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Sample records for femoroacetabular impingement arthroscopic

  1. ARTHROSCOPIC TREATMENT OF FEMOROACETABULAR IMPINGEMENT

    PubMed Central

    Polesello, Giancarlo C.; Queiroz, Marcelo C.; Ono, Nelson K.; Honda, Emerson K.; Guimarāes, Rodrigo P; Junior, Walter Ricioli

    2015-01-01

    Objective: The purpose of this study is to evaluate the short-term follow-up results of arthroscopic treatment of femoroacetabular impingement. Our hypothesis is that arthroscopic treatment results are favorable. Methods: Between August 2003 and August 2007, 28 hips had femoroacetabular impingement treated by hip arthroscopy. The mean age was 34 years, with mean follow-up period of 27 months. Clinical results were graded with the modified Harris hip score, which was measured pre- and postoperatively. Patients had also their internal rotation analyzed. These parameters were calculated by using Wilcoxon's t test for analysis of nonparametric paired samples performed. Results: The mean preoperative Harris Hip Score was 54.2, improving to 94.8 postoperatively (p<0,001). The mean increase was 37.5 points. We had 4 good results (15%) and 24 excellent results (85%). Preoperatively, the patients had a mean internal rotation of 17°, and, postoperatively, 36°. The average internal rotation increase was 19° (p<0,001). Conclusions: The arthroscopic treatment of femoroacetabular impingement presents satisfactory results. PMID:27004177

  2. 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

  3. 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

  4. Femoroacetabular impingement.

    PubMed

    Volpon, José Batista

    2016-01-01

    The femoroacetabular impingement (FAI) is as condition recently characterized that results from the abnormal anatomic and functional relation between the proximal femur and the acetabular border, associated with repetitive movements, which lead labrum and acetabular cartilage injuries. Such alterations result from anatomical variations such as acetabular retroversion or decrease of the femoroacetabular offset. In addition, FAI may result from acquired conditions as malunited femoral neck fractures, or retroverted acetabulum after pelvic osteotomies. These anomalies lead to pathological femoroacetabular contact, which in turn create impact and shear forces during hip movements. As a result, there is early labrum injury and acetabulum cartilage degeneration. The diagnosis is based on the typical clinical findings and images. Treatment is based on the correction of the anatomic anomalies, labrum debridement or repair, and degenerate articular cartilage removal. However, the natural evolution of the condition, as well as the outcome from long-term treatment, demand a better understanding, mainly in the asymptomatic individuals.

  5. 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.

  6. Creating and Closing the T-Capsulotomy for Improved Visualization During Arthroscopic Treatment of Femoroacetabular Impingement

    PubMed Central

    Camp, Christopher L.; Reardon, Patrick J.; Levy, Bruce A.; Krych, Aaron J.

    2015-01-01

    Treatment of femoroacetabular impingement through an arthroscopic approach has gained widespread popularity in recent years. Although outcomes are generally favorable, one of the most common reasons for failure is incomplete resection of cam lesions of the femoral neck. As a result, the T-capsulotomy has been introduced as a method for improving access to the femoral head-neck junction, which is not always visible through a standard interportal capsulotomy. The T-capsulotomy has the benefits of improving arthroscopic visualization of the femoral neck, reducing overall fluoroscopy exposure for the patient and surgeon, and facilitating capsular plication. We present a reliable and efficient method for creating and repairing the T-capsulotomy. We routinely perform this technique in patients with cam lesions that are too large or too distal to safely visualize and decompress through an interportal capsulotomy. PMID:26870654

  7. Hip impingement: beyond femoroacetabular

    PubMed Central

    Bardakos, Nikolaos V.

    2015-01-01

    In the last 20 years, femoroacetabular impingement has been at the forefront of clinical practice as a cause of hip pain in young adults. As arthroscopic techniques for the hip continue to evolve, the possible presence of a new group of conditions creating mechanical conflict in and around the hip joint (ischiofemoral, subspine and iliopsoas impingement) has recently been elucidated whilst interest in already known ‘impingement’ syndromes (pelvic-trochanteric and pectineofoveal impingement) is now revived. This article attempts to increase awareness of these relatively uncommon clinical entities by describing their pathomorphology, contact mechanics, treatment and published results available to present. It is hoped that such knowledge will diversify therapeutic options for the clinician, thereby improving outcomes in a small but not negligible portion of patients with previously unexplained persistent symptoms. PMID:27011843

  8. Femoroacetabular Impingement

    DTIC Science & Technology

    2008-04-01

    or pincer type impingement. On conventional radiographs, prominence of the anterolateral femoral head-neck junction, a “pistol grip deformity,” and...morphologic abnormalities of the hip. There are two types of FAI, termed cam impingement and pincer impingement, which have distinct imaging...to several different morphologic abnormalities of the hip. There are two types of FAI, termed cam impingement and pincer impingement. Though each

  9. Improved Squat and Gait Biomechanics 6-Months Post-Arthroscopic Surgery for Femoroacetabular Impingement

    PubMed Central

    Cvetanovich, Gregory; Farkas, Gary Jordan; Rajan, Kumar; Espinoza, Alejandro; Nho, Shane Jay

    2016-01-01

    Objectives: This study aimed to assess gait and squat biomechanics 6-months following arthroscopic surgery for femoroacetabular impingement. Methods: Symptomatic patients with clinical and radiographic diagnosis of FAI who had failed non-operative treatment underwent gait and squat analysis preoperatively and at 6-months postoperatively following arthroscopic surgery for FAI. Age- and BMI-matched controls without radiographic FAI or other lumbar or lower extremity pathology underwent a single analysis for comparison. Comparisons between preoperative and 6-month postoperative gait and squat parameters as well as comparison to the control group were performed using paired and independent sample t-tests. Statistical significance was set at p<0.05. Results: Fifteen FAI patients and 9 controls were analyzed. Age for the patients vs. controls was 28.7±9.6 y vs. 27.8±6.5 y (p>0.05), respectively; while BMI was 23.5±5.1 kg/m2 vs. 22.8±3.5 kg/m2 (p>0.05). All gait parameters were unchanged between preoperative and 6-month postoperative testing (p>0.05), with a trend toward significance for hip external rotation moment (p=0.056) (Table 1). Squat testing revealed that FAI arthroscopic surgery increased maximum hip extension (p=0.011), with a trend toward significance for hip adduction moment (p=0.059). All other squat parameters did not differ from preoperative to 6-month follow-up (p>0.05). Compared to the control group, preoperative FAI patients had reduced hip external rotation moment during gait (p=0.024), with a trend toward significance for hip abduction moment (p=0.082). No other gait or squat differences were detected between FAI patients preoperatively or 6-months postoperatively compared to controls (p>0.05). Conclusion: Biomechanical gait and squat analysis at 6-month follow-up from arthroscopic FAI surgery revealed a tendency to improve external hip rotation during gait and maximum hip extension and hip adduction during squat. Arthroscopic surgery for FAI may

  10. Arthroscopic treatment of femoroacetabular impingement in patients older than 60 years

    PubMed Central

    Mardones, Rodrigo; Via, Alessio Giai; Rivera, Alvaro; Tomic, Alexander; Somarriva, Marcelo; Wainer, Mauricio; Camacho, Daniel

    2016-01-01

    Summary Background The indications of hip arthroscopy increased over the past decade. Although mostly recommended for treatment of femoroacetabular impingement (FAI) in young patients, well-selected older patients (> 60 years old) may benefit from this surgery. However, the role of hip arthroscopy for the management of older patients is controversial. The aim of the study is to evaluate the clinical outcomes of a series of patients aged 60 years and older who underwent hip arthroscopy for FAI at mid-term follow-up. Materials and methods Sixty-year-old patients and older, with a joint space greater than 2 mm, and a grade I and II hip osteoarthrosis (OA) according Tönnis scale were included into the study. Twenty-three patients (28 hips) met the inclusion criteria. The T-Student test was used to detect for differences between variables (p<0.05). Results The mean age of the patients was 63.4 years, and the mean follow-up was 4.4 years (2–9 years). We found an improvement in mHHS and VAS score from the baseline to the final follow-up in 87% of patients (p<0.05). Three patients (13%) were submitted to a THA at a mean of 12 months, while the survivorship rate at the final follow-up was 75%. No major complications have been reported. Conclusion Arthroscopic treatment of FAI in patients over 60 years old, with no signs of advanced osteoarthrosis, showed a significant improvement of functional score and pain in most of cases, and it can be consider a reasonable option in well selected patients. Level of evidence: IV case series. PMID:28066746

  11. New perspectives on femoroacetabular impingement syndrome.

    PubMed

    Khan, Moin; Bedi, Asheesh; Fu, Freddie; Karlsson, Jon; Ayeni, Olufemi R; Bhandari, Mohit

    2016-05-01

    Femoroacetabular impingement (FAI) is characterized by an abnormality in the shape of the femoral head-neck or acetabulum that results in impingement between these two structures. Arthroscopic treatment has become the preferred method of management of FAI owing to its minimally invasive approach. Surgical correction involves resection of impinging osseous structures as well as concurrent management of the associated chondral and labral pathology. Research from the past 5 years has shown that repair of the labrum results in a better anatomic correction and improved outcomes compared with labral debridement. Research is underway to improve cartilage assessment by using innovative imaging techniques and biochemical tests to inform predictions of prognosis. Several ongoing randomized controlled trials, including the Femoroacetabular Impingement Trial (FAIT) and the Femoroacetabular Impingement Randomized Controlled Trial (FIRST), will provide critical information regarding the diagnosis, management and prognosis of patients undergoing arthroscopic management of FAI.

  12. Arthroscopic treatment of pincer-type femoroacetabular impingement performing acetabuloplasty without labral detachment

    PubMed Central

    Comba, Fernando; Slullitel, Pablo; Bronenberg, Pedro; Buttaro, Martin; Zanotti, Gerardo; Piccaluga, Francisco

    2017-01-01

    Objectives: In order to access and resect the acetabular rim, arthroscopic acetabuloplasty was described with labral detachment. However, when the chondrolabral junction remains intact, acetabuloplasty and labral refixation can be performed maintaining an unharmed labrum. We aimed to evaluate the outcome of a group of patients treated with arthroscopic acetabuloplasty without labral detachment. Methods: During the study period, we retrospectively analyzed 44 patients with pincer-type o combined impingement and an intact chondroblabral junction, with an average followup of 32 months (range: 27-38). We excluded patients with CAM-type impingement and previous hip pathology. Radiographs were analyzed to define impingement and classify grade of osteoarthritis. Clinical evaluation consisted of preoperative and postoperative modified Harris Hip Score (mHHS) and WOMAC as well as postoperative Visual Analogue Scale (VAS) of pain and satisfaction. Reoperations were considered surgical failures for purposes of survival analysis.. Results: Mean preoperative anterior and lateral center-edge angles were 35º and 29º, respectively. Mean preoperative alfa angle was 52º. Crossover sign was found in 82% of cases. mHHS changed from 51.06 (SD 4.81) preoperatively to 84.97 (SD 12.79) postoperatively. Preoperative WOMAC was 29.18 (SD 8) and postoperative, 13.10 (SD 11). Postoperative VAS was 7.5 and 2.27 for satisfaction and pain, respectively. When comparing patients with Tönnis 0 to those with Tönnis 1, the former showed better results regarding postoperative mHHS (89.9s vs 77.85, p=0.03), pain VAS (1.5 vs 6.3, p=0.03) and satisfaction VAS (8.2 vs 6.3, p=0.01). Postoperative WOMAC was slightly better for Tönnis 0 patients (8.31 vs 19.3, p=0.05). No differences were found in preoperative WOMAC and mHHS. Three of 44 patients required a second surgical procedure and were considered failures. Survival was 100% at 24 months and 76% at 40 months (95%CI: 35%-98%). Conclusion

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

    PubMed Central

    2014-01-01

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

  14. The Horsens-Aarhus Femoro Acetabular Impingement (HAFAI) cohort: outcome of arthroscopic treatment for femoroacetabular impingement. Protocol for a prospective cohort study

    PubMed Central

    Kierkegaard, Signe; Lund, Bent; Dalgas, Ulrik; Sørensen, Henrik; Søballe, Kjeld; Mechlenburg, Inger

    2015-01-01

    Introduction During the past decade, it has become increasingly more common to offer hip arthroscopic surgery when treating people with femoroacetabular impingement (FAI). Nevertheless, the latest reviews conclude that it still remains to be properly investigated how surgery affects the patients. Specifically, detailed information on the functional, muscular and mechanical impact of surgery in larger groups is lacking. Furthermore, the long-term outcome of the surgery is still to be investigated. Methods and analysis In this prospective cohort study, a total of 60 patients with FAI scheduled for arthroscopic surgery will be followed and tested preoperatively, and again after 3, 6, 9 and 12 months. Assessment includes isokinetic dynamometry evaluating hip flexion and extension; evaluation of functional capacity in a three-dimensional motion laboratory; pain assessment; self-reported function, quality of life, expectation and satisfaction with the surgery; recording of previous and present sporting activities and accelerometry. In addition, data on surgical procedure, rehabilitation progress, adverse events and failure will be recorded. Patients will be compared with an age-matched and gender-matched reference group of 30 persons with no hip, knee, ankle or back problems. Long-term follow-up of this cohort may evaluate possible reoperations and development of hip osteoarthritis. Furthermore, analysis on how subgroups respond to the treatment could be performed together with identification of possible “non-responders”. Ethics and dissemination The study is approved by the Central Denmark Region Committee on Biomedical Research Ethics (Journal No 1-10-72-239-14). The results from this study will be presented at national and international congresses and published in peer-reviewed journals. Trial registration number NCT02306525. PMID:26346877

  15. Protocol for a multicentre, parallel-arm, 12-month, randomised, controlled trial of arthroscopic surgery versus conservative care for femoroacetabular impingement syndrome (FASHIoN)

    PubMed Central

    Griffin, D R; Dickenson, E J; Wall, P D H; Donovan, J L; Foster, N E; Hutchinson, C E; Parsons, N; Petrou, S; Realpe, A; Achten, J; Achana, F; Adams, A; Costa, M L; Griffin, J; Hobson, R; Smith, J

    2016-01-01

    Introduction Femoroacetabular impingement (FAI) syndrome is a recognised cause of young adult hip pain. There has been a large increase in the number of patients undergoing arthroscopic surgery for FAI; however, a recent Cochrane review highlighted that there are no randomised controlled trials (RCTs) evaluating treatment effectiveness. We aim to compare the clinical and cost-effectiveness of arthroscopic surgery versus best conservative care for patients with FAI syndrome. Methods We will conduct a multicentre, pragmatic, assessor-blinded, two parallel arm, RCT comparing arthroscopic surgery to physiotherapy-led best conservative care. 24 hospitals treating NHS patients will recruit 344 patients over a 26-month recruitment period. Symptomatic adults with radiographic signs of FAI morphology who are considered suitable for arthroscopic surgery by their surgeon will be eligible. Patients will be excluded if they have radiographic evidence of osteoarthritis, previous significant hip pathology or previous shape changing surgery. Participants will be allocated in a ratio of 1:1 to receive arthroscopic surgery or conservative care. Recruitment will be monitored and supported by qualitative intervention to optimise informed consent and recruitment. The primary outcome will be pain and function assessed by the international hip outcome tool 33 (iHOT-33) measured 1-year following randomisation. Secondary outcomes include general health (short form 12), quality of life (EQ5D-5L) and patient satisfaction. The primary analysis will compare change in pain and function (iHOT-33) at 12 months between the treatment groups, on an intention-to-treat basis, presented as the mean difference between the trial groups with 95% CIs. The study is funded by the Health Technology Assessment Programme (13/103/02). Ethics and dissemination Ethical approval is granted by the Edgbaston Research Ethics committee (14/WM/0124). The results will be disseminated through open access peer

  16. Femoroacetabular Impingement (FAI)

    MedlinePlus

    ... FAI. Because athletically active people may work the hip joint more vigorously, they may begin to experience pain ... the impingement can prevent future damage to the hip joint. However, not all of the damage can be ...

  17. Treatment of pincer-type femoroacetabular impingement

    PubMed Central

    SABETTA, ETTORE; SCARAVELLA, EDOARDO

    2015-01-01

    Pincer femoroacetabular impingement (FAI) consists of pathological contact between the acetabular labrum and rim and the femoral head-neck junction. Manifold conditions underlie pincer FAI: anatomical abnormalities, malorientation of the acetabulum, torsional abnormalities of the neck and femoral shaft (these defects can be constitutional, post-traumatic or post-surgical), and involvement in sports characterized by repeated and sudden maximum joint excursions. In a high percentage of cases, pincer FAI is associated with cam FAI. The aims of surgical treatment of pincer FAI are to eliminate the cause of the contact and repair the joint damage; the surgery may be open or arthroscopic, performed with an articular or extra-articular approach. Recently, arthroscopic treatment of FAI had a rapid and widespread diffusion due to the advantages it offers compared with the open technique. Arthroscopic treatment can repair the joint damage and in some cases, characterized by minor deformity, compensate for extra-articular defects. The acetabular labrum must always be preserved and sutured; only in extreme cases can it be sacrificed. Post-operative mobilization must respect the healing time of the labral repair. PMID:26605255

  18. [Femoroacetabular impingement: frequently missed in patients with chronic groin pain].

    PubMed

    Röling, Maarten A; Pilot, Peter; Krekel, Peter R; Bloem, Rolf M

    2012-01-01

    Femoroacetabular impingement is a diagnosis that is often missed in patients with chronic groin pain. The condition often appears in young athletes. An anatomic deformity of the femoral head and the acetabular ridge causes an impingement that damages the subchondral tissue. This damage can result in sharp pain in the groin during specific hip movements and the acetabular labrum may also be ruptured. Diagnosing femoroacetabular impingement and a labral tear can be a challenge. We present the case of a 19-year-old male who twisted his right hip joint during a game of football. Physiotherapy only aggravated the pain. Further diagnostics showed femoroacetabular impingement and a labral tear. Arthroscopic intervention in the hip joint by an orthopedic surgeon lead to immediate pain relief, and two years after surgery the patient is still free of pain and has returned playing sport at his previous level. Femoroacetabular impingement can be a cause of chronic groin pain in young athletes. Hip arthroscopy is a safe and effective treatment, enabling the patient to return to playing sport at their previous level.

  19. Treatment of cam-type femoroacetabular impingement

    PubMed Central

    FIORENTINO, GENNARO; FONTANAROSA, ALBERTO; CEPPARULO, RICCARDO; GUARDOLI, ALBERTO; BERNI, LUCA; COVIELLO, GIANLUCA; GUARDOLI, ALDO

    2015-01-01

    Purpose the aim of this study was to evaluate preliminary clinical and radiographic results of arthroscopic treatment of cam-type femoroacetabular impingement (FAI). Methods thirty-eight patients underwent hip arthroscopy for cam-type FAI between 2009 and 2012. Preoperative assessment was based on clinical examination, modified Harris Hip Score (mHHS) and radiographic examination with anteroposterior pelvis, frog-leg and Lequesne views. The patients’ clinical conditions at follow-up were assessed using the mHHS administered as a telephone survey. Radiographic outcome measurements evaluated pre and postoperatively were the alpha angle and femoral head-neck offset. Results the patients were clinically evaluated at a mean follow-up of 36 months. Radiographic follow-up was performed at an average of 12.7 months. Thirty of the 38 patients (79%) were satisfied with the results of the arthroscopic procedure. A total of nine patients subsequently underwent a total hip replacement. All 30 patients who declared themselves satisfied recorded an mHHS increase; in particular, the mHHS increased from a mean of 52.9 preoperatively (range: 27.5–82.5) to a mean of 85.6 postoperatively (range: 45.1–100.1). Three significant differences between the two groups of patients (satisfied and not satisfied) were recorded: mean age, alpha angle and BMI were all significantly greater in the patients who were not satisfied with the treatment. Conclusions a crucial aspect in order to obtain good clinical outcomes of arthroscopic treatment of cam-type impingement is correct selection of patients who are likely to benefit from this kind of surgery. Hip arthroscopy should be avoided in patients aged over 50 years with risk factors for early osteoarthritis (high BMI and a significantly increased alpha angle). Level of evidence Level IV, therapeutic case series. PMID:26605253

  20. Arthroscopic release of iliopsoas tendon in patients with femoro-acetabular impingement: clinical results at mid-term follow-up

    PubMed Central

    Mardones, Rodrigo; Via, Alessio Giai; Tomic, Alexander; Rodriguez, Claudio; Salineros, Matias; Somarriva, Marcelo

    2016-01-01

    Summary Background The iliopsoas tendon is a recognized cause of extra-articular hip pain, and tenotomy has been described as an effective treatment in patients who do not respond to conservative treatments. Endoscopic release showed higher success rate, lower recurrence, fewer complications compared to open surgery. The aim of the study is to report the results at a mean of 4 years follow-up of a series of patients affected by femoroacetabular impingement (FAI) and an associated iliopsoas tendinopathy, treated with hip arthroscopy and transcapsular tendon release. Methods Fifteen patients were retrospectively reviewed. Assessment of radiographic signs of FAI was performed, the alpha angle, the femoral head-neck offset and the lateral center edge angle (LCEA) were collected. Osteoarthritis was assessed from the AP pelvic and graded according to the Tönnis classification. Modified Harris Hip Score (mHHS), VAIL score and VAS score were administered to all patients before surgery, at follow-up at 1 year (T1) and final follow-up (T2). Results We found a statistical significant improvement in functional scores (mHHS and VAIL score) from the baseline to T2. According to VAS score, a statistical significant improvement was also found from T0 to T2, from a median of 5.5 (range 3–7) to 0 (range 0–5) (P<0.001). Two patients referred a recurrence of pain one year after surgery who were treated conservatively. No other complications have been reported. Conclusion Iliopsoas tendinopathy can be associated to FAI in some patients, and failure in diagnosing and treating may be the reason of poor results and a revision surgery. Arthroscopic iliopsoas tendon release seems to produce good clinical outcome, reducing pain and the rate of a revision surgeries. Level of evidence: IV case series. PMID:28066744

  1. Hip arthroscopy for challenging deformities: global pincer femoroacetabular impingement.

    PubMed

    Matsuda, Dean K; Gupta, Nikhil; Hanami, Dylan

    2014-04-01

    Pincer femoroacetabular impingement occurs in focal or global forms, the latter having more generalized and typically more extreme acetabular overcoverage. Severe global deformities are often treated with open surgical dislocation of the hip. Arthroscopic technical challenges relate to difficulties with hip distraction; central-compartment access; and instrument navigation, acetabuloplasty, and chondrolabral surgery of the posterior acetabulum. Techniques addressing these challenges are introduced permitting dual-portal hip arthroscopy with central-compartment access, subtotal acetabuloplasty, and circumferential chondrolabral surgery. The modified midanterior portal in combination with a zone-specific sequence of acetabular rim reduction monitored with fluoroscopic templating enables precision subtotal acetabuloplasty. Guidelines for acetabular rim reduction include the following suggested radiographic endpoints: postoperative center-edge angle of 35°, a neutral posterior wall sign, and an anterior margin ratio of 0.5. Arthroscopic zone-specific chondrophobic rim preparation and circumferential labral reparative and reconstructive techniques and tools permit the arthroscopic treatment of these challenging deformities.

  2. Femoroacetabular impingement and osteoarthritis of the hip

    PubMed Central

    Zhang, Charlie; Li, Linda; Forster, Bruce B.; Kopec, Jacek A.; Ratzlaff, Charles; Halai, Lalji; Cibere, Jolanda; Esdaile, John M.

    2015-01-01

    Objective To outline the clinical presentation, physical examination findings, diagnostic criteria, and management options of femoroacetabular impingement (FAI). Sources of information PubMed was searched for relevant articles regarding the pathogenesis, diagnosis, treatment, and prognosis of FAI. Main message In recent years, FAI has been increasingly recognized as a potential precursor and an important contributor to hip pain in the adult population and idiopathic hip osteoarthritis later in life. Femoroacetabular impingement is a collection of bony morphologic abnormalities of the hip joint that result in abnormal contact during motion. Cam-type FAI relates to a non-spherical osseous prominence of the proximal femoral neck or head-neck junction. Pincer-type FAI relates to excessive acetabular coverage over the femoral head, which can occur owing to several morphologic variants. Patients with FAI present with chronic, deep, or aching anterior groin pain most commonly in the sitting position, or during or after activity. Patients might also experience occasional sharp pains during activity. A thorough history should be taken that includes incidence of trauma and exercise frequency. A physical examination should be performed that includes a full hip, low back, and abdominal examination to assess for alternate causes of anterior groin pain. Diagnosis of FAI should be confirmed with radiography. Femoroacetabular impingement can be managed conservatively with rest, modification of activities, medications, and physiotherapy, or it can be treated surgically. Conclusion Femoroacetabular impingement is an important cause of anterior groin pain. Early recognition and intervention by the primary care provider might be critical to alleviating morbidity and preventing FAI progression. PMID:26668284

  3. Closed Intramedullary Derotational Osteotomy and Hip Arthroscopy for Cam Femoroacetabular Impingement From Femoral Retroversion

    PubMed Central

    Matsuda, Dean K.; Gupta, Nikhil; Martin, Hal D.

    2014-01-01

    Femoral retroversion is an uncommon cause of cam femoroacetabular impingement that may require surgical treatment beyond arthroscopic or open femoroplasty. We present the case of a young adult with bilateral severe femoral retroversion in whom such treatment failed. We discuss the rationale, surgical technique, and outcome of this patient, who underwent bilateral closed intramedullary derotational proximal femoral osteotomies and interlocked nailing with adjunctive pre- and post-osteotomy hip arthroscopies. Clinical improvement with normal foot progression angles, radiographic union, and resolution of bilateral cam femoroacetabular impingement from femoral retroversion was achieved. This surgery permits rapid institution of weight-bearing ambulation and an early rehabilitative program. Femoral retroversion may be an underappreciated and insufficiently treated cause of cam femoroacetabular impingement that may be readily detected and successfully remedied with this less invasive procedure. PMID:24749047

  4. The Natural History of Femoroacetabular Impingement

    PubMed Central

    Kuhns, Benjamin D.; Weber, Alexander E.; Levy, David M.; Wuerz, Thomas H.

    2015-01-01

    Femoroacetabular impingement (FAI) is a clinical syndrome resulting from abnormal hip joint morphology and is a common cause of hip pain in young adults. FAI has been posited as a precursor to hip osteoarthritis (OA); however, conflicting evidence exists and the true natural history of the disease is unclear. The purpose of this article is to review the current understanding of how FAI damages the hip joint by highlighting its pathomechanics and etiology. We then review the current evidence relating FAI to OA. Lastly, we will discuss the potential of hip preservation surgery to alter the natural history of FAI, reduce the risk of developing OA and the need for future arthroplasty. PMID:26636088

  5. Statistical Shape Modeling of Cam Femoroacetabular Impingement

    SciTech Connect

    Harris, Michael D.; Dater, Manasi; Whitaker, Ross; Jurrus, Elizabeth R.; Peters, Christopher L.; Anderson, Andrew E.

    2013-10-01

    In this study, statistical shape modeling (SSM) was used to quantify three-dimensional (3D) variation and morphologic differences between femurs with and without cam femoroacetabular impingement (FAI). 3D surfaces were generated from CT scans of femurs from 41 controls and 30 cam FAI patients. SSM correspondence particles were optimally positioned on each surface using a gradient descent energy function. Mean shapes for control and patient groups were defined from the resulting particle configurations. Morphological differences between group mean shapes and between the control mean and individual patients were calculated. Principal component analysis was used to describe anatomical variation present in both groups. The first 6 modes (or principal components) captured statistically significant shape variations, which comprised 84% of cumulative variation among the femurs. Shape variation was greatest in femoral offset, greater trochanter height, and the head-neck junction. The mean cam femur shape protruded above the control mean by a maximum of 3.3 mm with sustained protrusions of 2.5-3.0 mm along the anterolateral head-neck junction and distally along the anterior neck, corresponding well with reported cam lesion locations and soft-tissue damage. This study provides initial evidence that SSM can describe variations in femoral morphology in both controls and cam FAI patients and may be useful for developing new measurements of pathological anatomy. SSM may also be applied to characterize cam FAI severity and provide templates to guide patient-specific surgical resection of bone.

  6. Femoroacetabular Impingement in Athletes, Part 1

    PubMed Central

    Byrd, J. W. Thomas

    2010-01-01

    Context: Femoroacetabular impingement (FAI) is a common cause of intra-articular hip pathology and secondary osteoarthritis. It affects athletes at a young age as they push their bodies beyond the diminished physiologic limits imposed by the altered joint morphology. Understanding the cause of this condition and its assessment in athletes is important. Evidence Acquisition: The scientific literature was reviewed to reflect the current understanding of hip joint pathology among athletic individuals. Focus is given to the literature since 2003, when FAI was first reported as a cause of joint damage in the native hip. Results: There are 3 types of FAI: pincer, cam, and combined. The pathomechanics and pattern of secondary intra-articular pathology are different among the types. History and examination usually reflect findings of joint damage among athletes, and radiographs can reveal the presence of underlying FAI. Other imaging studies may variably aid in detecting the pathology. Conclusions: FAI is a common cause of hip problems in athletes. Early recognition is an important first step in order to avoid the severe secondary damage that can occur. PMID:23015955

  7. Femoroacetabular impingement and its implications on range of motion: a case report

    PubMed Central

    2011-01-01

    Introduction Femoroacetabular impingement leads to limited hip motion, pain and progressive damage to the labrum. Assessment of the amount and location of excessive ossification can be difficult, and removal does not always lead to pain relief and an increase of function. One of the challenges ahead is to discover why certain cases have poor outcomes. Case presentation The technical and clinical results of two consecutive arthroscopic shavings of an osseous cam protrusion are described in our patient, a 50-year-old Caucasian man with complaints of femoroacetabular impingement. At 12 weeks after the first arthroscopic shaving, our patient still experienced pain. Using a range of motion simulation system based on computed tomography images the kinematics of his hip joint were analyzed. Bone that limited range of motion was removed in a second arthroscopic procedure. At six months post-operatively our patient is almost pain free and has regained a range of motion to a functional level. Conclusion This case demonstrates the relevance of range of motion simulation when the outcome of primary arthroscopic management is unsatisfactory. Such simulations may aid clinicians in determining the gain of a second operation. This claim is supported by the correlation of the simulations with clinical outcome, as shown in this case report. PMID:21477363

  8. Surgical hip dislocation for treatment of cam femoroacetabular impingement

    PubMed Central

    Chaudhary, Milind M; Chaudhary, Ishani M; Vikas, KN; KoKo, Aung; Zaw, Than; Siddhartha, A

    2015-01-01

    Background: Cam femoroacetabular impingement is caused by a misshapen femoral head with a reduced head neck offset, commonly in the anterolateral quadrant. Friction in flexion, adduction and internal rotation causes limitation of the hip movements and pain progressively leading to labral and chondral damage and osteoarthritis. Surgical hip dislocation described by Ganz permits full exposure of the hip without damaging its blood supply. An osteochondroplasty removes the bump at the femoral head neck junction to recreate the offset for impingement free movement. Materials and Methods: Sixteen patients underwent surgery with surgical hip dislocation for the treatment of cam femoroacetabular impingement by open osteochondroplasty over last 6 years. Eight patients suffered from sequelae of avascular necrosis (AVN). Three had a painful dysplastic hip. Two had sequelae of Perthes disease. Three had combined cam and pincer impingement caused by retroversion of acetabulum. All patients were operated by the trochanteric flip osteotomy with attachments of gluteus medius and vastus lateralis, dissection was between the piriformis and gluteus minimus preserving the external rotators. Z-shaped capsular incision and dislocation of the hip was done in external rotation. Three cases also had subtrochanteric osteotomy. Two cases of AVN also had an intraarticular femoral head reshaping osteotomy. Results: Goals of treatment were achieved in all patients. No AVN was detected after a 6 month followup. There were no trochanteric nonunions. Hip range of motion improved in all and Harris hip score improved significantly in 15 of 16 cases. Mean alpha angle reduced from 86.13° (range 66°–108°) to 46.35° (range 39°–58°). Conclusion: Cam femoroacetabular Impingement causing pain and limitation of hip movements was treated by open osteochondroplasty after surgical hip dislocation. This reduced pain, improved hip motion and gave good to excellent results in the short term. PMID

  9. Advanced hip joint degeneration associated with femoroacetabular impingement in a retired chiropractor

    PubMed Central

    Emary, Peter C.; Taylor, John A.

    2016-01-01

    Femoroacetabular impingement is a relatively new clinical entity only recently described in the orthopedic literature. In this report, we document a severe case of hip joint osteoarthritis associated with cam-type impingement in a retired chiropractor. PMID:27713583

  10. Editorial Commentary: Ligamentum Teres Tears and Femoroacetabular Impingement: Complex Coexistence of Impingement and Instability.

    PubMed

    Larson, Christopher M

    2016-07-01

    In a large Level IV case series of 2,213 hip arthroscopies with the diagnosis of femoroacetabular impingement, the intraoperative status of the ligamentum teres (LT) was recorded as normal in 11%, frayed and/or partially torn in 88%, and completely torn in 1.5% of hips. Although specific physical examination maneuvers for detecting LT tears were not available early in the study period, thus limiting a detailed assessment of such tests, the authors identified that female gender, a lower lateral center edge angle, a higher Tonnis angle, and capsular laxity were all associated with complete LT tears. This study further supports the complex coexistence of impingement and instability.

  11. The etiology of primary femoroacetabular impingement: genetics or acquired deformity?

    PubMed

    Packer, Jonathan D; Safran, Marc R

    2015-10-01

    The etiology of primary femoroacetabular impingement (FAI) remains controversial. Both genetic and acquired causes have been postulated and studied. While recent studies suggest that genetic factors may have a role in the development of FAI, there is no conclusive evidence that FAI is transmitted genetically. Currently, the most popular theory for the development of cam-type deformities is that a repetitive injury to the proximal femoral physis occurs during a critical period of development. There is a correlation between a high volume of impact activities during adolescence and the development of cam-type deformities. Multiple studies have found a high prevalence of FAI in elite football, ice hockey, basketball and soccer players. In this article, we review the current literature relating to the etiology of primary FAI.

  12. Management of a Large Acetabular Chondrolabral Injury in a Young Patient With Femoroacetabular Impingement

    PubMed Central

    Sherman, Thomas I.; Marcel, John J.; Postma, William

    2014-01-01

    Patients with mixed-type femoroacetabular impingement syndrome often have concomitant chondrolabral pathology in addition to the characteristic cam and pincer lesions. Unfortunately, these patients are typically young, and the pathology is localized to the weight-bearing dome of the acetabulum. Complete preoperative characterization of labral and cartilage lesions is often not possible even with advanced imaging techniques, and the full extent of the injury may not be appreciated without direct arthroscopic visualization. Thus management decisions regarding intra-articular pathology may not be possible until the time of surgery. Often, the cartilage and labral pathology in these young patients is part of a contiguous complex of tissue that separates from the underlying subchondral bone. We present an arthroscopic management technique for young patients with this pattern of injury. This includes limited debridement of loose labral and chondral tissue, labral repair to restore the suction-seal effect, microfracture to promote reparative tissue formation, and takedown of the underlying pathoanatomic cam and pincer lesions. PMID:25685678

  13. Advanced Imaging in Femoroacetabular Impingement: Current State and Future Prospects.

    PubMed

    Bittersohl, Bernd; Hosalkar, Harish S; Hesper, Tobias; Tiderius, Carl Johan; Zilkens, Christoph; Krauspe, Rüdiger

    2015-01-01

    Symptomatic femoroacetabular impingement (FAI) is now a known precursor of early osteoarthritis (OA) of the hip. In terms of clinical intervention, the decision between joint preservation and joint replacement hinges on the severity of articular cartilage degeneration. The exact threshold during the course of disease progression when the cartilage damage is irreparable remains elusive. The intention behind radiographic imaging is to accurately identify the morphology of osseous structural abnormalities and to accurately characterize the chondrolabral damage as much as possible. However, both plain radiographs and computed tomography (CT) are insensitive for articular cartilage anatomy and pathology. Advanced magnetic resonance imaging (MRI) techniques include magnetic resonance arthrography and biochemically sensitive techniques of delayed gadolinium-enhanced MRI of cartilage (dGEMRIC), T1rho (T1ρ), T2/T2* mapping, and several others. The diagnostic performance of these techniques to evaluate cartilage degeneration could improve the ability to predict an individual patient-specific outcome with non-surgical and surgical care. This review discusses the facts and current applications of biochemical MRI for hip joint cartilage assessment covering the roles of dGEMRIC, T2/T2*, and T1ρ mapping. The basics of each technique and their specific role in FAI assessment are outlined. Current limitations and potential pitfalls as well as future directions of biochemical imaging are also outlined.

  14. Advanced Imaging in Femoroacetabular Impingement: Current State and Future Prospects

    PubMed Central

    Bittersohl, Bernd; Hosalkar, Harish S.; Hesper, Tobias; Tiderius, Carl Johan; Zilkens, Christoph; Krauspe, Rüdiger

    2015-01-01

    Symptomatic femoroacetabular impingement (FAI) is now a known precursor of early osteoarthritis (OA) of the hip. In terms of clinical intervention, the decision between joint preservation and joint replacement hinges on the severity of articular cartilage degeneration. The exact threshold during the course of disease progression when the cartilage damage is irreparable remains elusive. The intention behind radiographic imaging is to accurately identify the morphology of osseous structural abnormalities and to accurately characterize the chondrolabral damage as much as possible. However, both plain radiographs and computed tomography (CT) are insensitive for articular cartilage anatomy and pathology. Advanced magnetic resonance imaging (MRI) techniques include magnetic resonance arthrography and biochemically sensitive techniques of delayed gadolinium-enhanced MRI of cartilage (dGEMRIC), T1rho (T1ρ), T2/T2* mapping, and several others. The diagnostic performance of these techniques to evaluate cartilage degeneration could improve the ability to predict an individual patient-specific outcome with non-surgical and surgical care. This review discusses the facts and current applications of biochemical MRI for hip joint cartilage assessment covering the roles of dGEMRIC, T2/T2*, and T1ρ mapping. The basics of each technique and their specific role in FAI assessment are outlined. Current limitations and potential pitfalls as well as future directions of biochemical imaging are also outlined. PMID:26258129

  15. Sports hernia and femoroacetabular impingement in athletes: A systematic review

    PubMed Central

    Munegato, Daniele; Bigoni, Marco; Gridavilla, Giulia; Olmi, Stefano; Cesana, Giovanni; Zatti, Giovanni

    2015-01-01

    AIM: To investigate the association between sports hernias and femoroacetabular impingement (FAI) in athletes. METHODS: PubMed, MEDLINE, CINAHL, Embase, Cochrane Controlled Trials Register, and Google Scholar databases were electronically searched for articles relating to sports hernia, athletic pubalgia, groin pain, long-standing adductor-related groin pain, Gilmore groin, adductor pain syndrome, and FAI. The initial search identified 196 studies, of which only articles reporting on the association of sports hernia and FAI or laparoscopic treatment of sports hernia were selected for systematic review. Finally, 24 studies were reviewed to evaluate the prevalence of FAI in cases of sports hernia and examine treatment outcomes and evidence for a common underlying pathogenic mechanism. RESULTS: FAI has been reported in as few as 12% to as high as 94% of patients with sports hernias, athletic pubalgia or adductor-related groin pain. Cam-type impingement is proposed to lead to increased symphyseal motion with overload on the surrounding extra-articular structures and muscle, which can result in the development of sports hernia and athletic pubalgia. Laparoscopic repair of sports hernias, via either the transabdominal preperitoneal or extraperitoneal approach, has a high success rate and earlier recovery of full sports activity compared to open surgery or conservative treatment. For patients with FAI and sports hernia, the surgical management of both pathologies is more effective than sports pubalgia treatment or hip arthroscopy alone (89% vs 33% of cases). As sports hernias and FAI are typically treated by general and orthopedic surgeons, respectively, a multidisciplinary approach for diagnosis and treatment is recommended for optimal treatment of patients with these injuries. CONCLUSION: The restriction in range of motion due to FAI likely contributes to sports hernias; therefore, surgical treatment of both pathologies represents an optimal therapy. PMID:26380829

  16. Symptomatic sacroiliac joint disease and radiographic evidence of femoroacetabular impingement.

    PubMed

    Morgan, Patrick M; Anderson, Anthony W; Swiontkowski, Marc F

    2013-01-01

    Symptomatic sacroiliac (SI) joint disease is poorly understood. The literature provides no clear aetiology for SI joint pathology, making evaluation and diagnosis challenging. We hypothesised that patients with documented sacroiliac pain might provide insight into the aetiology of these symptoms. Specifically, we questioned whether SI joint symptoms might be associated with abnormal hip radiographs. We reviewed the pelvic and hip radiographs of a prospectively collected cohort of 30 consecutive patients with SI joint pathology. This database included 33 hips from 30 patients. Radiographic analysis included measurements of the lateral centre edge angle, Tönnis angle, and the triangular index, of the ipsilateral hip. Evidence for retrotorsion of the hemipelvis was recorded. Hips were graded on the Tönnis grading system for hip arthrosis. In this cohort 14/33 (42%) of hips had evidence of significant osteoarthrosis indicated by Tönnis grade 2 or greater and 15/33 (45%) displayed subchondral cyst formation around the hip or head neck junction. In assessing acetabular anatomy, 21% (7/33) had retroversion, 12% (4/33) had a lateral centre edge angle >40° with 3% (1/33) >45°. Tönnis angle was <0° in 27% (9/33). Coxa profunda and acetabuli protrusio were present in 47% (17/33) and 3% (1/33), respectively. When femoral head morphology was assessed, 33% (11/33) showed evidence of cam impingement. Overall, 76% (25/33) had at least one abnormality on their hip radiograph. A significant number of patients meeting strict diagnostic criteria for SI joint pain had radiographic evidence of femoroacetabular impingement (FAI) and hip arthrosis. The clinician should maintain FAI in the differential diagnosis when investigating patients with buttock pain.

  17. Descriptive Epidemiology of Symptomatic Femoroacetabular Impingement in Young Athlete: Single Center Study

    PubMed Central

    Lee, Woo-Yong; Kang, Chan; Jeon, Je-Hyung; Zheng, Long

    2016-01-01

    Purpose The purpose of this study was to determine the prevalence of symptomatic femoroacetabular impingement (FAI) in athletic patients. Materials and Methods From July 2003 to May 2013, 388 patients (422 hips) who underwent arthroscopic surgery for FAI were evaluated demographic characteristics. The patients' age, gender, diagnosis, and type of sports were analyzed using medical records and radiography. Results Among 422 hips in 388 patients, 156 hips were involved with sports. Among the 156 hips, 86, 43, and 27 hips were categorized as cam, pincer, and mixed type, respectively. Types of sports were soccer, baseball and taekwondo which showed 44, 36 and 35 hips, respectively. Also, cases related to sports according to age were 63 hips for twenties and 12 hips for teenagers in which the two showed highest association to FAI. The kinds of sports that showed high association were 28 hips of soccer and 20 cases of martial arts such as taekwondo and judo for twenties and 9 hips of martial arts for teenagers which was the highest. Conclusion FAI usually occurs in young adults and is highly related to sports activity. Most of the FAI type related to sports activity was cam type, and soccer and martial arts such as taekwondo were the most common cause of it. PMID:27536641

  18. Radiographic Evidence of Femoroacetabular Impingement in Athletes With Athletic Pubalgia

    PubMed Central

    Economopoulos, Kostas J.; Milewski, Matthew D.; Hanks, John B.; Hart, Joseph M.; Diduch, David R.

    2014-01-01

    Background: Two of the most common causes of groin pain in athletes are femoroacetabular impingement (FAI) and athletic pubalgia. An association between the 2 is apparent, but the prevalence of radiographic signs of FAI in patients undergoing athletic pubalgia surgery remains unknown. The purpose of this study was to determine the prevalence of radiologic signs of FAI in patients with athletic pubalgia. Hypothesis: We hypothesized that patients with athletic pubalgia would have a high prevalence of underlying FAI. Study Design: Case series. Level of Evidence: Level 4. Methods: A retrospective review of all patients evaluated at our institution with athletic pubalgia who underwent surgical treatment (ie, for sports hernia) from 1999 to 2011 was performed. The radiographs of patients with athletic pubalgia were reviewed for radiographic signs of FAI. Alpha angles were measured using frog-leg lateral radiographs. Pincer lesions were identified by measuring the lateral center-edge angle and identifying the presence of a “crossover” sign on anteroposterior radiographs. Phone follow-up was performed 2 years or more after the initial sports hernia surgery to evaluate recurrent symptoms. Results: Forty-three patients underwent 56 athletic pubalgia surgeries. Radiographic evidence of FAI was identified in at least 1 hip in 37 of 43 patients (86%). Cam lesions were identified in 83.7% of the population; the alpha angle averaged 66.7° ± 17.9° for all hips. Pincer lesions were present in 28% of the hips. Eight patients had recurrent groin pain, 3 patients had revision athletic pubalgia surgery, and 1 had hip arthroscopy. Conclusion: The study demonstrates a high prevalence of radiographic FAI in patients with athletic pubalgia. Clinical Relevance: Underlying FAI may be a cause of continued groin pain after athletic pubalgia surgery. Patients with athletic pubalgia should be evaluated closely for FAI. PMID:24587869

  19. Vibratory sense deficits in patients with symptomatic femoroacetabular impingement

    PubMed Central

    Farkas, G.J.; Shakoor, N.; Cvetanovich, G.L.; Fogg, L.F.; Orías, A.A. Espinoza; Nho, S.J.

    2016-01-01

    Objective: Sensory deficits, measured through vibratory perception threshold (VPT), have been recognized in hip and knee osteoarthritis (OA), but have not been evaluated in femoroacetabular impingement (FAI), thought to be a pre-OA condition. This study aimed to assess VPT in symptomatic FAI pre- and 6-months post-arthroscopy vs. controls. Methods: FAI patients and controls were assessed for VPT at the first metatarsophalangeal joint. Pain was assessed using a visual analog pain scale. FAI participants were evaluated again 6-months after surgery for FAI. Differences between groups and pre- and post- surgery were evaluated with independent and paired sample t-tests, respectively. Secondary analysis was performed using repeated-measures ANOVA to evaluate the effect of pain and time since surgery on VPT pre- and post-operatively. Results: No differences in age and BMI were seen between groups (p>0.05). Reduced VPT (higher value is worse) was evident in the pre- (8.0±3.9V, t=2.81, p=0.009) and post-operative (6.8±2.8V, t=2.34, p=0.027) patients compared to controls (4.7±1.3V). After hip arthroscopy, there was a trend toward improved VPT (t=1.97, p=0.068). Preoperative and 6-months postoperative pain and time since surgery were not found to influence VPT (F-ratio≥0.00, p≥0.427). Conclusion: Sensory deficits were observed in FAI patients both before and 6-months after hip arthroscopy. PMID:26944822

  20. Hip joint biomechanics during gait in people with and without symptomatic femoroacetabular impingement.

    PubMed

    Diamond, Laura E; Wrigley, Tim V; Bennell, Kim L; Hinman, Rana S; O'Donnell, John; Hodges, Paul W

    2016-01-01

    Femoroacetabular impingement (FAI) is a morphological hip condition that can cause hip/groin pain and impaired function in younger active adults, and may lead to stiffness, muscle weakness, structural damage, and hip osteoarthritis. Understanding the impairments associated with FAI is crucial to guide treatment and rehabilitation strategies. Evidence is limited and conflicting about whether hip biomechanics are impaired during walking in people with symptomatic FAI. The objective of this study was to determine whether kinematics and kinetics during gait differ between people with symptomatic FAI and control participants. Fifteen participants diagnosed with symptomatic cam-type or combined (cam plus pincer) FAI who were scheduled for arthroscopic surgery and 14 age-, and sex-matched disease-free controls underwent three-dimensional gait analysis. Tri-planar hip kinematics and kinetics were compared between the two groups. There were limited significant between-group differences with respect to spatiotemporal variables. Participants with FAI walked with less range of motion in the sagittal plane during a gait cycle, but did not exhibit any significant kinematic differences in the frontal or transverse planes. There were no systematic differences in kinetics between the groups in any plane. Findings suggest that individuals with symptomatic FAI have minimal impairments in gait biomechanics. Although these individuals demonstrate reduced hip joint motion in the sagittal plane, the size of the difference is small and its significance for symptoms and function is unclear. More pronounced deficits in hip kinetics and kinematics may be evident during functional tasks that challenge the hip towards the position of impingement.

  1. A Qualitative Assessment of Return to Sport After Hip Arthroscopy for Femoroacetabular Impingement

    PubMed Central

    Tjong, Vehniah K.; Cogan, Charles J.; Riederman, Brett D.; Terry, Michael A.

    2016-01-01

    Background: Hip arthroscopy for femoroacetabular impingement (FAI) is known to produce excellent outcomes, yet some patients do not return to their preinjury level of sport participation. Much literature on return to sport has revolved around anterior cruciate ligament reconstruction and even shoulder instability, but none to date have used qualitative, semistructured patient interviews on patients with hip labral tears. Purpose: To understand the factors influencing the decision to return to sport after arthroscopic hip surgery for FAI. Study Design: Case series; Level of evidence, 4. Methods: An experienced interviewer conducted qualitative, semistructured interviews of patients aged 18 to 60 years who had arthroscopic hip surgery for FAI. All had preinjury participation in sport and a minimum 2-year follow-up with no revision surgery. Qualitative analysis was then performed to derive codes, categories, and themes. An assessment of preinjury and current sports participation by type, level of competition, and frequency along with patient-reported hip function was also obtained. In addition, current modified Harris Hip Score (mHHS), international Hip Outcome Tool (iHOT-12), Hip Outcome Score–sports-specific subscale (HOS-SSS), and a coping mechanism evaluation (Brief COPE) were also recorded. Results: A total of 23 patients were interviewed to reveal the overarching themes of internal motivation, external encouragement, and resetting expectations as the predominant factors influencing a patient’s decision to return to preinjury sport. Subjective outcome measurements (mHHS, iHOT-12, patient satisfaction) showed significant differences between patients who did and did not return to sport. Interestingly, the adaptive and maladaptive coping mechanisms matched and supported our themes in those patients who described fear and self-motivation as defining features influencing their cessation of or return to play, respectively. Conclusion: Self-motivation, aging, pain

  2. Hip Arthroscopy in athletes with Femoroacetabular Impingement: functional outcomes

    PubMed Central

    Magi, Gonzalo; Carucci, Juan Pablo; Berro, Manuel; Bergues, Sebastián

    2017-01-01

    Introduction: Hip pathology is being recognized with more frequency as source of disability and functional limitation in athletes. It has been stated that the overload made with certain positions during some sports activities can develop condral damage. Moreover, the sum of bone deformity and repetitive movements of the hip requiered in sports may increase the risk of causing injuries. These can be treated with hip arthroscopy. Despite of this, there is a lack of evidence about the time taken to return to sports activity and the level reached afterwards by those patients treated with this procedure. Objective: Describe the clinical evolution, the time taken to return to sports activity and the level reached a year after the treatment of femoroacetabular impingement (FAI) with hip arthroscopy in 23 athletes. Method: 23 athletes were included in the study, defined as those patients with a minimum of 6 hours a week of sports practice, who were treated for FAI with hip arthroscopy between 2010 and 2015 by the same surgeon at our institution. The diagnosis was clinical (positive impingement test, hip pain and functional limitation of the hip), radiological (cam and pincer) and with magnetic nuclear resonance (labral tears). Preoperative modified Harris hip score was registered in all cases. Tonnis radiographic score was used. All patients had type 0 or 1 Tonnis hips. After 3 months of ineffective non operative treatment the arthroscopy was performed. Patients were treated in dorsal decubitus with orthopedic table. Labral reconstruction with anchors and femoral and acetabular osteoplasty was made. After surgery, patients were able to walk with support for 4 weeks and began physiotherapy. A year after surgery, all patients were questioned about the time taken to return to sports activity and the level of activity reached at that time compared to the one they had before symptoms appeared. The modified Harris hip score was also registered. Results: Ten patients played

  3. Good Results After Hip Arthroscopy for Femoroacetabular Impingement in Top-Level Athletes

    PubMed Central

    Sansone, Mikael; Ahldén, Mattias; Jonasson, Pall; Thomeé, Christoffer; Swärd, Leif; Baranto, Adad; Karlsson, Jón; Thomeé, Roland

    2015-01-01

    Background: Femoroacetabular impingement (FAI) is a common cause of hip pain and dysfunction among athletes. Although arthroscopic surgery is an established treatment option for FAI, there are few studies reporting detailed outcomes using validated outcome measurements specifically designed for young and active athletes. Purpose: To report outcomes 1 year after arthroscopic treatment of FAI in top-level athletes using validated outcome measurements adapted for a young and active population. Study Design: Case series; Level of evidence, 4. Methods: A total of 85 top-level athletes (68 males, 17 females) with a mean (±SD) age of 25 ± 5 years underwent arthroscopic surgery for FAI. All athletes who reported Hip Sports Activity Scale (HSAS) levels 7 or 8 (range, 0-8) prior to symptom onset were included. The cohort was prospectively evaluated using online web-based validated health-related patient-reported outcomes measures (HR-PROMs), including the short version of the International Hip Outcome Tool (iHOT-12), the Copenhagen Hip and Groin Outcome Score (HAGOS; 6 subscales), the EuroQOL 5 dimensions questionnaire (EQ-5D; 2 subscales), the Hip Sports Activity Scale (HSAS) for physical activity level, and a visual analog scale (VAS) for overall hip function. Furthermore, patients reported their overall satisfaction with treatment. Results: The mean follow-up time was 12.3 ± 0.6 months. Preoperative scores compared with those obtained at the 12-month follow-up revealed statistically and clinically significant improvements (P < .0001) for all measured outcomes: iHOT-12 (42 vs 73), VAS for global hip function (52 vs 77), HSAS (4.3 vs 5.7), EQ-5D index (0.60 vs 0.83), EQ-VAS (68 vs 82), and HAGOS subscales (60 vs 83, 50 vs 73, 66 vs 86, 39 vs 75, 27 vs 70, and 34 vs 67). At the 12-month follow-up, 79 athletes (93%) reported that they were satisfied with the outcome of surgery. At follow-up, 62 athletes (73%) had returned to competitive sports (HSAS levels 5-8) and 44 (52

  4. Prevalence of Radiographic Parameters Predisposing to Femoroacetabular Impingement in Young Asymptomatic Chinese and White Subjects

    PubMed Central

    Van Houcke, Jan; Yau, Wan Pan; Yan, Chun Hoi; Huysse, Wouter; Dechamps, Hannes; Lau, Wing Hang; Wong, Chun Sing; Pattyn, Christophe; Audenaert, Emmanuel Albert

    2015-01-01

    Background: Osteoarthritis of the hip is five to ten times more common in white people than in Chinese people. Little is known about the true prevalence of femoroacetabular impingement or its role in the development of osteoarthritis in the Chinese population. A cross-sectional study of both white and Chinese asymptomatic individuals was conducted to compare the prevalences of radiographic features posing a risk for femoroacetabular impingement in the two groups. It was hypothesized that that there would be proportional differences in hip anatomy between the white and Asian populations. Methods: Pelvic computed tomography scans of 201 subjects (ninety-nine white Belgians and 102 Chinese; 105 men and ninety-six women) without hip pain who were eighteen to forty years of age were assessed. The original axial images were reformatted to three-dimensional pelvic models simulating standardized radiographic views. Ten radiographic parameters predisposing to femoroacetabular impingement were measured: alpha angle, anterior offset ratio, and caput-collum-diaphyseal angle on the femoral side and crossover sign, ischial spine projection, acetabular anteversion angle, center-edge angle, acetabular angle of Sharp, Tönnis angle, and anterior acetabular head index on the acetabular side. Results: The white subjects had a less spherical femoral head than the Chinese subjects (average alpha angle, 56° compared with 50°; p < 0.001). The Chinese subjects had less lateral acetabular coverage than the white subjects, with average center-edge angles of 35° and 39° (p < 0.001) and acetabular angles of Sharp of 38° and 36° (p < 0.001), respectively. A shallower acetabular configuration was predominantly present in Chinese women. Conclusions: Significant differences in hip anatomy were demonstrated between young asymptomatic Chinese and white subjects. However, the absolute size of the observed differences appears to contrast with the reported low prevalence of femoroacetabular

  5. Femoro-acetabular impingement clinical research: is a composite outcome the answer?

    PubMed

    Ayeni, Olufemi R; Sansone, Mikael; de Sa, Darren; Simunovic, Nicole; Bedi, Asheesh; Kelly, Bryan T; Farrokhyar, Forough; Karlsson, Jon

    2016-01-01

    Femoro-acetabular impingement (FAI) is increasingly recognized as an important cause of hip pain in the young adult. However, the methods of evaluating the efficacy of surgical intervention are often not validated and/or inconsistently reported. Important clinical, gait, radiographic and biomarker outcomes are discussed. This article (1) presents the rationale for considering a composite outcome for FAI patients; (2) examines a variety of important end points currently used to evaluate FAI surgery; (3) discusses a strategy to generate a composite outcome by combining these end points; and (4) highlights the challenges and current areas of controversy that such an approach to evaluating symptomatic FAI patients may present.

  6. The Role of Femoroacetabular Impingement in Core Muscle Injury/Athletic Pubalgia: Diagnosis and Management.

    PubMed

    Strosberg, David S; Ellis, Thomas J; Renton, David B

    2016-01-01

    Chronic groin pain in athletes represents a major diagnostic and therapeutic challenge in sports medicine. Two recognized causes of inguinal pain in the young adult athlete are core muscle injury/athletic pubalgia (CMI/AP) and femoroacetabular impingement (FAI). CMI/AP and FAI were previously considered to be two distinct entities; however, recent studies have suggested both entities to frequently coincide in the athlete with groin pain. This article briefly discusses the role of FAI in CMI/AP and the diagnosis and management of this complex disease.

  7. The Role of Femoroacetabular Impingement in Core Muscle Injury/Athletic Pubalgia: Diagnosis and Management

    PubMed Central

    Strosberg, David S.; Ellis, Thomas J.; Renton, David B.

    2016-01-01

    Chronic groin pain in athletes represents a major diagnostic and therapeutic challenge in sports medicine. Two recognized causes of inguinal pain in the young adult athlete are core muscle injury/athletic pubalgia (CMI/AP) and femoroacetabular impingement (FAI). CMI/AP and FAI were previously considered to be two distinct entities; however, recent studies have suggested both entities to frequently coincide in the athlete with groin pain. This article briefly discusses the role of FAI in CMI/AP and the diagnosis and management of this complex disease. PMID:26904546

  8. Cam Femoroacetabular Impingement as a Possible Explanation of Recalcitrant Anterior Knee Pain

    PubMed Central

    Sanchis-Alfonso, Vicente; Tey, Marc; Monllau, Joan Carles

    2016-01-01

    We present a case of a patient with chronic anterior knee pain (AKP) recalcitrant to conservative treatment who returned to our office for severe hip pain secondary to Cam femoroacetabular impingement (Cam FAI) at 10 months after the onset of knee pain. This case highlights the fact that the main problem is not in the patella but in the hip in some patients with AKP. We hypothesize that there is an external femoral rotation in order to avoid the impingement and therefore the hip pain in patients with Cam FAI. This functional femoral rotation could provoke a patellofemoral imbalance that may be, in theory, responsible for patellofemoral pain in this particular patient. In our case, Cam FAI resolution was related to the resolution of AKP. PMID:27247817

  9. Conservative management of an elite ice hockey goaltender with femoroacetabular impingement (FAI): a case report

    PubMed Central

    MacIntyre, Kyle; Gomes, Brendan; MacKenzie, Steven; D’Angelo, Kevin

    2015-01-01

    Objective: To detail the presentation of an elite male ice hockey goaltender with cam-type femoroacetabular impingement (FAI) and acetabular labral tears. This case will outline the prevalence, clinical presentation, imaging criteria, pathomechanics, and management of FAI, with specific emphasis on the ice hockey goaltender. Clinical Features: A 22-year old retired ice hockey goaltender presented to a chiropractor after being diagnosed by an orthopaedic surgeon with MRI confirmed left longitudinal and chondral flap acetabular labral tears and cam-type femoroacetabular impingement (FAI). As the patient was not a candidate for surgical intervention, a multimodal conservative treatment approach including manual therapy, electroacupuncture and rehabilitation exercises were implemented. Summary: FAI is prevalent in ice hockey players, particularly with goaltenders. Both skating and position-dependent hip joint mechanics involved in ice hockey may exacerbate or contribute to acquired and congenital forms of symptomatic FAI. As such, practitioners managing this population must address sport-specific demands in manual therapy, rehabilitation and physical training, to improve functional outcomes and prevent future injury. PMID:26816416

  10. Core Muscle Injury/Sports Hernia/Athletic Pubalgia, and Femoroacetabular Impingement.

    PubMed

    Ross, James R; Stone, Rebecca M; Larson, Christopher M

    2015-12-01

    Core muscle injury/sports hernia/athletic pubalgia is an increasingly recognized source of pain, disability, and time lost from athletics. Groin pain among athletes, however, may be secondary to various etiologies. A thorough history and comprehensive physical examination, coupled with appropriate diagnostic imaging, may improve the diagnostic accuracy for patients who present with core muscular injuries. Outcomes of nonoperative management have not been well delineated, and multiple operative procedures have been discussed with varying return-to-athletic activity rates. In this review, we outline the clinical entity and treatment of core muscle injury and athletic pubalgia. In addition, we describe the relationship between athletic pubalgia and femoroacetabular impingement along with recent studies that have investigated the treatment of these related disorders.

  11. Surgical innovation and safety: femoroacetabular impingement and the IDEAL collaborative framework

    PubMed Central

    Lee, Cara Beth

    2016-01-01

    Operative treatment of femoroacetabular impingement (FAI) is a relatively new, yet rapidly expanding surgical innovation. Although the practice of surgery is inherently innovative, there is no clear distinction between minor technical variation and true modification that warrants testing. This raises important questions about how new procedures should be evaluated before being broadly disseminated. The IDEAL Collaborative is a consortium that promotes safe and responsible translation of research into clinical practice. The collaborative has delineated the typical stages of evolution of new interventional technologies, and the type of study designs appropriate for each stage. This report examines the surgical treatment of FAI as a case study of the IDEAL framework and discusses both missed and future opportunities for critical assessment. PMID:27583143

  12. Atypical hip pain: coexistence of femoroacetabular impingement (FAI) and osteoid osteoma.

    PubMed

    Banga, Kamaljeet; Racano, Antonella; Ayeni, Olufemi R; Deheshi, Benjamin

    2015-05-01

    The objective of this article was to emphasize the importance of including less common causes of hip pain in a differential diagnosis, particularly when clinical and radiographic variables are atypical. This article presents the case of a 52-year-old patient with a history of progressive hip pain resulting from the coexistence of both a femoroacetabular impingement (FAI) and an intraarticular osteoid osteoma. The intraarticular osteoid osteoma was initially overlooked due to its unremarkable features on radiographic and resonance imaging. Consequently, the patient was surgically treated for FAI with only partial relief. An osteolytic nidus characteristic of osteoid osteoma was discovered only 1.5 years following surgery. The patient was subsequently treated for osteoid osteoma with anti-inflammatories, after which his pain began to resolve. The patient was completely pain free after 7 months. Level of evidence V.

