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Sample records for arthroscopic partial repair

  1. 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.

  2. Arthroscopic hip labral repair.

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    Philippon, Marc J; Faucet, Scott C; Briggs, Karen K

    2013-05-01

    Labral tears in the hip may cause painful clicking or locking of the hip, reduced range of motion, and disruption to sports and daily activities. The acetabular labrum aids stabilization of the hip joint, particularly during hip motion. The fibrocartilaginous structure extends the acetabular rim and provides a suction seal around the femoroacetabular interface. Treatment options for labral tears include debridement, repair, and reconstruction. Repair of the labrum has been shown to have better results than debridement. Labral refixation is achieved with sutures anchored into the acetabular rim. The acetabular rim is trimmed either to correct pincer impingement or to provide a bleeding bed to improve healing. Labral repair has shown excellent short-term to midterm outcomes and allows patients to return to activities and sports. Arthroscopic rim trimming and labral refixation comprise an effective treatment for labral tears with an underlying diagnosis of femoroacetabular impingement and are supported by the peer-reviewed literature. PMID:23875153

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

    Institute of Scientific and Technical Information of China (English)

    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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    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.

  5. 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

  6. 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. PMID:26761928

  7. 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

  8. 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...

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

    OpenAIRE

    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...

  10. 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.

  11. 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.

  12. Arthroscopic Subacromial Decompression for Small and Medium Size Tears of Rotator Cuff without Tendon Repair

    OpenAIRE

    Suhail Karkabi; Nahum Rosenberg

    2014-01-01

    According to our previous clinical impression, we hypothesized that patients who had symptomatic rotator cuff tendon tear in a diamemter below 3 cm would benefit from arthroscopic subacromial decompression only, without the need for the repair of the thorn tendon. From 1998 to 2003, 160 patients (168 shoulders) had arthroscopic subacromial decompression for impingement syndrome with a torn rotator cuff without repairing the tear of the cuffs (120 males and 40 females). The average patient age...

  13. 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 ...

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

    OpenAIRE

    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...

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

    OpenAIRE

    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...

  16. Clinical Outcomes of Conservative Treatment and Arthroscopic Repair of Rotator Cuff Tears: A Retrospective Observational Study

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    Lee, Woo Hyung; Do, Hyun Kyung; Lee, Joong Hoon; Kim, Bo Ram; Noh, Jee Hyun; Choi, Soo Hyun; Chung, Sun Gun; Lee, Shi-Uk; Choi, Ji Eun; Kim, Seihee; Kim, Min Jee

    2016-01-01

    Objective To compare the clinical outcomes following conservative treatment and arthroscopic repair in patients with a rotator cuff tear. Methods In this retrospective study, patients aged >50 years with a symptomatic rotator cuff tear were reviewed. The rotator cuff tendons were evaluated using ultrasonography, shoulder magnetic resonance imaging or MR arthrography, and the patients with either a high-grade partial-thickness or small-to-medium-sized (≤3 cm) full-thickness tear were included in this study. The primary outcome measures were a pain assessment score and range of motion (ROM) at 1-year follow-up. The secondary outcomes were the rate of tear progression or retear along with the rate of symptom aggravation after the treatments. Results A total of 357 patients were enrolled, including 183 patients that received conservative treatment and 174 patients who received an arthroscopic repair. The pain assessment score (p50 years old with a less than medium-sized rotator cuff tear in a 1-year follow-up period. Further study is warranted to find the optimal combination of conservative treatment for a symptomatic rotator cuff tear. PMID:27152275

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

    DEFF Research Database (Denmark)

    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...

  18. 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

  19. 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.

  20. The Burden of Craft in Arthroscopic Rotator Cuff Repair: Where Have We Been and Where We Are Going.

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    Burkhart, Stephen S

    2015-08-01

    The rather turbulent history of arthroscopic rotator cuff repair went through stages of innovation, conflict, disruption, assimilation, and transformation that might be anticipated when a new and advanced technology (arthroscopic cuff repair) displaces an entrenched but outdated discipline (open cuff repair). The transition from open to arthroscopic rotator cuff repair has been a major paradigm shift that has greatly benefited patients. However, this technical evolution/revolution has also imposed a higher "burden of craft" on the practitioners of arthroscopic rotator cuff repair. Technological advancements in surgery demand that surgeons accept this burden of craft and master the advanced technology for the benefit of their patients. This article outlines the author's involvement in the development of arthroscopic rotator cuff repair, and it also explores the surgeon's obligation to accept the burden of craft that is imposed by this discipline. PMID:26251931

  1. 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

  2. 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...

  3. 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...

  4. 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.

  5. 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...

  6. 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,

  7. 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.

  8. 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...

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

    Directory of Open Access Journals (Sweden)

    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.

  10. 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.

  11. 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.

  12. 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

  13. 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

  14. Arthroscopic-assisted repair of triangular fibrocartilage complex foveal avulsion in distal radioulnar joint injury

    Science.gov (United States)

    Woo, Sung Jong; Jegal, Midum; Park, Min Jong

    2016-01-01

    Background: Disruption of the triangular fibrocartilage complex (TFCC) foveal insertion can lead to distal radioulnar joint (DRUJ) instability accompanied by ulnar-sided pain, weakness, snapping, and limited forearm rotation. We investigated the clinical outcomes of patients with TFCC foveal tears treated with arthroscopic-assisted repair. Materials and Methods: Twelve patients underwent foveal repair of avulsed TFCC with the assistance of arthroscopy between 2011 and 2013. These patients were followed up for an average of 19 months (range 14–25 months). The avulsed TFCC were reattached to the fovea using a transosseous pull-out suture or a knotless suture anchor. At the final followup, the range of motion, grip strength and DRUJ stability were measured as objective outcomes. Subjective outcomes were assessed using the Visual Analog Scale (VAS) for pain, patient rated wrist evaluation (PRWE), Disabilities of the Arm, Shoulder and Hand questionnaire (DASH score) and return to work. Results: Based on the DRUJ stress test, 5 patients had normal stability and 7 patients showed mild laxity as compared with the contralateral side. Postoperatively, the mean range of pronation supination increased from 141° to 166°, and the mean VAS score for pain decreased from 5.3 to 1.7 significantly. The PRWE and DASH questionnaires also showed significant functional improvement. All patients were able to return to their jobs. However, two patients complained of persistent pain. Conclusions: Arthroscopically assisted repair of TFCC foveal injury can provide significant pain relief, functional improvement and restoration of DRUJ stability. PMID:27293286

  15. 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.

  16. 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

  17. 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

  18. 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.

  19. 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

    moderate reduction was again apparent at 4 years post-APM (SMD: -0.56, (-1.20-0.08) compared to controls. CONCLUSIONS: Our findings suggest that middle-aged and older individuals undergoing APM have reduced knee extensor muscle strength in the operated leg compared to control data. As meniscus pathology...... extensor strength in people undergoing an arthroscopic partial meniscectomy (APM). METHODS: Six databases (MEDLINE, CINAHL, SportDISCUS, EMBASE, PEDro and AMED) were searched up to June 22(nd) , 2014. Studies that measured knee extensor muscle strength in people aged 30 years and older undergoing APM for a...

  20. 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

  1. 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.

  2. Arthroscopic repair of "peel-off" lesion of the posterior cruciate ligament at the femoral condyle.

    Science.gov (United States)

    Rosso, Federica; Bisicchia, Salvatore; Amendola, Annunziato

    2014-02-01

    Posterior cruciate ligament (PCL) injuries are uncommon, and most occur in association with other lesions. The treatment of PCL injuries remains controversial; in addition, PCL injuries have been documented to have a propensity to heal. In the literature several different patterns of PCL injury have been described including midsubstance tears/injuries, tibial bony avulsions, femoral bony avulsions, and femoral "peel-off" injuries. A peel-off injury is a complete or incomplete soft-tissue disruption of the PCL at its femoral attachment site without associated bony avulsion. In recent years arthroscopic repair of femoral avulsion and peel-off lesions of the PCL has been reported. In most of these articles, a transosseous repair with sutures passed through 2 bone tunnels into the medial femoral condyle has been described. We present a case of a femoral PCL avulsion in a 20-year-old collegiate football player with an associated medial collateral ligament injury, and we report about a novel technique for PCL repair using 2 No. 2 FiberWire sutures and two 2.9-mm PushLock anchors (Arthrex) to secure tensioning the ligament at its footprint. PMID:24749037

  3. 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

    25.8 (3.4) kg/m(2)) without radiographic knee OA before and 12 months after medial APM. Static alignment was assessed by radiography and self-reported outcomes by Knee injury and Osteoarthritis Outcome Score (KOOS). RESULTS: Peak KAM and KAM impulse increased in the APM leg compared to the contra......OBJECTIVE: Patients undergoing arthroscopic partial meniscectomy (APM) are at increased risk of knee osteoarthritis (OA). Meniscal damage and/or surgery may alter knee joint loading to increase OA risk. We investigated changes in knee joint loading following medial APM surgery, compared 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...

  4. 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

  5. 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.

  6. 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

  7. 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

  8. Mid-term results of arthroscopic subacromial decompression in patients with or without partial thickness rotator cuff tears

    OpenAIRE

    Eid, Ahmed S; Dwyer, Amitabh J.; Chambler, Andrew F. W.

    2012-01-01

    Aim: To evaluate mid-term outcome in patients who underwent arthroscopic subacromial decompression (ASD) for shoulder impingement syndrome with intact and partially torn rotator cuffs. Materials and Methods: A total of 80 consecutive patients (83 shoulders) who underwent ASD for impingement syndrome between 2003 and 2006 were analyzed. Mean age was 57.1 years. Patients′ self-reported Oxford Shoulder Score (OSS) for pain was collected prospectively and was used as an instrument to measure s...

  9. The American Society of Shoulder and Elbow Therapists' consensus statement on rehabilitation following arthroscopic rotator cuff repair.

    Science.gov (United States)

    Thigpen, Charles A; Shaffer, Michael A; Gaunt, Bryce W; Leggin, Brian G; Williams, Gerald R; Wilcox, Reg B

    2016-04-01

    This is a consensus statement on rehabilitation developed by the American Society of Shoulder and Elbow Therapists. The purpose of this statement is to aid clinical decision making during the rehabilitation of patients after arthroscopic rotator cuff repair. The overarching philosophy of rehabilitation is centered on the principle of the gradual application of controlled stresses to the healing rotator cuff repair with consideration of rotator cuff tear size, tissue quality, and patient variables. This statement describes a rehabilitation framework that includes a 2-week period of strict immobilization and a staged introduction of protected, passive range of motion during weeks 2-6 postoperatively, followed by restoration of active range of motion, and then progressive strengthening beginning at postoperative week 12. When appropriate, rehabilitation continues with a functional progression for return to athletic or demanding work activities. This document represents the first consensus rehabilitation statement developed by a multidisciplinary society of international rehabilitation professionals specifically for the postoperative care of patients after arthroscopic rotator cuff repair. PMID:26995456

  10. “Subcritical” Glenoid Bone Loss Increases Redislocation Rates in Primary Arthroscopic Bankart Repair

    OpenAIRE

    Shaha, James S.; Cook, Jay B.; Song, Daniel J.; Rowles, Douglas J.; Bottoni, Craig R.; Shaha, Steven H.; Tokish, John M.

    2014-01-01

    Objectives: While bone loss is increasingly recognized as a risk factor for failure after arthroscopic stabilization, the precise definition of critical bone loss has not been defined. Additionally, there is no clarity on the amount of bone loss routinely present in patients presenting for primary arthroscopic stabilization of anterior glenohumeral instability. The purpose of this study is to report on the average bone loss measured in primary isolated Bankart reconstructions of the shoulder ...

  11. MR arthrography of partial thickness tears of the undersurface of therotator cuff: and arthroscopic correlation

    International Nuclear Information System (INIS)

    This study evaluated the efficacy of MR arthrography (MR-ARTH) in diagnosing these tears. Design and patients The study design was a retrospective review of medical records of patients who had presented with refractory shoulder complaints and subsequently undergone MR arthrography with multiple signal MRI sequences followed by shoulder arthroscopy. Of particular interest were patients who had oblique T1 fat suppression (COT1FS), coronal oblique T2 (COT2), and coronal oblique T2 fat suppression (COT2FS) images taken. Seventy-six subjects met the study criteria. Investigators examined the MR-ARTH images from these patients' charts while blinded as to arthroscopic results, clinical signs and symptoms. Results Based on COT1FS images, investigators identified nine subjects as having had full thickness tears, 28 as having had partial thickness tears of the undersurface of the rotator cuff (PRTC), and 39 as having had intact RTC. These results were compared to actual findings at arthroscopy: nine full thickness tears, 26 of 28 with PRTC and 34 of 39 intact. The sensitivity of MR-ARTH was 84%, with a positive predictive value of 93%. The overall accuracy was 91% (69/76). The specificity was 96%. That is, if a PRTC was not seen on the MR-ARTH images, it was very unlikely to exist. COT2 and COT2FS sequences failed to increase sensitivity and overall efficacy of MRI. Conclusion PRTC can be diagnosed accurately by MR-ARTH with gadopentatate contrast. A COT1FS sequence is recommended for evaluation when tears are suspected

  12. 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

    BACKGROUND: Functional limitations exist postmeniscectomy, but preoperative data are scarce. PURPOSE: To examine knee function, knee muscle strength and performance in middle-aged patients with degenerative meniscal tears, eligible for arthroscopic partial meniscectomy. STUDY DESIGN: Cross......-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...

  13. On models of degradation and partial repairs

    Czech Academy of Sciences Publication Activity Database

    Volf, Petr

    Galsgow : Strathclyde University, 2007, s. 1-8. ISBN 978-1-58603-865-6. [Fifth International Conference Mathematical Methods in Reliability. Glasgow (GB), 01.07.2007-04.07.2007] R&D Projects: GA MŠk(CZ) 1M06047 Institutional research plan: CEZ:AV0Z10750506 Keywords : intensity of failure * degradation process * incomplete repair Subject RIV: BB - Applied Statistics, Operational Research

  14. Mid-term results of arthroscopic subacromial decompression in patients with or without partial thickness rotator cuff tears

    Science.gov (United States)

    Eid, Ahmed S.; Dwyer, Amitabh J.; Chambler, Andrew F. W.

    2012-01-01

    Aim: To evaluate mid-term outcome in patients who underwent arthroscopic subacromial decompression (ASD) for shoulder impingement syndrome with intact and partially torn rotator cuffs. Materials and Methods: A total of 80 consecutive patients (83 shoulders) who underwent ASD for impingement syndrome between 2003 and 2006 were analyzed. Mean age was 57.1 years. Patients’ self-reported Oxford Shoulder Score (OSS) for pain was collected prospectively and was used as an instrument to measure surgical outcome. Results: The mean initial and final OSS for patients with an intact rotator cuff was 26.1 and 40.3, respectively, at a mean follow up of 71.9 months (nearly 7 years). The mean initial and final OSS for patients with a partially torn articular sided tear was 22.6 and 41.9, respectively, at mean follow up of 70.7 months. Both groups showed significant sustained improvement (P < 0.0001). The mean improvement of OSS following ASD was statistically greater (P < 0.03) for partially torn rotator cuff group (19.3 points) as compared to those with normal rotator cuff (14.2 points). Conclusion: Patients with dual pathology (partial rotator cuff tear and impingement) appreciated a significantly greater improvement following ASD compared to those with impingement alone. Both groups of patients had a similar final outcome at a mid-term follow up. Level of Evidence: IV, retrospective study on consecutive series of patients. PMID:23204763

  15. 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

  16. 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

    International Nuclear Information System (INIS)

    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

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

    Science.gov (United States)

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

    2014-11-01

    We elaborately describe our novel arthroscopic technique of the symphysis pubis in athletes with osteitis pubis and concomitant adductor enthesopathy who fail to conservative treatment modalities. The symphysis pubis is debrided arthroscopically and the degenerated origin of adductor tendon (enthesis) is excised and reattached. With our surgical procedure the stability of the symphysis pubis is successfully preserved and the adductor longus enthesopathy simultaneously addressed in the same setting. PMID:25055756

  18. 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

  19. 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

    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...... with decreased patella cartilage volume (B = −17.9 (95 % CI −35.4, −0.4) p = 0.045) while knee adduction moment impulse was associated with increased medial tibial plateau area (B = 7.7 (95 % CI 0.9, 13.3) p = 0.025). A number of other variables approached significance. Conclusions Knee joint biomechanics...

  20. 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

  1. Fiber-optics couple arthroscope to TV

    Science.gov (United States)

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

    1981-01-01

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

  2. 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.

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

    Directory of Open Access Journals (Sweden)

    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

  4. Arthroscopic microdiskectomy.

    Science.gov (United States)

    Kambin, P

    1991-03-01

    Arthroscopic microdiskectomy through a posterolateral approach has opened a new window of opportunity in the treatment of lumbar disk disorders. Radiographic identification of the triangular working zone has permitted the safe introduction of instruments with an external diameter of 7-8 mm into the intervertebral disk. The technique allows not only evacuation and decompression of contained herniated disks, but also the introduction of instruments for decortication of the vertebral plates and bone grafting for percutaneous interbody fusion. Endoscopic laser nucleolysis, currently under investigation, may also enhance existing technological achievement in the field of minimal-intervention spinal surgery. Arthroscopic microdiskectomy has proven to be safe, effective, and cost efficient. In properly selected patients, satisfactory results of approximately 85% have been realized. PMID:1857361

  5. 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

  6. 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.

  7. 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

  8. 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

  9. 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 ...

  10. 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

  11. Repairing method of fixed partial prostheses in dentistry: laser welding

    Science.gov (United States)

    Negrutiu, Meda L.; Sinescu, Cosmin; Cozarov, Dalibor; Culea, Laurentiu; Rominu, Mihai; Pop, Daniela M.

    2008-02-01

    Laser Welding is an advantageous method of connecting or repairing metal prosthetic frameworks because there are fewer effects of heating on the area surrounding the spot to be welded, and no further procedures, such as those used for conventional soldering, are necessary. Laser welding has been increasingly applied for fabricating the metal frameworks of prostheses and for other procedures, such as recovering the metal ridge and cusp, blocking holes on the occlusal surfaces after excess occlusal adjustment, thickening the metal framework, or adding contact points after excess grinding and adjusting of the crown margins. The objective of this study are represented by investigation and evaluation of three types of soldering compare to laser welding. The method is represented by the laser welding with a pulsed Nd-Yag Laser equipment. Other joints were produced, using three different soldering techniques. These joining areas were investigated for their quality and their corrosion properties. Corrosion attack was confirmed by electron microscopy. The investigations confirm the quality of laser welding. The investigated different laser welding methods revealed minimal corrosion and offers clear-cut advantages compared to the other soldering methods. Dental alloys are subjected to functional influences in the oral cavity and interact with the intraoral enviroment.

  12. Robot-Assisted Repair of Right Partial Anomalous Pulmonary Venous Return.

    Science.gov (United States)

    Onan, Burak; Aydin, Unal; Turkvatan, Aysel; Bakir, Ihsan

    2016-06-01

    Partial anomalous venous return from the right lung to the right atrium is a rare congenital heart anomaly in adults. We report a 20-year-old female, who presented with right partial anomalous pulmonary venous return and an associated inferior atrial septal defect. A complex repair was successfully done through a right atriotomy approach using a robotic surgical system. doi: 10.1111/jocs.12753 (J Card Surg 2016;31:394-397). PMID:27098377

  13. 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

  14. Arthroscopic surgery for degenerative knee

    DEFF Research Database (Denmark)

    Thorlund, J B; 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....... DATA SOURCES: Systematic searches for benefits and harms were carried out in Medline, Embase, CINAHL, Web of Science, and the Cochrane Central Register of Controlled Trials (CENTRAL) up to August 2014. Only studies published in 2000 or later were included for harms. ELIGIBILITY CRITERIA FOR SELECTING...... STUDIES: Randomised controlled trials assessing benefit of arthroscopic surgery involving partial meniscectomy, debridement, or both for patients with or without radiographic signs of osteoarthritis were included. For harms, cohort studies, register based studies, and case series were also allowed...

  15. 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)

  16. 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...

  17. Intraoral repair of all ceramic fixed partial denture utilizing preimpregnated fiber reinforced composite.

    Science.gov (United States)

    Turkaslan, Süha; Tezvergil-Mutluay, Arzu

    2008-01-01

    All ceramic fixed partial dentures (FPD)s exhibit enhanced biocompatibility and esthetics as compared to metal-ceramic restorations. However, framework fractures are frequently reported especially when the connector dimensions are inadequate to withstand the high tensile stresses. The repair of the failed connector would be desirable rather than the complete removal and renewal since the latter is an expensive and time consuming procedure. Furthermore, the replacement or removal of the restoration for extra-oral repair purposes might increase the risk of destroying the entire restoration or damaging the abutment teeth during the removal. This article presents a direct intra-oral method that may be used to repair the connector fractures of all-ceramic FPDs which are otherwise clinically satisfactory. In the present technique, the connector is reconstructed intraorally utilizing composite resin restorative material reinforced with E-glass-fiber. PMID:19212511

  18. 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

  19. Arthroscopic subacromial decompression

    OpenAIRE

    Akpinar, Sercan; Demirhan, Mehmet

    2004-01-01

    Arthroscopic subacromial decompression is the arthroscopic equivalent of a standart open procedure. Although technically demanding, it has several advantages to the open procedure. Overall it facilitates early and rapid rehabilitation. The results in stage II and in selected stage III patients are equal or better than those achieved through open surgery. In this study we reviewed the literature with our small case group experience.

