-
Foot & Ankle International Sep 2020The anterocentral portal is not a standard portal in anterior ankle arthroscopy due to its proximity to the anterior neurovascular bundle. However, it provides certain...
BACKGROUND
The anterocentral portal is not a standard portal in anterior ankle arthroscopy due to its proximity to the anterior neurovascular bundle. However, it provides certain advantages, including a wide field of vision, and portal changes become redundant. The purpose of this study was to evaluate the neurovascular complications after anterior ankle arthroscopy using the anterocentral portal.
METHODS
We retrospectively identified patients who had undergone anterior ankle arthroscopy with an anterocentral portal at our institution from 2013 to 2018. Medical record data were reviewed and patients were invited for clinical follow-up, where a clinical examination, quantitative sensory testing for the deep peroneal nerve, and ultrasonography of the structures at risk were performed. A total of 101 patients (105 arthroscopies) were identified and evaluated at a mean follow-up of 31.5 ± 17.7 months.
RESULTS
Leading indications to surgery were heterogeneous and included anterior impingement (48.6%), osteochondral lesions of the talus (24.8%), chronic ankle instability (14.3%), and fractures (8.6%). The overall complication rate was 7.6%, and no major complications were observed. In 1.9% (2/105) of the cases, the complications were associated with the anterocentral portal and included injury to the medial branch of the superficial nerve (1/105) and to the deep peroneal nerve (1/105). Injury to the deep peroneal nerve was associated with a loss of detection and nociception. There were no injuries to the anterior tibial artery. In 41.9% (44/105) of the cases, only 1 working portal was used in addition to the anterocentral portal, and in 19% (20/105) the anterolateral portal could be avoided. Ultrasonography confirmed the integrity of the deep peroneal nerve, the medial branch of the superficial peroneal nerve, and the anterior tibial artery in all patients. Patients with nerve injuries associated with the anterocentral portal showed no signs of neuroma or pseudoaneurysm.
CONCLUSION
Using a standardized technique, the anterocentral portal in ankle arthroscopy is safe with a low number of neurovascular injuries and can be recommended as a standard portal. The anterolateral portal remains associated with a high number of injuries to the superficial peroneal nerve.
LEVEL OF EVIDENCE
Level III, retrospective cohort study.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Ankle Joint; Arthroscopy; Cohort Studies; Female; Humans; Male; Middle Aged; Peroneal Nerve; Postoperative Complications; Retrospective Studies; Young Adult
PubMed: 32546005
DOI: 10.1177/1071100720931095 -
Scientific Reports Aug 2022Cases of arthroscopic surgery have increased over the past two decades, and arthroscopic shaver systems have become a commonly used orthopedic tool. Nevertheless, most...
Cases of arthroscopic surgery have increased over the past two decades, and arthroscopic shaver systems have become a commonly used orthopedic tool. Nevertheless, most shavers generally have problems such as the cutting edge is not sharp enough and easy to wear. This paper aims to discuss the structural characteristics of BJKMC's (Bojin Kinetic Medical) novel arthroscopic shaver, the double serrated blade. The product's design and verification process are outlined. BJKMC's articular arthroscopy shaver has a "tube in a tube" structure, comprising a stainless steel outer sleeve and a rotating hollow inner tube. The outer sleeve and inner tube have corresponding suction and cutting windows, and there are serrated teeth on the inner and outer casing. To verify the design rationality, it was compared to Dyonics's equivalent product, the Incisor Plus Blade. The appearance, cutting tool hardness, metal pipe roughness, cutting tool wall thickness, tooth profile, and angle, overall structure, and the key dimensions were examined and compared. Compared with Dyonics's Incisor Plus Blade, BJKMC's Double Serrated Blade had a smoother working surface, harder and thinner blade head. Therefore, BJKMC's product may have satisfactory performance when it comes to surgery.