  13. MAGNETIC RESONANCE IMAGING OF THE HIP FOR THE EVALUATION OF FEMOROACETABULAR IMPINGEMENT; PAST, PRESENT, AND FUTURE

    PubMed Central

    Riley, Geoffrey M.; McWalter, Emily J.; Stevens, Kathryn J.; Safran, Marc R.; Lattanzi, Riccardo; Gold, Garry E.

    2014-01-01

    The concept of femoroacetabular impingement (FAI) has, in a relatively short time, come to the forefront of orthopedic imaging. In just a few short years MRI findings that were in the past ascribed to degenerative change, normal variation, or other pathologies must now be described and included in radiology reports, as they have been shown, or are suspected to be related to, FAI. Crucial questions have come up in this time, including: what is the relationship of bony morphology to subsequent cartilage and labral damage, and most importantly, how is this morphology related to the development of osteoarthritis? In this review we attempt to place a historical perspective on the controversy, provide guidelines for interpretation of MRI examinations of patients with suspected FAI, and offer a glimpse into the future of MRI of this complex condition. PMID:25155435

  14. Measuring hip muscle strength in patients with femoroacetabular impingement and other hip pathologies

    PubMed Central

    Mayne, E.; Memarzadeh, A.; Raut, P.; Arora, A.

    2017-01-01

    Objectives The aim of this study was to systematically review the literature on measurement of muscle strength in patients with femoroacetabular impingement (FAI) and other pathologies and to suggest guidelines to standardise protocols for future research in the field. Methods The Cochrane and PubMed libraries were searched for any publications using the terms ‘hip’, ‘muscle’, ‘strength’, and ‘measurement’ in the ‘Title, Abstract, Keywords’ field. A further search was performed using the terms ‘femoroacetabular’ or ‘impingement’. The search was limited to recent literature only. Results A total of 29 articles were reviewed to obtain information on a number of variables. These comprised the type of device used for measurement, rater standardisation, the type of movements tested, body positioning and comparative studies of muscle strength in FAI versus normal controls. The studies found that hip muscle strength is lower in patients with FAI; this is also true for the asymptomatic hip in patients with FAI. Conclusions Current literature on this subject is limited and examines multiple variables. Our recommendations for achieving reproducible results include stabilising the patient, measuring isometric movements and maximising standardisation by using a single tester and familiarising the participants with the protocol. Further work must be done to demonstrate the reliability of any new testing method. Cite this article: E. Mayne, A. Memarzadeh, P. Raut, A. Arora, V. Khanduja. Measuring hip muscle strength in patients with femoroacetabular impingement and other hip pathologies: A systematic review. Bone Joint Res 2017;6:66–72. DOI: 10.1302/2046-3758.61.BJR-2016-0081. PMID:28108483

  15. Does high level youth sports participation increase the risk of femoroacetabular impingement? A review of the current literature.

    PubMed

    de Silva, Viran; Swain, Michael; Broderick, Carolyn; McKay, Damien

    2016-03-11

    Sports participation can be an integral part of adolescent development with numerous positive short and long-term effects. Despite these potential benefits very high levels of physical activity, during skeletal maturation, have been proposed as a possible cause of cam-type femoroacetabular impingement (FAI). The influence of physical activity on the developing physis has been previously described both in animal studies and epidemiological studies of adolescent athletes. It is therefore important to determine whether the development of FAI is secondary to excessive physical activity or a combination of a vulnerable physis and a set level of physical activity. A review of the current literature suggests that adolescent males participating in ice-hockey, basketball and soccer, training at least three times a week, are at greater risk than their non-athletic counterparts of developing the femoral head-neck deformity associated with femoroacetabular impingement.

  16. Incidence of symptomatic femoroacetabular impingement in the general population: a prospective registration study

    PubMed Central

    Röling, Maarten A.; Mathijssen, Nina M.C.; Bloem, Rolf M.

    2016-01-01

    Groin pain is a frequent cause of discomfort in patients and highly prevalent in active patients. One of the diagnoses causing groin pain is femoroacetabular impingement (FAI). However, the incidence of FAI in the general population is unknown. This study aimed to identify the incidence of groin pain suggestive of FAI in a cohort of 31 451 patients in the Netherlands during 1 year. A cooperation of 16 general practitioners (GPs) participated in this prospective registry. All GPs were educated in the clinical manifestation of FAI and the physical examination for FAI. Patients of all ages were registered when presenting with ‘groin pain’. Between July 2013 and July 2014, 84 patients aged between 15 and 60 years of age presented with groin pain, reflecting an incidence of 0.44%. Of these patients, 17% (14 patients) were radiologically diagnosed with FAI. Another 30% of these patients had a high clinical suspicion for FAI. This is the first report on the incidence of groin pain suggestive of FAI in a general population diagnosed by GPs. Of all 84 patients presenting with groin pain, 17% were diagnosed with FAI. Creating awareness of FAI in GPs helps identifying patients that might benefit from FAI treatment. PMID:27583159

  17. Femoroacetabular Impingement: A Retrospective Case Study With 8-Year Follow-Up

    PubMed Central

    Stobert, Julia R.; Emary, Peter C.; Taylor, John A.

    2015-01-01

    Objective The purpose of this case report is to describe a patient with femoroacetabular impingement (FAI) who was initially misdiagnosed and treated for a hip flexor strain. Clinical Features A 36-year-old male patient presented with insidious onset of progressive anterior right hip and groin pain of 7 years' duration. He was diagnosed with a right-sided hip flexor muscle strain and was discharged from care 1 month later. The patient then returned to the office 8 years later for treatment of unrelated lower back pain. This time, the doctor of chiropractic learned that the patient was misdiagnosed years before. The patient's past radiographs in fact revealed FAI, including severe hip joint osteoarthritis on the right and mild osteoarthritis on the left. As a result, the patient had undergone right hip joint replacement surgery. Recent radiographs also revealed FAI in the contralateral hip. Intervention and Outcome After investigating for FAI, the doctor of chiropractic was able to identify through symptomatology, history, physical examination, and radiographs the presence of FAI in the patient's left hip. An “active surveillance” approach is being taken. Conclusion This case illustrates the importance of an increasing awareness of FAI, as doctors of chiropractic are frequently the primary contact for patients with this condition. PMID:26793042

  18. Personalised Hip Therapy: development of a non-operative protocol to treat femoroacetabular impingement syndrome in the FASHIoN randomised controlled trial

    PubMed Central

    Wall, Peter DH; Dickenson, Edward J; Robinson, David; Hughes, Ivor; Realpe, Alba; Hobson, Rachel; Griffin, Damian R; Foster, Nadine E

    2016-01-01

    Introduction Femoroacetabular impingement (FAI) syndrome is increasingly recognised as a cause of hip pain. As part of the design of a randomised controlled trial (RCT) of arthroscopic surgery for FAI syndrome, we developed a protocol for non-operative care and evaluated its feasibility. Methods In phase one, we developed a protocol for non-operative care for FAI in the UK National Health Service (NHS), through a process of systematic review and consensus gathering. In phase two, the protocol was tested in an internal pilot RCT for protocol adherence and adverse events. Results The final protocol, called Personalised Hip Therapy (PHT), consists of four core components led by physiotherapists: detailed patient assessment, education and advice, help with pain relief and an exercise-based programme that is individualised, supervised and progressed over time. PHT is delivered over 12–26 weeks in 6–10 physiotherapist-patient contacts, supplemented by a home exercise programme. In the pilot RCT, 42 patients were recruited and 21 randomised to PHT. Review of treatment case report forms, completed by physiotherapists, showed that 13 patients (62%) received treatment that had closely followed the PHT protocol. 13 patients reported some muscle soreness at 6 weeks, but there were no serious adverse events. Conclusion PHT provides a structure for the non-operative care of FAI and offers guidance to clinicians and researchers in an evolving area with limited evidence. PHT was deliverable within the National Health Service, is safe, and now forms the comparator to arthroscopic surgery in the UK FASHIoN trial (ISRCTN64081839). Trial registration number ISRCTN 09754699. PMID:27629405

  19. Herniation pits in the femoral neck: a radiographic indicator of femoroacetabular impingement?

    PubMed

    Kim, Jin Ah; Park, Ji Seon; Jin, Wook; Ryu, Kyungnam

    2011-02-01

    The purpose was to assess the significance of herniation pits in the femoral neck for radiographic diagnosis of femoroacetabular impingement (FAI). Eighty hips in 62 patients (bilateral in 18) with neutral pelvic orientation were enrolled. Herniation pits were diagnosed when they were located at the anterosuperior femoral neck, close to the physis, and with a diameter of >3 mm. The five radiographic signs of FAI were used: lateral center edge angle (LCE) >39°, acetabular index (AI) ≤0, extrusion index (EI) <25%, acetabular retroversion, and pistol-grip deformity. Patients with radiographs suggesting FAI were retrospectively correlated with their clinical symptoms. Positive radiographic signs were observed in 7 hips with LCE, 7 with AI, and 80 with EI criteria. Only 3 hips out of 80 (3.8%) showed all of the signs. The acetabular retroversion and pistol-grip deformity were seen in 12/80 and 3/80 hips, respectively. The total number of hips that met radiographic criteria for FAI, including pincer type and cam type, was 18 (23%). However, none of these hips were clinically diagnosed with FAI. All symptomatic hips (11/80) presented only with nonspecific pain, and 2 hips out of 11 showed radiographic signs of FAI. The low frequency of positive radiographic signs suggesting FAI with related symptoms among patients with herniation pits suggests that herniation pits have limited significance in the diagnosis of FAI. Therefore it can be concluded that an incidental finding of herniation pits does not necessarily imply a correlation with FAI.

  20. Pelvic Rotation in Femoroacetabular Impingement Is Decreased Compared to Other Symptomatic Hip Conditions.

    PubMed

    Azevedo, Daniel Camara; Paiva, Edson Barreto; Lopes, Alexia Moura Abuhid; Santos, Henrique de Oliveira; Carneiro, Ricardo Luiz; Rodrigues, André Soares; de Andrade, Marco Antonio Percope; Novais, Eduardo N; Van Dillen, Linda R

    2016-11-01

    Study Design Cross-sectional, case-control design. Background Pelvic movement has been considered a possible discriminating parameter associated with femoroacetabular impingement (FAI) symptom onset. Decreased pelvic rotation has been found during squatting in people with FAI when compared to people with healthy hips. However, it is possible that changes in pelvic movement may occur in other hip conditions because of pain and may not be specific to FAI. Objectives To compare sagittal pelvic rotation during hip flexion and in sitting between people with FAI and people with other symptomatic hip conditions. Methods Thirty people with symptomatic FAI, 30 people with other symptomatic hip conditions, and 20 people with healthy hips participated in the study. Sagittal pelvic rotation was calculated based on measures of pelvic alignment in standing, hip flexion to 45° and 90°, and sitting. Results There were significant differences in sagittal pelvic rotation among the 3 groups in all conditions (P<.05). Post hoc analyses revealed that participants in the symptomatic FAI group had less pelvic rotation during hip flexion to 45° and 90° compared to participants in the other symptomatic hip conditions group and the hip-healthy group (mean difference, 1.2°-1.9°). In sitting, participants in the other symptomatic hip conditions group had less posterior pelvic rotation compared to those in the hip-healthy group (mean difference, 3.9°). Conclusion People with symptomatic FAI have less posterior pelvic rotation during hip flexion when compared to people with other symptomatic hip conditions and those with healthy hips. Level of Evidence Diagnosis, level 4. J Orthop Sports Phys Ther 2016;46(11):957-964. Epub 29 Sep 2016. doi:10.2519/jospt.2016.6713.

  1. Are “normal hips” being labeled as femoroacetabular impingement due to EE angle?

    PubMed Central

    You, Tian; Yang, Bei; Zhang, Xin-tao; Jiang, Xiao-cheng; Wang, Shuang; Zhang, Wen-tao

    2017-01-01

    Abstract Gluteal muscle contracture (GMC) is a clinical syndrome characterized by gait abnormality and limb dysfunction, as well as secondary deformities of pelvis and femur. Femoroacetabular impingement (FAI) typically could be diagnosed on the basis of computed tomography (CT) such as the equatorial-edge angle (EE angle), but it did not work well in GMC patients. In this study, we retrospected all image data and found small EE angles in GMCs, which meant retroverted acetabulum; however, none of them showed no symptoms and signs of FAI. Therefore, we had reasons to think that, some normal hips with unbalanced hip myodynamia as same as GMCs, may be incorrectly diagnosed as FAI through measuring EE angle only. In consequence, the paper was designed to assess the use of the EE angle in the assessment of FAI in the diagnosis, as described by Werner. Twenty-three patients (46 hips) were collected and calculated with the “equatorial-edge angle” (EE angle) by CT scans. All of them were excluded from FAI. Review of the hips showed a mean EE angle was 12.93°, with a minimum of -3.42° and a maximum of 24.08°. The mean value for males and females were 13.52° and 12.40°, respectively, without statistical significance, although the mean value of left hips and right sides reached 13.32° and 12.54° individually, not having statistical differences neither. There were not any symptoms or signs of FAI in all patients. Thus, the reduced EE angle could suggest the local excessive coverage of the femoral head by the anterior acetabular edge, but might not be a reasonably good predictor of FAI. GMC patient's acetabular deformity mainly manifests as increased retroversion, which may be the anatomical basis for FAI and lead to high risks of the acetabular impingement. However, all patients in this study showed no symptoms and signs of FAI, suggesting that the measurement of EE angle can only be applied to assessing those people with normal hip myodynamia, and the bone

  2. Radiographic Prevalence of Femoroacetabular Impingement in a Young Population with Hip Complaints Is High

    DTIC Science & Technology

    2010-01-27

    impingement (abnormal alpha angle or pistol grip deformity only), whereas 16 patients (18%) had signs of pure pincer -type impingement (abnormal center-edge or...care and orthopaedic clinics. Radiographs were analyzed for signs of FAI (herniation pits, pistol grip deformity, center-edge angle, alpha angle, and...11, 12]. Two types of FAI have been described: cam and pincer . In cam-type impingement, the abnormally shaped femoral head-neck junction abuts the

  3. The direct environmental impact of hip arthroscopy for femoroacetabular impingement: a surgical waste audit of five cases

    PubMed Central

    de SA, Darren; Stephens, Kellee; Kuang, Michelle; Simunovic, Nicole; Karlsson, Jon; Ayeni, Olufemi R.

    2016-01-01

    Health care facilities produce significant waste (2200 kg/bed/year) creating 2% of greenhouse gas emissions and 1% total solid waste nationwide, with 20–70% of waste coming from operating rooms. We performed a waste audit of hip arthroscopy for femoroacetabular impingement (FAI) to understand its environmental impact and identify areas for greening practices. A waste audit of five hip arthroscopy procedures for FAI was performed. All waste was collected and separated into six waste streams in real time: (i) normal/landfill waste; (ii) recyclable cardboards and plastics; (iii) biohazard waste; (iv) sharp items; (v) linens and (vi) sterile wrapping. The surgical waste (except laundered linens) from five FAI surgeries totaled 47.4 kg, including 21.7 kg (45.7%) of biohazard waste, 11.7 kg (24.6%) of sterile wrap, 6.4 kg (13.5%) of normal/landfill waste, 6.4 kg (13.5%) of recyclable plastics and 1.2 kg (2.6%) of sharp items. An average of 9.4 kg (excluding laundered linens) of waste was produced per procedure. Given the considerable biohazard waste produced by FAI procedures, additional recycling programs, continued adherence to proper waste segregation and an emphasis on ‘green outcomes’ is encouraged to demonstrate environmental responsibility and effectively manage and allocate finite resources. PMID:27583149

  4. Augmented home exercise program for a 37-year-old female with a clinical presentation of femoroacetabular impingement.

    PubMed

    Wright, Alexis A; Hegedus, Eric J

    2012-08-01

    Previous researchers have reported on the use of augmented home exercise programs with potential carry-over effects from manual therapy treatment. While there is no direct evidence to support augmented manual therapy, tangential evidence demonstrates that specific, supervised, and adherent exercises result in improved outcomes. The purpose of this case report is to describe an augmented home program simulating the manual techniques provided by the therapist. A 37-year-old female presented with symptoms and signs consistent with femoroacetabular impingement (FAI). Grade III lateral and inferior femoral glides decreased reported pain from 5/10 to 0/10. Given the immediate response to hip mobilizations, the patient was prescribed standing lateral glides and supine inferior glides of the hip with the use of a belt. During this time, the patient's Lower Extremity Functional Scale score improved from 74 to 78 and she reported increased ability to self-manage her symptoms. The immediate report of decreased pain helped determine the specific home program selected for this individual patient. This case highlights the importance of a specific augmented home exercise program unique to the individual patient resulting in self-management of pain associated with FAI.

  5. The direct environmental impact of hip arthroscopy for femoroacetabular impingement: a surgical waste audit of five cases.

    PubMed

    de Sa, Darren; Stephens, Kellee; Kuang, Michelle; Simunovic, Nicole; Karlsson, Jon; Ayeni, Olufemi R

    2016-07-01

    Health care facilities produce significant waste (2200 kg/bed/year) creating 2% of greenhouse gas emissions and 1% total solid waste nationwide, with 20-70% of waste coming from operating rooms. We performed a waste audit of hip arthroscopy for femoroacetabular impingement (FAI) to understand its environmental impact and identify areas for greening practices. A waste audit of five hip arthroscopy procedures for FAI was performed. All waste was collected and separated into six waste streams in real time: (i) normal/landfill waste; (ii) recyclable cardboards and plastics; (iii) biohazard waste; (iv) sharp items; (v) linens and (vi) sterile wrapping. The surgical waste (except laundered linens) from five FAI surgeries totaled 47.4 kg, including 21.7 kg (45.7%) of biohazard waste, 11.7 kg (24.6%) of sterile wrap, 6.4 kg (13.5%) of normal/landfill waste, 6.4 kg (13.5%) of recyclable plastics and 1.2 kg (2.6%) of sharp items. An average of 9.4 kg (excluding laundered linens) of waste was produced per procedure. Given the considerable biohazard waste produced by FAI procedures, additional recycling programs, continued adherence to proper waste segregation and an emphasis on 'green outcomes' is encouraged to demonstrate environmental responsibility and effectively manage and allocate finite resources.

  6. Arthroscopic Management of Posteromedial Ankle Impingement

    PubMed Central

    Lui, Tun Hing

    2015-01-01

    Posteromedial ankle impingement is a rare clinical entity. It usually follows an inversion injury, with compression of the posterior tibiotalar ligament between the medial malleolus and talus. This can be treated by posterior ankle endoscopy through the posteromedial and posterolateral portals. The flexor hallucis longus tendon can be examined for any tenosynovitis or tendinopathy. The posteromedial corner of the ankle joint is reached with the instruments staying on the lateral side of the flexor hallucis longus tendon. The inflamed synovium, scar tissue, and fibrillated cartilage are debrided. PMID:26697299

  7. Arthroscopic Management of Posteromedial Ankle Impingement.

    PubMed

    Lui, Tun Hing

    2015-10-01

    Posteromedial ankle impingement is a rare clinical entity. It usually follows an inversion injury, with compression of the posterior tibiotalar ligament between the medial malleolus and talus. This can be treated by posterior ankle endoscopy through the posteromedial and posterolateral portals. The flexor hallucis longus tendon can be examined for any tenosynovitis or tendinopathy. The posteromedial corner of the ankle joint is reached with the instruments staying on the lateral side of the flexor hallucis longus tendon. The inflamed synovium, scar tissue, and fibrillated cartilage are debrided.

  8. Treatment of ischiofemoral impingement: results of diagnostic injections and arthroscopic resection of the lesser trochanter

    PubMed Central

    Wilson, Mark D.; Keene, James S.

    2016-01-01

    Ischiofemoral impingement (IFI) is an often unrecognized cause of hip pain caused by abnormal contact between the lesser trochanter and the ischium. To date, surgical treatment for those whose pain is not relieved by activity modification and steroid injections has not been defined. This study describes our imaging protocol and reports the results of arthroscopic, lesser trochanteric resections that were performed to treat this condition. Seven patients with symptomatic, MRI-documented IFI had ultrasound injections of ropivicaine and steroid into their ischiofemoral space. The injections provided complete but only transient relief of their groin and buttock pain and thus, all seven ultimately had an arthroscopic resection of their lesser trochanter. All hips were evaluated preoperatively and at 3, 6 and 12 months postoperatively with Byrd’s modified Harris hip scoring system. Average age of the seven patients was 46 years and there were five females and one male. Preoperative scores averaged 43 points. After surgery, all patients used crutches for 4–6 weeks, and had 6-week scores that averaged 58 points. The patients and their scores continued to improve and at 6 and 12 months, their scores averaged 86 and 91 points, and none had chronic hip flexor weakness or recurrence of their hip pain or snapping. Arthroscopic iliopsoas tenotomies in combination with a resection of the lesser trochanter will provide complete relief of the painful snapping, groin and buttock pain caused by ischiofemoral impingement. PMID:27583151

  9. Descriptive Epidemiology of Patients Undergoing Total Hip Arthroplasty in Korea with Focus on Incidence of Femoroacetabular Impingement: Single Center Study

    PubMed Central

    2017-01-01

    We analyzed the causes leading to total hip arthroplasty (THA), aimed to clarify the incidence of femoroacetabular impingement (FAI) among the causes, and compared the incidence in Korea with those in other countries. From January 2000 to December 2014, 1,206 hips of 818 patients who underwent primary THA at our institute were reviewed retrospectively in terms of radiographs and electronic charts. The radiographs and radiographic parameters were reviewed and measured by 2 of the authors, who are orthopedic surgeons. Patients were categorized in terms of the causes leading to THA as primary osteoarthritis (OA), rheumatoid arthritis (RA), posttraumatic arthritis, post infectious arthritis, avascular necrosis (AVN) of the femoral head, fracture of the femoral head or neck, ankylosing spondylitis (AS), developmental dysplasia of the hip (DDH), Legg-Calvé-Perthes disease (LCPD), FAI, and others. There were 32 patients (3.91%) in the primary OA group, 41 (5.01%) in the RA group, 84 (10.27%) in the posttraumatic arthritis group, 39 (4.77%) in the post infectious arthritis group, 365 (44.62%) in the AVN group, 39 (4.77%) in the fracture group, 21 (2.57%) in the AS group, 52 (6.36%) in the DDH group, 71 (8.68%) in the LCPD group, 52 (6.36%) in the FAI group, and 22 (2.69%) in the ‘other’ group. The causes leading to THA in Korea differ from those in Western countries. FAI could be causes of severe secondary OA that requires THA in Korea, therefore symptomatic FAI should not be neglected. PMID:28244282

  10. Hip Joint Stresses Due to Cam-Type Femoroacetabular Impingement: A Systematic Review of Finite Element Simulations

    PubMed Central

    Ng, K. C. Geoffrey; Lamontagne, Mario; Labrosse, Michel R.; Beaulé, Paul E.

    2016-01-01

    Background The cam deformity causes the anterosuperior femoral head to obstruct with the acetabulum, resulting in femoroacetabular impingement (FAI) and elevated risks of early osteoarthritis. Several finite element models have simulated adverse loading conditions due to cam FAI, to better understand the relationship between mechanical stresses and cartilage degeneration. Our purpose was to conduct a systematic review and examine the previous finite element models and simulations that examined hip joint stresses due to cam FAI. Methods The systematic review was conducted to identify those finite element studies of cam-type FAI. The review conformed to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and studies that reported hip joint contact pressures or stresses were included in the quantitative synthesis. Results Nine articles studied FAI morphologies using finite element methods and were included in the qualitative synthesis. Four articles specifically examined contact pressures and stresses due to cam FAI and were included in the quantitative synthesis. The studies demonstrated that cam FAI resulted in substantially elevated contact pressures (median = 10.4 MPa, range = 8.5–12.2 MPa) and von Mises stresses (median 15.5 MPa, range = 15.0–16.0 MPa) at the acetabular cartilage; and elevated maximum-shear stress on the bone (median = 15.2 MPa, range = 14.3–16.0 MPa), in comparison with control hips, during large amplitudes of hip motions. Many studies implemented or adapted idealized, ball-and-cup, parametric models to predict stresses, along with homogeneous bone material properties and in vivo instrumented prostheses loading data. Conclusion The formulation of a robust subject-specific FE model, to delineate the pathomechanisms of FAI, remains an ongoing challenge. The available literature provides clear insight into the estimated stresses due to the cam deformity and provides an assessment of its risks leading to early

  11. Open Surgical Treatment for Femoroacetabular Impingement in Patients over Thirty Years: Two Years Follow-up Results

    PubMed Central

    2015-01-01

    Purpose We report short term results of open surgical treatment for symptomatic femoroacetabular impingement (FAI) in patients over the age of 30 years. Materials and Methods Between May 2011 and June 2012, thirteen FAI hips (11 patients) with hip pain persisting longer than 6 months were treated by either surgical hip dislocation (SHD) or anterior mini-open. They were followed up for longer than 2 years. The 11 patients included 7 females and 4 males with a mean age of 45 (range, 33-60) years. They were clinically evaluated for modified Harris hip score (MHHS) and University of California at Los Angeles (UCLA) activity level. Their lateral center-edge angle, acetabular index, and alpha angle were measured and compared. Results Acetabuloplasties were performed for seven cases. Femoral osteochondroplasty was performed for all thirteen cases. At minimum follow-up of two year (range, 24-29 months), all patients had substantial relief in preoperative pain with improvement in range of motion. The median MHHS was significantly (P<0.05) improved from 61 points preoperatively to 87 points at the last follow-up. The median UCLA activity level was 7 (range, 5-8) at last follow-up. Radiological indices improved. Two cases showed mild residual pain attributable to adhesion between capsule and reshaped femoral head-neck area. Conclusion Open surgical treatment of FAI was a reliable and effective treatment method in symptomatic FAIs for patients over the age of 30 years without advanced arthritic change of hip joint at short term follow-up. PMID:27536632

  12. Femoro-acetabular impingement: can indirect MR arthrography be considered a valid method to detect endoarticular damage? A preliminary study.

    PubMed

    Pozzi, Grazia; Stradiotti, Paola; Parra, Cleber Garcia; Zagra, Luigi; Sironi, Sandro; Zerbi, Alberto

    2009-01-01

    To assess the effectiveness of indirect Magnetic Resonance arthrography (i-MRa) in the detection of chondral and labral lesions related to femoro-acetabular impingement (FAI) a series of 21 hip joints in 17 patients with a clinical diagnosis of FAI were examined either with standard MR imaging, i-MRa and direct-MR arthrography (d-MRa). Sensitivity and accuracy of i-MRa in detecting chondral, labral and tardive lesions were calculated and compared with standard MR. The agreement in detecting endoarticular damage between i-MRa and d-MRa and the interobserver agreement was assessed by K statistic (p<0.05). Finally the presence of trocanteric bursitis was evaluated. I-MRa showed higher values of both sensivity and accuracy than standard MR in detecting chondral damage, with an increase to 92% for the first item and 95% for the second. The same was noticed in labrum evaluation with an increase to 88% and 90% respectively. The level of agreement between i-MRa and d-MRa in detection of chondral lesions was excellent, substantial for the labral damage and absolute for early osteoarthritic changes. An excellent interobserver agreement resulted in detection of both chondral and labral damages with i-MRa. In 6 hips (28,5%) we also found the presence of peri-trochanteric soft tissue inflammation that indicated the possibility of extrarticular involvement in FAI. Indirect-MRa can be considered a valid method of assessing endoarticular damage related to FAI, in comparison to d-MRa. It should be performed instead of standard MR if d-MRa is not available.

  13. Impingement.

    ERIC Educational Resources Information Center

    Uziel, Mary S.

    1978-01-01

    Presents a literature review of the impact of impingement in fishery resources at different power plants in the United States, covering publications of 1976-77. Consideration is given to engineering studies and biological effects for reducing impingement. A list of 96 references is also presented. (HM)

  14. COMPARISON OF RANGE OF MOTION, STRENGTH, AND HOP TEST PERFORMANCE OF DANCERS WITH AND WITHOUT A CLINICAL DIAGNOSIS OF FEMOROACETABULAR IMPINGEMENT

    PubMed Central

    Carcia, Christopher R.; Christoforetti, John J.; Martin, RobRoy L.

    2016-01-01

    ABSTRACT Background Dancers commonly experience anterior hip pain caused by femoroacetabular impingement (FAI) that interrupts training and performance in dance. A paucity of literature exists to guide appropriate evaluation and management of FAI among dancers. Purpose The purpose of this study was to determine if dancers with clinical signs of FAI have differences in hip range of motion, strength, and hop test performance compared to healthy dancers. Study Design Quasi-experimental, cohort comparison. Methods Fifteen dancers aged between 18- 21 years with clinical signs of FAI that included anterior hip pain and provocative impingement tests were compared to 13 age-matched dancers for passive hip joint range of motion, isometric hip strength, and performance of the medial triple hop, lateral triple hop, and cross-over hop tests. Results No statistically significant differences in range of motion were noted for flexion (Healthy = 145° + 7°; FAI = 147° + 10°; p=0.59), internal rotation (Healthy = 63° + 7°; FAI = 61° + 11°; p=0.50), and external rotation (Healthy = 37° + 9°; FAI = 34° + 12°; p=0.68) between the two groups. Hip extension strength was significantly less in the dancers with FAI (224 + 55 Newtons) compared to the healthy group (293 ± 58 Newtons; F(1,26) = 10.2; p=0.004). No statistically significant differences were noted for flexion, internal rotation, external rotation, abduction, or adduction isometric strength. The medial triple hop test was significantly less in the FAI group (354 ± 43 cm) compared to the healthy group (410 ± 50 cm; F(1,26) = 10.3; p = 0.004). Similar results were observed for the lateral hop test, as the FAI group (294 ± 38 cm) performed worse than the healthy controls (344 ± 54cm; F(1,26) = 7.8; p = 0.01). There was no statistically significant difference between the FAI group (2.7 ± 0.92 seconds) and the healthy

  15. IMPROVEMENTS IN KNEE EXTENSION STRENGTH ARE ASSOCIATED WITH IMPROVEMENTS IN SELF-REPORTED HIP FUNCTION FOLLOWING ARTHROSCOPY FOR FEMOROACETABULAR IMPINGEMENT SYNDROME

    PubMed Central

    Ellis, Thomas J.; Amesur, Ajit K.; Hewett, Timothy E.; Di Stasi, Stephanie

    2016-01-01

    Background Recovery of strength is critical for return to sport, and is a known predictor of functional outcomes in post-surgical orthopedic populations. Muscle weakness is a known impairment in patients with femoroacetabular impingement syndrome (FAIS) but whether improvements in muscle strength after arthroscopy are associated with improved hip function is unknown. Hypothesis/Purpose To examine the relationships between changes in hip and thigh muscle strength and self-reported function in athletes undergoing arthroscopy for FAIS. Study Design Single cohort descriptive and correlational study Methods Twenty-eight athletes underwent strength testing and completed the Hip Outcome Score Activities of Daily Living (HOS-ADL) and Sports (HOS-S) subscales prior to and six months after surgery. Isokinetic knee extension and flexion strength were measured using a Biodex dynamometer at 60 °/s and 300 °/s. Isometric hip abduction strength was measured using a custom dynamometer. Changes in strength, limb symmetry, and HOS scores were assessed using paired t-tests. Spearman's rank correlations were used to examine relationships between change in involved limb strength and change in HOS scores. Results Subjects were tested an average of 32 days before and 178 days after surgery. HOS-ADL and HOS-S subscales improved by a mean of 19.0 ± 21.1 and 23.8 ± 31.9, respectively, over time (p < 0.001). Hip abduction strength did not increase over time in either limb (p ≥ 0.27). Involved limb knee flexion and extension strength did not increase significantly over time (p-values: 0.10-0.48) with the exception of knee extension at 300 °/s (p = 0.04). Uninvolved limb knee extension strength at both velocities and knee flexion strength at 60 °/s improved significantly over time (p < 0.012). Increases in knee extension strength (60 °/s) of the involved limb were significantly correlated with improvements on the HOS-ADL (r = 0.431; 0 = 0

  16. Unrecognized osteoid osteoma of the proximal femur with associated cam impingement

    PubMed Central

    Ly, Justin A.; Coleman, Erin M.; Cohen, Gary S.; Kropf, Eric J.

    2016-01-01

    Femoro-acetabular impingement is a common cause of hip pain in young athletes. Evaluation typically includes radiographs and magnetic resonance imaging. It is important to appreciate uncommon diagnoses and the role of complimentary imaging. This clinical vignette emphasizes the need complete imaging with CT in select case of atypical hip pain. We present a 19-year old soccer player who underwent seemingly successful arthroscopic FAI surgery but returned with pain. Computed tomography (CT) revealed osteoid osteoma of the lesser trochanter. The lesion was successfully treated with percutaneous CT guided radiofrequency ablation. PMID:27583164

  17. Arthroscopic Resection of Osteochondroma of Hip Joint Associated with Internal Snapping: A Case Report

    PubMed Central

    Jung, Heung-Tae; Hwang, Deuk-Soo; Jeon, Yoo-Sun

    2015-01-01

    A 16-year old male patient visited the hospital complaining of inguinal pain and internal snapping of right hip joint. In physical examination, the patient was presumed to be diagnosed femoroacetabular impingement (FAI) and acetabular labral tear. In radiologic evaluation, FAI and acetabular labral tear were identified and bony tumor associated with internal snapping was found on the posteromedial portion of the femoral neck. Despite of conservative treatment, there was no symptomatic improvement. So arthroscopic labral repair, osteoplasty and resection of bony tumor were performed. The tumor was pathologically diagnosed as osteochondroma through biopsy and all symptoms improved after surgery. There was no recurrence, complication or abnormal finding during 1 year follow up. Osteochondroma located at posteromedial portion of femoral neck can be a cause of internal snapping hip and although technical demands are challenging, arthroscopic resection can be a good treatment option. PMID:27536601

  18. Prospective 12-month functional and vocational outcomes of hip arthroscopy for femoroacetabular impingement as part of an evidence-based hip pain rehabilitation pathway in an active military population

    PubMed Central

    Bennett, A N; Nixon, J; Roberts, A; Barker-Davies, R; Villar, R; Houghton, J M

    2016-01-01

    Background Femoroacetabular impingement (FAI) is common with an estimated prevalence of 10–15% among young active individuals. The natural history of the disorder is progression to early osteoarthritis. Hip arthroscopy is recommended if conservative treatments fail; however, outcomes are unclear, particularly in highly active populations. Aim To evaluate the functional and vocational outcome of hip arthroscopy, as part of an evidence-based rehabilitation hip pain pathway, for the treatment of FAI in an active military population. Methods All patients in the defence rehabilitation hip pain pathway, with a confirmed diagnosis of FAI who failed conservative treatment, were assessed prior to surgery and at 2, 6 and 12 months postsurgery. Outcome measures included the Visual Analogue Scale (VAS) for hip pain, Non-Arthritic Hip Score (NAHS) for function, and vocational assessments including functional activity assessment (FAA) and Joint Medical Employment Standard for military employability and deployability. Results 101 patients completed the study (mean age=33 years) (male:female:75:26) (Royal Navy/British Army/Royal Air Force: 13%/48%/39%). Outcomes demonstrated significant improvements with large effect size. Preoperative NAHS mean=62.9 (SD 16.4), 12-month postoperative NAHS mean=78.8 (18.3), mean improvement in NAHS=15.9 (95% CI 12.3 to 19.5, p<0.001). Preoperative VAS pain mean=51.3 (20.9), 12-month postoperative VAS pain=25.6 (24.5). Mean improvement 25.7 (95% CI 19.4 to 31.99, p<0.001). 73% of patients had a deployable medical category at 12 months postoperative. Conclusions These data confirm that hip arthroscopy as part of a structured evidence-based multidisciplinary care pathway produces significant and continued symptomatic, functional and vocational improvements over a 12-month period in a military population exposed to high intensity, weight-bearing exercise in uncontrolled and unforgiving environments. PMID:27900190

  19. [Athletic pubalgia and hip impingement].

    PubMed

    Berthaudin, A; Schindler, M; Ziltener, J-L; Menetrey, J

    2014-07-16

    Athletic pubalgia is a painful and complex syndrom encountered by athletes involved in pivoting and cutting sports such as hockey and soccer. To date, there is no real consensus on the criteria for a reliable diagnostic, the different investigations, and the appropriate therapy. Current literature underlines intrinsic and extrinsic factors contributing to athletic pubalgia. This review article reports upon two novelties related to the issue: the importance and efficience of prevention program and the association of femoro-acetabular impingement with the pubalgia.

  20. MRI of lower extremity impingement and friction syndromes in children

    PubMed Central

    Aydıngöz, Üstün; Özdemir, Zeynep Maraş; Güneş, Altan; Ergen, Fatma Bilge

    2016-01-01

    Although generally more common in adults, lower extremity impingement and friction syndromes are also observed in the pediatric age group. Encompassing femoroacetabular impingement, iliopsoas impingement, subspine impingement, and ischiofemoral impingement around the hip; patellar tendon–lateral femoral condyle friction syndrome; iliotibial band friction syndrome; and medial synovial plica syndrome in the knee as well as talocalcaneal impingement on the hindfoot, these syndromes frequently cause pain and may mimic other, and occasionally more ominous, conditions in children. Magnetic resonance imaging (MRI) plays a key role in the diagnosis of musculoskeletal impingement and friction syndromes. Iliopsoas, subspine, and ischiofemoral impingements have been recently described, while some features of femoroacetabular and talocalcaneal impingements have recently gained increased relevance in the pediatric population. Fellowship-trained pediatric radiologists and radiologists with imaging workloads of exclusively or overwhelmingly pediatric patients (particularly those without a structured musculoskeletal imaging program as part of their imaging training) specifically need to be aware of these rare syndromes that mostly have quite characteristic imaging findings. This review highlights MRI features of lower extremity impingement and friction syndromes in children and provides updated pertinent pathophysiologic and clinical data. PMID:27538047

  1. Arthroscopic treatment of unstable total hip replacement.

    PubMed

    Cuéllar, Ricardo; Aguinaga, Iñaki; Corcuera, Irene; Ponte, Juan; Usabiaga, Jaime

    2010-06-01

    Hip arthroscopy may be useful in the diagnosis and treatment of apparently well-implanted but unstable total hip replacement prostheses. We present 2 cases of arthroscopically assisted capsular tightening in unstable total hip replacements. Both cases had significant capsular laxity. Case 2 had impingement of the lower part of the acetabulum with the lesser trochanter that caused hip dislocation. Early revision surgery can be avoided with the use of this technique in selected cases of unstable total hip replacements.

  2. Treatment of anterolateral impingements of the ankle joint by arthroscopy.

    PubMed

    Hassan, Al-Husseiny Moustafa

    2007-09-01

    Impingement syndromes of the ankle joint are among the most common intraarticular ankle lesions. Soft tissue impingement lesions of the ankle usually occur as a result of synovial, or capsular irritation secondary to traumatic injuries, usually ankle sprains, leading to chronic ankle pain. The aim of this prospective study was to evaluate arthroscopic debridement of an anterolateral soft tissue impingement of the ankle. During the period between October 2000 and February 2004, 23 patients with residual complaints after an ankle sprain were diagnosed as anterolateral impingement of the ankle, and were treated by arthroscopic debridement. At a minimum of 6 months follow up, patients were asked to complete an American orthopaedic foot and ankle society (AOFAS) ankle and hind foot score. The average follow-up was 25 months (range 12-38). The average pre-operative patient assessed AOFAS score was 34 (range 4-57). At the end of follow-up the mean AOFAS score was 89 (range 60-100). In terms of patient satisfaction 22 patients said they would accept the same arthroscopic procedure again for the same complaints. At the end of follow-up, 7 patients had excellent results, and 14 patients had good results while two patients had fair results. We believe that arthroscopic debridement of the anterolateral impingement soft tissues are a good, and effective method of treatment.

  3. Normal anatomy and imaging of the hip: emphasis on impingement assessment.

    PubMed

    Jesse, Mary Kristen; Petersen, Brian; Strickland, Colin; Mei-Dan, Omer

    2013-07-01

    A comprehensive knowledge of normal hip anatomy and imaging techniques is essential in the evaluation and assessment of the patient with hip pain. This article reviews the osseous, soft tissue, and vascular components of the hip and the normal anatomical variants encountered in routine hip imaging. Basic and advanced hip imaging is discussed with particular emphasis on radiographic and computed tomography measurements and their utility in evaluating patients with developmental hip dysplasia and femoroacetabular impingement syndrome.

  4. Arthroscopic Interphalangeal Arthrodesis of the Thumb.

    PubMed

    Lui, Tun Hing

    2016-12-01

    Arthrodesis of the interphalangeal joint of the thumb is an effective treatment for pain, deformity, or instability at the joint. Arthroscopic interphalangeal arthrodesis of the thumb is a minimally invasive surgery and has better cosmetic results and less surgical trauma as compared with the open approaches. The purpose of this technical note is to report the details of the arthroscopic interphalangeal arthrodesis with oblique placement of the headless screw. No traction device is used for this technique. It is indicated in recalcitrant painful arthritis of the interphalangeal joint of the thumb. It is contraindicated in case of significant deformity of the joint as a result of subchondral bone collapse. It is also contraindicated if there is impinging volar osteophyte, local infection, or lack of expertise.

  5. Anterior Inferior Iliac Spine (AIIS) and Subspine Hip Impingement

    PubMed Central

    Carton, Patrick; Filan, David

    2016-01-01

    Summary Background Abnormal morphology of the anterior inferior iliac spine (AIIS) and the subspine region of the acetabular rim are increasingly being recognised as a source of symptomatic extra-articular hip impingement. This review article aims to highlight important differences in the pathogenesis, clinical presentation and management of extra-articular hip impingement from both the AIIS and subspine bony regions, and the outcome following surgical intervention. Methods A literature review was undertaken to examine the supporting evidence for AIIS and subspine hip impingement. A narrative account of the Author’s professional experience in this area, including operative technique for arthroscopic correction, is also presented. Results Abnormal morphology of the AIIS and subspine region has been classified using cadaveric, radiological and arthroscopic means; the clinical presentation and operative treatment has been documented in several case series studies. Dual pathology is often present - recognition and treatment of both intra- and extra-articular components are necessary for good postoperative outcome. Conclusions AIIS and sub-spine hip impingement should be considered as distinct pathological entities, which may also co-exist. Symptom relief can be expected following arthroscopic deformity correction with the treatment of concomitant intra-articular pathology. Failure to recognise and treat the extra-articular component may affect postoperative outcome. Level of evidence V. PMID:28066737

  6. Arthroscopic Management of Osteoarthritis.

    PubMed

    Pitta, Michael; Davis, William; Argintar, Evan H

    2016-02-01

    Arthroscopic surgery is commonly performed in the knee, shoulder, elbow, and hip. However, the role it plays in the management of osteoarthritis is controversial. Routine arthroscopic management of osteoarthritis was once common, but this practice has been recently scrutinized. Although some believe that there is no role for arthroscopic treatment in the management of osteoarthritis, it may be appropriate and beneficial in certain situations. The clinical success of such treatment may be rooted in appropriate patient selection and adherence to a specific surgical technique. Arthroscopy may serve as an effective and less invasive option than traditional methods of managing osteoarthritis.

  7. Endoscopic treatment of calcaneo-fibular impingement.

    PubMed

    Bauer, T; Deranlot, J; Hardy, Ph

    2011-01-01

    The calcaneo-fibular impingement syndrome is frequent after calcaneal fracture and is linked to the decreased space between the tip of the fibula and the lateral wall of the calcaneus. The reasons for the painful symptoms are mixed with both bony and soft tissue involvement. The abnormal bony contact between the lateral calcaneal cortex and the tip of the fibula depends mainly on the size and localization of the lateral exostosis of the calcaneal wall. The soft tissue impingement is due to the fibrosis and scar tissues in the lateral gutter and to the compression of the peroneal tendons in the retromalleolar groove and under the tip of the malleolus. A 2-portal endoscopic technique is described for the treatment of calcaneo-fibular impingement with bone resection, soft tissue debridement and peroneal tendons release. One of the advantages of this endoscopic technique is the possibility of an assessment and treatment of associated lesions in the same procedure. A subtalar joint fusion can be done before if needed under arthroscopic control. As this endoscopic technique is very efficient to relieve symptoms of calcaneo-fibular impingement and is focused on the most relevant symptoms, it can thus be indicated for most of cases of calcaneal malunions, whatever the type of malunion and depending of the painful symptoms.

  8. 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.

  9. Finite element prediction of contact pressures in cam-type femoroacetabular impingement with varied alpha angles.

    PubMed

    Liu, Qian; Wang, Wanchun; Thoreson, Andrew R; Zhao, Chunfeng; Zhu, Weihong; Dou, Pengcheng

    2017-02-01

    Three dimensional finite element models of cam-type FAI with alpha angles of 60°, 70°, 80°, and 90° were created to investigate the cartilage contact mechanics in daily activities. Intra-articular cartilage contact pressures during routine daily activities were assessed and cross-compared with a normal control hip. Alpha angles and hip range of motion were found to have a combined influence on the cartilage contact mechanics in hips with cam-type FAI, thereby resulting in abnormally high pressures and driving the cartilage damage. In particular, alpha angles of 80° or greater contribute to substantial pressure increase under certain types of daily activities.

  10. EVALUATION OF PRESENTATION OF SIGNS AND SYMPTOMS OF FEMOROACETABULAR IMPINGEMENT AFTER EPIPHYSIOLYSIS OF THE PROXIMAL FEMUR

    PubMed Central

    Krüger, Fábio Peng; de Britto, Paulo Sérgio Gérzon; Neto, Lauro Machado; Schwartsmann, Carlos Roberto

    2015-01-01

    The long-bone fractures occur most frequently in the tibial shaft. Adequate treatment of such fractures avoids consolidation failure, skewed consolidation and reoperation. To classify these fractures, the AO/OTA classification method is still used, but it is worthwhile getting to know the Ellis classification method, which also includes assessment of soft-tissue injuries. There is often an association with compartmental syndrome, and early diagnosis can be achieved through evaluating clinical parameters and constant clinical monitoring. Once the diagnosis has been made, fasciotomy should be performed. It is always difficult to assess consolidation, but the RUST method may help in this. Radiography is assessed in two projections, and points are scored for the presence of the fracture line and a visible bone callus. Today, the dogma of six hours for cleaning the exposed fracture is under discussion. It is considered that an early start to intravenous antibiotic therapy and the lesion severity are very important. The question of early or late closure of the lesion in an exposed fracture has gone through several phases: sometimes early closure has been indicated and sometimes late closure. Currently, whenever possible, early closure of the lesion is recommended, since this diminishes the risk of infection. Milling of the canal when the intramedullary nail is introduced is still a controversial subject. Despite strong personal positions in favor of milling, studies have shown that there may be some advantage in relation to closed fractures, but not in exposed fractures. PMID:27027007

  11. EVALUATION OF PRESENTATION OF SIGNS AND SYMPTOMS OF FEMOROACETABULAR IMPINGEMENT AFTER EPIPHYSIOLYSIS OF THE PROXIMAL FEMUR.

    PubMed

    Krüger, Fábio Peng; de Britto, Paulo Sérgio Gérzon; Neto, Lauro Machado; Schwartsmann, Carlos Roberto

    2011-01-01

    The long-bone fractures occur most frequently in the tibial shaft. Adequate treatment of such fractures avoids consolidation failure, skewed consolidation and reoperation. To classify these fractures, the AO/OTA classification method is still used, but it is worthwhile getting to know the Ellis classification method, which also includes assessment of soft-tissue injuries. There is often an association with compartmental syndrome, and early diagnosis can be achieved through evaluating clinical parameters and constant clinical monitoring. Once the diagnosis has been made, fasciotomy should be performed. It is always difficult to assess consolidation, but the RUST method may help in this. Radiography is assessed in two projections, and points are scored for the presence of the fracture line and a visible bone callus. Today, the dogma of six hours for cleaning the exposed fracture is under discussion. It is considered that an early start to intravenous antibiotic therapy and the lesion severity are very important. The question of early or late closure of the lesion in an exposed fracture has gone through several phases: sometimes early closure has been indicated and sometimes late closure. Currently, whenever possible, early closure of the lesion is recommended, since this diminishes the risk of infection. Milling of the canal when the intramedullary nail is introduced is still a controversial subject. Despite strong personal positions in favor of milling, studies have shown that there may be some advantage in relation to closed fractures, but not in exposed fractures.

  12. Arthroscopic Resection of Too-Long Anterior Process of the Calcaneus.

    PubMed

    Lui, Tun Hing

    2016-10-01

    A too-long anterior process (TLAP) of the calcaneus is an elongated anteromedial process of the calcaneus impinging the navicular or the talar head. TLAP can cause recurrent ankle sprain, peroneal muscle spasm, or persistent tarsal pain in adolescents. Arthroscopic resection is indicated if the symptoms do not respond to conservative treatment. It has the advantage of assessment of completeness of bone resection and treatment of associated lesions of the adjacent joints. The purpose of this technical note is to report an arthroscopic approach of the resection of the TLAP with the lateral midtarsal portal as the viewing portal.

  13. US in ankle impingement syndrome.

    PubMed

    Pesquer, Lionel; Guillo, Stephane; Meyer, Philippe; Hauger, Olivier

    2014-06-01

    Ankle impingement is a common condition occurring secondary to sprain or repeated microtrauma. Clinical symptoms are chronic pain located in the affected region and limited range of ankle motion. There are three types of ankle impingement syndrome: anterior impingement, which can be subdivided into anterolateral, anteromedial and purely anterior impingement; posterior impingement, which can be subdivided into posterior and posteromedial impingement; and calcaneal peroneal impingement which is secondary to planovalgus foot deformity. This paper evaluates physiological and clinical elements of these three types of ankle impingement syndrome as well as the role of ultrasound (US) imaging and US-guided treatment.

  14. Arthroscopic psoas tenotomy.

    PubMed

    Wettstein, Michael; Jung, Jochen; Dienst, Michael

    2006-08-01

    Tenotomy may be indicated for psoas tendinitis or painful snapping if conservative treatment remains unsuccessful. Because of significant complications with open techniques, endoscopic operations have been developed. We present a new arthroscopic technique to access and release the psoas tendon from the hip joint. This procedure can be performed in addition to other arthroscopic procedures of the hip joint or alone. To exclude additional hip disease, a diagnostic round of the joint should be completed. After hip arthroscopy of the central compartment has been performed, traction is released and the 30 degrees arthroscope is placed via the proximal anterolateral portal lying on the anterior femoral neck. The medial synovial fold can be identified. This fold lies slightly medially underneath the anteromedial capsule at the level of the psoas tendon. The arthroscope is turned toward the anterior capsule. Sometimes, the tendon shines through a thin articular capsule, or it may even be accessed directly via a hole connecting the hip joint and the iliopectineal bursa at the level of the anterior head-neck junction. If this cannot be done, an electrothermic probe is introduced via the anterior portal to make a 2-cm transverse capsular incision. The tendon is released with the back side of the electrothermic device turned to the iliacus muscle that lies anterior to the psoas tendon. A complete release is achieved when the tendon stumps can be seen gapping at a distance and the fibers of the iliacus muscle are visible. The first 9 patients who underwent surgery performed according to this technique developed no complications, and their hip flexion strength was restored to normal within 3 months.

  15. ARTHROSCOPIC TREATMENT OF ELBOW STIFFNESS

    PubMed Central

    Vieira, Luis Alfredo Gómez; Dal Molin, Fabio Farina; Visco, Adalberto; Fernandes, Luis Filipe Daneu; dos Santos, Murilo Cunha Rafael; Cardozo Filho, Nivaldo Souza; Gómez Cordero, Nicolas Gerardo

    2015-01-01

    To present the arthroscopic surgical technique and the evaluation of the results from this technique for treating elbow stiffness. Methods: Between April 2007 and January 2010, ten elbows of ten patients with elbow stiffness underwent arthroscopic treatment to release the range of motion. The minimum follow-up was 11 months, with an average of 27 months. All the patients were male and their average age was 32.8 years (ranging from 22 to 48 years). After the arthroscopic treatment, they were followed up weekly in the first month and every three months thereafter. The clinical evaluation was made using the criteria of the University of California at Los Angeles (UCLA). Results: All the patients were satisfied with the results from the arthroscopic treatment. The average UCLA score was 33.8 points. Conclusion: Arthroscopic treatment for elbow stiffness is a minimally invasive surgical technique that was shown to be efficient for treating this complication. PMID:27027027

  16. [Arthroscopic treatment for osteoarthritic knee].

    PubMed

    Bloom, Shlomo; Lebel, David; Cohen, Eugen; Atar, Dan; Rath, Ehud

    2008-04-01

    Osteoarthritis (OA) is the leading cause of knee morbidity. Age and overweight are the main risk factors for development of knee OA. The majority of patients respond to conservative treatment. For those who don't, surgical treatment is the only alternative. Arthroscopic surgery for the osteoarthritic knee is a well known procedure. Recently, numerous publications addressed the advantages of arthroscopic treatment for this indication. Some of the publications concluded that arthroscopic treatment for knee OA equals placebo. Others found temporary relief of symptoms. Among special subgroup of patients, in which acute pain exacerbation, mechanical block or early OA, utilizing arthroscopic techniques revealed satisfactory results. In this review, we discuss the indications and contraindications for arthroscopic treatment of the osteoarthritic knee according to the latest literature.

  17. Impingement syndrome (image)

    MedlinePlus

    ... arch of the shoulder blade, it can cause shoulder pain called impingement syndrome. The tendons become compressed, damaged, and inflamed leading to rotator cuff tendonitis. This can occur ... use of the shoulder like baseball pitching, or from an injury.

  18. Decompression of Posterior Ankle Impingement With Concomitant Anterior Ankle Pathology by Posterior Ankle Arthroscopy in the Supine Position.

    PubMed

    Lui, Tun Hing

    2016-10-01

    Posterior ankle endoscopy is a safe and effective approach for treatment of posterior ankle impingement. This is usually performed with the patient in prone position. The purpose of this technical note is to describe an arthroscopic approach of decompression of posterior ankle impingement with the patient in supine position. This is indicated if there is posterior ankle impingement together with other ankle pathology requiring anterior ankle arthroscopy. This approach allows treatment of both anterior ankle and posterior ankle pathology with the patient in the supine position. Concomitant anterior ankle arthroscopy can be performed with the usual orientation without the need of change of patient's position.

  19. Arthroscopic bursectomy with concomitant iliotibial band release for the treatment of recalcitrant trochanteric bursitis.

    PubMed

    Farr, Derek; Selesnick, Harlan; Janecki, Chet; Cordas, Daniel

    2007-08-01

    Trochanteric bursitis with lateral hip pain is a commonly encountered orthopaedic condition. Although most patients respond to corticosteroid injections, rest, physical therapy (PT), stretching, and anti-inflammatory medications, those with recalcitrant symptoms may require operative intervention. Studies have explored the use of the arthroscope in the treatment of these patients. However, these reports have not addressed the underlying pathology in this chronic condition. We believe that the iliotibial band must be addressed and is the main cause of pain, inflammation, and trochanteric impingement leading to the development of bursitis. We report a new technique for arthroscopic trochanteric bursectomy with iliotibial band release. Our technique involves 2 incisions--one 4 cm proximal to the greater trochanter along the anterior border of the iliotibial band, and the other 4 cm distal and along the posterior border. The 30 degrees arthroscope is introduced through the inferior portal, and a cannula is introduced through the superior portal. A 5.5-mm arthroscopic shaver is inserted through the superior cannula to clear off the surface of the iliotibial band, so that it may be adequately visualized. A hooked electrocautery probe is then used to longitudinally incise the iliotibial band until it no longer rubs, causing impingement over the greater trochanter.

  20. Arthroscopic excision of ganglion cysts.

    PubMed

    Bontempo, Nicholas A; Weiss, Arnold-Peter C

    2014-02-01

    Arthroscopy is an advancing field in orthopedics, the applications of which have been expanding over time. Traditionally, excision of ganglion cysts has been done in an open fashion. However, more recently, studies show outcomes following arthroscopic excision to be as good as open excision. Cosmetically, the incisions are smaller and heal faster following arthroscopy. In addition, there is the suggested benefit that patients will regain function and return to work faster following arthroscopic excision. More prospective studies comparing open and arthroscopic excision of ganglion cysts need to be done in order to delineate if there is a true functional benefit.

  1. Direct Flame Impingement

    SciTech Connect

    2005-09-01

    During the DFI process, high velocity flame jets impinge upon the material being heated, creating a high heat transfer rate. As a result, refractory walls and exhaust gases are cooler, which increases thermal efficiency and lowers NOx emissions. Because the jet nozzles are located a few inches from the load, furnace size can be reduced significantly.

  2. [Surgical treatment of hip osteoarthritis: hpdete on hip arthroscopy].

    PubMed

    Ilizaliturri Sánchez, Víctor M; Camacho Galindo, Javier

    2007-10-01

    Arthroscopic surgery of the hip is a routine procedure in an increasing number of institutions around the world. Indications for this procedure increase as more experience is developed. Thanks to hip arthroscopy some intraarticular lesions like labral or ligamentum teres tears and cartilage lesions have been recognized. All of these have the potential to develop hip osteoarthritis. Open techniques for the treatment of femoroacetabular impingement have been transformed to arthroscopic techniques. Femoroacetabular impingement has the potential to cause hip osteoarthritis. The role of hip arthroscopy in the treatment of formally established hip osteoarthritis is limited and has better results in young patients with early degenerative changes.

  3. Posterior ankle impingement syndrome.

    PubMed

    Maquirriain, Javier

    2005-10-01

    Posterior ankle impingement syndrome is a clinical disorder characterized by posterior ankle pain that occurs in forced plantar flexion. The pain may be acute as a result of trauma or chronic from repetitive stress. Pathology of the os trigonum-talar process is the most common cause of this syndrome, but it also may result from flexor hallucis longus tenosynovitis, ankle osteochondritis, subtalar joint disease, and fracture. Patients usually report chronic or recurrent posterior ankle pain caused or exacerbated by forced plantar flexion or push-off maneuvers, such as may occur during dancing, kicking, or downhill running. Diagnosis of posterior ankle impingement syndrome is based primarily on clinical history and physical examination. Radiography, scintigraphy, computed tomography, and magnetic resonance imaging depict associated bone and soft-tissue abnormalities. Symptoms typically improve with nonsurgical management, but surgery may be required in refractory cases.

  4. Arthroscopic revision of Bankart repair.

    PubMed

    Neri, Brian R; Tuckman, David V; Bravman, Jonathan T; Yim, Duke; Sahajpal, Deenesh T; Rokito, Andrew S

    2007-01-01

    The success of revision surgery for failed Bankart repair is not well known. This purpose of this study was to report the success rates achieved using arthroscopic techniques to revise failed Bankart repairs. Twelve arthroscopic revision Bankart repairs were performed on patients with recurrent unidirectional shoulder instability after open or arthroscopic Bankart repair. Follow-up was available on 11 of the 12 patients at a mean of 34.4 months (range, 25-56 months). The surgical findings, possible modes of failure, shoulder scores (Rowe score, University of California Los Angeles [UCLA], Simple Shoulder Test), and clinical outcome were evaluated. Various modes of failure were recognized during revision arthroscopic Bankart repairs. Good-to-excellent results were obtained in 8 patients (73%) undergoing revision stabilization according to Rowe and UCLA scoring. A subluxation or dislocation event occurred in 3 (27%) of the 11 patients at a mean of 8.7 months (range, 6-12 months) postoperatively. Arthroscopic revision Bankart repairs are technically challenging procedures but can be used to achieve stable, pain-free, functional shoulders with return to prior sport. Owing to limited follow-up and the small number of patients in this study, we were unable to conclude any pattern of failure or selection criteria for this procedure.

  5. Liquid film target impingement scrubber

    DOEpatents

    McDowell, William J.; Coleman, Charles F.

    1977-03-15

    An improved liquid film impingement scrubber is provided wherein particulates suspended in a gas are removed by jetting the particle-containing gas onto a relatively small thin liquid layer impingement target surface. The impingement target is in the form of a porous material which allows a suitable contacting liquid from a pressurized chamber to exude therethrough to form a thin liquid film target surface. The gas-supported particles collected by impingement of the gas on the target are continuously removed and flushed from the system by the liquid flow through each of a number of pores in the target.

  6. Intratendinous supraspinatus cyst as a cause of shoulder impingement

    PubMed Central

    Garg, Akshay; Karuppaiah, Karthik; Elias, David; Tavakkolizadeh, Adel

    2014-01-01

    We report the case of a 29-year-old gentleman with shoulder impingement. An articular-sided intratendinous supraspinatus cyst was identified as the cause of his symptoms. Arthroscopic cyst debridement resulted in a good outcome at 1-year follow-up. Cysts around the shoulder are a well described pathological entity. They consist of different categories, including intraosseus cysts of the humeral head and glenoid, paralabral cysts and cysts associated with the acromioclavicular joint. Although paralabral cysts that lie intramuscularly or between the muscle bellies have frequently been reported, this is the first report of an intratendinous supraspinatus cyst with an intact rotator cuff. We describe the case, its management and the postsurgical outcome. PMID:27582975

  7. Tibiocalcaneal arthrodesis: a new arthroscopic procedure.

    PubMed

    Arriaza, R; Leyes, M

    2011-01-01

    Tibiocalcaneal arthrodesis is considered an aggressive and technically demanding procedure that can be used to treat severe deformities of the hindfoot, and it is rarely performed. The indications for ankle arthroscopy are increasing, and arthroscopic tibiotalar arthrodesis is a common and successful procedure, but arthroscopic tibiocalcaneal arthrodesis has not been previously reported in the literature. A case of extensive talus necrosis with severe hindfoot deformity treated by means of an arthroscopic tibiocalcaneal arthrodesis is presented.

  8. Morphological classification of acromial spur: correlation between Rockwood tilt view and arthroscopic finding

    PubMed Central

    Kongmalai, Pinkawas; Apivatgaroon, Adinun; Chernchujit, Bancha

    2017-01-01

    Purpose and hypothesis: Acromion spur is the extrinsic factor for impingement syndrome and rotator cuff tear. The Rockwood tilt view can be used to evaluate prominence of the anterior acromion, however no study has shown the correlation of findings between the Rockwood tilt view and the arthroscopic finding. Methods: We developed the arthroscopic classification of acromion spur as type 1 flat spur, type 2 bump spur, type 3 heel spur, type 4 keel spur, and type 5 irregular spur. Patients with rotator cuff syndrome who underwent arthroscopic surgery were recruited. Two observers were asked to classify the type of spur from arthroscopic findings and Rockwood tilt views separately in random pattern. The prevalence of supraspinatus tendon tear was also recorded as no tear, partial-thickness tear, and full-thickness tear. Results: The keel spur (33.9%) was the most common finding followed by the heel spur (27.8%). The correlation was high especially for the heel, the keel, and the irregular spur (75.47%, 74.03%, and 72.73%, respectively.) These three types of spurs have a high prevalence of full thickness of supraspinatus tendon tear. Conclusion: The Rockwood tilt view can be used to evaluate the morphology of an acromion spur, especially the at-risk spur that correlates highly with the full-thickness supraspinatus tendon tear. The arthroscopic classification will also be a useful tool to improve communication between the surgeon and the guide for appropriate treatment in a rotator cuff tear patient when encountering the heel, keel, and irregular spur. PMID:28074776

  9. A Simple Technique for Capsular Repair After Hip Arthroscopy

    PubMed Central

    Camp, Christopher L.; Reardon, Patrick J.; Levy, Bruce A.; Krych, Aaron J.

