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EFORT Open Reviews Jul 2018Acromioclavicular (AC) joint injury is a frequent diagnosis after an acute shoulder trauma - often found among athletes and people involved in contact sports.This injury...
Acromioclavicular (AC) joint injury is a frequent diagnosis after an acute shoulder trauma - often found among athletes and people involved in contact sports.This injury occurs five times more frequently in men than in women, with the highest incidence in the 20- to 30-year-old age group. Patients usually complain of pain and tenderness over the shoulder, particularly over the AC joint.Depending on the degree of injury, the clavicle may become prominent on the injured site.The original classification was described by Rockwood and Green according to the injured ligament complex and degree and direction of clavicular displacement.Many surgical procedures have been described; among these are screws, plates, muscle transfer, ligamentoplasty procedures and ligament reconstruction using either autograft or allografts.With the advancement of shoulder arthroscopy, surgeons are much more capable of performing mini-open or arthroscopically-assisted procedures, allowing patients an earlier return to their daily living activities. However, the results of conventional open techniques are still comparable.The introduction of new arthroscopic equipment provides a great variety of surgical procedures, though every new technique has its own advantages and pitfalls. Currently there is no gold standard for the surgical treatment of any type of AC injury, though it should be remembered that whenever an arthroscopic technique is chosen, the surgeon's expertise is likely to be the most significant factor affecting outcome. Cite this article: 2018;3:426-433. DOI: 10.1302/2058-5241.3.170027.
PubMed: 30233818
DOI: 10.1302/2058-5241.3.170027 -
Arthroscopy Techniques May 2020As a result of the continued improvement in arthroscopic equipment and techniques, subscapularis tears are now more reliably identified and are being repaired at higher...
As a result of the continued improvement in arthroscopic equipment and techniques, subscapularis tears are now more reliably identified and are being repaired at higher rates than previously reported. Whereas small upper-border subscapularis tears can usually be effectively managed using an intra-articular view, larger tears often cannot be fully visualized with a standard 30° arthroscope when viewed from the posterior portal. These tears may require either using a 70° arthroscope or viewing through the standard 30° arthroscope from a subacromial portal-site location to completely visualize the tear. This article illustrates and discusses the advantages of using a subacromial-space portal site to view and arthroscopically manage large subscapularis tears.
PubMed: 32489832
DOI: 10.1016/j.eats.2020.01.011 -
Cureus Aug 2021Osteochondroma is the most common benign tumor of the growing bone that commonly involves the knee joint region. Hereby we present a case of an arthroscopic resection of...
Osteochondroma is the most common benign tumor of the growing bone that commonly involves the knee joint region. Hereby we present a case of an arthroscopic resection of a symptomatic intra-articular osteochondroma of the knee. A 32-year-old woman presented with diffuse and persistent pain of her right knee followed by discomfort for over three months. She did not report any history of injury or any other medical problem. Physical examination and imaging, with plain radiographs and MRI, revealed a bony mass arising from the supero-lateral aspect of her right distal femur without a stalk. This bone tumor, an osteochondroma, was arthroscopically resected and the diagnosis was confirmed by the histologic examination. The arthroscopic resection of this benign tumor led to complete relief of the symptoms of the patient and her return to daily and athletic activities in one month postoperatively. No recurrence of symptoms occurred during the seven-year follow-up period. Arthroscopic resection of a symptomatic osteochondroma is less painful, more cosmetically accepted, and can result in a quicker recovery than the traditional approach with an open incision.
PubMed: 34532184
DOI: 10.7759/cureus.17154 -
Arthroscopy Techniques Jul 2023Chronic lateral ankle instability is a common orthopaedic problem. The continuous stress applied by the lateral instability may affect the superficial deltoid ligament....
Chronic lateral ankle instability is a common orthopaedic problem. The continuous stress applied by the lateral instability may affect the superficial deltoid ligament. The combination of lateral ankle instability and injury to the most anterior fascicles of the deltoid ligament contributes to rotational ankle instability. The purpose of this Technical Note is to describe the details of arthroscopic deltoid ligament reconstruction in rotational ankle instability. This minimally invasive approach allows other associated lesions to be detected and managed arthroscopically.
