Due to a check-valve mechanism, synovial fluid accumulates, leading to the parameniscal manifestation of these cysts. The posteromedial portion of the knee often houses these components. Published literature details various repair techniques for decompression and subsequent repair. Employing arthroscopic open- and closed-door repair methods, an isolated intrameniscal cyst situated within an intact meniscus was treated.
The meniscal roots are indispensable for the meniscus to uphold its normal shock-absorbing ability. Without appropriate intervention for a meniscal root tear, the subsequent meniscal extrusion compromises the meniscus's function, thus potentially resulting in the development of degenerative arthritis. Meniscal root pathology treatment is increasingly trending towards preserving meniscal tissue and restoring the meniscus's anatomical connection. In active patients who have suffered acute or chronic injuries, without any notable osteoarthritis or misalignment, root repair may be indicated; however, not all patients are suitable candidates. Two repair methods, classified as direct fixation (suture anchor) and indirect fixation (transtibial pullout), have been documented. In the realm of root repair, the transtibial method stands out as the most prevalent technique. Sutures are introduced into the damaged meniscal root, then navigated through a tibial tunnel before being tied distally, completing the repair using this approach. To fix the meniscal root distally, our approach utilizes FiberTape (Arthrex) threads wound around the tibial tubercle, traversing a posterior transverse tunnel. The knots remain buried inside the tunnel, eliminating the requirement for metal buttons or anchors. Without the loosening of knots and tension typical of metal buttons, this method provides secure repair tension, thereby avoiding the irritation that metal buttons and knotted areas can cause to patients.
Anterior cruciate ligament graft fixation using suture button-based femoral cortical suspension constructs may enable fast and dependable stability. The decision to remove Endobutton is frequently debated. Current surgical approaches frequently fail to provide a direct view of the Endobutton(s), hindering its removal; the buttons are fully inverted, without any intervening soft tissues between the Endobutton and the femur. Through the lateral femoral portal, this technical note presents the endoscopic method for removing Endobuttons. Hardware removal is facilitated by this technique's capacity for direct visualization, enhancing the advantages of a less-invasive procedure.
High-velocity trauma frequently causes posterior cruciate ligament (PCL) tears, which are often associated with concurrent damage to other knee ligaments. Surgical management is generally recommended for individuals experiencing severe and multiligamentous posterior cruciate ligament injuries. Traditionally, PCL reconstruction has been the preferred course of action; however, arthroscopic primary PCL repair has experienced a resurgence in consideration recently for proximal tears exhibiting suitable tissue strength. Two technical problems are often encountered in current PCL repair techniques: the risk of suture abrasion or laceration during the stitching process, and the challenge of re-tensioning the ligament after its fixation using either suture anchors or ligament buttons. We present in this technical note the arthroscopic surgical procedure for primary repair of proximal PCL tears, incorporating a looping ring suture device (FiberRing) and an adjustable loop cortical fixation device (ACL Repair TightRope). The strategy behind this technique is to offer a minimally invasive way of maintaining the native PCL and avoiding the shortcomings prevalent in alternative arthroscopic primary repair techniques.
Surgical techniques for full-thickness rotator cuff repairs exhibit variability, contingent upon numerous factors, including the configuration of the tear, the detachment of soft tissues, the caliber of the tissues, and the degree of rotator cuff retraction. The technique described offers a repeatable method for managing tear patterns, characterized by a wider lateral tear but a smaller medial footprint. A single medial anchor, in conjunction with a knotless lateral-row technique, can address small tears, or two medial row anchors are needed for tears of moderate to large sizes. In this variant of the standard knotless double row (SpeedBridge) method, two medial row anchors are employed, one augmented with supplementary fiber tape, and an additional lateral row anchor is used to establish a triangular repair configuration, thereby expanding and fortifying the lateral row's footprint.