    2015-01-01

    Capsulotomy is typically performed during arthroscopic treatment for femoroacetabular impingement. As the frequency of hip arthroscopy continues to expand rapidly, increased attention is being paid to the implications of interportal capsulotomy and the need for repair. To minimize the risk of postoperative instability, capsular closure has been recommended to restore the anatomy and biomechanical function of the capsule. We present a reliable, efficient, and effective method for arthroscopic closure of the interportal capsulotomy after hip arthroscopy. PMID:26870655

  10. Results of arthroscopic meniscal repair

    PubMed Central

    Orlowski, María Belén; Arroquy, Damián; Chahla, Jorge; Guiñazú, Jorge; Bisso, Martín Carboni; Vilaseca, Tomás

    2017-01-01

    Objectives: Currently the arthroscopic treatment of meniscal pathology has become one of the most common procedures in orthopedic practice and although in most cases meniscectomy is done, meniscal sutures are the treatment of choice when a reparable lesion is diagnosed, especially in young patients. It has been reported that the meniscal repair leads to a lower incidence of developing degenerative changes in the long-term when compared with meniscectomy and nonsurgical treatment of meniscal injuries. The aim of this study was to determine the success rate of meniscal repair achieved in our sports medicine practice. Methods: Between 2006 and 2015, 62 meniscal tears in 58 patients with a mean age of 31 years (range 15-58) were repaired. Mean follow-up was 52 months (range 6-120 months). In 16 patients (28%) was associated with arthroscopic ACL reconstruction. The repair techniques used included outside-in sutures, inside-out sutures, all-inside sutures and a combination of techniques. Failure of the repair was defined by the requirement for repeat knee arthroscopy and partial or subtotal meniscectomy. The indication of arthroscopic revision was based on the presence of mechanical symptoms, after the suture. Results: Failure of meniscus repair occurred in four patients (failure rate: 6.45%), one case was associated with ACL reconstruction (failure rate: 6.25%) and 3 had undergone isolated meniscal suture (failure rate: 8%). The average time for the reoperation was 15 months (4-24). We had no intraoperative complications. Conclusion: The reported failure rate of meniscal repair in stable knees varies between 12% and 43%, with reports that demonstrate a clinical success rate of 100%. In this study, we obtained a success rate of 93.5%. These results are slightly higher than those in the literature, which can be attributed to careful selection of patients and the fact that clinical success tends to be better than the assessed arthroscopically. In summary, we consider the

  11. Ankle instability and arthroscopic lateral ligament repair.

    PubMed

    Acevedo, Jorge I; Mangone, Peter

    2015-03-01

    Over the last 50 years, the surgical management of chronic lateral ankle ligament insufficiency has focused on 2 main categories: local soft-tissue reconstruction and tendon grafts/transfer procedures. There is an increasing interest in the arthroscopic solutions for chronic instability of the ankle. Recent biomechanical studies suggest the at least one of the arthroscopic techniques can provide equivalent results to current open local soft-tissue reconstruction (such as the modified Brostrom technique). Arthroscopic lateral ankle ligament reconstruction is becoming an increasingly acceptable method for the surgical management of chronic lateral ankle instability.

  12. Arthroscopic subacromial decompression in the treatment of full thickness rotator cuff tears: a 3- to 6-year follow-up.

    PubMed

    Zvijac, J E; Levy, H J; Lemak, L J

    1994-10-01

    Arthroscopic subacromial decompression has become an accepted treatment for patients with impingement syndrome; however, its use for full thickness rotator cuff tears continues to be controversial. The purpose of this study is to determine if the results of arthroscopic subacromial decompression alone for full thickness rotator cuff tears deteriorate at long-term follow-up. We reevaluated all 25 patients with full thickness rotator cuff tears who underwent arthroscopic subacromial decompression from our original study group. Based on the University of California at Los Angeles shoulder rating, 68% of patients were rated as excellent or good at the present mean follow-up of 45.8 months (range 36-72 months). This represents a significant decrease from our initial report of 84% satisfactory results at a mean follow-up of 24.6 months. There was a significant decrease in ratings with regard to pain and function; however, no significant deterioration was noted with regard to motion and strength. Two additional patients required open rotator cuff repair since the time of initial follow-up for a total of six. Large and massive rotator cuff tears fared worse over time as compared with small and moderate size tears. Although 1- to 3-year results of arthroscopic subacromial decompression and rotator cuff debridement were favorable, the long-term follow-up demonstrates deterioration of results. We therefore cannot support the use of decompression and debridement alone in the treatment of repairable full thickness rotator cuff tears.

  13. Is there a pathological alpha angle for hip impingement? A diagnostic test study

    PubMed Central

    Barrientos, Cristián; Barahona, Maximiliano; Diaz, Jorge; Brañes, Julian; Chaparro, Felipe; Hinzpeter, Jaime

    2016-01-01

    The normal value of alpha angle is controversial. The aim of this study was to compare the alpha angle in asymptomatic volunteers versus patients who had undergone surgery for symptomatic cam-type femoroacetabular impingement (FAI) and determine a diagnostic cut-off value for symptomatic cam impingement. This is a diagnostic test study. Cases were defined as those patients who had undergone surgery for symptomatic cam or mixed type FAI. Controls were defined as asymptomatic volunteers, with no history of hip pain who had undergone a computed tomography (CT) scan of the abdomen and pelvis for a non-joint or bone-related reason. In both groups, the alpha angle was measured in an oblique axial CT reconstruction of the femoral neck. A logistic regression model was first estimated and a receiver operating characteristics (ROC) curve was then calculated. The diagnostic cut-off value selected was the one that maximizes sensitivity and specificity. Data were analysed from 38 consecutive cases of cam or mixed FAI and 101 controls. The average alpha angle was 67°(±12°) among cases and 48°°(±5°) among controls. An odds ratio of 1.28 [1.18–1.39] was obtained. A ROC curve of 0.96 [0.93–0.99] was calculated, and using an alpha angle of 57° as the diagnostic cut-off value, provided a sensitivity of 92% and a specificity of 95%. If a patient complains of hip pain and an alpha angle of 57° is found in CT, strongly suggest that cam impingement is causing the pain. PMID:27583162

  14. Arthroscopic training resources in orthopedic resident education.

    PubMed

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

    2015-02-01

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

  15. Arthroscopic lysis in knee arthrofibrosis.

    PubMed

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

    1993-01-01

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

  16. An arthroscopic hip documentation form.

    PubMed

    Gokhale, Satesh; Khan, Munir; Kuiper, Jan-Herman; Richardson, James B; Davies, Jonathan P

    2008-07-01

    Hip arthroscopy is becoming increasingly popular. A simple, precise, and practical means of recording arthroscopic findings will be useful for diagnostic, research, and audit purposes. Basic principles of cartography exist to produce two-dimensional paper representations of our spherical planet. We used the same principles to produce a two-dimensional map of the acetabulum and femoral head. The resulting hip diagram shows the acetabulum as viewed from the side and the femoral head as viewed from above. The ligamentum teres is attached to the medial margin of the head. The head-neck junction and part of the femoral neck is shown at the opposite margin of the ligamentum teres. The hip documentation form is simple, precise, and accurate. We use it to record our findings at hip arthroscopy, which we have used to assist us in our practice.

  17. Electrical Aspects of Impinging Flames

    NASA Astrophysics Data System (ADS)

    Chien, Yu-Chien

    This dissertation examines the use of electric fields as one mechanism for controlling combustion as flames are partially extinguished when impinging on nearby surfaces. Electrical aspects of flames, specifically, the production of chemi-ions in hydrocarbon flames and the use of convective flows driven by these ions, have been investigated in a wide range of applications in prior work but despite this fairly comprehensive effort to study electrical aspects of combustion, relatively little research has focused on electrical phenomena near flame extinguishment, nor for flames near impingement surfaces. Electrical impinging flames have complex properties under global influences of ion-driven winds and flow field disturbances from the impingement surface. Challenges of measurements when an electric field is applied in the system have limited an understanding of changes to the flame behavior and species concentrations caused by the field. This research initially characterizes the ability of high voltage power supplies to respond on sufficiently short time scales to permit real time electrical flame actuation. The study then characterizes the influence of an electric field on the impinging flame shape, ion current and flow field of the thermal plume associated with the flame. The more significant further examinations can be separated into two parts: 1) the potential for using electric fields to control the release of carbon monoxide (CO) from surface-impinging flames, and 2) an investigation of controlling electrically the heat transfer to a plate on which the flame impinges. Carbon monoxide (CO) results from the incomplete oxidation of hydrocarbon fuels and, while CO can be desirable in some syngas processes, it is usually a dangerous emission from forest fires, gas heaters, gas stoves, or furnaces where insufficient oxygen in the core reaction does not fully oxidize the fuel to carbon dioxide and water. Determining how carbon monoxide is released and how heat transfer

  18. Rotational effects on impingement cooling

    NASA Technical Reports Server (NTRS)

    Epstein, A. H.; Kerrebrock, J. L.; Koo, J. J.; Preiser, U. Z.

    1987-01-01

    The present consideration of rotation effects on heat transfer in a radially exhausted, impingement-cooled turbine blade model gives attention to experimental results for Reynolds and Rossby numbers and blade/coolant temperature ratio values that are representative of small gas turbine engines. On the basis of a model that encompasses the effects of Coriolis force and buoyancy on heat transfer, bouyancy is identified as the cause of an average Nusselt number that is 20-30 percent lower than expected from previous nonrotating data. A heuristic model is proposed which predicts that the impingement jets nearest the blade roots should deflect inward, due to a centripetal force generated by their tangential velocity counter to the blade motion. Potentially serious thermal stresses must be anticipated from rotation effects in the course of blade design.

  19. Arthroscopic landmarks of the equine carpus.

    PubMed

    Hurtig, M B; Fretz, P B

    1986-11-15

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

  20. Outcome Predictors in Nonoperative Management of Newly Diagnosed Subacromial Impingement Syndrome: A Longitudinal Study

    PubMed Central

    TaheriAzam, Afshin; Sadatsafavi, Mohsen; Moayyeri, Alireza

    2005-01-01

    subacromial injection of local anesthetics. Three current accepted approaches to treatment of impingement syndrome include conservative management, arthroscopic surgery, and open surgical interventions. All of these therapeutic modalities have been found to be effective, even though there is controversy in the medical literature[2–6] about their success rates. Based on the effectiveness of noninvasive therapies, many investigators recommend a period of conservative management for at least 6–12 months.[6–10] Nevertheless, with the advent of arthroscopic surgical techniques, which are remarkably less invasive and require shorter rehabilitation periods than open surgical procedures, some surgeons suggest earlier arthroscopic intervention in rotator cuff disorders.[11] A significant amount of our knowledge about the prognostic factors associated with the response to conservative therapy is from retrospective studies. The aim of our study is to determine these prognostic factors on the basis of a prospective investigation. PMID:16369368

  1. Excimer laser in arthroscopic surgery

    NASA Astrophysics Data System (ADS)

    Koort, Hans J.

    1991-05-01

    The development of efficient high-power lasersystems for use in surgery, especially in arthroscopic fields, leads to a new push for all endoscopic techniques. Both techniques, laser and endoscope, complete each other in an ideal way and allow applications which could not be reached with conventional techniques. One of the newer laser types is the excimer laser, which will be a good choice for surface treatment because of its very considerate interaction with tissue. One example is the ablation or smoothing of articular cartilage and meniscal shaving in orthopaedics. On the other hand, the power of this laser system is high enough to cut tissue, for instance in the lateral release, and offers therefore an alternative to the mechanical and electrical instruments. All lasers can only work fine with effective delivery systems. Sometimes there is only a single fiber, which becomes very stiff at diameters of more than 800 micrometers . This fiber often allows only the tangential treatment of tissue, most of the laser power is lost in the background. New fiber systems with many, sometimes hundreds of very thin single fibers, could offer a solution. Special handpieces and fibersystems offer distinct advantages in small joint arthroscopy, especially those for use with excimer lasers will be discussed.

  2. Arthroscopic Findings in Anterior Shoulder Instability

    PubMed Central

    Hantes, Michael; Raoulis, Vasilios

    2017-01-01

    Background: In the last years, basic research and arthroscopic surgery, have improved our understanding of shoulder anatomy and pathology. It is a fact that arthroscopic treatment of shoulder instability has evolved considerably over the past decades. The aim of this paper is to present the variety of pathologies that should be identified and treated during shoulder arthroscopy when dealing with anterior shoulder instability cases. Methods: A review of the current literature regarding arthroscopic shoulder anatomy, anatomic variants, and arthroscopic findings in anterior shoulder instability, is presented. In addition, correlation of arthroscopic findings with physical examination and advanced imaging (CT and MRI) in order to improve our understanding in anterior shoulder instability pathology is discussed. Results: Shoulder instability represents a broad spectrum of disease and a thorough understanding of the pathoanatomy is the key for a successful treatment of the unstable shoulder. Patients can have a variety of pathologies concomitant with a traditional Bankart lesion, such as injuries of the glenoid (bony Bankart), injuries of the glenoid labrum, superiorly (SLAP) or anteroinferiorly (e.g. anterior labroligamentous periosteal sleeve avulsion, and Perthes), capsular lesions (humeral avulsion of the glenohumeral ligament), and accompanying osseous-cartilage lesions (Hill-Sachs, glenolabral articular disruption). Shoulder arthroscopy allows for a detailed visualization and a dynamic examination of all anatomic structures, identification of pathologic findings, and treatment of all concomitant lesions. Conclusion: Surgeons must be well prepared and understanding the normal anatomy of the glenohumeral joint, including its anatomic variants to seek for the possible pathologic lesions in anterior shoulder instability during shoulder arthroscopy. Patient selection criteria, improved surgical techniques, and implants available have contributed to the enhancement of

  3. Arthroscopically assisted percutaneous fixation of Bennett fractures.

    PubMed

    Culp, Randall W; Johnson, Jeff W

    2010-01-01

    Arthroscopic-assisted reduction and fixation of Bennett-type fractures of the thumb metacarpal allow for the confirmation of reduction as well as the assessment of the degree of chondral damage. With use of a 1.9-mm arthroscope and a traction tower, direct visualization and reduction is possible. Traditional methods of fixation are used to secure the fracture fragment. Postoperative rehabilitation follows the usual protocol used in both open and percutaneous techniques. However, the potential to obtain and confirm a more accurate articular reduction may reduce the incidence of late arthritis of the thumb carpometacarpal articulation.

  4. [Comprehensive arthroscopic management of shoulder osteoarthritis].

    PubMed

    Ríos, D; Martetschlager, F; Millett, P J

    2012-01-01

    Shoulder osteoarthritis has been considered as a cause of severe pain and loss of shoulder function. Many patients with shoulder osteoarthritis are young and have demanding activities, which leads to questioning the choice of arthroplasty. This is why in this paper we describe the comprehensive arthroscopic management (CAM) that combines arthroscopic debridement, capsular release, osteoplasty of the lower humeral head, and auxiliary nerve decompression. In our experience this technique has shown short-term promising results as it decreases pain and allows patients to resume high performance demanding activities.

  5. Arthroscopic Capsular Release of the Ankle Joint.

    PubMed

    Lui, Tun Hing

    2016-12-01

    Adhesive capsulitis of the ankle is also known as frozen ankle and results in marked fibrosis and contracture of the ankle capsule. Arthroscopic capsular release is indicated for symptomatic frozen ankle that is resistant to conservative treatment. It is contraindicated for ankle stiffness due to degenerative joint disease, intra-articular malunion, or adhesion of the extensors of the ankle. The procedure consists of endoscopic posterior ankle capsulectomy and arthroscopic anterior ankle capsulotomy. It has the advantages of being minimally invasive surgery and allowing early postoperative vigorous mobilization of the ankle joint.

  6. Modified Arthroscopic Brostrom Procedure With Bone Tunnels.

    PubMed

    Lui, Tun Hing

    2016-08-01

    The open anatomic repair of the anterior talofibular and calcaneofibular ligaments (modified Brostrom procedure) is widely accepted as the standard surgical stabilization procedure for lateral ankle instability that does not respond to conservative measures. Arthroscopic Brostrom procedures with a suture anchor have been reported to achieve both anatomic repair of the lateral ankle ligaments and management of the associated intra-articular lesions. However, the complication rates are higher than open Brostom procedures. Many of these complications are associated with the use of a suture anchor. We report a modified arthroscopic Brostrom procedure in which the anterolateral ankle capsule is anchored to the lateral malleolus through small bone tunnels instead of suture anchors.

  7. Modelling techniques for jet impingement

    NASA Technical Reports Server (NTRS)

    Haviland, J. K.; Herling, W. W.

    1977-01-01

    A technique for testing scale models for the determination of fluctuating pressure loads due to jet impingement has been investigated using a quarter-scale model of a boilerplate test facility in which a JT-15D engine with a rectangular outer nozzle blows over a small curved airfoil representing the upper-surface of a wing. When model and full-scale spectra of fluctuating surface pressures are reduced to plots of pressure coefficient power-spectral density vs Strouhal number, moderate agreement is obtained, but a shift of spectral peaks is noted. However, when a correction for the ratio of average jet to ambient temperature is applied, the spectral peaks agree.

  8. Externally blown flap impingement noise.

    NASA Technical Reports Server (NTRS)

    Putnam, T. W.; Lasagna, P. L.

    1972-01-01

    An investigation of externally blown flap impingement noise was conducted using a full-scale turbofan engine and aircraft wing. The noise produced with a daisy nozzle installed on the engine exhaust system was greater than that produced by a conical nozzle at the same thrust. The daisy nozzle caused the jet velocity to decay about 35 percent at the flap. The presence of the wing next to the conical nozzle increased the noise, as did increasing the flap deflection. Compared with the conical nozzle, the daisy nozzle produced slightly less noise at a flap deflection of 60 deg but produced more noise at the lower flap deflections tested.

  9. Nanofluid impingement jet heat transfer

    PubMed Central

    2012-01-01

    Experimental investigation to study the heat transfer between a vertical round alumina-water nanofluid jet and a horizontal circular round surface is carried out. Different jet flow rates, jet nozzle diameters, various circular disk diameters and three nanoparticles concentrations (0, 6.6 and 10%, respectively) are used. The experimental results indicate that using nanofluid as a heat transfer carrier can enhance the heat transfer process. For the same Reynolds number, the experimental data show an increase in the Nusselt numbers as the nanoparticle concentration increases. Size of heating disk diameters shows reverse effect on heat transfer. It is also found that presenting the data in terms of Reynolds number at impingement jet diameter can take into account on both effects of jet heights and nozzle diameter. Presenting the data in terms of Peclet numbers, at fixed impingement nozzle diameter, makes the data less sensitive to the percentage change of the nanoparticle concentrations. Finally, general heat transfer correlation is obtained verses Peclet numbers using nanoparticle concentrations and the nozzle diameter ratio as parameters. PMID:22340669

  10. Arthroscopic Arthrodesis of the Distal Tibiofibular Syndesmosis.

    PubMed

    Lui, Tun Hing

    2015-01-01

    Chronic syndesmosis disruption can occur if an acute lesion is missed or inadequately managed. This can result in significant functional deficit and development of post-traumatic ankle arthritis. Anatomic reduction of the syndesmosis and maintenance of the reduction by syndesmotic screw fixation alone, ligamentous reconstruction, or fusion of the syndesmosis are recommended. A technique of arthroscopic distal tibiofibular syndesmosis arthrodesis is described.

  11. Fluorescence Imaging Study of Impinging Underexpanded Jets

    NASA Technical Reports Server (NTRS)

    Inman, Jennifer A.; Danehy, Paul M.; Nowak, Robert J.; Alderfer, David W.

    2008-01-01

    An experiment was designed to create a simplified simulation of the flow through a hole in the surface of a hypersonic aerospace vehicle and the subsequent impingement of the flow on internal structures. In addition to planar laser-induced fluorescence (PLIF) flow visualization, pressure measurements were recorded on the surface of an impingement target. The PLIF images themselves provide quantitative spatial information about structure of the impinging jets. The images also help in the interpretation of impingement surface pressure profiles by highlighting the flow structures corresponding to distinctive features of these pressure profiles. The shape of the pressure distribution along the impingement surface was found to be double-peaked in cases with a sufficiently high jet-exit-to-ambient pressure ratio so as to have a Mach disk, as well as in cases where a flow feature called a recirculation bubble formed at the impingement surface. The formation of a recirculation bubble was in turn found to depend very sensitively upon the jet-exit-to-ambient pressure ratio. The pressure measured at the surface was typically less than half the nozzle plenum pressure at low jet pressure ratios and decreased with increasing jet pressure ratios. Angled impingement cases showed that impingement at a 60deg angle resulted in up to a factor of three increase in maximum pressure at the plate compared to normal incidence.

  12. Externally blown flap impingement noise

    NASA Technical Reports Server (NTRS)

    Lasagna, P. L.; Putnam, T. W.

    1972-01-01

    Tests of the noise produced by the impingement of the jet exhaust on the wing and flap for an externally blown flap system were conducted with a CF700 turbofan engine and an F-111B wing panel. The noise produced with a daisy nozzle installed on the engine was greater than that produced by a conical nozzle at the same thrust. The presence of the wing next to the test nozzles increased the noise, as did increasing the flap deflection angle. Compared with the conical nozzle, the daisy nozzle produced slightly less noise at a flap deflection of 60 deg but produced more noise at the lower flap deflections tested. Tests showed that the single-slotted flap deflected 60 deg, produced less noise than the double-slotted flaps. Also, maintaining the maximum distance between the exit nozzle and flap system resulted in a minor reduction in noise.

  13. A new interdisciplinary treatment strategy versus usual medical care for the treatment of subacromial impingement syndrome: a randomized controlled trial

    PubMed Central

    Dorrestijn, Oscar; Stevens, Martin; Diercks, Ron L; van der Meer, Klaas; Winters, Jan C

    2007-01-01

    Background Subacromial impingement syndrome (SIS) is the most frequently recorded shoulder disorder. When conservative treatment of SIS fails, a subacromial decompression is warranted. However, the best moment of referral for surgery is not well defined. Both early and late referrals have disadvantages – unnecessary operations and smaller improvements in shoulder function, respectively. This paper describes the design of a new interdisciplinary treatment strategy for SIS (TRANSIT), which comprises rules to treat SIS in primary care and a well-defined moment of referral for surgery. Methods/Design The effectiveness of an arthroscopic subacromial decompression versus usual medical care will be evaluated in a randomized controlled trial (RCT). Patients are eligible for inclusion when experiencing a recurrence of SIS within one year after a first episode of SIS which was successfully treated with a subacromial corticosteroid injection. After inclusion they will receive injection treatment again by their general practitioner. When, after this treatment, there is a second recurrence within a year post-injection, the participants will be randomized to either an arthroscopic subacromial decompression (intervention group) or continuation of usual medical care (control group). The latter will be performed by a general practitioner according to the Dutch National Guidelines for Shoulder Problems. At inclusion, at randomization and three, six and 12 months post-randomization an outcome assessment will take place. The primary outcome measure is the patient-reported Shoulder Disability Questionnaire. The secondary outcome measures include both disease-specific and generic measures, and an economic evaluation. Treatment effects will be compared for all measurement points by using a GLM repeated measures analyses. Discussion The rationale and design of an RCT comparing arthroscopic subacromial decompression with usual medical care for subacromial impingement syndrome are

  14. Arthroscopic Marginal Resection of a Lipoma of the Supraspinatus Muscle in the Subacromial Space

    PubMed Central

    Pagán Conesa, Alejandro; Aznar, Carlos Verdú; Herrera, Manuel Ruiz; Lopez-Prats, Fernando Anacleto

    2015-01-01

    Subacromial impingement syndrome is a common cause of shoulder pain in young adults and seniors at present. The etiology of this syndrome is associated with several shoulder disorders, most related to aging, overhead activities, and overuse. The subacromial space is well circumscribed and limited in size, and soft-tissue growing lesions, such as tumors, can endanger the normal function of the shoulder girdle. We present a case of shoulder impingement syndrome caused by an intramuscular lipoma of the supraspinatus muscle in the subacromial space in a 50-year-old male bank manager. Radiographs, magnetic resonance imaging, and a computed tomography scan showed a well-circumscribed soft-tissue tumor at the supraspinatus-musculotendinous junction. It was arthroscopically inspected and dissected and complete marginal excision was performed through a conventional augmented anterolateral portal, avoiding the need to open the trapezius fascia or perform an acromial osteotomy. Microscopic study showed a benign lipoma, and the shoulder function of the patient was fully recovered after a rehabilitation period of 4 months. This less invasive technique shows similar results to conventional open surgery. PMID:26759779

  15. Arthroscopic retrograde osteochondral autologous transplantation to chondral lesion in femoral head.

    PubMed

    Cetinkaya, Sarper; Toker, Berkin; Taser, Omer

    2014-06-01

    This report describes the treatment of 2 cases of full-thickness cartilage defect of the femoral head. The authors performed osteochondral autologous transplantation with a different technique that has not been reported to date. One patient was 37 years old, and the other was 42 years old. Both presented with hip pain. In both patients, radiograph and magnetic resonance imaging scan showed a focal chondral defect on the weight-bearing area of the femoral head and acetabular impingement. A retrograde osteochondral autologous transplantation technique combined with hip arthroscopy and arthroscopic impingement treatment was performed. After a 2-month recovery period, the symptoms were resolved. In the first year of follow-up, Harris Hip scores improved significantly (case 1, 56.6 to 87.6; case 2, 58.6 to 90). The technique described yielded good short- and midterm clinical and radiologic outcomes. To the authors' knowledge, this report is the first to describe a retrograde osteochondral transplantation technique performed with hip arthroscopy in the femoral head.

  16. Arthroscopic Keller technique for Freiberg disease.

    PubMed

    Carro, Luis Perez; Golano, Pau; Fariñas, Oscar; Cerezal, Luis; Abad, Jose

    2004-07-01

    Freiberg disease is a disorder that has a predilection for the second metatarsal head. Keller excision of the base of the proximal phalanx is a procedure described for the treatment of late-stage Freiberg disease. We describe a case of a 60-year-old man, with a stage IV lesion according to Smillie's classification, treated by debridement, removal of the free body, and arthroscopic Keller excision. Arthroscopic treatment allows the patient to begin and maintain an aggressive postoperative physical therapy program immediately after surgery, thus decreasing the risk of scarring and contracture. At last evaluation, 2 years postoperatively, he is symptom-free. A suggested pattern of minimally invasive surgery management of this disease is proposed.

  17. Arthroscopic Taloplasty for an Anterolateral Snapping Ankle.

    PubMed

    Lui, Tun Hing

    2016-12-01

    Anterior ankle snapping syndrome is rare. Snapping of the extensor digitorum longus due to attenuated inferior extensor retinaculum and snapping due to hypertrophied or low-lying peroneal tertius muscle have been reported. We reported a new mechanism of anterolateral snapping due to a hypertrophied talar head. Anterolateral snapping ankle can be revealed by active dorsiflexion and plantarflexion of the ankle with the foot inverted. Foot inversion will tension the inferior extensor retinaculum and uncover the dorsolateral prominence of the talar head. The dorsolateral prominence of the talar head will snap over the proximal edge of the inferior extensor retinaculum. This technical note reports the technique of arthroscopic contouring of the talar head via extra-articular ankle arthroscopy. We named this technique arthroscopic taloplasty.

  18. Complications of arthroscopic surgery of the hip

    PubMed Central

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

    2012-01-01

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

  19. Achilles Impingement Tendinopathy on Magnetic Resonance Imaging.

    PubMed

    Bullock, Mark J; Mourelatos, Jan; Mar, Alice

    2017-02-28

    Haglund's syndrome is impingement of the retrocalcaneal bursa and Achilles tendon caused by a prominence of the posterosuperior calcaneus. Radiographic measurements are not sensitive or specific for diagnosing Haglund's deformity. Localization of a bone deformity and tendinopathy in the same sagittal section of a magnetic resonance imaging scan can assist with the diagnosis in equivocal cases. The aim of the present cross-sectional study was to determine the prevalence of Haglund's syndrome in patients presenting with Achilles tendinopathy and note any associated findings to determine the criteria for a diagnosis of Haglund's syndrome. We reviewed 40 magnetic resonance imaging scans with Achilles tendinopathy and 19 magnetic resonance imaging scans with Achilles high-grade tears and/or ruptures. Achilles tendinopathy was often in close proximity to the superior aspect of the calcaneal tuberosity, consistent with impingement (67.5%). Patients with Achilles impingement tendinopathy were more often female (p < .04) and were significantly heavier than patients presenting with noninsertional Achilles tendinopathy (p = .014) or Achilles tendon rupture (p = .010). Impingement tendinopathy occurred medially (8 of 20) and centrally (10 of 20) more often than laterally (2 of 20) and was associated with a posterior prominence or hyperconvexity with a loss of calcaneal recess more often than a superior projection (22 of 27 versus 8 of 27; p < .001). Haglund's deformity should be reserved for defining a posterior prominence or hyperconvexity with loss of calcaneal recess because this corresponds with impingement. Achilles impingement tendinopathy might be more appropriate terminology for Haglund's syndrome, because the bone deformity is often subtle. Of the 27 images with Achilles impingement tendinopathy, 10 (37.0%) extended to a location prone to Achilles tendon rupture. Given these findings, insertional and noninsertional Achilles tendinopathy are not mutually

  20. Cleaning verification by air/water impingement

    NASA Technical Reports Server (NTRS)

    Jones, Lisa L.; Littlefield, Maria D.; Melton, Gregory S.; Caimi, Raoul E. B.; Thaxton, Eric A.

    1995-01-01

    This paper will discuss how the Kennedy Space Center intends to perform precision cleaning verification by Air/Water Impingement in lieu of chlorofluorocarbon-113 gravimetric nonvolatile residue analysis (NVR). Test results will be given that demonstrate the effectiveness of the Air/Water system. A brief discussion of the Total Carbon method via the use of a high temperature combustion analyzer will also be given. The necessary equipment for impingement will be shown along with other possible applications of this technology.

  1. Posterior ankle impingement in the dancer.

    PubMed

    Moser, Brad R

    2011-01-01

    Dancers spend a lot of time in the relevé position in demi-pointe and en pointe in their training and their careers. Pain from both osseous and soft tissue causes may start to occur in the posterior aspect of their ankle. This article reviews the potential causes of posterior ankle impingement in dancers. It will discuss the clinical evaluation of a dancer and the appropriate workup and radiographic studies needed to further evaluate a dancer with suspected posterior ankle impingement.

  2. [Treatment of lateral ankle joint instability. Open or arthroscopic?].

    PubMed

    Galla, M

    2016-02-01

    Chronic ankle joint instability often necessitates operative treatment. Operative treatment methods are classified into non-anatomical tenodesis, anatomical reconstruction and direct repair. In addition to open approaches, arthroscopic techniques are increasingly becoming established. This article describes the various operative treatment procedures, their advantages and disadvantages and in particular the arthroscopic feasibility.

  3. Arthroscopic visualization during excision of a central physeal bar.

    PubMed

    Stricker, S

    1992-01-01

    A centrally located developmental physeal bar in the proximal tibia was removed via a metaphyseal window. The use of an arthroscope to assist in the complete removal of the bone bridge is described. The arthroscope improved visualization and allowed reduction in the size of the metaphyseal window. At 2-year follow-up, the growth plate showed no evidence of bar reformation.

  4. Rationale of arthroscopic surgery of the temporomandibular joint.

    PubMed

    Murakami, KenIchiro

    2013-01-01

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

  5. Arthroscopic ablation of osteoid osteoma in the wrist.

    PubMed

    Kamrani, Reza Shahryar; Farhadi, Leyla; Emamzadehfard, Sahra

    2013-09-01

    Osteoid osteoma is a benign bone tumor that rarely involves joints. Although there are several reports of arthroscopic osteoid osteoma excisions, to our knowledge, there are no reports of this type of treatment for osteoid osteoma in carpal bones. We report two cases of arthroscopic (a person who had a pain in the left wrist and the other one with carpal tunnel syndrome) with excision of osteoid osteoma in the carpal bones. We think arthroscopic excision is the best choice for treatment as long as the tumor is accessible for arthroscopic surgery, when osteoid osteoma has classic clinical and imaging findings and is near an articular surface. However, when the tumor is far from the joint surfaces, when we need pathologic confirmation or when the tumor is easily accessible using a non-articular approach, arthroscopic excision may not be the most appropriate technique.

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

    PubMed

    Lubowitz, James H

    2015-03-01

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

  7. Properties of the cartilage layer from the cam-type hip impingement deformity.

    PubMed

    Speirs, Andrew D; Beaulé, Paul E; Huang, Adrian; Frei, Hanspeter

    2017-04-11

    Femoro-acetabular impingement (FAI) is associated with significant acetabular cartilage damage and degenerative arthritis. To understand the contact stress and thus biomechanical mechanisms that may contribute to degeneration, the material behaviour of the cartilage layer is required. The objective of this study is to determine the fibril-reinforced poroelastic properties and composition of cartilage from cam deformities and to compare to those of normal cartilage. Patients undergoing surgical treatment of a symptomatic cam FAI deformity were recruited from the clinical practice of one of the authors. Osteochondral specimens were retrieved from the deformity during surgery using a trephine. Control specimens were retrieved from the anterior femoral head bearing surface during autopsy procedures. Indentation stress-relaxation tests were performed to determine the modulus (ES), Poisson's ratio (ν) and permeability (k0) of the poroelastic component, and the strain-independent (E0) and -dependent (Eε) moduli of the fibril-reinforcement using finite element analysis and optimization. Safranin-O staining was used to quantify proteoglycan content. ES and ν were 71% and 37% lower, respectively, in Cam specimens compared to controls, and k0 was approximately triple that of Control specimens (p<0.05). No significant differences were seen in the fibrillar components, E0 and Eε. Proteoglycan content was substantially depleted in Cam specimens, and was correlated with ES, ν and k0. This study showed that cartilage from the cam deformity exhibits severe degeneration in terms of the mechanical behaviour and composition changes, and is consistent with osteoarthritis. This further supports the hypothesis that FAI is a cause of hip osteoarthritis.

  8. [Arthroscopic treatment for calcaneal spur syndrome].

    PubMed

    Stropek, S; Dvorák, M

    2008-10-01

    PURPOSE OF THE STUDY Arthroscopic treatment of calcaneal spur syndrome is a tissue-sparing and effective approach when conservative therapy has failed. This method, its results and our experience with the treatment of this syndrome are presented here. MATERIAL Between January 2003 and November 2007, 26 patients underwent an arthroscopic procedure for calcaneal spur syndrome; of these, 20 were women with an average age of 49 years, and six were men with an average age of 45 years. Four, three women and one man, were lost to follow-up, therefore 22 patients with 24 heels were eventually evaluated. All had conservative therapy for 3 to 6 monts. METHODS The arthroscopic method used was developed by the arthroscopic group of the Orthopaedic Service of Hospital Hermanos Ameijeiras in Havana, Cuba. The surgical technique insolves treatment of the spur and plantar fasciitis commonly found in calcaneal spur syndrome, but it also addresses adjacent calcaneal periostitis. RESULTS The results were evaluated on the scale that is part of the foot function index developed by Budiman-Mak for measuring rheumatoid arthritis pain. The patients were asked mine questions on pain intensity during various activities before and after surgery. Pain was evaluated on a scale with grades from 0 to 9. The average value was 5.9 before surgery and 1.4 after surgery. A 0-1 pain range was reported by 25 %, 1-2 by 26 % and 2-4 by 22 % of the patients. All patients reported improvement. DISCUSSION The orthopaedic group in Havana led by Carlos achieved 85 % excellent outcomes (pain range, 0-2) at one-year followup; this was 79 % in our study, in which no problems with foot arches or wound infection were recorded. CONCLUSIONS The heel spur syndrome is a result of an inflamed ligament (plantar fascia) due to repeated microtrauma. It is not a traction osteophyte,but a reaction of the tissue where it attaches to the calcaneus. Adjacent calcaneal periostitis is usually present as well. Therefore, this

  9. Design an efficient air impingement nozzle array

    SciTech Connect

    Steinberg, N.I.

    1995-08-01

    Direct air impingement is the most commonly used system for heating, cooling,and drying webs and films. Air impingement heat-transfer systems blow jets of air (or other gas) perpendicular to the web from an array of nozzles. These may be slot nozzles positioned across the web or a two-dimensional array of round nozzles, typically holes in a plate. Designing air impingement systems essentially means specifying the key geometric parameters that control the heat-transfer coefficient: slot width, slot-to-slot pitch, and slot-to-web stand-off distance, as well as some secondary parameters that affect heat transfer uniformity in the longitudinal and transverse directions. Slot nozzle array designs based on published optimization correlations usually have a near-maximum heat-transfer coefficient for a given impingement velocity, but an accessibly high nozzle area per unit impinged area. This increase construction and operating cost because the air volumes are too high. This article addresses that problem by providing a systematic design procedure along with the required design data.

  10. Microtextured Surfaces for Turbine Blade Impingement Cooling

    NASA Technical Reports Server (NTRS)

    Fryer, Jack

    2014-01-01

    Gas turbine engine technology is constantly challenged to operate at higher combustor outlet temperatures. In a modern gas turbine engine, these temperatures can exceed the blade and disk material limits by 600 F or more, necessitating both internal and film cooling schemes in addition to the use of thermal barrier coatings. Internal convective cooling is inadequate in many blade locations, and both internal and film cooling approaches can lead to significant performance penalties in the engine. Micro Cooling Concepts, Inc., has developed a turbine blade cooling concept that provides enhanced internal impingement cooling effectiveness via the use of microstructured impingement surfaces. These surfaces significantly increase the cooling capability of the impinging flow, as compared to a conventional untextured surface. This approach can be combined with microchannel cooling and external film cooling to tailor the cooling capability per the external heating profile. The cooling system then can be optimized to minimize impact on engine performance.

  11. Improved Stirling engine performance using jet impingement

    NASA Technical Reports Server (NTRS)

    Johnson, D. C.; Britt, E. J.; Thieme, L. G.

    1982-01-01

    Of the many factors influencing the performance of a Stirling engine, that of transferring the combustion gas heat into the working fluid is crucial. By utilizing the high heat transfer rates obtainable with a jet impingement heat transfer system, it is possible to reduce the flame temperature required for engine operation. Also, the required amount of heater tube surface area may be reduced, resulting in a decrease in the engine nonswept volume and a related increase in engine efficiency. A jet impingement heat transfer system was designed by Rasor Associates, Inc., and tested in the GPU-3 Stirling engine at the NASA Lewis Research Center. For a small penalty in pumping power (less than 0.5% of engine output) the jet impingement heat transfer system provided a higher combustion-gas-side heat transfer coefficient and a smoothing of heater temperature profiles resulting in lower combustion system temperatures and a 5 to 8% increase in engine power output and efficiency.

  12. Calculations of slurry pump jet impingement loads

    SciTech Connect

    Wu, T.T.

    1996-03-04

    This paper presents a methodology to calculate the impingement load in the region of a submerged turbulent jet where a potential core exits and the jet is not fully developed. The profile of the jet flow velocities is represented by a piece-wise linear function which satisfies the conservation of momentum flux of the jet flow. The adequacy of the of the predicted jet expansion is further verified by considering the continuity of the jet flow from the region of potential core to the fully developed region. The jet impingement load can be calculated either as a direct impingement force or a drag force using the jet velocity field determined by the methodology presented.

  13. Industrial stator vane with sequential impingement cooling inserts

    DOEpatents

    Jones, Russell B; Fedock, John A; Goebel, Gloria E; Krueger, Judson J; Rawlings, Christopher K; Memmen, Robert L

    2013-08-06

    A turbine stator vane for an industrial engine, the vane having two impingement cooling inserts that produce a series of impingement cooling from the pressure side to the suction side of the vane walls. Each insert includes a spar with a row of alternating impingement cooling channels and return air channels extending in a radial direction. Impingement cooling plates cover the two sides of the insert and having rows of impingement cooling holes aligned with the impingement cooling channels and return air openings aligned with the return air channel.

  14. Arthroscopically assisted central physeal bar resection.

    PubMed

    Marsh, James S; Polzhofer, Gert K

    2006-01-01

    Thirty-seven central physeal bars were removed with an arthroscopically assisted technique. Thirty children (32 cases) have been followed to maturity or physeal closure. There were 19 boys and 11 girls, aged 4-14 years (mean, 9.5 years). Site of arrest was distal femur (15), proximal tibia (9), distal tibia (6), and distal radius (2). Mean follow-up was 6.5 years (range, 2-12 years). Adequate longitudinal growth was realized in 21 patients (70%) just after bar resection. Five patients (17%) required osteotomy, lengthening, or epiphysiodesis in addition to bar resection. In 4 patients (13%), bar resection failed. Failures occurred in those patients whose source of growth arrest was infection (3) or degree of physeal trauma approached 50% (1 case). This is the first series that studies and documents the efficacy of the arthroscope in central physeal bar resection. It provides the best visualization with minimal morbidity. The technique is described, including a discussion of technical tips and pitfalls.

  15. Arthroscopic tibiotalar and subtalar joint arthrodesis.

    PubMed

    Roussignol, X

    2016-02-01

    Arthroscopy has become indispensable for performing tibiotalar and subtalar arthrodesis. Now in 2015, it is the gold-standard surgical technique, and open surgery is reserved only for cases in which arthroscopy is contraindicated: material ablation after consolidation failure, osteophytes precluding a work chamber, excentric talus, severe malunion, bone defect requiring grafting, associated midfoot deformity, etc. The first reports of arthroscopic tibiotalar and subtalar arthrodesis date from the early 1990s. Consolidation rates were comparable to open surgery, but with significantly fewer postoperative complications: infection, skin necrosis, etc. Arthroscopy was for many years reserved to moderate deformity, with frontal or sagittal deviation less than 10°. The recent literature, however, seems to extend indications, the only restriction being the surgeon's experience. Tibiotalar arthrodesis on a posterior arthroscopic approach remains little used. And yet the posterior work chamber is much larger, and initial series showed consolidation rates similar to those of an anterior approach. The surgical technique for posterior tibiotalar arthrodesis was described by Van Dijk et al., initially using a posterior para-Achilles approach. This may be hampered by posterior osteophytes or ankylosis of the subtalar joint line (revision of non-consolidated arthrodesis, sequelae of calcaneal thalamus fracture) and is now used only by foot and ankle specialists. Posterior double tibiotalar-subtalar arthrodesis, described by Devos Bevernage et al., is facilitated by transplantar calcaneo-talo-tibial intramedullary nailing.

  16. Primary Frozen Shoulder Syndrome: Arthroscopic Capsular Release

    PubMed Central

    Arce, Guillermo

    2015-01-01

    Idiopathic adhesive capsulitis, or primary frozen shoulder syndrome, is a fairly common orthopaedic problem characterized by shoulder pain and loss of motion. In most cases, conservative treatment (6-month physical therapy program and intra-articular steroid injections) improves symptoms and restores shoulder motion. In refractory cases, arthroscopic capsular release is indicated. This surgical procedure carries several advantages over other treatment modalities. First, it provides precise and controlled release of the capsule and ligaments, reducing the risk of traumatic complications observed after forceful shoulder manipulation. Second, release of the capsule and the involved structures with a radiofrequency device delays healing, which prevents adhesion formation. Third, the technique is straightforward, and an oral postoperative steroid program decreases pain and allows for a pleasant early rehabilitation program. Fourth, the procedure is performed with the patient fully awake under an interscalene block, which boosts the patient's confidence and adherence to the physical therapy protocol. In patients with refractory primary frozen shoulder syndrome, arthroscopic capsular release emerges as a suitable option that leads to a faster and long-lasting recovery. PMID:26870652

  17. Pseudoaneurysm after arthroscopic procedure in the knee.

    PubMed

    Filho, Edmar Stieven; Isolani, Guilherme Rufini; Baracho, Filipe Ribas; de Oliveira Franco, Ana Paula Gebert; Ridder Bauer, Luiz Antônio; Namba, Mario

    2015-01-01

    The aim of this study was to review all cases of pseudoaneurysm in the literature, in predominantly arthroscopic procedures on the knee, and to report on a case of pseudoaneurysm that we treated. A bibliographic search was conducted for scientific articles published in Brazilian and foreign periodicals over the last 23 years. Forty-seven cases were found, in 40 articles. In addition to these 47 cases, there was the case that we treated, which was also included in the data. Among the operations that progressed with formation of a pseudoaneurysm, 60% were cases of meniscal injuries and 23%, anterior cruciate ligament injuries. In 46% of the cases, the artery affected with the popliteal, and in 21%, the inferomedial genicular artery. The commonest clinical symptom was pain (37%), followed by pulsating tumor (31%), edema of the calf (12%) and hemarthrosis (11%). The median time taken to make the diagnosis was 11 days, but it ranged from one day to 10 weeks after the procedure. Although rare, pseudoaneurysms are a risk that is inherent to arthroscopic surgery. All patients should be made aware of the vascular risks, even in small-scale procedures.

  18. 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

  19. Arthroscopic treatment of rotator cuff disease.

    PubMed

    Jarrett, Claudius D; Schmidt, Christopher C

    2011-09-01

    The goal of this article is to summarize the current concepts on rotator cuff disease with an emphasis on arthroscopic treatment. Most rotator cuff tears are the result of an ongoing attritional process. Once present, a tear is likely to gradually increase in size. Partial-thickness and subscapularis tears can both be successfully treated arthroscopically if conservative management fails. Partial tears involving greater than 50% of tendon thickness should be repaired. Articular-sided partial tears involving less than 50% of the rotator cuff can reliably be treated with debridement. A more aggressive approach should be considered for low-grade tears (<50%) if they occur on the bursal side. Biomechanical and anatomic studies have shown clear superiority with dual-row fixation compared with single-row techniques. However, current studies have yet to show clear clinical advantage with dual-row over single-row repairs. Biceps tenotomy or tenodesis can reliably provide symptomatic improvement in patients with irreparable massive tears. True pseudoparalysis of the shoulder is a contraindication to this procedure alone and other alternatives should be considered.

  20. Arthroscopic approach and anatomy of the hip

    PubMed Central

    Aprato, Alessandro; Giachino, Matteo; Masse, Alessandro

    2016-01-01

    Summary Background Hip arthroscopy has gained popularity among the orthopedic community and a precise assessment of indications, techniques and results is constantly brought on. Methods In this chapter the principal standard entry portals for central and peripheral compartment are discussed. The description starts from the superficial landmarks for portals placement and continues with the deep layers. For each entry point an illustration of the main structures encountered is provided and the principal structures at risk for different portals are accurately examined. Articular anatomical description is carried out from the arthroscope point of view and sub-divided into central and peripheral compartment. The two compartments are systematically analyzed and the accessible articular areas for each portal explained. Moreover, some anatomical variations that can be found in the normal hip are reported. Conclusion The anatomical knowledge of the hip joint along with a precise notion of the structures encountered with the arthroscope is an essential requirement for a secure and successful surgery. Level of evidence: V. PMID:28066735

  1. Plume impingement forces on inclined flat plates

    NASA Astrophysics Data System (ADS)

    Legge, H.

    Plume impingement from spacecraft control thrusters on vehicles in space is simulated in wind tunnel scale experiments. Pressure and shear stress are measured on flat plates inclined to the plume axis between 0 and 90 deg. In addition to a nozzle of a 0.5N thruster, a free jet from a thin plate orifice was used, by which the flow regime from nearly free molecular flow to continuum flow was covered. Simple pressure and shear stress laws are given by which the impingement pressure and shear stress can be estimated for engineering applications.

  2. Acoustics measurements in normal jet impingement

    NASA Technical Reports Server (NTRS)

    Kleis, S. J.

    1977-01-01

    The dependence of far field acoustic measurements for a uniform jet on nozzle to plate spacing for small dimensionless spacings (h/d - 0.75 to 3.0) was investigated. Spectra from a real time analyzer were read and processed by an HP 2116 minicomputer in on-line mode. Similar data was generated for a fully developed pipe flow exit condition jet to compare with other investigations. The data base for normal jet impingement was extended to smaller values of nozzle to plate spacing. The effects of slight noise heating (30 deg rise) of the jet on the far field noise produced by the impinging jet are demonstrated.

  3. Optimal management of shoulder impingement syndrome

    PubMed Central

    Escamilla, Rafael F; Hooks, Todd R; Wilk, Kevin E

    2014-01-01

    Shoulder impingement is a progressive orthopedic condition that occurs as a result of altered biomechanics and/or structural abnormalities. An effective nonoperative treatment for impingement syndrome is aimed at addressing the underlying causative factor or factors that are identified after a complete and thorough evaluation. The clinician devises an effective rehabilitation program to regain full glenohumeral range of motion, reestablish dynamic rotator cuff stability, and implement a progression of resistive exercises to fully restore strength and local muscular endurance in the rotator cuff and scapular stabilizers. The clinician can introduce stresses and forces via sport-specific drills and functional activities to allow a return to activity. PMID:24648778

  4. [Arthroscopically assisted treatment of ankle fractures].

    PubMed

    Braunstein, M; Baumbach, S F; Böcker, W; Mutschler, W; Polzer, H

    2016-02-01

    Acute ankle fractures are one of the most common fractures in adults with an incidence of 0.1-0.2 % per year. Operative treatment by open reduction and internal fixation (ORIF) is the standard method of treatment for unstable or dislocated fractures. The main goal of the operation is the anatomical realignment of the joint and restoration of ankle stability; nevertheless, anatomical reduction does not automatically lead to favorable clinical results. According to several studies the mid-term and in particular the long-term outcome following operative treatment is often poor with residual symptoms including chronic pain, stiffness, recurrent swelling and ankle instability. There is growing evidence that this poor outcome might be related to occult intra-articular injuries involving cartilage and soft tissues. In recent studies the frequency of fracture-related osteochondral lesions was reported to be approximately 64 %. By physical examination, standard radiography or even computed tomography (CT), these intra-articular pathologies cannot be reliably diagnosed; therefore, many authors emphasize the value of ankle arthroscopy in acute fracture treatment as it has become a safe and effective diagnostic and therapeutic procedure. Arthroscopically assisted open reduction and internal fixation (AORIF) allows control of the reduction as well examination of all intra-articular structures. If necessary, intra-articular pathologies can be addressed by removing ruptured ligaments and loose bodies, performing chondroplasty or microfracturing. So far there is no evidence that supplementary ankle arthroscopy increases the complication rate. On the other hand, the positive effect of AORIF has also not been clearly documented; nevertheless, there are clear indications that arthroscopically assisted fracture treatment is beneficial, especially in complex fractures.

  5. SHOULDER MUSCLE IMBALANCE AND SUBACROMIAL IMPINGEMENT SYNDROME IN OVERHEAD ATHLETES

    PubMed Central

    2011-01-01

    Subacromial impingement is a frequent and painful condition among athletes, particularly those involved in overhead sports such as baseball and swimming. There are generally two types of subacromial impingement: structural and functional. While structural impingement is caused by a physical loss of area in the subacromial space due to bony growth or inflammation, functional impingement is a relative loss of subacromial space secondary to altered scapulohumeral mechanics resulting from glenohumeral instability and muscle imbalance. The purpose of this review is to describe the role of muscle imbalance in subacromial impingement in order to guide sports physical therapy evaluation and interventions. PMID:21655457

  6. Vortex rings impinging on permeable boundaries

    NASA Astrophysics Data System (ADS)

    Mujal-Colilles, Anna; Dalziel, Stuart B.; Bateman, Allen

    2015-01-01

    Experiments with vortex rings impinging permeable and solid boundaries are presented in order to investigate the influence of permeability. Utilizing Particle Image Velocimetry, we compared the behaviour of a vortex ring impinging four different reticulated foams (with permeability k ˜ 26 - 85 × 10-8 m2) and a solid boundary. Results show how permeability affects the stretching phenomena of the vortex ring and the formation and evolution of the secondary vortex ring with opposite sign. Moreover, permeability also affects the macroscopic no-slip boundary condition found on the solid boundary, turning it into an apparent slip boundary condition for the most permeable boundary. The apparent slip-boundary condition and the flux exchange between the ambient fluid and the foam are jointly responsible for both the modified formation of the secondary vortex and changes on the vortex ring diameter increase.

  7. An approximation technique for jet impingement flow

    SciTech Connect

    Najafi, Mahmoud; Fincher, Donald; Rahni, Taeibi; Javadi, KH.; Massah, H.

    2015-03-10

    The analytical approximate solution of a non-linear jet impingement flow model will be demonstrated. We will show that this is an improvement over the series approximation obtained via the Adomian decomposition method, which is itself, a powerful method for analysing non-linear differential equations. The results of these approximations will be compared to the Runge-Kutta approximation in order to demonstrate their validity.

  8. Gas turbine bucket with impingement cooled platform

    DOEpatents

    Jones, Raphael Durand

    2002-01-01

    In a turbine bucket having an airfoil portion and a root portion, with a substantially planar platform at an interface between the airfoil portion and root portion, a platform cooling arrangement including at least one bore in the root portion and at least one impingement cooling tube seated in the bore, the tube extending beyond the bore with an outlet in close proximity to a targeted area on an underside of the platform.

  9. Nozzle cavity impingement/area reduction insert

    DOEpatents

    Yu, Yufeng Phillip; Itzel, Gary Michael; Osgood, Sarah Jane

    2002-01-01

    A turbine vane segment is provided that has inner and outer walls spaced from one another, a vane extending between the inner and outer walls and having leading and trailing edges and pressure and suction sides, the vane including discrete leading edge, intermediate, aft and trailing edge cavities between the leading and trailing edges and extending lengthwise of the vane for flowing a cooling medium; and an insert sleeve within at least one of the cavities and spaced from interior wall surfaces thereof. The insert sleeve has an inlet for flowing the cooling medium into the insert sleeve and has impingement holes defined in first and second walls thereof that respectively face the pressure and suction sides of the vane. The impingement holes of at least one of those first and second walls are defined along substantially only a first, upstream portion thereof, whereby the cooling flow is predominantly impingement cooling along a first region of the insert wall corresponding to the first, upstream portion and the cooling flow is predominantly convective cooling along a second region corresponding to a second, downstream portion of the at least one wall of the insert sleeve.

  10. Crater Formation Due to Lunar Plume Impingement

    NASA Technical Reports Server (NTRS)

    Marsell, Brandon

    2011-01-01

    Thruster plume impingement on a surface comprised of small, loose particles may cause blast ejecta to be spread over a large area and possibly cause damage to the vehicle. For this reason it is important to study the effects of plume impingement and crater formation on surfaces like those found on the moon. Lunar soil, also known as regolith, is made up of fine granular particles on the order of 100 microns.i Whenever a vehicle lifts-off from such a surface, the exhaust plume from the main engine will cause the formation of a crater. This crater formation may cause laterally ejected mass to be deflected and possibly damage the vehicle. This study is a first attempt at analyzing the dynamics of crater formation due to thruster exhaust plume impingement during liftoff from the moon. Though soil erosion on the lunar surface is not considered, this study aims at examining the evolution of the shear stress along the lunar surface as the engine fires. The location of the regions of high shear stress will determine where the crater begins to form and will lend insight into how big the crater will be. This information will help determine the probability that something will strike the vehicle. The final sections of this report discuss a novel method for studying this problem that uses a volume of fluid (VOF)ii method to track the movement of both the exhaust plume and the eroding surface.

  11. Circular and Elliptic Submerged Impinging Water Jets

    NASA Astrophysics Data System (ADS)

    Claudey, Eric; Benedicto, Olivier; Ravier, Emmanuel; Gutmark, Ephraim

    1999-11-01

    Experiments and CFD have been performed to study circular and elliptic jets in a submerged water jet facility. The tests included discharge coefficient measurement to evaluate pressure losses encountered in noncircular nozzles compared to circular ones. Three-dimensional pressure mappings on the impingement surface and PIV measurement of the jet mean and turbulent velocity have been performed at different compound impingement angles relative to the impingement surface and at different stand-off distances. The objective was to investigate the effect of the non-circular geometry on the flow field and on the impact region. The tests were performed in a close loop system in which the water was pumped through the nozzles into a clear Plexiglas tank. The Reynolds numbers were typically in the range of 250000. Discharge coefficients of the elliptic nozzle was somewhat lower than that of the circular jet but spreading rate and turbulence level were higher. Pressure mapping showed that the nozzle exit geometry had an effect on the pressure distribution in the impact region and that high-pressure zones were generated at specific impact points. PIV measurements showed that for a same total exit area, the elliptic jets affected a surface area that is 8the equivalent circular. The turbulence level in the elliptic jet tripled due to the nozzle design. Results of the CFD model were in good agreement with the experimental data.

  12. Arthroscopic treatment of glenohumeral instability in soccer goalkeepers.

    PubMed

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

    2013-06-01

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

  13. Comparison of two arthroscopic pump systems based on image quality.

    PubMed

    Tuijthof, G J M; van den Boomen, H; van Heerwaarden, R J; van Dijk, C N

    2008-06-01

    The effectiveness of arthroscopic pump systems has been investigated with either subjective measures or measures that were unrelated to the image quality. The goal of this study is to determine the performance of an automated pump in comparison to a gravity pump based on objective assessment of the quality of the arthroscopic view. Ten arthroscopic operations performed with a gravity pump and ten performed with an automated pump (FMS Duo system) were matched on duration of the surgery and shaver usage, type of operation, and surgical experience. Quality of the view was defined by means of the presence or absence of previously described definitions of disturbances (bleeding, turbidity, air bubbles, and loose fibrous tissue). The percentage of disturbances for all operations was assessed with a time-disturbance analysis of the recorded operations. The Mann-Whitney U test shows a significant difference in favor of the automated pump for the presence of turbidity only (Exact Sig. [2*(1-tailed Sig.)] = 0.015). Otherwise, no differences were determined (Exact Sig. [2*(1-tailed Sig.)] > 0.436). A new objective method is successfully applied to assess efficiency of pump systems based on the quality of the arthroscopic view. Important disturbances (bleeding, air bubbles, and loose fibrous tissue) are not reduced by an automated pump used in combination with a tourniquet. The most frequent disturbance turbidity is reduced by around 50%. It is questionable if this result justifies the use of an automated pump for straightforward arthroscopic knee surgeries using a tourniquet.

  14. Using the Arthroscopic Surgery Skill Evaluation Tool as a Pass-Fail Examination

    PubMed Central

    Koehler, Ryan J.; Nicandri, Gregg T.

    2013-01-01

    Background: Examination of arthroscopic skill requires evaluation tools that are valid and reliable with clear criteria for passing. The Arthroscopic Surgery Skill Evaluation Tool was developed as a video-based assessment of technical skill with criteria for passing established by a panel of experts. The purpose of this study was to test the validity and reliability of the Arthroscopic Surgery Skill Evaluation Tool as a pass-fail examination of arthroscopic skill. Methods: Twenty-eight residents and two sports medicine faculty members were recorded performing diagnostic knee arthroscopy on a left and right cadaveric specimen in our arthroscopic skills laboratory. Procedure videos were evaluated with use of the Arthroscopic Surgery Skill Evaluation Tool by two raters blind to subject identity. Subjects were considered to pass the Arthroscopic Surgery Skill Evaluation Tool when they attained scores of ≥3 on all eight assessment domains. Results: The raters agreed on a pass-fail rating for fifty-five of sixty videos rated with an interclass correlation coefficient value of 0.83. Ten of thirty participants were assigned passing scores by both raters for both diagnostic arthroscopies performed in the laboratory. Receiver operating characteristic analysis demonstrated that logging more than eighty arthroscopic cases or performing more than thirty-five arthroscopic knee cases was predictive of attaining a passing Arthroscopic Surgery Skill Evaluation Tool score on both procedures performed in the laboratory. Conclusions: The Arthroscopic Surgery Skill Evaluation Tool is valid and reliable as a pass-fail examination of diagnostic arthroscopy of the knee in the simulation laboratory. Clinical Relevance: This study demonstrates that the Arthroscopic Surgery Skill Evaluation Tool may be a useful tool for pass-fail examination of diagnostic arthroscopy of the knee in the simulation laboratory. Further study is necessary to determine whether the Arthroscopic Surgery Skill

  15. Ankle impingement syndromes: a review of etiology and related implications.

    PubMed

    Hess, Gregory William

    2011-10-01

    Ankle injuries are common occurrences in athletics involving and requiring extreme ranges of motion. Ankle sprains specifically occur with a 1 in 10,000 person rate in active individuals each day. If trauma is repetitive, the ankle structures have potential to experience secondary injury and dysfunction. Included in this category of dysfunction are both anterior and posterior ankle impingement syndromes where disruption of the bony structures, joint capsule, ligaments, and tendons typically occurs. Ankle impingement is described as ankle pain that occurs during athletic activity, with recurrent, extreme dorsiflexion or plantar flexion with the joint under a load. Ankle impingements can be classified according to what structures become involved both anteriorly and posteriorly. Osseous impingement, soft tissue impingement, impingement of the distal fascicle of anterior inferior tibiofibular ligament, and meniscoid lesions are all documented causes of ankle impingement. These changes tend to be brought about and exacerbated by extreme ranges of motion. Understanding various impingement types will better enable the clinician to prevent, identify, treat, and rehabilitate affected ankles. Acknowledging activities that predispose to ankle impingement syndrome will enhance prevention and recovery processes. Description of ankle impingement etiology and pathology is the objective of the current review.

  16. Arthroscopic bursectomy for recalcitrant trochanteric bursitis after hip arthroplasty.

    PubMed

    Van Hofwegen, Christopher; Baker, Champ L; Savory, Carlton G; Baker, Champ L

    2013-01-01

    This study evaluated the use of arthroscopic bursectomy for pain relief in patients with trochanteric bursitis after hip arthroplasty. In this retrospective case series of 12 patients undergoing arthroscopic treatment of recalcitrant trochanteric bursitis after hip arthroplasty, outcomes were assessed via phone interview with a numeric pain rating scale from 1 to 10 and were compared with preoperative pain ratings. Patients were asked the percentage of time they had painless hip function and whether they would have the surgery again. At an average 36-month follow-up (range, 4-85 months), the average numeric pain scale rating improved from 9.3 to 3.3. At an average of 62% of the time, patients had painless use of the hip. Ten of 12 patients in the study felt the pain relief gained was substantial enough to warrant having procedure again. In these patients, arthroscopic bursectomy was a viable option for patients with recalcitrant bursitis after hip arthroplasty.

