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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 hip labral repair: the iberian suture technique.  

PubMed

Arthroscopic hip labral repair has beneficial short-term outcomes; however, debate exists regarding ideal surgical labral repair technique. This technical note presents an arthroscopic repair technique that uses intrasubstance labral suture passage to restore the chondrolabral interface. This "Iberian suture technique" allows for an anatomic repair while posing minimal risk of damage to the labral and chondral tissues. PMID:25126502

Stubbs, Allston J; Andersen, Jason S; Mannava, Sandeep; Wooster, Benjamin M; Howse, Elizabeth A; Winter, S Bradley

2014-06-01

3

Arthroscopic Hip Labral Repair: The Iberian Suture Technique  

PubMed Central

Arthroscopic hip labral repair has beneficial short-term outcomes; however, debate exists regarding ideal surgical labral repair technique. This technical note presents an arthroscopic repair technique that uses intrasubstance labral suture passage to restore the chondrolabral interface. This “Iberian suture technique” allows for an anatomic repair while posing minimal risk of damage to the labral and chondral tissues. PMID:25126502

Stubbs, Allston J.; Andersen, Jason S.; Mannava, Sandeep; Wooster, Benjamin M.; Howse, Elizabeth A.; Winter, S. Bradley

2014-01-01

4

Arthroscopic rotator cuff repair: 4- to 10-year 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

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 Capsular Repair in the Treatment of Femoroacetabular Impingement  

PubMed Central

The role of capsular repair in the arthroscopic treatment of femoroacetabular impingement remains poorly defined. Some surgeons rarely repair the capsule, whereas others perform repairs routinely. There is little direct clinical evidence to guide surgeon decision making. When capsular repairs are performed, the procedure requires adequate visualization and careful suture placement either to re-establish the patient's normal capsular volume or to plicate a redundant capsule in a hip with hyperlaxity preoperatively. We present our preferred technique for arthroscopic capsular repair. PMID:24749018

Chow, Roxanne M.; Engasser, William M.; Krych, Aaron J.; Levy, Bruce A.

2013-01-01

7

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

8

Open versus Two Forms of Arthroscopic Rotator Cuff Repair  

PubMed Central

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

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

2009-01-01

9

Arthroscopic Bankart repair. Operative technique and surgical pitfalls.  

PubMed

The arthroscopic management of patients with shoulder instability continues to evolve. The obvious benefits include a reduction of operative time, preservation of the subscapularis, improved visualization, and less blood loss. Newer techniques that allow the plastic deformation of the IGHLC to be addressed are emerging, which may yield results as successful as those of open Bankart repair. The ability to adequately tension the IGHLC may result in some loss of external rotation, which may improve results. Capsular tensioning must be critically analyzed at the time of surgery. Adequate stabilization with an arthroscopic approach should provide a convincing postoperative examination of stability. A careful examination after suture placement may indicate residual laxity that must be addressed. Finally, periods of immobilization are similar in open and arthroscopic techniques. The process of biologic healing is not accelerated by arthroscopic techniques, and early return to sport activities that may endanger the repair will likely result in early failure. PMID:10652664

Higgins, L D; Warner, J J

2000-01-01

10

Arthroscopic Labral Repair in the Treatment of Femoroacetabular Impingement  

PubMed Central

Labral repair has become an essential technique in the arthroscopic surgical management of femoroacetabular impingement. Several clinical studies suggest that labral repair results in superior patient outcomes in comparison to labral debridement alone. The repair procedure requires accurate evaluation of labral tissue quality, precise placement of sutures and anchors, and careful re-tensioning of the labrum. We present our preferred technique for labral repair. PMID:24400177

Chow, Roxanne M.; Owens, Christopher J.; Krych, Aaron J.; Levy, Bruce A.

2013-01-01

11

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

PubMed

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

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

2012-06-01

12

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.

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

2014-01-01

13

Patient Satisfaction after Arthroscopic Repair of Acetabular Labral Tears  

PubMed Central

Background Acetabular labral tear is a main cause of hip pain and disability, often requiring surgical treatment. Improvements of hip arthroscopic technique have produced positive outcomes after labral repair with arthroscopy. The purpose of this study was to determine clinical outcomes and patient satisfaction after arthroscopic repair of acetabular labral tear. Methods We interviewed 21 patients (10 men and 11 women; mean age, 36 years [range, 22 to 57 years]) with acetabular labral tears that had been repaired arthroscopically in terms of satisfaction of the procedure. In addition, clinical outcome was assessed using visual analog scale (VAS) score, University of California, Los Angeles (UCLA) activity, Western Ontario and McMaster Universities (WOMAC) osteoarthritis index, and Harris hip score, and radiologic outcome was assessed using serial radiography. The patients were followed for 24-50 months. Results The mean Harris hip score was 73 points (range, 64 to 84 points) preoperatively and 83 points (range, 66 to 95 points) postoperatively. Fifteen hips (71%) were rated excellent and good. The mean WOMAC osteoarthritis index and VAS scores were improved at final follow-up. UCLA activity at the latest follow-up improved in 16 patients. The Tonnis grade of osteoarthritis at the latest follow-up did not change in all patients. Eighteen of the patients (86%) were satisfied with the procedure. Conclusions High rate of satisfaction after arthroscopic repair of acetabular labral tears is an encouraging outcome. Arthroscopic treatment of labral tears might be a useful technique in patients with hip pathologies, such as femoroacetabular impingement with labral tears. PMID:24900896

Ha, Yong-Chan; Shin, Yong-Eun

2014-01-01

14

Posterosuperior suture granuloma impingement after arthroscopic SLAP repair using suture anchors: a case report.  

PubMed

Arthroscopic refixation of the glenoid labrum has become a standard treatment of type II SLAP lesions although postoperative results are not uniformly good due to factors which are yet unclear. We present the case of an active overhead athlete with an intraarticular posterosuperior impingement syndrome arising from a suture granuloma formation complicating the postoperative course after arthroscopic SLAP repair. The symptoms resolved completely following revision arthroscopy during which the granuloma and the permanent sutures were removed. Implant related complications should be considered when patients present with recurrent pain after arthroscopic SLAP repair using suture anchors, in particular during overhead activity. PMID:18365177

Ifesanya, Adeleke; Scheibel, Markus

2008-07-01

15

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

Microsoft Academic Search

INTRODUCTION: Arthroscopic repair of the rotator cuff is a demanding surgery. Accurate placement of anchors is key to success. CASE PRESENTATION: A 38-year-old woman received arthroscopic repair of her rotator cuff using a double row suture anchor technique. Postoperatively, she developed impingement syndrome which resulted from vertical displacement of a suture anchor once the shoulder was mobilised. The anchor was

Rohit Rambani; Roger G Hackney

2009-01-01

16

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

Microsoft Academic Search

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

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

2010-01-01

17

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

18

Is Early Passive Motion Exercise Necessary After Arthroscopic Rotator Cuff Repair?  

Microsoft Academic Search

Background: Early passive motion exercise has been the standard rehabilitation protocol after rotator cuff repair for preventing postoperative stiffness. However, recent approaches show that longer immobilization may enhance tendon healing and quality.Purpose: To elucidate whether early passive motion exercise affects functional outcome and tendon healing after arthroscopic rotator cuff repair.Study Design: Randomized controlled trial; Level of evidence, 1.Methods: One hundred

Yang-Soo Kim; Seok Won Chung; Joon Yub Kim; Ji-Hoon Ok; Joo Han Oh

2012-01-01

19

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

20

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

PubMed

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

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

2013-01-01

21

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

22

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

23

Arthroscopic Direct Repair for a Complete Radial Tear of the Posterior Root of the Medial Meniscus  

PubMed Central

We report here on a new arthroscopic direct repair technique for a radial tear of the posterior root of the medial meniscus (PRMM) using a posterior trans-septal portal. Radial tears of the PRMM are commonly observed in the elderly population of Korea and Japan, and the life style of these people requires squatting and kneeling down in daily life. A radial tear of the PRMM results in the loss of hoop tension and this accelerates degenerative changes in the knee joint and causes early osteoarthritis. Several reports in the medical literature have focused on various repair techniques for these tears by using pull out sutures. These techniques result in nonanatomic fixation of the meniscus, which may lead to disturbed meniscal excursion and failure to restore hoop tension. Arthroscopic direct repair may contribute to restoring hoop tension and preventing accelerated degenerative changes in the knee joint of these patients. PMID:22162797

Wang, Kook Hyun; Hwang, Dae Hee; Cho, Jin Ho; Changale, Sachin D.; Woo, Sung Jong

2011-01-01

24

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

PubMed

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

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

2010-03-01

25

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

PubMed Central

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

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

2009-01-01

26

Arthroscopic meniscal repair with an absorbable screw: results and surgical technique  

Microsoft Academic Search

The results of a new method for arthroscopic all-inside meniscus repair using a biodegradable cannulated screw (Clearfix meniscal screw) were assessed in a medium-term follow-up prospective study. The Clearfix meniscal screw system consists of delivery cannulae, screw driver, and screw implants. After tear debridement, a screw is located on the driver and passed through the cannula to the insertion site,

Michael E. Hantes; Elias S. Kotsovolos; Dimitrios S. Mastrokalos; Joerg Ammenwerth; Hans H. Paessler

2005-01-01

27

Arthroscopic Labral Repair and Treatment of Femoroacetabular Impingement in Professional Hockey Players  

Microsoft Academic Search

Background: Hip injuries are common among professional hockey players in the National Hockey League (NHL).Hypothesis: Professional hockey players will return to a high level of function and ice hockey after arthroscopic labral repair and treatment of femoroacetabular impingement.Study Design: Case series; Level of evidence, 4.Methods: Twenty-eight professional hockey players (NHL) were unable to perform at the professional level due to

Marc J. Philippon; Douglass R. Weiss; David A. Kuppersmith; Karen K. Briggs; Connor J. Hay

2010-01-01

28

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

29

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

PubMed

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

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

2010-12-01

30

Generation of meniscal cyst after arthroscopic meniscal repair.  

PubMed

Meniscal cyst is a common condition and it has been suggested that the degeneration of the meniscus may be largely associated with the occurrence of a meniscal cyst. However, meniscal cysts forming after meniscal repair are exceedingly rare. Previous reports have suggested that meniscal cyst after meniscal repair can be attributed to the cystic degeneration of the meniscus and the thread used for the meniscal suture. In this report, the developmental mechanism of a meniscal cyst after meniscal repair suturing is discussed. PMID:15483551

Nagura, Issei; Yagi, Masayoshi; Kokubu, Takeshi; Yoshiya, Shinnichi; Kurosaka, Masahiro

2004-10-01

31

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

32

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

PubMed Central

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

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

2013-01-01

33

Labrum repair combined with arthroscopic reduction of capsular volume in shoulder instability  

PubMed Central

We performed arthroscopic treatment of traumatic anterior and anteroinferior shoulder instability combining three procedures— labrum repair, reduction of capsular volume and suture of the rotator cuff interval—with the aim of analysing the results with regard to stability and function. Between January 1999 and December 2003, 27 patients underwent arthroscopic treatment for labrum repair with metal anchors, reduction of capsular volume through thermal capsulorrhaphy and suture of rotator cuff interval. These patients were evaluated in the pre- and postoperative period using the UCLA and Rowe scales and in the postoperative period using the ASES scale. During a mean follow-up period of 32.4 months (range 22–74 months) all shoulders remained stable. Using the UCLA scale, there was improvement from the preoperative period, with a mean score of 24.7, to the postoperative period, with a mean of 32.81. Improvement was also shown by the Rowe scale, with a mean score of 39.81 in the preoperative period and 90.74 in the postoperative period. On the ASES scale the mean score was 92.22. All shoulders remained stable and there was marked functional improvement in the patients who were treated. These results are comparable to those obtained with open surgery, observing similar patient selection criteria. PMID:16715457

Belangero, William Dias

2006-01-01

34

Labrum repair combined with arthroscopic reduction of capsular volume in shoulder instability.  

PubMed

We performed arthroscopic treatment of traumatic anterior and anteroinferior shoulder instability combining three procedures--labrum repair, reduction of capsular volume and suture of the rotator cuff interval--with the aim of analysing the results with regard to stability and function. Between January 1999 and December 2003, 27 patients underwent arthroscopic treatment for labrum repair with metal anchors, reduction of capsular volume through thermal capsulorrhaphy and suture of rotator cuff interval. These patients were evaluated in the pre- and postoperative period using the UCLA and Rowe scales and in the postoperative period using the ASES scale. During a mean follow-up period of 32.4 months (range 22-74 months) all shoulders remained stable. Using the UCLA scale, there was improvement from the preoperative period, with a mean score of 24.7, to the postoperative period, with a mean of 32.81. Improvement was also shown by the Rowe scale, with a mean score of 39.81 in the preoperative period and 90.74 in the postoperative period. On the ASES scale the mean score was 92.22. All shoulders remained stable and there was marked functional improvement in the patients who were treated. These results are comparable to those obtained with open surgery, observing similar patient selection criteria. PMID:16715457

Lino, Waldo; Belangero, William Dias

2006-08-01

35

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

PubMed

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

Cusack, Lara; Johnson, Matthew

2013-01-01

36

Acute femoral "peel-off" tears of the posterior cruciate ligament: technique for arthroscopic anatomical repair.  

PubMed

Management of posterior cruciate ligament injuries remains a topic of discussion among treating physicians. Injury severity, anatomical location, and presence of concomitant associated knee injuries are important factors that may be used to guide treatment strategies. Various subtypes of posterior cruciate ligament injury have been identified. Each has unique properties that affect treatment design. Among these subtypes is the acute femoral "peel-off" tear, which represents a distinct pattern of injury that consistently has demonstrated a favorable capacity for healing with repair rather than reconstruction. In this article, we present an arthroscopic anatomical repair technique that has been used with success at our institution. It is important to properly identify such injuries in a timely manner so that appropriate treatment is initiated and the patient may be spared a lengthier and more technically complex reconstruction procedure. PMID:21734931

Giordano, Brian D; Dehaven, Kenneth E; Maloney, Michael D

2011-05-01

37

Outcome of arthroscopic rotator cuff repair in large tears: the exposed footprint.  

PubMed

The purpose of this retrospective study was to evaluate the clinical results of arthroscopic single-row repair in large rotator cuff tears. Selection was based on the extent of the "exposed footprint" (EFP) obtained by adding up the width of the subscapularis tear and the width of the supra/infraspinatus tear. Three groups were studied: Type I had an EFP of less than 5 cm; Type II had an EFP of 5 cm or more; tears allowing only partial repair were studied separately. During a period of nearly three years (in 2002-04) 49 shoulders complied with our selection. There were 25 type I and 24 type II tears. Subscapularis tears were found in 32/49 shoulders (65%); 10 shoulders (20%) had only partial repair. At an average follow-up of 33 months, all patients were subjected to an outcome assessment using the VAS, the Simple Shoulder Test (SST), Constant score (CS) and strength measurement. A near normal shoulder function (11-12 Yes-answers in the SST) was obtained in 68% of the patients with type I tears, compared to 33% of type II tears (p = 0.02). The adjusted CS for patients with a type I tear was 88%, compared to 77% for patients with a type II (p = 0.01); strength was 69% for type I and 36% for type II shoulders (p = 0.001). After arthroscopic single-row and margin-convergence repair, a near normal shoulder function was obtained in two-thirds of the shoulders with an EFP of up to 5 cm. When the EFP was larger, this outcome was achieved in only one-third of the shoulders. PMID:22308618

Buess, Eduard; Waibl, Bernhard; Seidner, Robert; Werlen, Stefan

2011-12-01

38

One strategy for arthroscopic suture fixation of tibial intercondylar eminence fractures using the Meniscal Viper Repair System  

PubMed Central

Background Principles for the treatment of tibial intercondylar eminence fracture are early reduction and stable fixation. Numerous ways to treatment of this fracture have been invented. We designed a simple, low-invasive, and arthroscopic surgical strategy for tibial intercondylar eminence fracture utilizing the Meniscal Viper Repair System used for arthroscopic meniscal suture. Methods We studied 5 patients, who underwent arthroscopic suture fixation that we modified. The present technique utilized the Meniscal Viper Repair System for arthroscopic suture of the meniscus. With one handling, a high-strength ultra-high molecular weight polyethylene(UHMWPE) suture can be passed through the anterior cruciate ligament (ACL) and the loops for suture retrieval placed at both sides of ACL. Surgical results were evaluated by the presence or absence of bone union on plain radiographs, postoperative range of motion of the knee joint, the side-to-side differences measured by Telos SE, and Lysholm scores. Results The reduced position achieved after surgery was maintained and good function was obtained in all cases. The mean distance of tibia anterior displacement and assessment by Lysholm score showed good surgical results. Conclusion This method simplified the conventional arthroscopic suture fixation and increased its precision, and was applicable to Type II fractures that could be reduced, as well as surgically indicated Types III and IV. The present series suggested that our surgical approach was a useful surgical intervention for tibial intercondylar eminence fracture. PMID:21831294

2011-01-01

39

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

PubMed Central

The arthroscopic surgical procedures reported previously for a rheumatic hip joint have been primarily performed as diagnostic procedures. Only a few studies have reported the success of arthroscopic surgery in hip joint preservation. We encountered a special case in which joint remodeling was seen in a patient with rheumatoid arthritis treated with biological drugs after hip arthroscopic synovectomy and labral repair. We report the case of a 39-year-old woman with rheumatism, which was controlled with tocilizumab, prednisolone, and tacrolimus. The hip joint showed Larsen grade 3 destruction, and the Harris Hip Score was 55 points. Because of the patient's strong desire to undergo a hip preservation operation, we performed hip arthroscopic synovectomy and repair of a longitudinal labral tear. After 2.5 years, the joint space had undergone rebuilding with improvement to Larsen grade 2, and the Harris Hip Score had improved to 78 points; the patient was able to return to work with the use of 1 crutch. It is possible to perform hip arthroscopic surgery for rheumatoid arthritis with a hip preservation operation with biological drugs. PMID:25276611

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

2014-01-01

40

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

41

Anaesthetic management of shoulder arthroscopic repair in Parkinson's disease with deep brain stimulator.  

PubMed

We describe the anaesthetic management of arthroscopic repair for complete rotator cuff tear of shoulder in a 59-year-old female with Parkinson's disease (PD) with deep brain stimulator (DBS) using a combination of general anaesthesia with interscalene approach to brachial plexus block. The DBS consists of implanted electrodes in the brain connected to the implantable pulse generator (IPG) normally placed in the anterior chest wall subcutaneously. It can be programmed externally from a hand-held device placed directly over the battery stimulator unit. In our patient, IPG with its leads was located in close vicinity of the operative site with potential for DBS malfunction. Implications of DBS in a patient with PD for shoulder arthroscopy for anaesthesiologist are discussed along with a brief review of DBS. PMID:25024475

Gandhi, Ranju; Chawla, Reeta

2014-05-01

42

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

PubMed Central

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

Rosso, Federica; Bisicchia, Salvatore; Amendola, Annunziato

2014-01-01

43

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.

Burt, David M.

2014-01-01

44

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

45

Arthroscopic Percutaneous Repair of Anterosuperior Rotator Cuff Tear Including Biceps Long Head: A 2-Year Follow-up  

PubMed Central

Background To report the results of an arthroscopic percutaneous repair technique for partial-thickness tears of the anterosuperior cuff combined with a biceps lesion. Methods The inclusion criteria were evidence of the upper subscapularis tendon tear and an articular side partial-thickness tear of the supraspinatus tendon, degeneration of the biceps long head or degenerative superior labrum anterior-posterior, above lesions treated by arthroscopic percutaneous repair, and follow-up duration > 24 months after the operation. American Shoulder and Elbow Surgeons (ASES) score, constant score, the pain level on a visual analogue scale, ranges of motion and strength were assessed. Results The mean (± standard deviation) age of the 20 enrolled patients was 56.0 ± 7.7 years. The forward flexion strength increased from 26.3 ± 6.7 Nm preoperatively to 38.9 ± 5.1 Nm at final follow-up. External and internal rotation strength was also significantly increased (14.2 ± 1.7 to 19.1 ± 3.03 Nm, 12.3 ± 3.2 to 18.1 ± 2.8 Nm, respectively). Significant improvement was observed in ASES and constant scores at 3 months, 1 year and the time of final follow-up when compared with preoperative scores (p < 0.001). The mean subjective shoulder value was 86% (range, 78% to 97%). Conclusions The implementation of complete rotator cuff repair with concomitant tenodesis of the biceps long head using arthroscopic percutaneous repair achieved full recovery of normal rotator cuff function, maximum therapeutic efficacy, and patient satisfaction. PMID:23205238

Kim, Do-Young; Lee, Sang-Soo; Seo, Eun-Min; Hwang, Jung-Taek; Kwon, Sun-Chang; Lee, Jae-Won

2012-01-01

46

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

PubMed Central

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

Sueyoshi, Tetsuro; Winters, Matthew; Zeman, David

2008-01-01

47

Arthroscopic double row cuff repair with suture-bridging and autologous conditioned plasma injection: Functional and structural results  

PubMed Central

Purpose: The double row cuff repair with suture bridging is commonly used for arthroscopic rotator cuff repair (RCR). Despite its biomechanical qualities, the rate of iterative tears with this technique is important. The aim of our study was to evaluate the effect of autologous conditioned plasma (ACP) on functional results and on the rate of iterative tears after RCR by suture bridging. Materials and Methods: A consecutive series of 65 patients who underwent arthroscopic double-row suture bridge (Speed-Bridge, Arthrex) primary cuff repair of symptomatic full-thickness supraspinatus tear (retraction <3 in the Patte classification) were evaluated. Mean patient age was 60 (+/-8). The supraspinatus was repaired by knot-less bridging (SwiveLock, Arthrex) with suture tape material. 2 homogenous groups were created (A: 33 patients, B: 32 patients). In group A, all patients received, besides the cuff repair, an intra-tendinous ACP injection. Constant scores and Simple Shoulder Tests (SST) were measured pre-operatively and after a minimum follow-up period of 12 months post-operatively. Structural integrity of the repairs was evaluated by MRI according to the Sugaya classification. Sugaya >4 were considered as iterative tears. Results: Mean follow-up was 19 months (+/?42) in the 2 groups. The mean quantity of ACP injected was 6ml. (+/?1.5) and no specific complication of the injection was found. Mean preoperative Constant-Murley scores were 41,2 (±7,7) and 38 (±11)in group B. Mean normalized Constant-Murley score increased from 41 points (±7) pre-operatively to 70 points (±8) post-operatively in group A and from 38 points (±11) to 73 points (±11) in group B. There were no significative differences between the two groups (P > 0.05). In group A, 31 repairs were Sugaya 1-3 (94%), vs. 30 in group B (93%), and 1 was type 4 in group A (5%) vs. 2 in group B (8%). Conclusion: In both groups, RCR with suture bridging gave successful functional outcomes, with a low rate of iterative tear. In this preliminary study, the adjuvant effect of ACP injections could not be showed on both functional and structural results. Longer follow-up is needed to evaluate potential differences.

Werthel, Jean-David; Pelissier, Alexandre; Massin, Philippe; Boyer, Patrick; Valenti, Philippe

2014-01-01

48

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

49

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

Microsoft Academic Search

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

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

1997-01-01

50

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

51

Arthroscopic Technique for Chondrolabral Capsular Preservation During Labral Repair and Acetabular Osteoplasty  

PubMed Central

Traditional techniques for acetabular osteoplasty in femoral acetabular impingement have required surgical detachment of the labrum at the chondrolabral junction. Such approaches compromise labral blood flow and contribute to a limited ability for healing at the chondrolabral junction. In this technical note and accompanying video, we present a technique for preservation of the chondrolabral junction during labral repair and acetabular osteoplasty. We elevate the chondrolabral complex subperiosteally off the acetabular rim, and the acetabular shelf is then contoured under fluoroscopic guidance. The labrum is then repaired and reconstituted to a new anatomic footprint. We find this technique to be advantageous because it preserves the blood flow to the labrum, thereby maximizing healing potential. Outcome studies are warranted to further elucidate the functional and outcome benefits of this surgical technique. PMID:24265986

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

2013-01-01

52

Arthroscopic technique for chondrolabral capsular preservation during labral repair and acetabular osteoplasty.  

PubMed

Traditional techniques for acetabular osteoplasty in femoral acetabular impingement have required surgical detachment of the labrum at the chondrolabral junction. Such approaches compromise labral blood flow and contribute to a limited ability for healing at the chondrolabral junction. In this technical note and accompanying video, we present a technique for preservation of the chondrolabral junction during labral repair and acetabular osteoplasty. We elevate the chondrolabral complex subperiosteally off the acetabular rim, and the acetabular shelf is then contoured under fluoroscopic guidance. The labrum is then repaired and reconstituted to a new anatomic footprint. We find this technique to be advantageous because it preserves the blood flow to the labrum, thereby maximizing healing potential. Outcome studies are warranted to further elucidate the functional and outcome benefits of this surgical technique. PMID:24265986

Nwachukwu, Benedict U; McCormick, Frank; Martin, Scott D

2013-01-01

53

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

54

A Novel Arthroscopic Inside-Out Repair Technique for PASTA Lesions.  

PubMed

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

2014-10-01

55

The beauty of stability: distal radioulnar joint stability in arthroscopic triangular fibrocartilage complex repair.  

PubMed

The triangular fibrocartilage complex (TFCC) has an important role in the stability of the distal radioulnar joint (DRUJ) stability. We designed a new method of TFCC tear repair that has satisfactory post-operative DRUJ stability. From May 2004 to August 2010, 14 patients who underwent this operation were reviewed. The average post-operative follow-up period was 8.2 months; 66.7% of the patients with TFCC tear in sigmoid notch had clinical DRUJ instability, while only 50% of tear in fovea and 16.7% of tear in base of ulnar styloid had clinical DRUJ instability. Transosseous suture via inside-outside technique was used for repair. At the final follow-up, all 14 patients have soft end point with < 5 mm translations of the DRUJ shown by the stress test. Based on this small sample with satisfactory outcome assessed by the Mayo modified wrist score and DRUJ stability, we recommend TFCC tear in sigmoid notch, which has a higher chance of DRUJ instability, to be repaired by transosseous suture. PMID:23413845

Tang, Chris; Fung, Boris; Chan, Rebecca; Fok, Margaret

2013-01-01

56

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

PubMed

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

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

2014-11-01

57

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. Cite this article: Bone Joint J 2014; 96-B:1688-92. PMID:25452374

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

2014-12-01

58

Arthroscopic Surgery.  

ERIC Educational Resources Information Center

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

Connors, G. Patrick

59

Can we improve the indication for Bankart arthroscopic repair? A preliminary clinical study using the ISIS score.  

PubMed

The objectives of this study on arthroscopic treatment of chronic anterior shoulder instability were the collection of the current practices for this indication, their development as reported in the literature, and the analysis of preliminary results on a multicenter prospective series of Bankart arthroscopic procedures undertaken using a common technique on patients selected based on the Instability Severity Index Score (ISIS). This procedure predominates in the English-speaking world, whereas the Latarjet protocol is preferred in France. The choice between the two seems to be cultural since neither technique could be demonstrated to be superior in an analysis of 171 responses to an Internet questionnaire in this study. The literature reports disappointing results in the Bankart arthroscopic procedure and recent articles have researched the predictive factors for its failure. Eleven centers prospectively included 125 patients from 1 December 2007 to 30 November 2008. The inclusion criteria were recurrence of anterior instability and an ISIS less than or equal to four points out of 10. All the selected patients underwent capsuloligamentous reinsertion with a common minimal technique of at least three anchors and four sutures with the same postoperative protocol. At a mean follow-up of 18 months, four patients (3.2%) had experienced recurrence. For the 84 patients reexamined at 1 year, the Walch-Duplay and Rowe scores were, respectively, 88.4 and 87.8 points out of 100. Subjectively, 88.1% of the patients declared they were satisfied and would undergo the intervention again. This study confirmed the use of the ISIS as a consultation tool. Only continuation of the study with a minimum follow-up of 3 years will allow us to validate the lower limit of the ISIS below which this technique could be proposed provided that it respects the technical prerequisite of at least four capsuloligamentous sutures. PMID:21035419

Thomazeau, H; Courage, O; Barth, J; Pélégri, C; Charousset, C; Lespagnol, F; Nourissat, G; Audebert, S; Guillo, S; Toussaint, B; Lafosse, L; Bradel, J; Veillard, D; Boileau, P

2010-12-01

60

Another light in the dark: review of a new method for the arthroscopic repair of triangular fibrocartilage complex.  

