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Sample records for arthroscopic partial repair

  1. Modified arthroscopic double row repair of partial thickness tear of the rotator Cuff involving articular and bursal side

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    Kwon Oh

    2008-01-01

    Full Text Available Partial thickness of rotator cuff tears is considered as a common cause of shoulder disability. Various techniques for arthroscopic repair of partial thickness tear of rotator cuff have been reported in the literature. These techniques have addressed the articular side partial thickness cuff tear. We present an arthroscopic repair of partial thickness tear of rotator cuff involving both articular and bursal surfaces without converting into a full thickness tear. Each side of the tear was repaired with suture anchors separately.

  2. Arthroscopic partial medial meniscectomy

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    Dašić Žarko

    2011-01-01

    Full Text Available Background/Aim. Meniscal injuries are common in professional or recreational sports as well as in daily activities. If meniscal lesions lead to physical impairment they usually require surgical treatment. Arthroscopic treatment of meniscal injuries is one of the most often performed orthopedic operative procedures. Methods. The study analyzed the results of arthroscopic partial medial meniscectomy in 213 patients in a 24-month period, from 2006, to 2008. Results. In our series of arthroscopically treated medial meniscus tears we noted 78 (36.62% vertical complete bucket handle lesions, 19 (8.92% vertical incomplete lesions, 18 (8.45% longitudinal tears, 35 (16.43% oblique tears, 18 (8.45% complex degenerative lesions, 17 (7.98% radial lesions and 28 (13.14% horisontal lesions. Mean preoperative International Knee Documentation Committee (IKDC score was 49.81%, 1 month after the arthroscopic partial medial meniscectomy the mean IKDC score was 84.08%, and 6 months after mean IKDC score was 90.36%. Six months after the procedure 197 (92.49% of patients had good or excellent subjective postoperative clinical outcomes, while 14 (6.57% patients subjectively did not notice a significant improvement after the intervention, and 2 (0.93% patients had no subjective improvement after the partial medial meniscectomy at all. Conclusion. Arthroscopic partial medial meniscetomy is minimally invasive diagnostic and therapeutic procedure and in well selected cases is a method of choice for treatment of medial meniscus injuries when repair techniques are not a viable option. It has small rate of complications, low morbidity and fast rehabilitation.

  3. Clinical and Magnetic Resonance Imaging Results of Arthroscopic Repair of Intratendinous Partial-thickness Rotator Cuff Tears

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    Jian Xiao; Guo-Qing Cui

    2015-01-01

    Background:Partial-thickness rotator cufftears (PTRCTs) are being diagnosed more often because of high-resolution magnetic resonance imaging (MRI).Compared with articular and bursal side tears,there have been few studies about evaluating the clinical and structural outcomes after intratendinous tear repair.Methods:From 2008 to 2012,33 consecutive patients with intratendinous PTRCTs underwent arthroscopic repair.All of them were retrospectively evaluated.The University of California at Los Angeles (UCLA) and constant scores were evaluated before operation and at the final follow-up.Postoperative cuff integrity was determined using MRI according to Sugaya's classification.Results:At the 2-year follow-up,the average UCLA score increased from 16.7 ± 1.9 to 32.5 ± 3.5,and the constant score increased from 66.2 ± 10.5 to 92.4 ± 6.9 (P < 0.001).Twenty seven patients received follow-up MRI examinations at an average of 15.2 months after surgery.Of these 27 patients,22 (81.5%) had a healed tendon,and five patients had partial tears.There was no association between functional and anatomic results.Conclusions:For intratendinous PTRCT,clinical outcomes and tendon healing showed good results at a minimum 2-year after arthroscopic repair.

  4. Arthroscopic quadriceps tendon repair: two case reports.

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    Saito, Hidetomo; Shimada, Yoichi; Yamamura, Toshiaki; Yamada, Shin; Sato, Takahiro; Nozaka, Koji; Kijima, Hiroaki; Saito, Kimio

    2015-01-01

    Recently, although some studies of open repair of the tendon of the quadriceps femoris have been published, there have been no reports in the literature on primary arthroscopic repair. In our present study, we present two cases of quadriceps tendon injury arthroscopically repaired with excellent results. Case 1 involved a 68-year-old man who was injured while shifting his weight to prevent a fall. MRI showed complete rupture at the insertion of the patella of the quadriceps tendon. The rupture was arthroscopically repaired using both suture anchor and pull-out suture fixation methods via bone tunnels (hereafter, pull-out fixation). Two years after surgery, retearing was not observed on MRI and both Japan Orthopedic Association (JOA) Knee and Lysholm scores had recovered to 100. Case 2 involved a 50-year-old man who was also injured when shifting his weight to prevent a fall. MRI showed incomplete superficial rupture at the insertion of the patella of the quadriceps tendon. The rupture was arthroscopically repaired using pull-out fixation of six strand sutures. One year after surgery, MRI revealed a healed tendon and his JOA and Lysholm scores were 95 and 100, respectively. Thus, arthroscopic repair may be a useful surgical method for repairing quadriceps tendon injury.

  5. Arthroscopic Quadriceps Tendon Repair: Two Case Reports

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    Hidetomo Saito

    2015-01-01

    Full Text Available Recently, although some studies of open repair of the tendon of the quadriceps femoris have been published, there have been no reports in the literature on primary arthroscopic repair. In our present study, we present two cases of quadriceps tendon injury arthroscopically repaired with excellent results. Case 1 involved a 68-year-old man who was injured while shifting his weight to prevent a fall. MRI showed complete rupture at the insertion of the patella of the quadriceps tendon. The rupture was arthroscopically repaired using both suture anchor and pull-out suture fixation methods via bone tunnels (hereafter, pull-out fixation. Two years after surgery, retearing was not observed on MRI and both Japan Orthopedic Association (JOA Knee and Lysholm scores had recovered to 100. Case 2 involved a 50-year-old man who was also injured when shifting his weight to prevent a fall. MRI showed incomplete superficial rupture at the insertion of the patella of the quadriceps tendon. The rupture was arthroscopically repaired using pull-out fixation of six strand sutures. One year after surgery, MRI revealed a healed tendon and his JOA and Lysholm scores were 95 and 100, respectively. Thus, arthroscopic repair may be a useful surgical method for repairing quadriceps tendon injury.

  6. Outcomes after Arthroscopic Bankart Repair

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    Marshall, Tyler James; Vega, Jose F.; Siqueira, Marcelo BP; Gelber, Jonathan David; Cagle, Robert; Saluan, Paul M.

    2016-01-01

    Objectives: The shoulder is the most common joint dislocation effecting roughly 2% of the general population. Males are effected to a higher degree that females at a ratio of 3:1.1-2 The young, athletic population make up the largest portion of shoulder instability, and treated nonoperatively have a recurrent dislocation rate approaching 50%.3-5 Owens et. al recently published a cohort looking at 45 college athletes with an in season shoulder instability event. 73% of athletes returned to play in season. Only 36% of athletes completed the season without re-injury and 64% of athletes had a recurrent instability event.6 It is unknown how the outcomes of those who go on to have a recurrent dislocation in season are effected versus those who have a stabilization procedure after a first time dislocation. The objective of the current study is to report the postoperative outcomes of first time dislocators versus patients with recurrent dislocations prior to surgery. Methods: CPT codes were used to identify patients who had arthroscopic Bankart repair between 2003-2013. 439 patients aged 16-30 years were identified across 8 fellowship trained surgical practices. The first phase of the study was a retrospective chart review to obtain patient demographics, number of reported preoperative dislocations, review imaging, and number of anchors placed. Patients were identified as first time dislocators or as recurrent dislocators when they had more than one dislocation prior to surgical intervention. The second phase consisted of a survey to obtain a simple shoulder test score, whether they returned to sport, postoperative instability events and further surgery on the shoulder. Postoperative instability was defined as a subluxation or dislocation reported by the patient survey in the postoperative period. Of the 439 patients identified, 296 were excluded for revision surgery, open repair, posterior instability, multidirectional instability, HAGL lesion, labral tears involving the

  7. Arthroscopic Knotless, Double-Row, Extended Linked Repair for Massive Rotator Cuff Tears.

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    Greenspoon, Joshua A; Petri, Maximilian; Millett, Peter J

    2016-02-01

    The management of massive rotator cuff tears remains a challenge for physicians, with failure rates being higher when compared with smaller tears. Many surgical treatment options exist including debridement with biceps tenodesis, complete repair, partial repair, repair with augmentation devices, superior capsule reconstruction, tendon transfer, and reverse total shoulder arthroplasty. The purpose of this article is to describe our preferred surgical technique for a complete arthroscopic repair using an extended linked, knotless, double-row construct. PMID:27330944

  8. Analysis of Direct Costs of Outpatient Arthroscopic Rotator Cuff Repair.

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    Narvy, Steven J; Ahluwalia, Avtar; Vangsness, C Thomas

    2016-01-01

    Arthroscopic rotator cuff surgery is one of the most commonly performed orthopedic surgical procedures. We conducted a study to calculate the direct cost of arthroscopic repair of rotator cuff tears confirmed by magnetic resonance imaging. Twenty-eight shoulders in 26 patients (mean age, 54.5 years) underwent primary rotator cuff repair by a single fellowship-trained arthroscopic surgeon in the outpatient surgery center of a major academic medical center. All patients had interscalene blocks placed while in the preoperative holding area. Direct costs of this cycle of care were calculated using the time-driven activity-based costing algorithm. Mean time in operating room was 148 minutes; mean time in recovery was 105 minutes. Calculated surgical cost for this process cycle was $5904.21. Among material costs, suture anchor costs were the main cost driver. Preoperative bloodwork was obtained in 23 cases, adding a mean cost of $111.04. Our findings provide important preliminary information regarding the direct economic costs of rotator cuff surgery and may be useful to hospitals and surgery centers negotiating procedural reimbursement for the increased cost of repairing complex tears.

  9. Analysis of Direct Costs of Outpatient Arthroscopic Rotator Cuff Repair.

    Science.gov (United States)

    Narvy, Steven J; Ahluwalia, Avtar; Vangsness, C Thomas

    2016-01-01

    Arthroscopic rotator cuff surgery is one of the most commonly performed orthopedic surgical procedures. We conducted a study to calculate the direct cost of arthroscopic repair of rotator cuff tears confirmed by magnetic resonance imaging. Twenty-eight shoulders in 26 patients (mean age, 54.5 years) underwent primary rotator cuff repair by a single fellowship-trained arthroscopic surgeon in the outpatient surgery center of a major academic medical center. All patients had interscalene blocks placed while in the preoperative holding area. Direct costs of this cycle of care were calculated using the time-driven activity-based costing algorithm. Mean time in operating room was 148 minutes; mean time in recovery was 105 minutes. Calculated surgical cost for this process cycle was $5904.21. Among material costs, suture anchor costs were the main cost driver. Preoperative bloodwork was obtained in 23 cases, adding a mean cost of $111.04. Our findings provide important preliminary information regarding the direct economic costs of rotator cuff surgery and may be useful to hospitals and surgery centers negotiating procedural reimbursement for the increased cost of repairing complex tears. PMID:26761928

  10. Cartilage change after arthroscopic repair for an isolated meniscal tear.

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    Soejima, Takashi; Murakami, Hidetaka; Inoue, Takashi; Kanazawa, Tomonoshin; Katouda, Michihiro; Nagata, Kensei

    2005-01-01

    To investigate the direct effect to the cartilage caused by the meniscal repair, we examined patients who underwent an isolated meniscal repair without any other abnormalities by arthroscopic examination. A total of 17 patients were examined by second-look arthroscopy after an average interval of 9 months from the meniscal repair, and have been evaluated the status of the repaired meniscus and of the relative femoral condylar cartilage. Changes in the severity of the cartilage lesion between at the time of meniscal repair and the time of the second-look arthroscopy were considered based on the status of the repaired meniscus. Regardless of the healing status of the repair site, it was possible to prevent degeneration in the cartilage in 9 of the 10 patients who demonstrated no degeneration in the meniscal body. Of the 7 patients who demonstrated degeneration in the meniscal body, progression in cartilage degeneration was noted as 1 grade in 2 patients and 2 grades in another 3 patients. Even in those in which stable fusion of the repair site was achieved, the condition of the inner meniscal body was not necessarily maintained favorably in all cases, indicating that degeneration in the meniscal body was a risk factor for cartilage degeneration. It was concluded that recovery could not be expected even at 9 months after the repair if the lesion had already demonstrated degeneration in the meniscal body at the time of repair.

  11. Midterm clinical outcomes following arthroscopic transosseous rotator cuff repair

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    Brody A Flanagin

    2016-01-01

    Full Text Available 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

  12. SLAP repair with arthroscopic decompression of spinoglenoid cyst

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    Hashiguchi Hiroshi

    2016-01-01

    Full Text Available Introduction: A spinoglenoid cyst with suprascapular nerve disorders is highly associated with superior labrum anterior posterior (SLAP lesion. Conservative or surgical treatment is applied to relieve pain and neurological symptoms. The purpose of this study was to evaluate clinical outcomes of patients treated by arthroscopic surgery for SLAP lesion with a spinoglenoid cyst. Methods: The subjects of this study were six patients with SLAP lesion with a spinoglenoid cyst who underwent arthroscopic surgery. There was one female and five males with a mean age of 48.5 years. SLAP lesion was found in all the patients at arthroscopy. A small tear of the rotator cuff was found in the two patients. The SLAP lesion was repaired using suture anchors, and the rotator cuff tears were repaired by suture-bridge fixation. The spinoglenoid cyst was decompressed through the torn labrum in three patients, and through the released superior to posterior portion of the capsule in the other three patients. Results: All patients showed excellent improvement in pain and muscle strength at the final follow-up examination. The mean Constant score was improved from 60.5 points preoperatively to 97.2 points postoperatively. The mean visual analog scale (VAS score decreased from 4.5 on the day of the surgery to 2.5 within one week postoperatively. Postoperative MRI showed disappearance or reduction of the spinoglenoid cyst in four and two patients, respectively. There were no complications from the surgical intervention and in the postoperative period. Discussion: The patients treated by decompression through the released capsule obtained pain relief at an early period after the surgery. Arthroscopic treatment for a spinoglenoid cyst can provide a satisfactory clinical outcome. Arthroscopic decompression of a spinoglenoid cyst through the released capsule is recommended for a safe and reliable procedure for patients with suprascapular nerve disorders.

  13. Functional outcome after open and arthroscopic Bankart repair for traumatic shoulder instability

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    Lützner J; Krummenauer F; Lübke J; Kirschner S; Günther K-P; Bottesi M

    2009-01-01

    Abstract Purpose Both open and arthroscopic Bankart repair are established procedures in the treatment of anterior shoulder instability. While the open procedure is still considered as the "golden standard" functional outcome is supposed to be better in the arthroscopic procedure. The aim of this retrospective study was to compare the functional outcome between open and arthroscopic Bankart repair. Materials and methods In 199 patients a Bankart procedure with suture anchors was performed, ei...

  14. The outcome study of arthroscopic repair with anchor suture for anterior shoulder instabilities

    OpenAIRE

    Guity MR; Sianati S

    2010-01-01

    "nBackground: Anterior glenohumeral instabilities can be corrected with open and arthroscopic surgery. The purpose of this study was to evaluate retrospectively the surgical outcomes of arthroscopic repair of anterior glenohumeral instabilities with use of suture anchors in a series of patients who were followed for twenty to fifty months."n "nMethods: The results of arthroscopic Bankart repair with use of suture anchors in 30 patients with traumatic recurrent anterior instabil...

  15. Arthroscopic isolated posterior labral repair in rugby players

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    Badge Ravi

    2009-01-01

    Full Text Available Background: The shoulder is the second most frequently injured joint after the knee in rugby players and labral tears appear to be common. There is limited data available in the literature regarding the mechanisms of posterior labral injury in rugby players and the management of these injuries. Objective: The aim of this study is to report the clinical presentation, arthroscopic findings, surgical technique for repair, and the functional outcome in elite English rugby players with isolated posterior labral injuries. Study Design: Case series (level IV evidence Materials and m0 ethods: Over a 5-year period we surgically treated 142 elite rugby players, of whom 11 (7.8% had isolated posterior labral injuries.All these 11 patients had significant contact injury. Only three (24% patients had a true posterior shoulder dislocation. Pre- and postoperative assessment included Constant score, Oxford shoulder score, and Oxford instability score. We also assessed the time taken to return to preinjury level of fitness and the complications of surgery. Results: Average follow-up was for 32 months (range 17-54 months. The mean Constant score improved from 66 to 99. The Oxford score indicated improvement, decreasing from 33 to 18; similarly, the Oxford instability score also decreased from 52.2 to 12.3. Return to playing rugby at peak level was at a mean of 4.3 months after arthroscopic repair. Conclusion: Successful clinical results and rapid return to play can be achieved by appropriate early arthroscopic repair and supervised accelerated rehabilitation for posterior labral tears in elite rugby players.

  16. Arthroscopic rotator cuff repair in elite rugby players

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    Tambe Amol

    2009-01-01

    Full Text Available Background: Rugby is an increasingly popular collision sport. A wide spectrum of injuries can be sustained during training and match play. Rotator cuff injury is uncommon in contact sports and there is little published literature on the treatment of rotator cuff tears in rugby players. Aims: We therefore reviewed the results and functional outcomes of arthroscopic rotator cuff repair in elite rugby players. Materials and Methods: Eleven professional rugby players underwent arthroscopic rotator cuff repair at our hospital over a 2-year period. We collected data on these patients from the operative records. The patients were recalled for outcome scoring and ultrasound scans. Results: There were seven rugby league players and four rugby union players, including six internationals. Their mean age was 25.7 years. All had had a traumatic episode during match play and could not return to the game after the injury. The mean time to surgery was 5 weeks. The mean width of the cuff tear was 1.8 cm. All were full- thickness cuff tears. Associated injuries included two Bankart lesions, one bony Bankart lesion, one posterior labral tear, and two 360° labral tears. The biceps was involved in three cases. Two were debrided and a tenodesis was performed in one. Repair was with suture anchors. Following surgery, all patients underwent a supervised accelerated rehabilitation programme. The final follow-up was at 18 months (range: 6-31 months post surgery. The Constant scores improved from 44 preoperatively to 99 at the last follow-up. The mean score at 3 months was 95. The Oxford shoulder score improved from 34 to 12, with the mean third month score being 18. The mean time taken to return to full match play at the preinjury level was 4.8 months. There were no complications in any of the patients and postoperative scans in nine patients confirmed that the repairs had healed. Conclusion: We conclude that full-thickness rotator cuff tears in the contact athlete can

  17. Arthroscopic partial meniscectomy in middle-aged patients with mild or no knee osteoarthritis

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    Hare, Kristoffer B; Lohmander, Stefan; Christensen, Robin;

    2013-01-01

    Arthroscopic partial meniscectomy has been shown to be of no benefit to patients with concomitant knee osteoarthritis, but the optimal treatment of a degenerative meniscus tear in patients with mild or no knee osteoarthritis is unknown. This article describes the rationale and methodology...... of a randomized sham-controlled trial to assess the benefit of arthroscopic partial meniscectomy of a medial meniscus tear in patients with mild or no knee osteoarthritis. The objective of the study is to test whether the benefit from arthroscopic partial meniscectomy in patients with knee pain, medial meniscus...... lesion and mild/no knee osteoarthritis, is greater after arthroscopic partial meniscectomy than following sham surgery....

  18. Functional outcome after open and arthroscopic Bankart repair for traumatic shoulder instability

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    Lützner J

    2009-01-01

    Full Text Available Abstract Purpose Both open and arthroscopic Bankart repair are established procedures in the treatment of anterior shoulder instability. While the open procedure is still considered as the "golden standard" functional outcome is supposed to be better in the arthroscopic procedure. The aim of this retrospective study was to compare the functional outcome between open and arthroscopic Bankart repair. Materials and methods In 199 patients a Bankart procedure with suture anchors was performed, either arthroscopically in presence of an detached, but not elongated capsulolabral complex (40 or open (159. After a median time of 31 months (12 to 67 months 174 patients were contacted and agreed to follow-up, 135 after open and 39 after arthroscopic Bankart procedure. Results Re-dislocations occurred in 8% after open and 15% after arthroscopic Bankart procedure. After open surgery 4 of the 11 re-dislocations occurred after a new adequate trauma and 1 of the 6 re-dislocations after arthroscopic surgery. Re-dislocations after arthroscopic procedure occured earlier than after open Bankart repair. An external rotation lag of 20° or more was observed more often (16% after open than after arthroscopic surgery (3%. The Rowe score demonstrated "good" or "excellent" functional results in 87% after open and in 80% patients after arthroscopic treatment. Conclusion In this retrospective investigation the open Bankart procedure demonstrated good functional results. The arthroscopic treatment without capsular shift resulted in a better range of motion, but showed a tendency towards more frequently and earlier recurrence of instability. Sensitive patient selection for arthroscopic Bankart repair is recommended especially in patients with more than five dislocations.

  19. Long term results of arthroscopic bankart repair for traumatic anterior shoulder instability

    OpenAIRE

    Ee, Gerard WW; Mohamed, Sedeek; Tan, Andrew HC

    2011-01-01

    Background The arthroscopic method offers a less invasive technique of Bankart repair for traumatic anterior shoulder instability. We would like to report the 2 year clinical outcomes of bio-absorbable suture anchors used in traumatic anterior dislocations of the shoulder. Methods Data from 79 shoulders in 74 patients were collected over 4 years (2004 - 2008). Each patient was followed-up over a period of 2 years. The patients underwent arthroscopic Bankart repair using bio-absorbable suture ...

  20. Analysis of the functional results of arthroscopic Bankart repair in posttraumatic recurrent anterior dislocations of shoulder

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    Amit Mishra; Pulak Sharma; Deepak Chaudhary

    2012-01-01

    Background: The Bankart lesion represents the most common form of labro-ligamentous injury in patients with traumatic dislocations of the shoulder leading to shoulder instability. We report the clinical outcome of arthroscopic repair of Bankart lesion in 50 patients. Materials and Methods: Sixty five patients with posttraumatic anterior dislocation of shoulder were treated by arthroscopic repair from Jan 2005 to Nov 2008. Fifty patients, with an average age of 26.83 years (range 18-45 yea...

  1. Clinical and Radiological Evaluation after Arthroscopic Rotator Cuff Repair Using Suture Bridge Technique

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    Lee, Kwang Won; Seo, Dong Wook; Bae, Kyoung Wan; Choy, Won Sik

    2013-01-01

    Background We retrospectively assessed the clinical outcomes and investigated risk factors influencing retear after arthroscopic suture bridge repair technique for rotator cuff tear through clinical assessment and magnetic resonance arthrography (MRA). Methods Between January 2008 and April 2011, sixty-two cases of full-thickness rotator cuff tear were treated with arthroscopic suture bridge repair technique and follow-up MRA were performed. The mean age was 56.1 years, and mean follow-up per...

  2. Outcome of arthroscopic subscapularis tendon repair: Are the results improving with improved techniques and equipment?: A retrospective case series

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    G R Arun

    2016-01-01

    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.

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

    Science.gov (United States)

    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.

  4. Arthroscopic Bony Bankart Repair Using Double-Threaded Headless Screw: A Case Report

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    Takeshi Kokubu

    2012-01-01

    Full Text Available We present a case of arthroscopic fixation for bony Bankart lesion using a double-threaded cannulated screw. A 39-year-old man sustained a left shoulder injury from a motorcycle accident. Radiographs showed bony Bankart lesion and CT revealed 40% defect of glenoid articular surface. Arthroscopic fixation was performed using double-threaded cannulated screw after the bony fragment was reduced by suturing the labrum at the edge with a suture anchor. Arthroscopic bony Bankart repair using double-threaded cannulated screw fixation is effective because compression force could be applied between bony fragments and the screw head is not exposed in the glenohumeral joint.

  5. Arthroscopic Fixation of Glenoid Rim Fractures After Reduction by Labral Repair.

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    Voleti, Pramod B; Camp, Christopher L; Sinatro, Alec L; Dines, Joshua S

    2016-04-01

    Surgical fixation of displaced, intra-articular glenoid fractures represents a clinical challenge. These fractures have traditionally been treated through open approaches to the glenohumeral joint; however, the morbidity associated with open surgery may be reduced with arthroscopic techniques. Previously described arthroscopic methods commonly use clamps and/or Kirschner wires to obtain and maintain provisional fixation. We describe our technique for minimally invasive, arthroscopic fixation of glenoid rim fractures using labral repair as an indirect reduction maneuver, followed by final fixation with an extra-articular screw. This method is safe, efficient, and reliable, and it can be used to approach a variety of intra-articular glenoid fractures. PMID:27462537

  6. Postoperative pain control after arthroscopic rotator cuff repair.

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    Uquillas, Carlos A; Capogna, Brian M; Rossy, William H; Mahure, Siddharth A; Rokito, Andrew S

    2016-07-01

    Arthroscopic rotator cuff repair (ARCR) can provide excellent clinical results for patients who fail to respond to conservative management of symptomatic rotator cuff tears. ARCR, however, can be associated with severe postoperative pain and discomfort that requires adequate analgesia. As ARCR continues to shift toward being performed as an outpatient procedure, it is incumbent on physicians and ambulatory surgical centers to provide appropriate pain relief with minimal side effects to ensure rapid recovery and safe discharge. Although intravenous and oral opioids are the cornerstone of pain management after orthopedic procedures, they are associated with drowsiness, nausea, vomiting, and increased length of hospital stay. As health care reimbursements continue to become more intimately focused on quality, patient satisfaction, and minimizing of complications, the need for adequate pain control with minimal complications will continue to be a principal focus for providers and institutions alike. We present a review of alternative modalities for pain relief after ARCR, including cryotherapy, intralesional anesthesia, nerve blockade, indwelling continuous nerve block catheters, and multimodal anesthesia. In choosing among these modalities, physicians should consider patient- and system-based factors to allow the efficient delivery of analgesia that optimizes recovery and improves patient satisfaction. PMID:27079219

  7. Efficacy of arthroscopically placed pain catheter adjacent to the suprascapular nerve (continuous arthroscopically assisted suprascapular nerve block following arthroscopic rotator-cuff repair

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    Yamakado K

    2014-05-01

    Full Text Available Kotaro YamakadoDepartment of Orthopaedics, Fukui General Hospital, Fukui, JapanBackground: Rotator-cuff surgery is well recognized to be a painful procedure.Objectives: The purpose of this study was to examine the effectiveness of an arthroscopically placed perineural catheter at the scapular notch to provide a continuous block of the suprascapular nerve (continuous arthroscopically assisted suprascapular nerve block [ca-SSNB] following arthroscopic rotator-cuff repair (ARCR.Materials and methods: This level II, prospective, randomized, controlled trial without postoperative blinding included 40 patients, who had a 48-hour pain pump, with 0.2% ropivacaine infusion and a continuous rate of 3 mL/hour, placed via an arthroscopically placed catheter following ARCR with arthroscopic release of the superior transverse ligament: 21 patients had a ca-SSNB, and 19 patients had a continuous subacromial bursal block (SAB. The visual analog scale (at 6 hours and on the first, second, and third postoperative days and the total number of additional pain-reduction attempts during the 3 postoperative days were calculated.Results: The respective visual analog scale scores (mm obtained from the ca-SSNB and SAB groups were 62.4 and 67.6 (P=0.73 before surgery, 9.1 and 19.4 (P=0.12 at 6 hours after surgery, 24.4 and 44.6 (P=0.019 on the first postoperative day, 19.4 and 40.4 (P=0.0060 on the second postoperative day, and 18.5 and 27.8 (P=0.21 on the third postoperative day. Total additional pain-reduction attempts recorded for the ca-SSNB and SAB groups during the 3 postoperative days were 0.3 times and 1.2 times (P=0.0020, respectively.Conclusion: ca-SSNB was highly effective in controlling postoperative pain after ARCR.Keywords: shoulder, rotator cuff tear, postoperative pain control, continuous suprascapular nerve block, arthroscopic rotator cuff repair

  8. Arthroscopic management of recalcitrant stiffness following rotator cuff repair: A retrospective analysis

    OpenAIRE

    Sanjeev Bhatia; Mather, Richard C.; Hsu, Andrew R.; Ferry, Amon T; Romeo, Anthony A.; Nicholson, Gregory P.; Cole, Brian J.; Verma, Nikhil N.

    2013-01-01

    Background : Rotator cuff repair surgery is one of the most commonly performed procedures in the world but limited literature exists for guidance of optimal management of post-operative arthrofibrosis following cuff repair. The purpose of this study is to report the results of arthroscopic capsular release, lysis of adhesions, manipulation under anesthesia, and aggressive physical therapy in patients with recalcitrant postoperative stiffness after rotator cuff repair. Materials and Method...

  9. A Simplified Approach for Arthroscopic Repair of Rotator Cuff Tear with Dermal Patch Augmentation

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    Anthony C. Levenda

    2015-01-01

    Full Text Available Here, we describe an arthroscopic method specifically developed to augment rotator cuff repair using a flexible acellular dermal patch (ADP. In this method, an apparently complex technique is simplified by utilizing specific steps to augment a rotator cuff repair. In this method, using a revised arthroscopic technique, rotator cuff repair was performed. This technique allowed easy passage of the graft, excellent visualization, minimal soft tissue trauma, and full four-corner fixation of an ADP. Twelve patients underwent rotator cuff repair with augmentation using the combination of this method and ADP. Due to the technique and biomechanical characteristics of the material, the repairs have been stable and with high patient satisfaction.

  10. Results of Latarjet Coracoid Transfer to Revise Failed Arthroscopic Instability Repairs

    Science.gov (United States)

    Nicholson, Gregory P.; Rahman, Zain; Verma, Nikhil N.; Romeo, Anthony A.; Cole, Brian J.; Gupta, Anil Kumar; Bruce, Benjamin

    2014-01-01

    Objectives: Arthroscopic instability repair has supplanted open techniques to anatomically reconstruct anteroinferior instability pathology. Arthroscopic technique can fail for a variety of reasons. We have utilized the Latarjet as a revision option in failed arthroscopic instability repairs when there is altered surgical anatomy, capsular deficiency and/or glenoid bone compromise and recurrent glenohumeral instability. Methods: We reviewed 51 shoulders (40 ♀, 11♂) that underwent Latarjet coracoid transfer for the revision of failed previous arthroscopic instability repair. The avg. age was 32.6 yrs (16-58). All patients had recurrent symptomatic anterior instability after previous arthroscopic surgery, and avg. time from arthroscopic repair to Latarjet was 13 months (4-40 mn). All had either CT or MRI that revealed suture anchor material in the glenoid, labral and capsular stripping, and anteroinferior glenoid bone loss or erosion. Advanced bone loss percentage analysis was not performed for this study. We excluded all patients that had a previous open repair, a seizure disorder, or if the Latarjet was a primary procedure. Outcome scores pre-operatively avg: SST: 6.7 (1-12); VAS: 3 (0-8); ASES: 63 (32-89). Coracoid transfer was performed thru a subscapularis split in 38, and with tendon takedown in 13. The coracoid was osteotomized along its long axis parallel to the undersurface of the lateral aspect. This provided at least 2.5 to 3.5 cm of graft with the conjoined tendon attached. The coracoacromial (CA) ligament was incised leaving a 1 cm. stump. The transfer was affixed flush with the articular surface but not lateral to it, with two 3.5 mm cortical screws in lag fashion overdrilling the coracoid with the CA ligament directed laterally. The capsule was then repaired to the CA ligament to make the transfer extra-articular. Results: At avg. 4 yr (2-7 yrs) follow-up stability had been maintained in 51 (100%).without further instability surgery. There were no

  11. Systematic Review of Arthroscopic Versus Open Repair for Recurrent Anterior Shoulder Dislocations

    OpenAIRE

    Godin, Jonathan; Sekiya, Jon K.

    2011-01-01

    Context: It remains unknown if arthroscopic repair of recurrent anterior shoulder instability is as effective as open repair. Objective: The purpose of this study is to analyze the literature to provide clinical recommendations regarding the most appropriate therapeutic intervention for recurrent anterior shoulder instability. Study Design: Systematic review of level I and II studies. Data Sources: PubMed, EMBASE, the Cochrane Database of Systematic Reviews, and secondary references from 1967...

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

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    Rambani Rohit

    2009-06-01

    Full Text Available Abstract Introduction Arthroscopic repair of the rotator cuff is a demanding surgery. Accurate placement of anchors is key to success. Case presentation A 38-year-old woman received arthroscopic repair of her rotator cuff using a double row suture anchor technique. Postoperatively, she developed impingement syndrome which resulted from vertical displacement of a suture anchor once the shoulder was mobilised. The anchor was removed eight weeks following initial surgery and the patient had an uneventful recovery. Conclusion Impingement syndrome following arthroscopic repair of the rotator cuffs using double row suture anchor has not been widely reported. This is the first such case where anchoring has resulted in impingement syndrome.

  13. Time Interval between Trauma and Arthroscopic Meniscal Repair Has No Influence on Clinical Survival.

    Science.gov (United States)

    van der Wal, Robert J P; Thomassen, Bregje J W; Swen, Jan-Willem A; van Arkel, Ewoud R A

    2016-07-01

    Arthroscopic meniscal repair is the gold standard for longitudinal peripheral meniscal tears. The time interval between trauma and meniscal repair remains controversial. The aim of this study was to evaluate failure rates and clinical outcome of arthroscopic meniscal repair in relation to chronicity of injury. A total of 238 meniscal repairs were performed in 234 patients. Anterior cruciate ligament (ACL) was reconstructed in almost all ACL-deficient knees (130 out of 133). Time interval between injury and repair was divided into acute ( 2 to  12 weeks). Patients completed postal questionnaires to evaluate clinical outcome and failure rates. Study instruments included Lysholm, Knee injury and Osteoarthritis Outcome Score (KOOS), and Tegner scoring systems. At a median follow-up of 41 months (interquartile range [IQR], 34-53 months) 55 medial and 10 lateral meniscal repairs failed (overall failure rate, 27%). There was a significant higher failure rate for medial meniscal repair (p meniscal repair has no influence on the failure rate. Differences in survival rate of meniscal repair are more dependent on location of the lesion and ACL status, rather than chronicity of injury.

  14. 关节镜下盂唇修补与关节囊复合部分肩胛下肌紧缩修复复发性肩关节前脱位%Arthroscopic glenoid labrum repair and combined joint capsule and partial subscapularis suture for recurrent anterior shoulder dislocation

    Institute of Scientific and Technical Information of China (English)

    徐斌; 涂俊

    2015-01-01

    BACKGROUND:Arthroscopic glenoid labrum repair is the main therapy for recurrent anterior shoulder dislocation, which cannot meet the demands of shoulder stability. How to strengthen the anterior shoulder stability is an issue that is always explored and pursued. OBJECTIVE:To explore the effectiveness of arthroscopic glenoid labrum repair and combined joint capsule and partial subscapularis suture for recurrent anterior shoulder dislocation. METHODS:Seventy patients admitted for recurrent anterior shoulder dislocation at the Department of Orthopedics, First Affiliated Hospital of Anhui Medical University in China from October 2010 to August 2013 were enroled, who received the arthroscopic glenoid labrum repair and combined joint capsule and partial subscapularis suture. Patients undergoing post-operative systematical rehabilitation were folowed up for Constant-Murley Score and the ROWE Score for Instability, and shoulder stability and motor functions were evaluated in patients. RESULTS AND CONCLUSION: The 70 patients were folowed-up for 11-46 months. Complications only appeared in one patient with acute pulmonary edema and five patients with elbow or forearm skin blisters, but al were cured by treatment. Anterior shoulder dislocation disappeared postoperatively in al patients. Sixty-five patients almost recovered in the range of motion of the shoulder, who were satisfied with normal life and work activity. Al the patients returned to work. At the last folow-up, the Constant-Murley score was improved from 71.2±5.3 to 94.3±4.9, and the ROWE score was increased from 32.1±4.2 to 95.1±4.7, both of which were better than before (P < 0.05). This study demonstrated arthroscopic glenoid labrum repair and combined joint capsule and partial subscapularis suture is better for recurrent anterior shoulder dislocation, which is conductive to shoulder stability and motor function recovery.%背景:复发性肩关节前脱位的修复目前以关节镜下盂唇修补为主,

  15. Clinical outcomes of arthroscopic single and double row repair in full thickness rotator cuff tears

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    Ji Jong-Hun

    2010-01-01

    Full Text Available Background: There has been a recent interest in the double row repair method for arthroscopic rotator cuff repair following favourable biomechanical results reported by some studies. The purpose of this study was to compare the clinical results of arthroscopic single row and double row repair methods in the full-thickness rotator cuff tears. Materials and Methods: 22 patients of arthroscopic single row repair (group I and 25 patients who underwent double row repair (group II from March 2003 to March 2005 were retrospectively evaluated and compared for the clinical outcomes. The mean age was 58 years and 56 years respectively for group I and II. The average follow-up in the two groups was 24 months. The evaluation was done by using the University of California Los Angeles (UCLA rating scale and the shoulder index of the American Shoulder and Elbow Surgeons (ASES. Results: In Group I, the mean ASES score increased from 30.48 to 87.40 and the mean ASES score increased from 32.00 to 91.45 in the Group II. The mean UCLA score increased from the preoperative 12.23 to 30.82 in Group I and from 12.20 to 32.40 in Group II. Each method has shown no statistical clinical differences between two methods, but based on the sub scores of UCLA score, the double row repair method yields better results for the strength, and it gives more satisfaction to the patients than the single row repair method. Conclusions: Comparing the two methods, double row repair group showed better clinical results in recovering strength and gave more satisfaction to the patients but no statistical clinical difference was found between 2 methods.

  16. Factors affecting healing after arthroscopic rotator cuff repair

    OpenAIRE

    Abtahi, Amir M.; Granger, Erin K.; Tashjian, Robert Z.

    2015-01-01

    Rotator cuff repair has been shown to have good long-term results. Unfortunately, a significant proportion of repairs still fail to heal. Many factors, both patient and surgeon related, can influence healing after repair. Older age, larger tear size, worse muscle quality, greater muscle-tendon unit retraction, smoking, osteoporosis, diabetes and hypercholesterolemia have all shown to negatively influence tendon healing. Surgeon related factors that can influence healing include repair constru...

  17. Arthroscopic repair of type II SLAP lesions: Clinical and anatomic follow-up

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    John N Trantalis

    2015-01-01

    Full Text Available Aims: The aim was to evaluate the clinical and anatomic outcome of arthroscopic repair of type II SLAP lesions. Materials and Methods: The senior author performed isolated repairs of 25 type II SLAP lesions in 25 patients with a mean age of 40.0 ± 12 years. All tears were repaired using standard arthroscopic suture anchor repair to bone. All patients were reviewed using a standardized clinical examination by a blinded, independent observer, and using several shoulder outcome measures. Patients were evaluated by magnetic resonance imaging arthrogram at a minimum of 1-year postoperatively. Statistical Analysis Used: Two-tailed paired t-test were used to determine significant differences in preoperative and postoperative clinical outcomes scores. In addition, a Fisher′s exact test was used. Results: At a mean follow-up of 54-month, the mean American Shoulder and Elbow Surgeons Shoulder Index (ASES scores improved from 52.1 preoperatively to 86.1 postoperatively (P < 0.0001 and the Simple Shoulder Test (SST scores from 7.7 to 10.6 (P < 0.0002. Twenty-two out of the 25 patients (88% stated that they would have surgery again. Of the 21 patients who had postoperative magnetic resonance imaging arthrographys (MRAs, 9 patients (43% demonstrated dye tracking between the labrum bone interface suggestive of a recurrent tear and 12 patients (57% had a completely intact repair. There was no significant difference in ASES, SST, and patient satisfaction scores in patients with recurrent or intact repairs. Conclusions: Arthroscopic repair of type II SLAP lesions demonstrated improvements in clinical outcomes. However, MRA imaging demonstrated 43% of patients with recurrent tears. MRA results do not necessarily correlate with clinical outcome.

  18. ARTHROSCOPIC REPAIR OF BANKART’S LESION USING SUTURE ANCHORS IN RECURRENT ANTERIOR SHOULDER INSTABILITY

    OpenAIRE

    Santosh Kumar; Anant Kumar; Sanjay

    2015-01-01

    BACKGROUND : Shoulder instability and its treatment were described even in ancient times by the Greek and Egyptian physicians. Evidence of shoulder dislocation has been found in archaeological and paleopathological examinations of human shoulders several thousand years old. 1 Many techniques have been described in literature for treatment of recurrent shoulder dislocation. Arthroscopic repair of Bankart’s lesion using suture anchors is a noble technique. A sut...

  19. Analysis of the functional results of arthroscopic Bankart repair in posttraumatic recurrent anterior dislocations of shoulder

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    Amit Mishra

    2012-01-01

    Full Text Available Background: The Bankart lesion represents the most common form of labro-ligamentous injury in patients with traumatic dislocations of the shoulder leading to shoulder instability. We report the clinical outcome of arthroscopic repair of Bankart lesion in 50 patients. Materials and Methods: Sixty five patients with posttraumatic anterior dislocation of shoulder were treated by arthroscopic repair from Jan 2005 to Nov 2008. Fifty patients, with an average age of 26.83 years (range 18-45 years, were reviewed in the study. The average followup period was 27 months (range 24-36 months. University of California Los Angeles shoulder rating scale was used to determine the outcome after surgery. The recurrence rates, range of motion, as well as postoperative function and return to sporting activities were evaluated. Results : Thirty six patients (72.0% had excellent results, whereas seven patients (14.0% had good results. The mean pre- and postoperative range of external rotation was 80.38° and 75.18°, respectively. Eighty-six percent patients had stability compared with the normal sided shoulder and were able to return to sports. There were no cases of redislocation observed in this study; however, three cases had mild laxity of the joint. Conclusion: Arthroscopic Bankart repair with the use of suture anchors is a reliable treatment method, with good clinical outcomes, excellent postoperative shoulder motion and low recurrence rates.

  20. Long term results of arthroscopic bankart repair for traumatic anterior shoulder instability

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    Tan Andrew HC

    2011-06-01

    Full Text Available Abstract Background The arthroscopic method offers a less invasive technique of Bankart repair for traumatic anterior shoulder instability. We would like to report the 2 year clinical outcomes of bio-absorbable suture anchors used in traumatic anterior dislocations of the shoulder. Methods Data from 79 shoulders in 74 patients were collected over 4 years (2004 - 2008. Each patient was followed-up over a period of 2 years. The patients underwent arthroscopic Bankart repair using bio-absorbable suture anchors for their shoulder instability. These surgeries were performed at a single institution by a single surgeon over the time period. The patients were assessed with two different outcome measurement tools. The University of California at Los Angeles (UCLA shoulder rating scale and the Simple Shoulder Test (SST score. The scores were calculated before surgery and at the 2-year follow-up. The recurrence rates, range of motion as well post-operative function and return to sporting activities were evaluated. Results SST results from the 12 domains showed a significant improvement from a mean of 6.1 ± 3.1 to 11.1 ± 1.8 taken at the 2-year follow-up (p Conclusion Arthroscopic Bankart repair with the use of suture anchors is a reliable treatment method, with good clinical outcomes, excellent post-operative shoulder motion and low recurrence rates.

  1. The outcome study of arthroscopic repair with anchor suture for anterior shoulder instabilities

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    Guity MR

    2010-10-01

    Full Text Available "nBackground: Anterior glenohumeral instabilities can be corrected with open and arthroscopic surgery. The purpose of this study was to evaluate retrospectively the surgical outcomes of arthroscopic repair of anterior glenohumeral instabilities with use of suture anchors in a series of patients who were followed for twenty to fifty months."n "nMethods: The results of arthroscopic Bankart repair with use of suture anchors in 30 patients with traumatic recurrent anterior instability of the shoulder were evaluated. At the time of follow-up (mean of thirty-three months, the patients were assessed with two outcome measurement tools (the Rowe score, the Constant score. The recurrence rate, range of motion, and risk factors for postoperative recurrence were evaluated."n "nResults: According to the Rowe scale, 12 patients (40% had an excellent score; 13 (43%, a good score; 4 (13%, a fair score; and 1 (4%, a poor score. The mean ROWE score was 81.8 and the mean CONSTANT score was 85.5. Overall, the rate of postoperative recurrence of instability was 10% (two dislocations, one subluxation. The mean delay to recurrence was 20 months. Loss of external rotation in regard to uninvolved extremity was less than 10 degrees in 30% and more than 10 degrees in 10% of patients. The average number of anchors used was 3.2 which follow-up radiographs showed all of them in the osseous glenoid without pullout. In preoperative studies, shoulder 3D CT scan was not performed routinely. Radiographic signs of degenerative changes were noted in one shoulder."n "nConclusion: Arthroscopic capsulolabral repair with use of suture anchors can provide satisfactory outcomes in terms of recurrence rate, activity, and range of motion.

  2. Outcome of arthroscopic subscapularis tendon repair: Are the results improving with improved techniques and equipment?: A retrospective case series

    Science.gov (United States)

    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

  3. Single-row vs. double-row arthroscopic rotator cuff repair: clinical and 3 Tesla MR arthrography results

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    Tudisco Cosimo

    2013-01-01

    Full Text Available Abstract Background Arthroscopic rotator cuff repair has become popular in the last few years because it avoids large skin incisions and deltoid detachment and dysfunction. Earlier arthroscopic single-row (SR repair methods achieved only partial restoration of the original footprint of the tendons of the rotator cuff, while double-row (DR repair methods presented many biomechanical advantages and higher rates of tendon-to-bone healing. However, DR repair failed to demonstrate better clinical results than SR repair in clinical trials. MR imaging at 3 Tesla, especially with intra-articular contrast medium (MRA, showed a better diagnostic performance than 1.5 Tesla in the musculoskeletal setting. The objective of this study was to retrospectively evaluate the clinical and 3 Tesla MRA results in two groups of patients operated on for a medium-sized full-thickness rotator cuff tear with two different techniques. Methods The first group consisted of 20 patients operated on with the SR technique; the second group consisted of 20 patients operated on with the DR technique. All patients were evaluated at a minimum of 3 years after surgery. The primary end point was the re-tear rate at 3 Tesla MRA. The secondary end points were the Constant-Murley Scale (CMS, the Simple Shoulder Test (SST scores, surgical time and implant expense. Results The mean follow-up was 40 months in the SR group and 38.9 months in the DR group. The mean postoperative CMS was 70 in the SR group and 68 in the DR group. The mean SST score was 9.4 in the SR group and 10.1 in the DR group. The re-tear rate was 60% in the SR group and 25% in the DR group. Leakage of the contrast medium was observed in all patients. Conclusions To the best of our knowledge, this is the first report on 3 Tesla MRA in the evaluation of two different techniques of rotator cuff repair. DR repair resulted in a statistically significant lower re-tear rate, with longer surgical time and higher implant

  4. EVALUATION OF RESULTS OF ARTHROSCOPIC BANKART REPAIR FOR POST TRAUMATIC ANTERIOR SHOULDER INSTABILITY

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    Mainak

    2015-08-01

    Full Text Available BACKGROUND: The study was to evaluate the surgical outcomes of arthroscopic repair of post - traumatic Bankart lesions with the use of suture anchors. Patients with >20% bony lesions, SLAP ( superior labral tear from anterior to posterior lesions and multi - directional instability were excluded. The patients were followed up for a period of minimum 4 years. MATERIALS AND ME THODS: We evaluated the results of arthroscopic Bankart repair with use of suture anchors in 35 patients with traumatic recurrent anterior instability of the shoulder. The mean age at operation was 25.71 years. The patients were evaluated pre - operatively a nd at follow - up using the UCLA (University of California Los Angeles shoulder scoring system and the modified Rowe scores, which were 6.2 and 29.3 respectively pre - operatively. RESULTS: The UCLA shoulder scoring system and the modified Rowe scores at foll ow - up were 32 and 72.57 respectively and both improvements were significant. The Modified Rowe Shoulder Scoring System showed 14 patients having excellent results, 12 patients good, 6 patients fair and 3 patients with poor results. One patient had subluxat ion and another had positive apprehension test. Five patients had discomfort/pain with arm in abducted and externally rotated position but negative apprehension test. Remaining 28 patients had negative apprehension test; no subluxation. Significant improve ments occurred for each motion tested for each follow up visit. CONCLUSION: We conclude that arthroscopic Bankart lesion repair with suture anchors is an effective surgical technique for the treatment of an isolated Bankart lesion having good results with respect to pain relief, stability and function.

  5. The global percutaneous shuttling technique tip for arthroscopic rotator cuff repair

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    Bryan G. Vopat

    2014-05-01

    Full Text Available Most arthroscopic rotator cuff repairs utilize suture passing devices placed through arthro- scopic 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.

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

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    Rachel M. Frank

    2013-01-01

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

  7. Functional evaluation of arthroscopic repair of rotator cuff injuries in patients with pseudoparalysis,

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    Alberto Naoki Miyazaki

    2014-04-01

    Full Text Available 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.

  8. Early rehabilitation affects functional outcomes and activities of daily living after arthroscopic rotator cuff repair: a case report.

    Science.gov (United States)

    Shimo, Satoshi; Sakamoto, Yuta; Tokiyoshi, Akinari; Yamamoto, Yasuhiro

    2016-01-01

    [Purpose] The effect of early rehabilitation protocols after arthroscopic rotator cuff repair is currently unknown. We examined short-term effects of early rehabilitation on functional outcomes and activities of daily living after arthroscopic rotator cuff repair. [Subject and Methods] An 82-year-old male fell during a walk, resulting in a supraspinatus tear. Arthroscopic rotator cuff repair was performed using a single-row technique. He wore an abduction brace for 6 weeks after surgery. [Results] From day 1 after surgery, passive range of motion exercises, including forward flexion and internal and external rotation were performed twice per day. Starting at 6 weeks after surgery, active range of motion exercises and muscle strengthening exercises were introduced gradually. At 6 weeks after surgery, his active forward flexion was 150°, UCLA shoulder rating scale score was 34 points, and Quick Disabilities of the Arm, Shoulder, and Hand questionnaire disability/symptom score was 36 points. At 20 weeks after surgery, his active forward flexion was 120°, UCLA shoulder rating scale score was 34 points, and Quick Disabilities of the Arm, Shoulder, and Hand questionnaire disability/symptom score was 0 points. [Conclusion] These protocols are recommended to physical therapists during rehabilitation for arthroscopic rotator cuff repair to support rapid reintegration into activities of daily living. PMID:27064886

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

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    Ochiai Satoshi

    2011-08-01

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

  10. Exercise therapy versus arthroscopic partial meniscectomy for degenerative meniscal tear in middle aged patients

    DEFF Research Database (Denmark)

    Kise, Nina Jullum; Risberg, May Arna; Stensrud, Silje;

    2016-01-01

    clinics in Norway. PARTICIPANTS: 140 adults, mean age 49.5 years (range 35.7-59.9), with degenerative medial meniscal tear verified by magnetic resonance imaging. 96% had no definitive radiographic evidence of osteoarthritis. INTERVENTIONS: 12 week supervised exercise therapy alone or arthroscopic partial....... Our results should encourage clinicians and middle aged patients with degenerative meniscal tear and no definitive radiographic evidence of osteoarthritis to consider supervised exercise therapy as a treatment option.Trial registration www.clinicaltrials.gov (NCT01002794)....

  11. Are the good functional results from arthroscopic repair of massive rotator cuff injuries maintained over the long term?☆

    Science.gov (United States)

    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

  12. The "paraglider-wing" sign: an arthroscopic indicator of partial-thickness bursal-surface tears of the supraspinatus tendon.

    Science.gov (United States)

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

    2007-06-01

    Partial-thickness bursal-surface tears of supraspinatus tendon may be missed on preoperative investigations and can be overlooked at surgery if not specifically sought. The authors describe an arthroscopic sign to detect these tears, when they involve more than half the tendon fibres, from the articular-side of the joint. The "paraglider-wing" sign, visualized during diagnostic glenohumeral arthroscopy, is demonstrated as an upward bulge of the capsulo-tendinous layer through the bursal-surface tear, under pressure of the inflow fluid. A positive sign indicates (1) presence of a partial-thickness bursal-side tear of the supraspinatus tendon, (2) significant depth (stage II or III) of the tear, and (3) the medial extent of the tear along the length of the tendon. A meticulous subacromial bursoscopy and excision of the bursa is then performed to visualize the tear from the subacromial space. Repair of the tear is performed with a double-row suture anchor fixation technique; the medial row of sutures is passed through the intact region of the tendon using the "paraglider-wing" sign as a guide. PMID:17119924

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

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    Ranju Gandhi

    2014-01-01

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

  14. The relationship between patellofemoral and tibiofemoral morphology and gait biomechanics following arthroscopic partial medial meniscectomy

    DEFF Research Database (Denmark)

    Dempsey, Alasdair R.; Wang, Yuanyuan; Thorlund, Jonas Bloch;

    2013-01-01

    osteoarthritis at arthroscopic partial medial meniscectomy, underwent gait analysis and MRI on the operated knee once for each sub-cohort of 3 months, 2 years, or 4 years post-surgery. Cartilage volume, cartilage defects, and bone size were assessed from the MRI using validated methods. The 1st peak in the knee...... adduction moment, knee adduction moment impulse, 1st peak in the knee flexion moment, knee extension range of motion, and the heel strike transient from the vertical ground reaction force trace were identified from the gait data. Results Increased knee stance phase range of motion was associated......Purpose To examine the relationship between tibiofemoral and patellofemoral joint articular cartilage and subchondral bone in the medial and gait biomechanics following partial medial meniscectomy. Methods For this cross-sectional study, 122 patients aged 30–55 years, without evidence of knee...

  15. Surgical repair of partial atrioventricular defect.

    Science.gov (United States)

    El-Rassi, Issam; Charafedine, Fatimah; Majdalani, Mariane; Arabi, Mariam; Khater, Daniele; Bitar, Fadi

    2015-01-01

    Long-term survival rate of patients operated for partial atrioventricular (AV) canal is lower than that of the general population, and late complications are relatively significant: between 10 and 30% of operated patients present with left AV valve regurgitation, and up to 25% have to be reoperated for valve repair or replacement, left ventricular outflow tract obstruction or residual atrial septal defect. Because the left AV valve regurgitation is the most common complication following surgery, technical details in the surgical management of the mitral valve are the most important aspects of this procedure; for example, the decision to close the cleft and to perform an annuloplasty. The presence of mitral valve anomalies in 7-28% of the cases complicates further the surgical management of these valves. This article will describe in detail the operative technique of partial AV canal repair, and review the relevant literature. PMID:26685152

  16. Outcomes following arthroscopic transosseous equivalent suture bridge double row rotator cuff repair: a prospective study and short-term results

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    Imam Mohamed Abdelnabi

    2016-01-01

    Full Text Available Background: The transosseous-equivalent cross bridge double row (TESBDR rotator cuff (RC repair technique has been developed to optimize healing biology at a repaired RC tendon insertion. It has been shown in the laboratory to improve pressurized contact area and mean foot print pressure when compared with a double row anchor technique. Pressure has been shown to influence healing between tendon and bone, and the tendon compression vector provided by the transosseous-equivalent suture bridges may enhance healing. The purpose was to prospectively evaluate the outcomes of arthroscopic TESBDR RC repair. Methods: Single center prospective case series study. Sixty-nine patients were selected to undergo arthroscopic TESBDR RC repair and were included in the current study. Primary outcome measures included the Oxford Shoulder Score (OSS, the University of California, Los Angeles (UCLA score, the Constant-Murley (CM Score and Range of motion (ROM. Secondary outcome measures included a Visual Analogue Scale (VAS for pain, another VAS for patient satisfaction from the operative procedure, EuroQoL 5-Dimensions Questionnaire (EQ-5D for quality of life assessment. Results: At 24 months post-operative, average OSS score was 44, average UCLA score was 31, average CM score was 88, average forward flexion was 145°, average internal rotation was 35°, average external rotation was 79°, average abduction was 150°, average EQ-5D score was 0.73, average VAS for pain was 2.3, and average VAS for patient satisfaction was 9.2. Conclusion: Arthroscopic TESBDR RC repair is a procedure with good post-operative functional outcome and low re-tear rate based on a short term follow-up.

  17. Evaluation of functional results from shoulders after arthroscopic repair of complete rotator cuff tears associated with traumatic anterior dislocation

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    Glaydson Gomes Godinho

    2016-04-01

    Full Text Available OBJECTIVE: To evaluate the clinical outcome of arthroscopic rotator cuff fixation and, when present, simultaneous repair of the Bankart lesion caused by traumatic dislocation; and to assess whether the size of the rotator cuff injury caused by traumatic dislocation has any influence on the postoperative clinical outcomes. METHODS: Thirty-three patients with traumatic shoulder dislocation and complete rotator cuff injury, with at least two years of follow up, were retrospectively evaluated. For analysis purposes, the patients were divided into groups: presence of fixed Bankart lesion or absence of this lesion, and rotator cuff lesions smaller than 3.0 cm (group A or greater than or equal to 3.0 cm (group B. All the patients underwent arthroscopic repair of the lesions and were evaluated postoperatively by means of the UCLA (University of California at Los Angeles score and strength measurements. RESULTS: The group with Bankart lesion repair had a postoperative UCLA score of 33.96, while the score of the group without Bankart lesion was 33.7, without statistical significance (p = 0.743. Group A had a postoperative UCLA score of 34.35 and group B, 33.15, without statistical significance (p = 0.416. CONCLUSION: The functional outcomes of the patients who only presented complete rotator cuff tearing after traumatic shoulder dislocation, which underwent arthroscopic repair, were similar to the outcomes of those who presented an associated with a Bankart lesion that was corrected simultaneously with the rotator cuff injury. The extent of the original rotator cuff injury did not alter the functional results in the postoperative evaluation.

  18. Evaluation of functional results from shoulders after arthroscopic repair of complete rotator cuff tears associated with traumatic anterior dislocation

    Science.gov (United States)

    Godinho, Glaydson Gomes; Freitas, José Márcio Alves; de Oliveira França, Flávio; Santos, Flávio Márcio Lago; de Simoni, Leandro Furtado; Godinho, Pedro Couto

    2016-01-01

    Objective To evaluate the clinical outcome of arthroscopic rotator cuff fixation and, when present, simultaneous repair of the Bankart lesion caused by traumatic dislocation; and to assess whether the size of the rotator cuff injury caused by traumatic dislocation has any influence on the postoperative clinical outcomes. Methods Thirty-three patients with traumatic shoulder dislocation and complete rotator cuff injury, with at least two years of follow up, were retrospectively evaluated. For analysis purposes, the patients were divided into groups: presence of fixed Bankart lesion or absence of this lesion, and rotator cuff lesions smaller than 3.0 cm (group A) or greater than or equal to 3.0 cm (group B). All the patients underwent arthroscopic repair of the lesions and were evaluated postoperatively by means of the UCLA (University of California at Los Angeles) score and strength measurements. Results The group with Bankart lesion repair had a postoperative UCLA score of 33.96, while the score of the group without Bankart lesion was 33.7, without statistical significance (p = 0.743). Group A had a postoperative UCLA score of 34.35 and group B, 33.15, without statistical significance (p = 0.416). Conclusion The functional outcomes of the patients who only presented complete rotator cuff tearing after traumatic shoulder dislocation, which underwent arthroscopic repair, were similar to the outcomes of those who presented an associated with a Bankart lesion that was corrected simultaneously with the rotator cuff injury. The extent of the original rotator cuff injury did not alter the functional results in the postoperative evaluation. PMID:27069884

  19. ARTHROSCOPIC REPAIR OF BANKART’S LESION USING SUTURE ANCHORS IN RECURRENT ANTERIOR SHOULDER INSTABILITY

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    Santosh Kumar

    2015-06-01

    Full Text Available BACKGROUND : Shoulder instability and its treatment were described even in ancient times by the Greek and Egyptian physicians. Evidence of shoulder dislocation has been found in archaeological and paleopathological examinations of human shoulders several thousand years old. 1 Many techniques have been described in literature for treatment of recurrent shoulder dislocation. Arthroscopic repair of Bankart’s lesion using suture anchors is a noble technique. A suture anchor is a tiny screw with a thread attached to it. The screw is inserted into the bone over the glenoid rim while the sutures hold onto the labral tissue. These anchors provide a stable base for reattachment of the capsulolabral complex. We conducted a study on evaluation of long term effe ct of arthroscopic repair of Bankart’s lesion using suture anchors and compared our results with other studies published in literature . MATERIALS & METHODS : Since June 2012, arthroscopic Bankart’s repair using suture anchors was performed on 35 patients, who presented with recurrent anterior dislocation of shoulder. 34 man and 1 woman patients were included in the study. METHOD OF COLLECTION OF DATA: Adult patients with recurrent dislocations of shoulder with . INCLUSION CRITERIA: All patients > 15 years but =2 . EXCLUSION CRITERIA: Age group 60 years. Clinical evidence of multidirectional instability. Surgery of injured shou lder before 1 st episode of traumatic shoulder dislocation. Number o f dislocations <2 . Generalised ligamentous laxity. Presence of neuromuscular disorders. Presence of other comorbid conditions . Majority of patients were in the age group between 17 years to 49years, with mean age of 27.43 years. Most patients were young active individuals in the age group of 25 to 35 years. 20 patients (57% were involved in significant occupation requiring overhead activity such as students with sporting activities, agricul turists. 21(60% patients had their Right shoulder involved

  20. Arthroscopic Management of Full-Thickness Rotator Cuff Tears in Major League Baseball Pitchers: The Lateralized Footprint Repair Technique.

