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Basics of Shoulder Arthroscopy Part I: Beach-Chair Patient Positioning and Operating Room Setup 肩关节镜手术基础第一部分：沙滩椅式患者定位和手术室设置
IF 1.2
Arthroscopy Techniques Pub Date : 2024-10-01 DOI: 10.1016/j.eats.2024.103082
{"title":"Basics of Shoulder Arthroscopy Part I: Beach-Chair Patient Positioning and Operating Room Setup","authors":"","doi":"10.1016/j.eats.2024.103082","DOIUrl":"10.1016/j.eats.2024.103082","url":null,"abstract":"<div><div>A broad range of shoulder pathologies are treated with shoulder arthroscopy due to its minimally invasive nature. Mastering the fundamentals is critical for high-quality care; this includes patient positioning. Surgeons must consider the advantages and disadvantages of the 2 most prominent patient positions: lateral decubitus and beach chair. The beach-chair position offers an intuitive anatomic view with the advantage of shoulder maneuverability. Understanding the associated pitfalls related to patient hemodynamics; head, neck, and shoulder positioning; and protection of bony prominences can guide the operative care team to obtaining a safe position for the patient. The purpose of this Technical Note and video is to present and demonstrate a reproducible and teachable method for safely positioning a patient in the beach-chair position for shoulder arthroscopy, as well as to describe the associated advantages and disadvantages.</div></div>","PeriodicalId":47827,"journal":{"name":"Arthroscopy Techniques","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141280164","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Dynamic Anterior Glenohumeral Capsular Ligament Tensioning During Arthroscopic Shoulder Stabilization in Overhead-Throwing Athletes 高空投掷运动员在关节镜下稳定肩关节时的动态前盂盂肱关节囊韧带张力
IF 1.2
Arthroscopy Techniques Pub Date : 2024-10-01 DOI: 10.1016/j.eats.2024.103069
{"title":"Dynamic Anterior Glenohumeral Capsular Ligament Tensioning During Arthroscopic Shoulder Stabilization in Overhead-Throwing Athletes","authors":"","doi":"10.1016/j.eats.2024.103069","DOIUrl":"10.1016/j.eats.2024.103069","url":null,"abstract":"<div><div>Although the most common surgical treatment for traumatic anterior shoulder instability is arthroscopic Bankart repair (ABR), which has shown good postoperative results, a potential risk of postoperative external rotation deficit exists. For overhead-throwing athletes, recovery of postoperative range of motion during abduction and external rotation is essential to return to preinjury performance levels. We consider that the key to returning to play after ABR on the dominant side in overhead-throwing athletes is to simultaneously gain anterior stability and mobility of the shoulder. However, no gold standard method for determining the appropriate tension of the glenohumeral capsular ligaments in overhead-throwing athletes exists. This Technical Note presents the dynamic anterior glenohumeral capsular ligament tensioning in the abduction and external rotation positions during ABR for the dominant side in overhead-throwing athletes. We consider this surgical technique to be reliable for traumatic anterior instability of the dominant shoulder in athletes who wish to return to overhead-throwing sports.</div></div>","PeriodicalId":47827,"journal":{"name":"Arthroscopy Techniques","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141399504","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The Physics of Postless Hip Arthroscopy 无柱髋关节镜检查的物理学原理
IF 1.2
Arthroscopy Techniques Pub Date : 2024-10-01 DOI: 10.1016/j.eats.2024.103077
Austin E. Wininger M.D. , Matthew J. Kraeutler M.D. , Haley Goble M.H.A. , Justin Cho B.S. , Omer Mei-Dan M.D. , Joshua D. Harris M.D.