PubMed

The triangular fibrocartilage complex (TFCC) is an anatomically and biomechanically important structure. Repair of radial-sided TFCC tear has previously been challenging. We designed a new method of radial-sided TFCC tear repair and found that it was also applicable for ulnar-sided TFCC tear repair. From October 2006 to December 2010, 10 patients underwent this operation and were reviewed: 9 men and 1 woman, with a mean age of 33.9 years. Average postoperative follow-up was 8 months. We graded results according to the Mayo modified wrist score. We rated 2 of the 10 patients (20%) as "excellent," 3 (30%) as "good," and 5 (50%) as "fair." The 5 patients who were rated as "fair" returned to regular jobs or had restricted employment. Based on this small sample, we recommend that this technique be considered an alternative method for TFCC repair. PMID:22624787

Tang, Chris Y K; Fung, B; Rebecca, Chan; Lung, C P

2012-06-01

61

The role of arthroscopic capsulo-labral repair in unidirectional post-traumatic shoulder instability in adolescent athletes participating in overhead or contact sports  

PubMed Central

Purpose this study was performed to identify the role of arthroscopic capsulo-labral repair (ACR) in unidirectional post-traumatic shoulder instability in adolescent athletes participating in overhead or contact sports. Methods sixty-five adolescent patients (aged 13 to 18 years) with post-traumatic shoulder instability submitted to arthroscopic surgery were selected from our database. The mean follow-up duration was 63 months. Shoulder range of motion and functional outcomes were evaluated preoperatively and postoperatively using the Single Assessment Numeric Evaluation (SANE), Rowe, and American Shoulder and Elbow Surgeons (ASES) scores. In addition, details in the database on the type of sport practiced, time until surgery, and number of dislocations were analyzed to look for possible correlations with the recurrence rate. Results at the final follow-up, the mean SANE score was 87.23% (range: 30% to 100%) (preoperative mean score: 46.15% [range, 20% to 50%]); the mean Rowe score was 85 (range: 30 to 100) (preoperative mean score: 35.9 [range: 30 to 50]); and the mean ASES score was 84.12 (range: 30 to 100) (preoperative mean score: 36.92 [range: 30 to 48]). Mean forward flexion and external rotation with the arm at 90° abduction did not show changes compared with preoperative values; 81.5% of the patients returned to their pre-injury level of sports activities, and the failure rate was 21.5%. The recurrence rate was not related to the postoperative scores (p = 0.556 for SANE, p = 0.753 for Rowe, and p = 0.478 for ASES), number of preoperative episodes of instability (p = 0.59), or time that elapsed between the first instability episode and the surgery (p = 0.43). A statistically significant association (p = 0.0021) was found between recurrence and the type of sport practiced. Conclusions ACR is a reasonable surgical option in an adolescent population participating in sports. It has a role in restoring shoulder stability with very low morbidity; however, the failure rate is higher than in the adult population and both the young patients and their relatives must be properly informed about the expected outcome of the procedure. Level of Evidence level IV, therapeutic case series.

ROSE, GIACOMO DELLE; BORRONI, MARIO; CASTAGNA, ALESSANDRO

2013-01-01

62

ORV Arthroscopic Reduction and Internal Fixation of Tibial Eminence Fractures.  

PubMed

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

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

64

Arthroscopic management of spinoglenoid cysts associated with SLAP lesions and suprascapular neuropathy.  

PubMed

Suprascapular neuropathy secondary to cyst compression in the spinoglenoid notch may occur in association with SLAP tears. Arthroscopic techniques may be employed for both cyst excision and repair of labral pathology. We describe 3 cases in which preoperative and postoperative electromyograms and magnetic resonance imaging documented cyst resolution and return of suprascapular nerve function after arthroscopic spinoglenoid cyst excision and labral repair. PMID:12861219

Chen, Andrew L; Ong, Bernard C; Rose, Donald J

2003-01-01

65

[Arthroscopic reconstruction of the rotor cuff].  

PubMed

Over the last years treatment of rotator cuff tears is evolving gradually from open to complete arthroscopic repair. There had been fast developments in arthroscopic techniques and instruments and there is a better understanding of biomechanical backgrounds. For a good clinical outcome it is not necessary to obtain a watertight closure in all cases but to balance the force couples in the coronal and transverse plane. There is recent discussion regarding the optimum techniques and stitches for cuff reconstruction and resulting developments in this field. To determine the individual reconstruction technique it is crucial to recognize the different tear categories. Based on these findings we are now able to treat nearly every cuff tear arthroscopically, even a retracted massive lesion. PMID:16897022

Bauer, G J; Kniesel, B

2006-08-01

66

Arthroscopic Anatomy of the Subdeltoid Space  

PubMed Central

From the first shoulder arthroscopy performed on a cadaver in 1931, shoulder arthroscopy has grown tremendously in its ability to diagnose and treat pathologic conditions about the shoulder. Despite improvements in arthroscopic techniques and instrumentation, it is only recently that arthroscopists have begun to explore precise anatomical structures within the subdeltoid space. By way of a thorough bursectomy of the subdeltoid region, meticulous hemostasis, and the reciprocal use of posterior and lateral viewing portals, one can identify a myriad of pertinent ligamentous, musculotendinous, osseous, and neurovascular structures. For the purposes of this review, the subdeltoid space has been compartmentalized into lateral, medial, anterior, and posterior regions. Being able to identify pertinent structures in the subdeltoid space will provide shoulder arthroscopists with the requisite foundation in core anatomy that will be required for challenging procedures such as arthroscopic subscapularis mobilization and repair, biceps tenodesis, subcoracoid decompression, suprascapular nerve decompression, quadrangular space decompression and repair of massive rotator cuff tears. PMID:24191185

J. Salata, Michael; J. Nho, Shane; Chahal, Jaskarndip; Van Thiel, Geoffrey; Ghodadra, Neil; Dwyer, Tim; A. Romeo, Anthony

2013-01-01

67

Arthroscopic Suture Anchor Tenodesis: Loop-Suture Technique  

PubMed Central

With advancements in arthroscopic surgery, arthroscopic biceps tenodesis with suture anchor recently has been reported to be a reasonable option for the treatment of biceps pathologies, especially for those that are symptomatic or accompanied by a rotator cuff tear. We introduce our technique of arthroscopic biceps tenodesis with suture anchor that we call the loop-suture technique, which is constructed with 1 loop strand and another sutured strand. This technique can help to improve biceps grip and simultaneously minimize longitudinal splitting of the tendon. In addition, it is relatively simple and can be performed with the use of conventional devices and arthroscopic portals used for rotator cuff repair, without the formation of additional portals or a separate incision for the tenodesis. PMID:23875133

Shon, Min Soo; Koh, Kyoung Hwan; Lim, Tae Kang; Lee, Seung Won; Park, Young Eun; Yoo, Jae Chul

2013-01-01

68

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

69

Results of Arthroscopic Repair of Type II Superior Labral Anterior Posterior Lesions in Overhead Athletes: Assessment of Return to Preinjury Playing Level and Satisfaction  

Microsoft Academic Search

Background: The majority of the literature on surgical outcomes of superior labral anterior posterior (SLAP) repairs has focused on short-term follow-up of 1 to 2 years, not allowing adequate time for full rehabilitation and return to maximum level of competition for all types of athletes. Also, previous studies have concentrated on using questionnaires that primarily evaluate patients’ activities of daily

Brian J. Neuman; C. Brittany Boisvert; Brian Reiter; Kevin Lawson; Michael G. Ciccotti; Steven B. Cohen

2011-01-01

70

Arthroscopic Management of Femoroacetabular Impingement: Early Outcomes Measures  

Microsoft Academic Search

Purpose: The purpose of this study was to evaluate the early outcomes of arthroscopic management of femoroacetabular impingement (FAI). Methods: Ninety-six consecutive patients (100 hips) with radiographically documented FAI were treated with hip arthroscopy, labral debridement or repair\\/ refixation, proximal femoral osteoplasty, or acetabular rim trimming (or some combination thereof). Outcomes were measured with the impingement test, modified Harris Hip

Christopher M. Larson; M. Russell Giveans

2008-01-01

71

"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

72

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

PubMed Central

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

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

2013-01-01

73

National Trends in Rotator Cuff Repair  

PubMed Central

Background: Recent publications suggest that arthroscopic and open rotator cuff repairs have had comparable clinical results, although each technique has distinct advantages and disadvantages. National hospital and ambulatory surgery databases were reviewed to identify practice patterns for rotator cuff repair. Methods: The rates of medical visits for rotator cuff pathology, and the rates of open and arthroscopic rotator cuff repair, were examined for the years 1996 and 2006 in the United States. The national incidence of rotator cuff repairs and related data were obtained from inpatient (National Hospital Discharge Survey, NHDS) and ambulatory surgery (National Survey of Ambulatory Surgery, NSAS) databases. These databases were queried with use of International Classification of Diseases, Ninth Revision (ICD-9) procedure codes for arthroscopic (ICD-9 codes 83.63 and 80.21) and open (code 83.63 without code 80.21) rotator cuff repair. We also examined where the surgery was performed (inpatient versus ambulatory surgery center) and characteristics of the patients, including age, sex, and comorbidities. Results: The unadjusted volume of all rotator cuff repairs increased 141% in the decade from 1996 to 2006. The unadjusted number of arthroscopic procedures increased by 600% while open repairs increased by only 34% during this time interval. There was a significant shift from inpatient to outpatient surgery (p < 0.001). Conclusions: The increase in national rates of rotator cuff repair over the last decade has been dramatic, particularly for arthroscopic assisted repair. PMID:22298054

Colvin, Alexis Chiang; Egorova, Natalia; Harrison, Alicia K.; Moskowitz, Alan; Flatow, Evan L.

2012-01-01

74

Arthroscopic Bone Graft Procedure for Anterior Inferior Glenohumeral Instability  

PubMed Central

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

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

2014-01-01

75

[Arthroscopic partial meniscectomy].  

PubMed

Partial closed meniscectomy under arthroscopic control is feasible in bucket handle tears and in some cases of L-shaped or longitudinal meniscal lesions. The operation is performed in general anesthesia but without hospitalization of the patient. Postoperative morbidity in 18 patients was surprisingly low, 16 patients being without disturbances two weeks after surgery. Mean duration of working inability was 6.5 days. For the experienced arthroscopist, low costs and decreased morbidity compared to arthrotomy recommend this procedure in selected cases of meniscal lesions. PMID:7440187

Glinz, W

1980-06-01

76

Meniscal Repair  

PubMed Central

The meniscus has several important roles, such as transmission of the load, absorption of the shock in the knee joint, acting as a secondary anteroposterior stabilizer of the knee joint, and contributing to proprioception of the knee joint. Degenerative changes of the knee joint develop in the long-term follow-up even after partial meniscectomy. Thus, there has been growing interest in meniscal repair. In addition, with increased understanding of the important roles of the meniscal root and advancement of diagnostic methods, efforts have been made to ensure preservation of the meniscal roots. In this review article, we will discuss operative techniques and clinical outcomes of arthroscopic repair of the meniscus and the meniscal root and postoperative rehabilitation and complications as well. PMID:24944971

Yoon, Kyoung Ho

2014-01-01

77

Arthroscopic excision of heterotopic calcification in a chronic rectus femoris origin injury: a case report.  

PubMed

Rectus femoris origin injuries in adult athletes are uncommon. In the acute phase, conservative treatment seems to have a favourable outcome, with surgical repair reserved for unsuccessful cases only. However, a group of patients may develop chronic pain and disability after recovery from the acute phase due to heterotopic calcification occurring at the site of injury. Open and arthroscopic excision of such calcifications has been described in the literature although arthroscopic excision of large calcified lesions in the rectus femoris has not been reported previously. A relevant case is presented and discussed. PMID:22507710

El-Husseiny, M; Sukeik, M; Haddad, F S

2012-04-01

78

Arthroscopic excision of heterotopic calcification in a chronic rectus femoris origin injury: a case report  

PubMed Central

Rectus femoris origin injuries in adult athletes are uncommon. In the acute phase, conservative treatment seems to have a favourable outcome, with surgical repair reserved for unsuccessful cases only. However, a group of patients may develop chronic pain and disability after recovery from the acute phase due to heterotopic calcification occurring at the site of injury. Open and arthroscopic excision of such calcifications has been described in the literature although arthroscopic excision of large calcified lesions in the rectus femoris has not been reported previously. A relevant case is presented and discussed. PMID:22507710

El-Husseiny, M; Sukeik, M; Haddad, FS

2012-01-01

79

Arthroscopic Suture Bridge Fixation of Tibial Intercondylar Eminence Fractures  

PubMed Central

Tibial intercondylar eminence fractures that are displaced and non-reducible require open or arthroscopically assisted repair. Ideally, fracture reduction and fixation would be performed with a technique that has low morbidity, allows easy visualization and reduction, provides firm fixation, does not violate the proximal tibial physis, avoids metal hardware, and does not require a second procedure for implant removal. The suture bridge technique, used in the shoulder for rotator cuff tears and greater tuberosity fracture repair, has the ability to produce high contact pressures with rigid fixation. We describe an all-inside and all-epiphyseal arthroscopic suture bridge technique for tibial intercondylar eminence fracture repair performed with PushLock anchors (Arthrex, Naples, FL). One or 2 anchors preloaded with No. 2 FiberWire (Arthrex) are placed in the posterior fracture bed, followed by fracture reduction. The suture limbs are shuttled through and around the anterior cruciate ligament and over the fracture fragment in crossing fashion and are secured by use of additional anchors placed at the anteromedial and anterolateral fracture margin. The anchors are placed obliquely to avoid the proximal tibial physis in the pediatric population. Anatomic reduction and secure fixation allow more aggressive rehabilitation and faster restoration of joint function. PMID:24400173

Sawyer, Gregory A.; Hulstyn, Michael J.; Anderson, Brett C.; Schiller, Jonathan

2013-01-01

80

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

81

Arthroscopic Osteosynthesis of Femoral Head Malunion  

PubMed Central

We present the case of a femoral head malunion with lateral cephalic femoroacetabular impingement managed by arthroscopic osteotomy/takedown, bone grafting, internal fixation, and cephaloplasty. The treatment rationale and surgical technique are presented. A successful outcome at 3 years was obtained with radiographic evidence of union without osteonecrosis. Even beyond acute femoral head osteosynthesis, arthroscopic surgery may enhance the ability to treat femoral head malunions. Moreover, arthroscopic osteosynthesis may address lateral cephalic FAI, a previously unreported condition. PMID:24749019

Matsuda, Dean K.

2013-01-01

82

21 CFR 888.1100 - Arthroscope.  

Code of Federal Regulations, 2013 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,...

2013-04-01

83

21 CFR 888.1100 - Arthroscope.  

Code of Federal Regulations, 2012 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,...

2012-04-01

84

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

85

21 CFR 888.1100 - Arthroscope.  

...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,...

2014-04-01

86

Arthroscopic laser in intra-articular knee cartilage disorders  

NASA Astrophysics Data System (ADS)

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

Nosir, Hany R.; Siebert, Werner E.

1996-12-01

87

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

88

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

89

The intracapsular atraumatic arthroscopic technique for closure of the hip capsule.  

PubMed

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

Asopa, Vipin; Singh, Parminder J

2014-04-01

90

The Intracapsular Atraumatic Arthroscopic Technique for Closure of the Hip Capsule  

PubMed Central

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

Asopa, Vipin; Singh, Parminder J.

2014-01-01

91

Arthroscopic posterior bone block procedure: a new technique using suture anchor fixation.  

PubMed

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

2013-11-01

92

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

93

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

94

Shoulder Strength After Open Versus Arthroscopic Stabilization  

Microsoft Academic Search

Background: With current techniques, the main difference between arthroscopic and open shoulder stabilization is the violation of the subscapularis tendon. No studies have looked at strength differences of internal and external rotation between these groups.Hypothesis: Internal rotation strength deficits will exist in patients having undergone an open shoulder stabilization procedure compared with an arthroscopic one.Study Design: Piggy-back randomized controlled trial;

Laurie A. Hiemstra; Treny M. Sasyniuk; Nicholas G. H. Mohtadi; Gordon H. Fick

2008-01-01

95

Arthroscopic alphabet soup: recognition of normal, normal variants, and pathology.  

PubMed

The capsule, labrum, glenohumeral ligaments, and rotator cuff represent the static and dynamic stabilizers of the glenohumeral joint. Various injuries can occur to one or more of these structures during traumatic shoulder dislocation, predisposing the patient to recurrent instability. Improved understanding of shoulder anatomy and biomechanics, and advancements in arthroscopic technique led to the recognition of various pathologic lesions that may contribute to instability. The ability to identify and address these lesions during arthroscopy will allow the surgeon to more fully tailor operative treatments for each individual patient suffering from shoulder instability. Furthermore, the ability to differentiate pathologic lesions from normal anatomic variants is critical to avoid inadvertent repair that will lead to loss of normal function and worsening symptoms. PMID:20497807

Yin, Bob; Vella, Jesse; Levine, William N

2010-07-01

96

Arthroscopic training resources in orthopedic resident education.  

PubMed

The purpose of this study was to determine the frequency of use, perceived effectiveness, and preference for arthroscopic surgical skill training resources. An electronic survey was sent to orthopedics residents, residency program directors, and orthopedic sports medicine attending physicians in the United States. The frequency and perceived effectiveness of 10 types of adjunctive arthroscopic skills training was assessed. Residents and faculty members were asked to rate their confidence in resident ability to perform common arthroscopic procedures. Surveys were completed by 40 of 152 (26.3%) orthopedic residency program directors, 70 of 426 (16.4%) sports medicine faculty, and 235 of 3,170 (7.4%) orthopedic residents. The use of adjunctive methods of training varied from only 9.8% of programs with virtual reality training to 80.5% of programs that used reading of published materials to develop arthroscopic skill. Practice on cadaveric specimens was viewed as the most effective and preferred adjunctive method of training. Residents trained on cadaveric specimens reported increased confidence in their ability to perform arthroscopic procedures. The resources for developing arthroscopic surgical skill vary considerably across orthopedic residency programs in the United States. Adjunctive training methods were perceived to be effective at supplementing traditional training in the operating room. PMID:24510522

Koehler, Ryan; John, Tamara; Lawler, Jeffrey; Moorman, Claude; Nicandri, Gregg

2015-02-01

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 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

99

[Arthroscopic surgery--current status and perspectives].  

PubMed

The morbidity after arthroscopic surgery is low; a hospitalization is not necessary in most patients. The possible operations of the knee joint include removal of loose bodies, resections on meniscus, plicae and synovium as well as more complicated procedures as suturing of a meniscus, total synovectomy and operations in patients with osteoarthritis. The advantage of the arthroscopic operation compared with arthrotomy is well documented in meniscal resection (shorter treatment, stay in the hospital and sick leave, reduced costs, and nevertheless excellent results) whereas the indication and clinical value of other arthroscopic procedures (i.e. suturing of a meniscal tear, lateral release, abrasion-arthroplasty) still are discussed. Diagnostic and operative arthroscopy of the shoulder joint has found its place and will certainly improve our knowledge on significance and treatment of disorders and injuries of this joint. In selected cases, an arthroscopy of the elbow, the hip, the ankle, the wrist or the temporomandibular joint offers important diagnostic information and may allow operative treatment. Arthroscopic surgery is technically difficult and not without problems. However, the rate of complications is extremely low (0.56%). Infections occur in significantly less than 1% of the cases. In veterinary medicine, therapeutic arthroscopy is used mainly in horses, but arthroscopies have been performed in the ox, the cow, the pig, the dog, the cat, and the rabbit. Modern joint surgery includes arthroscopic techniques; the training of trauma surgeons and orthopedic surgeons in arthroscopy is therefore mandatory. PMID:2666347

Glinz, W

1989-04-01

100

Arthroscopic Treatment of Talar Body Fractures  

PubMed Central

Talar fractures can be severe injuries with complications leading to functional disability. Open reduction–internal fixation remains the treatment of choice for displaced talar fractures. Arthroscopic evaluation of the fracture and articular surfaces can play an important role in the treatment of these fractures. Arthroscopic reduction–internal fixation (ARIF) is increasingly used for certain intra-articular fracture types through the body. The minimally invasive nature of ARIF and high accuracy are enviable attributes of an evolving technique. This technical note describes arthroscopic evaluation of 2 intra-articular talar head fractures, using posterior portals, with ARIF performed in 1 case and excision of the fracture fragments in the other case. PMID:24904775

Jorgensen, Nicholas B.; Lutz, Michael

2014-01-01

101

Revision Wrist Arthroscopy after Failed Primary Arthroscopic Treatment  

PubMed Central

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

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

2014-01-01

102

Arthroscopically Confirmed Femoral Button Deployment  

PubMed Central

The anterior cruciate ligament TightRope RT (Arthrex, Naples, FL) is a graft suspension device for cruciate ligament reconstruction. It is an adjustable-length graft loop cortical fixation device designed to eliminate the requirement for loop length calculation and to facilitate complete graft fill of short femoral sockets that are common with anatomic anterior cruciate ligament placement. The adjustable loop length means “one size fits all,” thus removing the need for multiple implant sizes and allowing graft tensioning even after fixation. However, the device has been associated with the same complications that have been described with EndoButton (Smith & Nephew Endoscopy, Andover, MA) fixation. The button of the TightRope RT may remain in the femoral tunnel rather than flipping outside of the tunnel to rest on the lateral femoral cortex, or it may become jammed inside the femoral canal. Conversely, the button may be pulled too far off the femoral cortex into the overlying soft tissue and flip in the substance of the vastus lateralis. We describe a new and simple arthroscopic technique to directly visualize the deployment and seating of the TightRope button on the lateral cortex of the femur to avoid all the aforementioned complications. PMID:25126492

Sonnery-Cottet, Bertrand; Rezende, Fernando C.; Martins Neto, Ayrton; Fayard, Jean M.; Thaunat, Mathieu; Kader, Deiary F.

2014-01-01

103

Peripheral tears of triangular fibrocartilage complex: results of primary repair  

Microsoft Academic Search

In 16 patients with ulnar wrist pain, we performed primary arthroscopic or open repair of the peripheral rim tears of the triangular fibrocartilage complex (TFCC) (14 ulnar, 4 volar, and 3 radial tears). The wrist function was assessed before and 1 year after the repair using the Mayo-modified wrist score. The average pain score improved from 9.1NJ.0 to 21.2Lj.5, the

Chen-Hsi Chou; Tu-Sheng Lee

2001-01-01

104

Outcome and Structural Integrity of Rotator Cuff after Arthroscopic Treatment of Large and Massive Tears with Double Row Technique: A 2-Year Followup  

PubMed Central

Purpose. The purpose of this study was to evaluate the functional outcome and the tendon healing after arthroscopic double row rotator cuff repair of large and massive rotator cuff tears. Methods. 82 patients with a full-thickness large and massive rotator cuff tear underwent arthroscopic repair with double row technique. Results were evaluated by use of the UCLA, ASES, and Constant questionnaires, the Shoulder Strength Index (SSI), and range of motion. Follow-up time was 2 years. Magnetic resonance imaging (MRI) studies were performed on each shoulder preoperatively and 2 years after repair. Results. 100% of the patients were followed up. UCLA, ASES, and Constant questionnaires showed significant improvement compared with preoperatively (P < 0.001). Range of motion and SSI in flexion, abduction, and internal and external rotation also showed significant improvement (P < 0.001). MRI studies showed 24 cases of tear after repair (29%). Only 8 cases were a full-thickness tear. Conclusions. At two years of followup, in large and massive rotator cuff tears, an arthroscopic double row rotator cuff repair technique produces an excellent functional outcome and structural integrity. PMID:23533788

Carbonel, Ignacio; Martínez, Angel A.; Aldea, Elisa; Ripalda, Jorge

2013-01-01

105

Comprehensive Approach to Arthroscopic Rotator Cuff Repair: Options and Techniques  

MedlinePLUS

... feel better, but it's an individualized process of decision-making. 00:03:46 LAURENCE D. HIGGINS, MD: But ... been -- that have occurred have been my own making, and that had to ... things that are surgeoncontrolled factors. Now you look here you see very nicely ...

106

Current Biomechanical Concepts for Rotator Cuff Repair  

PubMed Central

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

2013-01-01

107

Arthroscopic Femoral Neck Osteoplasty in the Treatment of Femoroacetabular Impingement  

PubMed Central

Femoral neck osteoplasty is an integral component for successful treatment of femoroacetabular impingement. Current techniques allow this to be performed arthroscopically, and results are equivalent to those of open procedures when typical anterior and anterosuperior lesions are considered. The arthroscopic procedure is dependent on obtaining adequate visualization through capsular management and proper leg positioning, and it requires fluoroscopy to guide and verify an adequate resection. We present our preferred technique for arthroscopic femoral neck osteoplasty. PMID:24749017

Chow, Roxanne M.; Kuzma, Scott A.; Krych, Aaron J.; Levy, Bruce A.

2013-01-01

108

Arthroscopic Capsulolabroplasty for Posteroinferior Multidirectional Instability of the Shoulder  

Microsoft Academic Search

Background: Arthroscopic treatment of posteroinferior multidirectional instability of the shoulder is not well documented.Purpose: To evaluate pathologic lesions of posteroinferior multidirectional instability and the results of arthroscopic capsulolabroplasty.Study Design: Prospective nonrandomized clinical trial.Methods: Thirty-one patients with posteroinferior multidirectional instability were prospectively evaluated after arthroscopic capsulolabroplasty (mean follow-up, 51 months). Labral lesion and height were measured in the MRI arthrogram and

Seung-Ho Kim; Hyo-Kon Kim; Jong-Il Sun; Jun-Sic Park; Irvin Oh

2004-01-01

109

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

Microsoft Academic Search

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

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

2010-01-01

110

Technical guide and tips on the all-arthroscopic Latarjet procedure.  

PubMed

Shoulder dislocation and subsequent anterior instability is a common problem in young athletes. The arthroscopic Bankart repair was originally described by Morgan et al. in 1987. The procedure has benefited from many technical advancements over the past 25 years and currently remains the most commonly utilized procedure in the treatment of anterior glenohumeral instability without glenoid bone loss. Capsulolabral repair alone may not be sufficient for treatment of patients with poor capsular tissue quality and significant bony defects. In the presence of chronic anterior glenoid bony defects, a bony reconstruction should be considered. The treatment of anterior shoulder instability with transfer of the coracoid and attached conjoint tendon such as the Latarjet procedure has provided reliable results. The arthroscopic Latarjet procedure was described in 2007 by the senior author, who has now performed the procedure over 450 times. The initial surgical technique has evolved considerably since its introduction, and this article presents a comprehensive update on this demanding but well-defined procedure. This article reviews technical tips to help the surgeon perform the surgery more smoothly, navigate through challenging situations, and avoid potential complications. Level of evidence V. PMID:24817106

Rosso, Claudio; Bongiorno, Vito; Samitier, Gonzalo; Dumont, Guillaume D; Szöllösy, Gregor; Lafosse, Laurent

2014-05-10

111

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

112

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

113

Whole-Organ Arthroscopic Knee Score (WOAKS)  

Microsoft Academic Search

BACKGROUND: To describe a semi-quantitative score for multi-feature, whole-organ evaluation of the knee in osteoarthritis based on the results of arthroscopic evaluation. METHODS: This was a study of 1,199 patients who were suffering from knee pain for over 3 months (range 3 to 48 months) and had undergone arthroscopy. The mean age of patients was 49.8 (range 17 to 85)

Gunter Spahn; Thomas Mückley; Hans M Klinger; Gunther O Hofmann

2008-01-01

114

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; Assunção, Jorge Henrique

2013-01-01

115

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

PubMed

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

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

2013-05-01

116

Arthroscopic management of osteochondritis dissecans of the first metatarsal head.  