  20. Transient Analysis of Multistage Degraded Systems with Partial Repairs of General Distribution Modeled by Erlang-k Distribution

    OpenAIRE

    Moustafa Magdi S.

    2006-01-01

    The paper presents a model of multistage degraded system subjected to random failures and partial repairs. A transient analysis is performed and transient probabilities are calculated to find the availability, the means of life time and operational life time. In the paper, constant state dependent transition rates for the degradation process as well as failure process are considered. On the other hand the partial repairs follow general distributions. This paper extends previous systems that c...

  1. 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 ...

  2. Rotator Cuff Repair

    Medline Plus

    Full Text Available ARTHROSCOPIC ROTATOR CUFF REPAIR DOCTORS HOSPITAL CENTER FOR ORTHOPEDICS AND SPORTS MEDICINE CORAL GABLES, FLORIDA June 18, ... we'll be meeting my colleague, internationally-renowned orthopedic surgeon and director of the Musculoskeletal Institute here ...

  3. 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

  4. 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.

  5. 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.

  6. Arthroscopic decompression for subacromial impingement syndrome.

    OpenAIRE

    S. J. Kim; Lee, J. W.; Kim, B. S.

    1997-01-01

    Arthroscopic decompression and cuff debridement was performed on 47 cases in 45 consecutive patients with either stage II or stage III impingement syndrome: 19 with no actual tear of the cuff (stage II); 13 with a partial thickness tear (stage IIIa); 10 with complete tear less than 3 cm long (stage IIIb); and 5 with complete tear longer than 3 cm (stage IIIc). Patients were classified into impingement syndrome without tear (Group I), impingement syndrome with partial thickness tear (Group II)...

  7. 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

  8. 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...

  9. Application of Petri nets to reliability prediction of occupant safety systems with partial detection and repair

    International Nuclear Information System (INIS)

    This paper presents an application of stochastic Petri nets (SPN) to calculate the availability of safety critical on-demand systems. Traditional methods of estimating system reliability include standards-based or field return-based reliability prediction methods. These methods do not take into account the effect of fault-detection capability and penalize the addition of detection circuitry due to the higher parts count. Therefore, calculating system availability, which can be linked to the system's probability of failure on demand (Pfd), can be a better alternative to reliability prediction. The process of estimating the Pfd of a safety system can be further complicated by the presence of system imperfections such as partial-fault detection by users and untimely or uncompleted repairs. Additionally, most system failures cannot be represented by Poisson process Markov chain methods, which are commonly utilized for the purposes of estimating Pfd, as these methods are not well-suited for the analysis of non-Poisson failures. This paper suggests a methodology and presents a case study of SPN modeling adequately handling most of the above problems. The model will be illustrated with a case study of an automotive electronics airbag controller as an example of a safety critical on-demand system.

  10. 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

  11. Implementation of the trans-abdominal partial extra-peritoneal (TAPE) technique in laparoscopic lumbar hernia repair

    OpenAIRE

    Sun, Jing; Chen, Xin; Li, Jianwen; Zhang, Yun; Dong, Feng; Zheng, Minhua

    2015-01-01

    Background There is still not any standardized operative strategy that is well-accepted all over the world for lumbarhernia. We are here to investigate the feasibility of the trans-abdominal partial extra-peritoneal (TAPE) technique in lumbar hernia repair. Methods The TAPE technique was applied to 14 patients with lumbar hernia from May 2009 until January 2014. The surgical technique was described in details and follow-ups were performed for further evaluation. Results The mean age of the 14...

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

    Directory of Open Access Journals (Sweden)

    Glaydson Gomes Godinho

    2015-02-01

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

  13. 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 ...

  14. 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...

  15. Bankart Repair to Correct Shoulder Instability

    Medline Plus

    Full Text Available ... it's been repaired? If you could talk about recurrence, and maybe even add the caveat of historically the discrepancy in recurrence rates from the open and arthroscopic approach, versus ...

  16. Bankart Repair to Correct Shoulder Instability

    Medline Plus

    Full Text Available ... Arthroscopic Bankart Repair. I think we really have something unique to offer here to Akron Children's in ... edge that we can pass a stitch through. Something that can heal back to the bone. So ...

  17. 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 ...

  18. Bankart Repair to Correct Shoulder Instability

    Medline Plus

    Full Text Available ... resume his or her busy lifestyle. ORlive makes it easy for you to learn more. Just click ... tonight is performed by Dr. Kerwyn Jones and it's called an Arthroscopic Bankart Repair. I think we ...

  19. 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.

  20. Rotator Cuff Repair

    Medline Plus

    Full Text Available ARTHROSCOPIC ROTATOR CUFF REPAIR DOCTORS HOSPITAL CENTER FOR ORTHOPEDICS AND SPORTS MEDICINE CORAL GABLES, FLORIDA June 18, 2008 00:00:00 JOHN ZVIJAC, M.D.: Good afternoon and welcome to Doctors Hospital in Coral Gables, Florida. I'm Dr. ...

  1. 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.)

  2. 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.)

  3. Arthroscopic decompression for subacromial impingement syndrome.

    Science.gov (United States)

    Kim, S. J.; Lee, J. W.; Kim, B. S.

    1997-01-01

    Arthroscopic decompression and cuff debridement was performed on 47 cases in 45 consecutive patients with either stage II or stage III impingement syndrome: 19 with no actual tear of the cuff (stage II); 13 with a partial thickness tear (stage IIIa); 10 with complete tear less than 3 cm long (stage IIIb); and 5 with complete tear longer than 3 cm (stage IIIc). Patients were classified into impingement syndrome without tear (Group I), impingement syndrome with partial thickness tear (Group II), and impingement syndrome with full thickness tear (Group III). Group I had 19 cases, group II had 13 cases, and group III had 15 cases. Patients were followed up for an average of 39.3 months (24 approximately 62 months). In group I, postoperative UCLA ratings improved in 18 cases (95%) to satisfactory result rate. In group II, 11 patients (85%) had improvement to satisfactory result rate. In group III, 12 cases (80%) had improvement to satisfactory result rate. The arthroscopic subacromial decompression and rotator cuff debridement was effective in the treatment of subacromial impingement syndrome. PMID:9170017

  4. 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

  5. 21 CFR 888.1100 - Arthroscope.

    Science.gov (United States)

    2010-04-01

    ... ORTHOPEDIC DEVICES Diagnostic Devices § 888.1100 Arthroscope. (a) Identification. An arthroscope is an... accessories also is intended to perform surgery within a joint. (b) Classification. (1) Class II...

  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. Arthroscopic management of the arthritic elbow: indications, technique, and results.

    Science.gov (United States)

    Savoie, F H; Nunley, P D; Field, L D

    1999-01-01

    Twenty-four patients with painful restricted motion of the elbow joint because of an arthritic process were treated with an arthroscopic modification of the open Outerbridge-Kashiwagi procedure. Average preoperative flexion was to 90 degrees (range 60 degrees to 140 degrees), and average extension loss was -40 degrees (range -5 degrees to -60 degrees). The average total arc of motion was 50 degrees. The procedure consisted of arthroscopic debridement, partial resection of the coronoid and olecranon processes, and fenestration of the olecranon fossa. The radial head was excised arthroscopically in 18 of the 24 patients. All patients were reexamined 24 to 60 months after operation (mean 32 months). All patients had a significant decrease in pain as described by a visual analog scale (preoperative 8.2; postoperative 2.2). Average flexion was to 139 degrees (range 95 degrees to 145 degrees), and average extension loss was -8 degrees (range 0 degree to 15 degrees). The average arc of motion was 131 degrees, an improvement of 81 degrees. Arthroscopic ulnohumeral arthroplasty provides satisfactory results in terms of pain control and improved motion. The complication rate is comparable to those reported in series of open ulnohumeral arthroplasties. This procedure seems to be a valuable adjunct in the management of the arthritic elbow, serving as an intermediate step between nonoperative management and elbow replacement surgery. PMID:10389075

  8. Spontaneous and Partial Repair of Ribbon Synapse in Cochlear Inner Hair Cells After Ototoxic Withdrawal.

    Science.gov (United States)

    Liu, Ke; Chen, DaiShi; Guo, WeiWei; Yu, Ning; Wang, XiaoYu; Ji, Fei; Hou, ZhaoHui; Yang, Wei-Yan; Yang, ShiMing

    2015-12-01

    Ototoxicity is one of the major causes of sensorineural deafness. However, it remains unclear whether sensorineural deafness is reversible after ototoxic withdrawal. Here, we report that the ribbon synapses between the inner hair cells (IHCs) and spiral ganglion nerve (SGN) fibers can be restored after ototoxic trauma. This corresponds with hearing restoration after ototoxic withdrawal. In this study, adult mice were injected daily with a low dose of gentamicin for 14 consecutive days. Immunostaining for RIBEYE/CtBP2 was used to estimate the number and size of synaptic ribbons in the cochlea. Hearing thresholds were assessed using auditory brainstem responses. Auditory temporal processing between IHCs and SGNs was evaluated by compound action potentials. We found automatic hearing restoration after ototoxicity withdrawal, which corresponded to the number and size recovery of synaptic ribbons, although both hearing and synaptic recovery were not complete. Thus, our study indicates that sensorineural deafness in mice can be reversible after ototoxic withdrawal due to an intrinsic repair of ribbon synapse in the cochlea. PMID:25377793

  9. 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...

  10. 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.

  11. 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.

  12. Repair and regeneration of vertebral body after antero-lateral partial vertebrectomy using beta-tricalcium phosphate

    International Nuclear Information System (INIS)

    Antero-lateral partial vertebrectomy (ALPV) was used for decompression in 91 patients with multilevel cervical disorders. The high-speed drill was used to excise about 1/3 of the vertebral body for relief of anterior compression of the cord and nerve roots under the operating microscope. The key point was opening of the medial wall of the foramen of transverse process at the beginning of the ALPV, allowing the determination of the lateral borders of the ALPVs. To repair and regenerate the vertebral body, a beta-tricalcium phosphate (β-TCP) block was trimmed into a cuneiform shape and implanted into the sites of the ALPV excluding the upper and lowermost vertebral bodies. Postoperative computed tomography confirmed that β-TCP was gradually replaced by newly formed bone from the surface towards the center of the block, and that the affected vertebral body was remodeled by 6 to 12 months after the implantation of β-TCP. The cortical bone borders on the bone marrow at the site of the regeneration. The pedicles on the side of the ALPVs were rebuilt during regeneration of the affected vertebrae. Thus, the vertebral foramen of the cervical spine was widened in the anterior direction at the levels of the ALPVs, resulting in restoration of the physiological size of the cervical cord. The cervical curvature remained unchanged and a certain degree of cervical mobility (mean 86%) was preserved in this series. (author)

  13. 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.

  14. 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

  15. 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...

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

    Science.gov (United States)

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

    2015-09-01

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

  17. 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.

  18. Synergistic interactions between RAD5, RAD16, and RAD54, three partially homologous yeast DNA repair genes each in a different repair pathway

    International Nuclear Information System (INIS)

    Considerable homology has recently been noted between the proteins encoded by the RAD5, RAD16 and RAD54 genes of Saccharomyces cerevisiae. These genes are members of the RAD6, RAD3 and RAD50 epistasis groups, respectively, which correspond to the three major DNA repair pathways in yeast. These proteins also share homology with other eucaryotic proteins, including those encoded by SNF2 and MO1 of yeast, brahma and lodestar of Drosophila and the human ERCC6 gene. The homology shares features with known helicases, suggesting a newly identified helicase subfamily. We have constructed a series of congenic single-, double- and triple-deletion mutants involving RAD5, RAD16 and RAD54 to examine the interactions between these genes. Each deletion mutation alone has only a moderate effect on survival after exposure to UV radiation. Each pairwise-double mutant exhibits marked synergism. The triple-deletion mutant displays further synergism. These results confirm the assignment of the RAD54 gene to the RAD50 epistasis group and suggest that the RAD16 gene plays a larger role in DNA repair after exposure to UV radiation than has been suggested previously. Additionally, the proteins encoded by RAD5, RAD16, and RAD54 may compete for the same substrate after damage induced by UV radiation, possibly at an early step in their respective pathways. 49 refs., 6 figs., 2 tabs

  19. 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.

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

    Science.gov (United States)

    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.

  1. 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.

  2. 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...

  3. 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.

  4. 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

  5. Arthroscopic subacromial decompression: one- to seven-year results

    OpenAIRE

    Atalar, Ata Can; Demirhan, Mehmet; Kocabey, Yavuz; Akalin, Yilmaz

    2004-01-01

    Objectives: Impingement syndrome is one of the most important causes of pain in the shoulder region. Advances in arthroscopic techniques allowed acromioplasty to be performed arthroscopically. In this study, we evaluated the results of arthroscopic subacromial decompression in patients with impingement syndrome. Methods: Seventy patients who were treated with arthroscopic subacromial decompression and who had a follow-up period of at least a year were retrospectively evaluated. There were ...

  6. 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

  7. 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

    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...... thresholds (P > 0.08) in the burn area before surgery compared to after surgery. CONCLUSION: Arthroscopic knee surgery did not modify nociceptive responses to a contralaterally applied experimental burn injury....... 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...

  8. 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 arthroscopy...... 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...... return to work after knee and ankle arthroscopy with the use of oral NSAIDs combined with bupivacaine plus morphine or combined with bupivacaine, morphine plus steroid....

  9. 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

  10. [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

  11. 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

  12. Substantial disability 3 months after arthroscopic partial meniscectomy

    DEFF Research Database (Denmark)

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

    2000-01-01

    minor pain and other symptoms postoperatively, significant physical disability and handicap were reported. Postoperatively, 30% of patients were active in sports compared with 63% before injury. A sedentary lifestyle was reported by 38% compared with 9% before injury. We conclude that patient...

  13. 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...

  14. 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...

  15. 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

  16. 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.

  17. Clinical Results of All-inside Meniscal Repair Using the FasT-Fix Meniscal Repair System

    Directory of Open Access Journals (Sweden)

    Chih-Wei Chiang

    2011-06-01

    Full Text Available Background: The meniscus plays a key role in the functioning of the knee. At the presenttime, meniscal repair has becomes the main treatment for meniscal tear.Compared to open surgery, arthroscopic meniscal repair has become popularbecause of shorter time need for the operation, the smaller wound, and betteraccessibility to the tear portion, which is particularly difficult during opensurgery. Three arthroscopic techniques are widely used, namely inside-out,outside-in, and all-inside. Arthroscopy all inside meniscal repair has the lowest neurovascular injury rate.Methods: This study prospectively evaluated 31 consecutively treated patients to determine the effectiveness/safety of arthroscopic meniscal repair using the FasTFix repair system. The inclusion criteria for this study were: vertical fullthickness tear > 10 mm in length; location of the meniscal tear < 6 mm fromthe meniscocapsular junction; repair of the meniscus solely with the FasTFix system; no former meniscus surgery; and no evidence of arthritis duringarthroscopy. Anterior cruciate ligament (ACL deficient knees were reconstructed using a hamstring autograft at the time of the meniscal repair.Follow-up examinations consisted of Lysholm knee score, Tegner activityscore and radiographic evaluation.Results: After an average of 3 years follow-up, no symptoms of meniscal tears werefound in 30/31 of the cases. For patients with isolated meniscal repair or concurrent ACL reconstruction, the Lysholm and Tegner activity scores hadsignificantly improved postoperatively. No neurovascular or other majorcomplications were directly associated with the use of the device.Conclusions: Arthroscopic all-inside repair using the FasT-Fix device appears to be a safeand effective procedure

  18. 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

  19. 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...

  20. Arthroscopic management of painful first metatarsophalangeal joint

    Directory of Open Access Journals (Sweden)

    Debnath U

    2005-01-01

    Full Text Available Background: Arthroscopy of the great toe MTP joint has been practiced with favourable outcomes. A range of indications have been described ranging from synovitis to osteochondral defects. The purpose of the present study was to describe our technique and to assess the functional outcome following arthroscopic management of Hallux MTP disorders using AOFAS scoring system. Methods: We describe the technique of Hallux MTP joint arthroscopy in twenty patients. Indications included hallux rigidus with osteophytes, chondromalacia, OCDs, loose bodies, arthrofibrosis, synovitis, tophaceous gout arthritis and intra-articular fractures of MTP joint. All patients had been evaluated clinically and radiologically with record of their AOFAS scores pre-operatively. At a minimum follow-up of two years the clinical assessment was carried out with AOFAS scores. Results: The mean pre-operative and post-operative AOFAS score were 47 (range 10-78 and 97 (87 -100 respectively. The patient with intra-articular fracture had an excellent outcome following arthroscopic reduction of the fracture. Conclusion: Arthroscopic management of painful hallucial MTP joint is a specialized technique, which if performed for the right indications, gives a favourable outcome with minimal complications.

  1. Arthroscopic arthrodesis of the shoulder: Fourteen-year follow-up.

    Science.gov (United States)

    Jiménez-Martín, Antonio; Pérez-Hidalgo, Santiago

    2011-04-01

    Shoulder arthrodesis is indicated in infections, brachial paralysis, irreparable rotator cuff tears, osteoarthritis without indication of prosthesis, rescue after arthroplasty, or after surgery for cancer. Arthroscopic arthrodesis is exceptional. Our aim is presenting our result after 14 years of follow-up of one patient. We present a case report of a 17-year-old male patient. He suffered fracture of left scapula (type V, Ideberg), fracture of left clavicle (type I, Craig), and fracture of left distal ulna. We realized osteosynthesis of clavicle (plate and screws) with the aim of treating this floating shoulder. Electromyography showed partial axonotmesis of axilar nerve. After 7 months of follow-up, axonotmesis was still present. We realized arthroscopic shoulder arthrodesis (three cannulated screws). Fourteen years later, shoulder movement was as follows: Flexion, 0-90°; maximum abduction, 40° with shoulder atrophy; Constant, 47 points; and UCLA, 17 points, without pain. Arthrodesis with screws reaches a subjective benefit in 82% of patients. Percentage of pseudarthrosis is less than in patients treated with plates, although the risks of infections, fractures, and material removal are greater than in patients treated with plates. Shoulder arthroscopic arthrodesis is exceptional, but it allows minimal surgical aggression. PMID:21897586

  2. Arthroscopic arthrodesis of the shoulder: Fourteen-year follow-up

    Directory of Open Access Journals (Sweden)

    Antonio Jiménez-Martín

    2011-01-01

    Full Text Available Shoulder arthrodesis is indicated in infections, brachial paralysis, irreparable rotator cuff tears, osteoarthritis without indication of prosthesis, rescue after arthroplasty, or after surgery for cancer. Arthroscopic arthrodesis is exceptional. Our aim is presenting our result after 14 years of follow-up of one patient. We present a case report of a 17-year-old male patient. He suffered fracture of left scapula (type V, Ideberg, fracture of left clavicle (type I, Craig, and fracture of left distal ulna. We realized osteosynthesis of clavicle (plate and screws with the aim of treating this floating shoulder. Electromyography showed partial axonotmesis of axilar nerve. After 7 months of follow-up, axonotmesis was still present. We realized arthroscopic shoulder arthrodesis (three cannulated screws. Fourteen years later, shoulder movement was as follows: Flexion, 0-90°; maximum abduction, 40° with shoulder atrophy; Constant, 47 points; and UCLA, 17 points, without pain. Arthrodesis with screws reaches a subjective benefit in 82% of patients. Percentage of pseudarthrosis is less than in patients treated with plates, although the risks of infections, fractures, and material removal are greater than in patients treated with plates. Shoulder arthroscopic arthrodesis is exceptional, but it allows minimal surgical aggression.

  3. 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

  4. 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

  5. Outcomes of Open Subacromial Decompression after Failed Arthroscopic Acromioplasty

    OpenAIRE

    Gavin Nimon; Joby Malal; Anand Pillai; Vivek Eranki

    2012-01-01

    Aim. To prospectively assess the effectiveness of revision with open subacromial decompression in patients who had a previous unsatisfactory outcome with the arthroscopic procedure. Methods. 11 patients were identified for the study, who did not demonstrate expected improvement in symptoms after arthroscopic acromioplasty. All patients underwent structured rehabilitation. Functional evaluation was conducted using the Hospital for Special Surgery, New York, shoulder rating questionnaire. Resul...