    Science.gov (United States)

    Dines, Joshua S; Jones, Kristofer; Maher, Patrick; Altchek, David

    2016-01-01

    Clinical outcomes of surgical management of full-thickness rotator cuff tears in professional baseball players have been uniformly poor. We conducted a study to investigate return-to-play data and functional performance using a novel arthroscopic repair technique. We hypothesized that arthroscopic rotator cuff repair would result in a high rate of return to professional pitching and favorable functional outcomes. We identified 6 consecutive Major League Baseball (MLB) pitchers who underwent surgical repair of full-thickness rotator cuff injuries using the lateralized footprint repair technique. At most recent follow-up, patients were evaluated to determine their ability to return to athletic activity. Functional outcomes were also assessed using player performance statistics. By mean follow-up of 66.7 months (range, 23.2-94.6 months), 5 (83%) of the 6 pitchers had returned to their preinjury level of competition for at least 1 full season. Despite the high rate of return to MLB play, few pitchers resumed pitching productivity at their preoperative level; mean number of innings pitched decreased from 1806.5 to 183.7. A slight performance reduction was also found in a comparison of preoperative and postoperative pitching statistics. Of note, the return rate was higher for players over age 30 years than for those under 30 years. Overhead athletes require a delicate balance of shoulder mobility and stability to meet functional demands. Anatomical adaptations at the glenohumeral joint should be considered when performing rotator cuff repair in these patients in order to preserve peak functional performance. This novel repair technique affords a high rate of return to MLB play, though elite overhead throwers should be counseled that pitching productivity might decrease after surgery. PMID:26991564

  1. Arthroscopic biceps tenodesis compared with repair of isolated type II SLAP lesions in patients older than 35 years.

    Science.gov (United States)

    Denard, Patrick J; Lädermann, Alexandre; Parsley, B K; Burkhart, Stephen S

    2014-03-01

    This study compared arthroscopic biceps tenodesis with biceps repair for isolated type II superior labrum anterior and posterior (SLAP) lesions in patients older than 35 years. The authors identified isolated type II SLAP lesions that were surgically managed over a 5-year period. Minimum 2-year follow-up data were available for 22 patients who underwent biceps repair (repair group) and for 15 patients who underwent a primary biceps tenodesis (tenodesis group). Mean age at surgery was 45.2±5.5 years in the repair group and 52.0±8.0 years in the tenodesis group. In the repair group, functional outcome improved from baseline to final follow-up using the American Shoulder and Elbow Surgeons (ASES) (47.5 to 87.4, respectively; PSLAP lesion had a shorter postoperative recovery, a more predictable functional outcome, and a higher rate of satisfaction and return to activity with a biceps tenodesis compared with a biceps repair. Based on these observations, biceps tenodesis is preferable to biceps repair for isolated type II SLAP lesions in nonoverhead athletes older than 35 years.

  2. High-Grade Articular, Bursal, and Intratendinous Partial-Thickness Rotator Cuff Tears: A Retrospective Study Comparing Functional Outcomes After Completion and Repair.

    Science.gov (United States)

    Donohue, Nicholas K; Nickel, Brian T; Grindel, Steven I

    2016-01-01

    We conducted a study to assess the impact of tear location on functional outcomes in high-grade partial-thickness rotator cuff tears (PTRCTs) after arthroscopic completion and repair. Retrospectively, we evaluated the preoperative and postoperative findings of 60 patients who underwent arthroscopic completion and repair of Ellman grade 3 partial-thickness tears of the supraspinatus. The 60 patients were grouped by tear subtype (20 articular, 20 bursal, 20 intratendinous) as identified by preoperative imaging and confirmed at time of surgery. After surgery, the 3 subtypes showed similar significant (P < .001) improvements in American Shoulder and Elbow Surgeons scores (articular, 46.9, 85.1; bursal, 44.3, 80.3; intratendinous, 43.6, 86.1), Constant scores (articular, 54.3, 79.4; bursal, 49.9, 75.0; intratendinous, 56.8, 80.9), and visual analog scale scores (articular, 5.1, 1.2; bursal, 5.8, 1.6; intratendinous, 6.0, 1.2). Our study findings validate use of the current algorithm for Ellman grade 3 PTRCTs of the supraspinatus and advocate their completion and repair, regardless of tear location. PMID:27552462

  3. Arthroscopic all-inside meniscal repair - Does the meniscus heal? A clinical and radiological follow-up examination to verify meniscal healing using a 3-T MRI

    Energy Technology Data Exchange (ETDEWEB)

    Hoffelner, Thomas; Resch, Herbert; Mayer, Michael; Tauber, Mark [Department of Traumatology and Sports Injuries, Salzburg (Austria); Forstner, Rosemarie [University Hospital of Salzburg, Department of Radiology, Salzburg (Austria); Minnich, Bernd [University of Salzburg, Department of Organismic Biology, Salzburg (Austria)

    2011-02-15

    The purpose of this study was to correlate clinical and radiological results using a 3-T MRI to verify meniscal healing after arthroscopic all-inside meniscus repair. We selected 27 patients (14 men and 13 women) with an average age of 31 {+-} 9 years and retrospective clinical examinations and radiological assessments using a 3-T MRI after all-inside arthroscopic meniscal repair were conducted. Repair of the medial meniscus was performed in 19 patients and of the lateral meniscus in eight. In 17 patients (63%), we performed concomitant anterior cruciate ligament reconstruction. The mean follow-up period was 4.5 {+-} 1.7 years. The Lysholm score and Tegner activity index were used for clinical evaluation. Four grades were used to classify the radiological signal alterations within the meniscus: central globular (grade 1); linear horizontal or band-like (grade 2); intrameniscal alterations and linear signal alterations communicating with the articular surface (grade 3); and complex tears (grade 4). At follow-up, the average Lysholm score was 76 {+-} 15 points, with ten of the patients placed in group 6 based on the Tegner activity index. MRI examinations revealed no signal alteration in three patients, grade 1 in 0, grade 2 in five, grade 3 in 13, and grade 4 in six. The MRI findings correlated positively with the clinical scores in 21 patients (78%). Correlation of clinical and radiological examination was performed using 3-T MRI. In spite of satisfactory clinical outcomes at follow-up, a radiological signal alteration may still be visible on MRI, which was believed to be scar tissue, but could not be proven definitively. Imaging with a 3-Tesla MRI after meniscal suture surgery provides good but no definitive reliability on meniscus healing and therefore gives no advantage compared to 1.5-T MRI, with good clinical outcome using an all-inside arthroscopic meniscal repair. 3T-MRI can not substitute diagnostic arthroscopy in patients with persistent complaints after

  4. Partial arthroscopic trapeziectomy with ligament reconstruction to treat primary thumb basal joint osteoarthritis.

    Science.gov (United States)

    Desmoineaux, P; Delaroche, C; Beaufils, P

    2012-11-01

    Since the outcome of partial trapeziectomy is not always satisfactory, we proposed using arthroscopy to perform partial trapeziectomy and to perform ligament reconstruction with the abductor pollicis longus tendon. A tendon strip was left intact at its insertion at the base of the first metacarpal and then slipped into the trapeziectomy space. It was fixed into a blind tunnel at the base of the second metacarpal with a bioabsorbable interference screw. Forty-nine patients were surgically treated between 2006 and 2009. With an average follow-up of 3.6 years, 83.5% of patients were satisfied with the procedure; 96% of thumbs were stable and 74% were pain free. The average recovery time was 4.5 months. There were four cases of radial nerve branch irritation and one case of flexor carpi radialis tendinitis; there were no cases of complex regional pain syndrome. This minimally-invasive technique is a less-aggressive treatment approach for thumb carpometacarpal joint arthritis, which simplify postoperative recovery. PMID:23098774

  5. Arthroscopic Superior Capsule Reconstruction for Irreparable Rotator Cuff Tears.

    Science.gov (United States)

    Petri, Maximilian; Greenspoon, Joshua A; Millett, Peter J

    2015-12-01

    Massive irreparable rotator cuff tears in young patients are a particular challenge for the orthopaedic surgeon. Surgical treatment options include debridement, partial rotator cuff repair, patch-augmented rotator cuff repair, bridging rotator cuff reconstruction with graft interposition, tendon transfer, and reverse total shoulder arthroplasty. Recently, reconstruction of the superior glenohumeral capsule using a fascia lata autograft has been suggested to reduce superior glenohumeral translation and restore superior stability. Promising clinical results have been reported in 1 case series of 23 patients, indicating that superior capsular reconstruction may be a promising tool to manage massive irreparable rotator cuff tears. This article describes our preferred technique for arthroscopic superior capsule reconstruction. PMID:27284506

  6. Plasma rico em plaquetas no reparo artroscópico das roturas completas do manguito rotador Platelet-rich plasma in arthroscopic repairs of complete tears of the rotator cuff

    Directory of Open Access Journals (Sweden)

    Eduardo Angeli Malavolta

    2012-01-01

    .5 (p25% = 6, p75% = 8 to 0.5 (p25% = 0, p75% = 3 (p = 0.0013 according to the VAS score. None of the patients presented complete retear. Three patients (21.4% showed partial retear, without transfixation. Only one patient developed complica tions (adhesive capsulitis. CONCLUSION: Patients submitted to arthroscopic rotator cuff repair augmented with PRP showed significant functional improvement and none of them had com plete retearing.

  7. Reparo artroscópico das lesões completas isoladas do subescapular Arthroscopic repair of complete, isolated lesions of the subscapularis tendon

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    Niso Eduardo Balsini

    2008-12-01

    Full Text Available OBJETIVO: Avaliar o resultado retrospectivo de 12 pacientes submetidos ao reparo artroscópico de lesões completas isoladas do tendão do subescapular com seguimento mínimo de um ano. MÉTODOS: De 11 de abril de 2002 a 24 de setembro de 2004, realizou-se o reparo artroscópico de lesões completas do manguito rotador em 95 pacientes no Instituto Balsini. Pacientes com subescapular lesado somavam 31; 12 lesões isoladas compunham o grupo de estudo. Foram reavaliados com seguimento mínimo de um ano da cirurgia, considerando grau de elevação anterior ativa, escala da UCLA e satisfação do paciente. RESULTADOS: A elevação anterior ativa pré-operatória atingiu a média de 102º, o grau de elevação anterior ativa pós-operatória obteve a média de 175º. O ganho médio na elevação anterior ativa foi de 73º (p OBJECTIVE: To evaluate the retrospective result of 12 patients submitted to arthroscopic repair of complete, isolated lesions of the subscapularis tendon with minimum follow-up of one year. METHODS: From April 11, 2002 to September 24, 2004, the authors performed the arthroscopic repair of complete rotator cuff lesions in 95 patients at the Balsini Institute. Patients with lesioned subscapularis amounted to 31, and 12 isolated lesions were included in the study group. They were re-analyzed with a minimum follow-up of one year after surgery to evaluate the degree of active anterior elevation, according to the UCLA scale and to patient satisfaction. RESULTS: Pre-operative active anterior elevation had a mean of 102º, and the degree of active anterior elevation after surgery presented a mean of 175º. The mean gain in active anterior elevation was 73º (p < 0.0001. Preoperative UCLA had a mean of 15.25 score points, and after surgery, a mean of 31.66 score points. The mean UCLA index was 16 score points (p < 0.0001; 10 excellent results, one good, and one poor. Satisfactory results: 10, unsatisfactory: 1. CONCLUSION: 1 The

  8. Exercise therapy versus arthroscopic partial meniscectomy for degenerative meniscal tear in middle aged patients: randomised controlled trial with two year follow-up

    Science.gov (United States)

    Risberg, May Arna; Stensrud, Silje; Ranstam, Jonas; Engebretsen, Lars; Roos, Ewa M

    2016-01-01

    Objective To determine if exercise therapy is superior to arthroscopic partial meniscectomy for knee function in middle aged patients with degenerative meniscal tears. Design Randomised controlled superiority trial. Setting Orthopaedic departments at two public hospitals and two physiotherapy clinics in Norway. Participants 140 adults, mean age 49.5 years (range 35.7-59.9), with degenerative medial meniscal tear verified by magnetic resonance imaging. 96% had no definitive radiographic evidence of osteoarthritis. Interventions 12 week supervised exercise therapy alone or arthroscopic partial meniscectomy alone. Main outcome measures Intention to treat analysis of between group difference in change in knee injury and osteoarthritis outcome score (KOOS4), defined a priori as the mean score for four of five KOOS subscale scores (pain, other symptoms, function in sport and recreation, and knee related quality of life) from baseline to two year follow-up and change in thigh muscle strength from baseline to three months. Results No clinically relevant difference was found between the two groups in change in KOOS4 at two years (0.9 points, 95% confidence interval −4.3 to 6.1; P=0.72). At three months, muscle strength had improved in the exercise group (P≤0.004). No serious adverse events occurred in either group during the two year follow-up. 19% of the participants allocated to exercise therapy crossed over to surgery during the two year follow-up, with no additional benefit. Conclusion The observed difference in treatment effect was minute after two years of follow-up, and the trial’s inferential uncertainty was sufficiently small to exclude clinically relevant differences. Exercise therapy showed positive effects over surgery in improving thigh muscle strength, at least in the short term. Our results should encourage clinicians and middle aged patients with degenerative meniscal tear and no definitive radiographic evidence of osteoarthritis to consider

  9. Arthroscopic meniscal allograft transplantation without bone plugs.

    Science.gov (United States)

    Alentorn-Geli, Eduard; Seijas Vázquez, Roberto; García Balletbó, Montserrat; Álvarez Díaz, Pedro; Steinbacher, Gilbert; Cuscó Segarra, Xavier; Rius Vilarrubia, Marta; Cugat Bertomeu, Ramón

    2011-02-01

    Partial or total meniscectomy are common procedures performed at Orthopedic Surgery departments. Despite providing a great relief of pain, it has been related to early onset knee osteoarthritis. Meniscal allograft transplantation has been proposed as an alternative to meniscectomy. The purposes of this study were to describe an arthroscopic meniscal allograft transplantation without bone plugs technique and to report the preliminary results. All meniscal allograft transplantations performed between 2001 and 2006 were approached for eligibility, and a total of 35 patients (involving 37 menisci) were finally engaged in the study. Patients were excluded if they had ipsilateral knee ligament reconstruction or cartilage repair surgery before meniscal transplantation or other knee surgeries after the meniscal transplantation. Scores on Lysholm, Subjective IKDC Form, and Visual Analogue Scale (VAS) scale for pain were obtained at a mean follow-up of 38.6 months and compared to pre-operative data. Data on chondral lesions were obtained during the arthroscopic procedure and through imaging (radiographs and MRI) studies pre-operatively. Two graft failures out of 59 transplants (3.4%) were found. Daily life accidents were responsible for all graft failures. Significant improvements for Lysholm, Subjective IKDC Form, and VAS for pain scores following the meniscal allograft transplantation were found (P lesion, there was no significant interactions for Lysholm (n.s.), Subjective IKDC Form (n.s.), and VAS for pain scores (n.s.). This study demonstrated that an arthroscopic meniscal allograft transplantation without bone plugs improved knee function and symptoms after a total meniscectomy. Improvements were observed independently of the degree of chondral lesion.

  10. 大型及巨大肩袖撕裂的肩关节镜下治疗%Arthroscopic repair of large to massive rotator cuff tears

    Institute of Scientific and Technical Information of China (English)

    周可; 陆伟; 王大平; 朱伟民; 柳海峰; 冯文哲; 彭亮权

    2010-01-01

    Objective To evaluate arthroscopic repair of large to massive rotator cuff tears (LMRCT) . Methods From March 2004 to September 2008, 13 LMRCT patients, 3 nales and 10 females, were treated under arthroscopy. Their mean age was 58.3 years old, with a range of 45 to 72 years.Arthroscopic operations included 11 cases of acromioplasty, 8 cases of rotator cuff repair with metal suture anchor and 5 cases of simple debridement. The clinical outcome was assessed by the visual analog scale (VAS) and University of California Los Angeles (UCLA) scoring system. Results The follow-up periods averaged 18.2 months, with a range of 16 to 32 months. The mean preoperative and end follow-up VAS scores were 6. 6 ± 1.3 vs. 1.5 ± 1.1. The mean preoperative and end follow-up UCLA scores were 11.2 ± 2. 2 vs.29. 5 ± 2.2. There were significant differences between preoperative and postoperative scores ( P < 0.05 ).Conclusion Arthroscopy may be the least invasive, most effective and safest treatment for LMRCT.%目的 探讨全关节镜下手术对大型及巨大肩袖撕裂进行治疗的手术技巧与临床疗效.方法 2004年3月至2008年9月对13例大型或巨大肩袖撕裂患者行肩关节镜下手术治疗,男3例,女10例;年龄45~72岁,平均58.3岁.4例有肩关节摔伤病史,3例有搬抬重物致伤史,其余患者无明显外伤史.肩关节疼痛、无力病史4个月~7年,平均10.6个月.关节镜下11例患者行肩峰成形术,8例行肩袖组织缝合锚修复,5例行单纯肩袖组织清理等.采用视觉模拟法(VAS)疼痛评分和加州大学洛杉矶分校(UCLA)肩关节功能评分进行疗效评估.结果 所有患者术后随访16~32个月,平均18.2个月.术前VAS评分为(6.6±1.3)分,末次随访时为(1.5±1.1)分.术前UCLA肩关节评分为(11.2±2.2)分,末次随访时为(29.5±2.2)分.术前与末次随访时各项评分差异均有统计学意义(P<0.05).结论 肩关节镜下手术治疗大型及巨大肩袖撕裂是一种微创、有效、安全的治疗方式.

  11. 关节镜下经肌腱修补治疗关节侧肩袖部分损伤%Arthroscopic treatment of articular side partial tear of supraspinatus tendon by the trans-tendon approach

    Institute of Scientific and Technical Information of China (English)

    汪滋民; 李全; 王一; 沈锋; 许国星; 宋爽

    2014-01-01

    Background Partial rotator cuff tears result in pain and disfunction in patients.An previous study,the researchers measured the supraspinatus tendon of 1 7 corpses and came to a conclusion that the average thickness of the supraspinatus tendon was 1 2 mm.Divides the rotator cuff tears into partial articular tears,partial bursa tears and intra-tendon tears according to the inj ury sites. Based on the thickness of inj ured rotator cuff measured during the operation,the tears are divided into 3 degrees:Degree I (≤3 mm),Degree Ⅱ (3-6 mm)and Degree Ⅲ (≥ 6 mm),and the injured thickness of the Degree Ⅲ is more than 50%.Waibl et al put forward the concept of partial articular surface tendon avulsions(PASTA)and the trans-tendon approach to repair the inj ury.The PASTA has a high morbidity.Modi et al reviewed 100 cases who were all over 35 years old.They recieved an arthroscopic surgery for rotator cuff lesions.Waibl then found 62 cases had PASTA.Yamanaka et al followed 40 PASTA patients using arthrography,the average follow-up was 412 days.They found that the PASTA had a tendency to expand (53%)and to progress to full-thickness tears (28%).Take this into account,most scholars tend to endorse the decision that tears over degree Ⅲ must be repaired.The methods include the conventional repair after the conversion of the full-thickness tear and the direct repair of the tears using the tendon approach.Compared with the former,the tendon repair can save the residual normal rotator cuff tissue,and the length-tension balance after rotator cuff repair is simmilar to normal anatomy.Up to now,China is still lack of treatment reports for such reported inj uries.From March 2008 to July 2010,we had 12 cases of patients with PASTA who recieved the arthroscopic trans-tendon repair using the method improved by Lo.All patients were followed up for 1 2 months or more,and the results are as follows.Methods I.General Information:There are 1 2 cases in the group, including 5 males,7

  12. 关节镜下经肌腱修补治疗关节侧肩袖部分损伤%Arthroscopic treatment of articular side partial tear of supraspinatus tendon by the trans-tendon approach

    Institute of Scientific and Technical Information of China (English)

    汪滋民; 李全; 王一; 沈锋; 许国星; 宋爽

    2014-01-01

    5 males and 7 females,and all of them had an Ellman degree Ⅲ tear.The patients were followed up from 12 to 36 months and the average follow-up period was (22±7.3)months.ASES score:follow-up score (89.7±5.6)points,significantly improved compared with the preoperative points (49.8±9.8)(t=12.25,P<0.0001).The follow-up UCLA score of (30.4±3.2)points improved significantly from the preoperative points of (17.3±3.3).The excellent rate was 91.7%.Discussion The principles of the joint side rotator cuff injury:The procedure for the joint lateral rotator cuff injury during the arthroscopic surgery includes:(1 ) clean up the rotator cuff with or without the subacromial decompression;(2)step 1 with the intra-tendon repair;(3)step 1 with the repair when the damage becomes into a complete tear.Despite earlier reports concluded that the simple clean of the rotator cuff with the subacromial decompression could relieve the pain and improve the function in patients,recent studies suggest cleaning and decompression cannot prevent the partial rotator cuff tear and damage to become a complete tear and symptoms to be worsen.Kartus et al found that 34.6% of the partial tear patients became a complete tear after a cleaning up of the rotator cuff with the subacromial decompression.And their pain and function scores were significantly less than the patients without a complete tear.By contrast,the rotator cuff repair obtains a more reliable effect,and prevents the progress of the rotator cuff tear.Evidence-based medicine shows that when tear is not more than 50%, the simply debridement of the rotator cuff with the subacromial decompression can achieve satisfactory results.But when the tear is not less than 50%,only the repair will be able to obtain satisfactory results.The traditional way which turns the damage into a complete tear has a direct and convenient advantage,and achieved good clinical results,but it is difficult to remodel the connection of fibrocartilage and has a high re

  13. 复发性肩关节前脱位的关节镜治疗%Arthroscopic Bankart repair for the treatment of recurrent anterior shoulder dislocation

    Institute of Scientific and Technical Information of China (English)

    朱以明; 鲁谊; 冯华; 洪雷; 姜春岩

    2008-01-01

    目的 探讨肩关节镜下Bankart重建手术治疗复发性肩关节前脱位的疗效、适应证和手术要点.方法 随访40例应用肩关节镜下Bankart重建进行治疗的复发性肩关节前脱位患者,随访时间为24~58个月,平均35.9个月;年龄15~54岁,平均27.8岁.40例均为单方向性不稳定.术前平均脱位次数为14.1次(2~90次),其中28例发生于主力侧.术中采用金属缝合锚(Mini-Revo)进行Bankart重建.随访内容包括ASKS评分、Constant-Murley评分、VAS不稳定评分及ROWE评分进行功能评估.结果 40例患者术前和终末随访时肩关节前屈上举平均为[(157.5±20.6)°,x ±s.下同]和(170.0±6.7)°,体侧外旋平均为(58.5±18.9)°和(55.9±15.0)°,ASES评分平均为(82.7±16.7)和(97.2±6.9),VAS不稳定评分平均为(6.2±1.6)和(1.3±1.4),Constant-Murley评分平均为(80.5 ±11.1)和(98.1±3.1),Rowe评分平均为(30.4±8.7)和(92.8±15.2).除体侧外旋术前和术后差异无统计学意义外,其余各项结果差异均有统计学意义.终末随访时有1例患者曾出现肩关节半脱位.随访时发现残存恐惧试验阳性3例(占7.5%).所有患者均恢复术前工作,29例(占70.7%)恢复到第一次脱位前的运动水平.结论 肩关节镜下Bankart重建手术是治疗复发性肩关节前脱位的有效方法之一.适当的病例选择、术者的关节镜下操作技术水平及术后长期而严格的功能康复锻炼是手术成功的关键.%Objective To discuss the indications, surgical techniques and results of arthroscopic Bankart repair for the treatment of recurrent anterior shoulder dislocation. Methods Fourty patients with recurrent anterior shoulder dislocation treated by athroscopic Bankart repair were reviewed with a mean follow- up period of 35.9 (24 -58) months. The mean age was 27.8 (15 -54) years. All patients were diagnosed as unidirectional anterior instability. They were treated with arthroscopic Bankart repair. Metal suture anchors

  14. The effects of neuromuscular exercise on medial knee joint load post-arthroscopic partial medial meniscectomy: ‘SCOPEX’ a randomised control trial protocol

    Directory of Open Access Journals (Sweden)

    Hall Michelle

    2012-11-01

    Full Text Available Abstract Background Meniscectomy is a risk factor for knee osteoarthritis, with increased medial joint loading a likely contributor to the development and progression of knee osteoarthritis in this group. Therefore, post-surgical rehabilitation or interventions that reduce medial knee joint loading have the potential to reduce the risk of developing or progressing osteoarthritis. The primary purpose of this randomised, assessor-blind controlled trial is to determine the effects of a home-based, physiotherapist-supervised neuromuscular exercise program on medial knee joint load during functional tasks in people who have recently undergone a partial medial meniscectomy. Methods/design 62 people aged 30–50 years who have undergone an arthroscopic partial medial meniscectomy within the previous 3 to 12 months will be recruited and randomly assigned to a neuromuscular exercise or control group using concealed allocation. The neuromuscular exercise group will attend 8 supervised exercise sessions with a physiotherapist and will perform 6 exercises at home, at least 3 times per week for 12 weeks. The control group will not receive the neuromuscular training program. Blinded assessment will be performed at baseline and immediately following the 12-week intervention. The primary outcomes are change in the peak external knee adduction moment measured by 3-dimensional analysis during normal paced walking and one-leg rise. Secondary outcomes include the change in peak external knee adduction moment during fast pace walking and one-leg hop and change in the knee adduction moment impulse during walking, one-leg rise and one-leg hop, knee and hip muscle strength, electromyographic muscle activation patterns, objective measures of physical function, as well as self-reported measures of physical function and symptoms and additional biomechanical parameters. Discussion The findings from this trial will provide evidence regarding the effect of a home

  15. Discoid lateral meniscus and its arthroscopic treatment

    OpenAIRE

    Asik, Mehmet; Sen, Cengiz; Dikici, Fatih; Sozen, Yunus V.; Taser, Omer F.; Alturfan, Aziz

    2004-01-01

    Objectives: We evaluated the results of arthroscopic meniscectomy in patients with lateral discoid menisci of the knee. Methods: Lateral discoid menisci were documented in 274 patients, of whom 183 patients (110 males, 73 females; mean age 34.8 years; range 6-67 years) were clinically and arthroscopically found to be symptomatic and underwent total, subtotal, or partial meniscectomy. The most common complaints were pain, lurch, feeling of giving way, locking, limited extension, and marked ...

  16. Transosseous Medial Meniscal Root Repair Using a Modified Mason-Allen Suture Configuration.

    Science.gov (United States)

    Lavender, Chad D; Hanzlik, Shane R; Caldwell, Paul E; Pearson, Sara E

    2015-12-01

    Medial meniscal tears are among the most common injuries to the knee joint. Loss of the meniscus has been linked to increased contact pressures on the adjacent articular cartilage and progression of degenerative changes in the knee. A subset of tears known as "root tears" involves the insertion of the posterior horn of the meniscus to the bone. Arthroscopic partial meniscectomy for root tears led to undesirable outcomes, which prompted surgeons to explore restorative procedures. Multiple repair techniques have been presented with an emphasis placed on initial secure fixation and stimulation of potential healing. We present an arthroscopic-assisted technique for medial meniscal root repair with these goals in mind. PMID:27284511

  17. Arthroscopic repair of meniscal injury with Fast-fix system%Fast-fix系统修复半月板损伤临床疗效观察

    Institute of Scientific and Technical Information of China (English)

    唐恒涛; 赵亮; 燕华; 金大地; 苏训同

    2012-01-01

    [ Objective ] To evaluate the effect of the arthroscopic repair of the meniscal injury with the Fast-fix system. [ Method ] From July 2007 to June 2009, totally 2S4 cases of meniscus injury were treated with Fast-fix system under arthroscope and 96 cases were followed up successfully. There were 58 males and 38 females,aged from 12 to 46(mean 24.3) years. The course was 3 days - 1 year (mean 43.5 days)from injury to treatment. Forty-six right and fifty left knees were involved. They were located in ante-homer (n = 12), body (n = 46) and post-horner (n = 38). The lesion were in the red ( n = 32 ) , red white ( n = 42) and while (n = 22) region, respectively. All inside were used in 56 cases, outside in were used in 8 cases and inside out was used in 32 cases. Generally ,1-3 sutures were used for each patient. The hospital stay was 3-14 days( mean 8 days). The clinical cure criteria of menical injury included no lock.no pain.no swell and negative McMurray test. [Result] All the patients were followed-up.Lysholm rating system was used to determine the function of the knee and the level of activity of the patients. After operation, all the patients were clinically cured. The effects of surgery were satisfactory. The preoperative Lysholm score was 45.10 ±12.55 and the postoperative Lysholm score was 82.34± 10.50,and there was significant difference (t =3. 25,P <0.01). [Conclusion]The Fast-fix system is an efficient,safe and effective suture instrument for meniscal repair.%[目的]评价Fast-fix系统修复半月板损伤的临床疗效.[方法]自2007年7月~2009年6月,关节镜辅助下用Fast-fix系统治疗半月板损伤患者254例,96例患者得到随访.男58例,女38例,年龄12~46岁,平均24.3岁.病程3d~1年,平均43.5 d.右膝46例,左膝50例;前角损伤12例,体部撕裂46例,后角撕裂38例;红区损伤32例,红白区损伤42例,白区损伤(延长红白区)22例.All-inside缝合56例,Outside-in缝合8例,Inside-Out缝合32

  18. 关节镜下联合修补技术治疗内侧半月板桶柄样撕裂20例临床分析%Arthroscopic hybrid suture technique for repairing 20 bucket-handle tear of inside meniscus

    Institute of Scientific and Technical Information of China (English)

    麦鸿飞; 冯光; 黎国权; 覃海宁

    2011-01-01

    Objective To investigate the arthroscopic inside-out repairing technique(hybrid suture technique) for bucket-handle tear of inside meniscus and present the short-term clinical outcome. Methods Twenty patients with 20 repairable inside meniscus tears were enrolled. With arthroscopic technique,the midbody portion and anterior portion of the lesion were repaired using standard inside-out technique with vertical and interlacing tibial and femoral side arrangement. For the most posterior portion, all-inside suture technique with two posterior portals were performed. For isolated red-white zone tears,fibrin clot was implanted into the repaired region for enhancing the healing pro-ACL injuries were reconstructed simultaneously. Results Twenty patients with 20 meniscal repairs were available for 5-36 (19.2 ± 2.3)months follow-up. Eighteen cases were asymptomatic at the latest clinical evaluation,and joint space tenderness in 2 cases. Twenty cases received MRI evaluation during follow-up, showing that 15 menisci were completely healed, 5 partially healed. Postoperative Lysholm scores of the knee joint function [82-97(90.3 ±1.5) points] were significantly improved compared with their preoperative scores [45-69 (56.7 ± 2.0)points] (P = 0.024).Conclusion For meniscal tears involving red-red and red-white zones,arthroscopic hybrid suture technique provides stable strength along the whole length of injured region, and consequently achieves satisfactory clinical outcomes.%目的 探讨关节镜下联合修补技术治疗内侧半月板桶柄样撕裂的临床疗效.方法 采用关节镜下联合修补技术修补20例(20个)内侧半月板桶柄样撕裂,均累及内侧半月板后角至前体部区域.半月板体部和前角采用标准的自内向外缝合;半月板后角采用全关节内缝合:经两个后内侧入路在关节内完成垂直褥式缝合.单纯的红-白交界处撕裂修补后局部植入血凝块促进愈合,合并前十字韧带损伤者同

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

    Science.gov (United States)

    Silver, Daniel M.; Campbell, Pat

    1985-01-01

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

  20. Large increase in arthroscopic meniscus surgery in the middle-aged and older population in Denmark from 2000 to 2011

    DEFF Research Database (Denmark)

    Thorlund, Jonas B; Hare, Kristoffer B; Lohmander, Stefan

    2014-01-01

    Background - Arthroscopic meniscal surgery is the most common orthopedic procedure, and the incidence has increased in Denmark over the last 10 years. Concomitantly, several randomized controlled trials have shown no benefit of arthroscopic procedures including arthroscopic partial meniscectomy in...... and 2011. Interpretation - The incidence of meniscal procedures performed in Denmark doubled from 2000 to 2011, with the largest increase in middle-aged and older patients. This increase contrasts with the mounting evidence showing no added benefit of arthroscopic partial meniscectomy over non...

  1. Arthroscopic surgery for degenerative knee

    DEFF Research Database (Denmark)

    Thorlund, Jonas Bloch; Juhl, C B; Roos, E M;

    2015-01-01

    OBJECTIVE: To determine benefits and harms of arthroscopic knee surgery involving partial meniscectomy, debridement, or both for middle aged or older patients with knee pain and degenerative knee disease. DESIGN: Systematic review and meta-analysis. MAIN OUTCOME MEASURES: Pain and physical function...... and absent at one to two years after surgery. Knee arthroscopy is associated with harms. Taken together, these findings do not support the practise of arthroscopic surgery for middle aged or older patients with knee pain with or without signs of osteoarthritis. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD....... DATA SOURCES: Systematic searches for benefits and harms were carried out in Medline, Embase, CINAHL, Web of Science, and the Cochrane Central Register of Controlled Trials (CENTRAL) up to August 2014. Only studies published in 2000 or later were included for harms. ELIGIBILITY CRITERIA FOR SELECTING...

  2. Arthroscopic Trans-osseous Suture of Peripheral Triangular Fibrocartilage Complex Tear.

    Science.gov (United States)

    Jegal, Midum; Heo, Kang; Kim, Jong Pil

    2016-10-01

    The importance of foveal repair of the triangular fibrocartilage complex (TFCC) on stability of the distal radioulnar joint (DRUJ) has been emphasized with increasing knowledge of the anatomy and biomechanics of the TFCC and DRUJ. Although both open and arthroscopic techniques have been described for improving DRUJ stability, there has been a marked evolution of arthroscopic TFCC repair technique with successful clinical outcome. Recently, an arthroscopic trans-osseous technique has been described to repair foveal tears of the TFCC. The advantage of the technique is that it allows for anatomical repair of both the superficial and deep layers. This article describes the details of this novel technique. PMID:27595945

  3. 关节镜下修复肩关节V型从前到后上盂唇损伤的临床效果%Clinical effect of arthroscopic repair on V type superior labral anterior posterior lesions

    Institute of Scientific and Technical Information of China (English)

    魏民; 刘玉杰; 李众利; 王志刚; 蔡谞; 朱娟丽; 刘洋

    2013-01-01

    Objective To observe the clinical effect of arthroscopic repair on V type superior labral anterior posterior lesions. Methods Sixteen patients with V type superior labral anterior posterior lesions admitted to our hospital from March 2008 to December 2010 served as an experimental group and 16 patients with Bankart lesions served as a control group in this study. Their labral lesions were repaired by arthroscopy with absorbable lines. Their pain was scored according to the visual analogue scale (VAS) and their shoulder joint function was assessed according to the American Shoulder and Elbow Surgeons (ASES) Scoring System and the Rowe Shoulder Scoring System, respectively. Results The VAS, ASES and Rowe scores were higher in the two groups after operation than before operation (P0.05). Conclusion Arthroscopic repair with absorbable line can achieve satisfactory clinical outcomes in patients with should joint dislocation due to V type superior labral anterior posterior lesions.%目的:观察关节镜下对V型从前到后上盂唇损伤(superior labral anterior to posterior,SLAP)的复发性肩关节前脱位修复的临床疗效。方法收集我单位2008年3月-2010年12月V型SLAP损伤患者16例,选取同期单纯Bankart损伤病例16例作为对照组。在关节镜下采用可吸收带线锚钉修复盂唇。采用视觉模拟评分(visual analogue scale,VAS)评价疼痛,美国肩肘外科协会(American Shoulder and Elbow Surgeons,ASES)评分系统和Rowe肩关节评分系统评价关节功能。结果两组患者术后VAS评分、ASES评分和Rowe评分均优于术前(P<0.05),没有脱位复发。两组患者术后结果的差异无统计学意义(P>0.05)。结论对V型SLAP损伤的复发性肩关节前脱位,采用可吸收带线锚钉进行修复可获得良好的临床效果。

  4. Rotator Cuff Repair

    Medline Plus

    Full Text Available ... be moderating today's events. In just a moment, we'll be meeting my colleague, internationally-renowned orthopedic ... be performing arthroscopic rotator cuff repair and before we get to him I would like you to ...

  5. Avaliação funcional do reparo artroscópico das lesões completas do manguito rotador associado a acromioplastia Functional evaluation of arthroscopic repairs of complete rotator cuff tears associated to acromioplasty

    Directory of Open Access Journals (Sweden)

    Marco Antonio de Castro Veado

    2008-12-01

    Full Text Available OBJETIVO: Realizar avaliação funcional dos pacientes portadores de lesão completa do MR que foram submetidos ao reparo artroscópico associados à acromioplastia. MÉTODOS: Trata-se de um estudo retrospectivo realizado com pacientes submetidos a tratamento cirúrgico artroscópico para reparo da lesão do MR. Foram incluídos os pacientes operados entre junho/2000 e outubro/2004 nos Hospitais Mater Dei e Felício Rocho, em Belo Horizonte. Dos 102 pacientes submetidos à reconstrução, 11 foram retirados por não cumprirem os critérios de inclusão, sendo o número final igual a 91 ombros em 91 pacientes. A avaliação funcional foi realizada pela escala UCLA (Universidade da Califórnia em Los Angeles e pelo teste Simples. RESULTADOS: Na avaliação pós-operatória em 35 pacientes, os resultados foram considerados excelentes (38,4%; em 47, bons (51,6%; seis, regulares (6,6%; e três, ruins (3,3%. Desse modo, 82 (90,1% pacientes foram avaliados como tendo obtido resultado bom ou excelente e nove como regulares ou ruins, sendo estes insatisfatórios. CONCLUSÃO: O reparo artroscópico do manguito rotador, associado a acromioplastia, apresentou resultado funcional excelente ou bom, na maioria dos pacientes, quando avaliados pelo método funcional da UCLA.OBJECTIVE: To perform a function evaluation of patients with complete rotator cuff tears that were submitted to arthroscopic repair associated to acromioplasty. METHODS: This is a retrospective study made with patients submitted to arthroscopic surgical treatment to repair rotator cuff tears. Patients included were operated on from June 2000 to October 2004 at the Mater Dei and Felício Rocho Hospitals, in Belo Horizonte. Of the 102 patients submitted to reconstruction, 11 were removed from the study because they did not meet the inclusion criteria, and so the final number of the series was 91 shoulders of 91 patients. The functional evaluation scale was the UCLA scale and the simple test was

  6. Arthroscopic glenoid labrum repair by anchor fixation for recurrent anterior shoulder dislocation%肩关节镜下带线锚钉内固定治疗复发性肩关节前脱位

    Institute of Scientific and Technical Information of China (English)

    姜侃; 孙荣鑫; 钟广军

    2012-01-01

    Objective:To investigate the curative effect of arthroscopic glenoid labrum repair by biodegradable anchor fixation for recurrent anterior shoulder dislocation. Methods: Twenty-one patients of recurrent anterior shoulder dislocation with the average UCLA function score of 22. 3 ±4. 1 were treated with arthroscopic glenoid labrum repair by biodegradable anchor fixation. The shoulder was fixed by shoulder-elbow elastic band for 4 - 6 weeks and canonical exercise of shoulder joint was taken postoperatively. Results; The patients were followed up for 3-18 (mean 8) months; and the average UCLA score was 32. 3 ± 2. 6 postoperatively. The excellent results (34 -35) were obtained in 11 patients, good (28-33) in 7 patients and fair (21-27) in 3-'patients. The activity of shoulder joint was normal in all patients with an excellent subjective degree of satisfaction. Conclusion; Arthroscopic glenoid labrum repair by anchor fixation for recurrent anterior shoulder dislocation has the advantages of less invasiveness, simpler procedure , reliable fixation, less complications and rapid functional recovery.%目的:探讨肩关节镜下应用可吸收带线锚钉内固定修复盂唇损伤治疗复发性肩关节前脱位的疗效与方法.方法:本组21例复发性肩关节前脱位患者,肩关节功能评估采用美国加州洛杉矶大学UCLA功能评分标准,术前评分平均(22.3±4.1)分.全部采用肩关节镜下可吸收带线锚钉内固定修复盂唇损伤.术后肩肘固定带固定患肩4~6周,按规定程序进行康复锻炼.结果:经3~18个月(平均8个月)的随访,术后UCLA评分平均(32.3±2.6)分.优(34~35分)11例,良(28 ~ 33分)7例,中(21 ~27分)3例,无差病例.术后肩关节活动范围正常.患者主观满意度:均较满意.结论:肩关节镜下应用可吸收带线锚钉内固定修复盂唇损伤治疗复发性肩关节前脱位,具有创伤小、操作简便、内固定可靠、术后并发症少、功能恢复快等优点,是

  7. Partial isolated rupture of the popliteus tendon in a professional soccer player: a case report

    Directory of Open Access Journals (Sweden)

    Mariani Pier

    2009-07-01

    Full Text Available Abstract The complete isolated rupture of the popliteus tendon has been described as a rare injury and this report describes the case of a 31-year-old soccer player who sustained a partial rupture of the popliteus tendon during a game. The injury was suspected clinically and at MRI but confirmed only by the arthroscopic examination. The treatment consisted in open debridment with no tendon repair or augmentation. Seven weeks post-operation the patient was symptom-free and returned to competitive professional soccer at the same preinjury level. The clinical and arthroscopic findings of the case reported suggest a possible overuse disease with degenerative expression.

  8. Arthroscopic anatomy of the subdeltoid space

    Directory of Open Access Journals (Sweden)

    Michael J. Salata

    2013-09-01

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

  9. DNA damage induced by boron neutron capture therapy is partially repaired by DNA ligase IV.

    Science.gov (United States)

    Kondo, Natsuko; Sakurai, Yoshinori; Hirota, Yuki; Tanaka, Hiroki; Watanabe, Tsubasa; Nakagawa, Yosuke; Narabayashi, Masaru; Kinashi, Yuko; Miyatake, Shin-ichi; Hasegawa, Masatoshi; Suzuki, Minoru; Masunaga, Shin-ichiro; Ohnishi, Takeo; Ono, Koji

    2016-03-01

    Boron neutron capture therapy (BNCT) is a particle radiation therapy that involves the use of a thermal or epithermal neutron beam in combination with a boron ((10)B)-containing compound that specifically accumulates in tumor. (10)B captures neutrons and the resultant fission reaction produces an alpha ((4)He) particle and a recoiled lithium nucleus ((7)Li). These particles have the characteristics of high linear energy transfer (LET) radiation and therefore have marked biological effects. High-LET radiation is a potent inducer of DNA damage, specifically of DNA double-strand breaks (DSBs). The aim of the present study was to clarify the role of DNA ligase IV, a key player in the non-homologous end-joining repair pathway, in the repair of BNCT-induced DSBs. We analyzed the cellular sensitivity of the mouse embryonic fibroblast cell lines Lig4-/- p53-/- and Lig4+/+ p53-/- to irradiation using a thermal neutron beam in the presence or absence of (10)B-para-boronophenylalanine (BPA). The Lig4-/- p53-/- cell line had a higher sensitivity than the Lig4+/+ p53-/-cell line to irradiation with the beam alone or the beam in combination with BPA. In BNCT (with BPA), both cell lines exhibited a reduction of the 50 % survival dose (D 50) by a factor of 1.4 compared with gamma-ray and neutron mixed beam (without BPA). Although it was found that (10)B uptake was higher in the Lig4+/+ p53-/- than in the Lig4-/- p53-/- cell line, the latter showed higher sensitivity than the former, even when compared at an equivalent (10)B concentration. These results indicate that BNCT-induced DNA damage is partially repaired using DNA ligase IV. PMID:26573366

  10. Arthroscopic treatment of glenoid bone loss.

    Science.gov (United States)

    Taverna, Ettore; Garavaglia, Guido; Ufenast, Henri; D'Ambrosi, Riccardo

    2016-02-01

    Recurrent anterior instability of the glenohumeral joint has long been an arduous problem to solve surgically, owing to its difficulty to the need to restore both osseous and dynamic constraints in the unstable shoulder. Biomechanical studies have indicated that glenoid bone loss shortens the safe arc through which the glenoid can resist axial forces; in these cases, a soft tissue repair alone may be insufficient to maintain stability. Clinical studies have confirmed that major bone loss is associated with an unfavourable outcome. The benefits of using arthroscopic procedures for surgical stabilization of the shoulder include smaller incisions and less soft tissue dissection, better access for repair and, potentially, the maximum respect for the undamaged anatomical structures. The biggest disadvantage of arthroscopic procedures until recently was the inability to successfully treat a significant bone defect. Over the last 10 years, several new arthroscopic techniques have been developed, providing new surgical options for successfully treating soft tissues and bony lesions in anterior-inferior glenohumeral instability. Level of evidence V. PMID:26658567

  11. Arthroscopic treatment of gonarthrosis

    OpenAIRE

    Taser, Omer; Alturfan, Aziz; Pinar, Halit; Gogus, Abdullah

    2004-01-01

    59 cases, who had arthroscopic debridement or arthroscopic abrasion arthroplasty (±drilling) for gonarthrosis between June 1988 and December 1990 were evaluated. Follow-up period was 1 ,5 to 30 months (average 9,2 months) in the debridement group (Group I) and 1, 5 to 24 months (average 7,5 months) in the abrasion arthroplas group (Group II). All patients became subjectively well In the first group (39 patients in total) activity level increased in 30 patients, stayed the same in 6 patients a...

  12. Arthroscopic Shoulder Surgery in Female Professional Tennis Players

    Science.gov (United States)

    Young, Simon W.; Safran, Marc R.; Dakic, Jodie; Nguyen, Michael L.; Stroia, Kathleen

    2013-01-01

    Objectives: Recent publications have highlighted the relatively poor outcome of other overhead athletes, particularly baseball players, with regard to return to sports at the same or higher level after shoulder surgery. However, true assessment of their ability when returning to sport is not as clear. Further, ability to return to other overhead sports has not been reported. Our objective was to assess outcome and time to return to previous level of function following shoulder surgery in professional tennis players. Methods: The records of all female tennis players on the Women’s Tennis Association (WTA) professional circuit between January 2008 and June 2010 were reviewed to identify players who underwent shoulder surgery on their dominant (serving) shoulder. Details of the surgery including date, procedures performed, and complications were recorded. The primary outcomes were ability and time to return to professional play, and if they were able to return to their previous level of function, as determined by singles ranking. Pre and post-operative singles rankings were used to determine rate and completeness of return to preoperative function. Their highest ranking pre-injury, post operatively, and the time to return to pre-injury ranking were evaluated. Results: During the study period eight professional women tennis players from the WTA underwent shoulder surgery on their dominant arm. All surgery was performed arthroscopically, 7 out of 8 players had more than one procedure performed during the surgery. In total, 3 players underwent debridement of a partial rotator cuff tear and 2 players underwent repair of a complete supraspinatus tear. Three players had an anterior labral repair or reconstruction for anterior instability, and one player underwent repair of a SLAP lesion. Two players underwent neurolysis of a suprascapular nerve, and three players in total underwent a subacromial decompression. All players (100%) returned to professional play. The mean

  13. Tfb5 Is Partially Dispensable for Rad26 Mediated Transcription Coupled Nucleotide Excision Repair in Yeast

    OpenAIRE

    Ding, Baojin; Ruggiero, Christine; Chen, Xuefeng; Li, Shisheng

    2007-01-01

    Nucleotide excision repair (NER) is a conserved DNA repair mechanism capable of removing a variety of helix-distorting DNA lesions. A specialized NER pathway, called transcription coupled NER (TC-NER), refers to preferential repair in the transcribed strand of an actively transcribed gene. To be distinguished from TCR-NER, the genome-wide NER process is termed as global genomic NER (GG-NER). In Saccharomyces cerevisiae, GG-NER is dependent on Rad7, whereas TC-NER is mediated by Rad26, the hom...

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

    OpenAIRE

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

    2012-01-01

    Rectus femoris origin injuries in adult athletes are uncommon. In the acute phase, conservative treatment seems to have a favourable outcome, with surgical repair reserved for unsuccessful cases only. However, a group of patients may develop chronic pain and disability after recovery from the acute phase due to heterotopic calcification occurring at the site of injury. Open and arthroscopic excision of such calcifications has been described in the literature although arthroscopic excision of ...

  15. Bankart Repair to Correct Shoulder Instability

    Medline Plus

    Full Text Available ... Jones and it's called an Arthroscopic Bankart Repair. I think we really have something unique to offer ... site. 00:01:39 To highlight that today, I'd like to introduce my colleagues. Dr. Kerwyn ...

  16. 关节镜辅助下一期修复重建膝关节三联损伤疗效观察%Clinical effect of one-stage arthroscopically assisted repair and reconstruction on Triplicate injuries of knee joint

    Institute of Scientific and Technical Information of China (English)

    何建华; 谢水华; 王小鹏; 丁浩

    2015-01-01

    目的:探讨关节镜下一期修复重建膝关节三联损伤(前交叉韧带,内侧副韧带和内侧半月板损伤)的方法及效果。方法2009年10月-2014年6月,对21例膝关节三联损伤患者采用一期关节镜下手术,取腘绳肌腱(或同种异体肌腱)重建前交叉韧带,止点重建或缝合修复治疗内侧副韧带损伤,一期缝合或修整损伤的内侧半月板。结果术后均获随访6-30个月,平均16个月,术前Lysholm膝关节功能评分为(40.4±15.8)术后末次随访为(84.5±12.8),有显著改善。患者在0°和20°应力测试时稳定性均完全恢复。结论膝关节三联损伤可以一期在关节镜下完成重建及修复,早期有效恢复膝关节稳定性。%Objective To investigate one-stage arthroscopic repair and reconstruction of the triplicate Injuries of knee joint (anterior cruciate ligament,medial collateral ligament and medial meniscus). Methods From October 2009- June 2014,21 cases of knee joint injury were treated as taking arthroscopic operation with one stage ,The ACL was reconstructed using the hamstring tendon autograft (or tendon allograft),medial collateral ligament was repaired and reconstruction of the interdictory point,One-stage suture or trimmed medial meniscus injury. Results All cases were followed up for 6-30 months,average 16 months,Accord-ing to the Lysholm scale of knee function,preoperative was (40.4+15.8),the last follow-up was (84.5+12.8) after operation,has im-proved significantly. Patients with stress test stability were recovered in 0 degree and 20 degree. Conclusion The triplicate In-juries of knee joint can be reconstructed and repaired for one stage under the arthroscope ,early and effective recovery of knee joint stability.

  17. Repaired tetralogy of Fallot with coexisting unrepaired partial anomalous pulmonary venous connection is associated with diminished right ventricular ejection fraction and more severe right ventricular dilation

    Energy Technology Data Exchange (ETDEWEB)

    Chan, Sherwin S. [Children' s Mercy Hospital and Clinics, Department of Radiology, Kansas City, MO (United States); Whitehead, Kevin K.; Kim, Timothy S.; Fu, Gregory L.; Fogel, Mark A.; Harris, Matthew A. [Children' s Hospital of Philadelphia, Department of Cardiology, Philadelphia, PA (United States); Keller, Marc S. [Children' s Hospital of Philadelphia, Department of Radiology, Philadelphia, PA (United States)

    2015-09-15

    There is an established association between tetralogy of Fallot and partial anomalous pulmonary venous connections. This association is important because surgically repaired tetralogy patients have increased risk of right heart failure. We hypothesize that partial anomalous venous connections increase right ventricular volumes and worsen right ventricular failure. We reviewed cardiac MRI exams performed at a tertiary pediatric hospital from January 2005 to January 2014. We identified patients with repaired tetralogy and unrepaired partial anomalous pulmonary venous connection. We used age- and gender-matched repaired tetralogy patients without partial anomalous pulmonary venous connection as controls. We analyzed the MRI results and surgical course and performed comparative statistics to identify group differences. There were eight patients with repaired tetralogy and unrepaired partial anomalous pulmonary venous connection and 16 controls. In all cases, the partial anomalous pulmonary venous connection was not detected on preoperative echocardiography. There were no significant differences in surgical course and body surface area between the two groups. Repaired tetralogy patients with unrepaired partial anomalous pulmonary venous connection showed significantly higher indexed right ventricular end diastolic volume (149 ± 33 mL/m{sup 2} vs. 118 ± 30 mL/m{sup 2}), right ventricle to left ventricle size ratios (3.1 ± 1.3 vs. 1.9 ± 0.5) and a higher incidence of reduced right ventricular ejection fraction compared to controls (3/8 vs. 0/16). Repaired tetralogy of Fallot with unrepaired partial anomalous pulmonary venous connection is associated with reduced right ventricular ejection fraction and more significant right ventricular dilation. (orig.)

  18. Repaired tetralogy of Fallot with coexisting unrepaired partial anomalous pulmonary venous connection is associated with diminished right ventricular ejection fraction and more severe right ventricular dilation

    International Nuclear Information System (INIS)

    There is an established association between tetralogy of Fallot and partial anomalous pulmonary venous connections. This association is important because surgically repaired tetralogy patients have increased risk of right heart failure. We hypothesize that partial anomalous venous connections increase right ventricular volumes and worsen right ventricular failure. We reviewed cardiac MRI exams performed at a tertiary pediatric hospital from January 2005 to January 2014. We identified patients with repaired tetralogy and unrepaired partial anomalous pulmonary venous connection. We used age- and gender-matched repaired tetralogy patients without partial anomalous pulmonary venous connection as controls. We analyzed the MRI results and surgical course and performed comparative statistics to identify group differences. There were eight patients with repaired tetralogy and unrepaired partial anomalous pulmonary venous connection and 16 controls. In all cases, the partial anomalous pulmonary venous connection was not detected on preoperative echocardiography. There were no significant differences in surgical course and body surface area between the two groups. Repaired tetralogy patients with unrepaired partial anomalous pulmonary venous connection showed significantly higher indexed right ventricular end diastolic volume (149 ± 33 mL/m2 vs. 118 ± 30 mL/m2), right ventricle to left ventricle size ratios (3.1 ± 1.3 vs. 1.9 ± 0.5) and a higher incidence of reduced right ventricular ejection fraction compared to controls (3/8 vs. 0/16). Repaired tetralogy of Fallot with unrepaired partial anomalous pulmonary venous connection is associated with reduced right ventricular ejection fraction and more significant right ventricular dilation. (orig.)

  19. Automatic ICRS scoring of cartilage lesions using arthroscopic OCT images

    OpenAIRE

    te Moller, Nikae; Pitkanen, M; Liukkonen, J.; Puhakka, P H; Brommer, Harold; J.S. Jurvelin; van Weeren, René; Toyras, J.

    2014-01-01

    Articular cartilage injury is a common cause of chronic disability in both humans and animals. Current treatment strategies offer several possibilities and in order to select the optimal repair procedure, accurate determination of size and severity of a lesion is important [1,2]. Recently, an equine ex vivo study showed that arthroscopic optical coherence tomography (OCT) provides high resolution optical images of the cartilage layer [3]. Furthermore, in that study morphological characteristi...

  20. Lesões extensas do manguito rotador: avaliação dos resultados do reparo artroscópico Extensive rotator cuff injuries: an evaluation of arthroscopic repair outcomes

    Directory of Open Access Journals (Sweden)

    Alberto Naoki Miyazaki

    2009-04-01

    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 93º to 141º, the mean lateral rotation went from 32º to 48º 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.

  1. Reliability Analysis of Partially Repairable Systems%部分可修系统的可靠性分析

    Institute of Scientific and Technical Information of China (English)

    苏保河

    2005-01-01

    The reliability analysis of a system with repairable failures and non-repairable failures is presented. It is assumed that the system has n repairable failure modes and m non-repairable failure modes. As one repairable failure mode takes place, the system will be repaired after the failure mode is detected, otherwise, it would never work again when attaining one non-repairable failure mode. Thus, the system brings about new reliability indices for having both repairable failures and non-repairable failures. The definitions of the new reliability indices are given, and the calculating methods for them are derived by using probability analysis and the supplementary variable technique.

  2. All-arthroscopic iliotibial band autograft harvesting and labral reconstruction technique.

    Science.gov (United States)

    Deshmane, Prashant P; Kahlenberg, Cynthia A; Patel, Ronak M; Han, Brian; Terry, Michael A

    2013-02-01

    The labrum is essential for stability, movement, and prevention of arthritis in the hip. In cases of labral damage where repair of a labral tear is not possible, reconstruction can be a useful alternative. Several different autografts have been used, including the iliotibial band (ITB), the ligamentum teres capitis, and the gracilis tendon. Authors have reported both open and arthroscopic techniques for reconstruction with good preliminary results. However, an all-arthroscopic labral reconstruction technique including the graft harvest and reconstruction portions of a labral reconstruction procedure using an ITB autograft has not been previously described. We describe a technique for an all-arthroscopic labral reconstruction performed using a novel method for arthroscopic harvest of the ITB. The decreased invasiveness of our described technique for labral reconstruction may potentially minimize scarring, bodily disfigurement, infection, and postoperative pain associated with the graft harvesting incision.

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

    Science.gov (United States)

    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 Technique for Acetabular Labral Reconstruction Using Iliotibial Band Autograft.

    Science.gov (United States)

    Chahla, Jorge; Soares, Eduardo; Bhatia, Sanjeev; Mitchell, Justin J; Philippon, Marc J

    2016-06-01

    The dynamic function of the acetabular labrum makes it an important structure for both hip stability and motion. Because of this, injuries to the labrum can cause significant dysfunction, leading to altered hip kinematics. Labral repair is the gold standard for symptomatic labral tears to keep as much labral tissue as possible; however, in cases where the labrum has been injured to such a degree that it is either deficient or repair is not possible, arthroscopic labral reconstruction is preferred. This article describes our preferred approach for reconstruction of the acetabular labrum using iliotibial band autograft.

  5. Arthroscopic diagnosis and repair of triangular fibrocartilage complex tears:a clinical efficiency study%腕关节镜对三角纤维软骨复合体损伤的诊断和治疗价值分析

    Institute of Scientific and Technical Information of China (English)

    郑鑫; 解学关; 王安远; 张义鹏; 高伟阳; 蒋良福; 陈星隆; 张国佑; 丁健; 周飞亚; 宋永焕; 李晓阳

    2011-01-01

    目的 对腕关节三角纤维软骨复合体(TFCC)损伤行关节镜检查,并分析其疗效.方法 对2006年1月至2009年12月诊断为TFCC损伤并行腕关节镜治疗的15例患者进行回顾性分析,其中男6例、女9例,平均年龄42岁,平均随访时间26.5个月.根据Palmer分型,Ⅰ型损伤5例(ⅠA型3例,ⅠB型1例,ⅠD型1例),Ⅱ型损伤10例(ⅡA型6例,ⅡC型4例).所有患者保守治疗3个月以上无效后行关节镜治疗.测量指标:腕关节疼痛、握力、关节活动度、腕关节评分(改良Mayo评分)、DASH问卷.结果 术后15例患者腕关节疼痛均有缓解,握力改善;腕关节屈伸(129±26)°,桡尺偏(40±8)°,旋转(174±11)°.按照改良Mayo评分:优3例,良8例,可4例;优良率为73%.术后DASH评分为4~28分,平均(15±7)分.结论 关节镜对于TFCC损伤的诊断明显优于MRI检查,而且关节镜能在检查的同时进行治疗,应作为腕尺痛的常规诊断手段.关节镜治疗各型TFCC损伤均能缓解疼痛,但Ⅰ型效果好于Ⅱ型.伴有尺骨正变异的TFCC损伤应同时行尺骨缩短术以提高术后效果.%Objective The objective of this study was to determine the efficiency of arthroscopic diagnosis and repair of triangular fibrocartilage complex (TFCC) tears. Methods Fifteen cases of TFCC tears diagnosed and treated with arthroscopic repair in our hospital between January 2006 and December 2009 were retrospectively reviewed. There were six males and nine females. The average age was 42 years. The average follow-up was 26.5 months. TFCC tears were classified by Palmer classification as follows:ⅠA (3 cases),ⅠB (1 case),ⅠD (1 case),ⅡA (6 cases),and ⅡC (4 cases). Arthroscopic repair was performed after at least 3 months of conservative treatment failed. Wrist pain,grip strength,range of motion (ROM),wrist score (modified Mayo wrist score),disabilities of the arm,shoulder,and hand questionnaire (DASH) score were evaluated. Results Postoperatively alleviation of

  6. All-arthroscopic rotator cuff repair versus mini-open for the treatment of rotator cuff injury:aMeta-analysis%全关节镜与小切口修复肩袖撕裂损伤的荟萃分析

    Institute of Scientific and Technical Information of China (English)

    王毅; 赵其纯

    2016-01-01

    BACKGROUND:There are controversies about the efficacy of al-arthroscopic rotator cuff repairversus mini-open for the treatment of rotator cuff injury. OBJECTIVE:To evaluate the efficacy of al-arthroscopic rotator cuff repairversusmini-open for the treatment of rotator cuff injury by conducting a meta-analysis. METHODS:A computer-based online search was conducted in PubMed, Embase, Cochrane Library and CBM databases from January 1966 to November 2015 to screen the relevant articles usingthe key words of“rotator cuff, arthroscopy, mini-open”. Meta-analysis was performed using Revman5.3 software. RESULTS AND CONCLUSION:A total of 11 studies, including 6randomized controled trialsand 5 cohort studies,were selected. The meta-analysis results showed that there were no significant differences in the function and strength of the shoulder joint, pain, motor range, recurrence of rotator cuff avulsion, the incidence rate of ankylosis between both two groups (P> 0.05). These results suggest that the efficacy of al-arthroscopic rotator cuff repair does not differ from those of mini-open for the treatment of rotator cuff injury. However arthroscopic rotator cuff repair induces less soft tissue injury and early incision pain, but better function recovery.%背景:对于全关节镜及小切口两种修复式的疗效比较,国内外尚有许多争议。  目的:对全关节镜及小切口两种方法治疗肩袖损伤的疗效进行荟萃分析。  方法:以“肩袖”、“关节镜”、“小切口”为检索词,计算机检索1966年1月至2015年11月PubMed, Embase,Cochrane图书馆和CBM,搜集所有的有关论研究。筛选并提取数据,采用Revman5.3软件进行荟萃分析。  结果与结论:共纳入11例研究,其中6例随机对照研究,5例队列研究,荟萃分析显示这两组肩关节功能、疼痛、活动范围、肩袖再撕裂率、关节僵硬发生率以及肩关节力量差异均无显著性意义(P>0

  7. Avaliação dos resultados do reparo artroscópico de lesões do manguito rotador em pacientes com até 50 anos de idade Evaluation of the results from arthroscopic repair on rotator cuff injuries among patients under 50 years of age

    Directory of Open Access Journals (Sweden)

    Alberto Naoki Miyazaki

    2011-01-01

    motion was 145˚ for elevation, 47˚ for lateral rotation and T10 for medial rotation. Unsatisfactory results were associated with prolonged duration of the injury, with a statistically significant relationship. CONCLUSION: Arthroscopic repair of rotator cuff injuries in young patients produces excellent or good results for most patients.

