anterior process (TLAP) of the calcaneus can manifest as lateral foot pain, peroneal spastic flatfoot, and repeated ankle sprain. Surgical resection of the bone bar is frequently required. We present here an arthroscopic approach that can be used to accurately assess pathoanatomy and resect the bone bar. A portal is established slightly dorsal to the angle of Gissane. This is the primary visualization portal. The working portal, which is identified under an image intensifier, is located at the space between the talonavicular and calcaneocuboid joints, directly over the TLAP or the calcaneonavicular coalition. With the 2.7-mm 30 degrees arthroscope placed at the primary visualization portal, soft tissue around the TLAP or the calcaneonavicular coalition is cleared up with the use of an arthroscopic shaver at the working portal. After the TLAP or the calcaneonavicular coalition is clearly visualized, it can be resected with an arthroscopic burr through the working portal. The bone bar is resected proximally until the medial side of the calcaneocuboid joint, the lateral side of the taloavicular joint, and the plantar-lateral aspect of the talar head are clearly seen. Inversion stress should then be applied to the foot to prevent further impingement of the anteromedial process of the calcaneus to the plantar-lateral part of the talar head. PMID:16904593

Lui, Tun Hing

2006-08-01

228

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

Microsoft Academic Search

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.

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

229

Validity of arthroscopic measurement of glenoid bone loss using the bare spot  

PubMed Central

Purpose Our aim was to test the validity of using the bare spot method to quantify glenoid bone loss arthroscopically in patients with shoulder instability. Methods Twenty-seven patients with no evidence of instability (18 males, nine females; mean age 59.1 years) were evaluated arthroscopically to assess whether the bare spot is consistently located at the center of the inferior glenoid. Another 40 patients with glenohumeral anterior instability who underwent shoulder arthroscopy (30 males, ten females; mean age 25.9 years) were evaluated for glenoid bone loss with preoperative three-dimensional computed tomography (3D-CT) and arthroscopic examination. In patients without instability, the distances from the bare spot of the inferior glenoid to the anterior (Da) and posterior (Dp) glenoid rim were measured arthroscopically. In patients with instability, we compared the percentage glenoid bone loss calculated using CT versus arthroscopic measurements. Results Among patients without instability, the bare spot could not be identified in three of 27 patients. Da (9.5±1.2 mm) was smaller than Dp (10.1±1.5 mm), but it was not significantly different. However, only 55% of glenoids showed less than 1 mm of difference between Da and Dp, and 18% showed more than 2 mm difference in length. The bare spot could not be identified in five of 40 patients with instability. Pearson’s correlation coefficient showed significant (P<0.001) and strong (R2=0.63) correlation in percentage glenoid bone loss between the 3D-CT and arthroscopy method measurements. However, in ten shoulders (29%), the difference in percentage glenoid bone loss between 3D-CT and arthroscopic measurements was greater than 5%. Conclusion The bare spot was not consistently located at the center of the inferior glenoid, and the arthroscopic measurement of glenoid bone loss using the bare spot as a landmark was inaccurate in some patients with anterior glenohumeral instability. Level of evidence Level II, prospective comparative study. PMID:24744612

Miyatake, Katsutoshi; Takeda, Yoshitsugu; Fujii, Koji; Takasago, Tomoya; Iwame, Toshiyuki

2014-01-01

230

Repairing Broken Bones  

NSDL National Science Digital Library

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

2014-09-18

231

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

PubMed Central

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

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

2014-01-01

232

Influence of deposit stage and failed ESWT on the surgical results of arthroscopic treatment of calcifying tendonitis of the shoulder  

Microsoft Academic Search

The purpose of the present study is the evaluation of a possible influence of the preoperative deposit stage, the postoperative\\u000a deposit elimination and failed preoperative extracorporeal shockwave therapy on the surgical outcome of arthroscopic treatment\\u000a of tendinosis calcarea. From 1997 to 2004, 65 patients underwent arthroscopic resection of calcific deposits of the shoulder\\u000a after failed conservative treatment. Patients with rotator

O. Lorbach; M. Kusma; D. Pape; D. Kohn; M. Dienst

2008-01-01

233

Intraarticular tramadol plus pericapsular incisional bupivacaine provides better analgesia than intraarticular plus pericapsular incisional bupivacaine after outpatient arthroscopic partial meniscectomy  

Microsoft Academic Search

Postoperative analgesic effects of intraarticular tramadol plus periarticular bupivacaine, and intraarticular plus periarticular\\u000a bupivacaine injections after day-case arthroscopic partial meniscectomy were compared. Seventy-four ASA I\\/II patients undergoing\\u000a arthroscopic partial meniscectomy, performed by a single surgeon under general anesthesia were assigned in a randomized, double-blinded\\u000a manner into two groups: Group TB (n = 41) received intraarticular 100 mg of tramadol in 20 ml normal saline

Tahsin Beyzadeoglu; Cemil Yilmaz; Halil Bekler; Alper Gokce; Murat M. Sayin

2007-01-01

234

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

Microsoft Academic Search

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

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

2010-01-01

235

Shaping chromatin for repair.  

PubMed

To counteract the adverse effects of various DNA lesions, cells have evolved an array of diverse repair pathways to restore DNA structure and to coordinate repair with cell cycle regulation. Chromatin changes are an integral part of the DNA damage response, particularly with regard to the types of repair that involve assembly of large multiprotein complexes such as those involved in double strand break (DSB) repair and nucleotide excision repair (NER). A number of phosphorylation, acetylation, methylation, ubiquitylation and chromatin remodeling events modulate chromatin structure at the lesion site. These changes demarcate chromatin neighboring the lesion, afford accessibility and binding surfaces to repair factors and provide on-the-spot means to coordinate repair and damage signaling. Thus, the hierarchical assembly of repair factors at a double strand break is mostly due to their regulated interactions with posttranslational modifications of histones. A large number of chromatin remodelers are required at different stages of DSB repair and NER. Remodelers physically interact with proteins involved in repair processes, suggesting that chromatin remodeling is a requisite for repair factors to access the damaged site. Together, recent findings define the roles of histone post-translational modifications and chromatin remodeling in the DNA damage response and underscore possible differences in the requirements for these events in relation to the chromatin context. PMID:23085398

Gospodinov, Anastas; Herceg, Zdenko

2013-01-01

236

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

PubMed Central

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

2014-01-01

237

Optimality in DNA repair  

PubMed Central

DNA within cells is subject to damage from various sources. Organisms have evolved a number of mechanisms to repair DNA damage. The activity of repair enzymes carries its own risk, however, because the repair of two nearby lesions may lead to the breakup of DNA and result in cell death. We propose a mathematical theory of the damage and repair process in the important scenario where lesions are caused in bursts. We use this model to show that there is an optimum level of repair enzymes within cells which optimises the cell's response to damage. This optimal level is explained as the best trade-off between fast repair and a low probability of causing double-stranded breaks. We derive our results analytically and test them using stochastic simulations, and compare our predictions with current biological knowledge. PMID:21945337

Richard, Morgiane; Fryett, Matthew; Miller, Samantha; Booth, Ian; Grebogi, Celso; Moura, Alessandro

2012-01-01

238

Optimality in DNA repair.  

PubMed

DNA within cells is subject to damage from various sources. Organisms have evolved a number of mechanisms to repair DNA damage. The activity of repair enzymes carries its own risk, however, because the repair of two nearby lesions may lead to the breakup of DNA and result in cell death. We propose a mathematical theory of the damage and repair process in the important scenario where lesions are caused in bursts. We use this model to show that there is an optimum level of repair enzymes within cells which optimises the cell's response to damage. This optimal level is explained as the best trade-off between fast repair and a low probability of causing double-stranded breaks. We derive our results analytically and test them using stochastic simulations, and compare our predictions with current biological knowledge. PMID:21945337

Richard, Morgiane; Fryett, Matthew; Miller, Samantha; Booth, Ian; Grebogi, Celso; Moura, Alessandro

2012-01-01

239

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.

240

Arthroscopic treatment of chronically painful calcific tendinitis of the rectus femoris  

PubMed Central

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

2013-01-01

241

Arthroscopic 4-Point Suture Fixation of Anterior Cruciate Ligament Tibial Avulsion Fractures  

PubMed Central

Tibial eminence avulsion fractures are rare injuries occurring mainly in adolescents and young adults. When necessary, regardless of patient age, anatomic reduction and stable internal fixation are mandatory for fracture healing and accurate restoration of normal knee biomechanics. Various arthroscopically assisted fixation methods with sutures, anchors, wires, or screws have been described but can be technically demanding, thus elongating operative times. The purpose of this article is to present a technical variation of arthroscopic suture fixation of anterior cruciate ligament avulsion fractures. Using thoracic drain needles over 2.4-mm anterior cruciate ligament tibial guidewires, we recommend the safe and easy creation of four 2.9-mm tibial tunnels at different angles and at specific points. This technique uses thoracic drain needles as suture passage cannulas and offers 4-point fixation stability, avoiding potential complications of bony bridge fracture and tunnel connection. PMID:25685674

Boutsiadis, Achilleas; Karataglis, Dimitrios; Agathangelidis, Filon; Ditsios, Konstantinos; Papadopoulos, Pericles

2014-01-01

242

Arthroscopic anatomic humeral head reconstruction with osteochondral allograft transplantation for large hill-sachs lesions.  

PubMed

Anatomic reconstruction of the humeral head with osteochondral allograft has been reported as a solution for large Hill-Sachs lesions with or without glenoid bone loss. However, to date, varying techniques have been used. This technical note describes an arthroscopic reconstruction technique using fresh-frozen, side- and size-matched osteochondral humeral head allograft. Allograft plugs are press fit into the defect without internal fixation and seated flush with the surrounding articular surface. This technique restores the native articular contour of the humeral head without compromising shoulder range of motion. Potential benefits of this all-arthroscopic approach include minimal trauma to the soft tissue and articular surface without the need for hardware or staged reoperation. PMID:24266001

Snir, Nimrod; Wolfson, Theodore S; Hamula, Mathew J; Gyftopoulos, Soterios; Meislin, Robert J

2013-01-01

243

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

PubMed

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

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

2015-05-01

244

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

PubMed Central

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

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

2013-01-01

245

Popliteal Cyst Excision Using Open Posterior Approach After Arthroscopic Partial Medial Meniscectomy  

PubMed Central

Popliteal cysts are known to be associated with intra-articular pathology, which must be addressed to prevent cyst recurrence. Indications for popliteal cyst excision include cases in which the popliteal cyst does not respond to conservative treatment or arthroscopic intervention or cases in which an underlying cause cannot be found. Several techniques have been described to excise these cysts. Traditionally, open techniques have been associated with cyst recurrence. More recently, arthroscopic cystectomy has been described. However, the risk of recurrence persists because arthroscopy may not afford complete surgical excision. This technical note presents an open posterior technique for popliteal cyst excision that allows for better visualization and complete removal of the cyst while minimizing the risk of neurovascular complications and soft-tissue damage. It is a safe, effective, and straightforward method to achieve symptomatic relief for refractory popliteal cysts. PMID:24266002

Snir, Nimrod; Hamula, Mathew; Wolfson, Theodore; Sherman, Orrin; Feldman, Andrew

2013-01-01

246

Arthroscopic trans-portal deep medial collateral ligament pie-crusting release.  

PubMed

Arthroscopic treatments of meniscal injuries of the knee are among the most common orthopaedic procedures performed. Adequate visualization of the posterior horn of the medial meniscus might be challenging, especially in patients with tight medial compartments. In these cases instrument manipulation in an attempt to reach the posterior horn of the meniscus can cause an iatrogenic chondral injury because of the narrow medial joint space. A transcutaneous medial collateral ligament (MCL) pie-crusting release facilitates expansion of the medial joint space in a case of a tight medial compartment. Nevertheless, it might cause injury to the superficial MCL, infection, and pain and injury to the saphenous nerve because of multiple needle punctures of the skin. We describe an inside-out, arthroscopic deep MCL pie-crusting release, which allows access to the medial meniscus through the anterior approach to provide good visualization of the footprint and sufficient working space. PMID:23802093

Atoun, Ehud; Debbi, Ronen; Lubovsky, Omri; Weiler, Andreas; Debbi, Eytan; Rath, Ehud

2013-02-01

247

Arthroscopic evaluation and treatment by tendon interpositional arthroplasty of first carpometacarpal joint arthritis.  

PubMed

Basal joint arthritis of the thumb is usually seen in females beginning from the fourth and fifth decades. In the last two decades, arthroscopic techniques have brought new chances of diagnosis and treatment for this condition. In this paper, the authors describe the indications and their experience concerning arthroscopic hemitrapezectomy and tendon interposition using the palmaris longus tendon. A series of 16 patients with a maximum follow-up of 12 months is analysed. All of the 16 patients were followed and assessed with grasp strength, pinch strength, DASH and MAYO evaluation score both pre- and post-operatively at 12 months follow-up. According to the MAYO score, there were six excellent results, six good, three fair and one poor. No complications occurred. According to our preliminary results, this procedure with the proper indications gives a valid option for the treatment of thumb carpometacarpal joint arthritis in stages I and II according to Eaton's classification. PMID:17613182

Pegoli, L; Parolo, C; Ogawa, T; Toh, S; Pajardi, G

2007-01-01

248

An in vitro analysis of the mechanical properties of 16 arthroscopic knots.  

PubMed

The purpose of this study was to determine the biomechanical characteristics of 16 arthroscopic knots and to determine if locking knots have superior loop security compared to non-locking knots. Sixteen knot types were tied in arthroscopic fashion and tested on a materials testing system. Knots were cyclically loaded to 30 Newtons (N) for 20 cycles and then loaded to failure at 1.25 mm/s. Ten samples of each knot were tied using both #2 Ethibond and #1 PDS II. Load to ultimate failure, load to clinical failure, post-cyclic stiffness, cyclical elongation, ultimate displacement, loop security, and mode of failure were determined for each knot. Nicky's Knot and the French Knot were most consistently ranked within the top five knot types for each of the biomechanical parameters. Locking knots did not improve loop security over non-locking knots. PMID:18719890

Baumgarten, Keith M; Brodt, Michael D; Silva, Matthew J; Wright, Rick W

2008-10-01

249

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

PubMed

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

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

2015-04-01

250

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

Microsoft Academic Search

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

Yee Han Dave Lee; David N. M. Caborn

251

Results of arthroscopic joint debridement in different stages of chondromalacia of the knee joint  

Microsoft Academic Search

A retrospective study was performed of 161 patients who had undergone arthroscopic operation for chondromalacia of the knee\\u000a joint. After an average follow-up period of 40 (range 10–72) months, patients with severe articular cartilage lesions who\\u000a had undergone articular lavage alone showed significantly poorer results (P < 0.001). With the same stage of chondromalacia and having undergone the same surgical

Thomas Krüger; David Wohlrab; Andreas Birke; Werner Hein

2000-01-01

252

Repairs of composite structures  

NASA Astrophysics Data System (ADS)

Repair on damaged composite panels was conducted. To better understand adhesively bonded repair, the study investigates the effect of design parameters on the joint strength. The design parameters include bondline length, thickness of adherend and type of adhesive. Adhesives considered in this study were tested to measure their tensile material properties. Three types of adhesively bonded joints, single strap, double strap, and single lap joint were considered under changing bondline lengths, thickness of adherend and type of adhesive. Based on lessons learned from bonded joints, a one-sided patch repair method for composite structures was conducted. The composite patch was bonded to the damaged panel by either film adhesive FM-73M or paste adhesive EA-9394 and the residual strengths of the repaired specimens were compared under varying patch sizes. A new repair method using attachments has been suggested to enhance the residual strength. Results obtained through experiments were analyzed using finite element analysis to provide a better repair design and explain the experimental results. It was observed that the residual strength of the repaired specimen was affected by patch length. Method for rapid repairs of damaged composite structures was investigated. The damage was represented by a circular hole in a composite laminated plate. Pre-cured composite patches were bonded with a quick-curing commercial adhesive near (rather than over) the hole. Tensile tests were conducted on specimens repaired with various patch geometries. The test results showed that, among the methods investigated, the best repair method restored over 90% of the original strength of an undamaged panel. The interfacial stresses in the adhesive zone for different patches were calculated in order to understand the efficiencies of the designs of these patch repairs. It was found that the composite patch that yielded the best strength had the lowest interfacial peel stress between the patch and the host composite structure.

Roh, Hee Seok

253

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

PubMed Central

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

2014-01-01

254

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

PubMed Central

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

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

2014-01-01

255

Massive cuff tears treated with arthroscopically assisted latissimus dorsi transfer. Surgical technique.  

PubMed

Latissimus dorsi transfer is our preferred treatment for active disabled patients with a posterosuperior massive cuff tear. We present an arthroscopically assisted technique which avoids an incision through the deltoid obtaining a better and faster clinical outcome. The patient is placed in lateral decubitus. After the arthroscopic evaluation of the lesion through a posterior and a posterolateral portal, with the limb in traction we perform the preparation of the greater tuberosity of the humerus. We place the arm in abduction and internal rotation and we proceed to the harvest of the latissimus dorsi and the tendon preparation by stitching the two sides using very resistant sutures. After restoring limb traction, under arthroscopic visualization, we pass a curved grasper through the posterolateral portal by going to the armpit in the space between the teres minor and the posterior deltoid. Once the grasper has exited the access at the level of the axilla we fix two drainage transparent tubes, each with a wire inside, and, withdrawing it back, we shuttle the two tubes in the subacromial space. After tensioning the suture wires from the anterior portals these are assembled in a knotless anchor of 5.5 mm that we place in the prepared site on the greater tuberosity of the humerus. A shoulder brace at 15° of abduction and neutral rotation protect the patient for the first month post-surgery but physical therapy can immediately start. PMID:23738290

De Cupis, Vincenzo; De Cupis, Mauro

2012-04-01

256

Periarticular osteoid osteoma of the ankle: a report of nine arthroscopically treated patients.  

