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Sample records for arthroscopic graftjacket repair

  1. Arthroscopic Transosseous Bony Bankart Repair

    PubMed Central

    Driscoll, Matthew D.; Burns, Joseph P.; Snyder, Stephen J.

    2015-01-01

    Restoration of glenoid bony integrity is critical to minimizing the risk of recurrence and re-creating normal kinematics in the setting of anterior glenohumeral instability. We present an arthroscopic suture anchor–based technique for treating large bony Bankart fractures in which the fragment is secured to the intact glenoid using mattress sutures placed through the bony fragment and augmented with soft-tissue repair proximal and distal to the bony lesion. This straightforward technique has led to excellent fragment reduction and good outcomes in our experience. PMID:25973373

  2. Arthroscopic knots and strength sutures for rotator cuff repair.

    PubMed

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

    2011-09-01

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

  3. Arthroscopic Labral Repair in the Treatment of Femoroacetabular Impingement

    PubMed Central

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

    2013-01-01

    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

  4. Dual-Camera Technique for Arthroscopic Rotator Cuff Repair

    PubMed Central

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

    2014-01-01

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

  5. Complications Following Arthroscopic Rotator Cuff Tear Repair

    PubMed Central

    Audigé, Laurent; Blum, Raphael; Müller, Andreas M.; Flury, Matthias; Durchholz, Holger

    2015-01-01

    Background Valid comparison of outcomes after surgical procedures requires consensus on which instruments and parameters should be used, including the recording and evaluation of surgical complications. An international standard outlining the terminology and definitions of surgical complications in orthopaedics is lacking. Purpose This study systematically reviewed the literature for terms and definitions related to the occurrence of negative events or complications after arthroscopic rotator cuff repair (ARCR) with specific focus on shoulder stiffness. Study Design Systematic review; Level of evidence, 4. Methods PubMed, EMBASE, Cochrane Library, and Scopus databases were searched for reviews, clinical studies, and case reports of complications associated with ARCR. Reference lists of selected articles were also screened. The terminology of complications and their definitions were extracted from all relevant original articles by a single reviewer and verified by a second reviewer. Definitions of shoulder stiffness or equivalent terms were tabulated. Results Of 654 references published after 2007 and obtained from the search, 233 full-text papers (44 reviews, 155 studies, 31 case reports, and 3 surgical technique presentations) were reviewed. Twenty-two additional references cited for a definition were checked. One report defined the term surgical complication. There were 242 different terms used to describe local events and 64 to describe nonlocal events. Furthermore, 16 definitions of terms such as frozen shoulder, shoulder stiffness, or stiff painful shoulder were identified. Diagnosis criteria for shoulder stiffness differed widely; 12 various definitions for restriction in range of motion were noted. One definition included a gradation of stiffness severity, whereas another considered the patient’s subjective assessment of motion. Conclusion The literature does not consistently report on complications after ARCR, making valid comparison of the incidence of these events among published reports impossible. Specifically, the variation in criteria used to diagnose shoulder stiffness is problematic for valid and accurate reporting of this event. A standard for reporting this event and other complications after ARCR is needed. Clinical Relevance This review serves as the basis for the development of a uniform documentation process for shoulder stiffness and the standardization of complication definitions in ARCR following international consensus.

  6. Patient Satisfaction after Arthroscopic Repair of Acetabular Labral Tears

    PubMed Central

    Ha, Yong-Chan; Shin, Yong-Eun

    2014-01-01

    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

  7. Arthroscopic Saucerization and Repair of Discoid Lateral Meniscal Tear

    PubMed Central

    Fields, Logan K.; Caldwell, Paul E.

    2015-01-01

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

  8. Arthroscopic stapling repair for chronic lateral instability.

    PubMed

    Hawkins, R B

    1987-10-01

    We have presented a preliminary report on a limited number of patients with chronic lateral instability of the ankle treated with arthroscopic stapling reconstruction. As stated, the longest follow-ups are about 5 years, so the results over the long term are not yet known. Early adults have been quite encouraging, however, with improved functional stability of the ankle. Only one patient in more than two dozen has had recurrent instability that required more surgery. He returned with a history of additional sports trauma. The principle of secure fixation of ligaments to exposed bone surfaces with staples is a well-accepted and effective technique familiar to surgeons for many years. What is changing is that microsurgical techniques can be adapted to common orthopedic problems. Ankle arthroscopy is expanding continually to meet the needs of many patients. Discomfort is minimal, and many patients do not even fill their prescriptions for analgesic medication. The period of disability is relatively short and rehabilitation is rapid. Because most patients prefer arthroscopy to an open procedure, we must continue to explore all avenues of surgical technique. New tools and developments are constantly on the horizon. As in most arthroscopic surgical procedures, instruments of the correct size are most important, as is precise surgical technique. The key to successful arthroscopic surgery is careful forethought, meticulous planning, constant education, and a dependable team. PMID:2960443

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

    PubMed

    Badia, Alejandro; Jiménez, Alexis

    2006-10-01

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

  10. Arthroscopic direct repair for radial tear of the triangular fibrocartilage complex.

    PubMed

    Cho, Chul-Hyun; Lee, Young-Kuk; Sin, Hong-Kwan

    2012-01-01

    Although various repair techniques for Palmer type 1B lesions of the triangular fibrocartilage complex (TFCC) have been introduced, arthroscopic repair techniques for Palmer type 1D lesions are still being honed. Until recently, inside-out techniques have commonly been used to repair radial tears of the TFCC. However, that technique has the disadvantages of a requirement for an extra skin incision, pain resulting from prominent subcutaneous suture knot stacks, and peripheral nerve injury. We describe an all-arthroscopic direct-repair technique using a suture hook with 2-0 polydioxanone that is relatively simple and safe and is thus a useful alternative for radial tears of the TFCC. PMID:23061960

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

    PubMed

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

    2013-01-01

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

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

    PubMed Central

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

    2013-01-01

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

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

    PubMed Central

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

    2014-01-01

    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

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

    PubMed Central

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

    2009-01-01

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

  15. Current Arthroscopic Concepts in Repairing Posterior Cruciate Ligament Tibial-Sided Avulsions.

    PubMed

    Malempati, Chaitu; Felder, Jerrod; Elliott, Michael; Brunkhorst, Joseph; Miller, Mark; Johnson, Darren L

    2015-09-01

    Posterior cruciate ligament (PCL) injuries are extremely rare and most commonly occur in the trauma setting. They can lead to instability, pain, diminished function, and eventual arthrosis. Several techniques of arthroscopic PCL repair for tibial-sided bony avulsions have been described in the literature; however, no single technique has emerged as the gold standard to predictably restore posterior knee stability, PCL function, and knee biomechanics. The authors believe that the best results will come from procedures that re-create the normal human anatomy and knee kinematics. In this article, 3 arthroscopic methods of PCL avulsion repairs performed at 2 academic institutions are analyzed. The techniques described here provide good options for the treatment of these injuries. [Orthopedics. 2015; 38(9):563-569.]. PMID:26375528

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

    PubMed Central

    Saccomanni, Bernardino

    2013-01-01

    Background/objectives Despite the improvements in the methods of arthroscopic stabilization of anterior shoulder instability, a recurrence rate of as high as 30% is reported in the literature. In this context, we report the outcome of arthroscopic Bankart repair in anterior shoulder instability, with the use of bio-absorbable suture anchors for patients that were followed up for at least two years from the date of surgery. The arthroscopic method offers a less invasive technique of Bankart repair for traumatic anterior shoulder instability. We would like to report the 2-year clinical outcomes of bio-absorbable suture anchors used in traumatic anterior dislocations of the shoulder. Methods Data from 79 shoulders in 74 patients were collected over 4 years (2005–2009). Each patient was followed up over a period of 2 years. The patients underwent arthroscopic Bankart repair using bio-absorbable suture anchors for their anterior shoulder instability. These surgeries were performed at a single institution by a single surgeon over the time period. The patients were assessed with two different outcome measurement tools. The University of California at Los Angeles (UCLA) shoulder rating scale and the Simple Shoulder Test (SST) score. The scores were calculated before surgery and at the 2-year follow-up. The recurrence rates, range of motion as well post-operative function and return to sporting activities were evaluated. Results SST results from the 12 domains showed a significant improvement from a mean of 6.1 ± 3.1 to 11.1 ± 1.8 taken at the 2-year follow-up (p < 0.0001). Data from the UCLA scale showed a pre and post-operative mean of 20.2 ± 5.0 and 32.4 ± 4.6 respectively (p < 0.0001). 34 had excellent post-operative scores, 35 had good scores, 1 had fair score and 3 had poor scores. 75% of the patients returned to sports while 7.6% developed a recurrence of shoulder dislocation or subluxation. Conclusion Arthroscopic Bankart repair with the use of suture anchors is a reliable treatment method, with good clinical outcomes, excellent post-operative shoulder motion and low recurrence rates. PMID:26403552

  17. Arthroscopic all inside repair of the lateral meniscus root tear.

    PubMed

    Ahn, Jin Hwan; Lee, Yong Seuk; Chang, Jae-Young; Chang, Moon Jong; Eun, Sang Soo; Kim, Sang Min

    2009-01-01

    It has been reported that lateral meniscus tears, including posterior horn tears, stable radial flap tears, or peripheral or posterior third tears that are combined with an Anterior Cruciate Ligament (ACL) injury can be treated with being left in situ. However, our experience has shown that the tear patterns are not so simple. They can show complex configurations and the inner side can be lost in chronic cases. Regarding the repair technique, there has been some controversy concerning the follow up results with repair devices and reduction is difficult using these devices if the inner side is non-viable or lost. If the tear involves whole width of bony insertion, it is believed that the meniscal function would be lost, particularly because the anatomic configuration is different in this area. In cases of chronic inner loss types, the meniscus was repaired using a side to side repair or pull out repair technique. Complete healing was achieved using this technique in some patients. Conclusively, Posterior Lateral Meniscus Root Tear (PLMRT) must be managed with different method with tears of other areas because the tear configuration is complex than simple looking. PMID:18930402

  18. Anterior Medial Meniscal Root Tears: A Novel Arthroscopic All Inside Repair

    PubMed Central

    Osti, L.; Del Buono, A.; Maffulli, N.

    2015-01-01

    Background Management of tears of the anterior and posterior roots of the meniscus is still controversial. We wish to propose a simple technique of suture anchor to repair tears of the anterior root of the medial meniscus. Methods Twelve patients, active males, underwent arthroscopic repair of the anterior meniscal horn between 2009 and 2011. All were assessed postoperatively at an average follow-up of 1 year after the index operation. Results At the last appointment, the average Lysholm scores was improved from a pre-operative average value of 48±17 to a postoperative value of 91±7 (P<0.001); five patients (45.3%) were scored as excellent (?95), and 7 (54.6%) as good (85–94). At the last appointment, 8 of 9 active patients practiced sport at the same preoperative level, 1 (8.5%) had changed to lower level of activity. No technique related complications were evident. PMID:26535186

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed

    Badia, Alejandro; Khanchandani, Prakash

    2007-03-01

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

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

    PubMed Central

    Gandhi, Ranju; Chawla, Reeta

    2014-01-01

    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

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

    PubMed

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

    2014-01-01

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

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

    PubMed Central

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

    2015-01-01

    Purpose : The PainVision™ system was recently developed for quantitative pain assessment. Here, we used this system to evaluate the effect of plexus brachialis block on postoperative pain after arthroscopic rotator cuff repair. Methods : Fifty-five patients who underwent arthroscopic rotator cuff repair were included in this study. First 26 cases received no plexus brachialis block (control group), and the next 29 cases received the plexus brachialis block before surgery (block group). Patients completed the visual analog scale at 4, 8, 16, and 24 hours after surgery, and the intensity of postoperative pain was assessed with PainVision™ at 16 hours. The postoperative use of non-steroidal anti-inflammatory agents was also recorded. Results : The pain intensity at 16 hours after surgery assessed by PainVision™ was significantly lower in the block group than in the control group (block, 252.0 ± 47.8, control, 489.0 ± 89.1, P < 0.05). However, there were no differences in the VAS values at 16 hours between the 2 groups (block, 4.3 ± 0.6, control, 5.7 ± 0.4, P = N.S.). The pain intensity and VAS at 16 hours after surgery were highly correlated (r = 0.59, P = 0.006 in the block group and r = 0.62, P = 0.003 in the control group). The effect size of the assessment by PainVision™ was bigger than that of VAS (r=0.31 in VAS and 0.51 in Pain vision). Conclusion : The PainVision™ system could be useful to evaluate postoperative pain because it enables the quantification and comparison of pain intensity independent of individual pain thresholds. PMID:26157522

  4. Early Results of Concurrent Arthroscopic Repair of Rotator Cuff and Type II Superior Labral Anterior Posterior Tears

    PubMed Central

    Strickland, Justin P.; Fleckenstein, Cassie M.; Ducker, Al; Hasan, Samer S.

    2010-01-01

    Background: Recent reports on concurrent arthroscopic rotator cuff and type II superior labral anterior posterior (SLAP) repair have raised concerns over postoperative stiffness and patient satisfaction. However, it is unclear if the observed stiffness relates to the repair of degenerative SLAP tears in older adults, the surgical technique, the postoperative rehabilitation, or to a combination of these factors. Purpose: The purpose of this study was to evaluate the outcome and repair integrity of concurrent arthroscopic rotator cuff and type II SLAP repair. Study Design: Case series. Methods: Of 11 patients identified, 7 had a full-thickness rotator cuff tear and 4 had a high-grade partial thickness tear that was completed. A cannula placed through the rotator cuff tear improved the trajectory for posterior suture anchor placement during SLAP repair. Postoperative rehabilitation employed continuous passive motion to prevent stiffness. Results: At minimum of 1-year follow-up, mean yes responses on the Simple Shoulder Test improved from 5.4 to 10.7 (out of 12; P < .01), and mean American Shoulder and Elbow Surgeons scores improved from 40 to 87 (out of 100; P < .01). Mean forward elevation improved from 148° to 161° (P < .01) and external rotation from 58° to 67° (P < .01). Magnetic resonance imaging, obtained at most recent follow-up in 10 patients, demonstrated a healed SLAP tear in all patients and a persistent rotator cuff defect in 1 patient. Conclusions: Arthroscopic rotator cuff repair can be successfully combined with type II SLAP repair in relatively young patients who have sustained traumatic injury to their shoulders. Allowing early passive motion may help prevent postoperative stiffness without compromising rotator cuff healing. PMID:23015981

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

    PubMed Central

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

    2015-01-01

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

  6. Arthroscopic "cuff-sparing" percutaneous (CUSP) technique for posterior instability repair in the beach-chair position.

    PubMed

    Bhatia, Deepak N

    2012-09-01

    Arthroscopic posterior labral repair and capsular shift procedures are technically difficult in the beach-chair position as compared with the lateral decubitus position. Optimal visualization in the beach-chair position, and anchor placement in the posterior glenoid rim, necessitate various lateral trans-cuff portals, and these may result in damage to the rotator cuff tendons. The author has devised a new technique for posterior labral repair in the beach-chair position; the technique involves visualization of the posterior capsulolabral complex through a 70-degree arthroscope placed in the posterior axillary pouch portal, and labral repair is performed through percutaneous medial portals. The cuff-sparing and percutaneous (CUSP) nature of the technique utilizes safe anatomic zones for visualization and percutaneous repair of the entire posterior labrum, and lateral portals that may potentially damage the rotator cuff tendons are avoided. Technical variants of the procedure include: (1) a "CUSP shift" technique (combined labral repair and capsular shift); (2) a "CUSP-stitch" technique (isolated labral repair without a capsular shift); and (3) a "posterior labroplasty" technique for reconstruction of deficient posterior labral tissue. Technical tips to avoid neurological injury, and a detailed rehabilitation protocol are presented. PMID:22914001

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

    PubMed

    Wahegaonkar, Abhijeet L; Mathoulin, Christophe L

    2013-05-01

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

  8. Arthroscopic Knee Cartilage Repair With Covered Microfracture and Bone Marrow Concentrate

    PubMed Central

    Gigante, Antonio; Cecconi, Stefano; Calcagno, Silvano; Busilacchi, Alberto; Enea, Davide

    2012-01-01

    In recent years several single-stage cartilage repair approaches have been devised to treat focal cartilage lesions. These usually associate microfracture (MFX) and a coverage scaffold. We describe a novel arthroscopic technique that combines MFX, autologous bone marrow concentrate (BMC), and a protective scaffold. Bone marrow aspirate from the iliac crest is centrifuged to obtain BMC. The cartilage defect is debrided, MFX holes are created, and the final defect is measured by use of a bent K-wire. The scaffold is then shaped to match the defect, immersed in BMC, introduced into the joint with a grasper, and fixed in place with a mixture of fibrin glue and BMC. This technique aims to augment the original single-stage procedure with a number of mesenchymal stem cells and growth factors contained in the BMC, to increase the defect filling and the rate of hyaline-like cartilage regeneration. The procedure combining MFX, BMC, and a protective scaffold is inexpensive and reproducible and has already shown the ability to regenerate hyaline-like cartilage. Its use as an alternative to autologous chondrocyte implantation requires further investigation. PMID:23766992

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

    PubMed Central

    Burt, David M.

    2014-01-01

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

  10. Risk factors for shoulder re-dislocation after arthroscopic Bankart repair

    PubMed Central

    2014-01-01

    Background Recent studies have shown effective clinical results after arthroscopic Bankart repair (ABR) but have shown several risk factors for re-dislocation after surgery. We evaluated whether patients are at a risk for re-dislocation during the first year after ABR, examined the recurrence rate after ABR, and sought to identify new risk factors. Methods We performed ABR using bioabsorbable suture anchors in 102 consecutive shoulders (100 patients) with traumatic anterior shoulder instability. Average patient age and follow-up period was 25.7 (range, 14–40) years and 67.5 (range, 24.5–120) months, respectively. We evaluated re-dislocation after ABR using patient telephone interviews (follow-up rate, 100%) and correlated re-dislocation with several risk factors. Results Re-dislocation after ABR occurred in nine shoulders (8.8%), of which seven sustained re-injuries within the first year with the arm elevated at 90° and externally rotated at 90°. Of the remaining 93 shoulders without re-dislocation, 8 had re-injury under the same conditions within the first year. Thus, re-injury within the first year was a risk for re-dislocation after ABR (P < 0.001, chi-squared test). Using multivariate analysis, large Hill-Sachs lesions (odds ratio, 6.77, 95% CI, 1.24–53.6) and <4 suture anchors (odds ratio, 9.86, 95% CI, 2.00–76.4) were significant risk factors for re-dislocation after ABR. Conclusions The recurrence rate after ABR is not associated with the time elapsed and that repair strategies should augment the large humeral bone defect and use >3 anchors during ABR. PMID:24993404

  11. A Meta-Analysis of Arthroscopic versus Open Repair for Treatment of Bankart Lesions in the Shoulder

    PubMed Central

    Wang, Lei; Liu, Yaosheng; Su, Xiuyun; Liu, Shubin

    2015-01-01

    Background The optimal treatment for Bankart lesion remains controversial. Therefore, we performed this meta-analysis to compare the clinical outcomes of patients managed with open Bankart repair versus arthroscopic Bankart repair. Material/Methods After systematic review of online databases, a total of 11 trials with 1022 subjects were included. The methodological quality of randomized controlled trials (RCTs) was assessed using the PEDro critical appraisal tool, and non-RCTs were evaluated by Newcastle-Ottawa (NO) quality assessment tool. Outcomes of shoulder stability, range of motion (ROM), functional scales, and surgical times were analyzed. Results Data synthesis showed significant differences between the two strategies, with regards to stability of the shoulder (P=0.008, RR=0.94, 95% CI: 0.89 to 0.98), and ROM (P<0.001, SMD=?0.47, 95% CI: ?0.72 to ?0.22). Conclusions Open Bankart repair produced a more stable shoulder but had a relatively poor shoulder motion, compared with arthroscopic Bankart repair, for the treatment of Bankart lesion. PMID:26446430

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

    PubMed Central

    Chen, Kai; Cai, Zhengdong; Li, Guodong

    2014-01-01

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

  13. Hospital Charges and Practice Patterns for General and Regional Anesthesia in Arthroscopic Anterior Cruciate Ligament Repair

    PubMed Central

    Foster, Brock D.; Terrell, Rodney; Montgomery, Scott R.; Wang, Jeffrey C.; Petrigliano, Frank A.; McAllister, David R.

    2013-01-01

    Background: Anesthetic use for arthroscopic anterior cruciate ligament (ACL) reconstruction may display variability in hospital charges and utilization in the United States. Purpose: To evaluate practice patterns and hospital charges for anesthesia in arthroscopic ACL reconstruction. Study Type: Cross-sectional study. Methods: The PearlDiver Patient Records Database, a national database of insurance billing records, was searched using the current procedural terminology (CPT) codes for arthroscopic ACL reconstruction in combination with different types of anesthesia. The search included the years between 2004 and 2009. Age, sex, number of procedures performed, geographic region, and hospital charges for each type of anesthesia were recorded and compared. Anesthetic types were categorized as general anesthesia (GA) only, GA with concomitant single femoral injection, GA with concomitant other regional anesthesia (RA), single femoral injection only, or other RA only. Results: Between 2004 and 2009, a total of 53,968 arthroscopic reconstructive procedures were identified. The mean per patient hospital charge for GA alone, GA in combination with single femoral injection, GA in combination with other RA, single femoral injection alone, and RA alone was $1065 (63% of cases), $1614 (29%), $1849 (4%), $630 (3%), and $612 (1%), respectively. The use of GA in combination with RA or single femoral nerve injection significantly increased during this time period (P = .004 and P < .001, respectively). Conclusion: The mean per patient hospital charges for arthroscopic ACL reconstruction varied with the mode of anesthesia utilized, where regional anesthetic techniques alone were least expensive. RA alone was utilized infrequently, and there was a significant increase in the rate of utilization of GA in combination with any form of RA. Clinical Relevance: This study provides information on current trends and hospital charges for anesthesia in arthroscopic ACL reconstruction. PMID:26535248

  14. Arthroscopic First Metatarsophalangeal Arthrodesis for Repair of Fixed Hallux Varus Deformity.

    PubMed

    Lui, Tun Hing

    2015-01-01

    Arthroscopic first metatarsophalangeal arthrodesis for fixed hallux varus deformity can be very difficult because narrowing of the medial joint space results in difficult access. The abductor hallucis tendon and the medial capsule can be released through a small proximal plantar medial incision. This will convert the deformity into a flexible one and open up the medial joint space. This allows arthroscopic arthrodesis using the standard dorsolateral and medial portals. The plantar medial incision can also be used for arthroscopy of the metatarsosesamoid compartment and insertion of a screw for first metatarsophalangeal arthrodesis. PMID:26319187

  15. All-arthroscopic repair of arcuate avulsion fracture with suture anchor.

    PubMed

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

    2011-05-01

    Arcuate avulsion fractures are very rare but present pathologic posterolateral rotation instability. Untreated instability may lead to overload of the reconstructed posterior cruciate ligament (PCL) graft. Surgical treatment and clinical results have not yet been reported to our knowledge. This study presents the case of a 45-year-old man with PCL injury and an arcuate avulsion fracture of the fibular head. The dial test was positive preoperatively, and magnetic resonance imaging showed an "arcuate" sign. The avulsed bone fragment was reduced and fixed with a suture anchor by an all-arthroscopic technique. At the 1-year follow-up, the patient had resumed all his normal activities, including sports. He scored 1+ on the posterior drawer test, and external rotation was 1° less than that in his contralateral normal knee. Compared with the values in the contralateral normal knee, the posterior tibial translation was reduced from 15.5 mm preoperatively to 6.3 mm postoperatively. The postoperative magnetic resonance imaging and computed tomography scans showed that the reconstructed PCL graft and the osseous fragment of the styloid process of the fibular head attached to the popliteofibular ligament were reduced. This technical note describes an all-arthroscopic reduction and fixation technique of arcuate avulsed fracture of the fibular head. PMID:21398077

  16. Modified arthroscopic Brostrom procedure.

    PubMed

    Lui, Tun Hing

    2015-09-01

    The open modified Brostrom anatomic repair technique is widely accepted as the reference standard for lateral ankle stabilization. However, there is high incidence of intra-articular pathologies associated with chronic lateral ankle instability which may not be addressed by an isolated open Brostrom procedure. Arthroscopic Brostrom procedure with suture anchor has been described for anatomic repair of chronic lateral ankle instability and management of intra-articular lesions. However, the complication rates seemed to be higher than open Brostrom procedure. Modification of the arthroscopic Brostrom procedure with the use of bone tunnel may reduce the risk of certain complications. PMID:26235865

  17. Arthroscopic Repair of a Posterior Bony Humeral Avulsion of the Glenohumeral Ligament With Associated Teres Minor Avulsion

    PubMed Central

    Smith, Patrick A.; Nuelle, Clayton W.; Bradley, James P.

    2014-01-01

    Humeral avulsion of the inferior glenohumeral ligament (HAGL) has recently gained more recognition as a cause of shoulder instability. Posterior HAGL lesions, being much more infrequent than anterior disruptions, have only recently been documented as a notable cause of posterior instability. We detail the treatment of a previously unreported case of a posterior HAGL variant lesion consisting of a bony avulsion with involvement of the teres minor tendon. Arthroscopic fixation was facilitated by use of a “sheathless” arthroscopic approach with a 70° arthroscope and suture anchor. PMID:24749048

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

    PubMed Central

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

    2015-01-01

    Background Infusion methods during regional analgesia using perineural catheters may influence the quality of postoperative analgesia. This study was conducted to compare the effects of combined or bolus-only infusion of 0.2% ropivacaine on the postoperative analgesia in interscalene brachial plexus block (ISBPB) with perineural catheterization. Methods Patients scheduled for arthroscopic rotator cuff repair were divided into two groups, one that would receive a combined infusion (group C, n = 32), and one that would receive intermittent infusion (group I, n = 32). A perineural catheter was inserted into the interscalene brachial plexus (ISBP) using ultrasound (US) and nerve stimulation, and 10 ml of 0.2% ropivacaine was administered. After the operation, group C received a continuous infusion of 4 ml/h, and a 4 ml bolus with a lockout interval of 60 min. Group I received only a 4 ml bolus, and the lockout interval was 30 min. Postoperative pain by the numeric rating scale (NRS) and the forearm muscle tone by the manual muscle test (MMT) were checked and evaluated at the following timepoints: preoperative, and postoperative 1, 4, 12, 24, 36, and 48 h. Supplemental opioid requirements, total consumed dose of local anesthetic, and adverse effects were compared between the two groups. Results Sixty-four patients completed the study and the postoperative values such as operation time, time to discharge, and operation site were comparable. There were no differences in NRS scores and supplemental opioid requirements between the two groups. The MMT scores of group I at 4 and 12 h after surgery were significantly higher than those of group C (P < 0.05). The total consumed dose of local anesthetic was significantly lower in group I than in group C (P < 0.05). The adverse effects were not different between the groups. Conclusions The bolus-only administration of 0.2% ropivacaine provided a similar analgesic effect with a lower total volume of local anesthetic and decreased motor weakness compared to combined infusion. Therefore, bolus-only administration is an effective postoperative analgesic method in ISBPB with perineural catheterization after rotator cuff repair. PMID:26175882

  19. Fiber-optics couple arthroscope to TV

    NASA Technical Reports Server (NTRS)

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

    1981-01-01

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

  20. Arthroscopic Surgery.

    ERIC Educational Resources Information Center

    Connors, G. Patrick

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

  1. Arthroscopic tennis elbow release.

    PubMed

    Savoie, Felix H; O'Brien, Michael J

    2015-01-01

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

  2. A secure arthroscopic knot.

    PubMed

    Delimar, D

    1996-06-01

    The proposed arthroscopic knot tying technique procedure is simple, easy to master, time saving, and the knot formed is not bulky. The initial tie loop holding capacity securely overcomes tension force between structures repaired. The completed know, secured with additional two throw square knot or with a three half-hitches incorporating the post switching and/or loop direction reversal, will fail by breakage rather than by slippage (for the most commercially available 0, 2/0, 3/0, absorbable and nonabsorbable, monofilament and braided sutures. PMID:8783832

  3. Arthroscopic technique of interposition arthroplasty of the glenohumeral joint.

    PubMed

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

    2006-05-01

    Arthroscopic glenohumeral interposition arthroplasty is performed with the patient placed in the lateral decubitus position. Standard posterior, anterior, and anterosuperior portals are created, a routine diagnostic arthroscopy is performed, and the joint is débrided with the use of an arthroscopic shaver. An arthroscopic burr is used to resect prominent osteophytes, to alter the version of the glenoid if necessary, and to create microfractures on the glenoid surface. Next, 3 absorbable sutures are passed percutaneously with a 30 degrees angled suture grasper from 3 different sites posteriorly through the posterior capsular-labral tissue and into the anterior portal cannula, where they are isolated by means of the suture saver kit. The prepared interposition membrane/tissue (GRAFTJACKET Regenerative Tissue Matrix, Wright Medical Technology, Inc., Arlington, TN) is tagged with the 3 sutures in the anterior cannula before it is introduced into the joint. Three additional sutures are attached to the membrane anteriorly at 1, 3, and 5 o'clock positions and are isolated with suture savers. The membrane is next introduced into the joint through the anterior cannula and is aligned with the glenoid rim. The anterior sutures are rerouted through the anterior capsular-labral tissue with a 70 degrees angled suture grasper, and they are retrieved through the anterior cannula. Intra-articular nonsliding knots are used anteriorly to anchor the interposition tissue to the anterior glenoid labrum and capsule. The posterior sutures are knotted intra-articularly, or they may be tied extra-articularly; the proximal and distal posterior sutures are retrieved subcutaneously out through the skin tract of the posterior portal and are knotted with the suture present in this portal, with the use of nonsliding knots. Stability of the interposition tissue is assessed by movement of the glenohumeral joint through its entire range of motion. The postoperative protocol consists of early passive exercises, active exercises after 3 weeks, and muscle-strengthening exercises after 6 weeks. PMID:16651174

  4. Results of Arthroscopic Bankart Lesion Repair in Patients with Post-Traumatic Anterior Instability of the Shoulder and a Non-Engaging Hill-Sachs Lesion with a Suture Anchor after a Minimum of 6-Year Follow-Up

    PubMed Central

    Szyluk, Karol; Jasi?ski, Andrzej; Widuchowski, Wojciech; Mielnik, Micha?; Koczy, Bogdan

    2015-01-01

    Background Shoulder instability is an important clinical problem. Arthroscopic surgery is an established treatment modality in shoulder instability, but it continues to be associated with a high rate of recurrences and complications. The purpose of the study was to analyze late outcomes of arthroscopic repair of Bankart lesions in patients with post-traumatic anterior shoulder instability and non-engaging Hill-Sachs lesion, with special focus on the incidence and causes of recurrences and complications. Material/Methods We investigated 92 patients (92 shoulders) who underwent surgery on account of post-traumatic anterior shoulder instability. The duration of follow-up ranged from 6 to 12.5 years (mean: 8.2 years). All patients were operated on in the lateral decubitus position using FASTak 2.8-mm suture anchors (FASTak, Arthrex, Naples, Florida). Treatment outcomes were evaluated using the Rowe and University of California at Los Angeles rating system (UCLA). Results According to Rowe scores, there were 71 (81.5%) excellent, 12 (12.6%) good, 5 (5.3%) satisfactory, and 2 (2.1%) poor results. Rowe scores improved in a statistically significant manner (p=0.00) post-surgery, to a mean of 90 (range: 25–100). Treatment outcomes measured as UCLA scores improved in a statistically significant manner (p=0.00), reaching post-operative levels of 12–35 (mean: 33.5). There were 9 recurrences, 1 case of axillary nerve praxia, and 1 case of anchor loosening. Conclusions With rigorous criteria for qualifying patients for surgery, arthroscopic treatment of post-traumatic anterior shoulder instability produces good outcomes and low recurrence and complication rates irrespective of the number of previous dislocations, age, or sex. PMID:26256225

  5. Arthroscopic Hip Revision Surgery for Residual FAI

    PubMed Central

    Larson, Christopher M.; Giveans, Russell; Bedi, Asheesh; Samuelson, Kathryn M.; Stone, Rebecca M.

    2014-01-01

    Objectives: There is a steep surgical learning curve when managing femoroacetabular impingement (FAI) and residual FAI can lead to continued pain and disability. There is very limited data reporting outcomes after revision arthroscopy for residual FAI. Methods: The records of patients that underwent arthroscopic hip revision surgery for residual FAI based on plain radiographs and 3D CT scans were reviewed. Pre and post-operative structural pathomorphology, intra-operative findings, and pre and post-operative outcomes measures using Modified Harris Hip Scoring (MHHS), SF-12 scoring, and pain on a visual analogue scale (VAS) were evaluated. Outcomes after revision arthroscopic FAI correction were compared to a cohort that underwent primary arthroscopic FAI correction. Results: 59 patients (85 hips) underwent arthroscopic revision FAI correction (mean 20.8 months follow-up). There were 98 previous arthroscopic surgeries and 4 previous surgical dislocations. There were 39 males and 46 females with a mean age of 29.5 years (range 16 - 59). 80 hips had residual cam-type FAI, and 64 hips had residual pincer-type FAI and underwent femoral and rim resections, respectively. The labrum was debrided in 27 hips, repaired in 48 hips and reconstructed with allograft in 8 hips. Adhesions were excised for 54 hips. The results of revision arthroscopic FAI correction were compared to 154 patients (169 hips) that underwent primary arthroscopic FAI correction (mean 25.2 months follow-up). The mean improvement for outcomes scores after revision FAI correction was 18.9 points (MHHS, p<.01), 13.4 points (SF-12, p<.01), and 2.2 points (VAS, p<.01) compared to 23.7 points (MHHS, p<.01), 22.3 points (SF-12, p<.01), and 4.6 points (VAS, p<.01) after primary arthroscopic FAI correction. Most recent outcomes scores and mean improvement in outcome scores were significantly better after primary (81.1% good/ excellent results) compared to revision (69.8% good/excellent results) FAI correction (MHS (p>.05), SF-12 (p<.01), VAS (p<.01). Conclusion: With appropriate indications and expectations, arthroscopic hip revision surgery for residual FAI led to significantly improved outcome measures. Outcomes, however, were inferior to those after primary arthroscopic FAI corrective surgery.

  6. Arthroscopic Anatomy of the Subdeltoid Space

    PubMed Central

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

    2013-01-01

    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

  7. Arthroscopic Surgical Techniques for the Management of Proximal Biceps Injuries.

    PubMed

    Werner, Brian C; Holzgrefe, Russell E; Brockmeier, Stephen F

    2016-01-01

    Current arthroscopic surgical techniques for the management of proximal biceps tendon disorders encompass 3 commonly advocated procedures: proximal biceps anchor reattachment (superior labrum anterior to posterior or SLAP repair), biceps tenotomy, and arthroscopic biceps tenodesis. The indications for each procedure vary based on injury pattern, symptomatic presentation, concomitant pathologic abnormality, and most notably, patient factors, such as age, functional demand, and specific sport or activity participation. Outcomes after SLAP repair are generally favorable, although recent studies have found biceps tenodesis to be the preferred treatment for certain patient populations. PMID:26614472

  8. Why arthroscopic partial meniscectomy?

    PubMed

    Lyu, Shaw-Ruey

    2015-09-01

    "Arthroscopic Partial Meniscectomy versus Sham Surgery for a Degenerative Meniscal Tear" published in the New England Journal of Medicine on December 26, 2013 draws the conclusion that arthroscopic partial medial meniscectomy provides no significant benefit over sham surgery in patients with a degenerative meniscal tear and no knee osteoarthritis. This result argues against the current practice of performing arthroscopic partial meniscectomy (APM) in patients with a degenerative meniscal tear. Since the number of APM performed has been increasing, the information provided by this study should lead to a change in clinical care of patients with a degenerative meniscus tear. PMID:26488013

  9. Why arthroscopic partial meniscectomy?

    PubMed Central

    2015-01-01

    Arthroscopic Partial Meniscectomy versus Sham Surgery for a Degenerative Meniscal Tear” published in the New England Journal of Medicine on December 26, 2013 draws the conclusion that arthroscopic partial medial meniscectomy provides no significant benefit over sham surgery in patients with a degenerative meniscal tear and no knee osteoarthritis. This result argues against the current practice of performing arthroscopic partial meniscectomy (APM) in patients with a degenerative meniscal tear. Since the number of APM performed has been increasing, the information provided by this study should lead to a change in clinical care of patients with a degenerative meniscus tear. PMID:26488013

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

    PubMed Central

    Aydin, Nuri; Sirin, Evrim; Arya, Alp

    2014-01-01

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

  11. The TOTS (temporary outside traction suture): a new technique to allow easy suture placement and improve capsular shift in arthroscopic bankart repair.

    PubMed

    Boileau, Pascal; Ahrens, Philip

    2003-01-01

    We describe a new technique to allow easy placement of anterior sutures and to improve the proximal capsular shift in arthroscopic anterior stabilization of the shoulder, which we call the temporary outside traction suture (TOTS). Two standard portals are used: posterior and anterosuperior. Using a curved suture hook, both the capsule and the labrum are perforated at approximately the 5-o'clock position, and a monofilament suture is passed through the tissues. The suture is first retrieved through the anterior canula and then placed outside the canula. After labrum detachment and glenoid preparation, 1 or 2 further inferior sutures can be placed before the first suture is retrieved inside the canula and used. The technique of the TOTS has many advantages. (1) It allows easy placement of the first suture before the anterior capsule and labrum have been released. This makes this step much more difficult due to the lack of tension in the anterior tissues and anterior subluxation of the humeral head. (2) It allows the surgeon to choose, with accuracy, the amount of capsule taken, according to the severity of the capsular lesions and the degree of capsular laxity. It can also allow anatomic recreation of the anterior band of the inferior glenohumeral ligament (IGHL). (3) By placing tension on the suture, it avoids damaging the anterior capsule and labrum with the shaver and burr while preparing the scapula neck and can aid with haemostasis. (4) Tension on the suture also allows one to easily place 1 or 2 further sutures in a lower position. (5) It avoids entangling the sutures in the canula. (6) It allows one to perform a capsular shift of approximately 10 to 15 mm when the traction suture is retrieved and implanted with an anchor in the 3- or even 2-o'clock position. PMID:12861206

  12. Arthroscopic Anatomic Glenoid Reconstruction Without Subscapularis Split

    PubMed Central

    Wong, Ivan H.; Urquhart, Nathan

    2015-01-01

    The role of bone loss from the anterior glenoid in recurrent shoulder instability has been well established. We present a completely arthroscopic technique for reconstructing the anterior glenoid with distal tibial allograft and without a subscapularis split. We perform the arthroscopy in the lateral position. We measure and size an allograft distal tibial graft and place it arthroscopically. We use an inside-out medial portal to introduce the graft into the shoulder, passing it through the rotator interval and above the subscapularis. A double-cannula system is used to pass the graft, which is temporarily fixed with K-wires and held in place with cannulated screws. We then perform a Bankart-like repair of the soft tissues to balance the shoulder and augment our repair. Our technique is not only anatomic in the re-creation of the glenoid surface but also anatomic in the preservation of the coracoid and subscapularis tendon and repair of the capsulolabral complex. PMID:26697303

  13. Arthroscopic acromioplasty. Current status.

    PubMed

    Altchek, D W; Carson, E W

    1997-04-01

    Impingment is a chronic syndrome characterized by microtrauma, which causes progressive injury to the rotator cuff tendon. In recent years, arthro- scopic subacromial decompression/acromioplasty has been frequently used for the treatment of impingement syndrome and is quickly becoming the preferred surgical treatment when conservative modalities fail. Arthroscopic acromioplasty offers many benefits over open acromioplasty, including better cosmesis, lessened preoperative morbidity, a more complete intraoperative examination, and a hastened, early rehabilitation program. PMID:9113712

  14. Arthroscopic Bone Graft Procedure for Anterior Inferior Glenohumeral Instability

    PubMed Central

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

    2014-01-01

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

  15. Arthroscopic Suture Fixation in Femoral-Sided Avulsion Fracture of Anterior Cruciate Ligament

    PubMed Central

    Prasathaporn, Niti; Umprai, Vantawat; Laohathaimongkol, Thongchai; Kuptniratsaikul, Somsak; Kongrukgreatiyos, Kitiphong

    2015-01-01

    A femoral-sided avulsion fracture of the anterior cruciate ligament (ACL) is a rare and challenging condition. Most reported cases have occurred in childhood or adolescence. Many techniques of ACL repair have been reported, and in recent years, techniques in arthroscopic surgery have been developed and have become ever more popular with orthopaedic surgeons. We created a technique of arthroscopic ACL repair with suture anchor fixation for a femoral-sided ACL avulsion fracture. This technique saves the natural ACL stump. It is available for cases in which creation of a tibial tunnel is not allowed. Moreover, it does not require a skin incision for fixation on the far femoral cortex and, therefore, does not require a second operation to remove the fixation device. The arthroscopic technique also has a good cosmetic outcome. PMID:26258035

  16. Meniscal Repair

    PubMed Central

    Yoon, Kyoung Ho

    2014-01-01

    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

  17. Arthroscopic management of a chronic primary anterior shoulder dislocation.

    PubMed

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

    2010-07-01

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

  18. Arthroscopic Versus Open Stabilization for Anterior Shoulder Subluxations

    PubMed Central

    Owens, Brett D.; Cameron, Kenneth L.; Peck, Karen Y.; DeBerardino, Thomas M.; Nelson, Bradley J.; Taylor, Dean C.; Tenuta, Joachim; Svoboda, Steven J.