  8. Effect of acupuncture combined with rehabilitation training on walking function after arthroscopic meniscus repair%针刺配合康复训练对膝关节半月板损伤术后步行功能的影响

    Institute of Scientific and Technical Information of China (English)

    刘新荣; 李旗

    2015-01-01

    目的:观察针刺配合康复训练对膝关节半月板损伤关节镜术后患者步行功能的影响。方法:将60例半月板损伤关节镜术后患者按随机数字表法分为两组,每组30例。观察组予针刺结合常规康复训练治疗,对照组仅采用与观察组相同的常规康复训练治疗。于治疗前及治疗1个月、2个月后对患者膝关节能量、支撑力矩及摆动力矩进行测量比较。结果:治疗前,两组膝关节能量、支撑力矩及摆动力矩差异均无统计意义(P>0.05)。治疗1个月及2个月后,两组患者膝关节能量、支撑力矩及摆动力矩均明显改善,与本组治疗前有统计学差异(P<0.05);两组间亦有统计学差异(P<0.05)。结论:针刺配合康复训练可增加膝关节半月板损伤关节镜术后患者下肢运动过程中膝关节能量、支撑力矩与摆动力矩,提高其步行功能。%Objective: To observe the effect of acupuncture combined with rehabilitation training on walking function after arthroscopic meniscus repair. Methods:A total of 60 cases after arthroscopic meniscus repair were randomly allocated into an observation group and a control group, 30 in each group. Cases in the observation group received acupuncture combined with standard rehabilitation training, whereas cases in the control group only received the standard rehabilitation training. The energy, support torque and swing torque of the knee joints in the two groups were measured and compared before treatment, after 1-month and 2-month treatments. Results:Before treatment, there were no between-group significant differences in the differences of energy, support torque and swing torque of the knee joints (P>0.05). After 1-month and 2-month treatments, there were intra-group and inter-group statistical differences in these parameters (P Conclusion:Acupuncture combined with rehabilitation training can increase the energy, support torque and swing torque of the

  9. Editorial Commentary: Iliotibial Band Allograft Shows Promise for Arthroscopic Hip Labral Reconstruction.

    Science.gov (United States)

    Rossi, Michael J

    2016-01-01

    Arthroscopic hip labral reconstruction using iliotibial band allograft in a modified front-to-back technique results in improved outcomes after 2-year follow-up. The authors' reasoning for reconstruction are reminiscent of similar arguments for restoring hoop stresses in knee meniscal surgery. Results are comparable to reported outcomes of labral repair, and allograft is particularly indicated for severe labral damage when repair is not possible. Don't miss the related technical note with video in Arthroscopy Techniques.

  10. Editorial Commentary: Iliotibial Band Allograft Shows Promise for Arthroscopic Hip Labral Reconstruction.

    Science.gov (United States)

    Rossi, Michael J

    2016-01-01

    Arthroscopic hip labral reconstruction using iliotibial band allograft in a modified front-to-back technique results in improved outcomes after 2-year follow-up. The authors' reasoning for reconstruction are reminiscent of similar arguments for restoring hoop stresses in knee meniscal surgery. Results are comparable to reported outcomes of labral repair, and allograft is particularly indicated for severe labral damage when repair is not possible. Don't miss the related technical note with video in Arthroscopy Techniques. PMID:26743407

  11. Effect of arthroscopic rotator cuff surgery in patients with preoperative restricted range of motion

    OpenAIRE

    Razmjou, Helen; Henry, Patrick; Costa, Giuseppe; Dwyer, Tim; Holtby, Richard

    2016-01-01

    Background The purpose of this study was to examine the impact of rotator cuff (RC) decompression and/or repair on post-operative ROM in patients with pre-operative restricted passive motion who had undergone arthroscopic subacromial debridement and/or rotator cuff repair. Potential predictors of ROM recovery such as age, sex, mechanism of injury, type of surgery, presence of an endocrine illness and having an active Worker Compensation claim related to the shoulder were explored. Methods A r...

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

    Directory of Open Access Journals (Sweden)

    Tomoyuki Muto

    2015-01-01

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

  13. Arthroscopic Release of Adhesive Capsulitis of the Shoulder Complicated With Shoulder Dislocation and Brachial Plexus Injury.

    Science.gov (United States)

    Nunez, Fiesky A; Papadonikolakis, Anastasios; Li, Zhongyu

    2016-01-01

    The incidence of brachial plexus injury after shoulder dislocation or arthroscopic shoulder surgery is low. Complex regional pain syndrome (CRPS) is an uncommon but painful condition that can develop after nerve injury. Historically, CRPS has been difficult to treat and therapeutic efforts are sometimes limited to ameliorating symptoms. However, if a dystrophic focus can be identified, the condition can be addressed with surgical exploration for potential neurolysis or nerve repair. The present article reports on a case of type II CRPS that developed in the postoperative setting of arthroscopic shoulder surgery complicated with simple shoulder dislocation. PMID:27518297

  14. Biomechanical comparison of double-row versus transtendon single-row suture anchor technique for repair of the grade Ⅲ partial articular-sided rotator cuff tears

    Institute of Scientific and Technical Information of China (English)

    ZHANG Chun-gang; ZHAO De-wei; WANG Wei-ming; REN Ming-fa; LI Rui-xin; YANG Sheng; LIU Yu-peng

    2010-01-01

    Background For partial-thickness tears of the rotator cuff, double-row fixation and transtendon single-row fixation restore insertion site anatomy, with excellent results. We compared the biomechanical properties of double-row and transtendon single-row suture anchor techniques for repair of grade Ⅲ partial articular-sided rotator cuff tears.Methods In 10 matched pairs of fresh-frozen sheep shoulders, the infraspinatus tendon from 1 shoulder was repaired with a double-row suture anchor technique. This comprised placement of 2 medial anchors with horizontal mattress sutures at an angle of .≤45° into the medial margin of the infraspinatus footprint, just lateral to the articular surface, and 2 lateral anchors with horizontal mattress sutures. Standardized, 50% partial, articular-sided infraspinatus lesions were created in the contralateral shoulder. The infraspinatus tendon from the contralateral shoulder was repaired using two anchors with transtendon single-row mattress sutures. Each specimen underwent cyclic loading from 10 to 100 N for 50 cycles, followed by tensile testing to failure. Gap formation and strain over the footprint area were measured using a motion capture system; stiffness and failure load were determined from testing data.Results Gap formation for the transtendon single-row repair was significantly smaller (P <0.05) when compared with the double-row repair for the first cycle ((1.74±0.38) mm vs. (2.86±0.46) mm, respectively) and the last cycle ((3.77±0.45) mm vs. (5.89±0.61) mm, respectively). The strain over the footprint area for the transtendon single-row repair was significantly smaller (P <0.05) when compared with the double-row repair. Also, it had a higher mean ultimate tensile load and stiffness.Conclusions For grade Ⅲ partial articular-sided rotator cuff tears, transtendon single-row fixation exhibited superior biomechanical properties when compared with double-row fixation.

  15. ARTHROSCOPIC RECONSTRUCTION OF ANTERIO R CRUCIATE LIGAMENT TEARS: OUR EXPERIENCE

    Directory of Open Access Journals (Sweden)

    Thimma Reddy

    2015-09-01

    Full Text Available BACKGROUND: Anterior knee instability associated with rupture of the ACL (Anterior Cruciate Ligament is a disabling clinical problem. The ACL has a poor capacity for intrinsic repair. Thus for patients who have knee symptoms related to ACL deficiency, one may consider ligament reconstruction as a means of stabilizing the T ibio - F emoral articulation and restoring high level function of the knee joint. Arthroscopically assisted ACLR ( ACL Reconstruction has the advantage of being minimally invasive, accurate graft placement, less disturbance of normal tissue resulting in quicker recovery and rehabilitation, minimal hospital stay and very less infection rate. MATERIAL AND METHODS: Between April 2012 to May 2013, 30 patients who underwent arthroscopic assisted ACL reconstructions using either bone - patellar tendon - bone auto graft ( BTB or Quadrupled hamstring auto graft ( QHG or Quadriceps tendon graft ( QTG in the Department of Orthopaedics and Traumatology, Osmania Medical College, Hyderabad, Andhra Pradesh is the material in our study. CONCLUSIONS : Arthroscopic reconstruction of Anterior Cruciate Ligament is a reliable, safe procedure. It helps in the early restoration of function and stability of the Knee joint and helps the patient to get back to his normal activity much earlier than with the traditional open surgical methods. The choice of the graft does not play a major role in the function of the knee in the long run.

  16. Repair versus shaving of partial-thickness articular-sided tears of the upper subscapularis tendon. A prospective randomized controlled trial

    Science.gov (United States)

    RANDELLI, PIETRO; ARRIGONI, PAOLO; ALIPRANDI, ALBERTO; SDAO, SILVANA; RAGONE, VINCENZA; D’AMBROSI, RICCARDO; RANDELLI, FILIPPO; CABITZA, PAOLO; BANFI, GIUSEPPE

    2015-01-01

    Purpose the purpose of this study was to evaluate whether treating partial-thickness articular-sided tears of the upper subscapularis (SSC) tendon with a dedicated suture anchor would result in an internal rotation strength improvement compared with simple shaving of the SSC tendon and footprint. Methods twenty-six patients with a limited SSC tendon tear (equal or inferior to the most superior centimeter) in association with a posterosuperior cuff lesion were prospectively randomized to two treatments: repair with a dedicated suture anchor versus shaving of the tendon and footprint. The patients also underwent long head of the biceps (LHB) treatment and posterosuperior cuff tear repair. In each patient the following parameters were measured both preoperatively and at a minimum follow-up of 2.5 years: strength in internal rotation in the bear-hug testing position (using a digital tensiometer), DASH score and Constant scores. MRI assessment of tendon healing was performed at the final follow-up. Results twenty of the 26 patients (76%) were reviewed after a mean follow-up time of 42 months: 11 patients had undergone SSC tendon repair and nine simple shaving. At final follow-up no significant differences were found between the repaired and shaving group in strength in internal rotation (9.5 ± 3.8 kg versus 10.3±5.4 kg; p=0.7). The DASH score and Constant score also failed to show significant differences between the two groups. Furthermore, no significant difference in SSC tendon healing rate was observed on MRI evaluation. Conclusions partial-thickness articular-sided tear of the upper SSC tendon in association with a posterosuperior rotator cuff repair and LHB treatment, when limited to the superior centimeter of the SSC tendon, shows a comparable performance in terms of strength in internal rotation either after simple shaving or a tendon-to-bone repair. Level of evidence Level II, prospective comparative study. PMID:26889466

  17. Arthroscopic treatment of symptomatic type D medial plica.

    Science.gov (United States)

    Uysal, Mustafa; Asik, Mehmet; Akpinar, Sercan; Ciftci, Feyyaz; Cesur, Necip; Tandogan, Reha N

    2008-12-01

    We aimed to review the results of subtotal arthroscopic resection of symptomatic type D medial plica. We retrospectively evaluated 23 knees with symptomatic type D medial plica in 22 patients without other intra-articular pathology. All patients complained of chronic knee pain that had not been alleviated by medical treatment or physical therapy. In only three (13%) of the patients studied was the plica diagnosed pre-operatively with magnetic resonance imaging. The type D medial plicae in our series were classified as fenestrated (14 knees), torn (5 knees), or reduplicated (4 knees). Fibrotic changes in the plicae and degenerative changes on the medial femoral condyle were found in 16 knees Patellofemoral chondromalacia was present in three knees Arthroscopic partial resection was performed in all patients. Comparative Lysholm Knee Scale scores before and after surgery revealed a significant clinical improvement (pre-operative status, 67.19 +/- 8.05 vs. post-operative status, 90.57 +/- 9.80; P knee pain. Arthroscopic partial resection of the plicae in symptomatic patients gives satisfactory results.

  18. Arthroscopic Conjoint Tendon Transfer: A Technique for Revision Anterior Shoulder Stabilization.

    Science.gov (United States)

    Tennent, Duncan; Colaço, Henry B; Arnander, Magnus; Pearse, Eyiyemi

    2016-02-01

    Revision anterior stabilization of the shoulder presents a challenge to the surgeon and carries a higher risk of recurrent dislocation than primary repair. The Latarjet procedure may be more reliable than revision soft-tissue repair but may not be indicated in patients without significant glenoid bone loss. We describe an arthroscopic technique of conjoint tendon transfer using a combination of suspensory and interference screw fixation for patients without significant glenoid bone loss (tendon, accurate bone tunnel placement, and subsequent labral repair. It avoids the additional steps of bone block preparation and the larger portals required for arthroscopic Latarjet techniques, in addition to eliminating potential complications due to coracoid bone block resorption. PMID:27274454

  19. Arthroscopic findings after shoulder dislocation

    OpenAIRE

    Medenica Ivica; Radunović Aleksandar; Madžarac Dragan; Zorić Miodrag; Bokonjić Dubravko; Stojković Bratislav

    2009-01-01

    Background/Aim. Recurrent instability of the shoulder joint is frequently difficult to differentiate from diseased or injured rotator cuff or tendon of the forearm flexor (m. biceps brachii). Shoulder joint arthroscopy has been only recently introduced into instable shoulder joint lesion examination. The aim of this study was to present and analyze an arthroscopic finding on instable shoulder joint in order to determine causes and mechanisms of instability, as well as principles of surgical t...

  20. Arthroscopic laser in intra-articular knee cartilage disorders

    Science.gov (United States)

    Nosir, Hany R.; Siebert, Werner E.

    1996-12-01

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

  1. Estudo prospectivo e comparativo dos resultados funcionais após reparo aberto e artroscópico das lesões do manguito rotador Prospective and comparative study on functional outcomes after open and arthroscopic repair of rotator cuff tears

    Directory of Open Access Journals (Sweden)

    Marco Antônio de Castro Veado

    2011-10-01

    Full Text Available OBJETIVO: Avaliar prospectivamente o resultado cirúrgico dos pacientes submetidos ao reparo das lesões do manguito rotador por via aberta e artroscópica, quanto ao aspecto funcional, clínico e por exame de ultrassonografia (US, além de comparar a ocorrência de reruptura. MÉTODOS: Foram operados 60 pacientes pelo mesmo cirurgião, sendo 29 pacientes por via aberta e 31 por via artroscópica para reparo das lesões completas do manguito rotador (MR, entre agosto de 2007 e fevereiro de 2009 no Hospital Governador Israel Pinheiro (HGIP e Hospital Mater Dei (HMD em Belo Horizonte, MG. Os pacientes foram avaliados funcionalmente através do escore da UCLA feito no pré e no pós-operatório e exames de ressonância magnética realizados no pré-operatório. Todos os pacientes foram reavaliados com um período mínimo de 12 meses de pós-operatório, quando foi realizado também exame de US. RESULTADOS: Dos 29 pacientes operados por via aberta, 27 (93,1% apresentaram resultados bons/excelentes, com UCLA médio de 32 no pós-operatório. O seguimento médio foi de 14 meses. Três pacientes apresentaram reruptura ao US, sendo que um deles permaneceu assintomático. Dos 31 pacientes operados por via artroscópica, 29 (93,5% apresentaram resultados bons/excelentes, com UCLA médio de 33 no pós-operatório. O seguimento médio foi de 19 meses. Dois pacientes apresentaram reruptura, sendo que um deles permaneceu assintomático, e um paciente evoluiu com soltura de âncora com resultado insatisfatório. CONCLUSÃO: O reparo das lesões do manguito rotador apresenta bons resultados tanto por via aberta como artroscópica, com resultados funcionais semelhantes entre os grupos, bem como a taxa de reruptura.OBJECTIVE: To prospectively assess the surgical results from patients undergoing repairs to rotator cuff injuries via open and arthroscopic procedures, with regard to functional and clinical features, and by means of ultrasound examinations, and to

  2. Single-Stage Repair of an Unusual Association: Congenital Gerbode Defect, Hypoplastic Aortic Arch, and Partially Anomalous Pulmonary Venous Return in an Infant.

    Science.gov (United States)

    Flores, Saul; Kimball, Thomas R; Nelson, David P; Morales, David L S

    2016-07-01

    We present the case of a two-month-old male with congenital Gerbode defect, hypoplastic aortic arch, and left-sided partially anomalous pulmonary venous return. The patient underwent single-stage surgical repair, which consisted of aortic arch advancement with resection of the coarctation segment, pulmonary vein repair, and primary closure of the Gerbode defect. The anomalous pulmonary vein posed a particular challenge due to its size and distance from the left atrium, which we approached with a posterior atrial wall trapdoor baffle technique, without mobilizing the affected vein. Postoperatively and at one year follow-up, there was no evidence of residual lesions and there was unobstructed flow pattern across the aortic arch and the affected pulmonary vein.

  3. Androgen receptor in Sertoli cells regulates DNA double-strand break repair and chromosomal synapsis of spermatocytes partially through intercellular EGF-EGFR signaling.

    Science.gov (United States)

    Chen, Su-Ren; Hao, Xiao-Xia; Zhang, Yan; Deng, Shou-Long; Wang, Zhi-Peng; Wang, Yu-Qian; Wang, Xiu-Xia; Liu, Yi-Xun

    2016-04-01

    Spermatogenesis does not progress beyond the pachytene stages of meiosis in Sertoli cell-specific AR knockout (SCARKO) mice. However, further evidence of meiotic arrest and underlying paracrine signals in SCARKO testes is still lacking. We utilized co-immunostaining of meiotic surface spreads to examine the key events during meiotic prophase I. SCARKO spermatocytes exhibited a failure in chromosomal synapsis observed by SCP1/SCP3 double-staining and CREST foci quantification. In addition, DNA double-strand breaks (DSBs) were formed but were not repaired in the mutant spermatocytes, as revealed by γ-H2AX staining and DNA-dependent protein kinase (DNA-PK) activity examination. The later stages of DSB repair, such as the accumulation of the RAD51 strand exchange protein and the localization of mismatch repair protein MLH1, were correspondingly altered in SCARKO spermatocytes. Notably, the expression of factors that guide RAD51 loading onto sites of DSBs, including TEX15, BRCA1/2 and PALB2, was severely impaired when either AR was down-regulated or EGF was up-regulated. We observed that some ligands in the epidermal growth factor (EGF) family were over-expressed in SCARKO Sertoli cells and that some receptors in the EGF receptor (EGFR) family were ectopically activated in the mutant spermatocytes. When EGF-EGFR signaling was repressed to approximately normal by the specific inhibitor AG1478 in the cultured SCARKO testis tissues, the arrested meiosis was partially rescued, and functional haploid cells were generated. Based on these data, we propose that AR in Sertoli cells regulates DSB repair and chromosomal synapsis of spermatocytes partially through proper intercellular EGF-EGFR signaling.

  4. ARTHROSCOPIC TREATMENT FOR DISCOID LATERAL MENISCUS INJURY OF THE KNEE IN CHILDREN

    Institute of Scientific and Technical Information of China (English)

    蒋垚; 赵金忠; 翟伟韬; 曾炳芳

    2001-01-01

    Objective To study the arthroscopic treatment results.for discoid lateral meniscus injury of the knee in children. Methods 74 children patients, including 98 knees underwent arthroscopic treatment due to discoid lateral meniscus injury were followed up. By Watanabe classification, incomplete discoid meniscus was seen in 34 knees, complete in 42 and Wrisberg type in 22. The methods of treatment were partial, subtotal or total meniscectomy. The follow-up time ranged from 3 to 24 months, averaged 8 months. The results were analyzed according to Lysholm knee evaluation method. Results By Lysholm evaluation the results were excellent in 68 knees (69.4 % ) and good in 30 (30.6%). Conclusion Arthroscopic treatment is a reliable way for discoid lateral meniscus injury in children.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2015-11-03

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

  6. Simplified Knotless Mattress Repair of Type II SLAP Lesions.

    Science.gov (United States)

    Chia, Marcus Robert; Hatrick, Cameron

    2015-12-01

    Arthroscopic repair of lesions of the superior labrum and biceps anchor has been shown to provide good to excellent results. We describe a simplified arthroscopic surgical technique using a single knotless anchor with a mattress suture configuration. This technique provides an effective and reproducible method to reattach and re-create the normal appearance of the superior labrum and biceps anchor in a time-efficient manner without the need for knot tying.

  7. SNPs in DNA repair or oxidative stress genes and late subcutaneous fibrosis in patients following single shot partial breast irradiation

    OpenAIRE

    Falvo Elisabetta; Strigari Lidia; Citro Gennaro; Giordano Carolina; Boboc Genoveva; Fabretti Fabiana; Bruzzaniti Vicente; Bellesi Luca; Muti Paola; Blandino Giovanni; Pinnarò Paola

    2012-01-01

    Abstract Background The aim of this study was to evaluate the potential association between single nucleotide polymorphisms related response to radiotherapy injury, such as genes related to DNA repair or enzymes involved in anti-oxidative activities. The paper aims to identify marker genes able to predict an increased risk of late toxicity studying our group of patients who underwent a Single Shot 3D-CRT PBI (SSPBI) after BCS (breast conserving surgery). Methods A total of 57 breast cancer pa...

  8. Arthroscopic Superior Capsule Reconstruction for Irreparable Rotator Cuff Tears

    Science.gov (United States)

    Mihata, Teruhisa; Lee, Thay Q.; Itami, Yasuo; HASEGAWA, Akihiko; Ohue, Mutsumi; Neo, Masashi

    2016-01-01

    follow-up (mean, 36.6 months after surgery; range, 12 to 96 months; ASES, 93.3 points; JOA, 92.2 points) (P < .00001). Ninety-two patients (92%) had neither graft tear nor re-tear of the repaired rotator cuff tendon during the follow-up period (5 to 8 years of follow-up, 17 patients; 3 to 4 years of follow-up, 19 patients; 1 to 2 years of follow-up, 56 patients). Postoperative clinical outcome scores and active elevation at final follow-up were significantly better in healed patients (ASES, 95.5 points; JOA, 93.7 points, 154.8° ± 24.2°) than in unhealed patients suffering from graft tear or re-tear of the repaired rotator cuff tendon (ASES, 76.3 points, P < 0.0001; JOA, 79.5, P < 0.001; 115.0° ± 41.8°, P < 0.001). Thirty-two patients returned fully to their previous jobs, whereas two patients returned with reduced hours and workloads. All 26 patients who had played sport before their injuries returned fully to their previous sports, although most of the patients had been playing at recreational level before their injuries. Conclusion: Arthroscopic superior capsule reconstruction restored shoulder function and resulted in high rates of return to recreational sport and work. Graft tear or re-tear of the repaired rotator cuff tendon exacerbated the clinical outcome after superior capsule reconstruction. These results suggest that arthroscopic superior capsule reconstruction is a viable surgical option for irreparable rotator cuff tears, especially in patients who work and enjoy sport.

  9. 关节镜下 FasT-Fix 缝合器修补半月板的五年随访报告%Arthroscopic meniscal repair with FasT-Fix suture device:a ifve-year follow-up report

    Institute of Scientific and Technical Information of China (English)

    张颉鸿; 符培亮; 吴宇黎; 祝云利; 钱齐荣; 吴海山

    2015-01-01

    目的:评价半月板撕裂患者关节镜下 FasT-Fix 缝合器修补术后5年的临床疗效。方法对2006年8月至2009年10月接受关节镜下 FasT-Fix 缝合器修补半月板撕裂手术的患者进行回顾性分析。本研究共纳入28例(32个撕裂的半月板),男20例,女8例,年龄13~48岁,平均26.2岁。病程2周至2年,平均6个月。撕裂类型均为纵裂,撕裂部位位于红区10个半月板(31.3%),红白区22个半月板(68.7%)。12例合并前交叉韧带( anterior cruciate ligament,ACL )损伤(44%)。根据 Barrett 标准评价半月板临床愈合情况,并用 IKDC、Lysholm、Tegner 评分评估膝关节功能改善情况。结果随访50~78个月,平均63.4个月。临床愈合率为84.4%(27/32),愈合失败5个的半月板,术后2~5年出现症状,平均3.5年。IKDC 评分:术前(43.4±16.8)分,术后(80.7±15.7)分;Lysholm 评分:术前(41.2±14.1)分,术后(83.7±22.1)分;Tegner 评分:术前(3.1±1.4)分,术后(6.2±1.6)分,差异均有统计学意义(P<0.05)。结论 FasT-Fix 修补半月板安全有效,术后5年临床疗效良好。%Objective To evaluate the 5-year clinical results of FasT-Fix suture device in arthroscopic meniscal repair.Methods Clinical results of 28 patients with 32 meniscal tears who underwent meniscal repair using the FasT-Fix device from August 2006 to October 2009 were retrospectively analyzed. There were 20 males and 8 females, whose mean age was 26.2 years old ( range: 13-48 years ). The average period from injury to surgery was 6 months ( range: 0.5 to 24 months ). All the meniscal tears belonged to peripheral longitudinal tears. The lesions were in the red / red zone (n=10, 31.3% ) and red / white zone (n=22, 68.7% ). Twelve patients ( 44% ) received the treatment of meniscal repair combined with anterior cruciate ligament ( ACL ) reconstruction. Clinical healing of the meniscus was assessed by Barrett’s criteria and the improvement of

  10. SNPs in DNA repair or oxidative stress genes and late subcutaneous fibrosis in patients following single shot partial breast irradiation

    Directory of Open Access Journals (Sweden)

    Falvo Elisabetta

    2012-01-01

    Full Text Available Abstract Background The aim of this study was to evaluate the potential association between single nucleotide polymorphisms related response to radiotherapy injury, such as genes related to DNA repair or enzymes involved in anti-oxidative activities. The paper aims to identify marker genes able to predict an increased risk of late toxicity studying our group of patients who underwent a Single Shot 3D-CRT PBI (SSPBI after BCS (breast conserving surgery. Methods A total of 57 breast cancer patients who underwent SSPBI were genotyped for SNPs (single nucleotide polymorphisms in XRCC1, XRCC3, GST and RAD51 by Pyrosequencing technology. Univariate analysis (ORs and 95% CI was performed to correlate SNPs with the risk of developing ≥ G2 fibrosis or fat necrosis. Results A higher significant risk of developing ≥ G2 fibrosis or fat necrosis in patients with: polymorphic variant GSTP1 (Ile105Val (OR = 2.9; 95%CI, 0.88-10.14, p = 0.047. Conclusions The presence of some SNPs involved in DNA repair or response to oxidative stress seem to be able to predict late toxicity. Trial Registration ClinicalTrials.gov: NCT01316328

  11. Arthroscopic findings after shoulder dislocation

    Directory of Open Access Journals (Sweden)

    Medenica Ivica

    2009-01-01

    Full Text Available Background/Aim. Recurrent instability of the shoulder joint is frequently difficult to differentiate from diseased or injured rotator cuff or tendon of the forearm flexor (m. biceps brachii. Shoulder joint arthroscopy has been only recently introduced into instable shoulder joint lesion examination. The aim of this study was to present and analyze an arthroscopic finding on instable shoulder joint in order to determine causes and mechanisms of instability, as well as principles of surgical treatment. Methods. Arthroscopy of the shoulder joint was performed in 158 patients with at least one documented shoulder joint dislocation. These patients were divided into two groups. The group I included the patients with one to three dislocations, while the group II those with more than three dislocations. Preoperative diagnosis was based on anamnestic data and clinical examination using specific tests, and on the diagnosis of shoulder joint using radiography or computed tomography. Results. Out of the total number of the patients 138 (87.34% had injury of the anterior patellar brim, 119 (75.32% had failure of the anterior capsule, 126 (79.75% had compressive cartilage injury of the posterior part of the head of the upper arm bone (Hill-Sachs lesion, 102 (64.56% had insufficiency of glenohumeral tendon, 11 (6.96 had complete cut of the rotator cuff, 23 (14.56% had injury of the posterior patellar brim, 12 (7.59% had injury of the upper anterior-posterior patellar brim (SLAP. Conclusion. According to the obtained results it could be concluded that there is no a unique injury that leads to shoulder joint instability. It is necessary to point out to the significance of anamnesis and clinical examination in making diagnosis. Arthroscopic diagnostics is indicated in clinically unreliable findings as an additional method for determining operative treatment.

  12. 关节镜下全关节内FasT-Fix技术缝合修复半月板损伤36例%Arthroscopic repair of meniscal tears by FasT-Fix technique: a report of 36 cases

    Institute of Scientific and Technical Information of China (English)

    王予彬; 王惠芳; 朱文辉; 崔芳; 袁锋; 卢亮宇; 孙文琳

    2008-01-01

    Objective To assess clinical outcomes of FasT-Fix technique in repair of meniscal injury under arthroscope. Methods A total of 36 cases (37 knees) of mensical tears were repaired with FasF-Fix technique. There were 26 males and 10 females, at mean age of 26 years (14-51 years). Eighteen meniscal tears were located in zone Ⅱ, 16 in zone Ⅲ and 3 in zone Ⅳ. The average length of the tear was 2.2 cm (1.0-3.0 cm). Results There were no any signs of early complications after sur gery. All cases were followed up For 6-26 months (mean 16 months). According to Lysholm scoring scale system ,the average score of operated knees was increased from preoperative 44.13+12.56 to postopera tive 80.24+12.67 (P<0.01). After operation, all the patients could move the knee joint at normal range, except for one case who had a limitation of 20 degree flexion, with no pain or interlocking symptom. All cases returned to original work and/or could continue sports game. Conclusion The FasT-Fix technique is a simple, safe and effective method for repair of properly selected meniscal tears.%目的 探讨关节镜下用FasT-Fix技术全关节内缝合修复半月板损伤的临床应用效果,评价其临床意义.方法 关节镜下用FasT-Fix技术全关节内缝合修复36例患者37个半月板损伤,其中男26例,女10例;年龄14-51岁,平均26岁.半月板损伤分区:Ⅱ区18例,Ⅲ区16例,Ⅳ区3例.撕裂长度平均为2.2 cm(1.0-3.0 cm).结果 所有患者术后均无早期并发症发生.随访时间6-26个月,平均16个月,除1侧膝关节屈曲受限20°外,其余膝关节伸屈功能正常,无疼痛及交锁症状.所有患者均恢复原工作、生活、运动.Lysholm评分:术前(44.13+12.56)分,术后(80.24+12.67)分(P<0.01).结论 对于合适的半月板损伤患者,FasT-Fix缝合系统是一种简便、快速、安全、有效的全关节内缝合方法.

  13. Arthroscopic Bankart repair for treatment of recurrent anterior shoulder dislocation with Mitek bioknotless suture anchors%关节镜下非打结型缝合锚钉修补Bankart损伤治疗复发陛肩关节前脱位

    Institute of Scientific and Technical Information of China (English)

    黄华扬; 郑小飞; 张余; 尹庆水

    2008-01-01

    Objective To investigate the clinical results of arthroscopic Bankart repair for the treatment of recurrent anterior shoulder dislocation with Mitek bioknotless suture anchors.Methods Fourteen patients of recurrent anterior shoulder dislocation were treated by arthroscopic Bankart repair with Mitek bioknotless suture anchors.All patients had unidirectional instabilities on the dominant sides.The average age at surgery was 25.2 years (range,18-34 years).The mean times of dislocations before surgery were 13.5 (range,3-36).American Shoulder and Elbow Surgeons(ASES) and Constant-Murley score were adopted for final evaluation at the last follow-up.Results The mean follow-up period was 17 months (range,11-22 months).A Hill-Sachs lesion was observed in 9 patients.A bony Bankart lesion was found in 3 patients.A type Ⅱ SLAP lesion was associated in 2 patients and treated with arthroscopie fixation.A posterior-inferior labral lesion was found in 2 patients and treated with arthroseopic debridement.A joint mouse was removed in 1 patient.The mean forward flexion was 163.4°±8.6° and 169.7°± 4.2° pre-and postoperatively.The mean external rotation in 90° abduction was 58.5°±13.6° and 90.30°±5.5°pre-and postoperatively,which was less 8.40°±6.2° than that of normal side shoulder postoperatively.The pre-and postoperative mean ASES score was 77.4±3.7 and 94.3±2.6,the mean VAS instability score were 7.2±1.4 and 1.2±0.6.The pre-and postoperative mean Constant-Murley score was 78.1 ±4.6 and 93.9±3.7.All patients did not suffer postoperative s houlder dislocation.All patients returned to their pre-injury works.Conclusion Arthroseopic Bankart repair with Mitek bioknotless suture anchors is a good option for treating recurrent anterior shoulder dislocation.%目的 探讨关节镜下非打结型缝合锚钉修补Bankan损伤治疗复发性肩关节前脱位的疗效.方法 复发性肩关节前脱位患者14例,均为男性;年龄18~34岁,平均25.2岁;左侧4

  14. 关节镜下4股半腱肌腱单束重建前交叉韧带部分损伤%Arthroscopic augmentation technique with 4-strand semitendinosus tendon for partial tears of the anterior cruciate ligament

    Institute of Scientific and Technical Information of China (English)

    皇甫小桥; 赵金忠; 何耀华; 杨星光; 刘彩龙; 陆振飞

    2009-01-01

    Objective To introduce an augmentation technique with 4-strand semitendinesus ten-don in treatment of partial anterior cruciate ligament (ACL) injury of under arthroscope and investigate the clinical outcome of the technique. Methods A total of 26 patients with posterolateral bundle rup-tures of ACL were treated arthroscopically with 4-strand semitendinosus tendon augmentation. The Inter-nationnal Knee Documentation Committee (IKDC) and Lysholm knee score scale were used for evaluation of knee function. The side-to-side difference in anterior knee laxity was examined by KT-1000 (25 de-grees flexion and 301b). Results There was no knee extension limitation, with knee flexion of 130°-150 °(average 142°). The patients were followed up for 12-18 months, which showed grade A in 25 pa-tients (96%) and grade B in one (4%) according to IKDC grade at final follow-up. The subjective IK-DC score was increased from preoperative (71.4±3.7) points to (95.8±3.4) points at final follow-up (t =9.836,P <0.01). The average side-to-side difference in maximal manual test with KT-1000 ar-thrometer at 25° flexion decreased from preoperative (5.1±1.2) mm to (2.1±1.3)mm at final follow-up (t = 10.48 ,P < 0.01). The Lysholm score of all patients was (76.7±3.2) preoperatively and (95. 7±2.4) at final follow-up (t =7.356,P<0.01). Conclusion Augmentation with 4-strand semiten-dinosus tendon under arthroscope can attain excellent clinical results and good anterior stability in treat-ment of partial tears of posterolateral bundle of ACL.%目的 介绍关节镜下单束蕈建增强治疗前交叉韧带(anterior cruciate ligament,ACL)后外侧束部分损伤方法 ,探讨其临床效果. 方法 对26例单纯ACL后外侧柬部分损伤患者,在关节镜下采用自体半腱肌腱进行单束解剖重建.按照国际膝关节评分委员会(internationalknee documentation committee,IKDC)和Lysholm膝关节功能评分表对患膝功能进行评估,通过KT-1000检查比

  15. Arthroscopic treatment of iliotibial band syndrome.

    Science.gov (United States)

    Cowden, Courtney H; Barber, F Alan

    2014-02-01

    Lateral knee pain in athletes is commonly seen in the sports medicine clinic, and the diagnosis of iliotibial band (ITB) syndrome is frequently made. Although conservative management including rest from activity, equipment modification, oral nonsteroidal anti-inflammatory drug use, and physical therapy is the mainstay of treatment initially, refractory cases do exist. Multiple surgical techniques have been described including an arthroscopic technique. Arthroscopic release of the ITB attachment to the lateral femoral epicondyle and resection of the lateral synovial recess for recalcitrant ITB syndrome comprise a valid option that can have a good outcome. This option avoids the complications associated with open surgery and allows for a complete arthroscopic knee examination. Division or lengthening of the ITB band itself is not a necessary step in this technique.

  16. Augmented virtuality for arthroscopic knee surgery.

    Science.gov (United States)

    Li, John M; Bardana, Davide D; Stewart, A James

    2011-01-01

    This paper describes a computer system to visualize the location and alignment of an arthroscope using augmented virtuality. A 3D computer model of the patient's joint (from CT) is shown, along with a model of the tracked arthroscopic probe and the projection of the camera image onto the virtual joint. A user study, using plastic bones instead of live patients, was made to determine the effectiveness of this navigated display; the study showed that the navigated display improves target localization in novice residents. PMID:22003616

  17. Editorial Commentary: It Is Best to Be on the Safe Side: Which Portal to Use for Safe Anchor Insertion for Hip Labral Repair.

    Science.gov (United States)

    Konyves, Arpad

    2016-09-01

    When repairing hip labra arthroscopically, labral anchors seem to have a better trajectory and less risk of joint penetration when placed from the distal anterolateral accessory portal compared with the traditional anterolateral and midanterior portals. PMID:27594330

  18. [Arthroscopic distal ulna resection after post traumatic ulno carpal abutment].

    Science.gov (United States)

    Mathoulin, C; Pagnotta, A

    2006-11-01

    Ulno carpal abutments secondary to the sequels of a fracture of the radius are often due to the inversion of the distal radio ulnar index by shortening relative to the radius. This positive ulnar variance eventually leads to an abutment between the head of the ulnar and the proximal articular face of the lunate with alteration of the cartilaginous carpal surfaces. The wrist arthroscopy makes diagnosis and treatment possible in a less invasive way. The patients are operated on as outpatients under local regional anaesthetic using a pneumatic tourniquet. The arthroscope is positioned using the 3-4 radio carpal opening permitting exploration of the joint. The surgical treatment is performed by arthroscopy using a burr and going in through the 6R radio carpal opening. In this way we use the technique of partial resection of the distal ulna. We have a series of 62 patients who have benefited from the technique of partial resection of the ulnar head by arthroscopy. There were 30 men and 32 women. The average age was 66 years old (between 45 and 82). Our average follow-up is 32 months (between 12 and 60 months). Recovery of mobility was immediate in all cases with persistent pain in the radio ulnar joint in 8 cases. Arthroscopic treatment of ulno carpal abutment has proved itself effective and innocuous. It should nevertheless be reserved for operations on small sized inversions of the distal radio ulnar index (less than 5 mm). In the event of larger ulnar variances we prefer ulnar shortening osteotomy. The other techniques will be restricted to cases where the distal radio ulnar joint has been impaired. PMID:17361890

  19. Tenotomia com ou sem tenodese da cabeça longa do bíceps no reparo artroscópico do manguito rotador Tenotomy with or without tenodesis of the long head of the biceps for arthroscopic repair of the rotator cuff

    Directory of Open Access Journals (Sweden)

    Roberto Yukio Ikemoto

    2012-01-01

    Full Text Available OBJETIVO: Comparação dos resultados funcionais nos pacientes submetidos à tenotomia com ou sem tenodese da CLB associada ao reparo da lesão do manguito rotador por visão artroscópica, com seguimento superior a dois anos. MÉTODO: Estudo retrospectivo não randomizado, com nível de evidência III, em que foram revisados os prontuários e realizada reavaliação clínica de 77 pacientes com lesão da cabeça longa do bíceps, sendo que 55 foram submetidos à tenotomia sem tenodese e 22 à tenotomia com a tenodese, com seguimento ambulatorial maior que dois anos. Foram avaliados idade, dominância, lado operado, tamanho das lesões classificadas por Gartsman, arco do movimento pré e pós-operatório, presença ou ausência do sinal do Popeye, dor na corredeira bicipital, avaliação segundo a escala University of California at Los Angeles e Elbow Strength Index. RESULTADOS: O UCLA médio total da amostra foi de 16,92 (8 a 25 para 31,45 (13 a 35 (p OBJECTIVE: To compare the functional results among patients un dergoing tenotomy with or without tenodesis of the long head of the biceps associated with arthroscopic repair of rotator cuff in juries, with a minimum two-year follow-up. METHOD: This was a retrospective non-randomized trial with evidence level III, in which the medical files of 77 patients with lesions of the long head of the biceps were reviewed and clinically reassessed. Among these, 55 patients underwent tenotomy without tenodesis and 22 underwent tenotomy with tenodesis, with outpatient follow-up for at least two years. The age, dominant side, operated side, lesion size using the Gartsman classification, pre and postoperative range of mo tion, presence or absence of the Popeye sign, pain in the bicipital groove and assessments using the University of California at Los Angeles (UCLA score and the elbow strength index. RESULTS: The mean UCLA score of the sample went from 16.92 (range: 8 to 25 to 31.45 (range: 13 to 35 (p < 0

  20. Open Versus Arthroscopic Tennis Elbow Release

    Science.gov (United States)

    Leiter, Jeff; Clark, Tod; McRae, Sheila; Dubberley, James; MacDonald, Peter B.

    2016-01-01

    Objectives: The primary objective of this study was to determine if quality of life and function are different following arthroscopic versus open tennis elbow release surgery. Based on retrospective studies, both approaches have been found to be beneficial, but no prospective randomized comparison has been conducted to date. Methods: Following a minimum six-months of conservative treatment, seventy-one patients (>16 yrs old) were randomized intraoperatively to undergo either arthroscopic or open lateral release. Outcome measures were the Disabilities of the Arm, Shoulder and Hand questionnaire (DASH), a 5-question VAS Pain Scale, and grip strength. Study assessments took place pre-, and 6-week, 3-, 6-, and 12-months post-surgery. Comparisons between groups and within groups over time were conducted using repeated measures ANOVA. A minimal clinically significant difference for the DASH had been previously identified as 15 points, and was used to compare groups as well at 12-months post-operative (Beaton et al. 2001). Results: Fifteen women and 19 men underwent the open procedure with a mean age of 47.1 years (6.7) and 13 women and 21 men were in the arthroscopic group with a mean age of 45.0 (6.9). No pre-surgery differences were found between groups based on age, sex, DASH or VAS scores. Both groups demonstrated a significant improvement in subjective measures and grip strength by 12-months post-surgery, and no significant differences were found between groups at any time point. The DASH, our primary outcome, decreased from a mean (SD) of 47.5 (14.5) pre-surgery to 21.9 (21.8) at 12-months post-surgery in the Open group and from 52.7 (16.0) to 22.6 (21.1) in the Arthroscopic group. VAS-pain scores (%) decreased in the Open group from 62.5 (17.2) pre-operatively to 30.0 (26.5) at 12-months. In the arthroscopic group, scores decreased from 63.7 (15.9) to 26.2 (24.6). Grip strength (kg) increased on the affected side from 23.6 (14.9) to 29.3 (16.3) and 21.4 (15.4) to

  1. Substantial disability 3 months after arthroscopic partial meniscectomy

    DEFF Research Database (Denmark)

    Roos, Ewa M.; Roos, H P; Ryd, L;

    2000-01-01

    , and the Lysholm Knee Scoring Scale were available for 74 consecutive patients (50 males, 24 females; mean age, 45 years) with isolated meniscus tear (n = 47) or meniscus tear combined with cartilage damage (n = 27). At postoperative follow-up (mean, 14.4 weeks) significant improvement was seen, but despite only...

  2. Etiology, Diagnosis, and Management of Failed SLAP Repair.

    Science.gov (United States)

    Werner, Brian C; Brockmeier, Stephen F; Miller, Mark D

    2014-09-01

    In general, favorable outcomes have been achieved with arthroscopic repair of superior labral anterior-posterior (SLAP) tears. However, some patients remain dissatisfied or suffer further injury after SLAP repair and may seek additional treatment to alleviate their symptoms. The cause of persistent pain or recurrent symptoms after repair is likely multifactorial; therefore, careful preoperative workup is required to elucidate the cause of pain. Review of the details of previous surgical procedures is crucial because certain fixation methods are prone to failure or can cause additional injury. Failed SLAP repair can be managed with nonsurgical or surgical options. Nonsurgical modalities include physical therapy and strengthening programs, anti-inflammatory agents, and activity modification. Surgical options include revision SLAP repair and biceps tenotomy or tenodesis with or without revision SLAP repair. Outcomes after surgical management of failed SLAP repair are inferior to those of primary repair. Select patients may be better served by primary biceps tenodesis rather than SLAP repair.

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

    Directory of Open Access Journals (Sweden)

    Ignacio Carbonel

    2013-01-01

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

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

    OpenAIRE

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

    2008-01-01

    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 sha...

  5. Arthroscopically Assisted Treatment of Acute Dislocations of the Acromioclavicular Joint

    Science.gov (United States)

    Braun, Sepp; Beitzel, Knut; Buchmann, Stefan; Imhoff, Andreas B.

    2015-01-01

    Arthroscopically assisted treatments for dislocations of the acromioclavicular joint combine the advantages of exact and visually controlled coracoid tunnel placement with the possibility of simultaneous treatment of concomitant injuries. The clinical results of previous arthroscopically assisted techniques have been favorable at midterm and long-term follow-up. The presented surgical technique combines the advantages of arthroscopically positioned coracoclavicular stabilization with an additional suture cord cerclage of the acromioclavicular joint capsule for improved horizontal stability. PMID:26870646

  6. Increased Post-Operative Stiffness after Arthroscopic Suprapectoral Biceps Tenodesis

    OpenAIRE

    Werner, Brian C.; Pehlivan, Hakan C.; Hart, Joseph M.; Carson, Eric W.; Diduch, David R.; Miller, Mark D.; Brockmeier, Stephen F.

    2014-01-01

    Objectives: Biceps tenodesis can be performed open or arthroscopically and can be positioned in a suprapectoral or subpectoral position. Suprapectoral tenodesis can be carried out arthroscopically, whereas the subpectoral tenodesis is performed as an open procedure. The goal of this study is to compare the incidence of postoperative stiffness between arthroscopic suprapectoral and open subpectoral biceps tenodesis and evaluate risk factors for its occurrence. Methods: Study Design: The charts...

  7. Avaliação da integridade anatômica por exame de ultrassom e funcional pelo índice de Constant & Murley do manguito rotador após reparo artroscópico Evaluation of anatomical integrity using ultrasound images, and functional integrity by the Constant & Murley score, of the rotator cuff following arthroscopic repair

    Directory of Open Access Journals (Sweden)

    Glaydson Gomes Godinho

    2010-01-01

    large/massive in 25 (23%. The clinical results were assessed according to the Constant and Murley criteria. The results of the ultrasound (US refer to the reports of several radiologists. Statistical analysis was carried out according to the chi-square methods, Fisher's exact test, Student T test, Pearson, Kruscall-Wallis correlation and logistic regression (significance value p < 0.05. RESULTS: the Constant evaluation average was 85.3 ± 10.06 (46 to 99 in the normal shoulders and 83.96 ± 8.67 (59 to 99 in the operated shoulders (p = 0.224. Excellent and good results were found in 74 shoulders (67%, satisfactory and adequate results in 32 (29% and poor results in 4 (4%. The ultrasound evaluation showed 38 shoulders with re-rupture (35%, absence of rupture in 71 (65%. Of the 74 (67% shoulders with excellent/good results, 22 (30% presented re-rupture in the ultrasound report (p = 0.294. Of the four shoulders (4% with poor results, two (50% presented intact tendons (p = 0.294. CONCLUSION: There is no statistically valid correlation between the ultrasound diagnosis and the clinical evaluation of results in patients who underwent arthroscopic repair to treat full tear lesions of the rotator cuff. The clinical results in complete rotator cuff repairs under arthroscopy present a high level of functional recovery (Constant 83.96 when compared with the contralateral shoulder. The postoperative ultrasound image reports present a high percentage of re-rupture (35%; The postoperative strength is higher in patients aged under 60 years (p = 0.002 and in cases of lesions less than or equal to 3 cm. (p = 0.003.

  8. Arthroscopic management of distal radius fractures.

    Science.gov (United States)

    Wiesler, Ethan R; Chloros, George D; Mahirogullari, Mahir; Kuzma, Gary R

    2006-11-01

    Arthroscopy has the advantage of providing a direct and accurate assessment of the articular surfaces and detecting the presence of injuries associated with distal radius fractures. Current indications, although numerous and potentially expanding, also are controversial. This report presents a global view of the current status of arthroscopy in the management of distal radius fractures. The rationale of arthroscopic treatment, the available evidence, and finally the diagnosis and treatment are discussed. PMID:17095385

  9. Stem cell procedures in arthroscopic surgery

    OpenAIRE

    Dyrna, Felix; Herbst, Elmar; Hoberman, Alexander; Imhoff, Andreas B.; Schmitt, Andreas

    2016-01-01

    The stem cell as the building block necessary for tissue reparation and homeostasis plays a major role in regenerative medicine. Their unique property of being pluripotent, able to control immune process and even secrete a whole army of anabolic mediators, draws interest. While new arthroscopic procedures and techniques involving stem cells have been established over the last decade with improved outcomes, failures and dissatisfaction still occur. Therefore, there is increasing interest in wa...

  10. Multimodal pain management after arthroscopic surgery

    DEFF Research Database (Denmark)

    Rasmussen, Sten

    Multimodal Pain Management after Arthroscopic Surgery By Sten Rasmussen, M.D. The thesis is based on four randomized controlled trials. The main hypothesis was that multimodal pain treatment provides faster recovery after arthroscopic surgery. NSAID was tested against placebo after knee arthrosco...... after knee and ankle arthroscopy with the use of oral NSAIDs combined with bupivacaine plus morphine or combined with bupivacaine, morphine plus steroid....... ankle arthroscopy. Oral NSAID reduced time to work from 17 to 14 days after knee arthroscopy. Intra-articular treatment with bupivacaine plus morphine and bupivacaine plus morphine plus steroid after arthroscopic knee meniscectomy reduced time to work from 10 to 5 to 3 days. Intraarticular treatment...... with bupivacaine plus morphine and bupivacaine plus morphine plus steroid after diagnostic knee arthroscopy reduced time to work from 10 to 5 to 2 days. Additional analysis revealed that the surgical trauma and the use of tourniquet influenced recovery. The thesis proves a reduction in the time to return to work...

  11. All-Arthroscopic Latissimus Dorsi Transfer.

    Science.gov (United States)

    Cutbush, Kenneth; Peter, Noel A; Hirpara, Kieran

    2016-06-01

    Massive irreparable rotator cuff tears are often associated with severe functional impairment and disabling pain. One viable treatment option is a latissimus dorsi tendon transfer. We propose an all-arthroscopic technique that we believe avoids insult to the deltoid musculature while reducing morbidity from open harvest of the tendon. The operation is performed with the patient in the lateral decubitus position, by use of a combination of viewing and working portals in the axilla. The initial viewing portal is placed along the anterior belly of the latissimus muscle in the axilla. The latissimus and teres major are identified, as is the thoracodorsal neurovascular pedicle. The tendons are carefully separated, and the inferior and superior borders of the latissimus are whipstitched using a suture passer, which helps facilitate subsequent mobilization of the muscle. The interval deep to the deltoid and superficial to the teres minor is developed into a subdeltoid tunnel for arthroscopic tendon transfer. The latissimus tendon is then transferred and stabilized arthroscopically to the supraspinatus footprint with suture anchors. Our preliminary data suggest that this surgical technique results in improvement in pain, range of motion, and function. PMID:27656385

  12. Arthroscopic Decompression for a Giant Meniscal Cyst.

    Science.gov (United States)

    Ohishi, Tsuyoshi; Suzuki, Daisuke; Matsuyama, Yukihiro

    2016-01-01

    The authors report the case of a giant medial meniscal cyst in an osteoarthritic knee of an 82-year-old woman that was successfully treated with only arthroscopic cyst decompression. The patient noticed a painful mass on the medial side of the right knee that had been gradually growing for 5 years. Magnetic resonance imaging showed an encapsulated large medial cystic mass measuring 80×65×40 mm that was adjacent to the medial meniscus. An accompanying horizontal tear was also detected in the middle and posterior segments of the meniscus. The medial meniscus was resected up to the capsular attachment to create bidirectional flow between the joint and the cyst with arthroscopic surgery. Magnetic resonance imaging performed 14 months postoperatively showed that the cyst had completely disappeared, and no recurrence was observed during a 2-year follow-up period. An excellent result could be obtained by performing limited meniscectomy to create a channel leading to the meniscal cyst, even though the cyst was large. Among previously reported cases of meniscal cysts, this case is the largest to be treated arthroscopically without open excision.

  13. Functional evaluation of arthroscopic treatment of SLAP lesions through the O’Brien portal☆

    Science.gov (United States)

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

    2015-01-01

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

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

    Science.gov (United States)

    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.

  15. Functional evaluation of arthroscopic treatment of SLAP lesions through the O'Brien portal

    Directory of Open Access Journals (Sweden)

    Fabiano Rebouças

    2015-06-01

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

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

    Science.gov (United States)

    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. PMID:24817106

  17. Arthroscopic treatment for chronic lateral epicondylitis

    Directory of Open Access Journals (Sweden)

    Bernardo Barcellos Terra

    2015-08-01

    Full Text Available ABSTRACTOBJECTIVE: To report the clinical and functional results from arthroscopic release of the short radial extensor of the carpus (SREC in patients with chronic lateral epicondylitis that was refractory to conservative treatment. METHODS: Over the period from January 2012 to November 2013, 15 patients underwent arthroscopic treatment. The surgical technique used was the one described by Romeo and Cohen, based on anatomical studies on cadavers. The inclusion criteria were that the patients needed to present lateral epicondylitis and that conservative treatment (analgesics, anti-inflammatory agents, corticoid infiltration or physiotherapy had failed over a period of more than six months. The patients were evaluated based on the elbow functional score of the Mayo Clinic, Nirschl's staging system and a visual analog scale (VAS for pain. RESULTS: A total of 15 patients (9 men and 6 women were included. The mean Mayo elbow functional score after the operation was 95 (ranging from 90 to 100. The pain VAS improved from a mean of 9.2 before the operation to 0.64 after the operation. On Nirschl's scale, the patients presented an improvement from a mean of 6.5 before the operation to approximately one. There were significant differences from before to after the surgery for the three functional scores used ( p 0.05. CONCLUSION: Arthroscopic treatment for lateral epicondylitis was shown to be a safe and effective therapeutic option when appropriately indicated and performed, in refractory cases of chronic lateral epicondylitis. It also allowed excellent viewing of the joint space for diagnosing and treating associated pathological conditions, with a minimally invasive procedure.

  18. Arthroscopic Posterior Subtalar Arthrodesis: Surgical Technique

    Science.gov (United States)

    Vilá y Rico, Jesús; Ojeda Thies, Cristina; Parra Sanchez, Guillermo

    2016-01-01

    Surgical fusion of the subtalar joint is a procedure indicated to alleviate pain of subtalar origin, such as in post-traumatic osteoarthritis, adult-acquired flatfoot deformity, and other disorders. Open subtalar arthrodesis has been performed with predictable results, but concerns exist regarding injury to proprioception and local vascularity due to wide surgical dissection. Minimally invasive techniques try to improve results by avoiding these issues but have a reputation for being technically demanding. We describe the surgical technique for arthroscopic subtalar arthrodesis, which has proved to be a safe and reliable technique in our experience, with consistent improvements in American Orthopaedic Foot & Ankle Society scores. PMID:27073783

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

    OpenAIRE

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

    2014-01-01

    Objectives: Arthrofibrosis is a serious complication following the reconstruction of anterior cruciate ligament (ACL) and posterolateral corner (PLC) injury. Loss of motion caused by arthrofibrosis can be disabling in young and active patients. We report the clinical results of the treatment of arthrofibrosis following arthroscopic reconstruction of ACL with ipsilateral hamstring tendon graft and surgically repairing PLC with 2 suture anchors in a 30 year-old professional dancer, treated with...

  20. Molecular cloning and characterization of a mammalian excision repair gene that partially restores UV resistance to xeroderma pigmentosum complementation group D cells

    International Nuclear Information System (INIS)

    A hamster DNA repair gene has been isolated by cosmid rescue after two rounds of transfection of an immortalized xeroderma pigmentosum (XP) complementation group D cell line with neomycin-resistance gene (neo)-tagged normal hamster DNA and selection with G418 and ultraviolet irradiation. The functional length of the sequence has been defined as 11.5 kilobase pairs by measurement of the region of overlap between two hamster DNA-containing cosmids, cloned by selection for the integrated neo gene, that are able to confer an increase in resistance to ultraviolet irradiation on two XP-D cell line but not on an XP-A line. Detailed molecular characterization of the hamster repair gene has revealed no obvious similarities to two human excision repair genes (ERCC1 and ERCC2) that correct repair-defective hamster cells but have no effect on XP cells. Hybridization analyses of normal human and XP cell genomic DNAs and mRNAs, using a cosmid-clone probe from which repeated sequences have been removed, show that homologues are present and expressed in all cases

  1. Arthroscopic optical coherence tomography provides detailed information on articular cartilage lesions in horses.

    Science.gov (United States)

    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. PMID:23810744

  2. Arthroscopic tibiotalar and subtalar joint arthrodesis.

    Science.gov (United States)

    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. PMID:26797006

  3. [Arthroscopic treatment of distal radius fracture].

    Science.gov (United States)

    Lindau, T

    2006-11-01

    The orthopaedic surgeons cannot predict the functional results after a distal intra articular radius fracture. The intra-articular incongruity of more than 1 mm is associated with the development of secondary osteoarthrosis. The wrist arthroscopy became an essential help for the reduction of these fractures. The hand is normally in an upright position with a traction of approximately 4-5 kg which facilitates the reduction of the extra-articular fracture component. It is possible to use a technique of horizontal traction. The arthroscopy allows the reduction and control of the fixing of the various fragments, but also the treatment associated lesions associated. One randomized study, which compared 34 arthroscopically treated fractures with 48 openly treated, concluded that the arthroscopy-treated group had better outcome, better reduction, better grip strength and better range of motion than the openly treated group. The treatment of intra articular distal radius fractures with arthroscopic assistance is thus the guaranteeing of the most anatomical reduction of articular surface. It allows the diagnosis and the treatment of the associated lesions, decreases the peripheral fibrous scars of soft tissues by avoiding initially extensive approaches and finally gives better functional results. PMID:17361885

  4. Primary Frozen Shoulder Syndrome: Arthroscopic Capsular Release.

    Science.gov (United States)

    Arce, Guillermo

    2015-12-01

    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

  5. Long-term functional evaluation of videoarthroscopic treatment of partial injuries of the rotator cuff

    Directory of Open Access Journals (Sweden)

    Glaydson Gomes Godinho

    2015-04-01

    Full Text Available OBJECTIVE: To compare the functional results from high and low-grade isolated partial lesions of the supraspinatus tendon of bursal and articular types, after arthroscopic treatment.METHODS: Sixty-four patients with isolated partial lesions of the supraspinatus tendon were evaluated. The mean length of follow-up was 76 months (range: 29-193. The mean age was 59 years (range: 36-82. The dominant side was affected in 44 patients (68.8%. There were 35 bursal lesions (54.7% and 29 articular lesions (45.3%. We used the Ellman classification and characterized the lesions as low or high-grade according to whether they affected less than or more than 50% of the tendon thickness, respectively. Debridement was performed in 15 patients (23.5%, repair without completing the lesion in 11 (17% and repair after completing the lesion in 38 (59.5%. The functional assessments on the patients were done using the Constant & Murley and UCLA scores.RESULTS: The mean Constant & Murley score among the patients with bursal lesions was 82.64 ± 6.98 (range: 59.3-99 and among those with articular lesions, 83.57 ± 7.58 (range: 66-95, while the mean UCLA score in the bursal lesions was 33.37 ± 2.85 (range: 21-35 and in the articular lesions, 32.83 ± 2.95 (range: 22-35.CONCLUSION: Videoarthroscopic treatment of partial lesions of the rotator cuff presents good or excellent results when the low-grade lesions are debrided and the high-grade lesions are completed and repaired. These results are maintained over the long term, with a high satisfaction rate and few complications.

  6. Technique of Arthroscopic Treatment of Impingement After Total Ankle Arthroplasty.

    Science.gov (United States)

    Gross, Christopher E; Neumann, Julie A; Godin, Jonathan A; DeOrio, James K

    2016-04-01

    Rates of medial and/or lateral gutter impingement after total ankle replacement are not insignificant. If impingement should occur, it typically arises an average of 17 months after total ankle replacement. Our patient underwent treatment for right ankle medial gutter bony impingement with arthroscopic debridement 5 years after her initial total ankle replacement. Standard anteromedial and anterolateral portals and a 30° 2.7-mm-diameter arthroscope were used. An aggressive soft-tissue and bony resection was performed using a combination of curettes, a 3.5-mm shaver, a 5.5-mm unsheathed burr, a drill, and a radiofrequency ablator. This case shows that arthroscopic treatment is an effective and potentially advantageous alternative to open treatment of impingement after total ankle replacement. In addition, symptoms of impingement often improve in a short amount of time after arthroscopic debridement of the medial and/or lateral gutter.

  7. Arthroscopic Treatment for Shoulder Instability with Glenoid Bone Loss Using Distal Tibia Allograft Augmentation - Short Term Results

    Science.gov (United States)

    Wong, Ivan; Amar, Eyal; Coady, Catherine M.; Dilman, Daryl B.; Smith, Ben

    2016-01-01

    Objectives: Background: The results of arthroscopic anterior labral (Bankart) repair have been shown to have high failure rate in patients with significant glenoid bone loss. Several reconstruction procedures using bone graft have been described to overcome the bone loss, including autogenous coracoid transfer to the anterior glenoid (Latarjet procedure) as well as iliac crest autograft and tibial allografts. In recent years, trends toward minimally invasive shoulder surgery along with improvements in technology and technique have led surgeons to expand the application of arthroscopic treatment. Purpose: This study aims to perform a retrospective analysis of prospectively collected data to evaluate the clinical and radiological follow up of patient who underwent anatomic glenoid reconstruction using distal tibia allograft for the treatment of shoulder instability with glenoid bone loss at 1-year post operation time point. Methods: Between December 2011 and January 2015, 55 patients underwent arthroscopic stabilization of the shoulder by means of capsule-labral reattachment to glenoid ream and bony augmentation of glenoid bone loss with distal tibial allograft for recurrent instability of the shoulder. Preoperative and postoperative evaluation included general assessment by the western Ontario shoulder instability index (WOSI) questionnaire, preoperative and postoperative radiographs and CT scans. Results: Fifty-five patients have been evaluated with mean age of 29.73 years at time of the index operation. There were 40 males (mean age of 29.66) and 15 female (mean age of 29.93). Minimum follow up time was 12 months. The following adverse effects were recorded: none suffered from recurrent dislocation, 2 patients suffered from bone resorption but without overt instability, 1 patient had malunion due to screw fracture, none of the patients had nonunion. The mean pre-operative WOSI score was 36.54 and the mean postoperative WOSI score was 61.0. Conclusion: Arthroscopic

  8. Prognostic Factors of Arthroscopic Adhesiolysis for Arthrofibrosis of the Knee

    OpenAIRE

    Kim, Young-Mo; Joo, Yong Bum

    2013-01-01

    Purpose To assess the results of arthroscopic adhesiolysis for arthrofibrosis of the knee and to investigate possible prognostic factors. Materials and Methods Among the patients who developed arthrofibrosis after knee joint surgery, 68 patients who underwent arthroscopic adhesiolysis and were available for at least one-year follow-up were evaluated with regard to the Lysholm knee score, International Knee Documentation Committee (IKDC) subjective knee score, patient satisfaction, and range o...