PubMed

Periarticular osteoid osteoma often presents with unspecific clinical symptoms, mimicking other clinical conditions. This can lead a clinician to a ''diagnostic side path'' and a delayed or missed diagnosis compared with extra-articular osteoid osteoma. We report the cases of 9 patients with a mean age of 22 (range 14 to 32) years who were diagnosed with periarticular osteoid osteoma of the ankle and were surgically treated in our department during a 12-year period. The diagnostic difficulties associated with periarticular osteoid osteoma must be resolved by obtaining a detailed patient history and performing a thorough physical examination. Computed tomography is the ultimate imaging method to confirm the suspicion of osteoid osteoma. Arthroscopic removal of the osteoid osteoma was performed in all 9 patients in the present case series, with synovectomy performed when indicated. Under arthroscopic visualization, a specimen was obtained for histopathologic analysis to confirm the diagnosis, followed by tumor excision. All the patients were pain free at the final follow-up visit after a mean duration of 6 years (range 6 months to 12.7 years) postoperatively. We suggest arthroscopic removal of periarticular osteoid osteomas of the ankle as an effective treatment method, because it allows complete tumor excision, synovectomy when needed, a short postoperative rehabilitation period, and satisfactory functional results. PMID:25459092

Dimnjakovi?, Damjan; Bojani?, Ivan; Smoljanovi?, Tomislav; Mahnik, Alan

2015-01-01

257

Distraction arthroplasty with arthroscopic microfracture in a patient with rheumatoid arthritis of the ankle joint.  

PubMed

We treated a 39-year-old female who had experienced destruction of her ankle joint owing to rheumatoid arthritis. This relatively young patient wished to avoid ankle fusion and joint replacement. Therefore, distraction arthroplasty with arthroscopic microfracture was performed to improve her symptoms and preserve motion. A microfracture procedure specifically for cartilage defects of the tibial plafond and talar dome was performed with the arthroscope, after which a hinged external fixator was applied to distract the ankle joint. The ankle joint space was enlarged by the external device and joint movement allowed. After 3 months, removal of the external device and repeat arthroscopy revealed newly formed fibrocartilage on the surfaces of both the tibia and the talus. At 2 years after the surgery, a radiograph showed that the joint space enlargement of the ankle had been maintained. The American Orthopaedic Foot and Ankle Society score improved from 37 points preoperatively to 82 points at 2 years postoperatively. Our findings suggest that good clinical results can be achieved with distraction arthroplasty and arthroscopic microfracture in a relatively young patient with rheumatoid arthritis. PMID:25619810

Nakasa, Tomoyuki; Adachi, Nobuo; Kato, Tomohiro; Ochi, Mitsuo

2015-01-01

258

Arthroscopic surgery for treatment of anterior displacement of the disc without reduction of the temporomandibular joint.  

PubMed

The aim of this study was to investigate the clinical results and efficacy of an arthroscopic approach to correct anterior displacement of the disc without reduction of the temporomandibular joint (TMJ) with limitation of mouth opening. We studied 28 joints with internal derangement in 23 patients, all of whom had had arthroscopic surgery (lavage, lysis of adhesions in the superior compartment, incision parallel to the disc-synovial crease of the upper joint compartment, and pull back of the anteriorly located disc). Objective and subjective data (increase in maximal interincisal opening, magnetic resonance imaging, and visual analogue pain score, VAS) were collected preoperatively and at 7, 30, 60 days, and 6 months or more postoperatively. Maximal interincisal opening improved from a mean (SD) of 20.4 (±4.5) mm preoperative measurement to 38.9 (±3.2) mm by 6 months postoperatively where indicated in previous line. The VAS showed a significant improvement in pain score (p=0.0023). Sixty days postoperatively the positions of the discs in 14 of the TMJs had improved considerably. In 13 of the TMJs the positions had improved slightly. Only 1 of the TMJs had not improved at all. There were no complications in any patient. Our arthroscopic procedure is safe, minimally invasive, and effective for the treatment of patients with displacement of the disc anteriorly without reduction of the TMJ. PMID:21377774

Zhu, YaoMin; Zheng, CangShang; Deng, YongQiang; Wang, Yang

2012-03-01

259

Intraligamentous ganglion cysts of the anterior cruciate Ligament: MR findings with clinical and arthroscopic correlations  

SciTech Connect

Magnetic resonance findings with clinical and arthroscopic correlation of intraligamentous cysts of the anterior cruciate ligament (ACL) are presented. Three cases of intraligamentous cysts of the ACL were identified out of 681 knee MRI examinations over a 2-year period. Arthroscopy and postoperative MRI were performed in all three patients, each of whom experienced knee pain with extreme flexion and extension. In all three cases the intraligamentous cyst was homogeneously hypointense on T1-weighted imaging and hyperintense on T2-weighted imaging relative to the ACL. Two of the three ACL cysts required a 70{degrees} scope for adequate visualization and establishment of posteromedial and posterolateral portals for arthroscopic treatment. One cyst could not be visualized arthroscopically and probing of the ACL from the anterior portal resulted in drainage of the cyst. No patient had presence of ACL cyst on follow-up MRI or recurrence of symptoms at a mean of 24 months. Intraligamentous cyst of ACL is a rare cause of knee pain. It should be suspected in patients having chronic pain with extremes of motion. Magnetic resonance findings are diagnostic and help to guide arthroscopy. 14 refs., 3 figs.

Do-Dai, D.D.; Youngberg, R.A.; Lanchbury, F.D.; Pitcher, J.D. Jr.; Garver, T.H. [Madigan Army Medical Center, Tacoma, WA (United States)] [Madigan Army Medical Center, Tacoma, WA (United States)

1996-01-01

260

Arthroscopic treatment of chronic patellar tendinopathy in high-level athletes  

PubMed Central

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

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

2012-01-01

261

The effect of warmed inspired gases on body temperature during arthroscopic shoulder surgery under general anesthesia  

PubMed Central

Background Perioperative hypothermia can develop easily during shoulder arthroscopy, because cold irrigation can directly influence core body temperature. The authors investigated whether active warming and humidification of inspired gases reduces falls in core body temperature and allows redistribution of body heat in patients undergoing arthroscopic shoulder surgery under general anesthesia. Methods Patients scheduled for arthroscopic shoulder surgery were randomly assigned to receive either room temperature inspired gases using a conventional respiratory circuit (the control group, n = 20) or inspired gases humidified and heated using a humidified and electrically heated circuit (HHC) (the heated group, n = 20). Results Core temperatures were significantly lower in both groups from 30 min after anesthesia induction, but were significantly higher in the heated group than in the control group from 75 to 120 min after anesthesia induction. Conclusions In this study the use of a humidified and electrically heated circuit did not prevent core temperature falling during arthroscopic shoulder surgery, but it was found to decrease reductions in core temperature from 75 min after anesthesia induction. PMID:23904934

Jo, Youn Yi; Kim, Hong Soon; Chang, Young Jin; Yun, Soon Young

2013-01-01

262

Snowmobile Repair. Teacher Edition.  

ERIC Educational Resources Information Center

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…

Hennessy, Stephen S.; Conrad, Rex

263

Wound repair and regeneration  

Microsoft Academic Search

The repair of wounds is one of the most complex biological processes that occur during human life. After an injury, multiple biological pathways immediately become activated and are synchronized to respond. In human adults, the wound repair process commonly leads to a non-functioning mass of fibrotic tissue known as a scar. By contrast, early in gestation, injured fetal tissues can

Geoffrey C. Gurtner; Sabine Werner; Yann Barrandon; Michael T. Longaker

2008-01-01

264

Home Appliance Repair Guide  

NSDL National Science Digital Library

This link in the howstuffworks website includes seven major topics to repairing major appliances, from ā??Major Appliance Repair Basicsā?¯ to ā??Repairing Pilot Lights and Thermocopules.ā?¯ Each topic contains multiple paragraphs to explain how to accomplish a task, general hints on repairing such devices easier and making them more trouble-free. In general, each topic contains numerous pictures or diagrams to aid in understanding the process. It should also be noted that when more difficult topics are discussed, even further in-depth explanations are included. Links are also provided in the navigation bar to similar articles that may also be of interest to the user. All the information contained on the site is free and well organized, making it a fantastic means to learn and understand the topics of Appliance Repair. [TB

265

INTERNAL REPAIR OF PIPELINES  

SciTech Connect

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 crossings. (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. In lieu of a field installation on an abandoned pipeline, a preliminary nondestructive testing protocol is being developed to determine the success or failure of the fiber-reinforced liner pipeline repairs. Optimization and validation activities for carbon-fiber repair methods are ongoing.

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

2005-07-20

266

Inflammation and wound repair.  

PubMed

Wound repair requires the integration of complex cellular networks to restore tissue homeostasis. Defects in wound repair are associated with human disease including pyoderma gangrenosum, a heterogeneous disorder that is characterized by unhealed wounds and chronic inflammation of unclear etiology. Despite its clinical importance, there remain significant gaps in understanding how different types of cells communicate to integrate inflammation and wound repair. Recent progress in wound and regenerative biology has been gained by studying genetically tractable model organisms, like zebrafish, that retain the ability to regenerate. The optical transparency and ease of genetic manipulation make zebrafish an ideal model system to dissect multi-cellular and tissue level interactions during wound repair. The focus of this review is on recent advances in understanding how inflammation and wound repair are orchestrated and integrated to achieve wound resolution and tissue regeneration using zebrafish. PMID:24853879

LeBert, Danny C; Huttenlocher, Anna

2014-08-01

267

Hypoxia and DNA Repair  

PubMed Central

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

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

2013-01-01

268

INTERNAL REPAIR OF PIPELINES  

SciTech Connect

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 crossings. (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. The first round of optimization and validation activities for carbon-fiber repairs are complete. Development of a comprehensive test plan for this process is recommended for use in the field trial portion of this program.

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

2004-12-31

269

INTERNAL REPAIR OF PIPELINES  

SciTech Connect

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.

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

2004-08-17

270

Salvage hypospadias repairs  

PubMed Central

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

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

2008-01-01

271

Partial-thickness tears of the gluteus medius: rationale and technique for trans-tendinous endoscopic repair.  

PubMed

Tears in the gluteus medius and minimus tendons, often misdiagnosed as trochanteric bursitis, have recently emerged as an important cause of recalcitrant greater trochanter pain syndrome. Advances in endoscopic surgery of the hip have created opportunities to better evaluate and treat pathology in the peritrochanteric compartment. We reviewed the literature on trochanteric pain syndrome and gluteus medius tendon injuries. Existing techniques for endoscopic and open gluteus tendon repair and potential challenges in restoration of abductor function were analyzed. Partial-thickness undersurface tears of the gluteus medius were identified as a common pathologic entity. Although these tears are otherwise analogous to partial-thickness tears of the rotator cuff, the lack of arthroscopic access to the deep side of the gluteus medius tendon represents a unique technical challenge. To address the difficulty in visualizing and thus repairing undersurface tears of the gluteus medius, a novel endoscopic trans-tendinous repair technique was developed. The purposes of this article are to review the anatomy, pathology, and existing repair techniques of gluteus medius tendon tears and to describe the rationale and surgical steps for endoscopic trans-tendinous repair. PMID:20951538

Domb, Benjamin G; Nasser, Rima Michel; Botser, Itamar B

2010-12-01

272

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

PubMed Central

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

2014-01-01

273

Arthroscopic release of the deep medial collateral ligament to assist in exposure of the medial tibiofemoral compartment.  

PubMed

Arthroscopy of the knee is a widely used surgical procedure for addressing intra-articular pathology. In assessing the intra-articular structures, visualization is of paramount importance. The medial tibiofemoral compartment is often difficult to fully visualize in tight knees in which limited access can compromise surgical efficacy. Poor visualization can increase the possibility of a residual meniscal tear after attempted partial meniscectomy, as well as the possibility of iatrogenic chondral injury from arthroscopic instruments. We describe a technique that allows improved medial tibiofemoral visualization with release of the deep medial collateral ligament. We use standard arthroscopic portals, without the need for further incisions or stab holes and with minimal additional patient morbidity. This procedure allows easier exposure of the medial knee chondral surfaces and meniscus and easier use of arthroscopic instrumentation in the medial compartment. PMID:25685677

Javidan, Pooya; Ahmed, Mohammed; Kaar, Scott G

2014-12-01

274

Arthroscopic Release of the Deep Medial Collateral Ligament to Assist in Exposure of the Medial Tibiofemoral Compartment  

PubMed Central

Arthroscopy of the knee is a widely used surgical procedure for addressing intra-articular pathology. In assessing the intra-articular structures, visualization is of paramount importance. The medial tibiofemoral compartment is often difficult to fully visualize in tight knees in which limited access can compromise surgical efficacy. Poor visualization can increase the possibility of a residual meniscal tear after attempted partial meniscectomy, as well as the possibility of iatrogenic chondral injury from arthroscopic instruments. We describe a technique that allows improved medial tibiofemoral visualization with release of the deep medial collateral ligament. We use standard arthroscopic portals, without the need for further incisions or stab holes and with minimal additional patient morbidity. This procedure allows easier exposure of the medial knee chondral surfaces and meniscus and easier use of arthroscopic instrumentation in the medial compartment. PMID:25685677

Javidan, Pooya; Ahmed, Mohammed; Kaar, Scott G.

2014-01-01

275

Early Clinical Results of Arthroscopic Remplissage in Patients with Anterior Shoulder Instability with Engaging Hill-Sachs Lesion in Iran  

PubMed Central

Background: To assess the outcome of the remplissage arthroscopic surgical method in patients with anterior shoulder dislocation associated with Hill-Sachs lesion. Methods: Ten patients with anterior shoulder dislocations and Hill-Sachs lesions were entered into this study and were operated on by the remplissage arthroscopic surgical method. They were followed up 22 months after surgery in order to evaluate the outcome of the treatment, including recurrence of dislocation and motion limitation. Results: During the internal follow up period, no case of recurrence was found. Motion limitation during the follow up period was not significant (internal rotation limitation=5°±1°, and external rotation limitation=4°±1°) Conclusions: Our findings suggest that the remplissage arthroscopic surgical method is an acceptable, safe and reliable treatment for anterior shoulder dislocation with engaging Hill-Sachs lesion. PMID:25207312

Aslani, Hamidreza; Zafarani, Zohreh; Ebrahimpour, Adel; Salehi, Shahin; Moradi, Ali; Sabzevari, Soheil

2014-01-01

276

Rectal prolapse repair  

MedlinePLUS

Rectal prolapse repair is surgery to fix a rectal prolapse . This is a condition in which the last part ... Rectal prolapse may be partial, involving only the mucosa . Or it may be complete, involving the entire wall of ...

277

Retinal detachment repair  

MedlinePLUS

... around it. This article describes the repair of rhegmatogenous retinal detachments. These occur due to a hole ... Connolly BP, Regillo CD. Rhegmatogenous retinal detachment. In: ... ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2013:vol 3, ...

278

Repairing ceramic insulating tiles  

NASA Technical Reports Server (NTRS)

Fused-silica tiles containing large voids or gauges are repaired without adhesives by plug insertion method. Tiles are useful in conduits for high-temperature gases, in furnaces, and in other applications involving heat insulation.

Dunn, B. R.; Laymance, E. L.

1980-01-01

279

Structural Repair Project  

NSDL National Science Digital Library

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

280

Rotator Cuff Repair  

MedlinePLUS

... CUFF REPAIR DOCTORS HOSPITAL CENTER FOR ORTHOPEDICS AND SPORTS MEDICINE CORAL GABLES, FLORIDA June 18, 2008 00:00: ... Coral Gables, Florida. I'm Dr. John Zvijac, sports medicine and shoulder surgeon here at Doctors Hospital, and ...

281

Femur fracture repair - discharge  

MedlinePLUS

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

282

Autologous Chondrocyte Cartilage Repair  

Microsoft Academic Search

\\u000a Articular cartilage injuries are one of the most common types of injuries seen in orthopaedic practice. The treatment of articular\\u000a cartilage damage remains a challenge because cartilage has a limited capacity for spontaneous repair after traumatic insult\\u000a or degenerative joint disease. As a result, several therapeutic strategies have been developed to restore articular cartilage\\u000a and produce a durable repair. Surgical

Stefan Marlovits

283

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.

284

Needle Assisted Arthroscopic Clysis of the Medial Collateral Ligament of the Knee: a Simple Technique to Improve Exposure in Arthroscopic Knee Surgery  

PubMed Central

During knee arthroscopy, narrowness and tightness maybe encountered in the medial compartment that does not allow sufficient visualization or instrumentation. When this occurs, our team has found it helpful to perform a percutaneous clysis of the deep portion of the medial collateral ligament with a spinal needle. With the knee positioned in 10° to 20° of flexion and a valgus stress is applied. A spinal needle (18 Gauge) is passed percutaneously through the medial collateral ligament between the tibial plateau and undersurface of the medial meniscus. Several passes are made with the spinal needle with the bevel of the needle angled to selectively divide the fibers while keeping the medial collateral ligament under tension. Then with controlled valgus force, the medial compartment will progressively open allowing improved visualization to the posteromedial corner of the knee. This increase in space gives an enhanced visual field and further allows more room for arthroscopic instrumentation. PMID:24416482

Li, Xinning; Selby, Ronald M.; Newman, Ashley; O’Brien, Stephen J.

2013-01-01

285

Arthroscopic tenodesis through positioning portals to treat proximal lesions of the biceps tendon.  