  17. Ganglion cyst in the supraspinous fossa: arthroscopically undetectable cases.

    PubMed

    Shimokobe, Hisao; Gotoh, Masafumi; Mitsui, Yasuhiro; Yoshikawa, Eiichiro; Kume, Shinichiro; Okawa, Takahiro; Higuchi, Fujio; Nagata, Kensei; Shiba, Naoto

    2013-01-01

    Studies have demonstrated favorable outcomes of arthroscopic decompression for ganglion cyst in the supraspinous fossa; however, little attention has been paid to the difficulty in detecting these cysts during arthroscopy. In this report, we present 2 cases in which ganglion cysts in the supraspinous fossa were undetectable during arthroscopy. The ganglion cysts were not identified in these cases during surgery despite arthroscopic decompression being performed through the area in which the cyst was expected until the suprascapular nerve was entirely exposed. After surgery, magnetic resonance imaging (MRI) confirmed the disappearance of the ganglion cyst and external rotation strength was fully improved, without shoulder pain. We emphasize here that surgeons should be aware of this difficulty when performing arthroscopic decompression of ganglion cysts in the supraspinous fossa.

  18. 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.

  19. Arthroscopic treatment of the septic knee.

    PubMed

    Smith, M J

    1986-01-01

    Pyarthrosis of the knee was treated in 30 patients by arthroscopic decompression and lavage, coupled with parenteral and oral antibiotics. There were 21 men and nine women patients whose ages ranged from 6 months to 65 years of age. Twenty-two patients were considered to have a hematogenous origin as a cause of their pyarthrosis, and eight were caused by penetrating trauma. Twenty-eight of these patients had the onset of symptoms within 72 h prior to arthroscopy. Two adults had the onset of their symptoms 1 week prior to treatment. Follow-up has ranged from 6 months to 5 years. Staphylococcus aureus was cultured in 20 knees, Streptococcus pneumonia in three knees, Haemophilus influenzae in four knees, and Neisseria gonorrhoeae in one knee. The average hospital stay among 22 children aged 12 years or younger was 3.50 days. The other eight patients had an average hospital stay of 9.50 days. Three adults with diabetes and other medical problems, such as renal failure, had an average hospital stay of 17.33 days. Excellent results were obtained in 28 (93.3%) of 30 patients and good results were obtained in two (6.7%) of 30 patients. There were no poor results or recurrences, and no cases of osteomyelitis occurred. This method of treatment markedly reduces the morbidity and hospital stay of patients with a septic knee.

  20. Effect of Mirrored Views on Endoscopic and Arthroscopic Skill Performance

    PubMed Central

    Benninger, Emanuel; Meier, Christoph; Wirth, Stefan; Koch, Peter Philipp; Meyer, Dominik

    2017-01-01

    Background: Arthroscopic procedures may be technically challenging because of impaired vision, limited space, and the 2-dimensional vision of a 3-dimensional structure. Spatial orientation may get more complicated when the camera is pointing toward the surgeon. Hypothesis: Spatial orientation and arthroscopic performance may be improved by simply mirroring the image on the monitor in different configurations regarding the position and orientation of camera and instrument. Study Design: Descriptive laboratory study. Methods: Thirty volunteers from an orthopaedic department were divided into 3 equal groups according to their arthroscopic experience (beginners, intermediates, seniors). All subjects were asked to perform a standardized task in a closed box mimicking an endoscopic space. The same task had to be performed in 4 different configurations regarding camera and instrument position and orientation (pointing toward or away from the subject) with either the original or mirrored image on the monitor. Efficiency (time per stick; TPS), precision (successful completion of the task), and difficulty rating using a visual analog scale (VAS) were analyzed. Results: Mirroring the image demonstrated no advantage over the original images in any configuration regarding TPS. Successful completion of the task was significantly better when the image was mirrored in the configuration with the camera pointing toward and the instrument away from the surgeon. There was a positive correlation between TPS and subjective VAS difficulty rating (r = 0.762, P = .000) and a negative correlation between the successful completion of the task and VAS (r = −0.515, P = .000). Conclusion: Mirroring the image may have a positive effect on arthroscopic performance of surgeons in certain configurations. A significantly improved performance was seen when the arthroscope was pointing toward and the grasping instrument pointing away from the subject. Mirroring the image may facilitate surgery in

  1. Complications Associated With Arthroscopic Labral Repair Implants: A Case Series.

    PubMed

    Felder, Jerrod J; Elliott, Michael P; Mair, Scott D

    2015-07-01

    Arthroscopic labral repair in the shoulder has become commonplace in recent years. A variety of implants have evolved in parallel with arthroscopic techniques. Any orthopedic implant that is placed in close proximity to the joint has the potential to cause subsequent damage to the articular surface if it is left prominent or dislodges secondary to improper surgical technique. This article focuses on a series of implant-related complications of labral surgery and their subsequent management. Additionally, correct patient selection and surgical technique are discussed.

  2. Results of arthroscopic acromioplasty for chronic rotator cuff lesion.

    PubMed

    De Baere, Tom; Dubuc, Jean-Emile; Joris, Daniel; Delloye, Christian

    2004-12-01

    The influence of acromioplasty in long standing rotator cuff deficiency with intractable pain was retrospectively evaluated in a consecutive series of 13 patients who were followed for a mean period of 19 months (range, 12 to 42 months) after arthroscopic acromioplasty. The Constant score improved from 59.3 (range, 39.9 to 90.3) preoperatively to 98.7 (69.1 to 122.7) postoperatively. Pain and motion improved significantly whereas strength did not improve. Arthroscopic acromioplasty in painful chronic rotator cuff avulsion was found to be an effective means to control pain and improve motion; it can be recommended when conservative treatment has failed.

  3. 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

  4. Arthroscopic Release of Lateral Half of the Talocalcaneonavicular Joint.

    PubMed

    Lui, Tun Hing

    2016-12-01

    Arthrofibrosis of the talocalcaneonavicular joint can follow trauma or surgery of the joint. Arthroscopic release of the lateral half of the talocalcaneonavicular joint is indicated if the painful restriction of hindfoot inversion together with tenderness of the lateral side of the joint that is not controlled with conservative treatment. This procedure is contraindicated in other causes of painful stiffness including post-traumatic arthritis, osteonecrosis, and malunion. This technique includes arthroscopic release of the lateral side of the anterior subtalar joint and the talonavicular joint. This is a technically demanding technique and should be reserved for the experienced foot and ankle arthroscopists.

  5. Meralgia Paresthetica and Femoral Acetabular Impingement: A Possible Association

    PubMed Central

    Ahmed, Aiesha

    2010-01-01

    Meralgia paresthetica consists of pain and dysesthesia in the anterolateral thigh. Etiology is divided into spontaneous and iatrogenic causes. To my knowledge this has never been attributed to femoral acetabular impingement. This case highlights the presence of lateral femoral cutaneous neuropathy in the setting of femoral acetabular impingement syndrome thus raising the possibility of an association. Keywords Femoral acetabular impingement; Lateral femoral cutaneous nerve; Dysesthesia; Nerve conduction studies PMID:22043261

  6. Endoscopic Pubic Symphysectomy for Athletic Osteitis Pubis

    PubMed Central

    Matsuda, Dean K.; Sehgal, Bantoo; Matsuda, Nicole A.

    2015-01-01

    Osteitis pubis is a common form of athletic pubalgia associated with femoroacetabular impingement. Endoscopic pubic symphysectomy was developed as a less invasive option than open surgical curettage for recalcitrant osteitis pubis. This technical note demonstrates the use of the anterior and suprapubic portals in the supine lithotomy position for endoscopic burr resection of pubic symphyseal fibrocartilage and hyaline endplates. Key steps include use of the suprapubic portal for burr resection of the posteroinferior symphysis and preservation of the posterior and arcuate ligaments. Endoscopic pubic symphysectomy is a minimally invasive bone-conserving surgery that retains stability and may be useful in the treatment of recalcitrant osteitis pubis or osteoarthritis. It nicely complements arthroscopic surgery for femoroacetabular impingement and may find broader application in this group of co-affected athletes. PMID:26258039

  7. Endoscopic Pubic Symphysectomy for Athletic Osteitis Pubis.

    PubMed

    Matsuda, Dean K; Sehgal, Bantoo; Matsuda, Nicole A

    2015-06-01

    Osteitis pubis is a common form of athletic pubalgia associated with femoroacetabular impingement. Endoscopic pubic symphysectomy was developed as a less invasive option than open surgical curettage for recalcitrant osteitis pubis. This technical note demonstrates the use of the anterior and suprapubic portals in the supine lithotomy position for endoscopic burr resection of pubic symphyseal fibrocartilage and hyaline endplates. Key steps include use of the suprapubic portal for burr resection of the posteroinferior symphysis and preservation of the posterior and arcuate ligaments. Endoscopic pubic symphysectomy is a minimally invasive bone-conserving surgery that retains stability and may be useful in the treatment of recalcitrant osteitis pubis or osteoarthritis. It nicely complements arthroscopic surgery for femoroacetabular impingement and may find broader application in this group of co-affected athletes.

  8. Arthroscopic skills assessment and use of box model for training in arthroscopic surgery using Sawbones – “FAST” workstation

    PubMed Central

    Goyal, Saumitra; Radi, Mohamed Abdel; Ramadan, Islam Karam-allah; Said, Hatem Galal

    2016-01-01

    Purpose: Arthroscopic skills training outside the operative room may decrease risks and errors by trainee surgeons. There is a need of simple objective method for evaluating proficiency and skill of arthroscopy trainees using simple bench model of arthroscopic simulator. The aim of this study is to correlate motor task performance to level of prior arthroscopic experience and establish benchmarks for training modules. Methods: Twenty orthopaedic surgeons performed a set of tasks to assess a) arthroscopic triangulation, b) navigation, c) object handling and d) meniscus trimming using SAWBONES “FAST” arthroscopy skills workstation. Time to completion and the errors were computed. The subjects were divided into four levels; “Novice”, “Beginner”, “Intermediate” and “Advanced” based on previous arthroscopy experience, for analyses of performance. Results: The task performance under transparent dome was not related to experience of the surgeon unlike opaque dome, highlighting the importance of hand-eye co-ordination required in arthroscopy. Median time to completion for each task improved as the level of experience increased and this was found to be statistically significant (p < .05) e.g. time for maze navigation (Novice – 166 s, Beginner – 135.5 s, Intermediate – 100 s, Advance – 97.5 s) and the similar results for all tasks. Majority (>85%) of subjects across all the levels reported improvement in performance with sequential tasks. Conclusion: Use of the arthroscope requires visuo-spatial coordination which is a skill that develops with practice. This simple box model can reliably differentiate the arthroscopic skills based on experience and can be used to monitor progression of skills of trainees in institutions. PMID:27801643

  9. Confined Impinging Jets in Porous Media

    NASA Astrophysics Data System (ADS)

    Buonomo, B.; Cirillo, L.; Manca, O.; Mansi, N.; Nardini, S.

    2016-09-01

    Impinging jets are adopted in drying of textiles, paper, cooling of gas turbine components, freezing of tissue in cryosurgery and manufacturing, electronic cooling. In this paper an experimental investigation is carried out on impinging jets in porous media with the wall heated from below with a uniform heat flux. The fluid is air. The experimental apparatus is made up of a fun systems, a test section, a tube, to reduce the section in a circular section. The tube is long 1.0 m and diameter of 0.012 m. The test section has a diameter of 0.10 m and it has the thickness of 10, 20 and 40 mm. In the test section the lower plate is in aluminum and is heated by an electrical resistance whereas the upper plate is in Plexiglas. The experiments are carried out employing a aluminum foam 40 PPI at three thickness as the test section. Results are obtained in a Reynolds number range from 5100 to 15300 and wall heat flux range from 510 W/m2 to 1400 W/m2. Results are given in terms of wall temperature profiles, local and average Nusselt numbers, pressure drops, friction factor and Richardson number.

  10. Sessile drop deformations under an impinging jet

    NASA Astrophysics Data System (ADS)

    Feng, James Q.

    2015-08-01

    The problem of steady axisymmetric deformations of a liquid sessile drop on a flat solid surface under an impinging gas jet is of interest for understanding the fundamental behavior of free surface flows as well as for establishing the theoretical basis in process design for the Aerosol direct-write technology. It is studied here numerically using a Galerkin finite-element method, by computing solutions of Navier-Stokes equations. For effective material deposition in Aerosol printing, the desired value of Reynolds number for the laminar gas jet is found to be greater than ~500. The sessile drop can be severely deformed by an impinging gas jet when the capillary number is approaching a critical value beyond which no steady axisymmetric free surface deformation can exist. Solution branches in a parameter space show turning points at the critical values of capillary number, which typically indicate the onset of free surface shape instability. By tracking solution branches around turning points with an arc-length continuation algorithm, critical values of capillary number can be accurately determined. Near turning points, all the free surface profiles in various parameter settings take a common shape with a dimple at the center and bulge near the contact line. An empirical formula for the critical capillary number for sessile drops with contact angle is derived for typical ranges of jet Reynolds number and relative drop sizes especially pertinent to Aerosol printing.

  11. Psoas impingement syndrome in hip osteoarthritis.

    PubMed

    Di Lorenzo, Luigi; Jennifer, Yanow; Pappagallo, Marco

    2009-01-01

    The degenerative processes underlying osteoarthritis of the hip produce both anatomical and biomechanical changes in and around the involved joint. A good understanding of hip anatomy and the forces crossing the hip joint is essential to understand both hip pathology and current treatment techniques. Total hip arthroplasty (THA) has become a mainstay of treatment for advanced osteoarthritis of the hip. Several factors contribute to post-operative hip pain in THA patients. Iliopsoas impingement on the prosthetic cup after total hip replacement is one of the causes of pain following hip surgery, often due to an anterior overlap of the implant with respect to the acetabulum. The anatomic shape of the anterior acetabular ridge, which may be straight or curved, influences this overlap. In this paper we present a case illustrating a psoas impingement-like syndrome in a patient with severe hip osteoarthritis who has not undergone hip replacement surgery. We discuss the compensatory strategies employed by the patient to reduce pain and prevent falls, and show CT scan images depicting the underlying anatomic pathology.

  12. ARTHROSCOPIC TREATMENT OF OSTEOCHONDRAL LESIONS OF THE TALUS

    PubMed Central

    de Araujo, Mariana Korbage; de Cillo, Mario Sergio Paulillo; Bittar, Cinthia Kelly; Zabeu, José Luis Amin; Cezar, Caroliny Nociti Moreira

    2016-01-01

    ABSTRACT Objective: To assess pain and function of the ankle in patients with injuries up to 1.5 cm diameter by the American Orthopaedic Foot and Ankle Society (AOFAS) score after arthroscopic treatment. Methods: The AOFAS scale was applied before and after arthroscopy, as well as the degree of subjective satisfaction of ambulatory patients. Patients with type I osteochondral injuries, acute trauma, using plaster, presenting lesions in other joints of the lower limbs and cognitive impairment that would prevent the application of the satisfaction questionnaire were excluded from the study. Statistical analysis was performed using unpaired t test with Welch correction, Mann Whitney test, and ANOVA, with Kruskal Wallis test and Dun test, considering p value lower than 0.05. Results: There was an increased AOFAS scores after arthroscopic treatment in 52 (94.5%) patients. The mean values of AOFAS score in 55 patients was 77.32 ± 6.67 points preoperative and 93.10± 8.24 points postoperative, with a mean variation of 15.8 points, p<0.001. Patients with stage II, III and IV injuries showed an increased AOFAS scores after arthroscopic treatment, p<0.001. No difference was found between medial and lateral injuries, p >0.05. Conclusion: Patients with stage II, III or IV osteochondral injuries of the talus of up to 1.5 cm diameter, whether medial or lateral, showed a significant improvement after arthroscopic treatment. Level of Evidence III, Retrospective Study. PMID:26997911

  13. Arthroscopic treatment of shoulder instability in professional athletes

    PubMed Central

    Pantalone, Andrea; Vanni, Daniele; Guelfi, Matteo; Di Mauro, Michele; Abate, Michele; Salini, Vincenzo

    2016-01-01

    Summary Background Post-traumatic shoulder instability is a common disease, especially in sportsmen. If inadequately or late treated, it may be responsible for an articular biomechanics alteration, with serious problems. This is much more obvious for professionals athletes, because corporate and market needs force them to a premature return to sport. The purpose of this retrospective study is to evaluate if arthroscopic approach may be better than the open one and allowing a shoulder function rapid recovery, with fast return to sport. Materials and methods From January 2003 to January 2014, 46 professional athletes underwent surgical treatment for post traumatic shoulder instability. Two groups were made: 25 athletes treated arthroscopically and 21 treated with open approach. Patients were followed up from 36 to 92 months, according to Rowe Score for Instability and VAS scoring system. Results Patients in the open group returned later than the first one to sport. Moreover, pain in postoperative period and during rehabilitation, was lower in the arthroscopic group. There was only one recurrence in the open group. Conclusions Arthroscopic surgical approach appears to be excellent in shoulder instability management, reducing recovery time, allowing a faster return to sport, with less pain, if compared with open surgery. Level of Evidence III, a case control-study. PMID:28217564

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

    PubMed Central

    Kim, Chang-Wan; Kim, Dong-Gyun

    2014-01-01

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

  15. Arthroscopic treatment of pigmented villonodular synovitis of the knee.

    PubMed

    Zvijac, J E; Lau, A C; Hechtman, K S; Uribe, J W; Tjin-A-Tsoi, E W

    1999-09-01

    Pigmented villonodular synovitis (PVNS) is a rare disease, with multiple forms, anatomic sites, and treatment methods having been described. During a 10-year period, 14 patients, 7 male and 7 female, average age 35 years (range, 19 to 64 years) were treated for PVNS with arthroscopic partial or total synovectomy. Average follow-up was 42 months (range, 8 to 83 months). Twelve patients had diffuse and 2 had a localized form. Results were assessed subjectively, clinically, and radiographically, and were rated as excellent, good, fair, or poor. There were no complications and 10 patients (72%) were rated as excellent or good, 2 patients (14%) as fair, and 2 patients (14%) as poor. The recurrence rate was 14% and occurred in the group with diffuse PVNS. Radiographs did not show any bone erosion. The most widely accepted treatment for PVNS is synovectomy, and both open and arthroscopic synovectomy have been advocated as treatment. Advantages of arthroscopic treatment include accurate evaluation of the knee joint, treatment of other pathology, more rapid rehabilitation, decreased risk of joint stiffness, and less pain. In our experience, it appears that arthroscopic synovectomy is an effective method of treatment of this disorder.

  16. Round impinging jets with relatively large stand-off distance

    NASA Astrophysics Data System (ADS)

    Shademan, Mehrdad; Balachandar, Ram; Roussinova, Vesselina; Barron, Ron

    2016-07-01

    Large eddy simulation and particle image velocimetry measurements have been performed to evaluate the characteristics of a turbulent impinging jet with large nozzle height-to-diameter ratio (H/D = 20). The Reynolds number considered is approximately 28 000 based on the jet exit velocity and nozzle diameter. Mean normalized centerline velocity in both the free jet and impingement regions and pressure distribution over the plate obtained from simulations and experiments show good agreement. The ring-like vortices generated due to the Kelvin-Helmholtz instabilities at the exit of the nozzle merge, break down and transform into large scale structures while traveling towards the impingement plate. A Strouhal number of 0.63 was found for the vortices generated at the exit of the nozzle. However, this parameter is reduced along the centerline towards the impingement zone. A characteristic frequency was also determined for the large scale structures impinging on the plate. The expansion, growth, tilt, and three-dimensionality of the impinging structures cause dislocation of the impinging flow from the centerline, which is significantly larger when compared with flows having small H/D ratios. Contrary to the behavior of impinging jets with small stand-off distance, due to the loss of coherence, the large scale structures do not result in significant secondary vortices in the wall jet region and consequently less fluctuations were observed for wall shear stress.

  17. Long Term Outcomes of Arthroscopic Shoulder Instability Surgery

    PubMed Central

    Karataglis, D.; Agathangelidis, F.

    2017-01-01

    Background: Anterior shoulder instability has been successfully managed arthroscopically over the past two decades with refined “anatomic” reconstruction procedures involving the use of anchors for the repositioning and re-tensioning of the antero-inferior capsuloligamentous complex, in an effort to recreate its “bumper effect”. Methods: Research and online content related to arthroscopic treatment of shoulder instability was reviewed and their results compared. Results: The short- and mid-term results of this technique have been very satisfactory. The greatest number of recent reports suggests that long-term results (>5 years follow-up) remain rather satisfactory, especially in the absence of significant glenoid bone loss (>20-25%). In these studies recurrent instability, in the form of either dislocation or subluxation, ranges from 5.1 to over 20%, clinical scores, more than 5 years after the index procedure, remain good or excellent in >80% of patient population as do patient satisfaction and return to previous level of activities. As regards arthroscopic non-anatomic bony procedures (Latarjet or Bristow procedures) performed in revision cases or in the presence of >20-25% bone loss of the anteroinferior aspect of the glenoid, recent reports suggest that their long-term results are very satisfactory both in terms of re-dislocation rates and patient satisfaction. Conclusion: It appears that even “lege artis” performance of arthroscopic reconstruction decelerates but does not obliterate the degenerative procedure of dislocation arthropathy. The presence and grade of arthritic changes correlate with the number of dislocations sustained prior to the arthroscopic intervention, the number of anchors used and the age at initial dislocation and surgery. However, the clinical significance of radiologically evident dislocation arthropathy is debatable.

  18. Magnetic Resonance Velocimetry analysis of an angled impinging jet

    NASA Astrophysics Data System (ADS)

    Irhoud, Alexandre; Benson, Michael; Verhulst, Claire; van Poppel, Bret; Elkins, Chris; Helmer, David

    2016-11-01

    Impinging jets are used to achieve high heat transfer rates in applications ranging from gas turbine engines to electronics. Despite the importance and relative simplicity of the geometry, simulations historically fail to accurately predict the flow behavior in the vicinity of the flow impingement. In this work, we present results from a novel experimental technique, Magnetic Resonance Velocimetry (MRV), which measures three-dimensional time-averaged velocity without the need for optical access. The geometry considered in this study is a circular jet angled at 45 degrees and impinging on a flat plate, with a separation of approximately seven jet diameters between the jet exit and the impingement location. Two flow conditions are considered, with Reynolds numbers of roughly 800 and 14,000. Measurements from the MRV experiment are compared to predictions from Reynolds Averaged Navier Stokes (RANS) simulations, thus demonstrating the utility of MRV for validation of numerical analyses of impinging jet flow.

  19. Regeneratively cooled transition duct with transversely buffered impingement nozzles

    DOEpatents

    Morrison, Jay A; Lee, Ching-Pang; Crawford, Michael E

    2015-04-21

    A cooling arrangement (56) having: a duct (30) configured to receive hot gases (16) from a combustor; and a flow sleeve (50) surrounding the duct and defining a cooling plenum (52) there between, wherein the flow sleeve is configured to form impingement cooling jets (70) emanating from dimples (82) in the flow sleeve effective to predominately cool the duct in an impingement cooling zone (60), and wherein the flow sleeve defines a convection cooling zone (64) effective to cool the duct solely via a cross-flow (76), the cross-flow comprising cooling fluid (72) exhausting from the impingement cooling zone. In the impingement cooling zone an undimpled portion (84) of the flow sleeve tapers away from the duct as the undimpled portion nears the convection cooling zone. The flow sleeve is configured to effect a greater velocity of the cross-flow in the convection cooling zone than in the impingement cooling zone.

  20. Multispecies impingement in a tropical power plant, Straits of Malacca.

    PubMed

    Azila, A; Chong, V C

    2010-07-01

    Marine organisms comprised about 70% of the total impinged materials by weight at water intake screens in the Kapar Power Station (KPS), Malaysia. The general groupings of 'fish', 'shrimp', 'crab', 'cephalopod' and 'others' contributed 26% (87 species), 65% (29), 2% (17), 2% (3) and 5% (42) of the total number of impinged organisms, respectively. In general, higher impingement occurred during spring tide, at nighttime and in shallow water. The glass perchlet, anchovies, ponyfishes, mojarra, catfishes, hairtail, scat and young croakers were the most vulnerable fishes. Vulnerable invertebrates included cephalopods, sea urchin, rockshells and jellyfishes, but penaeid shrimps were the most susceptible in terms of both mortality and body injury. Annually, KPS is estimated to kill 8.5 x 10(6) marine organisms (42 tons) by impingement. This amount, however, is minimal compared to commercial fishery harvests. Multispecies impingement at Malaysian power plants poses the problem of finding the best mitigation options for tropical situations.

  1. Subsampling program for the estimation of fish impingement

    NASA Astrophysics Data System (ADS)

    Beauchamp, John J.; Kumar, K. D.

    1984-11-01

    Federal regulations require operators of nuclear and coal-fired power-generating stations to estimate the number of fish impinged on intake screens. During winter months, impingement may range into the hundreds of thousands for certain species, making it impossible to count all intake screens completely. We present graphs for determinig the appropriate“optimal” subsample that must be obtained to estimate the total number impinged. Since the number of fish impinged tends to change drastically within a short time period, the subsample size is determined based on the most recent data. This allows for the changing nature of the species-age composition of the impinged fish. These graphs can also be used for subsampling fish catches in an aquatic system when the size of the catch is too large to sample completely.

  2. Drop Impingement on Highly Wetting Micro/Nano Porous Surfaces

    NASA Astrophysics Data System (ADS)

    Buie, Cullen; Joung, Youngsoo

    2011-11-01

    Recently, we developed a novel fabrication method using a combination of electrophoretic deposition (EPD) and break down anodization (BDA) to achieve highly wetting nanoporous surfaces with microscale features. In this study we investigate droplet impingement behavior on these surfaces as a function of impact velocity, droplet size, and liquid properties. We observe impingement modes we denote as ``necking'' (droplet breaks before full penetration in the porous surface), ``spreading'' (continuous wicking into the porous surface), and ``jetting'' (jets of liquid emanate from the edges of the wicking liquid). To predict the droplet impingement modes, we've developed a non-dimensional parameter that is a function of droplet velocity, dynamic viscosity, effective pore radius and contact angle. The novel dimensionless parameter successfully predicts drop impingement modes across multiple fluids. Results of this study will inform the design of spray impingement cooling systems for electronics applications where the ``spreading'' mode is preferred.

  3. Removal of biofilms by impinging water droplets

    NASA Astrophysics Data System (ADS)

    Cense, A. W.; van Dongen, M. E. H.; Gottenbos, B.; Nuijs, A. M.; Shulepov, S. Y.

    2006-12-01

    The process of impinging water droplets on Streptococcus mutans biofilms was studied experimentally and numerically. Droplets were experimentally produced by natural breakup of a cylindrical liquid jet. Droplet diameter and velocity were varied between 20 and 200 μm and between 20 and 100 m/s, respectively. The resulting erosion process of the biofilm was determined experimentally with high-speed recording techniques and a quantitative relationship between the removal rate, droplet size, and velocity was determined. The shear stress and the pressure on the surface during droplet impact were determined by numerical simulations, and a qualitative agreement between the experiment and the simulation was obtained. Furthermore, it was shown that the stresses on the surface are strongly reduced when a water film is present.

  4. Investigations of scaling laws for jet impingement

    NASA Technical Reports Server (NTRS)

    Morton, J. B.; Haviland, J. K.; Catalano, G. D.; Herling, W. W.

    1976-01-01

    The statistical properties of tangential flows over surfaces were investigated by two techniques. In one, a laser-Doppler velocimeter was used in a smoke-laden jet to measure one-point statistical properties, including mean velocities, turbulent intensities, intermittencies, autocorrelations, and power spectral densities. In the other technique, free stream and surface pressure probes connected to 1/8 inch microphones were used to obtain single point rms and 1/3 octave pressures, as well as two point cross correlations, the latter being converted to auto spectra, amplitude ratios, phase lags, and coherences. The results of these studies support the vortex model of jets, give some insights into the effects of surface impingement, and confirm that jet diameter and velocity are the scaling parameters for circular jets, while Reynolds number is relatively unimportant.

  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

  6. Turbine vane segment and impingement insert configuration for fail-safe impingement insert retention

    DOEpatents

    Burdgick, Steven Sebastian; Kellock, Iain Robertson

    2003-05-13

    An impingement insert sleeve is provided that is adapted to be disposed in a coolant cavity defined through a stator vane. The insert has a generally open inlet end and first and second pairs of diametrically opposed side walls, and at least one fail-safe tab defined at a longitudinal end of the insert for limiting radial displacement of the insert with respect to the stator vane.

  7. Osteoid osteoma of the glenoid: Arthroscopic treatment.

    PubMed

    Malavolta, E A; Assunção, J H; Rebolledo, D C S; Gracitelli, M E C; Correia, L F M; Ferreira Neto, A A; de Camargo, O P

    2015-12-01

    Osteoid osteoma is a benign tumor that is rarely found in the scapula. We report a clinical case involving a 36-year-old female patient who suffered from progressive pain in her right shoulder for 1 year. This patient was initially diagnosed with impingement syndrome and was treated unsuccessfully with medication and physical therapy for approximately 2 months. Based on imaging exams, a juxta-articular osteoid osteoma of the glenoid was identified. The patient underwent a shoulder arthroscopy that included tumor removal and treatment of the resulting chondral lesion. At 6-, 12- and 36-month assessments, the patient was asymptomatic, with a normal range of motion and experienced a pain intensity corresponding to 0 points on the Visual Analog Scale (VAS) and 35 points on the University of California, Los Angeles (UCLA) Scale. A postoperative MRI indicated the absence of any residual tumor tissue or inflammatory signs. We believe that the approach described in this paper allows juxta-articular osteoid osteomas to be accessed in a minimally invasive manner and permits not only adequate resection but also the treatment of chondral lesions that could remain after tumor resection.

  8. Arthroscopic Resection Arthroplasty of the Radial Column for SLAC Wrist

    PubMed Central

    Cobb, Tyson K.; Walden, Anna L.; Wilt, Jessica M.

    2014-01-01

    Background Symptomatic advanced scapholunate advanced collapse (SLAC) wrists are typically treated with extensive open procedures, including but not limited to scaphoidectomy plus four-corner fusion (4CF) and proximal row carpectomy (PRC). Although a minimally invasive arthroscopic option would be desirable, no convincing reports exist in the literature. The purpose of this paper is to describe a new surgical technique and outcomes on 14 patients who underwent arthroscopic resection arthroplasty of the radial column (ARARC) for arthroscopic stage II through stage IIIB SLAC wrists and to describe an arthroscopic staging classification of the radiocarpal joint for patients with SLAC wrist. Patients and Methods Data were collected prospectively on 17 patients presenting with radiographic stage I through III SLAC wrist who underwent ARARC in lieu of scaphoidectomy and 4CF or PRC. Fourteen patients (12 men and 2 women) subject to 1-year follow-up were included. The average age was 57 years (range 41 to 78). The mean follow-up was 24 months (range 12 to 61). Arthroscopic resection arthroplasty of the radial column is described for varying stages of arthritic changes of the radioscaphoid joint. Midcarpal resection was not performed. Results The mean Disabilities of the Arm, Shoulder, and Hand (DASH) score was 66 preoperatively and 28 at final follow-up. The mean satisfaction (0 = not satisfied, 5 = completely satisfied) at final follow-up was 4.5 (range 3 to 5). The pain level (on 0–10 scale) improved from 6.6 to 1.3. The total arc of motion changed from 124° preoperatively to 142° postoperatively following an ARARC. Grip was 16 kg preoperatively and 18 kg postoperatively. Radiographic stages typically underestimated arthroscopic staging. Although four of our patients appeared to be radiographic stage I, all were found to have arthritis involving some or all of the radioscaphoid articulation at the time of arthroscopy. Clinical Relevance

  9. Shoulder impingement syndrome in relation to shoulder intensive work

    PubMed Central

    Frost, P.; Andersen, J. H.

    1999-01-01

    OBJECTIVES: To analyse the risk of shoulder impingement syndrome relative to shoulder intensive work. METHODS: A cross sectional study of a historical cohort of 1591 workers employed between 1986 and 1993 at a slaughterhouse or a chemical factory. Workers not doing tasks in slaughtering or meat processing constituted the reference group. Intensity of shoulder work in meat processing tasks was assessed by video based observations. Information on shoulder disorders was collected by questionnaire and by physical examinations. Impingement syndrome was diagnosed when shoulder symptoms had been present for at least 3 months during the past year and there were signs of subacromial impingement in the corresponding shoulder at physical examination. Shoulder function was assessed at the same occasion with the Constant scoring technique. Prevalence of shoulder impingement syndrome was analysed according to job title and cumulative exposure. RESULTS: Prevalence ratio for shoulder impingement syndrome was 5.27 (95% confidence interval (95% CI), 2.09 to 12.26) among currently working and 7.90 (95% CI, 2.94 to 21.18) among former slaughterhouse workers. Transformed model based prevalence ratios according to years in slaughterhouse work showed an overall association between cumulative exposure and risk for shoulder impingement syndrome. CONCLUSIONS: This study supports the hypothesis that shoulder intensive work is a risk factor for impingement syndrome of the shoulder. Despite the historical cohort design healthy worker selection may have influenced the exposure- response relation found.   PMID:10472322

  10. CERVICAL CONTRIBUTION TO FUNCTIONAL SHOULDER IMPINGEMENT: TWO CASE REPORTS

    PubMed Central

    2016-01-01

    Background Subacromial impingement is a common condition among overhead athletes. The cause of subacromial impingement can be multifactorial and often involves impaired rotator cuff function. Case Description The following cases outline the presentation, examination and intervention of two overhead athletes, a high school football quarterback and a collegiate swimmer, each presenting with signs and symptoms of subacromial impingement. The unique feature in each case was the manifestation of the cervical spine as the apparent source of rotator cuff weakness, which contributed to functional subacromial impingement although other overt signs of cervical or associated nerve root involvement were absent. Outcome Subsequent to this finding, the athletes demonstrated a rapid recovery of rotator cuff strength and resolution of impingement symptoms in response to cervical retraction and retraction with extension range of motion exercises along with posture correction. They both returned to unrestricted sporting activities within a week, with maintenance of strength and without reoccurrence of symptoms. Discussion The signs of functional subacromial impingement often include weakness of the supraspinatus and infraspinatus. The cause of the weakness in the two cases appeared to be the result of stresses associated with forward head posture contributing to a possible intermittent C5 nerve root compression. The findings in the two cases would suggest the cervical spine should be considered as a potential cause of rotator cuff weakness in individuals presenting with subacromial impingement. Future research should examine the influence of cervical postures and shoulder muscle strength. Level of Evidence 4 PMID:27904800

  11. Scaling laws for drop impingement on porous films and papers.

    PubMed

    Joung, Young Soo; Buie, Cullen R

    2014-01-01

    This study investigates drop impingement on highly wetting porous films and papers. Experiments reveal previously unexplored impingement modes on porous surfaces designated as necking, spreading, and jetting. Dimensional analysis yields a nondimensional parameter, denoted the Washburn-Reynolds number, relating droplet kinetic energy and surface energy. The impingement modes correlate with Washburn-Reynolds number variations spanning four orders of magnitude and a corresponding energy conservation analysis for droplet spreading shows good agreement with the experimental results. The simple scaling laws presented will inform the investigation of dynamic interactions between porous surfaces and liquid drops.

  12. Experimental and Computational Study of Underexpanded Jet Impingement Heat Transfer

    NASA Technical Reports Server (NTRS)

    Rufer, Shann J.; Nowak, Robert J.; Daryabeigi, Kamran; Picetti, Donald

    2009-01-01

    An experiment was performed to assess CFD modeling of a hypersonic-vehicle breach, boundary-layer flow ingestion and internal surface impingement. Tests were conducted in the NASA Langley Research Center 31-Inch Mach 10 Tunnel. Four simulated breaches were tested and impingement heat flux data was obtained for each case using both phosphor thermography and thin film gages on targets placed inside the model. A separate target was used to measure the surface pressure distribution. The measured jet impingement width and peak location are in good agreement with CFD analysis.

  13. Ankle Arthroscopic Reconstruction of Lateral Ligaments (Ankle Anti-ROLL)

    PubMed Central

    Takao, Masato; Glazebrook, Mark; Stone, James; Guillo, Stéphane

    2015-01-01

    Ankle instability is a condition that often requires surgery to stabilize the ankle joint that will improve pain and function if nonoperative treatments fail. Ankle stabilization surgery may be performed as a repair in which the native existing anterior talofibular ligament or calcaneofibular ligament (or both) is imbricated or reattached. Alternatively, when native ankle ligaments are insufficient for repair, a reconstruction of the ligaments may be performed in which an autologous or allograft tendon is used to reconstruct the anterior talofibular ligament or calcaneofibular ligament (or both). Currently, ankle stabilization surgery is most commonly performed through an open incision, but arthroscopic ankle stabilization using repair techniques has been described and is being used more often. We present our technique for anatomic ankle arthroscopic reconstruction of the lateral ligaments (anti-ROLL) performed in an all–inside-out manner that is likely safe for patients and minimally invasive. PMID:26900560

  14. Arthroscopy for shoulder instability and a technique for arthroscopic repair.

    PubMed

    Wiley, A M

    1988-01-01

    At this time the principal role of the arthroscope in the management of dislocating shoulder seems to be the identification of the intra-articular pathology. The findings should enable a surgeon to carry out an appropriate open repair, and the results of such surgery are excellent. Is there a place for arthroscopic repair? Some patients sometimes request it; others have had a failed open repair, or wish to avoid a scar. The author has devised a removable "Rivet," which fixes a loose labrum and the inferior glenohumeral ligament back on to a roughened glenoid margin. Use of this technique avoids some of the hazards that occur with implanting a staple or similar device in the joint. The "Rivet" is removed after 4-6 weeks. Ten patients have been so treated, with a follow-up of 6 months to 2 years. There was one failure, with a return of dislocation.

  15. Ankle Arthroscopic Reconstruction of Lateral Ligaments (Ankle Anti-ROLL).

    PubMed

    Takao, Masato; Glazebrook, Mark; Stone, James; Guillo, Stéphane

    2015-10-01

    Ankle instability is a condition that often requires surgery to stabilize the ankle joint that will improve pain and function if nonoperative treatments fail. Ankle stabilization surgery may be performed as a repair in which the native existing anterior talofibular ligament or calcaneofibular ligament (or both) is imbricated or reattached. Alternatively, when native ankle ligaments are insufficient for repair, a reconstruction of the ligaments may be performed in which an autologous or allograft tendon is used to reconstruct the anterior talofibular ligament or calcaneofibular ligament (or both). Currently, ankle stabilization surgery is most commonly performed through an open incision, but arthroscopic ankle stabilization using repair techniques has been described and is being used more often. We present our technique for anatomic ankle arthroscopic reconstruction of the lateral ligaments (anti-ROLL) performed in an all-inside-out manner that is likely safe for patients and minimally invasive.

  16. 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

  17. Three cases of septic arthritis following a recent arthroscopic procedure

    PubMed Central

    Rowton, Joseph

    2013-01-01

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

  18. Arthroscopic foveal repair of the triangular fibrocartilage complex.

    PubMed

    Atzei, Andrea; Luchetti, Riccardo; Braidotti, Federica

    2015-02-01

    Background Foveal disruption of the triangular fibrocartilage complex (TFCC) is associated with distal radioulnar joint (DRUJ) instability. TFCC fixation onto the fovea is the suitable treatment, which is not achieved by conventional arthroscopic techniques. We describe an all-inside arthroscopic technique that uses a suture anchor through distal DRUJ arthroscopy for foveal repair of the TFCC. Materials and Methods Forty-eight patients with TFCC foveal tear and DRUJ instability were selected according to the Atzei-European Wrist Arthroscopy Society (EWAS) algorithm of treatment. Retrospective evaluation included pain, DRUJ instability, range of motion (ROM), grip strength, Modified Mayo Wrist Score (MMWS), and the Disabilities of the Arm, Shoulder, and Hand (DASH) Score. Description of Technique DRUJ arthroscopy was performed to débride the TFCC and the foveal area. Under arthroscopic guidance, a suture anchor was inserted via the distal foveal portal to repair the TFCC onto the fovea. Sutures were tied on the radiocarpal surface of the TFCC. Postoperative immobilization of forearm rotation was maintained for 4 weeks. Heavy tasks were allowed after 3 months. Results After a mean follow-up of 33 months, pain improved significantly but remained moderate in four patients, severe in one. DRUJ instability resolved in 44 patients. Wrist ROM increased. Grip strength, MMWS, and DASH score improved significantly. Excellent and good MMWS equaled 83.3%. Forty-one patients (85.5%) resumed previous work and sport activities. As a postoperative complication, five patients experienced neuroapraxia of the dorsal sensory branch of the ulnar nerve (DSBUN) with full spontaneous recovery. Conclusions With appropriate indications and patient selection, arthroscopic foveal repair of the TFCC may restore DRUJ stability and provide satisfactory results without significant complications.

  19. Arthroscopic Foveal Repair of the Triangular Fibrocartilage Complex

    PubMed Central

    Atzei, Andrea; Luchetti, Riccardo; Braidotti, Federica

    2015-01-01

    Background Foveal disruption of the triangular fibrocartilage complex (TFCC) is associated with distal radioulnar joint (DRUJ) instability. TFCC fixation onto the fovea is the suitable treatment, which is not achieved by conventional arthroscopic techniques. We describe an all-inside arthroscopic technique that uses a suture anchor through distal DRUJ arthroscopy for foveal repair of the TFCC. Materials and Methods Forty-eight patients with TFCC foveal tear and DRUJ instability were selected according to the Atzei–European Wrist Arthroscopy Society (EWAS) algorithm of treatment. Retrospective evaluation included pain, DRUJ instability, range of motion (ROM), grip strength, Modified Mayo Wrist Score (MMWS), and the Disabilities of the Arm, Shoulder, and Hand (DASH) Score. Description of Technique DRUJ arthroscopy was performed to débride the TFCC and the foveal area. Under arthroscopic guidance, a suture anchor was inserted via the distal foveal portal to repair the TFCC onto the fovea. Sutures were tied on the radiocarpal surface of the TFCC. Postoperative immobilization of forearm rotation was maintained for 4 weeks. Heavy tasks were allowed after 3 months. Results After a mean follow-up of 33 months, pain improved significantly but remained moderate in four patients, severe in one. DRUJ instability resolved in 44 patients. Wrist ROM increased. Grip strength, MMWS, and DASH score improved significantly. Excellent and good MMWS equaled 83.3%. Forty-one patients (85.5%) resumed previous work and sport activities. As a postoperative complication, five patients experienced neuroapraxia of the dorsal sensory branch of the ulnar nerve (DSBUN) with full spontaneous recovery. Conclusions With appropriate indications and patient selection, arthroscopic foveal repair of the TFCC may restore DRUJ stability and provide satisfactory results without significant complications. PMID:25709875

  20. Arthroscopic stabilization procedures for recurrent anterior shoulder instability.

    PubMed

    Yahiro, M A; Matthews, L S

    1989-11-01

    Anterior shoulder instability is a common and functionally disabling problem in young athletes. The goal in treatment of this condition is a stable, yet mobile, joint. Current methods now being utilized in the arthroscopic stabilization of the anterior shoulder include staple capsulorrhaphy, removable rivet capsulorrhaphy, cannulated screw fixation, and the transglenoid suture technique. These techniques and the clinical experience with each are reviewed, with an emphasis on providing stability, improving function, and allowing earlier rehabilitation in the unstable shoulder of the athlete.

  1. Arthroscopic Lysis of Arthrofibrosis of the Fifth Tarsometatarsal Joint.

    PubMed

    Lui, Tun Hing

    2015-12-01

    Loss of motion of the fifth tarsometatarsal joint can be a cause of lateral foot pain after Lisfranc fracture-dislocation or fracture of the fifth metatarsal tubercle. Arthroscopic lysis of the joint can be an effective surgical treatment with the advantage of minimal soft-tissue trauma and early vigorous mobilization of the joint. The lysis can be extended to the fourth tarsometatarsal joint and the adjacent tendons if indicated.

  2. Arthroscopic Synovectomy for Zone 2 Flexor Hallucis Longus Tenosynovitis.

    PubMed

    Lui, Tun Hing

    2015-10-01

    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.

  3. Wenzel to Cassie transition for droplet impingement

    NASA Astrophysics Data System (ADS)

    Clavijo, Cristian; Crockett, Julie; Maynes, Daniel

    2015-11-01

    Advantages posed by self-cleaning, superhydrophobic surfaces quickly diminish as the liquid penetrates gas-filled cavities resulting in the so-called Wenzel state. To prevent penetration, surfaces must exhibit nanoscale features since penetrating pressure increases significantly for decreasing feature size. However, certain applications require microscale roughness such as those seeking to relax the no-slip condition and thus penetration reversal in microscale features remains of interest. Unfortunately, recent efforts to accomplish such reversal are complicated or locally-disruptive to the flow such as electrically-tunable surfaces and boiling. Here, we show that a Wenzel-to-Cassie transition is possible with a modest surface temperature increase. Dynamics are discussed for a water droplet impinging (We =100) on a wide range of superhydrophobic surfaces with features varying in height from 4 microns to 18 microns and separation distance of 8 microns to 16 microns. Results reveal that dewetting rates increase with increasing feature height and temperature up to 30 mL/s. A first order model is constructed to validate our hypothesis that surface tension and triple line dissipation are the two dominating forces during dewetting. Good agreement is found between the model and experimental results. We gratefully acknowlege the National Science Foundation for funding this work.

  4. Control of Impingement Heat Transfer Using Mist

    NASA Astrophysics Data System (ADS)

    Kanamori, Azusa; Hiwada, Munehiko; Mimatsu, Junji; Sugimoto, Hiraku; Oyakawa, Kenyuu

    Impingement heat transfer from a circular orifice jet by using latent heat of water mists was studied experimentally. The amounts of mists of about Zauter's mean diameter 14 µm were from 60 to 200 g/h within a range where liquid films were not formed on the target plate and mists were added near the orifice edge. Experiments covered Reynolds numbers from 12,500 to 50,000 and a heat flux is 1,400 W/m2. The experimental results indicate that adding mists had little influence on free jet mean velocity profiles and target plate pressure coefficients. On the other hand, mists had a strong influence on temperature and humidity profiles of a free jet and they also influenced Nusselt number distributions on the target plate. Increases of mists and Reynolds number caused increases in Nusselt number on the developed region. In addition, we investigated influence of the way mists were added and these results showed that Nusselt number was influenced not only by the amounts of mists but also by the adding method. Local Nusselt number profiles with mists were closely related to temperature distributions of the free jet at the location corresponding to the target plate.

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

    PubMed

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

    2015-10-01

    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.

  6. Use of an Irrigation Pump System in Arthroscopic Procedures.

    PubMed

    Hsiao, Mark S; Kusnezov, Nicholas; Sieg, Ryan N; Owens, Brett D; Herzog, Joshua P

    2016-05-01

    Since its inception, arthroscopic surgery has become widely adopted among orthopedic surgeons. It is therefore important to have an understanding of the basic principles of arthroscopy. Compared with open techniques, arthroscopic procedures are associated with smaller incisions, less structural damage, improved intra-articular visualization, less pain in the immediate postoperative period, and faster recovery for patients. Pump systems used for arthroscopic surgery have evolved over the years to provide improved intraoperative visualization. Gravity flow systems were described first and are still commonly used today. More recently, automated pump systems with pressure or dual pressure and volume control have been developed. The advantages of automated irrigation systems over gravity irrigation include a more consistent flow, a greater degree of joint distention, improved visualization especially with motorized instrumentation, decreased need for tourniquet use, a tamponade effect on bleeding, and decreased operative time. Disadvantages include the need for additional equipment with increased cost and maintenance, the initial learning curve for the surgical team, and increased risk of extra-articular fluid dissection and associated complications such as compartment syndrome. As image quality and pump systems improve, so does the list of indications including diagnostic and treatment modalities to address intra-articular pathology of the knee, shoulder, hip, wrist, elbow, and ankle joints. This article reviews the current literature and presents the history of arthroscopy, basic science of pressure and flow, types of irrigation pumps and their functions, settings, applications, and complications. [Orthopedics. 2016; 39(3):e474-e478.].

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

    PubMed

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

    2015-10-01

    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.

  8. ARTHROSCOPIC TREATMENT OF CALCIFYING TENDINITIS OF THE ROTATOR CUFF

    PubMed Central

    Neto, Arnaldo Amado Ferreira; Trevizani, Cassio Silva; Benegas, Eduardo; Malavolta, Eduardo Angeli; Gracitelli, Mauro Emílio Conforto; Bitar, Alexandre Carneiro; Neto, Francisco José dos Santos

    2015-01-01

    To evaluate the clinical and radiographic results from arthroscopic surgical treatment of the rotator cuff in patients with calcifying tendinitis. Method: A retrospective study was conducted on twenty patients who underwent arthroscopic treatment for calcifying tendinitis of the shoulder between March 1999 and November 2005. Six patients were excluded due to loss of follow-up. The average follow-up period was 41.4 months. Eight patients (57%) were female and six (43%) were male. The right side was affected in 10 cases (71%) and the left in four cases (29%). Nine cases (64%) had calcification in the supraspinatus tendon, two (14%) in the infraspinatus tendon, and three (21%) in both tendons. Results: In all cases, resection of the calcium deposits was performed by means of a needle (Jelco® No. 14) in combination with curettage (mini-curette). Two shoulders (14%) underwent subacromial decompression, and one (7%) underwent excision of the distal clavicle. A tendon-tendon suture was performed in three shoulders (21%). None of the patients underwent tendon-bone reinsertion. The mean score obtained on the UCLA scale was 33 points (26-35), thus indicating that a majority of patients had good results. In the final radiographic evaluation, none of the patients showed signs of calcification. Conclusion: Arthroscopic treatment of calcifying tendinitis of the shoulder safely allows excision of the calcification, leading to good results in relation to shoulder pain and function. PMID:27022591

  9. ARTHROSCOPIC TREATMENT OF POST-TRAUMATIC ELBOW STIFFNESS

    PubMed Central

    Júnior, Jose Carlos Garcia; Zabeu, Jose Luis Amim; Junior, Ivaldo Angelo Cintra; Mattos, Carlos Augusto; Myrrha, Jesely Pereira

    2015-01-01

    To evaluate patients undergoing arthroscopic release of a stiff elbow, with discussion of the technique, possible difficulties and risks. Methods: Twenty-four elbow arthroscopy procedures were performed. All the patients were evaluated using goniometry before the operation and six months afterwards and were rated using the Mayo elbow performance score (MEPS). Results: Fifteen men and nine women underwent surgery (14 right elbows and ten left elbows). Their mean age was 34.58 years and length of follow-up, 38.41 months. Their mean gain of range of motion was 43.3° and of MEPS, 85.4. Conclusion: Arthroscopic release might enable better intra-articular viewing and enhance the options for changing strategy during surgery, reducing surgical trauma and enabling early rehabilitation. This technique can reach similar or better results than open surgery. The disadvantages of arthroscopy are the long learning curve and higher cost of the procedure. Neurovascular complications are reported with both techniques. To avoid such problems, the protocol for portal construction must be rigorously followed. Arthroscopic release was shown to be a safe and effective option for achieving range-of-motion gains in cases of post-traumatic stiff elbow. PMID:27042641

  10. Arthroscopic Removal of Shotgun Pellet From Within the Medial Meniscus

    PubMed Central

    Lacy, Kyle; Cooke, Chris; Cooke, Pat; Tonnos, Frederick

    2016-01-01

    Arthroscopic techniques are effective for the removal of intra-articular bullet and metal fragments after gunshot wounds to the shoulder, hip, knee, and sacroiliac joints. Surgical removal of bullets retained within the synovial joints is indicated; lead is dissolved by synovial fluid over time, leading to proliferative synovitis, lead arthropathy, elevated serum lead levels, and lead toxicity. We present an arthroscopic technique for removal of a shotgun pellet retained within the medial meniscus. In this technique, diagnostic knee arthroscopy is initially performed, which allows for localization of the pellet within the medial meniscus. An up-biter is used to resect the inner rim of meniscus surrounding the pellet, and the pellet is removed with a grasper. This arthroscopic approach is advantageous because it allows for efficient visualization of the pellet within the meniscus, thorough visualization of all compartments of the knee, a reduction in blood loss, and a decrease in surgical morbidity to the surrounding cartilaginous, neurovascular, and soft-tissue structures. This technique may therefore be one option to address bullet fragments or shotgun pellets that are retained within the medial meniscus. PMID:27073774

  11. Mixing Characteristics of Turbulent Twin Impinging Axisymmetric Jets at Various Impingement Angles

    NASA Astrophysics Data System (ADS)

    Landers, Brian Donn

    An experimental study is first presented on the comparison between two commonly used velocity measurement techniques applied in experimental fluid dynamics: Constant Temperature Anemometry (CTA) and Particle Image Velocimetry (PIV). The comparison is performed in the near-field region of an axisymmetric circular turbulent jet where the flow field contains large scale turbulent structures. The comparison was performed for five Reynolds numbers, based on diameter, between 5,000 and 25,000. The Reynolds numbers selected cover the critical Reynolds number range, 10,000 to 20,000 where the characteristics of the flow transition to a fully developed turbulent mixing layer. A comparison between these two measurement techniques was performed in order to determine the differences between an intrusive (CTA) and non-intrusive (PIV) method when applied to a practical application. The results and observations obtained from the comparison between the two techniques were applied to better characterize the time-averaged characteristics of a single axisymmetric turbulent jet with a Reynolds number of 7,500. The mean and fluctuating velocities, turbulent kinetic energy (TKE), and vorticity were measured as a baseline case. Additionally, smoke visualization was utilized to determine the mixing characteristics of the transient start of an axisymmetric turbulent jet. The shedding frequencies, also known as, the `preferred mode were investigated for a single jet. Particle Image Velocimetry (PIV) was also utilized to characterize the pre-and post-regions of the interaction region of two axisymmetric, incompressible turbulent jets at included angles: 30, 45, and 60 degrees. The Reynolds number selected (7,500) was within the range of critical Reynolds numbers and the geometrical distance to twin jet impingement, X0, remained constant at 10.33D for each impingement angle. The mean and fluctuating velocities, vorticity, and turbulent kinetic energy (TKE) were measured. Smoke Visualization

  12. Effect of impinging plate geometry on the self-excitation of subsonic impinging jets

    NASA Astrophysics Data System (ADS)

    Vinoth, B. R.; Rathakrishnan, E.

    2011-11-01

    In the generation of discrete tones by subsonic impinging jets, there exists a difference of opinion as how the feedback is achieved, i.e., the path of the feedback acoustic waves is whether inside the jet or outside the jet? The only available model (Tam and Ahuja model) for the prediction of an average subsonic jet impingement tone frequency assumes that the upstream part of the feedback loop is closed by an upstream propagating neutral wave of the jet. But, there is no information about the plate geometry in the model. The present study aims at understanding the effect of the plate geometry (size and co-axial hole in the plate) on the self-excitation process of subsonic impinging jets and the path of the acoustic feedback to the nozzle exit. The present results show that there is no effect of plate diameter on the frequency of the self-excitation. A new type of tones is generated for plates with co-axial hole (hole diameter is equal to nozzle exit diameter) for Mach numbers 0.9 and 0.95, in addition to the axisymmetric and helical mode tones observed for plates without co-axial hole. The stability results show that the Strouhal number of the least dispersive upstream propagating neutral waves match with the average Strouhal number of the new tones observed in the present experiments. The present study extends the validity of the model of Tam and Ahuja to a plate with co-axial hole (annular plate) and by doing so, we indirectly confirmed that the major acoustic feedback path to the nozzle exit is inside the jet.

  13. Coracoid impingement syndrome due to intensive rock climbing training.

    PubMed

    Schöffl, Volker; Schneider, Hans; Küpper, Thomas

    2011-06-01

    Overuse and acute injuries to the upper body are common in rock climbing. Such injuries primarily affect the fingers; but shoulder problems are increasingly common, especially among more experienced and older climbers who climb at a high ability level. Such shoulder problems are often due to subacromial impingement, shoulder dislocations with bankart lesions, hyperlaxity, SLAP lesions or irritations of the long biceps tendon. In contrast to these known conditions, we describe a case of an ambitious female rock climber who trained intensively and developed a coracoid impingement caused by hypertrophied subscapularis tendon and muscle following sport-specific training. Diagnosis was made through clinical evaluation and confirmed by magnetic resonance tomography. Coracoid impingement syndrome is a less common cause of shoulder pain and occurs when the subscapularis tendon impinges between the coracoid and the lesser tuberosity of the humerus. The patient was treated successfully with a conservative therapy and returned to full activity within 6 weeks.

  14. Impinging jet separators for liquid metal magnetohydrodynamic power cycles

    NASA Technical Reports Server (NTRS)

    Bogdanoff, D. W.

    1973-01-01

    In many liquid metal MHD power, cycles, it is necessary to separate the phases of a high-speed liquid-gas flow. The usual method is to impinge the jet at a glancing angle against a solid surface. These surface separators achieve good separation of the two phases at a cost of a large velocity loss due to friction at the separator surface. This report deals with attempts to greatly reduce the friction loss by impinging two jets against each other. In the crude impinging jet separators tested to date, friction losses were greatly reduced, but the separation of the two phases was found to be much poorer than that achievable with surface separators. Analyses are presented which show many lines of attack (mainly changes in separator geometry) which should yield much better separation for impinging jet separators).

  15. Talar Osteochondroma Fracture Presenting as Posterior Ankle Impingement.

    PubMed

    Ercin, Ersin; Bilgili, Mustafa Gokhan; Gamsizkan, Mehmet; Avsar, Serdar

    2016-05-01

    Osteochondromas are the most common benign bone tumors. They are usually asymptomatic and found incidentally. When symptomatic, the symptoms are usually due to its location and size. Fracture of an osteochondroma presenting as posterior ankle impingement is a rare condition. We describe a 22-year-old man with solitary exostosis who presented with a posterior ankle mass and posterior ankle impingement with 2 years of follow-up. Surgical intervention was the treatment of choice in this patient, and histologic examination revealed a benign osteochondroma. Osteochondromas found in the posterior aspect of the talus can be complicated by fracture due to persistent motion of the ankle. Talar osteochondroma should be included in the differential diagnosis of posterior ankle impingement causes. Posterior talar osteochondromas, especially when a stalk is present, should be treated surgically before it is more complicated by a fracture and posterior ankle impingement.

  16. Shoulder Impingement Syndromes: Implications on Physical Therapy Examination and Intervention

    PubMed Central

    2005-01-01

    A painful shoulder presents challenges in examination, diagnosis and intervention for the physical therapist because of the complexity of the structures involved. A common cause of shoulder pain is shoulder impingement syndrome. This was first described as a condition in which the soft tissues of the subacromial space were chronically entrapped and compressed between the humeral head and the subacromial arch. This definition does not account for the myriad potential causes of shoulder impingement conditions, as forms of impingement other than subacromial soft tissue compression may explain different symptomatic shoulder injuries. This paper describes shoulder impingement syndromes that have been hypothesized, identified and analyzed in the literature. Physical Therapy examination and intervention for these syndromes are also discussed. PMID:25792938

  17. Experimental water droplet impingement data on modern aircraft surfaces

    NASA Technical Reports Server (NTRS)

    Papadakis, Michael; Breer, Marlin D.; Craig, Neil C.; Bidwell, Colin S.

    1991-01-01

    An experimental method has been developed to determine the water droplet impingement characteristics on two- and three-dimensional aircraft surfaces. The experimental water droplet impingement data are used to validate particle trajectory analysis codes that are used in aircraft icing analyses and engine inlet particle separator analyses. The aircraft surface is covered with thin strips of blotter paper in areas of interest. The surface is then exposed to an airstream that contains a dyed-water spray cloud. The water droplet impingement data are extracted from the dyed blotter paper strips by measuring the optical reflectance of each strip with an automated reflectometer. Preliminary experimental and analytical impingement efficiency data are presented for a NLF(1)-0414F airfoil, s swept MS(1)-0317 airfoil, a swept NACA 0012 wingtip and for a Boeing 737-300 engine inlet model.

  18. Measurements in a large angle oblique jet impingement flow

    NASA Technical Reports Server (NTRS)

    Foss, J. F.

    1978-01-01

    The flow field associated with the oblique impingement of an axisymmetric jet was investigated in the externally blown flap configuration for the STOL aircraft. The passive and active spreading characteristics of the shallow angle (a greater than or = approximately to 15 degrees) oblique impingement flow, the role of the initially azimuthal vorticity field, and the stagnation point region were studied, and compared to the large ( a = 45 degres) oblique jet impingement flow. A description of the characteristics of the large angle impingement flow is presented: A flow field near the plate as showing two distinct patterns, one near the location of the maximum surface pressure, and another about the geometric intersection of the jet axis with the plate; and turbulence in the region above the plate which is greater than the one accounted for by the convection of turbulence energy by the mean motion.

  19. Two stage serial impingement cooling for isogrid structures

    SciTech Connect

    Lee, Ching-Pang; Morrison, Jay A.

    2014-09-09

    A system for cooling a wall (24) of a component having an outer surface with raised ribs (12) defining a structural pocket (10), including: an inner wall (26) within the structural pocket and separating the wall outer surface within the pocket into a first region (28) outside of the inner wall and a second region (40) enclosed by the inner wall; a plate (14) disposed atop the raised ribs and enclosing the structural pocket, the plate having a plate impingement hole (16) to direct cooling air onto an impingement cooled area (38) of the first region; a cap having a skirt (50) in contact with the inner wall, the cap having a cap impingement hole (20) configured to direct the cooling air onto an impingement cooled area (44) of the second region, and; a film cooling hole (22) formed through the wall in the second region.

  20. A flash photographic method for droplet impingement studies

    SciTech Connect

    Hart, V.

    1999-07-01

    This paper describes an experimental method to visualize the impingement process of a liquid droplet onto a solid surface with sufficient clarity to reveal fine details of the droplet surface structure and rim jet produced during the impingement process. The method incorporates a 35 mm SLR camera with bellows, motor drive, macro lens, backlighting by a short duration flash lamp, diffusers and a commercially available timing control unit to trigger the flash. Results using the experimental arrangement are demonstrated for a water droplet striking a horizontal surface at a velocity of about 1 m/s, though the photographic method may be applied to any other condition and liquid. A series of photographs are presented that show the repeatability of the impingement process, image clarity, surface structure of the droplet during impingement.

  1. Impingement in Total Hip Replacement: Mechanisms and Consequences

    PubMed Central

    Brown, Thomas D.; Callaghan, John J.

    2009-01-01

    The occurrence of total hip impingement, whether or not accompanied by frank dislocation, holds substantial untoward clinical consequences, especially as less-forgiving advanced bearing implant designs come into ever more widespread use. Biomechanical aspects of impingement and dislocation have historically received relatively little scientific attention, although that situation is now rapidly changing. The present article reviews contemporary laboratory and clinical research on the impingement/dislocation phenomena, focusing particularly on how implant design variables, surgical implantation factors and patient activity each act individually and in concert to pose impingement and dislocation challenges. In recent years, several powerful new research methodologies have emerged that have greatly expanded the scope for clinical translation of systematic laboratory study. Transferring the findings from such research into yet better implant designs, and even better surgical procedures, offers encouragement that the clinical impact of this troublesome complication can be further reduced. PMID:19956356

  2. Plume Impingement Analysis for the European Service Module Propulsion System

    NASA Technical Reports Server (NTRS)

    Yim, John Tamin; Sibe, Fabien; Ierardo, Nicola

    2014-01-01

    Plume impingement analyses were performed for the European Service Module (ESM) propulsion system Orbital Maneuvering System engine (OMS-E), auxiliary engines, and reaction control system (RCS) engines. The heat flux from plume impingement on the solar arrays and other surfaces are evaluated. This information is used to provide inputs for the ESM thermal analyses and help determine the optimal configuration for the RCS engines.