  9. Arthroscopic fixation with a minimally invasive axillary approach for latissimus dorsi transfer using an endobutton in massive and irreparable postero-superior cuff tears

    Directory of Open Access Journals (Sweden)

    Yariv Goldstein

    2013-01-01

    Full Text Available Arthroscopically assisted latissimus dorsi transfer is a viable option for treatment of patients in their 50s to 70s, without arthritis of the glenohumeral joint, who suffer from massive rotator cuff tears that are not amendable to primary repair due to fatty changes in the muscle tissue, or that have failed previous repair attempts. This procedure offers immediate and dramatic pain relief and is not as technically demanding as one might think. Understanding and respecting the principles of tendon transfer is a key to the success of this procedure.

  10. Fisioterapia após substituição artroscópica do ligamento cruzado cranial em cães: I - avaliação clínica, radiográfica e ultrassonográfica Physiotherapy after arthroscopic repair of the cranial cruciate ligament in dogs: I - clinical, radiographic, and ultrasonographic evaluation

    Directory of Open Access Journals (Sweden)

    L.A.L. Muzzi

    2009-08-01

    Full Text Available Foram avaliadas a aplicabilidade da cirurgia artroscópica na substituição do ligamento cruzado cranial (LCC e o efeito da fisioterapia pós-operatória, por meio de exames clínicos, radiográficos e ultrassonográficos, em 16 cães sem raça definida, machos, com pesos entre 19,2 e 26,3kg, submetidos à ruptura experimental do LCC e subsequente substituição deste ligamento pelo enxerto autógeno da fascia lata. Os animais foram distribuídos em dois grupos de oito cada: no grupo I os cães foram submetidos ao programa de fisioterapia pós-operatória e no grupo II à imobilização temporária do membro. Por meio dos exames citados, não foram verificadas diferenças significativas entre os dois grupos, e ambos demonstraram sinais de processo articular degenerativo. A função do membro foi avaliada com auxílio da plataforma de força, e os animais do grupo I apresentaram melhor apoio do membro operado durante o período de reabilitação. Conclui-se que a cirurgia artroscópica é uma técnica eficaz para substituição do LCC em cães, apesar de não impedir o desenvolvimento da doença articular degenerativa, e que a fisioterapia permite recuperação mais rápida no apoio do membro durante o período de reabilitação.The reconstruction of experimentally ruptured cranial cruciate ligament (CCL under arthroscopic guidance and the effects of an early postoperative rehabilitation program by clinical, radiographic, and ultrasonographic exams were evaluated. Sixteen male mongrel dogs weighing from 19.2 to 26.3kg had the CCL experimentally ruptured and the stifle joint was stabilized by the use of an intracapsular arthroscopical technique with fascia lata as an autogenous graft. Eight dogs were included in a postoperative physiotherapy group and the other eight in a temporary immobilization group. From serial clinical, radiographic, and ultrasonographic examinations, no differences between groups were observed, although all dogs had showed

  11. Torn discoid lateral meniscus treated with arthroscopic meniscectomy: observations in 62 knees

    Institute of Scientific and Technical Information of China (English)

    LU Ying; LI Qiang; HAO Jie

    2007-01-01

    Background Discoid lateral meniscus of the knee is common in Chinese population. There has been considerable debate about the best treatment for discoid lateral meniscus tears. The purpose of this study was to observe the effect of arthroscopic meniscectomy for the treatment of discoid lateral meniscus tears.Methods Between July 1999 and December 2004, arthroscopic meniscectomy was performed on 62 menisci of 57 patients with discoid lateral meniscus tears (52 unilateral, 5 bilateral). 41 menisci were "complete discoid meniscus", 21 "incomplete". According to the extent of the meniscus tears, partial meniscectomy was performed on 52 knees, total meniscectomy on 7 knees, and partial meniscectomy combined with meniscus suture on 3 knees through an arthroscope.After the operations, early rehabilitation training programs, including straight-leg-raising and range-of-motion exercises,were carried out. 51 patients were followed up for 1 year 2 months to 6 years 5 months (mean, 3 years 3 months), 6 patients were lost. Lysholm-Ⅱ scoring system was used to assess the function of the knee joints before the operation and during the follow-up.Results The operations on all the 62 knees were successful without complications. The patients could walk normally after completing the 2-week postoperation rehabilitation program. After 3-4 weeks they could lead a normal life and participate in a moderate amount of sports or other physical activities. The mean Lysholm-Ⅱ score was 89 (60-100)during the follow-up, which was significantly higher than that before the operation (50, range 34-74; P<0.01). 88% of the patients achieved excellent or good clinical results.Conclusions Arthroscopic meniscectomy is an alternative for treatment of discoid lateral meniscus tears with minimal traumatic effects. It can achieve early mobilization and a low complication rate, as well as the preservation of the meniscus structure and functions to the largest extent. In combination with proper

  12. Arthroscopic Reverse Remplissage for Posterior Instability.

    Science.gov (United States)

    Lavender, Chad D; Hanzlik, Shane R; Pearson, Sara E; Caldwell, Paul E

    2016-02-01

    Posterior shoulder dislocation is an unusual injury often associated with electrical shock or seizure. As with anterior instability, patients frequently present with an impaction injury to the anterior aspect of the humeral head known as a "reverse Hill-Sachs lesion." The treatment of this bony defect is controversial, and multiple surgical procedures to fill the defect in an effort to decrease recurrence have been described. Most of the reports have focused on an open approach using variations of lesser tuberosity and subscapularis transfers, bone allograft, and even arthroplasty to assist with persistent instability. We advocate an arthroscopic technique that involves a suture anchor-based distal tenodesis of the subscapularis tendon or a reverse remplissage procedure. PMID:27073776

  13. Arthroscopical treatment of elbow joint disease

    Directory of Open Access Journals (Sweden)

    C.M.F. Rezende

    2012-02-01

    Full Text Available Elbow arthroscopy was performed in 30 dogs of different breeds. The procedure was performed bilaterally in 20 of these dogs, yielding a total of 50 joints. Different lesions were found, varying from cartilage fissures (8 to fragmentation (42 of medial coronoid process (FCP of the ulna. Osteochondritis dissecans (OCD of the humerus medial condyle was associated in four of them. All of these cases displayed varying degrees of synovitis. Osteoarthrosis (OA in varying intensity was observed in 44 joints. The majority of cases were treated two to four months after the manifestation of clinical signs. Good clinical recovery occurred in dogs with minimal joint lesions, where these were diagnosed and treated within four weeks of the onset of clinical symptoms. Early diagnosis and arthroscopic treatment prevent osteoarthrosis and preserve locomotor function.

  14. Arthroscopic knee surgery does not modify hyperalgesic responses to heat injury

    DEFF Research Database (Denmark)

    Werner, Mads U; Duun, Preben; Kraemer, Otto;

    2003-01-01

    thresholds were higher during the second burn injury in patients (P 0.8), secondary hyperalgesia areas (P > 0.1), mechanical and thermal pain perception (P > 0.1), or mechanical and thermal pain......BACKGROUND: Experimental studies suggest that surgical injury may up- or down-regulate nociceptive function. Therefore, the aim of this clinical study was to evaluate the effect of elective arthroscopically assisted knee surgery on nociceptive responses to a heat injury. METHODS: Seventeen patients...... scheduled to undergo repair of the anterior cruciate ligament and 16 healthy controls were studied. The first burn injury was induced 6 days before surgery, and the second burn was induced 1 day after surgery with a contact thermode (12.5 cm2, 47 degrees C for 7 min) placed on the medial aspect of the calf...

  15. Arthroscopic knee surgery does not modify hyperalgesic responses to heat injury

    DEFF Research Database (Denmark)

    Werner, Mads U; Duun, Preben; Kraemer, Otto;

    2003-01-01

    thresholds were higher during the second burn injury in patients (P injury (P > 0.8), secondary hyperalgesia areas (P > 0.1), mechanical and thermal pain perception (P > 0.1), or mechanical and thermal pain......BACKGROUND: Experimental studies suggest that surgical injury may up- or down-regulate nociceptive function. Therefore, the aim of this clinical study was to evaluate the effect of elective arthroscopically assisted knee surgery on nociceptive responses to a heat injury. METHODS: Seventeen patients...... scheduled to undergo repair of the anterior cruciate ligament and 16 healthy controls were studied. The first burn injury was induced 6 days before surgery, and the second burn was induced 1 day after surgery with a contact thermode (12.5 cm2, 47 degrees C for 7 min) placed on the medial aspect of the calf...

  16. Molecular cloning of eucaryotic genes required for excision repair of UV-irradiated DNA: isolation and partial characterization of the RAD3 gene of Saccharomyces cerevisiae.

    OpenAIRE

    Naumovski, L; Friedberg, E C

    1982-01-01

    We describe the molecular cloning of a 6-kilobase (kb) fragment of yeast chromosomal DNA containing the RAD3 gene of Saccharomyces cerevisiae. When present in the autonomously replicating yeast cloning vector YEp24, this fragment transformed two different UV-sensitive, excision repair-defective rad3 mutants of S. cerevisiae to UV resistance. The same result was obtained with a variety of other plasmids containing a 4.5-kb subclone of the 6-kb fragment. The UV sensitivity of mutants defective ...

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

    Science.gov (United States)

    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 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

  18. Quantitative ultrasound biomicroscopy for the analysis of healthy and repair cartilage tissue

    OpenAIRE

    Gelse, K; A Olk; Eichhorn, S.; B Swoboda; M Schoene; K Raum

    2010-01-01

    The increasing spectrum of different cartilage repair strategies requires the introduction of adequate non-destructive methods to analyse their outcome in-vivo, i.e. arthroscopically. The validity of non-destructive quantitative ultrasound biomicroscopy (UBM) was investigated in knee joints of five miniature pigs. After 12 weeks, six 5-mm defects, treated with different cartilage repair approaches, provided tissues with different structural qualities. Healthy articular cartilage from each con...

  19. Transinguinal preperitoneal groin hernia repair technique with a partially adsorbable three-dimensional preperitoneal mesh%腹膜前间隙部分可吸收网片治疗腹股沟疝

    Institute of Scientific and Technical Information of China (English)

    胡孔旺; 熊茂明; 张嘉伟; 黄鹏; 盛龙; 董添

    2012-01-01

    85例原发单侧腹股沟疝患者随机采用UHS、UPP或Rutkow术.UHS组及UPP组在恢复工作时间、并发症和复发率与Rutkow组比较,差异无统计学意义,住院费用上UHS及UPP术较高,术后疼痛异物感方面UHS及UPP术较好.在住院费用许可,对生活质量要求高患者建议用UHS术或UPP术.%85 patients with inguinal hernia who suffered from the transinguinal preperitoneal groin hernia repair were treated with a partially adsorbable three-dimensional preperitoneal mesh named UHS, UPP, Rutkow procedure randomly. There was no significant difference in recovery work time, postoperative complication and recurrent rate compared Rutkow procedure. However, UHS, UPP procedures had a significantly higher cost than that of Rutkow procedure. Rutkow group had a higher incidence of foreign body sensation and postoperative pain. UHS and UPP hernioplasty is recommended for repair of primary inguinal hernia if patients who have a good economic condition and pursuit a higher level on life quality.

  20. 腹腔镜胃底180°前折叠术治疗食管裂孔疝疗效分析%Curative effect analysis of laparoscopic esophageal hiatal hernia repair and anterior 180 degrees partial fundoplication

    Institute of Scientific and Technical Information of China (English)

    张重阳; 田志强; 田霖; 周立芳; 肖彬; 秦鸣放

    2014-01-01

    Objective To explore the feasibility and safety of laparoscopic hiatal hernia repair and anterior 180 degrees partial fundoplication for the treatment of esophageal hiatal hernia. Methods The clinical data of 180 patients who under went laparoscopic surgery for esophageal hiatal hernia from September 2008 to June 2013 at Cangzhou hospital of ITWM and Nankai hospital of Tianjin were retrospectively analyzed.All cases were conducted anterior 180 degrees partial fundoplication,including patch repair was used in 30 patients and silk sutures were used for the repair of esophageal perforation in the rest patients. Results All operations were performed smoothly,no conversions were needed.After the follow up period of 3 ~ 60 months,the satisfaction rate of operation was 92.31%. The symptoms in most cases were adequately relieved after operation.Endoscopy,radiology were repeated 3 months after surgery. Seven cases had mild symptom recurrence of acid reflux relieved with in 4 months ,no case occurred severely dysphagia and recurrence. Conclusion Laparoscopic repair of esophageal hiatal hernia and 180 degrees partial fundoplication has the following advantages:minimized trauma,quick recovery,safe and reliable effect procedures for hiatal hernia.%目的:探讨腹腔镜食管裂孔疝修补联合胃底180°前折叠术治疗食管裂孔疝疾病的可行性和安全性。方法回顾性分析了沧州市中西医结合医院与天津南开医院2008年9月至2013年6月采用腹腔镜技术治疗的180例食管裂孔疝患者资料,其中30例应用补片修补裂孔,剩余患者丝线缝合裂孔,均加做胃底180°前折叠(Dor手术)。结果手术顺利,无中转开腹者。术后随访3~60个月,手术效果满意率92.31%,术后3个月复查胃镜、上消化道造影等检查基本恢复正常。其中7例患者术后早期出现轻度反酸、烧心症状,均在4个月内通过保守治疗好转,无复发病例,无严重吞咽

  1. The Arthroscopic Ulnohumeral Arthroplasty: From Mini-Open to Arthroscopic Surgery

    Directory of Open Access Journals (Sweden)

    Ilse Degreef

    2011-01-01

    Full Text Available In cubarthritis—osteoarthritis of the elbow—surgical procedures may be considered to debride the elbow joint to reduce pain, to increase mobility, and to postpone joint replacement surgery. The ulnohumeral arthroplasty as described by Outerbridge and Kashiwagi was originally introduced to debride both anterior and posterior elbow compartments through a direct posterior mini-open approach. To achieve this, a distal humeral fenestration throughout the humeral fossa is performed. Although with an elbow arthroscopy, a technique that was obviously developed later on, all compartments can be easily visualized. The arthroscopic fenestration of the humerus preserves its advantages, with good clinical results focused on pain relief and gaining mobility. On top, future elbow joint locking based on degenerative loose bodies can be prevented. Therefore, this surgery is often done in young, more active patients and even in sportsmen. These patients, however, need to be prompted to restrict loading on the elbow in the immediate postoperative period, because the elbow is biomechanically weakened and may be prone to a fracture. However, both outcome and postoperative rehabilitation are promising and the arthroscopic Outerbridge procedure is a reliable procedure with an easy rehabilitation. Therefore, the threshold is relatively low in early cubarthritis and recurrent locking of the elbow. In this paper, we present a literature review and the author's experience and own research on the Outerbridge procedure.

  2. Affinity purification and partial characterization of a yeast multiprotein complex for nucleotide excision repair using histidine-tagged Rad14 protein

    International Nuclear Information System (INIS)

    The nucleotide excision repair (NER) pathway of eukaryotes involves approximately 30 polypeptides. Reconstitution of this pathway with purified components is consistent with the sequential assembly of NER proteins at the DNA lesion. However, recent studies have suggested that NER proteins may be pre-assembled in a high molecular weight complex in the absence of DNA damage. To examine this model further, we have constructed a histidine-tagged version of the yeast DNA damage recognition protein Rad14. Affinity purification of this protein from yeast nuclear extracts resulted in the co-purification of Rad1, Rad7, Rad10, Rad16, Rad23, RPA, RPB1, and TFIIH proteins, whereas none of these proteins bound to the affinity resin in the absence of recombinant Rad14. Furthermore, many of the co-purifying proteins were present in approximately equimolar amounts. Co-elution of these proteins was also observed when the nuclear extract was fractionated by gel filtration, indicating that the NER proteins were associated in a complex with a molecular mass of >1000 kDa prior to affinity chromatography. The affinity purified NER complex catalyzed the incision of UV-irradiated DNA in an ATP-dependent reaction. We conclude that active high molecular weight complexes of NER proteins exist in undamaged yeast cells

  3. [Rehabilitation after arthroscopic anterior cruciate ligament reconstruction].

    Science.gov (United States)

    Smékal, D; Kalina, R; Urban, J

    2006-12-01

    Rehabilitation is an important part of therapy in patients who have had arthroscopic anterior cruciate ligament reconstruction. A well-designed rehabilitation program avoids potential graft damage and speeds up patients' return to their full function level. The course of rehabilitation depends on the type of surgery, mode of fixation and possible co-existing injury to the knee's soft tissues. The rehabilitation program presented here is based on the present-day knowledge of neurophysiological and biomechanical principles and is divided into five phases. In the pre-operative phase (I), the main objective is to prepare patients for surgery in terms of maximum muscle strength and range of motion. It also includes providing full information on the procedure. In the early post-operative phase (II) we are concerned with pain alleviation and reduction of knee edema. After suture removal we begin with soft techniques for the patella and post-operative physical therapy to reduce scarring. In the next post-operative phase (III) patients are able to walk with their full weight on the extremity operated on, and we continue doing exercises that improve flexor/extensor co-contraction. In this phase we also begin with exercises improving the patient's proprioceptive and sensorimotor functions. In the late post-operative phase (IV) we go on with exercises promoting proprioception of both lower extremities with the aim of increasing muscle control of the knee joints. In the convalescent phase (V) patients gradually return to their sports activities.

  4. Arthroscopic intervention in early hip disease.

    Science.gov (United States)

    McCarthy, Joseph C; Lee, Jo-Ann

    2004-12-01

    Advancement in diagnostic and therapeutic applications for hip arthroscopy have dispelled previous myths about early hip disease. Arthroscopic findings have established the following facts: Acetabular labral tears do occur; acetabular chondral lesions do exist; tears are most frequently anterior and often associated with sudden twisting or pivoting motions; and labral tears often occur in association with articular cartilage lesions of the adjacent acetabulum or femoral head, and if present for years, contribute to the progression of delamination process of the chondral cartilage. Magnetic resonance arthrography represents an improvement over conventional magnetic resonance imaging, it does have limitations when compared with direct observation. Although indications for hip arthroscopy are constantly expanding, the most common indications include: labral tears, loose bodies, chondral flap lesions of the acetabular or femoral head, synovial chondromatosis, foreign body removal, and crystalline hip arthropathy (gout, pseudogout, and others). Contraindications include conditions that limit the potential for hip distraction such as joint ankylosis, dense heterotopic bone formation, considerable protrusio, or morbid obesity. Complication rates have been reported between 0.5 and 5%, most often related to distraction and include sciatic or femoral nerve palsy, avascular necrosis, and compartment syndrome. Transient peroneal or pudendal nerve effects and chondral scuffing have been associated with difficult or prolonged distraction. Meticulous consideration to patient positioning, distraction time and portal placement are essential. Judicious patient selection and diagnostic expertise are critical to successful outcomes. Candidates for hip arthroscopy should include only those patients with mechanical symptoms (catching, locking, or buckling) that have failed to respond to conservative therapy. The extent of articular cartilage involvement has the most direct relationship

  5. The results of arthroscopic anterior stabilisation of the shoulder using the bioknotless anchor system

    Directory of Open Access Journals (Sweden)

    Cooke Stephen J

    2009-01-01

    Full Text Available Abstract Background Shoulder instability is a common condition, particularly affecting a young, active population. Open capsulolabral repair is effective in the majority of cases, however arthroscopic techniques, particularly using suture anchors, are being used with increasing success. Methods 15 patients with shoulder instability were operated on by a single surgeon (VK using BioKnotless anchors (DePuy Mitek, Raynham, MA. The average length of follow-up was 21 months (17 to 31 with none lost to follow-up. Constant scores in both arms, patient satisfaction, activity levels and recurrence of instability was recorded. Results 80% of patients were satisfied with their surgery. 1 patient suffered a further dislocation and another had recurrent symptomatic instability. The average constant score returned to 84% of that measured in the opposite (unaffected shoulder. There were no specific post-operative complications encountered. Conclusion In terms of recurrence of symptoms, our results show success rates comparable to other methods of shoulder stabilisation. This technique is safe and surgeons familiar with shoulder arthroscopy will not encounter a steep learning curve. Shoulder function at approximately 2 years post repair was good or excellent in the majority of patients and it was observed that patient satisfaction was correlated more with return to usual activities than recurrence of symptoms.

  6. Arthroscopic treatment of bony loose bodies in the subacromial space

    Directory of Open Access Journals (Sweden)

    Wei Li

    2015-01-01

    Conclusion: The mechanism of formation of bony loose bodies is not clear, may be associated with synovial cartilage metaplasia. Arthroscopic removal of loose bodies and bursa debridement is a good option for treatment of the loose body in the subacromial space, which can receive good function.

  7. An arthroscopic technique to treat the iliotibial band syndrome.

    Science.gov (United States)

    Michels, F; Jambou, S; Allard, M; Bousquet, V; Colombet, P; de Lavigne, C

    2009-03-01

    Iliotibial band syndrome (ITBS) is an overuse injury mainly affecting runners. The initial treatment is conservative. Only, in recalcitrant cases surgery is indicated. Several open techniques have been described. The purpose of this study is to evaluate the results of a standardized arthroscopic technique for treatment of a resistant ITBS. Thirty-six athletes with a resistant ITBS were treated with a standardized arthroscopic technique, limited to the resection of lateral synovial recess. Thirty-three patients were available for follow-up (mean 2 years 4 months). Thirty-two patients (34 knees) had good or excellent results. All patients went back to sports after 3 months. In two patients a meniscal lesion was found, which required treatment. One patient with only a fair result had associated cartilage lesions of the femoral condyle. Our results show that arthroscopic treatment of resistant ITBS is a valid option with a consistently good outcome. In addition, this arthroscopic approach allows excluding or treating other intra-articular pathology.

  8. Arthroscopic management of mucoid degeneration of anterior cruciate ligament

    Directory of Open Access Journals (Sweden)

    Chirag H Chudasama

    2012-01-01

    Conclusions: Mucoid hypertrophy of the ACL should be suspected in elderly persons presenting pain on terminal extension or flexion without preceding trauma, especially when there is no associated meniscal lesion or ligamentous insufficiency. They respond well to a judicious arthroscopic release of the ACL with notchplasty.

  9. Displaced anterior cruciate ligament avulsion fractures: Arthroscopic staple fixation

    Directory of Open Access Journals (Sweden)

    S R Sundararajan

    2011-01-01

    Full Text Available Background: Anterior cruciate ligament (ACL avulsion fracture is commonly associated with knee injuries and its management is controversial ranging from conservative treatment to arthroscopic fixation. The aim of our study was to assess the clinical and radiological results of arthroscopic staple fixation in the management of ACL avulsion fractures. Materials and Methods: Twenty-two patients (17 males and 5 females who underwent arthroscopic staple fixation for displaced ACL avulsion fractures were analysed. The mean age was 32.2 years (15-55 years with a mean followup of 21 months (6-36 months. All patients were assessed clinically by calculating their Lysholm and International Knee Documentation Committee (IKDC scores and the radiological union was assessed in the followup radiographs. Results: The mean Lysholm score was 95.4(83-100 and the mean IKDC score was 91.1(77-100 at the final followup. In 20 patients anterior drawer′s test was negative at the end of final followup while two patients had grade I laxity. Associated knee injuries were found in seven cases. The final outcome was not greatly influenced by the presence of associated injuries when treated simultaneously. At final followup all the patients were able to return to their pre-injury occupation Conclusion: Arthroscopic staple fixation is a safe and reliable method for producing clinical and radiological outcome in displaced ACL avulsion fractures.

  10. Plate presetting arthroscopic reduction technique for the distal radius fractures.

    Science.gov (United States)

    Abe, Yukio; Tsubone, Tetsu; Tominaga, Yasuhiro

    2008-09-01

    Wrist arthroscopy for the distal radius fractures is an effective adjunct to evaluate the reduction of intraarticular fragments and soft tissue injuries. In recent years, volar locking plate fixation has become popular, and arthroscopic procedures for distal radius fracture reduction have become problematic because vertical traction has to be both on and off during surgery. We developed a plate presetting arthroscopic reduction technique to simplify the combination of plating and arthroscopy. The fracture was reduced, and anatomic alignment was regained under an image intensifier, and then the volar locking plate was preset. Wrist arthroscopy was introduced under vertical traction, and the intraarticular condition was assessed. If dislocations of the intraarticular fragments were residual, they were reduced arthroscopically, and soft tissue injuries were treated subsequently. Finally, the traction was removed, and the plate was securely fixed. Since May 2005, the authors have used this technique in more than 50 patients. This article will review the history, indications, contraindications, technique, rehabilitation, and complications for the plate presetting arthroscopic reduction technique for distal radius fractures. PMID:18776773

  11. Arthroscopically Assisted Open Reduction-Internal Fixation of Ankle Fractures: Significance of the Arthroscopic Ankle Drive-through Sign.

    Science.gov (United States)

    Schairer, William W; Nwachukwu, Benedict U; Dare, David M; Drakos, Mark C

    2016-04-01

    Standalone open reduction-internal fixation (ORIF) of unstable ankle fractures is the current standard of care. Intraoperative stress radiographs are useful for assessing the extent of ligamentous disruption, but arthroscopic visualization has been shown to be more accurate. Concomitant arthroscopy at the time of ankle fracture ORIF is useful for accurately diagnosing and managing syndesmotic and deltoid ligament injuries. The arthroscopic ankle drive-through sign is characterized by the ability to pass a 2.9-mm shaver (Smith & Nephew, Andover, MA) easily through the medial ankle gutter during arthroscopy, which is not usually possible with both an intact deltoid ligament and syndesmosis. This arthroscopic maneuver indicates instability after ankle reduction and fixation and is predictive of the need for further stabilization. Furthermore, when this sign remains positive after fracture fixation, it may guide the surgeon to further evaluate the adequacy of fixation for the possible need for further fixation of the syndesmosis or deltoid. We present the case of an ankle fracture managed with arthroscopy-assisted ORIF and describe the clinical utility of the arthroscopic ankle drive-through sign. PMID:27462542

  12. Bladder exstrophy repair

    Science.gov (United States)

    Bladder birth defect repair; Everted bladder repair; Exposed bladder repair; Repair of bladder exstrophy ... Bladder exstrophy repair involves two surgeries. The first surgery is to repair the bladder and the second one is to attach ...

  13. Technical tips for (dry) arthroscopic reduction and internal fixation of distal radius fractures.

    Science.gov (United States)

    Del Piñal, Francisco

    2011-10-01

    Contrary to general belief, arthroscopic assisted reduction in distal radius fractures can be done in an expeditious manner and with minimal consumption of operating room resources. This article presents the steps for a pleasant arthroscopic experience in detail. The technique proposed combines the benefits of rigid fixation with volar locking plates (for the extra-articular component) and arthroscopic control of the reduction (for the articular component). It is important that the operation be carried out using the dry arthroscopic technique. However, arthroscopy is just an addition to conventional methods. Thorough knowledge of and facility with classic techniques of distal radius fracture treatment is essential for a good result. PMID:21971058

  14. Neuromuscular Exercise Post Partial Medial Meniscectomy

    DEFF Research Database (Denmark)

    Hall, Michelle; Hinman, Rana S; Wrigley, Tim V;

    2015-01-01

    : An assessor-blinded, randomised controlled trial including people aged 30-50 years with no to mild pain following medial arthroscopic partial meniscectomy was conducted. Participants were randomly allocated to either a 12-week neuromuscular exercise program that targeted neutral lower limb alignment...... outcomes included additional measures of knee joint load distribution, patient-reported outcomes, maximal knee and hip muscle strength, and physical function measures. RESULTS: 60 out of 62 randomized participants (97%) completed the trial. There were no significant between-group differences in the change...

  15. 经腹部分腹膜外修补术治疗腰疝12例临床研究%Transabdominal partial extraperitoneal repair of lumbar hernia:A clinical study of 12 patients

    Institute of Scientific and Technical Information of China (English)

    陈鑫; 李健文; 孙晶; 王骥; 王文瑞; 张云; 林谋斌; 董峰; 郑民华

    2014-01-01

    目的:探讨经腹部分腹膜外修补术(TAPE)治疗腰疝的安全性和有效性。方法回顾性分析上海交通大学医学院附属瑞金医院普外科2009年5月至2013年7月行TAPE治疗的12例腰疝病人的临床资料。结果疝缺损面积为(81.3±43.9)cm2,补片面积为(266.7±103.0)cm2。手术无中转,手术时间为(60.3±10.4)min,术中无并发症发生。术后无病人使用镇痛剂,术后第1天(POD1)和术后第3天(POD3)的视觉模拟疼痛评分(VAS)分别为3.9±0.7和2.7±0.6。术后住院时间为(5.0±1.4)d,2周内均恢复非限制性活动。随访期间无复发,亦无并发症发生。结论短期疗效显示,TAPE是治疗腰疝的一种安全、有效的微创技术。%Objective To explore the safety and effectiveness of transabdominal partial extraperitoneal (TAPE) repair of lumbar hernia. Methods The clinical data of 12 patients with lumbar hernia underwent TAPE repair between May 2009 and July 2013 in Ruijin Hospital,Shanghai Jiao Tong University School of Medicine were analyzed retrospectively. Results The average size of the hernia defect was (81.3±43.9) cm2. The average size of the mesh employed was (266.7± 103.0) cm2. There was no conversion to open surgery. The mean surgical time was (60.3 ± 10.4) minutes. No intra-operative complications occurred. No patients need to take analgesic postoperatively. The mean VAS were 3.9 ± 0.7 and 2.7 ± 0.6 on the first day and the third day after surgery (POD1 and POD3) respectively. The mean postoperative hospitalization was (5.0 ± 1.4) days. All patients returned to unrestricted activity within two weeks after surgery. During the follow-up period,no recurrence and complications were observed. Conclusion TAPE is a novel laparoscopic technique with safety and effectiveness for lumbar hernia repair. Its efficacy in short-term is certain.

  16. Rotator Cuff Repair

    Medline Plus

    Full Text Available ... more comfortable arthroscopically, or a combination called the "mini open" that we described years ago. So, as ... can be done through small open incisions called mini-deltoid splitting incisions. In addition, there a variety ...

  17. Rotator Cuff Repair

    Medline Plus

    Full Text Available ... the arm and to be a little more cosmetic, we'll incorporate that tear, the biceps that ... that's one of the common complications of arthroscopic surgery or open rotator cuff surgery is you remove ...

  18. 不同材料支架式可摘局部义齿修复牙列缺损的生物相容性分析%Different removable partial dentures in repair of dentition defects:a biocompatibility analysis

    Institute of Scientific and Technical Information of China (English)

    林鸿雷; 王月燕; 卢阳

    2016-01-01

    BACKGROUND: Removable partial denture is the main way of repairing dentition defects, and its casting materials mainly include pure titanium, cobalt-chromium al oy and Vital um 2000. OBJECTIVE: To analyze the biocompatibility of removable partial dentures made of different materials in repair of dentition defects. METHODS: Total y 120 patients with dentition defects, aged 24-68 years old, were enrol ed and underwent repair with removable partial dentures. Among these patients, 40 patients were treated with cobalt-chromium al oy-casted removable partial dentures, 40 patients with pure titanium-casted removable partial dentures, and 40 patients with Vital ium 2000 casted removable partial dentures. Al patients were fol owed up for 2 years. The chewing efficiency, coagulation, thrombosis, alveolar bone loss, patient satisfaction, and the incidence of adverse reactions, such as abutments periodontal disease and secondary caries were compared between these three groups. RESULTS AND CONCLUSION: (1) Chewing efficiency and patient satisfaction rate: Vital um 2000 group > titanium group > cobalt-chromium al oy group (P 纯钛材料组>钴铬合金材料组(P 均<0.05)。②凝血、血栓、牙槽骨吸收发生率:Vital um 2000材料组<纯钛材料组<钴铬合金材料组(P 均<0.05)。③不良反应发生率:Vital um 2000材料组<纯钛材料组<钴铬合金材料组(P 均<0.05)。④表明Vital ium 2000可摘局部义齿修复牙列缺损,可有效降低义齿性口炎、基牙牙周病及继发龋的发生率,保证舒适度、咀嚼力及语言功能。

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

    Science.gov (United States)

    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.

  20. Evaluation of arthroscopic treatment of posterior shoulder instability

    Science.gov (United States)

    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

  1. Arthroscopic cartilage regeneration facilitating procedure for osteoarthritic knee

    Directory of Open Access Journals (Sweden)

    Lyu Shaw-Ruey

    2012-11-01

    Full Text Available Abstract Background The effectiveness of arthroscopic treatment for osteoarthritic knee is a controversy. This study presents the technique of a novel concept of arthroscopic procedure and investigates its clinical outcome. Method An arthroscopic procedure targeted on elimination of focal abrasion phenomenon and regaining soft tissue balance around patello-femoral joint was applied to treat osteoarthritis knees. Five hundred and seventy-one knees of 367 patients with osteoarthritis received this procedure. There were 70 (19% male and 297 (81% female and the mean age was 60 years (SD 10. The Knee Society score (KSS and the knee injury and osteoarthritis outcome score (KOOS were used for subjective outcome study. The roentgenographic changes of femoral-tibial angle and joint space width were evaluated for objective outcomes. The mean follow-up period was 38 months (SD 3. Results There were 505 knees in 326 patients available with more than 3 years follow-up and the mean follow-up period was 38 months (SD 3. The subjective satisfactory rate for the whole series was 85.5%. For 134 knees with comprehensive follow-up evaluation, the KSS and all subscales of the KOOS improved statistically. The femoral-tibial angle improved from 1.57 degrees (SD 3.92 to 1.93 degrees (SD 4.12 (mean difference: 0.35, SD 0.17. The joint space width increased from 2.02 millimeters (SD 1.24 to 2.17 millimeters (SD 1.17 (mean difference: 0.13, SD 0.05. The degeneration process of the medial compartment was found being reversed in 82.1% of these knees by radiographic evaluation. Conclusions Based on these observations arthroscopic cartilage regeneration facilitating procedure is an effective treatment for osteoarthritis of the knee joint and can be expected to satisfy the majority of patients and reverse the degenerative process of their knees.

  2. Arthroscopic Synovectomy for Zone 2 Flexor Hallucis Longus Tenosynovitis

    OpenAIRE

    Lui, Tun Hing

    2015-01-01

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

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

    Science.gov (United States)

    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. PMID:26697294

  4. Open and Arthroscopic Surgical Treatment of Femoroacetabular Impingement

    Directory of Open Access Journals (Sweden)

    Benjamin D. Kuhns

    2015-12-01

    Full Text Available 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 peri-acetabular osteotomy, (3 the direct anterior mini-open approach, and (4 arthroscopic surgery for femoroacetabular impingement.

  5. Arthroscopic treatment of symptomatic type D medial plica

    OpenAIRE

    Uysal, Mustafa; Asik, Mehmet; Akpinar, Sercan; Ciftci, Feyyaz; Cesur, Necip; Tandogan, Reha N.

    2007-01-01

    We aimed to review the results of subtotal arthroscopic resection of symptomatic type D medial plica. We retrospectively evaluated 23 knees with symptomatic type D medial plica in 22 patients without other intra-articular pathology. All patients complained of chronic knee pain that had not been alleviated by medical treatment or physical therapy. In only three (13%) of the patients studied was the plica diagnosed pre-operatively with magnetic resonance imaging. The type D medial plicae in our...

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

    Science.gov (United States)

    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. Use of an Irrigation Pump System in Arthroscopic Procedures.

    Science.gov (United States)

    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.]. PMID:27135450

  8. Arthroscopic debridement of osteoarthritic elbow in professional athletes

    Institute of Scientific and Technical Information of China (English)

    YAN Hui; CUI Guo-qing; WANG Jian-quan; YIN Yu; AO Ying-fang

    2011-01-01

    Background Arthroscopic debridement is an appropriate procedure for osteoarthritic elbow in general populations.However,the results of arthroscopic debridement in the professional athletes,a younger and highly active patient cohort is unclear.The purposes of this study were to assess the clinical outcomes of arthroscopic debridement of osteoarthritic elbow in professional athletes and to evaluate the effect of prognostic factors on the clinical outcomes.Methods From January 1999 to January 2006,35 professional athletes with osteoarthritc elbow (36 elbows) were treated with arthroscopic debridement,consisted of osteophytes removal,loose bodies removal and fenestration of the olecranon fossa as necessary.Average patient age was (23±5) years (range 7-34 years).Average follow-up was (43±23) months (range 16-98 months).Athletic activities consisted mainly of wrestling,judo and weightlifting.Patients were evaluated preoperatively and postoperatively with the modified Hospital for Special Surgery (HSS) elbow scoring system.Results According to the modified HSS elbow scoring system,the result was excellent for 16 elbows,good for 14 and poor for 6.No case had got worse after surgery.All athletes reported an improvement in pain.After athletic training,15 elbows were not painful,16 mildly painful,3 moderately painful and 2 severely painful.The arc of flexion-extension improved from 111 ° preoperatively to 127° postoperatively.All of the athletes were able to return to their previous level of training.Five athletes won national-level championships.At follow-up,17 athletes (18 elbows) were greatly satisfied with the results,12 satisfied and 6 unsatisfied.Postoperatively,one athlete reported ulnar nerve symptoms and two others had residual loose bodies.The fenestration of the olecranon fossa was associated with a significantly increased chance of a poor outcome.The nature of the osteoarthritis,duration of symptoms,osteophytes removal and loose bodies removal did not predict

  9. Arthroscopic washout of the ankle for septic arthritis in a three-month-old boy

    Directory of Open Access Journals (Sweden)

    Hagino Tetsuo

    2011-10-01

    Full Text Available Abstract There is no report of athroscopic treatment for septic arthritis of the ankle in infants. We report a case of successful management of septic arthritis of the ankle in a three-month-old boy by arthroscopic washout. Arthroscopic washout may be a useful treatment for septic arthritis in young infants when performed early after onset.

  10. Ultrasonography-assisted arthroscopic proximal iliotibial band release and trochanteric bursectomy.

    Science.gov (United States)

    Weinrauch, Patrick; Kermeci, Sharon

    2013-01-01

    We describe arthroscopic iliotibial band release and trochanteric bursectomy assisted by intraoperative ultrasonography for accurate placement of arthroscopic portals and to ensure adequate decompression of the peritrochanteric space. We have found ultrasonography for endoscopic iliotibial band release a useful tool to assist with localizing the site and length of decompression.

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

    OpenAIRE

    Weinrauch, Patrick; Kermeci, Sharon

    2013-01-01

    We describe arthroscopic iliotibial band release and trochanteric bursectomy assisted by intraoperative ultrasonography for accurate placement of arthroscopic portals and to ensure adequate decompression of the peritrochanteric space. We have found ultrasonography for endoscopic iliotibial band release a useful tool to assist with localizing the site and length of decompression.

  12. Deep vein thrombosis and thromboprophylaxis in arthroscopic anterior cruciate ligament reconstruction

    Directory of Open Access Journals (Sweden)

    Raviraj Adala

    2011-01-01

    Conclusion: In our study the incidence of deep vein thrombosis in patients undergoing arthroscopic ACL reconstruction is 1.78%. We do not recommend routine thromboprophylaxis in patients, who are not high risk candidates for thrombosis and are of less than 45 years, in patients undergoing arthroscopic ACL reconstruction, with early postoperative rehabilitation.

  13. Craniosynostosis repair

    Science.gov (United States)

    ... will be asleep and will not feel pain. Traditional surgery is called open repair. It includes these ... helps keep the swelling down. Talking, singing, playing music, and telling stories may help soothe your child. ...

  14. Pectus excavatum repair

    Science.gov (United States)

    Funnel chest repair; Chest deformity repair; Sunken chest repair; Cobbler's chest repair; Nuss repair; Ravitch repair ... There are two types of surgery to repair this condition -- open surgery ... surgery is done while the child is in a deep sleep and pain- ...

  15. The thrower's elbow: arthroscopic treatment of valgus extension overload syndrome.

    Science.gov (United States)

    O'Holleran, James D; Altchek, David W

    2006-02-01

    Injury to the medial collateral ligament of the elbow (MCL) can be a career-threatening injury for an overhead athlete without appropriate diagnosis and treatment. It has been considered separately from other athletic injuries due to the unique constellation of pathology that results from repetitive overhead throwing. The past decade has witnessed tremendous gains in understanding of the complex interplay between the dynamic and static stabilizers of the athlete's elbow. Likewise, the necessity to treat these problems in a minimally invasive manner has driven the development of sophisticated techniques and instrumentation for elbow arthroscopy. MCL injuries, ulnar neuritis, valgus extension overload with osteophyte formation and posteromedial impingement, flexor pronator strain, medial epicondyle pathology, and osteochondritis dissecans (OCD) of the capitellum have all been described as sequelae of the overhead throwing motion. In addition, loose body formation, bony spur formation, and capsular contracture can all be present in conjunction with these problems or as isolated entities. Not all pathology in the thrower's elbow is amenable to arthroscopic treatment; however, the clinician must be familiar with all of these problems in order to form a comprehensive differential diagnosis for an athlete presenting with elbow pain, and he or she must be comfortable with the variety of open and arthroscopic treatments available to best serve the patient. An understanding of the anatomy and biomechanics of the thrower's elbow is critical to the care of this population. The preoperative evaluation should focus on a thorough history and physical examination, as well as on specific diagnostic imaging modalities. Arthroscopic setup, including anesthesia, patient positioning, and portal choices will be discussed. Operative techniques in the anterior and posterior compartments will be reviewed, as well as postoperative rehabilitation and surgical results. Lastly, complications

  16. Arthroscopic Management of Complications Following Total Ankle Replacement.

    Science.gov (United States)

    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.

  17. Femoral hernia repair

    Science.gov (United States)

    Femorocele repair; Herniorrhaphy; Hernioplasty - femoral ... During surgery to repair the hernia, the bulging tissue is pushed back in. The weakened area is sewn closed or strengthened. This repair ...

  18. Undescended testicle repair

    Science.gov (United States)

    Orchidopexy; Inguinal orchidopexy; Orchiopexy; Repair of undescended testicle; Cryptorchidism repair ... first year of life without treatment. Undescended testicle repair surgery is recommended for patients whose testicles do ...

  19. Arthroscopic Labral Reconstruction of the Hip Using Iliotibial Band Allograft and Front-to-Back Fixation Technique.

    Science.gov (United States)

    White, Brian J; Herzog, Mackenzie M

    2016-02-01

    Labral repair has been shown to be an effective treatment option with excellent early outcomes; however, in cases of severe labral damage or when the labral tissue is too large or diminutive, labral repair may be less effective. The purpose of this article is to present a modified technique for hip labral reconstruction using iliotibial band allograft tissue and a front-to-back fixation technique. The described technique is modified from the original report of a technique for arthroscopic labral reconstruction. The front-to-back technique allows the surgeon to make a graft that is longer than necessary and cut excess graft after front-to-back fixation, resulting in the correct graft size and a reproducible procedure. Allograft tissue offers several advantages, including the ability to control graft thickness and length, as well as the ability to eliminate donor-site morbidity. This procedure adds to the available techniques for treatment of labral pathology by providing a labral reconstruction technique using allograft tissue.

  20. Arthroscopic Labral Reconstruction of the Hip Using Iliotibial Band Allograft and Front-to-Back Fixation Technique.

    Science.gov (United States)

    White, Brian J; Herzog, Mackenzie M

    2016-02-01

    Labral repair has been shown to be an effective treatment option with excellent early outcomes; however, in cases of severe labral damage or when the labral tissue is too large or diminutive, labral repair may be less effective. The purpose of this article is to present a modified technique for hip labral reconstruction using iliotibial band allograft tissue and a front-to-back fixation technique. The described technique is modified from the original report of a technique for arthroscopic labral reconstruction. The front-to-back technique allows the surgeon to make a graft that is longer than necessary and cut excess graft after front-to-back fixation, resulting in the correct graft size and a reproducible procedure. Allograft tissue offers several advantages, including the ability to control graft thickness and length, as well as the ability to eliminate donor-site morbidity. This procedure adds to the available techniques for treatment of labral pathology by providing a labral reconstruction technique using allograft tissue. PMID:27073784

  1. FUNCTIONAL OUTCOME OF ARTHROSCOPICALLY ASSISTED ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION USING PATELLAR BTB GRAFT: A PROSPECTIVE STUDY OF 45 CASES

    Directory of Open Access Journals (Sweden)

    Suresh

    2014-09-01

    Full Text Available : In today’s world high velocity road traffic accidents, sports activities and increased fitness awareness, ACL injuries is a common clinical problem. Once upon a time ACL rupture led to a relatively safe existence and was thought to be of less significance. Now with improved knee kinematics and clinical skills, it has been established that post ACL injury, the prevalence of clinically significant meniscal damage increases with time and is associated with increasing disability and arthrosis. Ligament reconstruction has not been shown to prevent arthrosis, but studies show that it appears to reduce the risk of subsequent meniscal injury and improve anteroposterior knee motion and facilitates return to high level sporting activities. As surgical techniques like Arthroscopy improve the ability to tackle complex problems, complex decisions regarding Meniscal repair and transplantation, Cartilage repair and regeneration are now commonplace, as are decisions regarding the need for Osteotomies in Arthritically unstable knees. Arthroscopic reconstruction of the Anterior Cruciate Ligament with patellar bone - tendon - bone graft is minimally invasive and is relatively quick and simple to perform, although attention to detail as required for good results. Thus arthroscopy helps in diagnosis and treatment of internal derangement and on extra articular reconstruction.

  2. Development of Atomic Force Microscope for Arthroscopic Knee Cartilage Inspection

    Science.gov (United States)

    Imer, Raphaël; Akiyama, Terunobu; de Rooij, Nicolaas F.; Stolz, Martin; Aebi, Ueli; Friederich, Niklaus F.; Koenig, Uwe; Wirz, Dieter; Daniels, A. U.; Staufer, Urs

    2006-03-01

    A recent study, based on ex vivo unconfined compression testing of normal, diseased, and enzymatically altered cartilage, revealed that a scanning force microscope (SFM), used as a nano-intender, is sensitive enough to enable measurement of alterations in the biomechanical properties of cartilage. Based on these ex vivo measurements, we have designed a quantitative diagnosis tool, the scanning force arthroscope (SFA), able to perform in vivo measurements during a standard arthroscopic procedure. For stabilizing and positioning the instrument relative to the surface under investigation, a pneumatic system has been developed. A segmented piezoelectric tube was used to perform the indentation displacement, and a pyramidal nanometer-scale silicon tip mounted on a cantilever with an integrated deflection sensor measured the biomechanical properties of cartilage. Mechanical means were designed to protect the fragile cantilever during the insertion of the instrument into the knee joint. The stability of the pneumatic stage was checked with a prototype SFA. In a series of tests, load-displacement curves were recorded in a knee phantom and, more recently, in a pig’s leg.

  3. Evaluation of pain after arthroscopically assisted anterior cruciate ligament reconstruction.

    Science.gov (United States)

    Brown, D W; Curry, C M; Ruterbories, L M; Avery, F L; Anson, P S

    1997-01-01

    Pain after arthroscopically assisted anterior cruciate reconstruction was examined during the first 5 postoperative days to evaluate its intensity and duration. One hundred consecutive patients who underwent arthroscopically assisted anterior cruciate ligament reconstruction using a bone-patellar tendon-bone autograft were examined. During surgery, ketorolac (60 mg) was given intravenously and 0.25% bupivicaine (1 ml/kg total) was injected into the joint space and the graft donor site. After surgery, all patients received scheduled doses of oral acetaminophen (650 mg) and ketorolac (10 mg) four times a day, and they were allowed to take oral oxycodone (5 to 10 mg) every 2 hours as needed. Pain scores at rest and with activity reached a maximum on the 2nd postoperative morning. Oxycodone consumption also peaked on the 2nd postoperative day. Eighty-nine (89%) patients reported overall pain as mild or moderate, and 95 patients (95%) reported either excellent or good overall relief of pain. The 5-day cumulative mean of visual analog scale pain scores for attempting straight leg raises was significantly higher for patients unable to successfully perform that activity than for patients who were able to perform it. The association between elevated pain scores and diminished ability to perform straight leg raises suggests that pain may inhibit function and therefore early rehabilitation. PMID:9079170

  4. Change in Driving Performance following Arthroscopic Shoulder Surgery.

    Science.gov (United States)

    Hasan, S; McGee, A; Weinberg, M; Bansal, A; Hamula, M; Wolfson, T; Zuckerman, J; Jazrawi, L

    2016-08-01

    The current study aimed to measure perioperative changes in driving performance following arthroscopic shoulder surgery using a validated driving simulator.21 patients who underwent arthroscopic surgery for rotator cuff or labral pathology were tested on a driving simulator preoperatively, and 6 and 12 weeks postoperatively. An additional 21 subjects were tested to establish driving data in a control cohort. The number of collisions, centerline crossings, and off-road excursions were recorded for each trial. VAS and SPADI scores were obtained at each visit.The mean number of collisions in the study group significantly increased from 2.05 preoperatively to 3.75 at 6 weeks (p<0.001), and significantly decreased to 1.95 at 12 weeks (p<0.001). Centerline crossings and off-road excursions did not significantly change from preoperative through 12 weeks, although centerline crossings were statistically different from the controls at each time point (p<0.001). Surgery on the dominant driving arm resulted in greater collisions at 6 weeks than surgery on the non-dominant driving arm (p<0.001).Preliminary data shows that driving performance is impaired for at least 6 weeks postoperatively, with a return to normal driving by 12 weeks. Driving is more profoundly affected in conditions that require avoiding a collision and when the dominant driving arm is involved. PMID:27487432

  5. Intestinal obstruction repair

    Science.gov (United States)

    Repair of volvulus; Intestinal volvulus - repair; Bowel obstruction - repair ... Intestinal obstruction repair is done while you are under general anesthesia . This means you are asleep and DO NOT feel pain. ...

  6. Aortic aneurysm repair - endovascular

    Science.gov (United States)

    EVAR; Endovascular aneurysm repair - aorta; AAA repair - endovascular; Repair - aortic aneurysm - endovascular ... Endovascular aortic repair is done because your aneurysm is very large, growing quickly, or is leaking or bleeding. You may have ...

  7. Motorcycle Repair.

    Science.gov (United States)

    Hein, Jim; Bundy, Mike

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

  8. Hydrocele repair

    Science.gov (United States)

    ... small surgical cut in the fold of the groin, and then drains the fluid. The sac (hydrocele) holding the fluid may be removed. The surgeon strengthens the muscle wall with stitches. This is called a hernia repair. Sometimes the surgeon uses a laparoscope to do ...

  9. Editorial Commentary: Book? … Book Report? … or Just a New Chapter in an Ongoing Story?: Knee Partial Meniscectomy Has Limited Benefit for "Nonobstructive" Meniscal Tears, but We Need to Know if Patients Have Osteoarthritis.

    Science.gov (United States)

    Whelan, Daniel B

    2016-09-01

    Knee partial meniscectomy has limited benefit for "nonobstructive" meniscal tears, but we need to know if included patients have osteoarthritis. Research on outcomes of arthroscopic partial meniscectomy versus nonsurgical treatment must consider not only signs and symptoms but also imaging findings, to determine the indications for surgical versus nonsurgical in a selected patient. PMID:27594333

  10. Two-Year Outcomes following Arthroscopic Treatment for Snapping Scapula Syndrome

    Science.gov (United States)

    Menge, Travis; Horan, Marilee P.; Mitchell, Justin; Tahal, Dimitri S.; Millett, Peter J.

    2016-01-01

    Objectives: Snapping scapula syndrome is a rare cause of shoulder pain that can result in significant dysfunction. The purpose of this study was to report clinical outcomes following arthroscopic treatment for snapping scapula syndrome, as well as identify associated risk factors that affect outcomes. Methods: One-hundred patients underwent arthroscopic treatment for snapping scapula syndrome from October 2005 to October 2013. This was an IRB-approved retrospective outcomes study with prospectively collected data. Patients were excluded if they had prior scapula or rib surgeries, or concomitant sternoclavicular or glenohumeral reconstructive procedures. Patients included in this study failed non-operative modalities for mechanical symptoms of snapping scapula and reported symptomatic relief from a local anesthetic injection prior to surgery. Preoperative and postoperative pain and functioning levels were assessed with the American Shoulder and Elbow Surgeons (ASES), QuickDASH (Disabilities of the Arm, Shoulder and Hand), and general health SF-12 including both physical (PCS) and mental (MCS) components. Patient satisfaction was recorded on a 10-point visual analog scale (VAS). Results: There were 86 scapulae in 79 patients that met inclusion criteria. Mean age at time of surgery was 33 years old (range 12-65). A partial scapulectomy and bursectomy was performed in 79 scapulae, with 7 having bursectomy alone. Mean duration from onset of symptoms to surgery was 3.8 years (range 90 days-16.6 years). One patient died in the follow-up period from unrelated causes, and 6 patients refused to participate. Of the remaining 72 scapula, 8/72 (11%) failed and underwent a revision procedure at a mean of 309 days (SD+283 days). Of those that met inclusion criteria and did not require revision surgery, 86% (55/64) returned surveys with a mean follow-up of 3.4 years (range 2-7 years). There was a significant improvement following surgery in SF-12 PCS (p<0.001), SF-12 MCS (p=0

  11. Knee extensor muscle strength in middle-aged and older individuals undergoing arthroscopic partial meniscectomy

    DEFF Research Database (Denmark)

    Hall, Michelle; Juhl, Carsten B; Lund, Hans;

    2015-01-01

    OBJECTIVE: People with meniscal tears are at high risk to develop or progress knee osteoarthritis. Knee extensor weakness is considered a risk factor for osteoarthritis and is often reported in these individuals. The purpose of this systematic review and meta-analysis was to investigate knee exte...

  12. Changes in knee joint load indices from before to 12 months after arthroscopic partial meniscectomy

    DEFF Research Database (Denmark)

    Thorlund, J B; Holsgaard-Larsen, A; Creaby, M W;

    2016-01-01

    with the contra-lateral leg. METHODS: We estimated indices of knee joint loading (external peak knee adduction moment (KAM), KAM impulse and peak knee flexion moment (KFM)) normalized to body size (i.e., body mass (BM) and height (HT)) using 3D gait analysis in 23 patients (17 men, mean (SD) 46.2 (6.4) years, BMI...

  13. A new method of arthroscopic reconstruction of the dislocated acromio-clavicular joint.

    OpenAIRE

    Trikha, S. P.; Acton, D.; Wilson, A. J.; Curtis, M. J.

    2004-01-01

    BACKGROUND: Symptomatic total acromio-clavicular joint dislocation (Rockwood et al. types III-VI) may be treated by surgical reconstruction. AIM: To describe an arthroscopically assisted technique to reconstruct anatomically the coraco-clavicular ligaments in acute or chronic (> 6 weeks) acromio-clavicular joint dislocation. METHODS: This new technique involves arthroscopic exposure of the coracoid process. Prior to introducing this technique, cadaveric studies were undertaken. RESULTS: Five ...

  14. Lipoma arborescens of the knee: report of a case managed by arthroscopic synovectomy.

    Science.gov (United States)

    Franco, Michel; Puch, J M; Carayon, M J; Bortolotti, D; Albano, Laetitia; Lallemand, A

    2004-01-01

    We report a case of lipoma arborescens treated with an arthroscopic procedure. Lipoma arborescens is an uncommon pseudo-tumoral synovial lesion usually located in the suprapatellar pouch of the knee. This diagnosis should be considered, particularly in patients with chronic joint effusion. Magnetic resonance imaging confirms the lipomatous nature of the synovial proliferation. When limited to the anterior compartment of the knee, lipoma arborescens can be treated by arthroscopic synovectomy. PMID:14769527

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

    Directory of Open Access Journals (Sweden)

    Masashi Koide

    2015-01-01

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

  16. Application of optical coherence tomography enhances reproducibility of arthroscopic evaluation of equine joints

    OpenAIRE

    Niemelä, Tytti; Virén, Tuomas; Liukkonen, Jukka; te Moller, Nikae; Puhakka, Pia H; Jurvelin, Jukka S.; Tulamo, R M; Töyräs, Juha

    2014-01-01

    Background: Arthroscopy is widely used in various equine joints for diagnostic and surgical purposes. However, accuracy of defining the extent of cartilage lesions and reproducibility in grading of lesions are not optimal. Therefore, there is a need for new, more quantitative arthroscopic methods. Arthroscopic optical coherence tomography (OCT) imaging is a promising tool introduced for quantitative detection of cartilage degeneration and scoring of the severity of chondral lesions. The aim o...

  17. Arthroscopic capsule reconstruction in the hip using iliotibial band allograft.

    Science.gov (United States)

    Trindade, Christiano A C; Sawyer, Gregory A; Fukui, Kiyokazu; Briggs, Karen K; Philippon, Marc J

    2015-02-01

    The hip capsule has been identified as an important static stabilizer of the hip joint. Despite the intrinsic bony stability of the hip socket, the capsule plays a key role in hip stability, particularly at the extremes of motion, and the iliofemoral ligament is the most important stabilizer in extension and external rotation. Patients who do not undergo capsular closure or plication may continue to complain of hip pain and dysfunction postoperatively, likely because of microinstability or muscle invagination into the capsular defect, and high-resolution magnetic resonance imaging or magnetic resonance arthrography will identify the capsular defect. Seen primarily in the revision setting, capsular defects can cause recurrent stress at the chondrolabral junction. An attempt at secondary closure can be challenging because of capsular limb adherence to the surrounding soft tissues. Therefore reconstruction may be the only possible surgical solution for this problem. We describe our new surgical technique for arthroscopic hip capsular reconstruction using iliotibial band allograft.

  18. Arthroscopic capsule reconstruction in the hip using iliotibial band allograft.

    Science.gov (United States)

    Trindade, Christiano A C; Sawyer, Gregory A; Fukui, Kiyokazu; Briggs, Karen K; Philippon, Marc J

    2015-02-01

    The hip capsule has been identified as an important static stabilizer of the hip joint. Despite the intrinsic bony stability of the hip socket, the capsule plays a key role in hip stability, particularly at the extremes of motion, and the iliofemoral ligament is the most important stabilizer in extension and external rotation. Patients who do not undergo capsular closure or plication may continue to complain of hip pain and dysfunction postoperatively, likely because of microinstability or muscle invagination into the capsular defect, and high-resolution magnetic resonance imaging or magnetic resonance arthrography will identify the capsular defect. Seen primarily in the revision setting, capsular defects can cause recurrent stress at the chondrolabral junction. An attempt at secondary closure can be challenging because of capsular limb adherence to the surrounding soft tissues. Therefore reconstruction may be the only possible surgical solution for this problem. We describe our new surgical technique for arthroscopic hip capsular reconstruction using iliotibial band allograft. PMID:25973378

  19. All-inside arthroscopic suturing technique for meniscal ruptures.

    Science.gov (United States)

    Darabos, Nikica; Dovzak-Bajs, Ivana; Bilić, Vide; Darabos, Anela; Popović, Iva; Cengić, Tomislav

    2012-03-01

    The most frequent indication for surgical treatment of the knee is lesion of the meniscus. The "all inside" arthroscopic technique with bioresorptive material for meniscus lesion is becoming the most popular treatment. This prospective study included 10 patients with posterior meniscal horn lesion operatively treated at Sports Traumatology Department. The "all inside" technique was performed by intra-articular application of bioresorptive pins-Darts sticks or Meniscus Viper and bioresorptive string. Patients were followed up for 2-6 months postoperatively and graded according to the IKDC 2000 scale. All surgical treatments showed satisfactory results. Young patients with acute longitudinal peripheral lesion-posterior horn lesions, in the red-red or red-white meniscal zone, 1-2 centimeters long are most appropriate for this type of treatment. In these patients, this technique proved to be superior and free from the risk of neurovascular damage. For better authentication of this conclusion, additional prospective randomized studies should be performed.