PubMed

Arthroscopic biceps tenodesis is a good choice for treating proximal lesions of the biceps tendon. However, there are few descriptions of the surgical approach. We introduce a technique for proximal biceps tenodesis using positioning portals and placing suture anchors. Our patients had a minimum of 12 months of follow-up. Between January 2010 and June 2012, a total of 49 patients (21 men, 28 women) underwent arthroscopic biceps tenodesis. The pathology was mainly associated with proximal lesions of the biceps tendon, with the diagnosis confirmed in all patients. Patients were evaluated preoperatively and then up to and including the final follow-up. Their pain and conditions were assessed using the Constant, American Shoulder and Elbow Surgeons (ASES), and University of California at Los Angeles (UCLA) scores for pain; range of active forward flexion; and active range of motion. All data were analyzed statistically. All patients were operated on successfully. They achieved good healing during the follow-up (mean 14 months; range 12-34 months). Before surgery the ASES, Constant, and UCLA scores were 17.0, 39.4, and 15.4, respectively. After surgery they were 33.6, 89.1, and 31.2, respectively. The scores had significantly improved: ASES scores from 17.0 to 33.6 (P < 0.05); Constant scores from 39.4 to 89.1 (P < 0.05); UCLA scores from 15.4 to 31.2 (P < 0.05). Arthroscopic tenodesis through positioning portals to treat proximal lesions of the biceps tendon produces satisfactory clinical outcomes. This technique is convenient and safe. PMID:25239022

Shen, Ji; Gao, Qing-feng; Zhang, Yao; He, Yao-hua

2014-12-01

286

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

PubMed Central

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

Rai, Deepak K; Kannampilly, Antony J

2014-01-01

287

Is intra-articular magnesium effective for postoperative analgesia in arthroscopic shoulder surgery?  

PubMed Central

BACKGROUND: Various medications are used intra-articularly for postoperative pain reduction after arthroscopic shoulder surgery. Magnesium, a N-methyl-D-aspartate receptor antagonist, may be effective for reduction of both postoperative pain scores and analgesic requirements. METHODS: A total of 67 patients undergoing arthroscopic shoulder surgery were divided randomly into two groups to receive intra-articular injections of either 10 mL magnesium sulphate (100 mg/mL; group M, n=34) or 10 mL of normal saline (group C, n=33). The analgesic effect was estimated using a visual analogue scale 1 h, 2 h, 6 h, 8 h, 12 h, 18 h and 24 h after operation. Postoperative analgesia was maintained by intra-articular morphine (0.01%, 10 mg) + bupivacaine (0.5%, 100 mL) patient-controlled analgesia device as a 1 mL infusion with a 1 mL bolus dose and 15 min lock-out time; for visual analogue scale scores >5, intramuscular diclofenac sodium 75 mg was administered as needed during the study period (maximum two times). RESULTS: Intra-articular magnesium resulted in a significant reduction in pain scores in group M compared with group C 1 h, 2 h, 6 h, 8 h and 12 h after the end of surgery, respectively, at rest and with passive motion. Total diclofenac consumption and intra-articular morphine + bupivacaine consumption were significantly lower in group M. Postoperative serum magnesium levels were significantly higher in group M, but were within the normal range. CONCLUSIONS: Magnesium causes a reduction in postoperative pain in comparison to saline when administered intra-articularly after arthroscopic shoulder surgery, and has no serious side effects. PMID:25222574

Saritas, Tuba Berra; Borazan, Hale; Okesli, Selmin; Yel, Mustafa; Otelcioglu, Seref

2015-01-01

288

Patellar instability with and without trochlear dysplasia: new arthroscopic medial soft tissue plication with pullout technique.  

PubMed

The aim of this study was to analyze clinical and radiologic results of an arthroscopic medial plication with the pullout technique and to define indications and limitations of this procedure for patellar instability. Records of 45 patients treated for patellar instability with arthroscopic medial plication with the pullout technique were reviewed. The mean patient age was 22.8±8.3 years. The tibial tuberosity-trochlear groove distance, trochlear depth (TD), and Insall-Salvati ratio were measured using magnetic resonance imaging taken preoperatively. Patients were evaluated clinically by the Insall and Kujala score and radiographically by measuring the congruence angle, lateral patellofemoral angle, and lateral patellar translation pre- and postoperatively. Patients were classified into 2 groups: group 1 comprised 23 patients with TD greater than or equal to 3.0 mm and group 2 comprised 22 patients with TD less than 3.0 mm. A significant improvement (P=.007) in postoperative clinical scores compared with preoperative values was observed. The congruence angle improved to 11.0°±20.6° (P=.006), the lateral patellofemoral angle improved to -1.6°±7.7° (P?.0001), and the lateral patellar translation improved to 8.7±5.3 mm (P?.0001) postoperatively. There were 5 (11%) failure cases. No significant difference existed in the number of failure cases and clinical scores between the 2 groups. This arthroscopic medial soft tissue pullout technique showed good clinical and radiologic results for patellar instability even in the presence of mild to moderate trochlear dysplasia. However, the technique showed limited success in severe trochlear dysplasia cases. PMID:24200442

Ahn, Jin Hwan; Kang, Jun Hee; Kasat, Niraj Sharad; Kim, Jae Gyoon

2013-11-01

289

Incidence of Venous Thromboembolism after Elective Knee Arthroscopic Surgery: A Historical Cohort Study  

PubMed Central

Summary Background The incidence of symptomatic venous thromboembolism (VTE) after knee arthroscopy is uncertain. In this study, we estimate the incidence of symptomatic VTE after knee arthroscopy. Objectives To estimate the incidence of symptomatic VTE after arthroscopic knee surgery. Methods In a population-based historical cohort study, all Olmsted County, MN residents undergoing a first arthroscopic knee surgery over the 18-year period, 1988-2005, were followed forward in time for incident deep vein thrombosis (DVT) or pulmonary embolism (PE). The cumulative incidence of VTE after knee arthroscopy was determined using the Kaplan-Meier product limit estimator. Patient age at surgery, sex, calendar year of surgery, body mass index, anesthesia characteristics and hospitalization were tested as potential predictors of VTE using Cox proportional hazards modeling, both univariately and adjusted for age and sex. Results Among 4833 Olmsted County residents with knee arthroscopy, 18 developed postoperative VTE, all within the first 6 weeks after surgery. The cumulative incidence rates of symptomatic VTE at 7, 14 and 35 days were 0.2%, 0.3% and 0.4%, respectively. The hazard for postoperative VTE was significantly increased for older patient age (HR=1.34 for each ten-year increase in patient age; p=0.03) and hospitalization either prior to or after knee arthroscopy (HR=14.1; p<0.001). Conclusions The incidence of symptomatic VTE after arthroscopic knee surgery is very low. Older age and hospitalization are associated with increased risk. Routine prophylaxis to prevent symptomatic venous thromboembolism is likely not needed in this patient population. PMID:23648016

Mauck, Karen F.; Froehling, David A.; Daniels, Paul R.; Dahm, Diane L.; Ashrani, Aneel A.; Crusan, Daniel J.; Petterson, Tanya M.; Bailey, Kent R.; Heit, John A.

2013-01-01

290

A push-pull distraction method for arthroscopic subtalar joint arthrodesis.  

PubMed

Unlike ankle joint arthroscopy, distraction of the subtalar joint can be challenging. We introduce a powerful distraction method that can be used during an arthroscopic subtalar joint arthrodesis procedure using a "push-pull" technique. A fully threaded screw is used to push the talus while the calcaneus is pulled to distract the joint. The technique allows the surgeon to access the rather tight joint without disrupting a significant amount of the ligamentous and capsular structures. It also allows preservation of the vascular structures that supply the talus. The "push-pull" screw can also be converted to a second point of fixation at the end of the procedure. PMID:24785201

Shibuya, Naohiro; Smith, Rebecca S; Escobedo, Laura A; Agarwal, Monica R

2014-01-01

291

A pyogenic, ruptured Baker's cyst induced by arthroscopic pressure pump irrigation.  

PubMed

Post-steroid septic arthritis can be treated with irrigation pump assisted arthroscopic synovectomy. The high-intra-articular fluid pressures can force the pyogenic fluid into a pre-existing Baker's cyst. The cyst can rupture and with the pre-existing steroid induced immune-suppression, the calf abscess will be hard to control. Therefore, thorough investigation with an ultrasound-guided aspiration followed by an early drainage of the collection is warranted and mandatory. Close monitoring for the development of a deep thrombosis of the popliteal vein is required. PMID:19083206

Corten, Kristoff; Vandenneucker, Hilde; Reynders, Peter; Nijs, Stefaan; Pittevils, Theo; Bellemans, Johan

2009-03-01

292

Comminuted fracture of the accessory carpal bone removed via an arthroscopic-assisted arthrotomy.  

PubMed

A 16-year-old American paint horse gelding was presented for evaluation of a left forelimb lameness grade III/V. Radiographs and computed tomography revealed a comminuted fracture of the accessory carpal bone involving the entire articulation with the distal radius and the proximal aspect of the articulation with the ulnar carpal bone. Multiple fragments were present in the palmar pouch of the antebrachiocarpal joint. An arthroscopic-assisted open approach was necessary to remove all fractured fragments. Subsequently the horse was re-admitted for lameness and was treated successfully with antibiotics and long-term supportive bandaging. PMID:25694665

Bonilla, Alvaro G; Santschi, Elizabeth M

2015-02-01

293

The relationship of neural structures to arthroscopic posterior portals according to knee positioning  

Microsoft Academic Search

Purpose  The purpose of this study was to investigate the relationship between the proximity of neural structures to standard posterior\\u000a portals in different knee positions.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  Ten fresh cadaveric knees were used to establish the standard posteromedial and posterolateral portals using an outside-in\\u000a technique with arthroscopic transillumination. The distance from each portal site to the adjacent neurovascular structures\\u000a (infrapatellar branches of the

Jin Hwan Ahn; Sang Hak Lee; Ho Joong Jung; Kyung Hyo Koo; Seong Hwan Kim

2011-01-01

294

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

PubMed Central

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.

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

2015-01-01

295

Arthroscopic Latarjet and Capsular Shift (ALCS) Procedure: A New "Freehand" Technique for Anterior Shoulder Instability Associated With Significant Bone Defects.  

PubMed

Anterior shoulder instability associated with significant bone loss has been described as "bony-instability," and this condition is usually treated with an anterior glenoid bone grafting procedure (Latarjet procedure). The Latarjet procedure involves transfer of the horizontal limb of the coracoid process along with the conjoint tendon to the anterior glenoid rim, and is traditionally performed as an open surgical procedure. Recently, an arthroscopic technique for the Latarjet procedure has been described; the technique necessitates the use of specialized instrumentation and involves excision of the entire anterior capsule to facilitate coracoid fixation. We describe a new "freehand" arthroscopic technique for the Latarjet procedure, and, in addition, a simultaneous capsular shift to further optimize mid and end range stability. This technique eliminates the use of additional instrumentation and can be done using routine arthroscopic instruments. Preliminary experience with this technique suggests that the arthroscopic Latarjet and capsular shift is a technically demanding procedure. Glenohumeral capsule can be preserved, and this should be attempted wherever possible to optimize stability. Additional specialized instrumentation would probably reduce surgical time; however, the procedure can be performed with routine instruments. PMID:25393057

Bhatia, Deepak N

2015-03-01

296

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

PubMed

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. [Orthopedics. 2015; 38(3):e223-e228.]. PMID:25760511

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

2015-03-01

297

Postreplicative Mismatch Repair  

PubMed Central

The mismatch repair (MMR) system detects non-Watson–Crick base pairs and strand misalignments arising during DNA replication and mediates their removal by catalyzing excision of the mispair-containing tract of nascent DNA and its error-free resynthesis. In this way, MMR improves the fidelity of replication by several orders of magnitude. It also addresses mispairs and strand misalignments arising during recombination and prevents synapses between nonidentical DNA sequences. Unsurprisingly, MMR malfunction brings about genomic instability that leads to cancer in mammals. But MMR proteins have recently been implicated also in other processes of DNA metabolism, such as DNA damage signaling, antibody diversification, and repair of interstrand cross-links and oxidative DNA damage, in which their functions remain to be elucidated. This article reviews the progress in our understanding of the mechanism of replication error repair made during the past decade. PMID:23545421

Jiricny, Josef

2013-01-01

298

Base Excision Repair  

PubMed Central

Base excision repair (BER) corrects DNA damage from oxidation, deamination and alkylation. Such base lesions cause little distortion to the DNA helix structure. BER is initiated by a DNA glycosylase that recognizes and removes the damaged base, leaving an abasic site that is further processed by short-patch repair or long-patch repair that largely uses different proteins to complete BER. At least 11 distinct mammalian DNA glycosylases are known, each recognizing a few related lesions, frequently with some overlap in specificities. Impressively, the damaged bases are rapidly identified in a vast excess of normal bases, without a supply of energy. BER protects against cancer, aging, and neurodegeneration and takes place both in nuclei and mitochondria. More recently, an important role of uracil-DNA glycosylase UNG2 in adaptive immunity was revealed. Furthermore, other DNA glycosylases may have important roles in epigenetics, thus expanding the repertoire of BER proteins. PMID:23545420

Krokan, Hans E.; Bjųrås, Magnar

2013-01-01

299

Arthroscopic Delivery of Cancellous Tibial Autograft for Unstable Osteochondral Lesions in the Adolescent Knee  

PubMed Central

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

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

2014-01-01

300

Septic arthritis caused by Erysipelothrix rhusiopathiae infection after arthroscopically assisted anterior cruciate ligament reconstruction.  

PubMed

A case of septic arthritis caused by Erysipelothrix rhusiopathiae, after an arthroscopically assisted anterior cruciate ligament (ACL) substitution in a non-immunosuppressed patient is described. An 18-year-old man underwent an ACL reconstruction with a quadruple hamstring graft. Eight days postoperatively, the patient developed fever, knee pain, and effusion without erythema or suppuration. He was readmitted to the hospital with the diagnosis of septic arthritis. The patient's erythrocyte sedimentation rate, C-reactive protein level, and white blood cell count were high. The joint was aspirated and the fluid was sent for cultures that revealed the presence of E rhusiopathiae. E rhusiopathiae is widespread in nature, it is transmitted by direct cutaneous laceration, and it causes septic arthritis, meningitis, endocarditis, and renal failure in immunosuppressed people with poor prognosis. In our case, the infection was treated with arthroscopic lavage and debridement, retention of the graft and hardware, and intravenous antibiotic administration for 6 weeks, followed by oral administration for 16 weeks. PMID:12627143

Allianatos, Panagiotis G V; Tilentzoglou, Anastasia C; Koutsoukou, Alexander D

2003-03-01

301

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

PubMed Central

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

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

2014-01-01

302

Synovial inflammation in patients undergoing arthroscopic meniscectomy: molecular characterization and relationship with symptoms  

PubMed Central

Objective Traumatic and degenerative meniscal tears have different anatomic features and different proposed etiologies, yet both are associated with development or progression of osteoarthritis (OA). In established OA, synovitis is associated with pain and progression, but a relationship between synovitis and symptoms in isolated meniscal disease has not been reported. Accordingly, we sought to characterize synovial pathology in patients with traumatic meniscal injuries and determine the relationships between inflammation, meniscal and cartilage pathology, and symptoms. Methods Thirty-three patients without evidence of OA undergoing arthroscopic meniscectomy for meniscal injuries were recruited. Pain and function were assessed preoperatively; meniscal and cartilage abnormalities were documented at the time of surgery. Inflammation in synovial biopsies was scored and associations between inflammation and clinical outcomes determined. Microarray analysis of synovial tissue was performed and gene expression patterns in patients with or without inflammation compared. Results Synovial inflammation was present in 43% of patients and was associated with worse pre-operative pain and function scores, independent of age, gender, or cartilage pathology. Microarray analysis and real-time PCR revealed a chemokine signature in synovial biopsies with increased inflammation scores. Conclusion In patients with traumatic meniscal injury undergoing arthroscopic meniscectomy without clinical or radiographic evidence of OA, synovial inflammation occurs frequently and is associated with increased pain and dysfunction. Synovia with increased inflammation scores exhibit a unique chemokine signature. Chemokines may contribute to the development of synovial inflammation in patients with meniscal pathology; they also represent potential therapeutic targets for reducing inflammatory symptoms. PMID:21279996

Scanzello, Carla R.; McKeon, Brian; Swaim, Bryan H.; DiCarlo, Edward; Asomugha, Eva U.; Kanda, Veero; Nair, Anjali; Lee, David M.; Richmond, John C.; Katz, Jeffrey N.; Crow, Mary K.; Goldring, Steven R.

2012-01-01

303

Correlation Between Magnetic Resonance Imaging and Arthroscopic Findings in the Knee Joint  

PubMed Central

Background: The knee joint is the largest and the most complex joint of the human body. It is not covered by any thick muscular covering anteriorly. Objectives: The purpose of this study was to explore the diagnostic capabilities of clinical examination, magnetic resonance imaging (MRI), and arthroscopy in traumatic disorders of the knee joint, to seek correlation between clinical findings, MRI findings and arthroscopic. Patients and Methods: A total of 26 patients with a presentation suggestive of traumatic knee pathology were studied prospectively. A detailed history was taken and relevant clinical examination was done, which was followed by MRI of the knee. The patients were scheduled for arthroscopy under general/spinal anesthesia, whenever indicated. Results: Keeping arthroscopic examination as standard, the correlation between clinical and arthroscopy showed a sensitivity of 80%, specificity of 86%, accuracy of 63.16%, negative predictive value of 93.48%; whereas MRI vs. arthroscopy showed a sensitivity of 74.42%, specificity of 93.10%, accuracy of 84.21%, and negative predictive value of 88.04%. Conclusions: The clinical examination is an important and accurate diagnostic modality for evaluation of traumatic derangement of the knee joint. It is noninvasive, easy, available, and valuable diagnostic modality. The MRI is an accurate diagnostic modality. It can be used whenever there is an uncertain indication for arthroscopy. However, costs have to be kept in mind, especially in patients with low socio-economic status.