PubMed

Osteochondritis dissecans of the first metatarsal head can be painfully disabling in the adolescent. It may be the forerunner of adolescent and adult hallux rigidus. Arthroscopic surgical treatment of this osteochondritis dissecans lesion is technically feasible. The case reported here suggests that arthroscopic treatment, at an early stage, can render a patient symptom-free and allow a return to full activity. PMID:3355642

Bartlett, D H

1988-01-01

117

Second-Look Arthroscopic Assessment and Clinical Results of Modified Pull-Out Suture for Posterior Root Tear of the Medial Meniscus  

PubMed Central

Purpose To identify the structural integrity of the healing site after arthroscopic repair of a posterior root tear of the medial meniscus by second-look arthroscopy and to determine the clinical relevance of the findings. Materials and Methods From January 2005 to December 2010, 20 consecutive patients underwent arthroscopic modified pull-out suture repair for a posterior root tear of the medial meniscus. Thirteen patients were available for second-look arthroscopic evaluation. The healing status of the medial meniscus was classified as complete healing, lax healing, scar tissue healing, and failed healing. We evaluated the correlation between the clinical symptoms and second-look arthroscopic findings. Clinical evaluation was based on the Lysholm knee scores and Hospital for Special Surgery (HSS) scores. Results There were 4 cases of complete healing, 4 lax healing, 4 scar tissue healing, and 1 failed healing. The healing status of the repaired meniscus appeared to be related to the clinical symptoms. Patients who achieved complete tissue healing had no complaint. The healing status exhibited no relationship with age, mechanical axis, degree of subluxation, and symptom duration. The mean Lysholm score improved from 34.7 preoperatively to 75.6 at follow-up and the mean HSS score also significantly increased from 33.5 to 82.2. Conclusions We achieved 4 complete and 8 partial healing (lax or scar) of the medial meniscus in this retrospective case series of posterior horn meniscus root repairs performed by 1 surgeon. Further research is needed to clarify why all patients showed clinical improvement despite findings of partial healing on second-look arthroscopy. PMID:24944976

Song, Jae-Gwang

2014-01-01

118

Arthroscopic decompression of the suprascapular nerve at the spinoglenoid notch and suprascapular notch through the subacromial space.  

PubMed

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 can be visualized between the supraspinatus and infraspinatus at the base of the scapular spine. While viewing the subacromial space through the lateral portal, the surgeon can use a shaver through the posterior portal to decompress a spinoglenoid notch cyst at the base of the scapular spine. To decompress the suprascapular nerve at the suprascapular notch, a shaver through the posterior portal removes the soft tissue on the acromion and distal clavicle to expose the coracoclavicular ligaments. The medial border of the conoid ligament is identified and followed to its coracoid attachment. The supraspinatus muscle is retracted with a blunt trocar placed through an accessory Neviaser portal. The transverse scapular ligament, which courses inferior to the suprascapular artery, is sectioned with arthroscopic scissors, and the suprascapular nerve is decompressed. PMID:19341933

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

2009-04-01

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 treatment options for irreparable rotator cuff tears of the shoulder.  

PubMed

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

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

2014-11-18

121

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

PubMed

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

2014-10-01

122

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

123

Arthroscopic Microscopy of Articular Cartilage Using Optical Coherence Tomography  

Microsoft Academic Search

Background: Optical coherence tomography is an echograph of infrared light that can yield microscopic cross-sectional images of articular cartilage without removing or damaging the tissue.Hypothesis: To determine whether optical coherence tomography images of human cartilage can be acquired arthroscopically and whether the resulting images have high correlation with histopathology.Methods: Optical coherence tomography was configured into an arthroscope and used to

Constance R. Chu; Diana Lin; Jessica L. Geisler; Charleen T. Chu; Freddie H. Fu; Yingtian Pan

2004-01-01

124

Arthroscopic Labralization of the Hip: An Alternative to Labral Reconstruction  

PubMed Central

Labralization, which may be performed by open or arthroscopic means, may be an attractive alternative to hip labral reconstruction. By preserving the articular cartilage in the region of labral deficit with meticulous rim trimming, the resultant undermined free chondral margin (“pseudolabrum”) may immediately restore a fluid seal function and may theoretically enhance hip preservation. Arthroscopic hip labralization is a relatively simple and fast procedure without graft harvest morbidity. It may be performed in patients tolerating rim reduction with encouraging preliminary outcomes. PMID:24749033

Matsuda, Dean K.

2014-01-01

125

Complications of Arthroscopic Femoroacetabular Impingement Treatment: A Review  

Microsoft Academic Search

Recent developments in hip arthroscopy techniques and technology have made it possible in many cases to avoid open surgical\\u000a technique for treating pincer-type and cam-type femoroacetabular impingement and rather treating it arthroscopically. Early\\u000a reports suggest favorable results using arthroscopic techniques. The frequency of complications reported for hip arthroscopy\\u000a for all indications is generally less than 1.5%, suggesting the procedure is

Victor M. Ilizaliturri

2009-01-01

126

Arthroscopic Acetabular Rim Resection in the Treatment of Femoroacetabular Impingement  

PubMed Central

Appropriate identification and precise resection of the pincer lesion are integral parts of the arthroscopic surgical treatment of femoroacetabular impingement. Preoperative radiographic planning of the bone resection, as well as executing the plan intraoperatively using both fluoroscopic and arthroscopic cues, is critical to adequately removing the pincer lesion. We present our surgical technique of removing the impinging bone by defining the focal acetabular rim overcoverage, accessing the pincer lesion with labral detachment, and then performing acetabular rim resection. PMID:24400176

Chow, Roxanne M.; Krych, Aaron J.; Levy, Bruce A.

2013-01-01

127

Arthroscopic treatment of symptomatic paralabral cysts in the hip.  

PubMed

Acetabular labral tears or paralabral cysts in the hip are frequently detected using magnetic resonance imaging or arthrography. Unlike parameniscal cysts in the knee and paralabral cysts in the shoulder, reports of the outcomes of surgical treatment for paralabral cysts in the hip recalcitrant to conservative management are limited in the literature.The authors report 2 cases of paralabral cysts in the hip that were treated with arthroscopic surgery. The patients presented with chronic hip pain, and preoperative magnetic resonance imaging showed paralabral cysts at the superior aspect of the acetabulum. After failure of conservative management for more than 6 months, arthroscopic surgery was performed while the patients were under general anesthesia and in a supine position on a fracture table. Arthroscopic examination confirmed the preoperative diagnosis of paralabral cysts with degenerative labral fibrillation or tears in both patients. Arthroscopic cyst decompression and debridement of the degenerative labral tissues were performed using an arthroscopic thermal probe and a shaver.Clinical outcomes, determined by the Harris Hip Score, Western Ontario and McMaster Universities Osteoarthritis Index score, and University of California, Los Angeles activity score, were satisfactory for the 2 patients at 2 and 3 years postoperatively, respectively. Magnetic resonance imaging obtained for 1 patient at 6 months postoperatively showed complete decompression of the paralabral cyst. The authors believe that arthroscopic treatment for symptomatic hip paralabral cysts is a safe and effective procedure with excellent clinical outcomes. PMID:23464960

Lee, Keun-Ho; Park, Youn-Soo; Lim, Seung-Jae

2013-03-01

128

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

129

Whole-Organ Arthroscopic Knee Score (WOAKS)  

PubMed Central

Background To describe a semi-quantitative score for multi-feature, whole-organ evaluation of the knee in osteoarthritis based on the results of arthroscopic evaluation. Methods This was a study of 1,199 patients who were suffering from knee pain for over 3 months (range 3 to 48 months) and had undergone arthroscopy. The mean age of patients was 49.8 (range 17 to 85) years old. Cartilage lesions were graded according to the ICRS protocol (grade 0 to 4 and for osteophytes "grade 5"). Meniscus lesions were classified regarding to the extent of resection which was needed (grade 0: intact meniscus, grade 1: partial meniscectomy, grade 2: subtotal meniscectomy, and grade 3: total meniscectomy). The whole grade of cartilage lesions was calculated as the sum of ICRS grades in all joint surfaces (bearing and non-bearing margin). The whole grade of meniscus lesions was calculated as the sum of the points for medial and lateral meniscus surgery. The Whole-Organ Arthroscopic Knee Score (WOAKS) was the sum of the cartilage and meniscus score. Results The mean knee osteoarthritis outcome score (KOOS) of all patients was 67.3 ± 26.0 (range 21 to 128) points. The WOAKS was significantly associated (p = 0.001) with patient age (R = 0.399), the subjective complaints (R = 0.630) in KOOS, and the radiological grade of OA (R = 0.731). Conclusion The good correlation between the WOAKS and the subjective complaints as well as the radiological grade of OA suggests that the score can be used as an instrument for description of the "whole organ" knee. This score may be useful for clinical or epidemiological studies in the future. PMID:19025645

Spahn, Gunter; Mückley, Thomas; Klinger, Hans M; Hofmann, Gunther O

2008-01-01

130

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.

Dilisio, Matthew F.; Neyton, Lionel

2014-01-01

131

Arthroscopic ulnar nerve identification during posterior elbow arthroscopy.  

PubMed

Elbow arthroscopy has increased in popularity in the past 10 years for both diagnostic and therapeutic purposes. A major limiting factor faced by the elbow arthroscopist is the close proximity of the neurovasculature to the working field, with the risk of iatrogenic injury. Many arthroscopic procedures are less extensive than their open equivalents because of an inability to consistently and safely eliminate the risk of neural and vascular injury. Many open procedures in the posterior compartment of the elbow joint are not routinely performed arthroscopically. The primary reason for this restriction in arthroscopic practice is the locality of the posteromedially positioned ulnar nerve in the posterior compartment. Experience and practice with elbow arthroscopic techniques allows surgeons to expand the indications for arthroscopic treatment of an increasing number of elbow pathologies. A philosophy that is routine in open surgery when dealing with pathology that is adjacent to neurovasculature is to identify the neurovasculature and hence reduce the risk of injury. Our aim is to translate this philosophy to arthroscopy by helping define a safe technique for identifying the ulnar nerve in the posteromedial elbow gutter and allowing for a safer performance of procedures in the posteromedial region of the elbow. PMID:23766965

Kamineni, Srinath; Hamilton, David Anthony

2012-09-01

132

Arthroscopic treatment of synovial chondromatosis in the ankle joint  

PubMed Central

INTRODUCTION Synovial chondromatosis is characterized by the presence of metaplastic cartilage nodules originating from the synovia, bursa and tendon sheaths. Although it is extremely rare in the ankle joint, malignant transformation is possible. The choice of treatment is usually open surgery for excision of loose bodies and synovectomy. Limited data is available concerning arthroscopic approaches. PRESENTATION OF CASE A 28-year-old male patient was evaluated for pain and swelling of the right ankle joint. Based on the findings of physical examination and radiographic investigations, arthroscopic surgery was performed due to ankle impingement syndrome. A diagnosis of synovial osteochondromatosis was made following the pathological survey. DISCUSSION Synovial chondromatosis is slowly progressive and is considered to be a self-limiting situation. Treatment strategies are decided on according to the patient's complaints, age and disease stage. Open or arthroscopic surgery. can be performed. Some advantages of arthroscopic surgery are wide visualization areas, easy access to areas difficult to reach, lower morbidity, no necessity for casting and immobilization, early rehabilitation and quick recovery period. CONCLUSION In conclusion, arthroscopic management can be successful in selected patients with synovial osteochondromatosis localized to the ankle joint. PMID:25460460

Ozmeric, Ahmet; Aydogan, Nevres Hurriyet; Kocadal, Onur; Kara, Talip; Pepe, Murad; Gozel, Serap

2014-01-01

133

Osteonecrosis of the Knee after Arthroscopic Partial Meniscectomy  

PubMed Central

Osteonecrosis of the femoral condyle is known as an uncommon complication after arthroscopic meniscectomy. The lesion of osteonecrosis can be irreversible, thus early detection of the disease is crucial for treatment. A 50-year-old male patient without known risk factors of osteonecrosis developed increasing knee pain after arthroscopic partial meniscectomy. Magnetic resonance imaging showed rapid progression of osteonecrosis of the medial femoral condyle. Unicompartmental knee arthroplasty was performed after 9 months of conservative therapy. The patient is now free from pain during daily activities. It might be important to remind that if the patient's pain after arthroscopic partial meniscectomy is severe than expected, clinical doctors should pay attention to the possibility of ongoing osteonecrosis of the femoral condyle. PMID:24032105

Son, Il Jin; Kim, Min Kyu; Kim, Jae Young

2013-01-01

134

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

135

Arthroscopic lysis of adhesions for the stiff total knee arthroplasty.  

PubMed

The management of the stiff knee after total knee arthroplasty is controversial. Manipulation under anesthesia and open lysis of adhesions are techniques that can theoretically address the fibrous scar tissue, but their efficacy has been shown to be variable. We describe the technique of arthroscopic lysis of adhesions for the stiff knee after total knee arthroplasty. The advantages of this technique include minimally invasive debridement of scar tissue within defined compartments of the knee and evaluation for the presence and treatment of focal lesions (e.g., loose bodies or impinging synovial or soft tissue). The total arc of motion can be improved with a systematic arthroscopic approach. PMID:25473616

Enad, Jerome G

2014-10-01

136

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

137

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, Angel; De La Corte-Rodriguez, Hortensia; Jimenez-Yuste, Victor

2014-11-14

138

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

139

Second-look arthroscopic observations after radiofrequency treatment of partial thickness articular cartilage defects in human knees: report of four cases.  

PubMed

Partial thickness articular cartilage defects in the knee are commonly encountered clinical problems. Recently, use of radiofrequency-based devices for performing arthroscopic chondroplasty has gained popularity. However, published experimental studies using different methods for evaluating the histologic effects of radiofrequency-chondroplasty on surrounding cartilage offer contradictory results. To date, few clinical findings after radiofrequency-based chondroplasty have been reported. We present four patients where follow-up arthroscopy documented partial thickness articular defects treated previously with radiofrequency-based chondroplasty to be completely filled with stable repair tissue. No attempt was made to stimulate cartilage regeneration (ie, abrasion or microfracture) in any of these cases. PMID:15915832

Voloshin, Ilya; DeHaven, Kenneth E; Steadman, J Richard

2005-04-01

140

Arthroscopic Treatment of Unresolved Osgood-Schlatter Lesions  

Microsoft Academic Search

Osgood-Schlatter disease is a self-limiting condition in most cases. Those with unresolved pain after conservative treatment can obtain relief with surgical debridement of the mobile ossicles and tibial tuberosity. We present an arthroscopic technique for debridement. The location of the inferomedial and lateral parapatella tendon portals can be raised slightly to allow improved instrumentation and visualization in the anterior interval.

Thomas M. DeBerardino; Joanna G. Branstetter; Brett D. Owens

2007-01-01

141

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

142

Haptic Feedback Can Provide an Objective Assessment of Arthroscopic Skills  

PubMed Central

The outcome of arthroscopic procedures is related to the surgeon’s skills in arthroscopy. Currently, evaluation of such skills relies on direct observation by a surgeon trainer. This type of assessment, by its nature, is subjective and time-consuming. The aim of our study was to identify whether haptic information generated from arthroscopic tools could distinguish between skilled and less skilled surgeons. A standard arthroscopic probe was fitted with a force/torque sensor. The probe was used by five surgeons with different levels of experience in knee arthroscopy performing 11 different tasks in 10 standard knee arthroscopies. The force/torque data from the hand and tool interface were recorded and synchronized with a video recording of the procedure. The torque magnitude and patterns generated were analyzed and compared. A computerized system was used to analyze the force/torque signature based on general principles for quality of performance using such measures as economy in movement, time efficiency, and consistency in performance. The results showed a considerable correlation between three haptic parameters and the surgeon’s experience, which could be used in an automated objective assessment system for arthroscopic surgery. Level of Evidence: Level II, diagnostic study. See the Guidelines for Authors for a complete description of levels of evidence. PMID:18213507

Ward, James W.; Phillips, Roger; Sherman, Kevin P.

2008-01-01

143

Arthroscopic Treatment of Cam-Type Femoroacetabular Impingement  

Microsoft Academic Search

Femoroacetabular impingement is defined as anterior hip abutment between the acetabular rim and proximal femur. When it is secondary to acetabular overcoverage, it is pincer impingement. When it is secondary to femoral head and neck deformity, it is cam impingement. Open remodeling of impinging deformities is the standard treatment of this condition. We describe arthroscopic treatment of cam impingement in

Victor M. Ilizaliturri; Liliana Orozco-Rodriguez; Eduardo Acosta-Rodríguez; Javier Camacho-Galindo

2008-01-01

144

[Diagnostic arthroscopy and arthroscopic surgery: experiences with 500 knee arthroscopies].  

PubMed

A diagnosis by clinical examination and arthrography was not possible in 160 out of 500 arthroscopically examined patients, most of them with post-traumatic knee disorders. In 157 cases the clinical diagnosis was wrong, and in another 58 cases incomplete. Only in 89 patients (18%) arthroscopy proved the clinical diagnosis to be correct. At arthroscopy, a meniscal injury was found in 156 patients (medial meniscus 57, lateral meniscus 64, both menisci 8). With regard to the menisci a previous arthrography was found correct only in 103 out of 213 cases, i.e. in 48%. Lesions of the articular cartilage were present in 210 patients, although they were expected clinically in only one third of these cases. Normal intraarticular structures were found in 95 examinations. The arthroscopic examination was insufficient three times because of a protruding fat pad, and wrong in 2 patients in whom an arthroscopically diagnosed meniscal tear could not be found at arthrotomy. The morbidity of arthroscopy is small. Only complications: A local allergic reaction because of a wound spray in four cases, bronchial asthma following general anesthesia in two patients. No infection occurred. Several therapeutic procedures may be carried out through the arthroscope. So loose bodies were removed from the joint in 39 and partial meniscectomy performed in 13 patients, all of them being treated as out-patients. PMID:468577

Glinz, W

1979-05-01

145

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

PubMed Central

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

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

2013-01-01

146

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

NASA Astrophysics Data System (ADS)

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

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

2007-03-01

147

Arthroscopic treatment of slipped capital femoral epiphysis screw impingement and concomitant hip pathology.  

PubMed

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

2014-08-01

148

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

149

A Randomized Controlled Trial Comparing Arthroscopic Surgery to Conservative Management of Femoroacetabular Impingement.  

E-print Network

??OBJECTIVE: To determine whether patients with femoroacetabular impingement (FAI) who undergo arthroscopic hip surgery experience similar outcomes at two years post-operative with respect to physical… (more)

Klaus, Heather C

2013-01-01

150

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

151

The use of double-loaded suture anchors for labral repair and capsular repair during hip arthroscopy.  

PubMed

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

2012-12-01

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

[Mismatch repair].  

PubMed

Specific repair systems are activated in response to the DNA damage. Mismatch repair protects the genome of prokaryotic and eukaryotic cells from lesions that appear during process of DNA replication or are induced by mutagenic factors. The methyl directed mismatch repair distinguishes the new strand from the old strand by the hemi-methylated state of the DNA and controls the fidelity of genetic information after homologous recombination. The very short patch repair restores the mismatches at the sites with nucleotide sequence CC(W/T)GG. The "8-oxoG" pathway is independent of the hemi-methylated state of the DNA, and removes the oxidated nucleotides from the genome of prokaryotes and eukaryotes. Mutations in genes of mismatch repair enhance the process of mutagenesis in prokaryotic cell, and are the reason for the development of the colon cancer in humans. The mechanisms of mismatch repair and the role of defective repair proteins in mutagenesis and carcinogenesis are discussed in this review. PMID:16637261

Goliasnaia, N V; Tsvetkova, N A

2006-01-01

154

Three cases of septic arthritis following a recent arthroscopic procedure  

PubMed Central

We report three cases of septic arthritis in patients who presented with a painful, swollen and supurative knee joint following a recent arthroscopic procedure, 8–15?days prior to attendance. In all three cases, patients presented with pain and swelling of the affected knee joint with discharge from the port sites. All were sent for washout of the affected joint and received intravenous antibiotic cover. Any patient presenting within 1?month of a recent arthroscopic procedure with pain and swelling of that joint should be presumed to have septic arthritis until proven otherwise. They must have urgent treatment in the form of joint washout and intravenous antibiotics, and receive 6?weeks oral antibiotics on discharge. PMID:23345477

Rowton, Joseph

2013-01-01

155

Arthroscopic Triangular Fibrocartilage Complex Debridement Using Radiofrequency Probes  

Microsoft Academic Search

The initial results of using radiofrequency probes for debridement of a torn triangular fibrocartilage complex were studied in 20 patients with a mean age of 44 (range 27–56) years presenting with ulnar-sided wrist pain. On arthroscopic examination, 18 central and two radial triangular fibrocartilage complex tears were identified and debrided to a stable rim using radiofrequency probes. The mean follow-up

N. A. DARLIS; R. W. WEISER; D. G. SOTEREANOS

2005-01-01

156

Arthroscopic Bony Bankart Fixation Using a Modified Sugaya Technique  

PubMed Central

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

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

2013-01-01

157

A novel ultrasound-guided shoulder arthroscopic surgery  

NASA Astrophysics Data System (ADS)

This paper presents a novel ultrasound-guided computer system for arthroscopic surgery of the shoulder joint. Intraoperatively, the system tracks and displays the surgical instruments, such as arthroscope and arthroscopic burrs, relative to the anatomy of the patient. The purpose of this system is to improve the surgeon's perception of the three-dimensional space within the anatomy of the patient in which the instruments are manipulated and to provide guidance towards the targeted anatomy. Pre-operatively, computed tomography images of the patient are acquired to construct virtual threedimensional surface models of the shoulder bone structure. Intra-operatively, live ultrasound images of pre-selected regions of the shoulder are captured using an ultrasound probe whose three-dimensional position is tracked by an optical camera. These images are used to register the surface model to the anatomy of the patient in the operating room. An initial alignment is obtained by matching at least three points manually selected on the model to their corresponding points identified on the ultrasound images. The registration is then improved with an iterative closest point or a sequential least squares estimation technique. In the present study the registration results of these techniques are compared. After the registration, surgical instruments are displayed relative to the surface model of the patient on a graphical screen visible to the surgeon. Results of laboratory experiments on a shoulder phantom indicate acceptable registration results and sufficiently fast overall system performance to be applicable in the operating room.

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

2006-03-01

158

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

159

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

160

Arthroscopic acetabular recession with chondrolabral preservation.  

PubMed

Cam and pincer lesions found in femoral acetabular impingement (FAI) serve as bony substrates for the development of labral tears and can lead to osteoarthritis. Prior acetabuloplasty techniques have described surgical detachment of the labrum at the chondrolabral junction to facilitate osteoplasty. Histologically, the healing at the chondrolabral junction may be limited and surgical labral detachment may compromise the vascular supply to the labrum. We present a technique of maintaining the chondrolabral junction during acetabuloplasty. The labrum/chondral complex is subperiosteally elevated off the acetabular rim and the acetabular shelf is contoured with fluoroscopic guidance. Intermittent traction is used to minimize total traction time. Vertical mattress stitches are used to repair the labrum. The main advantage of this technique is that it allows contouring of the underlying pincer deformity commonly found in FAI without compromising the contiguous transition zone between the articular surface of the acetabulum and labrum. PMID:23630678

Syed, Hasan M; Martin, Scott D

2013-04-01

161

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

162

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

163

Railroad Repair  

NSDL National Science Digital Library

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

Wnet

2011-01-01

164

Railroad Repair  

NSDL National Science Digital Library

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

2008-01-01

165

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

166

Outcomes of Type II Superior Labrum, Anterior to Posterior (SLAP) Repair: Prospective Evaluation at a minimum 2-year follow-up  

PubMed Central

Hypothesis Patients with type II superior labrum, anterior to posterior (SLAP) lesions will have improved function and decrease pain at a minimum two years after arthroscopic SLAP repair using bioabsorbable suture anchor fixation. Materials and Methods The study population consisted of 48 patients who underwent arthroscopic SLAP repair. Subjective shoulder scores, range of motion, and strength (post-operative only) were assessed pre-operatively and at a minimum of two years post-operatively. Results At an average of 3.4 years following surgery, statistically significant improvement was seen in ASES, UCLA, SST, CADL, VAS, and SF-12 physical outcome scores. Improvements were made in forward flexion, abduction, external rotation, and internal rotation. Subgroup analysis of non-athletes, non-overhead athletes, recreational overhead athletes, and collegiate overhead athletes showed pre- to post-operative improvements in subjective outcomes scores. Overhead laborers and non-laborers subgroups also showed pre- to post-operative improvements in subjective shoulder scores. Discussion On the basis of this data, arthroscopic SLAP repair of type II lesions with bioabsorbable suture anchors provides a significant improvement in functional capacity and pain relief. No differences were seen between the outcomes of non-athletes, non-overhead athletes, recreational overhead athletes, and collegiate overhead athletes, suggesting that SLAP type II repair is successful independent of the patient’s vocation or sport. Level of Evidence IV, Case Series, Treatment Study PMID:20554453

Friel, Nicole A.; Karas, Vasili; Slabaugh, Mark A.; Cole, Brian J.

2013-01-01

167

A new technique for patch augmentation of rotator cuff repairs.  

PubMed

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

2014-06-01

168

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

169

Arthroscopic lateral epicondylitis release using the "bayonet" technique.  

PubMed

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

2014-02-01

170

Arthroscopic-assisted arthrodesis of the trapeziometacarpal joint.  

PubMed

Arthroscopic-assisted surgery of the trapeziometacarpal (TMC) joint has been described before for the treatment of TMC joint arthritis including, debridement, partial or total trapezectomy, and interpositional arthroplasty, but its use for fusion is not reported. TMC joint arthroscopy is a novel technique for arthrodesis which aims to maintain joint stability and strength. We have successfully used this technique to perform fusion of the TMC joint. We think that this would offer the possibility of expanding the indications for TMC joint arthroscopy. PMID:23689861

Yousef, Mohamed A A; Pegoli, Loris

2013-06-01

171

Arthroscopic Identification of the Anterolateral Ligament of the Knee  

PubMed Central

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

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

2014-01-01

172

Arthroscopic Identification of the Anterolateral Ligament of the Knee.  

PubMed

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

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

2014-06-01

173

Arthroscopic treatment of unresolved Osgood-Schlatter lesions.  