  20. Evaluation of Midterm Clinical Results of All inside Suture Technique in Meniscus Repair

    Directory of Open Access Journals (Sweden)

    Murat Gül

    2015-03-01

    Full Text Available Aim: The aim of this study was to evaluate the functional outcomes of arthroscopic all-inside meniscal repair at an average 5-year follow-up. Methods: Thirty-two patients (29 males 3 females; 19 right knees, 13 left knees, who underwent arthroscopic all-inside meniscal repair, were included in the study. Clinical examination and magnetic resonance imaging were the main diagnostic tools. The mean age of the patients was 28 years (23-41 years. ACL reconstruction was performed in the same session in 12 patients with meniscal injury associated with ACL tear. Preoperative and postoperative functional knee scores of the patients were assessed by modified Marshall functional knee scores in their last follow-up. Results: The mean follow-up period was 58 months (range 49- 81. Marshall knee scores in the last follow-up were found to be excellent in 23 patients, good - in 8 patients, and moderate in 1 patient. ACL reconstruction was performed in the same session in 12 patients with meniscal injury associated with ACL tear. A statistically significant functional improvement was detected in patients with meniscal repair after 5 years. Conclusion: This study showed that all-inside meniscal repair technique is an easy and reliable method for the treatment of meniscus tears. (The Medical Bulletin of Haseki 2015; 53:47-51

  1. Cartilage repair: Generations of autologous chondrocyte transplantation

    Energy Technology Data Exchange (ETDEWEB)

    Marlovits, Stefan [Department of Traumatology, Center for Joint and Cartilage, Medical University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna (Austria)]. E-mail: stefan.marlovits@meduniwien.ac.at; Zeller, Philip [Department of Traumatology, Center for Joint and Cartilage, Medical University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna (Austria); Singer, Philipp [Department of Traumatology, Center for Joint and Cartilage, Medical University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna (Austria); Resinger, Christoph [Department of Traumatology, Center for Joint and Cartilage, Medical University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna (Austria); Vecsei, Vilmos [Department of Traumatology, Center for Joint and Cartilage, Medical University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna (Austria)

    2006-01-15

    Articular cartilage in adults has a limited capacity for self-repair after a substantial injury. Surgical therapeutic efforts to treat cartilage defects have focused on delivering new cells capable of chondrogenesis into the lesions. Autologous chondrocyte transplantation (ACT) is an advanced cell-based orthobiologic technology used for the treatment of chondral defects of the knee that has been in clinical use since 1987 and has been performed on 12,000 patients internationally. With ACT, good to excellent clinical results are seen in isolated post-traumatic lesions of the knee joint in the younger patient, with the formation of hyaline or hyaline-like repair tissue. In the classic ACT technique, chondrocytes are isolated from small slices of cartilage harvested arthroscopically from a minor weight-bearing area of the injured knee. The extracellular matrix is removed by enzymatic digestion, and the cells are then expanded in monolayer culture. Once a sufficient number of cells has been obtained, the chondrocytes are implanted into the cartilage defect, using a periosteal patch over the defect as a method of cell containment. The major complications are periosteal hypertrophy, delamination of the transplant, arthrofibrosis and transplant failure. Further improvements in tissue engineering have contributed to the next generation of ACT techniques, where cells are combined with resorbable biomaterials, as in matrix-associated autologous chondrocyte transplantation (MACT). These biomaterials secure the cells in the defect area and enhance their proliferation and differentiation.

  2. uv photobiology: excision repair

    International Nuclear Information System (INIS)

    The following topics are discussed: steps in nucleotide excision; damage to DNA by uv-endonuclease; use of complementation to study DNA repair in Escherichia coli and mammalian cells; role of BUDR photolysis in excision repair, relation between DNA repair defect and human disease; base excision repair; and excision repair by removal of damaged region of a base in DNA without excision

  3. Quantitative ultrasound biomicroscopy for the analysis of healthy and repair cartilage tissue

    Directory of Open Access Journals (Sweden)

    K Gelse

    2010-02-01

    Full Text Available The increasing spectrum of different cartilage repair strategies requires the introduction of adequate non-destructive methods to analyse their outcome in-vivo, i.e. arthroscopically. The validity of non-destructive quantitative ultrasound biomicroscopy (UBM was investigated in knee joints of five miniature pigs. After 12 weeks, six 5-mm defects, treated with different cartilage repair approaches, provided tissues with different structural qualities. Healthy articular cartilage from each contralateral unoperated knee joint served as a control. The reflected and backscattered ultrasound signals were processed to estimate the integrated reflection coefficient (IRC and apparent integrated backscatter (AIB parameters. The cartilage repair tissues were additionally assessed biomechanically by cyclic indentation, histomorphologically and immunohistochemically. UBM allowed high-resolution visualisation of the structure of the joint surface and subchondral bone plate, as well as determination of the cartilage thickness and demonstrated distinct differences between healthy cartilage and the different repair cartilage tissues with significant higher IRC values and a steeper negative slope of the depth-dependent backscatter amplitude AIBslope for healthy cartilage. Multimodal analyses revealed associations between IRC and the indentation stiffness. Furthermore, AIBslope and AIB at the cartilage-bone boundary (AIBdC were associated with the quality of the repair matrices and the subchondral bone plate, respectively. This ex-vivo pilot study confirms that UBM can provide detailed imaging of articular cartilage and the subchondral bone interface also in repaired cartilage defects, and furthermore, contributes in certain aspects to a basal functional characterization of various forms of cartilage repair tissues. UBM could be further established to be applied arthroscopically in-vivo.

  4. Repair welding process of friction stir welding groove defect

    Institute of Scientific and Technical Information of China (English)

    LIU Hui-jie; ZHANG Hui-jie

    2009-01-01

    The groove defect formed in the friction stir welding dramatically deteriorates weld appearances and mechanical properties of the joints owing to its larger size and penetration. Therefore, the friction stir repair welding was utilized to remove such a groove defect, and the focus was placed on the mechanical properties and microstructural characteristics of the repair joints so as to obtain an optimum repair welding process. The experimental results indicate that the groove defect can be removed by friction stir repair welding, and the offset repair welding process is superior to the symmetrical repair welding process. In the symmetrical repair welding process, a large number of fine cavity defects and an obvious aggregation of hard-brittle phase Al2Cu occur, accordingly the mechanical properties of the repair joint are weakened, and the fracture feature of repair joint is partially brittle and partially plastic. A good-quality repair joint can be obtained by the offset repair welding process, and the repair joint is fractured near the interface between the weld nugget zone and thermal-mechanically affected zone.

  5. Brain aneurysm repair

    Science.gov (United States)

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

  6. Patch repair: compatibility issues

    OpenAIRE

    Garbacz, Andrzej; Courard, Luc; Bissonnette, Benoît; Głodkowska, W.

    2014-01-01

    Repair of any concrete structure results in formation of complex, at least two-component repair systems. Compatibility approach is treated as a basic requirement during selection of repair material. Recently, the understanding for compatibility requirements in repair systems approach is demonstrated in many papers. The aim of this paper is analyzing the compatibility between repair materials and concrete substrate in the case of patch repair. The compatibility issues were discussed in light o...

  7. HIGH-RESOLUTION ULTRASONOGRAPHY OF SHOULDER FOR ROTATOR CUFF TEAR: CORRELATION WITH ARTHROSCOPIC FINDINGS

    Directory of Open Access Journals (Sweden)

    Vishnumurthy H. Y

    2016-09-01

    Full Text Available INTRODUCTION Rotator cuff disease is the most common cause of shoulder pain. Ultrasonography being non-invasive, widely available, more cost-effective method and is the first choice in imaging of rotator cuff tears. Arthroscopy of shoulder is considered as the gold standard for diagnosis of rotator cuff tears. Objective of this study was to compare the diagnostic accuracy of high-resolution ultrasonography of shoulder for rotator cuff tears with arthroscopy of shoulder. METHODS Thirty patients clinically suspected to have rotator cuff tear who underwent ultrasonography and arthroscopy of shoulder were included in the study. Duration of study was for two years. All ultrasonography examinations were conducted in ultrasound machine using GE Voluson 730 PRO high frequency (10-12 MHz linear array transducer done by two experienced radiologists. Arthroscopies were done by two experienced shoulder arthroscopic surgeons. RESULTS Age of the patients with rotator cuff tears ranged from 40 to 80 years. 57% were females and 43% were males among the patients who had rotator cuff tears. 71.43% of the rotator cuff tears were found in the dominant arm. 64.28% of patients with rotator cuff tear had given history of fall or trauma to the corresponding shoulder within 6 months prior to presentation. 39.28% of patients who had rotator cuff tears were known diabetics. Supraspinatus tendon was the most commonly affected tendon, followed by infraspinatus and subscapularis tendons. For overall detection of rotator cuff tears, ultrasonography in comparison with the arthroscopy has sensitivity and specificity of 92.85% and 100%. For detection of full thickness rotator cuff tear, its sensitivity and specificity was 94.73% and 100% and for partial thickness rotator cuff tears 76.92% and 100%. Ultrasonography has 100% sensitivity and specificity for detection of supraspinatus full thickness tear. For supraspinatus partial thickness tear, sensitivity and specificity was 88

  8. Arthroscopic treatment of ulnar impaction syndrome%尺骨撞击综合征的关节镜治疗

    Institute of Scientific and Technical Information of China (English)

    朱波; 赵力; 赵金岩

    2016-01-01

    ).The preoperative values of wrist range of motion (ROM) were 44.17°±6.22° at volar flexion,42.72°±3.37° at dorsal extension,17.45°±4.11° at radial deviation,19.12°±3.70° at ulnar deviation,66.81°±4.28° at pronation,and 70.27°±5.30° at supination.Arthroscopic exploration was conducted in all patients,aiming to observe the ulnar variance,wrist osteonecrosis,articular cartilage damage and triangular fibrocartilage complex tear.Arthroscopic synovectomy were performed in all cases;33 cases of articular cartilage injury were treated with arthroscopic chondroplasty;16 cases of osteonecrosis were treated with arthroscopic drilling decompression;30 cases with tear of TFC were treated with arthroscopic repair;26 cases with ulna positive mutation were treated with arthroscopic distal ulna resection.Patients were followed at 3,6,and 12 months after operation.At 12 months follow-up,the values of wrist range of motion was evaluated for volar flexion,dorsal extension,radial deviation,ulnar deviation,pronation,and supination.GreenO'Brien method was used to evaluate the function of wrist joint.Results Primary healing was presented in all patients without neurovascular injury and joint infection.All patients were followed up 12-36 months (mean,17.5 months).At 12 months followup,the values of ROM compared with that preoperative increased with significant difference,49.13° ±3.47° at volar flexion,47.13°±2.39° at dorsal extension,19.33°±3.29° at radial deviation,25.17°±4.89° at ulnar deviation,75.73°±7.66° at pronation,and 77.22°±4.89° at supination.According to Green-O'Brien standard,the results were excellent in 21 case,good in 17 cases and fair in 3 case,with 93% excellent and good rate.Conclusion Wrist arthroscopy dose not only contribute to the diagnosis in ulnar impingement syndrome but also can be used in treating inflammatory synovium and cartilage lesions,bone drilling decompression,TFC repair and arthroscopic distal ulna resection with improvement in the

  9. Heat exchanger repair

    International Nuclear Information System (INIS)

    There are two ways to rapir heater tubes in tubular heat exchangers, partial replacement of tubes and a technique called sleeving. In the former case, the defective tube section is cut out, removed, and replaced by a new section butt welded to the old piece of tube which remained in place. In the sleeving technique, a tube sleeve is slid into the defective tube and, after expansion, welded to the original tube. In this case, the welding technique employed is not laser welding, as is often maintained in the literature, but TIG pulsation welding. The results of preliminary tests and the qualification of both processes are outlined in the article; an account is given also of the replacement of the tube sections when repairing condensate coolers. (orig.)

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

    Science.gov (United States)

    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

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

    Science.gov (United States)

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

    2015-06-01

    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.

  12. A novel technique of rotator cuff repair using spinal needle and suture loop

    Directory of Open Access Journals (Sweden)

    Muzaffar Nasir

    2010-11-01

    Full Text Available Abstract Background We present a simple technique of arthroscopic rotator cuff repair using a spinal needle and suture loop. Methods With the arthroscope laterally, a spinal needle looped with PDS is inserted percutaneously into the shoulder posteriorly and penetrated through the healthy posterior cuff tear margin. Anteriorly, another spinal needle loaded with PDS is inserted percutaneously to engage the healthy tissue at the anterior tear margin. The suture in the anterior needle is then delivered into the suture loop of the posterior needle using a suture retriever. The posterior needle and loop are then pulled out carrying the anterior suture with it. The two limbs of this suture are then retrieved through a cannula for knotting. The same procedure is then repeated for additional suturing. Suture anchors placed over the greater tuberosity are used to complete the repair. Conclusion This is an easy method of rotator cuff repair using simple instruments and lesser time, hence can be employed at centers with less equipment and at reduced cost to the patient.

  13. Review of Arthroscopic and Histological Findings Following Knee Inlay Arthroplasty.

    Science.gov (United States)

    Markarian, Gregory G; Kambour, Michael T; Uribe, John W

    2016-01-01

    The phenomenon of cartilage rim loading in defects exceeding the threshold diameter of 10 mm is well documented. Contoured defect fill off-loads the perimeter and counteracts further delamination and progression of defects. When biological procedures have failed, inlay arthroplasty follows these concepts. The human biological response to contoured metallic surface implants has not been described. Four patients underwent non-implant-related, second-look arthroscopy following inlay arthroplasty for bi- (n=3) and tricompartmental (n=1) knee arthrosis without subchondral bone collapse. Arthroscopic probing of the implant-cartilage interface of nine prosthetic components did not show signs of implant-cartilage gap formation, loosening, or subsidence. The implant periphery was consistently covered by cartilage confluence leading to a reduction of the original defect size diameter. Femoral condyle cartilage flow appeared to have more hyaline characteristics. Trochlear cartilage flow showed greater histological variability and less organization with fibrocartilage and synovialized scar tissue. This review reconfirmed previous basic science results and demonstrated effective defect fill and rim off-loading with inlay arthroplasty.

  14. Arthroscopic assisted fixation for the distal radius fractures

    International Nuclear Information System (INIS)

    Anatomic reduction of the articular surface of the distal radius is still the main goal when treating fractures in the young population. Appropriate assessment of intra-articular reduction is difficult when performing open reduction and internal fixation without having to open the joint capsule. This preliminary report focuses on the description of the surgical technique, philosophy, indications and advantages of using wrist arthroscopy to assist fixation of distal radius fractures. Twenty-seven patients (16 males and 11 females) underwent arthroscopic assisted fixation for intra-articular distal radius fractures between March of 1999 and august of 2002. According to the AO classification there were 9 C1, 12 C2, 2 C3, 3 B1 and 1 B2. Average age was 41 years old (range: 18-48). Average follow up was 6 months. Patients were evaluated at final follow-up for wrist motion, pain and grip strength. Radiographic studies were also obtained to evaluate final position of the distal radius

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

    Directory of Open Access Journals (Sweden)

    Nevres Hurriyet Aydogan

    2013-01-01

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

  16. [Arthroscopic management of intra-articular fractures of the distal radius].

    Science.gov (United States)

    Cognet, J-M; Martinache, X; Mathoulin, C

    2008-09-01

    The use of arthroscopy in the management of intra-articular fractures of the distal radius has become established over the last ten years, but the operative technique is not yet standardised. We report our experience with this technique and give a stage by stage description of the operative procedure. The arthroscopic part of the procedure consists firstly of an evaluation of the bony, cartilaginous and ligamentous injuries and secondly direct visual control of the reduction. The choice of bone fixation depends on the individual preferences of the surgeon but may be influenced by the configuration of the fracture. A literature review reiterates the advantages of arthroscopic assistance in managing these fractures without revealing any disadvantages. However, mastery of the arthroscopic techniques is vital before the full advantages of this type of management can be realised. PMID:18774328

  17. The isokinetic study of different surgical procedures for the treatment of patients with arthroscopic knee meniscus%膝半月板损伤后关节镜手术不同术式的等速肌力测试分析

    Institute of Scientific and Technical Information of China (English)

    邵正海; 张玉发; 吕宏; 毕霞; 高亮亮; 刘小垒; 黄鑫凝

    2014-01-01

    目的:回顾性分析关节镜下行半月板缝合修整成型术和射频消融术的疗效差异,以向临床推广合适的术式。方法:对60例膝半月板损伤患者关节镜术后采取半月板缝合修整成型术和射频消融术,采用等速肌力测试比较两组治疗的差异。结果:观察组屈膝60°、120°时膝关节单次最大做功、力矩加速能、屈膝伸肌峰力矩测试和平均做功率均优于对照组,差异有统计学意义(P<0.05)。结论:半月板缝合修整成型术对膝半月板损伤关节镜手术后患者具有较好的改善,能够明显改善患者的预后状况。%Objective:Retrospective analysis of the isokinetic study of different surgical procedures for the treatment of arthroscopic meniscal suture repair angioplasty and radiofrequency ablation for patients with arthroscop-ic knee meniscus ,in order to promote the appropriate surgery methods for clinical treatment .Methods :60 cases of patients with knee meniscus injury were treated by the treatment of arthroscopic meniscal suture repair angioplasty and radiofrequency ablation and the isokinetic treatment were used to compared the difference between the two groups .Results :The knee maximum single acting ,torque acceleration energy ,knee extensor peak torque testing and average power of the observation group were better than those in the control group and all P <0 .05 .Conclu-sion:The treatment of arthroscopic meniscal suture repair angioplasty for the patients can significantly improve the patient's prognosis ,and worthy of clinical application .

  18. Patient Satisfaction and Clinical Efficacy Observation of Fixed Partial Denture and Removable Denture Repair for Denti-tion Defect%固定义齿与活动义齿修复牙列缺损临床疗效及患者满意度观察

    Institute of Scientific and Technical Information of China (English)

    周光英

    2014-01-01

    目的:探讨固定义齿与活动义齿修复牙列缺损的临床疗效及患者满意度。方法:将126例患者分为活动义齿组和固定义齿组两组,修复后通过问卷调查疗效及患者满意度。结果:固定义齿组患者在咀嚼功能、固定功能方面明显优于活动义齿组(P<0.001),在使用的方便、舒适以及佩戴美观程度方面,固定义齿组也明显优于活动义齿组(P<0.001)。但是在满意度方面,两组患者对费用、治疗过程以及治疗周期的评价相当( P>0.05 ),修复效果整体评价差异也没有统计学意义(P>0.05)。结论:牙列缺损患者对修复方式的满意程度和修复效果不完全相关,加强与患者的沟通,提前告知患者可能的疗效,可以帮助提高治疗满意度。%Objective :To explore patient satisfaction and clinical efficacy observation of fixed partial denture and re‐movable denture repair for dentition defect .Methods :126 patients were divided into fixed partial denture group and re‐movable denture group ,the treatment effect and satisfaction were investigated by questionnaire .Results:The masticato‐ry function and fix function in group of fixed denture is better than removable denture group (P0 .05) . Conclusion:The repair satisfaction of patients with dentition defects is not completely related to the repair effect .By strengthening communication and informed patients the expected effect in advance ,it can improve the treatment satis‐faction .

  19. Use of a Bone Graft Drill Harvester to Create the Fenestration During Arthroscopic Ulnohumeral Arthroplasty.

    Science.gov (United States)

    Wijeratna, Malin D; Ek, Eugene T; Hoy, Gregory A; Chehata, Ash

    2015-10-01

    The Outerbridge-Kashiwagi procedure, or ulnohumeral arthroplasty, was described in 1978 as a method of treating elbow arthritis by creating a fenestration in the olecranon fossa. This fenestration diminishes the likelihood of recurrent spurs in the olecranon fossa and coronoid fossa, without loss of structural bony strength. Arthroscopic techniques have now been developed to perform this procedure. We describe an efficient method of creating the fenestration between the olecranon fossa and coronoid fossa during an arthroscopic ulnohumeral arthroplasty, or Outerbridge-Kashiwagi procedure, that also reduces the amount of residual bone debris produced during the resection.

  20. Technique of synovial biopsy of metacarpophalangeal joints using the needle arthroscope.

    Science.gov (United States)

    Gáspár, Levente; Szekanecz, Zoltán; Dezso, Balázs; Szegedi, Gyula; Csernátony, Zoltán; Szepesi, Kálmán

    2003-01-01

    We demonstrate the technique, advantages, and disadvantages of metacarpophalangeal joint examination with needle arthroscope. We evaluated our experience from biopsies of 10 metacarpophalangeal joints of eight rheumatoid women aged 41-45 years. The procedures were performed using a 1-mm needle arthroscope. The synovium biopsy was taken with a microforceps. The procedure was performed under local anesthesia. The tight tension of the joint and traction of the finger is necessary for good visualization, but despite this visibility can be difficult. Needle biopsy is a useful method for the early diagnosis of rheumatoid arthritis. PMID:12548452

  1. 磁性、球帽附着体和传统卡环固位体在老年下颌可摘局部义齿修复中的应用价值比较%Comparative of application value among the magnetic attachments,cap attachment and traditional snap ring retainer in elderly patients with mandibular removable partial denture repair

    Institute of Scientific and Technical Information of China (English)

    王一敏

    2012-01-01

    Objective To investigate the application value of magnetic attachments, cap attachment and traditional snap ring retainer in the elderly patients with mandibular removable partial denture repair. Methods 60 cases of elderly patients with dentition defects in our hospital from March 2009 to March 2010 were selected, 20 cases of patients (40 abutments) were given installation of magnetic attachment ( magnetic group), 20 cases of patients(40 abutments) were given installation of cap attachment (cap group), other 20 cases of patients(40 abutments) were given clasp retention repair (snap ring group), repair satisfaction of three groups of patients after treatment was followed-up and periodontal pocket depth, alveolar bone height were measured. Results The repair satisfaction of magnetic group in aesthetics, retention, comfort and chew aspects were significantly higher than the snap ring group, the differences were all statistically significant (all P < 0.05), the differences of gingival index and tooth mobility among the three groups were statistically significant (P < 0.05), periodontal pocket depth of magnetic group and cap group was statistically different from snap ring group (P < 0.05), the differences of alveolar bone height between three groups were statistically significant (P < 0.05). Conclusion The magnetic attachments in the elderly patients with mandibular removable partial denture repair can fix better, patients' comfort is significantly better than the cap and snap ring, it can reduce the absorption of alveolar bone, ensure the periodontal health and the stability of the abutment teeth, then increase the service life of the denture, so it is worthy of clinical application.%目的 探讨磁性附着体、球帽附着体和传统卡环固位体在老年下颌可摘局部义齿修复中的应用价值.方法 选择本院2009年3月~2010年3月收治的老年牙列缺损患者60例,其中20例患者下颌40颗基牙安装磁性附着体(磁性组),20

  2. Patch-Augmented Rotator Cuff Repair and Superior Capsule Reconstruction

    Science.gov (United States)

    Petri, M.; Greenspoon, J.A.; Moulton, S.G.; Millett, P.J.

    2016-01-01

    Background: Massive rotator cuff tears in active patients with minimal glenohumeral arthritis remain a particular challenge for the treating surgeon. Methods: A selective literature search was performed and personal surgical experiences are reported. Results: For patients with irreparable rotator cuff tears, a reverse shoulder arthroplasty or a tendon transfer are often performed. However, both procedures have rather high complication rates and debatable long-term results, particularly in younger patients. Therefore, patch-augmented rotator cuff repair or superior capsule reconstruction (SCR) have been recently developed as arthroscopically applicable treatment options, with promising biomechanical and early clinical results. Conclusion: For younger patients with irreparable rotator cuff tears wishing to avoid tendon transfers or reverse total shoulder arthroplasty, both patch-augmentation and SCR represent treatment options that may delay the need for more invasive surgery.

  3. Effect of Exercise Therapy Compared with Arthroscopic Surgery on Knee Muscle Strength and Functional Performance in Middle-Aged Patients with Degenerative Meniscus Tears

    DEFF Research Database (Denmark)

    Stensrud, Silje; Risberg, May Arna; Roos, Ewa M.

    2015-01-01

    group improved isokinetic knee extension peak by a mean of 25 Nm (range, 18-33 Nm) from baseline to follow-up. Furthermore, patients assigned to exercise therapy showed statistically significant improvements (P ≤ 0.002) in all other measured variables, with moderate to large effect sizes (0......OBJECTIVE: The aim of this study was to compare the effect of a 12-wk exercise therapy program and arthroscopic partial meniscectomy on knee strength and functional performance in middle-aged patients with degenerative meniscus tears. DESIGN: A total of 82 patients (mean age, 49 yrs; 35% women...... isokinetic knee muscle strength, lower extremity performance, and self-reported global rating of change. RESULTS: Mean difference in isokinetic knee extension peak torque between the two groups was 16% (95% confidence interval, 7.1-24.0) (P group. Patients in the exercise...

  4. FUNCTIONAL OUTCOME OF ARTHROSCOPIC RECONSTRUCTION OF ANTERIOR CRUCIATE LIGAMENT TEARS

    Directory of Open Access Journals (Sweden)

    Ashok Kumar

    2016-02-01

    Full Text Available BACKGROUND Anterior Cruciate Ligament (ACL tear is the most common serious ligamentous injury to the knee joint. Anterior Cruciate Ligament (ACL injury is quite common among young active population, athletes and contact sports. The exact incidence of anterior cruciate ligament tears is not known as the cases are being under reported. The ACL is the primary stabilizer against anterior translation of the tibia on the femur and is important in counteracting rotation and valgus stress. MATERIALS AND METHODS Between November 2012 to October 2014, 34 consecutive patients who underwent arthroscopic assisted ACL reconstructions in the Department of Orthopedics and Traumatology, King George Hospital, Visakhapatnam were the material in our study. Age groups between 18 to 45 years considered. We utilised both BPTB and Quadrupled hamstring graft depending on the patient’s age, outcome testing in all cases was performed at the latest follow-up (at least 6 months. Post-operative physiotherapy rehabilitation protocol followed for 06 months. RESULTS Standard protocol of Lysholm and IKDC knee scoring system were used for evaluation of the results of the surgery during followup. Patients were evaluated periodically at preop, 3 months, 6 months, 12 months, 18 months and 24 months. CONCLUSION Patients with isolated ACL injury had better outcome compared to patients who underwent associated meniscectomy. Most common mechanism of injury was activity of sports in 20 patients. Postoperatively at 3 months, anterior drawer’s was 1+ in 6, 29 (85.2% patients had normal range of motion; 29 (85.29% patients had 5/5 quadriceps power (MRC grading 94% of them had 5/5 power at latest followup. No significant difference between outcomes of BPTB and Hamstrings graft. Functional outcome of our study were similar to the previously published studies.

  5. Ceramic restoration repair: report of two cases

    Directory of Open Access Journals (Sweden)

    Luís Henrique Araújo Raposo

    2009-04-01

    Full Text Available The esthetic and functional rehabilitation of patients with multiple missing teeth can be performed with several techniques and materials. Ceramic restorations provide reliable masticatory function and good esthetics. However, fracture can occur in some cases due to their brittle behavior. In some cases, the replacement of an extensive prosthesis is a problem due to the high treatment cost. In this paper, two cases are presented, in which fractures occurred in extensive metal-ceramic fixed partial dentures, and their replacement was not possible. Ceramic repair was chosen and the sequences of treatment with and without presence of the ceramic fragment are also discussed. The cases illustrate that, in some situations, fractured metal-ceramic partial dentures can be successfully repaired when prosthetic replacement is not a choice. Prosthodontists must use alternatives that allow a reliable repair to extensive metal-ceramic fixed partial dentures. Surface preparation of the ceramic with hydrofluoric acid in conjunction with a silane coupling agent is essential for a predictable bonding of composite resin. The repair performed with composite resin is an esthetic and functional alternative when extensive fixed partial dentures cannot be replaced.

  6. Automatic ICRS scoring of cartilage lesions using arthroscopic OCT images

    NARCIS (Netherlands)

    te Moller, Nikae; Pitkanen, M; Liukkonen, J.; Puhakka, P H; Brommer, Harold; Jurvelin, J.S.; van Weeren, René; Toyras, J.

    2014-01-01

    Articular cartilage injury is a common cause of chronic disability in both humans and animals. Current treatment strategies offer several possibilities and in order to select the optimal repair procedure, accurate determination of size and severity of a lesion is important [1,2]. Recently, an equine

  7. 关节镜下治疗骨性膝关节炎56例临床分析%Clinical analysis of arthroscopic treatment of 56 cases with osteoarthritis

    Institute of Scientific and Technical Information of China (English)

    梁现会; 尚志平

    2015-01-01

    Objective:To investigate the clinical effect of arthroscopic treatment on osteoarthritis.Methods:56 cases with osteoarthritis were treated with arthroscopically assisted meniscus repair,synovial hyperplasia,cartilage resection of loose bodies and broken extraction,the removal of osteophytes and lateral retinacular release,postoperative joint Chinese herbal fumigation.Results: According to the evaluation standard of curative effect,among the 62 knees in the group,21 knees were cured excellent,24 knees satisfactory,11 knees acceptable,6 knees poor recovered and the total effective rate was 90.3%.Conclusion:Arthroscopic treatment of knee osteoarthritis has significant curative effect with small trauma and low cost which is an effective method for the treatment of knee osteoarthritis.%目的:探讨关节镜下治疗膝骨性关节炎的临床疗效。方法:对56例骨性膝关节炎采用关节镜下半月板修复、增生滑膜切除、游离体及破碎软骨摘除、切除部分骨赘及外侧支持带松解、术后关节中药熏洗等方法。结果:根据疗效评价标准评价疗效,本组共62个膝,优21个,良24个,可11个,差6个,总有效率90.3%。结论:关节镜下治疗骨性膝关节炎疗效肯定,创伤小,费用低,是治疗膝骨性关节炎的有效方法。

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

    Science.gov (United States)

    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.

  9. Adductor canal blockade for moderate to severe pain after arthroscopic knee surgery

    DEFF Research Database (Denmark)

    Espelund, M; Grevstad, U; Jaeger, P;

    2014-01-01

    BACKGROUND: The analgesic effect of the adductor canal block (ACB) after knee surgery has been evaluated in a number of trials. We hypothesized that the ACB would provide substantial pain relief to patients responding with moderate to severe pain after arthroscopic knee surgery. METHODS: Fifty...

  10. Analgesic efficacy of intra-articular morphine after arthroscopic knee surgery in sport injury patients

    Directory of Open Access Journals (Sweden)

    Mitra Yari

    2013-07-01

    Full Text Available BACKGROUND: Anterior Cruciate Ligament (ACL tearing is a common injury among football players. The present study aims to determine the best single-dose of intra-articular morphine for pain relief after arthroscopic knee surgery that, in addition to adequate and long-term analgesia, leads to fewer systemic side effects. METHODS: This clinical trial was conducted on 40 ASA-I athletes. After surgery, all participants received an injection of 20cc of 0.5% intra-articular bupivacaine. In addition, the first control group received a saline injection and 5, 10 and 15 mg of morphine were respectively injected into the joints of the second, third and fourth groups by use of Arthroscopic equipment before the Arthroscopic removal. The amount of pain based on VAS at 1, 2, 4, 6 and 24 hours after surgery, duration of analgesia and the consumption of narcotic drugs were recorded. RESULTS: The VAS scores in the fourth, sixth and twenty-fourth hours after surgery showed a significant difference between the study groups. The average time to the first analgesic request from the bupivacaine plus 15 mg morphine group was significantly longer than other groups and total analgesic requests were significantly lower than other groups. No drowsiness complications were observed in any of the groups in the first 24 hours after injection. CONCLUSION: Application of 15 mg intra-articular morphine after Arthroscopic knee surgery increases the analgesia level as well as its duration (IRCT138902172946N3 .

  11. The efficacy of adductor canal blockade after minor arthroscopic knee surgery

    DEFF Research Database (Denmark)

    Espelund, M; Fomsgaard, J S; Haraszuk, J;

    2014-01-01

    BACKGROUND: Adductor canal blockade (ACB) has been demonstrated to be effective in the treatment of post-operative pain after major knee surgery. We hypothesised that the ACB would reduce pain and analgesic requirements after minor arthroscopic knee surgery. METHODS: Seventy-two patients schedule...

  12. Arthroscopically assisted osteosynthesis of tibial plateau fractures in patients older than 55 years

    NARCIS (Netherlands)

    Roerdink, WH; Oskam, J; Vierhout, PAM

    2001-01-01

    Purpose: To evaluate the end results of arthroscopically assisted osteosynthesis of tibial plateau fractures in patients older than 55 years of age. Type of Study: Case series. Methods: Over a 5-year period, 201 consecutive patients presented with tibial plateau fracture; 131 of these patients were

  13. Editorial Commentary: Arthroscopic Hip Preservation Is Critical for Preserving Health and Function in Adolescents and Adults.

    Science.gov (United States)

    Martin, Hal David

    2016-09-01

    Hip health is a critical factor in preserving daily life activities and wellbeing for both adults and adolescents. There are several potential economic influences in developing arthroscopic hip techniques for the evaluation and treatment of hip pathology in patients of all ages. PMID:27594331

  14. Application of optical coherence tomography enhances reproducibility of arthroscopic evaluation of equine joints

    NARCIS (Netherlands)

    Niemelä, Tytti; Virén, Tuomas; Liukkonen, Jukka; te Moller, Nikae; Puhakka, Pia H.; Jurvelin, Jukka S.; Tulamo, R.M.; Töyräs, Juha

    2014-01-01

    Background: Arthroscopy is widely used in various equine joints for diagnostic and surgical purposes. However, accuracy of defining the extent of cartilage lesions and reproducibility in grading of lesions are not optimal. Therefore, there is a need for new, more quantitative arthroscopic methods. A

  15. Treatment of intra-articular fractures of the distal radius: fluoroscopic or arthroscopic reduction?

    Science.gov (United States)

    Varitimidis, S E; Basdekis, G K; Dailiana, Z H; Hantes, M E; Bargiotas, K; Malizos, K

    2008-06-01

    In a randomised prospective study, 20 patients with intra-articular fractures of the distal radius underwent arthroscopically- and fluoroscopically-assisted reduction and external fixation plus percutaneous pinning. Another group of 20 patients with the same fracture characteristics underwent fluoroscopically-assisted reduction alone and external fixation plus percutaneous pinning. The patients were evaluated clinically and radiologically at follow-up of 24 months. The Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire and modified Mayo wrist score were used at 3, 9, 12 and 24 months postoperatively. In the arthroscopically- and fluoroscopically-assisted group, triangular fibrocartilage complex tears were found in 12 patients (60%), complete or incomplete scapholunate ligament tears in nine (45%), and lunotriquetral ligament tears in four (20%). They were treated either arthroscopically or by open operation. Patients who underwent arthroscopically- and fluoroscopically-assisted treatment had significantly better supination, extension and flexion at all time points than those who had fluoroscopically-assisted surgery. The mean DASH scores were similar for both groups at 24 months, whereas the difference in the mean modified Mayo wrist scores remained statistically significant. Although the groups are small, it is clear that the addition of arthroscopy to the fluoroscopically-assisted treatment of intra-articular distal radius fractures improves the outcome. Better treatment of associated intra-articular injuries might also have been a reason for the improved outcome. PMID:18539672

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

    Directory of Open Access Journals (Sweden)

    Kurji HM

    2015-11-01

    Full Text Available Hafeez M Kurji,1 Yohei Ono,2,3 Atiba A Nelson,2 Kristie D More,2 Ben Wong,4 Corinne Dyke,4 Richard S Boorman,2 Gail M Thornton,2,5 Ian KY Lo2 1College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada; 2Department of Surgery, Section of Orthopaedic Surgery, McCaig Institute for Bone and Joint Health, University of Calgary, Calgary, AB, Canada; 3Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan; 4Department of Radiology, University of Calgary, Calgary, AB, Canada; 5Department of Orthopaedics, University of British Columbia, Vancouver, BC, Canada Background: Arthroscopic repair of type II superior labrum from anterior to posterior (SLAP lesions is a common surgical procedure. However, anatomic healing following repair has rarely been investigated. The intraobserver and interobserver reliability of magnetic resonance imaging arthrography (MRA following type II SLAP repair has not previously been investigated. This is of particular interest due to recent reports of poor clinical results following type II SLAP lesion repair. Purpose: To evaluate the MRA findings following arthroscopic type II SLAP lesion repair and determine its intraobserver and interobserver reliability. Study design: Cohort study (diagnosis, Level of Evidence, 2. Methods: Twenty-five patients with an isolated type II SLAP lesion (confirmed via diagnostic arthroscopy underwent standard suture anchor-based repair. At a mean of 25.2 months postoperatively, patients underwent a standardized MRA protocol to investigate the integrity of the repair. MRAs were independently reviewed by two radiologists and a fellowship trained shoulder surgeon. The outcomes were classified as healed SLAP repair or re-torn SLAP repair. Results: On average, 54% of MRAs were interpreted as healed SLAP repairs while 46% of MRAs were interpreted as having a re-torn SLAP repair. Overall, only 43% of the studies had 100% agreement across all

  17. Tissue Engineering for Rotator Cuff Repair: An Evidence-Based Systematic Review

    Directory of Open Access Journals (Sweden)

    Nicola Maffulli

    2012-01-01

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

  18. ARTHROSCOPIC DEBRIDEMENT IN OSTEOARTHROSIS OF KNEE JOINT - ANALYSIS OF SHORT TERM BENEFITS

    Directory of Open Access Journals (Sweden)

    Jayakrishnan

    2015-08-01

    Full Text Available BACKGROUND: Many studies have reported symptomatic relief after arthroscopic debridement of knee for osteoarthrosis. The purpose of the study is to find out the outcome of arthroscopic debridement in osteoarthrosis of knee and to arrive at a consensus regarding the subsets of patients with osteoarthrosis who will benefit from the procedure. MATERIALS AND METHODS : 30 patients with osteoarthrosis were subjected for arthroscopic debridement. Patients included were of age greater than 50 years. Standard antero - posterior and lateral radiographs of knee were taken and grading was done using Kellegren and Lawrence system. Arthroscopic grading was done using the Outer bridge classification. Outcomes were assessed at multiple intervals over a 12 month period with a knee score and a functional score. RESULTS: Results were analyzed based on Knee society clinical rating system (1989. At the end of 1month 86.6% had excellent to good results. At the end of 6 months 60% had excellent to good results. At the end of 1 year 37.6% had excellent to good results. At six months follow up results was also evaluated based on different variables - varus deformity, radiographic and arthroscopic grading. Patients with malalignment more than 10 degrees and those with radiographic grading 3 or more were associated with poor results. CONCLUSION: Patients with mild to moderate osteoarthrosis benefitted with excellent to good results from the procedur e. Results were good and long lasting particularly if there was minimal or no malalignment of knee or there was associated mechanical restriction of movement due to meniscal tear or loose bodies.

  19. Laparoscopic Inguinal Hernia Repair

    Science.gov (United States)

    ... wall to weaken or separate. What are the Advantages of Laparoscopic Inguinal Hernia Repair? Laparoscopic Hernia Repair ... underlying medical conditions. What Preparation is Required? Keep reading... Page 1 of 2 1 2 » Brought to ...

  20. Rotator Cuff Repair

    Medline Plus

    Full Text Available ... wouldn't recommend a repair and are there treatments that you would do prior to repairing?" So, ... and certain people that you would recommend other treatments?" 00:08:59 JOHN URIBE, M.D.: That's ...

  1. Rotator Cuff Repair

    Medline Plus

    Full Text Available ... qualified therapist, which is also key that they stress the repair enough that it strengthens the repair ... that they're involved in one of our studies and there's a question of, he's involved in ...

  2. Aortic Aneurysm Repair

    Medline Plus

    Full Text Available ... to become you to our live webcast. Today we’re going to repair an abdominal aortic aneurysm ... and together as a team of multidisciplinary physicians, we’re going to repair an abdominal aortic aneurysm ...

  3. Rotator Cuff Repair

    Medline Plus

    Full Text Available ... qualified therapist, which is also key that they stress the repair enough that it strengthens the repair ... D.: Fiddle factor to it, a little skill level. I was going to use the term skill ...

  4. Applications of repaired endonucleases

    International Nuclear Information System (INIS)

    The possibilities of using antimutagenously various endonucleases are discussed. Since mutageniety of excision repair is considerably lower than the repair in the replication moment or after thereof the intensification of the excision repair of premutation disorders can suppress mutagenesis. Experimental aproaches of using repair endonucleases for sounding premutation changes are described. The optimal object has been chosen for endonuclear sounding of premutation DNA disorders following an ionizing radiation action

  5. MRI assessment of tibial tunnel and its relation to complication following arthroscopic reconstruction of anterior cruciate ligament

    Directory of Open Access Journals (Sweden)

    Nadia F. El Ameen

    2014-09-01

    Conclusion: Anterior cruciate ligament reconstruction is one of the most commonly performed sports medicine procedures. MRI proved as an accurate method for post arthroscopic reconstruction evaluation that can help predict post ACL reconstruction complication.

  6. Dry arthroscopy with a retraction system for matrix-aided cartilage repair of patellar lesions.

    Science.gov (United States)

    Sadlik, Boguslaw; Wiewiorski, Martin

    2014-02-01

    Several commercially available cartilage repair techniques use a natural or synthetic matrix to aid cartilage regeneration (e.g., autologous matrix-induced chondrogenesis or matrix-induced cartilage implantation). However, the use of matrix-aided techniques during conventional knee joint arthroscopy under continuous irrigation is challenging. Insertion and fixation of the matrix can be complicated by the presence of fluid and the confined patellofemoral joint space with limited access to the lesion. To overcome these issues, we developed a novel arthroscopic approach for matrix-aided cartilage repair of patellar lesions. This technical note describes the use of dry arthroscopy assisted by a minimally invasive retraction system. An autologous matrix-induced chondrogenesis procedure is used to illustrate this novel approach.

  7. The Double-Pulley Anatomic Technique for Type II SLAP Lesion Repair.

    Science.gov (United States)

    Parnes, Nata; Ciani, Mario; Carr, Brian; Carey, Paul

    2015-10-01

    The annual incidence and number of repairs of SLAP lesions in the United States are constantly increasing. Surgical repairs of type II SLAP lesions have overall good success rates. However, a low satisfaction rate and low rate of return to preinjury level of play remain a challenge with elite overhead and throwing athletes. Recent anatomic studies suggest that current surgical techniques over-tension the biceps anchor and the superior labrum. These studies suggest that restoration of the normal anatomy will improve clinical outcomes and sports performance. We present a "double-pulley" technique for arthroscopic fixation of type II SLAP lesions. In this technique the normal anatomy is respected by preserving the mobility of the articular aspect of the superior labrum while reinforcing the biceps anchor and its posterior fibers medially.

  8. COMPREHENSIVE POST‐ARTHROSCOPIC MANAGEMENT OF A MIDDLE‐AGED ADULT WITH GLENOHUMERAL OSTEOARTHRITIS: A CASE REPORT

    OpenAIRE

    Hagen, Nicholas D.; Olson, Thomas; Millett, Peter

    2013-01-01

    Comprehensive Arthroscopic Management (CAM) is a new glenohumeral debridement procedure developed as a joint preserving alternative to total shoulder arthroplasty (TSA). The procedure consists of several arthroscopic components including: A. scar tissue and chondral debridement, B. synovectomy, C. inferior humeral osteoplasty, D. capsular release, E. axillary nerve decompression, and F. tenodesis of the long head of the biceps. In this case, an active, middle age patient who failed physical t...

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

    OpenAIRE

    Hamid Reza Aslani; Zohreh Zafarani; Adel Ebrahimpour; Shahin Salehi; Ali Moradi; Soheil Sabzevari

    2014-01-01

    Background:   To assess the outcome of the remplissage arthroscopic surgical method in patients with anterior shoulder dislocation associated with Hill-Sachs lesion.     Methods:   Ten patients with anterior shoulder dislocations and Hill-Sachs lesions were entered into this study and were operated on by the remplissage arthroscopic surgical method. They were followed up 22 months after surgery in   order to evaluate the outcome of the treatment, including recurrence of dislocation and motion...

  10. Effects of interscalene brachial plexus block to intra-operative hemodynamics and postoperative pain for arthroscopic shoulder surgery

    OpenAIRE

    Lee, Hyun-Young; Kim, Sang Hun; So, Keum Yung; Kim, Dong Jun

    2012-01-01

    Background Although arthroscopic shoulder surgery is less invasive and painful than open shoulder surgery, it can often cause intra-operative hemodynamic instability and severe post-operative pain. This study was conducted to investigate the efficacy of the interscalene brachial plexus block (IBPB) on intra-operative hemodynamic changes and post-operative pain during arthroscopic shoulder surgery. Methods After institutional review board approval, 50 consecutive patients that had undergone ar...

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

    OpenAIRE

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

    2013-01-01

    Objectives To report the five-year results of a randomised controlled trial examining the effectiveness of arthroscopic acromioplasty in the treatment of stage II shoulder impingement syndrome. Methods A total of 140 patients were randomly divided into two groups: 1) supervised exercise programme (n = 70, exercise group); and 2) arthroscopic acromioplasty followed by a similar exercise programme (n = 70, combined treatment group). Results The main outcome measure was self-reported pain as mea...

  12. Arthroscopic button plate fixation therapy for instable distal clavicular fracture%关节镜下纽扣钢板固定术治疗不稳定锁骨远端骨折

    Institute of Scientific and Technical Information of China (English)

    陈建海; 党育; 付中国; 姜保国

    2015-01-01

    Background The cases of distal clavicular fracture account for 12%-1 5% of all clavicular fracture cases.Distal clavicular fracture combined with coracoclavicular ligament rupture frequently behave as unstable fracture,with the opportunity for fracture non-union in conservative therapy being as high as 21%.Although partial patients with fracture nonunion show mild clinical symptoms,the symptomatic nonunion may affect the functions of shoulder joint.Therefore,most of physicians suggest operative treatment for unstable distal clavicular fracture.The operative treatment can achieve fracture union rate up to 98%.The distal clavicular fracture is characterized by fracture combined with ligament injury, and there are also diversified clinical therapies. The frequently reported internal fixation methods include kirschner wire,tension band,coraco-clavicular screw, anchor,clavicular hook plate,anatomical locking plate as well as suture fixation,etc.After fracture union,the metallic internal implants are frequently required to be taken out through operation. Different therapies have both their advantages and disadvantages.At present,there has been no unified therapy for unstable distal clavicular fracture.Arthroscopic button plate fixation therapy for unstable distal clavicular fracture is a relatively new minimally invasive treatment method,and its technology is originated from arthroscopic button plate fixation for the treatment of dislocation of acromioclavicular joint.We made retrospective analysis on the clinical effects of arthroscopic button plate fixation on distal clavicular fracture and discussed the potential advantages and disadvantages of this therapy.Method Ⅰ.General materials:Twenty-one patients with unstable distal clavicular fracture who received operative treatment in our department during the period from September 2010 to December 2012 are collected,seventeen cases of these meet inclusion criteria,namely 10 male cases and 7 female cases,with an average

  13. Mechanical characterization of composite repairs for fiberglass wind turbine blades

    Science.gov (United States)

    Chawla, Tanveer Singh

    affects the propagation fracture toughness values of the repair. Repairs conducted on surfaces with partially ground top plies possess higher fracture toughness values than those conducted on surfaces with complete top plies ground off. The three top repair resin candidates were then evaluated against the base repair resin under fatigue loading. The specimen configuration and testing method were chosen so as to be able to test hand layup repairs under tension -- tension cyclic loading. It was observed that all three new repair resins perform better than the base repair resin. The selection of the optimum repair resin was based on results from mode I and fatigue testing. Global manufacturing regulations and standards were also of prime concern. The final new repair resin is being used by the company in all of its plants over the globe. The balance of this work involves study of the effect of mixed mode I -- mode II loading on the strength of repairs conducted on fiber reinforced composite parts using hand lay-up technique. The specimens for this part were similar to those manufactured for mode I testing but with different dimensions and layup. They were made and tested in accordance with ASTM D 6671 (Standard Test Method for Mixed Mode I -- Mode II Interlaminar Fracture Toughness of Unidirectional Fiber Reinforced Polymer Matrix Composites). Comparison was made between the fracture toughness of the above chosen optimum repair resin and the base repair resin. At least two levels of mode mixture GII/G (Mode II fracture toughness / Mode I and II fracture toughness) were examined. Also, two levels of grinding were considered (complete ply vs. partial ply ground off) in order to establish the influence of varying top-ply grinding depths on the strength of hand layup repairs conducted on fiberglass composite structures. The results of this work have the potential to improve the repair process for current fiberglass wind turbine blades.

  14. Pseudocyclops: two cases of ACL graft partial tears mimicking cyclops lesions on MRI.

    Science.gov (United States)

    Simpfendorfer, Claus; Miniaci, Anthony; Subhas, Naveen; Winalski, Carl S; Ilaslan, Hakan

    2015-08-01

    Arthroscopic reconstruction of the anterior cruciate ligament (ACL) using autografts or allografts is a common surgical procedure, particularly in young athletes. Although the procedure has excellent success rates, complications such as mechanical impingement, graft rupture, and arthrofibrosis can occur, often necessitating additional surgery. Magnetic resonance (MR) imaging has become a valuable tool in evaluating complications after ACL reconstruction. We report two cases of ACL reconstruction complicated by arthroscopically proven partial graft tears. In both cases the torn anterior graft fibers were flipped into the intercondylar notch, mimicking anterior arthrofibrosis, i.e., a "cyclops lesion," on MR imaging. Careful review of the direction of graft fibers on MR imaging in the "pseudocyclops" lesions can help differentiate these partial tears from the fibrosis of a true cyclops. The "pseudocyclops" lesion is a previously undescribed MR imaging sign of partial ACL graft tear. Larger studies are required to determine the sensitivity and specificity of the sign, as well as the clinical importance of these partial graft tears. PMID:25620690

  15. Pseudocyclops: two cases of ACL graft partial tears mimicking cyclops lesions on MRI

    Energy Technology Data Exchange (ETDEWEB)

    Simpfendorfer, Claus; Subhas, Naveen; Winalski, Carl S.; Ilaslan, Hakan [Cleveland Clinic, Department of Radiology, Cleveland, OH (United States); Miniaci, Anthony [Cleveland Clinic, Department of Orthopedics, Cleveland, OH (United States)

    2015-08-15

    Arthroscopic reconstruction of the anterior cruciate ligament (ACL) using autografts or allografts is a common surgical procedure, particularly in young athletes. Although the procedure has excellent success rates, complications such as mechanical impingement, graft rupture, and arthrofibrosis can occur, often necessitating additional surgery. Magnetic resonance (MR) imaging has become a valuable tool in evaluating complications after ACL reconstruction. We report two cases of ACL reconstruction complicated by arthroscopically proven partial graft tears. In both cases the torn anterior graft fibers were flipped into the intercondylar notch, mimicking anterior arthrofibrosis, i.e., a ''cyclops lesion,'' on MR imaging. Careful review of the direction of graft fibers on MR imaging in the ''pseudocyclops'' lesions can help differentiate these partial tears from the fibrosis of a true cyclops. The ''pseudocyclops'' lesion is a previously undescribed MR imaging sign of partial ACL graft tear. Larger studies are required to determine the sensitivity and specificity of the sign, as well as the clinical importance of these partial graft tears. (orig.)

  16. Large myelomeningocele repair

    Directory of Open Access Journals (Sweden)

    Farideh Nejat

    2011-01-01

    Full Text Available Background: Wound closure is accomplished in most cases of myelomeningocele (MMC by undermining of the skin edges surrounding the defect. However, large defects cannot be closed reliably by this simple technique. Due to the technical challenge associated with large MMC, surgeons have devised different methods for repairing large defects. In this paper, we report our experience of managing large defects, which we believe bears a direct relationship to decrease the incidence of wound complications. Materials and Methods: Forty children with large MMCs underwent surgical repair and represent our experience. We recommend using all hairy skin around the defect as a way to decrease the tension on the edges of the wound and the possible subsequent necrosis. It is our experience that vertical incision on one or two flanks parallel to the midline can decrease the tension of the wound. Moreover, ventriculo-peritoneal shunting for children who developed hydrocephalus was performed simultaneously, which constitutes another recommendation for preventing fluid collection and build up of pressure on the wound. Results: Patients in this study were in the age range of 2 days to 8 years. The most common location of MMC was in the thoracolumbar area. All but four patients had severe weakness in lower extremities. We used as much hairy skin around the MMC sac as possible in all cases. Vertical incisions on one or both flanks and simultaneous shunt procedure were performed in 36 patients. We treated children with large MMC defects with acceptable tension-free closure. Nonetheless, three patients developed superficial skin infection and partial wound dehiscence, and they were managed conservatively. Conclusions: We recommend using all hairy skin around the MMC defect for closure of large defects. In cases that were expected to be at a higher risk to develop dehiscence release incisions on one or two flanks towards the fascia were found to be useful. Simultaneous

  17. Effect of continuous passive motion on functional recovery after senile arthroscope operation of knee joint%持续被动活动对老年膝关节镜术后功能恢复的作用

    Institute of Scientific and Technical Information of China (English)

    李泓

    2003-01-01

    @@ INTRODUCTION With popularit and development of arthroscope technique, it has been broadly ursed in treatment of disease of knee joint. Rehabilitation after arthroscope operation especially after senile arthxoscope operation of knee joint is very important.

  18. Arthroscopic lysis of adhesions for the stiff total knee: results after failed manipulation.

    Science.gov (United States)

    Tjoumakaris, Fotios Paul; Tucker, Bradfords Chofield; Post, Zachary; Pepe, Matthew David; Orozco, Fabio; Ong, Alvin C

    2014-05-01

    Arthrofibrosis after total knee arthroplasty (TKA) is a potentially devastating complication, resulting in loss of motion and function and residual pain. For patients in whom aggressive physical therapy and manipulation under anesthesia fail, lysis of adhesions may be the only option to rescue the stiff TKA. The purpose of this study is to report the results of arthroscopic lysis of adhesions after failed manipulation for a stiff, cruciate-substituting TKA. This retrospective study evaluated patients who had undergone arthroscopic lysis of adhesions for arthrofibrosis after TKA between 2007 and 2011. Minimum follow-up was 12 months (average, 31 months). Average total range of motion of patients in this series was 62.3°. Average preoperative flexion contracture was 16° and average flexion was 78.6°. Statistical analysis was performed using Student's t test. Pre- to postoperative increase in range of motion was significant (Psurgery.

  19. Over-optimistic patient expectations of recovery and leisure activities after arthroscopic meniscus surgery

    DEFF Research Database (Denmark)

    Pihl, Kenneth; Roos, Ewa M; Nissen, Nis;

    2016-01-01

    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......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...... 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...

  20. Osteoid osteoma (OO of the coracoid: a case report of arthroscopic excision and review of literature

    Directory of Open Access Journals (Sweden)

    Goyal Saumitra

    2015-01-01

    Full Text Available Osteoid osteoma (OO of the coracoid is a rare entity that may present with variable symptoms from shoulder leading to delay in diagnosis and treatment. We present the clinical and radiological findings and management of one such case along with a review of similar cases reported in the literature. There was a delay of 2 years in diagnosis, which was later confirmed by computed tomography in addition to magnetic resonance imaging (MRI. The lesion was accessed arthroscopically and excised by unroofing and curettage. “OO” should be included in the differential diagnosis of shoulder pain in young patients not responding to long-term conservative treatment. Arthroscopic excision and curettage provide a good choice for management, with low morbidity and rapid recovery.

  1. Optimality in DNA repair.

    Science.gov (United States)

    Richard, Morgiane; Fryett, Matthew; Miller, Samantha; Booth, Ian; Grebogi, Celso; Moura, Alessandro

    2012-01-01

    DNA within cells is subject to damage from various sources. Organisms have evolved a number of mechanisms to repair DNA damage. The activity of repair enzymes carries its own risk, however, because the repair of two nearby lesions may lead to the breakup of DNA and result in cell death. We propose a mathematical theory of the damage and repair process in the important scenario where lesions are caused in bursts. We use this model to show that there is an optimum level of repair enzymes within cells which optimises the cell's response to damage. This optimal level is explained as the best trade-off between fast repair and a low probability of causing double-stranded breaks. We derive our results analytically and test them using stochastic simulations, and compare our predictions with current biological knowledge. PMID:21945337

  2. Supervised strengthening exercises versus home-based movement exercises after arthroscopic acromioplasty : A randomized clinical trial

    OpenAIRE

    Holmgren, Theresa; Öberg, Birgitta; Sjöberg, Irene; Johansson, Kajsa

    2012-01-01

    Objective: To evaluate and compare the efficacy of 2 rehabilitation strategies after arthroscopic acromioplasty: supervised physical therapy focusing on strengthening exercises of the rotator cuff and scapula stabilizers (PT-group) vs home-based movement exercises (H-group). Design: A randomized, single-blinded, clinically controlled study. Patients: Thirty-six patients entered the study. Thirteen in the PT-group and 16 in the H-group fulfilled all the assessments. Methods: For 12 weeks follo...

  3. Arthroscopic resection of the distal clavicle in osteoarthritis of the acromioclavicular joint

    Directory of Open Access Journals (Sweden)

    Tae-Soo Park

    2016-01-01

    Full Text Available Background: Symptomatic acromioclavicular joint (ACJ lesions are a common cause of shoulder complaints that can be treated successfully with both conservative and surgical methods. There are several operative techniques, including both open and arthroscopic surgery, for excising the distal end of the clavicle. Here, we present a new modified arthroscopic technique for painful osteoarthritis of the ACJ and evaluate its clinical outcomes. Our hypothesis was that 4- to 7-mm resection of the distal clavicle in an en bloc fashion would have several advantages, including no bony remnants, maintenance of stability of the ACJ, and reduced prevalence of heterotopic ossification, in addition to elimination of the pathologic portion of the distal clavicle. Materials and Methods: 20 shoulders of 20 consecutive patients with painful and isolated osteoarthritis of the ACJ who were treated by arthroscopic en bloc resection of the distal clavicle were included in the study. There were 10 males and 10 females with an average age of 56 years (range 42-70 years. The mean duration of followup was 6 years and 2 months (range 4-8 years 10 months. The results were evaluated using the University of California Los Angeles (UCLA shoulder rating score. Results: The overall UCLA score was 13.7 preoperatively, which improved to 33.4 postoperatively. All subscores were improved significantly ( P < 0.001. There were no specific complications at the latest followup. Conclusion: It is critical in this procedure to resect the distal clavicle evenly from superior to inferior in an en bloc fashion without any small bony remnants and to preserve the capsule and acromioclavicular ligament superoposteriorly. This arthroscopic procedure is a reliable and reproducible technique for painful osteoarthritis of the ACJ lesions in active patients engaged in overhead throwing sports and heavy labor.

  4. Eikenella corrodens septic hip arthritis in a healthy adult treated with arthroscopic irrigation and debridement.

    Science.gov (United States)

    Gowda, Ashok L; Mease, Samuel J; Dhar, Yasmin

    2014-09-01

    We present the case of a seemingly spontaneous septic hip arthritis in a patient with no pertinent medical history. Our patient presented with persistent and worsening sharp lower back pain and underwent arthrocentesis of the hip joint, yielding purulent fluid positive for Eikenella corrodens. Our patient's treatment consisted of arthroscopic irrigation with debridement and limited synovectomy that used a supine 2-incision technique. To our knowledge, this is the first reported case of an E corrodens septic hip arthritis.

  5. Arthroscopic treatment for osteochondral lesions of the talus: analysis of outcome predictors

    Institute of Scientific and Technical Information of China (English)

    GUO Qin-wei; HU Yue-lin; JIAO Chen; YU Chang-long; AO Ying-fang

    2010-01-01

    Background Compared with traditional arthrotomy procedures, arthroscopic treatment for osteochondral lesions of the talus has some advantages. However, there has been considerable debate about the outcome predictors for this surgical technique. This study aimed to investigate the outcomes of arthroscopic treatment for osteochondral lesions of the talus, and analyze its outcome predictors.Methods Clinical data of 48 patients with osteochondral lesions of the talus who underwent ankle arthroscopy were studied. Arthroscopic debridement was performed on all patients, and microfracture was also performed in 36 cases. Scores on a subjective satisfaction questionnaire, visual analog scale (VAS) for pain, and the American Orthopedic Foot & Ankle Society (AOFAS) ankle and hindfoot scores were obtained before and after surgery.Results Five patients lost to follow up. The other forty-three patients, 8 of whom were athletes, were followed up for an average of 23.9 months. The average AOFAS post-operative score was 90.16±9.96, compared with 70.81±6.96 before surgery (t=9.353, P <0.001). The VAS pain score after the operation (2.51±9.45) was significantly lower than that before the operation (6.95±1.40) (t=8.647, P<0.001). Of the 43 patients, 35 (81.4%) had good or excellent results. There was no significant difference in outcome between the medial and lateral groups (z=0.205, P=0.838), while a better outcome was found with lesions smaller than 10 mm than those with larger lesions (z=2.199, P=0.028). Age, sex, athletic profession and location of the lesion did not significantly correlate with outcomes.Conclusions Arthroscopic treatment is effective and safe for osteochondral lesions of the talus. A strong correlation was found between the size of the lesion and successful outcome.

  6. Preoperative interscalene brachial plexus block aids in perioperative temperature management during arthroscopic shoulder surgery

    Science.gov (United States)

    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.

  7. Perioperative Rehabilitation Using a Knee Extension Device and Arthroscopic Debridement in the Treatment of Arthrofibrosis

    OpenAIRE

    Biggs-Kinzer, Angie; Murphy, Brian; Shelbourne, K. Donald; Urch, Scott

    2010-01-01

    Background: Arthrofibrosis is a postoperative complication of intra-articular knee surgery that can be difficult to treat. Evidence suggests that maximizing knee range of motion may improve outcomes in patients with arthrofibrosis who undergo arthroscopic debridement. Hypothesis: Patients who achieve greater knee range of motion will have better subjective scores. Study Design: Retrospective case series analysis. Methods: A review of records was performed for 33 patients with arthrofibrosis w...

  8. Arthroscopic lysis of adhesions for the stiff total knee: results after failed manipulation.

    Science.gov (United States)

    Tjoumakaris, Fotios Paul; Tucker, Bradfords Chofield; Post, Zachary; Pepe, Matthew David; Orozco, Fabio; Ong, Alvin C

    2014-05-01

    Arthrofibrosis after total knee arthroplasty (TKA) is a potentially devastating complication, resulting in loss of motion and function and residual pain. For patients in whom aggressive physical therapy and manipulation under anesthesia fail, lysis of adhesions may be the only option to rescue the stiff TKA. The purpose of this study is to report the results of arthroscopic lysis of adhesions after failed manipulation for a stiff, cruciate-substituting TKA. This retrospective study evaluated patients who had undergone arthroscopic lysis of adhesions for arthrofibrosis after TKA between 2007 and 2011. Minimum follow-up was 12 months (average, 31 months). Average total range of motion of patients in this series was 62.3°. Average preoperative flexion contracture was 16° and average flexion was 78.6°. Statistical analysis was performed using Student's t test. Pre- to postoperative increase in range of motion was significant (P<.001) (average, 62° preoperatively to 98° postoperatively). Average preoperative extension deficit was 16°, which was reduced to 4° at final follow-up. This value was also found to be statistically significant (P<.0001). With regard to ultimate flexion attained, average preoperative flexion was 79°, which was improved to 103° at final follow-up. This improvement in flexion was statistically significant (P<.0001). Patients can reliably expect an improvement after arthroscopic lysis of adhesions for a stiff TKA using a standardized arthroscopic approach; however, patients achieved approximately half of the improvement that was obtained at the time of surgery. PMID:24810826

  9. Prevention of arthrofibrosis after arthroscopic screw fixation of tibial spine fracture in children and adolescents.

    Science.gov (United States)

    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. PMID:24683658

  10. Suprascapular nerve palsy after arthroscopic Latarjet procedure: a case report and review of literature.

    Science.gov (United States)

    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.