  6. 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.

  7. 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...

  8. 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

  9. [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

  10. 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

  11. Pseudoaneurysm after arthroscopic procedure in the knee☆

    Science.gov (United States)

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

    2015-01-01

    The aim of this study was to review all cases of pseudoaneurysm in the literature, in predominantly arthroscopic procedures on the knee, and to report on a case of pseudoaneurysm that we treated. A bibliographic search was conducted for scientific articles published in Brazilian and foreign periodicals over the last 23 years. Forty-seven cases were found, in 40 articles. In addition to these 47 cases, there was the case that we treated, which was also included in the data. Among the operations that progressed with formation of a pseudoaneurysm, 60% were cases of meniscal injuries and 23%, anterior cruciate ligament injuries. In 46% of the cases, the artery affected with the popliteal, and in 21%, the inferomedial genicular artery. The commonest clinical symptom was pain (37%), followed by pulsating tumor (31%), edema of the calf (12%) and hemarthrosis (11%). The median time taken to make the diagnosis was 11 days, but it ranged from one day to 10 weeks after the procedure. Although rare, pseudoaneurysms are a risk that is inherent to arthroscopic surgery. All patients should be made aware of the vascular risks, even in small-scale procedures. PMID:26229905

  12. A RANDOMIZED TRIAL OF ISOKINETIC VERSUS ISOTONIC REHABILITATION PROGRAM AFTER ARTHROSCOPIC MENISCECTOMY

    Science.gov (United States)

    Koutras, Georgios; Letsi, Magdalini; Papadopoulos, Pericles; Gigis, Ioannis

    2012-01-01

    Background: Although both isotonic and isokinetic exercises are commonly used in the rehabilitation of patients after arthroscopic meniscectomy no studies have compared their effect on strength recovery and functional outcomes. Purpose: The purpose of this study was to investigate the effects of two rehabilitation programs (isotonic and isokinetic) on muscle strength and functional performance after partial knee meniscectomy. A secondary purpose was to assess the correlation between isokinetic strength deficits and hop test performance deficits. Methods: Twenty male patients who underwent arthroscopic partial meniscectomy volunteered for the study. Both isotonic and isokinetic training were performed with the same equipment thereby blinding subjects to the mode of exercise. Main outcome measures were collected on the 14th and 33rd postoperative days and included isokinetic strength of the knee extensors and flexors, functional performance (single, triple, and vertical hopping) and the Lysholm questionnaire. Multivariate and univariate analyses of variance were used to assess the effects of the independent variables on the isokinetic variables, functional tests, and Lysholm score. Pearson's correlation was used to assess the relationship between isokinetic strength deficits and functional performance deficits. Results: Isokinetic measures, functional tests, and the Lysholm score all increased between initial and final assessment (p≤0.003). However, there were no group or group*time effects on any of the outcome variables (p≥0.33). Functional tests were better predictors of isokinetic deficits in the 14th compared to the 33rd postoperative day. Conclusion: No differences were found in the outcomes of patients treated using an isokinetic and an isotonic protocol for rehabilitation after arthroscopic meniscectomy. More than half of patients did not meet the 90% criterion in the hop tests for safe return to sports five weeks after meniscectomy. There were

  13. Injuries to the cranial cruciate ligament and associated structures: summary of clinical, radiographic, arthroscopic and pathological findings from 10 horses

    International Nuclear Information System (INIS)

    The clinical, radiographic, arthroscopic and pathological findings of 10 horses with injury to the cranial cruciate ligament are presented. The most consistent clinical signs included moderate to severe distension of the femoropatellar joint and a Grade III to a Grade V out of V lameness. Craniocaudal instability could be elicited in five horses under general anaesthesia and in one conscious horse. Radiographic evaluation of the stifles revealed that avulsion fracture of the medial intercondylar eminence was the most common finding in six out of 10 horses. Arthroscopic examination of the affected femorotibial joints were performed in five horses. This confirmed the presumptive diagnosis of cranial cruciate ligament injury or rupture. Post mortem examinations were performed on two horses which documented partial tears of the cranial cruciate ligament

  14. 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

  15. 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

  16. 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

  17. Arthroscopic Reverse Remplissage for Posterior Instability

    Science.gov (United States)

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

    2016-01-01

    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

  18. [Arthroscopic resection of dorsal wrist ganglia].

    Science.gov (United States)

    Borisch, N

    2014-10-01

    In arthroscopic wrist surgery, the resection of dorsal wrist ganglia has become a well accepted practice. As advantages for the minimally invasive procedure the low complication rate and low postoperative morbidity, less postoperative pain and faster recovery over open techniques are discussed. The possibility to assess accompanying joint pathology is considered as another advantage. The importance of identifying a so-called ganglion cyst stalk seems to have been overstated. Regarding the technique, the main discussion points are the size and localisation of the capsular window and the necessity of additional midcarpal arthroscopy. The possibility and results of treatment of recurrent ganglion cysts are still controversial. Our own experience and that of some authors are positive. Hardly mentioned in the literature is the treatment of occult dorsal wrist ganglia and its results, which is considered as very successful by the authors. PMID:25290273

  19. 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

  20. 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.

  1. Methylene blue-enhanced arthroscopic resection of dorsal wrist ganglions.

    Science.gov (United States)

    Lee, Byung Joo; Sawyer, Gregory A; Dasilva, Manuel F

    2011-12-01

    The ganglion is the most common soft tissue mass of the hand and wrist. Over the past 10 to 15 years, there has been a growing interest in arthroscopic treatment of dorsal wrist ganglions. Proposed advantages of arthroscopy include greater motion (particularly wrist flexion), improved cosmesis, and potential to identify/treat other intra-articular pathology. Despite the documented clinical success of arthroscopic ganglion excision, limitations include inconsistent identification of the ganglion stalk. Our described technique offers a means by which to improve visualization of the ganglion stalk intra-articularly to produce a more effective and efficient arthroscopic ganglion excision. During the procedure, a small volume of methylene blue solution is injected into the cyst. Its communication with the joint is apparent arthroscopically, thus identifying the location of the stalk. With the ability to precisely identify the ganglion stalk using an injection of methylene blue, the surgeon can direct the arthroscopic debridement toward the appropriate pathologic tissue. Unnecessary debridement of uninvolved tissue can be avoided with the technique. This also allows for optimal portal placement and, in particular, indicates whether a midcarpal portal should be employed. This should result in fewer recurrences, decreased operative time, and less iatrogenic injury. PMID:22105637

  2. 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 ...

  3. 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...

  4. 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

    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...... initiation were 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 < 0.0001), favoring the exercise group. Patients in......) with a symptomatic, unilateral, magnetic resonance imaging-verified degenerative meniscus tear and no or mild radiographic osteoarthritis were randomly assigned to a supervised neuromuscular and strength exercise program or arthroscopic partial meniscectomy. Outcomes assessed 3 mos after intervention...

  5. 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.

  6. Outcomes of Open Subacromial Decompression after Failed Arthroscopic Acromioplasty

    Science.gov (United States)

    Pillai, Anand; Eranki, Vivek; Malal, Joby; Nimon, Gavin

    2012-01-01

    Aim. To prospectively assess the effectiveness of revision with open subacromial decompression in patients who had a previous unsatisfactory outcome with the arthroscopic procedure. Methods. 11 patients were identified for the study, who did not demonstrate expected improvement in symptoms after arthroscopic acromioplasty. All patients underwent structured rehabilitation. Functional evaluation was conducted using the Hospital for Special Surgery, New York, shoulder rating questionnaire. Results. M : F was 7 : 4. The mean age was 57 years. The average shoulder score improved from 49.6 preoperatively to 56 postoperatively at an average followup of 16 months. Two patients showed deterioration in their shoulder scores after revision while the rest showed only marginal improvement. All except one patient stated that they would opt for surgery again if given a second chance. Conclusion. In the group of patients that fail to benefit from the arthroscopic decompression, only a marginal improvement was noted after revision with open decompression. PMID:22649740

  7. Avascular osteonecrosis of the femoral condyle after arthroscopic surgery

    International Nuclear Information System (INIS)

    Avascular osteonecrosis of the femoral condyle after arthroscopic surgery. Retrospective review of 10 patients who presented with avascular necrosis of the ipsilateral femoral condyle following arthroscopic meniscectomy (9 medial, 1 lateral). The bone lesions were evaluated by radiography and MRI, which were repeated for few patients. MRI allows earlier diagnosis of avascular necrosis of the femoral condyle and offers an evaluation of extent of the lesions whose evolution is variable: 3 patients required a knee prosthesis, the other 7 patients were treated medically. (authors)

  8. 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

  9. 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.

  10. 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.

  11. 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

  12. Rotator cuff tears: assessment with MR arthrography in 275 patients with arthroscopic correlation

    Energy Technology Data Exchange (ETDEWEB)

    Waldt, S.; Bruegel, M.; Mueller, D.; Holzapfel, K.; Rummeny, E.J.; Woertler, K. [Technische Universitaet Muenchen, Department of Radiology, Munich (Germany); Imhoff, A.B. [Technische Universitaet Muenchen, Department of Sports Orthopedics, Munich (Germany)

    2007-02-15

    We assessed the diagnostic performance of magnetic resonance (MR) arthrography in the diagnosis of articular-sided partial-thickness and full-thickness rotator cuff tears in a large symptomatic population. MR arthrograms obtained in 275 patients including a study group of 139 patients with rotator cuff tears proved by arthroscopy and a control group of 136 patients with arthroscopically intact rotator cuff tendons were reviewed in random order. MR imaging was performed on a 1.0 T system (Magnetom Expert, Siemens). MR arthrograms were analyzed by two radiologists in consensus for articular-sided partial-thickness and full-thickness tears of the supraspinatus, infraspinatus, and subscapularis tendons. At arthroscopy, 197 rotator cuff tears were diagnosed, including 105 partial-thickness (93 supraspinatus, nine infraspinatus, three subscapularis) and 92 full-thickness (43 supraspinatus, 20 infraspinatus, 29 subscapularis) tendon tears. For full-thickness tears, sensitivity, specificity, and accuracy were 96%, 99%, and 98%, respectively, and for partial tears 80%, 97%, and 95%, respectively. False negative and positive assessments in the diagnosis of articular-sided partial-thickness tears were predominantly [78% (35/45)] observed with small articular-sided (Ellman grade1) tendon tears. MR arthrography is highly accurate in the diagnosis of full-thickness rotator cuff tears and is accurate in the diagnosis of articular-sided partial-thickness tears. Limitations in the diagnosis of partial-thickness tears are mainly restricted to small articular-sided tears (Ellman grade 1) due to difficulties in differentiation between fiber tearing, tendinitis, synovitic changes, and superficial fraying at tendon margins. (orig.)

  13. Rotator cuff tears: assessment with MR arthrography in 275 patients with arthroscopic correlation

    International Nuclear Information System (INIS)

    We assessed the diagnostic performance of magnetic resonance (MR) arthrography in the diagnosis of articular-sided partial-thickness and full-thickness rotator cuff tears in a large symptomatic population. MR arthrograms obtained in 275 patients including a study group of 139 patients with rotator cuff tears proved by arthroscopy and a control group of 136 patients with arthroscopically intact rotator cuff tendons were reviewed in random order. MR imaging was performed on a 1.0 T system (Magnetom Expert, Siemens). MR arthrograms were analyzed by two radiologists in consensus for articular-sided partial-thickness and full-thickness tears of the supraspinatus, infraspinatus, and subscapularis tendons. At arthroscopy, 197 rotator cuff tears were diagnosed, including 105 partial-thickness (93 supraspinatus, nine infraspinatus, three subscapularis) and 92 full-thickness (43 supraspinatus, 20 infraspinatus, 29 subscapularis) tendon tears. For full-thickness tears, sensitivity, specificity, and accuracy were 96%, 99%, and 98%, respectively, and for partial tears 80%, 97%, and 95%, respectively. False negative and positive assessments in the diagnosis of articular-sided partial-thickness tears were predominantly [78% (35/45)] observed with small articular-sided (Ellman grade1) tendon tears. MR arthrography is highly accurate in the diagnosis of full-thickness rotator cuff tears and is accurate in the diagnosis of articular-sided partial-thickness tears. Limitations in the diagnosis of partial-thickness tears are mainly restricted to small articular-sided tears (Ellman grade 1) due to difficulties in differentiation between fiber tearing, tendinitis, synovitic changes, and superficial fraying at tendon margins. (orig.)

  14. CT assisted follow-up of arthroscopically placed hydroxylapatite grafts in repair of fracture of the tibial head. Initial results of a CT assisted, quantitative assessment of the incorporation of the calcium hydroxylapatite graft and the reactions of the surrounding tissue

    International Nuclear Information System (INIS)

    Four patients bearing a hydroxylapatite graft in repair of tibial head fracture have been examined by CT immediately after surgery and several times in the post operative period of up to 24 months. Density measurements of the graft, the spongiosa immediately next to it, and the spongiosa in fibula and tibia reveal the integration and ossous connection of the graft, quantifiable by the X-ray density. The spongiosa in immediate contact with the graft shows an initial density increase related to the first post-operative data, followed by a density decrease observed by subsequent measurements. These results are in agreement with animal experimental data and histomorphologic studies of other authors, which show that porous hydroxylapatite is used by the bone as a matrix serving as a pathway for osteoblast migration and subsequent ossification of the graft. Thus CT is capable of showing the post-operative integration process by quantifying and reproducible data. (orig.)

  15. 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

  16. 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 (pperformance 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

  17. 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.

  18. 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.

  19. 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

  20. Arthroscopic subacromial decompression in the treatment of impingement syndrome

    OpenAIRE

    Guven, Osman; Bezer, Murat

    2004-01-01

    During the past decade, arthroscopy has become an accepted tool for the evaluation and management of shoulder disorders. The glenohumeral joint, subacromial space, acromioclavicular joint, and even the scapulothoracic articulation can be assessed through arthroscopy. Proper portal placement allows a safe access without risk for neurovascular, tendon, or articular injuries. Anterior acromioplasty is probably the most common arthroscopic procedure performed in the shoulder, with reported result...

  1. 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.

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

    OpenAIRE

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

    2015-01-01

    Intraosseous ganglion cysts are rare causes of wrist pain. Surgical treatment of this pathologic condition yields good results and a low recurrence rate. The main complications are joint stiffness and vascular disturbances of the lunate bone. Wrist arthroscopy is a surgical technique that reduces the intra-articular operative area and therefore minimizes postoperative stiffness. This article describes an arthroscopic technique used for lunate intraosseous cyst resection associated with an aut...

  3. 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

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

    Science.gov (United States)

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

    2015-10-01

    Intraosseous ganglion cysts are rare causes of wrist pain. Surgical treatment of this pathologic condition yields good results and a low recurrence rate. The main complications are joint stiffness and vascular disturbances of the lunate bone. Wrist arthroscopy is a surgical technique that reduces the intra-articular operative area and therefore minimizes postoperative stiffness. This article describes an arthroscopic technique used for lunate intraosseous cyst resection associated with an autologous bone graft in a series of cases to prevent joint stiffness while respecting the scapholunate ligament. This study was based on a series of 4 patients, all of whom had wrist pain because of intraosseous ganglion cysts. Arthrosynovial cyst resection, ganglion curettage, and bone grafting were performed arthroscopically. Pain had totally disappeared within 2 months after the operation in 100% of patients. The average hand grip strength was estimated at 100% compared with the opposite side, and articular ranges of motion were the same on both sides in 100% of cases. No complications were reported after surgery. On the basis of these results, arthroscopic treatment of intraosseous synovial ganglion cysts seems to be more efficient and helpful in overcoming the limitations of classic open surgery in terms of complications. PMID:26697314

  5. Arthroscopically assisted treatment of intraosseous ganglions of the lunate.

    Science.gov (United States)

    Bain, Gregory I; Turner, Perry C; Ashwood, Neil

    2008-12-01

    Intraosseous ganglia (IOGs) of the lunate are a relatively rare, but by no means insignificant, condition because treatment by traditional open curettage and bone grafting can lead to ongoing pain and stiffness of the wrist.An arthroscopically assisted minimally invasive technique of debridement and grafting of the lunate IOG is discussed, as well as the history of the condition, indications and contraindications, surgical technique with postoperative rehabilitation, and potential complications.The outcomes of 8 patients with persistent symptoms and typical radiographic and bone scan findings were assessed independently preoperatively and postoperatively by using a modified Green and O'Brien wrist score. The intraosseous cyst was drilled under arthroscopic and fluoroscopic guidance via either a volar or dorsal portal, depending on the position identified on the computed tomography scan. Average follow-up time was 3.8 years (range, 1-5.6 yrs). All patients returned to employment within 4 months. Wrist scores improved 34 points, from 51 to 85 points, by 1 year after surgery, with trabeculation being noted within the grafting lunate. The greatest improvements were seen in visual and analog pain scores, reducing from 68.3 to 11.2, and flexion-extension arcs, which increased from 98 to 114 degrees.The technique of arthroscopically assisted debridement of IOGs of the lunate is safe, with minimal morbidity and recurrence of symptoms during the follow-up period. PMID:19060679

  6. Modified arthroscopic suture fixation of a displaced tibial eminence fracture.

    Science.gov (United States)

    Lehman, Ronald A; Murphy, Kevin P; Machen, M Shaun; Kuklo, Timothy R

    2003-02-01

    This study describes a new arthroscopic method using a whip-stitch technique for treating a displaced type III tibial eminence fracture. A 12-year-old girl who sustained a displaced type III tibial eminence fracture was treated with arthroscopic fixation using the Arthrosew disposable suture device (Surgical Dynamics, Norwalk, CT) to place a whip stitch into the anterior cruciate ligament (ACL). The Arthrex ACL guide (Arthrex, Naples, FL) was used to reduce the avulsed tibial spine fragment. Sutures were then passed through the tibial tunnel and secured over a bony bridge with the knee in 20 degrees of flexion. At 9 months, the patient has a full range of motion with normal Lachman and anterior drawer testing, and she has returned to competitive basketball. Radiographs show complete fracture healing. KT-1000 and isokinetic testing at 9-month follow-up show only minimal side-to-side differences. The Arthrosew device provides a significant advantage in the treatment of type III and IV fractures of the tibial eminence by obtaining arthroscopic fixation within the substance of the ACL, thus obviating arthrotomy and hardware placement. This technique also restores the proper length and tension to the ACL, and provides a simplified, reproducible method of treatment for this injury. PMID:12579135

  7. 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 ...

  8. 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 ...

  9. Neuromuscular Exercise Post Partial Medial Meniscectomy

    DEFF Research Database (Denmark)

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

    2015-01-01

    PURPOSE: To evaluate the effects of a 12-week, home-based, physiotherapist-guided neuromuscular exercise program on the knee adduction moment (an indicator of mediolateral knee load distribution) in people with a medial arthroscopic partial meniscectomy within the past 3-12 months. METHODS...... or a control group with no exercise. The exercise program included eight individual sessions with one of seven physiotherapists in private clinics, together with home exercises. Primary outcomes were the peak external knee adduction moment during normal pace walking and during a one-leg sit-to-stand. Secondary...

  10. 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.

  11. Functional outcomes after arthroscopic treatment of lateral epicondylitis

    International Nuclear Information System (INIS)

    The purpose of this study was to evaluate surgical outcomes of arthroscopic debridement for lateral epicondylitis using a validated, patient-assessed scoring system as well as conventional outcome measures. We also wanted to identify potential predictive factors that may be associated with the outcomes. A total of 20 elbows in 18 patients with chronic lateral epicondylitis who underwent arthroscopic surgery were included. There were nine men and nine women with a mean age of 54 years (range 42-71 years). Operative treatment consisted of debridement of the extensor carpi radialis brevis (ECRB) origin and resection of the radiocapitellar synovial plica interposed in the joint. Outcomes were assessed using a patient rating, visual analogue scale (VAS) pain score, the Japanese Orthopaedic Association (JOA) elbow score, and the Disability of the Arm, Shoulder, and Hand (DASH) questionnaire. The average length of follow-up was 28 months (range 24-40 months). After surgery, according to the patients' reports, 14 of 20 elbows were much better, and 6 elbows were better. A mean preoperative VAS pain score at rest of 3.9 points improved to 0.3 points (P<0.0001), and that during activity improved from 7.8 points to 0.9 points (P<0.0001). The mean preoperative JOA elbow score of 29 points was improved to 90 points (P<0.0001). The mean postoperative DASH score was 10.6 (range 0-50). Absent of T2-weighted high signal focus of the ECRB origin on preoperative magnetic resonance imaging (MRI) (P=0.02) and receiving public assistance (P=0.01) were significantly associated with worse DASH scores. Arthroscopic release was a satisfactory procedure for chronic lateral epicondylitis. Preoperative MRI of the ECRB origin and socioeconomic factors were significantly associated with postoperative residual symptoms evaluated with the DASH score. (author)

  12. 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

  13. Arthroscopic findings in patients with painful wrist ganglia.

    Science.gov (United States)

    Povlsen, B; Peckett, W R

    2001-09-01

    The aetiology of painful dorsal wrist ganglia remains obscure. In a prospective study we investigated the link between a painful dorsal wrist ganglion and wrist joint abnormality with wrist arthroscopy before excision of the ganglion. Of 16 wrists arthroscoped 12 were abnormal, 10 had an abnormal scapholunate joint, and two had abnormal lunatetriquetral joints. We think that painful dorsal wrist ganglia, like popliteal cysts in the knee, are markers of underlying joint abnormalities. Surgeons who treat painful ganglia should be aware of a possible underlying cause so that they can target treatment more accurately, particularly in recurrent cases and those patients with persistent wrist pain after excision of the ganglion. PMID:11680404

  14. Bankart Repair to Correct Shoulder Instability

    Medline Plus

    Full Text Available ... bone. During the webcast, you'll learn how doctors reattach the ligaments arthroscopically through three small incisions. ... the surgery, and meet orthopedic surgeon Kerwyn Jones. Doctor Jones is performing the leading edge arthroscopic procedure ...