Khan, Hayat Ahmad; Ahad, Humayun; Sharma, Pradeep; Bajaj, Pankaj; Hassan, Nazia; Kamal, Younis

2015-01-01

304

Septic arthritis with Staphylococcus lugdunensis following arthroscopic ACL revision with BPTB allograft.  

PubMed

Septic arthritis following anterior cruciate ligament reconstruction is an uncommon but a serious complication resulting in six times greater hospital costs than that of uncomplicated ACL surgery and an inferior postoperative activity level. Promptly initiating a specific antibiotic therapy is the most critical treatment, followed by open or arthroscopic joint decompression, debridement and lavage. Staphylococcus lugdunensis is a coagulase-negative staphylococcus predominantly infecting the skin and soft tissue. The few reported cases of bone and joint infections by S. lugdunensis indicate that the clinical manifestations were severe, the diagnosis elusive, and the treatment difficult. If the microbiology laboratory does not use the tube coagulase (long) test to confirm the slide coagulase test result, the organism might be misidentified as Staphylococcus aureus. S. lugdunensis is more virulent than other coagulase-negative staphylococcus; in many clinical situations it behaves like S. aureus, further increasing the confusion and worsening the expected outcome. S. lugdunensis is known to cause infective endocarditis with a worse outcome, septicemia, deep tissue infection, vascular and joint prosthesis infection, osteomyelitis, discitis, breast abscess, urine tract infections, toxic shock and osteitis pubis. We present the first case report in the literature of septic arthritis with S. lugdunensis following arthroscopic ACL revision with bone-patellar-tendon-bone allograft. PMID:17684731

Mei-Dan, Omer; Mann, Gideon; Steinbacher, Gilbert; Ballester, Soleda J; Cugat, Ramon Bertomeu; Alvarez, Pedro Diaz

2008-01-01

305

Massive bone loss from fungal infection after anterior cruciate ligament arthroscopic reconstruction.  

PubMed

Although there are numerous reports of septic pyogenic arthritis after arthroscopic anterior cruciate ligament (ACL) reconstruction, there is limited information regarding the outcomes of fungal infection. We determined the outcomes of six patients with mycotic infection after regular ACL reconstruction. There were four males and two females with a mean age of 33 years. We determined the number of procedures performed, bone loss originating to control infection, and final reconstruction in these patients. An average of five arthroscopic lavage procedures had been performed at the referring centers. Fungal infection was diagnosed based on pathologic samples; five infections were the result of mucormycosis and one was Candida. After final débridement, the mean segmental bone loss was 12.8 cm. All patients were treated with intravenous antifungal coverage and cement spacers before final reconstruction. At final followup, all patients were free of clinical infection. Three had reconstruction with an allograft-prosthesis composite, two with hemicylindrical allografts, and one with an intercalary allograft arthrodesis. Despite the extremely unusual presentation of this complication, surgeons should be aware of potential and catastrophic consequences of this severe complication after ACL reconstruction. PMID:19190972

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

2009-09-01

306

Femur-mounted navigation system for the arthroscopic treatment of femoroacetabular impingement  

NASA Astrophysics Data System (ADS)

Femoroacetabular impingement stems from an abnormal shape of the acetabulum and proximal femur. It is treated by resection of damaged soft tissue and by the shaping of bone to resemble normal features. The arthroscopic treatment of femoroacetabular impingement has many advantages, including minimal incisions, rapid recovery, and less pain. However, in some cases, revision is needed owing to the insufficient resection of damaged bone from a misreading of the surgical site. The limited view of arthroscopy is the major reason for the complications. In this research, a navigation method for the arthroscopic treatment of femoroacetabular impingement is developed. The proposed navigation system consists of femur attachable measurement device and user interface. The bone mounted measurement devices measure points on head-neck junction for registration and position of surgical instrument. User interface shows the three-dimensional model of patient's femur and surgical instrument position that is tracked by measurement device. Surgeon can know the three-dimensional anatomical structure of hip joint and surgical instrument position on surgical site using navigation system. Surface registration was used to obtain relation between patient's coordinate at the surgical site and coordinate of three-dimensional model of femur. In this research, we evaluated the proposed navigation system using plastic model bone. It is expected that the surgical tool tracking position accuracy will be less than 1 mm.

Park, S. H.; Hwang, D. S.; Yoon, Y. S.

2013-07-01

307

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

PubMed Central

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

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

2014-01-01

308

Rescheduling with iterative repair  

NASA Technical Reports Server (NTRS)

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.

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

1992-01-01

309

Rescheduling with iterative repair  

NASA Technical Reports Server (NTRS)

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, and produce modified schedules quickly. 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. These experiments were performed within the domain of Space Shuttle ground processing.

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

1992-01-01

310

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.

311

Joking Repair and the Organization of Repair in Conversation.  

ERIC Educational Resources Information Center

This analysis looks at the humorous use of second-speaker repeats to initiate conversational repair. It is proposed that consideration of joking repeats forces reanalysis of the organization of conversational repair. The preference analysis theory is rejected in favor of a locally governed analysis of conversational repair in which participants…

Norrick, Neal R.

312

46 CFR Sec. 19 - Ship Repair Summaries.  

Code of Federal Regulations, 2014 CFR

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

2014-10-01

313

46 CFR Sec. 19 - Ship Repair Summaries.  

Code of Federal Regulations, 2012 CFR

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

2012-10-01

314

46 CFR Sec. 19 - Ship Repair Summaries.  

Code of Federal Regulations, 2011 CFR

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

2011-10-01

315

46 CFR Sec. 19 - Ship Repair Summaries.  

Code of Federal Regulations, 2013 CFR

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

2013-10-01

316

Recombinational DNA Repair in Bacteria  

E-print Network

Recombinational DNA Repair in Bacteria: Postreplication Kevin P Rice,University of Wisconsin Recombinational DNA repair represents the primary function for homologous DNA recombination in bacteria. Most of genetic diversity, primarily during conjugation, homologous DNA recombination in bacteria is now

Cox, Michael M.

317

Cleft lip repair - series (image)  

MedlinePLUS

A cleft lip is an abnormal opening in the middle of the upper lip. A cleft palate is an opening in the ... Cleft lip repair and cleft palate repair are indicated for: Repair of physical deformity Nursing, feeding, or speech problems ...

318

Lawn and Garden Equipment Repair.  

ERIC Educational Resources Information Center

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…

Hardway, Jack; And Others

319

One-Stage Hypospadias Repair  

Microsoft Academic Search

Purpose: We evaluated one-stage hypospadias repairs in providing a normal looking penis with a normal functioning urethra. Also we looked critically at the effects of the severity of hypospadias, the type of repair and the experience of the surgeon on the outcome. Materials and Methods: From 1987 to 1996 we performed 578 primary hypospadias repairs. The type and surgical results

A. M. A. Ghali; E. M. A. El-Malik; T. Al-Malki; A. H. Ibrahim

1999-01-01

320

Repairing CAD models  

Microsoft Academic Search

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

Gill Barequet; Subodh Kumar

1997-01-01

321

Basic Book Repair Methods.  

ERIC Educational Resources Information Center

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…

Schechter, Abraham A.

322

Repair of proboscis lateralis.  

PubMed

We report an 8-year-old girl presented with a proboscis on the right nasal nostril, right heminasal hypoplasia, hypertelorism, and cleft lip and palate on the other side. After repair of the cleft lip and palate and the hypertelorism, we successfully reconstructed the heminose with a V-Y advancement flap containing the proboscis tube. PMID:16019753

U?urlu, Kemal; Kar?idag, Semra; Ozēelik, Derya; Sadiko?lu, Bu?ra; Ba?, Lütfü

2005-01-01

323

Automotive Body Repair Competencies.  

ERIC Educational Resources Information Center

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,…

D'Armond, Jack; And Others

324

Comprehensive Small Engine Repair.  

ERIC Educational Resources Information Center

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

Hires, Bill; And Others

325

Clinical outcome of arthroscopic reduction and suture for displaced acute and chronic tibial spine fractures.  

PubMed

This paper reports the clinical outcome of the arthroscopic reduction and pull-out suture technique in acute and chronic displaced tibial spine anterior cruciate ligament (ACL) avulsion fractures. Between April 1997 and December 2000, 14 patients received an arthroscopic reduction and pull-out suturing of displaced tibial spine fractures (ACL avulsion fractures of tibia). Of 14 cases, ten were acute fractures and four were chronic nonunion fractures, in which all patients showed extension limitation. The mean follow-up period was 51 months (ranging from 30 to 80 months). At final follow-up, review of range of motion, Lachman test, anterior drawer test, KT-2000 arthrometer, Lysholm knee score, and Hospital for Special Surgery (HSS) score were evaluated. Compared to conventional pull-out suturing, several key modifications to surgical techniques were used. In all 14 patients, radiological bony union was detected at mean 12.3 weeks (range, 8-16 weeks) after surgery. All patients were able to return to their preinjury activity and sports level. At final follow-up, full range of motion was achieved in all patients. Anterior draw test, Lachman test, and KT-2000 (less than 3 mm side-to-side) were all negative in 13 patients. One female patient, who was 6 years old at the time of surgery, complained of no subjective instability, but showed Lachman grade I, and 5 mm side-to-side difference in KT-2000. She also revealed 10 degrees difference of genu recurvatum deformity. Two children (including the previously-mentioned 6-year-old female patient) showed leg-length discrepancy of 1 cm-the affected legs being longer-at final follow-up. The mean Lysholm knee scores were 95.6 (range, 92-100) and HSS knee scores were 96.4 (range, 91-100). Arthroscopic reduction with modified pull-out suturing technique in displaced tibial spine ACL avulsion fractures showed excellent union rate for both acute and chronic cases, without instability or extension limitations at minimum two-year follow-up. PMID:15756616

Ahn, Jin Hwan; Yoo, Jae Chul

2005-03-01

326

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

PubMed Central

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.

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

2014-01-01

327

Biomechanics of integrative cartilage repair.  

PubMed

Cartilage repair is required in a number of orthopaedic conditions and rheumatic diseases. From a macroscopic viewpoint, the complete repair of an articular cartilage defect requires integration of opposing cartilage surfaces or the integration of repair tissue with the surrounding host cartilage. However, integrative cartilage repair does not occur readily or predictably in vivo. Consideration of the 'integrative cartilage repair process', at least in the relatively early stages, as the formation of a adhesive suggests several biomechanical approaches for characterizing the properties of the repair tissue. Both strength of materials and fracture mechanics approaches for characterizing adhesives have recently been applied to the study of integrative cartilage repair. Experimental configurations, such as the single-lap adhesive test, have been adapted to determine the strength of the biological repair that occurs between sections of bovine cartilage during explant culture, as well as the strength of adhesive materials that are applied to opposing cartilage surfaces. A variety of fracture mechanics test procedures, such as the (modified) single edge notch, 'T' peel, dynamic shear, and trouser tear tests, have been used to assess Mode I, II, and III fracture toughness values of normal articular cartilage and, in some cases, cartilaginous tissue undergoing integrative repair. The relationships between adhesive biomechanical properties and underlying cellular and molecular processes during integrative cartilage repair remain to be elucidated. The determination of such relationships may allow the design of tissue engineering procedures to stimulate integrative cartilage repair. PMID:10367013

Ahsan, T; Sah, R L

1999-01-01

328

Arthroscopic Distal Tibial Allograft Augmentation for Posterior Shoulder Instability With Glenoid Bone Loss  

PubMed Central

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

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

2013-01-01

329

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

PubMed

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

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

2015-01-01

330

Graft infection following arthroscopic anterior cruciate ligament reconstruction: a report of four cases.  

PubMed

Septic arthritis following arthroscopic anterior cruciate ligament reconstruction (ACL) is a rare complication and associated with severe morbidity. Its risk factors include (1) concomitant procedures during the reconstruction, (2) previous knee surgery, (3) allograft usage, (4) peri-operative wound contamination, and (5) presence of intra-articular foreign bodies. We present a series of 3 men and one woman aged 22 to 35 years who developed septic arthritis following ACL reconstruction. The risk factors identified were local infection (n=2), previous ipsilateral knee surgery (n=2), and the use of an allograft (n=1). All patients underwent emergency knee washout and debridement with graft retention within 24 hours, together with a course of intravenous antibiotic therapy. All the patients achieved eradication of their infections (with intact ACL grafts) and satisfactory functional outcome at a mean follow-up of 32 (range, 25-45) months. PMID:24781628

Wee, James; Lee, Keng Thiam

2014-04-01

331

[Scapholunar ligament injuries in acute wrist trauma. Arthroscopic diagnosis and minimally invasive surgery].  

PubMed

The final result of the treatment of distal intraarticular radius fractures depends both on the accuracy of the fracture reduction and on the presence or absence of additional carpal injuries. In particular, lesions of the intrinsic ligaments usually cause severe degenerative damage of the wrist joint if they are missed primarily. With the introduction of wrist arthroscopy these tears can be evaluated and treated earlier. Since 1993 arthroscopically assisted treatment has been performed in 23 patients with distal intraarticular fractures of the radius (mainly C fractures according to the AO classification system or group VII and VIII fractures according to Frykman). SL tears have been found in 11 patients (47.8%), 7 of whom showed marked instability and were stabilised at the time of surgery. PMID:9333952

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

1997-06-01

332

Repair of recurrent prolapse.  

PubMed

The pathogenesis of prolapse and the requirements for a successful surgical outcome vary from one person to another. The importance of traditional risk factors is questionable, but failed previous repair is definitely an adverse prognosticator. An ideal operation should re-attach apical support to the pelvic skeleton, restore integrity within anterior and posterior suspensory hammocks and re-distribute some of the expulsive load back onto the pelvic diaphragm. Reasons for failure are best analysed by location; recurrence within the operated compartment should also be distinguished from recurrence in a different compartment. There is no all-encompassing secret to re-operating on recurrent prolapse. Success depends on sound strategic planning and using tactics to negate the greater technical difficulty and reduced collagen strength in women with prior operative failure. If an augmented repair is to be carried out, choice of biomaterials must reflect surgical objectives, movement dynamics and functional anatomy at the intended implantation site. PMID:21353645

Reid, Richard I

2011-04-01

333

Prokaryotic Nucleotide Excision Repair  

PubMed Central

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

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

2013-01-01

334

Same-day microsurgical arthroscopic lateral-approach laser-assisted (SMALL) fluoroscopic discectomy.  

PubMed

The 2-year experience of one neurosurgeon with Kambin's orthopedic instruments and frame for arthroscopic microdiscectomy is reported. Arthroscopy using a unilateral approach and monoportal technique is a valuable adjunct to fluoroscopic monitoring. One hundred patients underwent same-day microsurgical arthroscopic lateral-approach laser-assisted (SMALL) fluoroscopic discectomy. In addition, suspected spinal tumors in three patients were treated by biopsy and infection of the disc space was drained in one. A prototype operating discoscope was employed for delivery of the neodymium:yttrium-aluminum-garnet laser beam to assist with hemostasis. Seventy-five "ideal" cases were identified that exhibited the following features: 1) up to a 6-month history of unilateral sciatica symptoms, which responded to bed rest; 2) mechanical signs of nerve root irritation when the patient was erect; 3) computerized tomography or magnetic resonance imaging studies interpreted as showing one protruding or prolapsed disc without extrusion; 4) no segmental spondylosis at the level of a herniated nucleus pulposus; 5) no motor weakness; 6) no prior disc surgery; 7) no obesity; and 8) no diabetes mellitus. Twenty-five "nonideal" cases failed to meet one or more of the above criteria. Good outcome rates were not substantially different in the two groups, success being judged in part by patient satisfaction. Complete success was evidenced in two-thirds of cases by early return to work, but improvement was also determined by increased mobility and a reduction in pain medication from narcotic to analgesic agents. Three patients underwent repeat surgery (laminotomy), but only one improved. Two years has provided sufficient clinical experience to determine that a percutaneous endoscopic procedure under neuroleptanalgesia may become a significant surgical alternative. PMID:8189259

Savitz, M H

1994-06-01

335

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

PubMed Central

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

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

2013-01-01

336

Arthroscopic removal of discrete palmar carpal osteochondral fragments in horses: 25 cases (1999-2013).  