Topics: Arthroscopy; Orthopedics; Suction; Surgical Instruments
PubMed: 35962054
DOI: 10.1038/s41598-022-17674-2 -
The National Medical Journal of India 1992
Topics: Arthroscopy; Humans; India; Orthopedics
PubMed: 1304237
DOI: No ID Found -
Sports Medicine and Arthroscopy Review Mar 2022Arthroscopy of the shoulder, elbow, hip, and knee has become increasingly utilized due to continued advancements in technique, training, and instrumentation. In... (Review)
Review
Arthroscopy of the shoulder, elbow, hip, and knee has become increasingly utilized due to continued advancements in technique, training, and instrumentation. In addition, arthroscopy is generally safe and effective in the utilization of joint preservation surgical techniques. The arthroscopist must utilize a thorough understanding of the surgical anatomy, detailed care with patient positioning, and safe instrumentation portals to prevent associated neurological injury. In the event of postoperative neurological complications, the physician must carefully document the patient history and physical examination while considering the utilization of additional imaging, testing, or surgical nerve exploration with a specialized team depending upon the severity of neurological injury. In this review, we discuss the prevention, evaluation, and treatment of neurological complications related for arthroscopic procedures of the shoulder, elbow, hip, and knee.
Topics: Arthroscopy; Elbow; Elbow Joint; Humans; Knee Joint; Shoulder
PubMed: 35113840
DOI: 10.1097/JSA.0000000000000322 -
Acta Ortopedica Mexicana 2018There are less and fewer opportunities for residents to learn and develop surgical skills in the operating room. In some parts of the world, the development and... (Review)
Review
BACKGROUND
There are less and fewer opportunities for residents to learn and develop surgical skills in the operating room. In some parts of the world, the development and adaptation of technology for the teaching of psychomotor skills in surgical specialties appears. Arthroscopy is a surgical technique that lends itself to simulation. So far there is no such thing as a structured and validated arthroscopy training program for orthopaedic residents in Mexico.
OBJECTIVE
To propose a structured arthroscopy training plan that incorporates the simulation for orthopaedic residents.
METHOD
A review of the literature on teaching with simulation in orthopaedics and arthroscopy was performed, a study was conducted to establish reference values for arthroscopy exercises in a virtual reality simulator and a training plan was developed with Arthroscopy simulation for orthopaedic residents.
RESULTS
A seven-stage program was developed with theoretical classes and simulation to improve motor skills. The complexity of the procedures increases through the practical modules. It is complemented by a semester evaluation.
DISCUSSION
Currently most of the efforts in teaching with simulators focus on medical students and first-and second-year residents. I believe that efforts should be focused to include residents of higher ranks and surgeons. This design will be proposed to the orthopaedic Unique Medical Education Program (PUEM in Spanish). It is important to develop validated curricula that incorporate the simulation for the development of motor skills in orthopaedic residents.
Topics: Arthroscopy; Clinical Competence; Computer Simulation; Internship and Residency; Knee Joint; Mexico; Orthopedics
PubMed: 30726593
DOI: No ID Found -
CMAJ : Canadian Medical Association... Jan 2002
Topics: Arthroscopy; Canada; Humans; Magnetic Resonance Imaging; Male; Menisci, Tibial; Middle Aged; Tibial Meniscus Injuries
PubMed: 11800254
DOI: No ID Found -
Journal of the American Academy of... Nov 2023Resilience is a person's capacity to overcome adversity. The purpose was to determine what patient factors correlate with resilience using the Brief Resilience Score. We...
INTRODUCTION
Resilience is a person's capacity to overcome adversity. The purpose was to determine what patient factors correlate with resilience using the Brief Resilience Score. We hypothesize that characteristics of female sex, younger age, Workers' Compensation status, and preoperative opioid use are predictors of a lower preoperative resilience score and that patients with positive psychosocial factors would have higher resilience scores.