{"title":"The Physics of Postless Hip Arthroscopy","authors":"Austin E. Wininger M.D. ,&nbsp;Matthew J. Kraeutler M.D. ,&nbsp;Haley Goble M.H.A. ,&nbsp;Justin Cho B.S. ,&nbsp;Omer Mei-Dan M.D. ,&nbsp;Joshua D. Harris M.D.","doi":"10.1016/j.eats.2024.103077","DOIUrl":"10.1016/j.eats.2024.103077","url":null,"abstract":"<div><div>Hip arthroscopy is commonly performed to treat femoroacetabular impingement syndrome. A post-assisted arthroscopic hip preservation surgery approach provides joint distraction for central-compartment access. Owing to the location, compression of the post in the perineum may cause injuries to the pudendal nerve, perineal soft tissue, or genitourinary system. A postless technique significantly reduces the risk of these complications. Postless arthroscopy uses friction between the patient’s torso and the table surface to permit distraction without the post. An air arthrogram, general anesthesia with muscle paralysis, and variable degrees of Trendelenburg positioning reduce the force needed for joint distraction. Early postless literature suggested Trendelenburg angles of approximately 15°, which may be disorienting to surgeons and compromise the precision and accuracy of the surgical procedure. With the described technique, hip arthroscopy can be effectively performed with a Trendelenburg angle of less than 5° in nearly every case. Understanding the physics of postless hip arthroscopy using free-body diagrams of inclined planes with friction permits surgeons to understand the required Trendelenburg angle of the bed, the force of traction for any patient given his or her body habitus, and the coefficient of static friction of the table surface to achieve a minimum amount of joint distraction.</div></div>","PeriodicalId":47827,"journal":{"name":"Arthroscopy Techniques","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142532740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
An Anatomic Reconstruction of Both the Anterior Cruciate Ligament and Fibular Collateral Ligament Using Autografts 使用自体移植物对前十字韧带和腓骨副韧带进行解剖重建
IF 1.2
Arthroscopy Techniques Pub Date : 2024-10-01 DOI: 10.1016/j.eats.2024.103085
Luke V. Tollefson B.S., Evan P. Shoemaker B.A., Nathan J. Jacobson M.D., Erik L. Slette M.D., Robert F. LaPrade M.D., Ph.D.
{"title":"An Anatomic Reconstruction of Both the Anterior Cruciate Ligament and Fibular Collateral Ligament Using Autografts","authors":"Luke V. Tollefson B.S.,&nbsp;Evan P. Shoemaker B.A.,&nbsp;Nathan J. Jacobson M.D.,&nbsp;Erik L. Slette M.D.,&nbsp;Robert F. LaPrade M.D., Ph.D.","doi":"10.1016/j.eats.2024.103085","DOIUrl":"10.1016/j.eats.2024.103085","url":null,"abstract":"<div><div>Fibular collateral ligament (FCL) tears rarely occur in isolation and are typically injured in conjunction with another ligament, including the anterior cruciate ligament (ACL). Reconstruction of both ACL and the FCL is critical to restore proper knee biomechanics and stability. This technique describes an anatomic reconstruction of both the ACL using a bone–patellar tendon–bone autograft and the FCL using a semitendinosus hamstring autograft. Previous biomechanical studies have reported on the effect of ACL and FCL tears on lateral gapping and the importance of reconstruction to restore near native stability. Outcomes studies have reported positive patient outcomes for both techniques individually and together.</div></div>","PeriodicalId":47827,"journal":{"name":"Arthroscopy Techniques","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142532643","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Combined, Pedicled Anterior Cruciate Ligament and Anterolateral Ligament Reconstruction - “PAAR” Technique 前十字韧带和前外侧韧带联合踝式重建术
IF 1.2
Arthroscopy Techniques Pub Date : 2024-10-01 DOI: 10.1016/j.eats.2024.103065