  3. Liquid jet impingement heat transfer with or without boiling

    NASA Astrophysics Data System (ADS)

    Ma, C. F.; Gan, Y. P.; Tian, Y. C.; Lei, D. H.; Gomi, T.

    1993-03-01

    The purpose of this paper is to summarize the important studies in the area of impingement heat transfer with or without phase change, with emphasis on the research conducted at Beijing Polytechnic University mainly with circular jets. Heat transfer characteristics of single phase jets are discussed in detail. Comment is presented on boiling heat transfer of impinging jets for steady and transient states. Some special cooling configurations of two-phase jets are also introduced.

  4. Arthroscopic revision arthrodesis for non-union of the naviculocuneiform joint: a case report.

    PubMed

    Lui, Tun Hing

    2015-08-01

    Naviculocuneiform arthrodesis is a viable treatment for symptomatic flatfoot with sag of the naviculocuneiform joint. Nonetheless, non-union is a common complication, and revision arthrodesis is indicated. This study reports arthroscopic revision arthrodesis for non-union of the naviculocuneiform. Accurate debridement and bone grafting of the nonunion site was performed arthroscopically.

  5. Simulating regolith ejecta due to gas impingement

    NASA Astrophysics Data System (ADS)

    Chambers, Wesley Allen; Metzger, Philip; Dove, Adrienne; Britt, Daniel

    2016-10-01

    Space missions operating at or near the surface of a planet or small body must consider possible gas-regolith interactions, as they can cause hazardous effects or, conversely, be employed to accomplish mission goals. They are also directly related to a body's surface properties; thus understanding these interactions could provide an additional tool to analyze mission data. The Python Regolith Interaction Calculator (PyRIC), built upon a computational technique developed in the Apollo era, was used to assess interactions between rocket exhaust and an asteroid's surface. It focused specifically on threshold conditions for causing regolith ejecta. To improve this model, and learn more about the underlying physics, we have begun ground-based experiments studying the interaction between gas impingement and regolith simulant. Compressed air, initially standing in for rocket exhaust, is directed through a rocket nozzle at a bed of simulant. We assess the qualitative behavior of various simulants when subjected to a known maximum surface pressure, both in atmosphere and in a chamber initially at vacuum. These behaviors are compared to prior computational results, and possible flow patterns are inferred. Our future work will continue these experiments in microgravity through the use of a drop tower. These will use several simulant types and various pressure levels to observe the effects gas flow can have on target surfaces. Combining this with a characterization of the surface pressure distribution, tighter bounds can be set on the cohesive threshold necessary to maintain regolith integrity. This will aid the characterization of actual regolith distributions, as well as informing the surface operation phase of mission design.

  6. Space Station flexible dynamics under plume impingement

    NASA Technical Reports Server (NTRS)

    Williams, Trevor

    1993-01-01

    Assembly of the Space Station requires numerous construction flights by the Space Shuttle. A particularly challenging problem is that of control of each intermediate station configuration when the shuttle orbiter is approaching it to deliver the next component. The necessary braking maneuvers cause orbiter thruster plumes to impinge on the station, especially its solar arrays. This in turn causes both overall attitude errors and excitation of flexible-body vibration modes. These plume loads are predicted to lead to CMG saturation during the approach of the orbiter to the SC-5 station configuration, necessitating the use of the station RCS jets for desaturation. They are also expected to lead to significant excitation of solar array vibrations. It is therefore of great practical importance to investigate the effects of plume loads on the flexible dynamics of station configuration SC-5 as accurately as possible. However, this system possesses a great many flexible modes (89 below 5 rad/s), making analysis time-consuming and complicated. Model reduction techniques can be used to overcome this problem, reducing the system model to one which retains only the significant dynamics, i.e. those which are strongly excited by the control inputs or plume disturbance forces and which strongly couple with the measured outputs. The particular technique to be used in this study is the subsystem balancing approach which was previously developed by the present investigator. This method is very efficient computationally. Furthermore, it gives accurate results even for the difficult case where the structure has many closed-spaced natural frequencies, when standard modal truncation can give misleading results. Station configuration SC-5 is a good example of such a structure.

  7. 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

  8. Hip arthroscopy and osteoarthritis: Where are the limits and indications?

    PubMed

    Mella, Claudio; Villalón, Ignacio E; Núñez, Álvaro; Paccot, Daniel; Díaz-Ledezma, Claudio

    2015-10-16

    The use of hip arthroscopy, as a surgical technique, has increased significantly over the past ten years. The procedure has shown good and excellent results in symptom relief and function improvement for patients with femoro-acetabular impingement (FAI) and concurrent chondro-labral lesions. It is also a reliable method to correct the characteristic pathomorphologic alteration of FAI. However, surgical results are less successful among patients with advanced articular damage and secondary hip osteoarthritis. The aim of this article is to present some clinical and imagenological tools to discriminate the good candidates for arthroscopic FAI treatment from those who are not, due to extensive articular damage.

  9. Hip arthroscopy and osteoarthritis: Where are the limits and indications?

    PubMed Central

    Mella, Claudio; Villalón, Ignacio E.; Núñez, Álvaro; Paccot, Daniel; Díaz-Ledezma, Claudio

    2015-01-01

    The use of hip arthroscopy, as a surgical technique, has increased significantly over the past ten years. The procedure has shown good and excellent results in symptom relief and function improvement for patients with femoro-acetabular impingement (FAI) and concurrent chondro-labral lesions. It is also a reliable method to correct the characteristic pathomorphologic alteration of FAI. However, surgical results are less successful among patients with advanced articular damage and secondary hip osteoarthritis. The aim of this article is to present some clinical and imagenological tools to discriminate the good candidates for arthroscopic FAI treatment from those who are not, due to extensive articular damage. PMID:27163082

  10. Thermal-hydraulic performance of convective boiling jet array impingement

    NASA Astrophysics Data System (ADS)

    Jenkins, R.; De Brún, C.; Kempers, R.; Lupoi, R.; Robinson, A. J.

    2016-09-01

    Jet impingement boiling is investigated with regard to heat transfer and pressure drop performance using a novel laser sintered 3D printed jet impingement manifold design. Water was the working fluid at atmospheric pressure with inlet subcooling of 7oC. The convective boiling performance of the impinging jet system was investigated for a flat copper target surface for 2700≤Re≤5400. The results indicate that the heat transfer performance of the impinging jet is independent of Reynolds number for fully developed boiling. Also, the investigation of nozzle to plate spacing shows that low spacing delays the onset of nucleate boiling causing a superheat overshoot that is not observed with larger gaps. However, no sensitivity to the gap spacing was measured once boiling was fully developed. The assessment of the pressure drop performance showed that the design effectively transfers heat with low pumping power requirements. In particular, owing to the insensitivity of the heat transfer to flow rate during fully developed boiling, the coefficient of performance of jet impingement boiling in the fully developed boiling regime deteriorates with increased flow rate due to the increase in pumping power flux.

  11. The Effect of Impingement on Transitional Behavior in Underexpanded Jets

    NASA Technical Reports Server (NTRS)

    Inman, Jennifer A.; Danehy, Paul M.; Nowak, Robert J.; Alderfer, David W.

    2009-01-01

    An investigation into the development of flow unsteadiness in impinging axisymmetric underexpanded jets has been conducted at NASA Langley Research Center. The study has examined the effect of an impingement target placed at various distances and angles on transitional behavior of such jets. Two nozzles, with exit Mach numbers of 1.0 and 2.6, were used in this investigation. Planar laser-induced fluorescence of nitric oxide (NO PLIF) has been used to identify flow unsteadiness and to image transitional and turbulent flow features. Measurements of the location of the onset of various degrees of unsteady flow behavior have been made using these PLIF images. Both qualitative and quantitative comparisons are presented to demonstrate the observed effects of impingement and flow parameters on the process of the transition to turbulence. The presence of the impingement target was found to significantly shorten the distance to transition to turbulence by up to a factor of approximately three, with closer targets resulting in slightly shorter distance to transition and turbulence. The location at which the flow first exhibits unsteadiness was found to have a strong dependence on the presence and location of key flow structures. This paper presents quantitative results on transition criteria for free and impinging jets.

  12. Supersonic moist air jet impingements on flat surface

    NASA Astrophysics Data System (ADS)

    Alam, Miah Md. Ashraful; Matsuo, Shigeru; Setoguchi, Toshiaki

    2010-02-01

    Pronounced aeroacoustic resonances are exhibited in the flowfield where a jet emerges from an orifice or a nozzle and impinges on a solid surface. One instance where such resonances are produced is in a high speed jet impingement, such as in the space launch vehicle systems, jet-engine exhaust impingement, and in the short take-off and vertical landing (STOVL) aircraft, etc. A highly unsteady flowfield leading to a drastic increase of noise level with very high dynamic pressure and thermal loads are noticed on nearby surfaces results dramatic lift loss, severe ground erosion and hot gas ingestion to the inlet in the jet engines. This highly unsteady behavior of the impinging jets is due to a feedback loop between the fluid and acoustic fields. In actual jet flow, the working gas may contain condensable gas such as steam or moist air. In these cases, the non-equilibrium condensation may occur at the region between nozzle exit and an object. The jet flow with non-equilibrium condensation may be quite different from that without condensation. Therefore, in this study, the effect of the non-equilibrium condensation of moist air on the axisymmetric under-expanded supersonic impinging jet on a vertical flat plate was investigated numerically.

  13. Arthroscopic Transosseous Rotator Cuff Repair: Technical Note, Outcomes, and Complications

    PubMed Central

    Black, Eric M.; Lin, Albert; Srikumaran, Uma; Jain, Nitin; Freehill, Michael T.

    2016-01-01

    The goal of this study was to review the authors’ initial experience with arthroscopic transosseous rotator cuff repair. Thirty-one patients with full-thickness rotator cuff tears underwent arthroscopic transosseous rotator cuff repair over a 15-month period. Preoperatively, demographics and subjective scores were recorded. Postoperatively, pain levels, subjective shoulder values, satisfaction scores, American Shoulder and Elbow Surgeons (ASES) scores, complications, and reoperations were noted with a minimum 2-year follow-up. The relationships between pre- and intraoperative variables and outcome scores were determined with univariate analysis. Average patient age was 56 years, and 23 patients (74%) were men. Twenty patients (65%) underwent primary rotator cuff repair, and 11 patients (35%) underwent revision repair. Average time to follow-up was 26 months. Average preoperative pain level and subjective shoulder value were 5.1 of 10 and 35%, respectively. Average postoperative scores included pain level of 0.9 of 10, subjective shoulder value of 84%, satisfaction score of 90.6 of 100, and ASES score of 86.3 of 100. There were 3 (9.7%) major and 2 (6%) minor complications. Patients undergoing revision rotator cuff repair had significantly worse outcomes (pain level, subjective shoulder value, ASES score; P<.05) compared with those undergoing primary repair, and cortical augmentation did not significantly affect outcome. Overall, outcomes after arthroscopic transosseous rotator cuff repair are good, although patients undergoing revision repair do not have the same outcomes as those undergoing primary cuff repair. The procedure is not without complications (9.7% major, 6% minor complications). Cortical augmentation may be used to supplement fixation, although it does not necessarily affect outcomes. Patients without such augmentation may be at increased risk for suture cutout through the bone. PMID:25970360

  14. FUNCTIONAL ASSESSMENT OF ARTHROSCOPIC REPAIR FOR RECURRENT ANTERIOR SHOULDER INSTABILITY

    PubMed Central

    de Almeida Filho, Ildeu Afonso; de Castro Veado, Marco Antônio; Fim, Márcio; da Silva Corrêa, Lincoln Vargas; de Carvalho Junior, Antônio Enéas Rangel

    2015-01-01

    Objective: To clinically and radiologically evaluate patients who underwent arthroscopic surgical treatment for anterior shoulder instability by means of the Bankart technique, using metal anchors. Methods: This was a retrospective study on 49 patients who underwent arthroscopic repair of anterior shoulder instability between 2002 and 2007. The patients were evaluated using the Carter-Rowe score and the Samilson and Prieto classification. The mean age at the time of surgery was 30 years. The mean length of follow-up was 42.7 months (ranging from 18 to 74). 85% of the patients were male. Results: The mean Carter-Rowe score was 83 points (ranging from 30 to 100) including 31 excellent results, 7 good, 3 fair and 8 poor. Recurrent dislocation was observed in 16% (8 patients), and 37.5% of them were of traumatic origin. Joint degeneration was present in 32.5% of the cases, including 5 cases of grade 1, 6 cases of grade 2 and 2 cases of grade 3. The average loss of external rotation was 12° and the loss of anterior elevation was 8°. There was a statistically significant relationship (p < 0.05) between arthritis and age at first dislocation, age at surgery and crackling. 92% of the patients reported high degrees of satisfaction after the procedure. Among the complications, there were two cases of stiff shoulder, one patient with prominence of the synthesis material and one case of anchor loosening. Conclusion: Arthroscopic repair of anterior shoulder instability using metal anchors was shown to be effective, with a low complication rate. PMID:27042624

  15. Outcomes of arthroscopic Bankart repair in collision versus noncollision athletes.

    PubMed

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

    2013-05-01

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

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

    PubMed Central

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

    2014-01-01

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

  17. Arthroscopic Management of Complications Following Total Ankle Replacement.

    PubMed

    Lui, Tun Hing; Roukis, Thomas S

    2015-10-01

    There is great potential of managing the complications of total ankle replacement arthroscopically and endoscopically, and these procedures can be summarized into 3 groups. Group 1 includes procedures of the ankle joint proper with close proximity to the articular components of the total ankle replacement. Group 2 includes procedures of the tibia and talus with close proximity to the nonarticular parts of the total ankle replacement. Group 3 includes procedures that are away from the total ankle replacement. However, these remain master arthroscopist procedures and should be performed by foot and ankle surgeons who perform them with regularity.

  18. Arthroscopic Management of Anterior, Posterior, and Multidirectional Shoulder Instabilities.

    PubMed

    Field, Larry D; Ryu, Richard K N; Abrams, Jeffrey S; Provencher, Matthew

    2016-01-01

    Arthroscopic shoulder stabilization offers several potential advantages compared with open surgery, including the opportunity to more accurately evaluate the glenohumeral joint at the time of diagnostic assessment; comprehensively address multiple pathologic lesions that may be identified; and avoid potential complications unique to open stabilization, such as postoperative subscapularis failure. A thorough understanding of normal shoulder anatomy and biomechanics, along with the pathoanatomy responsible for anterior, posterior, and multidirectional shoulder instability patterns, is very important in the management of patients who have shoulder instability. The treating physician also must be familiar with diagnostic imaging and physical examination maneuvers that are required to accurately diagnose shoulder instability.

  19. Midterm clinical outcomes following arthroscopic transosseous rotator cuff repair

    PubMed Central

    Flanagin, Brody A.; Garofalo, Raffaele; Lo, Eddie Y.; Feher, LeeAnne; Castagna, Alessandro; Qin, Huanying; Krishnan, Sumant G.

    2016-01-01

    Purpose: Arthroscopic transosseous (TO) rotator cuff repair has recently emerged as a new option for surgical treatment of symptomatic rotator cuff tears. Limited data is available regarding outcomes using this technique. This study evaluated midterm clinical outcomes following a novel arthroscopic TO (anchorless) rotator cuff repair technique. Materials and Methods: A consecutive series of 107 patients and 109 shoulders underwent arthroscopic TO (anchorless) rotator cuff repair for a symptomatic full-thickness tear. Pre and postoperative range of motion (ROM) was compared at an average of 11.8 months. Postoperative outcome scores were obtained at an average of 38.0 months. Statistical analysis was performed to compare pre and postoperative ROM data. Univariate analysis was performed using Student's t-test to compare the effect of other clinical characteristics on final outcome. Results: Statistically significant improvements were noted in forward flexion, external rotation and internal rotation (P < 0.0001). Average postoperative subjective shoulder value was 93.7, simple shoulder test 11.6, and American Shoulder and Elbow Surgeons (ASES) score 94.6. According to ASES scores, results for the 109 shoulders available for final follow-up were excellent in 95 (87.1%), good in 8 (7.3%), fair in 3 (2.8%), and poor in 3 (2.8%). There was no difference in ROM or outcome scores in patients who underwent a concomitant biceps procedure (tenodesis or tenotomy) compared with those who did not. Furthermore, there was no significant difference in outcome between patients who underwent either biceps tenodesis or tenotomy. Age, history of injury preceding the onset of pain, tear size, number of TO tunnels required to perform the repair, and presence of fatty infiltration did not correlate with postoperative ROM or subjective outcome measures at final follow-up. Two complications and four failures were noted. Conclusions: Arthroscopic TO rotator cuff repair technique leads to

  20. Apollo Video Photogrammetry Estimation of Plume Impingement Effects

    NASA Technical Reports Server (NTRS)

    Immer, Christopher; Lane, John; Metzger, Philip; Clements, Sandra

    2008-01-01

    Each of the six Apollo mission landers touched down at unique sites on the lunar surface. Aside from the Apollo 12 landing site located 180 meters from the Surveyor III lander, plume impingement effects on ground hardware during the landings were largely not an issue. The Constellation Project's planned return to the moon requires numerous landings at the same site. Since the top few centimeters are loosely packed regolith, plume impingement from the lander ejects the granular material at high velocities. With high vacuum conditions on the moon (10 (exp -14) to 10 (epx -12) torr), motion of all particles is completely ballistic. Estimates from damage to the Surveyor III show that the ejected regolith particles to be anywhere 400 m/s to 2500 m/s. It is imperative to understand the physics of plume impingement to safely design landing sites for the Constellation Program.

  1. The jet impingement phase of molten core-concrete interactions

    SciTech Connect

    Sienicki, J.J.; Spencer, B.W.

    1986-01-01

    Scoping calculations have been carried out demonstrating that a significant and abrupt reduction in the corium temperature may be realized when molten corium drains as a jet from a localized breach in the RPV lower head to impinge upon the concrete basemat. The temperature decrease may range from a value of approx.170 K (approx.140 K) for limestone (basaltic) aggregate concrete to a value approaching the initial corium superheat depending upon whether the forced convection impingement heat flux is assumed to be controlled by either thermal conduction across a slag film layer or the temperature boundary condition represented by a corium crust. The magnitude of the temperature reduction remains significant as the initial corium temperature, impinging corium mass, and initial localized breach size are varied over their range of potential values.

  2. Synergistic degradation of chitosan by impinging stream and jet cavitation.

    PubMed

    Huang, Yongchun; Wang, Pengfei; Yuan, Yuan; Ren, Xian'e; Yang, Feng

    2015-11-01

    Chitosan degradation was investigated using a combination of jet cavitation and impinging stream. Different operating parameters such as the initial concentration (1-5 g L(-1)), initial pH (3.2-4.8), solution temperature (30, 40, 50, 60, and 70°C), inlet pressure (0.1-0.45 MPa), and treatment time (0-120 min) were optimized to achieve the maximum degradation of chitosan. After the optimization of jet cavitation parameters, chitosan degradation was carried out using venturi tubes of different structures (the fluidic generator). The efficiency of the jet cavitation degradation was improved significantly by combining with impinging stream. The structures of the degradation products were characterized by Fourier-transform infrared spectroscopy and X-ray diffraction. This study has conclusively established that a combination of jet cavitation and impinging stream can be effectively used for the complete degradation of chitosan.

  3. 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

  4. Polymer-induced turbulence modifications in an impinging jet

    NASA Astrophysics Data System (ADS)

    Mejia-Alvarez, R.; Christensen, K. T.

    2012-05-01

    This effort explores the impact of dilute polymer solutions on the turbulence characteristics in a submerged liquid impinging-jet configuration. Turbulent impinging jets are commonly used in technological applications such as drying, scouring, cooling, or heating due to an enhancement in transport characteristics in the impingement region under certain nozzle-to-wall configurations. Previous efforts have identified significant turbulence modifications in the presence of dilute concentrations of polymer in both bounded and unbounded flows, though the former has received considerably more attention. To this end, particle-image velocimetry measurements were taken for an axisymmetric turbulent impinging jet with a nozzle-to-wall distance H/ D = 6.8 and nominal Reynolds number of 26,000. Measurements were performed for both plain water and dilute polymer solutions of polyethylene oxide at concentrations of 50 and 100 ppm. The mean and turbulence characteristics of these three flows are contrasted and it is observed that the two polymer solutions modify both the mean and turbulent characteristics of the jet in all three regions of interest (the free-jet, impingement, and wall-jet regions). Of interest, the 50 ppm case yielded a slight suppression of the turbulence in the free-jet region accompanied by a longer axial length of the potential core compared to the case of plain water. In contrast, the 100 ppm case exhibits clear enhancement of the turbulence in the free-jet region and a shortening of the potential core length. The effect of polymer was opposite in the impingement and wall-jet regions wherein the turbulence was slightly suppressed in the 100 ppm case in a manner consistent with the onset of the Toms effect in this wall-bounded region of the flow.

  5. Impingement and Dislocation in Total HIP Arthroplasty: Mechanisms and Consequences

    PubMed Central

    Brown, Thomas D; Elkins, Jacob M; Pedersen, Douglas R; Callaghan, John J

    2014-01-01

    In contemporary total hip arthroplasty, instability has been a complication in approximately 2% to 5% of primary surgeries and 5% to 10% of revisions. Due to the reduction in the incidence of wear-induced osteolysis that has been achieved over the last decade, instability now stands as the single most common reason for revision surgery. Moreover, even without frank dislocation, impingement and subluxation are implicated in a set of new concerns arising with advanced bearings, associated with the relatively unforgiving nature of many of those designs. Against that backdrop, the biomechanical factors responsible for impingement, subluxation, and dislocation remain under-investigated relative to their burden of morbidity. This manuscript outlines a 15-year program of laboratory and clinical research undertaken to improve the scientific basis for understanding total hip impingement and dislocation. The broad theme has been to systematically evaluate the role of surgical factors, implant design factors, and patient factors in predisposing total hip constructs to impinge, sublux, and/or dislocate. Because this class of adverse biomechanical events had not lent itself well to study with existing approaches, it was necessary to develop (and validate) a series of new research methodologies, relying heavily on advanced finite element formulations. Specific areas of focus have included identifying the biomechanical challenges posed by dislocation-prone patient activities, quantifying design parameter effects and component surgical positioning effects for conventional metal-on-polyethylene implant constructs, and the impingement/dislocation behavior of non-conventional constructs, quantifying the stabilizing role of the hip capsule (and of surgical repairs of capsule defects), and systematically studying impingement and edge loading of hard-on-hard bearings, fracture of ceramic liners, confounding effects of patient obesity, and subluxation-mediated worsening of third body

  6. Arthroscopic Excision of an Intraarticular Osteoid Osteoma in the Distal Femur

    PubMed Central

    Kang, Suk; Kim, Young Sung; Lee, Ho Min; Lee, Min Young

    2016-01-01

    An intraarticular osteoid osteoma of the knee is uncommon, and its treatment is challenging. The authors present a case of arthroscopic excision of an intraarticular osteoid osteoma in the distal femur, which was accessible through the knee joint. After confirming the nidus of the osteoid osteoma by computed tomography, the lesion was completely removed arthroscopically. The patient reported complete pain relief immediately after surgery. This case demonstrates that intraarticular osteoid osteomas in the knee joint can be treated by arthroscopic excision and that good results can be obtained. PMID:27904732

  7. Arthroscopic Excision of an Intraarticular Osteoid Osteoma in the Distal Femur.

    PubMed

    Kang, Suk; Kim, Young Sung; Lee, Ho Min; Lee, Min Young; Kim, Jong Pil

    2016-12-01

    An intraarticular osteoid osteoma of the knee is uncommon, and its treatment is challenging. The authors present a case of arthroscopic excision of an intraarticular osteoid osteoma in the distal femur, which was accessible through the knee joint. After confirming the nidus of the osteoid osteoma by computed tomography, the lesion was completely removed arthroscopically. The patient reported complete pain relief immediately after surgery. This case demonstrates that intraarticular osteoid osteomas in the knee joint can be treated by arthroscopic excision and that good results can be obtained.

  8. Arthroscopic excision of distal pole of patella for refractory patellar tendinitis.

    PubMed

    Kelly, John D

    2009-07-01

    This article examines the results of arthroscopic tendon debridement with excision of the distal pole of the patella for refractory patellar tendinitis. Nine patients failed at least 3 months of conservative therapy and underwent arthroscopic excision of the distal patellar pole with debridement of the deep proximal patella tendon. At least 3 months postoperatively (range, 3 months-5 years), 8 patients reported no distal patellar pole tenderness (Bassett sign), and 1 patient reported only mild tenderness. Arthroscopic excision of the distal patellar pole with tendon debridement holds promise for the treatment of refractory patellar tendinitis.

  9. Extremely high heat fluxes beneath impinging liquid jets

    NASA Astrophysics Data System (ADS)

    Liu, X.; Lienhard, J. H., V.

    1993-05-01

    Measurements of jet-impingement heat fluxes up to 400 MW/sq m were obtained using a specially designed experimental arrangement where a thin metal plate was heated from one side with a plasma arc and cooled from the other side with an unsubmerged impinging water jet produced by a 34 MPa piston pump supplying a large cylindrical plenum. The results of this study, where heating was confined to the stagnation region, show no evidence of a critical heat flux, even up to the maximum power applied. The large fluxes were limited only by wall failure and the power of the heating source, and not by liquid-side thermal resistance.

  10. Fundamental studies of impingement cooling thermal boundary conditions

    NASA Astrophysics Data System (ADS)

    Lucas, M. G.; Ireland, P. T.; Wang, Z.; Jones, T. V.; Pearce, W. J.

    1993-02-01

    Measurements were made of the local heat transfer at the surface of a flat plate underneath a confined impinging jet. Thermochromic liquid crystals were used to measure the surface temperature of a uniformly heated plate cooled by an impinging jet. The temperature of the wall through which the jet passes was controlled, and experiments were performed to measure the two heat transfer coefficients which arise from this three temperature problem. The effect of Reynolds number and plate to jet spacing on heat transfer was investigated. The heat transfer results are discussed in terms of the interpreted flow field.

  11. Experimental Study of Supercooled Large Droplet Impingement Effects

    NASA Technical Reports Server (NTRS)

    Papadakis, M.; Rachman, A.; Wong, S. C.; Hung, K. E.; Vu, G. T.

    2003-01-01

    Typically, ice accretion results from small supercooled droplets (droplets cooled below freezing), usually 5 to 50 microns in diameter, which can freeze upon impact with an aircraft surface. Recently, ice accretions resulting from supercooled large droplet (SLD) conditions have become a safety concern. Current ice accretion codes have been extensively tested for Title 14 Code of Federal Regulations Part 25, Appendix C icing conditions but have not been validated for SLD icing conditions. This report presents experimental methods for investigating large droplet impingement dynamics and for obtaining small and large water droplet impingement data.

  12. Slow electrons impinging on dielectric solids. I. Basic aspects

    SciTech Connect

    Dapor, M.; Miotello, A.

    1997-07-01

    The basic aspects related to the scattering processes, useful for both the analytical and Monte Carlo calculation of backscattering and the depth distribution of low-energy ({ital E}{sub 0}{le}10 keV) electrons impinging on solid targets, are described. After a careful analysis of the scattering mechanisms, selected new results regarding elastic and inelastic scattering of low-energy electrons impinging on SiO{sub 2} are reported. Comparison with experimental data and earlier theoretical results show a general good agreement. {copyright} {ital 1997} {ital The American Physical Society}

  13. Ultrasound-guided arthroscopic management of hallux rigidus

    PubMed Central

    Kruczyński, Jacek

    2016-01-01

    Introduction The use of metatarso-phalangeal joint arthroscopy in the treatment of osteochondritis dissecans was first described in 1988. The technique produces good results. However, it can be difficult to enter a joint when it is deformed by degenerative disease. Sonography is a modern visualisation modality which can be used in orthopaedic surgery. Aim To describe a method of intraoperative sonographic navigation during first metatarso-phalangeal joint arthroscopy. Material and methods The modality was used in 3 patients. The joint was visualised in the ultrasound scanner. After confirming the intra-articular position of the guide needle, a medial portal was established. The procedure started with the removal and vaporisation of the hypertrophic synovium. Gradual resection of the osteophytes was then carried out. The procedure was terminated after the ultrasound image showed that a smooth upper surface of the metatarsal head had been achieved. Results All 3 patients were satisfied with the procedure and function of the treated feet. Average surgery time was 81 min. No complications were found. Conclusions Mini-invasive treatment of hallux rigidus with sonography-guided arthroscopic cheilectomy appears to be a reproducible procedure leading to good clinical results. We encourage surgeons familiar with ultrasound visualisation of the joints to use the technique described in this paper in the arthroscopic treatment of hallux rigidus. PMID:27829936

  14. 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.

  15. Arthroscopic gluteal muscle contracture release with radiofrequency energy.

    PubMed

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

    2009-03-01

    Gluteal muscle contracture is common after repeated intramuscular injections and sometimes is sufficiently debilitating to require open surgery. We asked whether arthroscopic release of gluteal muscle contracture using radiofrequency energy would decrease complications with clinically acceptable results. We retrospectively reviewed 108 patients with bilateral gluteal muscle contractures (57 males, 51 females; mean age, 23.7 years). We used inferior, anterosuperior, and posterosuperior portals. With the patient lying laterally, we developed and enlarged a potential space between the gluteal muscle group and the subcutaneous fat using blunt dissection. Under arthroscopic guidance through the inferior portal, we débrided and removed fatty tissue overlying the contractile band of the gluteal muscle group using a motorized shaver introduced through the superior portal. Radiofrequency then was introduced through the superior portal to gradually excise the contracted bands from superior to inferior. Finally, hemostasis was ensured using radiofrequency. Patients were followed a minimum of 7 months (mean, 17.4 months; range, 7-42 months). At last followup, the adduction and flexion ranges of the hip were 45.3 degrees +/- 8.7 degrees and 110.2 degrees +/- 11.9 degrees, compared with 10.4 degrees +/- 7.2 degrees and 44.8 degrees +/- 14.1 degrees before surgery. No hip abductor contracture recurred and no patient had residual hip pain or gluteal muscle wasting. We found gluteal muscle contracture could be released effectively with radiofrequency energy.

  16. Noise generated by impingement of a jet upon a large flat board

    NASA Technical Reports Server (NTRS)

    Olsen, W. A.; Miles, J. H.; Dorsch, R. G.

    1972-01-01

    Data were obtained on the noise generated by an air jet impinging on a large flat board. The board was large enough so that the flow leaving the edges of the board generated no significant noise. The impingement angle, nozzle shape and size, jet velocity, and the distance from the nozzle to the board were varied in the experiment. Far-field noise data are presented. The nozzle-alone noise contribution to the total noise was generally small and was subtracted from the total, leaving the impingement-only noise. The impingement-only noise was adequately correlated by eighth power of the peak impingement velocity and first power of the impingement area. The spectral data were correlated by a Strouhal number based on the peak impingement velocity and a characteristic impingement diameter.

  17. A battery-powered slide impinger for ultra-low volume droplet sampling.

    PubMed

    Wilhide, J D; Daniel, P

    1995-12-01

    A variation of the battery-powered slide impinger is described. The impinger uses a commercially available cordless screwdriver to rotate teflon-coated glass microscope slides for collection of aerosol droplets. The device is inexpensive and easy to construct.

  18. Rocket exhaust plume impingement on the Voyager spacecraft

    NASA Technical Reports Server (NTRS)

    Baerwald, R. K.

    1978-01-01

    In connection with the conduction of the long-duration Voyager missions to the outer planets and the sophisticated propulsion systems required, it was necessary to carry out an investigation to avoid exhaust plume impingement problems. The rarefied gas dynamics literature indicates that, for most engineering surfaces, the assumption of diffuse reemission and complete thermal accommodation is warranted in the free molecular flow regime. This assumption was applied to an analysis of a spacecraft plume impingement problem in the near-free molecular flow regime and yielded results to within a few percent of flight data. The importance of a correct treatment of the surface temperature was also demonstrated. Specular reflection, on the other hand, was shown to yield results which may be unconservative by a factor of 2 or 3. It is pointed out that one of the most difficult portions of an exhaust plume impingement analysis is the simulation of the impinged hardware. The geometry involved must be described as accurately and completely as possible.

  19. Wetting and spreading behaviors of impinging microdroplets on textured surfaces

    NASA Astrophysics Data System (ADS)

    Kwon, Dae Hee; Lee, Sang Joon; CenterBiofluid and Biomimic Reseach Team

    2012-11-01

    Textured surfaces having an array of microscale pillars have been receiving large attention because of their potential uses for robust superhydrophobic and superoleophobic surfaces. In many practical applications, the textured surfaces usually accompany impinging small-scale droplets. To better understand the impinging phenomena on the textured surfaces, the wetting and spreading behaviors of water microdroplets are investigated experimentally. Microdroplets with diameter less than 50 μm are ejected from a piezoelectric printhead with varying Weber number. The final wetting state of an impinging droplet can be estimated by comparing the wetting pressures of the droplet and the capillary pressure of the textured surface. The wetting behaviors obtained experimentally are well agreed with the estimated results. In addition, the transition from bouncing to non-bouncing behaviors in the partially penetrated wetting state is observed. This transition implies the possibility of withdrawal of the penetrated liquid from the inter-pillar space. The maximum spreading factors (ratio of the maximum spreading diameter to the initial diameter) of the impinging droplets have close correlation with the texture area fraction of the surfaces. This work was supported by Creative Research Initiatives (Diagnosis of Biofluid Flow Phenomena and Biomimic Research) of MEST/KOSEF.

  20. A comprehensive analysis of cavitation and liquid impingement erosion data

    NASA Technical Reports Server (NTRS)

    Rao, P. V.; Young, S. G.

    1983-01-01

    Cavitation-erosion experimental data previously covering several materials tested in a rotating disk device and a magnetostriction apparatus were analyzed using new normalization and curve-fitting techniques. From this process a universal approach is derived which can include data from cavitation and liquid impingement studies for specific materials from different test devices.

  1. Liquid jet impinging orthogonally on a wettability-patterned surface

    NASA Astrophysics Data System (ADS)

    Koukoravas, Theodore; Ghosh, Aritra; Sinha Mahapatra, Pallab; Ganguly, Ranjan; Megaridis, Constantine

    2016-11-01

    Jet impingement has many technological applications because of its numerous merits, especially those related to the ability of liquids to carry away heat very efficiently. The present study introduces a new configuration employing a wettability-patterning approach to divert an orthogonally-impinging laminar water jet onto a predetermined portion of the target surface. Diverging wettable tracks on a superhydrophobic background provide the means to re-direct the impinging jet along paths determined by the shape of these tracks on the solid surface. In a heat transfer example of this method, an open-surface heat exchanger is constructed and its heat transfer performance is characterized. Since this approach facilitates prolonged liquid contact with the underlying heated surface through thin-film spreading, evaporative cooling is also promoted. We demonstrate flow cases extracting 100 W/cm2 at water flow rates of O(10 mL/min). By comparing with other jet-impingement cooling approaches, the present method provides roughly four times more efficient cooling by using less amount of coolant. The reduced coolant use, combined with the gravity-independent character of this technique, offer a new paradigm for compact heat transfer devices designed to operate in reduced- or zero-gravity environments.

  2. [Impingement syndrome of the shoulder. Clinical data and radiologic findings].

    PubMed

    Masala, S; Fanucci, E; Maiotti, M; Nardocci, M; Gaudioso, C; Apruzzese, A; Di Mario, M; Simonetti, G

    1995-01-01

    Subcoracoid impingement syndrome pain is elicited by some positions of the upper limbs, i.e., adduction and inward rotation, whenever coracohumeral space reduces. Although acquired or congenital malformations of the humeral head and/or coracoid apophysis are the most common causes of painful syndromes, repeated flections and inward rotations of the upper limbs, typical of some sports, such as swimming and tennis, and of some sports, such as swimming and tennis, and of some kinds of work, are predisposing factors. The subcoracoid impingement syndrome exhibits on pathogenomonic signs at clinics and the specificity of diagnostic methods is low, which calls for reliable radiologic assessment of this condition. Fifteen patients with subcoracoid impingement syndrome underwent X-ray, US, CT and MR studies. Plain radiography detected no specific signs of this syndrome, but yielded useful information regarding other painful syndromes of the shoulder, such as anatomical variants of the acromion and degenerative changes. US yield was poor because of the acoustic window of the coracoid apophysis, but supraspinatus tendon changes were demonstrated in 2 cases. CT and MRI proved to be the most reliable and accurate diagnostic methods, the former thanks to its sensitivity to even slight bone changes and to its capabilities in measuring coracohumeral distance and acquiring dynamic scans and the latter because it detects tendon, bursa and rotator cuff changes. To conclude, in our opinion, when the subcoracoid impingement syndrome is clinically suspected, plain X-ray films should be performed first and followed by MR scans.

  3. ARTHROSCOPIC TREATMENT OF ACROMIOCLAVICULAR JOINT DISLOCATION BY TIGHT ROPE TECHNIQUE (ARTHREX®)

    PubMed Central

    GÓmez Vieira, Luis Alfredo; Visco, Adalberto; Daneu Fernandes, Luis Filipe; GÓmez Cordero, Nicolas Gerardo

    2015-01-01

    Presenting the arthroscopic treatment by Tight Rope - Arthrex® system for acute acromioclavicular dislocation and to evaluate results obtained with this procedure. Methods: Between August 2006 and May 2007, 10 shoulders of 10 patients with acute acromioclavicular dislocation were submitted to arthroscopic repair using the Tight Rope - Arthrex® system. Minimum follow-up was 12 months, with a mean of 15 months. Age ranged from 26 to 42, mean 34 years. All patients were male. Radiology evaluation was made by trauma series x-ray. The patients were assisted in the first month weekly and after three months after the procedure. Clinical evaluation was based on the University of California at Los Angeles (UCLA) criteria. Results: All patients were satisfied after the arthroscopic procedure and the mean UCLA score was 32,5. Conclusion: The arthroscopic treatment by Tight Rope – Arthrex® system for acute acromioclavicular dislocation showed to be an efficient technique. PMID:26998453

  4. Arthroscopic and open management of posterolateral rotatory instability of the elbow.

    PubMed

    O'Brien, Michael J; Savoie, Felix H

    2014-09-01

    Posterolateral rotatory instability (PLRI) is the most common cause of residual instability following a simple elbow dislocation. PLRI may result from trauma or iatrogenic injury to the radial ulnohumeral ligament during treatment for other conditions, such as lateral epicondylitis. PLRI can be identified through a combination of history and physical examination, and confirmed with magnetic resonance imaging arthrography. Once diagnosed, surgery is necessary to correct persistent instability. Instability can be confirmed arthroscopically through several findings, including subluxation of the radial head on the capitellum and the arthroscopic "drive through sign of the elbow." Acute repairs, both open and arthroscopic, heal with excellent patient outcomes. In the chronic setting, graft reconstruction may be required. This report describes arthroscopic repair of the radial ulnohumeral ligament and open reconstruction with associated outcomes. A high index of suspicion is necessary to correctly diagnosis this condition in patients with lateral elbow pain and feelings of instability.

  5. McMurray Test: A Prediction of Arthroscopic Meniscectomy Outcomes in Patients with Knee Osteoarthritis.

    PubMed

    Ji, Cheng; Lin, Xiangjin; Zhu, Liulong; Li, Min

    2015-05-01

    The McMurray test is used to evaluate patients with meniscal tears of the knee. Analysis of the sensitivity and specificity of McMurray test and the correlation between McMurray sign and postoperative outcomes are helpful to screen the candidates for arthroscopic meniscectomy. The present study compares the results of McMurray test with arthroscopic examination in patients with knee osteoarthritis. We studied 149 patients diagnosed as meniscal lesion with osteoarthritis by radiology and had arthroscopic surgery. Our data show that positive McMurray sign implies good postoperative outcomes for the patients with meniscal tear associated with osteoarthritis. For patients with osteoarthritis, those whose positive McMurray signs are in line with their radiological findings indicate they are eligible candidates for arthroscopic meniscectomy. Our study suggests that McMurray sign can be used as an indication for both symptomatic meniscal tear and postoperative outcomes.

  6. Result from arthroscopic surgical treatment of renewed tearing of the rotator cuff of the shoulder☆

    PubMed Central

    Godinho, Glaydson Gomes; França, Flávio de Oliveira; Freitas, José Márcio Alves; Santos, Flávio Márcio Lago; Prandini, Alexandre; Godinho, André Couto; Costa, Rafael Patrocínio de Paula

    2015-01-01

    Objectives To evaluate function among patients with postoperative recurrence of rotator cuff injuries that was treated arthroscopically (case series) and compare this with function in patients without recurrence (control group); and to compare function among patients with recurrence of rotator cuff injuries that were greater than and smaller than 3 cm. Methods This was a retrospective evaluation of patients who underwent arthroscopic revision of rotator cuff injuries using the ASES, Constant & Murley and UCLA scores and a visual analog pain scale, in comparison with patients in a control group who underwent primary rotator cuff repair. Results The size of the rotator cuff injury recurrence had a statistically significant influence on the result from the arthroscopic surgical treatment. The functional scores showed worse results than those from the first procedure. Conclusion Arthroscopic surgical treatment of renewed tearing of rotator cuff injuries showed worse functional scores than those from primary repair of the injury. PMID:26229900

  7. Compression of the suprascapular nerve by a ganglion cyst of the spinoglenoid notch: the arthroscopic solution.

    PubMed

    Lichtenberg, Sven; Magosch, Petra; Habermeyer, Peter

    2004-01-01

    We evaluated an all arthroscopic technique for treating suprascapular nerve entrapment by cyst formation in the spinoglenoid notch. Eight patients showed positive MRI and EMG findings with clinical sign of weakness and pain and with atrophy of the muscle. All patients underwent an all-arthroscopic procedure. The patients were evaluated preoperatively and 6 weeks and 3 months postoperatively and for the latest follow-up by clinical examination, MRI, and EMG. All patients improved in terms of pain, strength, and function. We found six superior labrum anterior and posterior (SLAP) lesions. In these patients the cyst was drained, and the SLAP lesion was repaired. In two patients there was no communication between the joint and the cyst, and therefore capsulotomy was performed and left open. The results of our study show that arthroscopic decompression of the suprascapular nerve can be achieved by an all arthroscopic technique if the cyst formation is located at the spinoglenoid notch.

  8. 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

  9. EFFECT OF IMPACTION, BOUNCE AND REAEROSOLIZATION ON THE COLLECTION EFFICIENCY OF IMPINGERS

    EPA Science Inventory

    The collection efficiency of liquid impingers was studied experimentally as a function of the sampling flow rate with test particles in the bacterial size range. Three impingers were tested: two All-Glass Impingers(AGI-4 and AGI-30),widely used for bioaerosol sampling, and a newl...

  10. The 1991 version of the plume impingement computer program. Volume 1: Description

    NASA Technical Reports Server (NTRS)

    Bender, Robert L.; Somers, Richard E.; Prendergast, Maurice J.; Clayton, Joseph P.; Smith, Sheldon D.

    1991-01-01

    The objective of this contract was to continue development of a vacuum plume impingement evaluator to provide an analyst with a capability for rapid assessment of thruster plume impingement scenarios. The research was divided into three areas: Plume Impingement Computer Program (PLIMP) modification/validation; graphics development; and documentation in the form of a Plume Handbook and PLIMP Input Guide.

  11. Arthroscopic assessment of Kienböck's disease.

    PubMed

    Watanabe, K; Nakamura, R; Imaeda, T

    1995-06-01

    Arthroscopic examination was performed on 32 wrists of 32 patients with Kienböck's disease to relate the appearance of the intraarticular structures, particularly the articular cartilage, to the radiographic stage. The articular cartilage showed osteoarthritic changes in stage III, although this was not evident on plain radiographs. Cracking in the distal facet and flapping at the proximal facet of the lunate were identified as features of Kienböck's disease. The incidence of interosseous ligament tears was correlated with radiographically determined stage, whereas changes in triangular fibrocartilage were correlated with age and ulnar variance. Wrist arthroscopy is a useful staging tool for Kienböck's disease, supplying helpful information about the intraarticular pathoanatomy which can be used to guide patient management.

  12. Arthroscopic Interpositional Arthroplasty of the Second Metatarsophalangeal Joint.

    PubMed

    Lui, Tun Hing

    2016-12-01

    Painful degenerative diseases of the second metatarsophalangeal joint are frequently progressive and difficult to treat. Surgical options for the degenerated second metatarsophalangeal joint include joint debridement and synovectomy, drilling and microfracture, core decompression, dorsal closing-wedge metatarsal osteotomies, joint arthroplasty (implant or interpositional), elevation of the depressed articular fragment and bone graft, distraction arthroplasty, osteochondral plug transplantation, osteochondral distal metatarsal allograft reconstruction, and resection arthroplasty (phalangeal base or metatarsal head). This technical note describes the arthroscopic approach of interpositional arthroplasty of the second metatarsophalangeal joint using the extensor digitorum brevis tendon. It is indicated in adult patients with extensive involvement of the metatarsal head cartilage, especially when cartilage degeneration of the proximal phalanx is also present. It is contraindicated if there is significant bone loss of the metatarsal head or the extensor digitorum brevis tendon is flimsy.

  13. Editorial Commentary: The Hip Bone's Connected to the Knee Bone, but Correlation Does Not Equal Causation-The Association of Hip Motion, Femoroacetabular Impingement, and Anterior Cruciate Ligament Injury.

    PubMed

    Harris, Joshua D

    2017-02-01

    Patients with anterior cruciate ligament (ACL) injury had significantly less hip rotational motion (internal rotation [IR] and sum of IR and external rotation) than control subjects without ACL tears. For each hip IR increase of 10°, the odds of sustaining an ACL rupture decreased by a factor of 0.419. Although this investigation does not prove (causation) that loss of hip rotational motion causes an ACL tear, it does continue to complement the growing and evolving literature base showing an upstream or downstream association (correlation) of decreased hip motion on adjacent structures.

  14. Extra-articular hip impingement: a narrative review of the literature

    PubMed Central

    Cheatham, Scott W.

    2016-01-01

    There is growing subgroup of patients with poor outcomes after hip arthroscopy for intra-articular pathology suggesting unrecognized cause(s) of impingement may exist. Extra-articular hip impingement (EHI) is an emerging group of conditions that have been associated with intra-articular causes of impingement and may be an unrecognized source of pain. EHI is caused by abnormal contact between the extra-articular regions of the proximal femur and pelvis. This review discusses the most common forms for EHI including: central iliopsoas impingement, subspine impingement, ischiofemoral impingement, and greater trochanteric-pelvic impingement. The clinical presentation of each pathology will be discussed since EHI conditions share similar clinical features as the intra-articular pathology but also contain some unique characteristics. PMID:27069266

  15. Heat transfer measurements and CFD simulations of an impinging jet

    NASA Astrophysics Data System (ADS)

    Petera, Karel; Dostál, Martin

    2016-03-01

    Heat transport in impinging jets makes a part of many experimental and numerical studies because some similarities can be identified between a pure impingement jet and industrial processes like, for example, the heat transfer at the bottom of an agitated vessel. In this paper, experimental results based on measuring the response to heat flux oscillations applied to the heat transfer surface are compared with CFD simulations. The computational cost of a LES-based approach is usually too high therefore a comparison with less computationally expensive RANS-based turbulence models is made in this paper and a possible improvement of implementing an anisotropic explicit algebraic model for the turbulent heat flux model is evaluated.

  16. Subdeltoid lipoma causing shoulder impingement syndrome – a case report

    PubMed Central

    Lenza, Mario; Lenza, Miguel Vicente; Carrerra, Eduardo da Frota; Ferretti, Mario

    2014-01-01

    The impingement syndrome is defined by the compression of the rotator cuff tendons against the coracoacromial arch. Several factors contribute to this condition and they are classified as structural or functional factors. The former are changes in the coracoacromial arch, proximal humerus, bursa and rotator cuff, and the latter are related to the mechanism of the upper limb by means of synchronized activity and balanced between the rotator cuff and scapular girdle muscles. The authors report here a case of parosteal lipoma of the proximal humerus, located between the muscles deltoid, teres minor and infraspinatus causing clinical signs of impingement. It is a rare occurrence, characterized as a structural cause for the onset of this symptom. PMID:25167335

  17. Convective heat transfer by impingement of circular liquid jets

    NASA Astrophysics Data System (ADS)

    Liu, X.; Lienhard, J. H. V.; Lombara, J. S.

    1991-08-01

    The impingement of circular, liquid jets provides a convenient method of cooling surfaces. Here, jet impingement cooling of uniformly heated surfaces is investigated analytically and experimentally for stable, unsubmerged, uniform velocity laminar jets in the absence of phase change. Analytical and numerical predictions are developed for a laminar radial film flow. Experiments using undisturbed laminar jets were performed to determine local Nusselt numbers from the stagnation point to radii of up to 40 diameters. Turbulent transition in the film flow is observed experimentally at a certain radius. Beyond this transition radius, a separate turbulent analysis is constructed. Integral method results are compared to numberical results, and Prandtl number effects are investigated. The predictions are found to agree well with the measurements for both laminar and turbulent flow. Predictive formulas are recommended for the entire range of radii.

  18. Convective heat transfer by impingement of circular liquid jets

    SciTech Connect

    Liu, X.; Lienhard, J.H. V; Lombara, J.S. )

    1991-08-01

    The impingement of circular, liquid jets provides a convenient method of cooling surfaces. Here, jet impingement cooling of uniformly heated surfaces is investigated analytically and experimentally for stable, unsubmerged, uniform velocity laminar jets in the absence of phase change. Analytical and numerical predictions are developed for a laminar radial film flow. Experiments using undisturbed laminar jets were performed to determine local Nusselt numbers from the stagnation point to radii of up to 40 diameters. Turbulent transition in the film flow is observed experimentally at a certain radius. Beyond this transition radius, a separate turbulent analysis is constructed. Integral method results are compared to numerical results, and Prandtl number effects are investigated. The predictions are found to agree well with the measurements for both laminar and turbulent flow. Predictive formulae are recommended for the entire range of radii.

  19. ISCHIOFEMORAL IMPINGEMENT – AN ETIOLOGY OF HIP PAIN: CASE REPORT

    PubMed Central

    Yanagishita, Carlos Massao Aramaki; Falótico, Guilherme Guadagnini; Rosário, Davi Araújo Veiga; Pugina, Gustavo Gambuggi; Wever, André Azambuja Neves; Takata, Edmilson Takehiro

    2015-01-01

    An association between hip pain and quadratus femoris muscle abnormality on magnetic resonance imaging (MRI) with concurrent narrowing of the ischiofemoral space has been reported in the recent literature. This raises the possibility that the muscle damage observed is due to ischiofemoral impingement. This diagnosis has been noted in middle-aged females either with or without a history of trauma or surgery, is a rarely described feature. We report here on a 31-year-old woman who presented with non-traumatic hip pain and evidence of narrowing of the ischiofemoral space and edema in the quadratus femoris. Nonsurgical treatment was administered, which relieved her hip pain. The diagnosis of ischiofemoral impingement should be considered in female patients complaining of hip pain without any other evident cause. PMID:27047901

  20. FRACTURE PROPAGATION PROPENSITY OF CERAMIC LINERS DURING IMPINGEMENT-SUBLUXATION

    PubMed Central

    Elkins, Jacob M.; Pedersen, Douglas R.; Callaghan, John J.; Brown, Thomas D.

    2011-01-01

    Although improvements in materials engineering have greatly reduced fracture rates in ceramic femoral heads, concerns still exist for liners. Ceramics are vulnerable fracture due to impact, and from stress concentrations (point and line loading) such as those associated with impingement-subluxation. Thus, ceramic cup fracture propensity is presumably very sensitive to surgical cup positioning. A novel fracture mechanics finite element formulation was developed to identify cup orientations most susceptible to liner fracture propagation, for several impingement-prone patient maneuvers. Other factors being equal, increased cup inclination and increased anteversion were found to elevate fracture risk. Squatting, stooping and leaning shoe-tie maneuvers were associated with highest fracture risk. These results suggest that fracture risk can be reduced by surgeons’ decreasing cup abduction and by patients’ avoiding of specific activities. PMID:21855277

  1. Experimental comparative study of doublet and triplet impinging atomization of gelled fuel based on PIV

    NASA Astrophysics Data System (ADS)

    Yang, Jian-lu; Li, Ning; Weng, Chun-sheng

    2016-10-01

    Gelled propellant is promising for future aerospace application because of its combination of the advantages of solid propellants and liquid propellants. An effort was made to reveal the atomization properties of gelled fuel by particle image velocimetry (PIV) system. The gelled fuel which was formed by gasoline and Nano-silica was atomized using a like-doublet impingement injector and an axisymmetric like-triplet impingement injector. The orifice diameter and length of the nozzle used in this work were of 0.8mm, 4.8mm, respectively. In the impinging spray process, the impingement angles were set at 90° and 120°, and the injection pressures were of 0.50MPa and 1.00MPa. The distance from the exit of the orifice to the impingement point was fixed at 9.6mm. In this study, high-speed visualization and temporal resolution particle image velocimetry techniques were employed to investigate the impingement atomization characteristics. The experimental investigation demonstrated that a long narrow high speed droplets belt formed around the axis of symmetry in the like-doublet impinging atomization area. However, there was no obvious high-speed belt with impingement angle 2θ = 90° and two high-speed belts appeared with impingement angle 2θ = 120° in the like-doublet impingement spray field. The high droplet velocity zone of the like-doublet impingement atomization symmetrically distributed around the central axis, and that of the like-triplet impingement spray deflected to the left of the central axis - opposite of injector. Although the droplets velocity distribution was asymmetry of like-triplet impingement atomization, the injectors were arranged like axisymmetric conical shape, and the cross section of spray area was similar to a circle rather than a narrow rectangle like the like-doublet impingement atomization.

  2. Turbulence measurements in a rectangular mesoscale confined impinging jets reactor

    NASA Astrophysics Data System (ADS)

    Somashekar, Vishwanath; Liu, Ying; Fox, Rodney O.; Olsen, Michael G.

    2012-12-01

    Mesoscale chemical reactors capable of operating in the turbulent flow regime, such as confined impinging jets reactors (CIJR), offer many advantages for rapid chemical processing at the microscale. One application where these reactors are used is flash nanoprecipitation, a method for producing functional nanoparticles. Because these reactors often operate in a flow regime just beyond transition to turbulence, modeling flows in these reactors can be problematic. Moreover, validation of computational fluid dynamics models requires detailed and accurate experimental data, the availability of which has been very limited for turbulent microscale flows. In this work, microscopic particle image velocimetry (microPIV) was performed in a mesoscale CIJR at inlet jet Reynolds numbers of 200, 1,000, and 1,500. Pointwise and spacial turbulence statistics were calculated from the microPIV data. The flow was observed to be laminar and steady in the entire reactor at a Reynolds number of 200. However, at jets Reynolds numbers of 1,000 and 1,500, instabilities as a result of the jets impinging along the centerline of the reactor lead to a highly turbulent impingement region. The peak magnitude of the normalized Reynolds normal and shear stresses within this region were approximately the same for the Reynolds numbers of 1,000 and 1,500. The Reynolds shear stress was found to exhibit a butterfly shape, consistent with a flow field dominated by an oblique rocking of the impingement zone about the center of the reactor. Finally, the spatial auto- and cross-correlations velocity fluctuations were calculated and analyzed to obtain an understanding of size of the coherent structures.

  3. Quantifying Cell Adhesion through Impingement of a Controlled Microjet

    PubMed Central

    Visser, Claas Willem; Gielen, Marise V.; Hao, Zhenxia; Le Gac, Séverine; Lohse, Detlef; Sun, Chao

    2015-01-01

    The impingement of a submerged, liquid jet onto a cell-covered surface allows assessing cell attachment on surfaces in a straightforward and quantitative manner and in real time, yielding valuable information on cell adhesion. However, this approach is insufficiently characterized for reliable and routine use. In this work, we both model and measure the shear stress exerted by the jet on the impingement surface in the micrometer-domain, and subsequently correlate this to jet-induced cell detachment. The measured and numerically calculated shear stress data are in good agreement with each other, and with previously published values. Real-time monitoring of the cell detachment reveals the creation of a circular cell-free area upon jet impingement, with two successive detachment regimes: 1), a dynamic regime, during which the cell-free area grows as a function of both the maximum shear stress exerted by the jet and the jet diameter; followed by 2), a stationary regime, with no further evolution of the cell-free area. For the latter regime, which is relevant for cell adhesion strength assessment, a relationship between the jet Reynolds number, the cell-free area, and the cell adhesion strength is proposed. To illustrate the capability of the technique, the adhesion strength of HeLa cervical cancer cells is determined ((34 ± 14) N/m2). Real-time visualization of cell detachment in the dynamic regime shows that cells detach either cell-by-cell or by collectively (for which intact parts of the monolayer detach as cell sheets). This process is dictated by the cell monolayer density, with a typical threshold of (1.8 ± 0.2) × 109 cells/m2, above which the collective behavior is mostly observed. The jet impingement method presents great promises for the field of tissue engineering, as the influence of both the shear stress and the surface characteristics on cell adhesion can be systematically studied. PMID:25564849

  4. Empirical relations for cavitation and liquid impingement erosion processes

    NASA Technical Reports Server (NTRS)

    Rao, P. V.; Buckley, D. H.

    1984-01-01

    A unified power-law relationship between average erosion rate and cumulative erosion is presented. Extensive data analyses from venturi, magnetostriction (stationary and oscillating specimens), liquid drop, and jet impact devices appear to conform to this relation. A normalization technique using cavitation and liquid impingement erosion data is also presented to facilitate prediction. Attempts are made to understand the relationship between the coefficients in the power-law relationships and the material properties.

  5. Apollo Video Photogrammetry Estimation Of Plume Impingement Effects

    NASA Technical Reports Server (NTRS)

    Immer, Christopher; Lane, John; Metzger, Philip T.; Clements, Sandra

    2008-01-01

    The Constellation Project's planned return to the moon requires numerous landings at the same site. Since the top few centimeters are loosely packed regolith, plume impingement from the Lander ejects the granular material at high velocities. Much work is needed to understand the physics of plume impingement during landing in order to protect hardware surrounding the landing sites. While mostly qualitative in nature, the Apollo Lunar Module landing videos can provide a wealth of quantitative information using modem photogrammetry techniques. The authors have used the digitized videos to quantify plume impingement effects of the landing exhaust on the lunar surface. The dust ejection angle from the plume is estimated at 1-3 degrees. The lofted particle density is estimated at 10(exp 8)- 10(exp 13) particles per cubic meter. Additionally, evidence for ejection of large 10-15 cm sized objects and a dependence of ejection angle on thrust are presented. Further work is ongoing to continue quantitative analysis of the landing videos.

  6. Droplet-surface Impingement Dynamics for Intelligent Spray Design

    NASA Technical Reports Server (NTRS)

    VanderWal, Randy L.; Kizito, John P.; Tryggvason, Gretar; Berger, Gordon M.; Mozes, Steven D.

    2004-01-01

    Spray cooling has high potential in thermal management and life support systems by overcoming the deleterious effect of microgravity upon two-phase heat transfer. In particular spray cooling offers several advantages in heat flux removal that include the following: 1. By maintaining a wetted surface, spray droplets impinge upon a thin fluid film rather than a dry solid surface 2. Most heat transfer surfaces will not be smooth but rough. Roughness can enhance conductive cooling, aid liquid removal by flow channeling. 3. Spray momentum can be used to a) substitute for gravity delivering fluid to the surface, b) prevent local dryout and potential thermal runaway and c) facilitate liquid and vapor removal. Yet high momentum results in high We and Re numbers characterizing the individual spray droplets. Beyond an impingement threshold, droplets splash rather than spread. Heat flux declines and spray cooling efficiency can markedly decrease. Accordingly we are investigating droplet impingement upon a) dry solid surfaces, b) fluid films, c) rough surfaces and determining splashing thresholds and relationships for both dry surfaces and those covered by fluid films. We are presently developing engineering correlations delineating the boundary between splashing and non-splashing regions.

  7. Spray Formation of Herschel-Bulkley Fluids using Impinging Jets

    NASA Astrophysics Data System (ADS)

    Rodrigues, Neil; Gao, Jian; Chen, Jun; Sojka, Paul E.

    2015-11-01

    The impinging jet spray formation of two non-Newtonian, shear-thinning, Herschel-Bulkley fluids was investigated in this work. The water-based gelled solutions used were 1.0 wt.-% agar and 1.0 wt.-% kappa carrageenan. A rotational rheometer and a capillary viscometer were used to measure the strain-rate dependency of viscosity and the Herschel-Bulkley Extended (HBE) rheological model was used to characterize the shear-thinning behavior. A generalized HBE jet Reynolds number Rej , gen - HBE was used as the primary parameter to characterize the spray formation. A like-on-like impinging jet doublet was used to produce atomization. Shadowgraphs were captured in the plane of the sheet formed by the two jets using a CCD camera with an Nd:YAG laser beam providing the back-illumination. Typical behavior for impinging jet atomization using Newtonian liquids was not generally observed due to the non-Newtonian, viscous properties of the agar and kappa carrageenan gels. Instead various spray patterns were observed depending on Rej , gen - HBE. Spray characteristics of maximum instability wavelength and sheet breakup length were extracted from the shadowgraphs. Multi-University Research Initiative Grant Number W911NF-08-1-0171.

  8. Mach number effect on jet impingement heat transfer.

    PubMed

    Brevet, P; Dorignac, E; Vullierme, J J

    2001-05-01

    An experimental investigation of heat transfer from a single round free jet, impinging normally on a flat plate is described. Flow at the exit plane of the jet is fully developed and the total temperature of the jet is equal to the ambient temperature. Infrared measurements lead to the characterization of the local and averaged heat transfer coefficients and Nusselt numbers over the impingement plate. The adiabatic wall temperature is introduced as the reference temperature for heat transfer coefficient calculation. Various nozzle diameters from 3 mm to 15 mm are used to make the injection Mach number M vary whereas the Reynolds number Re is kept constant. Thus the Mach number influence on jet impingement heat transfer can be directly evaluated. Experiments have been carried out for 4 nozzle diameters, for 3 different nozzle-to-target distances, with Reynolds number ranging from 7200 to 71,500 and Mach number from 0.02 to 0.69. A correlation is obtained from the data for the average Nusselt number.

  9. Axisymmetric wall jet development in confined jet impingement

    NASA Astrophysics Data System (ADS)

    Guo, Tianqi; Rau, Matthew J.; Vlachos, Pavlos P.; Garimella, Suresh V.