The Achilles tendon often ruptures in patients representing a wide spectrum of ages and activity levels. A comprehensive analysis of treatment options for these injuries is required, and the literature shows satisfactory results from both operative and non-operative procedures. Patient-specific decisions regarding surgical intervention must take into account the patient's age, projected athletic goals, and co-existing medical conditions. A novel, minimally invasive percutaneous technique for repairing the Achilles tendon has been introduced as a comparable alternative to the standard open surgery, thereby preventing the complications linked to extensive wound management. selleck kinase inhibitor Surgeons have, in many cases, been hesitant in implementing these strategies, due to inadequate visual acuity, questions regarding the durability of suture-tendon engagement, and the prospect of producing iatrogenic sural nerve damage. Within this Technical Note, a technique for minimally invasive Achilles tendon repair, employing high-resolution intraoperative ultrasound, is illustrated. This minimally invasive technique compensates for the visualization challenges often linked with percutaneous repair, thereby neutralizing its drawbacks.
Various techniques are employed for the repair of distal biceps tendons. Intramedullary unicortical button fixation's strength is notable, with minimal proximal radial bone reduction and a low probability of posterior interosseous nerve damage. A negative consequence of revision surgery can be the persistence of implants lodged in the medullary canal. This article details a novel method for revision distal biceps repair, initially utilizing intramedullary unicortical buttons, employing the original implants.
Post-traumatic peroneal tendon subluxation or dislocation results most often from damage to the superior peroneal retinaculum. Classic open surgeries frequently necessitate extensive soft-tissue dissection, posing a risk of peritendinous fibrous adhesions, sural nerve harm, compromised movement range, repetitive or prolonged peroneal tendon instability, and tendon inflammation. This Technical Note will delineate the specifics of endoscopic superior peroneal retinaculum reconstruction utilizing the Q-FIX MINI suture anchor. Minimally invasive endoscopic surgery, in this approach, boasts advantages including superior cosmetic results, reduced dissection of soft tissues, less postoperative pain, decreased peritendinous fibrosis, and lessened subjective tightness at the peroneal tendons. The Q-FIX MINI suture anchor's insertion, performed within a drill guide, helps preclude the capture of surrounding soft tissue.
Degenerative meniscal tears, including degenerative flaps and horizontal cleavage tears, are frequently observed in association with meniscal cysts as a subsequent complication. Although arthroscopic decompression with partial meniscectomy is currently deemed the gold standard for this affliction, three points of concern arise regarding this treatment. Degenerative damage situated inside the meniscus often co-occurs with meniscal cysts. Furthermore, if the lesion proves elusive, a check-valve mechanism becomes crucial, demanding a comprehensive meniscectomy. As a result, postoperative osteoarthritis stands as a recognized long-term effect of surgical interventions. A meniscal cyst's treatment originating from the inner rim of the meniscus is demonstrably ineffective and roundabout in addressing the pathological site, given that most such cysts are positioned at the perimeter of the meniscus. In conclusion, this report discusses the direct decompression of a large lateral meniscal cyst and the meniscus repair, employing an intrameniscal decompression approach. selleck kinase inhibitor To ensure meniscal preservation, this technique is both simple and appropriate.
Graft fixation sites on the greater tuberosity and superior glenoid, crucial for superior capsule reconstruction (SCR), present a risk for graft failure. selleck kinase inhibitor Fixation of the superior glenoid graft is challenging, primarily due to the restricted surgical field, the diminutive graft attachment zone, and the difficulties encountered in the suturing procedure. A surgical technique for managing irreparable rotator cuff tears, called SCR, leverages an acellular dermal matrix allograft and remnant tendon augmentation, in addition to a specific suture management method to avoid suture tangles, as detailed in this note.
Anterior cruciate ligament (ACL) injuries, a prevalent issue in orthopaedic treatment, are still associated with unsatisfactory outcomes in as much as 24% of all cases. Residual anterolateral rotatory instability (ALRI) following isolated anterior cruciate ligament (ACL) reconstruction has been attributed to unaddressed anterolateral complex (ALC) injuries, which have also been linked to increased graft failure rates. To ensure both anteroposterior and anterolateral rotational stability during ACL and ALL reconstruction, this article introduces a technique combining the advantages of anatomical placement with intraosseous femoral fixation.
The traumatic glenoid avulsion of the glenohumeral ligament (GAGL) is a contributing factor to the development of shoulder instability. Anterior shoulder instability is the most prevalent reported consequence of GAGL lesions, a rare shoulder pathology, and there are no current records implicating them in causing posterior shoulder instability.