PubMed

Osgood-Schlatter disease is a self-limiting condition in most cases. Those with unresolved pain after conservative treatment can obtain relief with surgical debridement of the mobile ossicles and tibial tuberosity. We present an arthroscopic technique for debridement. The location of the inferomedial and lateral parapatella tendon portals can be raised slightly to allow improved instrumentation and visualization in the anterior interval. An anterior interval release is performed with the mechanical shaver and radiofrequency ablation device. Care is taken to visualize the meniscal anterior horns and intermeniscal ligament. By staying anterior to these structures, debridement can be performed aggressively onto the anterior tibial slope. The bony lesions are shelled out from their soft-tissue attachments. Small and loose fragments are removed with a pituitary ronguer, whereas larger lesions are removed with an arthroscopic burr. Working deep along the anterior tibial slope is facilitated by extending the knee and taking tension off the patellar tendon. Postoperatively, patients are allowed full weight bearing and unrestricted range of motion. The advantages of this technique include the avoidance of the patellar tendon longitudinal split required for open procedures and the ability to address concomitant intra-articular pathology. PMID:17916481

DeBerardino, Thomas M; Branstetter, Joanna G; Owens, Brett D

2007-10-01

174

Arthroscopic gluteal muscle contracture release with radiofrequency energy.  

PubMed

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 degrees +/- 8.7 degrees and 110.2 degrees +/- 11.9 degrees, compared with 10.4 degrees +/- 7.2 degrees and 44.8 degrees +/- 14.1 degrees 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. PMID:18975040

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

2009-03-01

175

Does Success Of Arthroscopic Laser Surgery In The Knee Joint Warrant Its Extension To "Non-Knee" Joints?  

NASA Astrophysics Data System (ADS)

One of the authors has performed 162 arthroscopic laser surgeries in the knee joint without any major complication. Other investigators have recently proposed diagnostic arthroscopy and arthroscopic surgery for "non-knee" joints. The authors have proposed that arthroscopic laser surgery he extended to "non-knee" joints. The authors have performed arthroscopic laser surgery on "non-knee" joints of twelve cadavers. One of the authors have performed one successful arthroscopic surgery on a shoulder joint with only a minor, transient complication of subcutaneous emphysema. Is laser arthroscopic surgery safe and effective in "non-knee" joints? The evolving answer appears to be a qualified "Yes," which needs to be verified by a multicenter trial.

Smith, Chadwick F.; Johansen, W. Edward; Vangness, C. Thomas; Yamaguchi, Ken; McEleney, Emmett T.; Bales, Peter

1987-03-01

176

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

177

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

178

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

179

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

180

Arthroscopic Femoroplasty in the Management of Cam-type Femoroacetabular Impingement  

Microsoft Academic Search

Cam-type femoroacetabular impingement is a recognized cause of intraarticular pathology and secondary osteoarthritis in young\\u000a adults. Arthroscopy is reportedly useful to treat selected hip abnormalities and has been proposed as a method of correcting\\u000a underlying impingement. We report the outcomes of arthroscopic management of cam-type femoroacetabular impingement. We prospectively\\u000a assessed all 200 patients (207 hips) who underwent arthroscopic correction of

J. W. Thomas Byrd; Kay S. Jones

2009-01-01

181

An Augmented Reality Navigation System for Computer Assisted Arthroscopic Surgery of the Knee  

Microsoft Academic Search

http:\\/\\/www.ior.it\\/biomec\\/ Abstract. This work presents a prototype navigation system for computer assisted arthroscopic surgery. Arthroscopic surgery is minimally invasive and ensures fast post-surgical recovery. It requires, however, considerable dexterity due to the limited 2D view of the scene and cramped operating area. Augmented reality can help the surgeon overcome these limitations. The key feature of the system presented is an

Oliver Tonet; Giuseppe Megali; Simona D’Attanasio; Paolo Dario; Maria Chiara Carrozza; Maurilio Marcacci; Sandra Martelli; Pier Francesco La Palombara

2000-01-01

182

Wide-Awake Wrist Arthroscopy and Open TFCC Repair  

PubMed Central

The wide-awake approach to hand surgery entails the use of local infiltration anesthesia using lidocaine with epinephrine and no tourniquet. The technique provides practitioners with an option to perform advanced hand surgical care in an ambulatory setting, without the need for general or regional anesthetics. We present our results using wide-awake approach in wrist surgery, both open and arthroscopic. Between June and August 2011, the wide-awake approach was used in nine elective wrist surgery cases; three arthroscopic procedures, four open triangular fibrocartilage complex (TFCC) repairs, and two combined arthroscopy/open surgery (eight men/one woman). The arthroscopic patients were anesthetized using dorsal infiltration of lidocaine with epinephrine (20?mL) with an additional intra-articular 5?mL injection 30 minutes before surgery. The open surgery patients received 40?mL of lidocaine with epinephrine around the ulnar aspect of the forearm, from 8-cm proximal to 3-cm distal to the distal radioulnar joint. Standard diagnostic radio- and midcarpal arthroscopies were performed, where one patient had a loose body removed and two patients underwent TFCC debridements due to central TFCC tears. The six open cases were all due to TFCC foveal disruptions, which were reinserted using osteosutures in the distal ulna. Following placement of the ligament sutures, a preliminary knot allowed active and passive motion testing of pronosupination, to determine the adequate amount of tension in the ligaments. The wide-awake approach to wrist surgery is a plausible and reliable technique that eliminates the need for general anesthesia, removes the need of a tourniquet, and provides a cost-efficient and safe approach to wrist surgery. The ability to control ligament reconstructions using active motion may additionally enhance the rehabilitation of these patients, both through early proprioceptive awareness and adequate tensioning of soft tissues. PMID:23904980

Hagert, Elisabet; Lalonde, Donald H.

2012-01-01

183

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

184

Combined intra- and extra-articular arthroscopic treatment of entrapment neuropathy of the infraspinatus branches of the suprascapular nerve caused by a periglenoidal ganglion cyst.  

PubMed

Entrapment neuropathy of the suprascapular nerve with pain and weakness of the affected shoulder is a rare clinical entity for which several treatment modalities have been reported. Instead of trying to evacuate the cyst from within the joint, the cyst was approached through the subacromial space after subacromial bursectomy, exposure of the spinoglenoid notch, and insertion of a small retractor through an additional posterior portal. This allowed retraction of the infraspinatus muscle together with the inferior branch of the suprascapular nerve for better visualization. After localization of the cyst and nerve, the membrane was incised and the entire viscous contents could be aspirated with a shaver. The intra-articular area of labral detachment was then repaired like a posterior aspect of a SLAP II lesion. The technique described combines the advantages of open and arthroscopic surgery, allowing one to address the underlying intra-articular pathology, completely evacuate the ganglion cyst, and protect the suprascapular nerve. PMID:17349485

Werner, Clément M L; Nagy, Ladislav; Gerber, Christian

2007-03-01

185

Iatrogenic suprascapular nerve injury after repair of type II SLAP lesion.  

PubMed

Suprascapular neuropathy after an arthroscopic repair of a SLAP lesion is theoretically possible, but it has been rarely reported. We present a case of suprascapular nerve injury at the spinoglenoid notch as a complication of an improperly inserted suture anchor after repair of a type II SLAP lesion. The diagnosis was confirmed by the magnetic resonance imaging findings and an electrodiagnostic study, and direct compression of the nerve was visualized under repeat arthroscopy. An anatomic study of the superior glenoid shows that the available bone stock of the superior glenoid rim for the anchor insertion is found to decrease posteriorly. During the repair of a SLAP lesion, surgeons should consider the possibility of an iatrogenic injury to the suprascapular nerve by an improperly inserted suture anchor. PMID:20620802

Kim, Sung-Hun; Koh, Yong-Gon; Sung, Chang-Hun; Moon, Hong-Kyo; Park, Young-Sik

2010-07-01

186

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

187

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

PubMed

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

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

2014-06-01

188

INTERNAL REPAIR OF PIPELINES  

SciTech Connect

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

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

2003-05-01

189

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

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 decompression of central acetabular impingement with notchplasty.  

PubMed

Acetabular notch osteophytes are often encountered during routine diagnostic arthroscopy of the hip. It has been our observation that when notch osteophytes are present, there is often corresponding chondral damage to the anterosuperior femoral head and ligamentum teres degeneration. We propose that removal of the notch osteophyte and decompression of the articulating surface offer an effective method of delaying the progression of arthritis. This article describes in detail the technique used to perform arthroscopic acetabular notchplasty, and a companion video, demonstrating the procedure, is included. Our experience suggests that decompression of the acetabular notch can remove offending structural abnormalities that can potentially cause further chondral damage and may hasten the progression of arthritis. PMID:25473605

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

2014-10-01

192

Return to sport after arthroscopic meniscectomy on stable knees  

PubMed Central

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

2013-01-01

193

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

194

Book Repair Manual.  

ERIC Educational Resources Information Center

This book repair manual developed for the Illinois Cooperative Conservation Program includes book structure and book problems, book repair procedures for 4 specific problems, a description of adhesive bindings, a glossary, an annotated list of 11 additional readings, book repair supplies and suppliers, and specifications for book repair kits. (LRW)

Milevski, Robert J.

1995-01-01

195

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

196

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

197

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

198

Arthroscopic management of mucoid degeneration of anterior cruciate ligament  

PubMed Central

Background: Mucoid degeneration of the anterior cruciate ligament (ACL) is a less understood entity. The purpose of this study was to diagnose mucoid degeneration of anterior cruciate ligament and to assess the effectiveness of arthroscopic treatment in these patients. Materials and Methods: Between December 2007 and November 2011, 20 patients were diagnosed to be suffering from mucoid degeneration of anterior cruciate ligament (ACL) on the basis of magnetic resonance imaging (MRI), histopathology, and arthroscopy findings. 12 patients were males and 8 patients were females, with mean age of 42.2 years for males (range 28-52 years) and 39.4 years for females (range 30–54 years). They presented with pain on terminal extension (n=10) and on terminal flexion (n=2) without history of significant preceding trauma. MRI showed an increased signal in the substance of the ACL both in the T1- and T2-weighted images, with a mass-like configuration that was reported as a partial or complete tear of the ACL by the radiologist. At arthroscopy, the ACL was homogenous, bulbous, hypertrophied, and taut, occupying the entire intercondylar notch. A debulking of the ACL was performed by a judicious excision of the degenerated mucoid tissue, taking care to leave behind as much of the intact ACL as possible. Releasing it and performing a notchplasty treated impingement of the ACL to the roof and lateral wall. In one patient, we had to replace ACL due to insufficient tissue left behind to support the knee. Results: Good to excellent pain relief on terminal flexion–extension was obtained in 19 of 20 knees. The extension deficit was normalized in all knees. Lachman and anterior drawer test showed a firm endpoint in all, and 85% (n=17) showed good to excellent subjective satisfaction. Conclusions: Mucoid hypertrophy of the ACL should be suspected in elderly persons presenting pain on terminal extension or flexion without preceding trauma, especially when there is no associated meniscal lesion or ligamentous insufficiency. They respond well to a judicious arthroscopic release of the ACL with notchplasty. PMID:23162150

Chudasama, Chirag H; Chudasama, Vyoma C; Prabhakar, Mukund M

2012-01-01

199

Arthroscopic resection of an extra-articular tenosynovial giant cell tumor from the ankle region.  

PubMed

This report describes the case of a 31-year-old man with a tenosynovial giant cell tumor in the left ankle region. The tumor developed over a period of 5 months. A conservatively treated fracture of the leg in the patient's history was important. The presurgical magnetic resonance imaging (MRI) examination allowed a specific diagnosis and the exclusion of infiltrative properties of the tumor. The tumor was excised using an exclusively arthroscopic technique. The procedure included treatment of intra-articular pathologies and the removal of 2 loose bodies. The excision was complete and no recurrence or complication was seen in 5 months' follow-up. In view of the possible recurrence (in about 50% of patients) and the unknown development of malignant tumors, arthroscopic excision can be advantageous. This procedure includes small scars and lower risks of infection and necrosis. Therefore, arthroscopic treatment of soft tissue tumors near the ankle joint may by an alternative to open excision. PMID:12966401

Spahn, Gunter; Bousseljot, Frank; Schulz, Hans-Joachim; Bauer, Thomas

2003-09-01

200

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

201

Review Article: Open versus arthroscopic synovectomy for pigmented villonodular synovitis of the knee.  

PubMed

Studies published in MEDLINE between January 2010 and October 2013 were reviewed to compare open with arthroscopic synovectomy for pigmented villonodular synovitis of the knee in terms of rates of recurrence, complication, and osteoarthritis. 10 studies specifically on this topic were analysed; all were retrospective case reports, and thus level of evidence was low. Respectively after open and arthroscopic synovectomy, the overall recurrence rates were 26.7% and 24.6%, the overall complication rates were 5.7% and 3.2%, and the overall osteoarthritis rates were 20% and 17.1%. Arthroscopic and open synovectomy did not differ significantly in terms of rates of recurrence, complication, and osteoarthritis. Prospective randomised studies are needed to confirm the findings. PMID:25550027

Rodriguez-Merchan, E C

2014-12-01

202

Arthroscopic Treatment of a Case with Concomitant Subacromial and Subdeltoid Synovial Chondromatosis and Labrum Tear  

PubMed Central

Synovial chondromatosis is a disease that seldomly seen in shoulder joint and is related to benign synovial proliferation and synchronous chondral tissue formation within the joint cavity. Patients suffer from progressive restriction of range of motion and shoulder pain. Extra-articular involvement is an extremely rare condition. Degenerative osteoarthritis, joint subluxation, and bursitis are common complications in untreated patients. Open or arthroscopic surgery is suitable while there is no consensus related to superiority of different approaches. We presented an arthroscopic treatment of a male patient, 48 years old with labrum tear and synovial chondromatosis localized in subacromial and subdeltoid region. Advantages of arthroscopic surgery in the presence of intra- and extra-articular combined pathologies are also discussed. PMID:24383030

Aydogan, Nevres Hurriyet; Kocadal, Onur; Ozmeric, Ahmet; Aktekin, Cem Nuri

2013-01-01

203

Arthroscopic Technique for the Treatment of Patellar Chondral Lesions With the Patient in the Supine Position  

PubMed Central

We describe an arthroscopic approach for the treatment of patellar chondral lesions with the patient in the supine position. This approach can be used to perform certain procedures such as matrix autologous chondrocyte implantation and autologous matrix–induced chondrogenesis. It is possible to perform these arthroscopic techniques working at an angle perpendicular to the patellar joint surface. First, with the patient in the supine position, arthroscopic longitudinal sectioning of the lateral patellar retinaculum is performed, and the patella is reverted with the help of a Codivilla forceps. It is then possible to place the chondral surface perpendicular to the floor, and it can be accessed directly through a lateral parapatellar portal. Short-term follow-up has shown the benignity of opening the patellar retinaculum. This procedure reduces morbidity compared with the traditional open surgery. PMID:25126506

Cuéllar, Ricardo; Cuéllar, Adrián; Ponte, Juan; Ruiz-Ibán, Miguel A.

2014-01-01

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

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

206

Arthroscopic Resection of Intra-Articular Osteochondromas of the Hip  

PubMed Central

Proximal femur osteochondromas are relatively rare, particularly in the femoral neck. The choice of treatment poses difficulties to the surgeon. We report an unusual case of a patient with 2 osteochondromas in the femoral neck causing femoroacetabular impingement. Appropriate identification and precise resection of the lesions are important steps of the surgical procedure. We present our arthroscopic surgical technique to access the lesions and perform their resection. To our knowledge, this is the first report of hip arthroscopic resection of 2 osteochondromas with considerable dimensions causing femoroacetabular impingement. PMID:25126501

Aguiar, Thiago; Dantas, Pedro

2014-01-01

207

All-arthroscopic double-bundle coracoclavicular ligament reconstruction using autogenous semitendinosus graft: a new technique.  

PubMed

We present our novel arthroscopic anatomic double-bundle coracoclavicular ligament reconstruction technique using a semitendinosus tendon autograft. The dorsal limb of the graft is positioned around the dorsal edge of the clavicle, re-creating the conoid ligament. The anterior limb proceeds superiorly and re-creates the trapezoid ligament. The solution effectively stabilizes the acromioclavicular joint and prevents anterior posterior translation. This new arthroscopic double-bundle coracoclavicular joint reconstruction is an effective and reliable method in stabilizing the clavicle and neutralizing the anterior-posterior translation, and we find it to be technically practical for the surgeon. PMID:23766964

Ranne, Juha O; Sarimo, Janne J; Rawlins, Mark I; Heinonen, Olli J; Orava, Sakari Y

2012-09-01

208

Arthroscopic biceps tendon tenodesis: the anchorage technical note.  

PubMed

Treatment of long head biceps (LHB) tendon pathology has become an area of renewed interest and debate among orthopaedic surgeons in recent years. The background of this manuscript is a description of biceps tenodesis which ensure continual dynamic action of the tendon which depresses the head and impedes lateral translation. A new technique has been developed in order to treat LHB tendon irreversible structural abnormalities associated with cuff rotator lesions. This technique entails the construction of a biological anchor between the LHB and supraspinatus and/or infraspinatus tendons according to arthroscopic findings. The rationale, although not supported by biomechanical studies is to obtain a triple, biomechanical effect. The first of these biomechanical effects which we try to promote through the procedure of transposition is the elimination of the deviation and oblique angle which occurs as the LHB completes its intra-articular course prior to reaching the bicipital groove. Furthermore, we have found this technique extremely useful in the presence of large ruptures of the rotator cuff with muscle retraction. The most common complication associated to this particular method, observed in less than 3%, is failed biological fixation which manifests as subsidence of the tenodesis and consequent descent of the tendon with evident aesthetic deformity. PMID:16374589

Castagna, A; Conti, M; Mouhsine, E; Bungaro, P; Garofalo, R

2006-06-01

209

Eye muscle repair - discharge  

MedlinePLUS

... Resection and recession - discharge; Lazy eye repair - discharge; Strabismus repair - discharge; Extraocular muscle surgery - discharge ... eyes. The medical term for crossed eyes is strabismus. Children usually receive general anesthesia for this surgery. ...

210

Retinal detachment repair  

MedlinePLUS

Retinal detachment repair is eye surgery to place a detached retina back into its normal position. A detached ... layers. This article describes the repair of rhegmatogenous retinal detachments -- retinal detachments that occur due to a hole ...

211

Repairing Broken Bones  

NSDL National Science Digital Library

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

Integrated Teaching and Learning Program, College of Engineering,

212

Arthroscopically-assisted reduction of intra-articular fractures of the distal radius  

Microsoft Academic Search

Twenty-seven patients with intraarticular fractures of the distal radius with a step of more than 1 mm in the joint surface after attempted closed reduction, were treated by reduction under arthroscopic control and percutaneous fixation. All fractures healed without measurable incongruity of the joint surface and at follow-up 3 to 38 months after surgery 19 patients had excellent and eight

L. Adolfsson; P. Jörgsholm

1998-01-01

213

Case Report The arthroscopic treatment of avascular necrosis of the proximal pole following scaphoid nonunion  

Microsoft Academic Search

The authors describe a technique of treating scaphoid nonunions with associated avascular necrosis consisting of arthroscopic resection of the distal pole of the scaphoid combined with radial styloidectomy. The results at 2-year follow-up showed all three patients to have complete relief of their mechanical pain and improvement in their range of motion as well as high satisfaction with the procedure.

DS Ruch; DS Chang; GG Poehling

1998-01-01

214

Enhancement of KTP\\/532 laser disc decompression and arthroscopic microdiscectomy with a vital dye  

Microsoft Academic Search

Currently, the clinical indications and results of arthroscopic microdiscectomy and laser disc decompression come close to, but do not exceed, the results of classic discectomy or microdiscectomy for the whole spectrum of surgical disc herniations. However, as minimally invasive techniques continue to evolve, results can be expected to equal or be potentially superior to conventional surgery. This exhibit demonstrates how

Anthony T. Yeung

1993-01-01

215

Functional and Radiographic Outcome of Juvenile Osteochondritis Dissecans of the Knee Treated with Transarticular Arthroscopic Drilling  

Microsoft Academic Search

Management of juvenile osteochondritis dissecans is controversial. The purpose of this study was to evaluate the functional and radiographic outcomes of transarticular arthroscopic drilling for isolated stable, juvenile osteochondritis dissecans lesions of the medial femoral condyle with an intact articular surface after 6 months of nonoperative management had failed. We reviewed 30 affected knees in 23 skeletally immature patients (mean

Mininder S. Kocher; Lyle J. Micheli; Moshe Yaniv; David Zurakowski; Andrew Ames; Anthony A. Adrignolo

2001-01-01

216

Analgesic Effects of Intraarticular Sufentanil and Sufentanil Plus Methylprednisolone After Arthroscopic Knee Surgery  

Microsoft Academic Search

We studied the effect of intraarticular saline, sufentanil, or sufentanil plus methylprednisolone after knee arthro- scopic meniscectomy. In a double-blind randomized study, 60 patients undergoing knee arthroscopic menis- cectomy were allocated to groups receiving intraarticular saline, intraarticular sufentanil 10 g, or sufentanil 10 g plus methylprednisolone 40 mg at the end of arthroscopy during general anesthesia. Postoperatively, pain levels at

Mehmet Kizilkaya; Omer Selim Yildirim; Nazim Dogan; Husnu Kursad; Ali Okur

2004-01-01

217

Arthroscopic synovial biopsy in definitive diagnosis of joint diseases: An evaluation of efficacy and precision  

PubMed Central

Context: Arthritis is an important cause of morbidity, presenting as monoarticular or polyarticular lesion. Arthroscopic synovial aspiration and biopsy can help in arriving specific etiological diagnosis. Aim and Objectives: To evaluate the efficacy of arthroscopic synovial biopsy as a diagnostic aid and study the characteristics of synovial fluid in various joint diseases. Materials and Methods: Arthroscopic synovial biopsy along with synovial fluid analysis was studied in 30 of the 50 enrolled cases arthritis. The fluid was subjected to physical, biochemical, and cytological analysis. Results: Both rheumatoid (n = 14, 28%) and tubercular (n = 13, 26%) arthritis were found to be more common compared to other etiologies. Next common etiology observed was chronic nonspecific synovitis (n = 10, 20%). Clinicopathological correlation was seen in 34 out of 50 cases. As a diagnostic tool, synovial biopsy had a sensitivity of 85%, specificity of 100%, positive predictive value of 100%, and negative predictive value of 62%. Conclusion: Arthroscopic synovial biopsy is a simple and easy to perform technique and is an important useful investigative adjunct that may give conclusive diagnosis where clinical diagnosis is equivocal. PMID:23776821

Singhal, Onis; Kaur, Viplesh; Kalhan, Shivani; Singhal, Manish Kumar; Gupta, Anshu; Machave, YV

2012-01-01

218

Sports and Recreation Activity of Patients With Femoroacetabular Impingement Before and After Arthroscopic Osteoplasty  

Microsoft Academic Search

Background: Hip arthroscopy represents a new and minimally invasive method of treating patients with femoroacetabular impingement (FAI). However, participation in popular sports after this procedure has not yet been analyzed.Hypotheses: Arthroscopic treatment of FAI increases the level of popular sports activities, and this level of activity correlates with the clinical outcome in terms of pain and function.Study Design: Case series;

Alexander Brunner; Monika Horisberger; Richard F. Herzog

2009-01-01

219

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

PubMed

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

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

2008-01-01

220

MRI and arthroscopic findings in the temporomandibular joint after mandibulectomy including the unilateral condyle  

Microsoft Academic Search

In this report, the MRI and arthroscopic findings in the temporomandibular joint (TMJ) of two patients who underwent partial mandibulectomy including the condyle are presented. The disc and superior joint compartment of the affected TMJs were preserved in both patients. MRI of the affected TMJs without condyle demonstrated that the intermediate zone of the discs was located anteriorly to the

Yoshiki Hamada; Toshirou Kondoh; Norihiko Takada; Kanichi Seto

2000-01-01

221

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

Microsoft Academic Search

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

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

2000-01-01

222

Articular and osseous lesions in recent ligament tears: arthroscopic changes compared with magnetic resonance imaging findings  

Microsoft Academic Search

The treatment of ligament injuries of the knee has undergone rapid progress, especially with the improvement of arthroscopic reconstruction of the anterior cruciate ligament (ACL). Since the advent of magnetic resonance imaging (MRI) after knee trauma with ligament injuries, interest has focussed on the clinical significance of concomitant articular and osseous lesions. In 48 of 141 MRIs, different types of

A Lahm; C Erggelet; M Steinwachs; A Reichelt

1998-01-01

223

Anterosuperior impingement of the shoulder as a result of pulley lesions: A prospective arthroscopic study  

Microsoft Academic Search

Lesions of the biceps pulley and the rotator cuff have been reported to be associated with an internal an- terosuperior impingement (ASI) of the shoulder. The purpose of this study was to determine the factors influ- encing the development of an ASI. Eighty-nine patients with an arthroscopically diagnosed pulley lesion were prospectively included in this study. Four patterns of intraarticular

Peter Habermeyer; Petra Magosch; Maria Pritsch; Markus Thomas Scheibel; Sven Lichtenberg

224

Anterosuperior impingement of the shoulder as a result of pulley lesions: a prospective arthroscopic study  

Microsoft Academic Search

Lesions of the biceps pulley and the rotator cuff have been reported to be associated with an internal anterosuperior impingement (ASI) of the shoulder. The purpose of this study was to determine the factors influencing the development of an ASI. Eighty-nine patients with an arthroscopically diagnosed pulley lesion were prospectively included in this study. Four patterns of intraarticular lesions could

Peter Habermeyer; Petra Magosch; Maria Pritsch; Markus Thomas Scheibel; Sven Lichtenberg

2004-01-01

225

The role of osteonecrosis in canine coronoid dysplasia: arthroscopic and histopathological findings.  

PubMed

Coronoid dysplasia (CD) or medial coronoid disease is part of canine elbow dysplasia and eventually results in osteoarthrosis. Although CD was originally attributed to disturbed endochondral ossification, more recent data point to the subchondral bone. The objective of this study was to assess dysplastic bone and cartilage of dogs that underwent unilateral or bilateral arthroscopic subtotal coronoidectomy for the treatment of CD. Arthroscopic findings and histopathology of bone and cartilage removed from elbow joints with CD were compared. The most common arthroscopic finding was fragmentation with softening of the subchondral bone of the central part of the medial coronoid process. In dogs without obvious fragmentation, CD was characterised by bone softening and chondromalacia. During arthroscopic intervention dysplastic bone and cartilage were collected for histopathological assessment. Forty-five slices of formalin-fixed, paraffin-embedded bone and cartilage samples were stained using haematoxylin and eosin and evaluated. Histopathological findings primarily consisted of osteonecrosis of subchondral bone with necrosis within the marrow spaces. Histopathological changes in the articular cartilage were characterised by fibrillation, chondrocyte clone formation, and focal cartilage necrosis. The pathology was found primarily in the subchondral bone and not in the articular cartilage. Vascular compromise may play a role in the pathogenesis of osteonecrosis in CD. PMID:24797106

Mariee, I C; Gröne, A; Theyse, L F H

2014-06-01

226

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

PubMed Central

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

Yilar, Sinan; Yildirim, Omer Selim

2014-01-01

227

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

228

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

229

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.

230

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

231

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

232

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

233

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

234

Arthroscopic Anatomic Humeral Head Reconstruction With Osteochondral Allograft Transplantation for Large Hill-Sachs Lesions  

PubMed Central

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

235

Arthroscopic knee surgery using the advanced flat panel high-resolution color head-mounted display  

NASA Astrophysics Data System (ADS)

The first ever deployed arthroscopic knee surgeries have been performed using a high resolution color head-mounted display (HMD) developed under the DARPA Advanced Flat Panel HMD program. THese procedures and several fixed hospital procedures have allowed both the system designers and surgeons to gain new insight into the use of a HMD for medical procedures in both community and combat support hospitals scenarios. The surgeons demonstrated and reported improved head-body orientation and awareness while using the HMD and reported several advantages and disadvantages of the HMD as compared to traditional CRT monitor viewing of the arthroscopic video images. The surgeries, the surgeon's comments, and a human factors overview of HMDs for Army surgical applications are discussed here.