PubMed: 37533912
DOI: 10.1016/j.eats.2023.03.007 -
Arthroscopy Techniques Jun 2023The intra-articular injury most often associated with a chronic anterior cruciate ligament tear involves the posterior horn of the medial meniscus. A specific type of...
The intra-articular injury most often associated with a chronic anterior cruciate ligament tear involves the posterior horn of the medial meniscus. A specific type of medial meniscal injury, called a ramp lesion, has received greater attention for identification and treatment because of its considerable incidence and diagnostic difficulty. Based on their location, these lesions may be arthroscopically "hidden" during traditional anterior visualization. The purpose of the present Technical Note is to describe the Recife maneuver. This maneuver diagnoses injuries to the posterior horn of the medial meniscus using additional arthroscopic management through a standard portal. The Recife maneuver is performed with the patient in the supine position. A 30° arthroscope is inserted through the anterolateral portal, and the posteromedial compartment is accessed according to the transnotch view (modified Gillquist view). In the proposed maneuver, with the knee in 30° of flexion, a valgus stress with internal rotation is performed, followed by palpation of the popliteal region and digital pressure on the joint interline. This maneuver allows a greater visualization of the posterior compartment, allowing the diagnostic evaluation of the integrity between the meniscus and the capsule, in a safer way, being able to identify ramp tears without the need to create a posteromedial portal. We recommend that the addition of the diagnostic visualization step of the posteromedial compartment as described by the Recife maneuver be performed to assess the meniscal status in routine anterior cruciate ligament reconstruction.
PubMed: 37424638
DOI: 10.1016/j.eats.2023.02.033 -
Frontiers in Surgery 2022This paper introduces the treatment and clinical outcome of the dorsal wrist ganglion cyst utilizing the Kiss-in method to establish a midcarpal volar portal.
INTRODUCTION
This paper introduces the treatment and clinical outcome of the dorsal wrist ganglion cyst utilizing the Kiss-in method to establish a midcarpal volar portal.
MATERIALS AND METHODS
Patients with dorsal ganglia of the wrist ( = 12, 6 females, 6 males) underwent arthroscopic surgery using the Kiss-in method at our hospital between September 2018 and January 2021. All patients underwent preoperative radiological investigations, such as magnetic resonance imaging (MRI; 12 cases) or ultrasonography (12 cases). The mean age of patients was 30.7 years (range: 19-46 years). The time lost from work, the wrist motion and strength, the presence of scarring, residual symptoms, complications, and recurrence were recorded at a mean follow-up of 24 months.
RESULTS
Eleven patients showed a good prognosis with active motion recovery. One patient showed the recurrence of ganglion, and the second arthroscopic resection was performed 5 months after the first surgery for this patient. After the surgery, the patient fully recovered.
CONCLUSIONS
Establishing the midcarpal volar portal by the Kiss-in method is safe. The dorsal ganglion cyst resection through the established midcarpal volar portal is a promising approach, allowing better visualization and a broader range motion of the arthroscope.
PubMed: 36117835
DOI: 10.3389/fsurg.2022.944396 -
Journal of Wrist Surgery Feb 2022Arthroscopy of the distal radioulnar joint is considered to be difficult to perform. At this time the integrity of the foveal insertion is indirectly evaluated with...
Arthroscopy of the distal radioulnar joint is considered to be difficult to perform. At this time the integrity of the foveal insertion is indirectly evaluated with a hook test. If a hook test is positive it is inferred that the foveal insertion is torn or incompetent. The ideal way to evaluate the foveal insertion is by direct visualization and probing. In order to do this, arthroscopic examination of the distal radioulnar joint and foveal insertion is required. The article describes how to reliably perform "dry" arthroscopy of the distal radioulnar joint and foveal insertion using a 1.9 mm arthroscope to accurately assess the triangular fibrocartilage complex and foveal insertion. A total of 169 dry DRUJ arthroscopies were performed by the primary author between January 2018 and February 2021. Using this technique, the foveal insertion was successfully visualized in 168 cases (99%). Dry arthroscopy of the DRUJ is a reliable technique to evaluate the integrity of the foveal insertion.
PubMed: 35127257
DOI: 10.1055/s-0041-1732414 -
Beijing Da Xue Xue Bao. Yi Xue Ban =... Apr 2016To evaluate the outcomes of lesser arc perilunate injuries (Perilunate dislocations) treated with arthroscopically assisted mini-invasive reduction and fixation.