    2017-02-01

    The flow field surrounding an axisymmetric, confined, impinging jet was investigated with a focus on the early development of the triple-layered wall jet structure. Experiments were conducted using stereo particle image velocimetry at three different confinement gap heights (2, 4, and 8 jet diameters) across Reynolds numbers ranging from 1000 to 9000. The rotating flow structures within the confinement region and their interaction with the surrounding flow were dependent on the confinement gap height and Reynolds number. The recirculation core shifted downstream as the Reynolds number increased. For the smallest confinement gap height investigated, the strong recirculation caused a disruption of the wall jet development. The radial position of the recirculation core observed at this small gap height was found to coincide with the location where the maximum wall jet velocity had decayed to 15% of the impinging jet exit velocity. After this point, the self-similarity hypothesis failed to predict the evolution of the wall jet further downstream. A reduction in confinement gap height increased the growth rates of the wall jet thickness but did not affect the decay rate of the wall jet maximum velocity. For jet Reynolds numbers above 2500, the decay rate of the maximum velocity in the developing region of the wall jet was approximately -1.1, which is close to previous results reported for the fully developed region of radial wall jets. A much higher decay rate of -1.5 was found for the wall jet formed by a laminar impinging jet at Re = 1000.

  10. Conservative management of posterior ankle impingement: a case report

    PubMed Central

    Senécal, Isabelle; Richer, Nadia

    2016-01-01

    Objective: To describe the pain and functional improvements of a patient with posterior ankle impingement following a treatment plan incorporating soft tissue therapy, chiropractic adjustment and a progressive rehabilitation program. Clinical Features: A 37-year- old male presented with posterolateral ankle pain exacerbated by plantar flexion two weeks after sustaining an inversion ankle sprain. Oedema was present and the patient was describing a sensation of instability while walking. The initial diagnosis of lateral ankle sprain was found to be complicated by a posterior ankle impingement caused by a tenosynovitis of the flexor hallucis longus sheath suspected during the physical examination and confirmed by MRI. Intervention and Outcome: The patient was treated over a 14-week period. Soft tissue therapy, a rehabilitation program and cortisone injection were used to treat this condition. A precise description of the rehabilitation program that contains open kinetic chain, closed kinetic chain, proprioception, and conditioning exercises prescribed to the patient is given. After the treatment plan, the patient returned to play pain free and had no daily living restrictions. Summary: A protocol including rest, soft tissue therapy, open and closed kinetic chain exercises, sport-specific exercises and cortisone injection appeared to facilitate complete recovery of this patient’s posterior ankle impingement. PMID:27385836

  11. Directional transport of impinging capillary jet on wettability engineered surfaces

    NASA Astrophysics Data System (ADS)

    Ghosh, Aritra; Chatterjee, Souvick; Sinha Mahapatra, Pallab; Ganguly, Ranjan; Megaridis, Constantine

    2015-11-01

    Impingement of capillary jet on a surface is important for applications like heat transfer, or for liquid manipulation in bio-microfluidic devices. Using wettability engineered surfaces, we demonstrate pump-less and directional transport of capillary jet on a flat surface. Spatial contrast of surface energy and a wedge-shape geometry of the wettability confined track on the substrate facilitate formation of instantaneous spherical bulges upon jet impingement; these bulges are further transported along the superhydrophilic tracks due to Laplace pressure gradient. Critical condition warranted for formation of liquid bulge along the varying width of the superhydrophilic track is calculated analytically and verified experimentally. The work throws light on novel fluid phenomena of unidirectional jet impingement on wettability confined surfaces and provides a platform for innovative liquid manipulation technique for further application. By varying the geometry and wettability contrast on the surface, one can achieve volume flow rates of ~ O(100 μL/sec) and directionally guided transport of the jet liquid, pumplessly at speeds of ~ O(10cm/sec).

  12. Splattering during turbulent liquid jet impingement on solid targets

    SciTech Connect

    Bhunia, S.K.; Lienhard, J.H. V . Dept. of Mechanical Engineering)

    1994-06-01

    In turbulent liquid jet impingement, a spray of droplets often breaks off of the liquid layer formed on the target. This splattering of liquid alters the efficiencies of jet impingement heat transfer processes and chemical containment safety devices, and leads to problems of aerosol formation in jet impingement cleaning processes. In this paper, the authors present a more complete study of splattering and improved correlations that extend and supersede the previous reports on this topic. The authors report experimental results on the amount of splattering for jets of water, isopropanol-water solutions, and soap-water mixtures. Jets were produced by straight tube nozzles of diameter 0.8--5.8 mm, with fully developed turbulent pipe-flow upstream of the nozzle exist. These experiments cover Weber numbers between 130--31,000, Reynolds numbers between 2,700--98,000, and nozzle-to-target separations of 0.2 [<=]l/d[<=]125. Splattering of up to 75 percent of the incoming jet liquid is observed. The results show that only the Weber number and l/d affect the fraction of jet liquid splattered. The presence of surfactants does not alter the splattering. A new correlation for the onset condition for splattering is given. In addition, the authors establish the range of applicability of the model of Lienhard et al. and the authors provide a more accurate set of coefficients for their correlation.

  13. Vascular Complications in Arthroscopic Repair Of Posterior Cruciate Ligament

    PubMed Central

    Agotegaray, Juan Ignacio; Comba, Ignacio; Bisiach, Luciana; Grignaffini, María Emilia

    2017-01-01

    Introduction: Posterior cruciate ligament is the primary stabilizer of the knee. Among the potential complications in arthroscopic repair of this ligament, there are vascular lesions, due to laceration, thrombosis and injury of the intima of the popliteal artery. We used one case to show the vascular complications that may arise in arthroscopic repair of the posterior cruciate ligament, how to handle it and the results. Methods: One patient, 33 years old, with a history of traffic accident. In a physical exam the patient shows pain and swelling of the knee, positive posterior drawer test and positive Godfrey test. X-rays on the knee show posterior tibial translation and MRI a complete fibers rupture at the middle third of the posterior cruciate ligament. An arthroscopic repair surgery was scheduled three weeks after trauma, with PCL reconstruction using simple band technique.After surgical intervention, hemostatic cuff was released, no peripheral pulse, paleness and coldness of the member was confirmed. An arteriography was carried out, which confirmed absences of distal vascular filling in the popliteal artery. An urgent referral was carried out with Vascular Surgery Services, who had been informed of the surgery previously (a notification that is part of our routine for this kind of interventions). Arteriorrhaphy and venorrhaphy of the popliteal arteries was fulfilled 12 hours later, with a leg fasciotomy. Daily monitoring was performed, and after 72 hours, muscle necrosis is seen with wound drainage, analysis shows presence of gram-negative bacilli, Proteus Mirabilis-Pseudomonas spp and the lab results showed leukocytes: 8.700/ml, ESR: 58, CRP: 48. A new surgery is performed with complete resection of the anterior external compartment of the leg, and a system of continuous cleansing is applied with physiological saline solution and boric acid for 14 days until drainage is eliminated. Vancomycin and ceftazidime EV was indicated for 14 days and, after a good

  14. 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

  15. 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

  16. Arthroscopically assisted reduction of type 1A ankle Fractures in Children: Case Report

    PubMed Central

    Al-Aubaidi, Zaid

    2013-01-01

    Introduction: The risk of growth arrest following paediatric ankle fractures type 1 A is very high. Therefore all attempts should be done to anatomically reduce this kind of fracture. The advances in ankle arthroscopy have brought the possibility to reduce these fractures under direct vision, without the need of capsulotomy. The purpose of this paper is to stress the importance of the use of arthroscopically assisted reduction of type 1 A fractures. Case Report: We describe two cases with SH type IV fractures of the distal medial tibia, one treated with open reduction and percutaneous screw fixation and the other treated with arthroscopically assisted reduction and percutaneous screw fixation. The first case ended with severe growth disturbance, while the second gave a very good result. Conclusion: The use of arthroscopically assisted reduction of type 1 A fractures should be considered to ensure anatomical reduction. PMID:27298899

  17. Arthroscopic decompression with indigo carmine for treating paralabral cysts in the shoulder.

    PubMed

    Kabuto, Y; Morihara, T; Furukawa, R; Kida, Y; Sukenari, T; Onishi, O; Minami, M; Arai, Y; Fujiwara, H; Kubo, T

    2016-12-01

    Paralabral cysts in the shoulder are a relatively rare pathology. It is sometimes difficult to detect the location of a paralabral cyst in the shoulder using arthroscopy, and it can be difficult to confirm sufficient decompression by arthroscopy. We describe the case of a 64-year-old woman who underwent arthroscopic decompression for a paralabral cyst in the shoulder. Indigo carmine was injected into the cyst under ultrasonography guidance just before the operation. The leakage point of indigo carmine was detected using arthroscopy. Arthroscopic decompression was performed until the indigo carmine was completely discharged. Her shoulder pain, limited range of motion, and muscle weakness during abduction and external rotation improved postoperatively. Magnetic resonance imaging confirmed the disappearance of the cyst. Arthroscopic decompression using an ultrasonography-guided injection of indigo carmine is a useful treatment for a paralabral cyst in the shoulder.

  18. Traumatic arteriovenous fistula as consequence of TMJ arthroscopic surgery. A case report

    PubMed Central

    Marin-Fernandez, Ana-Belen; Monsalve-Iglesias, Fernando; Roman-Ramos, Maria; Garcia-Medina, Blas

    2016-01-01

    The ocurrence of a traumatic arteriovenous fistula after arthroscopic surgery of TMJ represents an extremely rare event. Specifically, this uncommon complication has been described only in a few case reports. In this light, the most frequent symptoms showed by this disease are thrills, bruits, pulsatile tinnitus, and an expansible vascular mass. Importantly, the severity of these symptoms is also dependent on the vessels involved. With regard to the management, is important to note that the vessel ligation with surgery as well as vessel emolization with endovascular procedures have been shown to be effective in the treatment of these cases. In view of that, the present study describes a case of superficial temporal arteriovenous fistula that arose as a postoperative complication of a bilateral arthroscopic eminoplasty of TMJ. The aim of the present report is to characterize this rare syndrome with the goal of proposing suitable treatments. Key words:Arteriovenous fistula, arthroscopic surgery, eminoplasty of TMJ, temporal vessels. PMID:27398189

  19. Impinging jet spray formation using non-Newtonian liquids

    NASA Astrophysics Data System (ADS)

    Rodrigues, Neil S.

    Over the past two decades there has been a heightened interest in implementing gelled propellants for rocket propulsion, especially for hypergolic bi-propellants such as monomethylhydrazine (MMH) and nitrogen tetroxide oxidizer (NTO). Due to the very high level of toxicity of hypergolic liquid rocket propellants, increasing safety is an important area of need for continued space exploration and defense operations. Gelled propellants provide an attractive solution to meeting the requirements for safety, while also potentially improving performance. A gelling agent can be added to liquid propellants exhibiting Newtonian behavior to transform the liquid into a non-Newtonian fluid with some solid-like behavior, i.e. a gel. Non-Newtonian jet impingement is very different from its Newtonian counterpart in terms of fluid flow, atomization, and combustion. This is due to the added agents changing physical properties such as the bulk rheology (viscosity) and interfacial rheology (surface tension). Spray characterization of jet impingement with Newtonian liquids has been studied extensively in existing literature. However, there is a scarcity in literature of studies that consider the spray characterization of jet impingement with gelled propellants. This is a rather critical void since a major tradeoff of utilizing gelled propellants is the difficulty with atomization due to the increased effective viscosity. However, this difficulty can be overcome by using gels that exhibit shear-thinning behavior---viscosity decreases with increasing strain rate. Shear-thinning fluids are ideal because they have the distinct advantage of only flowing easily upon pressure. Thereby, greatly reducing the amount of propellant that could be accidentally leaked during both critical functions such as liftoff or engagement in the battlefield and regular tasks like refilling propellant tanks. This experimental work seeks to help resolve the scarcity in existing literature by providing drop size

  20. Droplet-Surface Impingement Dynamics for Intelligent Spray Design

    NASA Technical Reports Server (NTRS)

    Wal, Randy L. Vander; Kizito, John P.; Tryggvason, Gretar

    2004-01-01

    Spray cooling has high potential in thermal management and life support systems by overcoming the deleterious effect of microgravity upon two-phase heat transfer. In particular spray cooling offers several advantages in heat flux removal that include the following: 1) By maintaining a wetted surface, spray droplets impinge upon a thin fluid film rather than a dry solid surface; 2. Most heat transfer surfaces will not be smooth but rough. Roughness can enhance conductive cooling, aid liquid removal by flow channeling; and 3. Spray momentum can be used to a) substitute for gravity delivering fluid to the surface, b) prevent local dryout and potential thermal runaway and c) facilitate liquid and vapor removal. Yet high momentum results in high We and Re numbers characterizing the individual spray droplets. Beyond an impingement threshold, droplets splash rather than spread. Heat flux declines and spray cooling efficiency can markedly decrease. Accordingly we are investigating droplet impingement upon a) dry solid surfaces, b) fluid films, c) rough surfaces and determining splashing thresholds and relationships for both dry surfaces and those covered by fluid films. We are presently developing engineering correlations delineating the boundary between splashing and non-splashing regions. Determining the splash/non-splash boundary is important for many practical applications. Coating and cooling processes would each benefit from near-term empirical relations and subsequent models. Such demonstrations can guide theoretical development by providing definitive testing of its predictive capabilities. Thus, empirical relations describing the boundary between splash and non-splash are given for drops impinging upon a dry solid surface and upon a thin fluid film covering a similar surface. Analytical simplification of the power laws describing the boundary between the splash and non-splash regions yields insight into the engineering parameters governing the splash and non

  1. Arthroscopic subtalar arthrodesis: the posterior approach in the prone position.

    PubMed

    Carro, Luis Perez; Golanó, Pau; Vega, Jordi

    2007-04-01

    Arthroscopic subtalar arthrodesis, as reported by Tasto, is done in the lateral decubitus position, and the portal sites are lateral. This report describes a new alternative method in which the patient is in the prone position and a posterior 2-portal approach is used, as described by van Dijk et al. The initial debridement and synovectomy are performed with 4- and 5-mm resectors. Debridement and decortication are done posterior to the interosseous ligament because only the posterior facet is fused. Denudation of the articular surfaces is performed with curettes, as well as 4.5- and 5.5-mm burs, to remove 2 mm of subchondral bone. Stabilization in 5 degrees of hindfoot valgus is accomplished with 2 percutaneous cannulated headless screws from the non-weight-bearing portion of the calcaneal tuberosity directed to a point 5 to 10 mm posterior to the anterior margin of the posterior facet. The advantages of this alternative treatment are better intra-articular visualization, more thorough preparation of the fusion site, and minimal bone removal of the lateral side with better control of the arthrodesis position and with less chance of malunion, as well as the possibility to perform a concomitant surgical fusion or debridement of the ankle joint during the same operative procedure with no need for additional portals or orientation.

  2. EXTENSIVE ROTATOR CUFF INJURIES: AN EVALUATION OF ARTHROSCOPIC REPAIR OUTCOMES

    PubMed Central

    Miyazaki, Alberto Naoki; Fregoneze, Marcelo; Santos, Pedro Doneux; Silva, Luciana Andrade; Eduardo, Cesar Moreira Mariz Pinto Rodrigo Tormin Ortiz; Checchia, Sergio Luiz

    2015-01-01

    To assess the outcomes of the surgical treatment of extensive rotator cuff injuries through arthroscopy. Methods: Between June 1998 and October 2006, 61 patients with extensive rotator cuff injuries and submitted to surgical arthroscopy technique by the Shoulder and Elbow Group of the Department of Orthopaedics and Traumatology, Santa Casa de Misericórdia Medical School were reassessed. The study included all patients with at least two tendons affected or with retraction at least on two tendons up to the glenoidal cavity edge and with at least 12 months of follow-up. Results: According to UCLA's evaluation criteria, 54 (89%) patients showed excellent or good outcomes; no fair outcome in none of the patients; and seven (11%) poor outcomes. A satisfaction rate of 92% was reported. Postoperative joint motion went from a mean lifting value of 93° to 141°, the mean lateral rotation went from 32° to 48° and the mean medial rotation went from L1 to T10. These differences were regarded as statistically significant. Conclusion: The arthroscopic repair of extensive rotator cuff injuries leads to satisfactory outcomes for most of the patients, with a high satisfaction degree. PMID:26998466

  3. Study of Plume Impingement Effects in the Lunar Lander Environment

    NASA Technical Reports Server (NTRS)

    Marichalar, Jeremiah; Prisbell, A.; Lumpkin, F.; LeBeau, G.

    2010-01-01

    Plume impingement effects from the descent and ascent engine firings of the Lunar Lander were analyzed in support of the Lunar Architecture Team under the Constellation Program. The descent stage analysis was performed to obtain shear and pressure forces on the lunar surface as well as velocity and density profiles in the flow field in an effort to understand lunar soil erosion and ejected soil impact damage which was analyzed as part of a separate study. A CFD/DSMC decoupled methodology was used with the Bird continuum breakdown parameter to distinguish the continuum flow from the rarefied flow. The ascent stage analysis was performed to ascertain the forces and moments acting on the Lunar Lander Ascent Module due to the firing of the main engine on take-off. The Reacting and Multiphase Program (RAMP) method of characteristics (MOC) code was used to model the continuum region of the nozzle plume, and the Direct Simulation Monte Carlo (DSMC) Analysis Code (DAC) was used to model the impingement results in the rarefied region. The ascent module (AM) was analyzed for various pitch and yaw rotations and for various heights in relation to the descent module (DM). For the ascent stage analysis, the plume inflow boundary was located near the nozzle exit plane in a region where the flow number density was large enough to make the DSMC solution computationally expensive. Therefore, a scaling coefficient was used to make the DSMC solution more computationally manageable. An analysis of the effectiveness of this scaling technique was performed by investigating various scaling parameters for a single height and rotation of the AM. Because the inflow boundary was near the nozzle exit plane, another analysis was performed investigating three different inflow contours to determine the effects of the flow expansion around the nozzle lip on the final plume impingement results.

  4. Optimization of a GO2/GH2 Impinging Injector Element

    NASA Technical Reports Server (NTRS)

    Tucker, P. Kevin; Shyy, Wei; Vaidyanathan, Rajkumar

    2001-01-01

    An injector optimization methodology, method i, is used to investigate optimal design points for a gaseous oxygen/gaseous hydrogen (GO2/GH2) impinging injector element. The unlike impinging element, a fuel-oxidizer- fuel (F-O-F) triplet, is optimized in terms of design variables such as fuel pressure drop, (Delta)P(sub f), oxidizer pressure drop, (Delta)P(sub o), combustor length, L(sub comb), and impingement half-angle, alpha, for a given mixture ratio and chamber pressure. Dependent variables such as energy release efficiency, ERE, wall heat flux, Q(sub w), injector heat flux, Q(sub inj), relative combustor weight, W(sub rel), and relative injector cost, C(sub rel), are calculated and then correlated with the design variables. An empirical design methodology is used to generate these responses for 163 combinations of input variables. Method i is then used to generate response surfaces for each dependent variable. Desirability functions based on dependent variable constraints are created and used to facilitate development of composite response surfaces representing some, or all, of the five dependent variables in terms of the input variables. Three examples illustrating the utility and flexibility of method i are discussed in detail. First, joint response surfaces are constructed by sequentially adding dependent variables. Optimum designs are identified after addition of each variable and the effect each variable has on the design is shown. This stepwise demonstration also highlights the importance of including variables such as weight and cost early in the design process. Secondly, using the composite response surface which includes all five dependent variables, unequal weights are assigned to emphasize certain variables relative to others. Here, method i is used to enable objective trade studies on design issues such as component life and thrust to weight ratio. Finally, specific variable weights are further increased to illustrate the high marginal cost of

  5. Impingement of Droplets in 60 Deg Elbows with Potential Flow

    NASA Technical Reports Server (NTRS)

    Hacker, Paul T.; Saper, Paul G.; Kadow, Charles F.

    1956-01-01

    Trajectories were determined for water droplets or other aerosol particles in air flowing through 600 elbows especially designed for two-dimensional potential motion. The elbows were established by selecting as walls of each elbow two streamlines of a flow field produced by a complex potential function that establishes a two-dimensional flow around. a 600 bend. An unlimited number of elbows with slightly different shapes can be established by selecting different pairs of streamlines as walls. Some of these have a pocket on the outside wall. The elbows produced by the complex potential function are suitable for use in aircraft air-inlet ducts and have the following characteristics: (1) The resultant velocity at any point inside the elbow is always greater than zero but never exceeds the velocity at the entrance. (2) The air flow field at the entrance and exit is almost uniform and rectilinear. (3) The elbows are symmetrical with respect to the bisector of the angle of bend. These elbows should have lower pressure losses than bends of constant cross-sectional area. The droplet impingement data derived from the trajectories are presented along with equations so that collection efficiency, area, rate, and distribution of droplet impingement can be determined for any elbow defined by any pair of streamlines within a portion of the flow field established by the complex potential function. Coordinates for some typical streamlines of the flow field and velocity components for several points along these streamlines are presented in tabular form. A comparison of the 600 elbow with previous calculations for a comparable 90 elbow indicated that the impingement characteristics of the two elbows were very similar.

  6. Study of Plume Impingement Effects in the Lunar Lander Environment

    NASA Astrophysics Data System (ADS)

    Marichalar, J.; Prisbell, A.; Lumpkin, F.; Lebeau, G.

    2011-05-01

    Plume impingement effects from the descent and ascent engine firings of the Lunar Lander were analyzed in support of the Lunar Architecture Team under the Constellation Program. The descent stage analysis was performed to obtain shear and pressure forces on the lunar surface as well as velocity and density profiles in the flow field in an effort to understand lunar soil erosion and ejected soil impact damage which was analyzed as part of a separate study. A Computational Fluid Dynamics (CFD)/Direct Simulation Monte Carlo (DSMC) decoupled methodology was used with the Bird continuum breakdown parameter to distinguish the continuum flow from the rarefied flow. The ascent stage analysis was performed to ascertain the forces and moments acting on the Lunar Lander Ascent Module due to the firing of the main engine on take-off. The Reacting and Multiphase Program (RAMP) method of characteristics (MOC) code was used to model the continuum region of the nozzle plume, and the DSMC Analysis Code (DAC) was used to model the impingement results in the rarefied region. The ascent module (AM) was analyzed for various pitch and yaw rotations and for various heights in relation to the descent module (DM). For the ascent stage analysis, the plume inflow boundary was located near the nozzle exit plane in a region where the flow number density was large enough to make the DSMC solution computationally expensive. Therefore, a scaling coefficient was used to make the DSMC solution more computationally manageable. An analysis of the effects of this scaling technique was performed. Because the inflow boundary was near the nozzle exit plane, another analysis was performed investigating three different inflow contours to determine the effects of the flow expansion around the nozzle lip on the final plume impingement results.

  7. Kinetics of particle deposition in the oblique impinging jet cell.

    PubMed

    Adamczyk, Zbigniew; Musiał, Elizeusz; Siwek, Barbara

    2004-01-01

    A new oblique impinging-jet (OBIJ) cell was developed, suitable for colloid deposition studies at various interfaces. In contrast to previously used orthogonal cells, the OBIJ construction makes possible direct microscope observations of particle deposition on nontransparent substrates. The cell performance was tested by studying kinetics of polystyrene latex particle deposition on mica. Two limiting cell configuration were used in the experiments: (i) the lower position (inverted microscope observation of substrate surface through air) and (ii) the upper position (observation of the substrate surface with adsorbed particles through the suspension layer). The dependence of local mass transfer rate (particle flux) on the position over the substrate surface was studied for various flow Reynolds numbers. It was demonstrated that deposition rate attained maximum at the flow stagnation point whose position was dependent on Re number. Moreover, it was shown that the local flux decreased at much slower rate when moving in the downstream direction, than for previously used impinging-jet cells. Consequently, the area of uniform transport conditions was larger, enabling more precise determination of the limiting particle flux at the stagnation-point. The dependence of the flux on Re number was systematically studied for various ionic strength of the suspension. It was demonstrated, in accordance with previous results for the ordinary impinging-jet, that the flux increased significantly for low ionic strength and high Re number. This phenomenon, referred to as the inverse salt effect, was interpreted in terms of the convective diffusion theory. The governing transport equation originating from this theory was solved numerically, for the region near the stagnation point, using the finite-difference method. These numerical solutions were used for nonlinear fitting of the flow intensity parameter dependence on the Re number. In this way the flow field in the vicinity of the

  8. Visualization of heat transfer for impinging swirl flow

    SciTech Connect

    Bakirci, K.; Bilen, K.

    2007-10-15

    The objective of the experimental study was to visualize the temperature distribution and evaluate heat transfer rate on the impingement surface kept at a constant wall temperature boundary condition for the swirling (SIJ), multi-channel (MCIJ) and conventional impinging jet (CIJ) using liquid crystal technique. The swirling jet assembly consisted of a housing tube and a solid swirl generator insert which had four narrow slots machined on its surface. The swirl angle, {theta}, was set as 0 , 22.5 , 41 , 50 to change the direction and strength of the swirl in the air flow exiting the housing tube. The local Nusselt numbers of the MCIJ ({theta} = 0 ) were generally much higher than those of CIJ and SIJs. As the swirl angle increased, the radial uniformity of the heat transfer was seen compared to MCIJ and SIJ; the best results were for {theta} = 50 and the jet-to-surface distance of H/D = 14. The location of the distance of the maximum heat transfer for the swirl angles of {theta} = 41 and 50 was shifted away from the stagnation point in a radial distance of nearly r/D = 2.5. Increasing Reynolds number for same swirler angle increased the heat transfer rate on the entire surface, and increased saddle shape heat transfer distribution on the surface, but had no significant effect on the position of the individual impingement regions, but increased saddle shape heat transfer distribution on the surface. The lower Reynolds number (Re = 10 000) and the highest H/D = 14 gave much more uniform local and average heat transfer distribution on the surface, but decreased their values on the entire surface. (author)

  9. Numerical study of a confined slot impinging jet with nanofluids

    PubMed Central

    2011-01-01

    Background Heat transfer enhancement technology concerns with the aim of developing more efficient systems to satisfy the increasing demands of many applications in the fields of automotive, aerospace, electronic and process industry. A solution for obtaining efficient cooling systems is represented by the use of confined or unconfined impinging jets. Moreover, the possibility of increasing the thermal performances of the working fluids can be taken into account, and the introduction of nanoparticles in a base fluid can be considered. Results In this article, a numerical investigation on confined impinging slot jet working with a mixture of water and Al2O3 nanoparticles is described. The flow is turbulent and a constant temperature is applied on the impinging. A single-phase model approach has been adopted. Different geometric ratios, particle volume concentrations and Reynolds number have been considered to study the behavior of the system in terms of average and local Nusselt number, convective heat transfer coefficient and required pumping power profiles, temperature fields and stream function contours. Conclusions The dimensionless stream function contours show that the intensity and size of the vortex structures depend on the confining effects, given by H/W ratio, Reynolds number and particle concentrations. Furthermore, for increasing concentrations, nanofluids realize increasing fluid bulk temperature, as a result of the elevated thermal conductivity of mixtures. The local Nusselt number profiles show the highest values at the stagnation point, and the lowest at the end of the heated plate. The average Nusselt number increases for increasing particle concentrations and Reynolds numbers; moreover, the highest values are observed for H/W = 10, and a maximum increase of 18% is detected at a concentration equal to 6%. The required pumping power as well as Reynolds number increases and particle concentrations grow, which is almost 4.8 times greater than the

  10. Thermal visualization of heat-transfer characteristics for single impinging jet

    NASA Astrophysics Data System (ADS)

    Li, Liguo; Zhu, Yun; Zhang, Jingzhou; Yu, Wei

    The local heat-transfer characteristics of an impingement-cooling jet are presently ascertained, for cases with and without crossflow, through the use of a combined metal heating-element and cholesteric liquid crystal system. The results obtained indicate that the impingement Nusselt numbers of double-peak values increase with rising jet Reynolds number. A moving cylindrical jet-source model is used to simulate and analyze the jet's impingement heat transfer.

  11. Ischiofemoral impingement of the hip: a novel approach to treatment.

    PubMed

    Safran, Marc; Ryu, Jessica

    2014-04-01

    Ischiofemoral impingement (IFI) is an uncommon source of hip pain recently described in the non-surgical hip, associated with decreased space between the lesser trochanter and the ischium. There are no reports in the English literature of surgical treatment of this problem. We describe a case of IFI in a 19-year-old female who failed conservative management and underwent endoscopic surgical intervention to increase the space between her ischium and proximal femur. More than 2 years later, the patient is doing very well with an improvement of her iHOT score of 53 points to 85.

  12. An Experimental Study of Jet Impingement on a Circular Cylinder.

    DTIC Science & Technology

    1984-08-01

    4, pp. 72--676. 22. Beltaos , S ., and Rajaratnam, N., "Impinging Circular Turbulent Jets," Proceedings of the ASCE Journal of Hydralics Division, Vol...11. CONTRACT OR GRANT NUMBER( s ) 00 Dennis W. Potts ID WI) :-wiFORMING ORGANIZATION NAME AND ADDRESS 10. PROGRAM ELEMENT. PROJECT. TASK - ANT STUDENT...necessary and identify by block niber) 70.1. AB6S M’AGC - Contlnu* on reverie side If necessary end vdentify by block number) S ATTACH ED [))"~- 1473

  13. Discharge coefficients of impingement and film cooling holes

    NASA Astrophysics Data System (ADS)

    Chu, T.; Brown, A.; Garret, S.

    1985-03-01

    In this article measurements of fluid flow through impingement and film cooling holes for typical turbine blade cooling systems are presented. The purpose of the measurements was to determine hole discharge coefficients over a range of Reynolds numbers from 5,000 to 30,000 and to observe in this range the dependence of discharge coefficient on Reynolds number. The effect of hole geometry, that is, sharp edged inlet or corner radius inlet, on discharge coefficients is also measured. Correlations relating discharge coefficients to Reynolds number, corner radius to hole diameter ratio, and blowing parameter are suggested.

  14. Unsteady conjugate heat transfer analysis for impinging jet cooling

    NASA Astrophysics Data System (ADS)

    Tejero, F.; Flaszyński, P.; Szwaba, R.; Telega, J.

    2016-10-01

    The paper presents the numerical investigations of the heat transfer on a flat plate cooled by a single impinging jet. The thermal conductivity of the plate was modified from a high thermal case (steel -λ= 35 W/m/K) to a low one (steel alloy Inconel -λ= 9.8 W/m/K). The numerical simulations results are compared with the experimental data from the Institute of Fluid-Flow Machinery Polish Academy of Sciences, Gdansk (Poland). The numerical simulations are carried out by means of Ansys/Fluent and k-ω SST turbulence model and the temperature evolution on the target plate is investigated by conjugated heat transfer computations.

  15. Recessed impingement insert metering plate for gas turbine nozzles

    DOEpatents

    Itzel, Gary Michael; Burdgick, Steven Sebastian

    2002-01-01

    An impingement insert sleeve is provided that is adapted to be disposed in a coolant cavity defined through a stator vane. The insert has a generally open inlet end and first and second diametrically opposed, perforated side walls. A metering plate having at least one opening defined therethrough for coolant flow is mounted to the side walls to generally transverse a longitudinal axis of the insert, and is disposed downstream from said inlet end. The metering plate improves flow distribution while reducing ballooning stresses within the insert and allowing for a more flexible insert attachment.

  16. Heat Transfer Effects on a Fully Premixed Methane Impinging Flame

    DTIC Science & Technology

    2014-10-30

    HEAT TRANSFER EFFECTS ON A FULLY PREMIXED METHANE IMPINGING FLAME D. Mira1, M. Zavala1, M. Avila1, H. Owen1, J.C. Cajas1, G. Houzeaux1 and M...to evaluate the numeri- cal algorithms and the effects of the thermal coupling with the flow dynamics is the case of a jet flame im- pinging on a...investigate the heat transfer effects and flow dynamics of an imping- ing flame with low nozzle-to-plate distance when the solid plate is considered non

  17. Labral Healing

    PubMed Central

    Catan, Agustín; Vilaseca, Tomas; Arroquy, Damián; Carboni, Martín; Guiñazú, Jorge Eduardo; Orlowsky, Belén; Irigoitia, Nicolas; Chahla, Jorge

    2017-01-01

    Objectives: The purpouse of this study was to evaluate MRI images of labral repair after one year, trying to stablish MRI images as a reliable tool for the diagnosis of labral healing. Methods: One hundred and sixty-two patients presenting with femoroacetabular impingement that underwent an arthroscopic surgery were treated between 2012 and 2015. Of these, 124 met the selection criteria and were included in this study. Only patients with 12 months of follow up and labral repair were included. Patients with previous hip surgery were excluded. Coronal, sagittal and axial MRI cuts were evaluated by three independent observers, an arthroscopic hip surgery, a fellow in hip arthroscopic surgery and a musculoeskeletal radiologist. Results: on regard of our statistics 68% of the patients had labral healing images, 16% had no healing signals and 16% unsatisfactory images. Just in the 47% the observers had a 100% of agreement. Interobserver variation was: intraobserver agreement was 94% ( arthroscopic surgeon), 72 % (radiologist), 67 % (fellow). Conclusion: The main finding of this study was that a high inter and intraobserver variability was found when analysing the healing status of hip repaired labrums. Assessment of labrum healing after an arthroscopic repair should not only rely on imaging methods and therefore should be concurrently performed with a comprehensive physical examination.

  18. Combined partial arthroscopic synovectomy and radiation therapy for diffuse pigmented villonodular synovitis of the knee.

    PubMed

    Blanco, C E; Leon, H O; Guthrie, T B

    2001-05-01

    We present the results of combined partial arthroscopic synovectomy and low-dose external-beam radiation therapy (RT) in the treatment of diffuse pigmented villonodular synovitis (PVNS) of the knee. Mechanical synovectomy is an effective tool in treating PVNS of the knee, but when used alone it may be insufficient to eliminate all affected tissue. Intra-articular radiation or external-beam radiation may be added to mechanical synovectomy to treat recurrence but is not routinely done at the time of initial synovectomy. Combining intra-articular synovectomy with RT at the initial treatment for PVNS of the knee may reduce the recurrence rate. We present a prospective study of the treatment of 22 patients with clinical, ultrasonic, and histologically confirmed findings of diffuse PVNS of the knee. Characteristic clinical findings included pain, swelling, and erythema. These patients were treated by the Arthroscopic Surgery Group of the Orthopaedic Service at the Hospital "Hermanos Ameijeiras" in Havana, Cuba from 1990 to 1998. The protocol included anterior (patellofemoral, medial, and lateral) arthroscopic synovectomy and postoperative RT with a total dose of 2,600 cGy. This combination therapy was effective in reducing symptoms of pain and edema, and in improving overall function of patients. Nineteen patients (86%) had good or excellent results at an average follow-up of 33 months (range, 26 to 76 months). Three patients had residual stiffness and swelling, 2 of whom also had pain. Three had clinically and ultrasonically confirmed recurrence of disease and were treated with repeat arthroscopic synovectomy without harmful effects from RT. In all of the cases requiring repeat arthroscopic synovectomy, we observed fibrous bands secondary to reorganization of synovial inflamed tissue, meniscal retraction, and microscopic findings of fibrosis and cellular paucity. Partial arthroscopic synovectomy combined with low-dose RT in anti-inflammatory doses produced good results

  19. 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.

  20. Experimental simulation of impingement cooling in midchord region of turbine blade

    NASA Astrophysics Data System (ADS)

    Li, Liguo; Jiang, Jun; Chang, Haiping; Zhang, Donglia

    1989-10-01

    Simulation experiments have been completed to research the characteristics of impingement cooling in the midchord region of a turbine blade for a given geometric parameter of jet array, initial crossflow, and pressure ratios of the film-cooling exhaust. Comparative experiments have been made on curvilinear and flat plate impinged surfaces, and impinged surfaces with and without a chordwise fin. Moreover, the thermal patterns from a liquid crystal show that the jet hole arrangement and distance between cooled surface and jet plate affect the heat transfer distributions for jet array impingement. Finally, the effects of the cooling air axially injected into guide tube on radial jet flow have also been determined.

  1. Jet array impingement with crossflow-correlation of streamwise resolved flow and heat transfer distributions

    NASA Technical Reports Server (NTRS)

    Florschuetz, L. W.; Metzger, D. E.; Truman, C. R.

    1981-01-01

    Correlations for heat transfer coefficients for jets of circular offices and impinging on a surface parallel to the jet orifice plate are presented. The air, following impingement, is constrained to exit in a single direction along the channel formed by the jet orifice plate and the heat transfer (impingement) surface. The downstream jets are subjected to a crossflow originating from the upstream jets. Impingement surface heat transfer coefficients resolved to one streamwise jet orifice spacing, averaged across the channel span, are correlated with the associated individual spanwise orifice row jet and crossflow velocities, and with the geometric parameters.

  2. Modeling Single-Phase and Boiling Liquid Jet Impingement Cooling in Power Electronics

    SciTech Connect

    Narumanchi, S. V. J.; Hassani, V.; Bharathan, D.

    2005-12-01

    Jet impingement has been an attractive cooling option in a number of industries over the past few decades. Over the past 15 years, jet impingement has been explored as a cooling option in microelectronics. Recently, interest has been expressed by the automotive industry in exploring jet impingement for cooling power electronics components. This technical report explores, from a modeling perspective, both single-phase and boiling jet impingement cooling in power electronics, primarily from a heat transfer viewpoint. The discussion is from the viewpoint of the cooling of IGBTs (insulated-gate bipolar transistors), which are found in hybrid automobile inverters.

  3. Nontraumatic glenohumeral instability and coracoacromial impingement in swimmers.

    PubMed

    Bak, K

    1996-06-01

    Competitive swimming is one of the most demanding and time-consuming sports. Swimmers at elite level practice 20-30 h per week. During 1 year's practice, the average top level swimmer performs more than 500,000 stroke revolutions per arm. These innumerable repetitions over many years of hard training together with an increasing muscular imbalance around the shoulder girdle seem to be the main etiological factors in the development of the over-use syndrome swimmer's shoulder. Shoulder pain in swimmers has in general been regarded as synonymous with coracoacromial impingement, i.e. anterior shoulder pain due to rotator cuff tendinitis, but new knowledge suggests that a concomitant glenohumeral instability plays an additional role. The diagnostic complexity of the problem is as challenging as the search for the gold standard of treatment. The condition should ideally be diagnosed as early as possible, and intensive functional rehabilitation of the shoulder girdle including the scapular muscles should be started in order to restore muscle balance. The surgical possibilities include subacromial decompression in cases of purely mechanical impingement. If a painful glenohumeral instability persists after intensive functional rehabilitation, anterior capsulolabral reconstruction can be performed. Still, however, short- and long-term results show that surgery is less successful in elite athletes involved in overhead sports. Prevention protocols include education of coaches in primary injury prophylaxis and the institution of resistance strength training in prepubescent swimmers. Emphasis should be made to improve muscular balance around the glenohumeral and scapulothoracic joints.

  4. Impinging Turbulent Boundary Layer Influence on Horseshoe Vortex Periodicity

    NASA Astrophysics Data System (ADS)

    Smith, Charles; Sabatino, Daniel

    2000-11-01

    The spatial-temporal flow-field and associated surface heat transfer for a turbulent juncture flow were experimentally examined in a water channel using PIV and thermochromic liquid crystals. Turbulent boundary layer "burst" events, which have been previously described as hairpin vortex "packets," are shown to interact and periodically strengthen the juncture-region horseshoe vortex (HV). This strengthening of the HV precipitates its movement upstream and toward the surface. This process that induces the ejection of a secondary vortex, which weakens the HV, with the strengthen-ejection-weakening cycle repeating quasi-periodically. The dominant period of motion for the HV correlates closely to the impinging turbulent boundary layer bursting frequency. This vortex-bursting interaction is responsible for the elevated endwall surface heat transfer upstream of the corner vortex region. The temporal endwall surface heat transfer behavior for a linear turbine cascade juncture was also determined to be essentially the same as that for a simple bluff body, with the impinging boundary layer bursting frequency again being the controlling parameter.

  5. Single-phase liquid jet impingement heat transfer

    SciTech Connect

    Webb, B.W.; Ma, C.F.

    1995-12-31

    Impinging liquid jets have been demonstrated to be an effective means of providing high heat/mass transfer rates in industrial transport processes. When a liquid jet strikes a surface, thin hydrodynamic and thermal boundary layers from in the region directly beneath due to the jet deceleration and the resulting increase in pressure. The flow is then forced to accelerate in a direction parallel to the target surface in what is termed the wall jet or parallel flow zone. The thickness of the hydrodynamic and thermal boundary layers in the stagnation region may be of the order of tens of micrometers. Consequently, very high heat/mass transfer coefficients exist in the stagnation zone directly under the jet. Transport coefficients characteristic of parallel flow prevail in the wall jet region. The high heat transfer coefficients make liquid jet impingement an attractive cooling option where high heat fluxes are the norm. Some industrial applications include the thermal treatment of metals, cooling of internal combustion engines, and more recently, thermal control of high-heat-dissipation electronic devices. Both circular and planar liquid jets have attracted research attention. 180 refs., 35 figs., 11 tabs.

  6. Impingement of Droplets in 90 deg Elbows with Potential Flow

    NASA Technical Reports Server (NTRS)

    Hacker, Paul T.; Brun, Rinaldo J.; Boyd, Bemrose

    1953-01-01

    Trajectories were determined for droplets in air flowing through 90 deg elbows especially designed for two-dimensional potential motion with low pressure losses. The elbows were established by selecting as walls of each elbow two streamlines of the flow field produced by a complex potential function that establishes a two-dimensional flow around a 90 deg bend. An unlimited number of elbows with slightly different shapes can be established by selecting different pairs of streamlines as walls. The elbows produced by the complex potential function selected are suitable for use in aircraft air-intake ducts. The droplet impingement data derived from the trajectories are presented along with equations in such a manner that the collection efficiency, the area, the rate, and the distribution of droplet impingement can be determined for any elbow defined by any pair of streamlines within a portion of the flow field established by the complex potential function. Coordinates for some typical streamlines of the flow field and velocity components for several points along these streamlines are presented in tabular form.

  7. Laser impingement on bare and encased high explosives: safety limits

    SciTech Connect

    Roeske, F

    1999-03-15

    During the course of experiments involving high explosives, (HE), alignment lasers are often employed where the laser beam impinges upon a metal encased HE sample or on the bare HE itself during manned operations. While most alignment lasers are of low enough power so as not to be of concern, safety questions arise when considering the maximum credible power output of the laser in a failure mode, or when multiple laser spots are focused onto the experiment simultaneously. Safety questions also arise when the focused laser spot size becomes very small, on the order of 100 {micro}m or less. This paper addresses these concerns by describing a methodology for determining safety margins for laser impingement on metal encased HE as well as one for bare HE. A variety of explosives encased in Al, Cu, Ta and stainless steel were tested using the first of these techniques. Additional experiments were performed using the second method where the laser beam was focused directly on eight different samples of pressed-powder HE.

  8. A simple confined impingement jets mixer for flash nanoprecipitation.

    PubMed

    Han, Jing; Zhu, Zhengxi; Qian, Haitao; Wohl, Adam R; Beaman, Charles J; Hoye, Thomas R; Macosko, Christopher W

    2012-10-01

    Johnson and Prud'homme (2003. AICHE J 49:2264-2282) introduced the confined impingement jets (CIJ) mixer to prepare nanoparticles loaded with hydrophobic compounds (e.g., drugs, inks, fragrances, or pheromones) via flash nanoprecipitation (FNP). We have modified the original CIJ design to allow hand operation, eliminating the need for a syringe pump, and we added a second antisolvent dilution stage. Impingement mixing requires equal flow momentum from two opposing jets, one containing the drug in organic solvent and the other containing an antisolvent, typically water. The subsequent dilution step in the new design allows rapid quenching with high antisolvent concentration that enhances nanoparticle stability. This new CIJ with dilution (CIJ-D) mixer is a simple, cheap, and efficient device to produce nanoparticles. We have made 55 nm diameter β-carotene nanoparticles using the CIJ-D mixer. They are stable and reproducible in terms of particle size and distribution. We have also compared the performance of our CIJ-D mixer with the vortex mixer, which can operate at unequal flow rates (Liu et al., 2008. Chem Eng Sci 63:2829-2842), to make β-carotene-containing particles over a series of turbulent conditions. On the basis of dynamic light scattering measurements, the new CIJ-D mixer produces stable particles of a size similar to the vortex mixer. Our CIJ-D design requires less volume and provides an easily operated and inexpensive tool to produce nanoparticles via FNP and to evaluate new nanoparticle formulation.

  9. The Role of Arthroscopic Partial Meniscectomy in the Management of Degenerative Meniscus Tears: A Review of the Recent Literature

    PubMed Central

    Azam, Mohsin; Shenoy, Ravi

    2016-01-01

    Background: The use of arthroscopic partial meniscectomy for middle aged to older adults with knee pain is one of the most common surgical procedures with approximately 150,000 knee arthroscopies being carried out in the United Kingdom each year, and about five times that number in the United States. Despite this, the procedure remains controversial. The aim of this paper is to provide a comprehensive review of the role of arthroscopic meniscectomy in patients with degenerative meniscus tears and suggest recommendations for clinical practice. Methods: A thorough literature search was performed using available databases, including Pubmed, Medline, EMBASE and the Cochrane Library to cover important randomised control trials surrounding the use of arthroscopic partial meniscectomy. Results: The majority of randomised control trials suggest that arthroscopic partial meniscectomy is not superior to conservative measures such as exercise programmes. Furthermore, one randomised control trial found that arthroscopic partial meniscectomy was not even superior to sham surgery. Conclusion: There is significant overtreatment of knee pain with arthroscopic partial meniscectomy when alternative, less invasive and less expensive treatment options are equally effective. First-line treatment of degenerative meniscus tears should be non-operative therapy focused on analgesia and physical therapy to provide pain relief as well as improve mechanical function of the knee joint. Arthroscopic partial meniscectomy should be considered as a last resort when extensive exercise programmes and physiotherapy have been tried and failed. PMID:28217206

  10. An arthroscopic evaluation of the anatomical "critical zone".

    PubMed

    Naidoo, Nerissa; Lazarus, Lelika; Osman, Shameem Ahmed; Satyapal, Kapil Sewsaran

    2016-09-26

    The "critical zone", a region of speculated vascularity, is situated approximately 10mm proximal to the insertion of the supraspinatus tendon. Despite its obvious role as an anatomical landmark demarcator, its patho-anatomic nature has been identified as the source of rotator cuff pathology. Although many studies have attempted to evaluate the vascularity of this region, the architecture regarding the exact length, width and shape of the critical zone, remains unreported. This study aimed to determine the shape and morphometry of the "critical zone" arthroscopically. The sample series, which comprised of 38 cases (n = 38) specific to pathological types, employed an anatomical investigation of the critical zone during routine real-time arthroscopy. Demographic representation: i) Sex: 19 Males, 19 Females; ii) Age range: 18 - 76 years old; iii) Race: White (29), Indian (7) and Coloured (2). The incidence of shape and the mean lengths and widths of the critical zone were determined in accordance with the relevant demographic factors and patient history. Although the cresenteric shape was predominant, hemispheric and sail-shaped critical zones were also identified. The lengths and widths of the critical zone appeared markedly increased in male individuals. While the increase in age may account for the increased incidence of rotator cuff degeneration due to poor end vascular supply, the additional factors of height and weight presented as major determinants of the increase in size of the critical zone. In addition, the comparisons of length and width with each other and shape yielded levels of significant difference, therefore indicating a directly proportional relationship between the length and width of the critical zone. This detailed understanding of the critical zone may prove beneficial for the success of post-operative rotator cuff healing.

  11. BiPOD Arthroscopic Acromioclavicular Repair Restores Bidirectional Stability.

    PubMed

    De Beer, Joe; Schaer, Michael; Latendresse, Kim; Raniga, Sumit; Moor, Beat K; Zumstein, Matthias A

    2016-09-19

    Stabilizing the acromioclavicular joint in the vertical and horizontal planes is challenging, and most current techniques do not reliably achieve this goal. The BiPOD repair is an arthroscopically assisted procedure performed with image intensifier guidance that reconstructs the coracoclavicular ligaments as well as the acromioclavicular ligaments to achieve bidirectional stability. Repair is achieved with a combination of 2-mm FiberTape (Arthrex, Naples, Florida) and 20-mm Poly-Tape (Neoligaments, Leeds, England) to achieve rigid repair, prevent bone abrasion, and promote tissue ingrowth. This study is a prospective review of the first 6 patients treated for high-grade acute acromioclavicular injury with the BiPOD technique. The study included 6 men who were 21 to 36 years old (mean, 27 years). At 6-month follow-up, complications were recorded and radiographic analysis was used to determine the coracoclavicular distance for vertical reduction and the amount of acromioclavicular translation on the Alexander axillary view was used to determine horizontal reduction. One patient had a superficial infection over the tape knot. The difference in coracoclavicular distance between the operated side and the uninvolved side was 9±2 mm preoperatively and 0.3±2 mm at 6-month follow-up. On Alexander axillary view, all 6 patients showed stable reduction, which is defined as a clavicle that is in line with the acromion. The findings show that BiPOD acromioclavicular reconstruction restores bidirectional stability of the acromioclavicular joint at 6 months. [Orthopedics. 201x; xx(x):exx-exx.].

  12. Effect of nabumetone on hemostasis during arthroscopic knee surgery.

    PubMed

    Schnitzer, T J; Donahue, J R; Toomey, E P; Holtby, R M; Scuderi, G R; Adams, P L; Poland, M P

    1998-01-01

    The known effects of commonly used nonsteroidal anti-inflammatory drugs (NSAIDs) on hemostatic parameters have led to concern over their use in the perioperative period. Nabumetone, unlike other NSAIDs, has little effect on collagen-induced platelet aggregation. To evaluate the effect of nabumetone 2000 mg daily on other hemostatic parameters (e.g., bleeding time, prothrombin time, and partial thromboplastin time) in the clinical setting, this double-masked study was conducted in patients with osteoarthritis undergoing arthroscopic knee surgery. After a 1-week placebo washout period, 58 patients were randomized to receive nabumetone and 53 were randomized to receive placebo. They were assessed before surgery (after 1 to 2 weeks of treatment) and again after surgery (after an additional 3 weeks of treatment). The study was designed to have 90% power to show equivalence in bleeding time to within 1.5 minutes, a difference assumed to be of no clinical importance. No meaningful differences were observed between the groups in any of the measured hemostatic parameters. Before surgery, the bleeding time increased by only 0.3 minutes with nabumetone and decreased by 0.2 minutes with placebo. The mean (+/- SD) difference between the groups in change from baseline was 0.5 +/- 0.3 minutes. After surgery, the changes were 0.1 minutes and 0.0 minutes, respectively, and the difference between groups was 0.2 +/- 0.3 minutes. These differences were neither statistically nor clinically significant, and maximum individual increases were similar in each group. Furthermore, there were no reports of abnormal bleeding in the operative knees. The results of this study show that nabumetone had little or no effect on hemostasis and suggest that this drug can be used safely in the perioperative period.

  13. Editorial Commentary: Arthroscopic Rotator Cuff Repair--Infection Rate After Rotator Cuff Repair With Arthroscopic, Open, and Mini-open Techniques.

    PubMed

    Brand, Jefferson C

    2016-03-01

    In "Risk Factors for Infection After Rotator Cuff Repair," B. G. Vopat et al. report a lower rate of postoperative infection with an arthroscopic rotator cuff repair than with an open or mini-open approach. Although there were only 14 infections (infection rate of 0.77%), the reason for the preponderance of male patients, 13 of the 14 infections, needs further research to determine effective preventive strategies.

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

    PubMed

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

    2014-10-01

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

  15. Arthroscopic Reduction and Transportal Screw Fixation of Acetabular Posterior Wall Fracture: Technical Note

    PubMed Central

    Park, Jin young; Kim, Che Keun; Huh, Soon Ho; Kim, Se Jin; Jung, Bo Hyun

    2016-01-01

    Acetabular fractures can be treated with variable method. In this study, acetabular posterior wall fracture was treated with arthroscopic reduction and fixation using cannulated screw. The patient recovered immediately and had a satisfactory outcome. In some case of acetabular fracture could be good indication with additional advantages of joint debridement and loose body removal. So, we report our case with technical note. PMID:27536654

  16. 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.

  17. Arthroscopic core decompression of the lunate in early stage Kienbock disease of the lunate.

    PubMed

    Bain, Gregory I; Smith, Michael L; Watts, Adam C

    2011-03-01

    Since the first description of Kienbock disease in 1910, the etiology and treatment have remained controversial topics. Core decompression is an accepted treatment option in early-stage avascular necrosis of the femoral head, and more recently the humeral head. This paper reports the technique of arthroscopic fluoroscopically guided core decompression of the lunate with 6-year results.

  18. Arthroscopically Assisted Acromioclavicular and Coracoclavicular Ligament Reconstruction for Chronic Acromioclavicular Joint Instability.

    PubMed

    Martetschläger, Frank; Tauber, Mark; Habermeyer, Peter; Hawi, Nael

    2016-12-01

    Acromioclavicular (AC) joint injuries are common injuries, especially in the young and active, male population. AC joint injuries account for 12% of all injuries of the shoulder girdle in the overall population. Although conservative treatment is recommended for Rockwood type I and type II injuries, there is controversial debate about optimal treatment for type III injuries. High-grade injuries are typically treated operatively to avoid painful sequelae. A vast number of different surgical methods have been described over the past few decades. Recent advances in arthroscopic surgery have enabled the shoulder surgeon to treat acute and chronic AC lesions arthroscopically assisted. Clinical studies have already shown good and reliable results. Although surgeons agree that a biological augmentation is required to minimize the risk of recurrent instability in chronic cases, a gold standard still needs to be defined. We present an arthroscopically assisted biological augmentation technique to reconstruct the AC and coracoclavicular ligaments, protected by a button-suture tape construct for chronic AC joint instability. The presented arthroscopic biological augmentation technique uses less and/or smaller drill holes in the clavicle and coracoid than previously described, thus reducing weakening of the bony structures. At the same time it enhances both horizontal and vertical stability.

  19. [Relation of ultrastructural changes of articular cartilage and the arthroscopic classification in osteoarthritic knee].

    PubMed

    Chai, B F

    1992-01-01

    This paper reported the ultrastructural changes found in the diseased articular cartilages of 43 osteoarthritic knee joints, which were assessed according to the "Arthroscopic classification of the articular cartilage". The electron microscopic findings and the arthroscopic classification of the articular lesions were correlated. The lesioned articular cartilage revealed two categories of pathological changes. 1. The changes on the part of the articular chondrocytes comprised (1) The nucleus showed pyknosis and karyorrhexis. (2) The cytoplasm exhibited fat droplets, glycogen granules, and/or microfilaments. Lysosomes also emerged frequently. The mitochondria swelled and the rough-surfaced endoplasmic reticulum dilated and became vesiculated. At the same time there was detachment of cell processes or of the cytoplasmic membrane. The chondrocyte underwent necrosis, contracted and eventually disintegrated into lipid debris. These changes increased in extent and degree with the lesion and the severity went parallel with the sequence of the "Arthroscopic stage classification". 2. The changes on the part of the matrix included appearance of electron-dense lipid debris and numerous, coarse and banded collagen fibrils. They resided both in the pericellular matrix and in the general matrix. Sometimes fibroblast-like cells made their appearance in the matrix. These cells also revealed degenerative changes. All these changes went parallel with the sequence of the "Arthroscopic grade classification".

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

    PubMed

    Mariee, I C; Gröne, A; Theyse, L F H

    2014-06-01

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

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

    PubMed Central

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

    2014-01-01

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

  2. SVDS plume impingement modeling development. Sensitivity analysis supporting level B requirements

    NASA Technical Reports Server (NTRS)

    Chiu, P. B.; Pearson, D. J.; Muhm, P. M.; Schoonmaker, P. B.; Radar, R. J.

    1977-01-01

    A series of sensitivity analyses (trade studies) performed to select features and capabilities to be implemented in the plume impingement model is described. Sensitivity analyses were performed in study areas pertaining to geometry, flowfield, impingement, and dynamical effects. Recommendations based on these analyses are summarized.

  3. A Single Parameter to Characterize Wall Shear Stress Developed from an Underexpanded Axisymmetric Impinging Jet

    NASA Astrophysics Data System (ADS)

    Fillingham, Patrick; Murali, Harikrishnan

    2016-11-01

    Wall shear stress is characterized for underexpanded axisymmetric impinging jets for the application of aerodynamic particle resuspension from a surface. Analysis of the flow field and the wall shear stress resulted from normally impinging axisymmetric jets is conducted using Computational Fluid Dynamics. A normally impinging jet is modeled with a constant area nozzle, while varying height to diameter ratio (H/D) and inlet pressures. Schlieren photography is used to visualize the density gradient of the flow field for validation of the CFD. The Dimensionless Jet Parameter (DJP) is developed to describe flow regimes and characterize the shear stress. The DJP is defined as being proportional to the jet pressure ratio divided by the H/D ratio squared. Maximum wall shear stress is examined as a function of DJP with three distinct regimes: (i) subsonic impingement (DJP<1), (ii) transitional (1impingement (DJP>2). Due to the jet energy dissipation in shock structures, which become a dominant dissipation mechanism in the supersonic impingement regime, wall shear stress is limited to a finite value. Additionally, formation of shock structures in the wall flow were observed for DJP>2 resulting in difficulties with dimensionless analysis. In the subsonic impingement and transitional regimes equations as a function of the DJP are obtained for the maximum wall shear stress magnitude, maximum shear stress location, and shear stress decay. Using these relationships wall shear stress can be predicted at all locations along the impingement surface.

  4. Water droplet impingement on airfoils and aircraft engine inlets for icing analysis

    NASA Technical Reports Server (NTRS)

    Papadakis, Michael; Elangovan, R.; Freund, George A., Jr.; Breer, Marlin D.

    1991-01-01

    This paper includes the results of a significant research program for verification of computer trajectory codes used in aircraft icing analysis. Experimental water droplet impingement data have been obtained in the NASA Lewis Research Center Icing Research Tunnel for a wide range of aircraft geometries and test conditions. The body whose impingement characteristics are required is covered at strategic locations by thin strips of moisture absorbing (blotter) paper and then exposed to an airstream containing a dyed-water spray cloud. Water droplet impingement data are extracted from the dyed blotter strips by measuring the optical reflectance of the dye deposit on the strips with an automated reflectometer. Impingement characteristics for all test geometries have also been calculated using two recently developed trajectory computer codes. Good agreement is obtained with experimental data. The experimental and analytical data show that maximum impingement efficiency and impingement limits increase with mean volumetric diameter for all geometries tested. For all inlet geometries tested, as the inlet mass flow is reduced, the maximum impingement efficiency is reduced and the location of the maximum impingement shifts toward the inlet inner cowl.

  5. Methods for obtaining and reducing experimental droplet impingement data on arbitrary bodies

    NASA Astrophysics Data System (ADS)

    Papadakis, Michael; Elangovan, R.; Freund, George A., Jr.; Breer, Marlin D.

    1991-05-01

    Experimental water droplet impingement data are used to validate particle trajectory computer codes used in the analysis and certification of aircraft de-icing/anti-icing systems. Water droplet impingement characteristics of aerodynamic surfaces are usually obtained from wind-tunnel dye tracer experiments. This paper presents a dye tracer method for measuring water droplet impingement characteristics on arbitrary geometries and a new data reduction method, based on laser reflectance measurements, for extracting impingement data. Extraction of impingement data has been a very time-consuming process in the past. The new data reduction method developed is at least an order of magnitude more efficient than the method previously used. The accuracy of the method is discussed and results obtained are presented.

  6. Numerical investigation of heat transfer under confined impinging turbulent slot jets

    SciTech Connect

    Tzeng, P.Y.; Soong, C.Y.; Hsieh, C.D. )

    1999-06-01

    Impinging jet systems are extensively used to provide rapid heating, cooling, or drying in diverse industrial applications. Among these applications are the annealing of metals and plastic sheets; tempering and shaping of glass; drying of textiles, veneer, paper, and film materials; and cooling of combustion walls, turbine blades, and electronic components. This work numerically investigates confined impinging turbulent slot jets. Eight turbulence models, including one standard and seven low-Reynolds-number [kappa]-[epsilon] models, are employed and tested to predict the heat transfer performance of multiple impinging jets. Validation results indicate that the prediction by each turbulence model depends on grid distribution and numerical scheme used in spatial discretization. In addition, spent fluid exits are set between impinging jets to reduce the cross-flow effect in degradation of the heat transfer of downstream impinging jets. The overall heat transfer performance can be enhanced by proper spent fluid removal.

  7. Methods for obtaining and reducing experimental droplet impingement data on arbitrary bodies

    NASA Technical Reports Server (NTRS)

    Papadakis, Michael; Elangovan, R.; Freund, George A., Jr.; Breer, Marlin D.

    1991-01-01

    Experimental water droplet impingement data are used to validate particle trajectory computer codes used in the analysis and certification of aircraft de-icing/anti-icing systems. Water droplet impingement characteristics of aerodynamic surfaces are usually obtained from wind-tunnel dye tracer experiments. This paper presents a dye tracer method for measuring water droplet impingement characteristics on arbitrary geometries and a new data reduction method, based on laser reflectance measurements, for extracting impingement data. Extraction of impingement data has been a very time-consuming process in the past. The new data reduction method developed is at least an order of magnitude more efficient than the method previously used. The accuracy of the method is discussed and results obtained are presented.

  8. Trailing edge cooling using angled impingement on surface enhanced with cast chevron arrangements

    SciTech Connect

    Lee, Ching-Pang; Heneveld, Benjamin E.; Brown, Glenn E.; Klinger, Jill

    2015-05-26

    A gas turbine engine component, including: a pressure side (12) having an interior surface (34); a suction side (14) having an interior surface (36); a trailing edge portion (30); and a plurality of suction side and pressure side impingement orifices (24) disposed in the trailing edge portion (30). Each suction side impingement orifice is configured to direct an impingement jet (48) at an acute angle (52) onto a target area (60) that encompasses a tip (140) of a chevron (122) within a chevron arrangement (120) formed in the suction side interior surface. Each pressure side impingement orifice is configured to direct an impingement jet at an acute angle onto an elongated target area that encompasses a tip of a chevron within a chevron arrangement formed in the pressure side interior surface.

  9. Modular jet impingement assemblies with passive and active flow control for electronics cooling

    DOEpatents

    Zhou, Feng; Dede, Ercan Mehmet; Joshi, Shailesh

    2016-09-13

    Power electronics modules having modular jet impingement assembly utilized to cool heat generating devices are disclosed. The modular jet impingement assemblies include a modular manifold having a distribution recess, one or more angled inlet connection tubes positioned at an inlet end of the modular manifold that fluidly couple the inlet tube to the distribution recess and one or more outlet connection tubes positioned at an outlet end of the modular manifold that fluidly coupling the outlet tube to the distribution recess. The modular jet impingement assemblies include a manifold insert removably positioned within the distribution recess and include one or more inlet branch channels each including an impinging slot and one or more outlet branch channels each including a collecting slot. Further a heat transfer plate coupled to the modular manifold, the heat transfer plate comprising an impingement surface including an array of fins that extend toward the manifold insert.

  10. Numerical study of twin-jet impingement upwash flow

    NASA Technical Reports Server (NTRS)

    Pegues, W. J.; Vanka, S. P.