METHODS
Eight hundred nine patients undergoing knee or shoulder arthroscopy were preoperatively categorized into low, normal, and high-resilience groups. Preoperative patient-reported outcome measures (PROMs) and demographics were assessed. Statistical analyses evaluated differences in demographics and PROMs between resilience groups.
RESULTS
Analysis disclosed notable differences between low, normal, and high-resilience groups regarding demographics and PROMs. High resilience was seen in older patients, male patients, and patients with positive psychosocial factors. Low resilience scores were discovered in Workers' Compensation patients and those with a history of preoperative opioid use. No difference in resilience scores was observed between smokers and nonsmokers.
DISCUSSION
Preoperative resilience score is associated with age, sex, preoperative opioid use, Workers' Compensation status, and smoking status of patients undergoing knee or shoulder arthroscopy.
Topics: Humans; Male; Female; Aged; Shoulder; Arthroscopy; Analgesics, Opioid; Treatment Outcome; Knee Joint
PubMed: 37967061
DOI: 10.5435/JAAOSGlobal-D-23-00207 -
Chang Gung Medical Journal 2011Like other intra-articular fractures, the tibial plateau fracture is challenging for orthopedic surgeons because of its severity of trauma, associated soft tissue... (Review)
Review
Like other intra-articular fractures, the tibial plateau fracture is challenging for orthopedic surgeons because of its severity of trauma, associated soft tissue injuries. Open reduction incurs serious complications, especially wound healing after traditional dissections. Unsatisfactory results often occur in complex or bicondylar tibial plateau fractures. Traditional surgical methods achieved satisfactory results in 70-80% of cases. However, these methods have a high incidence of complications including loss of reduction, infection, and septic arthritis. The advantages of arthroscopy-assisted reduction and internal fixation include direct visualization of intra-articular fracture, accurate fracture reduction, and reduced morbidity. It is straightforward in the diagnosis and treatment of meniscal and ligamentous injuries, and removal of loose fragments. Good early to medium-term results of arthroscopically assisted osteosynthesis of tibial plateau fractures have been reported. The author reviews the current surgical principles, pitfalls, approaches, clinical results, and complications of arthroscopyassisted surgery for tibial plateau fractures.
Topics: Arthroscopy; Humans; Postoperative Complications; Radiography; Tibial Fractures
PubMed: 21733353
DOI: No ID Found -
The Journal of Medical Investigation :... 2014Elbow arthroscopy has become a safe and effective treatment option for a number of elbow disorders. The most rewarding and successful indication is the removal of loose... (Review)
Review
Elbow arthroscopy has become a safe and effective treatment option for a number of elbow disorders. The most rewarding and successful indication is the removal of loose bodies. Loose bodies are often a result of osteochondritis dissecans (OCD) of the capitellum, and arthroscopy in this case is useful for performing debridement, thereby eliminating the need for a more extensive open procedure associated with complications. In this review, we describe our arthroscopic technique for OCD of the capitellum. We usually conduct arthroscopy in the supine position, and use 2.9-mm arthroscopes of 30° and 70°. The 70° arthroscope provides a greater operative field than the 30° arthroscope. Arthroscopic treatment for OCD may require 2 anterior and 2 posterior portals. Loose bodies are commonly found in the radial fossa, coronoid fossa, and in the olecranon fossa. Once the loose bodies are removed, all unstable cartilage of the capitellum lesion is removed to create a stable bed. If any sclerotic changes to the lesion bed are observed, we create microfractures in the lesion bed. The most significant complication in arthroplasty is neurovascular injury. However, we have never experienced this devastating complication, which can be avoided by paying careful attention to detail.
Topics: Arthroscopy; Elbow Joint; Humans; Osteochondritis Dissecans; Postoperative Care
PubMed: 25264040
DOI: 10.2152/jmi.61.233 -
Orthopaedics & Traumatology, Surgery &... Dec 2022
Topics: Humans; Arthroscopy; Orthopedics; Clinical Competence
PubMed: 36410929
DOI: 10.1016/j.otsr.2022.103473