PubMed

Objective-To characterize discrete palmar carpal osteochondral fragmentation in horses and to document the effect of osteoarthritis and surgical removal of these fragments on functional outcome. Design-Retrospective case series. Animals-25 horses. Procedures-Medical records and radiographic views were reviewed to identify horses that had radiographic evidence of palmar carpal fragmentation, which was subsequently treated by arthroscopic removal. Information collected included cause of fracture, initial and long-term clinical and radiographic findings, and functional outcome. Results-Palmar carpal fragmentation of 30 carpal bones was identified in 25 unilaterally affected horses. A known traumatic event was reported to cause the fragmentation in 17 of the 25 (68%) horses. Of the 25 horses, 17 (68%) had fragmentation involving the antebrachiocarpal joint, 7 (28%) had fragmentation involving the middle carpal joint, and 1 (4%) had fragmentation involving the carpometacarpal joint. The proximal aspect of the radial carpal bone was the most commonly affected site (12/30 fragments), followed by the accessory carpal bone (6/30). Of the 25 horses, 19 (76%) were not lame (sound) after surgery and returned to their intended use, 4 (16%) were considered pasture sound, and 2 were euthanized (because of severe postoperative osteoarthritis or long bone fracture during recovery from anesthesia). Eight of the 14 horses with preoperative evidence of osteoarthritis returned to function after surgery. Twelve of 17 horses with antebrachiocarpal joint fragments and 6 of 7 horses with middle carpal joint fragments returned to their previous use. Conclusions and Clinical Relevance-Results indicated that the prognosis for horses after arthroscopic removal of palmar carpal osteochondral fragments is good. Early intervention, before the development of osteoarthritis, is recommended. PMID:25875672

Lang, Hayley M; Nixon, Alan J

2015-05-01

337

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

PubMed Central

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

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

2010-01-01

338

Experimental and numerical validation for the novel configuration of an arthroscopic indentation instrument  

NASA Astrophysics Data System (ADS)

Softening of articular cartilage, mainly attributable to deterioration of superficial collagen network and depletion of proteoglycans, is a sign of incipient osteoarthrosis. Early diagnosis of osteoarthrosis is essential to prevent the further destruction of the tissue. During the past decade, a few arthroscopic instruments have been introduced for the measurement of cartilage stiffness; these can be used to provide a sensitive measure of cartilage status. Ease of use, accuracy and reproducibility of the measurements as well as a low risk of damaging cartilage are the main qualities needed in any clinically applicable instrument. In this study, we have modified a commercially available arthroscopic indentation instrument to better fulfil these requirements when measuring cartilage stiffness in joints with thin cartilage. Our novel configuration was validated by experimental testing as well as by finite element (FE) modelling. Experimental and numerical tests indicated that it would be better to use a smaller reference plate and a lower pressing force (3 N) than those used in the original instrument (7-10 N). The reproducibility (CV = 5.0%) of the in situ indentation measurements was improved over that of the original instrument (CV = 7.6%), and the effect of material thickness on the indentation response was smaller than that obtained with the original instrument. The novel configuration showed a significant linear correlation between the indenter force and the reference dynamic modulus of cartilage in unconfined compression, especially in soft tissue (r = 0.893, p < 0.001, n = 16). FE analyses with a transversely isotropic poroelastic model indicated that the instrument was suitable for detecting the degeneration of superficial cartilage. In summary, the instrument presented in this study allows easy and reproducible measurement of cartilage stiffness, also in thin cartilage, and therefore represents a technical improvement for the early diagnosis of osteoarthrosis during arthroscopy.

Korhonen, Rami K.; Saarakkala, Simo; Töyräs, Juha; Laasanen, Mikko S.; Kiviranta, Ilkka; Jurvelin, Jukka S.

2003-06-01

339

Comparison of Bristow procedure and Bankart arthroscopic method as the treatment of recurrent shoulder instability  

PubMed Central

Background: Anterior shoulder dislocation is the most common major joint dislocation. In patients with recurrent shoulder dislocation, surgical intervention is necessary. In this study, two methods of treatment, Bankart arthroscopic method and open Bristow procedure, were compared. Materials and Methods: This clinical trial survey had been done in the orthopedic department of Alzahra and Kashani hospitals of Isfahan during 2008-2011. Patients with recurrent anterior shoulder dislocation who were candidates for surgical treatment were randomly divided into two groups, one treated by Bankart arthroscopic technique and the other treated by Bristow method. All the patients were assessed after the surgery using the criteria of ROWE, CONSTANT, UCLA, and ASES. Data were analyzed by SPSS software. Results: Six patients (16.22%) had inappropriate condition with ROWE score (score less than 75); of them, one had been treated with Bristow and five with Bankart (5.26 vs. 27.78). Nine patients (24.32%) had appropriate condition, which included six from Bristow group and three treated by Bankart technique (31.58 vs. 16.67). Finally, 22 patients (59.46%) showed great improvement with this score, which included 12 from Bristow and 10 from Bankart groups (63.16 vs. 55.56). According to Fisher's exact test, there were no significant differences between the two groups (P = 0.15). Conclusion: The two mentioned techniques did not differ significantly, although some parameters such as level of performance, pain intensity, use of analgesics, and range of internal rotation showed more improvement in Bristow procedure. Therefore, if there is no contraindication for Bristow procedure, it is preferred to use this method. PMID:25590034

Zarezade, Abolghasem; Dehghani, Mohammad; Rozati, Ali Reza; Banadaki, Hossein Saeid; Shekarchizade, Neda

2014-01-01

340

Risk factors for readmission and revision surgery following rotator cuff repair.  

PubMed

Risk factors for revision surgery and hospitalization following rotator cuff repair (RCR) have not been clearly identified. We hypothesized patient factors and surgeon and hospital volume independently contribute to the risk of readmission within 90 days and revision RCR within one year. Using the SPARCS database, we included patients undergoing primary RCR in New York State between 1997 and 2002. These patients were tracked for readmission within 90 days and revision RCR within 1 year. A generalized estimating equation was developed to determine whether patient factors, surgeon volume, or hospital volume were independent risk factors for the above outcome measures. The total annual number of RCR increased from 6,656 in 1997 to 10,128 in 2002. Ambulatory cases increased from 57% to 82% during this time period. Independent risk factors for readmission within 90 days included increasing age and increased number of comorbidities. Independent risk factors for revision RCR included increasing age, increased comorbidity, and lower surgeon volume. Hospital volume had a minimal effect on either outcome measure. The shift toward out-patient surgery mirrors the shift from open to arthroscopic rotator cuff repair. The finding that surgeon volume is a predictor of revision RCR reflects the findings in other orthopaedic procedures. PMID:18264848

Sherman, Seth L; Lyman, Stephen; Koulouvaris, Panagiotis; Willis, Andrew; Marx, Robert G

2008-03-01

341

Arthroscopic meniscectomy for discoid lateral meniscus in children and adolescents: 4.5 year follow-up.  

PubMed

We retrospectively reviewed the 4.5 year (range, 21-88 months) follow-up results of arthroscopic partial meniscectomies performed in 11 knees between 1994 and 2000 to treat a symptomatic discoid lateral meniscus. The average age at surgery was 11.5 years (range, 5-17 years). All except one of the discoid menisci were of a complete type, and all except three were torn menisci. At the latest follow-up examination, the result was excellent for nine knees, and good for two; no degenerative changes were evident on the roentgenograms. Arthroscopic partial meniscectomy should be the treatment of choice for the complete type symptomatic lateral discoid meniscus, even if it is intact. Preoperative lack of the knee extension requires a gentle rehabilitation program postoperatively. PMID:14530697

O?üt, Tahir; Kesmezacar, Hayrettin; Akgün, I?ik; Cansü, Eren

2003-11-01

342

Safety and efficacy of three arthroscopic procedures using Holmium: Yag laser in two high-responder haemophiliacs.  

PubMed

We report here on the efficacy and safety of three arthroscopic procedures using a Holmium: Yag laser in two high-responder haemophiliacs. The two patients were treated with an activated prothrombin complex concentrate (FEIBA; Immuno, Vienna, Austria). Treatment was started just before surgery and continued for 4-8 days. On one occasion antifibrinolytics were concomitantly used without thromboembolic complication. Post-operative blood loss was slight, joint mobility was rapidly acceptable and full weight bearing without pain was possible on day 4. Such a procedure would appear to be superior to conventional arthroscopic synovectomy utilizing mechanical devices in haemophiliacs, because it might improve the quality of local haemostasis and the rapidity of post-operative recovery. In addition, it is also the technical procedure of choice in haemophilic patients with inhibitors who need synovectomy. PMID:10469185

Ménart, C; Lalain, J J; Lienhart, A; Dechavanne, M; Négrier, C

1999-07-01

343

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

PubMed Central

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

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

2014-01-01

344

The Use of Cold Therapy in the Postoperative Management of Patients Undergoing Arthroscopic Anterior Cruciate Ligament Reconstruction  

Microsoft Academic Search

In this prospective, randomized study we assessed the use of cold therapy after arthroscopic anterior cruciate ligament reconstruction. Seventy-one patients were randomly allocated, without the knowledge of the sin gle surgeon, to one of three groups: Group I had an ice water-filled CryoCuff fitted in the operating theater after surgery, Group II had room temperature water in the CryoCuff, and

Dennis J. Edwards; Martin Rimmer; Greg C. R. Keene

1996-01-01

345

Arthroscopic all-inside suture of symptomatic Baker's cysts: a technical option for surgical treatment in adults.  

PubMed

Synovial fluid caused by repeated effusions may replete the gastrocnemius-semimembranosus bursa (GSB) communicating with the knee joint. Fluid trapped inside the GSB through an alleged unidirectional valve-like mechanism forms a so-called Baker's cyst. Since a significant association of Baker's cysts with knee joint disorders has been reported, treatment should primarily address articular lesions causing recurrent effusions. Arthroscopic surgery provides an effective treatment in that both the cyst and associated joint disorders can be optimally visualized and accordingly treated. In the present paper an all-inside arthroscopic technique for suturing the gateway to the GSB through an anterolateral viewing portal and a posteromedial working portal is proposed. The rationale underlying this technique is that no conclusive evidences exist that the one-way valve-like mechanism is purely anatomical. A retrospective study was conducted on 22 patients (9 males and 13 females, mean age 56 +/- 10 SD years) affected by a symptomatic Baker's cyst associated to knee joint disorders. Pre- and post-operative evaluation at 2 year follow-up consisted of clinical assessment by Rauschning and Lindgren criteria and magnetic resonance imaging (MRI). The results showed that 96% of patients showed clinical improvement. Baker's cyst disappeared in 64% of patients, reduced in 27% and persisted in 9% on MRI. All patients with cyst reduction exhibited clinical amelioration. Our results suggest the all-inside arthroscopic suture technique would improve Baker's cyst-related symptoms by either disappearance or reduction of the cyst. We believe the availability of multiple arthroscopic techniques to treat symptomatic Baker's cysts could broaden the therapeutic armamentarium of knee arthroscopists. PMID:17671780

Calvisi, Vittorio; Lupparelli, Stefano; Giuliani, Pierandrea

2007-12-01

346

Outcome of Arthroscopic Débridement is Worse for Patients With Glenohumeral Arthritis of Both Sides of the Joint  

Microsoft Academic Search

Glenohumeral arthritis in the young patient presents a difficult problem with potentially devastating sequelae. Reports in\\u000a the literature suggest a role for arthroscopic treatment in patients with symptomatic degenerative joint disease of the shoulder.\\u000a However, no published study directly compares patients with unipolar versus bipolar cartilage lesions. We retrospectively\\u000a reviewed 19 patients (20 shoulders) younger than 55 years with Outerbridge Grade

Brian J. Kerr; Eric C. McCarty

2008-01-01

347

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

Microsoft Academic Search

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

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

1998-01-01

348

49 CFR 1242.42 - Administration, repair and maintenance, machinery repair, equipment damaged, dismantling retired...  

Code of Federal Regulations, 2014 CFR

...2014-10-01 false Administration, repair and maintenance, machinery repair, equipment damaged, dismantling retired property... § 1242.42 Administration, repair and maintenance, machinery repair, equipment damaged, dismantling retired...

2014-10-01

349

49 CFR 1242.42 - Administration, repair and maintenance, machinery repair, equipment damaged, dismantling retired...  

Code of Federal Regulations, 2012 CFR

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2012-10-01

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49 CFR 1242.42 - Administration, repair and maintenance, machinery repair, equipment damaged, dismantling retired...  

Code of Federal Regulations, 2011 CFR

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2011-10-01

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49 CFR 1242.42 - Administration, repair and maintenance, machinery repair, equipment damaged, dismantling retired...  

Code of Federal Regulations, 2010 CFR

...2010-10-01 false Administration, repair and maintenance, machinery repair, equipment damaged, dismantling retired property... § 1242.42 Administration, repair and maintenance, machinery repair, equipment damaged, dismantling retired...

2010-10-01

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49 CFR 1242.42 - Administration, repair and maintenance, machinery repair, equipment damaged, dismantling retired...  

Code of Federal Regulations, 2013 CFR

...2013-10-01 false Administration, repair and maintenance, machinery repair, equipment damaged, dismantling retired property... § 1242.42 Administration, repair and maintenance, machinery repair, equipment damaged, dismantling retired...

2013-10-01

353

The bony partial articular surface tendon avulsion lesion: an arthroscopic technique for fixation of the partially avulsed greater tuberosity fracture.  

PubMed

The partial articular surface tendon avulsion (PASTA) is a common lesion that involves the supraspinatus tendon in most cases. We present an arthroscopic fixation technique for a previously undescribed lesion that may be considered a variant of the PASTA. The lesion involves a partial avulsion of the greater tuberosity with an intact deep insertion of the supraspinatus tendon into the fractured bone fragment and an intact superficial insertion of the supraspinatus into the unavulsed lateral aspect of the greater tuberosity: a "bony PASTA" lesion. The surgical technique involves the use of a 70 degree arthroscope to provide an "end-on" view of the pathology. A superior-medial transmuscular portal is used for anchor insertion and suture management; the portal avoids damage to the intact tendinous insertion of the supraspinatus, which can occur during transtendon anchor/screw insertion. Abduction of the arm to 50 degrees, after creation of the portal and passage of the cannula, permits an optimal "deadman" angle of anchor placement. An angled suture grasper is used to retrieve the 4 suture strands from the double-loaded suture anchor through the intact superficial and deep supraspinatus tendon fibers along the length of the fracture; these are tied as 2 mattress sutures over the tendon fibers in the subacromial space by use of sliding-locking knots. Adequacy of reduction is confirmed by intra-articular arthroscopic observation during movement of the extremity through its complete range of motion. PMID:17637417

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

2007-07-01

354

Dexamathasone added to levobupivacaine improves postoperative analgesia in ultrasound guided interscalene brachial plexus blockade for arthroscopic shoulder surgery  

PubMed Central

Background The purpose of this study was to evaluate the effect of the addition of 5 mg dexamethasone to 10 ml of 0.5% levobupivacaine on postoperative analgesic effects of ultrasound guided-interscalene brachial plexus block (ISBPB) in arthroscopic shoulder surgery under general anesthesia. Methods In 60 patients scheduled for arthroscopic shoulder surgery that underwent general anesthesia, ISBPB was preoperatively performed with 10 ml of 0.5% levobupivacaine under the guidance of ultrasound and a nerve stimulator. Patients were randomly allocated to receive the same volume of normal saline (Group I), 5 mg of dexamethasone (Group II), or 1 : 400,000 epinephrine (Group III) as an adjuvant to the mixture. A blind observer recorded total analgesic consumption, sleep quality, complication, and patient satisfaction using a verbal numerical rating scale (VNRS) at 0, 1, 6, 12, 24, 48 h after the operation. Results All patients had successful ISBPB and excellent analgesic effects less than VNRS 4 up to discharge time. VNRS in Group II at 12 h and 48 h was statistically much lower than in Group I and III. There were no differences in total analgesic consumption, sleep quality, complications, and patient satisfaction. Conclusions We conclude that the addition of 5 mg of dexamethasone to 10 ml of 0.5% levobupivacaine in ISBPB showed improvement of postoperative analgesia for arthroscopic shoulder operation without any specific complications. PMID:22379567

Lee, Guie Yong; Kim, Dong Yeon; Kim, Chi Hyo; Baik, Hee-Jung; Heo, Seok

2012-01-01

355

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

PubMed Central

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

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

2015-01-01

356

DNA repair in cultured keratinocytes  

SciTech Connect

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.

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

1983-07-01

357

Advances in nerve repair.  

PubMed

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

Khuong, Helene T; Midha, Rajiv

2013-01-01

358

RNA-templated DNA repair  

Microsoft Academic Search

RNA can act as a template for DNA synthesis in the reverse transcription of retroviruses and retrotransposons and in the elongation of telomeres. Despite its abundance in the nucleus, there has been no evidence for a direct role of RNA as a template in the repair of any chromosomal DNA lesions, including DNA double-strand breaks (DSBs), which are repaired in

Francesca Storici; Katarzyna Bebenek; Thomas A. Kunkel; Dmitry A. Gordenin; Michael A. Resnick

2007-01-01

359

Successful overlapping anal sphincter repair  

Microsoft Academic Search

BACKGROUND: Fecal incontinence from single anal sphincter defects are surgically remedial and commonly the result of obstetric injuries. Overlapping anal sphincter repair has previously been associated in small series with good results in 69 to 97 percent of patients. OBJECTIVES: The aims of this study were to assess the results of overlapping anal sphincter repair in one institution and to

Christopher J. Young; Manu N. Mathur; Anthony A. Eyers; Michael J. Solomon

1998-01-01

360

Laparoscopic Repair of Perineal Hernia  

PubMed Central

Perineal hernia is a rare but known complication following major pelvic surgery. It may occur spontaneously or following abdominoperineal resection, sacrectomy, or pelvic exenteration. Very little is known about spontaneous perineal hernia. Surgical repair via open transabdominal and transperineal approaches has been previously described. We report laparoscopic repair of spontaneous and postoperative perineal hernia in 2 patients. PMID:19660225

Rayhanabad, Jessica; Sassani, Pejvak

2009-01-01

361

Major Appliance Repair. Teacher Edition.  

ERIC Educational Resources Information Center

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

Smreker, Eugene; Calvert, King

362

Instructional Guide for Autobody Repair.  

ERIC Educational Resources Information Center

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…

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

363

Drug resistance and DNA repair  

Microsoft Academic Search

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

Margaret Fox; John J. Roberts

1987-01-01

364

Pipe inspection and repair system  

NASA Technical Reports Server (NTRS)

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.

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

2004-01-01

365

Cytoskeleton Responses in Wound Repair  

PubMed Central

Wound repair on the cellular and multicellular levels is essential to the survival of complex organisms. In order to avoid further damage, prevent infection, and restore normal function, cells and tissues must rapidly seal and remodel the wounded area. The cytoskeleton is an important component of wound repair, needed for actomyosin contraction, recruitment of repair machineries, and cell migration. Recent use of model systems and high-resolution microscopy has provided new insight into molecular aspects of the cytoskeletal response during wound repair. Here we discuss the role of the cytoskeleton in single cell, embryonic, and adult repair, as well as the striking resemblance of these processes to normal developmental events and many diseases. PMID:22349211

Abreu-Blanco, Maria Teresa; Watts, James J.; Verboon, Jeffrey M.; Parkhurst, Susan M.

