Wang Wei M.D., Jianlong Ni M.D., Qichun Song M.D., Ruiying Li M.D., Dazhi Wang M.B.B.S., Zhihao Chen M.B.B.S., Zenan Tian M.B.B.S., Zhibin Shi M.D.
{"title":"How to Expose the Long Head of the Biceps Tendon in Shoulder Arthroscopy Efficiently: The Tubercle–Traction and Touch–Tendon Method","authors":"Wang Wei M.D., Jianlong Ni M.D., Qichun Song M.D., Ruiying Li M.D., Dazhi Wang M.B.B.S., Zhihao Chen M.B.B.S., Zenan Tian M.B.B.S., Zhibin Shi M.D.","doi":"10.1016/j.eats.2024.103219","DOIUrl":"10.1016/j.eats.2024.103219","url":null,"abstract":"<div><div>Arthroscopic tenodesis of the long head of the biceps tendon (LHBT) is a common procedure in a series of bicipital tendinopathies, including tendinitis, SLAP lesions, and tendon instability. Locating and exposing the LHBT during arthroscopy present a technical challenge in tenodesis. Blind exploration of the subacromial space may result in inadvertent tendon transection and iatrogenic damage to surrounding structures, leading to increased patient trauma, bleeding, and operation time. Using the tubercle–traction and touch–tendon method facilitates a roadmap-style, accurate, prompt exposure of the LHBT, minimizing blind exploration-related damage to the subacromial bursal area and adjacent structures, which is conducive to early and rapid postoperative shoulder recovery for patients.</div></div>","PeriodicalId":47827,"journal":{"name":"Arthroscopy Techniques","volume":"14 2","pages":"Article 103219"},"PeriodicalIF":1.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143387177","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}
Malte Ohlmeier M.D. , Adrian Schlichter M.D. , Richard Stange M.D.
{"title":"Arthroscopic-Controlled Reduction of Hill-Sachs Lesions: Treatment Option for Off-Track Lesions in Young Patients?","authors":"Malte Ohlmeier M.D. , Adrian Schlichter M.D. , Richard Stange M.D.","doi":"10.1016/j.eats.2024.103235","DOIUrl":"10.1016/j.eats.2024.103235","url":null,"abstract":"<div><div>Large Hill-Sachs lesions (HSL) are currently treated via a remplissage procedure. Although the good stabilizing properties of this surgery are apparent, there are some disadvantages in terms of the functional outcome. In the following Technical Note, we present a method of arthroscopic-controlled reduction of HSL for anatomical restoration of the humeral head without functional limitations. For HSL reduction, we place a 1.6-mm K-wire in the central lesion under arthroscopic and fluoroscopic control from posterior to anterior in lateral drilling direction. Then, a 7-mm cannulated drill is used for preparing the reduction canal. Afterward, the HSL is reduced via bone tamp, also under arthroscopic and fluoroscopic control. No bone substitution material is used to fill the canal; only a standard wound closure is performed. Arthroscopic-controlled reduction of impacted humeral head fractures seems to be a possible and relatively easy way to perform an anatomical restoration of HSLs. Because the exact location of HSLs can vary slightly, the exact surgical setting might be slightly different each time. Biomechanical studies already show similar stabilizing properties of this procedure compared with established techniques but without losing external rotation. Further studies need to review the potential rate of humeral head necrosis or secondary loss of reduction.</div></div>","PeriodicalId":47827,"journal":{"name":"Arthroscopy Techniques","volume":"14 2","pages":"Article 103235"},"PeriodicalIF":1.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143387845","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}
Tyler R. McCarroll M.D. , Ady H. Kahana-Rojkind M.D. , Jessica C. Keane B.S. , Andrew R. Schab B.S. , Benjamin D. Kuhns M.D. , Benjamin G. Domb M.D.