  15. 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.

  16. DNA repair

    International Nuclear Information System (INIS)

    In this chapter a series of DNA repair pathways are discussed which are available to the cell to cope with the problem of DNA damaged by chemical or physical agents. In the case of microorganisms our knowledge about the precise mechanism of each DNA repair pathway and the regulation of it has been improved considerably when mutants deficient in these repair mechanisms became available. In the case of mammalian cells in culture, until recently there were very little repair deficient mutants available, because in almost all mammalian cells in culture at least the diploid number of chromosomes is present. Therefore the frequency of repair deficient mutants in such populations is very low. Nevertheless because replica plating techniques are improving some mutants from Chinese hamsters ovary cells and L5178Y mouse lymphoma cells are now available. In the case of human cells, cultures obtained from patients with certain genetic diseases are available. A number of cells appear to be sensitive to some chemical or physical mutagens. These include cells from patients suffering from xeroderma pigmentosum, Ataxia telangiectasia, Fanconi's anemia, Cockayne's syndrome. However, only in the case of xeroderma pigmentosum cells, has the sensitivity to ultraviolet light been clearly correlated with a deficiency in excision repair of pyrimidine dimers. Furthermore the work with strains obtained from biopsies from man is difficult because these cells generally have low cloning efficiencies and also have a limited lifespan in vitro. It is therefore very important that more repair deficient mutants will become available from established cell lines from human or animal origin

  17. Local Anaesthetic Infusion with Elastomeric Pump After Arthroscopic Subacromial Decompression

    Science.gov (United States)

    Little, Kevin; Pillai, Anand; Fazzi, Umberto; Storey, Neil

    2007-01-01

    INTRODUCTION The use of extended local anaesthesia for postoperative pain has previously been reported, and has several advantages over other methods, including ease of placement, safety, reliability, lower cost and effective analgesia. We present our experience with a portable elastomeric infusion device in patients undergoing arthroscopic subacromial decompression, and make a case for its potential to allow same-day discharge. PATIENTS AND METHODS Forty patients undergoing arthroscopic subacromial decompression were followed-up. At the end of the procedure, an epidural catheter connected to a portable elastomeric local anaesthetic infusion system was inserted into the subacromial space. All patients were electively admitted for overnight stay postoperatively and assessed using a visual analogue scale (VAS) to evaluate their level of pain. RESULTS No patient reported severe pain at any stage. None of the patients required any parenteral opiate analgesia with the pump in situ. CONCLUSIONS These findings suggest that the use of this elastomeric infusion device following shoulder surgery allows safe and early discharge of patients with decreased need for parenteral opiate analgesia. PMID:17535622

  18. Does arthroscopic subacromial decompression improve quality of life

    Science.gov (United States)

    Whiteman, A; Wilson, J; Paul, E; Roy, B

    2015-01-01

    Introduction There has been a significant rise in the volume of subacromial decompression surgery performed in the UK. This study aimed to determine whether arthroscopic subacromial decompression improves health related quality of life in a cost effective manner. Methods Patients undergoing arthroscopic subacromial decompression surgery for impingement were enrolled between 2012 and 2014. The Oxford shoulder score and the EQ-5D™ instruments were completed prior to and following surgery. A cost–utility analysis was performed. Results Eighty-three patients were eligible for the study with a mean follow-up duration of 15 months (range: 4–27 months). The mean Oxford shoulder score improved by 13 points (95% confidence interval [CI]: 11–15 points). The mean health utility gain extrapolated from the EQ-5D™ questionnaire improved by 0.23 (95% CI: 0.16–0.30), translating to a minimum cost per QALY of £5,683. Conclusions Subacromial decompression leads to significant improvement in function and quality of life in a cost effective manner. This provides justification for its ongoing practice by appropriately trained shoulder surgeons in correctly selected patients. PMID:26263808

  19. 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

  20. Prospective outcomes of arthroscopic treatment of dorsal wrist ganglia.

    Science.gov (United States)

    Aslani, Hamidreza; Najafi, Arvin; Zaaferani, Zohre

    2012-03-01

    The purpose of this study was to assess the results of arthroscopic resection of dorsal wrist ganglia. Between November 2002 and September 2007, all patients with dorsal wrist ganglia underwent arthroscopic resection in our institution. Average follow-up was 39.2 months (range, 24-71 months). Fifty-two patients (40 women and 12 men; mean age, 29.8 years) were treated with our operative technique. Symptoms at presentation were unpleasant appearance in 15 patients (28.8 %), pain in 30 (57.6%), and unpleasant appearance and pain in 7 (13.5%). The ganglion cyst site was in front of the midcarpal joint in 41 patients (78.8%), in front of the radiocarpal joint in 6 patients (11.5%), and in front of the radiocarpal and midcarpal joints in 5 patients (9.6%). Our surgical technique resulted in a significant improvement in flexion, extension, and grip strength (P≤.005). In patients with painful ganglia, treatment also had a significant effect. Nine (17.3%) recurrences were observed. Mean time off work was 14 days, but 19 patients returned to work immediately. According to the results of this study, we recommend the use of arthroscopy as the primary treatment method for dorsal wrist ganglion excision. PMID:22385448

  1. 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

  2. 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 ...

  3. Arthroscopic lysis and lavage in patients with temporomandibular anterior disc displacement without reduction

    Czech Academy of Sciences Publication Activity Database

    Machoň, V.; Šedý, Jiří; Klíma, K.; Hirjak, D.; Foltán, R.

    2012-01-01

    Roč. 41, č. 1 (2012), s. 109-113. ISSN 0901-5027 R&D Projects: GA MŠk(CZ) LC554; GA ČR GAP304/10/0320 Grant ostatní: GA MŠk(CZ) 1M0538 Institutional research plan: CEZ:AV0Z50390703 Keywords : temporomandibular joint * arthroscopic lysis * arthroscopic lavage Subject RIV: FJ - Surgery incl. Transplants Impact factor: 1.521, year: 2012

  4. 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

  5. Clinical Effect of Steroid Administration in Patients with Chronic Impingement Syndrome on Postoperative Arthroscopic Subacromial Decompression

    OpenAIRE

    YILDIZ, Vahit; Aydin, Ali; KALALI, Fatih; Ömer Selim YILDIRIM; Topal, Murat; AYDIN, Pelin

    2012-01-01

    Objective: We aimed in our study to investigate the effect of intraarticular corticosteroid injection applied to patients with the chronic impingement syndrome after arthroscopic subacromial decompression on the clinical result. Materials and Methods: We employed in our study a total of 44 (24 males, 20 females) patients with chronic impingement syndrome to whom intraarticular corticosteroid injection was applied before arthroscopic subacromial decompression between 1-7 times. We measured c...

  6. Prediction of post-operative pain following arthroscopic subacromial decompression surgery: an observational study

    OpenAIRE

    Anthony Davis; Chinn, David J; Sunil Sharma

    2013-01-01

    Background: Arthroscopic shoulder surgery is increasingly performed as a day case procedure. Optimal post-operative pain relief remains a challenge due to considerable variations in the level of pain experienced between individuals. Our aim was to examine whether the preoperative electrical pain threshold was a strong predictor of elevated postoperative pain levels following arthroscopic subacromial decompression (ASD) surgery. Methods: Forty consenting patients with American Society of Anest...

  7. Arthroscopic Resection of The Distal Clavicle With Concomitant Subacromial Decompression: A Case Series

    OpenAIRE

    Chan, HZ; Ooi, CL; Lim, MY; Ong, EKS; Zulkiflee, O

    2014-01-01

    Abstract Shoulder impingement syndrome and acromioclavicular joint osteoarthritis often occur simultaneously and easily missed. Kay et al. reported excellent results with combined arthroscopic subacromial decompression and resection of the distal end of the clavicle in patients with both disorders1. Arthroscopic treatment of these disorders produces more favourable results than open procedures. We report two patients who were not responding to conservative management and were treated with dir...

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

    OpenAIRE

    Peng, Xu; Feng, Yong; Chen, Guangxing; Yang, Liu

    2013-01-01

    Background Relatively large calcific tendinitis with persistent symptoms after extended periods of conservative treatment is an indication for operative therapy. Arthroscopy, as a treatment for calcific tendinitis of the hip abductors and calcinosis circumscripta, has been described previously; however, to our knowledge, the clinical and radiological response to arthroscopic removal of calcific tendinitis of the rectus femoris tendon has not. Methods We present arthroscopic treatment of unusu...

  9. 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.

  10. 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 ...

  11. 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…

  12. Bladder exstrophy repair

    Science.gov (United States)

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

  13. 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

  14. 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

  15. Partial priapism

    DEFF Research Database (Denmark)

    Høyerup, Peter; Dahl, Claus; Azawi, Nessn Htum

    2014-01-01

    Partial priapism, also called partial segmental thrombosis of the corpus cavernosum, is a rare urological condition. Factors such as bicycle riding, drug usage, penile trauma and haematological diseases have been associated with the condition. Medical treatment with low molecular weight heparin (...... (LMWH) or acetylsalicylic acid is first choice treatment, and surgery is preserved for patients unresponsive to analgesics. In this report we describe the case of a 70-year-old man with partial priapism after blood transfusions treated successfully with LMWH....

  16. MRI studies of osteoarthritis of the knee joint after partial medial meniscectomy

    International Nuclear Information System (INIS)

    MRI studies of the knee joint after arthroscopic partial medial meniscectomy was made on 18 joints in 16 patients before and after the operation to examine the changes in the articular cartilage, subcartilaginous bone, and bone marrow of the femoral and tibial bones. Postoperative MRI showed that the changes in the cartilage, subcartilaginous bone, and bone marrow occurred only on the medial side of the femoral and tibial bones. Examining the relationship between these medial changes and the postoperative period showed that the cartilage and subcartilagious bone at the posterior site of the tibial bone started to change within one year postoperatively, and that the change was more widely spread in those with longer postoperative periods. Changes in the bone marrow were noted only in those patients whose postoperative period exceeded five years. These results indicate that articular degeneration may occur relatively early even after arthroscopic partial meniscectomy, and that careful deliberation is necessary before this technique is indicated. (author)

  17. MRI studies of osteoarthritis of the knee joint after partial medial meniscectomy

    Energy Technology Data Exchange (ETDEWEB)

    Iso, Yoshinori [Iso Orthopaedic Clinic, Tokyo (Japan); Nozaki, Hiroyuki; Mizutani, Kazuhiro; Suguro, Toru; Kudo, Yukihiko; Nakamura, Takuji

    1999-12-01

    MRI studies of the knee joint after arthroscopic partial medial meniscectomy was made on 18 joints in 16 patients before and after the operation to examine the changes in the articular cartilage, subcartilaginous bone, and bone marrow of the femoral and tibial bones. Postoperative MRI showed that the changes in the cartilage, subcartilaginous bone, and bone marrow occurred only on the medial side of the femoral and tibial bones. Examining the relationship between these medial changes and the postoperative period showed that the cartilage and subcartilagious bone at the posterior site of the tibial bone started to change within one year postoperatively, and that the change was more widely spread in those with longer postoperative periods. Changes in the bone marrow were noted only in those patients whose postoperative period exceeded five years. These results indicate that articular degeneration may occur relatively early even after arthroscopic partial meniscectomy, and that careful deliberation is necessary before this technique is indicated. (author)

  18. 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.

  19. 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

  20. 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

  1. 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 ...

  2. Eye muscle repair - discharge

    Science.gov (United States)

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

  3. 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.

  4. MR findings of chondromalacia Patella : correlation of the grade and associated lesions with arthroscopic findings

    Energy Technology Data Exchange (ETDEWEB)

    Chung, Yon Su; Kwon, Soon Tae; Lee, Hwan Do; Kang, Yong Soo; Byun, Ki Yong; Rhee, Kwang Jin [Chungnam National Univ., Taejon (Korea, Republic of). Coll. of Medicine

    1998-02-01

    To assess the MR findings of chondromalacia patella and correlate the grade and associated lesions with the arthroscopic findings. Twenty-five patients with pain in the anterior part of the knee underwent fat-suppressed axial and coronal T2-weighted and T2-weighted imaging, using a 10-cm field of view, and a 5-inch general purpose coil. We retrospectively assessed these findings, and the locations, grades and associated lesions, and correlated these with arthroscopic findings. We evaluated the exact location and grade of chondromalacia patella and associated lesions, as seen on MR images. These and the arthroscopic findings showed close correlation, and in cases involving this condition, MRI is thus a useful indicator of an appropriate surgical method and plan. (author). 18 refs., 5 figs.

  5. [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

  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. Mutations in yeast Rad51 that partially bypass the requirement for Rad55 and Rad57 in DNA repair by increasing the stability of Rad51–DNA complexes

    OpenAIRE

    Fortin, Gary S.; Symington, Lorraine S.

    2004-01-01

    Yeast Rad51 promotes homologous pairing and strand exchange in vitro, but this activity is inefficient in the absence of the accessory proteins, RPA, Rad52, Rad54 and the Rad55–Rad57 heterodimer. A class of rad51 alleles was isolated that suppresses the requirement for RAD55 and RAD57 in DNA repair, but not the other accessory factors. Five of the six mutations isolated map to the region of Rad51 that by modeling with RecA corresponds to one of the DNA-binding sites. The other mutation is in ...

  8. 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.)

  9. 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. PMID:26697312

  10. 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

  11. 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.

  12. Arthroscopic intralesional curettage for large benign talar dome cysts

    Directory of Open Access Journals (Sweden)

    El Shazly Ossama

    2015-01-01

    Full Text Available Introduction: Surgical management of large talar dome cysts is challenging due to increased morbidity by associated cartilage damage and malleolar osteotomy. The purpose of this study is to evaluate the clinical and radiological outcome of endoscopic curettage and bone graft for large talar dome cysts. Methods: This is a retrospective analysis of data for eight patients (eight feet who were treated by arthroscopic curettage and grafting for large talar dome cysts. Seven cases were treated by posterior ankle arthroscopy as the lesion was located posteriorly while one case was treated by anterior ankle arthroscopy as the lesion was breached anteriorly. Results: The final diagnosis, was; large osteochondral lesion of talus (two cases, aneurysmal bone cyst (ABC (two case, intra-osseous ganglion (two cases, Chronic infection in talus (one case and angiomatous lesion of the talus (one case. The mean follow up period was 18.3 (±3.06 SD months (range 16–25 months. The median preoperative AOFAS score was 74.5 (±5.34 SD points. The mean postoperative AOFAS score at one year follow up was 94.6 (±2.97 SD points. None of the patient had recurrence of the lesion during follow up. Return to normal daily activity was achieved at 11.25 (±2.37 SD weeks. Discussion: In this short case series study, large talar dome bony cysts of different pathologies including aneurysmal bone cysts could be treated effectively by endoscopic curettage and bone grafting with no recurrence no complications during the follow-up period.

  13. Partial priapism

    DEFF Research Database (Denmark)

    Hoyerup, Peter; Azawi, Nessn Htum

    2013-01-01

    With only 34 prior cases in world literature, partial priapism (PP), also called partial segmental thrombosis of the corpus cavernosum, is a rare urological condition. The aetiology and treatment of PP is still unclear, but bicycle riding, trauma, drug usage, sexual intercourse, haematological...... diseases and α-blockers have been associated with PP. In this case report and world literature review, we describe the case of a 50-year-old man suffering from PP after ingesting 100 mg of sildenafil. The patient was treated with a surgical incision for corpus cavernosum and clot evacuation, as a...

  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. 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

  16. 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

  17. Arthroscopic treatment of impingement of the ankle reduces pain and enhances function

    DEFF Research Database (Denmark)

    Rasmussen, S; Hjorth Jensen, C

    2002-01-01

    pain. Gait was improved in 30/41 patients and 22 resumed sporting activities. The results were graded excellent in 67, good in 25, fair in six and poor in seven patients. There were four deep infections and one synovial fistula in this series. The deep infections all responded well to arthroscopic...

  18. 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 .

  19. 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

  20. 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 .

  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. 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.

  3. [Partial onychectomy and plastic surgery as treatment of ingrown nails].

    Science.gov (United States)

    Briziarelli, P; Moretti, M; Barbetti, G; Pasquini, F

    1982-05-26

    The Authors report on a technique for a preserving treatment of the ingrowing nail, by means of partial onycectomy associated with plastic repair of soft tissues of the surrounding nail bed. PMID:7088382

  4. 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

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

    OpenAIRE

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

    2014-01-01

    Objective: To perform dual-bundle reconstruction of posterior cruciate ligament using full arthroscopic tibial inlay technology with self-designed tibia tunnel drilling system and to compare the effect of arthroscopic tibial inlay versus traditional technique for posterior cruciate ligament reconstruction. Material and methods: 32 patients were randomly divided into experiment group (improved tibial inlay, n = 17) and control group (traditional tibial inlay, n = 15). Self-designed tibia tunne...

  6. 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...

  7. Arthroscopic verification of objectivity of the orthopaedic examination and magnetic resonance imaging in intra-articular knee injury. Retrospective study

    OpenAIRE

    Dutka, Julian; Skowronek, Michał; Skowronek, Paweł; Dutka, Łukasz

    2011-01-01

    Introduction Arthroscopy of the knee joint is regarded as the most objective diagnostic method in intra-articular knee joint lesions. Aim The purpose of this study was to assess the objectivity and diagnostic value of orthopaedic examination (OE) and magnetic resonance imaging (MRI) in reference to the arthroscopic result. Material and methods In a group of 113 patients treated by arthroscopic surgery for post-traumatic knee pathology between 2008 and 2010 in our department, accuracy of clini...

  8. 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...

  9. 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...

  10. 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...

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

    OpenAIRE

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

    2009-01-01

    Abstract Background Osteochondral talar defects usually affect athletic patients. The primary surgical treatment consists of arthroscopic debridement and microfracturing. Although this is mostly successful, early sport resumption is difficult to achieve, and it can take up to one year to obtain clinical improvement. Pulsed electromagnetic fields (PEMFs) may be effective for talar defects after arthroscopic treatment by promoting tissue healing, suppressing inflammation, and relieving pain. We...

  12. 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.

  13. Effects of conservative therapy applied before arthroscopic subacromial decompression on the clinical outcome in patients with stage 2 shoulder impingement syndrome

    OpenAIRE

    Aydin, Ali; YILDIZ, Vahit; Topal, Murat; TUNCER, Kutsi; KÖSE, Mehmet; Şenocak, Eyüp

    2014-01-01

    To investigate the effects of conservative therapy applied before arthroscopic subacromial decompression on the clinical outcome in patients with stage 2 shoulder impingement syndrome. Materials and methods: Sixty-eight patients having stage 2 shoulder impingement syndrome and treated with arthroscopic subacromial decompression were included in the study. We divided these patients into 2 groups, whereby 32 (47%) patients received conservative therapy before arthroscopic subacromial decompres...

  14. 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 ...

  15. 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 ...

  16. 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 ...

  17. 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 ... players, we like to keep them from significant trauma for about four months. 00:46:17 JOHN ...

  18. 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 ... fail, and particularly in rotator cuff surgery. The literature is all over the board. What are you ...

  19. 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 ... URIBE, M.D.: I think certainly a physical exam is key. I think symptoms, you can almost ...

  20. 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 ...

  1. Rotator Cuff Repair

    Medline Plus

    Full Text Available ... that actually into the repair, so it will help to reinforce the repair as well. 00:08: ... stitches, when we put the anchors in, it helps us do that fairly easily. 00:26:01 ...

  2. 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 ...

  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 ... The other thing you have to do is work rather quickly because what we're using, and ...