    2015-01-01

    Background: Most of the literature on shoulder instability focuses on patients experiencing anterior glenohumeral dislocation, with little known about the treatment of anterior subluxation events. Purpose: To determine the outcomes of surgical stabilization of patients with anterior glenohumeral subluxations and to compare open and arthroscopic approaches. Study Design: Randomized controlled trial; Level of evidence, 2. Methods: We prospectively enrolled patients with anterior glenohumeral subluxations undergoing surgical stabilization. Patients were offered randomization between open and arthroscopic stabilization. Inclusion criteria included patients with anterior glenohumeral subluxations undergoing Bankart repair, while exclusions included the presence of glenoid or humeral bone loss, multidirectional instability, capsular tear/humeral avulsion of the glenohumeral ligament lesion, and rotator cuff tear requiring repair. Patients were randomized to an open Bankart repair through a subscapularis takedown or an arthroscopic Bankart repair, both using the same bioabsorbable suture anchors, and they were followed for a minimum of 2 years. Outcomes were evaluated with the Single Assessment Numeric Evaluation (SANE), Western Ontario Shoulder Instability Index (WOSI), American Shoulder and Elbow Surgeons Score (ASES), Simple Shoulder Test (SST), Rowe, and Tegner activity scores. Results: A total of 26 patients were enrolled, with 7 being lost to follow-up. Complete follow-up data were available on 19 subjects (74%): 10 in the open group and 9 in the arthroscopic group. There were no significant differences noted between the randomized groups, with a 2-year WOSI score of 320 in the open subjects and 330 in the arthroscopic subjects, and similar findings in the other scoring scales. There were no cases of dislocation following surgery. There were 3 patients with recurrent instability (subluxations only) in each group at a mean of 17 months, for an overall recurrent subluxation rate of 31%. These subjects with recurrence had lower outcome scores (WOSI, 532; SANE, 88.4). The outcomes of the 9 subjects with ?3 subluxation events were superior to those of the 10 subjects with >3 events prior to stabilization. The patients with ?3 events had a WOSI score of 143, compared with 470 (P = .042), and an ASES mean score of 98.8, compared with 87.1 (P = .048). Four of the 6 patients with recurrent subluxations had sustained >3 subluxations prior to stabilization. Conclusion: Overall, patients with Bankart lesions resulting from an anterior glenohumeral subluxation event had excellent outcomes with surgical stabilization. The overall recurrence in the 19 subjects with at least 2-year follow-up was 6 cases (31%), with no instances of dislocation in this young, active cohort. There was no significant benefit to open or arthroscopic stabilization, and we did find that stabilization of subluxation patients with ?3 events resulted in superior outcomes compared with chronic recurrent subluxation patients with >3 events. We recommend early surgical stabilization of young athletes with Bankart lesions that result from anterior subluxation events. PMID:26535374

  19. The successful arthroscopic treatment of suprascapular intraneural ganglion cysts.

    PubMed

    Prasad, Nikhil K; Spinner, Robert J; Smith, Jay; Howe, Benjamin M; Amrami, Kimberly K; Iannotti, Joseph P; Dahm, Diane L

    2015-09-01

    OBJECT High-resolution magnetic resonance imaging (MRI) can distinguish between intraneural ganglion cysts and paralabral (extraneural) cysts at the glenohumeral joint. Suprascapular intraneural ganglion cysts share the same pathomechanism as their paralabral counterparts, emanating from a tear in the glenoid labrum. The authors present 2 cases to demonstrate that the identification and arthroscopic repair of labral tears form the cornerstone of treatment for intraneural ganglion cysts of the suprascapular nerve. METHODS Two patients with suprascapular intraneural ganglion cysts were identified: 1 was recognized and treated prospectively, and the other, previously reported as a paralabral cyst, was identified retrospectively through the reinter-pretation of high-resolution MR images. RESULTS Both patients achieved full functional recovery and had complete radiological involution of the intraneural ganglion cysts at the 3-month and 12-month follow-ups, respectively. CONCLUSIONS Previous reports of suprascapular intraneural ganglion cysts described treatment by an open approach to decompress the cysts and resect the articular nerve branch to the glenohumeral joint. The 2 cases in this report demonstrate that intraneural ganglion cysts, similar to paralabral cysts, can be treated with arthroscopic repair of the glenoid labrum without resection of the articular branch. This approach minimizes surgical morbidity and directly addresses the primary etiology of intraneural and extraneural ganglion cysts. PMID:26323813

  20. Augmented Virtuality for Arthroscopic Knee Surgery

    E-print Network

    Stewart, James

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

  1. Arthroscopic treatment of recurrent acetabulum osteoid osteoma.

    PubMed

    Tokis, Anastasios; Tsakotos, Georgios; Demesticha, Theano

    2014-04-01

    In this case report, arthroscopic treatment of a recurrent osteoid osteoma in the posterior column of the pelvis extending to the acetabular fovea in a young adolescent is being presented. PMID:24346741

  2. Arthroscopic Remplissage for Engaging Hill-Sachs Lesions in Patients With Anterior Shoulder Instability

    PubMed Central

    Camp, Christopher L.; Dahm, Diane L.; Krych, Aaron J.

    2015-01-01

    Anterior shoulder instability is often accompanied by a Hill-Sachs defect on the humeral head that can contribute to recurrent instability if not addressed at the time of surgery. We describe a method of performing arthroscopic remplissage to treat engaging Hill-Sachs lesions in patients with glenohumeral instability. It has the benefits of being an efficient procedure that can be performed with minimal technical difficulty and can be used to augment other stabilization procedures such as labral repair. The indications for this technique include the presence of an engaging Hill-Sachs defect in patients will little or no glenoid bone loss. In appropriately selected patients, arthroscopic remplissage has shown reduced rates of recurrent instability. PMID:26697311

  3. Arthroscopic treatment of glenoid fractures.

    PubMed

    Bauer, Thomas; Abadie, Olivier; Hardy, Philippe

    2006-05-01

    The patient was placed in the lateral decubitus position. The arthroscope was introduced through the posterior approach. The probe hook was introduced through a working cannula through the anterosuperior portal performed in an inside-out technique. The mobilization possibilities of the osteochondral fragments were then assessed. The use of a shaver was always necessary to clean the fracture site and evacuate clots. A nonabsorbable suture was passed through the labrum and the capsule tissue of the displaced articular fragment in its superior edge. The first suture was used as a traction stitch and allowed replacing the fragment in its original position and maintaining it during the placement of others sutures. A hole was made in the anterosuperior edge of the nonfractured glenoid and then a long drill was passed backward according to the transglenoid suture technique of Caspari or Morgan. Stitches were passed through the glenoid to the infraspinatus fossa. When articular congruity was judged satisfactory, the stitches were tied on the fascia of the infraspinatus muscle. The patients were immobilized in a sling for 3 weeks. PMID:16651173

  4. Arthroscopically Confirmed Femoral Button Deployment

    PubMed Central

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

    2014-01-01

    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

  5. Arthroscopic Treatment of Hip Chondral Defects With Bone Marrow Stimulation and BST-CarGel

    PubMed Central

    Tey, Marc; Mas, Jesús; Pelfort, Xavier; Monllau, Joan Carles

    2015-01-01

    Microfracture, the current standard of care for the treatment of non-degenerative chondral lesions in the hip joint, is limited by the poor quality of the filling fibrocartilaginous tissue. BST-CarGel (Piramal Life Sciences, Laval, Quebec, Canada) is a chitosan-based biopolymer that, when mixed with fresh, autologous whole blood and placed over the previously microfractured area, stabilizes the blood clot and enhances marrow-triggered wound-healing repair processes. BST-CarGel has been previously applied in the knee, with statistically significant greater lesion filling and superior repair tissue quality compared with microfracture treatment alone. In this report we describe the application of BST-CarGel for the arthroscopic treatment of hip chondral lesions. Our preliminary data suggest that our BST-CarGel procedure provides high-quality repair tissue and therefore may be considered a safe, cost-efficient therapeutic choice for the treatment of hip chondral defects. PMID:25973370

  6. Arthroscopic Implantation of a Bio-Inductive Collagen Scaffold for Treatment of an Articular-Sided Partial Rotator Cuff Tear

    PubMed Central

    Ryu, Richard K.N.; Ryu, Jessica H.J.; Abrams, Jeffrey S.; Savoie, Felix H.

    2015-01-01

    The treatment of articular-sided partial rotator cuff tears remains a challenge to the treating orthopaedic surgeon. Treatment algorithms have included nonoperative management, debridement alone, and debridement and subacromial decompression, as well as articular-sided rotator cuff repair and completion of the tear on the bursal side followed by a traditional arthroscopic rotator cuff repair. Implantation of a bio-inductive collagen scaffold on the bursal side of the rotator cuff to potentially heal an articular-sided tear represents a novel approach to this difficult clinical entity. PMID:26697308

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

    MedlinePLUS Videos and Cool Tools

    ... tuberosity, I think there's ample evidence from basic science work and from also clinical work that double- ... least that it's multifactorial. We know from basic science for people like Christian Gerber and many others ...

  8. Arthroscopic Osteochondral Grafting for Radiocarpal Joint Defects

    PubMed Central

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

    2013-01-01

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

  9. Arthroscopic Femoral Neck Osteoplasty in the Treatment of Femoroacetabular Impingement

    PubMed Central

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

    2013-01-01

    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

  10. Arthroscopic removal of an osteoid osteoma of the acetabulum.

    PubMed

    Barnhard, Renske; Raven, Eric E J

    2011-09-01

    In this case report, we describe the arthroscopic removal of an osteoid osteoma from the acetabulum in a young adolescent. After identifying the osteoid osteoma close to the cartilage with MRI and CT investigations, we decided that in this case, arthroscopic removal was the best treatment. In the case of an osteoid osteoma in the acetabulum close to the cartilage, arthroscopic removal should be considered as one can treat the associated osteochondritic lesion during this procedure. PMID:21445593

  11. Functional evaluation of arthroscopic treatment of SLAP lesions through the O’Brien portal?

    PubMed Central

    Rebouças, Fabiano; Pereira, Bruno Cesar; Rocha, Ricardo Dantas; Filardi, Cantídio Salvador; da Costa, Miguel Pereira; Filho, Romulo Brasil; Junior, Antonio Carlos Tenor

    2015-01-01

    Objective To evaluate the functional results from arthroscopic repair of SLAP lesions through the portal described by O’Brien. Methods A retrospective evaluation was conducted on 19 shoulders in 18 patients who underwent arthroscopic repair of SLAP lesions through the O’Brien portal between November 2007 and January 2012. Results Nineteen shoulders in 18 patients were evaluated: 16 male patients (84.2%) and three female patients (15.7%). The patients’ ages ranged from 27 to 40 years (mean of 34.3 years). There were 12 patients (63.1%) with injuries on the right shoulder, six (31.5%) with injuries on the left shoulder and one (5.2%) with bilateral injury. In relation to dominance, 13 patients (68.4%) presented the injury on the dominant limb and five (26.3%) were affected on the non-dominant limb. We observed that nine cases (47.3%) had SLAP lesions alone and 10 cases (52.6%) were related to glenohumeral instability. There was one case (5.2%) of recurrence of glenohumeral dislocation, but this patient chose not to undergo a new surgical intervention. According to the UCLA and ASES scales translated and adapted to the Portuguese language, 96% of the results were good or excellent. Conclusion The approach for treating SLAP lesions through the portal described by O’Brien et al. is easy to reproduce, with a high rate of good and excellent results and a low complication rate. PMID:26229936

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

    PubMed

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

    2014-05-10

    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

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

    PubMed

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

    2014-11-01

    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

  14. Arthroscopic treatment in split depression-type tibial pilon fracture.

    PubMed

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

    2015-02-01

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

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

    ERIC Educational Resources Information Center

    Silver, Daniel M.; Campbell, Pat

    1985-01-01

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

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

    PubMed Central

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

    2014-01-01

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

  17. Arthroscopic treatment for chronic lateral epicondylitis?

    PubMed Central

    Terra, Bernardo Barcellos; Rodrigues, Leandro Marano; Filho, Anis Nahssen; de Almeida, Gustavo Dalla Bernardina; Cavatte, José Maria; De Nadai, Anderson

    2015-01-01

    Objective To report the clinical and functional results from arthroscopic release of the short radial extensor of the carpus (SREC) in patients with chronic lateral epicondylitis that was refractory to conservative treatment. Methods Over the period from January 2012 to November 2013, 15 patients underwent arthroscopic treatment. The surgical technique used was the one described by Romeo and Cohen, based on anatomical studies on cadavers. The inclusion criteria were that the patients needed to present lateral epicondylitis and that conservative treatment (analgesics, anti-inflammatory agents, corticoid infiltration or physiotherapy) had failed over a period of more than six months. The patients were evaluated based on the elbow functional score of the Mayo Clinic, Nirschl's staging system and a visual analog scale (VAS) for pain. Results A total of 15 patients (9 men and 6 women) were included. The mean Mayo elbow functional score after the operation was 95 (ranging from 90 to 100). The pain VAS improved from a mean of 9.2 before the operation to 0.64 after the operation. On Nirschl's scale, the patients presented an improvement from a mean of 6.5 before the operation to approximately one. There were significant differences from before to after the surgery for the three functional scores used (p < 0.01). No correlations were observed using the Spearman test between the results and age, gender, length of time with symptoms before the operation or injury mechanism (p > 0.05). Conclusion Arthroscopic treatment for lateral epicondylitis was shown to be a safe and effective therapeutic option when appropriately indicated and performed, in refractory cases of chronic lateral epicondylitis. It also allowed excellent viewing of the joint space for diagnosing and treating associated pathological conditions, with a minimally invasive procedure. PMID:26401498

  18. Adipose derived mesenchymal stem cell therapy in the treatment of isolated knee chondral lesions: design of a randomised controlled pilot study comparing arthroscopic microfracture versus arthroscopic microfracture combined with postoperative mesenchymal stem cell injections

    PubMed Central

    Freitag, Julien; Ford, Jon; Bates, Dan; Boyd, Richard; Hahne, Andrew; Wang, Yuanyuan; Cicuttini, Flavia; Huguenin, Leesa; Norsworthy, Cameron; Shah, Kiran

    2015-01-01

    Introduction The management of intra-articular chondral defects in the knee remains a challenge. Inadequate healing in areas of weight bearing leads to impairment in load transmission and these defects predispose to later development of osteoarthritis. Surgical management of full thickness chondral defects include arthroscopic microfracture and when appropriate autologous chondrocyte implantation. This latter method however is technically challenging, and may not offer significant improvement over microfracture. Preclinical and limited clinical trials have indicated the capacity of mesenchymal stem cells to influence chondral repair. The aim of this paper is to describe the methodology of a pilot randomised controlled trial comparing arthroscopic microfracture alone for isolated knee chondral defects versus arthroscopic microfracture combined with postoperative autologous adipose derived mesenchymal stem cell injections. Methods and analysis A pilot single-centre randomised controlled trial is proposed. 40 participants aged 18–50?years, with isolated femoral condyle chondral defects and awaiting planned arthroscopic microfracture will be randomly allocated to a control group (receiving no additional treatment) or treatment group (receiving postoperative adipose derived mesenchymal stem cell treatment). Primary outcome measures will include MRI assessment of cartilage volume and defects and the Knee Injury and Osteoarthritis Outcome Score. Secondary outcomes will include further MRI assessment of bone marrow lesions, bone area and T2 cartilage mapping, a 0–10 Numerical Pain Rating Scale, a Global Impression of Change score and a treatment satisfaction scale. Adverse events and cointerventions will be recorded. Initial outcome follow-up for publication of results will be at 12?months. Further annual follow-up to assess long-term differences between the two group will occur. Ethics and dissemination This trial has received prospective ethics approval through the Latrobe University Human Research Ethics Committee. Dissemination of outcome data is planned through both national and international conferences and formal publication in a peer-reviewed journal. Trial registration number Australia and New Zealand Clinical Trials Register (ANZCTR Trial ID: ACTRN12614000812695). PMID:26685030

  19. Arthroscopic anterior shoulder stabilization with percutaneous assistance and posteroinferior capsular plication.

    PubMed

    Levy, David M; Gvozdyev, Borys V; Schulz, Brian M; Boselli, Karen J; Ahmad, Christopher S

    2014-08-01

    To study the technique and clinical outcomes of arthroscopic shoulder stabilization with anterior labral repair and percutaneous posteroinferior capsular plication, we retrospectively reviewed 20 cases. Mean (SD) final postoperative follow-up was 3.4 (0.6) years (range, 2.7-5.1 years). A mean (SD) of 4.9 (0.9) suture anchors (range, 4-7) was used during surgery, with 1.6 (0.7) (range, 1-3) devoted to the posteroinferior plication. There were statistically significant improvements in forward elevation (P = .016) and internal rotation (P = .018) from before surgery to final postoperative follow-up; external rotation did not change (P = .336). Significant improvements (P < .001) were also seen in visual analog scale pain ratings, American Shoulder and Elbow Surgeons survey scores, and Simple Shoulder Test scores. Mean (SD) Rowe instability score at final follow-up was 81.1 (28.9). Eighty-five percent of the patients returned to sport at or above preinjury level, and 70% returned to a degree of athletic physical contact at or above preinjury level. Two cases (10%) were categorized as treatment failures (redislocation). Percutaneously assisted arthroscopic anterior stabilization with posteroinferior capsular plication produces acceptable results, with functional outcomes and redislocation rates comparable to those reported in the literature. PMID:25136869

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

    PubMed Central

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

    2014-01-01

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

  1. Arthroscopic preparation of the posterior and posteroinferior glenoid labrum.

    PubMed

    Provencher, Matthew T; Romeo, Anthony A; Solomon, Daniel J; Bach, Bernard R; Cole, Brian J

    2007-11-01

    Using an anterior portal for a labral elevator and shaver instrument, with the arthroscope in the anterosuperior portal, allows the posterior and posteroinferior chondrolabral junction to be safely prepared. PMID:18019981

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

    PubMed Central

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

    2015-01-01

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

  3. Arthroscopic Acetabular Rim Resection in the Treatment of Femoroacetabular Impingement

    PubMed Central

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

    2013-01-01

    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

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

    PubMed Central

    Tao, Matthew A.; Garrigues, Grant E.

    2015-01-01

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

  5. Bankart arthroscopic procedure: comparative study on use of double or single-thread anchors after a 2-year follow-up?

    PubMed Central

    Godinho, Glaydson Gomes; Freitas, José Márcio Alves; França, Flávio de Oliveira; de Lago e Santos, Flávio Márcio; Aragão, Alan Arruda; Barros, Marcos Knoll

    2014-01-01

    Objective To compare the use of anchors with double and single-thread loading in the single-row Bankart arthroscopic procedure. Methods 252 patients (258 shoulders) underwent Bankart arthroscopic surgery with evaluation after a minimum follow-up of 2 years. They underwent repairs either using anchors with single loading of a high-resistance non-absorbable braided thread (206 shoulders; group AS) or using double loading of thread with the same characteristics (52 shoulders; group AD). The patients were evaluated using the UCLA and Carter-Rowe scales. The patients’ return to sports activity and recurrences were also compared. Results There was no significant difference between the groups regarding the surgical failure rate (group AS 5.8%; group AD 7.7%; p = 0.62). Group AS presented a better mean Carter-Rowe score (group AS 94.4; group AD 88.6; p < 0.05) and greater return to the same sports level (group AS 79.1; group AD 72.1; p < 0.05). Conclusion Use of anchors with double thread loading did not show any clinical advantage for arthroscopic repair of traumatic anterior shoulder instability, in relation to use of single-thread anchors, over a 2-year follow-up. PMID:26229884

  6. A navigation system for shoulder arthroscopic surgery.

    PubMed

    Tyryshkin, K; Mousavi, P; Beek, M; Ellis, R E; Pichora, D R; Abolmaesumi, P

    2007-10-01

    The general framework and experimental validation of a novel navigation system designed for shoulder arthroscopy are presented. The system was designed to improve the surgeon's perception of the three-dimensional space within the human shoulder. Prior to surgery, a surface model of the shoulder was created from computed tomography images. Intraoperatively, optically tracked arthroscopic instruments were calibrated. The surface model was then registered to the patient using tracked freehand ultrasound images taken from predefined landmark regions on the scapula. Three-dimensional models of the surgical instruments were displayed, in real time, relative to the surface model in a user interface. Laboratory experiments revealed only small registration and calibration errors, with minimal time needed to complete the intraoperative tasks. PMID:18019466

  7. SLAP Repairs With Combined Procedures Have Lower Failure Rate Than Isolated Repairs in a Military Population

    PubMed Central

    Waterman, Brian R.; Arroyo, William; Heida, Kenneth; Burks, Robert; Pallis, Mark

    2015-01-01

    Background: Injuries to the superior glenoid labrum represent a significant cause of shoulder pain among active patients. The physical requirements of military service may contribute to an increased risk of injury. Limited data are available regarding the success of superior labral anterior posterior (SLAP) repairs in an active military population. Purpose: To quantify the rate of clinical failure and surgical revision after isolated and combined SLAP repair. Study Design: Cohort study; Level of evidence, 3. Methods: All consecutive active-duty servicemembers undergoing arthroscopic repair of type II SLAP lesions at a single institution between 2006 and 2012 were identified. Patients with less than 2-year clinical follow-up and nonmilitary status were excluded. Demographic variables, surgical variables, and occupational outcomes were extracted from electronic medical records and confirmed with the US Army Physical Disability Agency database. Failure was defined as subsequent revision surgery or medical discharge with persistent shoulder complaints. Results: A total of 192 patients with SLAP repair were identified with a mean follow-up of 50.0 months (SD, 17.0 months). Isolated SLAP repair occurred in 31.3% (n = 60) versus 68.8% (n = 132) with concomitant procedures. At final follow-up, 37.0% (n = 71) of patients reported some subjective activity-related shoulder pain. Postoperative return to duty occurred in 79.6% (n = 153), and only 20.3% (n = 39) were discharged with continuing shoulder disability. The combined rotator cuff repair (96%; P = .023) and anteroinferior labral repair group (88%; P = .056) had a higher rate of functional return than isolated SLAP repair (70%). Thirty-one (16.1%) patients were classified as surgical failure and required revision. Of these, the majority of patients undergoing biceps tenodesis (76%) returned to active duty, as compared with revision SLAP repair (17%). Lower demand occupation and the presence of combined shoulder injuries (P = .011 and .016, respectively) were significantly associated with a lower risk of medical discharge and revision surgery, respectively. Conclusion: Favorable outcomes can be anticipated in the majority of military servicemembers after arthroscopic SLAP repair, particularly with combined shoulder injuries. Revision surgery occurred in 16% of patients after primary SLAP repair. Clinical Relevance: Isolated repair of unstable SLAP lesions and/or increased upper extremity demands are associated with higher failure rates in this population. PMID:26535389

  8. Comma Sign–Directed Repair of Anterosuperior Rotator Cuff Tears

    PubMed Central

    Dilisio, Matthew F.; Neyton, Lionel

    2014-01-01

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

  9. [Arthroscopic versus open anterior shoulder stabilization. A systematic validation].

    PubMed

    Steinbeck, J; Witt, K-A; Marquardt, B

    2009-01-01

    The treatment of traumatic anterior glenohumeral instability has been a topic of debate over the last couple of decades. However, a consensus exists regarding the necessity of an individualized treatment plan based on the type and degree of instability and the patient's functional demands. Various open and arthroscopic techniques are among the currently used surgical procedures. Open reconstruction of the capsulolabral complex had been considered the treatment of choice for many years, but the latest results for arthroscopic anterior shoulder stabilization demonstrate its increasing use. The current literature suggests that with the introduction of suture anchors, it is possible to mirror the principles of open anterior shoulder stabilization and thus combine the general advantages of arthroscopic surgery with a low recurrence rate. PMID:19093098

  10. The Results of All-Inside Meniscus Repair Using the Viper Repair System Simultaneously with Anterior Cruciate Ligament Reconstruction

    PubMed Central

    Kang, Hong Je; Kim, Kwang Mee; Cho, Hang Hwan; Espinosa, Johnsel C.

    2015-01-01

    Background Meniscus tears are commonly associated with anterior cruciate ligament (ACL) ruptures. It is essential to repair meniscal tears as much as possible to prevent early osteoarthritis and to gain additional stability in the knee joint. We evaluated the results of arthroscopic all-inside repair using the Meniscal Viper Repair System (Arthrex) on meniscus tears simultaneously with ACL reconstruction. Methods Nineteen out of 22 patients who were treated with arthroscopic all-inside repair using the Meniscal Viper Repair System for meniscus tear associated with ACL rupture were evaluated. ACL reconstructions were performed at the same period. The mean follow-up period was 16.5 months (range, 12 to 24 months). The clinical results of the meniscus repair were evaluated by symptoms (such as catching or locking), tenderness, effusion, range of motion limitation, and the McMurray test. Clinical success was defined by negative results in all five categories. The Hospital for Special Surgery (HSS) score was evaluated. Objective results were evaluated with secondary look arthroscopy or magnetic resonance imaging (MRI). The MRI results were categorized as completely repaired, incompletely repaired, and failure by Henning's classification. The results of second-look arthroscopy were evaluated with the criteria of meniscal healing. Results The clinical success rate was 95.4% and the HSS scores were 93.9 ± 5.4 at the final follow-up. According to Henning's classification, 15 out of 18 cases showed complete healing (83.3%) and two cases (11.1%) showed incomplete healing. Seventeen out of 18 cases that underwent second-look arthroscopy showed complete healing (94.4%) according to the criteria of meniscal healing. Only one case showed failure and the failure was due to a re-rupture at the sutured area. Complications of ACL reconstruction or meniscus repair were not present. Conclusions The results demonstrate that arthroscopic all-inside repair using the Meniscal Viper Repair System is an effective treatment method when it is performed simultaneously with ACL reconstruction. PMID:26217463

  11. Simulation of arthroscopic surgery using MRI data

    NASA Technical Reports Server (NTRS)

    Heller, Geoffrey; Genetti, Jon

    1994-01-01

    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.

  12. Arthroscopic Labral Reconstruction of the Hip Using Local Capsular Autograft

    PubMed Central

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

    2014-01-01

    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

  13. Image-driven haptic simulation of arthroscopic surgery.

    PubMed

    Rasool, Shahzad; Sourin, Alexei; Kagda, Fareed

    2013-01-01

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

  14. Arthroscopic Correction of a Supracondylar Malunion in a Child

    PubMed Central

    Koehler, Steven M.; Sakamoto, Sara; Abernathie, Brenon L.; Hausman, Michael R.

    2015-01-01

    Malunions are a well-recognized complication of pediatric supracondylar humeral fractures. Results of corrective osteotomies vary, and complication rates have been reported to be as high as 40%. Considering the high rate of complications for malunion correction, we investigated the feasibility of arthroscopy. We present a technique for arthroscopic supracondylar osteotomy and percutaneous pinning. There are many advantages of an arthroscopic approach to malunion correction, including extension-type deformity correction, safe access to the anterior humerus, and minimal dissection and scarring; any intracapsular contracture can be addressed as well. Elbow arthroscopy appears to be a viable option in the pediatric orthopaedic surgeon's armamentarium. PMID:26258033

  15. Arthroscopic extirpation of an osteoid osteoma of the acetabulum.

    PubMed

    Alvarez, M S; Moneo, P R; Palacios, J A

    2001-09-01

    We present the case of a 16-year-old boy with an 18-month history of pain in the left groin for 18 months. In addition to the simple radiographic examination, magnetic resonance imaging, bone scan, and computed tomography were necessary to finally diagnose an acetabulum osteoid osteoma (AOO). Excision of the lesion was performed arthroscopically and pathologic testing confirmed the diagnosis. The patient's symptoms disappeared immediately after the surgery, and had not reappeared as of the 6-month postoperative evaluation. We conclude that arthroscopic excision of an AOO is possible and avoids the aggressive open approach as well as operative hip dislocation. PMID:11536099

  16. The “Flying Swan” Technique: A Novel Method for Anterior Labral Repair Using a Tensioned Suture Bridge

    PubMed Central

    Alexander, Susan; Wallace, Andrew L.

    2014-01-01

    Arthroscopic labral repair is an effective technique for most cases of traumatic shoulder instability. However, patients with anterior labroligamentous periosteal sleeve avulsion lesions frequently have multiple episodes of subluxation or dislocation and a high recurrence rate after surgery, even with modern methods of labral repair. One reason may be failure of biological healing of the labrum due to an inadequate “footprint” of contact between the capsulolabral tissue and the glenoid bone. We have developed a technique that facilitates a tensioned suture bridge between suture anchors that may improve the results of labral repair in patients with anterior labroligamentous periosteal sleeve avulsion lesions. PMID:24749030

  17. Arthroscopic excision of osteoid osteoma in the posteroinferior portion of the acetabulum.

    PubMed

    Chang, Byeong-Keun; Ha, Yong-Chan; Lee, Young-Kyun; Hwang, Deuk-Soo; Koo, Kyung-Hoi

    2010-12-01

    Osteoid osteoma in the acetabulum is very rare and the surgical extirpation is difficult. We present a case of osteoid osteoma in the posteroinferior portion of the acetabulum which was treated with arthroscopic excision. A 29-year-old woman presented with 18 months of pain in the left groin. Computed tomography suggested an osteoid osteoma in the posteroinferior portion of the acetabulum. Arthroscopic excision of the lesion was performed with the aid of image intensifier. The patient's symptoms disappeared immediately after the surgery. This case report shows that arthroscopic excision is possible in a lesion in the posteroinferior portion in the acetabulum, which previously deemed inaccessible arthroscopically. PMID:20422402

  18. Evaluation of arthroscopic treatment of posterior shoulder instability

    PubMed Central

    Garcia, José Carlos; Maia, Lucas Russo; Fonseca, Juliano Rocha; Zabeu, José Luís Amim; Garcia, Jesely Pereira Myrrha

    2015-01-01

    OBJECTIVE: To provide data for the analysis of arthroscopy as a method of surgical treatment for shoulder and discuss its actual indications and preliminary results. METHODS: We evaluated 15 patients submitted to reverse Bankart arthroscopic surgery. We used the UCLA (University of California at Los Angeles) score to measure the results before surgery and 12 months thereafter. RESULTS: The average UCLA score changed from 26.67±0.25 (SD 0.97) before surgery to 34.20±0.53 (SD 2.04) after surgery. The effectiveness of surgery was 93%. In five cases loose bodies were found. A patient undergoing remplissage was evaluated separately. The data did not change after 24 months post-surgery. CONCLUSION: The arthroscopic treatment of posterior shoulder instability and posterior dislocation of the shoulder has been proved feasible and results in our series followed the same trends as in the literature. Level of Evidence III, Transversal Retrospective Study. PMID:26207089

  19. Arthroscopic Bony Bankart Fixation Using a Modified Sugaya Technique

    PubMed Central

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

    2013-01-01

    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

  20. Femoral Neck Fracture After Arthroscopic Femoroplasty of the Hip.

    PubMed

    Merz, Michael K; Christoforetti, John J; Domb, Benjamin G

    2015-08-01

    Hip arthroscopy is an increasingly common procedure, particularly for the treatment of femoroacetabular impingement. Various complications have been previously reported, and the authors sought to further evaluate the safety of this procedure. This study was conducted to identify the incidence of femoral neck fracture as well as treatment and outcomes after arthroscopic femoroplasty. In April 2013, a survey was administered to 28 established hip arthroscopists regarding the breadth of their experience, including the total number of hip arthroscopies and proximal femoroplasties performed and the number of postoperative femoral neck fractures. Fracture type, patient age, patient sex, time to fracture, comorbidities, treatments, and outcomes were queried. The study identified 27,200 total arthroscopies and 14,945 proximal femoroplasties performed by the surgeons, with 11 postoperative proximal femur fractures. The incidence of proximal femur fracture after arthroscopic femoroplasty was 0.07%, based on combined data of high-volume hip arthroscopists at multiple medical centers. Mean time to fracture after arthroscopic femoroplasty was 40.5 (±26.6) days postoperatively. The male-to-female ratio was approximately 1:3 for those with fracture, and mean patient age was 52 (±13) years. More than half of the fractures were caused by violation of weight-bearing precautions. All patients had improvement in symptoms after treatment. Femoral neck fracture after arthroscopic femoroplasty is a rare complication for established hip arthroscopists. It is most common in women and patients older than 50 years. Treatment is based on the severity of the fracture, and patients have improved outcomes after treatment. PMID:26270756

  1. Open and Arthroscopic Surgical Treatment of Femoroacetabular Impingement

    PubMed Central

    Kuhns, Benjamin D.; Frank, Rachel M.; Pulido, Luis

    2015-01-01

    Femoroacetabular impingement (FAI) is a common cause of hip pain, and when indicated, can be successfully managed through open surgery or hip arthroscopy. The goal of this review is to describe the different approaches to the surgical treatment of FAI. We present the indications, surgical technique, rehabilitation, and complications associated with (1) open hip dislocation, (2) reverse periacetabular osteotomy, (3) the direct anterior “mini-open” approach, and (4) arthroscopic surgery for FAI. PMID:26697431

  2. Arthroscopic pancapsular plication for multidirectional shoulder instability in overhead athletes.

    PubMed

    Ma, Hsiao-Li; Huang, Hui-Kuang; Chiang, En-Rung; Wang, Shih-Tein; Hung, Shih-Chieh; Liu, Chein-Lin

    2012-04-01

    Treating shoulder multidirectional instability with an open stabilization procedure has been reported to have good results. However, few studies exist of arthroscopic plication, especially in overhead athletes. The purpose of this study was to evaluate the clinical outcomes of arthroscopic pancapsular plication for multidirectional instability in overhead athletes.Twenty-three athletes with symptomatic multidirectional instability were treated with arthroscopic pancapsular plication and evaluated at a mean follow-up of 36.3 months (range, 24-61 months). Mean patient age was 23.3 years (range, 19-33 years). Functional outcomes were evaluated with the American Shoulder and Elbow Surgeons (ASES) score, Constant shoulder score, and Rowe instability score. The degree of pain and range of motion were also recorded. All postoperative functional scores were rated good to excellent, with an average ASES score of 88.4 (range, 82-95), average Constant shoulder score of 88.1 (range, 81-100), and average Rowe instability score of 86.7 (range, 80-100). Five patients returned to the same level of competitive sports, and 18 returned to a limited level. All patients were satisfied with the stability postoperatively. No significant change was observed in postoperative range of motion, but patients who returned to a limited level of sports had lower functional scores and more pain than did those who fully returned to sports.Arthroscopic pancapsular plication for treating multidirectional instability in overhead athletes can provide good stability. However, the low rate of return to a full level of overhead sports is a problem. Further evaluation of the benefits of this procedure for overhead athletes with symptomatic multidirectional instability is needed. PMID:22495849

  3. Arthroscopic Synovectomy for Zone 2 Flexor Hallucis Longus Tenosynovitis

    PubMed Central

    Lui, Tun Hing

    2015-01-01

    Tenosynovitis of the flexor hallucis longus tendon is a condition typically found in ballet dancers and sometimes in soccer players and is related to chronic overuse. It mostly involves the portion of the tendon behind the ankle joint. However, the portion of the tendon under the sustentaculum tali can also be involved. Open synovectomy requires extensive dissection. We report the technique of arthroscopic synovectomy of the deep portion of the flexor hallucis longus. PMID:26697294

  4. Arthroscopically assisted excision of osteoid osteoma involving the hip.

    PubMed

    Khapchik, V; O'Donnell, R J; Glick, J M

    2001-01-01

    Two cases of arthroscopically assisted excision of osteoid osteoma involving the femoral neck and acetabulum are presented. This technique allows for percutaneous excision of this benign bone lesion in those rare circumstances when it occurs in an intra-articular location. The approach enables direct visualization of the tumor as well as histologic confirmation. There was minimal morbidity, excellent relief of symptoms, and rapid functional restoration. PMID:11154368

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

    PubMed

    Hwang, Yong Gil; Kwoh, C Kent

    2014-04-01

    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

  6. The Comprehensive Arthroscopic Management Procedure for Treatment of Glenohumeral Osteoarthritis

    PubMed Central

    Mook, William R.; Petri, Maximilian; Greenspoon, Joshua A.; Millett, Peter J.