Nelson, Scott A.; Jones, D. E. Casey; St. Pierre, Patrick; Sampson, James B.

1997-06-01

236

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

Microsoft Academic Search

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

Monika Horisberger; Alexander Brunner; Richard F. Herzog

2010-01-01

237

Outcomes of arthroscopic "Remplissage": capsulotenodesis of the engaging large Hill-Sachs lesion  

PubMed Central

Background A Hill-Sachs lesion of the humeral head after a shoulder dislocation is clinically insignificant in most cases. However, a sizable defect will engage with the anterior rim of the glenoid and cause instability even after anterior glenoid reconstruction. The purpose of this study was to evaluate the outcome of arthroscopic capsulotenodesis of the posterior capsule and infraspinatus tendon ("remplissage") to seal a large engaging Hill-Sachs lesion in an unstable shoulder. Methods This was a prospective follow-up study of patients who underwent arthroscopic surgery for recurrent shoulder instability with a large engaging Hill-Sachs lesion from 2007 to 2009. The clinical results were measured preoperatively and postoperatively with the Simple Shoulder test (SST) and the Rowe score for instability. Results Eleven patients met the inclusion criteria of this study. The mean follow-up time was 30 months (range 24 to 35 months). At the last follow-up, significant improvement was observed in both scores with no recurrent dislocations. The mean SST improved from 6.6 to 11 (p < 0.001). The mean Rowe Score improved from 10.6 to 85 points (p < 0.001). On average patients regained more than 80% of shoulder external rotation. Conclusions Arthroscopic remplissage for shoulder instability is an effective soft tissue technique to seal a large engaging Hill-Sachs lesion with respect to recurrence rate, range of motion and shoulder function. PMID:21676226

2011-01-01

238

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

239

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

PubMed Central

Summary 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

2012-01-01

240

Biceps tenoscopy in arthroscopic treatment of primary synovial chondromatosis of the shoulder.  

PubMed

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

2014-08-01

241

A Modified Technique of Arthroscopically Assisted AC Joint Reconstruction and Preliminary Results  

PubMed Central

Surgical treatment of high-grade acromioclavicular (AC) joint separations has become analogous to ligament reconstructions elsewhere in the body with the goal being restoration of the native anatomy. Circumferential access to the base of the coracoid is essential to reconstruct the coracoclavicular ligament complex. Using some of the traditional open approaches, this access requires detaching the deltoid insertion and performing extensive soft tissue dissection. Also, poor visualization risks injury to nearby neurovascular structures. An arthroscopically assisted reconstruction offers the advantage of less soft tissue dissection and superior visualization to the base of the coracoid. We have developed a unique arthroscopically assisted technique that uses a subacromial approach to pass suture material and a tendon graft around the coracoid to reconstruct the coracoclavicular ligament complex. We describe our technique and preliminary results in 10 patients who have undergone coracoclavicular ligament reconstruction for high-grade AC separation. All patients improved subjectively with regard to pain and function at a minimum followup of 3 months (mean, 5 months; range, 3–18 months). This arthroscopically assisted technique has the potential to allow for safe and at least in the short term reliable restoration of the coracoclavicular ligament complex and provides an alternative technique to treat AC joint separations. Level of Evidence: Level IV, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence. PMID:18264852

Altchek, David W.; Davila, Jeffrey; Cordasco, Frank A.

2008-01-01

242

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

PubMed Central

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

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

2014-01-01

243

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

244

Femoroacetabular impingement in 45 professional athletes: associated pathologies and return to sport following arthroscopic decompression  

PubMed Central

Femoroacetabular impingement (FAI) occurs when an osseous abnormality of the proximal femur (cam) or acetabulum (pincer) triggers damage to the acetabular labrum and articular cartilage in the hip. Although the precise etiology of FAI is not well understood, both types of FAI are common in athletes presenting with hip pain, loss of range-of-motion, and disability in athletics. An open surgical approach to decompressing FAI has shown good clinical outcomes; however, this highly invasive approach inherently may delay or preclude a high level athlete’s return to play. The purpose of this study was to define associated pathologies and determine if an arthroscopic approach to treating FAI can allow professional athletes to return to high-level sport. Hip arthroscopy for the treatment of FAI allows professional athletes to return to professional sport. Between October 2000 and September 2005, 45 professional athletes underwent hip arthroscopy for the decompression of FAI. Operative and return-to-play data were obtained from patient records. Average time to follow-up was 1.6 years (range: 6 months to 5.5 years). Forty two (93%) athletes returned to professional competition following arthroscopic decompression of FAI. Three athletes did not return to play; however, all had diffuse osteoarthritis at the time of arthroscopy. Thirty-five athletes (78%) remain active in professional sport at an average follow-up of 1.6 years. Arthroscopic treatment of FAI allows professional athletes to return to professional sport. PMID:17479250

Schenker, Mara; Briggs, Karen; Kuppersmith, David

2007-01-01

245

Is there a niche for arthroscopic laser surgery of the temporomandibular joint?  

NASA Astrophysics Data System (ADS)

The purpose of this in vitro study was to investigate and compare effects of currently available laser systems at different wavelengths (XeCl excimer laser, Holmium:YAG laser, Erbium:YAG laser) on porcine articulating facets, capsule and meniscus of the temporomandibular joint via photomacroscopy, light and scanning electron microscopy. From a critical review of the relevant literature and the preliminary observations of this investigation, it appears that the Neodymium:YAG laser is inappropriate for TMJ arthroscopic surgery with regard to the huge thermal injury caused to the remaining tissue. The Holmium:YAG laser suffers from remarkable photomechanical and photothermal side effects, whereas the Erbium:YAG laser ablates temporomandibular joint tissue efficiently with minimal adjacent damage--similar to the XeCl excimer laser, without entailing the risk of potential mutagenity. To sum up, it can be concluded that there is a clinical need for laser- assisted arthroscopic surgery of the craniomandibular articulation. Nevertheless, at present none of the available laser systems meet the medical demands completely. Currently, the Erbium:YAG laser seems to be the most suitable for TMJ arthroscopic surgery.

Nuebler-Moritz, Michael; Hering, Peter; Bachmaier, Uli; Schiessl, Robert; Rueschoff, Josef; Meister, Joerg

1996-04-01

246

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

247

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

248

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

249

Rapid road repair vehicle  

DOEpatents

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

Mara, Leo M. (Livermore, CA)

1999-01-01

250

Aortic Aneurysm Repair  

MedlinePLUS

... to repair an abdominal aortic aneurysm using a technology called an “endograft,” which is sometimes called the “ ... separate area, and it’s because of this small technology that allows you to do this. Exactly. So ...

251

Laparoscopic ventral hernia repair.  

PubMed

Ventral hernias, whether naturally occurring or the result of previous surgery, comprise one of the most common problems confronting general surgeons. As many as 25% of laparotomy incisions develop a hernia over long-term follow-up, which is a difficult problem with many treatment algorithms. Laparoscopic ventral hernia repair has improved over the last decade and has proven to be an effective treatment option. With fewer wound complications and low recurrence rates, it is a useful tool in the surgeon's armamentarium. Care should be taken regarding patient selection, operative technique, and mesh size to ensure adequate repair of the hernia, thereby preventing recurrence at a later date. The first attempt at a hernia repair has the highest chance of long-term success, so it is important that the surgeon take all the factors into mind before proceeding with operative repair. PMID:21424876

Melvin, W Scott; Renton, David

2011-07-01

252

Hypospadias repair - series (image)  

MedlinePLUS

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

253

Unilateral cleft lip repair.  

PubMed

Modern cleft surgery requires four-dimensional and functional anatomic understanding of the cleft (and noncleft) lip, nose, and alveolus. Some techniques for nasolabial repair rely more on precise anatomic geometry, whereas others afford the surgeon a more flexible design. Consistent anthropometry enables accurate assessment and reporting of long-term outcomes; such reports are needed to guide perioperative care, delineate optimal repair principles, and resolve ongoing controversies. PMID:24607186

Vyas, Raj M; Warren, Stephen M

2014-04-01

254

Repairing Foam Insulation  

NASA Technical Reports Server (NTRS)

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

Corbin, J.; Buras, D.

1986-01-01

255

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

256

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.

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

2014-01-01

257

Femoral hernia repair.  

PubMed

Femoral hernia repair has a long history. In the nineteenth century, simple closure of the femoral orifice by the femoral approach was favored. Such renowned surgeons as Bassini, Marcy, and Cushing authored papers about the femoral approach to femoral hernia. The recurrence rate was so high, however, that it was replaced by the inguinal approach. The man who popularized the inguinal approach was Chester McVay, who demonstrated the precise insertion of the tranversus abdominis muscle and transversalis fascia to the Cooper's ligament. He used Cooper's ligament for the femoral hernia repair by the inguinal approach. The complication and recurrence rate after the Cooper's ligament repair for femoral hernia was not satisfactory, however, due to tension on the approximated tissues, which caused postoperative pain and inability to resume normal activities. Irving Lichtenstein first introduced the plug technique to femoral hernia repair and it was further developed by Gilbert and Rutkow. In the present series, all elective cases were repaired by the PerFix mesh plug technique without any complications. Patients were discharged from the hospital on the first postoperative day and returned to normal activities shortly thereafter. These patients had few complaints of pain in the groin. The operating time using a PerFix plug was markedly shorter when contrasted with the Cooper's ligament repair. No infection of the prosthesis occurred, even in the cases in which the small intestine was necrotic and resected. From our 7-year experience of mesh plug femoral hernia repairs, I have come to regard this operation as the first choice in elective and noninfected cases of femoral hernia. In strangulated cases in which severe infection occurs. Cooper's ligament repair should be used, because there is a risk or infection to implanted prosthesis. Finally, femoral hernia is usually thought of as requiring emergency surgical treatment. Only 30% of our cases were treated as emergency operations, however, whereas 70% were elective. Unless patients complain of severe abdominal pain or ileus, surgeons need not perform emergency operations. In summary, the PerFix mesh plug hernia repair for femoral hernia has resulted in a reduced recurrence rate, shortened hospital stay, and a low rate of postoperative complications. PMID:14533910

Hachisuka, Takehiro

2003-10-01

258

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

259

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

260

Arthroscopic versus percutaneous release of common extensor origin for treatment of chronic tennis elbow  

Microsoft Academic Search

Background  Lateral epicondylitis is a common orthopedic problem. Rest, activity modification, and conservative therapies are generally\\u000a efficacious in relieving symptoms in the majority of patients; however, a small percentage of people will experience refractory\\u000a pain and require surgical intervention to alleviate their discomfort. Surgical release of the common extensor origin can be\\u000a done through an open, percutaneous, or arthroscopic approach.\\u000a \\u000a \\u000a \\u000a \\u000a Patients

Ahmed Mohamed Ahmed Othman

2011-01-01

261

Arthroscopically assisted anterior decompression for femoroacetabular impingement: technique and early clinical results  

Microsoft Academic Search

Introduction  In patients with symptomatic femoroacetabular impingement resection osteochondroplasty of the femoral head–neck junction may\\u000a improve hip pain and range of motion. We evaluated the short-term treatment results of an arthroscopically assisted mini-open\\u000a anterior approach to compare it with the results after surgical dislocation for FAI.\\u000a \\u000a \\u000a \\u000a Methods  The clinical and radiographic results of 33 patients were reviewed retrospectively 15 months after the surgery.

Albrecht Hartmann; Klaus-Peter Günther

2009-01-01

262

Arthroscopic-Assisted Core Decompression for Osteonecrosis of the Femoral Head  

PubMed Central

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

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

2013-01-01

263

Arthroscopic-assisted core decompression for osteonecrosis of the femoral head.  

PubMed

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

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

2014-02-01

264

Arthroscopic discectomy and interbody fusion of the thoracic spine: A report of ipsilateral 2-portal approach  

PubMed Central

Background The standard approach to the thoracic disc is through thoracotomy. The video-assisted thoracoscopic approach has been used as an alternative to the open approach for nearly 20 years, and more recently, extracavitary, posterolateral approaches have been introduced. Both the transthoracic procedures involve deflating the lung for access to the spine, and postoperative thoracic drainage is necessary; postoperative morbidity can be significant. The retropleural procedures are in their infancy, but the published results are promising. The purpose of this study is to introduce the posterolateral arthroscopic thoracic decompression and fusion procedure, which is extrapleural, less disruptive to normal anatomy, and cost-effective. Methods Fifteen consecutive patients who underwent arthroscopic decompression and interbody fusion of the thoracic spine were prospectively studied according to the hospital's institutional review board protocol. The Short Form 36 and visual analog scale questionnaires were completed preoperatively and postoperatively. Paired t tests were used for statistical analysis. The patient was placed in the prone position on a radiolucent table, and instrumentation was performed under fluoroscopic control. Two portals were developed ipsilaterally (one for the arthroscope and the other for instruments) on the side of disc herniation, and a single portal was used on the contralateral side. Various instruments were used for disc excision and exploration of the spinal canal. Fusion was accomplished with bilateral corticocancellous dowels obtained from the iliac crests. Infiltration of the access channel and facet injections of the contiguous joints were performed with bupivacaine, for immediate postoperative pain control. Results Fifteen patients with a mean age of 54 years were followed up for 28 months postoperatively. The overall back pain score decreased from 7.2 (SD, 1.5) to 3 (SD, 2) after the procedure (P < .005). Eleven patients were satisfied with their current lifestyle postoperatively as opposed to one preoperatively. Two patients had reoccurrences. Hospital stay averaged 18.5 hours. The operating room cost and the cost of hospital stay was 51.9% of the cost of anterior open discectomy. Conclusions The extrapleural, biportal, ipsilateral arthroscopic approach for the decompression and interbody fusion of the thoracic spine is feasible, cost-effective, less traumatic, and associated with minimal complications. The best results were obtained in patients with single-level thoracic disc herniation. The technique is applicable for most thoracic disc herniations.

Osman, Said G.; Schwartz, Jeremy A.; Marsolais, E. B.

2012-01-01

265

46 CFR Sec. 19 - Ship Repair Summaries.  

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

2014-10-01

266

46 CFR Sec. 19 - Ship Repair Summaries.  

Code of Federal Regulations, 2012 CFR

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

2012-10-01

267

46 CFR Sec. 19 - Ship Repair Summaries.  

Code of Federal Regulations, 2011 CFR

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

2011-10-01

268

46 CFR Sec. 19 - Ship Repair Summaries.  

Code of Federal Regulations, 2010 CFR

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

2010-10-01

269

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

270

Imperforate anus repair - series (image)  

MedlinePLUS

... for passage of stool. Complete absence of an anal opening requires emergency surgery for the newborn. Surgical ... for several months before attempting the more complex anal repair. The anal repair involves an abdominal incision, ...

271

Intraoperative Fluoroscopy for Evaluation of Bony Resection During Arthroscopic Management of Femoroacetabular Impingement in the Supine Position  

Microsoft Academic Search

There is a steep learning curve regarding many aspects of arthroscopic management of femoroacetabular impingement. One of the concerns with regard to this approach is verification of appropriate bony resection for cam- and pincer-type pathology. Dynamic assessment and direct visualization of bony resection are the primary means of evaluating appropriate resection. Intraoperative fluoroscopy, however, can be a helpful adjunct when

Christopher M. Larson; Corey A. Wulf

2009-01-01

272

Arthroscopic treatment of a medial meniscal cyst using a posterior trans-septal approach: a case report.  

PubMed

Arthroscopic partial menisectomy followed by cyst decompression is currently recommended for treatment of a meniscal cyst. However, it is doubtful whether partial menisectomy should be performed on cysts communicating with the joint in cases without a meniscal tear on its surface since meniscal function will be sacrificed. In this report, a meniscal cyst arising from the posterior horn of the medial meniscus without meniscal tear on its surface was resected using an arthroscopic posterior trans-septal approach. A 59 year-old male presented to our hospital with popliteal pain when standing up after squatting down. Magnetic resonance imaging revealed a multilobulated meniscal cyst arising from the posterior horn of the medial meniscus extending to the posterior septum with a grade 2 meniscal tear by Mink's classification. The medial meniscus was intact on the surface on arthroscopic examination. The meniscal cyst and posterior septum were successfully resected using a posterior trans-septal approach without harming the meniscus. This is the first report on a meniscal cyst being resected using an arthroscopic posterior trans-septal approach with a 9-month follow-up period. PMID:20939883

Ohishi, Tsuyoshi; Torikai, Eiji; Suzuki, Daisuke; Banno, Tomohiro; Honda, Yosuke

2010-01-01

273

Automotive Engine Maintenance and Repair.  

ERIC Educational Resources Information Center

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

Marine Corps Inst., Washington, DC.

274

Recombinational DNA Repair in Bacteria  

E-print Network

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

Cox, Michael M.

275

Percutaneous Achilles tendon repair  

Microsoft Academic Search

Fourteen patients underwent percutaneous Achilles tendon repairs between 1982 and 1989 for ruptures approximately 2 to 8 cm from the calcaneal insertion. They were evaluated subjectively (questionnaires) and objectively (physical examinations, Cybex II dynamom eter). The minimum follow-up time was 2 years with an average of 3.8 years. Subjectively, all of the patients were satisfied with their overall results. Objectively,

Robert E. Fitzgibbons; John Hefferon; James Hill

1993-01-01

276

Laparoscopic inguinal hernia repair.  

PubMed

Between March 1991 and May 1994, 444 laparoscopic inguinal hernia repairs were undertaken in 375 patients: 386 transperitoneal and 58 extraperitoneal. During a follow-up period of 20.5 months (range 1-38) there have been three recurrences at 6, 7 and 12 months, all direct and all after transperitoneal repair. A total of 52 patients were treated as a day case (< 6 h), 317 patients spent less than 24 h in hospital and four patients were discharged on the second postoperative day. Operating time for transperitoneal hernia repair was 27 min (range 10-68) and extraperitoneal repair, 29 min (range 11-48). Short-term complications occurred in 18 patients: six haematomas, four seromas, one urinary retention and seven suffered persistent groin pain. Six patients have had neuralgia, three have had mesh removed and three further patients had individual clips removed from within the inguinal canal. There have been two adhesive small bowel obstructions. The first occurred 2 months after laparoscopic surgery and required laparotomy; the second occurred 2 years after surgery and had laparoscopic division of an adhesive band to a pelvic staple. There was one infected lymphocoele treated percutaneously. PMID:7741670

Fielding, G A

1995-05-01

277

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

278

Laboratory For Telerobotic Repair  

NASA Technical Reports Server (NTRS)

Laboratory telerobotic system performs such complicated tasks as picking up tools, removing thermal blanket, and replacing screws. Human operator in control room operates remote robot with aid of video monitors, torque and force displays, and force feedback. System used to perform research and to develop telerobotic-repair capabilities equal to those of human operator.

Fiorini, Paolo; Bejczy, Antal K.; Das, Hari; Zak, Haya

1993-01-01

279

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

280

Long-term outcomes of arthroscopic debridement and thermal shrinkage for isolated partial intercarpal ligament tears.  

PubMed

A retrospective analysis was performed based on the medical records and imaging studies of 16 wrists (14 patients) with isolated partial intercarpal ligament tears (scapholunate ligament: 6 wrists, lunotriquetral ligament, 10 wrists) treated with arthroscopic debridement and thermal shrinkage. Three wrists had Geissler grade 1 tears and 13 wrists had grade 2 tears. Mean follow-up was 52.8 months. Overall pain visual analog scale scores improved significantly (P<.05) at rest and during activities of daily living and heavy manual work. Mean flexion-extension arc was 136.5°. Mean postoperative grip strength was 106 lb, which was significantly better than preoperative grip strength. Mean modified Mayo wrist score was 70 preoperatively and 94.7 postoperatively, a significant improvement. Overall functional outcomes according to the modified Mayo wrist score were rated as excellent in 13 wrists and good in 3. No patient had radiographic evidence of instability or arthritic changes. The scapholunate and lunotriquetral intervals in all patients were less than 3 mm on neutral and pronation grip radiographs. On lateral radiographs, no signs of intercalated segmental instability were seen, with a mean scapholunate angle of 55.3°. The results of this study suggest that arthroscopic debridement and thermal shrinkage provide symptomatic pain relief and prevention of intercarpal instability for a significant period of time in patients with partial intercarpal ligament tear. PMID:22868606

Lee, Jung I L; Nha, Kyung Wook; Lee, Guen Young; Kim, Baek Hyun; Kim, Jung Wook; Park, Jong Woong

2012-08-01

281

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

282

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

283

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

284

Modified Arthroscopic Latarjet Procedure With Coracoid Exteriorization for Treatment of Anterior Glenohumeral Instability  

PubMed Central

The Latarjet procedure for treating anterior glenohumeral instability includes transfer of the coracoid and biceps tendon to the anterior glenoid. A modified method for the arthroscopic procedure was developed to facilitate the procedure and minimize the risk of injury to the brachial plexus. The detached coracoid was exteriorized through the anteroinferior portal for drilling and shaping. A Coracoid Drill Guide (Arthrex, Naples, FL) was used to help cut the coracoid to the desired size and make 2 drill holes in the coracoid for fixation to the glenoid. The Coracoid Transfer Instrument (Acierart, Masku, Finland) was designed to facilitate coracoid transfer and serve as a pin guide for fixation. Ten patients with severe anterior glenohumeral instability were treated with this technique. They had only mild to moderate postoperative pain. There were no postoperative infections or recurrent dislocations. The safety of this operation was similar to that of other operations on the coracoid process in the proximity of the brachial plexus. The modified arthroscopic Latarjet procedure may be applied successfully to the treatment of anterior glenohumeral instability, with good patient satisfaction and functional outcome. PMID:24400183

Ranne, Juha O.; Kainonen, Terho U.; Lehtinen, Janne T.; Heinonen, Olli J.

2013-01-01

285

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

PubMed Central

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

Kostov, Hristijan; Stojmenski, Slavcho; Kostova, Elena

2014-01-01

286

Two-stage arthroplasty for the treatment of chronic osteomyelitis after routine arthroscopic knee surgery.  

PubMed

Corynebacterium pseudodiphtheriticum is a normal inhabitant of the upper respiratory tract and is rarely thought of as a true pathogen. Although this microorganism has been associated with respiratory complications, a few case reports have demonstrated its ability to cause orthopedic infections. A recent review of the literature was performed regarding this specific bacteria and its association with bone and joint infection. To the author's knowledge, the current case is the first reported case of chronic osteomyelitis from Corynebacterium pseudodiphtheriticum after arthroscopic knee surgery. Isolation of this bacterial species on routine microbial cultures has been proven to be challenging in prior studies. In the current case, difficulty isolating this bacterial species on routine cultures led to a significant delay in diagnosis, which ultimately resulted in end-stage joint destruction. Treatment of the infection was accomplished using a 2-stage total knee arthroplasty technique, with the initial placement of an articulated, antibiotic-loaded spacer followed by a subsequent conversion to total knee arthroplasty. This case serves as a useful reminder that clinically subtle infections can occur after minor orthopedic surgery. Surgeons must remain vigilant to render a timely diagnosis and avoid severe sequelae that can result from an undetected pathogen after arthroscopic surgery. PMID:23276341

Moyad, Thomas F

2013-01-01

287

Intravascular Ultrasound (IVUS): A Potential Arthroscopic Tool for Quantitative Assessment of Articular Cartilage  

PubMed Central

Conventional ultrasound examination of the articular cartilage performed externally on the body surface around the joint has limited accuracy due to the inadequacy in frequency used. In contrast to this, minimally invasive arthroscopy-based ultrasound with adequately high frequency may be a better alternative to assess the cartilage. Up to date, no special ultrasound transducer for imaging the cartilage in arthroscopic use has been designed. In this study, we introduced the intravascular ultrasound (IVUS) for this purpose. An IVUS system with a catheter-based probe (Ø ? 1mm) was used to measure the thickness and surface acoustical reflection of the bovine patellar articular cartilage in vitro before and after degeneration induced by enzyme treatments. Similar measurement was performed using another high frequency ultrasound system (Vevo) with a probe of much larger size and the results were compared between the two systems. The thickness measured using IVUS was highly correlated (r = 0.985, p < 0.001) with that obtained by Vevo. Thickness and surface reflection amplitude measured using IVUS on the enzymatically digested articular cartilage showed changes similar to those obtained by Vevo, which were expectedly consistent with previous investigations. IVUS can be potentially used for the quantitative assessment of articular cartilage, with its ready-to-use arthroscopic feature. PMID:19662152

Huang, Yan-Ping; Zheng, Yong-Ping

2009-01-01

288

Arthroscopic osteochondral autograft transplantation for chondral lesion of the tibial plateau of the knee.  

PubMed

Arthroscopic osteochondral autograft transplantation is often used to treat chondral/osteochondral lesions of the femoral condyle of the knee. However, arthroscopic autologous osteochondral grafting to the tibial plateau has not been reported. We report the surgical technique and the clinical course of a patient who underwent engraftment by this method. A 26-year-old man developed symptoms of pain and catching in his knee. Arthroscopy revealed a deep chondral lesion, 10 x 15 mm in size, down to the subchondral bone on the posterocentral area of the lateral tibial plateau. The injured cartilage was debrided using a curette and an abrader until normal healthy cartilage bordered the debrided defect. An osteochondral plug, 10 mm in diameter and 20 mm long, the chondral surface of which was orientated 25 degrees obliquely, was harvested from the most peripheral and proximal part of the lateral patellar groove. A bony hole was created in the center of the defect through the tibia using a core reamer. The osteochondral plug was inserted from the tibial window through the bony hole. To enhance the stability of the osteochondral fragment, bioactive ceramic fillers were used to fill the space below the plug. A second-look arthroscopy 10 months after surgery showed that the grafted osteochondral plug was well adapted and integrated into the surrounding cartilage on the lateral tibial plateau. PMID:11447556

Matsusue, Y; Kotake, T; Nakagawa, Y; Nakamura, T

2001-07-01

289

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

290

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

291

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

PubMed

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

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

2014-06-01

292

Sensing of repair in chemically self-repairing composites  

NASA Astrophysics Data System (ADS)

The question to be answered in this paper is how "does a user determine if a chemical self repair system has succeeded in self repairing damage". Three sensing methods indicated that chemical has been released into damage areas, another four methods were used to indicate that the container or encapsulator had been broken to release repair chemical, but only one method is known to indicate that the chemical reaction of the repair chemical has been accomplished. Many other methods were used to assess the structural or dynamic efficacy of the repairs. These methods of sensing of repair action are detailed with experimental data and results. The novel and ground breaking method of determining repair efficacy receives most emphasis.