2012-01-01

366

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.

367

DNA repair in Chromobacterium violaceum.  

PubMed

Chromobacterium violaceum is a Gram-negative beta-proteobacterium that inhabits a variety of ecosystems in tropical and subtropical regions, including the water and banks of the Negro River in the Brazilian Amazon. This bacterium has been the subject of extensive study over the last three decades, due to its biotechnological properties, including the characteristic violacein pigment, which has antimicrobial and anti-tumoral activities. C. violaceum promotes the solubilization of gold in a mercury-free process, and has been used in the synthesis of homopolyesters suitable for the production of biodegradable polymers. The complete genome sequence of this organism has been completed by the Brazilian National Genome Project Consortium. The aim of our group was to study the DNA repair genes in this organism, due to their importance in the maintenance of genomic integrity. We identified DNA repair genes involved in different pathways in C. violaceum through a similarity search against known sequences deposited in databases. The phylogenetic analyses were done using programs of the PHILYP package. This analysis revealed various metabolic pathways, including photoreactivation, base excision repair, nucleotide excision repair, mismatch repair, recombinational repair, and the SOS system. The similarity between the C. violaceum sequences and those of Neisserie miningitidis and Ralstonia solanacearum was greater than that between the C. violaceum and Escherichia coli sequences. The peculiarities found in the C. violaceum genome were the absence of LexA, some horizontal transfer events and a large number of repair genes involved with alkyl and oxidative DNA damage. PMID:15100997

Duarte, Fįbio Teixeira; Carvalho, Fabķola Marques de; Bezerra e Silva, Uaska; Scortecci, Kįtia Castanho; Blaha, Carlos Alfredo Galindo; Agnez-Lima, Lucymara Fassarella; Batistuzzo de Medeiros, Silvia Regina

2004-01-01

368

Preventing hypothermia in elective arthroscopic shoulder surgery patients: a protocol for a randomised controlled trial  

PubMed Central

Background Patients having arthroscopic shoulder surgery frequently experience periods of inadvertent hypothermia. This common perioperative problem has been linked to adverse patient outcomes such as myocardial ischaemia, surgical site infection and coagulopathy. International perioperative guidelines recommend patient warming, using a forced air warming device, and the use of warmed intraoperative irrigation solutions for the prevention of hypothermia in at-risk patient groups. This trial will investigate the effect of these interventions on patients’ temperature, thermal comfort, and total recovery time. Method/Design The trial will employ a randomised 2 x 2 factorial design. Eligible patients will be stratified by anaesthetist and block randomised into one of four groups: Group one will receive preoperative warming with a forced air warming device; group two will receive warmed intraoperative irrigation solutions; group three will receive both preoperative warming and warmed intraoperative irrigation solutions; and group four will receive neither intervention. Participants in all four groups will receive active intraoperative warming with a forced air warming device. The primary outcome measures are postoperative temperature, thermal comfort, and total recovery time. Primary outcomes will undergo a two-way analysis of variance controlling for covariants such as operating room ambient temperature and volume of intraoperative irrigation solution. Discussion This trial is designed to confirm the effectiveness of these interventions at maintaining perioperative normothermia and to evaluate if this translates into improved patient outcomes. Australian New Zealand Clinical Trials Registry number ACTRN12610000591055 PMID:22817672

2012-01-01

369

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

PubMed

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

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

2008-11-01

370

A Comparison of Three Methods for Postoperative Pain Control in Patients Undergoing Arthroscopic Shoulder Surgery  

PubMed Central

Background Arthroscopic shoulder operations (ASS) are often associated with severe postoperative pain. Nerve blocks have been studied for pain in shoulder surgeries. Interscalene brachial plexus blocks (ISB) and an intra-articular injection (IA) have been reported in many studies. The aim of the present study is to evaluate the effect of ISB, a continuous cervical epidural block (CCE) and IA as a means of postoperative pain control and to study the influence of these procedures on postoperative analgesic consumption and after ASS. Methods Fifty seven patients who underwent ASS under general anesthesia were randomly assigned to one of three groups: the ISB group (n = 19), the CCE group (n = 19), and the IA group (n = 19). Patients in each group were evaluated on a postoperative numerical rating scale (NRS), their rescue opioid dosage (ROD), and side effects. Results Postoperative NRSs were found to be higher in the IA group than in the ISB and CCE groups both at rest and on movement. The ROD were 1.6 ± 2.3, 3.0 ± 4.9 and 7.1 ± 7.9 mg morphine equivalent dose in groups CCE, ISB, and IA groups (P = 0.001), respectively, and statistically significant differences were noted between the CCE and IA groups (P = 0.01) but not in between the ISB and CCE groups. Conclusions This prospective, randomized study demonstrated that ISB is as effective analgesic technique as a CCE for postoperative pain control in patients undergoing ASS. PMID:25589946

Park, Sun Kyung; Choi, Sung Wook; Song, Sung Wook

2015-01-01

371

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

PubMed Central

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

Wechalekar, Mihir D; Smith, Malcolm D

2014-01-01

372

DNA Repair Deficiency in Neurodegeneration  

PubMed Central

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

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

2011-01-01

373

Fix-It Careers: Jobs in Repair  

ERIC Educational Resources Information Center

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

Torpey, Elka Maria

2010-01-01

374

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

PubMed

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

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

2010-11-01

375

Simultaneous use of lateral calcaneal ostectomy and subtalar arthroscopic debridement for residual pain after a calcaneal fracture.  

PubMed

Inadequate primary treatment of calcaneal fractures frequently results in persistent, residual pain. This can be caused by subtalar arthritis, an increased calcaneal width, and/or calcaneal fibular impingement of the peroneal tendons. Many patients experience multiple disorders simultaneously, requiring a combination of procedures to treat the injury. The purpose of the present study was to evaluate the clinical outcomes of arthroscopic debridement with lateral calcaneal ostectomy for residual pain after a calcaneal fracture. Four feet (4 patients) were treated with arthroscopic debridement and lateral calcaneal ostectomy. The patients were 3 males and 1 female, with a mean age of 55.3 ± 14.1 years. The mean follow-up duration was 33.5 ± 10.5 months postoperatively. Three patients received worker's compensation as a result of their condition. The patients were examined for improvement in pain levels using the numeric pain intensity scale and healing was assessed using the Japanese Society of Surgery of the Foot score. The mean Japanese Society of Surgery of the Foot score improved from 64.5 ± 13.8 preoperatively to 82.5 ± 7.1 postoperatively. The mean postoperative numeric pain intensity scale score was 2.3 ± 1.9. No complications, such as deep infection or problems with wound healing, were observed in any of the patients. The simultaneous use of arthroscopic subtalar debridement and lateral calcaneal ostectomy is a valuable intervention for the treatment of residual pain after a calcaneal fracture in patients who present with increased calcaneal width and mild or no degenerative changes in the subtalar joint. PMID:25459094

Yoshimura, Ichiro; Ichimura, Ryuji; Kanazawa, Kazuki; Ida, Takahiro; Hagio, Tomonobu; Karashima, Hirotaka; Naito, Masatoshi

2015-01-01

376

Rotator cuff repair - series (image)  

MedlinePLUS

Surgery to repair a torn rotator cuff is usually very successful at relieving pain in the shoulder. The procedure is less predictable at returning strength to the shoulder. Recovery time often depends on the extent of the tear.

377

Umbilical hernia repair - series (image)  

MedlinePLUS

... treatment. The indications for umbilical hernia repair include: incarcerated (strangulated) umbilical hernia defects not spontaneously closed by 4 to 5 years of age children under 2 with very large defects unacceptable to parents for cosmetic reasons

378

Precision Instrument and Equipment Repairers.  

ERIC Educational Resources Information Center

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

Wyatt, Ian

2001-01-01

379

Short-Term Effects of Different Arthroscopic Techniques in the Treatment of Chondral Defects (Shaving, Coblation, and Microfacturing)  

Microsoft Academic Search

Background and Objective: Arthroscopic treatment of chondral defects includes different techniques. This study is intended to compare the short-term\\u000a effects of mechanical shaving, electrosurgical coblation, and microfracturing.\\u000a \\u000a \\u000a \\u000a \\u000a Patients and Methods: In 123 patients suffereing from medial arthrosis of the knee joint, an arthroscopy was performed. Evaluation included determination\\u000a of the Lysholm score and measurement of pain by a visual analog

Gunter Spahn; Ralf Wittig

2002-01-01

380

MRI Evaluation of Isolated Arthroscopic Partial Meniscectomy Patients at a Minimum Five-Year Follow-up  

Microsoft Academic Search

Background  The risk of radiographic knee degeneration after partial or total meniscectomy is well documented, but no prior study has\\u000a employed cartilage-sensitive MRI technology to assess degenerative changes after meniscectomy.\\u000a \\u000a \\u000a \\u000a Hypothesis  Arthroscopic partial meniscectomy results in early articular cartilage wear and subchondral bony degeneration, even in the\\u000a absence of clinical symptoms, and these findings can be evaluated with cartilage-sensitive MRI.\\u000a \\u000a \\u000a \\u000a Study design  Retrospective

Riley J. Williams III; Kristin K. Warner; Frank A. Petrigliano; Hollis G. Potter; Joshua Hatch; Frank A. Cordasco

2007-01-01

381

Laparoscopic Repair of Inguinal Hernias  

Microsoft Academic Search

For patients with recurrent inguinal hernia, or bilateral inguinal hernia, or for women, laparoscopic repair offers significant\\u000a advantages over open techniques with regard to recurrence risk, pain, and recovery. For unilateral first-time hernias, either\\u000a laparoscopic or open repair with mesh can offer excellent results. The major drawback of laparoscopy is that the technique\\u000a requires a significant number of cases to

Jonathan Carter; Quan-Yang Duh

382

Injection repair of composite delaminations  

SciTech Connect

Composites are used extensively in Naval aircraft for increased strength and weight savings. These aircraft contain many composite access panels that require frequent removal for servicing equipment. Often during removal and replacement the edges of these panels are damaged from prying the panel off, impacting the edge of the panel, and excessive fastener torque. A proposed method for repairing these panels is to inject resin into the delaminations. The type of resin that can be used for repair must be ambient storable in the navy environment, have a low injection viscosity, and restore the structural integrity. Developmental efforts at the Naval Air Warfare Center, Aircraft Division, Warminster, Pennsylvania supporting naval aircraft in the fleet led to the evaluation of four injection resins for delamination repair. The resins, including Dexter Hysol EA 9390, Dexter Hysol EA9396, Magnolia Plastics Magnobond 108-134, and Defense Research Establishment Pacific (DREP) Delamination Repair Epoxy, were tested to determine compatibility with repair procedures, mechanical strength, and thermal stability in a 180 F wet environment. Results of the evaluation for the repair materials are presented.

Mehrkam, P.A.; Alley, D. [Naval Air Warfare Center, Warminster, PA (United States). Aircraft Division

1995-12-31

383

Angiomyogenesis for Myocardial Repair  

PubMed Central

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

Akbar, Syed Ali; Ashraf, Muhammad

2009-01-01

384

Lateral meniscus allograft transplantation: an arthroscopically-assisted single-incision technique using all-inside sutures with a suture hook.  

PubMed

We present an arthroscopically-assisted single-incision technique using all-inside sutures with a suture hook in the lateral meniscus allograft transplantation. Although this technique is technically demanding, it provides vertically oriented and secure sutures with good tissue approximation without the accessory skin incision. PMID:23328984

Lee, Su-Chan; Chang, Woo-Hyuk; Park, Seung-Jun; Kim, Tae-Ho; Sung, Byung-Yoon

2014-02-01

385

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

PubMed

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

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

2014-12-01

386

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

PubMed Central

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

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

2014-01-01

387

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

PubMed

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

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

2015-02-01

388

The Di Giacomo technique: simplified suture passing in SLAP repair.  

PubMed

A 30 degrees arthroscope is introduced via the posterior soft spot portal, and an anterosuperior portal is created with the use of a 7-mm disposable cannula. The anterosuperior portal is used for instrumentation. An 18-gauge spinal needle is passed via the portal of Neviaser and the rotator cuff into arthroscopic view above the superior labrum. A No. 1 polydioxanone suture (PDS; Ethicon, Somerville, NJ) is advanced through the spinal needle. An arthroscopic retriever or meniscal clamp is used to retrieve the free end of the suture and bring it out through a small anterior stab wound. A suture anchor is inserted via the anterosuperior portal into the superior neck of the glenoid. The more medial limb of the No. 2 Ethibond suture (Ethicon) from the suture anchor is retrieved with the inferior limb of the No. 1 PDS suture, and both are brought out through the anterosuperior cannula. The opposite end of the No. 1 PDS suture is then manually pulled, while, under direct arthroscopic visualization, the No. 2 Ethibond suture, now tied to the opposite end of the PDS, is pulled through the superior labral tissue. That anchor suture is retrieved and is placed outside the cannula that contains the other anchor suture. Standard arthroscopic knot tying is then employed. PMID:17418338

Selby, Ronald M; Altchek, David W; Di Giacomo, Giovanni

2007-04-01

389

Minimally invasive transrotator cuff approach for arthroscopic stabilization of the posterosuperior glenoid labrum  

Microsoft Academic Search

We describe a novel technique for repair of the superior glenoid labrum posterior to the biceps anchor. This approach optimizes access for fixation of the superior and posterosuperior labrum, but involves significantly less trauma to the rotator cuff and subacromial space compared with previously described transrotator cuff methods. We suspect that the relative lack of trauma to the rotator cuff

Heber C Crockett; John M Wright; Daniel P Slawski; Bruce Kohtz; Dwain Rosse; Sandra Rosse

2004-01-01

390

Reprogramming Cells for Brain Repair  

PubMed Central

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

Guarino, Alyx T.; McKinnon, Randall D.

2013-01-01

391

Techniques of peripheral nerve repair.  

PubMed

Nerve injuries extend from simple nerve compression lesions to complete nerve injuries and severe lacerations of the nerve trunks. A specific problem is brachial plexus injuries where nerve roots can be ruptured, or even avulsed from the spinal cord, by traction. An early and correct diagnosis of a nerve injury is important. A thorough knowledge of the anatomy of the peripheral nerve trunk as well as of basic neurobiological alterations in neurons and Schwann cells induced by the injury are crucial for the surgeon in making adequate decisions on how to repair and reconstruct nerves. The technique of peripheral nerve repair includes four important steps (preparation of nerve end, approximation, coaptation and maintenance). Nerves are usually repaired primarily with sutures applied in the different tissue components, but various tubes are available. Nerve grafts and nerve transfers are alternatives when the injury induces a nerve defect. Timing of nerve repair is essential. An early repair is preferable since it is advantageous for neurobiological reasons. Postoperative rehabilitation, utilising the patients' own coping strategies, with evaluation of outcome are additional important steps in treatment of peripheral nerve injuries. in the rehabilitation phase adequate handling of pain, allodynia and cold intolerance are emphasised. PMID:19211385

Dahlin, L B

2008-01-01

392

Protein damage, repair and proteolysis.  

PubMed

Proteins are continuously affected by various intrinsic and extrinsic factors. Damaged proteins influence several intracellular pathways and result in different disorders and diseases. Aggregation of damaged proteins depends on the balance between their generation and their reversal or elimination by protein repair systems and degradation, respectively. With regard to protein repair, only few repair mechanisms have been evidenced including the reduction of methionine sulfoxide residues by the methionine sulfoxide reductases, the conversion of isoaspartyl residues to L-aspartate by L-isoaspartate methyl transferase and deglycation by phosphorylation of protein-bound fructosamine by fructosamine-3-kinase. Protein degradation is orchestrated by two major proteolytic systems, namely the lysosome and the proteasome. Alteration of the function for both systems has been involved in all aspects of cellular metabolic networks linked to either normal or pathological processes. Given the importance of protein repair and degradation, great effort has recently been made regarding the modulation of these systems in various physiological conditions such as aging, as well as in diseases. Genetic modulation has produced promising results in the area of protein repair enzymes but there are not yet any identified potent inhibitors, and, to our knowledge, only one activating compound has been reported so far. In contrast, different drugs as well as natural compounds that interfere with proteolysis have been identified and/or developed resulting in homeostatic maintenance and/or the delay of disease progression. PMID:23107776

Chondrogianni, Niki; Petropoulos, Isabelle; Grimm, Stefanie; Georgila, Konstantina; Catalgol, Betul; Friguet, Bertrand; Grune, Tilman; Gonos, Efstathios S

2014-02-01

393

Reprogramming cells for brain repair.  

PubMed

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

Guarino, Alyx T; McKinnon, Randall D

2013-01-01

394

Automotive Repair Shops Case Study ME 4171 Automotive Repair Shops  

E-print Network

, antifreeze, and corrosive wastes from lead batteries. Very few automotive paint and body shops conduct in this study were selected from the industry classifications which include top and body shops and paint shops on collision repair and painting. These shops are distributed throughout the state. The heaviest concentrations

395

Flexor tendon repairs: techniques, eponyms, and evidence.  

PubMed

The evolution in surgical technique and suture technology has provided an abundance of options for flexor tendon repairs. Multiple biomechanical studies have attempted to identify the best surgical technique based on suture properties, technical modifications, and repair configurations. However, the burgeoning amount of research on flexor tendon repairs has made it difficult to follow, and no gold standard has been determined for the optimal repair algorithm. Therefore, it seems that repairs are usually chosen based on a combination of familiarity from training, popularity, and technical difficulty. We will discuss the advantages, disadvantages, and technical aspects of some of the most common core flexor tendon repairs in the literature. We will also highlight the nomenclature carried through the years, drawings of the repairs referred to by that nomenclature, and the data that support those repairs. PMID:25154573

Chauhan, Aakash; Palmer, Bradley A; Merrell, Gregory A

2014-09-01

396

Final report [DNA Repair and Mutagenesis - 1999  

SciTech Connect

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.