  11. A Comparison of Functional Outcomes After Metallic and Bioabsorbable Interference Screw Fixations in Arthroscopic ACL Reconstructions

    OpenAIRE

    Hegde, Atmananda S; Rai, Deepak K; Kannampilly, Antony J

    2014-01-01

    Introduction: Anterior Cruciate Ligament (ACL) is as one of the most frequently injured ligaments in the modern contact sports scenario. Graft fixations can be achieved during anterior cruciate ligament (ACL) reconstructions by using either bioabsorbable screws or metal screws. The objective of this study was to compare the functional outcomes after bioabsorbable and metallic interference screw fixations in arthroscopic anterior cruciate ligament reconstructions done by using hamstring grafts.

  12. Analysis of the Arthroscopically Diagnosed Soft-Tissue Injuries Associated With the Distal Radius Fractures

    OpenAIRE

    Katerina Katerina Kasapinova; Viktor Kamiloski

    2014-01-01

    AIM: The aim of this study was to analyze the frequencies of these soft-tissue injuries and to describe the arthroscopic technique used for their diagnosis. METHODS: The prospective study included 85 patients with operatively treated distal radius fracture. Wrist arthroscopy was used to identify the associated lesions of triangular fibrocartilage complex (TFCC), scapholunate ligament (SL) and lunitriquetral ligament (LT), extrinsic ligaments, and chondral lesions. RESULTS: Wrist arthr...

  13. Massive Bone Loss from Fungal Infection after Anterior Cruciate Ligament Arthroscopic Reconstruction

    OpenAIRE

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

    2009-01-01

    Although there are numerous reports of septic pyogenic arthritis after arthroscopic anterior cruciate ligament (ACL) reconstruction, there is limited information regarding the outcomes of fungal infection. We determined the outcomes of six patients with mycotic infection after regular ACL reconstruction. There were four males and two females with a mean age of 33 years. We determined the number of procedures performed, bone loss originating to control infection, and final reconstruction in th...

  14. Concurrent arthroscopic bicruciate ligament reconstruction using Achilles tendon-bone allografts: experience with 15 cases

    Institute of Scientific and Technical Information of China (English)

    Shi De-hai; CAI Dao-zhang; WANG Kun; RONG Li-min; XU Yi-chun

    2008-01-01

    Objective: To evaluate the clinical outcome of arthroscopically assisted combined anterior and posterior cruciate ligament (ACL/PCL) reconstructions using Achil-les tendon-bone allografts. Methods: Associated meniscus injuries were treated according to established methods prior to ligament recon-structions during arthroscopic surgery. Thirty Achilles ten-don-bone allografts were used to reconstruct torn ACL and PCL in 15 knees. At postoperative follow-up, all knees were graded using the modified IKDC and the Lysholm scoring systems just as done preoperatively. Results were analyzed compared with the contralateral healthy knees. Results: Eleven men and 4 women with a minimum of 3-year follow-up (mean 38 months) were included in the study. Preoperatively, the group ratings by the modified IKDC standards were all severely abnormal. Twelve bicruciate reconstructions were performed in subacute or chronic stage (>3-8 weeks), 3 for acute ligamentous deficien-cies (≤ 3 weeks). The noticeable early complication was transitory local fever combined with joint effusion in one case. At postoperative follow-up, 9 knees were normal, 5 nearly normal and 1 abnormal. On Lysholm score the differ-ence was statistically significant (t- test, P<0.001) before and after operation. Conclusions: Achilles tendon-bone allograft offers an alternative for simultaneous arthroscopic ACL/PCL reconstructions. However, further investigation is needed to eradicate its potential immunogenicity for better use.

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

    Directory of Open Access Journals (Sweden)

    Mayo Lee

    2011-06-01

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

  16. ARTHROSCOPIC RELEASE OF THE SUPRASCAPULAR NERVE: SURGICAL TECHNIQUE AND EVALUATION OF CLINICAL CASES

    Science.gov (United States)

    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

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

    Energy Technology Data Exchange (ETDEWEB)

    Do-Dai, D.D.; Youngberg, R.A.; Lanchbury, F.D.; Pitcher, J.D. Jr.; Garver, T.H. [Madigan Army Medical Center, Tacoma, WA (United States)

    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.

  18. Arthroscopic resection of the distal clavicle in osteoarthritis of the acromioclavicular joint

    Science.gov (United States)

    Park, Tae-Soo; Lee, Kwang-Won

    2016-01-01

    Background: Symptomatic acromioclavicular joint (ACJ) lesions are a common cause of shoulder complaints that can be treated successfully with both conservative and surgical methods. There are several operative techniques, including both open and arthroscopic surgery, for excising the distal end of the clavicle. Here, we present a new modified arthroscopic technique for painful osteoarthritis of the ACJ and evaluate its clinical outcomes. Our hypothesis was that 4- to 7-mm resection of the distal clavicle in an en bloc fashion would have several advantages, including no bony remnants, maintenance of stability of the ACJ, and reduced prevalence of heterotopic ossification, in addition to elimination of the pathologic portion of the distal clavicle. Materials and Methods: 20 shoulders of 20 consecutive patients with painful and isolated osteoarthritis of the ACJ who were treated by arthroscopic en bloc resection of the distal clavicle were included in the study. There were 10 males and 10 females with an average age of 56 years (range 42–70 years). The mean duration of followup was 6 years and 2 months (range 4–8 years 10 months). The results were evaluated using the University of California Los Angeles (UCLA) shoulder rating score. Results: The overall UCLA score was 13.7 preoperatively, which improved to 33.4 postoperatively. All subscores were improved significantly (P painful osteoarthritis of the ACJ lesions in active patients engaged in overhead throwing sports and heavy labor. PMID:27512219

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

    Directory of Open Access Journals (Sweden)

    Satish Shervegar

    2015-09-01

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

  20. Periarticular osteoid osteoma of the ankle: a report of nine arthroscopically treated patients.

    Science.gov (United States)

    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.

  1. Resultados do tratamento artroscópico das rupturas do manguito rotador Outcomes of arthroscopic treatment for rotator cuff tears

    Directory of Open Access Journals (Sweden)

    Carlos Henrique Ramos

    2010-01-01

    long head of the biceps tendon (57.1%. Nevertheless, the presence of other lesions did not alter the end results. The same occurred in relation to age and follow-up period. When comparing large and massive tears with small and mid-sized ones, the first group had significantly inferior functional results. The function was worse in cases of massive tear. CONCLUSION: Arthroscopic rotator cuff repair provides lower surgical morbidity and intrarticular diagnosis of associated lesions in comparison to open surgery. The benefit of the procedure was confirmed mainly by pain relief, even in cases of more extensive lesions.

  2. Forward lunge knee biomechanics before and after partial meniscectomy

    DEFF Research Database (Denmark)

    Hall, Michelle; Nielsen, Jonas Høberg; Holsgaard-Larsen, Anders;

    2015-01-01

    BACKGROUND: Patients following meniscectomy are at increased risk of developing knee osteoarthritis in the tibiofemoral compartment and at the patellofemoral joint. As osteoarthritis is widely considered a mechanical disease, it is important to understand the potential effect of arthroscopic...... partial meniscectomy (APM) on knee joint mechanics. The purpose of this study was to evaluate changes in knee joint biomechanics during a forward lunge in patients with a suspected degenerative meniscal tear from before to three months after APM. METHODS: Twenty-two patients (35-55years old......) with a suspected degenerative medial meniscal tear participated in this study. Three dimensional knee biomechanics were assessed on the injured and contralateral leg before and three months after APM. The visual analogue scale was used to assess knee pain and the Knee Injury Osteoarthritis Outcome Score was used...

  3. INTRAARTICULAR INJECTION OF HYALURONIC ACID AFTER ARTHROSCOPIC LAVAGE OF THE KNEE: LONG-TERM RESULTS

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    Lidia Vladimirovna Luchikhina

    2013-01-01

    Full Text Available Objective: to evaluate the efficiency of arthroscopic lavage in combination with subsequent injection of hyaluronic acid into the joint cavity at shortand long-term follow-ups. Subjects and methods. Eighty-two patients with knee osteoarthrosis (OA were examined in accordance with the American College of Rheumatology criteria. Group 1 consisted of 40 patients only after arthroscopic lavage; Group 2 comprised 42 patients who were administered hyaluronic acid after arthroscopic lavage. Clinical evaluation encompassed pain while walking, resting, and moving (by a visual analogue scale, limited ability in covering 100 m (by a 5-point scale, general clinical evaluation (by a 5-point ordinal scale, the presence or absence of pain after 100-m walking, as well as resting pain (its presence or absence. Results. The treatment effect evaluated using different indicators was comparably positive in both groups within 3 months. Following 3 months of therapy, its effect remained stable and even better in Group 2. The latter showed a particularly noticeable superiority a year later. Thus, there were excellent and good results in 88 and 47.5% in Groups 2 and 1, respectively. The clinical symptoms of the disease were absent in 58% in Group 2 and in only 15% in Group 1. Moreover, Group 1 showed worsening and 20% of the patients had no effect. This trend was also seen while evaluating the therapeutic effectiveness in different periods. Thus, after therapy, no substantial difference was found in both groups, but 3 months later this difference was as many as 0.8 scores and a year later Group 2 had many points in its favor (1.2 scores. Conclusion. Arthroscopic lavage followed by the administration of hyaluronic acid makes it possible to prevent the negative effect of a washing liquid on the metabolism and structure of the articular cartilage and to achieve a long-term effect against the major clinical symptoms (joint pain and function affecting the quality of life. The

  4. FUNCTIONAL OUTCOME OF ACCELERATED REHABILITATION IN ARTHROSCOPIC ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION WITH BONE PATELLAR TENDON BONE GRAFT A PROSPECTIVE STUDY

    Directory of Open Access Journals (Sweden)

    Hiranyakumar

    2016-03-01

    Full Text Available INTRODUCTION An ideal rehabilitation program post anterior cruciate ligament reconstruction enables an individual to return to pre injury levels at a faster rate with minimal to no risk of reinjury to the graft. Rehabilitation protocols have changed considerably over time in the past. It has become “aggressive”, meaning an intensive rehabilitation which includes greater variety of exercises and sports related training. AIM OF THE STUDY The aim of our study is to assess the outcome of accelerated rehabilitation post anterior cruciate ligament (ACL reconstruction. METHODOLOGY 106 patients were operated by a single surgeon underwent arthroscopic anterior cruciate ligament reconstruction using bone patella tendon bone graft and partial meniscectomy for associated meniscal tear. Patients were put on an accelerated rehabilitation protocol designed in our institute on first post-operative day, under the guidance of a physical therapist in consultation with the operated surgeon. Patients were followed up at 3 weeks, 6 months and 9 months, post onset of rehabilitation, patients were assessed using KT1000 Arthrometer and Lysholm knee scoring system. RESULTS Out of 106 patients, who were selected, 96(91% were males and 10(9% were females. The mean pre-operative Lysholm score was 55.09. Post operatively, while on accelerated rehabilitation program the Lysholm scores were 69.73 at 3 weeks, 89.13 at 6 months and 89.19 at 9 months. In our pre-operative evaluation mean KT 1000 arthrometer score was 10.53 and post-operative at six months was 3.49. At nine months 105 patients had excellent results whereas 1 patient had good result. CONCLUSION Accelerated rehabilitation protocol enables the patient to functionally recover faster to pre injury levels. A rehabilitation protocol for 6 months is sufficient in enabling a patient to get back to pre-injury levels. Functional outcome is the same with or without associated meniscal injuries.

  5. Molecular basis for DNA strand displacement by NHEJ repair polymerases

    OpenAIRE

    Bartlett, Edward J.; Brissett, Nigel C.; Plocinski, Przemyslaw; Carlberg, Tom; Doherty, Aidan J.

    2015-01-01

    The non-homologous end-joining (NHEJ) pathway repairs DNA double-strand breaks (DSBs) in all domains of life. Archaea and bacteria utilize a conserved set of multifunctional proteins in a pathway termed Archaeo-Prokaryotic (AP) NHEJ that facilitates DSB repair. Archaeal NHEJ polymerases (Pol) are capable of strand displacement synthesis, whilst filling DNA gaps or partially annealed DNA ends, which can give rise to unligatable intermediates. However, an associated NHEJ phosphoesterase (PE) re...

  6. Evaluation of Direct and Indirect Methods of Repairing Fractured

    OpenAIRE

    Piotrowski, P.; Krysinski, Z.; Rztowski, S.

    2002-01-01

    INTRODUCTION: The most common technology used in producing a fixed partial denture is firing porcelain to metal. The fracture of veneering material rarely occurs, although it is one of the most striking problems in daily practise. PURPOSE: The purpose of this study was to evaluate the shear bond strength of composite to porcelain and metal by using two intraoral repair methods: direct and indirect. MATERIAL AND METHODS: The direct method was performed by using Ceramic Repair System (Ivo...

  7. Bankart Repair to Correct Shoulder Instability

    Medline Plus

    Full Text Available ... far as treatment recommendations and your expectations for success of treatment recommendations? 00:05:11 KERWYN JONES, ... really feel that we can achieve the same success using it through the arthroscope and with less ...

  8. Pseudoaneurisma de artéria genicular após cirurgia artroscópica de joelho: Relato de dois casos Geniculate artery pseudoaneurysm after arthroscopic knee surgery: Two case reports

    Directory of Open Access Journals (Sweden)

    Edgard dos Santos Pereira Junior

    2010-01-01

    Full Text Available A artroscopia do joelho é considerado um procedimento cirúrgico muito seguro, com um número relativamente pequeno de complicações. Relatamos o caso de dois pacientes do sexo masculino que foram submetidos à artroscopia de joelho (para meniscectomia parcial e reconstrução do ligamento cruzado anterior com parafuso transverso femoral e interferência tibial que desenvolveram um pseudoaneurisma de artéria genicular superior lateral após o procedimento. A ultrassonografia com Doppler realizou o diagnóstico e os pacientes foram tratados cirurgicamente com ligadura arterial. Um paciente apresentou extenso hematoma na coxa e foi necessária reposição volêmica. Estes casos exemplificam uma complicação vascular rara, nem sempre benigna, em uma cirurgia minimamente invasiva do joelho.Arthroscopy of the knee is a very safe surgical procedure, with relatively few complications. Here we present the cases of two patients submitted to arthroscopic surgery for partial meniscectomy and reconstruction of the anterior cruciate ligament with femoral transverse screw and tibial interference screw that developed a superior lateral genicular artery pseudoaneurysm. Doppler ultrasonography was performed for diagnostic purposes and the patients were treated by direct arterial suture. One patient developed a large haematoma requiring volemic replacement. These cases illustrate a rare, and not always benign vascular complication, in a minimally invasive arthroscopic surgery.

  9. Development and Validation of Cognitive Rehearsal as a Training Strategy for Arthroscopic Surgery

    Science.gov (United States)

    Kovacevic, David; Hodgins, Justin Lane; Lowe, Dylan T.; He, Janice; Popkin, Charles Aaron; Lynch, Thomas Sean; Ahmad, Christopher S.

    2016-01-01

    Objectives: Surgical performance is a highly intellectual activity that involves the processing of perceptual information from the five senses. Strategies to process, organize, and retain this perceptual information may benefit learning techniques. Once such strategy, cognitive rehearsal, is the activity where a skill is rehearsed in memory prior to the actual performance. This study aimed to develop and validate a cognitive rehearsal strategy for arthroscopic knee surgery in orthopaedic residents. We hypothesized that this training tool will lead to increased comfort and confidence with arthroscopic surgery performance. Methods: An expert surgeon was filmed performing an arthroscopic ACL reconstruction using patellar bone-tendon-bone autograft. An instructional training video was then created incorporating the extracorporeal and arthroscopic footage with voice over and subtitles. Following the surgery, cognitive recall of the procedure was conducted with the surgeon to identify key visual, cognitive, and kinesthetic cues to develop a mental imagery script to enhance rehearsal of arthroscopic surgery. Orthopaedic residents from two academic training programs were invited to participate. Demographic information including training level, previous musical experience, organized sports participation, and preferred learning style was collected. The training session consisted of a relaxation exercise, instructional video of an expert performing the procedure, learning the mental imagery script, and rehearsing the procedure out loud with a partner. The residents’ ability to rehearse the procedure was assessed before and after the training session with a modified version of a previously validated questionnaire, and a post-training session survey was administered to define which components of the rehearsal seemed most beneficial. Statistical analysis included a reliability analysis for internal consistency, and a nonparametric Wilcoxon test to compare the composite

  10. Laparoscopic lumbar hernia repair.

    Science.gov (United States)

    Madan, Atul K; Ternovits, Craig A; Speck, Karen E; Pritchard, F Elizabeth; Tichansky, David S

    2006-04-01

    Lumbar hernias are rare clinical entities that often pose a challenge for repair. Because of the surrounding anatomy, adequate surgical herniorraphy is often difficult. Minimally invasive surgery has become an option for these hernias. Herein, we describe two patients with lumbar hernias (one with a recurrent traumatic hernia and one with an incisional hernia). Both of these hernias were successfully repaired laparoscopically.

  11. Workshop on DNA repair.

    NARCIS (Netherlands)

    A.R. Lehmann (Alan); J.H.J. Hoeijmakers (Jan); A.A. van Zeeland (Albert); C.M.P. Backendorf (Claude); B.A. Bridges; A. Collins; R.P.D. Fuchs; G.P. Margison; R. Montesano; E. Moustacchi; A.T. Natarajan; M. Radman; A. Sarasin; E. Seeberg; C.A. Smith; M. Stefanini (Miria); L.H. Thompson; G.P. van der Schans; C.A. Weber (Christine); M.Z. Zdzienika

    1992-01-01

    textabstractA workshop on DNA repair with emphasis on eukaryotic systems was held, under the auspices of the EC Concerted Action on DNA Repair and Cancer, at Noordwijkerhout (The Netherlands) 14-19 April 1991. The local organization of the meeting was done under the auspices of the Medical Genetic C

  12. Evaluation of patients submitted to the arthroscopic treatment of the lateral epicondylitis refractory to the conservative treatment

    Directory of Open Access Journals (Sweden)

    Fabio Alexandre Martynetz

    2013-12-01

    Full Text Available Objective: to evaluate the results of the arthroscopic treatment of the lateral epicondylitis. Methods: we evaluated 14 patients (15 elbows submitted to the arthroscopic treatment of the lateral epicondylitis refractory to the conservative treatment, which was realized for a minimum period of 18 months. Beyond the demographic data collection, patients were evaluated according to the arthroscopic classification of Baker et al., the Disabilities of the Arm, Shoulder, and Hand (DASH questionnaire and the Mayo Elbow Performance Score (MEPS. The patients' ages ranged between 23 and 56 years (average 46 years (eight males and six females. Of the 15 elbows, 12 were the dominant and one patient had bilateral lesion. The follow-up after surgery was minimum 24 months and maximum 72 months (average 41 months. Results: we found, according to the arthroscopic classification of Baker et al., two patients with type I lesions, nine with type II lesions and three with type III lesions. We found the following complications: one patient with altered sensitivity in the region of the lateral portal, one with a deficit of ten degrees in length, one with synovial plica and one with synovitis in the lateral compartment. Our score on the DASH questionnaire was minimum of 32 points and maximum of 120 points (average 57 points and the scale of MEPS had a minimum score of 60 points and a maximum of 100 points (average 90 points. Conclusion: the arthroscopic treatment of the lateral epicondylitis, plus insurance, provides satisfactory results.

  13. All-Arthroscopic Autologous Matrix-Induced Chondrogenesis for the Treatment of Osteochondral Lesions of the Talus

    Science.gov (United States)

    Usuelli, Federico Giuseppe; de Girolamo, Laura; Grassi, Miriam; D'Ambrosi, Riccardo; Montrasio, Umberto Alfieri; Boga, Michele

    2015-01-01

    Several surgical techniques have been described for the treatment of talar chondral lesions. Among them, microfracture is well established. Autologous matrix-induced chondrogenesis (AMIC), using microfracture and biomaterials, has shown promising results for the treatment of knee osteochondral lesions and has been proposed for the ankle as an open technique. We describe an all-arthroscopic AMIC technique. The benefits of an all-arthroscopic procedure include smaller incisions with less soft-tissue dissection, better visualization of the joint, and a quicker recovery compared with open surgery. The use of matrix to support cartilage regeneration promotes good-quality cartilage tissue with satisfactory long-term outcomes. Our all-arthroscopic AMIC technique uses a type I–type III porcine collagen matrix (Chondro-Gide; Geistlich Pharma, Wolhusen, Switzerland) and is characterized by 2 different arthroscopic surgical phases. First, adequate exposure is achieved through use of a Hintermann spreader (Integra LifeSciences, Plainsboro, NJ) with sufficient joint distraction and wet lesion preparation. The second surgical step is performed dry, involving matrix placement and fixation. The all-arthroscopic AMIC technique for the treatment of osteochondral lesions of the talus allows a very precise reconstruction in the case of cartilage defects and avoids the need for a more invasive operation associated with higher morbidity and a longer surgical time. PMID:26258040

  14. INTERNAL REPAIR OF PIPELINES

    Energy Technology Data Exchange (ETDEWEB)

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

    2005-07-20

    The two broad categories of fiber-reinforced composite liner repair and deposited weld metal repair technologies were reviewed and evaluated for potential application for internal repair of gas transmission pipelines. Both are used to some extent for other applications and could be further developed for internal, local, structural repair of gas transmission pipelines. Principal conclusions from a survey of natural gas transmission industry pipeline operators can be summarized in terms of the following performance requirements for internal repair: (1) Use of internal repair is most attractive for river crossings, under other bodies of water, in difficult soil conditions, under highways, under congested intersections, and under railway crossings. (2) Internal pipe repair offers a strong potential advantage to the high cost of horizontal direct drilling when a new bore must be created to solve a leak or other problem. (3) Typical travel distances can be divided into three distinct groups: up to 305 m (1,000 ft.); between 305 m and 610 m (1,000 ft. and 2,000 ft.); and beyond 914 m (3,000 ft.). All three groups require pig-based systems. A despooled umbilical system would suffice for the first two groups which represents 81% of survey respondents. The third group would require an onboard self-contained power unit for propulsion and welding/liner repair energy needs. (4) The most common size range for 80% to 90% of operators surveyed is 508 mm (20 in.) to 762 mm (30 in.), with 95% using 558.8 mm (22 in.) pipe. Evaluation trials were conducted on pipe sections with simulated corrosion damage repaired with glass fiber-reinforced composite liners, carbon fiber-reinforced composite liners, and weld deposition. Additional un-repaired pipe sections were evaluated in the virgin condition and with simulated damage. Hydrostatic failure pressures for pipe sections repaired with glass fiber-reinforced composite liner were only marginally greater than that of pipe sections without

  15. DNA repair protocols

    DEFF Research Database (Denmark)

    Bjergbæk, Lotte

    In its 3rd edition, this Methods in Molecular Biology(TM) book covers the eukaryotic response to genomic insult including advanced protocols and standard techniques in the field of DNA repair. Offers expert guidance for DNA repair, recombination, and replication. Current knowledge of the mechanisms...... that regulate DNA repair has grown significantly over the past years with technology advances such as RNA interference, advanced proteomics and microscopy as well as high throughput screens. The third edition of DNA Repair Protocols covers various aspects of the eukaryotic response to genomic insult including...... recent advanced protocols as well as standard techniques used in the field of DNA repair. Both mammalian and non-mammalian model organisms are covered in the book, and many of the techniques can be applied with only minor modifications to other systems than the one described. Written in the highly...

  16. Knee function and knee muscle strength in middle-aged patients with degenerative meniscal tears eligible for arthroscopic partial meniscectomy

    DEFF Research Database (Denmark)

    Stensrud, Silje; Risberg, May Arna; Roos, Ewa M.

    2014-01-01

    -sectional study. METHODS: Eighty-two participants with MRI verified degenerative meniscal tear (35% women, mean age 49 years) answered the Knee injury and Osteoarthritis Outcome Score (KOOS) and were tested for isokinetic knee muscle strength and lower extremity performance (one-leg hop for distance, 6 m timed...... hop and maximum number of knee-bends in 30 s). Limb Symmetry Index (LSI) was used to express side-to-side differences in per cent using the non-injured leg as the control. An LSI ≥90% was considered normal. RESULTS: Mean scores of the five subscales of the KOOS were from 13 to 36 points lower compared...... with a population-based reference group and similar to patients prior to anterior cruciate ligament reconstruction. Quadriceps strength and lower-extremity performance were impaired for the injured leg compared with the non-injured leg (p10% differences between the injured and the non-injured leg....

  17. Repair of articular cartilage defects in minipigs by microfracture surgery and BMSCs transplantation

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    Objective: To investigate the feasibility of minimal invasive repair of cartilage defect by arthroscope-aided microfracture surgery and autologous transplantation of mesenchymal stem cells. Methods: Bone marrow of minipigs was taken out and the bone marrow derived mesenchymal stem cells (BMSCs) were isolated and cultured to passage 3. Then 6 minipigs were randomly divided into 2 groups with 6 knees in each group. After the articular cartilage defect was induced in each knee. the left defect received microfracture surgery and was injected with 2. 5 ml BMSCs cells at a concentration of 3×107 cells/ml into the articular cavity; while right knee got single microfracture or served as blank control group. The animals were killed at 8 or 16 weeks, and the repair tissue was histologically and immunohistochemically examined for the presence of type Ⅱ collagen and glycosaminoglycans (GAGs) at 8 and 16 weeks. Results:Eight weeks after the surgery, the overlying articular surface of the cartilage defect showed normal color and integrated to adjacent cartilage. And 16 weeks after surgery, hyaline cartilage was observed at the repairing tissues and immunostaining indicated the diffuse presence of this type Ⅱ collagen and GAGs throughout the repair cartilage in the treated defects. Single microfracture group had the repairing of fibro-cartilage, while during the treatment, the defects of blank group were covered with fewer fiber tissues, and no blood capillary growth or any immunological rejection was observed. Conclusion:Microfracture technique and BMSCs transplantation to repair cartilage defect is characterized with minimal invasion and easy operation, and it will greatly promote the regeneration repair of articular cartilage defect.

  18. INTERNAL REPAIR OF PIPELINES

    Energy Technology Data Exchange (ETDEWEB)

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

    2004-12-31

    The two broad categories of fiber-reinforced composite liner repair and deposited weld metal repair technologies were reviewed and evaluated for potential application for internal repair of gas transmission pipelines. Both are used to some extent for other applications and could be further developed for internal, local, structural repair of gas transmission pipelines. Principal conclusions from a survey of natural gas transmission industry pipeline operators can be summarized in terms of the following performance requirements for internal repair: (1) Use of internal repair is most attractive for river crossings, under other bodies of water, in difficult soil conditions, under highways, under congested intersections, and under railway crossings. (2) Internal pipe repair offers a strong potential advantage to the high cost of horizontal direct drilling when a new bore must be created to solve a leak or other problem. (3) Typical travel distances can be divided into three distinct groups: up to 305 m (1,000 ft.); between 305 m and 610 m (1,000 ft. and 2,000 ft.); and beyond 914 m (3,000 ft.). All three groups require pig-based systems. A despooled umbilical system would suffice for the first two groups which represents 81% of survey respondents. The third group would require an onboard self-contained power unit for propulsion and welding/liner repair energy needs. (4) The most common size range for 80% to 90% of operators surveyed is 508 mm (20 in.) to 762 mm (30 in.), with 95% using 558.8 mm (22 in.) pipe. Evaluation trials were conducted on pipe sections with simulated corrosion damage repaired with glass fiber-reinforced composite liners, carbon fiber-reinforced composite liners, and weld deposition. Additional un-repaired pipe sections were evaluated in the virgin condition and with simulated damage. Hydrostatic failure pressures for pipe sections repaired with glass fiber-reinforced composite liner were only marginally greater than that of pipe sections without

  19. 膝关节镜下自体腘绳肌腱移植重建前十字韧带部分束损伤%Arthroscopic treatment for anterior cruciate ligament with harmstring autograft transplant

    Institute of Scientific and Technical Information of China (English)

    郑民庆; 侯之启; 陈铭

    2011-01-01

    目的 探讨关节镜下自体腘绳肌腱单束移植重建前十字韧带(anterior cruciate ligament,ACL)部分束损伤的临床效果.方法 2007年1月至2010年5月关节镜下行自体腘绳肌单束重建ACL部分束损伤16例.术前Lysholm评分平均为55.4±6.7分.结果 全部获得随访,随访时间为12~23个月,平均18±4.3个月.术后Lysholm 评分增至平均89.3 +3.3分,有统计学差异(P<0.05).所有患者主观症状均消失,全部恢复正常工作与体育锻炼.结论 应用自体腘绳肌腱重建ACL部分束损伤明显改善膝关节功能.%Objective To observe the clinical outcome of arthroscopic anterior cruciate ligament (ACL) partial bundle reconstruction with harmstring autograft tendon. Methods Sixteen patients underwent reconstruction arthroscopic ACL partial bundle reconstruction with harmstring autograft tendon from January 2007 to May 2010. Results All the patients were followed up, and the duration ranged from 12 to 23 months (average 18 ±4. 3 months). The preoperative subjective symptoms disappeared in all patients. Lysholm scores increased from preoperatively 55. 4 ±6. 7 to 89. 3 ±3. 3 post-operatively (P<0. 05). All patients returned to normal work and physical exercise. Conclusion ACL partial bundle reconstruction with harmstring autograft tendon can significantly improve the function of postoperative knees.

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

    Directory of Open Access Journals (Sweden)

    Hamid Reza Aslani

    2014-03-01

    Full Text Available Background:   To assess the outcome of the remplissage arthroscopic surgical method in patients with anterior shoulder dislocation associated with Hill-Sachs lesion.     Methods:   Ten patients with anterior shoulder dislocations and Hill-Sachs lesions were entered into this study and were operated on by the remplissage arthroscopic surgical method. They were followed up 22 months after surgery in   order to evaluate the outcome of the treatment, including recurrence of dislocation and motion limitation.     Results:   During the internal follow up period no case of recurrence was found. Motion limitation during the follow up   period was not significant (internal rotation limitation=5°±1°, and external rotation limitation=4°±1° Conclusions:   Our findings suggest that the remplissage arthroscopic surgical method is an acceptable, safe and   reliable treatment for anterior shoulder dislocation with engaging Hill-Sachs lesion.

  1. 深低温保存的节段性部分脱钙异体骨关节移植修复兔骨关节缺损%Osteoarticular allograft with distal segment partial demineralized for repairing large osteoarticular defect in a rabbit model: radiological and histological results

    Institute of Scientific and Technical Information of China (English)

    杨强; 李建民; 夏群; 李庆波; 孙鹏飞; 李恩惠; 谢飞彬; 千建荣; 李振峰

    2013-01-01

    Objective To investigate the results of osteoarticular allograft with distal segment partial demineralized for repairing large osteoarticular defect in a rabbit model.Methods The osteoarticular allograft about 20mm long was excised by hacksaw from the proximal portion of radius obtained from other 24 rabbits of the same strain.The grafts were procured aseptically and stripped of attached soft tissues,including the periosteum,ligaments and muscles.The marrow was removed.The osteoarticular allograft was treated in two methods:(1) The distal end (about 5mm long) of the osteoarticular allograft was demineralized by 0.6 moFL HC1 at 4℃ for 4 hours,then the osteoarticular allograft was crypreserved (-80℃) for at least 2 weeks.(2) Not demineralized,merely cryopreserved for at least 2 weeks.Large osteoarticular defects about 2cm in New Zealand whit rabbits' radius were created.Then we inserted the frozen osteoarticular allograft with the distal segment partial demineralized into left oteoarticular defects,and frozen osteoarticular allograft into the right.The results was evaluated with plain films,gross specimen,histological examination and bone scintigraphy at 1,2,3 months postoperatively.Results The scoring outcome of radiological and histological analysis between the experimental and control side at 1,2,3 months postoperatively showed that the process of partial demineralization at the distal segment of the osteoarticular allograft was significant in enhancing bone incorporation at the sites of graft-host bone junction.ECT scan showed that bone metabolism was more active in the 1 month and became stable in the 2 and 3 months postoperatively.The bone metabolism of distal segment of the osteoarticular allograft of experimental side was more active than that of control side.Conclusion Partial demineralization at the distal segment of osteoarticular allograft can accelerate the incorporation of graft-hostjunction and reduce the complications,which makes it a suitable

  2. INTERNAL REPAIR OF PIPELINES

    Energy Technology Data Exchange (ETDEWEB)

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

    2004-08-17

    The two broad categories of fiber-reinforced composite liner repair and deposited weld metal repair technologies were reviewed and evaluated for potential application for internal repair of gas transmission pipelines. Both are used to some extent for other applications and could be further developed for internal, local, structural repair of gas transmission pipelines. Principal conclusions from a survey of natural gas transmission industry pipeline operators can be summarized in terms of the following performance requirements for internal repair: (1) Use of internal repair is most attractive for river crossings, under other bodies of water, in difficult soil conditions, under highways, under congested intersections, and under railway. (2) Internal pipe repair offers a strong potential advantage to the high cost of horizontal direct drilling when a new bore must be created to solve a leak or other problem. (3) Typical travel distances can be divided into three distinct groups: up to 305 m (1,000 ft.); between 305 m and 610 m (1,000 ft. and 2,000 ft.); and beyond 914 m (3,000 ft.). All three groups require pig-based systems. A despooled umbilical system would suffice for the first two groups which represents 81% of survey respondents. The third group would require an onboard self-contained power unit for propulsion and welding/liner repair energy needs. (4) The most common size range for 80% to 90% of operators surveyed is 508 mm (20 in.) to 762 mm (30 in.), with 95% using 558.8 mm (22 in.) pipe. Evaluation trials were conducted on pipe sections with simulated corrosion damage repaired with glass fiber-reinforced composite liners, carbon fiber-reinforced composite liners, and weld deposition. Additional un-repaired pipe sections were evaluated in the virgin condition and with simulated damage. Hydrostatic failure pressures for pipe sections repaired with glass fiber-reinforced composite liner were only marginally greater than that of pipe sections without liners

  3. Salvage hypospadias repairs

    Directory of Open Access Journals (Sweden)

    Sripathi V

    2008-01-01

    Full Text Available Aim: Review of our experience and to develop an algorithm for salvage procedures in the management of hypospadias cripples and treatment of urethral strictures following hypospadias repair. Methods: This is a retrospective review of hypospadias surgeries over a 41-month period. Out of a total 168 surgeries, 20 were salvage/re-operative repairs. In three children a Duplay repair was feasible, while in four others a variety of single-stage repairs could be done. The repair was staged in seven children - buccal mucosal grafts (BMGs in five, buccal mucosal tube in one, and skin graft in one. Five children with dense strictures were managed by dorsal BMG inlay grafting in one, vascularized tunical onlay grafting on the ventrum in one, and a free tunical patch in one. Three children were treated by internal urethrotomy and stenting for four weeks with a poor outcome. Results: The age of children ranged from 1.5-15 years (mean 4.5. Follow-up ranged from 3 months to 3.5 years. Excellent results were obtained in 10 children (50% with a well-surfaced erect penis and a slit-like meatus. Glans closure could not be achieved and meatus was coronal in three. Two children developed fistulae following a Duplay repair and following a staged BMG. Three repairs failed completely - a composite repair broke down, a BMG tube stenosed with a proximal leak, and a stricture recurred with loss of a ventral free tunical graft. Conclusions: In salvage procedures performed on hypospadias cripples, a staged repair with buccal mucosa as an inlay in the first stage followed by tubularization 4-6 months later provides good results. A simple algorithm to plan corrective surgery in failed hypospadias cases and obtain satisfactory results is devised.

  4. Nuclear reactor repairing device

    International Nuclear Information System (INIS)

    Purpose: To enable free repairing of an arbitrary position in an LMFBR reactor. Constitution: A laser light emitted from a laser oscillator installed out of a nuclear reactor is guided into a portion to be repaired in the reactor by using a reflecting mirror, thereby welding or cutting it. The guidance of the laser out of the reactor into the reactor is performed by an extension tube depending into a through hole of a rotary plug, and the guidance of the laser light into a portion to be repaired is performed by the transmitting and condensing action of the reflecting mirror. (Kamimura, M.)

  5. T2 relaxometry of the infrapatellar fat pad after arthroscopic surgery

    Energy Technology Data Exchange (ETDEWEB)

    Torriani, Martin; Bredella, Miriam A. [Massachusetts General Hospital and Harvard Medical School, Musculoskeletal Imaging and Intervention, Department of Radiology, Boston, MA (United States); Taneja, Atul K. [Hospital do Coracao (HCor), Teleimagem, and Hospital Israelita Albert Einstein, Division of Musculoskeletal Imaging, Department of Radiology, Sao Paulo (Brazil); Hosseini, Ali; Li, Guoan [Massachusetts General Hospital and Harvard Medical School, Bioengineering Laboratory, Department of Orthopedics, Boston, MA (United States); Gill, Thomas J. [Massachusetts General Hospital and Harvard Medical School, Sports Medicine Center, Department of Orthopedics, Boston, MA (United States)

    2014-03-15

    To investigate the T2 relaxation values of the infrapatellar fat pad (IFP) after arthroscopic surgery. This study was approved by the institutional review board; all individuals signed informed consent. We performed MRI in 16 knees from 8 subjects. Prior to imaging, each subject had unilateral arthroscopic knee surgery and an asymptomatic non-operated contralateral knee. We used a 10-echo multiple-TE fast-spin echo pulse sequence for creation of T2 relaxation time maps. Two musculoskeletal radiologists independently placed regions of interest in the IFP, suprapatellar subcutaneous and deep intermuscular adipose tissue. Qualitative assessments were performed to assess fibrotic changes affecting patellar retinaculum and IFP. Statistical analyses of T2 values determined differences between groups, correlation with time after surgery, and cut-off values to differentiate groups. The average time between arthroscopy and imaging was 3.5 ± 0.4 years. IFP of knees with prior surgery had significantly shorter mean T2 values (133 ± 14 ms) compared with control knees (147 ± 8 ms, P = 0.03). There was no significant difference between operated and control knees regarding T2 values of suprapatellar subcutaneous (P = 0.3) or deep intermuscular adipose tissue (P = 0.2). There was no correlation between IFP T2 values and time after surgery (P > 0.2). IFP T2 values ≤ 139 ms had 75 % sensitivity and 88 % specificity in identifying prior arthroscopy. Shortening of T2 relaxation values is present in IFP chronically after arthroscopic surgery and may be an indicator of adipose tissue fibrosis. (orig.)

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

    Directory of Open Access Journals (Sweden)

    Bruno Dutra Roos

    2015-08-01

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

  7. A comparison of magnetic resonance arthrography and arthroscopic findings in the assessment of anterior shoulder dislocations

    Energy Technology Data Exchange (ETDEWEB)

    Jordan, R.W.; Naeem, R.; Srinivas, K.; Shyamalan, G. [Birmingham Heartlands Hospital, Birmingham (United Kingdom)

    2015-05-01

    The aim of this study is to establish the sensitivity and specificity of MRA in the investigation of patients with traumatic anterior shoulder dislocations. A retrospective analysis of consecutive patients undergoing both magnetic resonance arthrography and arthroscopic assessment after a traumatic anterior shoulder dislocation between January 2011 and 2014 was performed. Demographic data were collected from electronic records. Images were interpreted by 8 musculoskeletal radiologists and patients were treated by 8 consultant orthopaedic surgeons. Arthroscopic findings were obtained from surgical notes and these findings were used as a reference for MRA. The sensitivity, specificity, and positive predictive value were calculated for the different injuries. Sixty-nine patients underwent both an MRA and shoulder arthroscopy during the study period; however, clinical notes were unavailable in 9 patients. Fifty-three patients (88 %) were male, the mean age was 28 years (range 18 to 50) and 16 subjects (27 %) had suffered a primary dislocation. The overall sensitivity and specificity of MRA to all associated injuries was 0.9 (CI 0.83-0.95) and 0.94 (CI 0.9-0.96) retrospectively. The lowest sensitivity was seen in osseous Bankart 0.8 (CI 0.44-0.96) and superior labral tear (SLAP) lesions 0.5 (CI 0.14-0.86). The overall positive predictive value was 0.88 (CI 0.76-0.91) with the lowest values found in rotator cuff 0.4 (CI 0.07-0.83) and glenohumeral ligament (GHL) lesions 0.29 (CI 0.05-0.7). Magnetic resonance angiography has a high sensitivity when used to identify associated injuries in shoulder dislocation, although in 8 patients (13 %) arthroscopy identified an additional injury. The overall agreement between MRA and arthroscopic findings was good, but the identification of GHL and rotator cuff injuries was poor. (orig.)

  8. Arthroscopic resection of multiple ossifying tumors in the infrapatellar fat pad

    Directory of Open Access Journals (Sweden)

    Oshigiri Tsutomu

    2012-11-01

    Full Text Available Abstract A 49 year-old male visited a nearby clinic five years back with a complaint of pain in the right knee during exercise. Plain radiographs revealed absence of any anomalies. He began to feel a lumpy mass in his right knee two years back. The pain worsened, on imaging, an anomaly was identified in the infrapatellar fat pad of his right knee, and he was subsequently referred to our department where he was hospitalized. On examination, a mass extending on either side of the patellar tendon was identified along with rigid tenderness in that area. The knee’s range of motion was 0degrees-130degrees, and knee flexion was accompanied by pain. The results of blood tests were normal. A plain radiograph of the knee revealed multiple ossifying tumors at a site consistent with the infrapatellar fat pad. T1-weighted MRI exhibited low-signal intensity, while T2-weighted MRI exhibited a mosaic-shaped tumor. We performed arthroscopic surgery to excise the tumor. The patient resumed work shortly after surgery and did not experience any pain during the two year postoperative observation period. The joint’s range of motion improved to the extent that it was comparable with that of the left knee. No recurrence was observed on radiographic examination. In past studies, resection of similar tumors has been performed with an arthrotomy; however, we performed arthroscopic resection on our patient, who demonstrated a quick improvement in symptoms and range of motion after surgery. We believe that arthroscopic surgery is a feasible option to consider while treating such cases.

  9. Arthroscopic single-bundle reconstruction of posterior cruciate ligament with quadrupled hamstring tendon

    Institute of Scientific and Technical Information of China (English)

    SUN Lei; NING Zhi-jie; ZHANG Hui; TIAN Min; NING Ting-min

    2007-01-01

    Objective:To evaluate the technique and outcome of arthroscopic single-bundle reconstruction of posterior cruciate ligament (PCL) with quadrupled hamstring tendon. Methods:From April 2001 to October 2004,49 knees with PCL tears in 49 patients were verified with arthroscope in this department. Of them, 13 were combined with anterior cruciate ligament tears,14 with disruptions of the posterolateral corner,6 with ruptures of the posteromedial corner and medial collateral ligament,9 with lateral meniscus tears,5 with medial meniscus tears and 2 with popliteal vascular tears.All the damaged PCLs were reconstructed with single-bundle of autogenous quadrupled hamstring tendons under arthroscope.Biodegradable interference screws or blunt titanium interference screws were used for direct anatomic fixation of the reconstructed ligament. Results:After operation,no severe complications occurred at early stage in the 49 patients.All of them were followed up for 10-52 months with an average of 22.0 months±10.7 months.Lysholm score was remarkably improved from 30-60 ( mean:47.96 ± 8.16) preoperatively to 70-95 ( mean:89.08 ± 6.10) at the last postoperative follow-up (P < 0.01 ).Furthermore,there was a significant improvement in International Knee Documentation Committee (IKDC) score from abnormal ( Grade C) in 10 knees and severely abnormal ( Grade D ) in 39 preoperatively to normal ( Grade A) in 20,nearly normal ( Grade B) in 24 and abnormal in 5 at the last follow-up.Of the 49 patients,40 returned to the same activity level as before and 9 were under the level. Conclusions:Single-bundle reconstruction of PCL with quadrupled hamstring tendons has the advantage of minimal trauma in surgery and satisfactory outcome.

  10. Progress of peripheral nerve repair

    Institute of Scientific and Technical Information of China (English)

    陈峥嵘

    2002-01-01

    Study on repair of peripheral nerve injury has been proceeding over a long period of time. With the use of microsurgery technique since 1960s,the quality of nerve repair has been greatly improved. In the past 40 years, with the continuous increase of surgical repair methods, more progress has been made on the basic research of peripheral nerve repair.

  11. Rotator Cuff Repair

    Medline Plus

    Full Text Available ... repair. So what I'll do at this time is to cut the biceps tendon and then ... pulling and obviously it's not attached, so over time, the muscle atrophies and this also retracts and ...

  12. Aortic Aneurysm Repair

    Medline Plus

    Full Text Available ... this is Dr. Rua, and together as a team of multidisciplinary physicians, we’re going to repair ... Institute is we have a highly- integrated multidisciplinary team; Dr. Rua and I being an example. There ...

  13. Rotator cuff repair - slideshow

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/presentations/100229.htm Rotator cuff repair - series—Normal anatomy To use the sharing ... slide 4 out of 4 Overview The rotator cuff is a group of muscles and tendons that ...

  14. Rotator Cuff Repair

    Medline Plus

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

  15. Rotator Cuff Repair

    Medline Plus

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

  16. INTERNAL REPAIR OF PIPELINES

    Energy Technology Data Exchange (ETDEWEB)

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

    2004-04-12

    The two broad categories of deposited weld metal repair and fiber-reinforced composite liner repair technologies were reviewed for potential application for internal repair of gas transmission pipelines. Both are used to some extent for other applications and could be further developed for internal, local, structural repair of gas transmission pipelines. Preliminary test programs were developed for both deposited weld metal repair and for fiber-reinforced composite liner repair. Evaluation trials have been conducted using a modified fiber-reinforced composite liner provided by RolaTube and pipe sections without liners. All pipe section specimens failed in areas of simulated damage. Pipe sections containing fiber-reinforced composite liners failed at pressures marginally greater than the pipe sections without liners. The next step is to evaluate a liner material with a modulus of elasticity approximately 95% of the modulus of elasticity for steel. Preliminary welding parameters were developed for deposited weld metal repair in preparation of the receipt of Pacific Gas & Electric's internal pipeline welding repair system (that was designed specifically for 559 mm (22 in.) diameter pipe) and the receipt of 559 mm (22 in.) pipe sections from Panhandle Eastern. The next steps are to transfer welding parameters to the PG&E system and to pressure test repaired pipe sections to failure. A survey of pipeline operators was conducted to better understand the needs and performance requirements of the natural gas transmission industry regarding internal repair. Completed surveys contained the following principal conclusions: (1) Use of internal weld repair is most attractive for river crossings, under other bodies of water, in difficult soil conditions, under highways, under congested intersections, and under railway crossings. (2) Internal pipe repair offers a strong potential advantage to the high cost of horizontal direct drilling (HDD) when a new bore must be created

  17. Rotator Cuff Repair

    Medline Plus

    Full Text Available ... the east, where there's a fair amount of ice and he actually was sliding and stretched his ... to the same question of, "Is there an age which you wouldn't recommend a repair and ...

  18. Rotator Cuff Repair

    Medline Plus

    Full Text Available ... a little bit about how calcifications can sometimes be debrided and other times require a repair. 00:43:25 JOHN URIBE, M.D.: Well, that's a good question because calcifications, even though ...

  19. Arthroscopic and computer-assisted high tibial osteotomy using standard total knee arthroplasty navigation software.

    Science.gov (United States)

    Thompson, Stephen R; Zabtia, Nazar; Weening, Bradley; Zalzal, Paul

    2013-05-01

    Opening-wedge high tibial osteotomy is an increasingly performed procedure for treatment of varus gonarthrosis and correction of malalignment during meniscal transplantation or cartilage restoration. Precise preoperative planning and meticulous surgical technique are required to achieve an appropriate mechanical axis correction. We describe our technique of arthroscopic and computer-assisted high tibial osteotomy using commonly available total knee arthroplasty navigation software as an intraoperative goniometer. We believe that our technique, by providing intraoperative real-time guidance of the degree of correction that is accurate and reliable, represents a useful tool for the surgeon who uncommonly performs high tibial osteotomy.

  20. Arthroscopic debridement and biological resurfacing of the glenoid in glenohumeral arthritis.

    Science.gov (United States)

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

    2010-12-01

    The purpose of this study was to analyse the intermediate-term results of an arthroscopic procedure to debride and resurface the arthritic glenoid, in a middle-aged population, using an acellular human dermal scaffold. Between 2003 and 2005, thirty-two consecutive patients underwent an arthroscopic debridement and biological glenoid resurfacing for glenohumeral arthritis. The diagnoses included primary osteoarthrosis (28 patients), arthritis after arthroscopic reconstruction for anterior instability (1 patient) and inflammatory arthritis (3 patients). All shoulders were assessed clinically using the Constant and Murley score, and results graded according to Neer's criteria. Statistical analysis was performed to determine significant parameters and associations. A significant improvement (P < 0.0001) in each parameter of the subjective evaluation component (severity of pain, limitation in daily living and recreational activities) of the Constant score was observed. The Constant and Murley score increased significantly (P < 0.0001) from a median of 40 points (range 26-63) pre-operatively to 64.5 (range 19-84) at the final assessment. Overall, the procedure was considered as "successful outcome" in 23 patients (72%) and as a "failure" in 9 patients (28%). According to Neer's criteria, the result was categorized as excellent in 9 (28%), satisfactory in 14 (44%) and unsatisfactory in 9 (28%). Within the unsatisfactory group, there were five conversions to prosthetic arthroplasty. A standard magnetic resonance imaging was performed on 22 patients in the successful outcome group; glenoid cartilage was identified in 12 (thick in 5, intermediate in 1, thin in 6) and could not be identified in 10 patients (complete/incomplete loss in 5, technical difficulties in 5). Overall, five complications included transient axillary nerve paresis, foreign-body reaction to biological material, inter-layer dissociation, mild chronic non-specific synovitis and post-traumatic contusion

  1. Evaluation Of Range Of Motion After Arthroscopic Arthroloysis In Postoperative Arthrofibrosis Of The Knee

    Directory of Open Access Journals (Sweden)

    Moghtader Azadi G

    2003-07-01

    Full Text Available Arthrofibrosis continue to be a difficult complication of operative procedures of trauma about the knee. We present our experience in 8 cases of arthroscopic Arthrolysis between 1997 and 2001. in 3 Cases the etiology was prior Knee ligament surgery and 5 cases had sustained fractures about the knee. Technique begins with the liberation of the adhesions of suprapatellar Pouch, continues down both gutters , and ends with a cleaning of the notch where necessary. The result obtained are very satisfactory, with an average increase in the arc of mobility of 61 degrees."n 

  2. Arthroscopic Excision of Juxta-articular Osteoid Osteoma of the Calcaneum

    Science.gov (United States)

    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

  3. [Arthroscopic treatment of chondral lesions of the ankle joint. Evidence-based therapy].

    Science.gov (United States)

    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

  4. Grey Repairable System Analysis

    Institute of Scientific and Technical Information of China (English)

    Renkuan Guo; Charles Ernie Love

    2006-01-01

    In this paper, we systematically discuss the basic concepts of grey theory, particularly the grey differential equation and its mathematical foundation, which is essentially unknown in the reliability engineering community. Accordingly,we propose a small-sample based approach to estimate repair improvement effects by partitioning system stopping times into intrinsic functioning times and repair improvement times. An industrial data set is used for illustrative purposes in a stepwise manner.

  5. Arthroscopic treatment of the athletic recurrent shoulder anterior dislocations%运动员复发性肩关节前脱位的关节镜治疗

    Institute of Scientific and Technical Information of China (English)

    马佳; 崔国庆; 王健全; 肖健; 闫辉; 杨渝平; 刘玉雷; 敖英芳; 于长隆

    2009-01-01

    目的 评价关节镜下肩关节前向稳定手术对运动员复发性肩关节前脱位的治疗效果.方法 2001年1月至2006年12月,应用关节镜下肩关节前向稳定手术治疗运动员复发性肩关节前脱位29例,男15例,女14例;年龄15~35岁,平均(20.7±1.4)岁.手术均采用关节镜下盂唇缝合固定术(带线锚钉技术),必要时辅以关节囊折叠缝合术、旋转间隙闭合术或热皱缩术.以脱位复发率、肩关节活动度、恢复运动水平级别及UCLA、Dawson、SST评分系统对术后疗效进行评价.结果 全部病例随访17~66个月,平均30.2个月.4例(13.8%)失败,其中3例(10.3%)脱位复发,1例发生半脱位.24例(82.8%)基本恢复到伤前运动水平(恢复≥90%).UCLA、Dawson及SST评分与术前比较差异均有统计学意义.优良率82.8%~89.7%.术后患侧前屈、0°外展位及90°外展位外旋活动度较术前增加,与健侧差值的差异均有统计学意义.结论 运动员复发性肩关节前脱佗的关节镜下肩关节前向稳定手术的治疗效果良好,术后肩关节功能评分及关节活动度有明显改善,脱位复发率及运动水平的恢复程度与大多数文献报道的切开手术效果相近.%Objective To assess the results of arthroscopic anterior shoulder stabilization of athletes with recurrent anterior shoulder dislocations. Methods From Jan. 2001 to Dec. 2006, 29 athletes (15 males and 14 females) suffered recurrent anterior shoulder dislocations underwent arthroscopic anterior shoulder stabilizations. The age of the patients at the time of surgery was from 15 to 35 years (average, 20.7±1.4 years). The surgical procedure was performed in a consistent manner:, arthroscopic suture anchor repair of the displaced labrum, rotator interval closure supplemented with thermal treatment of the capsule when indicat-ed. The clinical results, including the postoperative recurrence rate, range of motion, and the levels of post-operative recovered to

  6. Open aortic surgery after thoracic endovascular aortic repair.

    Science.gov (United States)

    Coselli, Joseph S; Spiliotopoulos, Konstantinos; Preventza, Ourania; de la Cruz, Kim I; Amarasekara, Hiruni; Green, Susan Y

    2016-08-01

    In the last decade, thoracic endovascular aortic aneurysm repair (TEVAR) has emerged as an appealing alternative to the traditional open aortic aneurysm repair. This is largely due to generally improved early outcomes associated with TEVAR, including lower perioperative mortality and morbidity. However, it is relatively common for patients who undergo TEVAR to need a secondary intervention. In select circumstances, these secondary interventions are performed as an open procedure. Although it is difficult to assess the rate of open repairs after TEVAR, the rates in large series of TEVAR cases (>300) have ranged from 0.4 to 7.9 %. Major complications of TEVAR that typically necessitates open distal aortic repair (i.e., repair of the descending thoracic or thoracoabdominal aorta) include endoleak (especially type I), aortic fistula, endograft infection, device collapse or migration, and continued expansion of the aneurysm sac. Conversion to open repair of the distal aorta may be either elective (as for many endoleaks) or emergent (as for rupture, retrograde complicated dissection, malperfusion, and endograft infection). In addition, in select patients (e.g., those with a chronic aortic dissection), unrepaired sections of the aorta may progressively dilate, resulting in the need for multiple distal aortic repairs. Open repairs after TEVAR can be broadly classified as full extraction, partial extraction, or full salvage of the stent-graft. Although full and partial stent-graft extraction imply failure of TEVAR, such failure is generally absent in cases where the stent-graft can be fully salvaged. We review the literature regarding open repair after TEVAR and highlight operative strategies.

  7. MRI for autologous plastic repair of the anterior cruciate ligament: A comparison of two operative methods

    International Nuclear Information System (INIS)

    The aim of this prospective MRI study was the analysis of the post-operative signals derived from two techniques for cruciate ligament reconstruction. Patients and Methods: Group 1 consisted of 15 patients who had undergone conventional plastic repair by patellar tendon transplant and group 2 was made up of 15 patients with arthroscopic reconstruction with semitendinosus grafts. They were examined at 6 weeks and 6 months post-operatively. Results: Typical appearances of normal transplants were found in 19 patients. After 6 months 8 of the patellar tendon transplants and three of the semitendinosis transplants could not be clearly defined. At this time there was a significant increase in signal intensity in the middle third of the transplant in group 1. Conclusion: Bearing in mind the different operative techniques, there was a higher impingement rate in group 1. The post-operative MRI findings at 6 months after surgery allowed differentiation between pathological changes (impingement) and revascularisation (remodelling). (orig.)

  8. The arthroscopic treatment of displaced tibial spine fractures in children and adolescents using Meniscus Arrows(A (R))

    NARCIS (Netherlands)

    Wouters, Diederick B.; de Graaf, Joost S.; Hemmer, Patrick H.; Burgerhof, Johannes G. M.; Kramer, William L. M.

    2011-01-01

    This article summarises the results of a newly developed technique that utilises Meniscus Arrows(A (R)) for the arthroscopic fixation of displaced tibial spine fractures in children and adolescents. Twelve tibial spine fractures in the knees of eleven children between 6 and 15 years old, with an ave

  9. Arthroscopic Latarjet and Capsular Shift (ALCS) procedure: a new "freehand" technique for anterior shoulder instability associated with significant bone defects.

    Science.gov (United States)

    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.

  10. Intra-articular versus intravenous magnesium-sulfate as adjuvant to femoral nerve block in arthroscopic knee sur

    Directory of Open Access Journals (Sweden)

    Mohamed Abdulatif

    2015-07-01

    Conclusion: The combined use of femoral nerve block with IA or IV MgSO4 is associated with significant reduction of the intensity and duration of postoperative pain and postoperative analgesic requirements in patients undergoing arthroscopic knee surgery with the IA MgSO4 being superior to IV route of administration.

  11. Risk Factors for Recurrent Shoulder Dislocation Arthroscopically Managed with Absorbable Knotless Anchors

    Directory of Open Access Journals (Sweden)

    Raffaele Russo

    2014-01-01

    Full Text Available Purpose. To evaluate the clinical outcome and risk factors for recurrent dislocation after arthroscopic stabilization with absorbable knotless anchor. Methods. We treated 197 patients affected by anterior shoulder instability, either traumatic or atraumatic with the same arthroscopic suture technique. We recorded age at surgery and number and type of dislocations (traumatic/atraumatic. Of the 197 patients, 127 (65.4% were examined with a mean follow-up of 5.6 years (range: 25–108 months. Eighty-one shoulders were evaluated with the Rowe score and 48 with the Simple Shoulder Test (SST. Results. The mean Rowe score was 90.8, while the mean SST score was 10.9. Recurrence occurred in 10 cases (7.7% but only in 4 cases was atraumatic, which reduces the real recurrence rate to 3.1%. Patients with recurrence were significantly younger at surgery than patients who did not relapse (P=0.040. Moreover, neither the number (P=0.798 nor the type of shoulder instability (P=0.751, or the amount of glenoid bone loss (P=0.184 significantly affected the probability of recurrence. Conclusions. In a patient population with involuntary monodirectional anterior shoulder instability, use of absorbable knotless anchor was reliable and resulted in a good outcome. In this series the statistical significant risk factors for recurrent dislocation were age of patient.

  12. RELEVANCE OF ARTHROSCOPIC SYNOVIAL BIOPSY IN JOINT DISORDERS - A PROSPECTIVE STUDY

    Directory of Open Access Journals (Sweden)

    Kali Vara Prasad

    2015-10-01

    Full Text Available BACK GROUND : Synovial biopsy is considered as the gold standard in the diagnosis of various joint disorders and synovial diseases. But sometimes the definitive diagnosis is elusive only by doing biopsy then clinical, hematological and x - ray examinations will help. The advantage with arthroscopic synovial biopsy is that it is easy to perform, minimal discomfort to the patient and can be done at intervals if the diagnosis can n ot be made in the first examination. MATERIAL & METHODS : The present study was conducted in the Department of Orthopedics & Traumatology, Osmania General Hospital/ Medical College, Hyderabad. The duration of the study was from Sept 2012 to Sept 2014. CONCLUSIONS : Arthroscopic synovial biopsy is the mainstay in the management of Joint disorders and Synovial diseases. It is patient friendly and repeated procedures can be undertaken when the definitive diagnosis could not be established in the initial attempt, as is common in some cases of Non - specific synovitis, later being diagnosed either as Osteoarthritis or Rheumatoid Arthritis. This is the greatest advantage in using this procedure.

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

    Science.gov (United States)

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

    2008-01-01

    Septic arthritis following anterior cruciate ligament reconstruction is an uncommon but a serious complication resulting in six times greater hospital costs than that of uncomplicated ACL surgery and an inferior postoperative activity level. Promptly initiating a specific antibiotic therapy is the most critical treatment, followed by open or arthroscopic joint decompression, debridement and lavage. Staphylococcus lugdunensis is a coagulase-negative staphylococcus predominantly infecting the skin and soft tissue. The few reported cases of bone and joint infections by S. lugdunensis indicate that the clinical manifestations were severe, the diagnosis elusive, and the treatment difficult. If the microbiology laboratory does not use the tube coagulase (long) test to confirm the slide coagulase test result, the organism might be misidentified as Staphylococcus aureus. S. lugdunensis is more virulent than other coagulase-negative staphylococcus; in many clinical situations it behaves like S. aureus, further increasing the confusion and worsening the expected outcome. S. lugdunensis is known to cause infective endocarditis with a worse outcome, septicemia, deep tissue infection, vascular and joint prosthesis infection, osteomyelitis, discitis, breast abscess, urine tract infections, toxic shock and osteitis pubis. We present the first case report in the literature of septic arthritis with S. lugdunensis following arthroscopic ACL revision with bone-patellar-tendon-bone allograft.

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

    Science.gov (United States)

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

    2009-09-01

    Although there are numerous reports of septic pyogenic arthritis after arthroscopic anterior cruciate ligament (ACL) reconstruction, there is limited information regarding the outcomes of fungal infection. We determined the outcomes of six patients with mycotic infection after regular ACL reconstruction. There were four males and two females with a mean age of 33 years. We determined the number of procedures performed, bone loss originating to control infection, and final reconstruction in these patients. An average of five arthroscopic lavage procedures had been performed at the referring centers. Fungal infection was diagnosed based on pathologic samples; five infections were the result of mucormycosis and one was Candida. After final débridement, the mean segmental bone loss was 12.8 cm. All patients were treated with intravenous antifungal coverage and cement spacers before final reconstruction. At final followup, all patients were free of clinical infection. Three had reconstruction with an allograft-prosthesis composite, two with hemicylindrical allografts, and one with an intercalary allograft arthrodesis. Despite the extremely unusual presentation of this complication, surgeons should be aware of potential and catastrophic consequences of this severe complication after ACL reconstruction.