Dry, Carolyn

2014-04-01

293

Arthroscopic Treatment of Osteochondral Lesions of the Ankle With Matrix-Associated Chondrocyte ImplantationEarly Clinical and Magnetic Resonance Imaging Results  

Microsoft Academic Search

Background: Conventional autologous chondrocyte transplantation in the ankle often requires tibial or fibular osteotomies with potential morbidity for the patient. Advances in biotechnology and surgical techniques have resulted in the development of matrix-associated chondrocyte implantation (MACI). As the chondrocyte-loaded scaffold can be applied arthroscopically, this procedure is especially useful for the treatment of osteochondral defects in the ankle.Hypothesis: Arthroscopic MACI

Matthias Aurich; Harvinder S. Bedi; Peter J. Smith; Bernd Rolauffs; Thomas Mückley; James Clayton; Mark Blackney

2011-01-01

294

Minimally Invasive Spigelian Hernia Repair  

PubMed Central

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

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

2009-01-01

295

Prokaryotic Nucleotide Excision Repair  

PubMed Central

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

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

2014-01-01

296

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

PubMed Central

Background Intra-articular adhesion (IA) is one of the important pathologic signs of intracapsular temporomandibular joint (TMJ) diseases, but this factor has been rarely described with respect to its arthroscopic characteristics and histology. The purpose of this study was to describe the incidence and distribution of IA in patients with internal derangement (ID) and to investigate the correlation between adhesions and the clinical symptoms of patients with ID of TMJ with closed-lock. Methods A retrospective analysis was conducted of 1822 TMJs with ID that were refractory to nonsurgical treatments and underwent arthroscopic surgery between May 2001 and June 2008 in our department. Clinical findings were assessed on the basis of mandibular range of motion, patients' age and locking duration at the initial visit. ID stages were judged according to the Wilkes and Bronstein classification based on clinical symptoms and pre-operative magnetic resonance imaging. 1506 patients (1822 joints) with ID were divided into an adhesion group (486 patients) and a non-adhesion group (1020 patients). The associations between the two groups with respect to interincisal opening, clicking duration, locking duration and patients' age were statistically analyzed using a t-test. Results Arthroscopy confirmed occurrences of adhesion in 28.76% of the joints (524 joints out of a total of 1822). Grade 1 adhesion was found in 68.89% of those cases; grade 2 in 20.61%; grade 3 in 4.58%; and grade 4 in 5.92%. The percentages of instances of adhesion in different stages were as follows: 13.89% of the joints in Stage II had adhesion, 25.47% in Stage III, 37.99% in Stage IV, and 40.37% in Stage V. There were statistically significant differences for patients' age (t = 10.41, P < 0.001), interincisal opening (t = 9.54, P < 0.001), paining duration (t = 3.66, P < 0.001) and locking duration (t = 3.89, P < 0.001) between the two groups, while no statistically significant difference was found for clicking duration (t = 1.08, P > 0.05). Conclusion The arthroscopic findings confirmed that the incidence ratio of adhesion was high and occurred predominantly with older patients with longer locking duration and less interincisal opening. As the stage of ID increased, the adhesion grade rose. PMID:19534789

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

2009-01-01

297

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

298

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

PubMed Central

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

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

2014-01-01

299

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

PubMed Central

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

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

2014-01-01

300

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

301

“Relaxed” Biceps Proximal Tenodesis: An Arthroscopic Technique With Decreased Residual Tendon Tension  

PubMed Central

Tenodesis of the long head of the biceps tendon (LHB) at the upper part of the bicipital groove has been related to persistent postoperative bicipital pain. This is possibly due to the inflammation of the remaining tendon within the groove. This, in turn, could be attributed to the continual mechanical stress placed on the tendon in the narrow bicipital groove. Theoretically, should the LHB be more “relaxed,” the mechanical stress applied on it would be diminished. On the basis of this rationale, we present an arthroscopic biceps tenodesis technique, according to which the tendon is fixed at the entrance of the bicipital groove, using a bioabsorbable screw, relaxed by 5 mm. In this lax position, the residual LHB tension is expected to be decreased compared with the initial tension, whereas no cosmetic deformity (Popeye sign) or impaired muscular performance is anticipated. PMID:25473621

Valenti, Philippe; Benedetto, Ivan; Maqdes, Ali; Lima, Sara; Moraiti, Constantina

2014-01-01

302

All-Inside Meniscal Repair  

PubMed Central

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

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

2009-01-01

303

Endovascular infrarenal abdominal aortic aneurysm repair  

Microsoft Academic Search

Abdominal aortic aneurysm repair has undergone a revolution since Volodos and Parodi described endoluminal repair in the early 1990s. Subsequent data from large registries have confirmed its efficacy. Randomised controlled trials have shown that although endoluminal repair may not be as cost effective as open repair, it can be performed with a lower mortality in patients fit for open repair.

M Davis; P R Taylor

2008-01-01

304

Analgesic effect of intra-articular magnesium sulphate compared with bupivacaine after knee arthroscopic menisectomy  

PubMed Central

This work aimed to evaluate the analgesic efficacy of intra-articular injection of magnesium sulphate (4%) compared with equivalent volume of bupivacaine (0.5%) after outpatient knee arthroscopic meniscectomy. Forty patients were randomly assigned to two groups. Group M (n = 20) received intra-articular magnesium sulphate 4%, group B (n = 20) received bupivacaine (0.5%). Analgesic effect was evaluated by analgesic duration, and by measuring pain intensity at 1, 2, 4, 6, 12, 24 h both at rest and on knee movement to 90°. The primary outcome variable was pain intensity on the VAS at 1, 2, 4, 6, 12, 24 h post arthroscopy at rest and on movement (flexion of knee to 90°), although the magnesium group had lower time weighted averages (TWAs) at rest and on movement, these TWAs were not statistically significant. The median duration of postoperative analgesia was significantly longer in the patients treated with magnesium sulphate (528 min) than in the bupivacaine group (317 min) (p < 0.0001), with less number of patients needing supplementary analgesia in magnesium group (8/20) than those of the bupivacaine group (16/20) (p < 0.022). Also analgesic consumption was significantly lower in the magnesium sulphate group (p < 0.002). We concluded that the use of magnesium sulphate is rational and effective in reducing pain, and is more physiological and shortens convalescence after outpatient arthroscopic meniscectomy, however our hypotheses that analgesic efficacy of intra-articular isotonic magnesium sulphate would be superior to intra-articular local anaesthetic cannot be supported with this study.

Radwan, Yasser A.; Alfeky, Atef A.; Faramawi, Mohammed F.

2012-01-01

305

Target-controlled infusion (Propofol) versus inhaled anaesthetic (Sevoflurane) in patients undergoing shoulder arthroscopic surgery  

PubMed Central

Background: One of the challenges of anaesthesia for shoulder arthroscopic procedures is the need for controlled hypotension to lessen intra-articular haemorrhage and thereby provide adequate visualisation to the surgeon. Achievement of optimal conditions necessitates several interventions and manipulations by the anaesthesiologist and the surgeon, most of which directly or indirectly involve maintaining intra-operative blood pressure (BP) control. Aim: This study aimed to compare the efficacy and convenience of target controlled infusion (TCI) of propofol and inhalational agent sevoflurane in patients undergoing shoulder arthroscopic surgery after preliminary inter-scalene blockade. Methods: Of thirty four patients studied, seventeen received TCI propofol (target plasma concentration of 3 ?g/ml) and an equal number, sevoflurane (1.2-1.5 Minimum Alveolar Concentration). N2O was used in both groups. Systolic, diastolic, mean blood pressures and heart rate were recorded regularly throughout the procedure. All interventions to control BP by the anaesthesiologist and pump manipulation requested by the surgeon were recorded. The volume of saline irrigant used and the haemoglobin (Hb) content of the return fluid were measured. Results: TCI propofol could achieve lower systolic, mean BP levels and the number of interventions required was also lower as compared to the sevoflurane group. The number of patients with measurable Hb was lower in the TCI propofol group and this translated into better visualisation of the joint space. A higher volume of saline irrigant was required in the sevoflurane group. No immediate peri-operative anaesthetic complications were noted in either category. Conclusion: TCI propofol appears to be superior to and more convenient than sevoflurane anaesthesia in inter-scalene blocked patients undergoing shoulder arthroscopy. PMID:23716764

Tantry, Thrivikrama Padur; Muralishankar, BG; Adappa, Karunakara Kenjar; Bhandary, Sudarshan; Shetty, Pramal; Shenoy, Sunil P

2013-01-01

306

Long-term results of arthroscopic excision of unstable osteochondral lesions of the lateral femoral condyle.  

PubMed

The purpose of this study was to evaluate the long-term functional and radiological outcomes of arthroscopic removal of unstable osteochondral lesions with subchondral drilling in the lateral femoral condyle. We reviewed the outcome of 23 patients (28 knees) with stage III or IV osteochondritis dissecans lesions of the lateral femoral condyle at a mean follow-up of 14 years (10 to 19). The functional clinical outcomes were assessed using the Lysholm score, which improved from a mean of 38.1 (SD 3.5) pre-operatively to a mean of 87.3 (SD 5.4) at the most recent review (p = 0.034), and the Tegner activity score, which improved from a pre-operative median of 2 (0 to 3) to a median of 5 (3 to 7) at final follow-up (p = 0.021). The radiological degenerative changes were evaluated according to Tapper and Hoover's classification and when compared with the pre-operative findings, one knee had grade 1, 22 knees had grade 2 and five knees had grade 3 degenerative changes. The overall outcomes were assessed using Hughston's rating scale, where 19 knees were rated as good, four as fair and five as poor. We found radiological evidence of degenerative changes in the third or fourth decade of life at a mean of 14 years after arthroscopic excision of the loose body and subchondral drilling for an unstable osteochondral lesion of the lateral femoral condyle. Clinical and functional results were more satisfactory. PMID:22323683

Lim, H-C; Bae, J-H; Park, Y-E; Park, Y-H; Park, J-H; Park, J-W; Suh, D-H

2012-02-01

307

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

308

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

309

DNA repair in Mycoplasma gallisepticum  

PubMed Central

Background DNA repair is essential for the maintenance of genome stability in all living beings. Genome size as well as the repertoire and abundance of DNA repair components may vary among prokaryotic species. The bacteria of the Mollicutes class feature a small genome size, absence of a cell wall, and a parasitic lifestyle. A small number of genes make Mollicutes a good model for a “minimal cell” concept. Results In this work we studied the DNA repair system of Mycoplasma gallisepticum on genomic, transcriptional, and proteomic levels. We detected 18 out of 22 members of the DNA repair system on a protein level. We found that abundance of the respective mRNAs is less than one per cell. We studied transcriptional response of DNA repair genes of M. gallisepticum at stress conditions including heat, osmotic, peroxide stresses, tetracycline and ciprofloxacin treatment, stationary phase and heat stress in stationary phase. Conclusions Based on comparative genomic study, we determined that the DNA repair system M. gallisepticum includes a sufficient set of proteins to provide a cell with functional nucleotide and base excision repair and mismatch repair. We identified SOS-response in M. gallisepticum on ciprofloxacin, which is a known SOS-inducer, tetracycline and heat stress in the absence of established regulators. Heat stress was found to be the strongest SOS-inducer. We found that upon transition to stationary phase of culture growth transcription of DNA repair genes decreases dramatically. Heat stress does not induce SOS-response in a stationary phase. PMID:24148612

2013-01-01

310

Arthroscopic decompression of an entrapped suprascapular nerve due to an ossified superior transverse scapular ligament: a case report  

PubMed Central

Introduction Suprascapular neuropathy is an uncommon cause of shoulder pain and weakness and therefore is frequently misdiagnosed. As a consequence, misdiagnosis can include inappropriate conservative treatment or unsuccessful surgical procedure. Case presentation A rare case is reported of a 54-year-old woman who suffered from suprascapular nerve entrapment syndrome. The patient was subjected to arthroscopy of the left shoulder, where a compression of the suprascapular nerve due to an ossified superior transverse scapular ligament was diagnosed. The arthroscopic release of the suprascapular nerve brought relief from pain, weakness and atrophy of the supraspinatus and infraspinatus muscles. Conclusion Arthroscopic decompression of the entrapped suprascapular nerve is technically challenging, but less invasive and potentially a more effective way to treat suprascapular neuropathy, as it may provide a more rapid recovery, especially in the rare case that the nerve is depressed by an ossified superior transverse scapular ligament. PMID:19918464

Sergides, Neoptolemos N; Boukoros, Euangelos; Papagiannopoulos, George

2009-01-01

311

Rotator Cuff Repair Rehabilitation  

PubMed Central

Background There is no consensus for the optimal postoperative rehabilitation protocol after rotator cuff repairs. Objective To determine if there is sufficient level I or II evidence available in the literature for establishment of a uniform, optimal rotator cuff rehabilitation protocol. Data Sources A systematic review of level I and II English-language, prospective, randomized controlled trials published between 1966 and 2008 was performed. MEDLINE, EMBASE, the Cochrane Database of Systematic Reviews, and secondary references were appraised for studies that met the inclusion criteria. Search terms included rotator cuff, supraspinatus, infraspinatus, subscapularis, teres minor, rehab, rehabilitation, physical therapy, and physiotherapy. Study Selection Inclusion criteria were English-language level I or level II studies, including randomized clinical trials involving the rehabilitation of rotator cuff repairs. Exclusion criteria were non-English language, level IV or V studies, or studies involving shoulder rehabilitation of diagnoses other than rotator cuff repairs. Three independent reviewers arrived at a consensus for including 4 studies in this review out of 12 studies identified by the literature search. Data Extraction Included studies underwent worksheet quality appraisal independently by each of the 3 authors identifying strengths, weaknesses, and biases. The quality appraisal was then discussed among the authors and consensus reached regarding the strengths, weaknesses, and value of the included studies. Results Two studies examined the use of continuous passive motion for rotator cuff rehabilitation, and 2 studies compared an unsupervised, standardized rehabilitation program to a supervised, individualized rehabilitation program. These studies did not support the use of continuous passive motion in rotator cuff rehabilitation, and no advantage was shown with a supervised, individualized rehabilitation protocol compared to an unsupervised, standardized home program. Each investigation had weaknesses in study design that decreased the validity of its findings. Conclusion There is not enough high-level evidence to develop an evidence-based medicine approach to rotator cuff rehabilitation. There is a need for well-designed level I and level II trials to elucidate the optimal rotator cuff repair rehabilitation protocol. PMID:23015863

Baumgarten, Keith M.; Vidal, Armando F.; Wright, Rick W.

2009-01-01

312

A case of arthroscopic removal of symptomatic ossicle associated with Osgood–Schlatter disease in an athletic  

Microsoft Academic Search

Osgood–Schlatter’s disease (OSD) is common and generally treated conservatively. However, surgical treatment is necessary\\u000a for some patients with recurrent or persistent pain that does not respond to conservative treatment. We present a case of\\u000a arthroscopic excision of ossicle associated with OSD that did not respond to conservative treatment. A 30-year-old rugby player\\u000a presented with a 3-year history of anterior knee

Yong Seuk Lee; Jin Hwan Ahn; Dong-Il Chun; Jae Ho Yoo

2011-01-01

313

ARTHROSCOPIC SUBACROMIAL DECOMPRESSION FOR ADVANCED (STAGE II) IMPINGEMENT SYNDROME : A STUDY OF 52 PATIENTS WITH FIVE YEARS FOLLOW-UP  

Microsoft Academic Search

The authors report a prospective five-year follow-up study of 52 patients who had arthroscopic subacro- mial decompression for advanced (stage II : type 1 and 2) rotator cuff disease. All patients were assessed preoperatively, at six months and at five years post- operatively using the Constant-Murley score and the revised American Shoulder and Elbow Surgeons (ASES) score. From six months

K. DOM

314

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

315

Industrial motor repair in the United States  

SciTech Connect

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

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

1994-09-01

316

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.

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

2015-01-01

317

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

318

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

319

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

PubMed Central

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

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

2013-01-01

320

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

321

Repair in Foreign Language Teaching.  

ERIC Educational Resources Information Center

Analyzes four types of repair activity in the foreign language classroom. A distinction is made according to whether the trouble source is produced by a teacher or a learner. Findings show that different preferences for repair patterns vary with the type of classroom activity (language-centered or content-centered). (Author/SED)

Kasper, Gabriele

1985-01-01

322

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

323

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.

324

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.

325

PTEN in DNA damage repair  

PubMed Central

The ability of DNA repair in a cell is vital to its genomic integrity and thus to the normal functioning of an organism. Phosphatase and tensin homolog (PTEN) is a well-established tumor suppressor gene that induces apoptosis and controls cell growth by inhibiting the PI3K/AKT pathway. In various human cancers, PTEN is frequently found to be mutated, deleted, or epigenetically silenced. Recent new findings have demonstrated that PTEN also plays a critical role in DNA damage repair and DNA damage response. This review summarizes the recent progress in the function of PTEN in DNA damage repair, especially in double strand break repair and nucleotide excision repair. In addition, we will discuss the role of PTEN in DNA damage response through its interaction with the Chk1 and p53 pathways. We will focus on the newly discovered mechanisms and the potential implications in cancer prevention and therapeutic intervention. PMID:22266095

Ming, Mei; He, Yu-Ying

2012-01-01

326

School Equipment--Repair or Replace?  

ERIC Educational Resources Information Center

Objective evaluations of whether to repair or replace existing school equipment depend on an equipment inventory, evaluation of equipment suitability, and knowledge of repair possibilities and costs. (MLF)

Patterson, Don E.

1983-01-01

327

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

...repair proficient and repair deficient bacteria: âBacterial DNA damage or repair tests...repair proficient and repair deficient bacteria: “Bacterial DNA damage or repair tests...growth inhibition of repair deficient bacteria in a set of repair proficient and...

2014-07-01

328

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

Code of Federal Regulations, 2012 CFR

...repair proficient and repair deficient bacteria: âBacterial DNA damage or repair tests...repair proficient and repair deficient bacteria: “Bacterial DNA damage or repair tests...growth inhibition of repair deficient bacteria in a set of repair proficient and...

2012-07-01

329

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

Code of Federal Regulations, 2013 CFR

...repair proficient and repair deficient bacteria: âBacterial DNA damage or repair tests...repair proficient and repair deficient bacteria: “Bacterial DNA damage or repair tests...growth inhibition of repair deficient bacteria in a set of repair proficient and...

2013-07-01

330

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

Code of Federal Regulations, 2011 CFR

...repair proficient and repair deficient bacteria: âBacterial DNA damage or repair tests...repair proficient and repair deficient bacteria: “Bacterial DNA damage or repair tests...growth inhibition of repair deficient bacteria in a set of repair proficient and...

2011-07-01

331

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

Code of Federal Regulations, 2010 CFR

...repair proficient and repair deficient bacteria: âBacterial DNA damage or repair tests...repair proficient and repair deficient bacteria: “Bacterial DNA damage or repair tests...growth inhibition of repair deficient bacteria in a set of repair proficient and...

2010-07-01

332

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 Kjølhede; Bohr, Vilhelm A.; Stevnsner, Tinna

2011-01-01

333

Endoscopic Proximal Hamstring Repair and Ischial Bursectomy  

PubMed Central

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

Dierckman, Brian D.; Guanche, Carlos A.

2012-01-01

334

Groin hernia repair: open techniques.  

PubMed

Since the introduction of the Bassini method in 1887, more than 70 types of pure tissue repair have been reported in the surgical literature. An unacceptable recurrence rate and prolonged postoperative pain and recovery time after tissue repair along with our understanding of the metabolic origin of inguinal hernias led to the concept of tension-free hernioplasty with mesh. Currently, the main categories of inguinal hernia repair are the open repairs and the laparoscopic repairs. In the open category, repair of the hernia is achieved by pure tissue approximation or by tension-free mesh repair. The most commonly performed tissue repairs are those of Bassini, Shouldice, and to a lesser extent McVay. In the tension-free mesh repair category, the mesh is placed in front of the transversalis fascia, such as with the Lichtenstein tension-free hernioplasty, or behind the transversalis fascia in the preperitoneal space, such as during the Nyhus, Rives, Read, Stoppa, Wantz, and Kugel procedures. Numerous comparative randomized trials have clearly demonstrated the superiority of the tension-free mesh repair over the traditional tissue approximation method. Placing mesh behind the transversalis fascia, although a sound concept, requires extensive dissection in the highly complex preperitoneal space and can lead to injury of the pelvic structures, major hematoma formation, or both. In addition, according to the prospective randomized comparative study of mesh placement in front of versus behind the transversalis fascia, the latter offers no advantage over the former, and it is more difficult to perform, learn, and teach. More importantly, preperitoneal mesh implantation (via open and laparoscopic procedure) leads to obliteration of the spaces of Retzius and Bogros, making certain vascular and urologic procedures, in particular radical prostatectomy and lymph node dissection, extremely difficult if not impossible. In conclusion, according to level A evidence from randomized comparative studies, (1) mesh repair is superior to pure tissue approximation repairs, and (2) mesh implantation in front of the transversalis fascia is superior, safer, and easier than open or laparoscopic mesh implantation behind the transversalis fascia. PMID:15983714

Amid, Parviz K

2005-08-01

335

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

336

Bonded composite repair of composite structures  

Microsoft Academic Search

Repair and maintenance cost drives a large percentage of the lifetime cost of aircraft structures. Understanding repair issues can lead to a structure that significantly lowers the lifetime cost. Advanced composite materials, while offering the potential to increase aircraft capabilities with minimum weight, are more susceptible to repairable damage than conventional aircraft materials. Improved inspection and repair methods are required

Mary A. Mahler

1999-01-01

337

Performance optimization of electronic circuits laser repair  

NASA Astrophysics Data System (ADS)

Electronics circuits are susceptible to production defects. Yield improvement can be obtained by in-process inspection and repair of these defects. We describe an automated laser repair system, and discuss how to optimize it to obtain best performance in terms of throughput and quality. The laser repair system can repair excess conductor defects (e.g., shorts) in printed circuit boards by an ablation process. Moreover, it includes a feedback loop by capturing images of the repaired area using a co-aligned imaging system. Here we present the automated laser system design and repair process as well as repair performance optimization.

Oron, Ram

2014-03-01

338

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

339

DNA repair and synthetic lethality  

PubMed Central

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

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

2011-01-01

340

Arthroscopic excision of an ununited ossicle due to Osgood-Schlatter disease.  

PubMed

Surgical excision of the ossicles has been suggested for unresolved sequelae of Osgood-Schlatter disease in adults resistant to conservative measures. A 24-year-old, male semiprofessional soccer player had anterior knee pain during sports activity and climbing stairs that had been treated conservatively for 2 years. On physical examination, there was a permanent tibial tubercle with pain. On radiographic examination, an ununited ossicle was seen beneath the patellar tendon. Arthroscopy was performed through the standard low anterolateral and anteromedial portals close to the patellar tendon. Soft tissue at the retropatellar surface and the inflamed infrapatellar fat pad beneath the patellar tendon were debrided with a motorized shaver. Localization of the ununited ossicle was performed by use of an image intensifier. The ossicle was separated from the surrounding soft tissue with a motorized shaver and removed by use of a grasper. After excision of the ossicle, the inflamed surface of the retropatellar tendon was also debrided. The contouring of the irregular surface of the tibial tubercle was performed by use of a motorized bur. After 6 weeks, the patient returned to sports activities without any restrictions. This study showed that all of the described procedures might be done arthroscopically and sports activity may be allowed earlier. PMID:18760218

Beyzadeoglu, Tahsin; Inan, Muharrem; Bekler, Halil; Altintas, Faik

2008-09-01

341

Arthroscopic rotator interval closure by purse string suture for symptomatic inferior shoulder instability.  

PubMed

Multidirectional instability of the shoulder is a complex condition that can be difficult to diagnose and treat. Clinically, it is characterized by symptomatic global laxity of the glenohumeral joint and may present either traumatically or atraumatically, unilaterally or bilaterally, and with or without generalized joint laxity. Capsular plication is a primary treatment option in these patients and is used to tension the redundant or lax capsule. We evaluated the role of rotator interval closure in restoring stability as a primary procedure in patients with multidirectional instability and a positive and painful sulcus sign.Twenty adult patients (16 men and 4 women) presenting with multidirectional instability were evaluated clinically and radiologically to assess the degree and direction of instability, were treated by arthroscopic rotator interval closure and inferior capsular plication, and were followed up for a minimum of 2 years. Clinical and functional results were excellent at 2-year follow-up. The results of the study indicate that the closure of the rotator interval in patients with symptomatic inferior instability will have a long-lasting effect on the stability and function of the shoulder, as the closure improves not only the static restraints but also the dynamic restraints of the shoulder through the improved proprioception secondary to restoration of the rotator interval structures. PMID:21469638

Moon, Young Lae; Singh, Harpreet; Yang, Hun; Chul, Lee Kwang

2011-04-01

342

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

PubMed Central

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

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

2011-01-01

343

A novel arthroscopic technique utilizing bone morphogenetic protein in the treatment of Kienböck disease.  

PubMed

Kienböck disease, first described in 1910, is osteonecrosis of the carpal lunate and has been associated with ulnar minus variance. Numerous joint leveling procedures have been developed for patients with ulnar-negative variance to decrease forces transmitted across the lunate. The basis of operative treatment is the presence or absence of advanced osteoarthritis associated with fragmentation of the carpal lunate and capitate descent. Bone morphogenetic proteins (BMPs) have been utilized successfully as adjunctive treatment in fracture healing and recently in the surgical treatment of a patient with Lichtman stage IIIA Kienböck disease. Arthroscopy is an available tool in assessing cartilage injury and coupled with the use of BMP may be of benefit in patients with ulnar-neutral or ulnar-negative wrists who have not progressed to severe arthritis and capitate descent. We report a novel arthroscopic technique in which a stage IIIA and IIIB carpal lunate osteonecrosis is treated by curettage and grafting with an admixture of autologous radial cancellous bone marrow graft and BMP-2. PMID:23423227

Rajfer, Rebecca A; Danoff, Jonathan R; Metzl, Joshua A; Rosenwasser, Melvin P

2013-03-01

344

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

345

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

PubMed Central

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

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

2014-01-01

346

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

347

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

348

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

PubMed

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

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

2014-08-01

349

Effects of Preoperative Non-Steroidal Anti-Inflammatory Drugs on Pain Mitigation and Patients' Shoulder Performance Following Rotator Cuff Repair  

PubMed Central

Purpose: Pain is one of the most important factors adversely affecting clinical outcomes of operated patients. The present study aims at evaluating effects of preoperative COX2 non-steroidal anti-inflammatory inhibitors on pain mitigation and performance of patients with shoulder rotator cuff tear. Methods: This case-control study was conducted on 60 patients suffering from rotator cuff injury candidate for arthroscopic repair. The patients were classified in two parallel and matched groups. One group (case group) was treated using Celecoxib (200mg/12h) started 48 hours before surgery and continued for 10 days after operation. In the control group, the placebo was prescribed in the same way. Postoperative pain, side effects, sleep disturbance, and short-term outcomes were compared between two groups using DASH questionnaire. Results: Postoperative pain in the Celecoxib group significantly decreased in comparison with the control one. The difference was statistically meaningful (P<0.001). Well motion ability was seen in 80% of patients of the Celecoxib group. It was 26.6% in the placebo group since pain inhibited them from exercising more motions. In this regard, there was a statistically meaningful difference between these two groups (P=0.02). Sleep disturbance was meaningfully at higher levels in the placebo group (P=0.001). Following up the patients for three months, it was made clear that performance of the Celecoxib group was better than that of the placebo one. Conclusion: COX2 inhibitors are well efficient in patients' pain management after arthroscopic rotator cuff repair surgery. It results in less life complications, less sleep disturbances, improvement of patients' short-term clinical outcome, and more quick recovery. PMID:25436192

Rouhani, Alireza; Tabrizi, Ali; Elmi, Asghar; Abedini, Naghi; Mirza Tolouei, Fardin

2014-01-01

350

MR imaging of meniscal bucket-handle tears: a review of signs and their relation to arthroscopic classification.  