OBJECTIVE
To evaluate the outcomes of lesser arc perilunate injuries (Perilunate dislocations) treated with arthroscopically assisted mini-invasive reduction and fixation.
METHODS
Between 2012 and 2014, 5 patients who had a perilunate dislocation were treated with arthroscopically assisted reduction and percutaneous fixation. The mean follow-up was 17.8 months (range, 10 to 32 months). Clinical outcomes were evaluated on the basis of range of motion; grip strength; Mayo wrist score; Quick disabilities of the arm, shoulder and hand questionnaire; and patient-rated wrist evaluation score. Radiographic evaluations included carpal alignments and any development of arthritis.
RESULTS
The range of flexion-extension motion of injured wrist averaged 84% of the values for contralateral wrist. The grip strength of the injured wrist averaged 90% of the values for the contralateral wrists. The mean Quick Disabilities of the arm, shoulder and hand score was 1, and the mean Patient-Rated Wrist Evaluation score was 5. According to the Mayo wrist scores, the overall functional outcomes were rated as excellent in all the patients. Reduction obtained during the operation was maintained within normal ranges in all the patients. Arthritis had not developed in any patient at the end of the follow-up.
CONCLUSION
Arthroscopic mini-invasive reduction with percutaneous fixation is a reliable and favorable alternative in the treatment of perilunate dislocations according to our early results.
Topics: Arthroscopy; Humans; Joint Dislocations; Lunate Bone; Range of Motion, Articular; Treatment Outcome; Wrist Injuries; Wrist Joint
PubMed: 27080273
DOI: No ID Found -
Archives of Medical Science : AMS 2021The purpose of this study was twofold. First, the efficacy of arthroscopic repair in patients with full thickness, isolated subscapularis tendon tears (I-STTs) or...
INTRODUCTION
The purpose of this study was twofold. First, the efficacy of arthroscopic repair in patients with full thickness, isolated subscapularis tendon tears (I-STTs) or combined subscapularis tendon tears (C-STTs) involving the rotator cuff tendons was evaluated. Second, the outcomes between these two groups were compared. The influence of age and gender on the cohort clinical outcomes was also analysed. Our hypothesis was that satisfactory functional results could be obtained arthroscopically in both groups without any influence of age or gender.
MATERIAL AND METHODS
Seventy-nine patients were enrolled: 15 with I-STTs and 64 with C-STTs. The clinical outcomes were assessed using Constant and Disabilities of the Arm, Shoulder and Hand (DASH) scores, Numeric Rating Scale (NRS) for pain and Visual Analogue Scale (VAS) for satisfaction. The subscapularis strength was assessed using a comparative dynamometric bear-hug test. Group outcomes were compared, including statistical analysis.
RESULTS
For each group, there were no differences regarding the subscapularis strength of the operated and non-operated shoulders. A comparison of the post- with the pre-operative outcomes showed an increase in the Constant score and a decrease in the NRS. Comparing the two groups, we found no difference in strength of the operated and non-operated shoulders, but a significant difference in relation to pre-operative Constant score and pre-operative NRS. Age was negatively correlated with both pre-operative and post-operative Constant scores. No association was found between gender and the outcomes, although the DASH score was higher in women.
CONCLUSIONS
Arthroscopic repair of STTs provided functional restoration, pain relief and patient satisfaction in both groups. Age and gender did not affect the clinical outcomes achieved by arthroscopic STT repair.
PubMed: 34522265
DOI: 10.5114/aoms.2020.97714 -
Arthroscopy Techniques Jan 2024Hip arthroscopy has become increasingly popular in recent years and continues to grow as techniques and understanding of hip arthroscopy evolve. Needle hip arthroscopy...
Hip arthroscopy has become increasingly popular in recent years and continues to grow as techniques and understanding of hip arthroscopy evolve. Needle hip arthroscopy is emerging as a technique that can offer potential advantages compared with a traditional arthroscope. These benefits include a higher degree field of view, lower profile design for easier maneuverability, decreased arthroscopic fluid, and potentially decreased postoperative pain and swelling. We herein present and describe a technique of needle hip arthroscopy as a viable option in the treatment of hip pathology.
PubMed: 38312889
DOI: 10.1016/j.eats.2023.08.024