  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. Arthroscopic Bioabsorbable Screw Fixation of Unstable Osteochondritis Dissecans in Adolescents: Clinical Results, Magnetic Resonance Imaging, and Second-Look Arthroscopic Findings

    Science.gov (United States)

    Chun, Keun Churl; Kim, Kwang Mee; Jeong, Ki Joon; Lee, Yong Chan; Kim, Jeong Woo

    2016-01-01

    Background This study aimed to evaluate the clinical and radiological outcomes of arthroscopic bioabsorbable screw fixation in osteochondritis dissecans (OCD) in adolescent patients with unstable lesions causing pain. Methods The study included 11 patients (10 males and 1 female) with OCD who underwent arthroscopic bioabsorbable screw fixation between July 2007 and February 2014 and were available for follow-up for more than 12 months. The mean age at diagnosis was 16.3 years (range, 11 to 19 years), and the average follow-up period was 51 months (range, 12 to 91 months). Clinical results were evaluated using the Knee Injury and Osteoarthritis Outcome Score (KOOS), Lysholm knee score, and International Knee Documentation Committee (IKDC) score measured before surgery and at follow-up. Functional evaluation was made using the Tegner activity scale. Magnetic resonance imaging (MRI) and second-look arthroscopy were performed at the 12-month follow-up. Results Between the preoperative assessment and follow-up, improvements were seen in the KOOS (range, 44.9 to 88.1), Lysholm knee score (range, 32.6 to 82.8), and IKDC score (range, 40.8 to 85.6). The Tegner activity scale also improved from 2.8 to 6.1. Based on postoperative MRI, there were eight Dipaola grade I cases and three grade II cases. No complications due to fixation failure developed in any case. Second-look arthroscopy at 12 months postoperatively revealed that the lesion was covered with cartilage in all cases. Conclusions For unstable OCD lesions causing pain in adolescents, arthroscopic bioabsorbable screw fixation provided favorable outcomes with reduced pain and restoration of movement. Therefore, it should be considered as an effective treatment for OCD. PMID:26929800

  6. ARTHROSCOPIC SUBACROMIAL DECOMPRESSION: ACROMIOPLASTY VERSUS BURSECTOMY ALONE-DOES IT REALLY MATTER? A SYSTEMATIC REVIEW

    Science.gov (United States)

    Donigan, Jonathan A; Wolf, Brian R

    2011-01-01

    Background Subacromial impingement is a common disorder mat in some cases results in surgical management. Arthroscopic subacromial bursectomy alone or in combination with acromioplasty are treatment options when non-operative measures fail. Methods A systematic review of all level-I and level-II studies regarding subacromial bursectomy and acromioplasty for impingement was performed. Medline publications were reviewed for appropriate studies. Results A total of six studies that met inclusion criteria were identified. However, only one randomized study was identified that directly compared the treatments in question. Additionally, only one prospective study of subacromial bursectomy was identified. A comparison of similar outcome measures revealed bursectomy alone provided similar results to bursectomy with acromioplasty. Discussion Limited high-level studies are available regarding arthroscopic treatment of subacromial impingement. Data available currently suggests that bursectomy alone provides similar outcomes to bursectomy with acromioplasty. PMID:22096430

  7. 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.

  8. 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...

  9. All-arthroscopic treatment of tibial avulsion fractures of the posterior cruciate ligament

    OpenAIRE

    Gwinner, Clemens; Hoburg, Arnd; Wilde, Sophie; Schatka, Imke; Krapohl, Björn Dirk; Jung, Tobias M.

    2016-01-01

    Background: The posterior cruciate ligament (PCL) avulsion fracture from its tibial insertion is a rare condition. Despite the further technical advent in refixation of avulsion fractures, the reported failure rate of current approaches remains high and the optimal surgical technique has not been elucidated yet. The purpose of the current study is to present an all-inside arthroscopic reconstruction technique for bony tibial avulsion fractures of the PCL and initial clinical outcomes. Methods...

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

    OpenAIRE

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

    2015-01-01

    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 co...

  11. 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.

  12. ASSESSMENT OF THE RESULTS FROM ARTHROSCOPIC SURGICAL TREATMENT FOR TRAUMATIC ANTERIOR SHOULDER DISLOCATION: FIRST EPISODE

    OpenAIRE

    Miyazaki, Alberto Naoki; Fregoneze, Marcelo; Santos, Pedro Doneux; da Silva, Luciana Andrade; do Val Sella, Guilherme; Botelho, Vinicius; Duarte, Clodoaldo; Checchia, Sergio Luiz

    2015-01-01

    Objective: To assess the clinical results obtained of patients who underwent arthroscopic surgical treatment following a first episode of traumatic anterior shoulder dislocation. Methods: Between August 2000 and October 2008, 14 shoulders of 14 patients were treated by the Shoulder and Elbow Group of Santa Casa Hospital, São Paulo. Thirteen patients (93%) were male and one (7%) was female; their ages ranged from 17 to 41 years, with a mean of 28 years. All of the patients evaluated were regul...

  13. Patients with shoulder impingement remain satisfied 6 years after arthroscopic subacromial decompression

    OpenAIRE

    Lunsjö, Karl; Bengtsson, Marie; Nordqvist, Anders; Abu-Zidan, Fikri M

    2011-01-01

    Background Although arthroscopic subacromial decompression (ASD) is a common procedure for treatment of shoulder impingement, few long term results have been published. In this prospective study, we determined whether the high degree of patient satisfaction at 6 months postoperatively reported by us earlier remained at the 6-year follow-up. Patients and methods We originally reported high patient satisfaction 6 months after ASD for shoulder impingement in 50 prospectively studied patients usi...

  14. Time and cost savings in arthroscopic subacromial decompression: the use of bipolar versus monopolar radiofrequency

    OpenAIRE

    Diab, Mohammed A.; Fernandez, G N; Elsorafy, Kareem

    2008-01-01

    There is currently an increased interest in the use of electro surgery in arthroscopy. Since the introduction of the bipolar arthroscopic radiofrequency (RF) wand, it has started to replace the classic Bovie monopolar probe on the assumption that the new technology provides multifunctional devices, combining both tissue removal and haemostasis into one instrument. The more efficient tissue ablation and precise haemostasis achieved with these instruments should result in a significant reductio...

  15. A Review of Arthroscopic Bone Marrow Stimulation Techniques of the Talus

    OpenAIRE

    Murawski, Christopher D.; Foo, Li Foong; Kennedy, John G

    2010-01-01

    Osteochondral lesions of the talus are common injuries following acute and chronic ankle sprains. Numerous surgical treatment strategies have been employed for treating these lesions; arthroscopic bone marrow stimulation is recognized as the first-line technique to provide fibrocartilage infill of the defect site. While the short- and medium-term outcomes of this technique are good, the long-term outcomes are not yet known. An increasing number of studies, however, show a cause for concern in...

  16. 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...

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

    OpenAIRE

    Bhatia, Deepak N.

    2015-01-01

    Intraosseous ganglion cysts (IOGs) are uncommon lesions of the carpal bones and can present with persistent pain and stiffness of the wrist. Surgical decompression is recommended, and a variety of approaches to decompress symptomatic IOGs of the wrist have been described. We describe an arthroscopic approach that can be performed with only 2 portals and offers excellent access for visualization and instrumentation. The procedure involves creating a 3.2-mm tunnel into the lunate cyst; this is ...

  18. 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.

  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. 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.

  1. 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

  2. Time and cost savings in arthroscopic subacromial decompression: the use of bipolar versus monopolar radiofrequency

    Science.gov (United States)

    Fernandez, G. N.; Elsorafy, Kareem

    2008-01-01

    There is currently an increased interest in the use of electro surgery in arthroscopy. Since the introduction of the bipolar arthroscopic radiofrequency (RF) wand, it has started to replace the classic Bovie monopolar probe on the assumption that the new technology provides multifunctional devices, combining both tissue removal and haemostasis into one instrument. The more efficient tissue ablation and precise haemostasis achieved with these instruments should result in a significant reduction in the operative time and cost. We ran a prospective comparative randomised study to test this hypothesis. Forty patients underwent arthroscopic subacromial decompression, randomised into two groups. The group treated with bipolar RF was associated with an average operative time saving of 8 min (P < 0.0001) and an average cost saving of £83 (€111) per case (P < 0.003), compared to monopolar RF. Bipolar RF is the instrument of choice in arthroscopic shoulder surgery, as it saves time and money. PMID:18414860

  3. 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.

  4. Radial tunnel syndrome caused by ganglion cyst: treatment by arthroscopic cyst decompression.

    Science.gov (United States)

    Mileti, Joseph; Largacha, Mauricio; O'Driscoll, Shawn W

    2004-05-01

    Compressive neuropathies of the radial nerve at the elbow can lead to one of 2 clinical entities. Posterior interosseous syndrome is primarily a motor deficiency of the posterior interosseous nerve, and radial tunnel syndrome presents as pain along the radial tunnel and extensor muscle mass. The radial nerve can be compressed at a number of sites around the elbow. In addition, numerous mass lesions reported in the literature can cause compressive neuropathy of the radial nerve at the elbow. Standard surgical management for persistent radial tunnel syndrome that is refractory to nonsurgical treatment is open decompression of the radial nerve. Cysts occurring in other joints are commonly treated arthroscopically. Supraglenoid cysts of the shoulder, meniscal cysts in the knee, and dorsal wrist ganglia are routinely treated with arthroscopic decompression or excision with management of the underlying etiology of the cyst. We present a case of radial tunnel syndrome caused by a ganglion cyst of the proximal radioulnar joint that was treated using arthroscopic excision of the cyst and decompression of the radial nerve. PMID:15122155

  5. 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.

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

    International Nuclear Information System (INIS)

    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.)

  7. 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

  8. 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.)

  9. 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

  10. A CLINICAL STUDY OF ARTHROSCOPIC MANAGEMENT OF ANTERIOR C RUCIATE LIGAMENT INJURIES OF KNEE JOINT

    Directory of Open Access Journals (Sweden)

    Paragjyoti

    2015-09-01

    Full Text Available BACKGROUND : Anterior C ruciate L igament (ACL tear is a common sports injury of the knee. There are a lot of controversies related to the management of this injury and more than 2000 papers have been published on the various aspects of the topic. Arthroscopic reconstruction of the ACL with autogenous graft material is widely used nowadays. The two most commonly used grafts are the central one - third of the patellar ligament (bone - tendon - bone, BTB and the hamstring tendon ( S emitendinosus - gracilis, STG construct but the former graft leads to increased donor site morbidity & hurdles in postoperative rehab & pain. The aim of the study is to study the Arthroscopic management of anterior cruciate ligament injury of knee joint using quadrupled hamstring graft. METHOD: The study was carried out on 30 cases of anterior cruciate ligament injury of knee joint attending the OPD and emergency of department of Orthopaedics, Silchar Medical College & Hospital who met the inclusion criteria. An informed consent was obtained from each patient prior to participation in the study. All the patients were examined in detail and worked up to obtain pre - anaesthetic clearance. X - rays and MRI were done routinely in all the cases. Clinical and radiological parameters were recorded. Arthroscopic anterior cruciate ligament reconstruction with quadrupled hamstring graft was done in all the patients. Concomitant meniscal inju ries were treated according to the merit of the injury. Patients were followed up at regular intervals and outcome variables were assessed and recorded. RESULTS: Results of our study clearly showed that arthroscopic ACL reconstruction using quadrupled hamstring graft is a safe, effective and reproducible procedure in restoring knee function with minimal donor site morbidity. At follow up evaluation, all patients had good outcomes in terms of clinical stability, range of motion and general symptoms. CONCLUSION: From the results in this study

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

    Directory of Open Access Journals (Sweden)

    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

  12. 46 CFR 91.30-1 - General or partial survey.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 4 2010-10-01 2010-10-01 false General or partial survey. 91.30-1 Section 91.30-1... INSPECTION AND CERTIFICATION Inspection After Accident § 91.30-1 General or partial survey. (a) A survey... made. The survey shall be such as to insure that the necessary repairs or renewals have...

  13. 46 CFR 189.30-1 - General or partial survey.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 7 2010-10-01 2010-10-01 false General or partial survey. 189.30-1 Section 189.30-1... AND CERTIFICATION Inspection After Accident § 189.30-1 General or partial survey. (a) A survey, either... made. The survey shall be such as to insure that the necessary repairs or renewals have...

  14. 46 CFR 71.40-1 - General or partial survey.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 3 2010-10-01 2010-10-01 false General or partial survey. 71.40-1 Section 71.40-1... CERTIFICATION Inspection After Accident § 71.40-1 General or partial survey. (a) A survey, either general or... survey shall be such as to insure that the necessary repairs or renewals have been effectively made,...

  15. 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.

  16. 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

  17. 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.

  18. Recombinant DNA repair genes

    International Nuclear Information System (INIS)

    We have developed a gene transfer system with Chinese hamster ovary (CHO) cells to identify, characterize, and potentially isolate functionally homologous human or CHO genes regulating repair initiation

  19. Bankart Repair to Correct Shoulder Instability

    Medline Plus

    Full Text Available ... 09 What's done in arthroscopic surgery is we use devices that are little tiny cameras and they ... hook, which is actually a probe that we use to feel and pull things with in the ...

  20. Bankart Repair to Correct Shoulder Instability

    Medline Plus

    Full Text Available ... into the joint, which is used simply to exchange for a stitch. So we're going to ... the caveat of historically the discrepancy in recurrence rates from the open and arthroscopic approach, versus now ...

  1. Bankart Repair to Correct Shoulder Instability

    Medline Plus

    Full Text Available ... arthroscopic procedure that is designed to help a child quickly resume his or her busy lifestyle. ORlive ... and the people who are sitting at home right now watching it's difficult for them to understand. ...

  2. Bankart Repair to Correct Shoulder Instability

    Medline Plus

    Full Text Available ... a great advance it's been since the arthroscopic age to see when we get these kids back ... 43:15 KERWYN JONES, MD: Well, that's the old adage. But, you know, in today's world a ...

  3. Bankart Repair to Correct Shoulder Instability

    Medline Plus

    Full Text Available ... from the bone. During the webcast, you'll learn how doctors reattach the ligaments arthroscopically through three ... lifestyle. ORlive makes it easy for you to learn more. Just click on the "Request Information" button ...

  4. Bankart Repair to Correct Shoulder Instability

    Medline Plus

    Full Text Available ... leading edge arthroscopic procedure that is designed to help a child quickly resume his or her busy ... that are watching online with us tonight, and help us to make things more relevant. So we' ...

  5. 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 ...

  6. Arthroscopic subacromial decompression results in normal shoulder function after two years in less than 50% of patients

    DEFF Research Database (Denmark)

    Konradsen, Lars Aage Glud; Jensen, Claus Hjorth

    2015-01-01

    INTRODUCTION: The aim of this study was to evaluate the outcome two years after arthroscopic subacromial decompression using the Western Ontario Rotator-Cuff (WORC) index and a diagram-based questionnaire to self-assess active shoulder range of motion (ROM). METHODS: Outcomes in 80 patients with...... impingement of the shoulder undergoing arthroscopic subacromial decompression were prospectively assessed preoperatively, at three months and at two years post-operatively using the WORC index. All patients had received non-operative treatment for at least six months before undergoing surgery. Active range of...... only 45% reported near normal or normal WORC scores, and 56% presented with a reduced active ROM at two years. CONCLUSION: Arthroscopic subacromial decompression -appears effective in alleviating symptoms in patients with subacromial impingement who are resistant to conservative treatment, but can only...

  7. 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.

  8. 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...

  9. 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...

  10. Aortic Aneurysm Repair

    Medline Plus

    Full Text Available Aortic Aneurysm Repair May 7, 2009 Good afternoon. Welcome to the Baptist Cardiac and Vascular Institute here in Miami. My name ... our live webcast. Today we’re going to repair an abdominal aortic aneurysm using a technology called ...

  11. Anterior vaginal wall repair

    Science.gov (United States)

    ... symptoms will go away. This improvement will often last for years. Alternative Names A/P repair; Vaginal wall repair; Anterior and/ ... writing by ADAM Health Solutions. About MedlinePlus Site Map FAQs Contact ... Institutes of Health Page last updated: 23 August 2016

  12. 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

  13. 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

  14. 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...

  15. 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.

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

    International Nuclear Information System (INIS)

    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.)

  17. 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.)

  18. 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.

  19. 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.)

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

    International Nuclear Information System (INIS)

    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.)

  1. 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

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

    DEFF Research Database (Denmark)

    Espelund, M; Fomsgaard, J S; Haraszuk, J; Dahl, J B; Mathiesen, O

    2014-01-01

    for minor knee surgery were enrolled in this placebo-controlled, blinded trial. The patients were randomised to receive an ACB with either 30 ml ropivacaine 7.5 mg/ml (n = 36) or saline (n = 35) in addition to a basic analgesic regimen with paracetamol and ibuprofen. Primary outcome measure was pain...... observed for any other outcome. CONCLUSION: No significant analgesic effect of the ACB could be detected after minor arthroscopic knee surgery with a basic analgesic regimen with acetaminophen and ibuprofen, except from a minor reduction in immediate requirements for supplemental opioids. Clinicaltrials...

  3. Arthroscopic treatment of pigmented villonodular synovitis of the proximal tibiofibular joint.

    Science.gov (United States)

    Lui, Tun Hing

    2015-08-01

    Disorders of the proximal tibiofibular joint should be kept in mind in the evaluation of lateral knee pain. They include osteoarthrosis, rheumatic disease, traumatic subluxation or dislocation, ganglion or synovial cysts, synostosis, synovial chondromatosis, pigmented villonodular synovitis and hypomobility of the joint. Peroneal nerve can be at risk with pathologies of the joint either by compressive effect or formation of intra-neural ganglion. A case of pigmented villonodular synovitis of the proximal tibiofibular joint was reported which presented with lateral knee pain. It was successfully treated by arthroscopic synovectomy. Level of evidence V. PMID:24788187

  4. [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

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

    Directory of Open Access Journals (Sweden)

    Woodmass JM

    2015-04-01

    Full Text Available Jarret M Woodmass,1 John G Esposito,1 Yohei Ono,1,2 Atiba A Nelson,1 Richard S Boorman,1 Gail M Thornton,1,3 Ian KY Lo1 1Department of Surgery, Section of Orthopaedic Surgery, McCaig Institute for Bone and Joint Health, University of Calgary, Calgary, AB, Canada; 2Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan; 3Department of Orthopaedics, University of British Columbia, Vancouver, BC, Canada Purpose: Over the past decade, a number of arthroscopic or arthroscopically assisted reconstruction techniques have emerged for the management of acromioclavicular (AC separations. These techniques provide the advantage of superior visualization of the base of the coracoid, less soft tissue dissection, and smaller incisions. While these techniques have been reported to provide excellent functional results with minimal complications, discrepancies exist within the literature. This systematic review aims to assess the rate of complications following these procedures. Methods: Two independent reviewers completed a search of Medline, Embase, PubMed, and the Cochrane Library entries up to December 2013. The terms “Acromioclavicular Joint (MeSH” OR “acromioclavicular* (text” OR “coracoclavicular* (text” AND “Arthroscopy (MeSH” OR “Arthroscop* (text” were used. Pooled estimates and 95% confidence intervals were calculated assuming a random-effects model. Statistical heterogeneity was quantified using the I2 statistic. Level of evidence: IV Results: A total of 972 abstracts met the search criteria. After removal of duplicates and assessment of inclusion/exclusion criteria, 12 articles were selected for data extraction. The rate of superficial infection was 3.8% and residual shoulder/AC pain or hardware irritation occurred at a rate of 26.7%. The rate of coracoid/clavicle fracture was 5.3% and occurred most commonly with techniques utilizing bony tunnels. Loss of AC joint reduction occurred in 26

  6. 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

  7. 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

  8. Pseudoaneurysm with Arteriovenous Fistula after Arthroscopic Procedure: A Rare Complication of Arthroscopy

    OpenAIRE

    Jin, Moran; Lee, Yang-Haeng; Yoon, Young Chul; Han, Il-Yong; Park, Kyung-Taek; Wi, Jin Hong

    2015-01-01

    Pseudoaneurysm with arteriovenous fistula is a rare complication of arthroscopy, and can be diagnosed by ultrasonography, computed tomography, magnetic resonance imaging, or angiography. This condition can be treated with open surgical repair or endovascular repair. We report our experience with the open surgical repair of a pseudoaneurysm with an arteriovenous fistula in a young male patient who underwent arthroscopy five months previously.

  9. Comparison of radiographic subchondral bone changes with arthroscopic findings in the equine femoropatellar and femorotibial joints: a retrospective study of 72 joints (50 horses)

    International Nuclear Information System (INIS)

    Radiographs of 72 femoropatellar and femorotibial joints from 50 horses were evaluated. Ninety four arthroscopically evaluated areas were graded according to a predetermined system. The radiographic grade was then compared to arthroscopic findings in the same location. Statistical analysis was performed to determine the association between the radiographic subchondral bone changes and arthroscopic findings. Radiographically normal areas in the femoropatellar joint were arthroscopically positive for cartilaginous changes in 40% of the femoropatellar joints. Areas of mild subchondral bone flattening (grade I) in the lateral trochlear ridge were arthroscopically positive for cartilage changes 78% of the time. Ninety six percent of moderate to severe subchondral bone changes (grades II-V) were arthroscopically positive for cartilage damage. This research demonstrates that (1) a significant number of radiographically normal joints will have cartilage changes, (2) areas of mild subchondral bone flattening have cartilage changes present in the majority of cases and (3) areas of moderate to severe subchondral bone changes have arthroscopically detectable cartilage changes present

  10. 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.)