{"title":"Setting Sail in Hip Arthroscopy: The “Rudder Technique” for Spinal Needle Access Through the Mid-anterior Portal","authors":"Tyler R. McCarroll M.D. , Ady H. Kahana-Rojkind M.D. , Jessica C. Keane B.S. , Andrew R. Schab B.S. , Benjamin D. Kuhns M.D. , Benjamin G. Domb M.D.","doi":"10.1016/j.eats.2024.103191","DOIUrl":"10.1016/j.eats.2024.103191","url":null,"abstract":"<div><div>Hip arthroscopy is a technically demanding procedure with a steep learning curve. Even accessing the hip joint, if performed improperly, will make the remainder of the case more difficult and potentially cause iatrogenic injury. Much like the rudder of a boat, the spinal needle bevel edge can be steered through tissue in a manner to ensure smooth sailing when accessing the hip. The purpose of this article is to provide a better understanding of how to maximize the capabilities of a bevel-edge needle through use of the “rudder technique” to gain access in a more efficient and atraumatic fashion.</div></div>","PeriodicalId":47827,"journal":{"name":"Arthroscopy Techniques","volume":"14 2","pages":"Article 103191"},"PeriodicalIF":1.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143387186","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}
Mark G. Soliman B.S. , Katherine S. Worcester M.S. , Thomas E. Herron D.O. , Kevin F. Bonner M.D.
{"title":"Arthroscopic Inlay Biceps Tenodesis Using a Tendon-Docking Anchor","authors":"Mark G. Soliman B.S. , Katherine S. Worcester M.S. , Thomas E. Herron D.O. , Kevin F. Bonner M.D.","doi":"10.1016/j.eats.2024.103284","DOIUrl":"10.1016/j.eats.2024.103284","url":null,"abstract":"<div><div>Pathology of the long head of the biceps tendon can be treated surgically with a multitude of tenodesis techniques; however, there is a lack of consensus on which technique provides the most optimal outcomes. Commonly used methods include inlay tenodesis with a bone tunnel and interference screw construct and onlay tenodesis with anchors or unicortical buttons. Although current methods typically provide satisfactory outcomes, many surgeons believe complications and failure rates remain suboptimal across techniques. In this article, we present an arthroscopic suprapectoral biceps tenodesis technique using an anchor device that was developed to address the shortcomings of current techniques, optimize outcomes, and minimize risk.</div></div>","PeriodicalId":47827,"journal":{"name":"Arthroscopy Techniques","volume":"14 2","pages":"Article 103284"},"PeriodicalIF":1.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143388240","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}
{"title":"Arthroscopic-Assisted Lower Trapezius Tendon Transfer for Irreparable Posterosuperior Rotator Cuff Tears Using a Quadricipital Tendon Allograft and a Double-Row Construct","authors":"Caio Santos Checchia M.D., Ph.D. , Renato Miyadahira M.D. , Eduardo Angeli Malavolta M.D., Ph.D. , Jorge Henrique Assunção M.D., Ph.D. , Sergio Luiz Checchia M.D., Ph.D. , Alberto de Castro Pochini M.D., Ph.D. , Carlos Vicente Andreoli M.D., Ph.D. , Benno Ejnisman M.D., Ph.D.","doi":"10.1016/j.eats.2024.103188","DOIUrl":"10.1016/j.eats.2024.103188","url":null,"abstract":"<div><div>Lower trapezius transfer is a joint salvage treatment option for irreparable posterosuperior rotator cuff tears in relatively young patients. It requires the use of a tendinous graft to bridge the gap between the lower trapezius and the greater tuberosity. Inlay fixation of hamstring autografts and onlay single-row fixation of Achilles allografts have been described in the literature. This technical note describes an arthroscopic-assisted lower trapezius transfer using a quadricipital tendon allograft fixed with an onlay knotless double-row construct.</div></div>","PeriodicalId":47827,"journal":{"name":"Arthroscopy Techniques","volume":"14 2","pages":"Article 103188"},"PeriodicalIF":1.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143388241","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}
{"title":"All-Inside Anterior Cruciate Ligament Reconstruction Using Full-Thickness All-Soft-Tissue Quadriceps Tendon Autograft With Independent Suture Tape Augmentation","authors":"Adam V. Daniel M.D., Patrick A. Smith M.D.","doi":"10.1016/j.eats.2024.103190","DOIUrl":"10.1016/j.eats.2024.103190","url":null,"abstract":"<div><div>The anterior cruciate ligament (ACL) is the most frequently injured knee ligament that requires surgical intervention. Surgical options to address ACL ruptures include reconstruction using autograft or allograft or performing primary repair. Subsequent ACL graft failure is a significant postoperative concern in the younger patient population. The addition of suture tape to the final construct is thought to protect the