    1990-01-01

    Two horizontally spaced jets impinging normally on a flat surface create a fountain upwash flow due to the collision of the radially flowing wall jets. This fountain flow is of importance to the dynamics and propulsion of STOVL aircraft. The fountain flow influences the lift forces on the aircraft and the ingestion of hot gases and debris by the engine inlet. In this paper, a multigrid based finite-difference numerical procedure has been applied to solve the equations governing this three-dimensional flow. The standard k-epsilon turbulence model has been used. Comparisons with experimental data reveal that while the mean velocities are predicted with reasonable accuracy, the turbulent kinetic energies are seriously in error. The reasons for this discrepancy could be the intense unsteadiness and large-scale structures of the flow in the near-wall region, which cannot be captured well by any Reynolds-averaged turbulence model.

  11. Liquid jet impingement normal to a disk in zero gravity

    NASA Technical Reports Server (NTRS)

    Labus, T. L.; Dewitt, K. J.

    1978-01-01

    An experimental and analytical investigation was conducted to determine the free surface shapes of circular jets impinging normal to sharp-edged disks in zero gravity. Experiments conducted in a zero gravity drop tower yielded three distinct flow patterns which were classified in terms of the relative effects of surface tension and inertial forces. An order of magnitude analysis was conducted indicating regions where viscous forces were not significant when computing free surface shapes. The free surface analysis was simplified by transforming the governing potential flow equations and boundary conditions into the inverse plane. The resulting nonlinear equations were solved numerically and comparisons were made with the experimental data for the inertia dominated regime.

  12. Heat transfer and phase change in an impinging droplet

    NASA Astrophysics Data System (ADS)

    Rangchian, Aysan; Shirazi, Nikki L.; Kavehpour, H. Pirouz

    2016-11-01

    Non isothermal droplet impact on solid surfaces has several industrial applications such as spray cooling and 3D printing. Impinging of a droplet on a surface involves an initial phase of spreading followed by a subsequent return to the equilibrium shape. Thermal energy exchanged within the droplet fluid as well as between liquid/solid during the impact has been studied using an ultra high speed infrared camera. Variable parameters in the experiment include droplet temperature and kinetic energy of the droplet during the impact. The evolution of droplet shape viewed by IR camera is similar to what previously observed by high speed photography. The thermal map of droplet over time in these experiments agrees with previously reported numerical simulation. In addition, spacial and temporal temperature variations of liquid droplets on a surface as they solidify are presented. IR camera provides an accurate temperature diagram as the phase change occurs, which is essential for understanding the physics of 3D printing.

  13. The subcoracoid impingement syndrome: clinical, semeiologic and therapeutic considerations.

    PubMed

    Russo, R; Togo, F

    1991-09-01

    Subcoracoid impingement is a relatively obscure syndrome. Guided by studies conducted by Gerber and Patte since 1985, the authors began to select cases of periarticular disease of the shoulder in which there was clinical evidence of involvement of the subcoracoid space. These patients underwent repeated clinical examination, radiographic examination according to Bernageau, CT scan, and Arthro-CT. All patients were tested with a novocaine infiltration into the subcoracoid space. This paper contains a precise diagnostic protocol that has evolved from the studies conducted by Gerber and Patte. Of the 23 patients selected, 3 were advised to undergo surgical widening of the subcoracoid space, consisting of resection of the coracoacromial and coracohumeral ligaments and special, reductive coracoidplasty.

  14. Measurements in a large angle oblique jet impingement flow

    NASA Technical Reports Server (NTRS)

    Foss, J. F.

    1974-01-01

    Velocity and surface pressure measurements, in the flow field of an obliquely impinging jet, and their interpretation as regards the governing mechanics and the aerodynamic noise generation characteristics of such a flow are reported. A computer controlled probe positioning mechanism allowed the measurement of the velocity magnitude and direction in the plane parallel to the plate. The mean velocity and Reynolds stress components were recorded. Measures of the terms in the momentum equation reveal the character of the pressure gradients in the neighborhood of the stagnation point. The effects of the stagnation streamline location on the vorticity field and the vortex sound considerations are discussed in relationship to the aerodynamic noise generation effects of this flow.

  15. Ice Accretion Modeling using an Eulerian Approach for Droplet Impingement

    NASA Technical Reports Server (NTRS)

    Kim, Joe Woong; Garza, Dennis P.; Sankar, Lakshmi N.; Kreeger, Richard E.

    2012-01-01

    A three-dimensional Eulerian analysis has been developed for modeling droplet impingement on lifting bodes. The Eulerian model solves the conservation equations of mass and momentum to obtain the droplet flow field properties on the same mesh used in CFD simulations. For complex configurations such as a full rotorcraft, the Eulerian approach is more efficient because the Lagrangian approach would require a significant amount of seeding for accurate estimates of collection efficiency. Simulations are done for various benchmark cases such as NACA0012 airfoil, MS317 airfoil and oscillating SC2110 airfoil to illustrate its use. The present results are compared with results from the Lagrangian approach used in an industry standard analysis called LEWICE.

  16. Jet Impingement and Forced Convection Cooling Experimental Study in Rotating Turbine Blades

    NASA Astrophysics Data System (ADS)

    Li, Hsin-Lung; Chiang, Hsiao-Wei D.; Hsu, Chih-Neng

    2011-06-01

    Both jet impingement and forced convection are attractive cooling mechanisms widely used in cooling gas turbine blades. Convective heat transfer from impinging jets is known to yield high local and area averaged heat transfer coefficients. Impingement jets are of particular interest in the cooling of gas turbine components where advancement relies on the ability to dissipate extremely large heat loads. Current research is concerned with the measurement and comparison of both jet impingement and forced convection heat transfer in the Reynolds number range of 10,000 to 30,000. This study is aimed at experimentally testing two different setups with forced convection and jet impingement in rotating turbine blades up to 700 RPM. This research also observes Coriolis force and impingement cooling inside the passage during rotating conditions within a cooling passage. Local heat transfer coefficients are obtained for each test section using thermocouple technique with slip rings. The cross section of the passage is 10 mm × 10 mm without ribs and the surface heating condition has enforced uniform heat flux. The forced convection cooling effects were studied using serpentine passages with three corner turns under different rotating speeds and different inlet Reynolds numbers. The impingement cooling study uses a straight passage with a single jet hole under different Reynolds numbers of the impingement flow and the cross flow. In summary, the main purpose is to study the rotation effects on both the jet impingement and the serpentine convection cooling types. Our study shows that rotation effects increase serpentine cooling and reduce jet impingement cooling.

  17. Pseudoaneurysm of a branch of the femoral circumflex artery as a complication of revision arthroscopic release of the iliopsoas tendon

    PubMed Central

    Nakano, Naoki; Lisenda, Laughter; Khanduja, Vikas

    2017-01-01

    Treatment of painful internal snapping hip via arthroscopic release of the iliopsoas tendon is becoming the preferred option over open techniques because of the benefits of minimal dissection and fewer complications. However, complications do occur with arthroscopic techniques as well. We present the case of a 33-year-old woman who presented with painful internal snapping of her right hip and underwent arthroscopic release of the iliopsoas tendon. Following the procedure she continued to complain of pain in her groin and was therefore investigated further with a magnetic resonance imaging (MRI) which revealed a swelling near the femoral circumflex vessels. A computed tomography (CT) angiogram revealed a 15 mm pseudoaneurysm of the femoral circumflex artery, which was successfully treated by selective catheterisation and embolisation. Hip arthroscopists should be sufficiently familiar with the vascular anatomy around the hip and keep this complication in mind when releasing the iliopsoas tendon arthroscopically especially in revision cases with adhesions. PMID:28322718

  18. The Development and Validation of Simple Empirical Models of Impingement Cooling from Full Surface Heat Transfer Coefficient Distributions

    DTIC Science & Technology

    2003-03-01

    the impingement hole. More recently workers have investigated enhancing impingement heat transfer by employing extended surfaces, Taslim et al. (2000...ed. Oates, G.C.. Taslim , M.E., Setayeshgar, L., Spring, S.D., 2000, "An Experimental Evaluation of Advanced Leading Edge Impingement Cooling Concepts

  19. Ear Acupuncture for Post-Operative Pain Associated with Ambulatory Arthroscopic Knee Surgery: A Randomized Controlled Trial

    DTIC Science & Technology

    2014-01-14

    E7(/(3+21(180%(5 ,QFOXGHDUHDFRGH 14 Jan 2014 Final Report Ear acupuncture for post-operative pain associated with ambulatory arthroscopic...DISTRIBUTION A. Approved for public release: distribution unlimited. The purpose of this study is to compare ear acupuncture plus standard therapy versus...3298 Ear Acupuncture for Post-operative Pa111 Assoc1ated With Ambulatory Arthroscopic Knee Surgery A Randomized Controlled Trial ’• V ’’ ’-’ I

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

    PubMed

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

    2014-11-01

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

  1. Diagnosis failure led to the recurrence of an intra-articular osteoid osteoma at the talus neck after arthroscopic excision.

    PubMed

    Dubuc, Jean-Emile; Docquier, Pierre-Louis; Schubert, Thomas; Galant, Christine; Malghem, Jacques

    2014-09-01

    Juxta-articular localization is not exceptional for an osteoid osteoma of the ankle. Arthroscopic treatment has been recently proposed. A case of recurrence of an osteoid osteoma at the talar neck is reported after arthroscopic resection performed following a diagnosis failure. The need for accurate imaging technique to precisely define and localize the nidus and the requirement to include osteoid osteoma in the differential diagnosis of monoarticular pain are discussed.

  2. Normal Impingement of a Circular Liquid Jet onto a Screen in a Weightless Environment

    NASA Technical Reports Server (NTRS)

    Symons, E. P.

    1976-01-01

    The normal impingement of a circular liquid jet onto a fine-mesh screen in a weightless environment was investigated. Equations were developed to predict the velocity of the emerging jet on the downstream side of the screen as a function of screen and liquid parameters and of the velocity of the impinging jet. Additionally, the stability of the emerging jet was found to be Weber number dependent. In general, excepting at high velocities, the screen behaved much as a baffle, deflecting the major portion of the impinging flow.

  3. Subacromial Tenoxicam Injection in the Treatment of Impingement Syndrome

    PubMed Central

    Çift, Hakan; Özkan, Feyza Ünlü; Şeker, Ali; İşyar, Mehmet; Ceyhan, Erman; Mahiroğulları, Mahir

    2014-01-01

    Objectives: As subacromial bursa injection is widely used for pain relief and functional improvements in patients with periarticular shoulder disorder, we aimed to present our results of subacromial tenoxicam injection in the treatment of impingement syndrome. Methods: Patients presented to the Department of Orthopaedics and Traumatology, Istanbul Medipol University with the primary complaints of shoulder pain from January 2012 to June 2013 were selected. Those who met the following inclusion criteria were finally considered: 1) who had a clinical sign of a painful arc and positive in Hawkins test and/or Neer impingement sign; 2) who had a precise rotator cuff injury including partial cuff tears, or subacromial bursitis detected during ultrasonography or MRI. The exclusion criteria were as follows: 1) who underwent shoulder surgery; 2) who had full thickness rotator cuff rupture; 3) who had hemiplegic shoulder pain; and 4) who displayed any suspected fracture on X-ray or had a recent shoulder trauma; 5) who showed limited active ROM and stiffness due to adhesive capsulitis. Thirty one shoulders out of thirty patients were treated with subacromial tenoxicam injection. Ten of them were left shoulders. Fifteen of the patients were women.. Patients had a mean age of 51.6 (30-73). Patients were evaluated 4 times. Before the first injection, 1 week after the first injection, 2 weeks after the second injection and 3 weeks after the third injection. In every injection 20 mg tenoxicam was performed. Results: In order to relieve the pain; two patients were given only one injection, thirteen patients were given two injections and “3 injections protocol” were done to fifteen patients. The mean pre- and posttreatment VAS scores were 7.9 (between, 7-9) and 2.7 (between, 2-4) points respectively. The average pre and posttreatment DASH scores were 59.41 (between, 45-80) and 14 (between, 8.3-25.8) points respectively. The mean pre and posttreatment range of motion were 106

  4. Space shuttle vehicle rocket plume impingement study for separation analysis. Tasks 2 and 3: Definition and preliminary plume impingement analysis for the MSC booster

    NASA Technical Reports Server (NTRS)

    Wojciechowski, C. J.; Penny, M. M.; Prozan, R. J.

    1970-01-01

    The results are presented of a space shuttle plume impingement study for the Manned Spacecraft Center configuration. This study was conducted as two tasks which were to (1) define the orbiter main stage engine exhaust plume flow field, and (2) define the plume impingement heating, force and resulting moment environments on the booster during the staging maneuver. To adequately define these environments during the staging maneuver and allow for deviation from the nominal separation trajectory, a multitude of relative orbiter/booster positions are analyzed which map the region that contains the separation trajectories. The data presented can be used to determine a separation trajectory which will result in acceptable impingement heating rates, forces, and the resulting moments. The data, presented in graphical form, include the effect of roll, pitch and yaw maneuvers for the booster. Quasi-steady state analysis methods were used with the orbiter engine operating at full thrust. To obtain partial thrust results, simple ratio equations are presented.

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

    PubMed Central

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

    2011-01-01

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

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

    PubMed

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

    2011-01-01

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

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

    PubMed

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

    2013-02-01

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

  8. 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

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

    PubMed

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

    2015-05-01

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

  10. 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.

  11. Interstitial Tear of the Subscapularis Tendon, Arthroscopic Findings and Technique of Repair

    PubMed Central

    Saremi, Hossein

    2016-01-01

    Tears of the subscapularis tendon have been significantly recognized as a source of shoulder pain and dysfunction in the past decade, thanks to arthroscopic evaluation of the shoulder and biomechanical and anatomical studies of the tendon. Current classification of subscapularis tendon tear is based on insertion site of the tendon. Recently, a classification for non-insertional types of subscapularis tendon tear has been published. Interstitial tear of subscapularis tendon has not been described in classifications available in the literature. This report describes significant interstitial tear of the subscapularis tendon. This tear looks normal in superior, bursal and articular sides. Then its specific arthroscopic findings as “Air bag sign” and repair technique of the pathology is explained. PMID:27200399

  12. Posterior ankle impingement syndrome: A systematic four-stage approach

    PubMed Central

    Yasui, Youichi; Hannon, Charles P; Hurley, Eoghan; Kennedy, John G

    2016-01-01

    Posterior ankle impingement syndrome (PAIS) is a common injury in athletes engaging in repetitive plantarflexion, particularly ballet dancers and soccer players. Despite the increase in popularity of the posterior two-portal hindfoot approach, concerns with the technique remain, including; the technical difficulty, relatively steep learning curve, and difficulty performing simultaneous anterior ankle arthroscopy. The purpose of the current literature review is to provide comprehensive knowledge about PAIS, and to describe a systematic four-stage approach of the posterior two-portal arthroscopy. The etiology, clinical presentation, diagnostic strategies are first introduced followed by options in conservative and surgical management. A detailed systematic approach to posterior hindfoot arthroscopy is then described. This technique allows for systematic review of the anatomic structures and treatment of the bony and/or soft tissue lesions in four regions of interest in the hindfoot (superolateral, superomedial, inferomedial, and inferolateral). The review then discusses biological adjuncts and postoperative rehabilitation and ends with a discussion on the most recent clinical outcomes after posterior hindfoot arthroscopy for PAIS. Although clinical evidence suggests high success rates following posterior hindfoot arthroscopy in the short- and mid-term it may be limited in the pathology that can be addressed due to the technical skills required, but the systematic four-stage approach of the posterior two-portal arthroscopy may improve upon this problem. PMID:27795947

  13. Absorption of impinging water droplet in porous stones.

    PubMed

    Lee, J B; Radu, A I; Vontobel, P; Derome, D; Carmeliet, J

    2016-06-01

    This paper presents an experimental investigation and numerical analysis of the absorption of water droplets impacting porous stones. The absorption process of an impinging droplet is here fully characterized from spreading to evaporation in terms of absorbed mass during droplet depletion and moisture content distribution in a time-resolved manner for three different natural stones. High-speed imaging and neutron radiography are used to quantify moisture absorption in porous stones of varying moisture properties from deposition until depletion. During impact and spreading, the droplet exhibits a dynamic non-wetting behavior. At maximum spreading, the droplet undergoes pinning, resulting into the contact radius remaining constant until droplet depletion. Absorption undergoes two phases: initially, absorption is hindered due a contact resistance attributed to entrapped air; afterwards, a more perfect capillary contact occurs and absorption goes on until depletion, concurrently with evaporation and further redistribution. A finite-element numerical model for isothermal unsaturated moisture transport in porous media captures the phases of mass absorption in good agreement with the experimental data. Droplet spreading and absorption are highly determined by the impact velocity of the droplet, while moisture content redistribution after depletion is much less dependent on impact conditions.

  14. Kinetic strategies of patients with shoulder impingement syndrome.

    PubMed

    Doiron, Yan; Delacroix, Sébastien; Denninger, Marc; Simoneau, Martin

    2010-01-01

    Our aim was to determine whether subjects with shoulder impingement syndrome (SIS) have abnormal multijoint torque patterns compared to healthy subjects during normalized isometric force along specific directions. Subjects had to generate an isometric force corresponding to 40% of the maximal pain-free force. Eight targets were displayed on a monitor (0, 45, 90, 135, 180, 225, 270, and 315 degrees ). We calculated shoulder and elbow torques (kinetic strategies) using a biomechanical model. Regardless of the target location, the SIS group succeeded in reaching the target; however, when compared to the healthy subjects, they needed more time to do so, suggesting that SIS may slow down the execution of the kinetic strategies. Moreover, the SIS group produced lower shoulder external/internal torque to reach the targets located at 0 degrees and 225 degrees, and they generated greater abduction/adduction torque for targets located at 0, 135, and 180 degrees. In addition, they had lower elbow extension/flexion torque for the target located at 315 degrees. The investigation of atypical kinetic strategies is essential to provide an understanding of the pathomechanics of the SIS and to develop more effective treatment strategies.

  15. Measurement and visualization of impingement cooling in narrow channels

    NASA Astrophysics Data System (ADS)

    Kaiser, E.

    Experimental measurement techniques such as naphthalene sublimation, liquid crystal thermography and real-time holographic interferometry are standard. Their application in narrow channels causes problems and is therefore limited. The channel width must not change too much because the naphthalene sublimation and the liquid crystal coating necessary for the thermography may cause non-negotiable variations. The interferometry fails in turbulent flow area. The diffraction along the channel edges is an additional difficulty. A comparison of the results obtained from the application of all three techniques, which has not been considered in earlier publications, is made here. The methods were used to measure and visualize the heat transfer characteristics of an array of 1.2mm diameter impinging jets in an enclosed channel (>=2.2mm) with single-sided flow-off at Reynolds numbers of about Rez 20,000. Scale-up ratios as low as 2.4 have been used in order to maintain similarity as it has not been previously reported. The naphthalene technique provided a high spatially resolved measurement of the Sherwood number along a downstream line. The liquid crystal thermography technique provided 2D contours of the Nusselt number. The temperature distribution within dead water zones was visualized with holographic interferometry. The cross-flow effects caused a shift in the stagnation point and a monotone decrease in the Nusselt number in the downstream direction.

  16. Flow Visualization and Heat Transfer Characteristics of Liquid Jet Impingement

    NASA Astrophysics Data System (ADS)

    Jafar, Farial A.; Thorpe, Graham R.; Turan, Özden F.

    2012-07-01

    Equipment used to cool horticultural produce often involves three-phase porous media. The flow field and heat transfer processes that occur in such equipment are generally quantified by means of empirical relationships amongst dimensionless groups. This work represents a first step towards the goal of harnessing the power of computational fluid dynamics (CFD) to better understand the heat transfer processes that occur in beds of irrigated horticultural produce. The primary objective of the present study is to use numerical predictions towards reducing the energy and cooling water requirement in cooling horticultural produce. In this paper, flow and heat transfer predictions are presented of a single slot liquid jet impinging on flat and curved surfaces using a CFD code (FLUENT) for 2D configurations. The effects of Reynolds number, nozzle to plate spacing, nozzle width, and target surface configuration have been studied. Reynolds numbers of 250, 375, 500, 700, 1000, 1500, 1800, and 1900 are studied where the liquid medium is water. Here, the Reynolds number is defined in terms of the hydraulic nozzle diameter, inlet jet velocity, and fluid kinematic viscosity. The results show that Reynolds numbers, nozzle to plate spacing, and nozzle width have a significant effect on the flow field and heat transfer characteristics, whereas the target surface configuration at the stagnation area has no substantial impact. The use of a numerical tool has resulted in a detailed investigation of these characteristics, which has not been available in the literature previously.

  17. Low extreme-ultraviolet luminosities impinging on protoplanetary disks

    SciTech Connect

    Pascucci, I.; Hendler, N. P.; Ricci, L.; Gorti, U.; Hollenbach, D.; Brooks, K. J.; Contreras, Y.

    2014-11-01

    The amount of high-energy stellar radiation reaching the surface of protoplanetary disks is essential to determine their chemistry and physical evolution. Here, we use millimetric and centimetric radio data to constrain the extreme-ultraviolet (EUV) luminosity impinging on 14 disks around young (∼2-10 Myr) sun-like stars. For each object we identify the long-wavelength emission in excess to the dust thermal emission, attribute that to free-free disk emission, and thereby compute an upper limit to the EUV reaching the disk. We find upper limits lower than 10{sup 42} photons s{sup –1} for all sources without jets and lower than 5 × 10{sup 40} photons s{sup –1} for the three older sources in our sample. These latter values are low for EUV-driven photoevaporation alone to clear out protoplanetary material in the timescale inferred by observations. In addition, our EUV upper limits are too low to reproduce the [Ne II] 12.81 μm luminosities from three disks with slow [Ne II]-detected winds. This indicates that the [Ne II] line in these sources primarily traces a mostly neutral wind where Ne is ionized by 1 keV X-ray photons, implying higher photoevaporative mass loss rates than those predicted by EUV-driven models alone. In summary, our results suggest that high-energy stellar photons other than EUV may dominate the dispersal of protoplanetary disks around sun-like stars.

  18. "Wet diapers--dry patients": an effective dressing for patients undergoing arthroscopic shoulder surgery.

    PubMed

    Kapila, Atul; Bhargava, Amit; Funk, Len; Copeland, Stephen; Levy, Ofer

    2005-02-01

    Shoulder arthroscopy is very commonly associated with postoperative leakage of irrigation fluid. This causes apprehension to patients and their relatives and leads to frequent change of dressings. We describe a simple and effective diaper dressing for patients undergoing arthroscopic shoulder surgery. It is highly absorbent, cost-effective, and easy to apply. We have used this dressing successfully in more than 1,500 shoulder arthroscopies over the last 3 years with no adverse reaction.

  19. Suprascapular nerve palsy after arthroscopic Latarjet procedure: a case report and review of literature.

    PubMed

    Sastre, Sergi; Peidro, Lluis; Méndez, Anna; Calvo, Emilio

    2016-02-01

    The Bristow and Latarjet procedures have become popular among orthopaedic surgeons thanks to the development of new instruments that allow the use of arthroscopic techniques to treat cases of glenohumeral instability with bone defects or capsular deficiency. Nonetheless, several complications have been reported after Latarjet procedures, including neurological injuries. This report describes surgical damage to the suprascapular nerve, an unusual complication. Level of evidence Expert opinion, Level V.

  20. Preoperative interscalene brachial plexus block aids in perioperative temperature management during arthroscopic shoulder surgery

    PubMed Central

    Lim, Se Hun; Lee, Wonjin; Park, JaeGwan; Kim, Myoung-hun; Cho, Kwangrae; Lee, Jeong Han; Cheong, Soon Ho

    2016-01-01

    Background Hypothermia is common during arthroscopic shoulder surgery under general anesthesia, and anesthetic-impaired thermoregulation is thought to be the major cause of hypothermia. This prospective, randomized, double-blind study was designed to compare perioperative temperature during arthroscopic shoulder surgery with interscalene brachial plexus block (IBPB) followed by general anesthesia vs. general anesthesia alone. Methods Patients scheduled for arthroscopic shoulder surgery were randomly allocated to receive IBPB followed by general anesthesia (group GB, n = 20) or general anesthesia alone (group GO, n = 20), and intraoperative and postoperative body temperatures were measured. Results The initial body temperatures were 36.5 ± 0.3℃ vs. 36.4 ± 0.4℃ in group GB vs. GO, respectively (P = 0.215). The body temperature at 120 minutes after induction of anesthesia was significantly higher in group GB than in group GO (35.8 ± 0.3℃ vs. 34.9 ± 0.3℃; P < 0.001). The body temperatures at 60 minutes after admission to the post-anesthesia care unit were 35.8 ± 0.3℃ vs. 35.2 ± 0.2℃ in group GB vs. GO, respectively (P < 0.001). The concentrations of desflurane at 0, 15, and 120 minutes after induction of anesthesia were 6.0 vs. 6.0% (P = 0.330), 5.0 ± 0.8% vs. 5.8 ± 0.4% (P = 0.001), and 3.4 ± 0.4% vs. 7.1 ± 0.9% (P < 0.001) in group GB vs. GO, respectively. Conclusions The present study demonstrated that preoperative IBPB could reduce both the intraoperative concentration of desflurane and the reduction in body temperature during and after arthroscopic shoulder surgery. PMID:27482313

  1. Direct Cost Analysis of Outpatient Arthroscopic Rotator Cuff Repair in Medicare and Non-Medicare Populations

    PubMed Central

    Narvy, Steven J.; Didinger, Tracey C.; Lehoang, David; Vangsness, C. Thomas; Tibone, James E.; Hatch, George F. Rick; Omid, Reza; Osorno, Felipe; Gamradt, Seth C.

    2016-01-01

    Background: Providing high-quality care while also containing cost is a paramount goal in orthopaedic surgery. Increasingly, insurance providers in the United States, including government payers, are requiring financial and performance accountability for episodes of care, including a push toward bundled payments. Hypothesis: The direct cost of outpatient arthroscopic rotator cuff repair was assessed to determine whether, due to an older population, rotator cuff surgery was more costly in Medicare-insured patients than in patients covered by other insurers. We hypothesized that operative time, implant cost, and overall higher cost would be observed in Medicare patients. Study Design: Cohort study; Level of evidence, 3. Methods: Billing and operative reports from 184 outpatient arthroscopic rotator cuff repairs performed by 5 fellowship-trained arthroscopic surgeons were reviewed. Operative time, number and cost of implants, hospital reimbursement, surgeon reimbursement, and insurance type were determined from billing records and operative reports. Patients were stratified by payer (Medicare vs non-Medicare), and these variables were compared. Results: There were no statistically significant differences in the number of suture anchors used, implant cost, surgical duration, or overall cost of arthroscopic rotator cuff repair between Medicare and other insurers. Reimbursement was significantly higher for other payers when compared with Medicare, resulting in a mean per case deficit of $263.54 between billing and reimbursement for Medicare patients. Conclusion: Operating room time, implant cost, and total procedural cost was the same for Medicare patients as for patients with private payers. Further research needs to be conducted to understand the patient-specific factors that affect the cost of an episode of care for rotator cuff surgery. PMID:27826595

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

    PubMed

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

    2014-01-01

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

  3. Apparatus and methods for impingement cooling of a side wall of a turbine nozzle segment

    DOEpatents

    Burdgick, Steven Sebastian

    2002-01-01

    A gas turbine nozzle segment has outer and inner bands and a vane therebetween. Each band includes a nozzle wall, a side wall, a cover and an impingement plate between the cover and the nozzle wall defining two cavities on opposite sides of the impingement plate. Cooling steam is supplied to one cavity for flow through apertures of the impingement plate to cool the nozzle wall. The side wall of the band and inturned flange define with the nozzle wall an undercut region. The impingement plate has a turned flange welded to the inturned flange. A backing plate overlies the turned flange and aligned apertures are formed through the backing plate and turned flange to direct and focus cooling flow onto the side wall of the nozzle segment.

  4. Comparison of burnout characteristics in jet impingement cooling and stray cooling

    NASA Astrophysics Data System (ADS)

    Cho, C. S. K.; Wu, K.

    Characteristics of spray cooling and jet impingement methods were investigated. The jet impingement cooling method created a large dry area on the test surface when the burnout heat flux was approached. In the spray cooling method, a liquid film with nucleate boiling was maintained for the entire experiment until a burnout was occurred. The spray cooling method produced a higher burnout heat flux than the jet impingement cooling method for the same liquid flow rate. In the spray cooling method, sprayed droplet velocity was a parameter for determining the burnout heat flux. The burnout heat flux in jet impingement cooling also showed dependency on the liquid jet velocity. Results of two methods for cooling the surface area were compared and correlated with the Weber number.

  5. ARTHROSCOPIC RELEASE OF THE SUPRASCAPULAR NERVE: SURGICAL TECHNIQUE AND EVALUATION OF CLINICAL CASES

    PubMed Central

    Garcia Júnior, José Carlos; Paccola, Ana Maria Ferreira; Tonoli, Cristiane; Zabeu, José Luis Amin; Garcia, Jesely Pereira Myrrha

    2015-01-01

    To describe a specific surgical technique for arthroscopic decompression of the suprascapular nerve (SSN) and evaluate its preliminary results. Methods: Ten shoulders of nine patients were operated using a technique with portals differing from the already-known techniques, which did not use traction and made use of materials available within the public healthcare system. Results: Among the ten shoulders of nine patients, eight were right shoulders and two were left shoulders. The mean age was 69.5 years. The UCLA score increased from 11.7 to 26.1 points over the postoperative follow-up of 16.6 months. The SF-36 questionnaire score was 122.9 and the raw pain scale value was 88%. Conclusion: Arthroscopic decompression of the SSN in accordance with the described technique is reproducible and less traumatic than the open techniques. The patients achieved improvements in many of the parameters evaluated, particularly with regard to pain. Arthroscopic decompression of the SSN may be a therapeutic option for pathological compression of the SSN. PMID:27027028

  6. Over-optimistic patient expectations of recovery and leisure activities after arthroscopic meniscus surgery.

    PubMed

    Pihl, Kenneth; Roos, Ewa M; Nissen, Nis; JøRgensen, Uffe; Schjerning, Jeppe; Thorlund, Jonas B

    2016-12-01

    Background and purpose - Patients' expectations of outcomes following arthroscopic meniscus surgery are largely unknown. We investigated patients' expectations concerning recovery and participation in leisure-time activities after arthroscopic meniscus surgery and the postoperative fulfillment of these. Patients and methods - The study sample consisted of 491 consecutively recruited patients (mean age 50 (SD 13) years, 55% men) who were assigned for arthroscopy on suspicion of meniscus injury and later verified by arthroscopy. Before surgery, patients completed questionnaires regarding their expectations of recovery time and postoperative participation in leisure activities. 3 months after surgery, the patients completed questionnaires on their actual level of leisure activity and their degree of satisfaction with their current knee function. We analyzed differences between the expected outcome and the actual outcome, and between fulfilled/exceeded expectations and satisfaction with knee function. Results - 478 patients (97%) completed the follow-up. 91% had expected to be fully recovered within 3 months. We found differences between patients' preoperative expectations of participation in leisure activities postoperatively and their actual participation in these, with 59% having unfulfilled expectations (p < 0.001). Satisfaction with current knee function was associated with expectations of leisure activities being fulfilled/exceeded. Interpretation - In general, patients undergoing arthroscopic meniscus surgery were too optimistic regarding their recovery time and postoperative participation in leisure activities. This highlights the need for shared decision making which should include giving the patient information on realistic expectations of recovery time and regarding participation in leisure-time activities after meniscal surgery.

  7. The global percutaneous shuttling technique tip for arthroscopic rotator cuff repair.

    PubMed

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

    2014-04-22

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

  8. Arthroscopic treatment of adhesive capsulitis of the shoulder with minimum follow up of six years

    PubMed Central

    Fernandes, Marcos Rassi

    2015-01-01

    OBJECTIVE: To evaluate the results of the arthroscopic treatment of adhesive capsulitis of the shoulder with six to nine years of follow up. METHODS: From August 2002 to December 2004, ten patients underwent arthroscopic capsular release for adhesive capsulitis refractory to conservative treatment. An interscalene catheter was used for postoperative analgesia, before the procedure. All were in stage II, with a minimum follow up of six years. The mean age was of 52.9 years old (range, 39 to 66), with female predominance (90%) and six left shoulders. The time between the onset of symptoms and surgery varied from six to 20 months. There were four patients in the primary form (40%) and six in the secondary (60%). RESULTS: In the preoperative evaluation, the mean active anterior elevation was 92°, 10.5° of external rotation, and internal rotation level L5. Postoperatively, the mean active elevation was 149°, 40° of external rotation and internal level T12, respectively. Thus, the average gains were 57° in forward active elevation, 29.5° in external rotation and six spinous processes, these values being statistically significant (p <0.001). According to the Constant functional score (arc of movements), the value increased from 13.8 (preoperative mean) to 32 points (postoperative mean). CONCLUSION: Arthroscopic treatment of adhesive capsulitis of the shoulder refractory to conservative treatment allows effective gain of range of motion of this joint. Level of Evidence IV, Retrospective Study (Case Series). PMID:27069406

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

    PubMed

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

    2003-02-01

    The management of osteochondritis dissecans of the capitellum of the adolescent elbow is still controversial. We report on 5 cases of female high-level athletes aged from 10 to 19 years (4 gymnasts, 1 waterpolo player). All these athletes had a symptomatic osteochondritis dissecans of the capitellum, which was treated arthroscopically in all cases. Follow-up time averaged 5 months (1 to 6.5 months). During the arthroscopy, loose osteochondral fragments of the capitellum and radial head were removed, and the defect was debrided. Thorough evaluation of the anterior and posterior joint including the olecranon fossa was performed. One of the 5 patients had a loose body requiring arthroscopic removal. Within 6 months after surgery, all except 1 elbow, the elbow with a loose body, regained maximum range of motion. Two patients returned to a high level of gymnastics and 1 was considering return. The short-term results of this treatment suggest that arthroscopic debridement of the loose osteochondral fragments provides a good result.

  10. Arthroscopic double-row suture anchor fixation of minimally displaced greater tuberosity fractures.

    PubMed

    Ji, Jong-Hun; Kim, Weon-Yoo; Ra, Ki-Hang

    2007-10-01

    In cases of displaced greater tuberosity fractures, treatments by arthroscopic-assisted reduction and percutaneous screw fixation have been reported. However, in cases in which there is a comminuted fracture or a minimally displaced fracture combined with concomitant lesions such as rotator cuff tear or labral pathology, it is difficult to reduce the fracture and to treat other pathologies by use of a percutaneous screw. Recently, many surgeons have used the double-row repair method in rotator cuff repair, which provides a tendon-bone interface better suited for biologic healing and restoring normal anatomy. In accordance with this method, we used the arthroscopic technique of double-row suture anchor fixation for a minimally displaced greater tuberosity fracture without additional incision. Initially, debridement was performed on the fracture surface by use of a shaver, and the medial-row anchor was inserted through the anterior portal or the intact cuff. Two lateral-row anchors were inserted just anterior and posterior to the lower margin of the fractured fragment under C-arm guidance. The medial-row sutures and lateral-row sutures were then placed. Arthroscopic double-row suture anchor fixation of a displaced greater tuberosity fracture restores the original footprint of the rotator cuff and normal tendon-bone interface of the displaced greater tuberosity fracture.

  11. 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.

  12. EVALUATION OF RESULTS AND COMPLICATIONS FROM ARTHROSCOPIC SUTURE OF SLAP LESIONS

    PubMed Central

    Miyazaki, Alberto Naoki; Fregoneze, Marcelo; Santos, Pedro Doneux; da Silva, Luciana Andrade; do Val Sella, Guilherme; Soares, André Lopes; Junior, Adriano Fernando Mendes; Checchia, Sérgio Luiz

    2015-01-01

    Objective: To evaluate the results and complications from arthroscopic suturing of SLAP lesions. Methods: Seventy-one patients who underwent arthroscopic suturing of SLAP lesions between July 1995 and May 2008 were evaluated. The procedures were performed by the Shoulder and Elbow Surgery Group of the Department of Orthopedics and Traumatology, Fernandinho Simonsen Wing, Santa Casa de São Paulo, Brazil. Associated lesions were seen in 68 of the 71 patients evaluated (96%), and the other three (4%) had SLAP lesions alone. Results: The associated lesions most frequently found in the patients under 40 years of age were labral lesions (69%), while in patients aged 40 years or over, impact syndrome with or without rotator cuff injury was the most commonly associated condition (71.4%). According to the UCLA method, 79% of our results (56 cases) were good or excellent. Postoperative complications occurred in 15 cases (21%); among these, the most common was the presence of residual pain (46.6%), followed by adhesive capsulitis (33.3%). Conclusions: There was a great association between SLAP lesions and other shoulder lesions, which varied according to the patients' age groups. Arthroscopic suturing of the SLAP lesions provided excellent results in the majority of the cases, but complications occurred in 21%. PMID:27026986

  13. Arthroscopic Treatment for Primary Septic Arthritis of the Hip in Adults

    PubMed Central

    2016-01-01

    Purpose. Primary septic arthritis is a rare differential diagnosis of acute hip pain in adults. Inspired by the success of all-arthroscopic treatment in pediatric patients, we developed a diagnostic and surgical pathway for our adult patients. Methods. Seven patients, average age 44 ± 13.7 years with acute hip pain since 4.4 ± 2.9 days in the average, were included. Septic arthritis was confirmed by joint aspiration and dissemination was excluded by MRI and standard radiographs. Surgical treatment consisted of immediate arthroscopic lavage using 4 portals for debridement, high-volume irrigation, partial synovectomy, and drainage. Results. Patients were treated in hospital for 12.4 ± 3.1 days (range 7–16 days). WBC and CRP returned to physiological levels. During the mean follow-up of 26.4 ± 19.4 months (range 13–66 months) no patient showed recurrence of infection. The 5 patients with an unimpaired hip joint prior to the infection had a mean modified Harris Hip Score of 94 ± 5.6 points (range 91–100) at final follow-up. Conclusions. Arthroscopic therapy using a minimally invasive approach with low perioperative morbidity for the treatment of primary septic arthritis of the adult hip is able to restore normal hip function in acute cases without dissemination of the infection. Level of Evidence. IV. PMID:27800188

  14. Arthroscopic arthrodesis of the shoulder: Fourteen-year follow-up

    PubMed Central

    Jiménez-Martín, Antonio; Pérez-Hidalgo, Santiago

    2011-01-01

    Shoulder arthrodesis is indicated in infections, brachial paralysis, irreparable rotator cuff tears, osteoarthritis without indication of prosthesis, rescue after arthroplasty, or after surgery for cancer. Arthroscopic arthrodesis is exceptional. Our aim is presenting our result after 14 years of follow-up of one patient. We present a case report of a 17-year-old male patient. He suffered fracture of left scapula (type V, Ideberg), fracture of left clavicle (type I, Craig), and fracture of left distal ulna. We realized osteosynthesis of clavicle (plate and screws) with the aim of treating this floating shoulder. Electromyography showed partial axonotmesis of axilar nerve. After 7 months of follow-up, axonotmesis was still present. We realized arthroscopic shoulder arthrodesis (three cannulated screws). Fourteen years later, shoulder movement was as follows: Flexion, 0-90°; maximum abduction, 40° with shoulder atrophy; Constant, 47 points; and UCLA, 17 points, without pain. Arthrodesis with screws reaches a subjective benefit in 82% of patients. Percentage of pseudarthrosis is less than in patients treated with plates, although the risks of infections, fractures, and material removal are greater than in patients treated with plates. Shoulder arthroscopic arthrodesis is exceptional, but it allows minimal surgical aggression. PMID:21897586

  15. 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

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

    PubMed

    Dimnjaković, Damjan; Bojanić, Ivan; Smoljanović, Tomislav; Mahnik, Alan

    2015-01-01

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

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

    PubMed Central

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

    2012-01-01

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

  18. Arthroscopic sternoclavicular joint resection arthroplasty: a technical note and illustrated case report.

    PubMed

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

    2014-02-01

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

  19. RESULTS FROM ARTHROSCOPIC REPAIR OF ISOLATED TEARS OF THE SUBSCAPULARIS TENDON

    PubMed Central

    Godinho, Glaydson Gomes; de Oliveira França, Flávio; Freita, José Márcio Alves; Santos, Flávio Márcio Lago; dos Santos, Ricardo Barreto Monteiro; Taglietti, Thiago Martins; Guevara, Carlos Leonidas Escobar

    2015-01-01

    Objective: To evaluate the functional and clinical outcomes and identify prognostic factors in patients undergoing arthroscopic repair of isolated tears of the subscapularis tendon. Methods: Between January 2003 and May 2009, we identified 18 shoulders with isolated tears or deinsertions that were complete or affected at least one third of the subscapularis tendon and underwent arthroscopic repair. Results: Three shoulders (17%) showed lesions in the upper third of the subscapularis; nine shoulders (50%) showed lesions in the upper two thirds; and six shoulders (33%) presented complete tears. In comparing the range of lateral rotation of the injured shoulder between before surgery and the time of the reevaluation, there was no statistical difference (p = 0.091). The LHBT was damaged in 11 shoulders (61%). According to the Constant score validation, we had excellent and good results in 83% of the cases and 17% were reasonable. The reevaluations on three patients showed re-tearing on MRI. Acromioplasty was performed on ten patients and this procedure did not represent statistical differences in the final results (p = 0.57). Conclusions: There was no statistically significant difference in relation to preoperative lateral rotation between the injured shoulder and the contralateral side. There was no significant loss of lateral rotation after surgery. The LHBT may be normal in deinsertions of the subscapularis tendon. Acromioplasty did not influence the results. The re-tearing rate for arthroscopic repair of the subscapularis tendon was 16.6%. PMID:27042642

  20. Conjugate heat transfer study of a turbulent slot jet impinging on a moving plate

    NASA Astrophysics Data System (ADS)

    Achari, A. Madhusudana; Das, Manab Kumar

    2017-03-01

    Numerical simulation of the flow field and conjugate heat transfer in an impinging jet with moving impingement plate is one of the important problems as it mimics closely with practical applications in industries. The Yang-Shih version of low Reynolds number k-ɛ model has been used to resolve the flow field and the temperature field in a two-dimensional, steady, incompressible, confined, turbulent slot jet impinging normally on a moving flat plate of finite thickness. The turbulence intensity and the Reynolds number considered at the inlet are 2 % and 15,000, respectively. The bottom face of the impingement plate has been maintained at a constant temperature higher than the nozzle exit temperature. The confinement plate has been considered to be adiabatic. The nozzle-to-surface spacing for the above study has been taken to be 6 and the surface-to-jet velocity ratios have been taken over a range of 0.25-1. The effects of impingement plate motion on the flow field and temperature field have been discussed elaborately with reference to stationary impingement plate. The dependence of flow field and fluid temperature field on impingement plate motion has been analyzed by plotting streamlines, isotherms for different plate speeds. A thorough study of flow characteristics for different surface-to-jet velocity ratios has been carried out by plotting profiles of mean vertical and horizontal components of velocity, pressure distribution, local shear stress distribution. The isotherms in the impingement plate of finite thickness, the distributions of solid-fluid interface temperature, the local Nusselt number, and the local heat flux for different surface-to-jet velocity ratios added to the understanding of conjugate heat transfer phenomenon.

  1. Physics of Particle Entrainment Under the Influence of an Impinging Jet

    DTIC Science & Technology

    2008-12-01

    Blown Sand and Desert Dunes, Methuen, London. Beltaos, S. and Rajaratnam, N., 1974: Impinging circular turbulent jets, Journal Hydraulic Division...entrainment function.” J. of Hydraulic Engineering, 123:3, 233-236. Doorschot, J.J.J. and M. Lehning, 2001: Equilibrium saltation: mass fluxes...H., P. Leister and B. Westrich, 1979: Flow field and scouring effects of steady and pulsating jets impinging on a movable bed. J. of Hyd. Res. 17

  2. Hydrodynamics and PIV study in the impingement zone formed by a droplet train

    NASA Astrophysics Data System (ADS)

    Kanjirakat, Anoop; Sadr, Reza; Zhang, Taolue; Muthusamy, Jayaveera; Alvarado, Jorge; Texas A; M University at Qatar Collaboration; Texas A; M University College Station Collaboration

    2016-11-01

    Droplet impingement is encountered in numerous technical applications, such as ink jet printing, spray cooling, and fuel injection in internal combustion engines. Even though many studies in droplet impingement were conducted in past, not many have measured the near-wall velocities in the droplet impingement zone. With the goal of gaining a better understanding of the hydrodynamics in the impingement zone, well-controlled experiments are performed in combination with micro-PIV measurements and numerical simulations. Hydrodynamics of HFE-7100 droplets generated using a piezoelectric droplet generator, impinging on a pre-wetted surface is investigated. Micro-PIV studies in the high-velocity impingement zone are performed using one-micron meter fluorescent particles dispersed in HFE-7100 along with the double exposed images. Three-dimensional and 2D-axisymmetric numerical modeling for a transient droplet crown development is performed. The interface between the gas and the liquid is modeled using a Volume of Fluid (VOF) method. Numerical simulation results obtained are observed to be in good agreement with that of the experimental observations. Supported by National Priority Research Program (NPRP) of Qatar National Research Fund (QNRF), Grant No.: NPRP 6-1304-2-525.

  3. Measurement of impinging butane flame using combined optical system with digital speckle tomography

    NASA Astrophysics Data System (ADS)

    Ko, Han Seo; Ahn, Seong Soo; Kim, Hyun Jung

    2011-11-01

    Three-dimensional density distributions of an impinging and eccentric flame were measured experimentally using a combined optical system with digital speckle tomography. In addition, a three-dimensional temperature distribution of the flame was reconstructed from an ideal gas equation based on the reconstructed density data. The flame was formed by the ignition of premixed butane/air from air holes and impinged upward against a plate located 24 mm distance from the burner nozzle. In order to verify the reconstruction process for the experimental measurements, numerically synthesized phantoms of impinging and eccentric flames were derived and reconstructed using a developed three-dimensional multiplicative algebraic reconstruction technique (MART). A new scanning technique was developed for the accurate analysis of speckle displacements necessary for investigating the wall jet regions of the impinging flame at which a sharp variation of the flow direction and pressure gradient occur. The reconstructed temperatures by the digital speckle tomography were applied to the boundary condition for numerical analysis of a flame impinged plate. Then, the numerically calculated temperature distribution of the upper side of the flame impinged plate was compared to temperature data taken by an infrared camera. The absolute average uncertainty between the numerical and infrared camera data was 3.7%.

  4. Detailed heat transfer coefficient distributions under an array of impinging jets with coolant extraction

    SciTech Connect

    Huang, Y.; Ekkad, S.V.; Han, J.C.

    1996-12-31

    Jet impingement cooling is a high performance technique for heat transfer enhancement. Local heat transfer distributions are presented for an array of jets impinging on a target plate with a series of coolant extraction holes. The flow enters the pressure channel, impinges on the target plate and exits toward the sides and through the coolant extraction holes. The impingement plate has four rows of 12 jet holes and the target plate has three rows of 11 coolant extraction holes. The jet holes and the coolant extraction holes have the same diameters and are staggered such that the air impinging from the jet hole does not exit directly through the extraction hole. The detailed heat transfer coefficient distributions are measured using a transient technique and liquid crystal coating. Results are presented for a range of jet Reynolds numbers between 4,000 and 20,000. The effect of crossflow is also studied by changing the exit opening of the impingement channel to provide three different spent air exit directions. Heat transfer results for the target plate with coolant extraction are compared with those without coolant extraction at the same flow conditions.

  5. Association of Bicipital Peritendinous Effusion with Subacromial Impingement: A Dynamic Ultrasonographic Study of 337 Shoulders

    PubMed Central

    Chang, Ke-Vin; Wu, Wei-Ting; Özçakar, Levent

    2016-01-01

    Bicipital peritendinous effusion (BPE) is the most common biceps tendon abnormality and can be related to various shoulder ultrasonographic findings. Since the association of BPE with subacromial impingement is unclear, our study aimed to explore its association with the dynamic subacromial impingement test during ultrasound (US) imaging. We included 337 shoulders referred for US examinations and quantified the amount of BPE. Effusion more than 1 mm in thickness was considered a positive finding. A comparison of three grades of subacromial impingement, adjusted by patient demographics, static sonographic shoulder pathology, and physical findings, by using multivariate regression models revealed that the odds ratio of subacromial impingement (with 95% confidence intervals) in the presence of BPE was 6.54 (3.21–13.32) in grade 1, 6.93 (3.05–15.76) in grade 2 and 3.18 (1.48–6.80) in grade 3. An increase in age, subdeltoid bursitis, full-thickness supraspinatus tendon tear, and shoulder stiffness were also associated with BPE. Since our study demonstrated a positive association of BPE with all grades of impingement, a US dynamic subacromial impingement test is suggested when BPE is present. Future prospective studies are needed to identify changes in BPE after treatment. PMID:27941908

  6. A computational study of highly viscous impinging jets

    SciTech Connect

    Silva, M.W.

    1998-11-01

    Two commercially-available computational fluid dynamics codes, FIDAP (Fluent, Inc., Lebanon, NH) and FLOW-3D (Flow Science, Inc., Los Alamos, NM), were used to simulate the landing region of jets of highly viscous fluids impinging on flat surfaces. The volume-of-fluid method was combined with finite difference and finite element approaches to predict the jet behavior. Several computational models with varying degrees of physical realism were developed, and the results were compared with experimental observations. In experiments, the jet exhibited several complex behaviors. As soon as it exited the nozzle, the jet began to neck down and become narrower. When it impacted the solid surface, the jet developed an instability near the impact point and buckled to the side. This buckling became a spiraling motion, and the jet spiraled about the impact point. As the jet spiraled around, a cone-shaped pile was build up which eventually became unstable and slumped to the side. While all of these behaviors were occurring, air bubbles, or voids, were being entrapped in the fluid pool. The results obtained from the FLOW-3D models more closely matched the behavior of real jets than the results obtained from /the FIDAP models. Most of the FLOW-3D models predicted all of the significant jet behaviors observed in experiments: necking, buckling, spiraling, slumping, and void entrapment. All of the FIDAP models predicted that the jet would buckle relatively far from the point of impact, whereas the experimentally observed jet behavior indicates that the jets buckle much nearer the impact point. Furthermore, it was shown that FIDAP is incapable of incorporating heat transfer effects into the model, making it unsuitable for this work.

  7. Quantifying shoulder rotation weakness in patients with shoulder impingement.

    PubMed

    Tyler, Timothy F; Nahow, Rachael C; Nicholas, Stephen J; McHugh, Malachy P

    2005-01-01

    The purpose of this study was to determine whether strength deficits could be detected in individuals with and without shoulder impingement, all of whom had normal shoulder strength bilaterally according to grading of manual muscle testing. Strength of the internal rotators and external rotators was tested isokinetically at 60 degrees /s and 180 degrees /s, as well as manually with a handheld dynamometer (HHD) in 17 patients and 22 control subjects. Testing was performed with the shoulder positioned in the scapular plane and in 90 degrees of shoulder abduction with 90 degrees of elbow flexion (90-90). The peak torque was determined for each movement. The strength deficit between the involved and uninvolved arms (patients) and the dominant and nondominant arms (control subjects) was calculated for each subject. Comparisons were made for the scapular-plane and 90-90 positions between isokinetic and HHD testing. Despite a normal muscle grade, patients had marked weakness (28% deficit, P < .01) in external rotators at the 90-90 position tested with the HHD. In contrast, external rotator weakness was not evident with isokinetic testing at the 90-90 position (60 degrees /s and 180 degrees /s, 0% deficit, P = .99). In control subjects, greater internal rotator strength in the dominant compared with the nondominant arm was evident with the HHD at the 90-90 position (11%, P < .01) and in the scapular plane (7%, P < .05). Using an HHD while performing manual muscle testing can quantify shoulder strength deficits that may not be apparent with isokinetic testing. By using an HHD during shoulder testing, clinicians can identify weakness that may have been presumed normal.

  8. Severe Impingement of Lumbar Disc Replacements Increases the Functional Biological Activity of Polyethylene Wear Debris

    PubMed Central

    Baxter, Ryan M.; MacDonald, Daniel W.; Kurtz, Steven M.; Steinbeck, Marla J.

    2013-01-01

    Background: Wear, oxidation, and particularly rim impingement damage of ultra-high molecular weight polyethylene total disc replacement components have been observed following surgical revision. However, neither in vitro testing nor retrieval-based evidence has shown the effect(s) of impingement on the characteristics of polyethylene wear debris. Thus, we sought to determine (1) differences in polyethylene particle size, shape, number, or biological activity that correspond to mild or severe rim impingement and (2) in an analysis of all total disc replacements, regardless of impingement classification, whether there are correlations between the extent of regional damage and the characteristics of polyethylene wear debris. Methods: The extent of dome and rim damage was characterized for eleven retrieved polyethylene cores obtained at revision surgery after an average duration of implantation of 9.7 years (range, 4.6 to 16.1 years). Polyethylene wear debris was isolated from periprosthetic tissues with use of nitric acid and was imaged with use of environmental scanning electron microscopy. Subsequently, particle size, shape, number, biological activity, and chronic inflammation scores were determined. Results: Grouping of particles by size ranges that represented high biological relevance (<0.1 to 1-μm particles), intermediate biological relevance (1 to 10-μm particles), and low biological relevance (>10-μm particles) revealed an increased volume fraction of particles in the <0.1 to 1-μm and 1 to 10-μm size ranges in the mild-impingement cohort as compared with the severe-impingement cohort. The increased volume fractions resulted in a higher specific biological activity per unit particle volume in the mild-impingement cohort than in the severe-impingement cohort. However, functional biological activity, which is normalized by particle volume (mm3/g of tissue), was significantly higher in the severe-impingement cohort. This increase was due to a larger volume

  9. Traction Drive Inverter Cooling with Submerged Liquid Jet Impingement on Microfinned Enhanced Surfaces (Presentation)

    SciTech Connect

    Waye, S.; Narumanchi, S.; Moreno, G.

    2014-09-01

    Jet impingement is one means to improve thermal management for power electronics in electric-drive traction vehicles. Jet impingement on microfin-enhanced surfaces further augments heat transfer and thermal performance. A channel flow heat exchanger from a commercial inverter was characterized as a baseline system for comparison with two new prototype designs using liquid jet impingement on plain and microfinned enhanced surfaces. The submerged jets can target areas with the highest heat flux to provide local cooling, such as areas under insulated-gate bipolar transistors and diode devices. Low power experiments, where four diodes were powered, dissipated 105 W of heat and were used to validate computational fluid dynamics modeling of the baseline and prototype designs. Experiments and modeling used typical automotive flow rates using water-ethylene glycol as a coolant (50%-50% by volume). The computational fluid dynamics model was used to predict full inverter power heat dissipation. The channel flow and jet impingement configurations were tested at full inverter power of 40 to 100 kW (output power) on a dynamometer, translating to an approximate heat dissipation of 1 to 2 kW. With jet impingement, the cold plate material is not critical for the thermal pathway. A high-temperature plastic was used that could eventually be injection molded or formed, with the jets formed from a basic aluminum plate with orifices acting as nozzles. Long-term reliability of the jet nozzles and impingement on enhanced surfaces was examined. For jet impingement on microfinned surfaces, thermal performance increased 17%. Along with a weight reduction of approximately 3 kg, the specific power (kW/kg) increased by 36%, with an increase in power density (kW/L) of 12% compared with the baseline channel flow configuration.

  10. FUNCTIONAL EVALUATION OF PATIENTS WHO HAVE UNDERGONE ARTHROSCOPIC DEBRIDEMENT TO TREAT MASSIVE AND IRREPARABLE TEARS OF THE ROTATOR CUFF

    PubMed Central

    Veado, Marco Antônio de Castro; Rodrigues, Alessandro Ulhôa

    2015-01-01

    To evaluate the results from patients who underwent arthroscopic debridement of extensive irreparable rotator cuff injuries. Methods: 27 patients were operated between 2003 and 2007, and 22 of them were evaluated. The surgical procedure consisted of arthroscopic debridement of the stumps of the tendons involved, bursectomy, removal of acromial osteophytes and, possibly, biceps tenotomy and tuberoplasty. Results: All the patients showed involvement of the supraspinatus and infraspinatus tendons at the preoperative stage. In the postoperative evaluation, 14 patients had a complete teres minor muscle, and three had partial tears of the subscapularis tendon. There was an improvement in the UCLA criteria, from 15 preoperatively to 31 postoperatively. There was no improvement in muscle strength, but there was a reduction in the pain. Conclusion: Arthroscopic debridement is a recommended procedure for elderly patients with irreparable rotator cuff tears, good range of motion and low functional demand, when the main objective is to diminish pain. PMID:27022590

  11. "Owl" Technique for All-Arthroscopic Augmentation of a Massive or Large Rotator Cuff Tear With Extracellular Matrix Graft.

    PubMed

    Narvani, A Ali; Consigliere, Paolo; Polyzois, Ioannis; Sarkhel, Tanaya; Gupta, Rohit; Levy, Ofer

    2016-08-01

    Despite the vast improvement in techniques and technology for arthroscopic rotator cuff surgery, repairs of massive and large tears remain challenging because they are associated with significantly high failure rates. In recent years, patch augmentation has gained popularity as a technique to decrease these high failure rates. Arthroscopic patch augmentation of rotator cuff repair, however, is technically difficult. The purpose of this report is to describe a simple and reproducible technique for all-arthroscopic extracellular matrix graft augmentation. With this technique, which we refer to as the "owl" technique because the prepared extracellular augment resembles an owl, there are relatively few suture ends involved; therefore, augment introduction is straightforward with a reduced risk of suture ends becoming tangled. In addition, the way in which our augmentation is prepared helps to prevent it from becoming bunched up when being secured.

  12. Outcome of arthroscopic subscapularis tendon repair: Are the results improving with improved techniques and equipment?: A retrospective case series

    PubMed Central

    Arun, G R; Kumar, Pradeep; Patnaik, Sarthak; Selvaraj, Karthik; Rajan, David; Singh, Anant; Kumaraswamy, Vinay

    2016-01-01

    Background: Rotator cuff tears are a common cause of shoulder pain and dysfunction. More recently, there has been a renewed interest in understanding the subscapularis tears. There are multiple articles in the literature showing the short term results of isolated subscapularis tendon repair. However, the midterm and long term outcome studies for arthroscopic subscapularis repair are few. This study evaluates the functional outcome after arthroscopic subscapularis repair. Materials and Methods: The records of 35 patients who underwent an arthroscopic subscapularis repair between May 2008 and June 2012 were included in this retrospective study. The records of all patients were reviewed. There were 22 males and 13 female patients with mean age of 58.2 years (range 41-72 years). All patients had a complete history, physical examination, and radiographs of their shoulders. Visual analogue scale (VAS), range of movements, power of cuff muscles, and modified University of California at Los Angeles (UCLA) score were assessed. Results: The mean followup was 2.8 years (range 2-4 year). Functional outcome after arthroscopic subscapularis repair has an excellent outcome as analysed by clinical outcome, VAS score and UCLA score. Results were analyzed and had statistically significant values. The VAS for pain improved significantly (P < 0.001), and the mean modified UCLA score improved significantly (P < 0.001) from 14.24 ± 4.72 preoperatively to 33.15 ± 2.29 at 2 years postoperative. According to the UCLA system, there were 22 excellent, 11 good, and 2 fair results. Around 95% of patients returned to their usual work after surgery. Conclusion: At a median followup of 2 years, 95% of patients had a good to excellent result after an arthroscopic subscapularis tendon repair. We conclude that the midterm results show that arthroscopic subscapularis repair remains a good option for the treatment of patients with subscapularis tendon repair. PMID:27293291

  13. Impingement of water droplets on wedges and double-wedge airfoils at supersonic speeds

    NASA Technical Reports Server (NTRS)

    Serafini, John S

    1954-01-01

    An analytical solution has been obtained for the equations of motion of water droplets impinging on a wedge in a two-dimensional supersonic flow field with a shock wave attached to the wedge. The closed-form solution yields analytical expressions for the equation of the droplet trajectory, the local rate of impingement and the impingement velocity at any point on the wedge surface, and the total rate of impingement. The analytical expressions are utilized to determine the impingement on the forward surfaces of diamond airfoils in supersonic flow fields with attached shock waves. The results presented include the following conditions: droplet diameters from 2 to 100 microns, pressure altitudes from sea level to 30,000 feet, free-stream static temperatures from 420 degrees r, free stream Mach numbers from 1.1 to 2.0, semiapex angles for the wedge from 1.14 degrees to 7.97 degrees, thickness-to-chord ratios for the diamond airfoil from 0.02 to 0.14, chord lengths from 1 to 20 feet, and angles of attack from zero to the inverse tangent of the airfoil thickness-to-chord ratio.

  14. Impingement of water droplets on wedges and diamond airfoils at supersonic speeds

    NASA Technical Reports Server (NTRS)

    Serafini, John S

    1953-01-01

    An analytical solution has been obtained for the equations of motion of water droplets impinging on a wedge in a two-dimensional supersonic flow field with a shock wave attached to the wedge. The closed-form solution yields analytical expressions for the equation of the droplet trajectory, the local rate of impingement and the impingement velocity at any point on the wedge surface, and the total rate of impingement. The analytical expressions are utilized to determine the impingement on the forward surfaces of diamond airfoils in supersonic flow fields with attached shock waves. The results presented include the following conditions: droplet diameters from 2 to 100 microns, pressure altitudes from sea level to 30,000 feet, free-stream static temperatures from 420 degrees to 460 degrees R. Also, free-stream Mach numbers from 1.1 to 2.0, semi-apex angles for the wedge from 1.14 degrees to 7.97 degrees, thickness-to-chord ratios for the diamond airfoil from 0.02 to 0.14, chord lengths from 1 to 20 feet, and angles of attack from zero to the inverse tangent of the airfoil thickness-to-chord ratio.

  15. The Relationship Between Pulsatile Flow Impingement and Intraluminal Thrombus Deposition in Abdominal Aortic Aneurysms.

    PubMed

    Lozowy, Richard J; Kuhn, David C S; Ducas, Annie A; Boyd, April J

    2017-03-01

    Direct numerical simulations were performed on four patient-specific abdominal aortic aneurysm (AAA) geometries and the resulting pulsatile blood flow dynamics were compared to aneurysm shape and correlated with intraluminal thrombus (ILT) deposition. For three of the cases, turbulent vortex structures impinged/sheared along the anterior wall and along the posterior wall a zone of recirculating blood formed. Within the impingement region the AAA wall was devoid of ILT and remote to this region there was an accumulation of ILT. The high wall shear stress (WSS) caused by the impact of vortexes is thought to prevent the attachment of ILT. WSS from impingement is comparable to peak-systolic WSS in a normal-sized aorta and therefore may not damage the wall. Expansion occurred to a greater extent in the direction of jet impingement and the wall-normal force from the continuous impact of vortexes may contribute to expansion. It was shown that the impingement region has low oscillatory shear index (OSI) and recirculation zones can have either low or high OSI. No correlation could be identified between OSI and ILT deposition since different flow dynamics can have similar OSI values.