    2015-01-01

    Younger, high-demand patients who are less suitable for joint replacement procedures are often affected by advanced glenohumeral osteoarthritis. There are several alternatives to total joint arthroplasty for the treatment of these patients. However, the outcomes of these procedures are less predictable and have limited durability. The comprehensive arthroscopic management procedure, which includes a combination of arthroscopic glenohumeral debridement, chondroplasty, synovectomy, loose body removal, humeral osteoplasty with excision of the goat's beard osteophyte, capsular releases, subacromial and subcoracoid decompressions, axillary nerve decompression, and biceps tenodesis, has been shown to reduce pain, improve function, and provide a predictable short-term joint-preserving option for patients with advanced glenohumeral osteoarthritis. A unique feature of the comprehensive arthroscopic management procedure is the indirect and direct decompression of the axillary nerve, which may explain the difference in outcomes with this technique compared with other approaches. Furthermore, the technique is technically demanding and associated with several notable pitfalls that are preventable when using the meticulous surgical technique detailed in this article and accompanying video. PMID:26697301

  7. Arthroscopic Treatment of Symptomatic Internal Snapping Hip with Combined Pathologies

    PubMed Central

    Hwang, Duck-Soo; Hwang, Jung-Mo; Kim, Pil-Sung; Rhee, Sung-Min; Park, Seung-Hwan; Kang, Soo Yong

    2015-01-01

    Background Arthroscopic iliopsoas tendon release was introduced in 2000. The purpose of this study was to evaluate clinical outcomes of arthroscopic iliopsoas tendon release for painful internal snapping hip with concomitant hip pathologies. Methods Between January 2009 and December 2011, we performed arthroscopic iliopsoas tendon release and related surgeries in 25 patients (20 men and 5 women; mean age, 32 years; range, 17 to 53 years) with combined intraarticular hip pathologies. The patients were followed for a minimum of 2 years postoperatively. Clinical and radiological evaluations were performed. Results Snapping sounds had disappeared by the 2-year follow-up in 24 of the 25 patients. All patients who had presented with loss of flexion strength postoperatively showed recovery at postoperative week 6 to 10. Harris hip score improved from 65 points (range, 46 to 86 points) preoperatively to 84 points (range, 67 to 98 points) postoperatively (p < 0.001). Seven hips (28%) had an excellent score, 15 hips (60%) a good score, 2 hips (8%) a fair score, and one hip (4%) a poor score (p < 0.001). The Tonnis grade of osteoarthritis did not change in any of the patients at the last follow-up. Conclusions Patients with painful internal snapping hip have combined hip pathologies. Therefore, the surgeon should keep in mind that painful internal snapping hips are frequently combined with concomitant intraarticular pathologies. PMID:26217460

  8. Arthroscopic Treatment of Intraosseous Ganglion Cyst of the Lunate Bone

    PubMed Central

    Cerlier, Alexandre; Gay, André-Mathieu; Levadoux, Michel

    2015-01-01

    Intraosseous ganglion cysts are rare causes of wrist pain. Surgical treatment of this pathologic condition yields good results and a low recurrence rate. The main complications are joint stiffness and vascular disturbances of the lunate bone. Wrist arthroscopy is a surgical technique that reduces the intra-articular operative area and therefore minimizes postoperative stiffness. This article describes an arthroscopic technique used for lunate intraosseous cyst resection associated with an autologous bone graft in a series of cases to prevent joint stiffness while respecting the scapholunate ligament. This study was based on a series of 4 patients, all of whom had wrist pain because of intraosseous ganglion cysts. Arthrosynovial cyst resection, ganglion curettage, and bone grafting were performed arthroscopically. Pain had totally disappeared within 2 months after the operation in 100% of patients. The average hand grip strength was estimated at 100% compared with the opposite side, and articular ranges of motion were the same on both sides in 100% of cases. No complications were reported after surgery. On the basis of these results, arthroscopic treatment of intraosseous synovial ganglion cysts seems to be more efficient and helpful in overcoming the limitations of classic open surgery in terms of complications.

  9. Magnetic resonance imaging arthrography following type II superior labrum from anterior to posterior repair: interobserver and intraobserver reliability

    PubMed Central

    Kurji, Hafeez M; Ono, Yohei; Nelson, Atiba A; More, Kristie D; Wong, Ben; Dyke, Corinne; Boorman, Richard S; Thornton, Gail M; Lo, Ian KY

    2015-01-01

    Background Arthroscopic repair of type II superior labrum from anterior to posterior (SLAP) lesions is a common surgical procedure. However, anatomic healing following repair has rarely been investigated. The intraobserver and interobserver reliability of magnetic resonance imaging arthrography (MRA) following type II SLAP repair has not previously been investigated. This is of particular interest due to recent reports of poor clinical results following type II SLAP lesion repair. Purpose To evaluate the MRA findings following arthroscopic type II SLAP lesion repair and determine its intraobserver and interobserver reliability. Study design Cohort study (diagnosis), Level of Evidence, 2. Methods Twenty-five patients with an isolated type II SLAP lesion (confirmed via diagnostic arthroscopy) underwent standard suture anchor-based repair. At a mean of 25.2 months post-operatively, patients underwent a standardized MRA protocol to investigate the integrity of the repair. MRAs were independently reviewed by two radiologists and a fellowship trained shoulder surgeon. The outcomes were classified as healed SLAP repair or re-torn SLAP repair. Results On average, 54% of MRAs were interpreted as healed SLAP repairs while 46% of MRAs were interpreted as having a re-torn SLAP repair. Overall, only 43% of the studies had 100% agreement across all interpretations. The intraobserver reliability ranged from 0.71 to 0.81 while the interobserver reliability between readers ranged from 0.13 to 0.44 (Table 1). Conclusion The intraobserver agreement of MRA in the evaluation of type II SLAP repair was substantial to excellent. However, the interobserver agreement of MRA was poor to fair. As a result, the routine use of MRA in the evaluation of type II SLAP lesion repair should be utilized with caution. A global evaluation of the patient, including detailed history and physical examination, is paramount in determining the cause of failure and one should not rely on MRA alone. PMID:26604841

  10. Ultrasonography-Assisted Arthroscopic Proximal Iliotibial Band Release and Trochanteric Bursectomy

    PubMed Central

    Weinrauch, Patrick; Kermeci, Sharon

    2013-01-01

    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

  11. Arthroscopic evaluation and management after repeated luxatio erecta of the glenohumeral joint.

    PubMed

    Tracy, Sean C; Myer, Jonathan J

    2009-05-01

    Luxatio erecta, inferior dislocation of the glenohumeral joint, is a relatively rare type of glenohumeral dislocation, accounting for <0.5% of all shoulder dislocations. It has been well described in terms of presentation and conservative management. Arthroscopic findings after the more commonly found anteroinferior glenohumeral dislocation have also been described. However, we know of only 1 case report that details the arthroscopic findings and open surgical management in a patient who sustained a single episode of luxatio erecta. Additionally, we were unable to find any reports in the literature of the arthroscopic management of this type of dislocation. We present the arthroscopic findings and arthroscopic management of an 18-year-old male college football player who reported 7 episodes of left shoulder luxatio erecta. Arthroscopic evaluation revealed an extensive anterior capsulolabral injury as well as a superior labrum anteroposterior (SLAP) tear. Additionally, there were extensive articular cartilage changes of the anterosuperior glenoid, a posterior Hill-Sachs lesion, and an anterosuperior humeral head cartilage indentation. The anterior capsulolabral injury and the SLAP lesion were fixed arthroscopically with suture anchors. The remainder of the lesions were debrided. The patient was able to return to college-level football and reported no further episodes of instability, pain, or stiffness at 3-year follow-up. PMID:19472949

  12. Arthroscopic Tenoplasty in Congenital Split Biceps Long Head

    PubMed Central

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

    2014-01-01

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

  13. Arthroscopic assessment of stifle synovitis in dogs with cranial cruciate ligament rupture.

    PubMed

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

    2014-01-01

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

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

    PubMed Central

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

    2014-01-01

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

  15. Bladder exstrophy repair

    MedlinePLUS

    Bladder birth defect repair; Everted bladder repair; Exposed bladder repair; Repair of bladder exstrophy ... in boys and is often linked to other birth defects. Surgery is necessary to: Allow the child to ...

  16. Turbine repair process, repaired coating, and repaired turbine component

    DOEpatents

    Das, Rupak; Delvaux, John McConnell; Garcia-Crespo, Andres Jose

    2015-11-03

    A turbine repair process, a repaired coating, and a repaired turbine component are disclosed. The turbine repair process includes providing a turbine component having a higher-pressure region and a lower-pressure region, introducing particles into the higher-pressure region, and at least partially repairing an opening between the higher-pressure region and the lower-pressure region with at least one of the particles to form a repaired turbine component. The repaired coating includes a silicon material, a ceramic matrix composite material, and a repaired region having the silicon material deposited on and surrounded by the ceramic matrix composite material. The repaired turbine component a ceramic matrix composite layer and a repaired region having silicon material deposited on and surrounded by the ceramic matrix composite material.

  17. Motorcycle Repair.

    ERIC Educational Resources Information Center

    Hein, Jim; Bundy, Mike

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

  18. Snowmobile Repair.

    ERIC Educational Resources Information Center

    Helbling, Wayne

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

  19. Arthroscopic Identification of the Anterolateral Ligament of the Knee.

    PubMed

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

    2014-06-01

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

  20. A minimally invasive medial patellofemoral ligament arthroscopic reconstruction.

    PubMed

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

    2014-02-01

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

  1. Treatment of Type 3 Arthrofibrosis Following Arthroscopic Reconstruction of ACL and Posterolateral Corner Injury with Tibia Plateau Fracture in a Professional Dancer

    PubMed Central

    Aksu, Neslihan; Abay, Burak; Soydan, Ramazan; Atansay, Vefa

    2014-01-01

    Objectives: Arthrofibrosis is a serious complication following the reconstruction of anterior cruciate ligament (ACL) and posterolateral corner (PLC) injury. Loss of motion caused by arthrofibrosis can be disabling in young and active patients. We report the clinical results of the treatment of arthrofibrosis following arthroscopic reconstruction of ACL with ipsilateral hamstring tendon graft and surgically repairing PLC with 2 suture anchors in a 30 year-old professional dancer, treated with surgical lysis and manipulation under general anesthesia followed by aggressive physical therapy. Methods: A 30 year-old male professional dancer presented with pain, effusion and severe instability in his left knee after falling in a dance event. The pain was evaluated on Visual analog scale (VAS) as 6 to 8. At the physical examination, anterior drawer test was evaluated as grade 3, pivot shift test, varus test, dial test and posterolateral drawer test were found positive. The Tegner Lysholm score was evaluated as 22 (poor). Under general anesthesia, left knee had tendency to external rotation and recurvatum when leg was suspended by toes. A magnetic resonance image (MRI) revealed the presence of a total ACL rupture, PLC injury and a fracture of lateral tibia plateau. The patient was treated with arthroscopic reconstruction of ACL with ipsilateral hamstring tendon graft fixed with endobutton through femoral tunnel and bio interference screw through tibial tunnel and PLC injury was treated with 2 suture anchors. Postoperatively first day, quadriceps musculature and active and passive ROM exercises was trained. During postoperatively third week, the patient was allowed to mobilize nonweight bearing with the use of two crutches without functional knee brace. At the sixth week, arthroscopic lysis was performed due to type 3 arthrofibrosis. At the tenth week, manipulation was performed to the left knee under general anesthesia. Results: At the 3 month- follow-up, the patient achieved full symmetric restoration of motion and he had returned to full daily activities. The Tegner Lysholm score was evaluated as 94 (excellent) postoperatively. Functional examination of the left knee reveled 155 of flexion, and full knee extension. The complaint of instability was disappeared. At 9 month-follow-up, clinical findings were unremarkable, with no sign of re-rupture and arthrofibrosis and he returned to his professional dance career. Conclusion: In the literature there is not any consensus regarding the management and rehabilitation intervention for arthrofibrosis in young athletes or professional dancers. The best treatment method is preventing the arthrofibrosis once it has occurred with surgical lysis and aggressive physical therapy. The combined surgical treatment and physiotherapy described in this case report may assist clinicians in the treatment of arthrofibrosis after arthroscopic reconstruction of ACL and PLC injury.

  2. Rotator Interval Lesion and Damaged Subscapularis Tendon Repair in a High School Baseball Player

    PubMed Central

    Muto, Tomoyuki; Ninomiya, Hiroki; Inui, Hiroaki; Komai, Masahiko; Nobuhara, Katsuya

    2015-01-01

    In 2013, a 16-year-old baseball pitcher visited Nobuhara Hospital complaining of shoulder pain and limited range of motion in his throwing shoulder. High signal intensity in the rotator interval (RI) area (ball sign), injured subscapularis tendon, and damage to both the superior and middle glenohumeral ligaments were identified using magnetic resonance imaging (MRI). Repair of the RI lesion and partially damaged subscapularis tendon was performed in this pitcher. During surgery, an opened RI and dropping of the subscapularis tendon were observed. The RI was closed in a 90° externally rotated and abducted position. To reconfirm the exact repaired state of the patient, arthroscopic examination was performed from behind. However, suture points were not visible in the >30° externally rotated position, which indicates that the RI could not be correctly repaired with the arthroscopic procedure. One year after surgery, the patient obtained full function of the shoulder and returned to play at a national convention. Surgical repair of the RI lesion should be performed in exactly the correct position of the upper extremity. PMID:26618017

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

    PubMed

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

    2010-10-01

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

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

    PubMed Central

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

    2014-01-01

    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

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

    PubMed

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

    2015-01-01

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

  6. Arthroscopic Treatment of Septic Arthritis of the Elbow in a 4-Year-Old Girl

    PubMed Central

    Koide, Masashi; Tojo, Yuichi; Hagiwara, Yoshihiro; Nakajima, Souichi; Tanaka, Minoru; Honda, Masahito; Itoi, Eiji

    2015-01-01

    Pediatric septic arthritis is uncommon and has been traditionally treated by joint aspiration or open arthrotomy. There are some reports about arthroscopic surgery in pediatric septic arthritis of the knee, hip, and shoulder. However, there is no report for the case of elbow. We report a case of pediatric septic arthritis of elbow treated with arthroscopically with good clinical condition at 3-year follow-up. This paper is based on a report first published in Japanese (Tojo (2012)). PMID:26713167

  7. All-Arthroscopic Technique for Reconstruction of Acute Acromioclavicular Joint Dislocations

    PubMed Central

    Cutbush, Kenneth; Hirpara, Kieran M.

    2015-01-01

    Acromioclavicular joint dislocations are a common injury particularly among contact sports players. There has been an increasing trend toward arthroscopic management of these injuries. To date, these reconstructions have primarily addressed superoinferior instability by reconstructing the coracoclavicular ligaments. We describe an all-arthroscopic technique for reconstruction of the coracoclavicular ligaments using Arthrex ABS TightRopes (Arthrex, Naples, FL), with additional stabilization of the superior acromioclavicular joint capsule using an anchor-based suture bridge to address anteroposterior instability. PMID:26697307

  8. A new "double-pulley" dual-row technique for arthroscopic fixation of bony Bankart lesion.

    PubMed

    Zhang, Jin; Jiang, Chunyan

    2011-09-01

    The double-row technique is a new concept for arthroscopic treatment of bony Bankart lesion in shoulder instability. It presents a new and reproducible technique for arthroscopic fixation of bony Bankart fragments with suture anchors. This technique creates double-mattress sutures which compress the fragment against its bone bed and restores better bony anatomy of the anterior glenoid rim with stable and non-tilting fixation that may improve healing. PMID:21290115

  9. Repairing Conveyor 

    E-print Network

    Unknown

    2011-08-17

    ..................................................................................................... 26 2.9 Bronze anchor from the Bodrum Museum of Underwater Archaeology, with associated stock showing clear curvature ................. 27 x 2.10 Wood remains attached to ABX-7 and what appears... intended as a repair or an attempt to complete the construction of a previously unfinished temple.3 Having sourced the drums 1 Pulak and Rogers 1994, 18-20. 2 Carlson and Aylward 2010, 145. 3...

  10. Arthroscopic Transfer of the Long Head of the Biceps Tendon

    PubMed Central

    Taylor, Samuel; Baret, Nikolas J.; Newman, Ashley; Delos, Demetris; Drakos, Mark; Copple, Zachary M.; DiPietro, James R.; O'Brien, Stephen J.

    2013-01-01

    Objectives: Evaluation of the mid-term clinical and functional outcome in a cohort of patients who underwent transfer of the long head of the biceps tendon (LHBT). Methods: Patients diagnosed with biceps instability or related pathology that underwent arthroscopic assisted or all arthroscopic transfer of the long head of the biceps tendon to the conjoint tendon were considered. The procedure was performed either as an isolated procedure on in conjunction with another procedure by the senior author. Outcome surveys were collected for 157 patients with a subset of 43 patients available for clinical examination at 2-10 years postop time point. Outcome measures were based on American Society of Shoulder and Elbow Surgeons (ASES), University of California at Los Angeles (UCLA), and L’Insalata questionnaires. Ipsilateral and contralateral metrics were also evaluated. Results: 157 patients (25 female, 132 male; average age 50 years; average postop 4.9 years) were evaluated with L’Insalata, UCLA, and ASES questionnaires, scoring 84.78, 29.77, and 83.4, respectively. In the 33 patients who had an isolated LHBT transfer, the L’Insalata, UCLA, and ASES scores were 79.52, 27.6, and 83.95, respectively. 43 shoulders (7 female, 36 male; average age 50 years; average postop 5.1 years) were available for clinical examination by a physician other than the treating surgeon. There was no statistically significant side-to- side strength difference using a 10-pound weight. All of the patients reported no arm pain at rest with regard to the biceps. 81% of patients reported no biceps tenderness upon palpation of the bicipital groove and 85.8% had a negative throwing test. 95.2% of patients had a negative active compression test. Speed’s and Yergason’s tests were negative in 90.5% and 95.2% of patients respectively. One patient (3%) complained of fatigue discomfort (soreness) isolated to the biceps muscle following resisted elbow flexion. Five patients (12.0%) had a Popeye sign and one patient (3%) exhibited biceps subsidence. 86% of patients were self-rated as good to excellent, with the remaining 14% reporting fair or poor results. Conclusion: Arthroscopic subdeltoid transfer of the LHBT to the conjoint tendon is an appropriate and reliable intervention for active patients with chronic, refractory biceps pathology. There was no loss of strength for biceps curls. All patients reported no pain isolated to biceps muscle at rest. Ninety-seven percent of patients had resolution of their preoperative biceps symptoms.

  11. Arthroscopic Decompression of Central Acetabular Impingement With Notchplasty

    PubMed Central

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

    2014-01-01

    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

  12. The pathoanatomy and arthroscopic management of femoroacetabular impingement

    PubMed Central

    Tibor, L. M.; Leunig, M.

    2012-01-01

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

  13. Arthroscopic Reduction of Complex Dorsal Metacarpophalangeal Dislocation of Index Finger

    PubMed Central

    Kodama, Akira; Itotani, Yuji; Mizuseki, Takaya

    2014-01-01

    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

  14. Return to sport after arthroscopic meniscectomy on stable knees

    PubMed Central

    2013-01-01

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

  15. Clinical Results of Meniscal Repair Using Submeniscal Horizontal Sutures

    PubMed Central

    Navali, Amir Mohammad; Aslani, Hossein

    2015-01-01

    Background: Parts of the implants placed over the meniscus during meniscal repair can wear down the cartilage in the contact zones and cause chronic synovitis. Placing horizontal sutures under the meniscus may overcome this potential hazard. The purpose of this prospective study was to evaluate the midterm results of arthroscopic meniscal repair using submeniscally placed out-in horizontal sutures. Methods: One hundred and three meniscal repairs with submeniscal horizontal out-in technique in 103 patients were performed between 2009 and 2012. Our indications for meniscal repair were all longitudinal tear in red-red and red-white zone with acceptable tissue quality. Clinical evaluation included the Tegner and Lysholm knee scores and clinical success was defined as absence of joint-line tenderness, locking, swelling, and a negative McMurray test. Results: The average follow-up was 19 months (range, 14 to 40 months). The time interval from injury to meniscal repair ranged from 2 days to 390 days (median, 96 days). At the end of follow-up, the clinical success rate was 86.5%. Fourteen of 103 repaired menisci (13.5%) were considered failures according to Barrett’s criteria. The mean Lysholm score significantly improved from 39.6 preoperatively to 84.5 postoperatively (P<0.001). Eighty five patients (82.5%) had an excellent or good result according to Lysholm knee score. Tegner activity score improved significantly (P<0.01) from an average of 3.4 (range, 2-6) preoperatively to 5.9 (range, 5-8) postoperatively. Statistical analysis showed that age, simultaneous anterior cruciate ligament reconstruction, chronicity of injury did not affect the clinical outcome. Conclusion: Our results showed that acceptable midterm results are expected from submeniscal horizontal out-in repair technique. This technique is cheap, safe and has the advantage of avoiding chondral abrasion caused by solid implants and suture materials placed over the meniscus. PMID:26213701

  16. Brain aneurysm repair

    MedlinePLUS

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

  17. Aortic aneurysm repair - endovascular

    MedlinePLUS

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

  18. Eye muscle repair - discharge

    MedlinePLUS

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

  19. Open Rotator Cuff Tear Repair Using Deltopectoral Approach

    PubMed Central

    Guity, Mohammad Reza; Eraghi, Amir Sobhani

    2015-01-01

    Background: The goal of this study was to evaluate the outcome of the open repair of rotator cuff tears via the deltopectoral approach in patients unable to afford arthroscopic repair costs. Methods: We evaluated 80 consecutive patients who were treated for full-thickness rotator cuff tears by open repair through the deltopectoral approach. There were 48 men and 32 women at a mean age of 60.1 years (range, 35-80 years). Preoperative and postoperative clinical assessments were performed with the Constant score, American Shoulder and Elbow Surgeons (ASES) score, modified University of California Los Angeles (UCLA) score, and pain visual analog scale. Results: The mean follow-up period was 30.6 months (range, 18-48 months). At final follow-up visits, the ASES, Constant score, and modified UCLA score were found to have improved significantly from 33.56, 39.24, and 13.0 to 85.64, 81.46, and 32.2, respectively (P <0.01). Pain, as measured on a visual analog scale, was improved significantly (P <0.01). The mean time for recovering the full range of motion was 2.5 months. Postoperative pain at 48 hours and at 6 weeks was relatively low. There were no cases of intractable stiffness. Conclusion: The deltopectoral approach for open rotator cuff repair produced satisfactory results and reduces rate of shoulder stiffness and postoperative pain. PMID:26622080

  20. INTERNAL REPAIR OF PIPELINES

    SciTech Connect

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

    2003-05-01

    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.

  1. Lateral Decubitus All-Arthroscopic Latarjet Procedure for Treatment of Shoulder Instability

    PubMed Central

    Lewington, Matthew R.; Urquhart, Nathan; Wong, Ivan H.

    2015-01-01

    Shoulder instability can be a challenging condition to treat when it becomes refractory to soft-tissue procedures or when bone loss exceeds 25% to 27% of the glenoid. The Bristow-Latarjet procedure has been developed and popularized to deal with these concerns. Traditionally, the procedure has been performed as an open approach; however, this has been recently supplanted by novel arthroscopic techniques. We present a technique for the procedure performed with the patient in a semi-lateral decubitus position that assists with optimal graft placement on the native glenoid. We use the cannulated Bristow-Latarjet Instability Shoulder System (DePuy Mitek, Raynham, MA). After a diagnostic arthroscopic evaluation, we use multiple arthroscopic anterior portals to debride the rim of the glenoid. The coracoid is prepared and taken down arthroscopically, and the cannulated guide is attached and advanced through an arthroscopically created subscapularis split. With the shoulder held in a reduced position, we are then able to drill and anchor the graft to the native glenoid. The patient is able to begin gentle range-of-motion exercises immediately postoperatively. PMID:26258032

  2. Evaluation of Skills in Arthroscopic Training Based on Trajectory and Force Data

    PubMed Central

    Tashiro, Yasutaka; Nakanishi, Yoshitaka; Okazaki, Ken; Iwamoto, Yukihide

    2008-01-01

    Objective evaluation of surgical skills is essential for an arthroscopic training system. We asked whether a quantitative assessment of arthroscopic skills using scores, time to completion, instrument tip trajectory data, and force data was valid. We presumed more experienced surgeons would perform better on a simulated arthroscopic procedure than novices, therefore validating the quantitative assessment. Surgical trainees (n = 12), orthopaedic residents (n = 12), and experienced arthroscopic surgeons (n = 6) were tested on a Sawbones® knee simulator. Subjects performed a joint inspection and probing task and a partial meniscectomy task. The trajectory data were measured using an electromagnetic motion tracking system and the force data were measured using a force sensor. The experienced group performed both tasks with higher scores and more quickly than the less experienced groups. The path length of the probe and the scissors was substantially shorter and the probe velocity was considerably faster in the experienced group. The trainee group applied substantially stronger forces to the joint during the joint inspection and probing task. Our data suggest a performance assessment using an electromagnetic motion tracking system and a force sensor provides an objective means of evaluating surgical skills in an arthroscopic training system. PMID:18791774

  3. Arthroscopic posterior cruciate ligament reconstruction with allograft versus autograft

    PubMed Central

    Sun, Xiujiang; Zhang, Jianfeng; Qu, Xiaoyi

    2015-01-01

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

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed Central

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

    2015-01-01

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

  6. Arthroscopic biceps tendon tenodesis: the anchorage technical note.

    PubMed

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

    2006-06-01

    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

  7. Arthroscopic lens distortion correction applied to dynamic cartilage loading.

    PubMed

    Kallemeyn, Nicole A; Grosland, Nicole M; Magnotta, Wincent A; Martin, James A; Pedersen, Douglas R

    2007-01-01

    It is difficult to study the deformation of articular cartilage because it is an inhomogenous material with depth dependent constituents. In many experimental studies, cartilage is assumed to behave homogeneously and is subjected to only static or quasi-static loads. In this study, a thick walled, mechanically active culture device (TRIAX) was used to apply cyclic loading to cartilage explants at physiological stress levels. An arthroscope was fitted into the wall of the TRIAX to monitorand record the cyclic compressive behavior of the cartilage and to measure depth dependent cartilage strains. A common concern with arthroscopy systems is that the images obtained are radially distorted about a central point ("fisheye" view); therefore it is necessary to correct this distortion in order to accurately quantify distances between objects within the images. To do this, an algorithm was developed which used a calibration pattern to create an image transform. Digital video of the cyclic cartilage compression was recorded, and the distortion algorithm was applied to the images to measure the cartilage as it deformed. This technique will provide valuable and practical insight into cartilage mechanics and viability (via calcein AM-stained chondrocytes) during multiday cyclic loading of living cartilage explants. The implementation of an arthroscopy system provides the advantage of bringing microscope-level resolution into a cartilage compression device to allow for digital visualization of the entire explant at the whole-tissue level. PMID:17907430

  8. Arthroscopic Resection of Intra-Articular Osteochondromas of the Hip

    PubMed Central

    Aguiar, Thiago; Dantas, Pedro

    2014-01-01

    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

  9. Tissue engineering for rotator cuff repair: an evidence-based systematic review.

    PubMed

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

    2012-01-01

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

  10. Rapid road repair vehicle

    DOEpatents

    Mara, Leo M. (Livermore, CA)

    1998-01-01

    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.

  11. Rapid road repair vehicle

    DOEpatents

    Mara, L.M.

    1998-05-05

    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.

  12. Editorial Commentary: Arthroscopic-Assisted Treatment of Ankle Fractures Could Have Benefits That Outweigh the Risks.

    PubMed

    Lubowitz, James H

    2015-11-01

    Review of ankle arthroscopy, as an adjunct during ankle fracture open reduction and internal fixation, suggests that the benefits may outweigh the risks, because cartilage injury and other soft-tissue pathology amenable to arthroscopic treatment are common in patients with fracture of the ankle. PMID:26542204

  13. Arthroscopic contact Nd:YAG laser meniscectomy: basic science, surgical technique, and clinical follow up

    NASA Astrophysics Data System (ADS)

    O'Brien, Stephen J.; Fealy, Stephen V.; Gibney, Mary A.; Miller, Drew V.; Kelly, Anne M.

    1990-06-01

    Recent basic science studies (5) have provided a scientific foundation for the use of the Contact Nd:YAG Laser as an arthroscopic tool for xneniscal resection and acroxnioplasty of the shoulder in a saline medium. This study prospectively evaluates the results of a three stage laboratory investigation as well as the clinical results of arthroscopic xneniscal resection. Fifteen patients with meniscal tears underwent subtotal meniscectomies utilizing a Contact Nd:YAG Laser (Surgical Laser Technologies; Malvern, Pennsylvania) . This was done in a saline medium with an average laser wattage of 25 W, (range 20 W to 30 W). Patients were evaluated postoperatively with reference to subjective and objective parameters at one week and four weeks postoperatively. Patients were evaluated with regard to wound healing, intraarticular swelling and pain. Assessment of technical parameters such as ease of resection, time of resection and instrument access were compared to conventional instruments. All fifteen patients were rated as having clinically excellent results based on pain relief, wound healing and swelling. In addition, although there was increased time with setting up the laser and calibrating it, there was not an increase in time for meniscal resection. Little, or no, secondary "trimmuning" was necessary with the laser. Increased accessibility was noted due to the small size of the laser. Arthroscopic Contact Nd:YAG Laser surgery is a safe and effective tool for menisca]. resection and coagulation in arthroscopic acromioplasties. It provides significant advantages over conventional cutting instruments with regard to accessibility and reduced need for secondary instruments.

  14. Arthroscopically assisted percutaneous fixation and bone grafting of a glenoid fossa fracture nonunion.

    PubMed

    Sears, Benjamin W; Lazarus, Mark D

    2012-08-01

    Arthroscopy is commonly used for evaluating intra-articular fracture patterns and assessing postfixation reduction; however, the use of arthroscopy for the definitive treatment of articular fracture nonunion has not been reported. This article describes a case of symptomatic glenoid fossa fracture nonunion that was successfully treated with arthroscopically assisted percutaneous screw fixation and bone grafting. A 48-year-old laborer sustained a glenoid fossa fracture following a fall from a height. An initial period of nonoperative management was attempted; however, the patient reported continued shoulder pain during his rehabilitation course. Imaging 5 months after injury showed no osseous union at the fracture. Using an arthroscopically assisted technique, percutaneous fixation and bone grafting of the nonunion with cancellous allograft was performed. Postoperatively, the patient progressed through a structured therapy program, and his pain improved. A computed tomography scan 4 months postoperatively showed osseous union at the fracture site. To the authors' knowledge, this is the first report in the literature of definitive arthroscopically assisted bone grafting and percutaneous fixation of a diarthrodial joint nonunion. Advantages of arthroscopic fixation of glenoid fossa fracture nonunion include avoiding potential axillary nerve injury and preserving the native subscapularis insertion, which may be important if subsequent procedures require access to the anterior access to the joint. PMID:22868621

  15. Arthroscopic treatment of osteochondral lesions of the talus: microfracture and drilling versus debridement.

    PubMed

    Backus, Jonathon D; Viens, Nicholas A; Nunley, James A

    2012-01-01

    Operative treatment of osteochondral lesions of the talus (OLTs) is frequently based on lesion size, stability, and surgeon preference. The purpose of this study was to determine if one arthroscopic treatment is superior to another for improving pain in patients with OLTs. Sixty-two patients treated by a single surgeon from 1999 to 2009 had sufficient medical records to be reviewed. Demographics, mechanism of injury, type of operation, lesion characteristics, and pain scores were analyzed. Thirty-one males and 31 females (mean age 32) were included; 54.1% of the lesions were on the medial talar dome and 72.3% were posttraumatic. Seventeen patients underwent arthroscopic debridement and 45 underwent arthroscopic drilling or microfracture. Visual analog scale pain scores were documented in 33 patients, demonstrating a statistically significant decrease at 6 months for debridement (p = .006) and drilling and microfracture (p = .0003) procedures. Neither procedure was superior to the other in pain reduction. No demographic variables were identified that influenced these postoperative pain scores. These results support that most OLTs are posttraumatic lesions caused by inversion or twisting and often occur on the medial talus. Arthroscopic interventions were effective for decreasing pain in both surgical groups. PMID:23327846

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

    PubMed Central

    Gupta, Ravi; Kapoor, Love; Shagotar, Saurabh

    2015-01-01

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

  17. Modeling Arthroscopic Camera with Haptic Devices in Image-based Virtual Environments

    E-print Network

    Sourin, Alexei

    Singapore ABSTRACT Minimally invasive arthroscopic surgery has become the gold standard for orthopaedic surgery procedures on joints. It is done by making small incisions on the skin through which special]: Three-Dimensional Graphics and Realism ­ virtual reality. 1 INTRODUCTION Many orthopaedic surgery

  18. Retinal detachment repair

    MedlinePLUS

    Retinal detachment repair is eye surgery to place a retina back into its normal position. The retina is ... it. This article describes the repair of rhegmatogenous retinal detachments. These occur due to a hole or tear ...

  19. Arthroscopic Assessment of Intra-Articular Lesion after Surgery for Rotational Ankle Fracture

    PubMed Central

    Cha, Seung-Do; Gwak, Heui-Chul; Ha, Dong-Jun; Kim, Jong-Yup; Kim, Ui-Cheol; Jang, Yue-Chan

    2015-01-01

    Background The purpose of this study was to report findings of exploratory arthroscopic assessment performed in conjunction with removal of internal fixation device placed in the initial surgery for rotational ankle fracture. Methods A total of 53 patients (33 male, 20 female) who underwent surgery for rotational ankle fracture between November 2002 and February 2008 were retrospectively reviewed. All patients gave consent to the exploratory arthroscopic surgery for the removal of internal fixation devices placed in the initial surgery. Lauge-Hansen classification system of ankle fractures was assessed for all patients. Intra-articular lesions (osteochondral lesion, loose body, and fibrosis) were evaluated via ankle arthroscopy. Comparative analysis was then performed between radiological classification of ankle fracture/patient's symptoms and arthroscopic findings. Results Lauge-Hansen classification system of ankle fractures included supination-external rotation type (n = 35), pronation-external rotation type (n = 9), and pronation-abduction type (n = 9). A total of 33 patients exhibited symptoms of pain or discomfort while walking whereas 20 exhibited no symptoms. Arthroscopic findings included abnormal findings around the syndesmosis area (n = 35), intra-articular fibrosis (n = 51), osteochondral lesions of the talus (n = 33), loose bodies (n = 6), synovitis (n = 13), and anterior bony impingement syndrome (n = 3). Intra-articular fibrosis was seen in 31 of symptomatic patients (93.9%). Pain or discomfort with activity caused by soft tissue impingement with meniscus-like intra-articular fibrosis were found in 19 patients. There was statistical significance (p = 0.02) between symptoms (pain and discomfort) and the findings of meniscus-like fibrosis compared to the group without any symptom. Conclusions Arthroscopic examination combined with treatment of intra-articular fibrosis arising from ankle fracture surgery may help improve surgical outcomes. PMID:26640633

  20. Arthroscopic Changes of the Biceps Pulley in Rotator Cuff Tear and Its Clinical Significance in Relation to Treatment

    PubMed Central

    Choi, Chang Hyuk; Kim, Se Sik; Lee, Ju Hwan

    2015-01-01

    Background In the case of rotator cuff tears, the biceps pulley can be stressed by the unstable biceps tendon, and this can subsequently affect the stability of the subscapularis tendon. Therefore, it is important to distinguish between normal variations and lesions of the biceps pulley that affect anterosuperior lesions in cases of rotator cuff tears. Methods From January 2002 through November 2010, we observed biceps pulley and associated anterosuperior lesions in 589 of 634 cases (93%) of arthroscopic rotator cuff repair, including 72 cases (12.2%) of small tears, 219 cases (37.2%) of medium tears, 134 cases (22.8%) of large tears, and 164 cases (27.8%) of massive tears. We classified normal stretched biceps pulleys as type I, stretched biceps pulleys with mild changes as type II, those with a partial tear as type III, and torn pulleys as type IV. Results We were able to classify 589 cases of biceps pulleys as type I, II, III, or IV associated lesions in rotator cuff tears. Type I was seen in 91 cases (15.4%), type II in 216 cases (36.7%), type III in 157 cases (26.7%), and type IV in 101 cases (17.1%); unidentified cases numbered 24 (4.1%). Nearly three-quarters, 73.3%, of the cases (432/589) had associated anterosuperior lesions, and combined treatment for the associated lesions was administered in 29.2% (172/589) of cases. Conclusions Biceps pulley lesions with more than partial tears were identified in 48% of rotator cuff tear cases. The incidence and severity of pulley lesions were related to the rotator cuff tear size, the status of the long head of the biceps tendon and subscapularis tendon lesion, and the treatment methods. PMID:26330960

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

    PubMed Central

    2014-01-01

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

  2. Arthroscopic fixation with intra-articular button for tibial intercondylar eminence fractures in skeletally immature patients.

    PubMed

    Memisoglu, Kaya; Muezzinoglu, Umit S; Atmaca, Halil; Sarman, Hakan; Kesemenli, Cumhur C

    2016-01-01

    The aim of this study was to describe our experiences with arthroscopy-guided intra-articular button fixation in the treatment of displaced tibial eminence fractures in skeletally immature children. Eleven adolescent patients with an average age of 12.2 years were treated arthroscopically between January 2005 and February 2007. At follow-up evaluation at 69 months, we did not find any instability. Only minimal differences were found in the functional outcomes (Lysholm and International Knee Documentation Committee scores: 95.7 and 94.3, respectively). None of the patients had a leg-length discrepancy defined at the time of the final follow-up. The advantages of this technique are as follows: (a) it is a simple and reliable arthroscopic technique with a direct view, (b) the fixation is stable, PMID:26340367

  3. Arthroscopic treatment of chronically painful calcific tendinitis of the rectus femoris

    PubMed Central

    2013-01-01

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

  4. Arthroscopic contact Nd:YAG laser meniscectomy: surgical technique and clinical follow-up

    NASA Astrophysics Data System (ADS)

    O'Brien, Stephen J.; Miller, Drew V.; Fealy, Stephen V.; Gibney, Mary A.; Kelly, Anne M.

    1991-05-01

    Fifteen patients were studied prospectively as a pilot study to evaluate the safety and efficacy of the contact Neodynium: Yttrium Aluminum Garnet (Nd:YAG) laser in performing arthroscopic meniscal resection in a saline medium, (Surgical Laser Technologies; Malverne, PA). All fifteen patients were rated as having clinically excellent results based on pain relief, wound healing, and post-operative swelling. Although there was increased time involved with setting up and calibrating the laser, there was not an increase in time for meniscal resection. In addition, the decreased need for secondary trimming and increased accessibility to the posterior horns of the menisci represent advantages over conventional instruments. Based on the findings, arthroscopic contact Nd:YAG laser surgery is a safe and effective clinical tool for meniscal resection which may, with increased technological advancements and cost reduction, replace standard instrumentation.