{"title":"Combined, Pedicled Anterior Cruciate Ligament and Anterolateral Ligament Reconstruction - “PAAR” Technique","authors":"","doi":"10.1016/j.eats.2024.103065","DOIUrl":"10.1016/j.eats.2024.103065","url":null,"abstract":"<div><div>Despite constant development of surgical implants, instruments, and rehabilitation protocols, the outcomes of anterior cruciate ligament reconstruction remain unpredictable, and the failure rate of isolated procedures remains unacceptably high. Several factors possibly concerning suboptimal outcomes and risk of graft rerupture have been highlighted, among which are graft healing, tunnel position, and residual rotational instability. Recent studies have suggested that addressing anterolateral complex injury and enhancing graft healing properties might improve the outcomes of surgery. We propose a simple technique of combined anterior cruciate ligament and anterolateral ligament reconstruction using pedicled semitendinosus and gracilis tendons with a single femoral tunnel and no additional tibial tunnels.</div></div>","PeriodicalId":47827,"journal":{"name":"Arthroscopy Techniques","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141401422","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Arthroscopic Pincer Resection Utilizing an Outside-In Approach for Intra-articular Access 利用关节外入路进行关节镜钳切除术
IF 1.2
Arthroscopy Techniques Pub Date : 2024-10-01 DOI: 10.1016/j.eats.2024.103074
{"title":"Arthroscopic Pincer Resection Utilizing an Outside-In Approach for Intra-articular Access","authors":"","doi":"10.1016/j.eats.2024.103074","DOIUrl":"10.1016/j.eats.2024.103074","url":null,"abstract":"<div><div>In the standard approach to hip arthroscopy, access to the joint is achieved using fluoroscopic guidance to enter the central compartment of the hip using the Seldinger technique, penetrating the capsule with a needle and subsequently cannulating and obtaining direct visualization of the joint. In such a way, arthroscopists then proceed with accessory portal creation and capsulotomy, as desired, under direct intra-articular visualization. In cases with severe pincer morphology or coxa profunda, it may not be possible to safely access the central compartment under fluoroscopic guidance due to significant lateral overcoverage of the femoral head. We present an outside-in arthroscopic approach for accessing the hip joint in such patients, allowing for safe visualization, osseous pincer resection, and improved central compartment access while minimizing the risk to cartilage and labral tissue.</div></div>","PeriodicalId":47827,"journal":{"name":"Arthroscopy Techniques","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141406222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Arthroscopic Fixation With Absorbable Suture Anchors for Pipkin Type I Femoral Head Fractures—Letter V Technique 关节镜下用可吸收缝合锚固定 Pipkin I 型股骨头骨折--Letter V 技术
IF 1.2
Arthroscopy Techniques Pub Date : 2024-10-01 DOI: 10.1016/j.eats.2024.103090
Xiang-Yu Yin M.D., Yi Liu M.D., Wen-Guang Liu M.D., Qing-Feng Yin M.D.
{"title":"Arthroscopic Fixation With Absorbable Suture Anchors for Pipkin Type I Femoral Head Fractures—Letter V Technique","authors":"Xiang-Yu Yin M.D.,&nbsp;Yi Liu M.D.,&nbsp;Wen-Guang Liu M.D.,&nbsp;Qing-Feng Yin M.D.","doi":"10.1016/j.eats.2024.103090","DOIUrl":"10.1016/j.eats.2024.103090","url":null,"abstract":"<div><div>Femoral head fractures are relatively uncommon high-energy injuries and usually associated with traumatic hip dislocation. Pipkin classified these fractures into 4 types according to the location of the head fragment related to the fovea and associated lesions on the femoral neck or acetabulum. Traditional open reduction and internal fixation for femoral head fracture has been proven to be effective, but it could be associated with significant complications. Arthroscopic fixation with screws is a less-invasive alternative to open reduction and internal fixation that offers several advantages. However, technical challenges could be encountered during the procedure and catastrophic consequences could occur in cases of fixation failure. Therefore, we propose an effective arthroscopic technique for Pipkin type I (small fracture caudal to the fovea capitis) femoral head fractures that uses an absorbable suture anchors. The anchors provide initial stability to the fracture fragments, and then the sutures are tied in a double-pulley fashion to further secure the fracture. Finally, a triangular suture bridge (“letter V”) is created, which supplies a convenient and stable fixation for proper femoral head fracture.</div></div>","PeriodicalId":47827,"journal":{"name":"Arthroscopy Techniques","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142532639","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Endoscopic Resection of Horseshoe Ganglion of the Great Toe 大脚趾马蹄神经节内窥镜切除术
IF 1.2
Arthroscopy Techniques Pub Date : 2024-10-01 DOI: 10.1016/j.eats.2024.103084
Richard James Harries Mb.Ch.B. , Tun Hing Lui M.B.B.S., F.R.C.S.