graft during moments of high stress by increasing graft stiffness under high load and preventing substantial graft elongation. Given the normal anatomic lengthening of the ACL from knee flexion to full extension, final fixation of both the suture tape and the graft is done with the knee hyperextended to avoid overconstraint. The use of adjustable loop fixation for both femoral and tibial fixation with the all-inside technique allows the graft to be retensioned after final suture tape fixation and subsequent knee cycling. This ensures that the suture tape is slightly laxer than the graft so that the graft experiences loads that are essential for its healing, with the suture tape sharing the load only during times of high stress.</div></div>","PeriodicalId":47827,"journal":{"name":"Arthroscopy Techniques","volume":"14 2","pages":"Article 103190"},"PeriodicalIF":1.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143387087","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}
{"title":"Preoperative Positioning and Socket-Anchor Technique for Arthroscopic Medial Patellofemoral Ligament Reconstruction Using Allograft Tendon","authors":"Zhenhan Deng M.D., Ph.D. , Zirong Huang M.D. , Wenzhe Feng M.D. , Shengwu Yang M.D. , Weimin Zhu M.D., Ph.D.","doi":"10.1016/j.eats.2024.103183","DOIUrl":"10.1016/j.eats.2024.103183","url":null,"abstract":"<div><div>Accurate positioning of the femoral insertion of the medial patellofemoral ligament (MPFL) is the main difficulty in MPFL reconstruction. This article describes an all-arthroscopic MPFL reconstruction procedure. Preoperative 3-dimensional computed tomography assists in MPFL patellar and femoral insertion positioning, with arthroscopic reconfirmation of femoral insertion positioning through a subcutaneous tunnel during surgery. In the socket-anchor technique for patellar insertion fixation, a 10-mm-deep bone tunnel (socket) is created along a previously located guide pin at the MPFL patellar insertion; then, an absorbable suture anchor is inserted into the end of the socket to fix the tendon graft. This technique provides the advantages of being minimally invasive, yielding accurate positioning, ensuring a sufficient tendon-bone interface healing area of the graft, and having no need for intraoperative fluoroscopy.</div></div>","PeriodicalId":47827,"journal":{"name":"Arthroscopy Techniques","volume":"14 2","pages":"Article 103183"},"PeriodicalIF":1.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143387096","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}
Michaela Kelly B.S., Jennifer Schuck A.T.C.-S.A., Andrew Gardner P.A.-C., Justin Newman M.D.
{"title":"Autologous Bone Graft Harvest Technique Using Reamer-Irrigator-Aspirator for 2-Stage Revision Anterior Cruciate Ligament Reconstruction","authors":"Michaela Kelly B.S., Jennifer Schuck A.T.C.-S.A., Andrew Gardner P.A.-C., Justin Newman M.D.","doi":"10.1016/j.eats.2024.103236","DOIUrl":"10.1016/j.eats.2024.103236","url":null,"abstract":"<div><div>Autologous or allograft bone grafting is commonly used for bone restoration in the setting of revision anterior cruciate ligament (ACL) reconstruction owing to bone loss or malpositioned or osteolytic tunnels. For significant defects, staged procedures with initial bone grafting to the femoral and/or tibial tunnels is occasionally required. In this setting, allograft shows variable rates and quality of healing and can incur increased expense. Historical techniques of autograft harvest are associated with limited graft volume and donor-site morbidity. Our technique of retrograde femoral autograft harvest shows excellent volume and quality of graft; minimal morbidity; operative expediency; and rapid, quality tunnel filling to facilitate an anatomic second-stage revision ACL reconstruction. Intramedullary bone graft harvest using a Reamer-Irrigator-Aspirator has shown efficacy for typical use in the setting of nonunion, particularly among orthopaedic trauma surgeons. Advantages of using the RIA 2 (Reamer-Irrigator-Aspirator) system (DePuy Synthes) for autologous bone graft harvest include lower donor-site morbidity, greater bone graft volume, decrease in number and size of incision sites, shorter harvest time, and efficacious healing. The goal of this procedure is to obtain an adequate amount of autologous bone graft using a minimally invasive device, RIA 2, safely and efficiently for a 2-stage revision ACL reconstruction.</div></div>","PeriodicalId":47827,"journal":{"name":"Arthroscopy Techniques","volume":"14 2","pages":"Article 103236"},"PeriodicalIF":1.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143388337","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}
Xiao-He Yang M.D. , Shu-Yin Chen M.D. , Chi Zhang M.D. , You-Zhi Cai M.D.