  5. Arthroscopic Microfracture Technique for Cartilage Damage to the Lateral Condyle of the Tibia

    PubMed Central

    Kan, Hiroyuki; Arai, Yuji; Nakagawa, Shuji; Inoue, Hiroaki; Minami, Ginjiro; Ikoma, Kazuya; Fujiwara, Hiroyoshi; Kubo, Toshikazu

    2015-01-01

    This report describes the use of arthroscopic microfracture to treat a 10-year-old female patient with extensive damage to the cartilage of the lateral condyle of the tibia before epiphyseal closure, resulting in good cartilage recovery. Magnetic resonance imaging showed a defect in part of the load-bearing surface of the articular cartilage of the condyle articular of the tibia. The patient was diagnosed with damage to the lateral condyle cartilage of the tibia following meniscectomy, and arthroscopic surgery was performed. The cartilage defect measured approximately 20 × 20?mm, and microfracture was performed. Arthroscopy performed four months postoperatively showed that the cartilage defect was completely covered with fibrous cartilage, and the patient was allowed to resume sports activities. Four years postoperatively, she has had no recurrence of pain or hydrarthrosis. PMID:26345523

  6. Anatomical popliteofibular ligament reconstruction of the knee joints: an all-arthroscopic technique.

    PubMed

    Song, Guan-Yang; Zhang, Hui; Zhang, Jin; Li, Yue; Feng, Hua

    2015-10-01

    Injuries to the posterolateral corner of the knee present with variable injury patterns that have produced a number of reconstructive procedures in the literature. The present paper describes an all-arthroscopic technique that anatomically reconstructs the popliteofibular ligament (PFL) using either a semitendinosus autograft or an anterior tibialis allograft. During the surgery, the fibular insertion site as well as the distal portion of PFL is feasible to be identified under arthroscopy without any additional skin incision. Level of evidence V. PMID:25666840

  7. Complications following arthroscopic fixation of acromioclavicular separations: a systematic review of the literature

    PubMed Central

    Woodmass, Jarret M; Esposito, John G; Ono, Yohei; Nelson, Atiba A; Boorman, Richard S; Thornton, Gail M; Lo, Ian KY

    2015-01-01

    Purpose Over the past decade, a number of arthroscopic or arthroscopically assisted reconstruction techniques have emerged for the management of acromioclavicular (AC) separations. These techniques provide the advantage of superior visualization of the base of the coracoid, less soft tissue dissection, and smaller incisions. While these techniques have been reported to provide excellent functional results with minimal complications, discrepancies exist within the literature. This systematic review aims to assess the rate of complications following these procedures. Methods Two independent reviewers completed a search of Medline, Embase, PubMed, and the Cochrane Library entries up to December 2013. The terms “Acromioclavicular Joint (MeSH)” OR “acromioclavicular* (text)” OR “coracoclavicular* (text)” AND “Arthroscopy (MeSH)” OR “Arthroscop* (text)” were used. Pooled estimates and 95% confidence intervals were calculated assuming a random-effects model. Statistical heterogeneity was quantified using the I2 statistic. Level of evidence IV Results A total of 972 abstracts met the search criteria. After removal of duplicates and assessment of inclusion/exclusion criteria, 12 articles were selected for data extraction. The rate of superficial infection was 3.8% and residual shoulder/AC pain or hardware irritation occurred at a rate of 26.7%. The rate of coracoid/clavicle fracture was 5.3% and occurred most commonly with techniques utilizing bony tunnels. Loss of AC joint reduction occurred in 26.8% of patients. Conclusion Arthroscopic AC reconstruction techniques carry a distinct complication profile. The TightRope/Endobutton techniques, when performed acutely, provide good radiographic outcomes at the expense of hardware irritation. In contrast, graft reconstructions in patients with chronic AC separations demonstrated a high risk for loss of reduction. Fractures of the coracoid/clavicle remain a significant complication occurring predominately with techniques utilizing bony tunnels. PMID:25914562

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

    PubMed

    De Cupis, Vincenzo; De Cupis, Mauro

    2012-04-01

    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

  9. Arthroscopic Reduction and Internal Fixation for Fracture of the Lateral Process of the Talus

    PubMed Central

    Funasaki, Hiroki; Hayashi, Hiroteru; Sugiyama, Hajime; Marumo, Keishi

    2015-01-01

    Fractures of the lateral process of the talus (LPT) are relatively rare. We describe arthroscopic reduction and internal fixation for a type I fracture of the LPT according to the Hawkins classification. Preoperative computed tomography is necessary to evaluate the type and displacement of the LPT fracture because this type of fracture is often overlooked on a plain radiograph. The ankle is approached through a standard medial portal as the working portal and an anterolateral portal as the viewing portal. A 2.7-mm-diameter 30° arthroscope is used. Hematoma and soft tissues around the talus are cleared with a motorized shaver, and the anterior and lateral aspects of the talar process are visualized. Fracture reduction is obtained by pushing the lateral fragment of the lateral process medially and is fixed temporally with a 1.1-mm guidewire from the medial portal under both arthroscopy and fluoroscopy. A headless compression screw is inserted through the guidewire. Arthroscopic reduction and internal fixation for a type I LPT fracture can be easily accomplished, and return to daily and sports activities can be achieved in a relatively short time. PMID:25973380

  10. Arthroscopic Technique for the Treatment of Pigmented Villonodular Synovitis of the Hip

    PubMed Central

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

    2015-01-01

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

  11. Functional Outcome Following Arthroscopic ACL Reconstruction with Rigid Fix: A Retrospective Observational Study

    PubMed Central

    Shervegar, Satish; Nagaraj, Prashanth; Grover, Amit; DJ, Niranthara Ganesh; Ravoof, Abdul

    2015-01-01

    Background: No uniform consensus exists to decide type of fixation for arthroscopic anterior cruciate ligament reconstruction. Hypothsis: There is similar functional outcome after rigid fix compared to other methods of fixation which has been published. Study design: Retrospective observational study. Methods: A total of 50 patients underwent arthroscopic anterior cruciate ligament reconstruction with hamstring tendons using femoral Rigid fix cross-pin and interference screw tibial fixation. The evaluation methods were clinical examination, IKDC scores, Lysholm and pre injury and post reconstruction Tegner score. Patients were followed up from minimum of 6 months to 4 year seven months. Results: C In our study of sample size 50 we found that mean age of patients was 30.8 Years with male preponderance. Mean post operative IKDC and Lysholm score has been 75.6 and 84.4 respectively. Mean Tegner pre-injury score and post reconstruction score has been 5.4 and 4.26. Box plot comparison of pre injury and post operativeTegner score reveals a statistically significant difference with respect to paired t test P<0.001. Conclusions: Arthroscopic anterior cruciate ligament reconstruction with femoral rigid fix cross pins and tibial interference screws results in comparable short term to midterm functional results compared to other types of fixation PMID:26550591

  12. Arthroscopic management of proximal tibial fractures: technical note and case series presentation

    PubMed Central

    BENEA, HOREA; TOMOAIA, GHEORGHE; MARTIN, ARTUR; BARDAS, CIPRIAN

    2015-01-01

    Background and aims The purpose of this article is to describe a new surgical method of arthroscopy assisted treatment of intraarticular proximal tibial fractures (ARIF – arthroscopic reduction and internal fixation), analyzing its efficiency and safety on a series of patients. Tibial plateau fractures affect the proximal tibial metaphyseal and articular surface, representing 1.2% of all fractures and up to 8% of all fractures in elderly. Patients and method Our case series consists of 6 patients with Schatzker types I-III tibial plateau fractures, treated in the Orthopedic and Traumatology Clinic of Cluj-Napoca from July 2012 to August 2014. Patients included in the study presented Schatzker type I-III tibial plateau fracture. Results The results obtained with the arthroscopic method were excellent in 5 cases (mean Rasmussen score 27.60 points) and good in 1 case (mean score 23.75). The radiological consolidation appeared after a mean of 12 weeks. No major complication was noted. Conclusions Diagnosis and treatment of associated lesions, shortening of hospitalization length and postoperative rehabilitation, but also the lower rate of complications, can make arthroscopic reduction and internal fixation the method of choice for the operative treatment of selected Schatzker I-III types of proximal tibial fractures. PMID:26528076

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

    SciTech Connect

    Do-Dai, D.D.; Youngberg, R.A.; Lanchbury, F.D.; Pitcher, J.D. Jr.; Garver, T.H.

    1996-01-01

    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.

  14. Arthroscopic stabilization of the shoulder for acute primary dislocations using a transglenoid suture technique.

    PubMed

    Salmon, J M; Bell, S N

    1998-03-01

    Many studies report the results of arthroscopic stabilization for recurrent shoulder instability, with widely variable recurrence rates; however, there are very few reports of the use of these techniques in acute first-time dislocations. We report the clinical outcomes of 17 patients who had arthroscopic stabilization using a transglenoid suture technique for acute primary dislocation. The surgery took place between March 1992 and March 1994 and, to date, there has been one recurrent dislocation (6%) and no recurrent subluxation. There were no major complications, although a number of patients found the knot tied over the infraspinatus fascia to be uncomfortable until it resorbed. All patients examined had normal power and range of motion, and a clinically stable shoulder. All 16 patients without recurrence were satisfied with their result. Nine patients returned to sports at the same or higher level, including such vigorous contact sports as Australian Rules football and rugby. Three patients did not return to the same level of sporting activity because of lack of confidence in the shoulder or a fear of dislocation despite no clinical evidence of instability. Five patients reported a lack of confidence in the shoulder without clinical evidence of instability. We suggest that arthroscopic stabilization with transglenoid sutures or a suture anchor technique is a reasonable option for the athlete with an acute primary shoulder dislocation who wishes to return to sports. PMID:9531124

  15. Repairs of composite structures

    NASA Astrophysics Data System (ADS)

    Roh, Hee Seok

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

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

    PubMed Central

    Thorlund, J B; Juhl, C B; Roos, E M; Lohmander, LS

    2015-01-01

    Objective To determine benefits and harms of arthroscopic knee surgery involving partial meniscectomy, debridement, or both for middle aged or older patients with knee pain and degenerative knee disease. Design Systematic review and meta-analysis. Main outcome measures Pain and physical function. Data sources Systematic searches for benefits and harms were carried out in Medline, Embase, CINAHL, Web of Science, and the Cochrane Central Register of Controlled Trials (CENTRAL) up to August 2014. Only studies published in 2000 or later were included for harms. Eligibility criteria for selecting studies Randomised controlled trials assessing benefit of arthroscopic surgery involving partial meniscectomy, debridement, or both for patients with or without radiographic signs of osteoarthritis were included. For harms, cohort studies, register based studies, and case series were also allowed. Results The search identified nine trials assessing the benefits of knee arthroscopic surgery in middle aged and older patients with knee pain and degenerative knee disease. The main analysis, combining the primary endpoints of the individual trials from three to 24 months postoperatively, showed a small difference in favour of interventions including arthroscopic surgery compared with control treatments for pain (effect size 0.14, 95% confidence interval 0.03 to 0.26). This difference corresponds to a benefit of 2.4 (95% confidence interval 0.4 to 4.3) mm on a 0–100?mm visual analogue scale. When analysed over time of follow-up, interventions including arthroscopy showed a small benefit of 3–5?mm for pain at three and six months but not later up to 24 months. No significant benefit on physical function was found (effect size 0.09, ?0.05 to 0.24). Nine studies reporting on harms were identified. Harms included symptomatic deep venous thrombosis (4.13 (95% confidence interval 1.78 to 9.60) events per 1000 procedures), pulmonary embolism, infection, and death. Conclusions The small inconsequential benefit seen from interventions that include arthroscopy for the degenerative knee is limited in time and absent at one to two years after surgery. Knee arthroscopy is associated with harms. Taken together, these findings do not support the practise of arthroscopic surgery for middle aged or older patients with knee pain with or without signs of osteoarthritis. Systematic review registration PROSPERO CRD42014009145. PMID:26383759

  17. Snowmobile Repair. Teacher Edition.

    ERIC Educational Resources Information Center

    Hennessy, Stephen S.; Conrad, Rex

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

  18. Mitral Valve Repair

    MedlinePLUS

    ... a Thoracic Surgeon? Adult Cardiac Surgery What is Pediatric Heart Disease? What is Risk Adjustment? Valve Repair/Replacement Surgery Mitral Valve Replacement Aortic Valve Mitral Valve Repair Esophageal Surgery Lung/Thoracic Surgery Aneurysm Surgery Arrhythmia Surgery Other Types of Surgery Clinical ...

  19. Vascular endothelial growth factor/bone morphogenetic protein-2 bone marrow combined modification of the mesenchymal stem cells to repair the avascular necrosis of the femoral head

    PubMed Central

    Ma, Xiao-Wei; Cui, Da-Ping; Zhao, De-Wei

    2015-01-01

    Vascular endothelial cell growth factor (VEGF) combined with bone morphogenetic protein (BMP) was used to repair avascular necrosis of the femoral head, which can maintain the osteogenic phenotype of seed cells, and effectively secrete VEGF and BMP-2, and effectively promote blood vessel regeneration and contribute to formation and revascularization of tissue engineered bone tissues. To observe the therapeutic effect on the treatment of avascular necrosis of the femoral head by using bone marrow mesenchymal stem cells (BMSCs) modified by VEGF-165 and BMP-2 in vitro. The models were avascular necrosis of femoral head of rabbits on right leg. There groups were single core decompression group, core decompression + BMSCs group, core decompression + VEGF-165/BMP-2 transfect BMSCs group. Necrotic bone was cleared out under arthroscope. Arthroscopic observation demonstrated that necrotic bone was cleared out in each group, and fresh blood flowed out. Histomorphology determination showed that blood vessel number and new bone area in the repair region were significantly greater at various time points following transplantation in the core decompression + VEGF-165/BMP-2 transfect BMSCs group compared with single core decompression group and core decompression + BMSCs group (P < 0.05). These suggested that VEGF-165/BMP-2 gene transfection strengthened osteogenic effects of BMSCs, elevated number and quality of new bones and accelerated the repair of osteonecrosis of the femoral head. PMID:26629044

  20. INTERNAL REPAIR OF PIPELINES

    SciTech Connect

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

    2005-07-20

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

  1. INTERNAL REPAIR OF PIPELINES

    SciTech Connect

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

    2004-12-31

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

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

    PubMed Central

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

    2014-01-01

    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

  3. INTERNAL REPAIR OF PIPELINES

    SciTech Connect

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

    2004-08-17

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

  4. Rapid road repair vehicle

    DOEpatents

    Mara, Leo M. (Livermore, CA)

    1999-01-01

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

  5. Salvage Flexor Hallucis Longus Transfer for a Failed Achilles Repair: Endoscopic Technique

    PubMed Central

    Gonçalves, Sérgio; Caetano, Rubén; Corte-Real, Nuno

    2015-01-01

    Flexor hallucis longus (FHL) transfer is a well-established treatment option in failed Achilles tendon (AT) repair and has been routinely performed as an open procedure. We detail the surgical steps needed to perform an arthroscopic transfer of the FHL for a chronic AT rupture. The FHL tendon is harvested as it enters in its tunnel beneath the sustentaculum tali; a tunnel is then drilled in the calcaneus as near to the AT footprint as possible. By use of a suture-passing device, the free end of the FHL is advanced to the plantar aspect of the foot. After adequate tension is applied to the construct, the tendon is fixed in place with an interference screw in an inside-out fashion. This minimally invasive approach is a safe and valid alternative to classic open procedures with the obvious advantages of preserving the soft-tissue envelope and using a biologically intact tendon. PMID:26697296

  6. Brain aneurysm repair - discharge

    MedlinePLUS

    ... endovascular repair: You may have pain in your groin area. You may have some bruising around and ... the doctor put a catheter in through your groin (endovascular surgery), it is okay to walk short ...

  7. Femur fracture repair - discharge

    MedlinePLUS

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

  8. Achilles tendon repair

    MedlinePLUS

    Achilles tendon rupture-surgery; Percutaneous Achilles tendon rupture repair ... To fix your torn Achilles tendon, the surgeon will: Make a cut down the back of your heel Make several small cuts rather than one ...

  9. Complex Abdominal Wall Repair

    MedlinePLUS

    ... bowel and underwent placement of Veritas in an inlay. And as we talked about during the case, ... repair either utilizing an underlay technique or an inlay technique. I would not recommend placing this in ...

  10. Laparoscopic Inguinal Hernia Repair

    MedlinePLUS

    ... Laparoscopic Inguinal Hernia Repair Surgery Patient Information from SAGES Download PDF Version Find a SAGES Surgeon About ... 2015 CME Credits Healthy Sooner: Patient Information Contact SAGES Society of American Gastrointestinal and Endoscopic Surgeons 11300 ...

  11. Laparoscopic Ventral Hernia Repair

    MedlinePLUS

    ... Login Laparoscopic Ventral Hernia Repair Patient Information from SAGES Download PDF Version Find a SAGES Surgeon Approximately ... 2015 CME Credits Healthy Sooner: Patient Information Contact SAGES Society of American Gastrointestinal and Endoscopic Surgeons 11300 ...

  12. Diaphragmatic hernia repair - congenital

    MedlinePLUS

    ... correct an opening or space in a baby's diaphragm. This opening is called a hernia. It is ... down into place through the opening in the diaphragm and into the abdominal cavity. The surgeon repairs ...

  13. Rotator Cuff Repair

    MedlinePLUS Videos and Cool Tools

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

  14. INTERNAL REPAIR OF PIPELINES

    SciTech Connect

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

    2004-04-12

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

  15. Proximal Hamstring Repair Strength

    PubMed Central

    Harvey, Margaret Ann; Singh, Hardeep; Obopilwe, Elifho; Charette, Ryan; Miller, Suzanne

    2015-01-01

    Background: Proximal hamstring repair for complete ruptures has become a common treatment. There is no consensus in the literature about postoperative rehabilitation protocols following proximal hamstring repair. Some protocols describe bracing to prevent hip flexion or knee extension while others describe no immobilization. There are currently no biomechanical studies evaluating proximal hamstring repairs; nor are there any studies evaluating the effect of different hip flexion angles on these repairs. Hypothesis: As hip flexion increases from 0° to 90°, there will be a greater gap with cyclical loading. Study Design: Controlled laboratory study. Methods: Proximal hamstring insertions were detached from the ischial tuberosity in 24 cadavers and were repaired with 3 single-loaded suture anchors in the hamstring footprint with a Krakow suture technique. Cyclic loading from 10 to 125 N at 1 Hz was then performed for 0°, 45°, and 90° of hip flexion for 1500 cycles. Gap formation, stiffness, yield load, ultimate load, and energy to ultimate load were compared between groups using paired t tests. Results: Cyclic loading demonstrated the least amount of gap formation (P < .05) at 0° of hip flexion (2.39 mm) and most at 90° of hip flexion (4.19 mm). There was no significant difference in ultimate load between hip flexion angles (326, 309, and 338 N at 0°, 45°, and 90°, respectively). The most common mode of failure occurred with knot/suture failure (n = 17). Conclusion: Increasing hip flexion from 0° to 90° increases the displacement across proximal hamstring repairs. Postoperative bracing that limits hip flexion should be considered. Clinical Relevance: Repetitive motion involving hip flexion after a proximal hamstring repair may cause compromise of the repair.

  16. Celebrating DNA's Repair Crew.

    PubMed

    Kunkel, Thomas A

    2015-12-01

    This year, the Nobel Prize in Chemistry has been awarded to Tomas Lindahl, Aziz Sancar, and Paul Modrich for their seminal studies of the mechanisms by which cells from bacteria to man repair DNA damage that is generated by normal cellular metabolism and stress from the environment. These studies beautifully illustrate the remarkable power of DNA repair to influence life from evolution through disease susceptibility. PMID:26638062

  17. Parastomal hernia repair.

    PubMed

    O'Neill, Conor H; Borrazzo, Edward C; Hyman, Neil H

    2015-04-01

    Parastomal herniation is a common clinical occurrence. Historically, there has been a high recurrence rate after repair, and conservative management is usually recommended for patients with mild symptoms. When operative intervention is warranted, we opt for a laparoscopic mesh sublay over the fascial defect and lateralization of the stoma limb, or the Sugarbaker technique. In patients who are considered poor risk for laparoscopy/laparotomy requiring repair, we perform a fascial onlay with mesh utilizing an anterior circumstomal approach. PMID:25504464

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

    PubMed

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

    2010-10-01

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

  19. The floating lunate: arthroscopic treatment of simultaneous complete tears of the scapholunate and lunotriquetral ligaments.

    PubMed

    Badia, Alejandro; Khanchandani, Prakash

    2009-09-01

    Carpal instabilities continue to be a controversial topic in hand surgery. Accurate diagnosis of the ligament injuries is usually difficult without an arthroscopic evaluation. Few studies have focused on the diagnosis and proper management of simultaneous scapholunate (SL) and lunotriquetral (LT) ligament tears. This is an uncommon injury that leads to marked disability and chronic wrist pain. This is essentially a "floating lunate" and indicates a severe ligamentous lesion. Thirteen patients (six female and seven male) with complete SL and LT tears and with gross arthroscopic dynamic carpal instability were included in the present study. None of the patients showed radiographic evidence of lunate dislocation. One patient presented acutely and was operated on 3 days after the injury. The average time from the initial injury to the arthroscopy for the other 12 patients was 13.5 months (range 1.5-84 months). All patients underwent arthroscopic debridement of the SL and LT ligaments coupled with percutaneous pinning (two 0.045-in. Kirschner wires) in both joints. At the final follow-up, the average range of motion was 50 degrees of flexion, 54 degrees of extension, 77 degrees of pronation, 80 degrees of supination, 25 degrees of ulnar deviation, and 15 degrees of radial deviation. The average final grip strength was 67% from the non-affected side. All patients had negative shifting tests at final follow-up. Furthermore, there was no evidence of any static or dynamic instability in all the patients except for one patient who developed a volar intercalated segment instability 8 months after the surgery. At the final follow-up, ten patients had no pain, one had mild pain, and two experienced moderate pain. PMID:19104901

  20. Arthroscopic Findings After Traumatic Shoulder Instability in Patients Older Than 35 Years

    PubMed Central

    Robinson, Elisabeth C.; Thangamani, Vijay B.; Kuhn, Michael A.; Ross, Glen

    2015-01-01

    Background: Shoulder instability in the older patient traditionally has received less attention in the literature than in the younger patient population. However, when traumatic dislocation does occur, these patients often still have frequent pain, disability, and even continued instability. Purpose: To characterize the pathoanatomy of traumatic anterior shoulder instability in the older patient population and to discuss the correlating symptoms that ultimately led to operative treatment. Study Design: Case series; Level of evidence, 4. Methods: Patients with a history of an initial traumatic anterior shoulder instability event occurring after the age of 35 years who underwent arthroscopic surgical intervention were prospectively enrolled. Exclusion criteria included posterior instability, major fractures of the shoulder girdle, and multidirectional instability. All patients initially underwent a period of nonoperative rehabilitation. Operative treatment was performed if a patient continued to have pain and/or instability. Operative reports and arthroscopic pictures were reviewed for pathoanatomical findings. Results: A total of 27 patients (28 shoulders) met the inclusion criteria and were analyzed in this study (22 men and 5 women; mean age, 55 years; age range, 35-74 years). Surgical intervention was performed for recurrent instability in 7 patients, pain for 8 patients, and pain with instability for 13 patients. Arthroscopic findings demonstrated 18 rotator cuff tears (RCTs) (64.3%) and 18 Bankart lesions (64.3%). Nine patients had both an RCT combined with a Bankart lesion (32.1%). Three humeral avulsion of the glenohumeral ligament (HAGL) lesions (10.7%) and 2 anterior labral periosteal sleeve avulsion (ALPSA) lesions (7.1%) were found. All shoulders demonstrated Hill-Sachs lesions of various size and depth. Conclusion: Traumatic shoulder instability in the older patient may result in a wide array of pathologic findings as well as a diversity of clinical presentations. These findings suggest that the clinical diagnostician should maintain a high index of suspicion for RCT, Bankart lesions, and HAGL lesions in older patients who remain symptomatic after traumatic anterior shoulder instability.

  1. Extracapsular approach for arthroscopic treatment of femoroacetabular impingement: clinical and radiographic results and complications?

    PubMed Central

    Roos, Bruno Dutra; Roos, Milton Valdomiro; Júnior, Antero Camisa; Lima, Ezequiel Moreno Ungaretti; Gyboski, Diego Paulo; Martins, Lucas Schirmer

    2015-01-01

    Objectives To evaluate the clinical and radiographic results and complications relating to patients undergoing arthroscopic treatment for femoroacetabular impingement by means of an extracapsular approach. Methods Between January 2011 and March 2012, 49 patients (50 hips) underwent arthroscopic treatment for femoroacetabular impingement, performed by the hip surgery team of the Orthopedic Hospital of Passo Fundo, Rio Grande do Sul. Forty patients (41 hips) fulfilled all the requirements for this study. The mean follow-up was 29.1 months. The patients were assessed clinically by means of the Harris Hip score, as modified by Byrd (MHHS), the Non-Arthritic Hip score (NAHS) and the internal rotation of the hip. Their hips were also evaluated radiographically, with measurement of the CE angle, dimensions of the joint space, alpha angle, neck-head index, degree of arthrosis and presence of heterotopic ossification of the hip. Results Out of the 41 hips treated, 31 (75.6%) presented good or excellent clinical results. There was a mean postoperative increase of 22.1 points for the MHHS, 21.5 for the NAHS and 16.4? for the internal rotation of the hip (p < 0.001). Regarding the radiographic evaluation, correction to normal values was observed for the alpha angle and neck-head index, with a mean postoperative decrease of 32.9? and mean increase of 0.10, respectively (p < 0.001). Conclusion Arthroscopic treatment of femoroacetabular impingement by means of an extracapsular approach presented satisfactory clinical and radiographic results over a mean follow-up of 29.1 months, with few complications. PMID:26401501

  2. Arthroscopic Resection of a Tenosynovial Giant Cell Tumor in the Wrist

    PubMed Central

    Lee, Young-Keun; Han, Youngshin; Lee, Malrey

    2015-01-01

    Abstract The treatment for giant cell tumors of the tendon sheath is surgical therapy, but surgical recurrence rates were reported to be as high as 50% in some cases. Therefore, complete radical excision of the lesion is the treatment of choice. If the tumor originates from the joint, it is important to perform capsulotomy. Here, the authors report the first case of successful treatment of a localized intra-articular giant cell tumor in the wrist by arthroscopic resection. A 28-year-old right-handed woman visited the clinic because of left wrist ulnar-side pain, which had been aggravated during the previous 15 days. Vague ulnar-side wrist pain had begun 2 years ago. When the authors examined the patient, the wrist showed mild swelling on the volo-ulnar aspect and the distal radioulnar joint, as well as volar joint line tenderness. She showed a positive result on the ulnocarpal stress test and displayed limited range of motion. Magnetic resonance imaging revealed an intra-articular mass with synovitis in the ulnocarpal joint. Wrist arthroscopy was performed using standard portals under regional anesthesia. The arthroscopic findings revealed a large, well-encapsulated, yellow lobulated soft-tissue mass that was attached to the volar side of the ulnocarpal ligament and connected to the extra-articular side. The mass was completely excised piece by piece with a grasping forceps. Histopathologic examination revealed that the lesion was an intra-articular localized form of a tenosynovial giant cell tumor. At 24-month follow-up, the patient was completely asymptomatic and had full range of motion in her left wrist, and no recurrence was found in magnetic resonance imaging follow-up evaluations. The authors suggest that the arthroscopic excision of intra-articular giant cell tumors, as in this case, may be an alternative method to open excisions, with many advantages. PMID:26496348

  3. Arthroscopic-Assisted Core Decompression for Osteonecrosis of the Femoral Head

    PubMed Central

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

    2013-01-01

    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

  4. Arthroscopic Reconstruction of Chronic Isolated Posterior Cruciate Ligament Instability in a Professional Dancer

    PubMed Central

    Aksu, Neslihan; Abay, Burak; Soydan, Ramazan; Ercan, Ertu?rul

    2014-01-01

    Objectives: Chronic isolated injuries of the posterior cruciate ligament (PCL) are very rare in the literature. PCL injuries are often presented undiagnosed because of the weak signs of the injury compared to the anterior cruciate ligament (ACL) injuries. We report the surgical outcome of arthroscopic reconstruction of the chronic isolated PCL rupture with ipsilateral autologous hamstring tendon in a professional Caucasian dancer. Methods: A 21-year-old male professional Caucasian dancer presented severe instability without any pain in his right knee lasting for one year. The patient did not describe any specific traumatic event but his both knees received repeatitive direct pretibial trauma during hyperflexion of the knee while landing to the floor. At the physical examination, posterior sagging of the tibia was observed on the affected side at 90o of knee flexion and step off test and posterior drawer test were positive preoperatively under general anesthesia. The Tegner Lysholm score was evaluated as 59 (poor). A magnetic resonance image (MRI) revealed the isolated total rupture of PCL. The treatment of choice was arthroscopic single bundle reconstruction of PCL with ipsilateral autologous hamstring tendon. A standard arthroscopic exploration of the joint was performed preoperatively and we didn't observe any meniscal, cartilage or ligamentous lesion. Anteromedial and anterolateral portals were made in order to visualize the posterior cortex of the tibia with a 70 degree scope. Intra-operative fluroscopy was used to confirm proper tunnel position. During postoperatively first week, the patient was allowed to mobilize nonweight bearing with the use of two crutches without functional knee brace. Quadriceps musculature and passive range of motion was trained. Results: At the 6 month- follow-up, the patient achieved full symmetric restoration of motion. He had returned to full daily activies. The Tegner Lysholm score was evaluated as 95 (excellent) postoperatively. Functional examination of the right knee reveled 140 of flexion, and full knee extension. No posterior sagging was observed and step off test and posterior drawer test was negative. The complaint of instability was disappeared. At 1-year follow-up, clinical findings were unremarkable, with no sign of re-rupture and he returned to his professional career. Conclusion: Surgical reconstruction technique of the PCL and associated rehabilitation protocols has not yet been fully standardized and much work still has be done optimizing correct treatment of PCL injuries. The arthroscopic reconstruction of chronic isolated PCL instability is a very difficult technique as well as its diagnosis. The reconstruction is very beneficial in the athletes and the patients who are not responding well to the conservative treatment.

  5. Usefulness of Arthroscopic Treatment of Painful Hip after Acetabular Fracture or Hip Dislocation

    PubMed Central

    Hwang, Jung-Taek; Lee, Woo-Yong; Kang, Chan; Kim, Dong-Yeol; Zheng, Long

    2015-01-01

    Background Painful hip following hip dislocation or acetabular fracture can be an important signal for early degeneration and progression to osteoarthritis due to intraarticular pathology. However, there is limited literature discussing the use of arthroscopy for the treatment of painful hip. The purpose of this retrospective study was to analyze the effectiveness and benefit of arthroscopic treatment for patients with a painful hip after major trauma. Methods From July 2003 to February 2013, we reviewed 13 patients who underwent arthroscopic treatment after acetabular fracture or hip dislocation and were followed up for a minimum of 2 postoperative years. The degree of osteoarthritis based on the Tonnis classification pre- and postoperatively at final follow-up was determined. Clinical outcomes were evaluated using visual analogue scale for pain (VAS) and modified Harris hip score (MHHS), and range of motion (ROM) of the hip pre- and postoperatively at final follow-up. Results There were nine male and four female patients with a mean age at surgery of 28 years (range, 20 to 50 years). The mean follow-up period of the patients was 59.8 months (range, 24 to 115 months), and the mean interval between initial trauma and arthroscopic treatment was 40.8 months (range, 1 to 144 months). At the final follow-up, VAS and MHHS improved significantly from 6.3 and 53.4 to 3.0 and 88.3, respectively (p = 0.002 and p < 0.001, respectively). However, there were no significant differences in hip flexion, abduction, adduction, external rotation, and internal rotation as minor improvements from 113.1°, 38.5°, 28.5°, 36.5°, and 22.7° to 118.5°, 39.0°, 29.2°, 38.9°, and 26.5° were observed, respectively (p = 0.070, p = 0.414, p = 0.317, p = 0.084, and p = 0.136, respectively). None of the patients exhibited progression of osteoarthritis of the hip at the final follow-up. Conclusions Arthroscopic treatment after acetabular fracture or hip dislocation is effective and delays the progression of traumatic osteoarthritis. PMID:26640626

  6. Treatment of tibial eminence fractures with arthroscopic suture fixation technique: a retrospective study

    PubMed Central

    Yuan, Yanhao; Huang, Xiaohan; Zhang, Yanjie; Wang, Zhanchao

    2015-01-01

    Aims: The present study aims to investigate the clinical outcomes of arthroscopic suture fixation in treating tibial eminence fracture with a retrospective study design of two years’ follow-up. Methods: A total of 33 patients with imaging evidence of tibial eminence avulsion fractures who underwent arthroscopic surgery between 2008 and 2012 were included in this study. The inclusion criteria for the study were a displaced tibial eminence avulsion fracture and anterior knee instability of grade II or higher inskeletally mature patients. These patients were treated with arthroscopic suture fixation and followed with a mean period of 24 months. Anteroposterior and lateral radiographs were obtained 3 months postoperatively to assess fracture healing. At 24 months after surgery, all patients were evaluated by an independent orthopaedic professor with clinical examination like anteroposterior laxity (Lachman-Noulis and anterior drawer tests) and Rolimeter knee tester (Aircast, Vista, CA). Knee range of motion was evaluated actively and passively with a goniometer. Knee function was evaluated by the Lysholm and International Knee Documentation Committee (IKDC) scores. Knee radiographs in standing anteroposterior, standing lateral, and Merchant views were examined for alignment, joint space narrowing, and degenerative knee changes. Results: No major complication like infection, deep venous thrombosis, or neurovascular deficit happened peri-operatively. At the final follow-up, there were no symptoms of instability and no clinical signs of ACL deficiency. Radiographs showed that all fractures healed 3 months post-operative, but at the last follow-up, there was one person with degenerative changes like joint space narrowing in radiographs. Anterior translation of the tibia was 0.47 mm on average (0 to 2.5 mm) compared with the uninjured side. Range-of-motion measurement showed a mean extension deficit of 1.5° (0° to 5°) and a mean flexion deficit of 2.7° (0° to 10°) compared with the unaffected side. The mean Lysholm score was 96 (85 to 100), and the mean IKDC score was 94 (80 to 100). Overall, the IKDC grade was A (normal) in 24 patients (58%), B (nearly normal) in 8 patients (33%), and C (abnormal) in 1 patient (8%). Conclusion: The present study demonstrated tibial eminence fractures in adults can be effectively treated with arthroscopic suture fixation. PMID:26550328

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

    PubMed Central

    Bonilla, Alvaro G.; Santschi, Elizabeth M.

    2015-01-01

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

  8. Arthroscopic excision of intra-articular hip osteoid osteoma: a report of 2 cases.

    PubMed

    Nehme, Alexandre H; Bou Ghannam, Alaa G; Imad, Joseph P; Jabbour, Fouad C; Moucharafieh, Ramzi; Wehbe, Joseph

    2012-01-01

    Intra-articular osteoid osteoma is uncommon accounting for approximately 12% of all osteoid osteomas. It presents diagnostic and therapeutic challenges since several traumatic or degenerative pathologies of the joint can be simulated with delay in the diagnosis. We report the clinical, radiographic, and histopathological findings in 2 cases of intra-articular osteoid osteoma of the femoral neck and of the acetabulum. Technical aspects of arthroscopic excision and results of surgery are discussed. Arthroscopy allowed complete excision of the osteoid osteomas, with a short postoperative rehabilitation and excellent functional results. PMID:23304593

  9. Arthroscopic Excision of Intra-Articular Hip Osteoid Osteoma: A Report of 2 Cases

    PubMed Central

    Nehme, Alexandre H.; Bou Ghannam, Alaa G.; Imad, Joseph P.; Jabbour, Fouad C.; Moucharafieh, Ramzi; Wehbe, Joseph

    2012-01-01

    Intra-articular osteoid osteoma is uncommon accounting for approximately 12% of all osteoid osteomas. It presents diagnostic and therapeutic challenges since several traumatic or degenerative pathologies of the joint can be simulated with delay in the diagnosis. We report the clinical, radiographic, and histopathological findings in 2 cases of intra-articular osteoid osteoma of the femoral neck and of the acetabulum. Technical aspects of arthroscopic excision and results of surgery are discussed. Arthroscopy allowed complete excision of the osteoid osteomas, with a short postoperative rehabilitation and excellent functional results. PMID:23304593

  10. Preclinical Studies for Cartilage Repair: Recommendations from the International Cartilage Repair Society.

    PubMed

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

    2011-04-01

    Investigational devices for articular cartilage repair or replacement are considered to be significant risk devices by regulatory bodies. Therefore animal models are needed to provide proof of efficacy and safety prior to clinical testing. The financial commitment and regulatory steps needed to bring a new technology to clinical use can be major obstacles, so the implementation of highly predictive animal models is a pressing issue. Until recently, a reductionist approach using acute chondral defects in immature laboratory species, particularly the rabbit, was considered adequate; however, if successful and timely translation from animal models to regulatory approval and clinical use is the goal, a step-wise development using laboratory animals for screening and early development work followed by larger species such as the goat, sheep and horse for late development and pivotal studies is recommended. Such animals must have fully organized and mature cartilage. Both acute and chronic chondral defects can be used but the later are more like the lesions found in patients and may be more predictive. Quantitative and qualitative outcome measures such as macroscopic appearance, histology, biochemistry, functional imaging, and biomechanical testing of cartilage, provide reliable data to support investment decisions and subsequent applications to regulatory bodies for clinical trials. No one model or species can be considered ideal for pivotal studies, but the larger animal species are recommended for pivotal studies. Larger species such as the horse, goat and pig also allow arthroscopic delivery, and press-fit or sutured implant fixation in thick cartilage as well as second look arthroscopies and biopsy procedures. PMID:26069576

  11. T2 Mapping Magnetic Resonance Imaging Encourages an Arthroscopic Approach for Osteoid Osteoma in the Acetabulum.

    PubMed

    Shoji, Takeshi; Yasunaga, Yuji; Yamasaki, Takuma; Mori, Ryo; Hamanishi, Michio; Shimose, Shoji; Ochi, Mitsuo

    2014-04-01

    Intra-articular osteoid osteoma (OO) is uncommon, especially in the hip joint. Delayed treatment may cause early osteoarthritis; however, diagnosis and complete excision are often challenging. We describe the feasibility of the combination of T2 mapping magnetic resonance imaging evaluation and arthroscopic excision of OO in the acetabulum. A 12-year-old boy presented with a 6-month history of hip pain. An undifferentiated tumor of the medial wall of the acetabulum was suspected on radiographs and computed tomography. T2 mapping showed joint effusion, and the T2 value of the acetabular cartilage just above the tumor was significantly high. These findings suggested OO in the acetabulum. An arthroscopic excision was performed for biopsy and excision of the tumor to avoid damage to the normal cartilage and growth plate. Histologic examination confirmed the OO. At 16 months' follow-up, there was no evidence of recurrence. This is the first report to evaluate intra-articular OO by T2 mapping and to treat it arthroscopically. Arthroscopic treatment assisted by T2 mapping has excellent potential as a minimally invasive technique to enable us to approach the tumor from the area of discriminative abnormal cartilage with minimal damage to the normal cartilage and surrounding tissue. PMID:24904771

  12. T2 Mapping Magnetic Resonance Imaging Encourages an Arthroscopic Approach for Osteoid Osteoma in the Acetabulum

    PubMed Central

    Shoji, Takeshi; Yasunaga, Yuji; Yamasaki, Takuma; Mori, Ryo; Hamanishi, Michio; Shimose, Shoji; Ochi, Mitsuo

    2014-01-01

    Intra-articular osteoid osteoma (OO) is uncommon, especially in the hip joint. Delayed treatment may cause early osteoarthritis; however, diagnosis and complete excision are often challenging. We describe the feasibility of the combination of T2 mapping magnetic resonance imaging evaluation and arthroscopic excision of OO in the acetabulum. A 12-year-old boy presented with a 6-month history of hip pain. An undifferentiated tumor of the medial wall of the acetabulum was suspected on radiographs and computed tomography. T2 mapping showed joint effusion, and the T2 value of the acetabular cartilage just above the tumor was significantly high. These findings suggested OO in the acetabulum. An arthroscopic excision was performed for biopsy and excision of the tumor to avoid damage to the normal cartilage and growth plate. Histologic examination confirmed the OO. At 16 months' follow-up, there was no evidence of recurrence. This is the first report to evaluate intra-articular OO by T2 mapping and to treat it arthroscopically. Arthroscopic treatment assisted by T2 mapping has excellent potential as a minimally invasive technique to enable us to approach the tumor from the area of discriminative abnormal cartilage with minimal damage to the normal cartilage and surrounding tissue. PMID:24904771

  13. LCD testing and repair

    NASA Astrophysics Data System (ADS)

    Waters, Rodney L.; Pothoven, Floyd R.; Branst, Lee

    1994-04-01

    Active-matrix liquid crystal displays (AMLCD) have come into increasing use in a variety of applications. As the size of the displays has gotten larger, their proper testing and repair has become critical. Quite simply, it is too costly to discard displays that fail to pass initial tests. Schemes have been devised that test AMLCDs as to whether they are operating or not, i.e., test that merely indicate whether the display will work, or not, once it is assembled. That is no longer enough. Manufacturers must know why a device is inoperable and whether it can be repaired. Since AMLCDs are basically large integrated circuits, a number of test and repair techniques have been borrowed from the semiconductor industry. This paper describes a method by which AMLCDs, especially large area devices, can be tested and repaired. This method primarily involves the incorporation of electrical probing to test individual lines and pixels. Once the defects have been located, lasers are used to effect the required repairs via material removal and deposition.

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

    PubMed Central

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

    2014-01-01

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

  15. Safety and analgesic efficacy of intravenous dexmedetomidine in arthroscopic knee surgery

    PubMed Central

    Kundu, Riddhi; Dehran, Maya; Chandralekha; Trikha, Anjan; Nag, H. L.