PubMed

Our objective was to review the MR imaging signs of meniscal bucket-handle tears and assess the relevance of these signs to the arthroscopic classification of displaced meniscal tears. Forty-five menisci in 42 patients who had a diagnosis of bucket-handle tear either on MR imaging or on subsequent arthroscopy (in which Dandy's classification of meniscal tears was used) were retrospectively analyzed for MR imaging findings of double posterior cruciate ligament (PCL), fragment within the intercondylar notch, absent bow tie, flipped meniscus, double-anterior horn, and disproportional posterior horn signs. Arthroscopy, which was considered as the gold standard, revealed 41 bucket-handle tears (either diagnosed or not diagnosed by MR imaging) in 38 patients (33 males, 5 females). There was a statistically significant male preponderance for the occurrence of meniscal bucket-handle tears. Overall, sensitivity and positive predictive value of MR imaging for the detection of meniscal bucket-handle tears were calculated as 90%. Common MR imaging signs of meniscal bucket-handle tears in arthroscopically proven cases of such tears were the fragment in the notch and absent bow tie signs (98% frequency for each). Double-PCL, flipped meniscus, double-anterior horn, and disproportional posterior horn signs, however, were less common (32, 29, 29, and 27%, respectively). An arthroscopically proven bucket-handle tear was found in all patients who displayed at least three of the six MR imaging signs of meniscal bucket-handle tears. The presence of three or more MR imaging signs of meniscal bucket-handle tears is highly suggestive of this condition. PMID:12594567

Aydingöz, Ustün; Firat, Ahmet K; Atay, O Ahmet; Doral, M Nedim

2003-03-01

351

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

352

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.Molecular Therapy (2014); doi:10.1038/mt.2014.198. PMID:25311491

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

2014-10-14

353

Regenerative Repair of Damaged Meniscus with Autologous Adipose Tissue-Derived Stem Cells  

PubMed Central

Mesenchymal stem cells (MSCs) are defined as pluripotent cells found in numerous human tissues, including bone marrow and adipose tissue. Such MSCs, isolated from bone marrow and adipose tissue, have been shown to differentiate into bone and cartilage, along with other types of tissues. Therefore, MSCs represent a promising new therapy in regenerative medicine. The initial treatment of meniscus tear of the knee is managed conservatively with nonsteroidal anti-inflammatory drugs and physical therapy. When such conservative treatment fails, an arthroscopic resection of the meniscus is necessary. However, the major drawback of the meniscectomy is an early onset of osteoarthritis. Therefore, an effective and noninvasive treatment for patients with continuous knee pain due to damaged meniscus has been sought. Here, we present a review, highlighting the possible regenerative mechanisms of damaged meniscus with MSCs (especially adipose tissue-derived stem cells (ASCs)), along with a case of successful repair of torn meniscus with significant reduction of knee pain by percutaneous injection of autologous ASCs into an adult human knee. PMID:24592390

Pak, Jaewoo; Lee, Jung Hun; Lee, Sang Hee

2014-01-01

354

Bonded composite repair of composite structures  

NASA Astrophysics Data System (ADS)

Repair and maintenance cost drives a large percentage of the lifetime cost of aircraft structures. Understanding repair issues can lead to a structure that significantly lowers the lifetime cost. Advanced composite materials, while offering the potential to increase aircraft capabilities with minimum weight, are more susceptible to repairable damage than conventional aircraft materials. Improved inspection and repair methods are required to ensure structural integrity and aircraft readiness in the existing operational environment. Many of today's innovative composite designs may result in aircraft structures that are unreasonably difficult to repair. As a first step, technical issues associated with bonded composite repair of composite structures were investigated. An extensive literature review identified many areas where real world composite repairs are being used successfully. An electronic database was developed summarizing the publications found during the literature review. The database includes publication, experimental test results and analytical results of advanced composite bonded repairs. The current analysis of repair does not account for the variations that exist in repair. To facilitate the analysis, a finite element interface was developed to provide analysts with a tool that would create complete finite element models of repaired structures efficiently and in a 3-dimensional view. The finite element models created by the developed interface were successfully correlated to test data for accuracy of the results. Parametric studies were performed using the interface to evaluate effects of repair variables. Thermal impact of repair on the repair panel is one area lacking attention in the repair literature. To understand the impact of heat and thermal gradients of the repair, an analytical investigation was performed to evaluate. the parameters affected by heat. For a solid laminate, the temperature at the adhesive bondline was investigated. The primary focus is on sandwich panels where heat transfer is known to impact the repair process. The internal pressure from the heat of the repair process and moisture trapped in honeycomb structure was evaluated and shown to produce sufficient pressure to disbond the facesheet from the core.

Mahler, Mary A.

355

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

356

Arthroscopically assisted combined anterior and posterior cruciate ligament reconstruction in the multiple ligament injured knee: 2- to 10-year follow-up  

Microsoft Academic Search

Purpose: This study presents the 2- to 10-year results of 35 arthroscopically assisted combined anterior cruciate ligament and posterior cruciate ligament (ACL\\/PCL) reconstructions evaluated preoperative and postoperatively using Lysholm, Tegner, and Hospital for Special Surgery knee ligament rating scales, KT-1000 arthrometer testing, stress radiography, and physical examination. Type of Study: Case series. Methods: This study population included 26 men and

Gregory C. Fanelli; Craig J. Edson

2002-01-01

357

Importance of the changes in joint effusion shown by magnetic resonance imaging before and after arthroscopic lysis and lavage of the temporomandibular joint  

Microsoft Academic Search

We investigated the changes in the amount of joint effusion estimated from T2-weighted magnetic resonance imaging (MRI) before and after arthroscopic lysis and lavage of the temporomandibular joint (TMJ). We studied 29 consecutive patients, each with internal derangement and osteoarthritis in one TMJ. Before operation, the MRI showed joint effusions in 22 of the patients (76%). After operation, the amount

J. Sato; N. Segami; K. Kaneyama; M. Nishimura; T. Suzuki

2002-01-01

358

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

359

Ruptured disc after arthroscopic repositioning in the temporomandibular joint: a retrospective magnetic resonance imaging study.  

PubMed

Our aim was to explore the incidence of rupture after arthroscopic repositioning of the disc of the temporomandibular joint (TMJ) by reviewing magnetic resonance images (MRI) of the TMJ taken before and after operation, and to investigate correlations retrospectively. We studied 247 patients with anterior disc displacement of the TMJ, and categorised them into 3 groups based on the postoperative MRI. The first group comprised those whose disc ruptured after repositioning, the second those who had a possible rupture of the disc after repositioning, and the third had no rupture of the disc after repositioning. Age, sex, duration of symptoms, maximum incisal mouth opening, whether the anterior disc displacement was unilateral or bilateral, and the Wilkes stage, were included in the analysis. The incidence of rupture (5/247) was 2%. Weak points at the intermediate zone of the disc were found in 4 of the 5 joints. The patients whose discs ruptured were significantly younger than the other 2 groups (p=0.001). There was no statistically significant difference in preoperative duration of symptoms and mouth opening among the groups. The proportions of unilateral and bilateral disc displacement (p=0.047) and Wilkes stage (p=0.027) differed among the 3 groups. The Wilkes stages was significantly more advanced in the ruptured group than in the other 2 groups (p=0.027) with 4/5 being bilateral. The weak point in the intermediate zone of the disc on MRI could be a sign of rupture. Teenagers and young adults with anterior disc displacement without reduction, particularly those in whom it is bilateral, are at a higher risk of a rupture after repositioning of the disc by arthroscopy. PMID:24736122

Li, Hui; Cai, Xieyi; Yang, Chi; Wang, Shaoyi; Huang, Linjian

2014-07-01

360

What Do the Patients Want and Worry in Korean Patients Who Undergo Arthroscopic Rotator Cuff Surgery?  

PubMed Central

Background To specify what patients want and worry preoperatively is important in orthopedic practice. The aim of the current study was to analyze the patient characteristics of rotator cuff disease in Korean population who were willing to undergo arthroscopic surgery, and to evaluate the differences in expectations and concerns by age and gender. Methods We prospectively enrolled 303 patients who underwent rotator cuff surgery between April 2004 and August 2008. Three questionnaires were completed before surgery: the first one addressing preoperative patient's expectation, the second one focusing on concerns by covering 64 items using a visual analogue scale, and the third one evaluating patient's demographic characteristics. The characteristics of preoperative expectation, concern, and demographic data were evaluated according to gender and age group. Results Female patients had lower level of sports activity (p = 0.007) and lower levels of information (p = 0.028). Gender specific worries are about a caregiver during hospital stay, operating on the working side, fear about ugly scars, postoperative pain, applying makeup or combing hair. The older group responded that they can't be willing to change activities of daily living (p = 0.001), are not living with a spouse (p = 0.002), had previous shoulder operation history (p = 0.008), and had a lower level of information (p = 0.007). They especially worried about medical bills, worried about the physician being too young and inexperienced, postoperative pain, loss of arm function, and hospital food. Conclusions Our data showed what Korean patients wanted and were concerned about prior to rotator cuff surgery. This can empower patients to formulate realistic expectations and make informed decisions. We feel that we can achieve higher levels of postoperative satisfaction by analyzing expectations and concerns in depth and addressing these proactively. PMID:23205237

Yoon, Jong Pil; Min, Woo-Kie; Kim, Joon Woo; Jeong, Won-Ju; Lee, Hyun-Joo

2012-01-01

361

Evaluation of Contrast Extravasation as a Diagnostic Criterion in the Evaluation of Arthroscopically Proven HAGL/pHAGL Lesions  

PubMed Central

Purpose. The validity of preoperative MRI in diagnosing HAGL lesions is debated. Various investigations have produced mixed results with regard to the utility of MRI. The purpose of this investigation is to apply a novel method of diagnosing HAGL/pHAGL lesions by looking at contrast extravasation and to evaluate the reliability of such extravasation of contrast into an extra-articular space as a sign of HAGL/pHAGL lesion. Methods. We utilized specific criteria to define contrast extravasation. We evaluated these criteria in 12 patients with arthroscopically proven HAGL/pHAGL lesion. We also evaluated these criteria in a control group. Results. Contrast extravasation occurred in over 83% of arthroscopically positive cases. Contrast extravasation as a diagnostic criterion in the evaluation of HAGL/pHAGL lesions demonstrated a high interobserver degree of agreement. Conclusions. In conclusion, extra-articular contrast extravasation may serve as a valid and reliable sign of HAGL and pHAGL lesions, provided stringent criteria are maintained to assure that the contrast lies in an extra-articular location. In cases where extravasation is not present, the “J” sign, though nonspecific, may be the only evidence of subtle HAGL and pHAGL lesions. Level of Evidence. Level IV, Retrospective Case-Control series. PMID:25530880

Maldjian, Catherine; Khanna, Vineet; Bradley, James; Adam, Richard

2014-01-01

362

COMPREHENSIVE POST?ARTHROSCOPIC MANAGEMENT OF A MIDDLE?AGED ADULT WITH GLENOHUMERAL OSTEOARTHRITIS: A CASE REPORT  

PubMed Central

Comprehensive Arthroscopic Management (CAM) is a new glenohumeral debridement procedure developed as a joint preserving alternative to total shoulder arthroplasty (TSA). The procedure consists of several arthroscopic components including: A. scar tissue and chondral debridement, B. synovectomy, C. inferior humeral osteoplasty, D. capsular release, E. axillary nerve decompression, and F. tenodesis of the long head of the biceps. In this case, an active, middle age patient who failed physical therapy treatment and corticosteroid injections was evaluated and diagnosed with glenohumeral osteoarthritis. Anterior? posterior (AP) and axillary radiographs showed grade IV changes of the articular cartilage, confirming the diagnosis. The patient was not an ideal candidate for TSA because of her age, activity level, and concern for implant survival; therefore surgical intervention was performed using the CAM procedure. After the surgery, the patient demonstrated increased joint space as shown using radiographic imaging. The patient underwent intensive postoperative rehabilitation with a heavy emphasis on joint range of motion (ROM) and capsular mobility. By eight weeks she achieved 85% active ROM compared to her uninvolved shoulder, and a 55% improvement on the Pennsylvania Shoulder Score. Radiographic imaging provided an understanding of the severity of the arthritic changes present in this patient, identified the limited potential of continued conservative management, and showed structural changes that may be correlated with improved function following the surgical intervention. For patients less than 55 years of age diagnosed with severe glenohumeral osteoarthritis, the CAM procedure and intensive, motion focused therapy presents a promising treatment combination. Level of Evidence: IIIb PMID:23439911

Olson, Thomas; Millett, Peter

2013-01-01

363

Arthroscopic partial meniscectomy: a 12-year follow-up and two-step evaluation of the long-term course.  

PubMed

The long-term results after arthroscopic partial meniscectomy of 119 patients with a mean follow-up of 12 years are presented in this study. The same series of patients had an earlier follow-up 4 years postoperatively. Thus, an evaluation of the actual long-term course and not only a single result after partial meniscectomy is presented. Arthroscopic partial meniscectomy is shown to be the definitive means of therapy for meniscal lesion of the knee joint; 91.7% of patients had an excellent or good result 4 years after surgery, and 78.1% rated excellent or good 12 years after surgery. Full recovery regarding ability to work and sports activity level was achieved in a very high percentage of patients. Early results were mostly representative and did not change significantly during the long-term course for the isolated meniscal lesion. The factor with the highest impact on long-term results was damage to the articular cartilage, which did not influence knee function for several years after surgery but became increasingly symptomatic over time after 5 years and more. Only 62% of patients with additional cartilage damage rated excellent and good 12 years after surgery, in contrast with 94.8% good and excellent results in patients with isolated meniscal tears. Similar observations were made for the untreated rupture of the anterior cruciate ligament. PMID:9531123

Schimmer, R C; Brülhart, K B; Duff, C; Glinz, W

1998-03-01

364

Techniques in Endovascular Aneurysm Repair  

PubMed Central

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

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

2011-01-01

365

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

ERIC Educational Resources Information Center

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

Schramm, C.; Osland, Walt

366

14 CFR 145.207 - Repair station manual.  

Code of Federal Regulations, 2010 CFR

...2010-01-01 2010-01-01 false Repair station manual. 145.207 Section 145.207...SCHOOLS AND OTHER CERTIFICATED AGENCIES REPAIR STATIONS Operating Rules § 145.207 Repair station manual. (a) A certificated repair...

2010-01-01

367

21 CFR 870.1350 - Catheter balloon repair kit.  

...2014-04-01 2014-04-01 false Catheter balloon repair kit. 870.1350 Section 870...Diagnostic Devices § 870.1350 Catheter balloon repair kit. (a) Identification. A catheter balloon repair kit is a device used to repair...

2014-04-01

368

Sanitizing private data for repair systems  

E-print Network

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

Fang, Katherine Jien-Yin

2014-01-01

369

Reducing Your Leak Rate Without Repairing Leaks  

E-print Network

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

Beals, C.

2005-01-01

370

Small molecule versus DNA repair nanomachine  

PubMed Central

The MRN protein megacomplex mediates repair of double-stranded DNA breaks (DSBs) by tethering together broken ends of chromosomes and signaling a cascade of events required for DNA repair. The first small-molecule inhibitor that disrupts MRN function provides a valuable new tool for functional studies of DSB repair in cells. PMID:18202674

Stivers, James T

2009-01-01

371

Aircraft battle damage repair - A force multiplier  

Microsoft Academic Search

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

Hess

1992-01-01

372

Contribution of Stem Cells to Kidney Repair  

Microsoft Academic Search

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

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

2009-01-01

373

Welding/brazing for Space Station repair  

NASA Technical Reports Server (NTRS)

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

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

1990-01-01

374

Standardized Curriculum for Shoe and Boot Repair.  

ERIC Educational Resources Information Center

This curriculum guide for shoe and boot 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 shoe and boot repair programs in the state. The guide contains objectives for shoe and boot repair I and II courses. Units in…

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

375

Flexor tendon injury, repair and rehabilitation.  

PubMed

Injuries to the flexor tendons remain among the most difficult problems in hand surgery. Historically, lacerations to the intrasynovial portion of the flexor tendons were thought to be unsuitable for primary repair. Despite continuing advances in our knowledge of flexor tendon biology, repair, and rehabilitation, good results following primary repair of flexor tendons remain challenging to achieve. PMID:25435036

Lutsky, Kevin F; Giang, Eric L; Matzon, Jonas L

2015-01-01

376

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.

377

Reoperation for failure of mitral valve repair  

Microsoft Academic Search

Background and Objective: Mitral valve repair is the procedure of choice to correct mitral regurgitation of all types. Up to 10% of patients who undergo mitral valvuloplasty require late reoperation for recurrent mitral valve dysfunction. To determine the causes of failed mitral valve repair, we examined the surgical pathology of patients who underwent reoperation for failed mitral valve repair. Patients

A. Marc Gillinov; Delos M. Cosgrove; Bruce W. Lytle; Paul C. Taylor; Robert W. Stewart; Patrick M. McCarthy; Nicholas G. Smedira; Derek D. Muehrcke; Carolyn Apperson-Hansen; Floyd D. Loop

1997-01-01

378

Microwave Oven Repair. Teacher Edition.  

ERIC Educational Resources Information Center

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

Smreker, Eugene

379

Disorders of nucleotide excision repair.  

PubMed

Deficient repair of ubiquitous errors in the genome risks faulty transcription or replication. Its direct and indirect phenotypic consequences are rare, complex, dementing, lethal disorders of children with inadequately understood overlapping genotypes and variable severity. Mutations of CSA or CSB responsible for impaired transcription-coupled repair cause Cockayne syndrome (CS). Its characteristics are (1) profound growth deficiency affecting all tissues, including the brain, (2) premature aging marked by cachexia, vascular disease, exocrine deficiency, and osteopenia, but not cancer, and (3) a selective degenerative disorder of central and peripheral myelin and by neuronal loss in the retina and inner ear, and in the cerebellum and basal ganglia where it is associated with calcification. Xeroderma pigmentosum (XP) can arise from mutations of at least eight genes involved in global genomic repair. Severe XPA and XPC cause innumerable carcinomas and melanomas in light-exposed eyes and skin, and enhanced risk of visceral cancers. XPA and XPD and others can cause childhood XP neurological disease with widespread neuronal loss, axonal sensorimotor neuropathy, and dwarfing. Four genes, including XPD, can cause trichothiodystrophy (TTD) with sulfur-deficient, brittle, tiger-tail hair, and growth and developmental inadequacy. CSB or XPD can cause the severe congenital cerebro-oculofacioskeletal (COFS) CS-like syndrome with joint contractures, cataracts, and early death. Three XP genes can also cause XP/CS complex. Much more needs to be learned about these and other disorders of DNA repair to enable prevention and treatment. PMID:23622385

Rapin, Isabelle

2013-01-01

380

How the Brain Repairs Stuttering  

ERIC Educational Resources Information Center

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

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

2009-01-01

381

Airframe Repair Specialist (AFSC 53153).  

ERIC Educational Resources Information Center

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

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

382

Cleft palate repair and variations  

PubMed Central

Cleft palate affects almost every function of the face except vision. Today a child born with cleft palate with or without cleft lip should not be considered as unfortunate, because surgical repair of cleft palate has reached a highly satisfactory level. However for an average cleft surgeon palatoplasty remains an enigma. The surgery differs from centre to centre and surgeon to surgeon. However there is general agreement that palatoplasty (soft palate at least) should be performed between 6-12 months of age. Basically there are three groups of palatoplasty techniques. One is for hard palate repair, second for soft palate repair and the third based on the surgical schedule. Hard palate repair techniques are Veau-Wardill-Kilner V-Y, von Langenbeck, two-flap, Aleveolar extension palatoplasty, vomer flap, raw area free palatoplasty etc. The soft palate techniques are intravelar veloplasty, double opposing Z-plasty, radical muscle dissection, primary pharyngeal flap etc. And the protocol based techniques are Schweckendiek's, Malek's, whole in one, modified schedule with palatoplasty before lip repair etc. One should also know the effect of each technique on maxillofacial growth and speech. The ideal technique of palatoplasty is the one which gives perfect speech without affecting the maxillofacial growth and hearing. The techniques are still evolving because we are yet to design an ideal one. It is always good to know all the techniques and variations so that one can choose whichever gives the best result in one's hands. A large number of techniques are available in literature, and also every surgeon incorporates his own modification to make it a variation. However there are some basic techniques, which are described in details which are used in various centres. Some of the important variations are also described. PMID:19884664

Agrawal, Karoon

2009-01-01

383

Devices for mitral valve repair.  

PubMed

The natural history of severe mitral regurgitation (MR) is unfavorable, leading to left ventricular failure, atrial fibrillation, stroke, and death. Many patients affected by severe regurgitation (MR) do not currently undergo surgery, mainly due to the perceived risk of the procedure (old age, impaired left ventricular function, and comorbidities). Mitral transcatheter interventions carry the hope of minimizing risks while preserving clinical efficacy of surgical repair, as an alternative to conventional treatment. Multiple technologies and diversified approaches are under development with the purpose of treating MR in less invasive ways. They can be categorized based on the anatomical and patho-physiological addressed target. Among them, MitraClip (Abbott Vascular, Inc., Menlo Park, California) has emerged as a clinically safe and effective method for percutaneous mitral valve repair in patients either with degenerative and functional regurgitation. This device mimics the surgical edge-to-edge repair initially described by Alfieri in the early 1990s. Other repair technologies include percutaneous direct and indirect annuloplasty, neochordae implantation, and left ventricular reshaping. They are still in early phase clinical trials or preclinical studies. The combination of different repair techniques is likely to be required to achieve good long-lasting results. In the future, novel devices, improved knowledge, more efficient imaging, and transcatheter mitral prosthetic valve implantation may expand the indications to those patients currently not treated, as well as improve the results both in terms of early efficacy and long-term durability. These treatments are currently reserved to high-risk and inoperable patients, and their application requires an integrated Heart-Team approach. They represent the natural evolution of surgery and promise to expand treatment options and improve patients' outcomes in the near future. PMID:24452608

Denti, Paolo; Maisano, Francesco; Alfieri, Ottavio

2014-04-01

384

Arthroscopic Treatment of Bucket-Handle Labral Tear and Acetabular Fracture  

PubMed Central

Traumatic hip dislocations are associated with chondral and labral pathology as well as loose bodies that can be incarcerated in the joint. These types of injury often lead to traumatic arthritis. In some cases an osseo-labral fragment may become incarcerated in the joint that is not readily visualized preoperatively. In place of open surgery, hip arthroscopy permits a technique to remove loose bodies and repair labral tears to restore joint congruity and achieve fracture reduction and fixation. PMID:24904778

Stabile, Kathryne J.; Neumann, Julie A.; Mannava, Sandeep; Howse, Elizabeth A.; Stubbs, Allston J.

2014-01-01

385

Experimental validation of arthroscopic cartilage stiffness measurement using enzymatically degraded cartilage samples  

NASA Astrophysics Data System (ADS)

In order to evaluate the ability of the arthroscopic indentation instrument, originally developed for the measurement of cartilage stiffness during arthroscopy, to detect cartilage degeneration, we compared changes in the stiffness with the structural and constitutional alterations induced by enzymes on the tissue in vitro. The culturing of osteochondral plugs on Petri dishes was initiated in Minimum Essential Medium with Earle's salts and the baseline stiffness was measured. Then, the experimental specimens were digested using trypsin for 24 h, chondroitinase ABC or purified collagenase (type VII) for 24 h or 48 h ( n = 8-15 per group). The control specimens were incubated in the medium. After the enzyme digestion, the end-point stiffness was measured and the specimens for the microscopic analyses were processed. The proteoglycan (PG) distribution was analysed using quantitative microspectrophotometry and the quantitative evaluation of the collagen network was made using a computer-based polarized light microscopy analysis. Decrease of cartilage stiffness was found after 24 h trypsin (36%) and 48 h chondroitinase ABC (24%) digestion corresponding to a decrease of up to 80% and up to 30% in the PG content respectively. Decrease of the superficial zone collagen content or arrangement (78%, ) after 48 h collagenase digestion also induced a decrease (30%, ) in cartilage stiffness. We conclude that our instrument is capable of detecting early structural and compositional changes related to cartilage degeneration.

Lyyra, T.; Arokoski, J. P. A.; Oksala, N.; Vihko, A.; Hyttinen, M.; Jurvelin, J. S.; Kiviranta, I.

1999-02-01

386

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

387

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

388

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

389

Acute onset of intracranial subdural hemorrhage five days after spinal anesthesia for knee arthroscopic surgery: a case report  

PubMed Central

Introduction Spinal anesthesia is a widely used general purpose anesthesia. However, serious complications, such as intracranial subdural hemorrhage, can rarely occur. Case presentation We report the case of a 73-year-old Japanese woman who had acute onset of intracranial subdural hemorrhage five days after spinal anesthesia for knee arthroscopic surgery. Conclusion This case highlights the need to pay attention to acute intracranial subdural hemorrhage as a complication after spinal anesthesia. If the headache persists even in a supine position or nausea occurs abruptly, computed tomography or magnetic resonance imaging of the brain should be conducted. An intracranial subdural hematoma may have a serious outcome and is an important differential diagnosis for headache after spinal anesthesia. PMID:22394604

2012-01-01

390

Intraoperative handling and wound healing of arthroscopic portal wounds: a clinical study comparing nylon suture with wound closure strips.  

PubMed

This prospective, single-centre study compared wound closure methods in patients undergoing arthroscopy. Closure of arthroscopic portal wounds with sterile adhesive strips is effective and convenient for wound management. The method was associated with a reduced potential for infection, faster renewal of tensile strength, greater cost effectiveness, and better cosmetic effects comparing with suture closure. This method of wound closure may also reduce the incidence of needle stick injury in the theatre environment. Thereby the incidence of percutaneous exposure following a surgical procedure may not facilitate transmission of blood borne pathogens such as human immunodeficiency virus (HIV), hepatitis C virus and hepatitis B virus. As a result it may reduce litigation in today's changing healthcare climate. PMID:18578357

Bhattacharyya, Mayukh; Bradley, Helen

2008-05-01

391

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

PubMed

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

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

2007-02-01

392

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

393

Growth factors in bone repair  

Microsoft Academic Search

The role of growth factors (GF) in bone repair is widely recognised, particularly for bone morphogenetic proteins (BMPs),\\u000a fibroblast growth factor (FGF), insulin-like growth factors (IGFs), platelet-derived growth factor (PDGF), transforming growth\\u000a factor-? (TGF-?) and vascular endothelial growth factor (VEGF). GF are usually stored in the extracellular matrix (ECM), but\\u000a after injury are actively released by ECM, cells and platelets.

Valentina Devescovi; Elisa Leonardi; Gabriela Ciapetti; Elisabetta Cenni

2008-01-01

394

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

395

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

396

A system for the registration of arthroscopic images to magnetic resonance images of the knee: for improved virtual knee arthroscopy  

NASA Astrophysics Data System (ADS)

Knee arthroscopy is a minimally invasive procedure that is routinely carried out for the diagnosis and treatment of pathologies of the knee joint. A high level of expertise is required to carry out this procedure and therefore the clinical training is extensive. There are several reasons for this that include the small field of view seen by the arthroscope and the high degree of distortion in the video images. Several virtual arthroscopy simulators have been proposed to augment the learning process. One of the limitations of these simulators is the generic models that are used. We propose to develop a new virtual arthroscopy simulator that will allow the use of pathology-specific models with an increased level of photo-realism. In order to generate these models we propose to use registered magnetic resonance images (MRI) and arthroscopic video images collected from patients with a variety of knee pathologies. We present a method to perform this registration based on the use of a combined X-ray and MR imaging system (XMR). In order to validate our technique we carried out MR imaging and arthroscopy of a custom-made acrylic phantom in the XMR environment. The registration between the two modalities was computed using a combination of XMR and camera calibration, and optical tracking. Both two-dimensional (2D) and three-dimensional (3D) registration errors were computed and shown to be approximately 0.8 and 3 mm, respectively. Further to this, we qualitatively tested our approach using a more realistic plastic knee model that is used for the arthroscopy training.