  11. 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.

  12. 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...... opposite study medication, according to randomization. Primary outcome was pain during 45 degrees active flexion of the knee at 45 min after the first block, assessed on a 0-100 mm visual analogue scale. Secondary outcome measures were: pain at rest and during flexion of the knee, worst pain experienced...... subjects with moderate to severe pain after arthroscopic knee surgery were enrolled in this placebo-controlled, blinded trial. All subjects received two ACBs; an initial ACB with either 30 ml ropivacaine 7.5 mg/ml (n = 25) (R group) or saline (n = 25) (C group) and after 45 min a second ACB with the...

  13. Arthroscopic Patelloplasty and Circumpatellar Denervation for the Treatment of Patellofemoral Osteoarthritis

    Science.gov (United States)

    Zhao, Gang; Liu, Yujie; Yuan, Bangtuo; Shen, Xuezhen; Qu, Feng; Wang, Jiangtao; Qi, Wei; Zhu, Juanli; Liu, Yang

    2015-01-01

    Background: Patellofemoral osteoarthritis commonly occurs in older people, often resulting in anterior knee pain and severely reduced quality of life. The aim was to examine the effectiveness of arthroscopic patelloplasty and circumpatellar denervation for the treatment of patellofemoral osteoarthritis (PFOA). Methods: A total of 156 PFOA patients (62 males, 94 females; ages 45-81 years, mean 66 years) treated in our department between September 2012 and March 2013 were involved in this study. Clinical manifestations included recurrent swelling and pain in the knee joint and aggravated pain upon ascending/descending stairs, squatting down, or standing up. PFOA was treated with arthroscopic patelloplasty and circumpatellar denervation. The therapeutic effects before and after surgery were statistically evaluated using Lysholm and Kujala scores. The therapeutic effects were graded by classification of the degree of cartilage defect. Results: A total of 149 cases were successfully followed up for 14.8 months, on average. The incisions healed well, and no complications occurred. After surgery, the average Lysholm score improved from 73.29 to 80.93, and the average Kujala score improved from 68.34 to 76.48. This procedure was highly effective for patients with cartilage defects I-III but not for patients with cartilage defect IV. Conclusions: For PFOA patients, this procedure is effective for significantly relieving anterior knee pain, improving knee joint function and quality of life, and deferring arthritic progression. PMID:25563318

  14. Arthroscopic Patelloplasty and Circumpatellar Denervation for the Treatment of Patellofemoral Osteoarthritis

    Directory of Open Access Journals (Sweden)

    Gang Zhao

    2015-01-01

    Full Text Available 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.

  15. 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.

  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. 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

  18. Direct "Cystoscopic" Approach for Arthroscopic Decompression of an Intraosseous Ganglion of the Lunate.

    Science.gov (United States)

    Bhatia, Deepak N

    2015-06-01

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

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

    Science.gov (United States)

    Bhatia, Deepak N.

    2015-01-01

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

  20. 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.

  1. 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.

  2. Large regional differences in incidence of arthroscopic meniscal procedures in the public and private sector in Denmark

    DEFF Research Database (Denmark)

    Hare, Kristoffer Borbjerg; Vinther, Jesper Høeg; Lohmander, L Stefan; Thorlund, Jonas Bloch

    2015-01-01

    arthroscopic meniscus surgery as a primary or secondary procedure in the years 2000 to 2011. Hospital identification codes enabled linkage of performed procedures to specific hospitals. PRIMARY AND SECONDARY OUTCOME MEASURES: Yearly incidence of meniscal procedures per 100 000 inhabitants was calculated with...

  3. 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.

  4. 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

  5. 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 ...

  6. 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, ...

  7. Aortic Aneurysm Repair

    Medline Plus

    Full Text Available ... Rua, and together as a team of multidisciplinary physicians, we’re going to repair an abdominal aortic ... takes a special type of training. Both the doctors in the room are board certified and highly ...

  8. 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 ...

  9. 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 ...

  10. 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

  11. 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 ...

  12. 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 ...

  13. 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 ...

  14. Rotator Cuff Repair

    Medline Plus

    Full Text Available ... are different ways that you can increase the ability of this to mobilize back to its site. ... unfortunately, even though the cuff repair works, their ability to throw and generate the same amount of ...

  15. 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.

  16. Locally Repairable Codes with Multiple Repair Alternatives

    OpenAIRE

    Pamies-Juarez, Lluis; Hollmann, Henk D. L.; Oggier, Frédérique

    2013-01-01

    Distributed storage systems need to store data redundantly in order to provide some fault-tolerance and guarantee system reliability. Different coding techniques have been proposed to provide the required redundancy more efficiently than traditional replication schemes. However, compared to replication, coding techniques are less efficient for repairing lost redundancy, as they require retrieval of larger amounts of data from larger subsets of storage nodes. To mitigate these problems, severa...

  17. Locally Repairable Codes

    OpenAIRE

    Papailiopoulos, Dimitris S.; Dimakis, Alexandros G.

    2012-01-01

    Distributed storage systems for large-scale applications typically use replication for reliability. Recently, erasure codes were used to reduce the large storage overhead, while increasing data reliability. A main limitation of off-the-shelf erasure codes is their high-repair cost during single node failure events. A major open problem in this area has been the design of codes that {\\it i)} are repair efficient and {\\it ii)} achieve arbitrarily high data rates. In this paper, we explore the r...

  18. Cellular and molecular repair of X-ray-induced damage: dependence on oxygen tension and nutritional status

    International Nuclear Information System (INIS)

    Cellular and molecular repair was studied at 230C using split-dose recovery and alkaline elution techniques, respectively, as a function of cellular oxygen and nutrient conditions. Hypoxic cells in full medium showed a partial reduction in the level of sublethal damage (SLD) repair relative to aerated cells; the respective repair kinetics were similar with a common repair half-time of 30 min. Similarly, hypoxic cells showed a slight reduction in strand break rejoining capacity compared to aerated cells. Under nutrient deprivation, anoxic cells displayed no SLD repair or strand break repair, while aerated cells exhibited the same level of SLD and strand break repair as for well-fed cells. In addition, nutrient deprived cells at low O2 levels displayed normal SLD and strand break repair capability. These results indicate that both nutrient and O2 deprivation are necessary for complete inhibition of cellular and molecular repair, and low levels of O2 can effectively reverse this inhibition

  19. Mechanical behaviour of structural concrete repairs : coupled effect of drying and loading

    OpenAIRE

    Molez, Laurent

    2003-01-01

    Drying shrinkage may be a significant cause of deterioration of thin concrete repairs. Shrinkage induced stresses can at least partially be relieved by tensile creep. Hydration effects and interface properties may have significant influence on concrete repair behaviour. An important experimental study was undertakento understand the overall behaviour and to feed a numerical analysis tool. Different repair materials and setting techniques were studied. Long term and short term flexural tests w...

  20. 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.)

  1. 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.)

  2. 关节镜下喙锁韧带增强术治疗肩锁关节脱位%Arthroscopic treatment of acute acromioclavicular joint dislocations by coracoacromial ligament augmentation and suture

    Institute of Scientific and Technical Information of China (English)

    皇甫小桥; 赵金忠; 何耀华; 杨星光; 刘旭东; 刘闻欣; 王海明

    2013-01-01

    extension of shoulder,which conforms to the biological nature of AC joint.Long learning of the arthroscopic skills is required due to its key role in the arthroscopically assisted augmentation of reconstructed CC ligaments. Additionally, such anatomical structures as coracoid base,AC joint and CC ligament should be known well.While establishing bone tunnel from the clavicle to the coracoid root,arthroscopy travels along the CC ligament to guarantee the uniformity of cortical bone around the tunnel.After arthroscopic reduction,the plate should be carefully fixed in the end of coracoidprocess to avoid rarefaction of bone that loosens fixation,breaks it off and thus leads to failure.In addition,arthroscopically assisted augmentation of the reconstructed CC ligaments is applicable for patients of type Ⅲ and Ⅴ in Rockwood classification.Open surgery is necessary to restore the stability of joint for type Ⅵ and Ⅳ patients with reduction difficulties.Conclusions Augmentation of CC ligaments with the suture to restore the anatomy of AC joint is an effective method in treating the dislocation.Minimal injury,reliable reduction of AC joint,less complication and rapid recovery of the shoulder joint function are found after the arthroscopic operation.Whether AC joint structure is stabilized and its biomechanic features are self-repaired to restore the normal anatomy and function or not,which required long term follow-up.

  3. Is rotator cuff repair worthwhile in patients with co-morbidities?

    Directory of Open Access Journals (Sweden)

    Yash Kishore Shah

    2015-04-01

    Full Text Available Background: Rotator cuff tears are a common source of shoulder pain. The incidence increases with age and is most frequently due to degeneration of the tendon, rather than injury. This study is done to see whether in patients having established rotator cuff tears with co-morbidities like hypertension diabetes, epilepsy, etc. a surgical repair is worthwhile or whether it is better to leave such patients alone in order to give them a better quality of life. Methods: A total of 35 patients with co-morbidities, treated by a single surgeon of which 8 by open method, 19 with arthroscopic assisted mini open rotator cuff repair and 8 entire arthroscopically were evaluated retrospectively. Small tears (<1 cm, medium tears (1-3 cm; large tears (3-5 cm were addressed by the same surgical procedure using bone tunnels, suture anchors, or a combination of both. The patients were evaluated by history, examination, pain scores and constant scores. Results: As compared to patients with no co-morbidities, these patients took longer time for healing especially diabetics. Despite that 27 patients had excellent pain relief, 5 good and 3 poor pain relief. Constant scores improved in all patients. Conclusion: Patients with co-morbidities take longer time to heal, yet the final outcome which is attained and relief of pain and relief in the form of activities of daily living that we could offer the patients makes the surgery worthwhile. It is well worth operating on patients with co-morbidities and a rotator cuff tear, giving them a better pain free life and better activities of daily living. [Int J Res Med Sci 2015; 3(4.000: 863-870

  4. Exercises versus arthroscopic decompression in patients with subacromial impingement: a randomised, controlled study in 90 cases with a one year follow up

    DEFF Research Database (Denmark)

    Haahr, J. P.; Ostergaard, S.; Dalsgaard, J.; Norup, K.; Frost, P.; Lausen, S.; Holm, E. A.; Andersen, JH

    2005-01-01

    OBJECTIVES: To compare the effect of graded physiotherapeutic training of the rotator cuff versus arthroscopic subacromial decompression in patients with subacromial impingement. METHODS: Randomised controlled trial with 12 months' follow up in a hospital setting. Ninety consecutive patients aged...

  5. 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

  6. 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...

  7. 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

  8. The role of two-stage repair in modern hypospadiology.

    Science.gov (United States)

    Bracka, Aivar

    2008-04-01

    Hypospadias surgery continues to evolve. The enthusiasm for flap-based urethroplasty is waning and instead there is an increasing preference for urethroplasty that uses either the urethral plate alone or in combination with grafts. From the vast armamentarium of hypospadias repairs that are still in use, the author suggests a simple protocol of just three closely related procedures with which we can now repair almost all hypospadias. The tubularised incised plate (TIP) repair and the 'Snodgraft' modification of the TIP principle are simple and effective one-stage solutions when partial circumference urethroplasty is required. Conversely, the Bracka two-stage graft repair remains an ideal and versatile solution when a full circumference urethroplasty is required. It is particularly appropriate for severe primary hypospadias associated with a poor plate and marked chordee and also to replace a scarred, hairy or balanitis xerotica obliterans diseased urethra in re-operative salvage hypospadias. PMID:19468400

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

    Directory of Open Access Journals (Sweden)

    Neeru Sahni

    2015-01-01

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

  10. 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.

  11. 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.)

  12. 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.

  13. 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.

  14. 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

  15. Isolated subacromial bursal fluid on MRI of the shoulder in symptomatic patients: correlation with arthroscopic findings

    International Nuclear Information System (INIS)

    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.)

  16. Arthroscopic-assisted fibular synthesis and syndesmotic stabilization of a complex unstable ankle injury.

    Science.gov (United States)

    Salvi, Andrea Emilio; Metelli, Giovanni Pietro; Bettinsoli, Rosita; Hacking, Steven Adam

    2009-03-01

    Traditional treatment of complex ankle fracture consists of open reduction and internal fixation. Nevertheless, this treatment can delay fracture healing and cause prolonged oedema. The surgeon should consider necessity of early recovery when treating athletes, especially football players. In this light, it was decided to perform an arthroscopy-assisted percutaneous minimal osteosynthesis of a fibular fracture together with a syndesmotic disruption in order to permit the patient, a 24-year-old male, to resume quicker and easier full sport activities. The outcome was good and allowed patient to play soccer since 6 months following surgery. The complete and detailed articular evaluation provided by the arthroscope permitted to manage carefully a complex articular traumatism, avoiding the necessity of plating the fracture and improving a rapid full recovery of the joint function. PMID:18368413

  17. 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

  18. 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

  19. 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.

  20. Prediction of post-operative pain following arthroscopic subacromial decompression surgery: an observational study

    Science.gov (United States)

    Davis, Anthony

    2013-01-01

    Background: Arthroscopic shoulder surgery is increasingly performed as a day case procedure. Optimal post-operative pain relief remains a challenge due to considerable variations in the level of pain experienced between individuals. Our aim was to examine whether the preoperative electrical pain threshold was a strong predictor of elevated postoperative pain levels following arthroscopic subacromial decompression (ASD) surgery. Methods: Forty consenting patients with American Society of Anesthesiologists (ASA) grade 1-2 presenting for elective ASD surgery were recruited. Patients’ electrical pain thresholds were measured preoperatively using a PainMatcher® (Cefar Medical AB, Lund, Sweden) device. Following surgery under general anaesthesia, the maximum pain experienced at rest and movement was recorded using a visual analogue scale until the end of postoperative day four. Results: In univariate analyses (t-test), the postoperative pain experienced (Area Under Curve) was significantly greater in patients with a low pain threshold as compared with a high pain threshold at both rest (mean 12.5, S.E. 1.7 v mean 6.5, S.E.1.2. P=0.008) and on movement (mean 18.7, S.E. 1.5 v mean 14.1, S.E.1.4. P=0.031). In multivariate analyses, adjusting for additional extra analgesia, the pain experienced postoperatively was significantly greater in the low pain threshold group both at rest (mean difference 4.9, 95% CI 1.5 to 8.4, P=0.007) and on movement (mean difference 4.1, 95%CI 0.03 to 8.2, P=0.049). Conclusions: Preoperative pain threshold can predict postoperative pain level following ASD of the shoulder. Trial registration: Clinicaltrials.gov identifier: NCT01351363 Level of Evidence: II PMID:24358863

  1. [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

  2. 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.

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

    Directory of Open Access Journals (Sweden)

    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.

  4. Experimental and numerical validation for the novel configuration of an arthroscopic indentation instrument

    International Nuclear Information System (INIS)

    Softening of articular cartilage, mainly attributable to deterioration of superficial collagen network and depletion of proteoglycans, is a sign of incipient osteoarthrosis. Early diagnosis of osteoarthrosis is essential to prevent the further destruction of the tissue. During the past decade, a few arthroscopic instruments have been introduced for the measurement of cartilage stiffness; these can be used to provide a sensitive measure of cartilage status. Ease of use, accuracy and reproducibility of the measurements as well as a low risk of damaging cartilage are the main qualities needed in any clinically applicable instrument. In this study, we have modified a commercially available arthroscopic indentation instrument to better fulfil these requirements when measuring cartilage stiffness in joints with thin cartilage. Our novel configuration was validated by experimental testing as well as by finite element (FE) modelling. Experimental and numerical tests indicated that it would be better to use a smaller reference plate and a lower pressing force (3 N) than those used in the original instrument (7-10 N). The reproducibility (CV = 5.0%) of the in situ indentation measurements was improved over that of the original instrument (CV = 7.6%), and the effect of material thickness on the indentation response was smaller than that obtained with the original instrument. The novel configuration showed a significant linear correlation between the indenter force and the reference dynamic modulus of cartilage in unconfined compression, especially in soft tissue (r = 0.893, p < 0.001, n = 16). FE analyses with a transversely isotropic poroelastic model indicated that the instrument was suitable for detecting the degeneration of superficial cartilage. In summary, the instrument presented in this study allows easy and reproducible measurement of cartilage stiffness, also in thin cartilage, and therefore represents a technical improvement for the early diagnosis of

  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. 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.

  7. 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...

  8. Proteoglycans and brain repair.

    Science.gov (United States)

    Properzi, Francesca; Fawcett, James W

    2004-02-01

    Proteoglycans are complex molecules composed of long, unbranched sugar chains attached to a protein core. In the mammalian central nervous system, they are a major component of the extracellular matrix and of the cellular surface. After a central nervous system injury, their expression in the lesion area changes strongly and contributes to the inhibition of axon regrowth and brain repair. PMID:14739401

  9. Laboratory For Telerobotic Repair

    Science.gov (United States)

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

    1993-01-01

    Laboratory telerobotic system performs such complicated tasks as picking up tools, removing thermal blanket, and replacing screws. Human operator in control room operates remote robot with aid of video monitors, torque and force displays, and force feedback. System used to perform research and to develop telerobotic-repair capabilities equal to those of human operator.

  10. 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 ...

  11. 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 ...

  12. 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 ...

  13. 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 ...

  14. 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...

  15. 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.

  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. Rotator Cuff Repair

    Medline Plus

    Full Text Available ... the tissues. So there are a lot of factors. It's not just age. I've repaired rotator cuffs in people well into their 80s and also treated people in their 50s conservatively, so it's fairly variable. But again, it's symptoms and activity-related, too. A very sedentary person with a small ...

  18. 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/ ...

  19. 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 ...

  20. 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.

  1. Emergent properties of neural repair: elemental biology to therapeutic concepts.

    Science.gov (United States)

    Carmichael, S Thomas

    2016-06-01

    Stroke is the leading cause of adult disability. The past decade has seen advances in basic science research of neural repair in stroke. The brain forms new connections after stroke, which have a causal role in recovery of function. Brain progenitors, including neuronal and glial progenitors, respond to stroke and initiate a partial formation of new neurons and glial cells. The molecular systems that underlie axonal sprouting, neurogenesis, and gliogenesis after stroke have recently been identified. Importantly, tractable drug targets exist within these molecular systems that might stimulate tissue repair. These basic science advances have taken the field to its first scientific milestone; the elemental principles of neural repair in stroke have been identified. The next stages in this field involve understanding how these elemental principles of recovery interact in the dynamic cellular systems of the repairing brain. Emergent principles arise out of the interaction of the fundamental or elemental principles in a system. In neural repair, the elemental principles of brain reorganization after stroke interact to generate higher order and distinct concepts of regenerative brain niches in cellular repair, neuronal networks in synaptic plasticity, and the distinction of molecular systems of neuroregeneration. Many of these emergent principles directly guide the development of new therapies, such as the necessity for spatial and temporal control in neural repair therapy delivery and the overlap of cancer and neural repair mechanisms. This review discusses the emergent principles of neural repair in stroke as they relate to scientific and therapeutic concepts in this field. Ann Neurol 2016;79:895-906. PMID:27043816

  2. Comparison of ultrasound and optical coherence tomography techniques for evaluation of integrity of spontaneously repaired horse cartilage.

    Science.gov (United States)

    Virén, T; Huang, Y P; Saarakkala, S; Pulkkinen, H; Tiitu, V; Linjama, A; Kiviranta, I; Lammi, M J; Brünott, A; Brommer, H; Van Weeren, R; Brama, P A J; Zheng, Y P; Jurvelin, J S; Töyräs, J

    2012-04-01

    The aim of this study was to compare sensitivity of ultrasound and optical coherence tomography (OCT) techniques for the evaluation of the integrity of spontaneously repaired horse cartilage. Articular surfaces of horse intercarpal joints, featuring both intact tissue and spontaneously healed chondral or osteochondral defects, were imaged ex vivo with arthroscopic ultrasound and laboratory OCT devices. Quantitative ultrasound (integrated reflection coefficient (IRC), apparent integrated backscattering coefficient (AIB) and ultrasound roughness index (URI)) and optical parameters (optical reflection coefficient (ORC), optical roughness index (ORI) and optical backscattering (OBS)) were determined and compared with histological integrity and mechanical properties of the tissue. Spontaneously healed tissue could be quantitatively discerned from the intact tissue with ultrasound and OCT techniques. Furthermore, several significant correlations (p < 0.05) were detected between ultrasound and OCT parameters. Superior resolution of OCT provided a more accurate measurement of cartilage surface roughness, while the ultrasound backscattering from the inner structures of the cartilage matched better with the histological findings. Since the techniques were found to be complementary to each other, dual modality imaging techniques could provide a useful tool for the arthroscopic evaluation of the integrity of articular cartilage. PMID:22439802

  3. Arthroscopic Treatment of Acute Tibial Avulsion Fracture of the Posterior Cruciate Ligament Using the TightRope Fixation Device

    OpenAIRE

    Gwinner, Clemens; Kopf, Sebastian; Hoburg, Arnd; Haas, Norbert P; Jung, Tobias M.