    2015-01-01

    Context: Dexmedetomidine, a highly selective alpha-2 agonist has been used as an adjuvant analgesic in vascular, bariatric, and thoracic surgery. We assessed the efficacy of intravenous dexmedetomidine as an analgesic adjunct to local anesthetic infiltration for control of postoperative pain in arthroscopic knee surgery. Settings and Design: This was a randomized control study performed in a Tertiary Care Hospital. Materials and Methods: Forty-five adult patients scheduled for anterior/posterior cruciate ligament reconstruction were randomized into three groups. Group B (bupivacaine group) received bupivacaine intraarticularly and normal saline by the intravenous route. Group D (dexmedetomidine group) received Intravenous dexmedetomidine and normal saline intraarticularly. Group BD (bupivacaine + dexmedetomidine group) received a combination of intravenous dexmedetomidine and intraarticular bupivacaine. Patient's cardiorespiratory parameters, time to first rescue, total rescue analgesic consumption in first 24 h, visual analog scale for pain were assessed. Statistical Analysis: The data were analyzed using analysis of variance and Chi-square test. Results: The time to first request for rescue analgesia was significantly prolonged in Group D and Group BD patients (P < 0.05) compared to Group B. Total rescue analgesic consumption was least in Group BD. Group D and Group BD patients had lower heart rate and systolic and diastolic blood pressure values. Conclusion: Intravenous dexmedetomidine in combination with intraarticular bupivacaine decreased perioperative analgesic requirement in patients undergoing arthroscopic knee surgery. However, monitoring and vigilance are essential if dexmedetomidine is used as part of a multimodal analgesic regimen in view of its hemodynamic side effects. PMID:26712980

  16. Direct “Cystoscopic” Approach for Arthroscopic Decompression of an Intraosseous Ganglion of the Lunate

    PubMed Central

    Bhatia, Deepak N.

    2015-01-01

    Intraosseous ganglion cysts (IOGs) are uncommon lesions of the carpal bones and can present with persistent pain and stiffness of the wrist. Surgical decompression is recommended, and a variety of approaches to decompress symptomatic IOGs of the wrist have been described. We describe an arthroscopic approach that can be performed with only 2 portals and offers excellent access for visualization and instrumentation. The procedure involves creating a 3.2-mm tunnel into the lunate cyst; this is performed through the dorsal non-articular surface of the lunate, under direct vision, and the position is confirmed with fluoroscopy. A 2.4-mm arthroscope is passed through the drill hole, and a direct “cystoscopic” view of the IOG is obtained. Biopsy of the cyst contents is performed under direct vision, and small-joint shavers and burrs are used for effective debridement. Advantages of this technique are actual visualization of the pathology, complete intracystic debridement, and simultaneous treatment of any coexistent intra-articular pathology. In addition, the minimal 3.2-mm lunate tunnel access maintains the structural integrity of the lunate and reduces the need for additional bone graft supplementation. PMID:26258034

  17. Arthroscopic treatment of synovial osteochondromatosis of the elbow. Case report and literature review.

    PubMed

    Terra, Bernardo Barcellos; Moraes, Eduardo Wanzenboeck; de Souza, Alceuleir Cardoso; Cavatte, José Maria; Teixeira, João Carlos de Medeiros; De Nadai, Anderson

    2015-01-01

    Synovial osteochondromatosis is a benign proliferative disorder with metaplasia of the synovial membrane that affects the fibroblasts of the synovial joints, tendons and bursae. In literature, there are few descriptions of synovial osteochondromatosis of the elbow. The objective of this article was to report a case of synovial osteochondromatosis of the elbow in a patient aged 32, basketball athlete, in which surgical treatment was chosen because of the pain and functional limitation and stage of disease with multiple loose bodies. Patient 32, male, presented with pain and limitation of motion of the elbow. The range of passive motion was 100° of flexion and 30° extension. The range of active motion was 40-90°. Magnetic resonance observed many loose bodies mainly in the posterior compartment in the olecranon fossa plus some chondral lesions in the capitellum. The arthroscopic treatment was chosen with two anteriors portals (medial and lateral) and two posterior portals (standard posterior and posterolateral) for easing loose bodies and osteoplasty of the olecranon fossa. The visual analog scale pain was 9-3 and its arc of active motion was 110° to -20° of flexion and extension. On a scale of performance from Mayo Clinic patients was 65 points preoperatively to 90 postoperatively with 9 months follow-up and the patient was satisfied with the treatment outcome. Arthroscopic treatment of synovial osteochondromatosis of the elbow is an effective and safe therapeutic management with low morbidity and early return to activities. PMID:26535210

  18. Arthroscopic treatment of synovial osteochondromatosis of the elbow. Case report and literature review?

    PubMed Central

    Terra, Bernardo Barcellos; Moraes, Eduardo Wanzenboeck; de Souza, Alceuleir Cardoso; Cavatte, José Maria; Teixeira, João Carlos de Medeiros; De Nadai, Anderson

    2015-01-01

    Synovial osteochondromatosis is a benign proliferative disorder with metaplasia of the synovial membrane that affects the fibroblasts of the synovial joints, tendons and bursae. In literature, there are few descriptions of synovial osteochondromatosis of the elbow. The objective of this article was to report a case of synovial osteochondromatosis of the elbow in a patient aged 32, basketball athlete, in which surgical treatment was chosen because of the pain and functional limitation and stage of disease with multiple loose bodies. Patient 32, male, presented with pain and limitation of motion of the elbow. The range of passive motion was 100° of flexion and 30° extension. The range of active motion was 40–90°. Magnetic resonance observed many loose bodies mainly in the posterior compartment in the olecranon fossa plus some chondral lesions in the capitellum. The arthroscopic treatment was chosen with two anteriors portals (medial and lateral) and two posterior portals (standard posterior and posterolateral) for easing loose bodies and osteoplasty of the olecranon fossa. The visual analog scale pain was 9–3 and its arc of active motion was 110° to ?20° of flexion and extension. On a scale of performance from Mayo Clinic patients was 65 points preoperatively to 90 postoperatively with 9 months follow-up and the patient was satisfied with the treatment outcome. Arthroscopic treatment of synovial osteochondromatosis of the elbow is an effective and safe therapeutic management with low morbidity and early return to activities. PMID:26535210

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

    PubMed

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

    2008-01-01

    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

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

    PubMed

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

    2009-09-01

    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

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

    NASA Astrophysics Data System (ADS)

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

    2013-07-01

    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.

  2. Cartilage Repair With Autologous Bone Marrow Mesenchymal Stem Cell Transplantation

    PubMed Central

    Yamasaki, Shinya; Mera, Hisashi; Itokazu, Maki; Hashimoto, Yusuke

    2014-01-01

    Clinical trials of various procedures, including bone marrow stimulation, mosaicplasty, and autologous chondrocyte implantation, have been explored to treat articular cartilage defects. However, all of them have some demerits. We focused on autologous culture-expanded bone marrow mesenchymal stem cells (BMSC), which can proliferate without losing their capacity for differentiation. First, we transplanted BMSC into the defective articular cartilage of rabbit and succeeded in regenerating osteochondral tissue. We then applied this transplantation in humans. Our previous reports showed that treatment with BMSC relieves the clinical symptoms of chondral defects in the knee and elbow joint. We investigated the efficacy of BMSC for osteoarthritic knee treated with high tibial osteotomy, by comparing 12 BMSC-transplanted patients with 12 cell-free patients. At 16-month follow-up, although the difference in clinical improvement between both groups was not significant, the arthroscopic and histological grading score was better in the cell-transplanted group. At the over 10-year follow-up, Hospital for Special Surgery knee scores improved to 76 and 73 in the BMSC-transplanted and cell-free groups, respectively, which were better than preoperative scores. Additionally, neither tumors nor infections were observed in all patients, and in the clinical study, we have never observed hypertrophy of repaired tissue, thereby guaranteeing the clinical safety of this therapy. Although we have never observed calcification above the tidemark in rabbit model and human histologically, the repair cartilage was not completely hyaline cartilage. To elucidate the optimum conditions for cell therapy, other stem cells, culture conditions, growth factors, and gene transfection methods should be explored. PMID:26069698

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

    PubMed

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

    2015-03-01

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

  4. Base Excision Repair

    PubMed Central

    Krokan, Hans E.; Bjørås, Magnar

    2013-01-01

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

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

    PubMed Central

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

    2014-01-01

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

  6. Rescheduling with iterative repair

    NASA Technical Reports Server (NTRS)

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

    1992-01-01

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

  7. Rescheduling with iterative repair

    NASA Technical Reports Server (NTRS)

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

    1992-01-01

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

  8. 46 CFR Sec. 19 - Ship Repair Summaries.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

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

  9. 46 CFR Sec. 19 - Ship Repair Summaries.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

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

  10. 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, ...

  11. Electric motor model repair specifications

    SciTech Connect

    1995-08-01

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

  12. Bone fracture repair - series (image)

    MedlinePLUS

    The three main treatment options for bone fractures are: Casting Open reduction, and internal fixation- this involves a surgery to repair the fracture-frequently, metal rods, screws or plates are used to repair the ...

  13. Thumb Carpometacarpal Ligaments Inside and Out: A Comparative Study of Arthroscopic and Gross Anatomy from the Robert A. Chase Hand and Upper Limb Center at Stanford University

    PubMed Central

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

    2013-01-01

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

  14. Protein methylation and DNA repair.

    PubMed

    Lake, Aimee N; Bedford, Mark T

    2007-05-01

    DNA is under constant attack from intracellular and external mutagens. Sites of DNA damage need to be pinpointed so that the DNA repair machinery can be mobilized to the proper location. The identification of damaged sites, recruitment of repair factors, and assembly of repair "factories" is orchestrated by posttranslational modifications (PTMs). These PTMs include phosphorylation, ubiquitination, sumoylation, acetylation, and methylation. Here we discuss recent data surrounding the roles of arginine and lysine methylation in DNA repair processes. PMID:17306845

  15. Automotive Engine Maintenance and Repair.

    ERIC Educational Resources Information Center

    Marine Corps Inst., Washington, DC.

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

  16. Laboratory For Telerobotic Repair

    NASA Technical Reports Server (NTRS)

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

    1993-01-01

    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.

  17. Automotive Body Repair Competencies.

    ERIC Educational Resources Information Center

    D'Armond, Jack; And Others

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

  18. Basic Book Repair Methods.

    ERIC Educational Resources Information Center

    Schechter, Abraham A.

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

  19. Comprehensive Small Engine Repair.

    ERIC Educational Resources Information Center

    Hires, Bill; And Others

    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,…

  20. Gene Therapy for Cartilage Repair

    PubMed Central

    Madry, Henning; Orth, Patrick; Cucchiarini, Magali

    2011-01-01

    The concept of using gene transfer strategies for cartilage repair originates from the idea of transferring genes encoding therapeutic factors into the repair tissue, resulting in a temporarily and spatially defined delivery of therapeutic molecules to sites of cartilage damage. This review focuses on the potential benefits of using gene therapy approaches for the repair of articular cartilage and meniscal fibrocartilage, including articular cartilage defects resulting from acute trauma, osteochondritis dissecans, osteonecrosis, and osteoarthritis. Possible applications for meniscal repair comprise meniscal lesions, meniscal sutures, and meniscal transplantation. Recent studies in both small and large animal models have demonstrated the applicability of gene-based approaches for cartilage repair. Chondrogenic pathways were stimulated in the repair tissue and in osteoarthritic cartilage using genes for polypeptide growth factors and transcription factors. Although encouraging data have been generated, a successful translation of gene therapy for cartilage repair will require an ongoing combined effort of orthopedic surgeons and of basic scientists. PMID:26069580

  1. Loop Biceps Tenotomy: An Arthroscopic Technique for Long Head of Biceps Tenotomy

    PubMed Central

    Goubier, Jean-Noel; Bihel, Thomas; Dubois, Elodie; Teboul, Frédéric

    2014-01-01

    The long head of the biceps tendon is frequently involved in shoulder pathologies, often in relation to inflammatory or degenerative damage to the rotator cuff. Biceps tenodesis in the bicipital groove and tenotomy are the main treatment options. Tenotomy of the long head of the biceps tendon is a simpler and quicker procedure than tenodesis, and it does not require the use of implants. However, retraction of the biceps tendon, leading to Popeye deformity, and biceps muscle cramps are common complications after tenotomy. Therefore we propose an arthroscopic technique for tenotomy that limits the risk of Popeye deformity. This procedure consists of creating a loop at the severed end of the biceps tendon, which prevents the tendon from retracting into the bicipital groove. PMID:25264503

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

    PubMed Central

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

    2013-01-01

    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

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

    PubMed Central

    Song, Seok Young

    2012-01-01

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

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

    PubMed

    Wee, James; Lee, Keng Thiam

    2014-04-01

    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

  5. Arthroscopic excision of acetabular osteoid osteoma in a 7-year-old patient.

    PubMed

    A??k, Mehmet; Er?en, Ali; Polat, Gökhan; Bilgili, Fuat; Tunal?, Onur

    2015-11-01

    The purpose of this study was to present the case report of a 7-year-old patient who was treated with hip arthroscopy for an acetabular osteoid osteoma. A 7-year-old patient was referred to our clinic with hip pain. In the assessment of the patient, an acetabular osteoid osteoma was detected in his right hip; it was adjacent to his triradiate cartilage. An arthroscopic surgery was planned as an alternative to open safe hip dislocation. The osteoid osteoma was completely removed with hip arthroscopy. Postoperative CT scanning and histopathological analysis confirmed the diagnosis. Exposure of the acetabulum can be problematic in paediatric patients due to the potential risks of open safe dislocation. Hip arthroscopy can safely be used for benign hip lesions in paediatric patients. Level of evidence Case report, Level V. PMID:24714976

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

    PubMed

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

    2015-04-01

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

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

    PubMed Central

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

    2015-01-01

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

  8. Percutaneous Arthroscopic Calcaneal Osteosynthesis: A Minimally Invasive Technique for Displaced Intra-Articular Calcaneal Fractures.

    PubMed

    Pastides, Philip S; Milnes, Lydia; Rosenfeld, Peter F

    2015-01-01

    The management of calcaneal fracture remains challenging. Open surgery has been fraught with high infection rates and soft tissue complications. More minimally invasive procedures have reduced this risk, but the patient outcomes after treatment of displaced calcaneal fractures have remained relatively unsatisfactory. We present a method for the management of Sanders grade II and III calcaneal fractures: percutaneous arthroscopic calcaneal osteosynthesis. Thirty-three fractures in 30 patients who had presented to our tertiary foot and ankle trauma center in central London were treated with percutaneous arthroscopic calcaneal osteosynthesis for calcaneal fractures, and the data were prospectively collected. The mean patient age at injury was 39 years. The mean follow-up period was 24 months. Of our patients, 58% were smokers at injury. Of the 33 fractures, 46% were classified as grade II and 54% as grade III. The mean length of stay was 1.92 days. At the final follow-up visit, the mean Böhler angle had increased from 11.10° (range 2° to 24°) to 23.41° (range 15° to 35°). The modified American Orthopaedic Foot and Ankle Society scale score was 72.18 (range 18 to 100), the calcaneal fracture scoring system score was 79.34 (range 42 to 100), and the visual analog scale score was 29.50 (range 0 to 100). We had a single case of a superficial port site infection and 2 cases of prominent screws, which were removed. No cases of deep infection developed, and no conversion to subtalar fusion was required. This technique significantly reduced the incidence of postoperative wound complications. Direct visualization of the fracture site allowed accurate restoration of the articular surface and correction of heel varus. Furthermore, it was associated with a high self-reported functional outcome and a return to preinjury employment levels. Also, the results did not appear to be influenced by tobacco consumption. PMID:25960056

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

    PubMed Central

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

    2014-01-01

    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

  10. Preemptive analgesia with intra-articular pethidine reduces pain after arthroscopic knee surgery

    PubMed Central

    Hashemi, Sayed Jalal; Soltani, Hasanali; Heidari, Sayed Morteza; Rezakohanfekr, Mahmoud

    2013-01-01

    Background: Postoperative pain relief is important in procedures of the lower extremity. Several previous studies have evaluated the efficacy of intra-articular (IA) pethidine as a compound, which has local anesthetic and opioid agonist properties, on postoperative pain relief in arthroscopic knee surgery (AKS). This study compared the postoperative analgesic effect of pre- and post-surgical IA pethidine administration in AKS. Materials and Methods: Seventy-five patients of American Society of Anesthesiologists (ASA) I and II undergoing AKS with general anesthesia were enrolled in this double-blind study. Patients were randomized in three equal groups to receive either 50 mg IA pethidine before surgical incision incision and saline after skin closure (PS), saline before surgical incision and pethedine after skin closure (SP), and only saline at two different times (SS). In each patient with operated knee joint, pain at rest and joint movement was evaluated at 1, 2, 6, 12, and 24 h after surgery completion using Visual Analog Scale (VAS). Data were analyzed using analysis of variance (ANOVA)-repeated measure, t-paired, and Chi-square tests. Results: Postoperative pain score at rest and joint movement in PS group was significantly lower than those in other groups. The time (Mean ± SD) between completion of operation and patient's request for morphine, total morphine consumption (Mean ± SD) in postoperative 24 h, and the numbers of patients requesting analgesic in PS, SP, SS, groups were: 5.2 ± 1.3, 3.3 ± 1.5, and 2 ± 1.3 h (P < 0.05); 4.4 ± 2.4, 8.7 ± 2, and 11.6 ± 4.4 mg (P < 0.05); 11, 18, and 21 persons (P < 0.05), respectively. Conclusion: The present study shows that preemptive intra-articular pethidine 50 mg injection is more effective than preventive injection for postoperative pain relief at rest and joint movement in arthroscopic knee surgery. PMID:23930254

  11. Prokaryotic Nucleotide Excision Repair

    PubMed Central

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

    2013-01-01

    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

  12. Arthroscopic partial limbectomy for labral injury of the hip: a case with a 16-year follow-up.

    PubMed

    Nakamura, Y; Ohishi, H; Kishiya, M; Toh, S

    2012-08-01

    Although good to excellent short-term results of arthroscopic partial limbectomy of the hip have been reported, there is little information on the long-term outcome of the procedure. We report a case with a 16-year follow-up. A 34-year old woman presented with a three-month history of severe pain and limitation of movement of the hip. Plain radiographs and arthrography showed no abnormality. MRI showed an effusion and a deformity of the anterosuperior part of the labrum. This was confirmed as an inverted labral tear that was debrided arthroscopically. At 16 years post-operatively, she remained symptom-free. Plain radiographs showed no abnormality and MRI suggested that the sealing effect of the scar tissue prevented articular damage and degeneration. PMID:22844060

  13. One step arthroscopically assisted Latarjet and posterior bone-block, for recurrent posterior instability and anterior traumatic dislocation

    PubMed Central

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

    2015-01-01

    This case presents the challenges of the surgical management for a patient with a history of recurrent posterior shoulder instability and subsequently traumatic anterior dislocation. The patient was already on the waiting list for an arthroscopic posterior stabilization with anchors, when a car accident caused an additional anterior shoulder dislocation. This traumatic anterior dislocation created a bone loss with a glenoid fracture and aggravated the preexisting posterior instability. In order to address both problems, we decided to perform an arthroscopically assisted Latarjet procedure for anterior instability and to stabilize with a bone graft for posterior instability. To our best knowledge, this type of surgical procedure has so far never been reported in the literature. The purpose of this report is to present the surgical technique and to outline the decision making process. PMID:26288539

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

    PubMed Central

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

    2008-01-01

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

  15. Arthroscopic Treatment of Chondral and Osteochondral Defects in the Ankle Using the Autologous Matrix-Induced Chondrogenesis Technique

    PubMed Central

    Piontek, Tomasz; B?kowski, Pawe?; Ciemniewska-Gorzela, Kinga; Naczk, Jakub

    2015-01-01

    One of the greatest challenges nowadays facing orthopaedic surgeons around the world is the problem of articular cartilage defects and their treatment. The autologous matrix-induced chondrogenesis technique is based on 2 elements—drilling into bones and matrix application. The purpose of this article is to present the surgical technique of arthroscopic treatment of chondral or osteochondral defects in the ankle using the autologous matrix-induced chondrogenesis technique. PMID:26697305

  16. Is platelet-rich plasma able to enhance the results of arthroscopic microfracture in early osteoarthritis and cartilage lesion over 40 years of age?

    PubMed

    Lee, Gun Woo; Son, Jung-Hwan; Kim, Jae-Do; Jung, Gu-Hee

    2013-07-01

    Most studies suggested that arthroscopic microfracture is effective method at only less than 40 years of age. Thus, the authors thought that "how can this indication regarding age be extended?," and tried to find a way to use this technique effectively over 40 years of age. The aim of this study was the first to report the results regarding the PRP as an adjunct for arthroscopic microfracture in the early osteoarthritic (OA) knee with cartilage lesion over 40 years of age. 49 patients who underwent arthroscopic microfracture for cartilage lesion sized less than 4 cm(2) with early OA, aged 40-50 years, were enrolled and randomly divided into 2 groups: a control group with only arthroscopic microfracture (25 patients) and a study group with arthroscopic microfracture and PRP (24 patients). The patients were prospectively evaluated with VAS, IKDC score at preoperative and postoperative 1, 6, 12, and 24 months. And we perform second arthroscopies in 10 patients of each group to identify the extent of cartilage restoration at 4-6 months postoperatively. There were significant improvements in clinical results between preoperative evaluation and postoperative 2 years in both groups (p = 0.017). In the postoperative 2 years, clinical results showed significantly better in the study group than in the control group (p = 0.012). In post-arthroscopic finding, hardness and elasticity degree was better in the study group. The PRP injection with arthroscopic microfracture would be improved the results in early osteoarthritic knee with cartilage lesion in 40-50 years old, and the indication of this technique could be extended to 50 years. PMID:23412171

  17. Arthroscopic lavage speeds reduction in effusion in the glenohumeral joint after primary anterior shoulder dislocation: a controlled randomized ultrasound study.

    PubMed

    Wintzell, G; Hovelius, L; Wikblad, L; Saebö, M; Larsson, S

    2000-01-01

    Recent studies have shown that arthroscopic lavage of the glenohumeral joint within 10 days following a primary anterior dislocation significantly lowers the recurrence rate when compared with a nonoperative regime. We hypothesize that the lavage reduces distension in the joint and thereby facilitates adaptation and healing of the soft tissue lesion. Using ultrasound, we assessed the hemarthrosis in the glenohumeral joint weekly in 16 consecutive patients after traumatic primary anterior shoulder dislocation. The patients were randomized into two groups for treatment with either arthroscopic lavage or a nonoperative regime. Except for the lavage the two groups followed an identical rehabilitation program. Transversal dorsal ultrasound of the glenohumeral joint was performed, in which the joint effusion was assessed as the distance between the humeral head and the glenoid. Prior to the lavage the two groups had a similar amount of excessive joint effusion. The effusion declined to a steady state level within 3-7 weeks. The joint effusion decreased more rapidly (33%) in the group treated with arthroscopic lavage (P = 0.02) than in the nonoperated group. PMID:10663322

  18. Comparative analysis on arthroscopic sutures of large and extensive rotator cuff injuries in relation to the degree of osteopenia?

    PubMed Central

    Almeida, Alexandre; Atti, Vinícius; Agostini, Daniel Cecconi; Valin, Márcio Rangel; de Almeida, Nayvaldo Couto; Agostini, Ana Paula

    2015-01-01

    Objective To analyze the results from arthroscopic suturing of large and extensive rotator cuff injuries, according to the patient's degree of osteopenia. Method 138 patients who underwent arthroscopic suturing of large and extensive rotator cuff injuries between 2003 and 2011 were analyzed. Those operated from October 2008 onwards formed a prospective cohort, while the remainder formed a retrospective cohort. Also from October 2008 onwards, bone densitometry evaluation was requested at the time of the surgical treatment. For the patients operated before this date, densitometry examinations performed up to two years before or after the surgical treatment were investigated. The patients were divided into three groups. Those with osteoporosis formed group 1 (n = 16); those with osteopenia, group 2 (n = 33); and normal individuals, group 3 (n = 55). Results In analyzing the University of California at Los Angeles (UCLA) scores of group 3 and comparing them with group 2, no statistically significant difference was seen (p = 0.070). Analysis on group 3 in comparison with group 1 showed a statistically significant difference (p = 0.027). Conclusion The results from arthroscopic suturing of large and extensive rotator cuff injuries seem to be influenced by the patient's bone mineral density, as assessed using bone densitometry. PMID:26229899

  19. The Existence of Myocardial Repair

    PubMed Central

    Schoenfeld, Matthew; Frishman, William H.; Leri, Annarosa; Kajstura, Jan; Anversa, Piero

    2014-01-01

    The lack of myocardial repair after myocardial infarction and the heart failure that eventually ensues was thought of as proof that myocardial cell regeneration and myocardial repair mechanisms do not exist. Recently, growing experimental and clinical evidence has proven this concept wrong. Cardiac stem cells and endogenous myocardial repair mechanisms do exist; however, they do not produce significant myocardial repair. Similarly, the preliminary results of stem cell therapy for myocardial repair have shown early promise but modest results. Preclinical studies are the key to understanding stem cell senescence and lack of cellular contact and vasculature in the infarcted region. Additional laboratory studies are sure to unlock the therapeutic mechanisms that will be required for significant myocardial repair. PMID:23568056

  20. DNA repair in cultured keratinocytes

    SciTech Connect

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

    1983-07-01

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

  1. DNA excision repair at telomeres.

    PubMed

    Jia, Pingping; Her, Chengtao; Chai, Weihang

    2015-12-01

    DNA damage is caused by either endogenous cellular metabolic processes such as hydrolysis, oxidation, alkylation, and DNA base mismatches, or exogenous sources including ultraviolet (UV) light, ionizing radiation, and chemical agents. Damaged DNA that is not properly repaired can lead to genomic instability, driving tumorigenesis. To protect genomic stability, mammalian cells have evolved highly conserved DNA repair mechanisms to remove and repair DNA lesions. Telomeres are composed of long tandem TTAGGG repeats located at the ends of chromosomes. Maintenance of functional telomeres is critical for preventing genome instability. The telomeric sequence possesses unique features that predispose telomeres to a variety of DNA damage induced by environmental genotoxins. This review briefly describes the relevance of excision repair pathways in telomere maintenance, with the focus on base excision repair (BER), nucleotide excision repair (NER), and mismatch repair (MMR). By summarizing current knowledge on excision repair of telomere damage and outlining many unanswered questions, it is our hope to stimulate further interest in a better understanding of excision repair processes at telomeres and in how these processes contribute to telomere maintenance. PMID:26422132

  2. Stimulating endogenous cardiac repair

    PubMed Central

    Finan, Amanda; Richard, Sylvain

    2015-01-01

    The healthy adult heart has a low turnover of cardiac myocytes. The renewal capacity, however, is augmented after cardiac injury. Participants in cardiac regeneration include cardiac myocytes themselves, cardiac progenitor cells, and peripheral stem cells, particularly from the bone marrow compartment. Cardiac progenitor cells and bone marrow stem cells are augmented after cardiac injury, migrate to the myocardium, and support regeneration. Depletion studies of these populations have demonstrated their necessary role in cardiac repair. However, the potential of these cells to completely regenerate the heart is limited. Efforts are now being focused on ways to augment these natural pathways to improve cardiac healing, primarily after ischemic injury but in other cardiac pathologies as well. Cell and gene therapy or pharmacological interventions are proposed mechanisms. Cell therapy has demonstrated modest results and has passed into clinical trials. However, the beneficial effects of cell therapy have primarily been their ability to produce paracrine effects on the cardiac tissue and recruit endogenous stem cell populations as opposed to direct cardiac regeneration. Gene therapy efforts have focused on prolonging or reactivating natural signaling pathways. Positive results have been demonstrated to activate the endogenous stem cell populations and are currently being tested in clinical trials. A potential new avenue may be to refine pharmacological treatments that are currently in place in the clinic. Evidence is mounting that drugs such as statins or beta blockers may alter endogenous stem cell activity. Understanding the effects of these drugs on stem cell repair while keeping in mind their primary function may strike a balance in myocardial healing. To maximize endogenous cardiac regeneration, a combination of these approaches could ameliorate the overall repair process to incorporate the participation of multiple cellular players. PMID:26484341

  3. Outcome of hypospadias fistula repair.

    PubMed

    Shankar, K R; Losty, P D; Hopper, M; Wong, L; Rickwood, A M K

    2002-01-01

    Objectives To examine the long-term results of hypospadias fistula repair, the factors involved in recurrence and the outcome in cases where this has occurred. Patients and methods The study comprised 113 children undergoing urethrocutaneous fistula repair between 1984 and 1996. Most of the fistulae were closed in two to three layers, with or without a transpositional skin flap. Tunica vaginalis or a scrotal dartos flap was used in patients with inadequate vascularized tissue adjacent to the fistula. Success rates were calculated for each attempt at fistula repair until the patient was cured. Results The median (range) age at primary fistula repair was 40 (18-169) months and the median follow-up after the most recent repair 7.5 (2.3-17) years. The overall success rate of primary fistula repair was 71%. Fistulae which were >2 mm (11 of 21, 52%) were more likely to recur than were those < or = 2 mm (22 of 92, 24%). Recurrence did not relate to the initial form of hypospadias repair, to the means of skin closure nor, with the exception of multiple lesions, to the location of the fistula. The success rates of subsequent repairs were 70% at the second and 50% at the third, fourth and fifth repairs. One child was cured at the sixth attempt. The use of tunica vaginalis or scrotal dartos as a 'waterproofing' layer was limited to the third or subsequent repairs and was successful in five of six cases. Conclusion A simple layered closure with or with no transpositional skin flap is effective in 71% of repairs. For recurrent fistulae, tissues from an unscarred area (tunica vaginalis or scrotal dartos layer) should be used to cover the fistula. PMID:11849173

  4. Industrial motor repair in the United States

    SciTech Connect

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

    1994-09-01

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

  5. 46 CFR Sec. 19 - Ship Repair Summaries.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ...2011-10-01 2011-10-01 false Ship Repair Summaries. Sec. 19 Section 19 Shipping MARITIME ADMINISTRATION, DEPARTMENT...AUTHORITY MASTER LUMP SUM REPAIR CONTRACT-NSA-LUMPSUMREP Sec. 19 Ship Repair Summaries. (a) Ship...

  6. 46 CFR Sec. 19 - Ship Repair Summaries.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ...2010-10-01 2010-10-01 false Ship Repair Summaries. Sec. 19 Section 19 Shipping MARITIME ADMINISTRATION, DEPARTMENT...AUTHORITY MASTER LUMP SUM REPAIR CONTRACT-NSA-LUMPSUMREP Sec. 19 Ship Repair Summaries. (a) Ship...

  7. Instructional Guide for Autobody Repair.

    ERIC Educational Resources Information Center

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

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

  8. Pipe inspection and repair system

    NASA Technical Reports Server (NTRS)

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

    2004-01-01

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

  9. Major Appliance Repair. Teacher Edition.

    ERIC Educational Resources Information Center

    Smreker, Eugene; Calvert, King

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

  10. Membrane Repair: Mechanisms and Pathophysiology.

    PubMed

    Cooper, Sandra T; McNeil, Paul L

    2015-10-01

    Eukaryotic cells have been confronted throughout their evolution with potentially lethal plasma membrane injuries, including those caused by osmotic stress, by infection from bacterial toxins and parasites, and by mechanical and ischemic stress. The wounded cell can survive if a rapid repair response is mounted that restores boundary integrity. Calcium has been identified as the key trigger to activate an effective membrane repair response that utilizes exocytosis and endocytosis to repair a membrane tear, or remove a membrane pore. We here review what is known about the cellular and molecular mechanisms of membrane repair, with particular emphasis on the relevance of repair as it relates to disease pathologies. Collective evidence reveals membrane repair employs primitive yet robust molecular machinery, such as vesicle fusion and contractile rings, processes evolutionarily honed for simplicity and success. Yet to be fully understood is whether core membrane repair machinery exists in all cells, or whether evolutionary adaptation has resulted in multiple compensatory repair pathways that specialize in different tissues and cells within our body. PMID:26336031

  11. Comparison of different routes of administration of clonidine for analgesia following anterior cruciate ligament repair

    PubMed Central

    Sahni, Neeru; Panda, Nidhi B; Jain, Kajal; Batra, Yatinder Kumar; Dhillon, Mandeep Singh; Jagannath, Pushpa

    2015-01-01

    Background and Aims: A high percentage of patients undergoing arthroscopic repairs on day care basis complain of inadequate postoperative pain relief. Clonidine was evaluated for the best route as an adjuvant in regional anesthesia in anterior cruciate ligament (ACL) repair to prolong analgesia. Material and Methods: A prospective randomized double-blinded study was planned in a tertiary care hospital in North India in which 85 American Society of Anesthesiologists I and II patients undergoing ACL repair were enrolled. All groups received 0.5% hyperbaric bupivacaine intrathecally as in control group C. Group IT received intrathecal 1 ?g/kg of clonidine along with hyperbaric bupivacaine, group IA received 0.25% bupivacaine and 1 ?g/kg clonidine intra-articularly, and group NB received 0.25% bupivacaine and 1 ?g/kg clonidine in femoro-sciatic nerve block (FSNB). Postoperative pain free interval and block characteristics were the primary outcomes studied. Results: Pain-free duration was 546.90 (±93.66) min in group NB (P < 0.001) in comparison to 234.90 (±20.99), 367.80 (±47.40) and 172.20 (±54.82) min in groups IA, IT and C, respectively. Sensory block and motor blockade in NB were 474.90 (±43.80) and 267.40 (±34.59) min, respectively, and were significantly prolonged (P > 0.001) in comparison to other groups. The mean rescue analgesic requirement and cumulative frequency of rescue analgesia were least in group NB, followed by groups IT, IA and C. Conclusion: Clonidine is safe and effective adjuvant with bupivacaine in prolonging analgesia through various routes employed for post knee surgery pain. The maximum prolongation of analgesia is achieved through FSNB with a risk of prolonging postanesthesia care unit stay. PMID:26702206

  12. Arthroscopic femoral osteoplasty/chielectomy for cam-type femoroacetabular impingement in the athlete.

    PubMed

    Vaughn, Zackary D; Safran, Marc R

    2010-06-01

    Femoroacetabular impingement (FAI) represents an underlying bony abnormality of either the femoral head-neck junction or acetabulum, or most commonly, both. This often is associated with damage to intra-articular structures, primarily the labrum and chondral surfaces. Like pincer impingement, cam impingement has been associated with pain, limited hip range of motion, pain affecting athletic performance, and has been linked to the development of osteoarthritis. Cam impingement is the loss of offset of the femoral head-neck junction associated with loss of sphericity of the femoral head. Isolated cam impingement, although more common than isolated pincer impingement, it is much less common than both cam and pincer coexisting in people with FAI. Classically, the patient with isolated cam impingement is a young athletic male near 20 years of age. The classic pathology associated with the cam lesion is an acetabular articular cartilage injury in the anterosuperior acetabulum that is fairly well defined and may be deep, 1 to 1.5 cm from the acetabular rim, initially sparing the labrum, but eventually leading to labral detachment from the underlying bone. Treatment generally focuses on restoring the femoral head-neck offset by removing the excess bone. This article will review the underlying pathology of cam-type FAI, the evaluation and diagnosis, arthroscopic treatment, and reported outcomes. PMID:20473127

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

    PubMed Central

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

    2014-01-01

    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

  14. [Intermediate-term results after arthroscopic subacromial decompression with special reference to ongoing disability claims].

    PubMed

    Rupp, S; Rehm, S; Tempelhof, S; Seil, R

    2001-10-01

    The objective was to evaluate mid-term results after arthroscopic subacromial decompression (ASD) with special focus on the bias due to an application to social insurance for pension based on sickness disability. The study group consisted of 42 patients (28 male, 14 female). ASD was performed in 1993 or 1994 for impingement stage II. The mean age was 49.5 years. Thirty-nine patients (93%) were evaluated by an independent observer for an average follow-up of 3.5 years (range 1.5-5). Patients satisfaction with the outcome was assessed by a visual analog scale graded from 0 (extremely dissatisfied) to 10 (extremely satisfied). The functional result was assessed using the Constant score. At follow-up the mean VAS value was 6.4 +/- 3.4. The Constant score improved from 49.6 +/- 18.5 to 84.8 +/- 14.3. The subgroup of patients having applied to social insurance for pension had significantly worse results compared with the remaining patients: VAS: 4.9 +/- 3.1 vs. 7.5 +/- 3.1; Constant-Score: 76.1 +/- 12.7 vs. 88.3 +/- 13.5. The fact that patients try to get benefit from social insurance based on sickness disability significantly biased the outcome after ASD. PMID:11699306

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

    PubMed

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

    2015-08-01

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

  16. Effect of irrigation fluid temperature on body temperature during arthroscopic elbow surgery in dogs

    PubMed Central

    Thompson, K.R.; MacFarlane, P.D.

    2013-01-01

    This prospective randomised clinical trial evaluated the effect of warmed irrigation fluid on body temperature in anaesthetised dogs undergoing arthroscopic elbow surgery. Nineteen dogs undergoing elbow arthroscopy were included in the study and were randomly allocated to one of two groups. Group RT received irrigation fluid at room temperature (RT) while dogs in group W received warmed (W) irrigation fluid (36°C). A standardised patient management and anaesthetic protocol was used and body temperature was measured at four time points; (T1) pre-anaesthetic examination, (T2) arrival into theatre, (T3) end of surgery and (T4) arrival into recovery. There was no significant difference in body temperature at any time point between the groups. The mean overall decrease in body temperature between pre-anaesthetic examination (T1) and return to the recovery suite (T4) was significant in both groups, with a fall of 1.06±0.58°C (p<0.001) in group RT and 1.53±0.76°C (p<0.001) group W. There was no significant difference between the groups. At the end of surgery (T3) 4/19 (21.1%) of dogs were hypothermic (<37°C). The addition of warmed irrigation fluids to a temperature management protocol in dogs undergoing elbow arthroscopy during general anaesthesia did not lead to decreased temperature losses.