Walker, Graham C.

2001-05-30

397

Abdominal aortic aneurysm repair - open - discharge  

MedlinePLUS

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

398

Biological Augmentation of Rotator Cuff Tendon Repair  

Microsoft Academic Search

A histologically normal insertion site does not regenerate following rotator cuff tendon-to-bone repair, which is likely due\\u000a to abnormal or insufficient gene expression and\\/or cell differentiation at the repair site. Techniques to manipulate the biologic\\u000a events following tendon repair may improve healing. We used a sheep infraspinatus repair model to evaluate the effect of osteoinductive\\u000a growth factors and BMP-12 on

David Kovacevic; Scott A. Rodeo

2008-01-01

399

Influence of deposit stage and failed ESWT on the surgical results of arthroscopic treatment of calcifying tendonitis of the shoulder.  

PubMed

The purpose of the present study is the evaluation of a possible influence of the preoperative deposit stage, the postoperative deposit elimination and failed preoperative extracorporeal shockwave therapy on the surgical outcome of arthroscopic treatment of tendinosis calcarea. From 1997 to 2004, 65 patients underwent arthroscopic resection of calcific deposits of the shoulder after failed conservative treatment. Patients with rotator cuff tears, major cartilage damage, or previous surgery were excluded. Out of 50 patients 45 (17 men, 28 women) that could be contacted with a mean age of 49 +/- 8 years could be followed-up with a mean of 36 months (14-89) after surgery. A total of 24 patients (53.3%) underwent preoperative extracorporeal shock-wave therapy (ESWT). For the clinical evaluation the Constant and Murley Score, the Simple Shoulder Test, the Western Ontario Rotator Cuff Index (WORC) and visual analog scales for pain, function and satisfaction were used. For the radiological evaluation, the classifications according to Gaertner and Bosworth were used. Statistical analysis was done with the Wilcoxon test, the Mann-Whitney test and ANOVA. The Constant and Murley Score improved significantly from preoperative 63.5 +/- 11.4 to postoperative 93.9 +/- 9.9 points (P < .0001) at follow-up, the Simple Shoulder Test from 1.7 +/- 2 to 9.9 +/- 2.8 points (P < .0001), the WORC score from 1,591.2 +/- 337.4 to 345.4 +/- 392 points (P < .0001). The visual analog scales for pain, function and patient satisfaction also significantly improved (P < .0001). Preoperative radiological evaluation according to the Gaertner classification revealed 37 type I deposits, 6 type II and 2 type III deposits; postoperative no calcific deposits were seen in 37 patients, 6 type I and 2 type III deposits. According to the Bosworth classification 13 type I, 19 type II and 13 type III deposits were seen preoperatively. Postoperative X-rays showed 6 type I and 1 type II and III deposits. There was no significant correlation of the clinical results with the pre- or postoperative findings. The 24 patients who underwent ESWT before surgery did not show significantly better results than patients without ESWT. In conclusion, arthroscopic removal of calcific deposits of the shoulder shows good clinical results for pain reduction, shoulder function and patient satisfaction. The type of calcific deposit and the preoperative treatment of the shoulder with ESWT did not have any significant impact on the postoperative results. PMID:18347778

Lorbach, O; Kusma, M; Pape, D; Kohn, D; Dienst, M

2008-05-01

400

Mismatch repair and drug responses in cancer  

Microsoft Academic Search

Defects in mismatch repair contribute to development of approximately 15% of colon cancers and to origination of endometrial, gastric and other cancers. Tumors with defects in mismatch repair exhibit marked resistance to alkylators and a variety of anticancer agents that modify DNA to create substrates for the mismatch repair system. These altered drug responses appear to derive from requirements for

W. David Sedwick; Sanford D. Markowitz; Martina L. Veigl

1999-01-01

401

MICROSURGICAL REPAIR OF THE ADOLESCENT VARICOCELE  

Microsoft Academic Search

PurposeSince clinically apparent varicoceles may affect testicular volume and sperm production, early repair has been advocated. However, repair of the pediatric varicocele with conventional nonmagnified techniques may result in persistence of the varicocele after up to 16% of these procedures. Also testicular artery injury and postoperative hydrocele formation can occur after nonmagnified repair. The microsurgical technique has been successfully completed

GARY E. LEMACK; ROBERT G. UZZO; PETER N. SCHLEGEL; MARC GOLDSTEIN

1998-01-01

402

Bringing mask repair to the next level  

NASA Astrophysics Data System (ADS)

Mask repair is an essential step in the mask manufacturing process as the extension of 193nm technology and the insertion of EUV are drivers for mask complexity and cost. The ability to repair all types of defects on all mask blank materials is crucial for the economic success of a mask shop operation. In the future mask repair is facing several challenges. The mask minimum features sizes are shrinking and require a higher resolution repair tool. At the same time mask blanks with different new mask materials are introduced to optimize optical performance and long term durability. For EUV masks new classes of defects like multilayer and phase defects are entering the stage. In order to achieve a high yield, mask repair has to cover etch and deposition capabilities and must not damage the mask. These challenges require sophisticated technologies to bring mask repair to the next level. For high end masks ion-beam based and e-based repair technologies are the obvious choice when it comes to the repair of small features. Both technologies have their pro and cons. The scope of this paper is to review and compare the performance of ion-beam based mask repair to e-beam based mask repair. We will analyze the limits of both technologies theoretically and experimentally and show mask repair related performance data. Based on this data, we will give an outlook to future mask repair tools.

Edinger, K.; Wolff, K.; Steigerwald, H.; Auth, N.; Spies, P.; Oster, J.; Schneider, H.; Budach, M.; Hofmann, T.; Waiblinger, M.

2014-10-01

403

Standardized Curriculum for Automotive Body Repair.  

ERIC Educational Resources Information Center

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

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

404

How nucleotide excision repair protects against cancer  

Microsoft Academic Search

Eukaryotic cells can repair many types of DNA damage. Among the known DNA repair processes in humans, one type — nucleotide excision repair (NER) — specifically protects against mutations caused indirectly by environmental carcinogens. Humans with a hereditary defect in NER suffer from xeroderma pigmentosum and have a marked predisposition to skin cancer caused by sunlight exposure. How does NER

Errol C. Friedberg

2001-01-01

405

Care needed in repairing safety valves  

Microsoft Academic Search

Recognizing the need for adequate repairs of ASME\\/National Board stamped safety and safety relief valves, the National Board Executive Committee approved procedures in January 1977 for the issuance of a National Board Certificate of Authorization for the use of a valve repair ''VR'' stamp. The intent of these procedures was to establish realistic standards by which proper repairs could be

Hurrison

1984-01-01

406

Standardized Curriculum for Small Engine Repair.  

ERIC Educational Resources Information Center

This curriculum guide for small engine repair was developed by the state of Mississippi to standardize vocational education course titles and core contents. The objectives contained in this document are common to all small engine repair programs in the state. The guide contains objectives for small engine repair I and II courses. Units in course I…

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

407

Laparoscopic arcuate line hernia repair.  

PubMed

Arcuate line hernia is considered a surgical rarity. This type of hernia is characterized by protrusion of intraperitoneal structures in a concave parietal fold in the abdominal wall. In this report, we aim to describe the diagnostic images of 2 cases of arcuate line hernia. Laparoscopic repair using a polypropylene mesh with a preattached inflatable balloon has been illustrated as well. PMID:24710227

Messaoudi, Nouredin; Amajoud, Zainab; Mahieu, Geert; Bestman, Raymond; Pauli, Steven; Van Cleemput, Marc

2014-06-01

408

Cleft lip and palate repair  

MedlinePLUS

Cleft lip and cleft palate repair is surgery to fix birth defects of the upper lip and palate (roof of the mouth). ... A cleft lip is a birth defect: A cleft lip may be just a small notch in the lip. It may ...

409

Umbilical and epigastric hernia repair  

Microsoft Academic Search

''You see things; and you say, Why? But I dream things that never were; and I say, Why not? ''-George Bernard Shaw, ''Back to Methuselah'' (1921), Part 1, Act 1 About 10% of all primary hernias consist of umbilical and epigastric hernias (1). Their repair therefore represents an important task in pediatric and adult surgery. Surprisingly, there is no consensus

Ulrike Muschaweck

410

Computer Equipment Repair Curriculum Guide.  

ERIC Educational Resources Information Center

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…

Reneau, Fred; And Others

411

Verification of Motor Repair Quality  

E-print Network

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

Butler, K.

412

Endovascular Repair of Thoracic Aortic Aneurysms  

PubMed Central

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

Findeiss, Laura K.; Cody, Michael E.

2011-01-01

413

Pulsed electromagnetic fields after arthroscopic treatment for osteochondral defects of the talus: double-blind randomized controlled multicenter trial  

PubMed Central

Background Osteochondral talar defects usually affect athletic patients. The primary surgical treatment consists of arthroscopic debridement and microfracturing. Although this is mostly successful, early sport resumption is difficult to achieve, and it can take up to one year to obtain clinical improvement. Pulsed electromagnetic fields (PEMFs) may be effective for talar defects after arthroscopic treatment by promoting tissue healing, suppressing inflammation, and relieving pain. We hypothesize that PEMF-treatment compared to sham-treatment after arthroscopy will lead to earlier resumption of sports, and aim at 25% increase in patients that resume sports. Methods/Design A prospective, double-blind, randomized, placebo-controlled trial (RCT) will be conducted in five centers throughout the Netherlands and Belgium. 68 patients will be randomized to either active PEMF-treatment or sham-treatment for 60 days, four hours daily. They will be followed-up for one year. The combined primary outcome measures are (a) the percentage of patients that resume and maintain sports, and (b) the time to resumption of sports, defined by the Ankle Activity Score. Secondary outcome measures include resumption of work, subjective and objective scoring systems (American Orthopaedic Foot and Ankle Society – Ankle-Hindfoot Scale, Foot Ankle Outcome Score, Numeric Rating Scales of pain and satisfaction, EuroQol-5D), and computed tomography. Time to resumption of sports will be analyzed using Kaplan-Meier curves and log-rank tests. Discussion This trial will provide level-1 evidence on the effectiveness of PEMFs in the management of osteochondral ankle lesions after arthroscopy. Trial registration Netherlands Trial Register (NTR1636) PMID:19591674

van Bergen, Christiaan JA; Blankevoort, Leendert; de Haan, Rob J; Sierevelt, Inger N; Meuffels, Duncan E; d'Hooghe, Pieter RN; Krips, Rover; van Damme, Geert; van Dijk, C Niek

2009-01-01

414

Large regional differences in incidence of arthroscopic meniscal procedures in the public and private sector in Denmark  

PubMed Central

Objectives A recent study reported a large increase in the number of meniscal procedures from 2000 to 2011 in Denmark. We examined the nation-wide distribution of meniscal procedures performed in the private and public sector in Denmark since different incentives may be present and the use of these procedures may differ from region to region. Setting We included data on all patients who underwent an arthroscopic meniscal procedure performed in the public or private sector in Denmark. Participants Data were retrieved from the Danish National Patient Register on patients who underwent arthroscopic meniscus surgery as a primary or secondary procedure in the years 2000 to 2011. Hospital identification codes enabled linkage of performed procedures to specific hospitals. Primary and secondary outcome measures Yearly incidence of meniscal procedures per 100?000 inhabitants was calculated with 95% CIs for public and private procedures for each region. Results Incidence of meniscal procedures increased at private and at public hospitals. The private sector accounted for the largest relative and absolute increase, rising from an incidence of 1 in 2000 to 98 in 2011. In 2011, the incidence of meniscal procedures was three times higher in the Capital Region than in Region Zealand. Conclusions Our study identified a large increase in the use of meniscal procedures in the public and private sector in Denmark. The increase was particularly conspicuous in the private sector as its proportion of procedures performed increased from 1% to 32%. Substantial regional differences were present in the incidence and trend over time of meniscal procedures. PMID:25712820

Hare, Kristoffer Borbjerg; Vinther, Jesper Hųeg; Lohmander, L Stefan; Thorlund, Jonas Bloch

2015-01-01

415

Shuttle orbiter TPS flight repair kit development  

NASA Technical Reports Server (NTRS)

The design and application of a TPS repair kit is presented. The repair kit is designed for on orbit use by a crew member working in the manned maneuvering unit (MMU). The kit includes the necessary equipment and materials to accomplish the repair tasks which include the following: HRSI emittance coating repair, damaged tile repair, missing tile repair, and multiple tile repair. Two types of repair materials required to do the small area repair and the large area repair are described. The materials area cure in place, silicone base ablator for small damaged areas and precured ablator tile for repair of larger damaged areas is examined. The cure in place ablator is also used as an adhesive to bond the precured tiles in place. An applicator for the cure in place ablator, designed to contain a two-part silicon compound, mix the two components at correct ratio, and dispense the materials at rates compatible with mission timelines established for the EVA is described.

1979-01-01

416

Investigation on Flexure Test of Composite Beam of Repair Materials and Substrate Concrete for Durable Repair  

NASA Astrophysics Data System (ADS)

An experimental study was conducted on composite beam of repair materials and substrate concrete to investigate the failures of concrete repair due to differences in strength of repair materials and substrate concrete. In this investigation the flexural strength, load-deflection curves and failure patterns of the composite beam specimens are studied for the durability of the concrete repair. Flexure test was conducted to simulate tensile stress in the concrete repair material. Compressive strength and split tensile strength of the repair materials and substrate concrete are investigated to aid in the analysis of the concrete repair. It was observed that the repair materials of higher compressive strength than the substrate concrete are causing an incompatible failure in the concrete repair.

Pattnaik, Rashmi R.; Rangaraju, Prasada Rao

2014-12-01

417

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

NASA Astrophysics Data System (ADS)

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

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

2013-09-01

418

Lateral foot pain following open reduction and internal fixation of the fracture of the fifth metatarsal tubercle: treated by arthroscopic arthrolysis and endoscopic tenolysis.  

PubMed

We report a case of fracture of the tuberosity of the fifth metatarsal which was managed by tension band wiring and bone grafting. It was complicated by symptomatic fibrosis of the operated site involving the cubometatarsal joint, peroneus brevis tendon, peroneus tertius tendon and the long extensor tendon to the fifth toe. This was successfully managed by arthroscopic lysis of the involved joint and tendons. PMID:24744074

Lui, Tun Hing

2014-01-01

419

A 7Year Follow-up of Patellar Tendon and Hamstring Tendon Grafts for Arthroscopic Anterior Cruciate Ligament ReconstructionDifferences and Similarities  

Microsoft Academic Search

Background: For arthroscopic anterior cruciate ligament reconstruction, the most commonly used graft constructs are either the hamstring tendon or patellar tendon. Well-controlled, long-term studies are needed to determine the differences between the 2 materials.Hypothesis: There is a difference between hamstring and patellar tendon grafts in the clinical results of anterior cruciate ligament reconstructions at 7 years.Study Design: Cohort study; Level

Justin Roe; Leo A. Pinczewski; Vivianne J. Russell; Lucy J. Salmon; Tomomaro Kawamata; Melvin Chew

2005-01-01

420

Methods of repairing a substrate  

NASA Technical Reports Server (NTRS)

A precursor of a ceramic adhesive suitable for use in a vacuum, thermal, and microgravity environment. The precursor of the ceramic adhesive includes a silicon-based, preceramic polymer and at least one ceramic powder selected from the group consisting of aluminum oxide, aluminum nitride, boron carbide, boron oxide, boron nitride, hafnium boride, hafnium carbide, hafnium oxide, lithium aluminate, molybdenum silicide, niobium carbide, niobium nitride, silicon boride, silicon carbide, silicon oxide, silicon nitride, tin oxide, tantalum boride, tantalum carbide, tantalum oxide, tantalum nitride, titanium boride, titanium carbide, titanium oxide, titanium nitride, yttrium oxide, zirconium boride, zirconium carbide, zirconium oxide, and zirconium silicate. Methods of forming the ceramic adhesive and of repairing a substrate in a vacuum and microgravity environment are also disclosed, as is a substrate repaired with the ceramic adhesive.

Riedell, James A. (Inventor); Easler, Timothy E. (Inventor)

2011-01-01

421

Wnt Signaling and Injury Repair  

PubMed Central

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

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

2012-01-01

422

Tendon healing: repair and regeneration.  