    2014-01-01

    Avulsion fracture of the posterior cruciate ligament from its tibial insertion is a rare condition. Early surgical treatment has been regarded as necessary, but the optimal surgical technique remains unclear. The purpose of this technical note is to present a novel all-inside arthroscopic reconstruction technique for bony tibial avulsion fractures of the posterior cruciate ligament using the TightRope device (Arthrex, Naples, FL).

  4. Pelleted Bone Marrow Derived Mesenchymal Stem Cells Are Better Protected from the Deleterious Effects of Arthroscopic Heat Shock

    Science.gov (United States)

    Kalamegam, Gauthaman; Abbas, Mohammed; Gari, Mamdooh; Alsehli, Haneen; Kadam, Roaa; Alkaff, Mohammed; Chaudhary, Adeel; Al-Qahtani, Mohammed; Abuzenadah, Adel; Kafienah, Wael; Mobasheri, Ali

    2016-01-01

    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 cells 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 × 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 metabolic activity of the cells in suspensions (63.27% at 30 min) and increased metabolic activity in cell pellets (62.86% at 10 min and 68.57% at 20 min). hBMMSCs exposed to 37, 45, and 55°C for 120 s 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 regeneration. PMID

  5. 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...

  6. 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...

  7. 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

  8. 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...

  9. Does arthroscopic sub-acromial decompression really work for sub-acromial impingement syndrome: a cohort study

    OpenAIRE

    Bhattacharyya, Rahul; Edwards, Kimberley; Angus W Wallace

    2014-01-01

    Background Health Economists in Denmark have reported poor outcomes and low and delayed return to work for patients treated for Sub-Acromial Impingement syndrome (SAIS) by Arthroscopic Sub-Acromial Decompression (ASAD). In this setting it is important to evaluate outcomes following this commonly performed operation to justify undertaking it on our patients. The purpose of the study was to evaluate the effectiveness of ASAD for patients with SAIS and correlate clinical outcome with rate of ret...

  10. A case of intra-articular ganglion cysts of the knee joint: correlation between arthroscopic and magnetic resonance imaging

    OpenAIRE

    Kodaira, Sayaka; Nakajima, Takahito; Takahashi, Ryosuke; Moriya, Shingo; Nakagawa, Tomoyuki; Ohtake, Hidenori; Tsushima, Yoshito

    2016-01-01

    Background Intra-articular ganglion cysts of the knee are rare. Here we report a case of an arthroscopically confirmed ganglion cyst arising from the posterior cruciate ligament (PCL) along with preoperative magnetic resonance imaging (MRI) findings. Case presentation A 39-year-old female admitted a hospital with left knee pain with flexion and extension. MRI revealed a cystic lesion along the PCL. The lesion exhibited slight but homogeneous hyperintensity on T1 weighted images. Thin septals ...

  11. Primary flexor enthesopathy of the canine elbow: imaging and arthroscopic findings in 8 dogs with discrete radiographic changes

    OpenAIRE

    Van Ryssen, Bernadette; de Bakker, Evelien; Baumlin, Yseult; Samoy, Yves; Van Vynckt, Delphine; Gielen, Ingrid; Ducatelle, Richard; van Bree, Henri

    2012-01-01

    Objective: To describe the radiographic, ultrasonographic, computed tomography (CT), magnetic resonance imaging (MRI), and arthroscopic findings in eight dogs with elbow lameness caused by primary flexor enthesopathy. Study design: Clinical study. Animals: Eight client-owned dogs. Methods: In all dogs, lameness was localized to the elbow by clinical examination. Radiographic examination, ultrasound, CT and MRI were performed prior to arthroscopy. In seven dogs, surgical treatment ...

  12. A comparative study between use of arthroscopic lavage and arthrocentesis of temporomandibular joint based on computational fluid dynamics analysis.

    Directory of Open Access Journals (Sweden)

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

    Science.gov (United States)

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

    2015-01-01

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

  14. 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.

  15. INGUINAL HERNIA REPAIR - ACTUAL STATUS

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    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.

  16. 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...

  17. Road Repair Deficit Reduction

    OpenAIRE

    Astrīda Rijkure

    2012-01-01

    Dissertation Annotation. The aim of the dissertation is to explore resource allocation problems for motor roads, reveal positive aspects and drawbacks in road maintenance and resource allocation scheme, as well as elaborate proposals for decreasing the deficit of motor road repairs in Latvia. The paper is composed in three large sections, according to the tasks. In the first section the Author considers number of basic issues related to the meaning of the motor transport ...

  18. Biomaterials for tendon repair

    OpenAIRE

    Rupal Mehta

    2008-01-01

    Electrospinning biomaterials for tendon repair A single bundle of electrospun submicron polycaprolactone fibres. The team at The University of Manchester believes the material could aid regeneration in tendons. Scientists at The University of Manchester, UK, are investigating the use of electrospun polycaprolactone nanofibres to regenerate damaged tendons. Because the bundle of fibres replicates the morphology of tendon tissue, researchers envisage that the synthetic structure will...

  19. 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...

  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. [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

  2. 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

  3. 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

  4. Preventing hypothermia in elective arthroscopic shoulder surgery patients: a protocol for a randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Duff Jed

    2012-07-01

    Full Text Available Abstract Background Patients having arthroscopic shoulder surgery frequently experience periods of inadvertent hypothermia. This common perioperative problem has been linked to adverse patient outcomes such as myocardial ischaemia, surgical site infection and coagulopathy. International perioperative guidelines recommend patient warming, using a forced air warming device, and the use of warmed intraoperative irrigation solutions for the prevention of hypothermia in at-risk patient groups. This trial will investigate the effect of these interventions on patients’ temperature, thermal comfort, and total recovery time. Method/Design The trial will employ a randomised 2 x 2 factorial design. Eligible patients will be stratified by anaesthetist and block randomised into one of four groups: Group one will receive preoperative warming with a forced air warming device; group two will receive warmed intraoperative irrigation solutions; group three will receive both preoperative warming and warmed intraoperative irrigation solutions; and group four will receive neither intervention. Participants in all four groups will receive active intraoperative warming with a forced air warming device. The primary outcome measures are postoperative temperature, thermal comfort, and total recovery time. Primary outcomes will undergo a two-way analysis of variance controlling for covariants such as operating room ambient temperature and volume of intraoperative irrigation solution. Discussion This trial is designed to confirm the effectiveness of these interventions at maintaining perioperative normothermia and to evaluate if this translates into improved patient outcomes. Australian New Zealand Clinical Trials Registry number ACTRN12610000591055

  5. 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

  6. 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

  7. 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.)

  8. 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.

  9. Patients with shoulder impingement remain satisfied 6 years after arthroscopic subacromial decompression

    Science.gov (United States)

    2011-01-01

    Background Although arthroscopic subacromial decompression (ASD) is a common procedure for treatment of shoulder impingement, few long term results have been published. In this prospective study, we determined whether the high degree of patient satisfaction at 6 months postoperatively reported by us earlier remained at the 6-year follow-up. Patients and methods We originally reported high patient satisfaction 6 months after ASD for shoulder impingement in 50 prospectively studied patients using the Disability of the Arm Shoulder and Hand questionnaire (DASH) and the Visual Analog Scale (VAS). Patients with associated shoulder disorders were excluded. The surgeons were experienced shoulder arthroscopists. 6 years after surgery, the DASH questionnaire and the VAS were sent to these 50 patients. 2 patients had other medical problems of the upper extremity that affected the DASH and VAS scores, 1 patient was lost to follow-up, and another refused to participate. Thus, 46 patients with a mean age of 55 (33–78) years were included in this 6-year evaluation. Results The considerable improvement in both the DASH score and the VAS that was observed 6 months after surgery persisted or had even improved 6 years after surgery. Interpretation Properly selected patients with shoulder impingement treated with ASD remain satisfied 6 years after surgery. PMID:21999621

  10. 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.)

  11. 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)

  12. 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.

  13. [Arthroscopically assisted techniques for treatment of acute and chronic acromioclavicular joint injuries].

    Science.gov (United States)

    Braun, S; Imhoff, A B; Martetschläger, F

    2015-05-01

    Acute and chronic acromioclavicular (AC) joint dislocation is frequently encountered in the routine clinical practice. This injury can lead to significant impairment of shoulder girdle function. Therapy based on the severity of injury is recommended to re-establish correct shoulder function. The static radiographic Rockwood classification is used to define the degree of dislocation but the clinical aspects and functional x-ray imaging of horizontal AC joint instability should also be considered for selection of the appropriate procedure. Rockwood grades I and II injuries are treated non-operatively with early functional exercise. The approach for Rockwood grade III injuries should be individual and patient-specific, with non-surgical procedures for low functional requirement patients with a high risk for surgical interventions. For patients with high demands on shoulder function surgery is recommended. A detailed diagnostic assessment frequently reveals Rockwood grade III injuries to be type IV injuries. Rockwood types IV and V AC joint dislocations require surgery for sustained stability. Treatment of acute injuries is recommended within 1-3 weeks after trauma but there is no clear evidence of a cut-off for the presence of chronic injuries. Various surgical techniques have been described in the literature. This article presents an arthroscopically assisted technique that addresses both vertical and horizontal instability of the AC joint. PMID:25964020

  14. 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.

  15. 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

  16. Intraoral repair of cosmetic restorations.

    Science.gov (United States)

    Denehy, G; Bouschlicher, M; Vargas, M

    1998-10-01

    The longevity of porcelain and composite resin restorations can often be prolonged by using sound principles, up-to-date materials, and judicious attention to repair when fracture problems arise. Careful case selection and correct usage of surface treatment agents, followed by the use of a quality bonding system and restorative materials, can result in a repair that exhibits excellent retention and natural color blending. This article outlines procedures and materials to repair both resin composite and porcelain intraorally. PMID:9891653

  17. 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......, in which MMR proteins are required for mutagenesis rather than for its prevention....

  18. Accelerator as a repairable system

    International Nuclear Information System (INIS)

    An accelerator is a prime example of a repairable system which is the type of device that can be restored to a fully operational condition via a process of repair other than replacement of the entire system. Since repairable systems can fail two or more times, the analysis of their reliability focuses on predicting the trends in the pattern of failures and repairs rather than the time to first failure. Thus, it needs to focus on the underlying random processes rather than the probability distribution function of the component failures. This paper summarises the analysis methods available today and proposes an approach to development of a simulation. (author)

  19. 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

  20. 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

  1. 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

  2. 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

  3. 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.

  4. COMPARATIVE ANALYSIS ON THE RESULT FOR ARTHROSCOPIC ROTATOR CUFF SUTURE BETWEEN SMOKING AND NON-SMOKING PATIENTS

    Science.gov (United States)

    Almeida, Alexandre; Valin, Márcio Rangel; Zampieri, Rodrigo; Almeida, Nayvaldo Couto de; Roveda, Gilberto; Agostini, Ana Paula

    2015-01-01

    Objective: To comparatively analyze the results from arthroscopic rotator cuff suture between smoking and non-smoking patients. Methods: A group of 286 patients who underwent arthroscopic suturing of primary rotator cuff injuries between June 12, 2002, and May 14, 2008, was analyzed. The patients included in the study were evaluated using the UCLA scale, with a minimum follow-up of 12 months and average of 56.52 months. The variables studied were age, sex, side operated, dominance, profile of cigarette use and UCLA index. Results: This study evaluated a total of 205 patients. Mean age (p = 0.289) and sex (p = 0.124) were analyzed statistically between the smoking and non-smoking patients and the two groups were considered to be similar. The average UCLA score for the non-smoking patients (143) was 34 (32 to 35). The average UCLA score for the smoking patients (51) was 33 (29 to 35). There was no statistically significant difference in UCLA score (p = 0.123) between the smoking and non-smoking patients. For the purposes of statistical analysis, we grouped the small and medium tears (107) and compared these with the large and extensive tears (80), between smokers and non-smokers. There was no statistically significant difference using the Mann-Whitney test regarding the small and medium tears (p = 818). There was a statistically significant difference using the Mann-Whitney test regarding the large and extended tears, between the smoking and non-smoking patients, such that the non-smokers showed better UCLA scores (p = 0.038). Conclusion: The results from arthroscopic suturing of large and extensive rotator cuff injuries are inferior among smoking patients. PMID:27027006

  5. 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.

  6. 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 ...

  7. Notes on partial conjugation

    OpenAIRE

    Fang, Chuying; He, Xuhua

    2011-01-01

    In this notes, we will give an exposition of some results on the method of partial conjugation action. We first discuss the partial conjugation action of a parabolic subgroup of a Coxeter group. We then discuss some applications to Lusztig's $G$-stable pieces and its affine generalization. We also discuss some recent work on the $\\s$-conjugacy classes of loop groups and affine Deligne-Lusztig varieties.

  8. Industrial motor repair in the United States

    Energy Technology Data Exchange (ETDEWEB)

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

    1994-09-01

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

  9. 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.

  10. 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

  11. 关节镜下治疗创伤复发性Bankart损伤疗效分析%Clinical curative effect of the arthroscopic reconstruction for recurrent anterior dislocation of the shoulder

    Institute of Scientific and Technical Information of China (English)

    李彦林; 王国梁; 何川; 李建; 郑家礼; 陈广超; 李松; 余洋

    2014-01-01

    dislocation of the shoulder joint. With the development and popularization of the arthroscopic technique,shoulder arthroscopic surgery in the treatment of recurrent anterior dislocation of the shoulder joint has been adopted by increasing surgeons.From June 2010 to April 2014,60 patients of recurrent anterior shoulder dislocation were treated arthroscopically with metallic suture anchor Bankart repair to explore its clinical efficacy. Methods Clinical data:From June of 2010 to April of 2014,sixty patients in our hospital were treated with arthroscopic reconstruction for Bankart inj ury of recurrent anterior dislocation of the shoulder. The patients were followed up for 10~38 months and the mean time was 26.6 months.Their ages ranged from 15 to 45 years with an average of 29 years.Each of 60 cases had a unidirectional instability of anterior shoulder,and the average number of dislocation before surgery was 6 .5 times (2-17 times).Suture anchor was applied for reconstruction of Bankart injury.ASES score and Constant-Murley score were adopted for the functional assessment during follow-ups. The postoperative recovery time of shoulder function was 6 weeks without redislocation in each case. Complete rotator cuff tear,subacromial impingement syndrome,etc.were excluded from this group of patients.Imaging examination:X-ray films of anteroposterior view,lateral view and supraspinatus outlet view,CT scanning,MRI and CT three-dimensional reconstruction with humeral head removed were done preoperatively.No obvious bone defect was shown on preoperative X-ray films,no definite bony Bankart inj ury was revealed on CT three-dimensional reconstruction, and all MRI showed hyperintense between anterior labrum and glenoid rim with 3 cases of glenoid labrum disappeared. Operative methods:After successful general anesthesia,the patient was placed in lateral position. Every 3000 ml saline for flushing purpose was added with 1 ml of 0.1% epinephrine,and the pressure of adjustable water pump was

  12. 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)

  13. 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

  14. 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

  15. Repairing leaks in casings

    Energy Technology Data Exchange (ETDEWEB)

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

    1992-06-23

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

  16. 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.

  17. 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

  18. 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

  19. 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

  20. 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.

  1. Reward optimization of a repairable system

    International Nuclear Information System (INIS)

    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

  2. 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.

  3. How to repair an episiotomy.

    Science.gov (United States)

    Steen, Mary; Cummins, Bernie

    2016-02-17

    Rationale and key points Skilful repair of an episiotomy is an important aspect of maternal health care. It is essential that midwives and doctors have the knowledge and skills to undertake this procedure in a safe and effective manner. ▶ An episiotomy should be repaired promptly to reduce blood loss and prevent infection. ▶ Repair of an episiotomy is undertaken in three stages: repair of the vaginal mucosa, repair of the muscle layer and repair of the skin layer. ▶ Adequate pain relief should be provided before suturing. Reflective activity Clinical skills articles can help update your practice and ensure it remains evidence based. Apply this article to your practice. Reflect on and write a short account of: 1. Why a rectal examination is recommended before and following repair of an episiotomy. 2. What you would do to improve your suturing skills. 3. The factors that may prevent or delay an episiotomy from healing. Subscribers can upload their reflective accounts at rcni.com/portfolio . PMID:26884039

  4. 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

  5. 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.

  6. Methanol partial oxidation reformer

    Science.gov (United States)

    Ahmed, Shabbir; Kumar, Romesh; Krumpelt, Michael

    1999-01-01

    A partial oxidation reformer comprising a longitudinally extending chamber having a methanol, water and an air inlet and an outlet. An igniter mechanism is near the inlets for igniting a mixture of methanol and air, while a partial oxidation catalyst in the chamber is spaced from the inlets and converts methanol and oxygen to carbon dioxide and hydrogen. Controlling the oxygen to methanol mole ratio provides continuous slightly exothermic partial oxidation reactions of methanol and air producing hydrogen gas. The liquid is preferably injected in droplets having diameters less than 100 micrometers. The reformer is useful in a propulsion system for a vehicle which supplies a hydrogen-containing gas to the negative electrode of a fuel cell.

  7. Arthroscopically assisted autologous osteochondral transplantation for osteochondral lesions of the talar dome: an MRI and clinical follow-up study.

    Science.gov (United States)

    Assenmacher, J A; Kelikian, A S; Gottlob, C; Kodros, S

    2001-07-01

    Osteochondral Lesions of the Talar Dome (OLT) are common problems encountered in orthopedics. Although the etiology remains uncertain, a myriad of treatment options exists. The authors describe arthroscopically assisted autologous osteochondral graft (OCG) transplantation procedures in the treatment of unstable OLTs in nine patients. The patients underwent standard preoperative MRI examination to assess fragment stability (using De Smet criteria for stability). Intraoperative arthroscopy was used to correlate the preoperative MRI assessment (using Cheng/Ferkel grading). After transplantation procedures, MRI (using De Smet criteria for stability) assessed graft incorporation for stability at an average of 9.3 months after the procedure. Preoperative MRI correlated highly with arthroscopic findings of OLT instability (sensitivity = 1.0). This has been demonstrated in the current orthopedic literature. The post transplantation MRI demonstrated stable graft osteointegration by De Smet criteria in all patients. Postoperative visual analogue pain scales showed significant improvement from preoperative assessment. Postoperative AOFAS Ankle-Hindfoot scores averaged 80.2 (S.D. +/- 18.9). Our favorable early results and those of other authors using similar techniques may validate OCG transplantation as a viable alternative for treating unstable osteochondral defects in the talus that are refractive to more commonly used surgical techniques. PMID:11503978

  8. Three Tesla MRI for the diagnosis of meniscal and anterior cruciate ligament pathology: a comparison to arthroscopic findings

    International Nuclear Information System (INIS)

    Aim: To assess the accuracy of 3 T magnetic resonance imaging (MRI) in the evaluation of meniscal and anterior cruciate ligament (ACL) injury. Materials and methods: Sixty-one consecutive patients were identified who were referred for evaluation of suspected intra-articular pathology with a 3 T MRI and who, subsequently, underwent an arthroscopic procedure of the knee were included for the study. Two musculoskeletal radiologists interpreted the images. The sensitivity, specificity, positive predictive value, and negative predictive value were then calculated for the MRI versus the arthroscopic findings as a reference standard. Results: The sensitivity and specificity for the overall detection of meniscal tears in this study was 84 and 93%, respectively. The results for the medial meniscus separately were 91 and 93% and for the lateral 77 and 93%. The evaluation of ACL integrity was 100% sensitive and specific. The meniscal tear type was correctly identified in 75% of cases and its location in 94%. Conclusion: This study demonstrates good results of 3 T MRI in the evaluation of the injured knee. Caution should still be given to the interpretation on MRI of a lateral meniscus tear, and it is suggested that the standard diagnostic criteria of high signal reaching the articular surface on two consecutive image sections be adhered to even at these higher field strengths

  9. Comparison of the postoperative analgesic effects of naproxen sodium and naproxen sodium-codeine phosphate for arthroscopic meniscus surgery

    Directory of Open Access Journals (Sweden)

    Cagla Bali

    2016-04-01

    Full Text Available ABSTRACT BACKGROUND AND OBJECTIVES: Nonsteroidal anti-inflammatory drugs (NSAIDs are frequently used to control arthroscopic pain. Addition of oral effective opioid "codeine" to NSAIDs may be more effective and decrease parenteral opioid consumption in the postoperative period. The aim of this study was to compare the efficacy and side effects of naproxen sodium and a new preparation naproxen sodium-codeine phosphate when administered preemptively for arthroscopic meniscectomy. METHODS: Sixty-one patients were randomized into two groups to receive either oral naproxen sodium (Group N or naproxen sodium-codeine phosphate (Group NC before surgery. The surgery was carried out under general anesthesia. Intravenous meperidine was initiated by patient-controlled analgesia (PCA for all patients. The primary outcome measure was pain score at the first postoperative hour assessed by the Visual Analogue Scale (VAS. Sedation assessed by Ramsey Sedation Scale, first demand time of PCA, postoperative meperidine consumption, side effects and hemodynamic data were also recorded. RESULTS: The groups were demographically comparable. Median VAS scores both at rest and on movement were significantly lower in Group NC compared with Group N, except 18th hour on movement (p 0.05. CONCLUSIONS: The combination of naproxen sodium-codeine phosphate provided more effective analgesia than naproxen sodium and did not increase side effects.