  15. Clinical and Arthroscopic Findings of Acute Anterior Cruciate Ligament Tears of the Knee

    Directory of Open Access Journals (Sweden)

    Kenji Shirakura

    1995-01-01

    Full Text Available Clinical, arthrographic, and arthroscopic findings in 53 patients with acutely torn anterior cruciate ligaments (ACLs were documented. Arthroscopy and instability tests under anesthesia were performed on all patients within 2 weeks after the initial injury. Twenty-three patients complained of extension blocks, and localized tenderness on the medial side was revealed in 26 patients at the initial examination. Aspiration from joints exhibited hemarthrosis in 52 patients. Arthroscopy revealed ACL ruptures in all patients. Four Segond's fractures, 26 meniscus tears (8 medial and 18 lateral, 1 osteochondral fracture, and 19 medial collateral ligament ruptures were revealed. Arthroscopy detected only 1 of the 5 ruptures of the posteromedial corner of the medial meniscus, which were noted on arthrography. Three ACL stumps were protruding among the femorotibial joint, which seemed to be restricting full extension. Statistical analysis showed that tenderness on the medial side was not revealed more frequently in knees with medial collateral ligament injuries than in the others. The volume of aspirated fluids in knees with no leakage in arthrography significantly increased over those with leakages (p < 0.05. Diagnosis of ACL injuries should be completed by clinical, arthrographic, and arthroscopic examinations.

  16. Arthroscopically assisted treatment for Schatzker type I-V tibial plateau fractures

    Institute of Scientific and Technical Information of China (English)

    DUAN Xiao-jun; YANG Liu; GUO Lin; CHEN Guang-xing; DAI Gang

    2008-01-01

    Objective: To report the clinical outcome of arthroscopically assisted treatment for tibial plateau fractures.Methods: A total of 39 patients with tibial plateau fractures were treated by arthroscopic fixation from February 2002 to December 2005,including 11 patients with bony avulsion of the anterior cruciate ligament and 19 with meniscal injury.There were 4 cases of type I fracture,12 type II,9 type III,12 type IV and 2 type V according to Schatzker criteria.Firstly,the combined injuries were treated.Then the plateau fractures with the displacement over 3 mm or more were reduced and fixed.Finally,the internal fixation was observed by X-ray equipment.Postoperative management was early motion and delayed weight bearing.Results: All the fractures healed in 3 or 4 months.All patients were followed up for 1 to 5 years after operation.No case had severe complications,such as poor wound healing,infection,osteofascial compartment syndrome and osteoarthritis.According to the Rasmussen scoring system,36 cases obtained excellent or good results and the other 3 cases had moderate clinical results.The average score was 26 ± 3.Conclusions: As an adjuvant treatment of intraarticular fractures such as tibial plateau fracture,arthroscopy has many advantages.It can treat associated intraarticular soft tissue components,visualize the chondral surface reduction,lavage the hematoma and smaller loose fragments,decrease soft tissue dissection,reduce the risk of scarring and promote rapid recovery.

  17. Analgesic effects of intra-articular fentanyl, pethidine and dexamethasone after knee arthroscopic surgery

    Directory of Open Access Journals (Sweden)

    H Saryazd

    2006-07-01

    Full Text Available BACKGROUND: Many different methods have been used in an effort to provide adequate analgesia after knee arthroscopic surgery. In this study analgesic effect of intra-articular fentanyl, pethidine and dexamethasone was compared. METHODS: In a double blind randomized study 48 male patients undergoing knee arthroscopic meniscectomy were allocated to groups receiving intra-articular fentanyl 50 µg or pethidine 20 mg or dexamethasone 8 mg at the end of arthroscopy during general aesthesia. Postoperative pain scores using visual analogue scale were measured and also analgesic requirements and the time of ability to walk were recorded. RESULTS: Pain scores at one, two, six and 24 h after intra-articular injection were not significantly different for fentanyl and pethidine but were higher significantly for dexamethasone at all four mentioned times. The mean average time of ability to walk was significantly longer for dexamethasone. The analgesic requirements during the first 24 h after intraarticular injection were significantly greater only for dexamethasone too. CONCLUSION: Better postoperative analgesia, less pain score and shorter time to walk were achieved by fentanyl and pethidine in comparison to dexamethasone but the results were not significantly different between fentanyl group and pethidine. KEYWORDS: Arthroscopy, opioid, pain.

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

    Science.gov (United States)

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

    2009-09-01

    Although there are numerous reports of septic pyogenic arthritis after arthroscopic anterior cruciate ligament (ACL) reconstruction, there is limited information regarding the outcomes of fungal infection. We determined the outcomes of six patients with mycotic infection after regular ACL reconstruction. There were four males and two females with a mean age of 33 years. We determined the number of procedures performed, bone loss originating to control infection, and final reconstruction in these patients. An average of five arthroscopic lavage procedures had been performed at the referring centers. Fungal infection was diagnosed based on pathologic samples; five infections were the result of mucormycosis and one was Candida. After final débridement, the mean segmental bone loss was 12.8 cm. All patients were treated with intravenous antifungal coverage and cement spacers before final reconstruction. At final followup, all patients were free of clinical infection. Three had reconstruction with an allograft-prosthesis composite, two with hemicylindrical allografts, and one with an intercalary allograft arthrodesis. Despite the extremely unusual presentation of this complication, surgeons should be aware of potential and catastrophic consequences of this severe complication after ACL reconstruction. PMID:19190972

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

    Science.gov (United States)

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

    2008-01-01

    Septic arthritis following anterior cruciate ligament reconstruction is an uncommon but a serious complication resulting in six times greater hospital costs than that of uncomplicated ACL surgery and an inferior postoperative activity level. Promptly initiating a specific antibiotic therapy is the most critical treatment, followed by open or arthroscopic joint decompression, debridement and lavage. Staphylococcus lugdunensis is a coagulase-negative staphylococcus predominantly infecting the skin and soft tissue. The few reported cases of bone and joint infections by S. lugdunensis indicate that the clinical manifestations were severe, the diagnosis elusive, and the treatment difficult. If the microbiology laboratory does not use the tube coagulase (long) test to confirm the slide coagulase test result, the organism might be misidentified as Staphylococcus aureus. S. lugdunensis is more virulent than other coagulase-negative staphylococcus; in many clinical situations it behaves like S. aureus, further increasing the confusion and worsening the expected outcome. S. lugdunensis is known to cause infective endocarditis with a worse outcome, septicemia, deep tissue infection, vascular and joint prosthesis infection, osteomyelitis, discitis, breast abscess, urine tract infections, toxic shock and osteitis pubis. We present the first case report in the literature of septic arthritis with S. lugdunensis following arthroscopic ACL revision with bone-patellar-tendon-bone allograft. PMID:17684731

  20. Acidic fibroblast growth factor composited by partially deproteinised bone in repair of early-stage avascular necrosis of the femoral head in rabbits An imageological evaluation%酸性成纤维细胞因子复合部分脱蛋白骨修复免早期股骨头缺血性坏死的影像学评价

    Institute of Scientific and Technical Information of China (English)

    朱肖奇; 郭浩

    2009-01-01

    BACKGROUND: Prior studies have demonstrated that acidic fibroblast growth factor (aFGF) composited by partially deproteinized bone (PDPB) (aFGF/PDPB) well promotes vascularization in animals with early-stage avascular necrosis of the femoral head (ANFH).OBJECTIVE: To evaluate the repairing effects of aFGF/PDPB on ANFH in rabbits using X-ray examination and to compare the effects with PDPB.DESIGN, TIME AND SETTING: A randomized, controlled, animal experiment was performed in the College of Life Science, Nanhua University between January 2008 and January 2009.MATERIALS: Ribs from healthy, adult, New Zealand rabbits were prepared into PDPB by a series of physico-chemical methods including degreasing, deproteinization, partial decalcification, and freeze drying, aFGF diluted with sterile distilled water was composited by PDPB particles to prepare artificial composite bone.METHODS: A bone window was made at the juncture of femoral head and femoral neck bilaterally in 24 healthy, adult, New Zealand rabbits. Rabbit models of bilateral ANFH were established by removing approximately 50% of cancellous bone and perfusion with 95% ethanol. Successful bilateral ANFH models were randomly divided into 3 groups: blank, PDPB, and aFGF/PDPB. PDPB and artificial composite bone were implanted into the PDPB and aFGF/PDPB groups accordingly. The blank group did not receive any implantation.MAIN OUTCOME MEASURES: At 2, 4, and 8 weeks after surgery, specimen tissue was harvested for X-ray examination.RESULTS: In the blank group, low-density shadow appeared through the whole process and it was present in the defect region at 8 weeks; in addition, 2 rabbits exhibited collapse of the femoral head. In the PDPB group, at 2 and 4 weeks, bone grafting region and adjacent normal bone tissue could be clearly seen, and at 8 weeks, X-ray examination showed normal femoral head in 1 rabbit, and bone defect regions could be distinguished, but unclear, from adjacent normal bone tissue after careful

  1. Partial tooth gear bearings

    Science.gov (United States)

    Vranish, John M. (Inventor)

    2010-01-01

    A partial gear bearing including an upper half, comprising peak partial teeth, and a lower, or bottom, half, comprising valley partial teeth. The upper half also has an integrated roller section between each of the peak partial teeth with a radius equal to the gear pitch radius of the radially outwardly extending peak partial teeth. Conversely, the lower half has an integrated roller section between each of the valley half teeth with a radius also equal to the gear pitch radius of the peak partial teeth. The valley partial teeth extend radially inwardly from its roller section. The peak and valley partial teeth are exactly out of phase with each other, as are the roller sections of the upper and lower halves. Essentially, the end roller bearing of the typical gear bearing has been integrated into the normal gear tooth pattern.

  2. The diagnostic value of direct CT arthrography using MDCT in the evaluation of acetabular labral tear: with arthroscopic correlation

    Energy Technology Data Exchange (ETDEWEB)

    Ha, Yong-Chan; Kim, Jae Yoon [Chung-Ang University College of Medicine, Department of Orthopaedic Surgery, Seoul (Korea, Republic of); Choi, Jung-Ah; Lee, Guen Young; Kang, Heung Sik [Seoul National University Bundang Hospital, Departments of Radiology, Seoul National University College of Medicine, 166 Gumi-ro, Bundang-gu, Seongnam (Korea, Republic of); Lee, Young-Kyun; Koo, Kyung-Hoi [Seoul National University Bundang Hospital, Orthopaedic Surgery, Seoul National University College of Medicine, Seongnam (Korea, Republic of)

    2013-05-15

    The purpose of this study was first, to determine the sensitivity, specificity, and accuracy of MDCT arthrography (CTA) for the diagnosis of acetabular labral tear and sulcus; second, to correlate tear types using the Lage classification system on CTA compared with the arthroscopic classification; and third, to correlate CTA localization with arthroscopic localization. Direct CTA was performed using 16- or 64-slice MDCT in 126 hips (124 patients) who had chronic groin pain and positive impingement test. Images were reviewed and evaluated by two experienced musculoskeletal radiologists preoperatively. CTA findings were compared with arthroscopic findings in 58 hips (56 patients) under consensus by two orthopedic surgeons. Forty-one of the 58 hips were diagnosed as labral tears on CT arthrography. Forty-three of the 58 hips were shown to have a labral tear on arthroscopy. Sensitivity, specificity, and accuracy for detecting labral tear and sulcus by CTA were 90.7%, 86.7%, and 89.7%, and 93.8%, 97.6% and 96.6% respectively for observer 1, and 90.7% and 80.0%, 87.9% and 87.5%, 95.2%, and 93.1 % respectively for observer 2. Thirty-five out of 41 hips (85%) that were diagnosed with labral tear on CTA correlated substantially with arthroscopic Lage classification (kappa coefficient = 0.65). CTA and arthroscopic findings showed similar distribution patterns of the tears with most lesions located in antero- and postero-superior areas (p = 0.013). Direct CT arthrography using MDCT may be a useful diagnostic technique in the detection of acetabular labral tear. (orig.)

  3. Equipment maintenance and repair

    Directory of Open Access Journals (Sweden)

    Walia DS

    2010-10-01

    Full Text Available The repair and maintenance of ophthalmic equipment, including surgical instruments and diagnostic devices, can be compared to the maintenance of a motor vehicle, something many of us understand well.If you had a car, would you drive it until the fuel runs out or until a tyre punctures, and then abandon it to buy a new car? Of course not. However, many eye care units purchase (or receive as a donation expensive and delicate equipment which, because of poor maintenance, ends up breaking down. If there is not a system in place to report breakdowns and to plan or carry out repairs, equipment can remain unusable for long periods of time. Sometimes, this equipment ends up being dumped. Good maintenance habits and an effective repair system will minimise the amount of time equipment is unusable.

  4. Essays on partial retirement

    OpenAIRE

    Kantarci, T.

    2012-01-01

    Abstract: The five essays in this dissertation address a range of topics in the micro-economic literature on partial retirement. The focus is on the labor market behavior of older age groups. The essays examine the economic and non-economic determinants of partial retirement behavior, the effect of partial retirement on retirement income and health, and the factors that could limit workers to participate in partial retirement. The analysis is mainly empirical and makes use of survey data on a...

  5. Groin hernia repair in young males: mesh or sutured repair?

    DEFF Research Database (Denmark)

    Bisgaard, T; Bay-Nielsen, M; Kehlet, H

    2010-01-01

    Large-scale data for the optimal inguinal hernia repair in younger men with an indirect hernia is not available. We analysed nationwide data for risk of reoperation in younger men after a primary repair using a Lichtenstein operation or a conventional non-mesh hernia repair....

  6. Cleft lip and palate repair

    Science.gov (United States)

    Orofacial cleft; Craniofacial birth defect repair; Cheiloplasty; Cleft rhinoplasty; Palatoplasty; Tip rhinoplasty ... these conditions at birth. Most times, cleft lip repair is done when the child is 6 to ...

  7. Long Term Follow up Results of the Arthroscopic Treatment of the Talus Osteochondral Lesions (Tol) and the Factors that Effect Results

    OpenAIRE

    Gökkuş, Kemal; Aydın, Ahmet Turan

    2014-01-01

    Objectives: The arthroscopic debritment, curettage and multidrilling /microfracture is well known and established method of treatment. However the factors that effect prognosis is still controversy at recent literature. The aim of this study is to present and evaluate the factors that effects the long term follow up results of our patients. Methods: 56 patients who admitted to our clinic with chronic ankle pain and diagnosed as TOL treated with arthroscopic debritement, curettage and multidri...

  8. Arthroscopic reconstruction of multiple ligaments injury of knees%膝关节多发韧带损伤的修复与重建

    Institute of Scientific and Technical Information of China (English)

    皇甫小桥; 赵金忠; 何耀华; 杨星光; 王锋; 朱越; 刘闻欣

    2011-01-01

    目的 探讨关节镜下重建膝关节前十字韧带(anterior cruciate ligament,ACL)、后十字韧带(posterior cruciate ligament,PCL)、后内侧韧带结构(posteromedial complex,PMC)或后外侧韧带结构(posterolateral complex,PLC)损伤的疗效.方法 2005年3月至2007年5月,43例膝关节多发韧带损伤患者采用异体肌腱于关节镜下重建ACL和PCL,同期重建增强PMC或PLC损伤.其中24例行ACL和PCL重建+PMC重建,19例行ACL和PCL重建+PLC重建.根据国际膝关节文献委员会(International Knee Documentation Committee,IKDC)评分和Lysholm膝关节功能评分表对患膝功能进行评估.结果 全部患者随访24~48个月,平均(33.10±9.65)个月.患者在0°和20°应力测试时稳定性均完全恢复.IKDC评分入院时均为显著异常(D级),术后随访时正常(A级)29例(67%,29/43)、接近正常(B级)11例(26%,11/43)、异常(C级)3例(7%,3/43).患者术前Lysholm膝关节功能评分为(46.7±4.2)分,末次随访时为(89.6±2.8)分,差异有统计学意义(t=8.563,P<0.01).结论 膝关节多发韧带损伤可于关节镜下行ACL和PCL联合重建,同期行关节外韧带结构修复增强,能有效恢复关节功能,治疗效果满意.%Objective To describe the surgical technique and outcomes of arthroscopic reconstruction anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) and repair of the injured posteromedial complex (PMC) or posterolateral complex (PLC) structures of the knee joint in treatment of multiple ligaments injuries of knee. Methods From March 2005 to May 2007, 43 patients with multiple ligaments injuries of knee underwent arthroscopic reconstruction. Twenty-four patients were treated with arthroscopic reconstruction of combined ACL and PCL with allograft tendons and augmentation of PMC. The other 19 patients were treated with repair the PLC in addition to reconstruction of ACL and PCL. The International Knee Documentation Committee (IKDC) and Lysholm knee score were

  9. Tratamento artroscópico do impacto femoroacetabular Arthroscopic treatment of femoroacetabular impingement

    Directory of Open Access Journals (Sweden)

    Giancarlo C. Polesello

    2009-06-01

    Full Text Available OBJETIVOS: O propósito deste estudo é avaliar os resultados em curto prazo do tratamento artroscópico do impacto femoroacetabular. A hipótese é a de que os resultados do tratamento artroscópico são favoráveis. MÉTODOS: Entre agosto de 2003 e agosto de 2007, 28 quadris foram submetidos ao tratamento do impacto femoroacetabular pela via artroscópica. A idade média dos pacientes foi de 34 anos, com média de seguimento de 27 meses. Quanto à melhora clínica, os pacientes foram avaliados pré e pósoperatoriamente pelo Harris Hip Score (HHS modificado por Byrd. Os pacientes foram avaliados pré e pós-operatoriamente em relação à rotação interna do quadril acometido. Os valores obtidos nos índices acima foram analisados estatisticamente através do método de Wilcoxon para a avaliação de variáveis não paramétricas. RESULTADOS: O Harris Hip Score médio pré-operatório foi de 54,2 e o pós-operatório, de 94,8 (p 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 17º, and, postoperatively, 36º. The average internal rotation increase was 19º (p<0,001. CONCLUSIONS

  10. Rotator Cuff Repair

    Medline Plus

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

  11. Femoral hernia repair

    Science.gov (United States)

    ... bulges out of a weak spot in the groin. Usually this tissue is part of the intestine. ... Your surgeon makes a cut (incision) in your groin area. The hernia is ... wall. This repairs the weakness in the wall. At the end ...

  12. Rotator Cuff Repair

    Medline Plus

    Full Text Available ... Dr. Uribe's going to go up into this space. It's called the subacromial space, and that is where the rotator cuff repair ... flap of tissue, gets caught in that subacromial space Dr. Zvijac was talking about and that produces ...

  13. Patent urachus repair

    Science.gov (United States)

    ... Drugs & Supplements Videos & Tools About MedlinePlus Show Search Search MedlinePlus GO GO About MedlinePlus Site Map FAQs Contact Us Health Topics Drugs & Supplements Videos & Tools Español You Are Here: Home → Medical Encyclopedia → Patent urachus repair URL of this page: //medlineplus.gov/ ...

  14. Patent urachus repair - slideshow

    Science.gov (United States)

    ... Drugs & Supplements Videos & Tools About MedlinePlus Show Search Search MedlinePlus GO GO About MedlinePlus Site Map FAQs Contact Us Health Topics Drugs & Supplements Videos & Tools Español You Are Here: Home → Medical Encyclopedia → Patent urachus repair - series—Normal anatomy URL of this ...

  15. Aortic Aneurysm Repair

    Medline Plus

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

  16. Rotator Cuff Repair

    Medline Plus

    Full Text Available ... shoulder in this case because of the large tear. You can see here is the whole repair. There's the edge of the bone here. It's well covered. It's in the trough. He should do extremely well. 00:45:26 ...

  17. Aircraft Propeller Hub Repair

    Energy Technology Data Exchange (ETDEWEB)

    Muth, Thomas R. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Peter, William H. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States)

    2015-02-13

    The team performed a literature review, conducted residual stress measurements, performed failure analysis, and demonstrated a solid state additive manufacturing repair technique on samples removed from a scrapped propeller hub. The team evaluated multiple options for hub repair that included existing metal buildup technologies that the Federal Aviation Administration (FAA) has already embraced, such as cold spray, high velocity oxy-fuel deposition (HVOF), and plasma spray. In addition the team helped Piedmont Propulsion Systems, LLC (PPS) evaluate three potential solutions that could be deployed at different stages in the life cycle of aluminum alloy hubs, in addition to the conventional spray coating method for repair. For new hubs, a machining practice to prevent fretting with the steel drive shaft was recommended. For hubs that were refurbished with some material remaining above the minimal material condition (MMC), a silver interface applied by an electromagnetic pulse additive manufacturing method was recommended. For hubs that were at or below the MMC, a solid state additive manufacturing technique using ultrasonic welding (UW) of thin layers of 7075 aluminum to the hub interface was recommended. A cladding demonstration using the UW technique achieved mechanical bonding of the layers showing promise as a viable repair method.

  18. Guided Data Repair

    CERN Document Server

    Yakout, Mohamed; Neville, Jennifer; Ouzzani, Mourad; Ilyas, Ihab F

    2011-01-01

    In this paper we present GDR, a Guided Data Repair framework that incorporates user feedback in the cleaning process to enhance and accelerate existing automatic repair techniques while minimizing user involvement. GDR consults the user on the updates that are most likely to be beneficial in improving data quality. GDR also uses machine learning methods to identify and apply the correct updates directly to the database without the actual involvement of the user on these specific updates. To rank potential updates for consultation by the user, we first group these repairs and quantify the utility of each group using the decision-theory concept of value of information (VOI). We then apply active learning to order updates within a group based on their ability to improve the learned model. User feedback is used to repair the database and to adaptively refine the training set for the model. We empirically evaluate GDR on a real-world dataset and show significant improvement in data quality using our user guided re...

  19. Tratamento artroscópico da luxação acromio-clavicular pelo método "tight rope" (arthrex® Arthroscopic treatment of acromioclavicular joint dislocation by tight rope technique (arthrex®

    Directory of Open Access Journals (Sweden)

    Luis Alfredo Gómez Vieira

    2009-02-01

    Full Text Available OBJETIVO: Apresentar a técnica cirúrgica artroscópica pelo método "Tight Rope" e a avaliação dos resultados com esta técnica no tratamento da luxação acrômio-clavicular aguda. MÉTODOS: entre agosto de 2006 e maio de 2007, 10 ombros de 10 pacientes com luxação acrômio-clavicular aguda foram submetidos a tratamento artroscópcio pela técnica Tight Rope-Arthrex®. O seguimento mínimo foi de 12 meses, com média de 15 meses. A idade variou de 26 e 42 anos com média de 34 anos. Todos os pacientes eram do sexo masculino. Todos os pacientes foram atendidos na fase aguda da lesão sendo avaliados por radiologia simples (série trauma. Os pacientes foram acompanhados semanalmente no primeiro mês e a cada três meses após o procedimento artroscópico. A avaliação clínica foi feita por meio dos critérios da University of Califórnia at Los Angeles (UCLA. RESULTADOS: Todos os pacientes operados agudamente encontravam-se satisfeitos com os resultados do tratamento cirúrgico artroscópico com uma média de 32,5 pontos na escala de avaliação da UCLA. CONCLUSÃO: O tratamento artroscópico da luxação acrômio-clavicular aguda pelo método "Tight Rope" é uma técnica cirúrgica minimamente invasiva que mostrou-se eficiente para o tratamento destas lesões.OBJECTIVE: 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

  20. Efficacy and safety of a subacromial continuous ropivacaine infusion for post-operative pain management following arthroscopic rotator cuff surgery: A protocol for a randomised double-blind placebo-controlled trial

    Directory of Open Access Journals (Sweden)

    Bell Simon N

    2008-04-01

    Full Text Available Abstract Background Major shoulder surgery often results in severe post-operative pain and a variety of interventions have been developed in an attempt to address this. The continuous slow infusion of a local anaesthetic directly into the operative site has recently gained popularity but it is expensive and as yet there is little conclusive evidence that it provides additional benefits over other methods of post-operative pain management. Methods/Design This will be a randomised, placebo-controlled trial involving 158 participants. Following diagnostic arthroscopy, all participants will undergo arthroscopic subacromial decompression with or without rotator cuff repair, all operations performed by a single surgeon. Participants, the surgeon, nurses caring for the patients and outcome assessors will be blinded to treatment allocation. All participants will receive a pre-incision bolus injection of 20 mls of ropivacaine 1% into the shoulder and an intra-operative intravenous bolus of parecoxib 40 mg. Using concealed allocation participants will be randomly assigned to active treatment (local anaesthetic ropivacaine 0.75% or placebo (normal saline administered continuously into the subacromial space by an elastomeric pump at 5 mls per hour post-operatively. Patient controlled opioid analgesia and oral analgesics will be available for breakthrough pain. Outcome assessment will be at 15, 30 and 60 minutes, 2, 4, 8, 12, 18 and 24 hours, and 2 or 4 months for decompression or decompression plus repair respectively. The primary end point will be average pain at rest over the first 12-hour post-operative period on a verbal analogue pain score. Secondary end points will be average pain at rest over the second 12-hour post-operative period, maximal pain at rest over the first and second 12-hour periods, amount of rescue medication used, length of inpatient stay and incidence of post-operative adhesive capsulitis. Discussion The results of this trial will

  1. Distal radius fracture arthroscopic intraarticular displacement measurement after open reduction and internal fixation from a volar approach

    International Nuclear Information System (INIS)

    The purpose of this study was to assess articular surface reduction arthroscopically after volar locked-plate fixation of distal radius fractures (DRFs) via fluoroscopy-guided open reduction/internal fixation. We also aimed to develop preoperative radiographic criteria to help assist in determining which DRFs may need arthroscopic evaluation. A total of 31 consecutive patients with DRF were prospectively enrolled. Posteroanterior (PA) and lateral radiographs as well as axial, coronal, and sagittal CT scans were obtained just after attempted reduction of the DRF. The widest articular displacement at the radiocarpal joint surface of the distal radius (preopD) was then measured using a digital radiography imaging system. The DRF was reduced under fluoroscopy, and a volar locked plate was applied. The degree of residual articular displacement was then measured arthroscopically, and the maximum displacement (postopD) was measured with a calibrated probe. Of the 31 patients, 7 had an arthroscopically assessed maximum postopD of ≥2 mm after internal fixation. The correlation coefficients between each preopD and postopD of all radiographs and CTs were statistically significant. The cutoff values were 0.5 mm for PA radiographs, 2.10 mm for lateral radiographs, 2.15 mm for axial CT scans, 3.15 mm for coronal CT scans, and 1.20 mm for sagittal CT scans. All cutoff values for PA and lateral radiographs and for axial, coronal, and sagittal CT scans were unsuitable as screening criteria for arthroscopic reduction of DRF because of their low sensitivities and specificities. The cutoff value of the new preopD (the sum of the preopDs determined by lateral radiography and coronal CT scan) was 5.80 mm, and its sensitivity and specificity were 100% and 83.3%, respectively. Because a new preopD cutoff value of 5.80 mm is a good indicator for residual articular displacement after internal fixation of >2 mm, it is also a good indicator for the need for arthroscopic evaluation after

  2. A case of unusual septic knee arthritis with Brucella abortus after arthroscopic meniscus surgery.

    Science.gov (United States)

    Lee, Keun Hwa; Kang, Hyunseong; Kim, Taejung; Choi, Sungwook

    2016-01-01

    We present a 51-year-old male patient with Brucella abortus septic arthritis in the right knee following arthroscopic meniscus surgery. He had eaten a traditional dish of raw minced cattle conceptus (bovine fetus) that was prepared after the cow was slaughtered. Despite treatment with empirical antibiotics and debridement of the postoperative surgical wound, the infection persisted without improvement. Polymerase chain reaction sequencing identified Brucella abortus from tissue samples obtained from the patient. After confirmation of the diagnosis of brucellar infection, antibiotics were replaced with doxycycline and rifampin, which were used for 4 months. In patients with a non-specific arthralgia who eat raw meat or live close to animals, it is important to consider the possibility of septic arthritis due to infection with Brucella spp.

  3. Isolated subacromial bursal fluid on MRI of the shoulder in symptomatic patients: correlation with arthroscopic findings

    Energy Technology Data Exchange (ETDEWEB)

    Monu, J.U.V. [Dept. of Radiology, Bowman Gray School of Medicine, Wake Forest Univ., Winston-Salem, NC (United States); Pruett, S. [Bowman Gray School of Medicine, Wake Forest Univ., Winston-Salem, NC (United States); Vanarthos, W.J. [Dept. of Radiology, Bowman Gray School of Medicine, Wake Forest Univ., Winston-Salem, NC (United States); Pope, T.L. Jr. [Dept. of Radiology, Bowman Gray School of Medicine, Wake Forest Univ., Winston-Salem, NC (United States)

    1994-10-01

    Fluid in the subacromial bursa (SAB) is a common finding on magnetic resonance (MR) images of the shoulder, and the implications of this finding have not been clarified. We retrospectively reviewed and correlated the MR features with arthroscopic findings in 21 symptomatic patients who had fluid in the SAB on MR imaging without demonstrable rotator cuff tear. Rotator cuff impingement was the most frequent surgical finding (42.9%). Other frequent surgical observations were glenbid labrum abnormality (28.6%), bursitis (19%), and supraspinatus tendinitis (14.3%). Distribution of acromial types was similar to that reported by Bigliani et al., and impingement was evenly distributed among acromial types in our study population. We conclude that in our patient population group the MR finding of isolated SAB fluid in symptomatic patients is highly likely to be associated with the finding of other abnormalities in the shoulder joint at surgery. (orig.)

  4. Anatomical reference point for harvesting a flexor graft during arthroscopic reconstruction of the anterior cruciate ligament

    Directory of Open Access Journals (Sweden)

    Clécio de Lima Lopes

    2015-04-01

    Full Text Available OBJECTIVES: To evaluate the prevalence of a vascular network adjacent to the insertion of the pes anserinus, so that it could be used as an anatomical reference point to facilitate harvesting flexor grafts for arthroscopic reconstruction of the anterior cruciate ligament (ACL.METHODS: Thirty patients with ACL tears who were going to undergo ACL reconstruction using the tendons of the semitendinosus and gracilis muscles as grafts were selected randomly. During the harvesting of these tendons, the presence or absence of this anatomical reference point was noted.RESULTS: All the patients presented a vascular network of greater or lesser diameter.CONCLUSION: The vascular network seems to be a good reference point during harvesting of the tendons of the semitendinosus and gracilis muscles, for facilitating graft harvesting.

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

    Science.gov (United States)

    Wee, James; Lee, Keng Thiam

    2014-04-01

    Septic arthritis following arthroscopic anterior cruciate ligament reconstruction (ACL) is a rare complication and associated with severe morbidity. Its risk factors include (1) concomitant procedures during the reconstruction, (2) previous knee surgery, (3) allograft usage, (4) peri-operative wound contamination, and (5) presence of intra-articular foreign bodies. We present a series of 3 men and one woman aged 22 to 35 years who developed septic arthritis following ACL reconstruction. The risk factors identified were local infection (n=2), previous ipsilateral knee surgery (n=2), and the use of an allograft (n=1). All patients underwent emergency knee washout and debridement with graft retention within 24 hours, together with a course of intravenous antibiotic therapy. All the patients achieved eradication of their infections (with intact ACL grafts) and satisfactory functional outcome at a mean follow-up of 32 (range, 25-45) months.

  6. Arthroscopic tibiotalocalcaneal arthrodesis in neurological pathologies: outcomes after at least one year of follow up.

    Science.gov (United States)

    Mencière, Maxime-Louis; Ferraz, Linda; Mertl, Patrice; Vernois, Joël; Gabrion, Antoine

    2016-03-01

    The main complications of open tibiotalocalcaneal arthrodesis are wound healing disorders and nonunion. Our hypothesis was that arthroscopy and interlocking intramedullary nailing decrease these complications. We retrospectively reviewed six patients (mean age: 58 years; mean preoperative Kitaoka score: 51/100) having undergone arthroscopic tibiotalocalcaneal arthrodesis with retrograde intramedullary nailing between January and November 2011 for equinus deformity of the hindfoot and subtalar instability of neurological origin. Postoperative pain disappeared completely in four cases, one patient presented some pain associated with projection of the proximal locking screw head under the skin and the remaining patient presented fibular tendinitis that resolved after infiltration of anti-inflammatory drugs. The mean postoperative Kitaoka score was 64/100. None of the patients presented any wound healing complications or nonunion. The observed incidence of wound complications and bone consolidation disorders after tibiotalocalcaneal arthrodesis was lower than the ones reported for open tibiotalocalcaneal arthrodesis. Level of clinical evidence IV: retrospective case series. PMID:26984662

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

    Directory of Open Access Journals (Sweden)

    Kenjiro Iwasa

    2014-01-01

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

  8. Arthroscopic Removal of Symptomatic Proximal Humerus Locking Plates With Bone-Void Filler Augmentation.

    Science.gov (United States)

    Voleti, Pramod B; Camp, Christopher L; Sinatro, Alec L; Dines, Joshua S

    2016-04-01

    Open reduction internal fixation of proximal humerus fractures is often accomplished with proximal humerus locking plates. While these plates have a good track record, they can become symptomatic and require removal once the fracture has healed. Open hardware removal is associated with a number of additional risks to the patient, including infection, scarring, nerve damage, and blood loss. In addition, the recovery time after open hardware removal may be prolonged, thereby predisposing the patient to postoperative stiffness. The purpose of this article is to describe a technique for removing proximal humerus locking plates arthroscopically. Although technically demanding, the benefits of this technique include smaller incisions, quicker recovery time, decreased risk of infection, and reduced blood loss. Arthroscopy also provides the surgeon with the ability to address concomitant intra-articular pathology at the time of surgery. Additionally, we use a bone-void filler to reduce the risk of fracture through stress caused by previous screw holes. PMID:27462532

  9. Arthroscopic treatment of impingement of the ankle reduces pain and enhances function

    DEFF Research Database (Denmark)

    Rasmussen, S; Hjorth Jensen, C

    2002-01-01

    A consecutive series of 105 patients with a median age of 35 (16-62) years who were operated on with arthroscopic resection for impingement of the ankle using standardized technique without distraction is presented. All patients complained of painful dorsiflexion and had failed to respond...... to conservative treatment. A total of 177 diagnoses were found, soft tissue impingement or synovitis in 89, anterior bony impingement in 44, chondral lesion in 20, loose bodies in 16 and osteoarthritis in eight. At follow-up after 2 years, 65 patients were pain free while 28 patients had experienced reduction...... synovectomy and intravenous antibiotics. In one patient persistent symptoms were recorded. Ankle arthroscopy yielded good results in the treatment of anterior impingement of the ankle as it effectively reduced pain and enhanced function....

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

    Science.gov (United States)

    Wee, James; Lee, Keng Thiam

    2014-04-01

    Septic arthritis following arthroscopic anterior cruciate ligament reconstruction (ACL) is a rare complication and associated with severe morbidity. Its risk factors include (1) concomitant procedures during the reconstruction, (2) previous knee surgery, (3) allograft usage, (4) peri-operative wound contamination, and (5) presence of intra-articular foreign bodies. We present a series of 3 men and one woman aged 22 to 35 years who developed septic arthritis following ACL reconstruction. The risk factors identified were local infection (n=2), previous ipsilateral knee surgery (n=2), and the use of an allograft (n=1). All patients underwent emergency knee washout and debridement with graft retention within 24 hours, together with a course of intravenous antibiotic therapy. All the patients achieved eradication of their infections (with intact ACL grafts) and satisfactory functional outcome at a mean follow-up of 32 (range, 25-45) months. PMID:24781628

  11. When should the external approach be resorted to in the arthroscopic treatment of perimeniscal cyst?

    Directory of Open Access Journals (Sweden)

    Bombaci Hasan

    2016-01-01

    Full Text Available Introduction: Meniscal cysts very often cause meniscal tears and especially when it is peripheral, some of the healthy parts of meniscus might be needlessly sacrificed. In particular conditions, extraarticular approaches might save some menisci. In the present study, we evaluated the conditions which required using the extraarticular approach in addition to the arthroscopic procedure, to maximally preserve the meniscus. Methods: Eight patients with perimeniscal cysts were evaluated retrospectively. One cyst was localized within the medial meniscus and seven in the lateral meniscus. The mean age was 36.13 (range; 19–63 years, mean follow-up time, 27.3 (range; 12–47 months. Patients were evaluated by using a Visual Analogue Score (VAS to measure pain relief and “Lysholm score” to measure functional improvement. In all patients except one, in which the cystic cavity was connected with the joint at the periphery of the meniscus, the cyst was drained from the intraarticular opening. When the cyst was too large (three cases and in one case where a large amount of meniscus was preserved for reasons mentioned above, additional extraarticular drainage was carried out. Results: The mean preoperative and postoperative VAS were 6 (range; 2–8 and 1.55 (range; 0–3 (p = 0.00058 and Lysholm scores were 64.75 (range; 48–86 and 93.11 (range; 80–100 (p = 0.0014, respectively. Discussion: In cysts, which have very limited or no connection with the joint on the most peripheral region of the meniscus and/or are larger than the meniscus height, extraarticular drainage of the cyst might produce unnecessary meniscal loss and function. In the extraarticular drainage, scrapping the walls of the cyst, while inspecting with an arthroscope, reduces recurrence of the cyst.

  12. Arthroscopic Patelloplasty and Circumpatellar Denervation for the Treatment of Patellofemoral Osteoarthritis

    Institute of Scientific and Technical Information of China (English)

    Gang Zhao; Yujie Liu; Bangtuo Yuan; Xuezhen Shen; Feng Qu; Jiangtao Wang; Wei Qi

    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.

  13. Development of an Arthroscopic Joint Capsule Injury Model in the Canine Shoulder.

    Directory of Open Access Journals (Sweden)

    David Kovacevic

    Full Text Available The natural history of rotator cuff tears can be unfavorable as patients develop fatty infiltration and muscle atrophy that is often associated with a loss of muscle strength and shoulder function. To facilitate study of possible biologic mechanisms involved in early degenerative changes to rotator cuff muscle and tendon tissues, the objective of this study was to develop a joint capsule injury model in the canine shoulder using arthroscopy.Arthroscopic surgical methods for performing a posterior joint capsulectomy in the canine shoulder were first defined in cadavers. Subsequently, one canine subject underwent bilateral shoulder joint capsulectomy using arthroscopy, arthroscopic surveillance at 2, 4 and 8 weeks, and gross and histologic examination of the joint at 10 weeks.The canine subject was weight-bearing within eight hours after index and follow-up surgeries and had no significant soft tissue swelling of the shoulder girdle or gross lameness. Chronic synovitis and macroscopic and microscopic evidence of pathologic changes to the rotator cuff bony insertions, tendons, myotendinous junctions and muscles were observed.This study demonstrates feasibility and proof-of-concept for a joint capsule injury model in the canine shoulder. Future work is needed to define the observed pathologic changes and their role in the progression of rotator cuff disease. Ultimately, better understanding of the biologic mechanisms of early progression of rotator cuff disease may lead to clinical interventions to halt or slow this process and avoid the more advanced and often irreversible conditions of large tendon tears with muscle fatty atrophy.

  14. Feasibility of arthroscopic placement of autologous matrix-induced chondrogenesis grafts in the cadaver hip joint

    Directory of Open Access Journals (Sweden)

    Fritz Thorey

    2013-09-01

    Full Text Available An assortment of clinical trials have been done presenting the effectiveness of autologous matrix-induced chondrogenesis (AMIC for the regeneration of chondral leasions. The purpose of the study was to underline the accessability of the acetabulum and the femoral head through the known portals and prove i the feasibility of placing the AMIC in the different zones of the hip joint and ii check for dislocation after joint movement. Six human cadavers underwent hip arthroscopy on both hips. Two chondral lesions were set on each femoral head and two in the acetabulum to evaluate a total of 48 defects. After microfracturing an autologous matrix-induced chondrogenesis graft was placed on these lesions arthroscopically. After repeated joint movement the dislocation of the graft was checked. It was possible to place the AMIC graft in all 48 chondral lesions. The time needed for placing the graft was 8±2.9 minutes. A trend of time reduction could be detected throughout this study as the surgeon gained more experience. For the femoral head, after twenty cycles of joint movement 18/24 spots showed no displacement, 4/24 showed minor displacement (<3 mm and 2/24 showed major displacement (>3 mm. None showed total displacement. For the acetabulum 22/24 spots showed no displacement and 2/24 showed minor displacement. A combined microfracturing and placing of an AMIC graft of focal chondral lesions of the hip joint can be done arthroscopically. Prospective randomized in vivo studies should compare the results of arthroscopilally placed AMIC grafts with microfracturing and microfracturing alone.

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

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    Abolghasem Zarezade

    2014-01-01

    Full Text Available Background: Anterior shoulder dislocation is the most common major joint dislocation. In patients with recurrent shoulder dislocation, surgical intervention is necessary. In this study, two methods of treatment, Bankart arthroscopic method and open Bristow procedure, were compared. Materials and Methods: This clinical trial survey had been done in the orthopedic department of Alzahra and Kashani hospitals of Isfahan during 2008-2011. Patients with recurrent anterior shoulder dislocation who were candidates for surgical treatment were randomly divided into two groups, one treated by Bankart arthroscopic technique and the other treated by Bristow method. All the patients were assessed after the surgery using the criteria of ROWE, CONSTANT, UCLA, and ASES. Data were analyzed by SPSS software. Results: Six patients (16.22% had inappropriate condition with ROWE score (score less than 75; of them, one had been treated with Bristow and five with Bankart (5.26 vs. 27.78. Nine patients (24.32% had appropriate condition, which included six from Bristow group and three treated by Bankart technique (31.58 vs. 16.67. Finally, 22 patients (59.46% showed great improvement with this score, which included 12 from Bristow and 10 from Bankart groups (63.16 vs. 55.56. According to Fisher′s exact test, there were no significant differences between the two groups (P = 0.15. Conclusion: The two mentioned techniques did not differ significantly, although some parameters such as level of performance, pain intensity, use of analgesics, and range of internal rotation showed more improvement in Bristow procedure. Therefore, if there is no contraindication for Bristow procedure, it is preferred to use this method.

  16. [Arthroscopic sub-acromial decompression. Comments on indications and surgical technique].

    Science.gov (United States)

    Hartig, A; Rojczyk, M

    1993-02-01

    Between January 1989 and December 1991 614 arthroscopic subacromial decompressions were performed for impingement syndromes. The first 100 cases represented our learning curve. The first 74 of the remaining 514 cases were available for evaluation and form the basis of the results presented here. Twenty (27.02%) patients were rated stage II in Neer's classification and 54 (72.98%) were rated stage III, 33 (44.59%) of them with a small full-thickness tear (less than 1 cm) and 21 (28.37%) with larger defects. Patients were evaluated pre- and postoperatively utilizing the ULCA shoulder score. The average follow-up was 7.9 months. The overall results were satisfactory in 67 cases (90.5%) and unsatisfactory in 7 cases (9.5%). Within the satisfactory group, 28 results (37.8%) were rated excellent and 39 (52.7%) were rated good. In the unsatisfactory group four results (5.4%) were rated fair and three (4.1%) poor. The results in advanced stage III (n = 21), with an average follow-up of 8.4 months, were satisfactory in 20 cases (excellent in 8 and good in 12) and unsatisfactory in one case. It is concluded that arthroscopic subacromial decompression is an effective treatment for both stage II and III impingement syndromes, producing acceptable results that are comparable to those of open procedures. Technically, it seems necessary to perform synovectomy of the ventral synovia in the glenohumeral joint, to resect the coracoacromial ligament completely and also to remove calcifications completely. Depending on the findings of a preoperative sonographic examination of the shoulder joint, the extent of the acromioplasty may be minimized. PMID:8451648

  17. INGUINAL HERNIA REPAIR - ACTUAL STATUS

    Directory of Open Access Journals (Sweden)

    R.Van Hee

    2007-04-01

    Full Text Available Even in 2006, there are a lot of controversy about the best technique for inguinal hernia repair. The factors that influence the choice of the technique are: uni- or bilateral hernia, “Nyhus” type of hernia, complicated hernia, large inguino-scrotal hernia, recurrent hernia or previous surgery, preferred type of anaesthesia. Surgeon has to answer to three question when he choices a type of hernia repair: What are there specific indications for this repair? What are the specific complications of the repair technique? What are the results with the repair technique? In the literature there are a lot of studies which give comparisons about the techniques of hernia repair: type and rate of complications, recurrence rate, costs and economic impact. There are various types of evidence: retrospective studies, prospective randomized trials, meta-analyses. This paper reviews some of the literature studies about: techniques of open non-mesh hernia repair, types of open mesh repair, mesh vs non-mesh open techniques, open vs laparoscopique techniques and types of laparoscopic hernia repair techniques. Conclusion: Open non-mesh repairs should be avoided. Lichtenstein mesh repair is the best open technique. Laparoscopic techniques (TAPP &TEP induce: less pain, shorter hospital stay, earlier return to work, more rapid resumption of activities and lower recurrence rates but at a higher cost, especially in “non-working” population.

  18. DNA repair deficiency in neurodegeneration

    DEFF Research Database (Denmark)

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

    2011-01-01

    Deficiency in repair of nuclear and mitochondrial DNA damage has been linked to several neurodegenerative disorders. Many recent experimental results indicate that the post-mitotic neurons are particularly prone to accumulation of unrepaired DNA lesions potentially leading to progressive...... neurodegeneration. Nucleotide excision repair is the cellular pathway responsible for removing helix-distorting DNA damage and deficiency in such repair is found in a number of diseases with neurodegenerative phenotypes, including Xeroderma Pigmentosum and Cockayne syndrome. The main pathway for repairing oxidative...... base lesions is base excision repair, and such repair is crucial for neurons given their high rates of oxygen metabolism. Mismatch repair corrects base mispairs generated during replication and evidence indicates that oxidative DNA damage can cause this pathway to expand trinucleotide repeats, thereby...

  19. Aneurysm growth after late conversion of thoracic endovascular aortic repair

    Directory of Open Access Journals (Sweden)

    Hirofumi Kasahara

    2015-01-01

    Full Text Available A 69-year-old man underwent thoracic endovascular aortic repair of a descending aortic aneurysm. Three years later, he developed impending rupture due to aneurysmal expansion that included the proximal landing zone. Urgent open surgery was performed via lateral thoracotomy, and a Dacron graft was sewn to the previous stent graft distally with Teflon felt reinforcement. Postoperatively, four sequential computed tomography scans demonstrated that the aneurysm was additionally increasing in size probably due to continuous hematoma production, suggesting a possibility of endoleaks. This case demonstrates the importance of careful radiologic surveillance after endovascular repair, and also after partial open conversion.

  20. Large myelomeningocele repair

    OpenAIRE

    Farideh Nejat; Nima Baradaran; Mostafa El Khashab

    2011-01-01

    Background: Wound closure is accomplished in most cases of myelomeningocele (MMC) by undermining of the skin edges surrounding the defect. However, large defects cannot be closed reliably by this simple technique. Due to the technical challenge associated with large MMC, surgeons have devised different methods for repairing large defects. In this paper, we report our experience of managing large defects, which we believe bears a direct relationship to decrease the incidence of wound complicat...

  1. Isometric exercises with elements postisometric relaxation to eliminate the knee joint contracture after arthroscopic plastics of anterior cruciate ligament

    Directory of Open Access Journals (Sweden)

    Pylypenko O.V.

    2014-02-01

    Full Text Available Purpose : to determine the efficiency of isometric exercises and post isometric relaxation of character for removal and prevention of contractures and recovery of motor function after arthroscopic reconstruction of the anterior cruciate ligament in the late postoperative period. Material: The study involved 22 patients aged less than 40 years. Results: The results showed that the level of pain decreased equally in patients of main and control group from 3 to 0 points, the performance difference in the amplitude of the bending of the knee joint during the goniometry in the treatment group was 70 in the control group – 30 and the extension 10 – fixed, reaching 5 hyperextension and not changed in the control group. Conclusions: The use of isometric exercises and post isometric relaxation prevent postoperative contracture of the knee joint. Methods of their application are recommended for use in the comprehensive rehabilitation of patients after arthroscopic plastics anterior cruciate ligament.

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

    Directory of Open Access Journals (Sweden)

    Riccardo D′Ambrosi

    2015-01-01

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

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

    Science.gov (United States)

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

    2015-01-01

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

  4. Arthroscopic burring of exposed cement following curettage and cavity filling cementation for chondroblastoma of the proximal tibia.

    Science.gov (United States)

    Park, Jong-Hoon; Chae, In-Jung; Han, Seung-Beom; Lee, Dae-Hee

    2015-03-01

    Chondroblastoma of the proximal tibia is difficult to treat because of its epiphyseal predilection. This condition can be treated by curettage, which results in immediate restoration of stability and a reduced recurrence rate, followed by cement filling of the bone defect. Nevertheless, contact with cement can damage articular cartilage, potentially leading to severe knee osteoarthritis. Most previous reports regarding this complication described patients with giant cell tumors of the proximal tibia. We present here a patient who underwent arthroscopic treatment for cement exposure caused by articular cartilage loss of the tibial plateau, which occurred after initial curettage and cementation for chondroblastoma of the proximal tibia. To our knowledge, this is the first report on arthroscopic treatment of this condition.

  5. Arthroscopic burring of exposed cement following curettage and cavity filling cementation for chondroblastoma of the proximal tibia.

    Science.gov (United States)

    Park, Jong-Hoon; Chae, In-Jung; Han, Seung-Beom; Lee, Dae-Hee

    2015-03-01

    Chondroblastoma of the proximal tibia is difficult to treat because of its epiphyseal predilection. This condition can be treated by curettage, which results in immediate restoration of stability and a reduced recurrence rate, followed by cement filling of the bone defect. Nevertheless, contact with cement can damage articular cartilage, potentially leading to severe knee osteoarthritis. Most previous reports regarding this complication described patients with giant cell tumors of the proximal tibia. We present here a patient who underwent arthroscopic treatment for cement exposure caused by articular cartilage loss of the tibial plateau, which occurred after initial curettage and cementation for chondroblastoma of the proximal tibia. To our knowledge, this is the first report on arthroscopic treatment of this condition. PMID:25750896

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

    Science.gov (United States)

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

    2015-01-01

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

  7. Arthroscopic meniscectomy of the middle and posterior parts of the medial and lateral meniscus and our operative technique

    OpenAIRE

    Alturfan, Aziz; Gogus, Abdullah; Taser, Omer; Daldal, Fehmi

    2004-01-01

    Between December 1983 and March 1991 , 2200 knee artnroscopies were performed at the Department of Orthopaedics and Traumatology of İstanbul University, İstanbul Faculty of Medicine. Ouring the last four years, over 500 surgical arthroscopies were performed and 63 in 62 patients were arthroscopic meniscectomies of the middle and posterior parts of the medial and lateral menisci for isolated meniscallesions without any instability. The mean age was 38, 8 (15-58) years. The right knee was invol...

  8. The effects of intraarticular bupivacaine, morphine and bupivacaine+morphine in arthroscopic knee surgery on postoperative analgesia

    OpenAIRE

    Kucukay, Suleyman; Celiker, Tulay Soner; Koyluoglu, Isil Okan; Taser, Omer; Alturfan, Aziz; Sozen, Yunus V.

    2004-01-01

    In this study, we investigated the effect of intraarticular injection of bupivacaine, morphine, bupivacaine+morphine and placebo on postoperative pain during arthroscopic knee surgery. The pain was evaluatedaccording to visualanalogousscale (VAS) at. 0.5, 1, 1. 5, 2, 6 and 24 hourafterthe operation. The need for additional analgesic administration was compared between different groups. In placebo group the values of VAS were higher than the three groups. In bupivacaine group the effective an...

  9. Acromioclavicular joint acceleration-deceleration injury as a cause of persistent shoulder pain: Outcome after arthroscopic resection

    OpenAIRE

    Ehud Atoun; Artan-Athanasios Bano; Alexander Van Tongel; Ali Narvani; Giuseppe Sforza; Ofer Levy

    2014-01-01

    Background: Shoulder pain in general and acromioclavicular joint (ACJ) pain specifically is common after acceleration-deceleration injury following road traffic accident (RTA). The outcome of surgical treatment in this condition is not described in the literature. The aim of the present study was to report the outcome of arthroscopic resection of the ACJ in these cases. Materials and Methods: Nine patients with localized ACJ pain, resistant to nonoperative treatment were referred on an a...

  10. Short-term evaluation of arthroscopic management of tennis elbow; including resection of radio-capitellar capsular complex

    Science.gov (United States)

    Babaqi, AbdulRahman A.; Kotb, Mohammed M.; Said, Hatem G.; AbdelHamid, Mohamed M.; ElKady, Hesham A.; ElAssal, Maher A.

    2014-01-01

    Background There has been controversy regarding the pathogenesis and treatment of lateral epicondylitis. Different surgical techniques for the treatment of lateral epicondylitis prescribed. The purpose of this study was to evaluate the short-term outcomes of arthroscopic management including resection of the radio-capitellar capsular complex, using different validated scores. Methods In this study, arthroscopic resection of a capsular fringe complex was done beside debridement of the undersurface of Extensor Carpi Radialis Brevis (ECRB). Thirty-one patients with recalcitrant lateral epicondylitis for a minimum of 6 months had surgery. In all patients, a collar-like band of radio-capitellar capsular complex was found to impinge on the radial head and subluxate into the radio-capitellar joint with manipulation under direct vision. Outcomes were assessed using Mayo Elbow Performance Index (MEPI), the Patient-Rated Tennis Elbow Evaluation (PRTEE), and the Disability of the Arm, Shoulder, and Hand (DASH), beside visual analog scale (VAS) for pain and satisfaction criteria. Results After arthroscopic surgery, overall satisfaction was extremely positive, over the 31 patients, 93.5% of the patients are satisfied. The mean score for pain improved from 8.64 to 1.48 points. The total PRTEE improved from 55.53 to 10.39 points. The mean MEPI score was improved from 61.82 to 94.10 points. DASH score also improved from 24.46 to 4.81 points. All improvements are statistically significant (P < 0.05). Conclusion Arthroscopic release of ECRB in patients with chronic lateral epicondylitis is a reproducible method with a marked improvement in function within a short period, with special consideration for resection of radio-capitellar capsular complex. PMID:25104891

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

    Directory of Open Access Journals (Sweden)

    Alexandre Almeida

    2015-02-01

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

  12. A comparative study between use of arthroscopic lavage and arthrocentesis of temporomandibular joint based on computational fluid dynamics analysis.

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    Yue Xu

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

  13. Is Gabapentin Effective on Pain Management after Arthroscopic Anterior Cruciate Ligament Reconstruc tion? A Triple Blinded Randomized Controlled Trial

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    Mohsen Mrdani Kivi

    2013-09-01

    Full Text Available Background: Acute pain is common after arthroscopic surgeries and it is one of the most important causes of patient dissatisfaction, admission time and increased morbidity . Gabapentin with anti-hyperalgesic effects can play a critical role in pre-emptive analgesia methods. The aim of this study was to assess the efficacy of gabapentin in pain management after surgery and the rate of drug consumption in patients who are candidate for anterior cruciate ligament (ACL reconstruction arthroscopic surgery. Methods: In this randomized, triple blind clinical trial, 114 patients who were candidate for arthroscopic ACL reconstruction were divided into two groups of gabapentin (G and placebo (p, with 57 patients in each group. The intervention group received gabapentin 600 mg and a placebo was administered in control group. Patients received on-demand pethedine for pain management. The primary outcome was pain intensity according to the visual analogue scale (VAS and the secondary outcome was the amount of opioid consumption and incidence of side effects (including: dizziness, sedation, nausea and vomiting at 6 and 24 h visits. Results: The mean pain intensity in G group at both the 6 and 24 hour visits was significantly lower than the control group (Both p

  14. EFFICACY OF SOFT TISSUE APPLICATION, MANUALLY-THERAPEUTICAL TECHNIQUES FOR KNEE ARTHROKINEMATICS RECOVERY COMPLEX IN PATIENTS AFTER ARTHROSCOPIC MENISCECTOMY

    Directory of Open Access Journals (Sweden)

    Kostov Rostislav V

    2015-07-01

    Full Text Available Introduction: In this article we present the final effect of the application of complex soft tissue manually-treatment system for recovery of joint kinematics in patients with moderate and minimal protective period of rehabilitation after arthroscopic meniscectomy. Material and Methods: The study was conducted in 2005-2012 into three medical centers in Bulgaria: Blagoevgrad, Sofia and Pleven. The study included a total of 110 patients divided into three groups (Control and Experimental I and Experimental Group II who studied the effect of topical application of the manual therapeutic techniques compared to traditional rehabilitation methods applied. For testing the efficacy of a treatment approach in the three groups of patients, the results have processed by the method of variational analysis. Results: After analysis of results we find significantly more fully and without residual short violations recovery for all controlled parameters in patients who have implemented comprehensive manually-therapeutic treatment compared with control group patients. Conclusion: Application of adequate physiological and pedagogically grounded complex rehabilitation is required in patients after arthroscopic meniscectomy model with motor deficits in tractable routine rehabilitation. Observations allow us to offer a methodology for implementation in general practice rehabilitation in patients after meniscal ruptures treated by arthroscopic meniscectomy and motor deficits, intractable routine rehabilitation.

  15. Physics of Partially Ionized Plasmas

    Science.gov (United States)

    Krishan, Vinod

    2016-05-01

    Figures; Preface; 1. Partially ionized plasmas here and everywhere; 2. Multifluid description of partially ionized plasmas; 3. Equilibrium of partially ionized plasmas; 4. Waves in partially ionized plasmas; 5. Advanced topics in partially ionized plasmas; 6. Research problems in partially ionized plasmas; Supplementary matter; Index.

  16. Molecular basis for DNA strand displacement by NHEJ repair polymerases.

    Science.gov (United States)

    Bartlett, Edward J; Brissett, Nigel C; Plocinski, Przemyslaw; Carlberg, Tom; Doherty, Aidan J

    2016-03-18

    The non-homologous end-joining (NHEJ) pathway repairs DNA double-strand breaks (DSBs) in all domains of life. Archaea and bacteria utilize a conserved set of multifunctional proteins in a pathway termed Archaeo-Prokaryotic (AP) NHEJ that facilitates DSB repair. Archaeal NHEJ polymerases (Pol) are capable of strand displacement synthesis, whilst filling DNA gaps or partially annealed DNA ends, which can give rise to unligatable intermediates. However, an associated NHEJ phosphoesterase (PE) resects these products to ensure that efficient ligation occurs. Here, we describe the crystal structures of these archaeal (Methanocella paludicola) NHEJ nuclease and polymerase enzymes, demonstrating their strict structural conservation with their bacterial NHEJ counterparts. Structural analysis, in conjunction with biochemical studies, has uncovered the molecular basis for DNA strand displacement synthesis in AP-NHEJ, revealing the mechanisms that enable Pol and PE to displace annealed bases to facilitate their respective roles in DSB repair. PMID:26405198

  17. Beginning partial differential equations

    CERN Document Server

    O'Neil, Peter V

    2011-01-01

    A rigorous, yet accessible, introduction to partial differential equations-updated in a valuable new edition Beginning Partial Differential Equations, Second Edition provides a comprehensive introduction to partial differential equations (PDEs) with a special focus on the significance of characteristics, solutions by Fourier series, integrals and transforms, properties and physical interpretations of solutions, and a transition to the modern function space approach to PDEs. With its breadth of coverage, this new edition continues to present a broad introduction to the field, while also addres

  18. Hyperbolic partial differential equations

    CERN Document Server

    Witten, Matthew

    1986-01-01

    Hyperbolic Partial Differential Equations III is a refereed journal issue that explores the applications, theory, and/or applied methods related to hyperbolic partial differential equations, or problems arising out of hyperbolic partial differential equations, in any area of research. This journal issue is interested in all types of articles in terms of review, mini-monograph, standard study, or short communication. Some studies presented in this journal include discretization of ideal fluid dynamics in the Eulerian representation; a Riemann problem in gas dynamics with bifurcation; periodic M

  19. Mammalian mismatch repair

    DEFF Research Database (Denmark)

    Pena Diaz, Javier; Jiricny, Josef

    2012-01-01

    A considerable surge of interest in the mismatch repair (MMR) system has been brought about by the discovery of a link between Lynch syndrome, an inherited predisposition to cancer of the colon and other organs, and malfunction of this key DNA metabolic pathway. This review focuses on recent...... advances in our understanding of the molecular mechanisms of canonical MMR, which improves replication fidelity by removing misincorporated nucleotides from the nascent DNA strand. We also discuss the involvement of MMR proteins in two other processes: trinucleotide repeat expansion and antibody maturation...

  20. Survivorship after Arthroscopic Management of Glenohumeral Osteoarthritis with a Minimum 5 year Follow-up

    Science.gov (United States)

    Mitchell, Justin; Horan, Marilee P.; Greenspoon, Joshua A.; Menge, Travis; Tahal, Dimitri S.; Millett, Peter J.