{"title":"Endoscopic Resection of Horseshoe Ganglion of the Great Toe","authors":"Richard James Harries Mb.Ch.B. ,&nbsp;Tun Hing Lui M.B.B.S., F.R.C.S.","doi":"10.1016/j.eats.2024.103084","DOIUrl":"10.1016/j.eats.2024.103084","url":null,"abstract":"<div><div>Twelve percent of the foot ganglion cysts occur on the toes, and they are often symptomatic and recurrent. When conservative treatment failed, surgical excision is recommended, which is classically an open resection of the ganglion cyst. However, communicating lesions between ganglion cysts and the interphalangeal joint or tendon sheath make it difficult to prevent a recurrence. Techniques of arthroscopic or endoscopic toe ganglionectomy have been reported, which is either arthroscopic/endoscopic internal drainage to the adjacent joint or tendon sheath or endoscopic resection of the ganglion cyst. Difficulty in identifying the communicating valvular lesion and high incidence of multiloculated lesions make endoscopic internal drainage not always feasible for toe ganglion. The purpose of this Technical Note is to describe the details of endoscopic resection of horseshoe ganglion of the great toe. This minimal invasive approach may help to reduce the risk of recurrence.</div></div>","PeriodicalId":47827,"journal":{"name":"Arthroscopy Techniques","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142532741","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Endoscopic En Bloc Resection of Giant Cell Tumor of Tendon Sheath of Anterior Ankle 内镜下踝关节前部腱鞘巨细胞瘤整体切除术
IF 1.2
Arthroscopy Techniques Pub Date : 2024-10-01 DOI: 10.1016/j.eats.2024.103086
Wun Kee Szeto M.B.B.S.(HK) , Tun Hing Lui M.B.B.S.(HK), F.R.C.S.(Edin), F.H.K.A.M., F.H.K.C.O.S.
{"title":"Endoscopic En Bloc Resection of Giant Cell Tumor of Tendon Sheath of Anterior Ankle","authors":"Wun Kee Szeto M.B.B.S.(HK) ,&nbsp;Tun Hing Lui M.B.B.S.(HK), F.R.C.S.(Edin), F.H.K.A.M., F.H.K.C.O.S.","doi":"10.1016/j.eats.2024.103086","DOIUrl":"10.1016/j.eats.2024.103086","url":null,"abstract":"<div><div>Giant cell tumor of the tendon sheath (GCTTS) originates from the synovial cells of the tendon sheath. It is one of the most common benign soft-tissue tumors of the foot and ankle affecting the joints, bursae, and tendon sheaths and can behave in a locally aggressive manner. Complete surgical resection with long-term follow-up is the preferred treatment. Because GCTTS is a benign condition, the equilibrium between the quality of the surgical margins and functional preservation should be considered. If more aggressive resection is applied, the outcome may negatively affect quality of life, whereas incomplete resection may lead to recurrence. The purpose of this technical note is to describe the details of endoscopic en bloc resection of GCTTS of the anterior ankle. This endoscopic approach can provide a magnified view of the operative site, allowing accurate surgical assessment to ensure complete resection of the lesion without damage to the adjacent normal structures.</div></div>","PeriodicalId":47827,"journal":{"name":"Arthroscopy Techniques","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142532742","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Basics of Shoulder Arthroscopy Part II: Diagnostic Arthroscopy in the Beach-Chair Position 肩关节镜基础知识第二部分：沙滩椅体位下的关节镜诊断检查
IF 1.2
Arthroscopy Techniques Pub Date : 2024-10-01 DOI: 10.1016/j.eats.2024.103083
Marisa N. Ulrich M.D., Fabien Meta M.D., Adam J. Tagliero M.D., Christopher L. Camp M.D.
{"title":"Basics of Shoulder Arthroscopy Part II: Diagnostic Arthroscopy in the Beach-Chair Position","authors":"Marisa N. Ulrich M.D.,&nbsp;Fabien Meta M.D.,&nbsp;Adam J. Tagliero M.D.,&nbsp;Christopher L. Camp M.D.","doi":"10.1016/j.eats.2024.103083","DOIUrl":"10.1016/j.eats.2024.103083","url":null,"abstract":"<div><div>Shoulder arthroscopy is a popular modality for the treatment of shoulder pathology. Since its advent in the 1970s, significant advancements have been made in both technology and technique. Shoulder arthroscopy is performed in either the beach-chair or lateral decubitus positions, and each position has its unique benefits and considerations. Beach-chair positioning, initially described in the 1980s, has become the preferred method of positioning for most arthroscopic procedures. In this work, we describe the history of beach-chair positioning for shoulder arthroscopy. We outline a reproducible and teachable method for consistent and comprehensive diagnostic arthroscopy in the beach-chair position. Pearls, pitfalls, advantages, and disadvantages of diagnostic arthroscopy in this position are discussed. When properly executed, diagnostic arthroscopy in the beach-chair position can effectively identify and characterize intra-articular shoulder pathologies.</div></div>","PeriodicalId":47827,"journal":{"name":"Arthroscopy Techniques","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142532733","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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