  17. Arthroscopic interposition in thumb carpometacarpal osteoarthritis: A series of 26 cases.

    PubMed

    Pereira, A; Ichihara, S; Facca, S; Hendriks, S; Gouzou, S; Liverneaux, P

    2015-12-01

    In 2011, we reported good results after a mean follow-up of 14months for a series of 25 patients who underwent thumb carpometacarpal osteoarthritis surgery in which a poly-L-lactic acid implant was interposed arthroscopically. The aim of this study was to evaluate the outcomes after a longer follow-up. The new series consisted of 26 patients, whose average age was 60years, operated with arthroscopy for the interposition of an implant made of poly-L-lactic acid in 12 cases and tendon interposition in 14 cases. After an average follow-up of 20months, the pain assessed with a visual analog scale was on average 6.61/10 before surgery and 6.03/10 after, the QuickDASH score was 56.36/100 before and 53.65/100 after, grip strength was 15.34kg before and 12.8kg after, pinch strength was 3.7kg before and 2.18kg after, Kapandji thumb opposition score was 8.96/10 before and 8.26/10 after. The radiological stage did not change. We noted one case of type 1 complex regional pain syndrome and 12 poor results, 11 of which were reoperated by trapeziectomy. Given our results and the lack of published studies with a high level of evidence, the value of isolated arthroscopy with interposition in the surgical treatment of thumb carpometacarpal osteoarthritis remains to be demonstrated. PMID:26603368

  18. Functional outcome in athletes at five years of arthroscopic anterior cruciate ligament reconstruction.

    PubMed

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

    2011-01-01

    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

  19. Preemptive versus postoperative lumiracoxib for analgesia in ambulatory arthroscopic knee surgery

    PubMed Central

    Grifka, Joachim; Enz, Rudolf; Zink, Joachim; Hugot, Jean Louis; Kreiss, Andreas; Arulmani, Udayasankar; Yu, Vincent; Rebuli, Rosemary; Krammer, Gerhard

    2008-01-01

    We compared the efficacy and safety of preemptive vs postoperative dosing of lumiracoxib 400 mg in patients undergoing minor ambulatory arthroscopic knee surgery. Eligible patients were randomized to preemptive lumiracoxib, postoperative lumiracoxib, and placebo. The main efficacy parameter was pain intensity (PI) (0–100 mm visual analog scale) in the target knee upon movement, 2 hours after surgery. Other efficacy variables included PI in the target knee at rest and upon movement at 1, 3, 4, and 24 hours, time to first rescue medication intake. In the lumiracoxib preemptive and postoperative groups, the estimated treatment difference compared to placebo for primary endpoint was ?4.0 (95% CI: ?9, ?1; p = 0.007) and ?3.5 (95% CI: ?8.5, 0; p = 0.052), respectively. There was no statistical significant difference between two active treatment groups (p = 0.602). Both preemptive and postoperative lumiracoxib resulted in significantly lower PI scores at rest and after movement at all time-points and no statistically significant difference was observed between the active treatments. Time to rescue medication intake was comparable for both active treatments. The proportion of adverse events was similar among all groups. We conclude that the efficacy of lumiracoxib 400 mg is not affected by the timing of administration (preemptive or postoperative). PMID:21197285

  20. Preemptive versus postoperative lumiracoxib for analgesia in ambulatory arthroscopic knee surgery.

    PubMed

    Grifka, Joachim; Enz, Rudolf; Zink, Joachim; Hugot, Jean Louis; Kreiss, Andreas; Arulmani, Udayasankar; Yu, Vincent; Rebuli, Rosemary; Krammer, Gerhard

    2008-01-01

    We compared the efficacy and safety of preemptive vs postoperative dosing of lumiracoxib 400 mg in patients undergoing minor ambulatory arthroscopic knee surgery. Eligible patients were randomized to preemptive lumiracoxib, postoperative lumiracoxib, and placebo. The main efficacy parameter was pain intensity (PI) (0-100 mm visual analog scale) in the target knee upon movement, 2 hours after surgery. Other efficacy variables included PI in the target knee at rest and upon movement at 1, 3, 4, and 24 hours, time to first rescue medication intake. In the lumiracoxib preemptive and postoperative groups, the estimated treatment difference compared to placebo for primary endpoint was -4.0 (95% CI: -9, -1; p = 0.007) and -3.5 (95% CI: -8.5, 0; p = 0.052), respectively. There was no statistical significant difference between two active treatment groups (p = 0.602). Both preemptive and postoperative lumiracoxib resulted in significantly lower PI scores at rest and after movement at all time-points and no statistically significant difference was observed between the active treatments. Time to rescue medication intake was comparable for both active treatments. The proportion of adverse events was similar among all groups. We conclude that the efficacy of lumiracoxib 400 mg is not affected by the timing of administration (preemptive or postoperative). PMID:21197285

  1. Technical and practical improvements in arthroscopic indentation technique for diagnostics of articular cartilage softening.

    PubMed

    Timonen, M A; Töyräs, J; Aula, A S; Karjalainen, J P; Riekkinen, O; Jurvelin, J S

    2011-01-01

    Indentation measurements have been proposed to serve as sensitive in vivo diagnostics of cartilage degeneration. However, practical difficulties have hindered the use of quantitative indentation techniques during routine arthroscopies. In this study we modified the previously commercial indentation technique by designing software for quality control of manual indentations. With the modifications, our aim was to introduce more rapid and less erroneous measurements, as well as more automatic and objective analyses. The performance of the technique was tested in situ using six bovine medial tibial plateaus. All measurements were conducted by three operators. The intraoperator reproducibility was reasonable (CV% ?= 7.1%) and the interoperator reproducibility was good (intraclass correlation coefficient? = 0.976). Further, the novel technique was tested by a single operator using 10 bovine medial tibial plateaus. The indentation stiffness values determined with the arthroscopic instrument correlated significantly with the dynamic (r = 0.823) and equilibrium (r = 0.752) moduli as well as tissue water (r =? -0.830) and hydroxyproline (r = 0.776) contents. To conclude, the novel measurement technique showed good reproducibility and was found to give valuable information on cartilage properties. Most importantly, the measurements and analyses were more straightforward and automatic than those introduced in the original indentation approach. PMID:21105836

  2. Repairing leaks in casings

    SciTech Connect

    Harris, K.L.; Vinson, E.F.; Bour, D.L.; Ewert, D.P.; Ekstrand, B.B.

    1992-06-23

    This patent describes a method for repairing a hole in a casing disposed in a wellbore. It comprises locating the hole in the casing; isolating the hole by defining a space within the casing in communication with the hole; introducing into the space a volume of a slurry of hydraulic cement in water; permitting the slurry to penetrate into the hole from the space; and maintaining the slurry in the hole for a time sufficient to enable the slurry to form a rigid plug of cement in the hole; wherein the slurry is comprised of a mixture of water and the hydraulic cement in the ratio of from about 0.5 to about 5.0 pounds of water per pound of cement.

  3. TPS Inspection and Repair

    NASA Technical Reports Server (NTRS)

    Parazynski, Scott

    2012-01-01

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

  4. Inside-Out Meniscus Repair

    PubMed Central

    Nelson, Clay G.; Bonner, Kevin F.

    2013-01-01

    Meniscus repair over resection, when feasible, should be strongly considered in an effort to preserve meniscus integrity and function, especially in younger patients. Currently, a number of techniques and implants may be used to achieve a successful result. Although all-inside meniscus repair devices have evolved significantly since their introduction and have become the repair technique of choice for many surgeons, the classic inside-out repair technique is still very useful to have in one's armamentarium. Though less popular because of the ease of current-generation fixators, the inside-out technique can still offer advantages for those surgeons who are proficient. With the versatility to address most tear patterns, the ability to deliver sutures with smaller needle diameters, and proven long-term results, it has been considered the gold standard in meniscus repair. We review the inside-out repair technique for both a medial and lateral meniscus tear with some helpful tips when performing the technique, and we present a video demonstration of the lateral meniscus repair technique. PMID:24400199

  5. DNA Repair Deficiency in Neurodegeneration

    PubMed Central

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

    2011-01-01

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

  6. 46 CFR 160.006-2 - Repairing.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 46 Shipping 6 2014-10-01 2014-10-01 false Repairing. 160.006-2 Section 160.006-2 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) EQUIPMENT, CONSTRUCTION, AND MATERIALS: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Life Preservers: Repairing § 160.006-2 Repairing. (a) General. No repairs, except in emergency, shall be made...

  7. Fix-It Careers: Jobs in Repair

    ERIC Educational Resources Information Center

    Torpey, Elka Maria

    2010-01-01

    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

  8. 46 CFR Sec. 19 - Ship Repair Summaries.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 46 Shipping 8 2011-10-01 2011-10-01 false Ship Repair Summaries. Sec. 19 Section 19 Shipping... Sec. 19 Ship Repair Summaries. (a) Ship Repair Summaries shall be prepared on Form MA-159 by the... jurisdiction and submitted to the District Ship Repair and Maintenance office involved. The summaries must...

  9. Precision Instrument and Equipment Repairers.

    ERIC Educational Resources Information Center

    Wyatt, Ian

    2001-01-01

    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)

  10. Cleft lip and palate repair

    MedlinePLUS

    Orofacial cleft; Craniofacial birth defect repair; Cheiloplasty; Cleft rhinoplasty; Palatoplasty; Tip rhinoplasty ... A cleft lip is a birth defect: A cleft lip may be just a small notch in the lip. It may also be a complete split in the ...

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

    PubMed Central

    Rupp, W. Dean

    2013-01-01

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

  12. Injection repair of composite delaminations

    SciTech Connect

    Mehrkam, P.A.; Alley, D.

    1995-12-31

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

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

    PubMed

    Mathies, B

    2006-01-01

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

  14. A longitudinal study of impact and early stance loads during gait following arthroscopic partial meniscectomy.

    PubMed

    Hall, Michelle; Wrigley, Tim V; Metcalf, Ben R; Hinman, Rana S; Dempsey, Alasdair R; Mills, Peter M; Cicuttini, Flavia M; Lloyd, David G; Bennell, Kim L

    2014-09-22

    People following arthroscopic partial medial meniscectomy (APM) are at increased risk of developing knee osteoarthritis. High impact loading and peak loading early in the stance phase of gait may play a role in the pathogenesis of knee osteoarthritis. This was a secondary analysis of longitudinal data to investigate loading-related indices at baseline in an APM group (3 months post-surgery) and a healthy control group, and again 2 years later (follow-up). At baseline, 82 participants with medial APM and 38 healthy controls were assessed, with 66 and 23 re-assessed at follow-up, respectively. Outcome measures included: (i) heel strike transient (HST) presence and magnitude, (ii) maximum loading rate, (iii) peak vertical force (Fz) during early stance. At baseline, maximum loading rate was lower in the operated leg (APM) and non-operated leg (non-APM leg) compared to controls (p ? 0.03) and peak Fz was lower in the APM leg compared to non-APM leg (p ? 0.01). Over 2 years, peak Fz increased in the APM leg compared to the non-APM leg and controls (p ? 0.01). Following recent APM, people may adapt their gait to protect the operated knee from excessive loads, as evidenced by a lower maximum loading rate in the APM leg compared to controls, and a reduced peak Fz in the APM leg compared to the non-APM leg. No differences at follow-up may suggest an eventual return to more typical gait. However, the increase in peak Fz in the APM leg may be of concern for long-term joint health given the compromised function of the meniscus. PMID:25169661

  15. Inner Synovial Membrane Footprint of the Anterior Elbow Capsule: An Arthroscopic Boundary

    PubMed Central

    Kamineni, Srinath; Bachoura, Abdo; Sasaki, Koichi; Reilly, Danielle; Harris, Kate N.; Sinai, Anthony; Deane, Andrew

    2015-01-01

    Introduction. The purpose of this study is to describe the inner synovial membrane (SM) of the anterior elbow capsule, both qualitatively and quantitatively. Materials and Methods. Twenty-two cadaveric human elbows were dissected and the distal humerus and SM attachments were digitized using a digitizer. The transepicondylar line (TEL) was used as the primary descriptor of various landmarks. The distance between the medial epicondyle and medial SM edge, SM apex overlying the coronoid fossa, the central SM nadir, and the apex of the SM insertion overlying the radial fossa and distance from the lateral epicondyle to lateral SM edge along the TEL were measured and further analyzed. Gender and side-to-side statistical comparisons were calculated. Results. The mean age of the subjects was 80.4 years, with six male and five female cadavers. The SM had a distinctive double arched attachment overlying the radial and coronoid fossae. No gender-based or side-to-side quantitative differences were noted. In 18 out of 22 specimens (81.8%), an infolding extension of the SM was observed overlying the medial aspect of the trochlea. The SM did not coincide with the outer fibrous attachment in any specimen. Conclusion. The humeral footprint of the synovial membrane of the anterior elbow capsule is more complex and not as capacious as commonly understood from the current literature. The synovial membrane nadir between the two anterior fossae may help to explain and hence preempt technical difficulties, a reduction in working arthroscopic volume in inflammatory and posttraumatic pathologies. This knowledge should allow the surgeon to approach this aspect of the anterior elbow compartment space with the confidence that detachment of this synovial attachment, to create working space, does not equate to breaching the capsule. Alternatively, stripping the synovial attachment from the anterior humerus does not constitute an anterior capsular release. PMID:26380112

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

    PubMed Central

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

    2014-01-01

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

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

    PubMed Central

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

    2014-01-01

    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

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

    PubMed

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

    2015-02-01

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

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

    PubMed Central

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

    2014-01-01

    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

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

    PubMed

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

    2007-04-01

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

  1. Reprogramming Cells for Brain Repair

    PubMed Central

    Guarino, Alyx T.; McKinnon, Randall D.

    2013-01-01

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

  2. Protein damage, repair and proteolysis.

    PubMed

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

    2014-02-01

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

  3. Sirtuins, Metabolism, and DNA repair

    PubMed Central

    Choi, Jee-Eun; Mostoslavsky, Raul

    2014-01-01

    Cells evolve to actively coordinate nutrient availability with cellular activity in order to maintain metabolic homeostasis. In addition, active pathways to repair DNA damage are crucial to avoid deleterious genomic instability. In recent years, it has become increasingly clear that availability of intermediate metabolites may play an important role in DNA repair, suggesting that these two seemingly distant cellular activities may be highly coordinated. The sirtuin family of proteins now described as deacylases (they can also remove acyl groups other than acetyl moieties), it appears to have evolved to control both metabolism and DNA repair. In this review, we discuss recent advances that lay the foundation to understanding the role of sirtuins in these two biological processes, and the potential crosstalk to coordinate them. PMID:25005742

  4. Techniques in Endovascular Aneurysm Repair

    PubMed Central

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

    2011-01-01

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

  5. Reducing Your Leak Rate Without Repairing Leaks 

    E-print Network

    Beals, C.

    2005-01-01

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

  6. Abdominal aortic aneurysm repair - open - discharge

    MedlinePLUS

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

  7. 46 CFR Sec. 19 - Ship Repair Summaries.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 46 Shipping 8 2014-10-01 2014-10-01 false Ship Repair Summaries. Sec. 19 Section 19 Shipping MARITIME ADMINISTRATION, DEPARTMENT OF TRANSPORTATION A-NATIONAL SHIPPING AUTHORITY PROCEDURE FOR ACCOMPLISHMENT OF VESSEL REPAIRS UNDER NATIONAL SHIPPING AUTHORITY MASTER LUMP SUM REPAIR...

  8. 46 CFR Sec. 19 - Ship Repair Summaries.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 46 Shipping 8 2012-10-01 2012-10-01 false Ship Repair Summaries. Sec. 19 Section 19 Shipping MARITIME ADMINISTRATION, DEPARTMENT OF TRANSPORTATION A-NATIONAL SHIPPING AUTHORITY PROCEDURE FOR ACCOMPLISHMENT OF VESSEL REPAIRS UNDER NATIONAL SHIPPING AUTHORITY MASTER LUMP SUM REPAIR...

  9. 46 CFR Sec. 19 - Ship Repair Summaries.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 46 Shipping 8 2013-10-01 2013-10-01 false Ship Repair Summaries. Sec. 19 Section 19 Shipping MARITIME ADMINISTRATION, DEPARTMENT OF TRANSPORTATION A-NATIONAL SHIPPING AUTHORITY PROCEDURE FOR ACCOMPLISHMENT OF VESSEL REPAIRS UNDER NATIONAL SHIPPING AUTHORITY MASTER LUMP SUM REPAIR...

  10. Welding/brazing for Space Station repair

    NASA Technical Reports Server (NTRS)

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

    1990-01-01

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

  11. 30 CFR 57.14104 - Tire repairs.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 30 Mineral Resources 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 repair, the valve core shall be partially removed to allow for gradual deflation and...

  12. 30 CFR 57.14104 - Tire repairs.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 30 Mineral Resources 1 2011-07-01 2011-07-01 false Tire repairs. 57.14104 Section 57.14104 Mineral... Devices and Maintenance Requirements § 57.14104 Tire repairs. (a) Before a tire is removed from a vehicle for tire repair, the valve core shall be partially removed to allow for gradual deflation and...

  13. 30 CFR 56.14104 - Tire repairs.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 30 Mineral Resources 1 2011-07-01 2011-07-01 false Tire repairs. 56.14104 Section 56.14104 Mineral... Devices and Maintenance Requirements § 56.14104 Tire repairs. (a) Before a tire is removed from a vehicle for tire repair, the valve core shall be partially removed to allow for gradual deflation and...

  14. 30 CFR 56.14104 - Tire repairs.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 30 Mineral Resources 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 repair, the valve core shall be partially removed to allow for gradual deflation and...

  15. Bringing mask repair to the next level

    NASA Astrophysics Data System (ADS)

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

    2014-10-01

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

  16. 33 CFR 115.40 - Bridge repairs.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 33 Navigation and Navigable Waters 1 2012-07-01 2012-07-01 false Bridge repairs. 115.40 Section 115.40 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY BRIDGES BRIDGE LOCATIONS AND CLEARANCES; ADMINISTRATIVE PROCEDURES § 115.40 Bridge repairs. Repairs to a bridge which...

  17. 33 CFR 115.40 - Bridge repairs.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 33 Navigation and Navigable Waters 1 2014-07-01 2014-07-01 false Bridge repairs. 115.40 Section 115.40 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY BRIDGES BRIDGE LOCATIONS AND CLEARANCES; ADMINISTRATIVE PROCEDURES § 115.40 Bridge repairs. Repairs to a bridge which...

  18. 33 CFR 115.40 - Bridge repairs.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 33 Navigation and Navigable Waters 1 2011-07-01 2011-07-01 false Bridge repairs. 115.40 Section 115.40 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY BRIDGES BRIDGE LOCATIONS AND CLEARANCES; ADMINISTRATIVE PROCEDURES § 115.40 Bridge repairs. Repairs to a bridge which...

  19. 33 CFR 115.40 - Bridge repairs.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 33 Navigation and Navigable Waters 1 2013-07-01 2013-07-01 false Bridge repairs. 115.40 Section 115.40 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY BRIDGES BRIDGE LOCATIONS AND CLEARANCES; ADMINISTRATIVE PROCEDURES § 115.40 Bridge repairs. Repairs to a bridge which...

  20. 33 CFR 115.40 - Bridge repairs.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 33 Navigation and Navigable Waters 1 2010-07-01 2010-07-01 false Bridge repairs. 115.40 Section 115.40 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY BRIDGES BRIDGE LOCATIONS AND CLEARANCES; ADMINISTRATIVE PROCEDURES § 115.40 Bridge repairs. Repairs to a bridge which...

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

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 8 2010-10-01 2010-10-01 false Ship Repair Summaries. Sec. 19 Section 19 Shipping MARITIME ADMINISTRATION, DEPARTMENT OF TRANSPORTATION A-NATIONAL SHIPPING AUTHORITY PROCEDURE FOR ACCOMPLISHMENT OF VESSEL REPAIRS UNDER NATIONAL SHIPPING AUTHORITY MASTER LUMP SUM REPAIR...

  2. How the Brain Repairs Stuttering

    ERIC Educational Resources Information Center

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

    2009-01-01

    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…

  3. Microwave Oven Repair. Teacher Edition.

    ERIC Educational Resources Information Center

    Smreker, Eugene

    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…

  4. Computer Equipment Repair Curriculum Guide.

    ERIC Educational Resources Information Center

    Reneau, Fred; And Others

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

  5. Verification of Motor Repair Quality 

    E-print Network

    Butler, K.

    1998-01-01

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

  6. Small Engine Repair Course Outline.

    ERIC Educational Resources Information Center

    DeClouet, Fred

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

  7. Tube joint leak repair coupling

    NASA Technical Reports Server (NTRS)

    Ferguson, W. B.

    1968-01-01

    Tube joint leak repair coupling consists of 2 split seals, 1 male split nut, 1 female split nut, and two aligning pins. Each split nut consists of 2 half-shell sections which, when engaged, are held together by a dovetail joint and an aligning pin.

  8. ["Plica disease" (synovial folds) of the knee-joint: arthroscopic and histological findings, with suggestions for treatment (author's transl)].

    PubMed

    Klein, W; Schulitz, K P; Huth, F

    1979-09-01

    A mediopatellar plica (synovial fold) of the knee-joint may develop without recognisable cause in adolescents or young adults, predominantly females. It leads to pain on pressure over the medial knee compartment, sudden or "springing" intraarticular movements and pseudolocking of the joint. Similar plicae occur after traumatic joint contusion, with meniscus disease, or more rarely with arthrosis deformans. Histologically they are characterized by band-like fibrosed evaginations of the synovial membrane and of the synovial fat and connective tissue into the joint spaces. The following therapeutic suggestions, based on the personal experience of 15 cases, are made in the knowledge that significant inflammatory or proliferative arthritic changes can be excluded: the plica can be cut through under arthroscopy; chondromalacial defects, directly or indirectly caused by plical rubbing, of the medial femoral condyle and the medial patella can be removed, also under arthroscopic control, with an electric razor. Arthrotomy is no longer needed in most cases. PMID:477536

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

    PubMed Central

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

    2009-01-01

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

  10. Analgesic efficacy of three different dosages of intra-articular morphine in arthroscopic knee surgeries: Randomised double-blind trial

    PubMed Central

    Gupta, Babita; Banerjee, Sumantra; Prasad, Arunima; Farooque, Kamran; Sharma, Vijay; Trikha, Vivek

    2015-01-01

    Background and Aims: Arthroscopic knee surgery is a common procedure and may cause enough pain to delay rehabilitation. Intra-articular (IA) morphine is a known modality for post-operative pain relief. However, the optimal dose of IA morphine has not been studied. The current study has been conducted to find out the optimal dosage of IA morphine when administered with 0.25% bupivacaine. Methods: Sixty adult patients of either sex, aged between 18 and 60 years, undergoing diagnostic/therapeutic knee arthroscopic surgery were included in the study and randomised into three groups. All patients underwent surgery under subarachnoid block. After the surgical closure, 20 ml of 0.25% bupivacaine with 1 mg, 3 mg and 5 mg of morphine as additive was injected intra-articularly in Group A, B and C patients, respectively. Post-operative pain assessment was performed with visual analogue scale score in the 1st, 2nd, 6th, 12th and 24th post-operative hour. The common complications were also recorded. Results: There was statistically significant analgesia in Group B and C than Group A in the 1st and 2nd post-operative hour; while at the 24th post-operative hour, Group C had statistically significant analgesia than the other two groups. Time to first rescue analgesia was statistically significantly less and consumption of supplemental analgesia was significantly higher in Group A than the other two groups. Conclusion: IA dose of 3 mg and 5 mg morphine with 20 ml of 0.25% bupivacaine provided adequate analgesia. However, 3 mg morphine group patients had fewer side effects than 5 mg group patients although the difference was not statistically significant.

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

    PubMed Central

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

    2014-01-01

    Objective: To perform dual-bundle reconstruction of posterior cruciate ligament using full arthroscopic tibial inlay technology with self-designed tibia tunnel drilling system and to compare the effect of arthroscopic tibial inlay versus traditional technique for posterior cruciate ligament reconstruction. Material and methods: 32 patients were randomly divided into experiment group (improved tibial inlay, n = 17) and control group (traditional tibial inlay, n = 15). Self-designed tibia tunnel drill system was used to produce intraoperative deep-limited bone tunnel. During follow-up, the location of the bone block and the healing situation were checked by knee X-ray and spiral CT scan. Blood loss, operation time and nerve vascular injuries were evaluated. Results: Mean intraoperative blood loss was 123.53 ± 74.05 ml in the improved tibial inlay group compared with 332 ± 114.26 ml in the traditional tibial inlay group (t = 6.12, P < 0.05). Mean operation time was 235.27 ± 58.88 min in the improved tibial inlay group compared with 346.37 ± 59.67 min in the traditional tibial inlay group (t = 5.19, P < 0.05). Posterior drawer test were negative in 15 cases, slight positive in 2 with improved tibial inlay technique compared with 14 negative cases and 2 positive cases of traditional tibial Inlay technique. The X-ray and spiral CT scan showed the location of the bone block were perfect and healed well with the patent who received improved tibial inlay technology after 12 weeks postoperatively. Conclusion: Accurate depth-limited bone tunnel can be produced by the tibia tunnel drill system with minor trauma, less bleeding and reducing of nerves or vessels and the recent clinical effects of PCL reconstruction were pretty good. PMID:25419349

  12. Chromatin Disassembly and Reassembly During DNA Repair

    PubMed Central

    Linger, Jeffrey G.; Tyler, Jessica K.

    2008-01-01

    Current research is demonstrating that the packaging of the eukaryotic genome together with histone proteins into chromatin is playing a fundamental role in DNA repair and the maintenance of genomic integrity. As is well established to be the case for transcription, the chromatin structure dynamically changes during DNA repair. Recent studies indicate that the complete removal of histones from DNA and their subsequent reassembly onto DNA accompanies DNA repair. This review will present evidence indicating that chromatin disassembly and reassembly occur during DNA repair and that these are critical processes for cell survival after DNA repair. Concomitantly, candidate proteins utilized for these processes will be highlighted. PMID:17303193

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

    PubMed Central

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

    2015-01-01

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

  14. Shuttle orbiter TPS flight repair kit development

    NASA Technical Reports Server (NTRS)

    1979-01-01

    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.

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

    PubMed Central

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

    2015-01-01

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

  16. Diagnosis of ligamentous and meniscal pathologies in patients with anterior cruciate ligament injury: comparison of magnetic resonance imaging and arthroscopic findings

    PubMed Central

    Sayampanathan, Andrew Arjun; Koh, Thean-Howe Bryan; Tan, Hwee-Chye Andrew

    2015-01-01

    Background Magnetic resonance imaging (MRI) is routinely used to diagnose or support clinical diagnoses for meniscal or ligamentous injuries prior to offering patients arthroscopic treatment. However, the sensitivity of MRI for the detection of meniscal injury is not yet 100%. Sportsmen have occasionally returned to play with undiagnosed meniscal lesions on the basis of a normal MRI examination. This study was designed to assess the diagnostic parameters of MRI in patients with acute anterior cruciate ligament (ACL) injury. Methods MRI and arthroscopic findings of 320 patients with acute ACL injury were included in this retrospective review. Patients belonged to a single surgeon from a high volume tertiary healthcare institution. All patients had either a MRI or an arthroscopic diagnosis of an acute ACL injury of one knee or both. All patients underwent therapeutic arthroscopy by the senior author routinely as part of arthroscopy-aided ACL reconstruction. Arthroscopic findings were the diagnostic reference based on which the positive predictive value (PPV), negative predictive value (NPV), sensitivity, specificity and concordance strength of association of MRI were calculated for ACL, posterior cruciate ligament (PCL), medial meniscus (MM) and lateral meniscus (LM) injuries. Results MRI was most accurate in diagnosing cruciate ligament injuries with a PPV approaching 100%. The PPV of MRI in diagnosing meniscal injuries was approximately 60%. MRI was almost 100% sensitive and specific in diagnosing ACL injuries and 82% sensitive and 100% specific in diagnosing PCL injuries. Conversely, MRI was 77% sensitive and 90% specific in diagnosing MM injuries; and 57% sensitive and 95% specific in diagnosing LM injuries. Conclusions MRI remains the gold standard for diagnosing soft tissue injuries of the knee. However, there is a false positive rate ranging from 6% to 11% for meniscal tears. PMID:26605289

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

    NASA Astrophysics Data System (ADS)

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

    2013-09-01

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

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

    PubMed Central

    Patzer, Thilo; Kircher, Jörn; Krauspe, Ruediger

    2012-01-01

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

  19. Methods of repairing a substrate

    NASA Technical Reports Server (NTRS)

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

    2011-01-01

    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.

  20. Scrunching During DNA Repair Synthesis

    PubMed Central

    Garcia-Diaz, Miguel; Bebenek, Katarzyna; Larrea, Andres A.; Havener, Jody M.; Perera, Lalith; Krahn, Joseph M.; Pedersen, Lars C.; Ramsden, Dale A.; Kunkel, Thomas A.

    2009-01-01

    Family X polymerases like DNA polymerase ? (pol ?) are well suited for filling short gaps during DNA repair because they simultaneously bind both the 5? and 3? ends of short gaps. DNA binding and gap filling are well characterized for one nucleotide gaps, but the location of yet-to-be-copied template nucleotides in longer gaps is unknown. Here we present crystal structures revealing that when bound to a two-nucleotide gap, pol ? scrunches the template strand and binds the additional uncopied template base in an extrahelical position within a binding pocket comprised of three conserved amino acids. Replacing these amino acids with alanine results in less processive gap filling and less efficient NHEJ involving two nucleotide gaps. Thus, akin to scrunching by RNA polymerase during transcription initiation, scrunching occurs during gap filling DNA synthesis associated with DNA repair. PMID:19701199

  1. Which mesh for hernia repair?

    PubMed Central

    Brown, CN; Finch, JG

    2010-01-01

    INTRODUCTION The concept of using a mesh to repair hernias was introduced over 50 years ago. Mesh repair is now standard in most countries and widely accepted as superior to primary suture repair. As a result, there has been a rapid growth in the variety of meshes available and choosing the appropriate one can be difficult. This article outlines the general properties of meshes and factors to be considered when selecting one. MATERIALS AND METHODS We performed a search of the medical literature from 1950 to 1 May 2009, as indexed by Medline, using the PubMed search engine (). To capture all potentially relevant articles with the highest degree of sensitivity, the search terms were intentionally broad. We used the following terms: ‘mesh, pore size, strength, recurrence, complications, lightweight, properties’. We also hand-searched the bibliographies of relevant articles and product literature to identify additional pertinent reports. RESULTS AND CONCLUSIONS The most important properties of meshes were found to be the type of filament, tensile strength and porosity. These determine the weight of the mesh and its biocompatibility. The tensile strength required is much less than originally presumed and light-weight meshes are thought to be superior due to their increased flexibility and reduction in discomfort. Large pores are also associated with a reduced risk of infection and shrinkage. For meshes placed in the peritoneal cavity, consideration should also be given to the risk of adhesion formation. A variety of composite meshes have been promoted to address this, but none appears superior to the others. Finally, biomaterials such as acellular dermis have a place for use in infected fields but have yet to prove their worth in routine hernia repair. PMID:20501011

  2. Animal models of cartilage repair

    PubMed Central

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

    2014-01-01

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

  3. XPD polymorphisms: effects on DNA repair proficiency.

    PubMed

    Lunn, R M; Helzlsouer, K J; Parshad, R; Umbach, D M; Harris, E L; Sanford, K K; Bell, D A

    2000-04-01

    XPD codes for a DNA helicase involved in transcription and nucleotide excision repair. Rare XPD mutations diminish nucleotide excision repair resulting in hypersensitivity to UV light and increased risk of skin cancer. Several polymorphisms in this gene have been identified but their impact on DNA repair is not known. We compared XPD genotypes at codons 312 and 751 with DNA repair proficiency in 31 women. XPD genotypes were measured by PCR-RFLP. DNA repair proficiency was assessed using a cytogenetic assay that detects X-ray induced chromatid aberrations (breaks and gaps). Chromatid aberrations were scored per 100 metaphase cells following incubation at 37 degrees C (1.5 h after irradiation) to allow for repair of DNA damage. Individuals with the Lys/Lys codon 751 XPD genotype had a higher number of chromatid aberrations (132/100 metaphase cells) than those having a 751Gln allele (34/100 metaphase cells). Individuals having greater than 60 chromatid breaks plus gaps were categorized as having sub-optimal repair. Possessing a Lys/Lys751 genotype increased the risk of sub-optimal DNA repair (odds ratio = 7.2, 95% confidence interval = 1.01-87.7). The Asp312Asn XPD polymorphism did not appear to affect DNA repair proficiency. These results suggest that the Lys751 (common) allele may alter the XPD protein product resulting in sub-optimal repair of X-ray-induced DNA damage. PMID:10753184

  4. 49 CFR 1242.42 - Administration, repair and maintenance, machinery repair, equipment damaged, dismantling retired...

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ...insurance, lease rentals, joint facility rents, other rents, depreciation, joint facility, repairs billed to others, and other...insurance, lease rentals, joint facility rents, other rents, depreciation, joint facility, repairs billed to others, and...

  5. Thermal protection system repair kit program

    NASA Technical Reports Server (NTRS)

    1979-01-01

    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.

  6. You Can Do It!: Repairing A Toilet. 

    E-print Network

    Anonymous,

    1979-01-01

    it closes the intake valve, shutting off the supply of fresh water when the tank is full. Toilet parts most often requiring repair are the flush valve, intake valve and float ball. Inexpensive replacements for these parts are readily available for most... ? YOU CAN DO IT! REPAIRING A TOILET Extension Housing and Home Furnishing Specialists The Texas A&M University System Water closets or toilets vary somewhat in design but are enough alike that the same general repair information applies to most...

  7. Alternative approaches for mitral valve repair

    PubMed Central

    Goldstone, Andrew B.

    2015-01-01

    Unique situations arise in which alternative exposures for mitral valve surgery offer distinct advantages over traditional approaches. Each exposure facilitates both mitral valve repair and replacement, although the standard repair procedures must be modified to accommodate these non-traditional exposures. Here, we detail the technical considerations required to perform transventricular and transaortic mitral valve repair as well as discuss the advantages for employing these less conventional approaches. PMID:26539353

  8. Cellular repair/misrepair track model

    NASA Technical Reports Server (NTRS)

    Wilson, John W.; Cucinotta, Francis A.

    1991-01-01

    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.

  9. 24 CFR 206.47 - Property standards; repair work.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 24 Housing and Urban Development 2 2014-04-01 2014-04-01 false Property standards; repair work... Property standards; repair work. (a) Need for repairs. Properties must meet the applicable property... insured mortgage. (b) Assurance that repairs are made. The mortgage may be closed before the repair...

  10. 24 CFR 206.47 - Property standards; repair work.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 24 Housing and Urban Development 2 2010-04-01 2010-04-01 false Property standards; repair work... Property standards; repair work. (a) Need for repairs. Properties must meet the applicable property... insured mortgage. (b) Assurance that repairs are made. The mortgage may be closed before the repair...

  11. 24 CFR 206.47 - Property standards; repair work.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 24 Housing and Urban Development 2 2012-04-01 2012-04-01 false Property standards; repair work... Property standards; repair work. (a) Need for repairs. Properties must meet the applicable property... insured mortgage. (b) Assurance that repairs are made. The mortgage may be closed before the repair...

  12. 14 CFR 145.107 - Satellite repair stations.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 14 Aeronautics and Space 3 2012-01-01 2012-01-01 false Satellite repair stations. 145.107 Section... Data § 145.107 Satellite repair stations. (a) A certificated repair station under the managerial control of another certificated repair station may operate as a satellite repair station with its...

  13. 14 CFR 145.107 - Satellite repair stations.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 3 2010-01-01 2010-01-01 false Satellite repair stations. 145.107 Section... Data § 145.107 Satellite repair stations. (a) A certificated repair station under the managerial control of another certificated repair station may operate as a satellite repair station with its...

  14. 14 CFR 145.107 - Satellite repair stations.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 14 Aeronautics and Space 3 2013-01-01 2013-01-01 false Satellite repair stations. 145.107 Section... Data § 145.107 Satellite repair stations. (a) A certificated repair station under the managerial control of another certificated repair station may operate as a satellite repair station with its...

  15. 14 CFR 145.107 - Satellite repair stations.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 14 Aeronautics and Space 3 2014-01-01 2014-01-01 false Satellite repair stations. 145.107 Section... Data § 145.107 Satellite repair stations. (a) A certificated repair station under the managerial control of another certificated repair station may operate as a satellite repair station with its...

  16. 14 CFR 145.107 - Satellite repair stations.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 14 Aeronautics and Space 3 2011-01-01 2011-01-01 false Satellite repair stations. 145.107 Section... Data § 145.107 Satellite repair stations. (a) A certificated repair station under the managerial control of another certificated repair station may operate as a satellite repair station with its...

  17. Scheduling and rescheduling with iterative repair

    NASA Technical Reports Server (NTRS)

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

    1992-01-01

    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.

  18. Preferential DNA repair in expressed genes

    SciTech Connect

    Hanawalt, P.C.

    1987-12-01

    Potentially deleterious alterations to DNA occur nonrandomly within the mammalian genome. These alterations include the adducts produced by many chemical carcinogens, but not the UV-induced cyclobutane pyrimidine dimer, which may be an exception. Recent studies in our laboratory have shown that the excision repair of pyrimidine dimers and certain other lesions is nonrandom in the mammalian genome, exhibiting a distinct preference for actively transcribed DNA sequences. An important consequence of this fact is that mutagenesis and carcinogenesis may be determined in part by the activities of the relevant genes. Repair may also be processive, and a model is proposed in which excision repair is coupled to transcription at the nuclear matrix. Similar but freely diffusing repair complexes may account for the lower overall repair efficiencies in the silent domains of the genome. Risk assessment in relations to chemical carcinogenesis requires assays that determine effective levels of DNA damage for producing malignancy. The existence of nonrandom repair in the genome casts into doubt the reliability of overall indicators of DNA binding and lesion repair for such determinations. Furthermore, some apparent differences between the intragenomic repair heterogeneity in rodent cells and that in human cells mandate a reevaluation of rodent test systems for human risk assessment. Tissue-specific and cell-specific differences in the coordinate regulation of gene expression and DNA repair may account for corresponding differences in the carcinogenic response.

  19. Integrated Electrical Wire Insulation Repair System

    NASA Technical Reports Server (NTRS)

    Williams, Martha; Jolley, Scott; Gibson, Tracy; Parks, Steven

    2013-01-01

    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

  20. Current Trends in Laparoscopic Ventral Hernia Repair

    PubMed Central

    Patapis, Paul; Zavras, Nick; Tzanetis, Panagiotis; Machairas, Anastasios

    2015-01-01

    Background and Objectives: The purpose of this study was to analyze the surgical technique, postoperative complications, and possible recurrence after laparoscopic ventral hernia repair (LVHR) in comparison with open ventral hernia repair (OVHR), based on the international literature. Database: A Medline search of the current English literature was performed using the terms laparoscopic ventral hernia repair and incisional hernia repair. Conclusions: LVHR is a safe alternative to the open method, with the main advantages being minimal postoperative pain, shorter recovery, and decreased wound and mesh infections. Incidental enterotomy can be avoided by using a meticulous technique and sharp dissection to avoid thermal injury. PMID:26273186

  1. Comparison Between Ultrasound-Guided Supraclavicular and Interscalene Brachial Plexus Blocks in Patients Undergoing Arthroscopic Shoulder Surgery

    PubMed Central

    Ryu, Taeha; Kil, Byung Tae; Kim, Jong Hae

    2015-01-01

    Abstract Although supraclavicular brachial plexus block (SCBPB) was repopularized by the introduction of ultrasound, its usefulness in shoulder surgery has not been widely reported. The objective of this study was to compare motor and sensory blockades, the incidence of side effects, and intraoperative opioid analgesic requirements between SCBPB and interscalene brachial plexus block (ISBPB) in patients undergoing arthroscopic shoulder surgery. Patients were randomly assigned to 1 of 2 groups (ISBPB group: n?=?47; SCBPB group: n?=?46). The side effects of the brachial plexus block (Horner's syndrome, hoarseness, and subjective dyspnea), the sensory block score (graded from 0 [no cold sensation] to 100 [intact sensation] using an alcohol swab) for each of the 5 dermatomes (C5–C8 and T1), and the motor block score (graded from 0 [complete paralysis] to 6 [normal muscle force]) for muscle forces corresponding to the radial, ulnar, median, and musculocutaneous nerves were evaluated 20 min after the brachial plexus block. Fentanyl was administered in 50 ?g increments when the patients complained of pain that was not relieved by the brachial plexus block. There were no conversions to general anesthesia due to a failed brachial plexus block. The sensory block scores for the C5 to C8 dermatomes were significantly lower in the ISBPB group. However, the percentage of patients who received fentanyl was comparable between the 2 groups (27.7% [ISBPB group] and 30.4% [SCBPB group], P?=?0.77). SCBPB produced significantly lower motor block scores for the radial, ulnar, and median nerves than did ISBPB. A significantly higher incidence of Horner's syndrome was observed in the ISBPB group (59.6% [ISBPB group] and 19.6% [SCBPB group], P?arthroscopic shoulder surgery under both brachial plexus blocks. However, SCBPB produces a better motor blockade and a lower incidence of Horner's syndrome than ISBPB. PMID:26448030

  2. 49 CFR 1242.42 - Administration, repair and maintenance, machinery repair, equipment damaged, dismantling retired...

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 9 2010-10-01 2010-10-01 false Administration, repair and maintenance, machinery repair, equipment damaged, dismantling retired property, fringe benefits, other casualties and insurance, lease rentals, joint facility rents, other rents, depreciation, joint facility, repairs billed to others, and other (accounts XX-22-01,...