    2016-01-01

    Objectives: We previously reported clinical improvement and pain relief following arthroscopic management of glenohumeral osteoarthritis (GHOA) at 2 years. The purpose of this study was to determine 5 year survivorship for the comprehensive arthroscopic management (CAM) procedure for the treatment of GHOA. Methods: This study had prior IRB approval. The CAM procedure was performed on a consecutive series of 42 young patients (44 shoulders) with GHOA who otherwise met criteria for shoulder arthroplasty but instead opted for joint preservation. The procedure included glenohumeral chondroplasty, capsular release, and synovectomy, humeral osteoplasty, axillary nerve neurolysis, subacromial decompression, loose body removal, microfracture and biceps tenodesis. Only patients who were a minimum of 5 years out from surgery were included in the study. Patients completed a subjective questionnaire, and further surgical intervention of the index shoulder was noted for survivorship analysis. Failure was defined as progression to TSA. Kaplan Meier survivorship analysis was performed. Results: Forty-two patients (with 44 shoulders) underwent a CAM procedure between 1/2006-12/2009 and were included. All patients were self-described recreational athletes. Seven patients were former collegiate or professional athletes. Mean follow-up was 5.9 years (range, 5 years to 8.1 years). Mean age at surgery was 52 (range 27- 68) years old in 13 women and 29 men. Eleven shoulders (26%) failed and progressed to TSA at a mean of 2.9 years (1.0-5.4 years). Shoulder status (progression to TSA or not) at minimum 5 years (range 5.3 - 9.4 years) was known for 95% (42/44). One patient progressed to another surgery for stiffness at a mean of 5.6 months and another patient underwent a revision CAM procedure at 7.9 years. From this cohort, Kaplan Meier survivorship was 92% at 1 year, 85.7% at 3 years, and 75.3% survivorship at 5 years. Conclusion: The long term durability of arthroscopic management for

  1. Partial knee replacement - slideshow

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/presentations/100225.htm Partial knee replacement - series To use the sharing features on ... A.M. Editorial team. Related MedlinePlus Health Topics Knee Replacement A.D.A.M., Inc. is accredited ...

  2. Partial motor status epilepticus

    OpenAIRE

    Gilberto Rebello de Mattos; José C. Rollemberg Filho

    1992-01-01

    We report the case of a young female patient with photosensitive primary epilepsy who presented partial motor status epilepticus provoked by the act of shutting the eyes. Clinical, EEG and neuroimage data are presented and discussed.

  3. Beginning partial differential equations

    CERN Document Server

    O'Neil, Peter V

    2014-01-01

    A broad introduction to PDEs with an emphasis on specialized topics and applications occurring in a variety of fields Featuring a thoroughly revised presentation of topics, Beginning Partial Differential Equations, Third Edition provides a challenging, yet accessible,combination of techniques, applications, and introductory theory on the subjectof partial differential equations. The new edition offers nonstandard coverageon material including Burger's equation, the telegraph equation, damped wavemotion, and the use of characteristics to solve nonhomogeneous problems. The Third Edition is or

  4. Generalized Partial Volume

    DEFF Research Database (Denmark)

    Darkner, Sune; Sporring, Jon

    2011-01-01

    Mutual Information (MI) and normalized mutual information (NMI) are popular choices as similarity measure for multimodal image registration. Presently, one of two approaches is often used for estimating these measures: The Parzen Window (PW) and the Generalized Partial Volume (GPV). Their theoret......Mutual Information (MI) and normalized mutual information (NMI) are popular choices as similarity measure for multimodal image registration. Presently, one of two approaches is often used for estimating these measures: The Parzen Window (PW) and the Generalized Partial Volume (GPV...

  5. Dynamic enhanced MRI of the subacromial bursa: correlation with arthroscopic and histological findings

    Energy Technology Data Exchange (ETDEWEB)

    Matsuzaki, S. [Dept. of Radiology, Osaka Kosei-nenkin Hospital (Japan); Yoneda, M. [Shoulder and Sports Medicine Service, Osaka Kosei-nenkin Hospital, Osaka City, Osaka (Japan); Kobayashi, Y. [Dept. of Pathology, Osaka Kosei-nenkin Hospital (Japan); Fukushima, S. [Dept. of Orthopaedic Surgery, Sapporo Tokeidai Hospital, Osaka (Japan); Wakitani, S. [Dept. of Orthopaedic Surgery, Shinsyu Univ., Matsumato (Japan)

    2003-09-01

    Objective: To assess dynamic MRI with Gd-DTPA enhancement for evaluating inflammatory changes in the subacromial bursa. Design and patients: We detected the signal intensity changes in dynamic MRI of the subacromial bursa, and confirmed these macroscopically by arthroscopy and histologically. The signal intensity was measured using built-in software, and the enhancement ratio (E ratio) was calculated from dynamic MR images. In addition, as a parameter of the rate of the increase in the signal intensity from 0 to 80 s, the mean increase per second in the E ratio was obtained as the coefficient of enhancement (CE). The correlation was studied of the E ratio and CE with the arthroscopic findings (redness, villous formation, thickening and adhesion), and of the E ratio and CE with the histological findings (capillary proliferation, papillary hyperplasia, fibrosis and inflammatory cell infiltration) of the subacromial bursa. Of patients with shoulder pain, this study included those with rotator cuff injury; patients with rheumatoid arthritis or pitching shoulder disorders were excluded. There were 27 patients (15 men, 12 women) ranging in age from 25 to 73 years (mean 49.1 years). Dynamic MRI of the shoulder was also performed on the healthy side of 10 patients and in five normal young volunteers. Results and conclusions: Changes in signal intensity on dynamic MRI were measured in the subacromial bursa. The E ratio (80 s) and CE (0-80 s) were significantly correlated with redness and villous formation as arthroscopic findings, positively correlated with capillary proliferation and papillary hyperplasia as histological findings (p < 0.05), and negatively correlated with fibrosis as a histological finding (p < 0.05) in the subacromial bursa. The patterns of dynamic curves were well correlated with the bursoscopic and histological findings of the synovium of the subacromial bursa. Dynamic MRI appears to correlate with inflammatory activity of synovium of the subacromial

  6. [Arthroscopic management of recent or chronic lesions of triangular fibrocartilage complex of the wrist].

    Science.gov (United States)

    Fontès, D

    2006-11-01

    Lesions of the triangular fibrocartilage complex of the wrist (TFCC) have perfectly been dismembered by Andrew Palmer and have largely benefited from progress of arthroscopy of the wrist. One distinguishes thus traumatic lesions (class 1) individualized according to their localization, central (1-A), ulnar (1-B), radial (1-D) or distal (1-C). Central lesions are classically associated to a positive ulnar variance. The clinical symptomatology evokes a meniscal like syndrome of the wrist. In case of failure of the medical treatment, it will be necessary to propose a surgical procedure guided by histopathology of the triangular complex. Thus, ulnar peripheral richly vascularized lesions (1-B) could therefore potentially heal and will have to benefit by an attempt of surgical reattachment (arthroscopic technique of Whipple, Poehling or other techniques) or by an osteosynthesis in case of fracture on the basis on the ulnar styloid process. Central fibrocartilage lesions (1-A) or radial avulsions (1-D) are less vascularized and have therefore little probability to heal; they will benefit then ideally from the endoscopic debridement of unstable flaps of the central portion of TFCC. No immobilization is required and rehabilitation is immediately undertaken. Less frequent class 1-C lesions justify in our practice a simple arthroscopic regularization, alone complete ruptures could have necessitate a direct suture. Class 2 degenerative lesions are graduated (A to E) according to evolution of the chondromalacia of the ulnar head and carpal bone, perforation of the central disc and lunotriquetral ligament degeneration. They are usually associated with a constitutional or an acquired ulnar plus variance syndrome, for example after a distal radius fracture malunion. The clinical symptomatology needs to differentiate them from the simple frequent physiological perforations after the age of 50 years. Arthroscopy will allow to regularize unstable non-vascularized lesions and to

  7. Dynamic enhanced MRI of the subacromial bursa: correlation with arthroscopic and histological findings

    International Nuclear Information System (INIS)

    Objective: To assess dynamic MRI with Gd-DTPA enhancement for evaluating inflammatory changes in the subacromial bursa. Design and patients: We detected the signal intensity changes in dynamic MRI of the subacromial bursa, and confirmed these macroscopically by arthroscopy and histologically. The signal intensity was measured using built-in software, and the enhancement ratio (E ratio) was calculated from dynamic MR images. In addition, as a parameter of the rate of the increase in the signal intensity from 0 to 80 s, the mean increase per second in the E ratio was obtained as the coefficient of enhancement (CE). The correlation was studied of the E ratio and CE with the arthroscopic findings (redness, villous formation, thickening and adhesion), and of the E ratio and CE with the histological findings (capillary proliferation, papillary hyperplasia, fibrosis and inflammatory cell infiltration) of the subacromial bursa. Of patients with shoulder pain, this study included those with rotator cuff injury; patients with rheumatoid arthritis or pitching shoulder disorders were excluded. There were 27 patients (15 men, 12 women) ranging in age from 25 to 73 years (mean 49.1 years). Dynamic MRI of the shoulder was also performed on the healthy side of 10 patients and in five normal young volunteers. Results and conclusions: Changes in signal intensity on dynamic MRI were measured in the subacromial bursa. The E ratio (80 s) and CE (0-80 s) were significantly correlated with redness and villous formation as arthroscopic findings, positively correlated with capillary proliferation and papillary hyperplasia as histological findings (p < 0.05), and negatively correlated with fibrosis as a histological finding (p < 0.05) in the subacromial bursa. The patterns of dynamic curves were well correlated with the bursoscopic and histological findings of the synovium of the subacromial bursa. Dynamic MRI appears to correlate with inflammatory activity of synovium of the subacromial

  8. Age-related neuronal degeneration: complementary roles of nucleotide excision repair and transcription-coupled repair in preventing neuropathology.

    Directory of Open Access Journals (Sweden)

    Dick Jaarsma

    2011-12-01

    Full Text Available Neuronal degeneration is a hallmark of many DNA repair syndromes. Yet, how DNA damage causes neuronal degeneration and whether defects in different repair systems affect the brain differently is largely unknown. Here, we performed a systematic detailed analysis of neurodegenerative changes in mouse models deficient in nucleotide excision repair (NER and transcription-coupled repair (TCR, two partially overlapping DNA repair systems that remove helix-distorting and transcription-blocking lesions, respectively, and that are associated with the UV-sensitive syndromes xeroderma pigmentosum (XP and Cockayne syndrome (CS. TCR-deficient Csa(-/- and Csb(-/- CS mice showed activated microglia cells surrounding oligodendrocytes in regions with myelinated axons throughout the nervous system. This white matter microglia activation was not observed in NER-deficient Xpa(-/- and Xpc(-/- XP mice, but also occurred in Xpd(XPCS mice carrying a point mutation (G602D in the Xpd gene that is associated with a combined XPCS disorder and causes a partial NER and TCR defect. The white matter abnormalities in TCR-deficient mice are compatible with focal dysmyelination in CS patients. Both TCR-deficient and NER-deficient mice showed no evidence for neuronal degeneration apart from p53 activation in sporadic (Csa(-/-, Csb(-/- or highly sporadic (Xpa(-/-, Xpc(-/- neurons and astrocytes. To examine to what extent overlap occurs between both repair systems, we generated TCR-deficient mice with selective inactivation of NER in postnatal neurons. These mice develop dramatic age-related cumulative neuronal loss indicating DNA damage substrate overlap and synergism between TCR and NER pathways in neurons, and they uncover the occurrence of spontaneous DNA injury that may trigger neuronal degeneration. We propose that, while Csa(-/- and Csb(-/- TCR-deficient mice represent powerful animal models to study the mechanisms underlying myelin abnormalities in CS, neuron

  9. Partial tearing of the anterior cruciate ligament: diagnosis and treatment

    Directory of Open Access Journals (Sweden)

    Eduardo Frois Temponi

    2015-02-01

    Full Text Available Partial tears of the anterior cruciate ligament (ACL are common and represent 10-27% of the total. The main reasons for attending to cases of non-torn bundles are biomechanical, vascular and proprioceptive. Continued presence of the bundle also serves as protection during the healing process. There is controversy regarding the definition of these injuries, which is based on anatomy, clinical examination, translation measurements, imaging examinations and arthroscopy. The way in which it is treated will depend on the existing laxity and instability. Conservative treatment is optional for cases without instability, with a focus on motor rehabilitation. Surgical treatment is a challenge, since it requires correct positioning of the bone tunnels and conservation of the remnants of the torn bundle. The pivot shift test under anesthesia, the magnetic resonance findings, the previous level and type of sports activity and the arthroscopic appearance and mechanical properties of the remnants will aid the orthopedist in the decision-making process between conservative treatment, surgical treatment with strengthening of the native ACL (selective reconstruction and classical (anatomical reconstruction.

  10. Pectoralis Major Tendon Repair

    Science.gov (United States)

    Cordasco, Frank A.; Degen, Ryan; Mahony, Gregory Thomas; Tsouris, Nicholas

    2016-01-01

    Objectives: Systematic reviews of the literature have identified 365 reported cases of Pectoralis Major Tendon (PMT) injuries. While surgical treatment has demonstrated improved outcomes compared to non-operative treatment, there is still relatively limited data on the functional outcome, return to sport and need for 2nd surgery in athletes following PMT repair. This study comprises the largest series of athletes following PMT repair reported to date. The Objective is to report on the functional outcomes, return to sport and need for 2nd surgery in a consecutive series of PMT tears. Methods: From 2009, 81 patients with PMT tears were enrolled in this prospective series. Baseline evaluation included patient demographics, mechanism of injury, physical examination and PMT specific MRI for confirmation of the diagnosis and analysis of the extent of injury. Each patient underwent surgical repair by the senior author utilizing a previously published surgical technique. Patients were then followed at 2 weeks, 6 weeks, 3 months and 6 months and further follow-up was conducted annually thereafter with functional outcome scores and adduction strength testing. The return to sport and incidence of 2nd surgery data were recorded. This study includes the first 40 athletes to reach the 2-year post-operative period. Results: All athletes were male, with an average age of 34.4 years (range 23-59). The patient cohort consisted of 4 professional NFL players and 36 recreational athletes. Average follow-up duration was 2.5 years (range 2 - 6.0 years). The most common mechanisms of injury occurred during the bench press (n=26) and contact sport participation (n=14). Sixteen injuries were complete avulsions involving both the clavicular and sternocostal heads, while 24 were isolated sternocostal head avulsions. Average pre-injury bench press of 396 lbs (range 170-500 lbs) was restored to 241 lbs post-operatively (range 140-550 lbs). Single Assessment Numeric Evaluation (SANE) scores

  11. Reply to "Analgesic Effect of Gabapentin on Post-Operative Pain After Arthroscopic Anterior Cruciate Ligament Reconstruction"

    Directory of Open Access Journals (Sweden)

    Mohsen Mardani-Kivi

    2014-03-01

    Full Text Available In Reply Dr. Ortiz and Dr. Romero-Quezada evaluated our study precisely and authors are grateful for their great survey on our article. There were some questions and concerns that we are going to answer. We wish it could help others to come up with better ideas and conclusions. 1. ACL tear may occur in two scenarios and we believe that there is not a third one: 1st- the ACL injury functionally disables the patient and becomes symptomatic; in this scenario the patient would suffer from giving way and the “Lachman test” is definitely positive (3+ or 4+ (1. Intra-operatively (post anesthesia “Pivot shift test” is almost positive in all cases. 2nd- ACL injury does not conflict with the patient’s routine and social activity and giving way are usually negative and Lachman test can be negative, 1+ and in the most severe condition 2+ positive. Partial ACL tear may be reported in MRI, however authors believe these cases do not benefit from a surgical intervention, and conservative treatment should be performed. 2. Although most of our patients were suffered from sports trauma, mechanisms of ACL tears were not the same in all patients. The duration between traumas to surgeries in all patients enrolled in this study were at least 6 weeks which were included the proceeding from acute trauma phase to performing physical therapy and accomplishing full range of motion pre-operatively. Since the present study was not about surgical technique and pre or post rehab protocols and programs, authors avoided such additional issues. 3. About Pethidine issue, this drug is the main protocol one in our hospital to provide analgesics for post-operative pain, so authors routinely decided to utilize the pethidine as analgesics such as recent relative article (2. We used the pethidine intravenously and by patient’s demand; if a patients requested for pain killers, we provided him/her with 0.5 mg-per-Kg pethidine which was injected intravenously. The time and

  12. Nucleotide excision repair in yeast

    NARCIS (Netherlands)

    Eijk, Patrick van

    2012-01-01

    Nucleotide Excision Repair (NER) is a conserved DNA repair pathway capable of removing a broad spectrum of DNA damage. In human cells a defect in NER leads to the disorder Xeroderma pigmentosum (XP). The yeast Saccharomyces cerevisiae is an excellent model organism to study the mechanism of NER. The

  13. Clamp wins pipe repair prize

    Energy Technology Data Exchange (ETDEWEB)

    Anon.

    2001-04-01

    This paper describes the permanent pipeline repair system, developed by Tekmar, which is powered by seawater hydraulics and is easily installed and tested by any workclass remotely operated vehicle (rov). Details are given of the two main components of the system, namely, the diverless high pressure split repair clamp and the rov-operated tool to install it.

  14. 关节镜下异体肌腱修复重建前后交叉韧带断裂的临床观察%Clinical Observation of Arthroscopic Reconstruction of Anterior Cruciate Ligament Rupture with Tendon Allograft

    Institute of Scientific and Technical Information of China (English)

    孙强; 才林; 艾光禹

    2016-01-01

    目的:探讨关节镜下异体肌腱修复重建前后交叉韧带断裂的临床效果。方法选取我院2013年9月-2014年9月经影像学、临床诊断为前后交叉韧带断裂患者18例,均采用深低温冷冻同种异体腱于关节镜下同期重建前后交叉韧带。记录Lachman试验、Lysholm评分结果进行治疗效果的评定。结果术后切口均I期愈合,术前存在的症状、阳性体征基本消失,患膝稳定性正常。其中Lachman试验测试均为阴性或I度阳性。关节活动度:17例达0°-130°,仅有1例0°-120°,手术前后的Lysholm、IKDC评分对比具有统计学意义(P<0.05)。结论关节镜下采用异体肌腱修复重建前后交叉韧带断裂能够恢复膝关节的稳定性及功能,疗效显著,值得临床推广应用。%Objective To investigate the clinical effect of arthroscopic reconstruction of anterior cruciate ligament.Methods 9 cases of -2014 in our hospital from September 2013 to 18 were diagnosed as anterior and anterior cruciate ligament rupture. The anterior and anterior cruciate ligaments were reconstructed with the same time of deep hypothermia and frozen allograft. Evaluation of therapeutic effect of Lachman test and Lysholm score.Results All the incisions healed by I, the symptoms and positive signs of the patients were disappeared, and the stability of the knee was normal. The Lachman test was negative or I positive. Joint mobility: 17 cases reached 0 degrees-130 degrees, only 0 cases of 1 degrees -120 degrees, Lysholm, IKDC before and after surgery, score compared with statistical significance (P<0.05).Conclusion Arthroscopic reconstruction of anterior cruciate ligament with allograft tendon repair can restore the stability and function of the knee joint, and the effect is remarkable. It is worth to be popularized.

  15. Tako-Tsubo syndrome in an anaesthetised patient undergoing arthroscopic knee surgery

    Directory of Open Access Journals (Sweden)

    Artukoglu Feyzi

    2008-01-01

    Full Text Available We present a case of stress-induced myocardial stunning, also known as tako-Tsubo syndrome, in an anaesthetised patient undergoing arthroscopic replacement of the cruciate ligament. The patient′s (44 y male, ASA class II had a history of hypertension with no other known disease. He underwent a femoral nerve block with 20 ml of 0.5% ropivacaine before receiving a balanced general anaesthesia (propofol induction, sevoflurane maintenance, 10 µg/kg sufentanil. Ten min after the beginning of surgery during endoscopic intra-articular manipulation, the patient suffered from bradycardia and hypotension; following the administration of ephedrine and atropine, he developed tachycardia, hypertension and ST segment depression. Subsequently, his systemic blood pressure dropped necessitating inotropic drug support and - later - intraaortic balloon counterpulsation; a TEE revealed no evidence of hypovolemia, anterior and antero-septal hypokinesia with an ejection fraction of 25%. Surgery was finished whilst stabilising the patient haemodynamically. Postoperative cardiac enzymes showed little elevation, an emergency coronary angiogram apical akinesia with typical ballooning and basal hyperkinesias, compatible with Tako-tsubo syndrome. The patient′s postoperative course was uneventful. We theorize that stress caused by sudden surgical pain stimulus (introduction of the endoscope into the articulation, superficial anaesthesia and insufficient analgesia created a stressful event which probably might have caused a catecholamine surge as basis of Tako-tsubo syndrome.

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

    Science.gov (United States)

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

    2015-08-01

    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

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

    Science.gov (United States)

    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. PMID:24972445

  18. MRI of the knee before and after arthroscopic synovectomy in patients with rheumatoid arthritis

    International Nuclear Information System (INIS)

    The effectiveness of arthroscopic synovectomy (A-S) for the knee of rheumatoid arthritis (RA) patients was assessed by comparing the severity of synovial proliferation on MRI before and after the surgery. Twenty-five patients (30 knees) were studied. The mean duration of RA was 6 years and 7 months and the mean age at the time of A-S was 49.0 years. The mean follow-up period was 19 months (range: 6-39 months). The preoperative Larsen's classification from grade I to IV was 8, 13, 6, and 3 knees, respectively. Synovial proliferation was evaluated by the modified Takeuchi's classification (MRI score). The MRI score was investigated in relationships with the radiographic grade, wet weight of excised tissue, treatment score for RA knees of the Japanese Orthopaedic Association (JOA score), and the CRP value. The MRI score, JOA score, and CRP all significantly improved during follow-up. The radiographic grade showed less progression, the JOA score improved more, and CRP was lower during follow-up in patients with a postoperative MRI score less than 5. The wet weight of excised tissue showed no related with the MRI score. These results suggest that the effectiveness of A-S can be determined by evaluation of improvement of the MRI score. (author)

  19. Use of MR arthrography in detecting tears of the ligamentum teres with arthroscopic correlation

    Energy Technology Data Exchange (ETDEWEB)

    Chang, Connie Y.; Gill, Corey M.; Huang, Ambrose J.; Simeone, Frank J.; Torriani, Martin; Bredella, Miriam A. [Massachusetts General Hospital, Division of Musculoskeletal Imaging and Intervention, Department of Radiology, Boston, MA (United States); McCarthy, Joseph C. [Massachusetts General Hospital, Department of Orthopedics, Boston, MA (United States)

    2014-12-20

    To demonstrate the normal appearance of the ligamentum teres on MR arthrography (MRA) and evaluate the accuracy of MRA in detecting ligamentum teres tears with arthroscopic correlation. Institutional Review Board approval was obtained with a waiver for informed consent because of the retrospective study design. A total of 165 cases in 159 patients (111 females, 48 males; mean age 41 ± 12 years) who underwent both MRA and hip arthroscopy were evaluated for appearance of the ligamentum teres, including the size, number of bundles, and ligamentum teres tears. Marrow edema of the fovea capitis adjacent to the ligamentum teres insertion and the presence of hip plicae were also recorded. The mean thickness and length of the ligamentum teres were 3.5 ± 1.5 mm and 25.2 ± 3.8 mm, respectively. Sensitivity, specificity, positive and negative predictive value, and accuracy of MRA for the detection of ligamentum teres tears were 78, 97, 74, 97, and 95 %, respectively. MRA is an accurate method to evaluate the normal morphology and to detect tears of the ligamentum teres. (orig.)

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

    Directory of Open Access Journals (Sweden)

    K.R. Thompson

    2013-10-01

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

  1. The POLPSA lesion: MR imaging findings with arthroscopic correlation in patients with posterior instability

    International Nuclear Information System (INIS)

    Objective. To evaluate the features of the posterior labrocapsular periosteal sleeve avulsion (POLPSA) lesion on MR imaging in athletes with posterior shoulder instability.Design and patients. Six male athletes (age range 19-43 years) with avulsion of the posterior glenoid periosteum were identified on MR imaging. There were four football players, one wrestler, and one competitive weightlifter. The weightlifter had a bilateral condition so that seven shoulders were evaluated. MR imaging was performed with a 1.5 T magnet utilizing conventional and fat-saturated fast spin-echo coronal oblique and sagittal oblique sequences and a 3D-GRE transaxial sequence. Surgical correlation was available in all shoulders.Results. All patients presented with pain and a joint effusion. The size of the periosteal sleeve and redundant joint recess was variable. Fibrous proliferation was noted arthroscopically in four shoulders beneath the sleeve. Although the posterior labrum was detached in all studies, only one labrum had a tear while two showed marked degeneration.Conclusion. The POLPSA lesion is an abnormality that can be associated with posterior instability. It differs from a reverse Bankart lesion because the periosteum, although detached, remains intact with the posterior capsule and detached posterior labrum. This lesion may represent an acute form of a Bennett lesion. (orig.)

  2. Procedures for maintenance and repairs

    International Nuclear Information System (INIS)

    After a general review of the operation experience in the history of more than 12 operating years, the organization in the plant will be shown with special aspect to quality assurance, capacity of the workshops and connected groups as radiation protection, chemical laboratories etc. The number, time intervals and manpower effort for the repeating tests will be discussed. Reasons and examples for back-fitting activities in the plant are given. Besides special repair and maintenance procedures as repair of the steam generators, in-service inspection of the reactor pressure vessel, repair of a feed-water pipe and repair of the core structure in the pressure vessel, the general system to handle maintenance and repair-work in the KWO-plant will be shown. This includes also the detailed planning of the annual refueling and revision of the plant. (orig./RW)

  3. Rethinking transcription coupled DNA repair.

    Science.gov (United States)

    Kamarthapu, Venu; Nudler, Evgeny

    2015-04-01

    Nucleotide excision repair (NER) is an evolutionarily conserved, multistep process that can detect a wide variety of DNA lesions. Transcription coupled repair (TCR) is a subpathway of NER that repairs the transcribed DNA strand faster than the rest of the genome. RNA polymerase (RNAP) stalled at DNA lesions mediates the recruitment of NER enzymes to the damage site. In this review we focus on a newly identified bacterial TCR pathway in which the NER enzyme UvrD, in conjunction with NusA, plays a major role in initiating the repair process. We discuss the tradeoff between the new and conventional models of TCR, how and when each pathway operates to repair DNA damage, and the necessity of pervasive transcription in maintaining genome integrity. PMID:25596348

  4. The Use of Calcaneal Anatomic Plate in Arthroscopically-assisted Open Reduction and Internal Fixation of Intra-articular Calcaneal Fractures

    Institute of Scientific and Technical Information of China (English)

    WANG Hong; ZHANG Qingsong; DUAN Deyu; YAN Lijun

    2006-01-01

    To discuss and evaluate the method and effect of using calcaneal anatomic plate in treatment of intra-articular fractures of the calcaneus with assistant of arthroscope, 86 intra-articular fractures of the calcaneus in 78 patients were reduced by open reduction, and rigid fixation was made with calcaneal anatomic plate under assistant of arthroscope. The average follow-up duration was 18 months (range 12-30 months). The effect of treatment was evaluated according to AOFAS and X-ray before and after operation. The results showed that 86 patients have obtained satisfactory reduction according to X-ray, and there was significant difference before and after operation (P<0.01), the total excellent and fine rate was 91.86 %. Treating intra-articular fractures of the calcaneus with calcaneal anatomic plate under arthroscope may provide more chance to achieve anatomical reconstruction, which can lead to satisfied recovery of function and few complication.

  5. Arthroscopic ultrasound technique for simultaneous quantitative assessment of articular cartilage and subchondral bone: an in vitro and in vivo feasibility study.

    Science.gov (United States)

    Liukkonen, J; Hirvasniemi, J; Joukainen, A; Penttilä, P; Virén, T; Saarakkala, S; Kröger, H; Jurvelin, J S; Töyräs, J

    2013-08-01

    Traditional arthroscopic examination is subjective and poorly reproducible. Recently, we introduced an arthroscopic ultrasound method for quantitative diagnostics of cartilage lesions. Here we describe our investigation of the feasibility of ultrasound arthroscopy for simultaneous measurements of articular cartilage and subchondral bone. Human osteochondral samples (n = 13) were imaged using a clinical 9-MHz ultrasound system. Ultrasound reflection coefficients (R, IRC), the ultrasound roughness index (URI) and the apparent integrated backscattering coefficient (AIB) were determined for both tissues. Mechanical testing, histologic analyses and micro-scale computed tomography imaging were the reference methods. Ultrasound arthroscopies were conducted on two patients. The ultrasound reflection coefficient correlated with the Mankin score and Young's modulus of cartilage (|r| > 0.56, p 0.70, p 0.59, p 0.65, p < 0.05). Arthroscopic ultrasound examination provided diagnostically valuable information on cartilage and subchondral bone in vivo. PMID:23743098

  6. Repair processes in diverse systems: overview

    International Nuclear Information System (INIS)

    Studies on DNA repair in several bacterial systems as well as in eukaryotes are reviewed. Some topics discussed are: excision repair of uv damage in Mycoplasma; repair replication in uv-irradiated Tetrahymena; repair of double-strand breaks in DNA of Micrococcus radiodurans; DNA repair in Neurospora; lack of dimer excision in x-irradiated Vicia faba; and DNA repair in Nicotiana, Haplopappus, and Chlamydomonas

  7. Wound repair in Pocillopora

    Science.gov (United States)

    Rodríguez-Villalobos, Jenny Carolina; Work, Thierry M.; Calderon-Aguileraa, Luis Eduardo

    2016-01-01

    Corals routinely lose tissue due to causes ranging from predation to disease. Tissue healing and regeneration are fundamental to the normal functioning of corals, yet we know little about this process. We described the microscopic morphology of wound repair in Pocillopora damicornis. Tissue was removed by airbrushing fragments from three healthy colonies, and these were monitored daily at the gross and microscopic level for 40 days. Grossly, corals healed by Day 30, but repigmentation was not evident at the end of the study (40 d). On histology, from Day 8 onwards, tissues at the lesion site were microscopically indistinguishable from adjacent normal tissues with evidence of zooxanthellae in gastrodermis. Inflammation was not evident. P. damicornis manifested a unique mode of regeneration involving projections of cell-covered mesoglea from the surface body wall that anastomosed to form gastrovascular canals.

  8. Reward optimization of a repairable system

    Energy Technology Data Exchange (ETDEWEB)

    Castro, I.T. [Departamento de Matematicas, Facultad de Veterinaria, Universidad de Extremadura, Avenida de la Universidad, s/n. 10071 Caceres (Spain)]. E-mail: inmatorres@unex.es; Perez-Ocon, R. [Departamento de Estadistica e Investigacion Operativa, Facultad de Ciencias, Universidad de Granada, Avenida de Severo Ochoa, s/n. 18071 Granada (Spain)]. E-mail: rperezo@ugr.es

    2006-03-15

    This paper analyzes a system subject to repairable and non-repairable failures. Non-repairable failures lead to replacement of the system. Repairable failures, first lead to repair but they lead to replacement after a fixed number of repairs. Operating and repair times follow phase type distributions (PH-distributions) and the pattern of the operating times is modelled by a geometric process. In this context, the problem is to find the optimal number of repairs, which maximizes the long-run average reward per unit time. To this end, the optimal number is determined and it is obtained by efficient numerical procedures.

  9. A Canine Non-Weight-Bearing Model with Radial Neurectomy for Rotator Cuff Repair.

    Directory of Open Access Journals (Sweden)

    Xiaoxi Ji

    Full Text Available The major concern of using a large animal model to study rotator cuff repair is the high rate of repair retears. The purpose of this study was to test a non-weight-bearing (NWB canine model for rotator cuff repair research.First, in the in vitro study, 18 shoulders were randomized to 3 groups. 1 Full-width transections repaired with modified Mason-Allen sutures using 3-0 polyglactin suture, 2 Group 1 repaired using number 2 (#2 polyester braid and long-chain polyethylene suture, and 3 Partial-width transections leaving the superior 2 mm infraspinatus tendon intact without repair. In the in vivo study of 6 dogs, the infraspinatus tendon was partially transected as the same as the in vitro group 3. A radial neurectomy was performed to prevent weight bearing. The operated limb was slung in a custom-made jacket for 6 weeks.In the in vitro study, mean ultimate tensile load and stiffness in Group 2 were significantly higher than Group 1 and 3 (p<0.05. In the in vivo study, gross inspection and histology showed that the preserved superior 2-mm portion of the infraspinatus tendon remained intact with normal structure.Based on the biomechanical and histological findings, this canine NWB model may be an appropriate and useful model for studies of rotator cuff repair.

  10. Partially strong WW scattering

    International Nuclear Information System (INIS)

    What if only a light Higgs boson is discovered at the CERN LHC? Conventional wisdom tells us that the scattering of longitudinal weak gauge bosons would not grow strong at high energies. However, this is generally not true. In some composite models or general two-Higgs-doublet models, the presence of a light Higgs boson does not guarantee complete unitarization of the WW scattering. After partial unitarization by the light Higgs boson, the WW scattering becomes strongly interacting until it hits one or more heavier Higgs bosons or other strong dynamics. We analyze how LHC experiments can reveal this interesting possibility of partially strong WW scattering.

  11. DNA repair in Chromobacterium violaceum.

    Science.gov (United States)

    Duarte, Fábio Teixeira; Carvalho, Fabíola Marques de; Bezerra e Silva, Uaska; Scortecci, Kátia Castanho; Blaha, Carlos Alfredo Galindo; Agnez-Lima, Lucymara Fassarella; Batistuzzo de Medeiros, Silvia Regina

    2004-03-31

    Chromobacterium violaceum is a Gram-negative beta-proteobacterium that inhabits a variety of ecosystems in tropical and subtropical regions, including the water and banks of the Negro River in the Brazilian Amazon. This bacterium has been the subject of extensive study over the last three decades, due to its biotechnological properties, including the characteristic violacein pigment, which has antimicrobial and anti-tumoral activities. C. violaceum promotes the solubilization of gold in a mercury-free process, and has been used in the synthesis of homopolyesters suitable for the production of biodegradable polymers. The complete genome sequence of this organism has been completed by the Brazilian National Genome Project Consortium. The aim of our group was to study the DNA repair genes in this organism, due to their importance in the maintenance of genomic integrity. We identified DNA repair genes involved in different pathways in C. violaceum through a similarity search against known sequences deposited in databases. The phylogenetic analyses were done using programs of the PHILYP package. This analysis revealed various metabolic pathways, including photoreactivation, base excision repair, nucleotide excision repair, mismatch repair, recombinational repair, and the SOS system. The similarity between the C. violaceum sequences and those of Neisserie miningitidis and Ralstonia solanacearum was greater than that between the C. violaceum and Escherichia coli sequences. The peculiarities found in the C. violaceum genome were the absence of LexA, some horizontal transfer events and a large number of repair genes involved with alkyl and oxidative DNA damage.

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

    Energy Technology Data Exchange (ETDEWEB)

    Aydingoez, Uestuen; Firat, Ahmet K. [Department of Radiology, Hacettepe University Medical Center, 06100 Ankara (Turkey); Atay, Ahmet Oe.; Doral, Nedim M. [Department of Orthopaedics and Traumatology, Hacettepe University Medical Center, 06100 Ankara (Turkey)

    2003-03-01

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

  13. Honesty in partial logic

    NARCIS (Netherlands)

    Hoek, W. van der; Jaspars, J.O.M.; Thijsse, E.

    1995-01-01

    We propose an epistemic logic in which knowledge is fully introspective and implies truth, although truth need not imply epistemic possibility. The logic is presented in sequential format and is interpreted in a natural class of partial models, called balloon models. We examine the notions of hones

  14. Partially ordered models

    NARCIS (Netherlands)

    Fernandez, R.; Deveaux, V.

    2010-01-01

    We provide a formal definition and study the basic properties of partially ordered chains (POC). These systems were proposed to model textures in image processing and to represent independence relations between random variables in statistics (in the later case they are known as Bayesian networks). O

  15. Partially Hidden Markov Models

    DEFF Research Database (Denmark)

    Forchhammer, Søren Otto; Rissanen, Jorma

    1996-01-01

    Partially Hidden Markov Models (PHMM) are introduced. They differ from the ordinary HMM's in that both the transition probabilities of the hidden states and the output probabilities are conditioned on past observations. As an illustration they are applied to black and white image compression where...

  16. Pelleted bone marrow derived mesenchymal stem cells are better protected from the deleterious effects of arthroscopic heat shock

    Directory of Open Access Journals (Sweden)

    Gauthaman eKalamegam

    2016-05-01

    Full Text Available Introduction: The impact of arthroscopic temperature on joint tissues is poorly understood and it is not known how mesenchymal stem cells (MSCs respond to the effects of heat generated by the device during the process of arthroscopy assisted experimental cell-based therapy. In the present study, we isolated and phenotypically characterized human bone marrow mesenchymal stem cells (hBMMSCs from osteoarthritis (OA patients, and evaluated the effect of arthroscopic heat on cell viability in suspension and pellet cultures.Methods: Primary cultures of hBMMSCs were isolated from bone marrow aspirates of OA patients and cultured using DMEM supplemented with 10% FBS and characterized for their stemness. hBMMSCs (1 x 106 cells cultured as single cell suspensions or cell pellets were exposed to an illuminated arthroscope for 10, 20 or 30 min. This was followed by analysis of cellular proliferation and heat shock related gene expression. Results: hBMMSCs were viable and exhibited population doubling, short spindle morphology, MSC related CD surface markers expression and tri-lineage differentiation into adipocytes, chondrocytes and osteoblasts. Chondrogenic and osteogenic differentiation increased collagen production and alkaline phosphatase activity. Exposure of hBMMSCs to an illuminated arthroscope for 10, 20 or 30 min for 72 h decreased cell proliferation in cell suspensions (63.27% at 30 min and increased cell proliferation in cell pellets (62.86% at 10 min and 68.57% at 20 min. hBMMSCs exposed to 37C, 45C and 55C for 120 seconds demonstrated significant upregulation of BAX, P53, Cyclin A2, Cyclin E1, TNF-α, and HSP70 in cell suspensions compared to cell pellets. Conclusions: hBMMSC cell pellets are better protected from temperature alterations compared to cell suspensions. Transplantation of hBMMSCs as pellets rather than as cell suspensions to the cartilage defect site would therefore support their viability and may aid enhanced cartilage

  17. Rethinking Transcription Coupled DNA Repair

    OpenAIRE

    Kamarthapu, Venu; Nudler, Evgeny

    2015-01-01

    Nucleotide excision repair (NER) is an evolutionarily conserved, multistep process that can detect a wide variety of DNA lesions. Transcription coupled repair (TCR) is a sub-pathway of NER that repairs the transcribed DNA strand faster than the rest of the genome. RNA polymerase (RNAP) stalled at DNA lesions mediates the recruitment of NER enzymes to the damage site. In this review we focus on a newly identified bacterial TCR pathway in which the NER enzyme UvrD, in conjunction with NusA, pla...

  18. Triple labrum tears repaired with the JuggerKnot™ soft anchor: Technique and results

    Directory of Open Access Journals (Sweden)

    Vivek Agrawal

    2015-01-01

    Full Text Available Purpose: The 2-year outcomes of patients undergoing repair of triple labrum tears using an all-suture anchor device were assessed. Materials and Methods: Eighteen patients (17 male, one female; mean age 36.4 years, range: 14.2-62.3 years with triple labrum tears underwent arthroscopic repair using the 1.4 mm JuggerKnot Soft Anchor (mean number of anchors 11.5, range: 9-19 anchors. Five patients had prior surgeries performed on their operative shoulder. Patients were followed for a mean of 2.0 years (range: 1.6-3.0 years. Constant-Murley shoulder score (CS and Flexilevel scale of shoulder function (FLEX-SF scores were measured, with preoperative and final postoperative mean scores compared with a paired Student′s t-test (P < 0.05. Magnetic resonance imaging (MRI was also performed at final postoperative. Results: Overall total CS and FLEX-SF scores increased from 52.9 ± 20.4 to 84.3 ± 10.7 (P < 0.0001 and from 29.3 ± 4.7 to 42.0 ± 7.3 (P < 0.0001, respectively. When divided into two groups by whether or not glenohumeral arthrosis was present at the time of surgery (n = 9 each group, significant improvements in CS and FLEX-SF were obtained for both groups (P < 0.0015. There were no intraoperative complications. All patients, including contact athletes, returned to their preinjury level of sports activity and were satisfied. MRI evaluation revealed no instances of subchondral cyst formation or tunnel expansion. Anchor tracts appeared to heal with fibrous tissue, complete bony healing, or combined fibro-osseous healing. Conclusion: Our results are encouraging, demonstrating a consistent healing of the anchor tunnels through arthroscopic treatment of complex labrum lesions with a completely suture-based implant. It further demonstrates a meaningful improvement in patient outcomes, a predictable return to activity, and a high rate of patient satisfaction. Level of Evidence: Level IV case series.

  19. The Roman Bridge: a "double pulley – suture bridges" technique for rotator cuff repair

    Directory of Open Access Journals (Sweden)

    Maffulli Nicola

    2007-12-01

    Full Text Available Abstract Background With advances in arthroscopic surgery, many techniques have been developed to increase the tendon-bone contact area, reconstituting a more anatomic configuration of the rotator cuff footprint and providing a better environment for tendon healing. Methods We present an arthroscopic rotator cuff repair technique which uses suture bridges to optimize rotator cuff tendon-footprint contact area and mean pressure. Results Two medial row 5.5-mm Bio-Corkscrew suture anchors (Arthrex, Naples, FL, which are double-loaded with No. 2 FiberWire sutures (Arthrex, Naples, FL, are placed in the medial aspect of the footprint. Two suture limbs from a single suture are both passed through a single point in the rotator cuff. This is performed for both anchors. The medial row sutures are tied using the double pulley technique. A suture limb is retrieved from each of the medial anchors through the lateral portal, and manually tied as a six-throw surgeon's knot over a metal rod. The two free suture limbs are pulled to transport the knot over the top of the tendon bridge. Then the two free suture limbs that were used to pull the knot down are tied. The end of the sutures are cut. The same double pulley technique is repeated for the other two suture limbs from the two medial anchors, but the two free suture limbs are used to produce suture bridges over the tendon, by means of a Pushlock (Arthrex, Naples, FL, placed 1 cm distal to the lateral edge of the footprint. Conclusion This technique maximizes the advantages of two techniques. On the one hand, the double pulley technique provides an extremely secure fixation in the medial aspect of the footprint. On the other hand, the suture bridges allow to improve pressurized contact area and mean footprint pressure. In this way, the bony footprint in not compromised by the distal-lateral fixation, and it is thus possible to share the load between fixation points. This maximizes the strength of the repair

  20. Impingement syndrome of the ankle following supination external rotation trauma: MR imaging findings with arthroscopic correlation

    Energy Technology Data Exchange (ETDEWEB)

    Schaffler, Gottfried J. [Department of Radiology, University of California San Francisco, 350 Parnassus Avenue, Suite 150, San Francisco, CA 94117 (United States); Department of Radiology, University Hospital Graz, Auenbruggerplatz 9, 8036 Graz (Austria); Tirman, Phillip F.J.; Stoller, David W. [San Francisco Magnetic Resonance Center, 3333 California Street, Suite 105, San Francisco, CA 94118 (United States); Genant, Harry K. [Department of Radiology, University of California San Francisco, 350 Parnassus Avenue, Suite 150, San Francisco, CA 94117 (United States); Ceballos, Cecar; Dillingham, Michael F. [Sports Orthopedics and Rehabilitation, 2884 Sand Hill Rd., Suite 110, Menlo Park, CA 94025 (United States)

    2003-06-01

    Our objective was to identify MR imaging findings in patients with syndesmotic soft tissue impingement of the ankle and to investigate the reliability of these imaging characteristics to predict syndesmotic soft tissue impingement syndromes of the ankle. Twenty-one ankles with chronic pain ultimately proven to have anterior soft tissue impingement syndrome were examined by MR imaging during January 1996 to June 2001. The MR imaging protocol included sagittal and coronal short tau inversion recovery (STIR), sagittal T1-weighted spin echo, axial and coronal proton-density, and T2-weighted spin-echo sequences. Nineteen ankles that underwent MR imaging during the same period of time and that had arthroscopically proven diagnosis different than impingement syndrome served as a control group. Fibrovascular scar formations distinct from the syndesmotic ligaments possibly related to syndesmotic soft tissue impingement were recorded. Arthroscopy was performed subsequently in all patients and was considered the gold standard. The statistical analysis revealed an overall frequency of scarred syndesmotic ligaments of 70% in the group with ankle impingement. Fibrovascular scar formations distinct from the syndesmotic ligaments presented with low signal intensity on T1-weighted images and remained low to intermediate in signal intensity on T2-weighted MR imaging. Compared with arthroscopy, MR imaging revealed a sensitivity of 89%, a specificity of 100%, and a diagnostic accuracy of 93% for scarred syndesmotic ligaments. The frequency of scar formation distinct from the syndesmotic ligaments in patients with impingement syndrome of the ankle was not statistically significantly higher than in the control group. In contrast to that, anterior tibial osteophytes and talar osteophytes were statistically significantly higher in the group with anterior impingement than in the control group. Conventional MR imaging was found to be insensitive for the diagnosis of syndesmotic soft tissue

  1. Impingement syndrome of the ankle following supination external rotation trauma: MR imaging findings with arthroscopic correlation

    International Nuclear Information System (INIS)

    Our objective was to identify MR imaging findings in patients with syndesmotic soft tissue impingement of the ankle and to investigate the reliability of these imaging characteristics to predict syndesmotic soft tissue impingement syndromes of the ankle. Twenty-one ankles with chronic pain ultimately proven to have anterior soft tissue impingement syndrome were examined by MR imaging during January 1996 to June 2001. The MR imaging protocol included sagittal and coronal short tau inversion recovery (STIR), sagittal T1-weighted spin echo, axial and coronal proton-density, and T2-weighted spin-echo sequences. Nineteen ankles that underwent MR imaging during the same period of time and that had arthroscopically proven diagnosis different than impingement syndrome served as a control group. Fibrovascular scar formations distinct from the syndesmotic ligaments possibly related to syndesmotic soft tissue impingement were recorded. Arthroscopy was performed subsequently in all patients and was considered the gold standard. The statistical analysis revealed an overall frequency of scarred syndesmotic ligaments of 70% in the group with ankle impingement. Fibrovascular scar formations distinct from the syndesmotic ligaments presented with low signal intensity on T1-weighted images and remained low to intermediate in signal intensity on T2-weighted MR imaging. Compared with arthroscopy, MR imaging revealed a sensitivity of 89%, a specificity of 100%, and a diagnostic accuracy of 93% for scarred syndesmotic ligaments. The frequency of scar formation distinct from the syndesmotic ligaments in patients with impingement syndrome of the ankle was not statistically significantly higher than in the control group. In contrast to that, anterior tibial osteophytes and talar osteophytes were statistically significantly higher in the group with anterior impingement than in the control group. Conventional MR imaging was found to be insensitive for the diagnosis of syndesmotic soft tissue

  2. [Examination of the knee joint. The value of clinical findings in arthroscopic control].

    Science.gov (United States)

    Steinbrück, K; Wiehmann, J C

    1988-01-01

    Purely clinical examination of the knee joint can, at best, only be regarded as a "screening procedure". Diagnosis with the aid of apparatus (sonography, arthrography, CT, NMR) produces better results. However, arthroscopy performed by an experienced examiner confirms the diagnosis in cases of suspected meniscus injury or isolated lesions of the cruciate ligaments and leads to early and therefore optimal therapy. In a retrospective study 300 arthroscopies performed in 1985 were selected and evaluated. In 1986/87, a further 300 patients were clinically examined prospectively, according to the same criteria, and findings were compared with the arthroscopy performed the following day. Clinically, in 287 patients with multiple diagnoses, internal meniscus lesions were diagnosed in 162 cases (54%), external meniscus lesions in 38 (13%), chondropathia patellae in 54 (18%), and old ruptures of the cruciate ligaments in 46 (15%). In 13 patients no diagnosis could be established. Arthroscopically, pathology of the internal meniscus was found in 98 (33%) of the 300 patients, of the external meniscus in 40 (13%), cartilage damage in 103 (34%), old cruciate ligament ruptures in 51 (17%), and recent anterior cruciate ligament ruptures in 156 (52%); in 40 cases findings were normal. At 78%, the highest positive predictive value (proportion of tentative clinical diagnoses confirmed by arthroscopy) was found in cases of old ruptures of the anterior cruciate ligament, followed by external meniscus lesions (61%) and internal meniscus lesions (55%); i.e., only 55 out of 100 clinically suspected internal meniscus lesions are diagnosed by arthroscopy.(ABSTRACT TRUNCATED AT 250 WORDS)

  3. Arthroscopic-Assisted Fixation of Tibial Plateau Fractures: Patient-Reported Postoperative Activity Levels.

    Science.gov (United States)

    Kampa, John; Dunlay, Ryan; Sikka, Robby; Swiontkowski, Marc

    2016-05-01

    Tibial plateau fractures may result in significant limitations postoperatively. Studies have described outcomes of arthroscopic-assisted percutaneous fixation (AAPF) of these injuries but have rarely reported postoperative activity levels. Between 2009 and 2013, patients who sustained a lateral split, split depression, or pure depression type tibial plateau fracture (Schatzker types I-III fractures) and underwent outpatient AAPF were eligible for the study. Outcomes were assessed using Knee Injury and Osteoarthritis Outcome Score (KOOS), International Knee Documentation Committee (IKDC) Subjective Knee Evaluation Form, Lysholm score, and Marx activity score. Twenty-five consecutive patients were eligible for the study, and 22 (88%) were included in the final analysis, with average follow-up of 2.5 years (range, 1-5.2 years). Thirteen women and 9 men with an average age of 48.3 years (range, 23-65 years) comprised the study population. Average number of screws used for fixation was 2 (range, 1-4). The average depression was 8 mm preoperatively and 0.9 mm (range, 0-3 mm) postoperatively. Four patients (18%) had complications: 2 with hardware removal and 2 with postoperative deep venous thrombosis. Average postoperative Marx activity score was 5.7. Average postoperative KOOS Symptoms, Sports, and Quality of Life scores were 88 (range, 68-100), 85 (range, 45-100), and 77 (range, 50-100), respectively. Average IKDC and Lysholm scores were 81 (range, 55-97) and 87 (range, 54-100), respectively. The AAPF surgical technique, which was performed in an outpatient setting, facilitated excellent postoperative range of motion, outcomes, and activity scores with minimal complications. [Orthopedics. 2016; 39(3):e486-e491.].

  4. MR Imaging of Stable Posterior Cruciate Ligament Grafts in 21 Arthroscopically Proven Cases

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Young Cheol; Chung, Hye Won; Ahn, Jin Hwan [Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2007-10-15

    To describe the magnetic resonance (MR) appearance of intact posterior cruciate ligament (PCL) grafts. Thirty-one postoperative MR examinations were performed in 21 grafts of 20 patients after PCL reconstruction. All 21 grafts were proven to be intact on second-look arthroscopic examination. Two musculoskeletal radiologists retrospectively analyzed the MR findings and reached decisions by consensus. The signal intensity (SI) of the graft on proton density-weighted and T2-weighted images, as well as the shapes, locations, and segments of increased SI were recorded. The graft thickness was also recorded and correlated to elapsed time since reconstructive surgery. The SI of the graft was high (15/31, 48%), intermediate (10/31, 32%), or low (6/31, 19%) on proton density-weighted images, and high (9/31, 29%), intermediate (6/31, 19%), or low (16/31, 52%) on T2-weighted images. The graft SI decreased significantly as postoperative time elapsed. The shape of the increased SI within the grafts was band-like (14/25, 56%) or focal (11/25, 44%). The increased SI was located in the proximal (18/25, 72%), middle (21/25, 82%), and distal (12/25, 48%) segments. In the axial plane, the location of increased SI was intrasubstance (19/25, 76%) or peripheral (10/25, 40%). A 'focal' shape of increased SI was found significantly more in Achilles tendon allografts, while a band-like shape was more frequent in autogenous double-loop hamstring tendon grafts. Graft thickness ranged from 5 15 mm. The difference in graft thickness relative to postoperative time was not statistically significant (p = 0.79). Stable PCL grafts commonly showed an increased SI at any segment or location, even though they were stable. The shape of increased SI differed according to allograft donor sites. However, SI tended to decrease as time elapsed.

  5. MR Imaging of Stable Posterior Cruciate Ligament Grafts in 21 Arthroscopically Proven Cases

    International Nuclear Information System (INIS)

    To describe the magnetic resonance (MR) appearance of intact posterior cruciate ligament (PCL) grafts. Thirty-one postoperative MR examinations were performed in 21 grafts of 20 patients after PCL reconstruction. All 21 grafts were proven to be intact on second-look arthroscopic examination. Two musculoskeletal radiologists retrospectively analyzed the MR findings and reached decisions by consensus. The signal intensity (SI) of the graft on proton density-weighted and T2-weighted images, as well as the shapes, locations, and segments of increased SI were recorded. The graft thickness was also recorded and correlated to elapsed time since reconstructive surgery. The SI of the graft was high (15/31, 48%), intermediate (10/31, 32%), or low (6/31, 19%) on proton density-weighted images, and high (9/31, 29%), intermediate (6/31, 19%), or low (16/31, 52%) on T2-weighted images. The graft SI decreased significantly as postoperative time elapsed. The shape of the increased SI within the grafts was band-like (14/25, 56%) or focal (11/25, 44%). The increased SI was located in the proximal (18/25, 72%), middle (21/25, 82%), and distal (12/25, 48%) segments. In the axial plane, the location of increased SI was intrasubstance (19/25, 76%) or peripheral (10/25, 40%). A 'focal' shape of increased SI was found significantly more in Achilles tendon allografts, while a band-like shape was more frequent in autogenous double-loop hamstring tendon grafts. Graft thickness ranged from 5 15 mm. The difference in graft thickness relative to postoperative time was not statistically significant (p = 0.79). Stable PCL grafts commonly showed an increased SI at any segment or location, even though they were stable. The shape of increased SI differed according to allograft donor sites. However, SI tended to decrease as time elapsed

  6. Evaluation of the intensive rehabilitation protocol after arthroscopically assisted anterior cruciate ligament reconstruction

    Directory of Open Access Journals (Sweden)

    Dubljanin-Raspopović Emilija

    2006-01-01

    Full Text Available Introduction: Optimal treatment of ACL (anterior cruciate injury injuries is one of the most dynamic topics of contemporary orthopedics. Despite huge amount of publications on this subject, golden rehabilitation standard has not been established yet. Objective: The aim of our study was to compare two different rehabilitation groups in respect to dynamics and safety of recovery, and accordingly to recommend contemporary rehabilitation approach. Method: A prospective study included 45 patients with unilateral ACL rupture who were randomized into conservative (THC and intensive rehabilitation (TH-I group. The arthroscopic reconstruction of ACL was performed using the BTBP or STG graft. After the operation, in the TH-C group, ROM was limited to 0-0-90˚ and weight bearing was not allowed in the first 4 postoperative weeks. In the TH-I group, progression depended only on the knee edema and pain. The groups were compared in relation to demographic, anamnestic, and clinical characteristics (knee circumference, thigh circumference, stability tests, Lysholm, Tegner and one-leg hop test, and single stance test. Data were recorded preoperatively and postoperatively after 6 weeks, 4, 6, 9 and 12 months, and compared with parametric and non-parametric statistical tests. Results: The investigated groups clearly differed already after 6 weeks by range of motion (p<0.05, thigh circumference (p<0.01 and Lysholm test score (p<0.01, after 4 months in relation to one leg hop test (p<0.05, and after 6 months according to Tegner test (p<0.01. In the TH-I group, graft integrity was not compromised in any of these patients, nor did postoperative arthrofibrosis develop. Conclusion: Our investigation has undoubtedly revealed that early intensive rehabilitation approach leads to faster functional recovery without complications compared to conventional rehabilitation treatment.

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

    Directory of Open Access Journals (Sweden)

    Srinath Kamineni

    2015-01-01

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

  8. A Two-Unit Cold Standby Repairable System with One Replaceable Repair Facility and Delay Repair:Some Reliability Problems

    Institute of Scientific and Technical Information of China (English)

    WEI Ying-yuan; TANG Ying-hui

    2004-01-01

    This paper considers a two-unit same cold standby repairable system with a replaceable repair facility and delay repair .The failure time of unit is assumed to follow exponential distribution , and the repair time and delay time of failed unit are assumed to follow arbitrary distributions , whereas the failure and replacement time distributions of the repair facility are exponential and arbitrary . By using the Markov renewal process theory, some primary reliability quantities of the system are obtained.

  9. 40 CFR 63.1024 - Leak repair.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 10 2010-07-01 2010-07-01 false Leak repair. 63.1024 Section 63.1024... Standards for Equipment Leaks-Control Level 2 Standards § 63.1024 Leak repair. (a) Leak repair schedule. The owner or operator shall repair each leak detected as soon as practical, but not later than 15...

  10. 40 CFR 65.105 - Leak repair.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 15 2010-07-01 2010-07-01 false Leak repair. 65.105 Section 65.105... FEDERAL AIR RULE Equipment Leaks § 65.105 Leak repair. (a) Leak repair schedule. The owner or operator shall repair each leak detected as soon as practical but not later than 15 calendar days after it...

  11. 40 CFR 63.1005 - Leak repair.

    Science.gov (United States)

    2010-07-01

    ... successful repair of the leak. (3) Maximum instrument reading measured by Method 21 of 40 CFR part 60... 40 Protection of Environment 10 2010-07-01 2010-07-01 false Leak repair. 63.1005 Section 63.1005... Standards for Equipment Leaks-Control Level 1 § 63.1005 Leak repair. (a) Leak repair schedule. The owner...

  12. Mammalian DNA Repair. Final Report

    Energy Technology Data Exchange (ETDEWEB)

    None

    2003-01-24

    The Gordon Research Conference (GRC) on Mammalian DNA Repair was held at Harbortown Resort, Ventura Beach, CA. Emphasis was placed on current unpublished research and discussion of the future target areas in this field.

  13. Early days of DNA repair: discovery of nucleotide excision repair and homology-dependent recombinational repair.

    Science.gov (United States)

    Rupp, W Dean

    2013-12-13

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

  14. Reprogramming Cells for Brain Repair

    OpenAIRE

    McKinnon, Randall D.; Alyx T. Guarino

    2013-01-01

    At present there are no clinical therapies that can repair traumatic brain injury, spinal cord injury or degenerative brain disease. While redundancy and rewiring of surviving circuits can recover some lost function, the brain and spinal column lack sufficient endogenous stem cells to replace lost neurons or their supporting glia. In contrast, pre-clinical studies have demonstrated that exogenous transplants can have remarkable efficacy for brain repair in animal models. Mesenchymal stromal c...

  15. Lateral repair of parastomal hernia.

    OpenAIRE

    Amin, S. N.; Armitage, N. C.; Abercrombie, J. F.; Scholefield, J H

    2001-01-01

    INTRODUCTION: Parastomal hernia is a common complication of stoma construction. Although the majority of patients are asymptomatic, about 10% require surgical correction. AIMS: We describe a new surgical approach for the repair of parastomal hernias, which avoids both the need for laparotomy and stoma mobilization. PATIENTS AND METHODS: Nine patients (4 female) with parastomal hernia underwent surgical repair. Median age was 55 years (range 38-73 years). There were 8 para-ileostomy herniae an...

  16. Laparoscopic repair of postoperative perineal hernia.

    LENUS (Irish Health Repository)

    Ryan, Stephen

    2010-01-01

    Perineal hernias are infrequent complications following abdominoperineal operations. Various approaches have been described for repair of perineal hernias including open transabdominal, transperineal or combined abdominoperineal repairs. The use of laparoscopic transabdominal repair of perineal hernias is not well-described. We present a case report demonstrating the benefits of laparoscopic repair of perineal hernia following previous laparoscopic abdominoperineal resection (APR) using a nonabsorbable mesh to repair the defect. We have demonstrated that the use of laparoscopy with repair of the pelvic floor defect using a non absorbable synthetic mesh offers an excellent alternative with many potential advantages over open transabdominal and transperineal repairs.

  17. Partially coherent ultrafast spectrography

    Science.gov (United States)

    Bourassin-Bouchet, C.; Couprie, M.-E.

    2015-01-01

    Modern ultrafast metrology relies on the postulate that the pulse to be measured is fully coherent, that is, that it can be completely described by its spectrum and spectral phase. However, synthesizing fully coherent pulses is not always possible in practice, especially in the domain of emerging ultrashort X-ray sources where temporal metrology is strongly needed. Here we demonstrate how frequency-resolved optical gating (FROG), the first and one of the most widespread techniques for pulse characterization, can be adapted to measure partially coherent pulses even down to the attosecond timescale. No modification of experimental apparatuses is required; only the processing of the measurement changes. To do so, we take our inspiration from other branches of physics where partial coherence is routinely dealt with, such as quantum optics and coherent diffractive imaging. This will have important and immediate applications, such as enabling the measurement of X-ray free-electron laser pulses despite timing jitter. PMID:25744080

  18. Partially predictable chaos

    CERN Document Server

    Wernecke, Hendrik; Gros, Claudius

    2016-01-01

    For a chaotic system pairs of initially close-by trajectories become eventually fully uncorrelated on the attracting set. This process of decorrelation is split into an initial decrease characterized by the maximal Lyapunov exponent and a subsequent diffusive process on the chaotic attractor causing the final loss of predictability. The time scales of both processes can be either of the same or of very different orders of magnitude. In the latter case the two trajectories linger within a finite but small distance (with respect to the overall size of the attractor) for exceedingly long times and therefore remain partially predictable. We introduce a 0-1 indicator for chaos capable of describing this scenario, arguing, in addition, that the chaotic closed braids found close to a period-doubling transition are generically partially predictable.

  19. Aircraft Metal Skin Repair and Honeycomb Structure Repair; Sheet Metal Work 3: 9857.02.

    Science.gov (United States)

    Dade County Public Schools, Miami, FL.

    The course helps students determine types of repairs, compute repair sizes, and complete the repair through surface protection. Course content includes goals, specific objectives, protection of metals, repairs to metal skin, and honeycomb structure repair. A bibliography and post-test are appended. A prerequisite for this course is mastery of the…

  20. Honesty in partial logic

    OpenAIRE

    Hoek, van, E.; Jaspars, J.O.M.; Thijsse, E.

    1995-01-01

    We propose an epistemic logic in which knowledge is fully introspective and implies truth, although truth need not imply epistemic possibility. The logic is presented in sequential format and is interpreted in a natural class of partial models, called balloon models. We examine the notions of honesty and circumscription in this logic: What is the state of an agent that `only knows $phi$' and which honest $phi$ enable such circumscription? Redefining {em stable sets enables us to provide suita...