  10. Three Tesla MRI for the diagnosis of meniscal and anterior cruciate ligament pathology: a comparison to arthroscopic findings

    Energy Technology Data Exchange (ETDEWEB)

    Sampson, M.J. [Department of Radiology Sports Surgery Clinic, Santry Demesne, Dublin (Ireland)], E-mail: allymattsampson@hotmail.com; Jackson, M.P.; Moran, C.J.; Moran, R. [Department of Orthopaedics, Sports Surgery Clinic, Santry Demesne, Dublin (Ireland); Eustace, S.J. [Department of Radiology Sports Surgery Clinic, Santry Demesne, Dublin (Ireland); Shine, S. [Department of Radiology, Cappagh Hospital, Finglas, Dublin (Ireland)

    2008-10-15

    Aim: To assess the accuracy of 3 T magnetic resonance imaging (MRI) in the evaluation of meniscal and anterior cruciate ligament (ACL) injury. Materials and methods: Sixty-one consecutive patients were identified who were referred for evaluation of suspected intra-articular pathology with a 3 T MRI and who, subsequently, underwent an arthroscopic procedure of the knee were included for the study. Two musculoskeletal radiologists interpreted the images. The sensitivity, specificity, positive predictive value, and negative predictive value were then calculated for the MRI versus the arthroscopic findings as a reference standard. Results: The sensitivity and specificity for the overall detection of meniscal tears in this study was 84 and 93%, respectively. The results for the medial meniscus separately were 91 and 93% and for the lateral 77 and 93%. The evaluation of ACL integrity was 100% sensitive and specific. The meniscal tear type was correctly identified in 75% of cases and its location in 94%. Conclusion: This study demonstrates good results of 3 T MRI in the evaluation of the injured knee. Caution should still be given to the interpretation on MRI of a lateral meniscus tear, and it is suggested that the standard diagnostic criteria of high signal reaching the articular surface on two consecutive image sections be adhered to even at these higher field strengths.

  11. Arthroscopic assistance does not improve the functional or radiographic outcome of unstable intra-articular distal radial fractures treated with a volar locking plate: a randomised controlled trial.

    Science.gov (United States)

    Yamazaki, H; Uchiyama, S; Komatsu, M; Hashimoto, S; Kobayashi, Y; Sakurai, T; Kato, H

    2015-07-01

    There is no consensus on the benefit of arthroscopically assisted reduction of the articular surface combined with fixation using a volar locking plate for the treatment of intra-articular distal radial fractures. In this study we compared the functional and radiographic outcomes of fluoroscopically and arthroscopically guided reduction of these fractures. Between February 2009 and May 2013, 74 patients with unilateral unstable intra-articular distal radial fractures were randomised equally into the two groups for treatment. The mean age of these 74 patients was 64 years (24 to 92). We compared functional outcomes including active range of movement of the wrist, grip strength and Disabilities of the Arm, Shoulder, and Hand scores at six and 48 weeks; and radiographic outcomes that included gap, step, radial inclination, volar angulation and ulnar variance. There were no significant differences between the techniques with regard to functional outcomes or radiographic parameters. The mean gap and step in the fluoroscopic and arthroscopic groups were comparable at 0.9 mm (standard deviation (SD) 0.7) and 0.7 mm (SD 0.7) and 0.6 mm (SD 0.6) and 0.4 mm (SD 0.5), respectively; p = 0.18 and p = 0.35). Arthroscopic reduction conferred no advantage over conventional fluoroscopic guidance in achieving anatomical reduction of intra-articular distal radial fractures when using a volar locking plate. PMID:26130352

  12. 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...

  13. 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.

  14. 关节镜诊治关节内桡骨远端粉碎性骨折的软组织损伤%Arthroscopic assessment of soft tissue injuries in comminuted intra-articular fractures of the distal radius

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    Objective To diagnose and evaluate soft tissue injuries in intra-articular fractures of the distal radius using arthroscopy. Methods Twenty young patients with displaced intra-articular fractures of distal radius were recruited in this prospective study. Three AO C2 and 17 C3 fractures were included. After arthroscopic examination fractures of distal radius were treated by external fixation with limited internal fixation or open plate fixation.Results Triangular fibrocartilage complex (TFCC) injury was found in 18 patients (90%) . Most were isolated Palmer type 1D injuries (67 %). Scapho-lunate ligament injury was found in two patients: one partial tear (grade Ⅱ) and one complete tear (grade Ⅲ). Follow-ups ranged from 6 to 18 months. At the last follow-up, wrist function was excellent in one patient (6%), good in eight(44%) and fair in 11 (50%). Conclusion TFCC injuries are common in intra-articular fractures of the distal radius while injuries to scapho-luuate ligament are uncommon.

  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. 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 wher...

  17. Partial Remission Definition

    DEFF Research Database (Denmark)

    Andersen, Marie Louise Max; Hougaard, Philip; Pörksen, Sven;

    2014-01-01

    OBJECTIVE: To validate the partial remission (PR) definition based on insulin dose-adjusted HbA1c (IDAA1c). SUBJECTS AND METHODS: The IDAA1c was developed using data in 251 children from the European Hvidoere cohort. For validation, 129 children from a Danish cohort were followed from the onset of...

  18. Conservative partially hyperbolic dynamics

    OpenAIRE

    Wilkinson, Amie

    2010-01-01

    We discuss recent progress in understanding the dynamical properties of partially hyperbolic diffeomorphisms that preserve volume. The main topics addressed are density of stable ergodicity and stable accessibility, center Lyapunov exponents, pathological foliations, rigidity, and the surprising interrelationships between these notions.

  19. Partial Participation Revisited.

    Science.gov (United States)

    Ferguson, Dianne L.; Baumgart, Diane

    1991-01-01

    This article reanalyzes the principle of partial participation in integrated educational programing for students with severe or profound disabilities. The article presents four "error patterns" in how the concept has been used, some reasons why such error patterns have occurred, and strategies for avoiding these errors. (Author/JDD)

  20. 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

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

    Science.gov (United States)

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

    2016-01-01

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

  2. 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.

  3. Innovative repair of subsidence damage

    International Nuclear Information System (INIS)

    In order to improve handling of subsidence damages the Illinois Mine Subsidence Insurance Fund supported the development of novel cost-effective methods of repair. The research in developing the repairs was directed towards the most common and costly damages that had been observed. As a result repair techniques were designed for structurally cracked foundations in the tension zone; structurally cracked foundations in the compression zone; and damaged or undamaged tilted foundations. When appropriate the postulated methods would result in: 1. significant cost savings (over conventional procedures); 2. a structural capacity greater than when the foundation was uncracked; and 3. an aesthetic appeal. All the postulated repair methodologies were laboratory and/or field tested. This paper will summarize the essentials of each technique developed and the test results

  4. Nucleotide excision repair in humans.

    Science.gov (United States)

    Spivak, Graciela

    2015-12-01

    The demonstration of DNA damage excision and repair replication by Setlow, Howard-Flanders, Hanawalt and their colleagues in the early 1960s, constituted the discovery of the ubiquitous pathway of nucleotide excision repair (NER). The serial steps in NER are similar in organisms from unicellular bacteria to complex mammals and plants, and involve recognition of lesions, adducts or structures that disrupt the DNA double helix, removal of a short oligonucleotide containing the offending lesion, synthesis of a repair patch copying the opposite undamaged strand, and ligation, to restore the DNA to its original form. The transcription-coupled repair (TCR) subpathway of NER, discovered nearly two decades later, is dedicated to the removal of lesions from the template DNA strands of actively transcribed genes. In this review I will outline the essential factors and complexes involved in NER in humans, and will comment on additional factors and metabolic processes that affect the efficiency of this important process. PMID:26388429

  5. Cleft lip and palate repair

    Science.gov (United States)

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

  6. Betonreparationers holdbarhed (Durability of Concrete Repairs)

    DEFF Research Database (Denmark)

    Brimnes, Eydbjørn; Dali, Bogi í; Larsen, Erik Stoklund; Nielsen, Anders

    1999-01-01

    Concrete repairs on 11 pillars on bridges built in the sixties and repaired 8 to 9 years ago have been examined. Especially the chloride penetration in the repair concrete have been measured. Chloride penetration in the repair concrete is much lower than in the original concrete....

  7. 关节镜下四骨道双束固定治疗急性肩锁关节Rockwood Ⅴ型脱位%Arthroscopic fixation in the treatment of Rockwood Ⅴ acute acromioclavicular joint dislocation

    Institute of Scientific and Technical Information of China (English)

    陆伟; 王大平; 朱伟民; 欧阳侃; 柳海峰; 彭亮权; 李皓; 冯文哲

    2014-01-01

    Background Treatment methods for acromioclavicular joint dislocation of Rockwood type V are numerous.The commonly used is the open surgery with large trauma (by clavicular hook plate fixation).In recent years,some scholars use clavicle-coracoid screws fixation method under arthroscopy,but the screws need to be removed after 6 weeks; there are also scholars using arthroscopic double Endobutton loops single bundle fixation method with good effect,but they found suture rupture between the Endobutton,redislocation or fracture,bone absorption under the loops in some patients. This article investigates the method of arthroscopic procedure with four-tunnel quadruple double-bundle Endobutton double-bundle fixation via self-designed positioning apparatus in the treatment of acute acromioclavicular joint (ACJ)Rockwood Ⅴ degree dislocations and their short-term therapeutic effect.Methods (1)Patient selection:12 patients (9 male and 3 female)with acute acromioclavicular joint dislocation of Rockwood type V were selected from October 2010 to June 2013. Their average age is 28.2 years.with sports injury in 10 cases and fall injury in 2 cases.All patients received surgical repair within 2 weeks after injury.The operations were performed by the same senior surgeon.(2)Preoperative bone tunnel positioning design:All patients had CT scan in the position of 90°internal rotating of bilateral shoulder joint (palm down).Measure the angle of scapular long axis and coronal section (A)separately,make the line in the coracoid neck parallel to the long axis of scapula (S),and then measure the width of parallel line in the part of coracoid neck (P).The midpoint of the coracoid neck is the center between the two preparatively drilled bone tunnels.Make the cross line vertical to line P,and the bone tunnels are located in the I and II quadrant.The distance between two bone tunnels is 6 mm.(3 )Surgical techniques:According to the data of preoperative measurement of bone tunnel,the self

  8. 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...

  9. 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...

  10. 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.

  11. Scarf Repair of Composite Laminates

    Directory of Open Access Journals (Sweden)

    Xie Zonghong

    2016-01-01

    Full Text Available The use of composite materials, such as carbon-fiber reinforced plastic (CFRP composites, aero-structures has led to an increased need of advanced assembly joining and repair technologies. Adhesive bonded repairs as an alternative to recover full or part of initial strength were investigated. Tests were conducted with the objective of evaluating the effectiveness of techniques used for repairing damage fiber reinforced laminated composites. Failure loads and failure modes were generated and compared with the following parameters: scarf angles, roughness of grind tool and number of external plies. Results showed that scarf angle was the critical parameter and the largest tensile strength was observed with the smallest scarf angle. Besides, the use of external plies at the outer surface could not increase the repairs efficiency for large scarf angle. Preparing the repair surfaces by sanding them with a sander ranging from 60 to 100 grit number had significant effect on the failure load. These results allowed the proposal of design principles for repairing CFRP structures.

  12. Model Repair via SAT Solvers

    CERN Document Server

    Attie, Paul

    2007-01-01

    We consider the following \\emph{model repair problem}: given a finite Kripke structure $M$ and a specification formula $\\phi$ in some modal or temporal logic, determine if $M$ contains a substructure $M'$ (with the same initial state) that satisfies $\\phi$. Thus, $M$ can be ``repaired'' to satisfy the specification $\\phi$ by deleting some transitions. Model repair can be used for automated debugging of finite-state shared memory concurrent programs. Given a program $P$, generate its transition graph $M$, repair $M$ with respect to the specification, and then extract a correct concurrent program $P'$ from the repaired model $M'$ by using the method of \\cite{AE96,AE01} to extract atomic read/write shared memory concurrent programs from Kripke structures. We show that model repair is NP-complete for CTL, and for any logic for which: (1) the model checking problem is in polynomial time, and (2) there is a polynomial time reduction from CTL to the logic. A notable example of such a logic is Alternating-Time Tempor...

  13. Base excision repair in sugarcane

    Directory of Open Access Journals (Sweden)

    Agnez-Lima Lucymara F.

    2001-01-01

    Full Text Available DNA damage can be induced by a large number of physical and chemical agents from the environment as well as compounds produced by cellular metabolism. This type of damage can interfere with cellular processes such as replication and transcription, resulting in cell death and/or mutations. The low frequency of mutagenesis in cells is due to the presence of enzymatic pathways which repair damaged DNA. Several DNA repair genes (mainly from bacteria, yeasts and mammals have been cloned and their products characterized. The high conservation, especially in eukaryotes, of the majority of genes related to DNA repair argues for their importance in the maintenance of life on earth. In plants, our understanding of DNA repair pathways is still very poor, the first plant repair genes having only been cloned in 1997 and the mechanisms of their products have not yet been characterized. The objective of our data mining work was to identify genes related to the base excision repair (BER pathway, which are present in the database of the Sugarcane Expressed Sequence Tag (SUCEST Project. This search was performed by tblastn program. We identified sugarcane clusters homologous to the majority of BER proteins used in the analysis and a high degree of conservation was observed. The best results were obtained with BER proteins from Arabidopsis thaliana. For some sugarcane BER genes, the presence of more than one form of mRNA is possible, as shown by the occurrence of more than one homologous EST cluster.

  14. Resultados do procedimento artroscópico de "remplissage" na luxação anterior recidivante do ombro Results from filling "remplissage" arthroscopic technique for recurrent anterior shoulder dislocation

    Directory of Open Access Journals (Sweden)

    Mauro Emilio Conforto Gracitelli

    2011-01-01

    Full Text Available OBJETIVO: Avaliar o resultado clínico da técnica de "remplissage" associada ao reparo da lesão de Bankart (BK para o tratamento da luxação anterior recidivante do ombro. MÉTODOS: Nove pacientes (10 ombros, com seguimento médio de 13,7 meses, apresentaram luxação traumática anterior recidivante do ombro. Todos tinham lesão de BK associada à lesão de Hill e Sachs (HS, com sinal do "encaixe". O defeito das lesões de HS foi medido e apresentava em média 17,3% (7,7% a 26,7% de perda óssea em relação ao diâmetro da cabeça do úmero. Todos foram submetidos ao reparo artroscópico da lesão de BK associado ao preenchimento ("remplissage" da lesão de HS pela tenodese do infraespinal. RESULTADOS: O escore de Rowe variou de 22,5 (10 a 45 no período pré-operatório para 80,5 (5 a 100 no período pós operatório (p OBJECTIVE: To evaluate the clinical result from the filling ("remplissage" technique in association with Bankart lesion repair for treating recurrent anterior shoulder dislocation. METHODS: Nine patients (10 shoulders, with a mean follow-up of 13.7 months, presented traumatic recurrent anterior shoulder dislocation. All of them had a Bankart lesion, associated with a Hill-Sachs lesion showing the "engaging" sign. The Hill-Sachs lesion defect was measured and showed an average bone loss of 17.3% (7.7% to 26.7% in relation to the diameter of the humeral head. All the cases underwent arthroscopic repair of the Bankart lesion, together with filling of the Hill-Sachs lesion by means of tenodesis of the infraspinatus. RESULTS: The Rowe score ranged from 22.5 (10 to 45 before the operation to 80.5 (5 to 100 after the operation (p < 0.001. The UCLA score ranged from 18.0 (8 to 29 to 31.1 (21 to 31 (p < 0.001. The measurements of external and internal rotation at abduction of 90º after the operation were 63.5º (45º to 90º and 73º (50º to 92º respectively. Two patients presented recurrence (one with dislocation and the other

  15. Can MRI distinguish between acute partial and complete anterior cruciate ligament tear?

    International Nuclear Information System (INIS)

    A study to elucidate the title problem was done. Subjects were 8 patients with partial anterior cruciate ligament (ACL) tear diagnosed by both MRI and arthroscopy within 6 weeks after trauma, 14 patients with complete ACL tear diagnosed similarly and 10 control patients with arthroscopically intact ACL. Proton density-and T2-weighted MRI imaging of the sagittal section of the knee was performed with 1.5 T magnets (Siemens Magnetom H15, Shimadzu SMT150GUX) by using a dedicated knee coil, with slice thickness of 4-5 mm and 14-16 cm field of view. The examination was done on the primary (discontinuity of low signal band, abnormal axis of the ligament and focal or diffuse increased signal intensity) and secondary (bone bruise, anterior translocation of the tibia and PCL curvature value) signs of ACL tear. In proton density-weighted sagittal images, it was found easy to distinguish acute partial ACL tear from normal ligament but not from complete ACL tear. In T2-weighted images, partial ACL tear was suggested to keep continuity of the ligament. (H.O.)

  16. Aging and DNA repair capability. [Review

    Energy Technology Data Exchange (ETDEWEB)

    Tice, R R

    1977-01-01

    A review of the literature on DNA repair processes in relation to aging is presented under the following headings: DNA repair processes; age-related occurrence of unrepaired DNA lesions; DNA repair capability as a function of age; tissue-specific DNA repair capability; acceleration of the aging process by exposure to DNA damaging agents; human genetic syndromes; and longevity and DNA repair processes. (HLW)

  17. 髌骨骨折关节镜下闭合复位内固定术后的康复训练%Rehabilitation exercises after closed reduction internal fixation of fracture of patella under arthroscope

    Institute of Scientific and Technical Information of China (English)

    朴成哲; 李培; 阿良; 王敏

    2003-01-01

    @@ INTRODUCTION Closed reduction internal fixation under arthroscope is performed from August, 2000 to April, 2001 and advanced domestic and foreign rehabilitation programs are combined to treat fracture of patella comprehensively, satisfying effects are achieved.

  18. Warden repair for superior sinus venosus atrial septal defect and anomalous pulmonary venous drainage in children: Anesthesia and transesophageal echocardiography perspectives

    OpenAIRE

    Neelam Aggarwal; Shrinivas Gadhinglajkar; Rupa Sreedhar; Baiju S Dharan; Keerthi Chigurupati; Saravana Babu

    2016-01-01

    Objective: Review of intraoperative anesthetic challenges and the role of transesophageal echocardiography in children with sinus venosus atrial septal defect and partial anomalous pulmonary venous drainage undergoing Warden repair. Design: A retrospective observational case series. Methodolgy: Pediatric patients who underwent Warden repair between October 2011-September 2015 were recruited. Their preoperative clinical details, anesthetic techniques, intraoperative TEE findings and postoperat...

  19. The XPB subunit of repair/transcription factor TFIIH directly interacts with SUG1, a subunit of the 26S proteasome and putative transcription factor.

    NARCIS (Netherlands)

    G. Weeda (Geert); M. Rossignol; R.A. Fraser; G.S. Winkler (Sebastiaan); W. Vermeulen (Wim); L.J. van 't Veer (Laura); L. Ma (Libin); J.H.J. Hoeijmakers (Jan); J-M. Egly (Jean-Marc)

    1997-01-01

    textabstractMutations in the basal transcription initiation/DNA repair factor TFIIH are responsible for three human disorders: xeroderma pigmentosum (XP), cockayne syndrome (CS) and trichothiodystrophy (TTD). The non-repair features of CS and TTD are thought to be due to a partial inactivation of th

  20. Partial transpose of permutation matrices

    OpenAIRE

    Hou, Qing-Hu; Mansour, Toufik; Severini, Simone

    2007-01-01

    The partial transpose of a block matrix M is the matrix obtained by transposing the blocks of M independently. We approach the notion of partial transpose from a combinatorial point of view. In this perspective, we solve some basic enumeration problems concerning the partial transpose of permutation matrices. More specifically, we count the number of permutations matrices which are equal to their partial transpose and the number of permutation matrices whose partial transpose is still a permu...