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

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

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

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

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

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

  5. 46 CFR 272.24 - Subsidy repair summaries.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

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

  6. 46 CFR 272.24 - Subsidy repair summaries.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

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

  7. 46 CFR 272.24 - Subsidy repair summaries.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

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

  8. 46 CFR 272.24 - Subsidy repair summaries.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

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

  9. 46 CFR 272.24 - Subsidy repair summaries.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

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

  10. Role of DNA repair protein ERCC1 in skin cancer 

    E-print Network

    Song, Liang

    2009-01-01

    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 ...

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

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

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

  12. International congress on DNA damage and repair: Book of abstracts

    SciTech Connect

    Not Available

    1987-01-01

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

  13. 49 CFR 192.311 - Repair of plastic pipe.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ...2013-10-01 false Repair of plastic pipe. 192.311 Section 192...and Mains § 192.311 Repair of plastic pipe. Each imperfection or damage...would impair the serviceability of plastic pipe must be repaired or...

  14. 49 CFR 192.311 - Repair of plastic pipe.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ...2012-10-01 false Repair of plastic pipe. 192.311 Section 192...and Mains § 192.311 Repair of plastic pipe. Each imperfection or damage...would impair the serviceability of plastic pipe must be repaired or...

  15. 49 CFR 192.311 - Repair of plastic pipe.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ...2014-10-01 false Repair of plastic pipe. 192.311 Section 192...and Mains § 192.311 Repair of plastic pipe. Each imperfection or damage...would impair the serviceability of plastic pipe must be repaired or...

  16. 49 CFR 192.311 - Repair of plastic pipe.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ...2010-10-01 false Repair of plastic pipe. 192.311 Section 192...and Mains § 192.311 Repair of plastic pipe. Each imperfection or damage...would impair the serviceability of plastic pipe must be repaired or...

  17. 49 CFR 192.311 - Repair of plastic pipe.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ...2011-10-01 false Repair of plastic pipe. 192.311 Section 192...and Mains § 192.311 Repair of plastic pipe. Each imperfection or damage...would impair the serviceability of plastic pipe must be repaired or...

  18. 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

    2012-01-01

    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

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

    PubMed Central

    Sum, Jonathan

    2011-01-01

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

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

    PubMed Central

    Kongmalai, Pinkawas; Chernchujit, Bancha

    2015-01-01

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

  1. Repairing high-temperature glazed tiles

    NASA Technical Reports Server (NTRS)

    Ecord, G. M.; Schomburg, C.

    1981-01-01

    Tetraethyl orthosilicate (TEOS) mixture fills chips and cracks in glazed tile surface. Filler is made by mixing hydrolyzed TEOS, silicon tetraboride powder, and pulverized tile material. Repaired tiles survived testing by intense acoustic emissions, arc jets, and intense heat radiation. Repair is reliable and rapid, performed in 1-1 1/2 hours with tile in any or orientation.

  2. Human DNA repair and recombination genes

    SciTech Connect

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

    1988-09-01

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

  3. Thermal protection system flight repair kit

    NASA Technical Reports Server (NTRS)

    1979-01-01

    A thermal protection system (TPS) flight repair kit required for use on a flight of the Space Transportation System is defined. A means of making TPS repairs in orbit by the crew via extravehicular activity is discussed. A cure in place ablator, a precured ablator (large area application), and packaging design (containers for mixing and dispensing) for the TPS are investigated.

  4. 40 CFR 63.1005 - Leak repair.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...monitoring. The leak identification on a connector in gas/vapor or light liquid service... (3) Delay of repair for valves, connectors, and agitators is also allowed if the...shutdown. (d) Unsafe-to-repair connectors. Any connector that is...

  5. 40 CFR 63.1005 - Leak repair.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ...monitoring. The leak identification on a connector in gas/vapor or light liquid service... (3) Delay of repair for valves, connectors, and agitators is also allowed if the...shutdown. (d) Unsafe-to-repair connectors. Any connector that is...

  6. 40 CFR 280.33 - Repairs allowed.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Tanks by Lining Without the Addition of Cathodic Protection.” (b) Repairs to fiberglass-reinforced... cathodic protection system must be tested in accordance with § 280.31 (b) and (c) to ensure that it is... 40 Protection of Environment 26 2010-07-01 2010-07-01 false Repairs allowed. 280.33 Section...

  7. 40 CFR 280.33 - Repairs allowed.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ...the Addition of Cathodic Protection.” (b) Repairs to fiberglass-reinforced plastic tanks may be made by the manufacturer's...as a result of corrosion or other damage must be replaced. Fiberglass pipes and fittings may be repaired in accordance with...

  8. 40 CFR 280.33 - Repairs allowed.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ...the Addition of Cathodic Protection.” (b) Repairs to fiberglass-reinforced plastic tanks may be made by the manufacturer's...as a result of corrosion or other damage must be replaced. Fiberglass pipes and fittings may be repaired in accordance with...

  9. 40 CFR 280.33 - Repairs allowed.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...the Addition of Cathodic Protection.” (b) Repairs to fiberglass-reinforced plastic tanks may be made by the manufacturer's...as a result of corrosion or other damage must be replaced. Fiberglass pipes and fittings may be repaired in accordance with...

  10. 40 CFR 280.33 - Repairs allowed.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ...the Addition of Cathodic Protection.” (b) Repairs to fiberglass-reinforced plastic tanks may be made by the manufacturer's...as a result of corrosion or other damage must be replaced. Fiberglass pipes and fittings may be repaired in accordance with...

  11. 40 CFR 280.33 - Repairs allowed.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ...the Addition of Cathodic Protection.” (b) Repairs to fiberglass-reinforced plastic tanks may be made by the manufacturer's...as a result of corrosion or other damage must be replaced. Fiberglass pipes and fittings may be repaired in accordance with...

  12. Robot Service and Repair. Teacher's Guide.

    ERIC Educational Resources Information Center

    Pittsburg State Univ., KS. Kansas Vocational Curriculum Dissemination Center.

    This document is a teacher's guide for teaching a course on robot service and repair. The guide is organized in four units covering the following topics: introduction to robots, power supply, robot control systems, and service and repair. Each unit contains several lesson plans on the unit topic. Lesson plans consist of objectives, tools and…

  13. Robot Service and Repair. Student Guide.

    ERIC Educational Resources Information Center

    Pittsburg State Univ., KS. Kansas Vocational Curriculum Dissemination Center.

    This document is a student guide for a course on robot service and repair. It is organized in four units covering the following topics: introduction to robots, power supply, robot control systems, and service and repair. Each unit contains several lesson plans on the unit topic. Lesson plans consist of lesson objectives, lists of teaching aids and…

  14. Self repairing composites for drone air vehicles

    NASA Astrophysics Data System (ADS)

    Dry, Carolyn

    2015-04-01

    The objective of this effort was to demonstrate the feasibility of impact-initiated delivery of repair chemicals through hollow fiber architectures embedded within graphite fiber reinforced polymer matrix composites, representative of advanced drone aircraft component material systems. Self-repairing structures through coupon and elements were demonstrated, and evaluated.

  15. 40 CFR 63.1024 - Leak repair.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... reading measured by Method 21 of 40 CFR part 60, appendix A at the time the leak is successfully repaired... detected. First attempt at repair for pumps includes, but is not limited to, tightening the packing gland... the bonnet bolts, and/or tightening the packing gland nuts, and/or injecting lubricant into...

  16. 40 CFR 63.1024 - Leak repair.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... reading measured by Method 21 of 40 CFR part 60, appendix A at the time the leak is successfully repaired... detected. First attempt at repair for pumps includes, but is not limited to, tightening the packing gland... the bonnet bolts, and/or tightening the packing gland nuts, and/or injecting lubricant into...

  17. 40 CFR 63.1024 - Leak repair.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... reading measured by Method 21 of 40 CFR part 60, appendix A at the time the leak is successfully repaired... detected. First attempt at repair for pumps includes, but is not limited to, tightening the packing gland... the bonnet bolts, and/or tightening the packing gland nuts, and/or injecting lubricant into...

  18. 40 CFR 63.1024 - Leak repair.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... reading measured by Method 21 of 40 CFR part 60, appendix A at the time the leak is successfully repaired... detected. First attempt at repair for pumps includes, but is not limited to, tightening the packing gland... the bonnet bolts, and/or tightening the packing gland nuts, and/or injecting lubricant into...

  19. Lin28: time for tissue repair.

    PubMed

    Reddien, Peter W

    2013-11-01

    Embryos and juveniles in many organisms repair tissue injuries better than adults. In this issue, Shyh-Chang et al. find that postnatal activation of Lin28a, a gene typically active in embryonic development, promotes better than normal tissue repair in mice, including following ear and digit injuries. PMID:24209612

  20. 21 CFR 870.3710 - Pacemaker repair or replacement material.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ...ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CARDIOVASCULAR DEVICES Cardiovascular Prosthetic Devices § 870.3710 Pacemaker repair or replacement material. (a) Identification. A pacemaker repair...

  1. On-Orbit Repair of RCC Structures

    NASA Technical Reports Server (NTRS)

    Singh, M.

    2004-01-01

    On-orbit repair technologies for reinforced carbon-carbon composite (RCC) structures are critically needed for space shuttle return to flight (RTF) efforts. These technologies are also critically needed for the repair and refurbishment of thermal protection system of future Crew Entry Vehicles (CEV) of space exploration programs. GRABER (Glenn Adhesive Refractory for Bonding and Exterior Repair) has shown multiuse capability for in-space repair of both large repairs and small cracks in space shuttle Reinforced Carbon Carbon (RCC) leading edge material. The concept consists of preparing an adhesive paste and then applying the paste tot he damaged/cracked area of the RCC composites with caulking gun. The adhesive paste cures at 100-120 C and transforms into a high temperature ceramic during vehicle re-entry conditions. Further development and testing are underway to optimize the materials properties and extend the application temperature.

  2. Chromatin structure and DNA damage repair

    PubMed Central

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

    2008-01-01

    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

  3. Repair Development for a Composite Cryotank

    NASA Technical Reports Server (NTRS)

    Cox, Sarah B.; Danley, Susan E.; Caraccio, Anne J.; Cheshire, Brian C.; Sampson, Jeffrey W.; Taylor, Brian J.

    2014-01-01

    The Composite Cryotank Technologies and Demonstration Project is working to advance the technologies for composite cryogenic propellant tanks at diameters suitable for future heavy lift vehicles and other in-space applications. The main goals of the project are to reduce weight and cost. One aspect of this project has focused on damage evaluation and repair development. Test panels have been impacted, repaired, and tested. Several repair methods were used to compare their effectiveness at restoring the integrity of the composite. Panels were evaluated by nondestructive evaluations at several points during the process to assess the damage and repair. The testing performed and the results and conclusions from the nondestructive evaluations and the destructive testing will be discussed. These results will lead to further development of inspection techniques and repair methods.

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

    SciTech Connect

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

    2004-09-01

    The two broad categories of fiber-reinforced composite liner repair and deposited weld metal repair technologies were reviewed and evaluated for potential application for internal repair of gas transmission pipelines. Both are used to some extent for other applications and could be further developed for internal, local, structural repair of gas transmission pipelines. Evaluation trials were conducted on pipe sections with simulated corrosion damage repaired with glass fiber-reinforced composite liners, carbon fiber-reinforced composite liners, and weld deposition. Additional un-repaired pipe sections were evaluated in the virgin condition and with simulated damage. Hydrostatic failure pressures for pipe sections repaired with glass fiber-reinforced composite liner were only marginally greater than that of pipe sections without liners, indicating that this type of liner is generally ineffective at restoring the pressure containing capabilities of pipelines. Failure pressure for pipe repaired with carbon fiber-reinforced composite liner was greater than that of the un-repaired pipe section with damage, indicating that this type of liner is effective at restoring the pressure containing capability of pipe. Pipe repaired with weld deposition failed at pressures lower than that of un-repaired pipe in both the virgin and damaged conditions, indicating that this repair technology is less effective at restoring the pressure containing capability of pipe than a carbon fiber-reinforced liner repair. Physical testing indicates that carbon fiber-reinforced liner repair is the most promising technology evaluated to-date. Development of a comprehensive test plan for this process is recommended for use in the next phase of this project.

  5. Systems Maintenance Automated Repair Tasks (SMART)

    NASA Technical Reports Server (NTRS)

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

    2010-01-01

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

  6. Shuttle Repair Tools Automate Vehicle Maintenance

    NASA Technical Reports Server (NTRS)

    2013-01-01

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

  7. Cardiac regeneration: epicardial mediated repair.

    PubMed

    Kennedy-Lydon, Teresa; Rosenthal, Nadia

    2015-12-22

    The hearts of lower vertebrates such as fish and salamanders display scarless regeneration following injury, although this feature is lost in adult mammals. The remarkable capacity of the neonatal mammalian heart to regenerate suggests that the underlying machinery required for the regenerative process is evolutionarily retained. Recent studies highlight the epicardial covering of the heart as an important source of the signalling factors required for the repair process. The developing epicardium is also a major source of cardiac fibroblasts, smooth muscle, endothelial cells and stem cells. Here, we examine animal models that are capable of scarless regeneration, the role of the epicardium as a source of cells, signalling mechanisms implicated in the regenerative process and how these mechanisms influence cardiomyocyte proliferation. We also discuss recent advances in cardiac stem cell research and potential therapeutic targets arising from these studies. PMID:26702046

  8. Proper repair stretches belt life

    SciTech Connect

    Tindle, L.

    1982-12-01

    Shows how selecting the right belt repair method can save mine operators thousands of dollars, reduce downtime by 50% and make the conveyor belt last 30% longer. With a splice every 200 to 400 ft in a typical mine, US underground coal mines spend about $30 million a year on belt splicing. Vulcanizing has been the splicing system of choice for most permanent main haulage belts underground. Synthetic belts last longer and operate at higher tensions than natural materials, and most mines have started to convert to them from natural fabric belts. Because synthetic belts are thinner, they are more difficult to vulcanize. Discusses how thinner belts lead to mechanical fasteners, how to square belt ends, and how belt ends can be used for short-term splices.

  9. Leakage test during mitral valve repair.

    PubMed

    Watanabe, Taiju; Arai, Hirokuni

    2014-11-01

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

  10. AAPSM repair utilizing transparent etch stop layer

    NASA Astrophysics Data System (ADS)

    Taylor, Darren; Cangemi, Michael; Lassiter, Matthew; Cangemi, Marc; Poortinga, Eric

    2004-12-01

    Repair of etched quartz defects on AAPSM products negatively affect manufacturability in the mask shop. Currently there are few solutions to repair etched quartz defects, two of these include mechanical removal or a combination of topography mapping and FIB milling of the defect. Both of the above methods involve large capital investments specifically for etched quartz repair. The method presented in this study readily repairs etched quartz without the need to purchase additional tools for AAPSM repair. Photronics' Advanced Materials Program has developed a transparent etch stop layer (TESL) integrated into the binary blank for the purpose of building AAPSM products with a high yield component. This etch stop layer is located under a layer of sputtered SiO2 deposited to 180° for a given lithography wavelength. These blanks can be used for a variety of etched quartz applications including cPSM and CPL. Photronics has developed software that reads in defect locations from automatic inspection tools and the jobdeck. A "repair" layer is created for the defect file and the plate is then re-exposed on the mask lithography tool. The defects are then etched away using the etch stop to control the phase of the surrounding trench. The repair method was tested using programmed defect masks from single etched 193nm AAPSM technologies. Inspection, SEM, AIMS and profilometry results will be shown.

  11. Repair of Electronics for Long Duration Spaceflight

    NASA Technical Reports Server (NTRS)

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

    2007-01-01

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

  12. Method of repairing discontinuity in fiberglass structures

    NASA Technical Reports Server (NTRS)

    Gelb, L. L.; Helbert, W. B., Jr.; Enie, R. B.; Mulliken, R. F. (inventors)

    1974-01-01

    Damaged fiberglass structures are repaired by substantially filling the irregular surfaced damaged area with a liquid, self-curing resin, preferably an epoxy resin mixed with chopped fiberglass, and then applying to the resin surface the first of several woven fiberglass swatches which has stitching in a zig-zag pattern parallel to each of its edges and a fringe of warp and fill glass fibers about the edges outward of the stitching. The method is especially applicable to repair of fiberglass rocket engine casings and is particularly advantageous since it restores the repaired fiberglass structure to substantially its original strength without any significant changes in the geometry or mass of the structure.

  13. Fanconi-like crosslink repair in yeast

    PubMed Central

    2012-01-01

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

  14. DNA Repair Pathways in Trypanosomatids: from DNA Repair to Drug Resistance

    PubMed Central

    Genois, Marie-Michelle; Paquet, Eric R.; Laffitte, Marie-Claude N.; Maity, Ranjan; Rodrigue, Amélie

    2014-01-01

    SUMMARY All living organisms are continuously faced with endogenous or exogenous stress conditions affecting genome stability. DNA repair pathways act as a defense mechanism, which is essential to maintain DNA integrity. There is much to learn about the regulation and functions of these mechanisms, not only in human cells but also equally in divergent organisms. In trypanosomatids, DNA repair pathways protect the genome against mutations but also act as an adaptive mechanism to promote drug resistance. In this review, we scrutinize the molecular mechanisms and DNA repair pathways which are conserved in trypanosomatids. The recent advances made by the genome consortiums reveal the complete genomic sequences of several pathogens. Therefore, using bioinformatics and genomic sequences, we analyze the conservation of DNA repair proteins and their key protein motifs in trypanosomatids. We thus present a comprehensive view of DNA repair processes in trypanosomatids at the crossroads of DNA repair and drug resistance. PMID:24600040

  15. 48 CFR 252.247-7025 - Reflagging or repair work.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 48 Federal Acquisition Regulations System 3 2014-10-01 2014-10-01 false Reflagging or repair work... of Provisions And Clauses 252.247-7025 Reflagging or repair work. As prescribed in 247.574(d), use the following clause: Reflagging or Repair Work (JUN 2005) (a) Definition. Reflagging or repair...

  16. 49 CFR 192.309 - Repair of steel pipe.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 49 Transportation 3 2013-10-01 2013-10-01 false Repair of steel pipe. 192.309 Section 192.309... Lines and Mains § 192.309 Repair of steel pipe. (a) Each imperfection or damage that impairs the serviceability of a length of steel pipe must be repaired or removed. If a repair is made by grinding,...

  17. 49 CFR 192.309 - Repair of steel pipe.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 3 2011-10-01 2011-10-01 false Repair of steel pipe. 192.309 Section 192.309... Lines and Mains § 192.309 Repair of steel pipe. (a) Each imperfection or damage that impairs the serviceability of a length of steel pipe must be repaired or removed. If a repair is made by grinding,...

  18. 49 CFR 192.309 - Repair of steel pipe.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 49 Transportation 3 2014-10-01 2014-10-01 false Repair of steel pipe. 192.309 Section 192.309... Lines and Mains § 192.309 Repair of steel pipe. (a) Each imperfection or damage that impairs the serviceability of a length of steel pipe must be repaired or removed. If a repair is made by grinding,...

  19. 49 CFR 192.309 - Repair of steel pipe.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 3 2010-10-01 2010-10-01 false Repair of steel pipe. 192.309 Section 192.309... Lines and Mains § 192.309 Repair of steel pipe. (a) Each imperfection or damage that impairs the serviceability of a length of steel pipe must be repaired or removed. If a repair is made by grinding,...

  20. 49 CFR 192.309 - Repair of steel pipe.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 49 Transportation 3 2012-10-01 2012-10-01 false Repair of steel pipe. 192.309 Section 192.309... Lines and Mains § 192.309 Repair of steel pipe. (a) Each imperfection or damage that impairs the serviceability of a length of steel pipe must be repaired or removed. If a repair is made by grinding,...

  1. EVALUA TION OF PINNING MATERIALS FOR MARBLE REPAIR Christina Muir

    E-print Network

    EVALUA TION OF PINNING MATERIALS FOR MARBLE REPAIR Christina Muir Submitted in partial fulfillment, Planning and Preservation Columbia University (May 2008) #12;Abstract The practice of repairing marble material is best suited for use in marble repair. Marble cores were cut and repaired with pins

  2. 48 CFR 1371.118 - Changes-ship repair.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 48 Federal Acquisition Regulations System 5 2011-10-01 2011-10-01 false Changes-ship repair. 1371... SUPPLEMENTAL REGULATIONS ACQUISITIONS INVOLVING SHIP CONSTRUCTION AND SHIP REPAIR Provisions and Clauses 1371.118 Changes—ship repair. Insert clause 1352.271-87, Changes—Ship Repair, in all solicitations...

  3. Shear Bond Strength of Repaired Composites Using Surface Treatments and Repair Materials: An In vitro Study

    PubMed Central

    Hemadri, M; Saritha, G; Rajasekhar, V; Pachlag, K Amit; Purushotham, R; Reddy, Veera Kishore Kumar

    2014-01-01

    Background: Enhancement of bond strength between new and old composite usually requires increased surface roughness of old composite to promote mechanical interlocking and subsequent coating with bonding agents to improve surface wetting and chemical bonding. So this study was carried out to evaluate and compare the effects of different surface treatments and repair materials on the shear bond strength (SBS) of composite repairs The mode of failure of repaired composites whether cohesive or adhesive was also evaluated. Materials and Methods: The substrates for 60 composite specimens were fabricated and aged with water treatment and subjected to various surface treatments. The surface treatment regimens used in the study were: No surface treatment, abraded with diamond bur, air abraded (sandblasted) with 50 µ aluminum oxide particles. Specimens were then repaired with fresh composite using either Clearfil™ repair or all-bond two adhesive systems. Specimens were water stored, thermocycled and tested for SBS using universal testing machine. Fractured specimens were then examined under stereomicroscope to determine the mode of failure. Results: It was clearly showed that surface roughening of the aged composite substrate with air abrasion, followed by the application of Clearfil™ repair adhesive system (Group IIIa) yielded the highest repair bond strength (32.3 ± 2.2 MPa). Conclusion: Surface treatment with air abrasion followed by bonding with Clearfil™ repair adhesive system can be attempted clinically for the repair of composite restorations. PMID:25628478

  4. Highway Repair: A New Silicosis Threat

    PubMed Central

    Valiante, David J.; Schill, Donald P.; Rosenman, Kenneth D.; Socie, Edward

    2004-01-01

    Objectives. We describe an emerging public health concern regarding silicosis in the fast-growing highway repair industry. Methods. We examined highway construction trends, silicosis surveillance case data, and environmental exposure data to evaluate the risk of silicosis among highway repair workers. We reviewed silicosis case data from the construction industry in 3 states that have silicosis registries, and we conducted environmental monitoring for silica at highway repair work sites. Results. Our findings indicate that a large population of highway workers is at risk of developing silicosis from exposure to crystalline silica. Conclusions. Exposure control methods, medical screenings, protective health standards, and safety-related contract language are necessary for preventing future occupational disease problems among highway repair workers. PMID:15117715

  5. Funding of Facility Repairs and Renovation.

    ERIC Educational Resources Information Center

    Kaiser, Harvey H.

    1984-01-01

    Compares the life cycle approach for campus building repair and renovation to the University of California's comprehensive building maintenance formula and advises that formulas be used cautiously as a method of determining appropriate budget levels. (MLF)

  6. Recombination and DNA Repair in Helicobacter pylori

    PubMed Central

    Dorer, Marion S.; Sessler, Tate H.; Salama, Nina R.

    2013-01-01

    All organisms have pathways that repair the genome, ensuring their survival and that of their progeny. But these pathways also serve to diversify the genome, causing changes on the level of nucleotide, whole gene, and genome structure. Sequencing of bacteria has revealed wide allelic diversity and differences in gene content within the same species, highlighting the importance of understanding pathways of recombination and DNA repair. The human stomach pathogen Helicobacter pylori is an excellent model system for studying these pathways. H. pylori harbors major recombination and repair pathways and is naturally competent, facilitating its ability to diversify its genome. Elucidation of DNA recombination, repair, and diversification programs in this pathogen will reveal connections between these pathways and their importance to infection. PMID:21682641

  7. Anesthesia For In Utero Repair of Myelomeningocele

    PubMed Central

    Ferschl, Marla; Ball, Robert; Lee, Hanmin; Rollins, Mark D.

    2013-01-01

    Recently published results suggest that prenatal repair of fetal myelomeningocele is a potentially preferable alternative when compared to postnatal repair. In this article, the pathology of myelomeningocele, unique physiologic considerations, perioperative anesthetic management, and ethical considerations of open fetal surgery for prenatal myelomeningocele repair are discussed. Open fetal surgeries have many unique anesthetic issues such as inducing profound uterine relaxation, vigilance for maternal or fetal blood loss, fetal monitoring, and possible fetal resuscitation. Postoperative management, including the requirement for postoperative tocolysis and maternal analgesia are also reviewed. The success of intrauterine myelomeningocele repair relies on a well-coordinated multidisciplinary approach. Fetal surgery is an important topic for anesthesiologists to understand, as the number of fetal procedures is likely to increase as new fetal treatment centers are opened across the United States. PMID:23508219

  8. One step closer to gut repair

    PubMed Central

    Shaker, Anisa; Rubin, Deborah C.

    2013-01-01

    The use of adult-tissue stem cells to treat gastrointestinal diseases holds much promise. A method for in vitro growth of gut stem cells and their use in repairing damaged intestines in mice has been described. PMID:22575955

  9. Repairing Type Errors in Functional Programs 

    E-print Network

    McAdam, Bruce J

    Type systems for programming languages can be used by compilers to reject programs which are found to be unsound and which may, therefore, fail to execute successfully. When a program is rejected the programmer must repair ...

  10. Light-Curing Adhesive Repair Tapes

    NASA Technical Reports Server (NTRS)

    Allred, Ronald; Haight, Andrea Hoyt

    2009-01-01

    Adhesive tapes, the adhesive resins of which can be cured (and thereby rigidized) by exposure to ultraviolet and/or visible light, are being developed as repair patch materials. The tapes, including their resin components, consist entirely of solid, low-outgassing, nonhazardous or minimally hazardous materials. They can be used in air or in vacuum and can be cured rapidly, even at temperatures as low as -20 C. Although these tapes were originally intended for use in repairing structures in outer space, they can also be used on Earth for quickly repairing a wide variety of structures. They can be expected to be especially useful in situations in which it is necessary to rigidize tapes after wrapping them around or pressing them onto the parts to be repaired.

  11. Screening EUV mask absorbers for defect repair

    NASA Astrophysics Data System (ADS)

    Isogawa, Takeshi; Seki, Kazunori; Lawliss, Mark; Gallagher, Emily; Akima, Shinji; Konishi, Toshio

    2014-07-01

    Five EUV film stacks were prepared and evaluated from the multiple viewpoints of mask repair process: etching property, CD control and wafer print. Etching property results revealed a thicker lower reflective (LR) layer stack showed good performance. Some types of defects were repaired and a CD comparison done with both CD-SEM and EUV microscope. It was found thinner total film stack (LR plus absorber) performs better than thicker ones for CD control. In addition, thicker LR performed better than thinner LR. Wafer print performance on the repaired site was evaluated through focus by imaging on an EUV microscope. Wafer printability performance showed that thinner total film stack performed better than a thicker one. Finally the best stack for EUV mask repair performance was determined to be a thinner total film stack and thicker a LR from all the various points of view.

  12. Exercises versus arthroscopic decompression in patients with subacromial impingement: a randomised, controlled study in 90 cases with a one year follow up

    PubMed Central

    Haahr, J; Ostergaard, S; Dalsgaard, J; Norup, K; Frost, P; Lausen, S; Holm, E; Andersen, J

    2005-01-01

    Objectives: To compare the effect of graded physiotherapeutic training of the rotator cuff versus arthroscopic subacromial decompression in patients with subacromial impingement. Methods: Randomised controlled trial with 12 months' follow up in a hospital setting. Ninety consecutive patients aged 18 to 55 years were enrolled. Symptom duration was between six months and three years. All fulfilled a set of diagnostic criteria for rotator cuff disease, including a positive impingement sign. Patients were randomised either to arthroscopic subacromial decompression, or to physiotherapy with exercises aiming at strengthening the stabilisers and decompressors of the shoulder. Outcome was shoulder function as measured by the Constant score and a pain and dysfunction score. "Intention to treat" analysis was used, with comparison of means and control of confounding variables by general equation estimation analysis. Results: Of 90 patients enrolled, 84 completed follow up (41 in the surgery group, 43 in the training group). The mean Constant score at baseline was 34.8 in the training group and 33.7 in the surgery group. After 12 months the mean scores improved to 57.0 and 52.7, respectively, the difference being non-significant. No group differences in mean pain and dysfunction score improvement were found. Conclusions: Surgical treatment of rotator cuff syndrome with subacromial impingement was not superior to physiotherapy with training. Further studies are needed to qualify treatment choice decisions, and it is recommended that samples are stratified according to disability level. PMID:15834056

  13. Near-infrared (NIR) spectroscopy. A new method for arthroscopic evaluation of low grade degenerated cartilage lesions. Results of a pilot study

    PubMed Central

    Spahn, Gunter; Plettenberg, Holger; Kahl, Enrico; Klinger, Hans M; Mückley, Thomas; Hofmann, Gunther O

    2007-01-01

    Background Arthroscopy is a highly sensitive method of evaluating high-grade cartilage lesions but the detection of low-grade lesions is often is unreliable. Objective measurements are required. A novel NIRS (near-infrared-spectroscopy) device for detection of low-grade cartilage defects was evaluated in a preliminary clinical study. Methods In 12 patients who had undergone arthroscopy, the cartilage lesions within the medial knee compartment were classified according to the ICRS protocol. With a NIR spectrometer system and an optical probe, similar in design to a hook used for routine arthroscopy, the optical properties of cartilage were measured during arthroscopy. Results The mean ratio of 2 NIR absorption bands of intact cartilage 3.8 (range 2.3 to 8.7).was significantly lower than that of cartilage with grade 1 lesions (12.8, range 4.8 to 19.6) and grade 2 lesions (13.4, range 10.4 to 15.4). No differences were observed between grade 1 and grade 2 lesions. Conclusion NIRS can be used to distinguish between ICRS grade 1 lesions and healthy cartilage during arthroscopic surgeries. The results of this clinical study demonstrate the potential of NIRS to objectify classical arthroscopic grading systems. PMID:17535439

  14. Intestinal Obstruction After Totally Extraperitoneal Laparoscopic Inguinal Hernia Repair

    PubMed Central

    Rink, Joanne

    2004-01-01

    Laparoscopic hernia repair is a frequently performed operation. Although it has many advantages over open inguinal hernia repair, laparoscopic surgery is not without complications. Small bowel obstruction is a complication unique to laparoscopic repair of inguinal hernias. It is reported following transabdominal preperitoneal repairs. We present a case of small bowel incarceration through a peritoneal defect after a totally extraperitoneal inguinal hernia repair. Techniques to avoid this complication are presented. The literature is reviewed. PMID:14974673

  15. Hypospadias Repair: A Single Centre Experience

    PubMed Central

    Majeed, Abdul; Ullah, Hidayat; Naz, Shazia; Shah, Syed Asif; Tahmeed, Tahmeedullah; Yousaf, Kanwal; Tahir, Muhammad

    2014-01-01

    Objectives. To determine the demographics and analyze the management and factors influencing the postoperative complications of hypospadias repair. Settings. Hayatabad Medical Complex Peshawar, Pakistan, from January 2007 to December 2011. Material and Methods. All male patients presenting with hypospadias irrespective of their ages were included in the study. The data were acquired from the hospital's database and analyzed with Statistical Package for Social Sciences (SPSS). Results. A total of 428 patients with mean age of 8.12 ± 5.04 SD presented for hypospadias repair. Midpenile hypospadias were the most common. Chordee, meatal abnormalities, cryptorchidism, and inguinal hernias were observed in 74.3%, 9.6%, 2.8%, and 2.1% cases, respectively. Two-stage (Bracka) and TIP (tubularized incised urethral plate) repairs were performed in 76.2% and 20.8% of cases, respectively. The most common complications were edema and urethrocutaneous fistula (UCF). The complications were significantly lower in the hands of specialists than residents (P-value = 0.0086). The two-stage hypospadias repair resulted in higher complications frequency than single-stage repair (P value = 0.0001). Conclusion. Hypospadias surgery has a long learning curve because it requires a great deal of temperament, surgical skill and acquaintance with magnifications. Single-stage repair should be encouraged wherever applicable due to its lower postoperative complications. PMID:24579043

  16. Subsidence resistant repair of a block basement

    SciTech Connect

    Mahar, J.W.; Marino, G.G.; Murphy, E.; Farnetti, J.

    1998-12-31

    A one story house was damaged by mine subsidence movement. The house is located in a small subsidence sag and is experiencing differential settlement and compressive ground strains. Instead of waiting for the ground movements to eventually stop, The Illinois Mine Subsidence Insurance Fund developed a permanent repair scheme that was implemented at the same time damaging mine subsidence movement was affecting the structure. This repair provided a significant structural resistance against the anticipated residual mine subsidence movement and was aesthetically acceptable to the homeowners. The repair consisted of epoxying vertical and horizontal steel straps and then applying a cover coat of fiber-cement on the unreinforced concrete block basement walls. The repair scheme was relatively untried, but had been successfully researched. This paper provides information on the mine subsidence movement/damage, the design concepts of steel strap/fiber-cement repair, construction details, performance and costs. Other applications of the use of the steel strap repair method are also discussed for releveling of a building and/or correcting subsidence damage to structures located in the tension zone.

  17. Repair of filament wound composite pipes

    NASA Astrophysics Data System (ADS)

    Amali, Ramin; Arnall, Heather

    2015-07-01

    Filament wound pipes are used in a wide variety of industries, due to the advantages composites have over metal pipes, such as a high strength to weight ratio, and resistance against frost, corrosion and heat. Composite pipes require minimal maintenance to ensure they are safe. Any damage occurring in composite pipes could lead to failure; therefore all damage should be assessed through NDT. If it is decided that the damage makes the pipe unsafe then a decision needs to be made whether to repair or replace the pipe. Repairing a composite pipe can be quicker, easier and cheaper than replacing it and can restore the strength of the pipe effectively. This investigation looks at the repair process and the parameters involved in determining the strength of the pipe following repair through the use of over 150 models in FEA software, Abaqus. Parameters considered include the pipe diameter and thickness, damage removal size and wrap width and thickness. It was found that if the pipe is thin-walled then it can be assumed that the pipe's thickness has no effect on the FOS following repair. Formulas were created to predict the FOS following repair for varying pipe diameters, damage sizes and wrap thickness. Formulas were also created to determine the wrap width required for varying wrap thicknesses and damage sizes.

  18. Nuclear position dictates DNA repair pathway choice

    PubMed Central

    Lemaître, Charlène; Grabarz, Anastazja; Tsouroula, Katerina; Andronov, Leonid; Furst, Audrey; Pankotai, Tibor; Heyer, Vincent; Rogier, Mélanie; Attwood, Kathleen M.; Kessler, Pascal; Dellaire, Graham; Klaholz, Bruno; Reina-San-Martin, Bernardo; Soutoglou, Evi

    2014-01-01

    Faithful DNA repair is essential to avoid chromosomal rearrangements and promote genome integrity. Nuclear organization has emerged as a key parameter in the formation of chromosomal translocations, yet little is known as to whether DNA repair can efficiently occur throughout the nucleus and whether it is affected by the location of the lesion. Here, we induce DNA double-strand breaks (DSBs) at different nuclear compartments and follow their fate. We demonstrate that DSBs induced at the nuclear membrane (but not at nuclear pores or nuclear interior) fail to rapidly activate the DNA damage response (DDR) and repair by homologous recombination (HR). Real-time and superresolution imaging reveal that DNA DSBs within lamina-associated domains do not migrate to more permissive environments for HR, like the nuclear pores or the nuclear interior, but instead are repaired in situ by alternative end-joining. Our results are consistent with a model in which nuclear position dictates the choice of DNA repair pathway, thus revealing a new level of regulation in DSB repair controlled by spatial organization of DNA within the nucleus. PMID:25366693

  19. Repair of radiation damage in mammalian cells

    SciTech Connect

    Setlow, R.B.

    1981-01-01

    The responses, such as survival, mutation, and carcinogenesis, of mammalian cells and tissues to radiation are dependent not only on the magnitude of the damage to macromolecular structures - DNA, RNA, protein, and membranes - but on the rates of macromolecular syntheses of cells relative to the half-lives of the damages. Cells possess a number of mechanisms for repairing damage to DNA. If the repair systems are rapid and error free, cells can tolerate much larger doses than if repair is slow or error prone. It is important to understand the effects of radiation and the repair of radiation damage because there exist reasonable amounts of epidemiological data that permits the construction of dose-response curves for humans. The shapes of such curves or the magnitude of the response will depend on repair. Radiation damage is emphasized because: (a) radiation dosimetry, with all its uncertainties for populations, is excellent compared to chemical dosimetry; (b) a number of cancer-prone diseases are known in which there are defects in DNA repair and radiation results in more chromosomal damage in cells from such individuals than in cells from normal individuals; (c) in some cases, specific radiation products in DNA have been correlated with biological effects, and (d) many chemical effects seem to mimic radiation effects. A further reason for emphasizing damage to DNA is the wealth of experimental evidence indicating that damages to DNA can be initiating events in carcinogenesis.

  20. Energy and Technology Review: Unlocking the mysteries of DNA repair

    SciTech Connect

    Quirk, W.A.

    1993-04-01

    DNA, the genetic blueprint, has the remarkable property of encoding its own repair following diverse types of structural damage induced by external agents or normal metabolism. We are studying the interplay of DNA damaging agents, repair genes, and their protein products to decipher the complex biochemical pathways that mediate such repair. Our research focuses on repair processes that correct DNA damage produced by chemical mutagens and radiation, both ionizing and ultraviolet. The most important type of DNA repair in human cells is called excision repair. This multistep process removes damaged or inappropriate pieces of DNA -- often as a string of 29 nucleotides containing the damage -- and replaces them with intact ones. We have isolated, cloned, and mapped several human repair genes associated with the nucleotide excision repair pathway and involved in the repair of DNA damage after exposure to ultraviolet light or mutagens in cooked food. We have shown that a defect in one of these repair genes, ERCC2, is responsible for the repair deficiency in one of the groups of patients with the recessive genetic disorder xeroderma pigmentosum (XP group D). We are exploring ways to purify sufficient quantities (milligrams) of the protein products of these and other repair genes so that we can understand their functions. Our long-term goals are to link defective repair proteins to human DNA repair disorders that predispose to cancer, and to produce DNA-repair-deficient mice that can serve as models for the human disorders.

  1. Bilingual Skills Training Program. Auto Body Repair. Module 3.0: Basic Metal Repair.

    ERIC Educational Resources Information Center

    Northern New Mexico Community Coll., El Rito.