  16. Study of the scapular muscle latency and deactivation time in people with and without shoulder impingement.

    PubMed

    Phadke, Vandana; Ludewig, Paula M

    2013-04-01

    Changes in muscle activities are commonly associated with shoulder impingement and theoretically caused by changes in motor program strategies. The purpose of this study was to assess for differences in latencies and deactivation times of scapular muscles between subjects with and without shoulder impingement. Twenty-five healthy subjects and 24 subjects with impingement symptoms were recruited. Glenohumeral kinematic data and myoelectric activities using surface electrodes from upper trapezius (UT), lower trapezius (LT), serratus anterior (SA) and anterior fibers of deltoid were collected as subjects raised and lowered their arm in response to a visual cue. Data were collected during unloaded, loaded and after repetitive arm raising motion conditions. The variables were analyzed using 2 or 3 way mixed model ANOVAs. Subjects with impingement demonstrated significantly earlier contraction of UT while raising in the unloaded condition and an earlier deactivation of SA across all conditions during lowering of the arm. All subjects exhibited an earlier activation and delayed deactivation of LT and SA in conditions with a weight held in hand. The subjects with impingement showed some significant differences to indicate possible differences in motor control strategies. Rehabilitation measures should consider appropriate training measures to improve movement patterns and muscle control.

  17. Is there a relationship between psoas impingement and increased trochanteric retroversion?

    PubMed Central

    Gómez-Hoyos, Juan; Schröder, Ricardo; Reddy, Manoj; Palmer, Ian J.; Khoury, Anthony; Martin, Hal David

    2015-01-01

    The concept of psoas impingement secondary to a tight or inflamed iliopsoas tendon causing impingement of the anterior labrum during hip extension has been suggested. The purpose of this study was to assess the relationship between the lesser trochanteric version (LTV) in symptomatic patients with psoas impingement as compared with asymptomatic hips. The femoral neck version (FNV) and LTV were evaluated on axial magnetic resonance imaging, as well as the angle between LTV and FNV. Data from 12 symptomatic patients and 250 asymptomatic patients were analysed. The mean, range and standard deviations were calculated. Independent t-tests were used to determine differences between groups. The lesser trochanteric retroversion was significantly increased in patients with psoas impingement as compared with asymptomatic hips (−31.1° SD ± 6.5 versus −24.2° ± 11.5, P < 0.05). The FNV (9° ± 8.8 versus 14.1° ± 10.7, P > 0.05) and the angle between FNV and LTV (40.2° ± 9.7 versus 38.3° ± 9.6, P > 0.05) were not significantly different between groups. In conclusion, the lesser trochanteric retroversion is significantly increased in patients with psoas impingement as compared with asymptomatic hips. PMID:27011834

  18. Experimental and numerical investigation of liquid jet impingement on superhydrophobic and hydrophobic convex surfaces

    NASA Astrophysics Data System (ADS)

    Kibar, Ali

    2017-02-01

    Experiments and numerical simulations were carried out to examine the vertical impingement a round liquid jet on the edges of horizontal convex surfaces that were either superhydrophobic or hydrophobic. The experiments examine the effects on the flow behaviour of curvature, wettability, inertia of the jet, and the impingement rate. Three copper pipes with outer diameters of 15, 22, and 35 mm were investigated. The pipes were wrapped with a piece of a Brassica oleracea leaf or a smooth Teflon sheet, which have apparent contact angles of 160° and 113°. The Reynolds number ranged from 1000 to 4500, and the impingement rates of the liquid jets were varied. Numerical results show good agreement with the experimental results for explaining flow and provide detailed information about the impingement on the surfaces. The liquid jet reflected off the superhydrophobic surfaces for all conditions. However, the jet reflected or deflected off the hydrophobic surface, depending on the inertia of the jet, the curvature of the surface, and the impingement rate. The results suggest that pressure is not the main reason for the bending of the jet around the curved hydrophobic surface.

  19. Confined jet impingement of liquid nitrogen onto different heat transfer surfaces

    NASA Astrophysics Data System (ADS)

    Zhang, P.; Xu, G. H.; Fu, X.; Li, C. R.

    2011-06-01

    Jet impingement of liquid nitrogen owns many applications in the cryogenic cooling aspects, such as, cooling of high-power chips in the electronic devices and cryoprobes in the cryosurgery. In the present study, we systematically investigated the confined jet impingement of liquid nitrogen from a tube of about 2.0 mm in diameter onto the heat transfer surfaces of about 5.0 mm in basement diameter with different heat transfer surface geometries and conditions, i.e., flat surface, hemispherical surface and flat surface with a needle. The effects of many influential factors, such as, the geometry of the heat transfer surface, jet velocity, distance between the nozzle exit and heat transfer surface, heat transfer surface condition, and some other, on the heat transfer were investigated. The heat transfer correlations were also proposed by using the experimental data, and it was found that the heat transfer mechanism of liquid impingement in the confined space was dominated by the convective evaporation rather than the nucleate boiling in the present case. The critical heat flux (CHF) of the confined jet impingement was measured and the visualization of the corresponding flow patterns of the confined jet impingement of liquid nitrogen was also conducted simultaneously to understand the heat transfer phenomena.

  20. Impact of impingement on the Hudson River white perch population. Final report

    SciTech Connect

    Barnthouse, L.W.; Van Winkle, W.; Kirk, B.L.; Vaughan, D.S.

    1982-02-01

    This report summarizes a series of analyses of the magnitude and biological significance of the impingement of white perch at the Indian Point Nuclear Generating Station and other Hudson River power plants. Included in these analyses were evaluations of: (1) two independent lines of evidence relating to the magnitude of impingement impacts on the Hudson River white perch population; (2) the additional impact caused by entrainment of white perch; (3) data relating to density-dependent growth among young-of-the-year white perch; (4) the feasibility of performing population-level analyses of impingement impacts on the white perch populations of Chesapeake Bay and the Delaware River; and (5) the feasibility of using simple food chain and food web models to evaluate community-level effects of impingement and entrainment. Estimated reductions in the abundances of the 1974 and 1975 white perch year classes, caused by impingement and entrainment, were high enough that the possibility of adverse long-term effects cannot be excluded.

  1. Experimental study of turbulence in isothermal jet impingement at intermediate plate spacings

    NASA Astrophysics Data System (ADS)

    Landfried, D. Tyler; Valentino, Alex; Mazumdar, Sagnik; Jana, Anirban; Kimber, Mark

    2013-11-01

    One fundamental problem in fluid dynamics is that of the axisymmetric round flow impinging on a plate placed some distance downstream of the jet. Impinging jets have a rich history of applications including small plate spacings, H/D ~ 1, such as encountered in electronics cooling, or large plate spacings, H/D ~ 102, such as vertical takeoff aircrafts and rocket engines. However, intermediate plate spacings, such as the lower plenum of the next generation nuclear reactors, are not typically studied. In this paper, an experimental study is conducted investigating the effect of the impingement plate on the flow behavior compared to the near free jet behavior when the plate is removed. Using air as the working fluid, a single jet is considered at jet Reynolds numbers of 10000, 20000, and 30000. A three-wire anemometer probe is used to quantify the mean components of velocities as well as the Reynolds stress and the third-order moments in the flow field at various distances between the jet outlet and the impingement plate. When present, the impingement plate is placed a distance of 8, 11, 14, and 17 diameters downstream of the jet. Additionally trends in the kinetic energy and dissipation are investigated for validation with numerical models.

  2. Diffusion controlled ice growth with soft impingement inside biological cells during freezing.

    PubMed

    Chen, Cong; Li, Weizhong

    2008-01-01

    An iterative method has been proposed to determine the relationship between the temperature depression of intracellular ice formation (IIF) and the equilibrium melting point depression for initial cryoprotective agent (CPA) concentrations larger than 1.5M. Using the iterative method coupling with a water transport model for freezing induced cell dehydration and intracellular ice growth, the temperature of IIF has been determined. The new model of temperature of IIF has been applied to predict nucleation parameters at various temperature and initial CPA concentrations according to Karlsson's approach. A geometrical model of soft impingement proposed by Bruna has been incorporated into Karlsson's diffusion limited crystal growth model to include the effect of soft impingement. The new crystal growth model has been verified by a comparison between the predicted critical cooling rates for vitrification with the reported values in literature. With the new crystal growth model, it has been found that the limiting value of the crystallized volume fraction increases as cooling progresses and decreases as the initial CPA concentration increases. A comparison of simulated crystallized volume fractions when soft impingement, hard impingement and no corrections are used has also been made and the result shows that soft impingement could not be omitted in the prediction of intracellular ice formation and growth, especially when the final crystallized volume fraction is larger than 0.1.

  3. Investigation of impinging jet resonant modes using unsteady pressure-sensitive paint measurements

    NASA Astrophysics Data System (ADS)

    Davis, Timothy; Edstrand, Adam; Alvi, Farrukh; Cattafesta, Louis; Yorita, Daisuke; Asai, Keisuke

    2015-05-01

    At given nozzle to plate spacings, the flow field of high-speed impinging jets is known to be characterized by a resonance phenomenon. Large coherent structures that convect downstream and impinge on the surface create strong acoustic waves that interact with the inherently unstable shear layer at the nozzle exit. This feedback mechanism, driven by the coherent structures in the jet shear layer, can either be axisymmetric or helical in nature. Fast-response pressure-sensitive paint (PSP) is applied to the impingement surface to map the unsteady pressure distribution associated with these resonant modes. Phase-averaged results acquired at several kHz are obtained using a flush mounted unsteady pressure transducer on the impingement plate as a reference signal. Tests are conducted on a Mach 1.5 jet at nozzle to plate spacings of . The resulting phase-averaged distribution reveals dramatically different flow fields at the corresponding impingement heights. The existence of a purely axisymmetric mode with a frequency of 6.3 kHz is identified at and is characterized by concentric rings of higher/lower pressure that propagate radially with increasing phase. Two simultaneous modes are observed at with one being a dominant symmetric mode at 7.1 kHz and the second a sub-dominant helical mode at 4.3 kHz. Complimentary phase-conditioned Schlieren images are also obtained visualizing the flow structures associated with each mode and are consistent with the PSP results.

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

    PubMed Central

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

    2013-01-01

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

  5. Arthroscopic treatment of displaced tibial eminence fractures using a suspensory fixation

    PubMed Central

    Loriaut, Philippe; Moreau, Pierre-Emmanuel; Loriaut, Patrick; Boyer, Patrick

    2017-01-01

    Background: Avulsion fractures of the tibial intercondylar eminence are fairly common injuries requiring surgery for the optimal functional outcome. The purpose of this study was to assess the clinical and radiological outcomes of an arthroscopic treatment of displaced tibial intercondylar eminence fractures using a suspensory device. Material and Methods: Five patients with type 2 and 3 displaced tibial intercondylar eminence fractures who received an arthroscopically assisted fixation using a double button device were enrolled from 2011 to 2012. Clinical assessment included the patient demographics, cause of injury, the delay before surgery, time for surgery, time to return to work and sport, the International Knee Documentation Committee (IKDC) and Lysholm knee scores. Stability was measured with the KT-2000 arthrometer with a force of 134 N. A side to side difference on the KT-2000 examination superior to 3 mm was considered as a significant and abnormal increase in the anterior translation. Radiological examination consisted of anteroposterior and lateral radiographs, as well as computed tomography (CT) scan of the affected knee. Clinical and radiological followup was done at 1, 2, 3, 6, and 12 months postoperatively and at final followup. CT-scan was performed before surgery and at 3 months followup. Results: The median age of patients was 31 years. Mean followup was 27 ± 5.1 months. The average delay before surgery was 3 days. At final followup, the mean IKDC and Lysholm knee scores were, 93.9 and 94.5 respectively. All patients had a complete functional recovery and were able to return to work and to resume their sport activities. No secondary surgeries were required to remove hardware. No complication was noted. Bony union was achieved in all patients. Conclusion: The arthroscopic treatment of displaced tibial intercondylar eminence fractures using a suspensory system provided a satisfactory clinical and radiological outcome at a followup of 2 years.

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

    PubMed

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

    2013-09-01

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

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

    PubMed

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

    2010-10-11

    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.

  8. Neurovascular relationships of the approaches for arthroscopic total trapeziectomy with ligamentous stabilization.

    PubMed

    Durand, S; Gagey, O; Masquelet, A C; Thoreux, P

    2005-08-01

    The aim of this study was to define the neurovascular relationships of the approaches used during arthroscopic total trapeziectomy with the Thompson "suspension-plasty." Fifteen fresh cadavers in which trapezio-metacarpal arthritis had been confirmed by preoperative radiographs were chosen. There were 12 women and 3 men (average age: 87 years), and small joint arthroscopy equipment was used. Two approaches for the trapezio-metacarpal joint were used: an ulnar approach situated at the ulnar border of the extensor pollicis brevis tendon and a radial approach placed at the middle of a line joining the tendons of the flexor carpi radialis and the abductor pollicis longus. A new transosseous approach at the base of the first metacarpal ("trans-M1" approach) is suggested and was used to do the ligamento-plasty. After the operation, a large skin flap was elevated in order to measure the distance between each surgical approach and the different neurovascular structures (radial artery, dividing branches of the superficial branch of the radial nerve and the end of the lateral cutaneous nerve of the forearm) and to verify the absence of neurovascular lesions. The different neurovascular structures at risk during this arthroscopic maneuver were the radial artery for the ulnar approach, the branches of the superficial branch of the radial nerve for all of the approaches and the ending of the lateral cutaneous nerve of the forearm for the radial and "trans-M1" approaches. The use of the approaches described allows arthroscopic trapeziectomy with the Thompson suspension-plasty without us having noted neurovascular lesion.

  9. Arthroscopic fixation of coronoid process fractures through coronoid tunnelling and capsular plication

    PubMed Central

    ARRIGONI, PAOLO; D’AMBROSI, RICCARDO; CUCCHI, DAVIDE; NICOLETTI, SIMONE; GUERRA, ENRICO

    2016-01-01

    Purpose the purpose of this study is to describe a new arthroscopic technique for reduction and fixation of coronoid process fractures (CPFs) and report clinical and functional results in 4 patients after a 24-month follow-up. Methods four patients underwent arthroscopic reduction and fixation of isolated CPFs (acute or non-unions, type I or type II according to the Regan-Morrey classification) performed using a new technique based on coronoid tunnelling and capsular plication. The patients were evaluated 6, 12 and 24 months after surgery, using the Disability of the Arm, Shoulder and Hand scale (DASH), the Mayo Elbow Performance Index (MEPI), and a visual analog scale (VAS); elbow range of motion (ROM) and joint stability were also evaluated and the rate of complications was reported. Results all 4 patients completed the follow-up. At 6, 12 and 24 months, respectively, they recorded mean DASH scores of 22, 14 and 7, mean MEPI scores of 74, 82 and 94, and mean VAS scores of 4, 2 and 1. The mean ROM increased in all directions (at 6, 12 and 24 months, respectively: flexion: 112°, 125°, 144°; extension: 3°, 5°, 6°; pronation: 76°, 84°, 91°; supination: 78°, 82°, 86°). No signs of instability were observed and no complications were reported. Conclusions the new all-arthroscopic coronoid tunnelling and capsular plication technique here proposed can restore elbow function, ROM and stability and allows anatomical reconstruction of the joint after type I or type II CPFs. If performed by an experienced arthroscopist, it is a valid alternative to open reduction and external fixation. Level of evidence Level IV, retrospective case series. PMID:27900307

  10. Reporting rotator cuff tears on magnetic resonance arthrography using the Snyder’s arthroscopic classification

    PubMed Central

    Aliprandi, Alberto; Messina, Carmelo; Arrigoni, Paolo; Bandirali, Michele; Di Leo, Giovanni; Longo, Stefano; Magnani, Sandro; Mattiuz, Chiara; Randelli, Filippo; Sdao, Silvana; Sardanelli, Francesco; Sconfienza, Luca Maria; Randelli, Pietro

    2017-01-01

    AIM To determine diagnostic performance of magnetic resonance arthrography (MRA) in evaluating rotator cuff tears (RCTs) using Snyder’s classification for reporting. METHODS One hundred and twenty-six patients (64 males, 62 females; median age 55 years) underwent shoulder MRA and arthroscopy, which represented our reference standard. Surgical arthroscopic reports were reviewed and the reported Snyder’s classification was recorded. MRA examinations were evaluated by two independent radiologists (14 and 5 years’ experience) using Snyder’s classification system, blinded to arthroscopy. Agreement between arthroscopy and MRA on partial- and full-thickness tears was calculated, first regardless of their extent. Then, analysis took into account also the extent of the tear. Interobserver agreement was also calculated the quadratically-weighted Cohen kappa statistics. RESULTS On arthroscopy, 71/126 patients (56%) had a full-thickness RCT. The remaining 55/126 patients (44%) had a partial-thickness RCT. Regardless of tear extent, out of 71 patients with arthroscopically-confirmed full-thickness RCTs, 66 (93%) were correctly scored by both readers. All 55 patients with arthroscopic diagnosis of partial-thickness RCT were correctly assigned as having a partial-thickness RCT at MRA by both readers. Interobserver reproducibility analysis showed total agreement between the two readers in distinguishing partial-thickness from full-thickness RCTs, regardless of tear extent (k = 1.000). With regard to tear extent, in patients in whom a complete tear was correctly diagnosed, correct tear extent was detected in 61/66 cases (92%); in the remaining 5/66 cases (8%), tear extent was underestimated. Agreement was k = 0.955. Interobserver agreement was total (k = 1.000). CONCLUSION MRA shows high diagnostic accuracy and reproducibility in evaluating RCTs using the Snyder’s classification for reporting. Snyder’s classification may be adopted for routine reporting of MRA.

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

    PubMed

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

    2014-12-01

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

  12. Arthroscopic grading of common wrist disorders and its role in management

    PubMed Central

    Bayoumy, Maysara Abdelhalim; Elkady, Hesham A.; Said, Hatem G.; El-Sayed, Amr; Saleh, Waleed Riad

    2015-01-01

    Palmer devised a classification system to guide treatment of triangular fibrocartilage complex tears in 1989. The main division is between traumatic Type I and atraumatic Type II tears. The wrist arthroscopy makes diagnosis and treatment of ulnar impaction syndrome possible in a less invasive way. Arthroscopy is the most valuable tool for diagnosis and treatment of acute scapholunate and lunotriquetral dissociation. Arthroscopic grading of Kienböck's disease better describes articular damage compared with plain radiographs and can help surgical treatment. The wrist arthroscopy generally makes it possible to make the diagnosis of the chondral lesion before they are visible by the usual imaging. PMID:27047230

  13. Arthroscopically assisted percutaneous fixation for trans-scaphoid perilunate fracture dislocation.

    PubMed

    Jeon, I-H; Kim, H-J; Min, W-K; Cho, H-S; Kim, P-T

    2010-10-01

    Trans-scaphoid perilunate fracture dislocation is a complex carpal dislocation causing marked disruption of the carpal structures. Open treatment has been accepted as standard for this injury. We have used arthroscopically assisted percutaneous screw fixation and bone grafting to treat this injury in four patients. The functional outcome was good. All patients achieved solid union without nonunion or malunion. The complication and morbidity was relatively low; all patients had proper alignment and there was no evidence of instability or avascular necrosis or midcarpal arthritis.

  14. Arthroscopic treatment of patients with moderate arthrofibrosis after total knee replacement.

    PubMed

    Jerosch, Joerg; Aldawoudy, Akram M

    2007-01-01

    The purpose of this study was to document the effect of arthroscopic management in patients with knee stiffness after total knee replacement. We present a case series study, in which 32 patients have been treated for moderate arthrofibrosis of the knee after total knee replacement, with the same regimen. We have excluded all cases of stiffness, because of infection, mechanical mal-alignment, loosening of the implants and other obvious reasons of stiffness of the knee, rather than pure arthrofibrosis. All patients first underwent a trial of conservative treatment before going for arthroscopic management. A pain catheter for femoral nerve block was inserted just before anesthesia for post-operative pain management. Arthroscopic arthrolysis of the intra-articular pathology was performed in a standardized technique with release of all fibrous bands in the suprapatellar pouch, reestablishing the medial and lateral gutter, release of the patella, resection of the remaining meniscal tissue or an anterior cyclops, if needed. Intensive physiotherapy and continuous passive motion were to start immediately post-operatively. All the patients were available for the follow up and they were evaluated using the knee society rating system. A total of 25 of the 32 procedures resulted in an improvement of the patients knee score. All the knees operated upon had intra-articular fibrous bands, hypertrophic synovitis and peri-patellar adhesions. A total of eight patients suffered from an anterior cyclops lesion and six patients showed pseudomenicus. In 19 cases a medial and lateral relapse of the patella was performed; only 5 patients got an isolated lateral release. The mean knee flexion was 119 degrees (100-130) at the end of arthroscopy and was 97 degrees (75-115) at the last follow up. The eight patients with extension lags decreased from 27 degrees (10 degrees-35 degrees) pre-operatively to 4 degrees (0-10) at time of follow up. The average knee society ratings increased from 70

  15. [Arthroscopic treatment of chondral lesions of the ankle joint. Evidence-based therapy].

    PubMed

    Thomas, M; Jordan, M; Hamborg-Petersen, E

    2016-02-01

    Ankle sprains are the most relevant injuries of the lower extremities and can lead to damage to ligaments and osteochondral lesions. Up to 50 % of patients with a sprained ankle later develop a lesion of the cartilage in the ankle joint or an osteochondral lesion of the talus. This can lead to osteoarthritis of the injured ankle joint. Spontaneous healing is possible in all age groups in cases of a bone bruise in the subchondral bone but in isolated chondral injuries is only useful in pediatric patients. In many cases chondral and osteochondral injuries lead to increasing demarcation of the affected area and can result in progressive degeneration of the joint if not recognized in time. There also exist a certain number of osteochondral changes of the articular surface of the talus without any history of relevant trauma, which are collectively grouped under the term osteochondrosis dissecans. Perfusion disorders are discussed as one of many possible causes of these alterations. Nowadays, chondral and osteochondral defects can be treated earlier due to detection using very sensitive magnetic resonance imaging (MRI) and computed tomography (CT) techniques. The use of conservative treatment only has a chance of healing in pediatric patients. Conservative measures for adults should only be considered as adjuvant treatment to surgery.Based on a comprehensive analysis of the current literature, this article gives an overview and critical analysis of the current concepts for treatment of chondral and osteochondral injuries and lesions of the talus. With arthroscopic therapy curettage and microfracture of talar lesions are the predominant approaches or retrograde drilling of the defect is another option when the chondral coating is retained. Implantation of autologous chondral cells or homologous juvenile cartilage tissue is also possible with arthroscopic techniques. Osteochondral fractures (flake fracture) are usually performed as a mini-open procedure supported by

  16. INDIRECT ARTHROSCOPIC DECOMPRESSION OF SPINOGLENOID CYST WITH SUPRASCAPULAR NEUROPATHY: REPORT OF TWO CASES AND LITERATURE REVIEW

    PubMed Central

    Fernandes, Marcos Rassi; Fernandes, Rui José

    2015-01-01

    Suprascapular nerve compression is rare and should be considered in the differential diagnosis of patients with shoulder pain and external rotation deficit. Spinoglenoidal cysts may cause compression, and posterosuperior glenoid labrum lesions are the most likely hypothesis to explain their appearance. Magnetic resonance imaging and electromyography define the diagnosis. Indirect arthroscopic decompression of the cyst and repair of the glenoid labrum enable complete neurological recovery. The authors report two cases of isolated paralysis of the infraspinatus muscle caused by compression due to spinoglenoidal cysts that were treated by means of arthroscopy, and present the pre and postoperative assessments. PMID:27022558

  17. Return to Sports After Arthroscopic Treatment of Rotator Cuff Calcifications in Athletes

    PubMed Central

    Ranalletta, Maximiliano; Rossi, Luciano A.; Sirio, Adrian; Bruchmann, Guillermina; Maignon, Gastón D.; Bongiovanni, Santiago L.

    2016-01-01

    Background: Arthroscopic treatment of calcific deposits of rotator cuff tears has been described with successful results in the general population. However, despite the high frequency of this condition, there is no information in the literature regarding arthroscopic treatment of rotator cuff calcifications in athletes. Purpose: To analyze the time to return to sport, clinical outcomes, and complications of complete arthroscopic removal of intratendinous calcific deposits and repair of the tendon lesion without acromioplasty in athletes. Study Design: Case series; Level of evidence, 4. Methods: This study retrospectively evaluated 24 consecutive patients with a mean age of 36.2 years. The mean follow-up was 59 months (range, 24-108 months). Patients completed a questionnaire focused on the time to return to sport and treatment course. Pre- and postoperative functional assessment was performed using the Constant score and University of California Los Angeles (UCLA) score. Pain was assessed by visual analog scale (VAS). Radiographs and magnetic resonance imaging (MRI) were performed to evaluate the recurrence of calcifications and the indemnity of the supraspinatus tendon repair. Results: Of the 24 patients, 23 (95.8%) were able to return to sports; 91.3% returned to the same level. The mean time to return to play was 5.3 months (range, 3-9 months): 26% of patients (6/23) returned to sports in less than 4 months, 61% (14/24) returned between 4 and 6 months, and 13% (3/24) returned after the sixth month. The mean Constant score increased from 26.9 preoperatively to 89.7 postoperatively (P < .001), and the UCLA score increased from 17.3 preoperatively to 33.2 postoperatively (P < .001). Significant improvement was obtained for pain (mean VAS, 8.4 [before surgery] vs 0.6 [after]; P < .001). The overall majority (91.6%) of patients were satisfied with their result. MRI examination at last follow-up (79% of patients) showed no tendon tears. Conclusion: In athletes with

  18. Arthroscopic Excision of Juxta-articular Osteoid Osteoma of the Calcaneum

    PubMed Central

    Tauheed, Mohammed; Korula, Ravi Jacob; Shankarnarayanan, Sriram

    2016-01-01

    Osteoid osteoma of the foot is a rare condition particularly of the calcaneum. This condition is difficult to diagnose and is more difficult to treat particularly if it involves deeper part of the joints. We present an arthroscopic technique to deal with a case of juxta-articular osteoid osteoma of the calcaneum using two portals: the anterolateral portal for instrumentation and the anterior anterolateral portal for visualization of the subtalar joint. Because this approach is minimally invasive, it offers early recovery and reduced morbidity compared with the conventional techniques. PMID:27073769

  19. Arthroscopic identification of iliopubic and ilioischial grooves in a single adult acetabulum

    PubMed Central

    Paliobeis, C P; Villar, R N

    2010-01-01

    We report the arthroscopic identification of combined morphological variants of the acetabulum in an adult. The combination of iliopubic and ilioischial grooves has not been reported before. Preoperative radiographic and MRI failed to detect the lesions. These grooves strongly suggest incomplete fusion between the three limbs of the triradiate cartilage. When identified, this condition should not be treated as pathological but as a rare anatomical variant. Hip arthroscopy is a competent tool in discovering such asymptomatic cartilage abnormalities and subtle anatomical variations even in the presence of normal preoperative imaging. PMID:22778204

  20. Arthroscopic extraction of a stainless steel foreign body imbedded in the tibial plateau.

    PubMed

    Kim, S J; Lee, Y T; Kim, H J

    1998-01-01

    We present a case of foreign body synovitis in the knee joint caused by a fragment of stainless steel imbedded in the tibial plateau for 10 years, which was extracted successfully using an arthroscope. The cause of synovitis was the long-standing release of small stainless steel particles resulting from the abrasion of the steel against the opposing lateral femoral condyle. For an articular foreign body, arthroscopy is by far the best treatment. Arthroscopy allows the surgeon to localize as well as to extract even the smallest foreign body fragment, and also provides for washing out of the joint cavity.

  1. Arthroscopic treatment of pigmented villonodular synovitis of the proximal tibiofibular joint.

    PubMed

    Lui, Tun Hing

    2015-08-01

    Disorders of the proximal tibiofibular joint should be kept in mind in the evaluation of lateral knee pain. They include osteoarthrosis, rheumatic disease, traumatic subluxation or dislocation, ganglion or synovial cysts, synostosis, synovial chondromatosis, pigmented villonodular synovitis and hypomobility of the joint. Peroneal nerve can be at risk with pathologies of the joint either by compressive effect or formation of intra-neural ganglion. A case of pigmented villonodular synovitis of the proximal tibiofibular joint was reported which presented with lateral knee pain. It was successfully treated by arthroscopic synovectomy. Level of evidence V.

  2. Heat transfer from a row of impinging jets to concave cylindrical surfaces

    NASA Technical Reports Server (NTRS)

    Hrycak, P.

    1981-01-01

    Starting from the first principles, and with one experimentally obtained parameter, an expression for stagnation heat transfer is derived, applicable to round, impinging jets. The results obtained with a row of air jets impinging on an electrically-heated surface in a small-scale setup characteristic of a typical turbine blade have been found compatible with the average heat transfer from a geometrically similar, steam-heated surface scaled up ten times, and comparable with the results of other investigators. These findings were linked to the flow fields likely to exist in the gas turbine blades, internally cooled by a row of round jets or a single jet of equivalent width. The magnitude of heat-transfer coefficients obtained here with impinging jets approaches that normally associated with forced convection of water and evaporative cooling.

  3. Impingement of a plume on a non-horizontal rigid boundary

    NASA Astrophysics Data System (ADS)

    Jamieson, Alan; Dalziel, Stuart

    2014-11-01

    Buoyancy driven flows created by density differences, plumes are a phenomenon observed in many situations in both nature and industry. Instances of plume impingement on a rigid boundary are also common. Whether this smoke from a candle impacting on a ceiling or, for a much larger scale example, plumes in the ocean descending onto the continental shelf, such as in dense water formation in the Weddell Sea. In both these cases, and many others, the boundary is rarely a horizontal plane and so motivates the study for a plume impacting on a non-horizontal geometry. After reviewing previous work of a plume impinging on a horizontal, we introduce the problem of a plume impinging on an incline by presenting experiments varying the angle of inclination and the distance between the boundary and plume source. In an attempt to understand dynamics of large scale plumes in ocean, we also present the same experiment in a rotating system.

  4. Apparatus for impingement cooling a side wall adjacent an undercut region of a turbine nozzle segment

    DOEpatents

    Burdgick, Steven Sebastian

    2002-01-01

    A gas turbine nozzle segment has outer and inner bands and vanes therebetween. Each band includes a side wall, a cover and an impingement plate between the cover and nozzle wall defining two cavities on opposite sides of the impingement plate. Cooling steam is supplied to one cavity for flow through apertures of the impingement plate to cool the nozzle wall. The side wall of the band and inturned flange define with the nozzle wall an undercut region. Slots are formed through the inturned flange along the nozzle side wall. A plate having through-apertures extending between opposite edges thereof is disposed in each slot, the slots and plates being angled such that the cooling medium exiting the apertures in the second cavity lie close to the side wall for focusing and targeting cooling medium onto the side wall.

  5. Long-term monitoring dataset of fish assemblages impinged at nuclear power plants in northern Taiwan

    NASA Astrophysics Data System (ADS)

    Chen, Hungyen; Liao, Yun-Chih; Chen, Ching-Yi; Tsai, Jeng-I.; Chen, Lee-Sea; Shao, Kwang-Tsao

    2015-12-01

    The long-term species diversity patterns in marine fish communities are garnering increasing attention from ecologists and conservation biologists. However, current databases on quantitative abundance information lack consistent long-term time series, which are particularly important in exploring the possible underlying mechanism of community changes and evaluating the effectiveness of biodiversity conservation measures. Here we describe an impinged fish assemblage dataset containing 1, 283, 707 individuals from 439 taxa. Once a month over 19 years (1987-1990 and 2000-2014), we systematically collected the fish killed by impingement upon cooling water intake screens at two nuclear power plants on the northern coast of Taiwan. Because impingement surveys have low sampling errors and can be carried out over many years, they serve as an ideal sampling tool for monitoring how fish diversity and community structure vary over an extended period of time.

  6. Long-term monitoring dataset of fish assemblages impinged at nuclear power plants in northern Taiwan.

    PubMed

    Chen, Hungyen; Liao, Yun-Chih; Chen, Ching-Yi; Tsai, Jeng-I; Chen, Lee-Sea; Shao, Kwang-Tsao

    2015-12-08

    The long-term species diversity patterns in marine fish communities are garnering increasing attention from ecologists and conservation biologists. However, current databases on quantitative abundance information lack consistent long-term time series, which are particularly important in exploring the possible underlying mechanism of community changes and evaluating the effectiveness of biodiversity conservation measures. Here we describe an impinged fish assemblage dataset containing 1, 283, 707 individuals from 439 taxa. Once a month over 19 years (1987-1990 and 2000-2014), we systematically collected the fish killed by impingement upon cooling water intake screens at two nuclear power plants on the northern coast of Taiwan. Because impingement surveys have low sampling errors and can be carried out over many years, they serve as an ideal sampling tool for monitoring how fish diversity and community structure vary over an extended period of time.

  7. Long-term monitoring dataset of fish assemblages impinged at nuclear power plants in northern Taiwan

    PubMed Central

    Chen, Hungyen; Liao, Yun-Chih; Chen, Ching-Yi; Tsai, Jeng-I; Chen, Lee-Sea; Shao, Kwang-Tsao

    2015-01-01

    The long-term species diversity patterns in marine fish communities are garnering increasing attention from ecologists and conservation biologists. However, current databases on quantitative abundance information lack consistent long-term time series, which are particularly important in exploring the possible underlying mechanism of community changes and evaluating the effectiveness of biodiversity conservation measures. Here we describe an impinged fish assemblage dataset containing 1, 283, 707 individuals from 439 taxa. Once a month over 19 years (1987–1990 and 2000–2014), we systematically collected the fish killed by impingement upon cooling water intake screens at two nuclear power plants on the northern coast of Taiwan. Because impingement surveys have low sampling errors and can be carried out over many years, they serve as an ideal sampling tool for monitoring how fish diversity and community structure vary over an extended period of time. PMID:26647085

  8. Partial transmalleolar approach for lateral impingement after total ankle arthroplasty: a case report.

    PubMed

    Matsumoto, Takumi; Nakamura, Ichiro; Miura, Ayumi; Momoyama, Gen; Ito, Katsumi

    2015-01-01

    Advances in implant technology have made total ankle arthroplasty an increasingly popular alternative to arthrodesis for the management of ankle arthritis. However, a frequent complication of the procedure is nerve impingement related to either to heterotrophic bone growth or the prosthesis itself. Successful resolution of this complication presents a challenge to clinicians. We present a case of lateral impingement following total ankle arthroplasty that was successfully treated using a partial transmalleolar approach to effect a partial osteotomy of the lateral malleolus and create a fragment attached to the anterior talofibular and calcaneofibular ligaments. This approach provides a good operative field in the lateral gutter with minimal soft tissue impairment. It also facilitates curettage, and resolution of tissue impingement. The osteotomy site healed fully by 3 months postoperative, and the pain around the lateral malleolus resolved. Furthermore, the patient's score on the Japanese Society for Surgery of the Foot Ankle/Hindfoot Scale improved from 33 preoperatively to 82 at 6 months postoperative.

  9. Heat Transfer Characteristics of Impinging Jets by Four Circular Nozzles Arranged in Square-type

    NASA Astrophysics Data System (ADS)

    Ichimiya, Koichi

    This paper presents the experimental results on the impingement heat transfer by 4-circular nozzles arranged in square type. Experiments were performed for the dimensionless space H(= h/D)=0.5-8,the Reynolds number Re(= VoD/v)=3000-40000, and the dimensionless pitch Pi(= pi/D)=8. The two-dimensional behavior of the local Nusselt number was corresponded to the flow visualization by oil film method on the impingement surface. The average Nusselt number was expressed by the geometric function and Re2/3. The maximum average Nusselt number was obtained at the dimensionless nozzle-impingement surface spacing H=2 for constant Reynolds number.

  10. Numerical computation of three-dimensional blunt body flow fields with an impinging shock

    NASA Technical Reports Server (NTRS)

    Holst, T. L.; Tannehill, J. C.

    1975-01-01

    A time-marching finite-difference method was used to solve the compressible Navier-Stokes equations for the three-dimensional wing-leading-edge shock impingement problem. The bow shock was treated as a discontinuity across which the exact shock jump conditions were applied. All interior shock layer detail such as shear layers, shock waves, jets, and the wall boundary layer were automatically captured in the solution. The impinging shock was introduced by discontinuously changing the freestream conditions across the intersection line at the bow shock. A special storage-saving procedure for sweeping through the finite-difference mesh was developed which reduces the required amount of computer storage by at least a factor of two without sacrificing the execution time. Numerical results are presented for infinite cylinder blunt body cases as well as the three-dimensional shock impingement case. The numerical results are compared with existing experimental and theoretical results.

  11. Automating an orbiter approach to Space Station Freedom to minimize plume impingement

    NASA Technical Reports Server (NTRS)

    Spehar, Peter T.; Le, Thomas Quan

    1991-01-01

    The Space shuttle orbiter Reaction Control System's (RCS) plume impingement during proximity operations with Space Station Freedom (SSF) is a structural design driver for the SSF solar panels and radiators. A study underway at JSC is investigating whether the use of an automated approach controller could result in the reduction of plume impingement induced loads during orbiter approach to SSF. Ongoing real time person-in-the-loop (PIL) simulations of an orbiter approaching the SSF show that orbiter trajectory control can vary significantly from one pilot to the next. This variation is a cause for concern since current analyses predict that plume impingement loads resulting from PIL orbiter approaches may exceed the solar panel and radiator load limits. The use of an automated approach controller is expected to reduce peak loads by both minimizing orbiter translational jet firings in certain directions and controlling the frequency at which they occur during various phases of the approach.

  12. OVERFLOW Validation for Predicting Plume Impingement of Underexpanded Axisymmetric Jets onto Angled Flat Plates

    NASA Technical Reports Server (NTRS)

    Lee, Henry C.; Klopfer, Goetz

    2011-01-01

    This report documents how OVERFLOW, a computational fluid dynamics code, predicts plume impingement of underexpanded axisymmetric jets onto both perpendicular and inclined flat plates. The effects of the plume impinging on a range of plate inclinations varying from 90deg to 30deg are investigated and compared to the experimental results in Reference 1 and 2. The flow fields are extremely complex due to the interaction between the shock waves from the free jet and those deflected by the plate. Additionally, complex mixing effects create very intricate structures in the flow. The experimental data is very limited, so these validation studies will focus only on cold plume impingement on flat and inclined plates. This validation study will help quantify the error in the OVERFLOW simulation when applied to stage separation scenarios.

  13. Nanofluid jet impingement heat transfer characteristics in the rectangular mini-fin heat sink

    NASA Astrophysics Data System (ADS)

    Naphon, Paisarn; Nakharintr, Lursukd

    2012-11-01

    The nanofluid jet impingement heat transfer characteristics in a rectangular mini-fin heat sink are studied. The heat sink is fabricated from aluminum by a wire electrical discharge machine. The nanofluid is a mixture of deionized water and nanoscale TiO2 particles with a volume nanoparticle concentration of 0.2%. The results obtained for nanofluid jet impingement cooling in the rectangular mini-fin heat sink are compared with those found in the water jet impingement cooling. The effects of the inlet temperature of the nanofluid, its Reynolds number, and the heat flux on the heat transfer characteristics of the rectangular mini-fin heat sink are considered. It is found that the average heat transfer rates for the nanofluid as coolant are higher than those for deionized water.

  14. Numerical study of unsteady viscous hypersonic blunt body flows with an impinging shock

    NASA Technical Reports Server (NTRS)

    Klopfer, G. H.; Yee, H. C.; Kutler, P.

    1988-01-01

    A complex two-dimensional, unsteady, viscous hypersonic shock wave interaction is numerically simulated by a high-resolution, second-order fully implicit shock-capturing scheme. The physical model consists of a nonstationary oblique shock impinging on the bow shock of a blunt body. Studies indicated that the unsteady flow patterns are slightly different from their steady counterparts. However, for the sample cases investigated the peak surface pressures for the unsteady flows seem to occur at very different impingement locations than for the steady flow cases.

  15. Analysis of reactor material experiments investigating corium crust stability and heat transfer in jet impingement flow

    SciTech Connect

    Sienicki, J.J.; Spencer, B.W.

    1985-01-01

    Presented is an analysis of the results of the CSTI-1, CSTI-3, and CWTI-11 reactor material experiments in which a jet of molten corium initially at 3080/sup 0/K was directed downward upon a stainless steel plate. The experiments are a continuation of a program of reactor material tests investigating LWR severe accident phenomena. Objective of the present analysis is to determine the existence or nonexistence of a corium crust during impingement from comparison of the measured heatup of the plate (as measured by thermocouples imbedded immediately beneath the steel surface) with model calculations assuming alternately the presence and absence of a stable crust during impingement.

  16. Visualization of impingement field of real-rocket-exhausted jets by using moire deflectometry

    NASA Astrophysics Data System (ADS)

    He, An-Zhi; Yan, Da-Peng; Miao, Peng C.; Wang, Hai-Ling

    1991-12-01

    The experimental methods and results of an impingement field of a real rocket exhausted jet are presented. By using large aperture and long path moire deflector, the moire deflectograms of rocket free jet and rocket jet impingement field are obtained. From these moire deflectograms, the location of the Mach disk, the oblique shock wave, and the value of boundary are calculated quantitatively and compared with the results of numerical simulating and wind tunnel simulating. At the same time, we have found five new shock wave structures from the experiments.

  17. Exploration of Impinging Water Spray Heat Transfer at System Pressures Near the Triple Point

    NASA Technical Reports Server (NTRS)

    Golliher, Eric L.; Yao, Shi-Chune

    2013-01-01

    The heat transfer of a water spray impinging upon a surface in a very low pressure environment is of interest to cooling of space vehicles during launch and re-entry, and to industrial processes where flash evaporation occurs. At very low pressure, the process occurs near the triple point of water, and there exists a transient multiphase transport problem of ice, water and water vapor. At the impingement location, there are three heat transfer mechanisms: evaporation, freezing and sublimation. A preliminary heat transfer model was developed to explore the interaction of these mechanisms at the surface and within the spray.

  18. [Combination of modern physiotherapeutic methods in rehabilitation of patients with osteoarthrosis and rheumatoid arthritis after arthroscopic surgery on the knee joint].

    PubMed

    Men'shikova, I V

    2008-01-01

    Duration of the rehabilitation period after arthroscopic surgery on the knee joint was reduced by the use of a combination of two modern physiotherapeutic modalities, local cryo-aerotherapy and electrostimulation of smooth muscle components of vascular walls using a Lymphavision apparatus (5-7 sessions). This treatment was given to 55 patients with osteoarthrosis following arthroscopic meniscal resection and abrasive chondropasty and to 20 ones with rheumatoid arthritis after arthroscopic total synovectomy. All patients reported alleviation of pain and oedema in the affected joint. The rehabilitation period was 2-5 days shorter than after the traditional treatment.

  19. Impingement of Water Droplets on an NACA 65(sub 1) -212 Airfoil at an Angle of Attack of 4 Deg

    NASA Technical Reports Server (NTRS)

    Brun, Rinaldo J.; Serafini, John S.; Moshos, George J.

    1952-01-01

    The trajectories of droplets in the air flowing past an NACA 651-212 airfoil at an angle of attack of 40 were determined. The collection efficiency, the area of droplet impingement, and the rate of droplet impingement were calculated from the trajectories and are presented herein.

  20. Efficacy of arthroscopic surgery and midlaser treatments for chronic temporomandibular joint articular disc derangement following motor vehicle accident.

    PubMed

    McNamara, D C; Rosenberg, I; Jackson, P A; Hogben, J

    1996-12-01

    As a result of motor vehicle accident soft-tissue injury, temporomandibular joint articular disc derangement may develop and persist despite symptomatic treatment and medication. This study reports the effectiveness of management directed at controlling the TMJ and masticatory neuromuscular pain dysfunction with a TMJ/interocclusal stabilization appliance, specific biofeedback and ultrasound therapy. Following these conservative measures residual articular disc derangement was present in some subjects who were offered arthroscopic surgery and infrared midlaser with TMJ/occlusal stabilization. Twenty subjects with residual disc derangement were randomly selected into two groups with and without arthroscopic surgery, and analyses of variance made before treatment, 12 months after conservative procedures, 3 months following arthroscopic surgery and midlaser therapy and 3 years since commencement of management. Dependent variables compared were pain-discomfort, Clinical Dysfunction Index, articular disc derangement and maximal voluntary jaw opening. Conservative management alone provided significant reduction of pain-discomfort and clinical dysfunction, while arthroscopic surgery resulted in significant reduction in articular disc derangement. The midlaser with TMJ/occlusal stabilization maintained significant improvement in the variables (p < 0.01) for both groups. The common articular deviations in form found at arthroscopy were soft tissue alteration with hyperaemia, synovitis, synovial membrane and posterior attachment folding with connective tissue hyperplasia, and disc displacement with fibrous adhesions. The Global Status Score of pain behaviour compared with residual function, confirmed the presence of greater pain before treatment commenced.

  1. Arthroscopic Latarjet and Capsular Shift (ALCS) procedure: a new "freehand" technique for anterior shoulder instability associated with significant bone defects.

    PubMed

    Bhatia, Deepak N

    2015-03-01

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

  2. Are the good functional results from arthroscopic repair of massive rotator cuff injuries maintained over the long term?☆

    PubMed Central

    Miyazaki, Alberto Naoki; Santos, Pedro Doneux; da Silva, Luciana Andrade; do Val Sella, Guilherme; Checchia, Sérgio Luiz; Yonamine, Alexandre Maris

    2015-01-01

    Objective To evaluate whether the good and excellent functional results from arthroscopic repair of massive rotator cuff tears are maintained over the long term. Methods From the sample of the study conducted by our group in 2006, in which we evaluated the functional results from arthroscopic repair of massive rotator cuff tears, 35 patients were reassessed, 8 years after the first evaluation. The inclusion criteria were that these patients with massive rotator cuff tears operated by means of an arthroscopic technique, who participated in the previous study and achieved good or excellent outcomes according to the UCLA criteria. Patients whose results were not good or excellent in the first evaluation according to the UCLA criteria were excluded. Results Among the 35 patients reassessed, 91% of them continued to present good and excellent results (40% excellent and 51% good), while 3% presented fair results and 6% poor results. The time interval between the first and second evaluations was 8 years and the minimum length of follow-up since the immediate postoperative period was 9 years (range: 9–17 years), with an average of 11.4 years. Conclusion The good and excellent results from arthroscopic repair of massive rotator cuff tears were mostly maintained (91%), with the same level of function and satisfaction, even though 8 years had passed since the first assessment, with a follow-up period averaging 11.4 years. PMID:26962491

  3. Arthroscopic Patelloplasty and Circumpatellar Denervation for the Treatment of Patellofemoral Osteoarthritis

    PubMed Central

    Zhao, Gang; Liu, Yujie; Yuan, Bangtuo; Shen, Xuezhen; Qu, Feng; Wang, Jiangtao; Qi, Wei; Zhu, Juanli; Liu, Yang

    2015-01-01

    Background: Patellofemoral osteoarthritis commonly occurs in older people, often resulting in anterior knee pain and severely reduced quality of life. The aim was to examine the effectiveness of arthroscopic patelloplasty and circumpatellar denervation for the treatment of patellofemoral osteoarthritis (PFOA). Methods: A total of 156 PFOA patients (62 males, 94 females; ages 45-81 years, mean 66 years) treated in our department between September 2012 and March 2013 were involved in this study. Clinical manifestations included recurrent swelling and pain in the knee joint and aggravated pain upon ascending/descending stairs, squatting down, or standing up. PFOA was treated with arthroscopic patelloplasty and circumpatellar denervation. The therapeutic effects before and after surgery were statistically evaluated using Lysholm and Kujala scores. The therapeutic effects were graded by classification of the degree of cartilage defect. Results: A total of 149 cases were successfully followed up for 14.8 months, on average. The incisions healed well, and no complications occurred. After surgery, the average Lysholm score improved from 73.29 to 80.93, and the average Kujala score improved from 68.34 to 76.48. This procedure was highly effective for patients with cartilage defects I-III but not for patients with cartilage defect IV. Conclusions: For PFOA patients, this procedure is effective for significantly relieving anterior knee pain, improving knee joint function and quality of life, and deferring arthritic progression. PMID:25563318

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

    PubMed Central

    Belangero, William Dias

    2006-01-01

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

  5. Signs of knee osteoarthritis common in 620 patients undergoing arthroscopic surgery for meniscal tear

    PubMed Central

    Pihl, Kenneth; Englund, Martin; Lohmander, L Stefan; Jørgensen, Uffe; Nissen, Nis; Schjerning, Jeppe; Thorlund, Jonas B

    2017-01-01

    Background and purpose — Recent evidence has questioned the effect of arthroscopic knee surgery for middle-aged and older patients with degenerative meniscal tears with or without concomitant radiographic knee osteoarthritis (OA). We investigated the prevalence of early or more established knee OA and patients’ characteristics in a cohort of patients undergoing arthroscopic surgery for a meniscal tear. Patients and methods — 641 patients assigned for arthroscopy on suspicion of meniscus tear were consecutively recruited from February 2013 through January 2015. Of these, 620 patients (mean age 49 (18–77) years, 57% men) with full datasets available were included in the present study. Prior to surgery, patients completed questionnaires regarding onset of symptoms, duration of symptoms, and mechanical symptoms along with the knee injury and osteoarthritis outcome score (KOOS). At arthroscopy, the operating surgeon recorded information about meniscal pathology and cartilage damage. Early or more established knee OA was defined as the combination of self-reported frequent knee pain, cartilage damage, and the presence of degenerative meniscal tissue. Results — 43% of patients (269 of 620) had early or more established knee OA. Of these, a large proportion had severe cartilage lesions with almost half having a severe cartilage lesion in at least 1 knee compartment. Interpretation — Based on a definition including frequent knee pain, cartilage damage, and degenerative meniscal tissue, early or more established knee OA was present in 43% of patients undergoing knee arthroscopy for meniscal tear. PMID:27798972

  6. Changes in temporomandibular joint spaces after arthroscopic disc repositioning: a self-control study

    PubMed Central

    Kai Hu, Ying; Abdelrehem, Ahmed; Yang, Chi; Cai, Xie Yi; Xie, Qian Yang; Sah, Manoj Kumar

    2017-01-01

    Disc repositioning is a common procedure for patients with anterior disc displacement (ADD). The purpose of this retrospective record-based study was to evaluate changes in the widths of joint spaces and condylar position changes in patients with unilateral ADD following arthroscopic disc repositioning, with the healthy sides as self-control, using magnetic resonance images (MRI).Widths of anterior, superior, and posterior joint spaces (AS, SS, and PS) were measured. The condylar position was described as anterior, centric or posterior, expressed as . Paired-t test and Chi-square test were used to analyze the data. Fifty-four records conformed to the inclusion criteria (mean age of 21.02 years). Widths of SS and PS increased significantly after surgery (P < 0.001) on the operative sides, while joint spaces of healthy sides and AS of operative sides had no significant changes. Dominant location of condyles of operative sides changed from a posterior position to an anterior position, while healthy sides were mostly centric condylar position no matter preoperatively or postoperatively. Therefore, the results of this study indicate that unilateral arthroscopic disc repositioning significantly increases the posterior and superior spaces of the affected joints, without affecting spaces of the healthy sides. PMID:28361905

  7. Signs of knee osteoarthritis common in 620 patients undergoing arthroscopic surgery for meniscal tear.

    PubMed

    Pihl, Kenneth; Englund, Martin; Lohmander, L Stefan; Jørgensen, Uffe; Nissen, Nis; Schjerning, Jeppe; Thorlund, Jonas B

    2017-02-01

    Background and purpose - Recent evidence has questioned the effect of arthroscopic knee surgery for middle-aged and older patients with degenerative meniscal tears with or without concomitant radiographic knee osteoarthritis (OA). We investigated the prevalence of early or more established knee OA and patients' characteristics in a cohort of patients undergoing arthroscopic surgery for a meniscal tear. Patients and methods - 641 patients assigned for arthroscopy on suspicion of meniscus tear were consecutively recruited from February 2013 through January 2015. Of these, 620 patients (mean age 49 (18-77) years, 57% men) with full datasets available were included in the present study. Prior to surgery, patients completed questionnaires regarding onset of symptoms, duration of symptoms, and mechanical symptoms along with the knee injury and osteoarthritis outcome score (KOOS). At arthroscopy, the operating surgeon recorded information about meniscal pathology and cartilage damage. Early or more established knee OA was defined as the combination of self-reported frequent knee pain, cartilage damage, and the presence of degenerative meniscal tissue. Results - 43% of patients (269 of 620) had early or more established knee OA. Of these, a large proportion had severe cartilage lesions with almost half having a severe cartilage lesion in at least 1 knee compartment. Interpretation - Based on a definition including frequent knee pain, cartilage damage, and degenerative meniscal tissue, early or more established knee OA was present in 43% of patients undergoing knee arthroscopy for meniscal tear.

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

    PubMed

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

    2012-10-01

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

  9. Innovations in arthroscopic management of Basal joint arthritis of the thumb.

    PubMed

    Carro, Luis Perez; Golano, Pau; Vega, Jordi; Cabestany, Jose María

    2006-12-01

    Thumb arthroscopy and arthroscopically assisted treatment of the thumb are safe and effective techniques. This report describes technical innovations particularly useful in the surgical performance of arthroscopically assisted treatment of basal joint arthritis. (1) With adduction and hyperextension of the thumb, the bony landmarks are easier to palpate and a volar radial soft spot is clearly defined between the trapezium and metacarpal (i.e., the adduction-hyperextension maneuver). (2) After the distension of the joint with saline solution, the thumb automatically abducts and flexes if the capsule has been distended successfully (i.e., the flexion-abduction sign). (3) The radial and ulnar borders of the proximal phalanx and the local tendons can serve as external landmarks if fluid extravasation occurred. (4) Finally, the simultaneous use of the 3 portals described in the first carpometacarpal joint is very effective for better visualization and performance of the procedures in this joint (i.e., the 3-portal technique). We propose a new description of the portals for carpometacarpal arthroscopy as follows: (1) volar portal, which is just distal to the oblique ridge of the trapezium following a line referencing the radial edge of the flexor carpi radialis; (2) ulnar portal, which is just ulnar to the extensor pollicis brevis; and (3) radial portal, which is just radial to the abductor pollicis longus.

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

    PubMed Central

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

    2015-01-01

    Background: The knee joint is the largest and the most complex joint of the human body. It is not covered by any thick muscular covering anteriorly. Objectives: The purpose of this study was to explore the diagnostic capabilities of clinical examination, magnetic resonance imaging (MRI), and arthroscopy in traumatic disorders of the knee joint, to seek correlation between clinical findings, MRI findings and arthroscopic. Patients and Methods: A total of 26 patients with a presentation suggestive of traumatic knee pathology were studied prospectively. A detailed history was taken and relevant clinical examination was done, which was followed by MRI of the knee. The patients were scheduled for arthroscopy under general/spinal anesthesia, whenever indicated. Results: Keeping arthroscopic examination as standard, the correlation between clinical and arthroscopy showed a sensitivity of 80%, specificity of 86%, accuracy of 63.16%, negative predictive value of 93.48%; whereas MRI vs. arthroscopy showed a sensitivity of 74.42%, specificity of 93.10%, accuracy of 84.21%, and negative predictive value of 88.04%. Conclusions: The clinical examination is an important and accurate diagnostic modality for evaluation of traumatic derangement of the knee joint. It is noninvasive, easy, available, and valuable diagnostic modality. The MRI is an accurate diagnostic modality. It can be used whenever there is an uncertain indication for arthroscopy. However, costs have to be kept in mind, especially in patients with low socio-economic status. PMID:25825695

  11. 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.

  12. 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

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

    PubMed

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

    2016-02-01

    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.

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

    PubMed

    Ichiseki, Toru; Ueda, Shusuke; Matsumoto, Tadami

    2015-01-01

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

  15. Isolated arthroscopic meniscal repair: a long-term outcome study (more than 10 years).

    PubMed

    Johnson, M J; Lucas, G L; Dusek, J K; Henning, C E

    1999-01-01

    A single surgeon's consecutive series of 50 arthroscopically repaired meniscal tears in 48 patients was retrospectively reviewed. None of these patients had concomitant ligament damage to the knee. The average follow-up period was 10 years, 9 months. Criteria for clinical success included 1) history of pain of grade 1 or less and absence of locking, catching, or giving way; 2) a physical examination demonstrating no significant effusion and a painless and negative jump sign; and 3) no subsequent surgical procedures on the repaired meniscus. Patient satisfaction was quite high, although clinical confirmation was possible in only 38 knees, indicating a clinical success rate of 76%. Bilateral standing radiographs were obtained on these 38 operated knees and were evaluated using Fairbank's classification. Evaluation of the radiographs revealed that 8% of the operated knees had minimal joint changes, as compared with 3% in the contralateral, nonoperated knee. This study demonstrates that arthroscopic meniscal repair in knees with isolated meniscal tears has the potential for a long-term successful clinical and radiographic outcome.

  16. Arthroscopic-assisted repair of triangular fibrocartilage complex foveal avulsion in distal radioulnar joint injury

    PubMed Central

    Woo, Sung Jong; Jegal, Midum; Park, Min Jong

    2016-01-01

    Background: Disruption of the triangular fibrocartilage complex (TFCC) foveal insertion can lead to distal radioulnar joint (DRUJ) instability accompanied by ulnar-sided pain, weakness, snapping, and limited forearm rotation. We investigated the clinical outcomes of patients with TFCC foveal tears treated with arthroscopic-assisted repair. Materials and Methods: Twelve patients underwent foveal repair of avulsed TFCC with the assistance of arthroscopy between 2011 and 2013. These patients were followed up for an average of 19 months (range 14–25 months). The avulsed TFCC were reattached to the fovea using a transosseous pull-out suture or a knotless suture anchor. At the final followup, the range of motion, grip strength and DRUJ stability were measured as objective outcomes. Subjective outcomes were assessed using the Visual Analog Scale (VAS) for pain, patient rated wrist evaluation (PRWE), Disabilities of the Arm, Shoulder and Hand questionnaire (DASH score) and return to work. Results: Based on the DRUJ stress test, 5 patients had normal stability and 7 patients showed mild laxity as compared with the contralateral side. Postoperatively, the mean range of pronation supination increased from 141° to 166°, and the mean VAS score for pain decreased from 5.3 to 1.7 significantly. The PRWE and DASH questionnaires also showed significant functional improvement. All patients were able to return to their jobs. However, two patients complained of persistent pain. Conclusions: Arthroscopically assisted repair of TFCC foveal injury can provide significant pain relief, functional improvement and restoration of DRUJ stability. PMID:27293286

  17. Functional evaluation of arthroscopic repair of rotator cuff injuries in patients with pseudoparalysis☆☆☆

    PubMed Central

    Miyazaki, Alberto Naoki; Fregoneze, Marcelo; Santos, Pedro Doneux; da Silva, Luciana Andrade; do Val Sella, Guilherme; Neto, Douglas Lobato Lopes; Muchiuti Junior, Melvis; Checchia, Sergio Luiz

    2014-01-01

    Objective to evaluate the functional result from arthroscopic repair of rotator cuff injuries in patients with pseudoparalysis, defined as incapacity to actively raise the arm above 90°, while complete passive elevation was possible. Methods we reevaluated 38 patients with a mean follow-up of 51 months (minimum of 24). We analyzed the pseudoparalysis reversion rate and the functional result obtained. Results according to the assessment criteria of the University of California in Los Angeles (UCLA), 31 (82%) patients had good and excellent results, two (5%) had fair results and five (13%) had poor results. The mean active elevation went from 39° before the operation to 139° after the operation (p < 0.05); the mean active lateral rotation went from 30° to 48° (p < 0.05) and the mean active medial rotation went from level L3 to T12 (p < 0.05). Conclusion arthroscopic repair of rotator cuff injuries produced good and excellent results in 82% of the cases and a statistically significant improvement of active range of motion, with reversion of the pseudoparalysis in 97.4% of the cases. It is therefore a good treatment option. PMID:26229796

  18. Experimental, water droplet impingement data on two-dimensional airfoils, axisymmetric inlet and Boeing 737-300 engine inlet

    NASA Technical Reports Server (NTRS)

    Papadakis, M.; Elangovan, E.; Freund, G. A., Jr.; Breer, M. D.

    1987-01-01

    An experimental method has been developed to determine the droplet impingement characteristics on two- and three-dimensional bodies. The experimental results provide the essential droplet impingement data required to validate particle trajectory codes, used in aircraft icing analyses and engine inlet particle separator analyses. A body whose water droplet impingement characteristics are required is covered at strategic locations by thin strips of moisture absorbing (blotter) paper, and then exposed to an air stream containing a dyed-water spray cloud. Water droplet impingement data are extracted from the dyed blotter strips, by measuring the optical reflectance of the dye deposit on the strips, using an automated reflectometer. Impingement efficiency data obtained for a NACA 65(2)015 airfoil section, a supercritical airfoil section, and Being 737-300 and axisymmetric inlet models are presented in this paper.

  19. Thermal chip fabrication with arrays of sensors and heaters for micro-scale impingement cooling heat transfer analysis and measurements.

    PubMed

    Shen, C H; Gau, C

    2004-07-30

    The design and fabrication for a thermal chip with an array of temperature sensors and heaters for study of micro-jet impingement cooling heat transfer process are presented. This thermal chip can minimize the heat loss from the system to the ambient and provide a uniform heat flux along the wall, thus local heat transfer processes along the wall can be measured and obtained. The fabrication procedure presented can reach a chip yield of 100%, and every one of the sensors and heaters on the chip is in good condition. In addition, micro-jet impingement cooling experiments are performed to obtain the micro-scale local heat transfer Nusselt number along the wall. Flow visualization for the micro-impinging jet is also made. The experimental results indicate that both the micro-scale impinging jet flow structure and the heat transfer process along the wall is significantly different from the case of large-scale jet impingement cooling process.

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

    PubMed

    Ng, Choong; Bialocerkowski, Andrea; Hinman, Rana

    2007-06-01

    Background  Anterior instability is a frequent complication following a traumatic glenohumeral dislocation. Frequently the underlying pathology associated with recurrent instability is a Bankart lesion. Surgical correction of Bankart lesions and other associated pathology is the key to successful treatment. Open surgical glenohumeral stabilisation has been advocated as the gold standard because of consistently low postoperative recurrent instability rates. However, arthroscopic glenohumeral stabilisation could challenge open surgical repair as the gold standard treatment for traumatic anterior glenohumeral instability. Objectives  Primary evidence that compared the effectiveness of arthroscopic versus open surgical glenohumeral stabilisation was systematically collated regarding best-practice management for adults with traumatic anterior glenohumeral instability. Search strategy  A systematic search was performed using 14 databases: MEDLINE, Cumulative Index of Nursing and Allied Health (CINAHL), Allied and Complementary Medicine Database (AMED), ISI Web of Science, Expanded Academic ASAP, Proquest Medical Library, Evidence Based Medicine Reviews, Physiotherapy Evidence Database, TRIP Database, PubMed, ISI Current Contents Connect, Proquest Digital Dissertations, Open Archives Initiative Search Engine, Australian Digital Thesis Program. Studies published between January 1984 and December 2004 were included in this review. No language restrictions were applied. Selection criteria  Eligible studies were those that compared the effectiveness of arthroscopic versus open surgical stabilisation for the management of traumatic anterior glenohumeral instability, which had more than 2 years of follow up and used recurrent instability and a functional shoulder questionnaire as primary outcomes. Studies that used non-anatomical open repair techniques, patient groups that were specifically 40 years or older, or had multidirectional instability or other concomitant