{"title":"Arthroscopic Nontransosseous Suture Fixation of Anterior Cruciate Ligament Avulsion Fractures","authors":"Xiao-He Yang M.D. , Shu-Yin Chen M.D. , Chi Zhang M.D. , You-Zhi Cai M.D.","doi":"10.1016/j.eats.2024.103216","DOIUrl":"10.1016/j.eats.2024.103216","url":null,"abstract":"<div><div>Few cases of anterior cruciate ligament (ACL) tibial avulsion injuries occur in adolescents. Bony ACL avulsion from the tibial side has been treated by various methods ranging from conservative management to a wide range of operative procedures. Various arthroscopic operative procedures are available to reduce and fix these fractures. We describe a technique of arthroscopic “8” knotted fixation without any tibial tunnels for tibial-sided ACL avulsion. This simple technique avoids the potential complications of hardware fixation within a joint. It represents an arthroscopic treatment option for ACL tibial avulsion injuries.</div></div>","PeriodicalId":47827,"journal":{"name":"Arthroscopy Techniques","volume":"14 2","pages":"Article 103216"},"PeriodicalIF":1.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143388333","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}
Fengyi Hu M.D., Shuai Yang M.D., Weili Shi M.D., Ziming Liu M.D., Qinwei Guo M.D.
{"title":"Single-Stage All-Arthroscopic Autologous Cancellous Bone Transplantation in Treatment of Cystic Osteochondral Lesion of the Talus","authors":"Fengyi Hu M.D., Shuai Yang M.D., Weili Shi M.D., Ziming Liu M.D., Qinwei Guo M.D.","doi":"10.1016/j.eats.2024.103208","DOIUrl":"10.1016/j.eats.2024.103208","url":null,"abstract":"<div><div>Osteochondral lesions of the talus (OLTs) are common sports-associated ankle injuries and are being increasingly recognized as a source of persistent ankle pain and disability. Although a vast array of surgical techniques have been reported, there are no rigid indications of decision-making for specific procedures. For symptomatic large or cystic lesions, multiple implants are introduced to reconstruct subchondral defects of the talus, which normally require malleolar osteotomy. However, this invasive procedure possibly arouses concerns of delayed union or nonunion, intraoperative chondral damage, and need for secondary surgery to remove internal fixations. This Technical Note introduces a technique of single-stage all-arthroscopic autologous cancellous bone transplantation in the treatment of cystic OLTs. With the creation of an accessory anteromedial portal, ideal perpendicular visualization of the osteochondral defects is provided, which facilitates thorough inspection and debridement under arthroscopy. After sufficient curettage and debridement, multiple subchondral channels are created by microfracture. Cancellous autograft is then harvested from the ipsilateral Gerdy tubercle and implanted into the defects with a specifically designed delivery guide apparatus, which suits the tight and narrow ankle cavity. This technique provides a promising alternative to address cystic OLTs with minimal invasion and no need for malleolar osteotomy.</div></div>","PeriodicalId":47827,"journal":{"name":"Arthroscopy Techniques","volume":"14 2","pages":"Article 103208"},"PeriodicalIF":1.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143388342","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}