Hu, Chengliang; Amati, Giancarlo; Gullick, Nicola; Oakley, Stephen; Hurmusiadis, Vassilios; Schaeffter, Tobias; Penney, Graeme; Rhode, Kawal

2009-02-01

397

No evidence of long-term benefits of arthroscopic acromioplasty in the treatment of shoulder impingement syndrome  

PubMed Central

Objectives To report the five-year results of a randomised controlled trial examining the effectiveness of arthroscopic acromioplasty in the treatment of stage II shoulder impingement syndrome. Methods A total of 140 patients were randomly divided into two groups: 1) supervised exercise programme (n = 70, exercise group); and 2) arthroscopic acromioplasty followed by a similar exercise programme (n = 70, combined treatment group). Results The main outcome measure was self-reported pain as measured on a visual analogue scale. At the five-year assessment a total of 109 patients were examined (52 in the exercise group and 57 in the combined treatment group). There was a significant decrease in mean self-reported pain on the VAS between baseline and the five-year follow-up in both the exercise group (from 6.5 (1 to 10) to 2.2 (0 to 8); p < 0.001) and the combined treatment group (from 6.4 (2 to 10) to 1.9 (0 to 8); p < 0.001). The same trend was seen in the secondary outcome measures (disability, working ability, pain at night, Shoulder Disability Questionnaire and reported painful days). An intention-to-treat analysis showed statistically significant improvements in both groups at five years compared with baseline. Further, improvement continued between the two- and five-year timepoints. No statistically significant differences were found in the patient-centred primary and secondary parameters between the two treatment groups. Conclusions Differences in the patient-centred primary and secondary parameters between the two treatment groups were not statistically significant, suggesting that acromioplasty is not cost-effective. Structured exercise treatment seems to be the treatment of choice for shoulder impingement syndrome. PMID:23836479

Ketola, S.; Lehtinen, J.; Rousi, T.; Nissinen, M.; Huhtala, H.; Konttinen, Y. T.; Arnala, I.

2013-01-01

398

Laparoscopic Repair of Incidentally Found Spigelian Hernia  

PubMed Central

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

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

2011-01-01

399

A Comparison of Ulnar Shortening Osteotomy Alone Versus Combined Arthroscopic Triangular Fibrocartilage Complex Debridement and Ulnar Shortening Osteotomy for Ulnar Impaction Syndrome  

PubMed Central

Background This study compared the results of patients treated for ulnar impaction syndrome using an ulnar shortening osteotomy (USO) alone with those treated with combined arthroscopic debridement and USO. Methods The results of 27 wrists were reviewed retrospectively. They were divided into three groups: group A (USO alone, 10 cases), group B (combined arthroscopic debridement and USO, 9 cases), and group C (arthroscopic triangular fibrocartilage complex [TFCC] debridement alone, 8 cases). The wrist function was evaluated using the modified Mayo wrist score, disabilities of the arm, shoulder and hand (DASH) score and Chun and Palmer grading system. Results The modified Mayo wrist score in groups A, B, and C was 74.5 ± 8.9, 73.9 ± 11.6, and 61.3 ± 10.2, respectively (p < 0.05). The DASH score in groups A, B, and C was 15.6 ± 11.8, 19.3 ± 11.9, and 33.2 ± 8.5, respectively (p < 0.05). The average Chun and Palmer grading score in groups A and B was 85.7 ± 8.9 and 84.7 ± 6.7, respectively. The difference in the Mayo wrist score, DASH score and Chun and Palmer grading score between group A and B was not significant (p > 0.05). Conclusions Both USO alone and combined arthroscopic TFCC debridement with USO improved the wrist function and reduced the level of pain in the patients treated for ulnar impaction syndrome. USO alone may be the preferred method of treatment in patients if the torn flap of TFCC is not unstable. PMID:21909465

Song, Hyun Seok

2011-01-01

400

Arthroscopic Reconstruction of the Anterior Cruciate Ligament With Hamstring Tendon Autograft and Fresh-Frozen Allograft: A Prospective, Randomized Controlled Study  

Microsoft Academic Search

Background: Most studies of allograft versus autograft for anterior cruciate ligament reconstruction have been of bone–patellar tendon–bone; outcome reports evaluating anterior cruciate ligament reconstruction with hamstring tendon autograft versus allograft are rare.Purpose: This study was undertaken to compare the clinical outcome of arthroscopic anterior cruciate ligament reconstruction with hamstring tendon autograft versus allograft.Study Design: Randomized controlled trial; Level of evidence,

Kang Sun; Jihua Zhang; Yan Wang; Changsuo Xia; Cailong Zhang; Tengbo Yu; Shaoqi Tian

2011-01-01

401

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

402

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

403

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

404

Does arthroscopic acromioplasty provide any additional value in the treatment of shoulder impingement syndrome?: a two-year randomised controlled trial.  

PubMed

We report a randomised controlled trial to examine the effectiveness and cost-effectiveness of arthroscopic acromioplasty in the treatment of stage II shoulder impingement syndrome. A total of 140 patients were randomly divided into two treatment groups: supervised exercise programme (n = 70, exercise group) and arthroscopic acromioplasty followed by a similar exercise programme (n = 70, combined treatment group). The main outcome measure was self-reported pain on a visual analogue scale of 0 to 10 at 24 months, measured on the 134 patients (66 in the exercise group and 68 in the combined treatment group) for whom endpoint data were available. An intention-to-treat analysis disclosed an improvement in both groups but without statistically significant difference in outcome between the groups (p = 0.65). The combined treatment was considerably more costly. Arthroscopic acromioplasty provides no clinically important effects over a structured and supervised exercise programme alone in terms of subjective outcome or cost-effectiveness when measured at 24 months. Structured exercise treatment should be the basis for treatment of shoulder impingement syndrome, with operative treatment offered judiciously until its true merit is proven. PMID:19794168

Ketola, S; Lehtinen, J; Arnala, I; Nissinen, M; Westenius, H; Sintonen, H; Aronen, P; Konttinen, Y T; Malmivaara, A; Rousi, T

2009-10-01

405

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

406

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

407

Laparoscopic repair of parastomal hernias: early results  

Microsoft Academic Search

Background: Open repair of parastomal hernias is associated with high rates of morbidity and recurrence. Laparoscopic repair with mesh has been described, and good results have been reported in small case series with short-term follow-up. The purpose of this study was to review our institution’s experience with the laparoscopic repair of parastomal hernias. Methods: Nine patients with symptomatic parastomal hernias

B. Safadi

2004-01-01

408

Cellular repair/misrepair track model  

NASA Technical Reports Server (NTRS)

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

Wilson, John W.; Cucinotta, Francis A.

1991-01-01

409

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

410

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.

Mori, Daisuke; Funakoshi, Noboru; Yamashita, Fumiharu

2014-01-01

411

DNA repair in microgravity: studies on bacteria and mammalian cells in the experiments REPAIR and KINETICS  

Microsoft Academic Search

The impact of microgravity on cellular repair processes was tested in the space experiments REPAIR and KINETICS, which were performed during the IML-2 mission in the Biorack of ESA: (a) survival of spores of Bacillus subtilis HA101 after UV-irradiation (up to 340 J m?2) in the experiment REPAIR; (b) in the experiment KINETICS the kinetics of DNA repair in three

G. Horneck; P. Rettberg; C. Baumstark-Khan; H. Rink; S. Kozubek; M. Schäfer; C. Schmitz

1996-01-01

412

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

413

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

414

77 FR 49740 - Repair Stations; Extension of Comment Period  

Federal Register 2010, 2011, 2012, 2013

...No. 12-03] RIN 2120-AJ61 Repair Stations; Extension of Comment Period AGENCY...and revise the regulations for repair stations. This extension is a result of formal requests from repair stations and industry associations to...

2012-08-17

415

49 CFR 236.555 - Repaired or rewound receiver coil.  

Code of Federal Regulations, 2010 CFR

...2010-10-01 false Repaired or rewound receiver coil. 236.555 Section 236.555 Transportation...Locomotives § 236.555 Repaired or rewound receiver coil. Receiver coil which has been repaired or rewound shall have the...

2010-10-01

416

14 CFR 91.1505 - Repairs assessment for pressurized fuselages.  

Code of Federal Regulations, 2013 CFR

...false Repairs assessment for pressurized...Airworthiness and Safety Improvements § 91.1505 Repairs assessment for pressurized...unless repair assessment guidelines applicable...approved by the FAA Aircraft...

2013-01-01

417

14 CFR 91.1505 - Repairs assessment for pressurized fuselages.  

...false Repairs assessment for pressurized...Airworthiness and Safety Improvements § 91.1505 Repairs assessment for pressurized...unless repair assessment guidelines applicable...approved by the FAA Aircraft...

2014-01-01

418

14 CFR 91.1505 - Repairs assessment for pressurized fuselages.  

Code of Federal Regulations, 2012 CFR

...false Repairs assessment for pressurized...Airworthiness and Safety Improvements § 91.1505 Repairs assessment for pressurized...unless repair assessment guidelines applicable...approved by the FAA Aircraft...

2012-01-01

419

14 CFR 121.1107 - Repairs assessment for pressurized fuselages.  

Code of Federal Regulations, 2012 CFR

... false Repairs assessment for pressurized...Airworthiness and Safety Improvements § 121.1107 Repairs assessment for pressurized...program. The repair assessment guidelines must be approved by the FAA Aircraft Certification...

2012-01-01

420

14 CFR 121.1107 - Repairs assessment for pressurized fuselages.  

Code of Federal Regulations, 2013 CFR

... false Repairs assessment for pressurized...Airworthiness and Safety Improvements § 121.1107 Repairs assessment for pressurized...program. The repair assessment guidelines must be approved by the FAA Aircraft Certification...

2013-01-01

421

14 CFR 121.1107 - Repairs assessment for pressurized fuselages.  

... false Repairs assessment for pressurized...Airworthiness and Safety Improvements § 121.1107 Repairs assessment for pressurized...program. The repair assessment guidelines must be approved by the FAA Aircraft Certification...

2014-01-01

422

29 CFR 1926.30 - Shipbuilding and ship repairing.  

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

2014-07-01

423

PREDICTION OF DEFORMATIONS DURING ENDOVASCULAR AORTIC ANEURYSM REPAIR USING  

E-print Network

1 PREDICTION OF DEFORMATIONS DURING ENDOVASCULAR AORTIC ANEURYSM REPAIR USING FINITE ELEMENT aortic aneurysm repair (EVAR), the introduction of medical devices deforms the arteries. The aim) fluoroscopy images taken during endovascular abdominal aortic aneurysm (AAA) repair. When these intraoperative

Boyer, Edmond

424

Role of DNA repair protein ERCC1 in skin cancer   

E-print Network

Nucleotide excision repair (NER) is one of the major repair systems for removal of DNA lesions. The NER pathway has evolved mainly to repair UV-induced DNA damage and is also active against a broad range of endogenously ...

Song, Liang

2009-01-01

425

Dynamics of DNA Mismatch Repair  

NASA Astrophysics Data System (ADS)

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

Coats, Julie; Lin, Yuyen; Rasnik, Ivan

2009-11-01

426

Endothelial precursors in vascular repair.  

PubMed

The endothelium is an essential component of the cardiovascular system, playing a vital role in blood vessel formation, vascular homeostasis, permeability and the regulation of inflammation. The integrity of the endothelial monolayer is also critical in the prevention of atherogenesis and as such, restoration of the monolayer is essential following damage or cell death. Over the past decade, data has suggested that progenitor cells from different origins within the body are released into the circulation and contribute to re-endothelialisation. These cells, termed endothelial progenitor cells (EPCs), also gave rise to the theory of new vessel formation within adults (vasculogenesis) without proliferation and migration of mature endothelial cells (angiogenesis). As such, intense research has been carried out identifying how these cells may be mobilised and contribute to vascular repair, either encouraging vasculogenesis into regions of ischemia or the re-endothelialisation of vessels with a dysfunctional endothelium. However, classification and isolation procedures have been a major problem in this area of research and beneficial use for therapeutic application has been controversial. In the present review we focus on the role of EPCs in vascular repair. We also provide an update on EPC classification and discuss autologous stem cell-derived endothelial cell (EC) as a functional source for therapy. PMID:20184904

Kirton, John Paul; Xu, Qingbo

2010-05-01

427

Bioengineering of foetal membrane repair.  

PubMed

Preterm premature rupture of the foetal membranes (früher vorzeitiger Blasensprung) has remained a devastating complication of pregnancy with very high risk of pregnancy loss. Several methods of sealing spontaneously ruptured membranes to stop amniotic fluid leakage and prolong pregnancy have been tested, but no one of them has achieved a clinical breakthrough. Also, needle and foetoscopic puncture of membranes for diagnostic or surgical interventions in the amniotic cavity carry a significant risk of persistent membrane leakage and subsequent rupture - thus limiting the developing field of intrauterine foetal surgery. Efforts are concentrated on taking action before rupture rather than reacting after rupture: one avenue of research concerns prophylactic plugging of foetoscopic access sites in foetal membranes at the time of intervention, thus inhibiting leakage and rupture. Foetal membrane injuries, spontaneous or iatrogenic, constitute extreme challenges to repair: thinness of foetal membrane tissue, difficult localisation and accessibility of the rupture site, the need for injectable sealants, wet gluing conditions and poor wound healing in this tissue all complicate repair. The goal is to achieve immediate and at the same time long-lasting closure of the membrane leak. Here we review approaches to closure of foetal membrane defects with liquid sealants or solid biomaterial scaffolds, with the focus on prophylactic plugging of foetoscopic access sites. PMID:18941945

Zisch, Andreas H; Zimmermann, Roland

2008-10-18

428

Repair of overheating linear accelerator  

SciTech Connect

Los Alamos Neutron Science Center (LANSCE) is a proton accelerator that produces high energy particle beams for experiments. These beams include neutrons and protons for diverse uses including radiography, isotope production, small feature study, lattice vibrations and material science. The Drift Tube Linear Accelerator (DTL) is the first portion of a half mile long linear section of accelerator that raises the beam energy from 750 keV to 100 MeV. In its 31st year of operation (2003), the DTL experienced serious issues. The first problem was the inability to maintain resonant frequency at full power. The second problem was increased occurrences of over-temperature failure of cooling hoses. These shortcomings led to an investigation during the 2003 yearly preventative maintenance shutdown that showed evidence of excessive heating: discolored interior tank walls and coper oxide deposition in the cooling circuits. Since overheating was suspected to be caused by compromised heat transfer, improving that was the focus of the repair effort. Investigations revealed copper oxide flow inhibition and iron oxide scale build up. Acid cleaning was implemented with careful attention to protection of the base metal, selection of components to clean and minimization of exposure times. The effort has been very successful in bringing the accelerator through a complete eight month run cycle allowing an incredible array of scientific experiments to be completed this year (2003-2004). This paper will describe the systems, investigation analysis, repair, return to production and conclusion.

Barkley, Walter; Baldwin, William; Bennett, Gloria; Bitteker, Leo; Borden, Michael; Casados, Jeff; Fitzgerald, Daniel; Gorman, Fred; Johnson, Kenneth; Kurennoy, Sergey; Martinez, Alberto; O’Hara, James; Perez, Edward; Roller, Brandon; Rybarcyk, Lawrence; Stark, Peter; Stockton, Jerry

2004-01-01

429

Designing for damage-tolerant composite repairs  

NASA Astrophysics Data System (ADS)

This paper presents a design methodology, and the associated data base, for the damage-tolerant design of adhesively bonded repairs. This methodology is illustrated by considering repairs to an edge-cracked panel and to multisite damage in a fuselage lap joint.

Chiu, W. K.; Rees, D.; Chalkley, P.; Jones, R.

430

Chemical Fume Hood Maintenance, Repair and Certification  

E-print Network

of laboratory hoods: chemical fume hoods and biological safety cabinets. This policy outlines the design, face velocity requirements, and test procedures for chemical fume hoods. Biological safety cabinets are tested personnel safety when repairing CFH Contact EH&S if clearance is needed. e. Repair and adjust flow rate

Jia, Songtao

431

Laparoscopic repair of incarcerated paraesophageal hernias  

Microsoft Academic Search

Paraesophageal hernias comprise only 2–5% of all hiatal hernias, yet unlike the more common sliding hiatal hernia, paraesophageal hernias are prone to undergo volvulus, with obstruction, ischemia, and gangrenous perforation. Due to their propensity toward calamitous complications, they must be recognized and repaired as expeditiously as possible. Traditionally these hernias have been repaired by either an open transabdominal or an

D. W. Cloyd

1994-01-01

432

Railroad track repairs are complete at KSC  

NASA Technical Reports Server (NTRS)

Railroad track repairs have been completed at Kennedy Space Center. This section of track is located on KSC property, just north of the NASA Causeway in the KSC Industrial Area. The repairs were required following the minor derailment of two solid rocket booster segment cars on July 18.

2000-01-01

433

Surgical repair of Achilles tendon ruptures  

Microsoft Academic Search

We evaluated the surgical results of 42 consecutive patients with spontaneous rupture of the Achilles ten don treated from 1973 to 1984 to determine the causes of rupture and to evaluate our treatment methods. Patients were divided into early and late repair groups and their charts reviewed to determine common clinical features. A new method of repair with early functional

James L. Beskin; Richard A. Sanders; Stephen C. Hunter; Jack C. Hughston

1987-01-01

434

Self-repairing composites for airplane components  

NASA Astrophysics Data System (ADS)

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

Dry, Carolyn

2008-03-01

435

Kinematics of Healthy and Meniscal Repaired Knees  

Microsoft Academic Search

Differences have been reported between in vitro and in vivo meniscal kinematics, and no clinical study to date has investigated the effect of meniscal repair on meniscal kinematics. Eleven subjects with healthy knees and eight subjects who had undergone meniscal repair for an isolated tear were scanned using magnetic resonance imaging. Sagittal plane scanning was performed at 0, 30, 60,

Marcia Epler; Michael Sitler; Raymond Moyer

2005-01-01

436

30 CFR 56.14104 - Tire repairs.  

Code of Federal Regulations, 2010 CFR

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

2010-07-01

437

30 CFR 57.14104 - Tire repairs.  

Code of Federal Regulations, 2010 CFR

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

2010-07-01

438

Laser thermal preconditioning enhances dermal wound repair  

Microsoft Academic Search

Preconditioning tissues with an initial mild thermal stress, thereby eliciting a stress response, can serve to protect tissue from subsequent stresses. Patients at risk for impaired healing, such as diabetics, can benefit from therapeutic methods which enhance wound repair. We present a laser thermal preconditioning protocol that accelerates cutaneous wound repair in a murine model. A pulsed diode laser (lambda

Gerald J. Wilmink; Terry Carter; Jeffrey M. Davidson; E. Duco Jansen

2008-01-01

439

Triple valve repair for young rheumatic patientsq  

Microsoft Academic Search

Background: Facing young foreign polyvalvular rheumatic patients, for which long-term anticoagulation is not available, we have chosen to attempt triple valve repair procedures in order to avoid prosthetic implantation in this particular population suffering from triple valve disease. Methods: Twenty-one young rheumatic patients (mean age:11 ^ 4 years) underwent triple valve repair procedures including cusp extension on the aortic valve

Jean-Michel Grinda; Christian Latremouille; Nicola D'Attellis; Alain Berrebi; Sylvain Chauvaud; Alain Carpentier; Jean-Noel Fabiani; Alain Deloche

440

Mitral valve repair in patients over  

Microsoft Academic Search

The question of whether to repair or replace the mitral valve in the elderly remains unanswered. The purpose of our study is to describe our experience with mitral valve repair (MVR) using Carpentier's technique in patients 70 years and older. Fifty consecutive patients underwent MVR between 1984-1992. There were 30 female patients. All had 2 + or more mitral regurgitation

H. Azar; S. Szentpetery

2009-01-01

441

Effect of acrylamide on hepatocellular DNA repair  

SciTech Connect

Acrylamide has recently been reported to induce tumors in laboratory animals. The effect of acrylamide on unscheduled DNA synthesis using the hepatocyte primary culture (HPC)/DNA repair test was examined. Isolated hepatocytes were exposed to acrylamide and (3H)thymidine ( (3H)TdR) for 18 hr. Incorporation of (3H)TdR into DNA was determined by autoradiography. No DNA repair was observed at acrylamide concentrations up to 10(-2) M. These findings were confirmed using density gradients. Acrylamide concentrations exceeding 10(-2) M were cytotoxic to hepatocytes. Because both autoradiography and density gradients measure DNA repair as an endpoint, the ability of acrylamide to inhibit these repair processes was also determined. Acrylamide had no effect on the repair of UV-damaged DNA. These results show that acrylamide is not genotoxic in isolated hepatocytes.

Miller, M.J.; McQueen, C.A.

1986-01-01

442

Phenotypic Transitions of Macrophages Orchestrate Tissue Repair  

PubMed Central

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

Novak, Margaret L.; Koh, Timothy J.

2014-01-01

443

Chromatin structure and DNA damage repair  

PubMed Central

The integrity of the genome is continuously challenged by both endogenous and exogenous DNA damaging agents. These damaging agents can induce a wide variety of lesions in the DNA, such as double strand breaks, single strand breaks, oxidative lesions and pyrimidine dimers. The cell has evolved intricate DNA damage response mechanisms to counteract the genotoxic effects of these lesions. The two main features of the DNA damage response mechanisms are cell-cycle checkpoint activation and, at the heart of the response, DNA repair. For both damage signalling and repair, chromatin remodelling is most likely a prerequisite. Here, we discuss current knowledge on chromatin remodelling with respect to the cellular response to DNA damage, with emphasis on the response to lesions resolved by nucleotide excision repair. We will discuss the role of histone modifications as well as their displacement or exchange in nucleotide excision repair and make a comparison with their requirement in transcription and double strand break repair. PMID:19014481

Dinant, Christoffel; Houtsmuller, Adriaan B; Vermeulen, Wim

2008-01-01

444

Repairing native defects on EUV mask blanks  

NASA Astrophysics Data System (ADS)

Mask defectivity is a serious problem for all lithographic masks, but especially for EUV masks. Defects in the EUV blank are particularly challenging because their elimination is beyond control of the mask fab. If defects have been identified on a mask blank, patterns can be shifted to place as many blank defects as possible in regions where printing impact will be eliminated or become unimportant. For those defects that cannot be mitigated through pattern shift, repair strategies must be developed. Repairing defects that occur naturally in the EUV blank is challenging because the printability of these defects varies widely. This paper describes some types of native defects commonly found and begins to outline a triage strategy for defects that are identified on the blank. Sample defects best suited to nanomachining repair are treated in detail: repairs are attempted, characterized using mask metrology and then tested for printability. Based on the initial results, the viability of repairing EUV blank native defects is discussed.

Lawliss, Mark; Gallagher, Emily; Hibbs, Michael; Seki, Kazunori; Isogawa, Takeshi; Robinson, Tod; LeClaire, Jeff

2014-10-01

445

DNA Repair by Reversal of DNA Damage  

PubMed Central

Endogenous and exogenous factors constantly challenge cellular DNA, generating cytotoxic and/or mutagenic DNA adducts. As a result, organisms have evolved different mechanisms to defend against the deleterious effects of DNA damage. Among these diverse repair pathways, direct DNA-repair systems provide cells with simple yet efficient solutions to reverse covalent DNA adducts. In this review, we focus on recent advances in the field of direct DNA repair, namely, photolyase-, alkyltransferase-, and dioxygenase-mediated repair processes. We present specific examples to describe new findings of known enzymes and appealing discoveries of new proteins. At the end of this article, we also briefly discuss the influence of direct DNA repair on other fields of biology and its implication on the discovery of new biology. PMID:23284047

Yi, Chengqi; He, Chuan

2013-01-01

446

Laparoscopic hernia repair--the best option?  

PubMed

For 100 years the Bassini-type repair for inguinal hernia was the standard method. The Lichtenstein "tension free" mesh repair replaced it on the grounds of much lower recurrence rates, < 5% vs approximately 15%. However, open procedures all have significant long-term discomfort rates of up to 53%. Laparoscopic repair has become a genuine option in the last 15 years and offers low recurrence (< 1%) and minimal long-term discomfort. However, it has not been widely taken up. There is a common misconception that it takes longer to perform, has more complications and is much more expensive. None of these caveats stand up under objective scrutiny. It is time that laparoscopic repair became the method of choice for most elective inguinal hernia repairs. PMID:18557141

Wall, M L; Cherian, Th; Lotz, J C

2008-01-01

447

INTERNAL REPAIR OF PIPELINES REVIEW & EVALUATION OF INTERNAL PIPELINE REPAIR TRIALS REPORT  

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. Evaluation trials were conducted on pipe sections with simulated corrosion damage repaired with glass fiber-reinforced composite liners, carbon fiber-reinforced composite liners, and weld deposition. Additional un-repaired pipe sections were evaluated in the virgin condition and with simulated damage. Hydrostatic failure pressures for pipe sections repaired with glass fiber-reinforced composite liner were only marginally greater than that of pipe sections without liners, indicating that this type of liner is generally ineffective at restoring the pressure containing capabilities of pipelines. Failure pressure for pipe repaired with carbon fiber-reinforced composite liner was greater than that of the un-repaired pipe section with damage, indicating that this type of liner is effective at restoring the pressure containing capability of pipe. Pipe repaired with weld deposition failed at pressures lower than that of un-repaired pipe in both the virgin and damaged conditions, indicating that this repair technology is less effective at restoring the pressure containing capability of pipe than a carbon fiber-reinforced liner repair. Physical testing indicates that carbon fiber-reinforced liner repair is the most promising technology evaluated to-date. Development of a comprehensive test plan for this process is recommended for use in the next phase of this project.

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

2004-09-01

448

Systems Maintenance Automated Repair Tasks (SMART)  

NASA Technical Reports Server (NTRS)

SMART is a uniform automated discrepancy analysis and repair-authoring platform that improves technical accuracy and timely delivery of repair procedures for a given discrepancy (see figure a). SMART will minimize data errors, create uniform repair processes, and enhance the existing knowledge base of engineering repair processes. This innovation is the first tool developed that links the hardware specification requirements with the actual repair methods, sequences, and required equipment. SMART is flexibly designed to be useable by multiple engineering groups requiring decision analysis, and by any work authorization and disposition platform (see figure b). The organizational logic creates the link between specification requirements of the hardware, and specific procedures required to repair discrepancies. The first segment in the SMART process uses a decision analysis tree to define all the permutations between component/ subcomponent/discrepancy/repair on the hardware. The second segment uses a repair matrix to define what the steps and sequences are for any repair defined in the decision tree. This segment also allows for the selection of specific steps from multivariable steps. SMART will also be able to interface with outside databases and to store information from them to be inserted into the repair-procedure document. Some of the steps will be identified as optional, and would only be used based on the location and the current configuration of the hardware. The output from this analysis would be sent to a work authoring system in the form of a predefined sequence of steps containing required actions, tools, parts, materials, certifications, and specific requirements controlling quality, functional requirements, and limitations.

Schuh, Joseph; Mitchell, Brent; Locklear, Louis; Belson, Martin A.; Al-Shihabi, Mary Jo Y.; King, Nadean; Norena, Elkin; Hardin, Derek

2010-01-01

449

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

PubMed Central

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

2012-01-01

450

Signaling Pathways in Cartilage Repair  

PubMed Central

In adult healthy cartilage, chondrocytes are in a quiescent phase characterized by a fine balance between anabolic and catabolic activities. In ageing, degenerative joint diseases and traumatic injuries of cartilage, a loss of homeostatic conditions and an up-regulation of catabolic pathways occur. Since cartilage differentiation and maintenance of homeostasis are finely tuned by a complex network of signaling molecules and biophysical factors, shedding light on these mechanisms appears to be extremely relevant for both the identification of pathogenic key factors, as specific therapeutic targets, and the development of biological approaches for cartilage regeneration. This review will focus on the main signaling pathways that can activate cellular and molecular processes, regulating the functional behavior of cartilage in both physiological and pathological conditions. These networks may be relevant in the crosstalk among joint compartments and increased knowledge in this field may lead to the development of more effective strategies for inducing cartilage repair. PMID:24837833

Mariani, Erminia; Pulsatelli, Lia; Facchini, Andrea

2014-01-01

451