    This module on basic metal repair is the third of four (CE 028 303-306) in the auto body repair course of a bilingual vocational training program. The course is designed to furnish theoretical and laboratory experience in welding, metal straightening, metal finishing, painting, and use of power and hand tools. Module objectives are for students to…

  2. Aortic arch repair today: open repair is best for most arch lesions.

    PubMed

    Coselli, J S; Green, S Y

    2015-08-01

    The transverse aortic arch is challenging to repair by either evolving open or emerging endovascular approaches. Contemporary experience in aortic arch repair can be difficult to assess because clinical practice varies substantially among centers with regard to temperature targets for hypothermic circulatory arrest, temperature monitoring sites, circulating perfusate temperatures, cerebral perfusion monitoring techniques, perfusion catheter flow rates, cannulation sites, pH management, and protective pharmacologic agents. Repair of the aortic arch has changed substantially over the last decade; these changes appear to have substantially reduced patient risk. In general, contemporary outcomes of open aortic arch repair are good to excellent. When acute aortic dissection is absent, many centers report early mortality rates below 5%; when acute aortic dissection is present, these rates are doubled or tripled. Not unexpectedly, mortality rates for total transverse aortic arch repair with elephant trunk or frozen elephant trunk approaches are greater than those for hemiarch repair (7-17% vs. 3-4%). In contemporary reports of mixed hemiarch and total arch repairs for aortic aneurysm, several authors report early mortality rates and stroke rates below 5%. Surprisingly, mortality rates for reoperation are not unlike those for primary repair and range from 8% to 9%; however, the risk of stroke appears somewhat greater and ranges from 5% to 6%. PMID:25752255

  3. General Mechanical Repair. Minor Automotive Maintenance, Small Engine [Repair, and] Welding: Student Manual.

    ERIC Educational Resources Information Center

    Hamlin, Larry

    This document is a student manual for a general mechanical repair course. Following a list of common essential elements of trade and industrial education, the manual is divided into three sections. The first section, on minor automotive maintenance, contains 13 units: automotive shop safety; engine principles; fuel system operation and repair;…

  4. Repair kinetic considerations in particle beam radiotherapy

    PubMed Central

    Carabe-Fernandez, A; Dale, R G; Paganetti, H

    2011-01-01

    Objectives A second-order repair kinetics model is developed to predict damage repair rates following low or high linear energy transfer (LET) irradiations and to assess the amount of unrepairable damage produced by such radiations. The model is a further development of an earlier version designed to test if low-LET radiation repair processes could be quantified in terms of second-order kinetics. The newer version allows calculation of both the repair rate of the proportion of DNA damages that repair according to second-order kinetics and the proportion of DNA damages that do not repair. Methods The original and present models are intercompared in terms of their goodness-of-fit to a number of data sets obtained from different ion beams. The analysis demonstrates that the present model provides a better fit to the data in all cases studied. Results The proportions of unrepairable damage created by radiations of different LET predicted by the new model correspond well with previous studies on the increased effectiveness of high-LET radiations in inducing reproductive cell death. The results show that the original model may underestimate the proportion of unrepaired damage at any given time after its creation as well as failing to predict very slow or unrepairable damage components, which may result from high-LET irradiation. Conclusion It is suggested that the second-order model presented here offers a more realistic view of the patterns of repair in cell lines or tissues exposed to high-LET radiation. PMID:21266398

  5. Mesh repair of vaginal wall prolapse

    PubMed Central

    Kapur, Krishan; Dalal, Vinod

    2014-01-01

    Background Over the last decade, mesh augmented surgical repair is being increasingly used in pelvic organ prolapse. Perigee and Apogee are comprehensive, single-use needle suspension kits that provide a standardized delivery method for mesh or graft-augmented repairs. This study has been carried out to study the safety and efficacy of the Perigee and Apogee mesh repair systems. Methods 10 cases of posterior vaginal wall prolapse with or without Apical prolapse underwent Apogee mesh repair surgery and 10 cases of anterior vaginal wall prolapse underwent Perigee mesh repair surgery. Depending on the findings either Apogee or Perigee or both were used. Patients were followed up for complications of the surgery if any, and for the relief of the symptoms related to prolapse and associated symptoms of bowel/bladder dysfunction. Objective cure rate was prolapse < stage 1 as per the POPQ system. Data collected was statistically analyzed. Results The objective and subjective cure rates were 100%. Postoperative complications were minor. No patient developed de novo urinary urge symptoms, stress urinary incontinence or UTI postoperatively. There were no operative complications like bladder injuries, hematoma and rectal injuries. The mean blood loss was 180 ml and the mean duration of surgery during the Apogee and Perigee mesh repair was 51.5 ± 2.99 min and 60.9 ± 4.65 min respectively. Conclusion In the present study there was a significant improvement in the degree of prolapse after the mesh repair surgeries and the results were consistent even at 12 months follow up. PMID:24843196

  6. DNA repair responses in human skin cells

    SciTech Connect

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

    1981-07-01

    Sunlight and some environmental chemical agents produce lesions in the DNA of human skin cells that if unrepaired may interfere with normal functioning of these cells. The most serious outcome of such interactions may be malignancy. It is therefore important to develop an understanding of mechanisms by which the lesions may be repaired or tolerated without deleterious consequences. Our models for the molecular processing of damaged DNA have been derived largely from the study of bacterial systems. Some similarities but significant differences are revealed when human cell responses are tested against these models. It is also of importance to learn DNA repair responses of epidermal keratinocytes for comparison with the more extensive studies that have been carried out with dermal fibroblasts. Our experimental results thus far indicate similarities for the excision-repair of ultraviolet-induced pyrimidine dimers in human keratinocytes and fibroblasts. Both the monoadducts and the interstrand crosslinks produced in DNA by photoactivated 8-methoxypsoralen (PUVA) can be repaired in normal human fibroblasts but not in those from xeroderma pigmentosum patients. The monoadducts, like pyrimidine dimers, are probably the more mutagenic/carcinogenic lesions while the crosslinks are less easily repaired and probably result in more effective blocking of DNA function. It is suggested that a split-dose protocol that maximizes the production of crosslinks while minimizing the yield of monoadducts may be more effective and potentially less carcinogenic than the single ultraviolet exposure regimen in PUVA therapy for psoriasis.

  7. Mechanical injury and repair of cells

    NASA Technical Reports Server (NTRS)

    Miyake, Katsuya; McNeil, Paul L.

    2003-01-01

    OBJECTIVE: To concisely review the field of cell plasma membrane disruption (torn cell surface) and repair. MAIN POINTS: Plasma membrane disruption is a common form of cell injury under physiologic conditions, after trauma, in certain muscular dystrophies, and during certain forms of clinical intervention. Rapid repair of a disruption is essential to cell survival and involves a complex and active cell response that includes membrane fusion and cytoskeletal activation. Tissues, such as cardiac and skeletal muscle, adapt to a disruption injury by hypertrophying. Cells adapt by increasing the efficiency of their resealing response. CONCLUSION: Plasma membrane disruption is an important cellular event in both health and disease. The disruption repair mechanism is now well understood at the cellular level, but much remains to be learned at the molecular level. Cell and tissue level adaptational responses to the disruption either prevent its further occurrence or facilitate future repairs. Therapeutically useful drugs might result if, using this accumulating knowledge, chemical agents can be developed that can enhance repair or adaptive responses.

  8. Nucleotide excision repair in Escherichia coli.

    PubMed Central

    Van Houten, B

    1990-01-01

    One of the best-studied DNA repair pathways is nucleotide excision repair, a process consisting of DNA damage recognition, incision, excision, repair resynthesis, and DNA ligation. Escherichia coli has served as a model organism for the study of this process. Recently, many of the proteins that mediate E. coli nucleotide excision have been purified to homogeneity; this had led to a molecular description of this repair pathway. One of the key repair enzymes of this pathway is the UvrABC nuclease complex. The individual subunits of this enzyme cooperate in a complex series of partial reactions to bind to and incise the DNA near a damaged nucleotide. The UvrABC complex displays a remarkable substrate diversity. Defining the structural features of DNA lesions that provide the specificity for damage recognition by the UvrABC complex is of great importance, since it represents a unique form of protein-DNA interaction. Using a number of in vitro assays, researchers have been able to elucidate the action mechanism of the UvrABC nuclease complex. Current research is devoted to understanding how these complex events are mediated within the living cell. PMID:2181258

  9. Innovative coke-oven repair techniques

    SciTech Connect

    Emish, G.J.; Ramani, R.V.

    1995-10-01

    Certain innovative coke-oven repair techniques are reviewed that represent an engineered approach to a successful rehabilitation of all types of coke-oven batteries. These techniques have been developed during the last 10 years and experience gained on a number of repair projects has shown that these techniques operate as a cohesive and comprehensive method of end flue and through-wall repairs to gain additional years of operating life to coke-oven batteries. Extended operations approaching 10 to 15 additional years of service at lower costs than a pad-up rebuild and, while meeting the environmental emission regulations, are attainable using the techniques of: Proper tie-in joint preparation; Improved bricking up methodology; Preheating refractory during bricking up; Installation of spring-loaded bracing system; and installation of flexible coke-oven doors. Repair methods that do not incorporate the above techniques are subject to premature failure of the refractory. The old methods of wall cool down and installing refractory as if the battery was brand new are outdated technology. A technology supplier, with new techniques, can coordinate the construction contractor and the battery heating to obtain a successful coke-oven and flue or through-wall repair.

  10. Repair of DNA Double-Strand Breaks

    NASA Astrophysics Data System (ADS)

    Falk, Martin; Lukasova, Emilie; Kozubek, Stanislav

    The genetic information of cells continuously undergoes damage induced by intracellular processes including energy metabolism, DNA replication and transcription, and by environmental factors such as mutagenic chemicals and UV and ionizing radiation. This causes numerous DNA lesions, including double strand breaks (DSBs). Since cells cannot escape this damage or normally function with a damaged genome, several DNA repair mechanisms have evolved. Although most "single-stranded" DNA lesions are rapidly removed from DNA without permanent damage, DSBs completely break the DNA molecule, presenting a real challenge for repair mechanisms, with the highest risk among DNA lesions of incorrect repair. Hence, DSBs can have serious consequences for human health. Therefore, in this chapter, we will refer only to this type of DNA damage. In addition to the biochemical aspects of DSB repair, which have been extensively studied over a long period of time, the spatio-temporal organization of DSB induction and repair, the importance of which was recognized only recently, will be considered in terms of current knowledge and remaining questions.

  11. HYDROGEN EFFECTS ON LASER ENGINEERED NET SHAPE (LENS) REPAIRED WELDMENTS

    SciTech Connect

    Korinko, P; Thad Adams, T

    2006-10-06

    New methods of repairing mis-machined components are always of interest. In this study, an innovative method using Laser Engineered Net Shape{trademark} (LENS{reg_sign}) forming was used to repair intentionally mis-machined test articles. The components were repaired and subsequently hydrogen charged and burst tested. The LENS repair did not have an adverse effect on the solid state weld process that was used to repair the components. Hydrogen charged samples failed in a similar manner to the uncharged samples. Overall, the prospects for LENS repairing similar products are favorable and further work is encouraged.

  12. Repair to the Huygens probe

    NASA Technical Reports Server (NTRS)

    1997-01-01

    Jet Propulsion Laboratory (JPL) workers examine the Huygens probe after removal from the Cassini spacecraft in the Payload Hazardous Servicing Facility (PHSF) at KSC. The spacecraft was returned to the PHSF after damage to the thermal insulation was discovered inside Huygens from an abnormally high flow of conditioned air. The damage required technicians to inspect the inside of the probe, repair the insulation, and clean the instruments. After returning from the PHSF to Launch Pad 40 at Cape Canaveral Air Station, Cassini/Huygens launched successfully in October 1997, and reached Saturn in July of 2004. Scientific instruments carried aboard the Cassini orbiter will study Saturn's atmosphere, magnetic field, rings, and several moons, while the Huygens probe will separate and land on the surface of Titan, Saturn's largest moon. The Cassini-Huygens mission owes its name to the Dutch astronomer Christiaan Huygens and Italian astronomer Giovanni Domenico Cassini. Both had spectacular careers as observers of the heavens, which included important discoveries about Saturn and its satellites. Huygens (1629-1695) discovered Saturn's largest moon, Titan, in 1655 and in 1656 described the shape and phase changes of Saturn's rings. Cassini (1625-1712) was the first to observe four of Saturn's moons, Iapetus, Rhea, Tethys, and Dione, in the 1670s and 1680s. He also, in 1675, discovered the gap in Saturn's rings, now called the Cassini Division, and proposed that the rings were formed from many tiny particles. Cassini-Huygens is a joint mission of NASA, the European Space Agency (ESA), and the Italian Space Agency, Agenzia Spaziale Italiana (ASI). JPL is managing the Cassini project for NASA. The mission was proposed in November 1982 by a group of European and American scientists from the European Science Foundation and the National Academy of Sciences. The Solar System Exploration Committee of the NASA Advisory Council endorsed the idea in April 1983, and NASA and ESA began a joint assessment study in 1984. ESA officially adopted the project in November 1988, and Congress approved funding for NASA's portion of the mission in FY 89.

  13. Amniotic membrane covering for facial nerve repair?

    PubMed Central

    Karaman, Murat; Tuncel, Arzu; Sheidaei, Shahrouz; ?enol, Mehmet Güney; Karabulut, Murat Hakan; Deveci, Ildem; Karaman, Nihan

    2013-01-01

    Amniotic membranes have been widely used in ophthalmology and skin injury repair because of their anti-inflammatory properties. In this study, we measured therapeutic efficacy and determined if amniotic membranes could be used for facial nerve repair. The facial nerves of eight rats were dissected and end-to-end anastomosis was performed. Amniotic membranes were covered on the anastomosis sites in four rats. Electromyography results showed that, at the end of the 3rd and 8th weeks after amniotic membrane covering, the latency values of the facial nerves covered by amniotic membranes were significantly shortened and the amplitude values were significantly increased. Compared with simple facial nerve anastomosis, after histopathological examination, facial nerve anastomosed with amniotic membrane showed better continuity, milder inflammatory reactions, and more satisfactory nerve conduction. These findings suggest that amniotic membrane covering has great potential in facial nerve repair. PMID:25206390

  14. Alkylation damage repair in mammalian genomes

    SciTech Connect

    Mitra, S.; Roy, R.; Kim, N.K. |; Tano, K. |; Ibeanu, G.C. |; Dunn, W.C.; Natarajan, A.T.; Hartenstein, B.; Kaina, B.

    1992-11-01

    The repair of O{sup 6} -alkylguanine in DNA involves only O{sup 6} -methyltransferase (MGMT) while the repair of N-alkylpurines requires multiple proteins including N-methylpurine-DNA glycosylase (MPG). While the biochemical properties human and mouse MGMTs are very similar, the mouse MPG removes 7-methylguanine more efficiently than the human protein. An increased level of MGMT, without a change in the level of MPG associated with gene amplification, was observed in a mouse cell line resistant to 2-chloroethyl-N-nitrosourea. In contrast, no correlation was observed between MPG level and resistance to methyl methanesulfonate in Chinese hamster ovary (CHO) cells. This result suggests a protein other than MPG limits the repair rate of N-alkylpurine in CHO cells.

  15. Alkylation damage repair in mammalian genomes

    SciTech Connect

    Mitra, S.; Roy, R.; Kim, N.K. . Sealy Center for Molecular Science Oak Ridge National Lab., TN ); Tano, K. Oak Ridge National Lab., TN ); Ibeanu, G.C. Oak Ridge National Lab., TN ); Dunn, W.C. (

    1992-01-01

    The repair of O{sup 6} -alkylguanine in DNA involves only O{sup 6} -methyltransferase (MGMT) while the repair of N-alkylpurines requires multiple proteins including N-methylpurine-DNA glycosylase (MPG). While the biochemical properties human and mouse MGMTs are very similar, the mouse MPG removes 7-methylguanine more efficiently than the human protein. An increased level of MGMT, without a change in the level of MPG associated with gene amplification, was observed in a mouse cell line resistant to 2-chloroethyl-N-nitrosourea. In contrast, no correlation was observed between MPG level and resistance to methyl methanesulfonate in Chinese hamster ovary (CHO) cells. This result suggests a protein other than MPG limits the repair rate of N-alkylpurine in CHO cells.

  16. Chromatin Remodeling, DNA Damage Repair and Aging

    PubMed Central

    Liu, Baohua; Yip, Raymond KH; Zhou, Zhongjun

    2012-01-01

    Cells are constantly exposed to a variety of environmental and endogenous conditions causing DNA damage, which is detected and repaired by conserved DNA repair pathways to maintain genomic integrity. Chromatin remodeling is critical in this process, as the organization of eukaryotic DNA into compact chromatin presents a natural barrier to all DNA-related events. Studies on human premature aging syndromes together with normal aging have suggested that accumulated damages might lead to exhaustion of resources that are required for physiological functions and thus accelerate aging. In this manuscript, combining the present understandings and latest findings, we focus mainly on discussing the role of chromatin remodeling in the repair of DNA double-strand breaks (DSBs) and regulation of aging. PMID:23633913

  17. [Flexor tendon repair: a short story].

    PubMed

    Moutet, F; Corcella, D; Forli, A; Mesquida, V

    2014-12-01

    This short story of flexor tendon repair aims to illustrate hesitations and wanderings of this surgery. Obviously tendon repair was very early considered, but it developed and diffused rather lately. It became a routine practice only in 20th century. This was due on the one hand, in Occident, to the Galen's dogmatic interdiction, on the other hand, to the repair difficulties of this paradoxical structure. Actually tendon is made of fibroblasts and collagen (sticky substances), and then its only goal is to move. According to this necessity, whatever the used techniques are, gliding is the final purpose. Technical evolutions are illustrated by historical contributions to flexor tendon surgery of several "giants" of hand surgery. PMID:24837978

  18. Learning to improve iterative repair scheduling

    NASA Technical Reports Server (NTRS)

    Zweben, Monte; Davis, Eugene

    1992-01-01

    This paper presents a general learning method for dynamically selecting between repair heuristics in an iterative repair scheduling system. The system employs a version of explanation-based learning called Plausible Explanation-Based Learning (PEBL) that uses multiple examples to confirm conjectured explanations. The basic approach is to conjecture contradictions between a heuristic and statistics that measure the quality of the heuristic. When these contradictions are confirmed, a different heuristic is selected. To motivate the utility of this approach we present an empirical evaluation of the performance of a scheduling system with respect to two different repair strategies. We show that the scheduler that learns to choose between the heuristics outperforms the same scheduler with any one of two heuristics alone.

  19. A Review on Perforation Repair Materials

    PubMed Central

    Veeramachaneni, Chandrasekhar; Majeti, Chandrakanth; Tummala, Muralidhar; Khiyani, Laxmi

    2015-01-01

    Perforation is an artificial communication between the root canal system and supporting tissues of the teeth. Root perforation complicates the treatment and deprives the prognosis if not properly managed. A wide variety of materials to seal the perforations have been suggested in literature. There are many comparative studies showing the efficacy of one material over the other. Literature shows many reviews on diagnosis, treatment plan and factors affecting prognosis of perforation repair; but none of these articles elaborated upon various materials available to seal the perforation. The present article aims at describing all the materials used for perforation repair from the past till date; it also offers a literature review of all the articles published over last four decades referred to the treatment of perforation with various root repair materials. PMID:26501031

  20. Epigenetic reduction of DNA repair in progression to gastrointestinal cancer

    PubMed Central

    Bernstein, Carol; Bernstein, Harris

    2015-01-01

    Deficiencies in DNA repair due to inherited germ-line mutations in DNA repair genes cause increased risk of gastrointestinal (GI) cancer. In sporadic GI cancers, mutations in DNA repair genes are relatively rare. However, epigenetic alterations that reduce expression of DNA repair genes are frequent in sporadic GI cancers. These epigenetic reductions are also found in field defects that give rise to cancers. Reduced DNA repair likely allows excessive DNA damages to accumulate in somatic cells. Then either inaccurate translesion synthesis past the un-repaired DNA damages or error-prone DNA repair can cause mutations. Erroneous DNA repair can also cause epigenetic alterations (i.e., epimutations, transmitted through multiple replication cycles). Some of these mutations and epimutations may cause progression to cancer. Thus, deficient or absent DNA repair is likely an important underlying cause of cancer. Whole genome sequencing of GI cancers show that between thousands to hundreds of thousands of mutations occur in these cancers. Epimutations that reduce DNA repair gene expression and occur early in progression to GI cancers are a likely source of this high genomic instability. Cancer cells deficient in DNA repair are more vulnerable than normal cells to inactivation by DNA damaging agents. Thus, some of the most clinically effective chemotherapeutic agents in cancer treatment are DNA damaging agents, and their effectiveness often depends on deficient DNA repair in cancer cells. Recently, at least 18 DNA repair proteins, each active in one of six DNA repair pathways, were found to be subject to epigenetic reduction of expression in GI cancers. Different DNA repair pathways repair different types of DNA damage. Evaluation of which DNA repair pathway(s) are deficient in particular types of GI cancer and/or particular patients may prove useful in guiding choice of therapeutic agents in cancer therapy. PMID:25987950

  1. Two-ventricle repair for complex congenital heart defects palliated towards single-ventricle repair

    PubMed Central

    Kottayil, Brijesh P.; Sunil, Gopalraj S.; Kappanayil, Mahesh; Mohanty, Sweta Harish; Francis, Edwin; Vaidyanathan, Balu; Balachandran, Rakhi; Nair, Suresh G.; Kumar, Raman Krishna

    2014-01-01

    OBJECTIVES Complex congenital heart defects that present earlier in life are sometimes channelled towards single-ventricle repair, because of anatomical or logistic challenges involved in two-ventricle correction. Given the long-term functional and survival advantage, we have been consciously exploring the feasibility of a biventricular repair in these patients when they present later for Fontan completion. METHODS Since June 2009, 71 patients were referred for staged completion of the Fontan procedure. Following detailed evaluation that included three-dimensional echocardiography and magnetic resonance imaging, 10 patients (Group 1—median age 6 years) were identified and later underwent complex biventricular repair with takedown of Glenn shunt, while completion of extracardiac Fontan repair was done in 61 patients (Group 2—median age 7 years). RESULTS Two-ventricle repair was accomplished in all the 10 Group 1 patients. One patient developed complete heart block requiring permanent pacemaker insertion. Late patch dehiscence occurred in another (awaiting repair). At a median follow-up of 15 months, there was no mortality among the Group 1 patients and all except for 1 patient were symptom free. There were 2 early deaths (3.3%) in the Group 2 patients. CONCLUSIONS Two-ventricular repair, although surgically challenging, should be considered in all patients with two functional ventricles who come for Fontan completion. Comprehensive preoperative imaging and meticulous planning helps in identifying suitable candidates. PMID:24310735

  2. Nucleotide excision repair in Trypanosoma brucei: specialization of transcription-coupled repair due to multigenic transcription

    PubMed Central

    Machado, Carlos R; Vieira-da-Rocha, João P; Mendes, Isabela Cecilia; Rajão, Matheus A; Marcello, Lucio; Bitar, Mainá; Drummond, Marcela G; Grynberg, Priscila; Oliveira, Denise A A; Marques, Catarina; Van Houten, Ben; McCulloch, Richard

    2014-01-01

    Nucleotide excision repair (NER) is a highly conserved genome repair pathway acting on helix distorting DNA lesions. NER is divided into two subpathways: global genome NER (GG-NER), which is responsible for repair throughout genomes, and transcription-coupled NER (TC-NER), which acts on lesions that impede transcription. The extent of the Trypanosoma brucei genome that is transcribed is highly unusual, since most genes are organized in multigene transcription units, each transcribed from a single promoter. Given this transcription organization, we have addressed the importance of NER to T.?brucei genome maintenance by performing RNAi against all predicted contributing factors. Our results indicate that TC-NER is the main pathway of NER repair, but only CSB, XPBz and XPG contribute. Moreover, we show that UV lesions are inefficiently repaired in T.?brucei, perhaps due to preferential use of RNA polymerase translesion synthesis. RNAi of XPC and DDB was found to be lethal, and we show that these factors act in inter-strand cross-link repair. XPD and XPB appear only to act in transcription, not repair. This work indicates that the predominance of multigenic transcription in T.?brucei has resulted in pronounced adaptation of NER relative to the host and may be an attractive drug target. PMID:24661334

  3. Repairable chip bonding/interconnect process

    DOEpatents

    Bernhardt, Anthony F. (Berkeley, CA); Contolini, Robert J. (Livermore, CA); Malba, Vincent (Livermore, CA); Riddle, Robert A. (Tracy, CA)

    1997-01-01

    A repairable, chip-to-board interconnect process which addresses cost and testability issues in the multi-chip modules. This process can be carried out using a chip-on-sacrificial-substrate technique, involving laser processing. This process avoids the curing/solvent evolution problems encountered in prior approaches, as well is resolving prior plating problems and the requirements for fillets. For repairable high speed chip-to-board connection, transmission lines can be formed on the sides of the chip from chip bond pads, ending in a gull wing at the bottom of the chip for subsequent solder.

  4. Repairable chip bonding/interconnect process

    DOEpatents

    Bernhardt, A.F.; Contolini, R.J.; Malba, V.; Riddle, R.A.

    1997-08-05

    A repairable, chip-to-board interconnect process which addresses cost and testability issues in the multi-chip modules is disclosed. This process can be carried out using a chip-on-sacrificial-substrate technique, involving laser processing. This process avoids the curing/solvent evolution problems encountered in prior approaches, as well is resolving prior plating problems and the requirements for fillets. For repairable high speed chip-to-board connection, transmission lines can be formed on the sides of the chip from chip bond pads, ending in a gull wing at the bottom of the chip for subsequent solder. 10 figs.

  5. Repairing organs: lessons from intestine and liver.

    PubMed

    Gehart, Helmuth; Clevers, Hans

    2015-06-01

    The concept of organ regeneration has fascinated humanity from ancient mythology to modern science fiction. Recent advances offer the potential to soon bring such technology within the grasp of clinical medicine. Rapidly expanding insights into the intrinsic repair processes of the intestine and liver have uncovered significant plasticity in epithelial tissues. Harnessing this knowledge, researchers have recently created culture systems that enable the expansion of stem cells into transplantable tissue in vitro. Here we discuss how the growing tool set of stem cell biology can bring organ repair from fictitious narrative to medical practice. PMID:25989898

  6. The awakening of DNA repair at Yale.

    PubMed

    Hanawalt, Philip C

    2013-12-01

    As a graduate student with Professor Richard Setlow at Yale in the late 1950s, I studied the effects of ultraviolet and visible light on the syntheses of DNA, RNA, and protein in bacteria. I reflect upon my research in the Yale Biophysics Department, my subsequent postdoctoral experiences, and the eventual analyses in the laboratories of Setlow, Paul Howard-Flanders, and myself that constituted the discovery of the ubiquitous pathway of DNA excision repair in the early 1960s. I then offer a brief perspective on a few more recent developments in the burgeoning DNA repair field and their relationships to human disease. PMID:24348216

  7. Space Habitat, assembly and repair facility

    NASA Technical Reports Server (NTRS)

    Colangelo, Todd A.; Hoetger, Debora C.; Kuo, Addison C.; Lo, Michael C.; Marcus, Leland R.; Tran, Phillip P.; Tutt, Chris J.; Wassmuth, Chad M.; Wildgrube, Gregory M.

    1992-01-01

    Integrated Space Systems (ISS) has designed a Low Earth Orbit Assembly Facility for submission in the 1992 AIAA/LORAL Team Space Design Competition. This facility, the Space Habitat, Assembly, and Repair Center (SHARC), will be used to construct, assemble, and service space vehicles. SHARC's primary mission will be the construction of interplanetary vehicles, but it will also be able to perform repair and refueling operations of craft which are in an Earth orbit. This facility has been designed using only present and near-present technology. The emphasis is on minimizing cost.

  8. Tank Remote Repair System Conceptual Design

    SciTech Connect

    Kriikku, E.

    2002-12-06

    This document describes two conceptual designs for a Tank Remote Repair System to perform leak site repairs of double shell waste tank walls (Types I, II, III, and IIIA) from the annulus space. The first concept uses a magnetic wall crawler and an epoxy patch system and the second concept uses a magnetic wall crawler and a magnetic patch system. The recommended concept uses the magnetic patch system, since it is simpler to deliver, easier to apply, and has a higher probability of stopping an active leak.

  9. Surgical repair of renal artery aneurysms

    PubMed Central

    Titze, Nicole; Ivanukoff, Victoria; Fisher, Tammy; Pearl, Gregory; Grimsley, Brad

    2015-01-01

    The pathogenesis of renal artery aneurysms (RAAs) is degenerative, which eventually leads to weakening of the vessel wall and, in extreme cases, rupture. RAAs are a rare occurrence. Patients generally are asymptomatic, with a small number presenting with uncontrollable hypertension or hematuria. Most RAAs are discovered incidentally on imaging and do not pose an immediate health threat. However, the risk of rupture is an indication for prophylactic repair in certain patients. Interest in interventional radiologic procedures in the management of RAAs has recently increased; however, open repair should still be considered in select instances. In this case series, we present three patients for whom an open approach was indicated and performed. PMID:26424954

  10. Lightweight Material Patches Allow for Quick Repairs

    NASA Technical Reports Server (NTRS)

    2010-01-01

    Cornerstone Research Group Inc., of Dayton, Ohio, has been the recipient of 16 Small Business Innovation Research (SBIR) contracts with NASA with a variety of different focuses, including projects like creating inflatable structures for radio frequency antennas and, most recently, healable polymer matrix composites for future space vehicles. One of its earlier SBIR contracts, with Kennedy Space Center, led to the development of a new type of structural patch for a variety of consumer uses: Rubbn Repair, for automotive uses; and Rec Repair for the outdoors and adventure market. Both are flexible, heat-activated structural patches.

  11. Laser repairing of parts in metallurgical industries

    NASA Astrophysics Data System (ADS)

    Yang, Xichen; Wang, Yunshan; Zhao, Xin

    1999-09-01

    A new repair system for hardfacing of parts in metallurgical industries has been developed. The system can produce single pass quenching or cladding width of 10 - 35 mm, thickness of 0.5 - 10 mm. The wide range of powder materials can be deposited to provide hardfacing layers against wear, corrosion and oxidation. Comparing with welding and flame spraying, it presents clear advantages with low distortion, low dilution, low cost and small postclad machining. It has been successfully used to repair some of parts, for example, roll, drawing wire wheel in high speed wire, and so on.

  12. The Awakening of DNA Repair at Yale

    PubMed Central

    Hanawalt, Philip C.

    2013-01-01

    As a graduate student with Professor Richard Setlow at Yale in the late 1950s, I studied the effects of ultraviolet and visible light on the syntheses of DNA, RNA, and protein in bacteria. I reflect upon my research in the Yale Biophysics Department, my subsequent postdoctoral experiences, and the eventual analyses in the laboratories of Setlow, Paul Howard-Flanders, and myself that constituted the discovery of the ubiquitous pathway of DNA excision repair in the early 1960s. I then offer a brief perspective on a few more recent developments in the burgeoning DNA repair field and their relationships to human disease. PMID:24348216

  13. GUIDES TO POLLUTION PREVENTION: THE MECHANICAL EQUIPMENT REPAIR INDUSTRY

    EPA Science Inventory

    Commercial mechanical equipment repair services are covered under SIC 76 and include activities such as repair of boilers, commercial appliances, lawn mowers, refrigerator and air conditioners, electric motors, generators and transformers, among others. This quide describes the ...

  14. 21 CFR 872.3570 - OTC denture repair kit.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES DENTAL DEVICES Prosthetic Devices § 872.3570 OTC denture repair kit. (a) Identification. An OTC denture repair kit is a device...

  15. 75 FR 11734 - Damage Tolerance Data for Repairs and Alterations

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-12

    ...make available to operators DT data for all future repairs they...therefore, will have the DT data for TC holder repairs necessary...or obtaining the necessary DT data to comply with the certification bases for these airplanes; it...

  16. 30 CFR 57.19109 - Shaft inspection and repair.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ...Resources 1 2011-07-01 2011-07-01 false Shaft inspection and repair. 57.19109 Section 57...STANDARDS-UNDERGROUND METAL AND NONMETAL MINES Personnel Hoisting Shafts § 57.19109 Shaft inspection and repair. Shaft inspection and...

  17. 30 CFR 56.19109 - Shaft inspection and repair.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...Resources 1 2010-07-01 2010-07-01 false Shaft inspection and repair. 56.19109 Section 56...STANDARDS-SURFACE METAL AND NONMETAL MINES Personnel Hoisting Shafts § 56.19109 Shaft inspection and repair. Shaft inspection and...

  18. 30 CFR 56.19109 - Shaft inspection and repair.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ...Resources 1 2011-07-01 2011-07-01 false Shaft inspection and repair. 56.19109 Section 56...STANDARDS-SURFACE METAL AND NONMETAL MINES Personnel Hoisting Shafts § 56.19109 Shaft inspection and repair. Shaft inspection and...

  19. 30 CFR 57.19109 - Shaft inspection and repair.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...Resources 1 2010-07-01 2010-07-01 false Shaft inspection and repair. 57.19109 Section 57...STANDARDS-UNDERGROUND METAL AND NONMETAL MINES Personnel Hoisting Shafts § 57.19109 Shaft inspection and repair. Shaft inspection and...

  20. A Generic Mechanism for Repairing Job Shop Schedules

    E-print Network

    Raheja, Amritpal Singh

    Reactive repair of a disrupted schedule is a better alternative to total rescheduling, as the latter is a time consuming process and also results in shop floor nervousness. The schedule repair heuristics reported in the ...

  1. Promotion of plasma membrane repair by vitamin E

    PubMed Central

    Howard, Amber C.; McNeil, Anna K.; McNeil, Paul L.

    2011-01-01

    Severe vitamin E deficiency results in lethal myopathy in animal models. Membrane repair is an important myocyte response to plasma membrane disruption injury as when repair fails, myocytes die and muscular dystrophy ensues. Here we show that supplementation of cultured cells with ?-tocopherol, the most common form of vitamin E, promotes plasma membrane repair. Conversely, in the absence of ?-tocopherol supplementation, exposure of cultured cells to an oxidant challenge strikingly inhibits repair. Comparative measurements reveal that, to promote repair, an anti-oxidant must associate with membranes, as ?-tocopherol does, or be capable of ?-tocopherol regeneration. Finally, we show that myocytes in intact muscle cannot repair membranes when exposed to an oxidant challenge, but show enhanced repair when supplemented with vitamin E. Our work suggests a novel biological function for vitamin E in promoting myocyte plasma membrane repair. We propose that this function is essential for maintenance of skeletal muscle homeostasis. PMID:22186893

  2. View of automotive repair and gas station, facing southwest from ...

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

    View of automotive repair and gas station, facing southwest from across Pope Street. Garage built for storage of employee automobiles in left background - Automotive Repair & Gas Station, Southwest corner of Pope Street & Olympic Avenue, Port Gamble, Kitsap County, WA

  3. Hierarchies of DNA repair in mammalian cells: biological consequences.

    PubMed

    Mullenders, L H; Vrieling, H; Venema, J; van Zeeland, A A

    1991-01-01

    Mammalian cells exposed to genotoxic agents exhibit heterogeneous levels of repair of certain types of DNA damage in various genomic regions. For UV-induced cyclobutane pyrimidine dimers we propose that at least three levels of repair exist: (1) slow repair of inactive (X-chromosomal) genes, (2) fast repair of active housekeeping genes, and (3) accelerated repair of the transcribed strand of active genes. These hierarchies of repair may be related to chromosomal banding patterns as obtained by Giemsa staining. The possible consequences of defective DNA repair in one or more of these levels may be manifested in different clinical features associated with UV-sensitive human syndromes. Moreover, molecular analysis of hprt mutations reveals that mutations are primarily generated by DNA damage in the poorly repaired non-transcribed strand of the gene. PMID:1944339

  4. 30 CFR 57.13019 - Pressure system repairs.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...NONMETAL MINES Compressed Air and Boilers § 57.13019 Pressure system repairs. Repairs involving the pressure system of compressors...receivers, or compressed-air-powered equipment...attempted until the pressure has been bled...

  5. 30 CFR 57.13019 - Pressure system repairs.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ...NONMETAL MINES Compressed Air and Boilers § 57.13019 Pressure system repairs. Repairs involving the pressure system of compressors...receivers, or compressed-air-powered equipment...attempted until the pressure has been bled...

  6. 30 CFR 56.13019 - Pressure system repairs.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...NONMETAL MINES Compressed Air and Boilers § 56.13019 Pressure system repairs. Repairs involving the pressure system of compressors...receivers, or compressed-air-powered equipment...attempted until the pressure has been bled...

  7. 30 CFR 56.13019 - Pressure system repairs.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ...NONMETAL MINES Compressed Air and Boilers § 56.13019 Pressure system repairs. Repairs involving the pressure system of compressors...receivers, or compressed-air-powered equipment...attempted until the pressure has been bled...

  8. 30 CFR 57.13019 - Pressure system repairs.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ...NONMETAL MINES Compressed Air and Boilers § 57.13019 Pressure system repairs. Repairs involving the pressure system of compressors...receivers, or compressed-air-powered equipment...attempted until the pressure has been bled...

  9. 30 CFR 56.13019 - Pressure system repairs.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ...NONMETAL MINES Compressed Air and Boilers § 56.13019 Pressure system repairs. Repairs involving the pressure system of compressors...receivers, or compressed-air-powered equipment...attempted until the pressure has been bled...

  10. 30 CFR 56.13019 - Pressure system repairs.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ...NONMETAL MINES Compressed Air and Boilers § 56.13019 Pressure system repairs. Repairs involving the pressure system of compressors...receivers, or compressed-air-powered equipment...attempted until the pressure has been bled...

  11. 30 CFR 57.13019 - Pressure system repairs.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ...NONMETAL MINES Compressed Air and Boilers § 57.13019 Pressure system repairs. Repairs involving the pressure system of compressors...receivers, or compressed-air-powered equipment...attempted until the pressure has been bled...

  12. 30 CFR 56.13019 - Pressure system repairs.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ...NONMETAL MINES Compressed Air and Boilers § 56.13019 Pressure system repairs. Repairs involving the pressure system of compressors...receivers, or compressed-air-powered equipment...attempted until the pressure has been bled...

  13. 30 CFR 57.13019 - Pressure system repairs.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ...NONMETAL MINES Compressed Air and Boilers § 57.13019 Pressure system repairs. Repairs involving the pressure system of compressors...receivers, or compressed-air-powered equipment...attempted until the pressure has been bled...

  14. 48 CFR 1371.118 - Changes-ship repair.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ...2013-10-01 2013-10-01 false Changes-ship repair. 1371.118 Section 1371.118 Federal...DEPARTMENT SUPPLEMENTAL REGULATIONS ACQUISITIONS INVOLVING SHIP CONSTRUCTION AND SHIP REPAIR Provisions and Clauses 1371.118...

  15. 48 CFR 1371.118 - Changes-ship repair.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ...2012-10-01 2012-10-01 false Changes-ship repair. 1371.118 Section 1371.118 Federal...DEPARTMENT SUPPLEMENTAL REGULATIONS ACQUISITIONS INVOLVING SHIP CONSTRUCTION AND SHIP REPAIR Provisions and Clauses 1371.118...

  16. 48 CFR 1371.118 - Changes-ship repair.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ...2010-10-01 2010-10-01 false Changes-ship repair. 1371.118 Section 1371.118 Federal...DEPARTMENT SUPPLEMENTAL REGULATIONS ACQUISITIONS INVOLVING SHIP CONSTRUCTION AND SHIP REPAIR Provisions and Clauses 1371.118...

  17. 48 CFR 1371.118 - Changes-ship repair.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ...2014-10-01 2014-10-01 false Changes-ship repair. 1371.118 Section 1371.118 Federal...DEPARTMENT SUPPLEMENTAL REGULATIONS ACQUISITIONS INVOLVING SHIP CONSTRUCTION AND SHIP REPAIR Provisions and Clauses 1371.118...

  18. 48 CFR 1371.118 - Changes-ship repair.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ...2011-10-01 2011-10-01 false Changes-ship repair. 1371.118 Section 1371.118 Federal...DEPARTMENT SUPPLEMENTAL REGULATIONS ACQUISITIONS INVOLVING SHIP CONSTRUCTION AND SHIP REPAIR Provisions and Clauses 1371.118...

  19. 14 CFR 145.207 - Repair station manual.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    14 Aeronautics and Space 3 2013-01-01 2013-01-01 false Repair station manual. 145.207 ...207 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION...CERTIFICATED AGENCIES REPAIR STATIONS Operating Rules §...

  20. 14 CFR 145.209 - Repair station manual contents.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    14 Aeronautics and Space 3 2010-01-01 2010-01-01 false Repair station manual contents. 145...209 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION...CERTIFICATED AGENCIES REPAIR STATIONS Operating Rules §...