PubMed

Injury and degeneration of tendon, the soft tissue that mechanically links muscle and bone, can cause substantial pain and loss of function. This review discusses the composition and function of healthy tendon and describes the structural, biological, and mechanical changes initiated during the process of tendon healing. Biochemical pathways activated during repair, experimental injury models, and parallels between tendon healing and tendon development are emphasized, and cutting-edge strategies for the enhancement of tendon healing are discussed. PMID:22809137

Voleti, Pramod B; Buckley, Mark R; Soslowsky, Louis J

2012-01-01

423

Metallic Biomaterials in Skeletal Repair  

Microsoft Academic Search

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

Karl-Heinz Frosch; Klaus Michael Stürmer

2006-01-01

424

Laparoscopic Repair of Paraesophageal Hernias  

PubMed Central

Background and Objectives: Laparoscopy has quickly become the standard surgical approach to repair paraesophageal hernias. Although many centers routinely perform this procedure, relatively high recurrence rates have led many surgeons to question this approach. We sought to evaluate outcomes in our cohort of patients with an emphasis on recurrence rates and symptom improvement and their correlation with true radiologic recurrence seen on contrast imaging. Methods: We retrospectively identified 126 consecutive patients who underwent laparoscopic repair of a large paraesophageal hernia between 2000 and 2010. Clinical outcomes were reviewed, and data were collected regarding operative details, perioperative and postoperative complications, symptoms, and follow-up imaging. Radiologic evidence of any size hiatal hernia was considered to indicate a recurrence. Results: There were 95 female and 31 male patients with a mean age (± standard deviation) of 71 ± 14 years. Laparoscopic repair was completed successfully in 120 of 126 patients, with 6 operations converted to open procedures. Crural reinforcement with mesh was performed in 79% of patients, and 11% underwent a Collis gastroplasty. Fundoplications were performed in 90% of patients: Nissen (112), Dor (1), and Toupet (1). Radiographic surveillance, obtained at a mean time interval of 23 months postoperatively, was available in 89 of 126 patients (71%). Radiographic evidence of a recurrence was present in 19 patients (21%). Reoperation was necessary in 6 patients (5%): 5 for symptomatic recurrence (4%) and 1 for dysphagia (1%). The median length of stay was 4 days. Conclusion: Laparoscopic paraesophageal hernia repair results in an excellent outcome with a short length of stay when performed at an experienced center. Radiologic recurrence is observed relatively frequently with routine surveillance; however, many of these recurrences are small, and few patients require correction of the recurrence. Furthermore, these small recurrent hernias are often asymptomatic and do not seem to be associated with the same risk of severe complications developing as the initial paraesophageal hernia. PMID:25392650

Borao, Frank; Squillaro, Anthony; Mansson, Jonas; Barker, William; Baker, Thomas

2014-01-01

425

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

PubMed Central

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

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

2014-01-01

426

Arthroscopic-assisted locking compression plate clavicular hook fixation for unstable fractures of the lateral end of the clavicle: a prospective study.  

PubMed

The aim of this prospective study was to assess the clinical outcomes of an unstable fracture of the lateral end of the clavicle treated with an arthroscopic-assisted locking compressive plate (LCP) clavicular hook plate. Twenty-three patients underwent arthroscopic assisted LCP clavicular hook plate fixation for these fractures. All patients achieved clinical and radiological union over a mean of 4.2 months (range, 3.4-5 months). Four patients (17%) showed some degree of acromial osteolysis. Three patients (13%) showed radiological signs of arthrosis of the acromioclavicular joint. In one patient, a second fracture (stress) was observed between the medial two screws of the plate without an additional injury. Five patients (22%) showed subacromial bursitis on dynamic ultrasonography. The mean Constant and Murley score was 91 points (range, 81-98). The average level of pain in the shoulder at rest and on abduction was 1 (range, 0-2) and 2.4 (range, 0-4), respectively. Based on our experience, arthroscopic-assisted LCP hook plate fixation for the treatment of unstable fractures of the lateral end of the clavicle is not without complications. However, it is an acceptable alternative method that is easy to apply with good results. Furthermore, it prevents rotator cuff impingement, allows early mobilisation and maintains the acromioclavicular joint biomechanics. PMID:19998033

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

2010-08-01

427

Arthroscopic combined medial and lateral meniscus transplantation after double-tunnel, double-bundle anterior cruciate ligament reconstruction in the same knee.  

PubMed

Meniscus transplantation in combination with anterior cruciate ligament (ACL) reconstruction has been used in the treatment of patients with meniscus and ACL deficiency. However, there have been no reports of arthroscopic surgery and the outcome of both medial and lateral meniscus allograft transplantation after double-tunnel, double-bundle ACL reconstruction. Herein, we report the case of a young male who received arthroscopic lateral and medial meniscectomy and ACL tibialis allograft reconstruction performed with the double-tunnel and double-bundle technique approximately 8 months after a knee injury. Approximately 4 months postoperatively he began to experience pain and weakness in the operated knee and subsequently underwent arthroscopic lateral and medial meniscus allograft transplantation in the same procedure. Second-look arthroscopy and magnetic resonance imaging revealed the meniscal allografts to have normal shape and the ACL grafts to be relatively intact at 18 and 30 months after surgery. His knee appeared stable and the range of motion was normal. Our hypothesis was that knee stability could reliably be restored with this combined procedure and the meniscal grafts and ACL graft could provide protection for each other. We suggest that medial and lateral meniscus allografts for one patient should be from the same donor. In the operation, attention must be paid to the direction of the bone tunnels used to fix the horns of the meniscal grafts to avoid communication with other tunnels in the tibial plateau. PMID:22560745

Zhang, Ya-Dong; Hou, Shu-Xun; Zhang, Yi-Chao; Luo, Dian-Zhong; Zhong, Hong-Bin; Zhang, Hong

2012-12-01

428

Does intravenous ketamine enhance analgesia after arthroscopic shoulder surgery with ultrasound guided single-injection interscalene block?: a randomized, prospective, double-blind trial.  

PubMed

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

Woo, Jae Hee; Kim, Youn Jin; Baik, Hee Jung; Han, Jong In; Chung, Rack Kyung

2014-07-01

429

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

PubMed Central

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

2014-01-01

430

Nucleotide excision repair in yeast.  

PubMed

In nucleotide excision repair (NER) in eukaryotes, DNA is incised on both sides of the lesion, resulting in the removal of a fragment approximately 25-30 nucleotides long. This is followed by repair synthesis and ligation. The proteins encoded by the various yeast NER genes have been purified, and the incision reaction reconstituted in vitro. This reaction requires the damage binding factors Rad14, RPA, and the Rad4-Rad23 complex, the transcription factor TFIIH which contains the two DNA helicases Rad3 and Rad25, essential for creating a bubble structure, and the two endonucleases, the Rad1-Rad10 complex and Rad2, which incise the damaged DNA strand on the 5'- and 3'-side of the lesion, respectively. Addition of the Rad7-Rad16 complex to this reconstituted system stimulates the incision reaction many fold. The various NER proteins exist in vivo as part of multiprotein subassemblies which have been named NEFs (nucleotide excision repair factors). Rad14 and Rad1-Rad10 form one subassembly called NEF1, the Rad4-Rad23 complex is named NEF2, Rad2 and TFIIH constitute NEF3, and the Rad7-Rad16 complex is called NEF4. Although much has been learned from yeast about the function of NER genes and proteins in eukaryotes, the underlying mechanisms by which damage is recognized, NEFs are assembled at the damage site, and the DNA is unwound and incised, remain to be elucidated. PMID:10915862

Prakash, S; Prakash, L

2000-06-30

431

Animal models of cartilage repair  

PubMed Central

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

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

2014-01-01

432

Optimizing imaging for aortic repair.  

PubMed

Imaging is an integral part of an aortic program. Careful preoperative planning is essential to successful evaluation and treatment of aortic pathology. Computed tomography angiography (CTA) is the dominant modality for such preoperative planning. The use of a dedicated workstation for 3D postprocessing is very favorable and is considered mandatory when treating complex aortic pathology. Intraoperative imaging during aortic repair still depends heavily on standard fluoroscopy and angiography. However, the introduction of image fusion has the potential to reduce the use of both contrast and radiation, for the benefit of both patients and operators. Using cross-sectional imaging intraoperatively also has the potential to reduce the need for early imaging follow-up and to reduce the technical failures of endovascular aneurysm repair (EVAR). Imaging follow-up after EVAR has changed dramatically since the introduction of minimally invasive aortic repair. CTA remains the gold standard but a significant shift towards ultrasound surveillance has occurred. With the introduction of newer generation EVAR devices, results have improved and a trend towards less rigorous follow-up is expected. PMID:25644824

Törnqvist, P; Dias, N V; Resch, T

2015-04-01

433

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

PubMed Central

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

Mori, Daisuke; Funakoshi, Noboru; Yamashita, Fumiharu

2014-01-01

434

Mechanism and evolution of recombinational repair  

SciTech Connect

Recently, hydrogen peroxide (H{sub 2}O{sub 2}), and its free-radical product the hydroxyl radical (OH{centered dot}), have been identified as major sources of DNA damage in living organisms. We examined DNA repair of hydrogen peroxide damage, using a standard bacteriophage T4 tests system in which several different types of repair could be determined. Post-replication recombinational repair and den V-dependent excision repair had little or no effect on H{sub 2}O{sub 2} damage. Also, an enzyme important in repair of H{sub 2}O{sub 2}-induced DNA damage in the E. coli host cells, exonuclease III, was not utilized in repair of lethal H{sub 2}O{sub 2} damage to the phage. However, multiplicity reactivation, a form of recombinational repair between multiply infecting phage genomes, was found to repair H{sub 2}O{sub 2} damages efficiently. The RAD52 gene of Saccharomyces cerevisiae and genes 46 and 47 of bacteriophage T4 are essential for most recombination and recombinational repair in their respective organisms. The RAD52 gene was introduced into expression vectors which were used to transform E. coli. RAD52 expression was induced, and its ability to complement either gene 46 or gene 47 phage mutants was determined with respect to phage growth, recombination, and recombinational repair.

Chen, D.S.H.

1988-01-01

435

Nucleotide excision repair rates in rat tissues.  

PubMed

We have determined and compared nucleotide excision repair capability of several rat tissues by a method based on restoration of the transformation activity of UV-irradiated pBlueScript by incubation in repair-competent protein extracts. After 3 h of incubation, plasmid DNA was isolated and used to transform competent Escherichia coli cells. Damaged plasmids showed low transformation efficiency prior to incubation in repair-competent extracts. After incubation the transformation efficiency was restored to different extents permitting calculation of the repair capacity of the extracts. Our results showed that rapidly proliferating tissues such as liver, kidney and testis showed higher nucleotide excision repair capacity than slowly proliferating tissues such as heart, muscle, lung and spleen. When liver and splenocytes were stimulated to proliferation by partial hepatectomy and mitogen stimulation, their repair capability increased in parallel with the respective proliferative rates. PMID:12603333

Gospodinov, Anastas; Ivanov, Rumen; Anachkova, Boyka; Russev, George

2003-03-01

436

Outcome of pediatric hypospadias repair in adulthood  

PubMed Central

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

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

2010-01-01

437

Does DNA repair occur during somatic hypermutation?  

PubMed Central

Activation-induced deaminase (AID) initiates a flood of DNA damage in the immunoglobulin loci, leading to abasic sites, single-strand breaks and mismatches. It is compelling that some proteins in the canonical base excision and mismatch repair pathways have been hijacked to increase mutagenesis during somatic hypermutation. Thus, the AID-induced mutagenic pathways involve a mix of DNA repair proteins and low fidelity DNA polymerases to create antibody diversity. In this review, we analyze the roles of base excision repair, mismatch repair, and mutagenesis during somatic hypermutation of rearranged variable genes. The emerging view is that faithful base excision repair occurs simultaneously with mutagenesis, whereas faithful mismatch repair is mostly absent. PMID:22728014

Saribasak, Huseyin; Gearhart, Patricia J.

2012-01-01

438

Single molecule Studies of DNA Mismatch Repair  

PubMed Central

DNA mismatch repair involves is a widely conserved set of proteins that is essential to limit genetic drift in all organisms. The same system of proteins plays key roles in many cancer related cellular transactions in humans. Although the basic process has been reconstituted in vitro using purified components, many fundamental aspects of DNA mismatch repair remain hidden due in part to the complexity and transient nature of the interactions between the mismatch repair proteins and DNA substrates. Single molecule methods offer the capability to uncover these transient but complex interactions and allow novel insights into mechanisms that underlie DNA mismatch repair. In this review, we discuss applications of single molecule methodology including electron microscopy, atomic force microscopy, particle tracking, FRET, and optical trapping to studies of DNA mismatch repair. These studies have led to formulation of mechanistic models of how proteins identify single base mismatches in the vast background of matched DNA and signal for their repair. PMID:24746644

Erie, Dorothy A.; Weninger, Keith R.

2015-01-01

439

Current strategies and approaches to meniscal repair.  

PubMed

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

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

2014-12-01

440

Nucleotide excision repair in differentiated cells  

Microsoft Academic Search

Nucleotide excision repair (NER) is the principal pathway for the removal of a wide range of DNA helix-distorting lesions and operates via two NER subpathways, i.e. global genome repair (GGR) and transcription-coupled repair (TCR). Although detailed information is available on expression and efficiency of NER in established mammalian cell lines, little is known about the expression of NER pathways in

Caroline van der Wees; Jacob Jansen; Harry Vrieling; Arnoud van der Laarse; Albert Van Zeeland; Leon Mullenders

2007-01-01

441

Base excision repair in nucleosome substrates  

Microsoft Academic Search

Eukaryotic cells must repair DNA lesions within the context of chromatin. Much of our current understanding regarding the\\u000a activity of enzymes involved in DNA repair processes comes from in-vitro studies utilizing naked DNA as a substrate. Here we review current literature investigating how enzymes involved in base\\u000a excision repair (BER) contend with nucleosome substrates, and discuss the possibility that some

Indu Jagannathan; Hope A. Cole; Jeffrey J. Hayes

2006-01-01

442

Repairing sealing surfaces on aluminum castings  

NASA Technical Reports Server (NTRS)

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.

Hanna, T. L.

1980-01-01

443

Thermal protection system repair kit program  

NASA Technical Reports Server (NTRS)

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

1979-01-01

444

Repair of boron/aluminum composites  

NASA Technical Reports Server (NTRS)

A program was performed to determine the repairability of boron/aluminum aerospace structural components. During the program, a list of repair guidelines was prepared to aid in determining the proper repair techniques for a given structure. These guidelines included specifying types of repair material and their applicability, corrosion prevention procedures, design criteria, and inspection criteria. Six sets of boron/aluminum structural components were repaired and tested to compare as-fabricated and repaired performance. The specimens included a honeycomb-stiffened panel, elastically buckled tubes, a skin-stringer panel, a tube combining bending and tension, a splice joint specimen, and a tension field panel. All but one set of specimens, when repaired, exceeded the strength of the original specimens. The repairs resulted in an average weight increase per structure of 9% and an average performance increase of 27%. It is concluded that metal-matrix composite material, damaged in service, can be repaired by techniques not very different from those currently in use for conventional materials.

Christian, J. L.; Miller, M. F.; Doyal, F. H.

1975-01-01

445

Integrated Electrical Wire Insulation Repair System  

NASA Technical Reports Server (NTRS)

An integrated system tool will allow a technician to easily and quickly repair damaged high-performance electrical wire insulation in the field. Low-melt polyimides have been developed that can be processed into thin films that work well in the repair of damaged polyimide or fluoropolymer insulated electrical wiring. Such thin films can be used in wire insulation repairs by affixing a film of this low-melt polyimide to the damaged wire, and heating the film to effect melting, flow, and cure of the film. The resulting repair is robust, lightweight, and small in volume. The heating of this repair film is accomplished with the use of a common electrical soldering tool that has been modified with a special head or tip that can accommodate the size of wire being repaired. This repair method can furthermore be simplified for the repair technician by providing replaceable or disposable soldering tool heads that have repair film already "loaded" and ready for use. The soldering tool heating device can also be equipped with a battery power supply that will allow its use in areas where plug-in current is not available

Williams, Martha; Jolley, Scott; Gibson, Tracy; Parks, Steven

2013-01-01

446

Scheduling and rescheduling with iterative repair  

NASA Technical Reports Server (NTRS)

This paper describes the GERRY scheduling and rescheduling system being applied to coordinate Space Shuttle Ground Processing. The system uses constraint-based iterative repair, a technique that starts with a complete but possibly flawed schedule and iteratively improves it by using constraint knowledge within repair heuristics. In this paper we explore the tradeoff between the informedness and the computational cost of several repair heuristics. We show empirically that some knowledge can greatly improve the convergence speed of a repair-based system, but that too much knowledge, such as the knowledge embodied within the MIN-CONFLICTS lookahead heuristic, can overwhelm a system and result in degraded performance.

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

1992-01-01

447

Rehabilitation Following Zone II Flexor Tendon Repairs.  

PubMed

Ongoing clinical and basic research has improved understanding of flexor tendon mechanics and physiology for surgical repair and rehabilitation after a zone II flexor tendon repair. Yet, the ideal surgical repair technique that includes sufficient strength to allow safe immediate active motion of the finger, without excessive repair stiffness, bulk or rough surfaces resulting in excessive resistance to flexion, does not exist. After optimizing the repair, the surgeon and therapist team must select a rehabilitation plan that protects the repair but helps to maintain tendon gliding. There are 3 types of rehabilitation programs for flexor tendon repairs: delayed mobilization, early passive mobilization, or an early active mobilization. No guideline for rehabilitation should be followed exactly. Many factors influence therapy decisions, including repair technique, associated tendon healing, passive versus active range of motion, edema, and tendon adhesions. These factors can assist in guiding rehabilitation progression and promote functional range of motion, safely mobilize the repaired tendon(s) and prevent gapping, rupture, and adhesions. PMID:25700105

Kannas, Stephanie; Jeardeau, Teresa A; Bishop, Allen T

2015-03-01

448

Easily repairable networks: reconnecting nodes after damage.  

PubMed

We introduce a simple class of distribution networks that withstand damage by being repairable instead of redundant. Instead of asking how hard it is to disconnect nodes through damage, we ask how easy it is to reconnect nodes after damage. We prove that optimal networks on regular lattices have an expected cost of reconnection proportional to the lattice length, and that such networks have exactly three levels of structural hierarchy. We extend our results to networks subject to repeated attacks, in which the repairs themselves must be repairable. We find that, in exchange for a modest increase in repair cost, such networks are able to withstand any number of attacks. PMID:25302922

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

2014-09-26

449

Easily Repairable Networks: Reconnecting Nodes after Damage  

NASA Astrophysics Data System (ADS)

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

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

2014-09-01

450