Julio Rosales M.D. , Guillermo Droppelmann Ph.D. , Nicolás García M.D. , Anthony Saravia M.D. , Claudio Molina M.D. , Carlos Jorquera Ph.D.
{"title":"Myotendinous Junction Anesthesia: An Alternative Infiltration Site for Ultrasound-Guided Injections","authors":"Julio Rosales M.D. , Guillermo Droppelmann Ph.D. , Nicolás García M.D. , Anthony Saravia M.D. , Claudio Molina M.D. , Carlos Jorquera Ph.D.","doi":"10.1016/j.eats.2024.103195","DOIUrl":"10.1016/j.eats.2024.103195","url":null,"abstract":"<div><div>The myotendinous junction is a highly specialized and complex structure between muscle and tendon. In recent years, various procedures have directly targeted the tendon, with corticosteroid, platelet-rich plasma, or biological therapy infiltrations being prominent. However, these interventions are painful, corticosteroids have demonstrated tendon damage, and anesthesia negatively impacts tenocyte proliferation and viability when used with platelet-rich plasma in the same injection site. There is a need to adapt the injection site to improve therapy effectiveness and pain tolerance. This article presents a proposal for an ultrasound-guided anesthetic block procedure in the myotendinous junction.</div></div>","PeriodicalId":47827,"journal":{"name":"Arthroscopy Techniques","volume":"14 2","pages":"Article 103195"},"PeriodicalIF":1.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143387182","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":"Dual Posteromedial Portal Technique: Arthroscopic Loop Suspensory Fixation–Posterior Cruciate Ligament Tibial Avulsion Fracture","authors":"Nuno Ramos-Marques M.D. , Vicente Campos M.D. , Thiago Aguiar M.D. , João Torrinha Jorge M.D.","doi":"10.1016/j.eats.2024.103187","DOIUrl":"10.1016/j.eats.2024.103187","url":null,"abstract":"<div><div>Posterior cruciate ligament avulsion fracture injuries have been associated with an increased risk of meniscal tears and premature patellofemoral/medial compartment osteoarthritis. Sports-related trauma is a common cause of posterior cruciate ligament avulsion fractures. Surgical management is recommended for displaced bony avulsion of the posterior cruciate ligament to stabilize the knee and prevent knee pain, nonunion, and osteoarthritis progression. This article discusses our preferred treatment using a loop suspensory fixation device through a dual posteromedial portal technique.</div></div>","PeriodicalId":47827,"journal":{"name":"Arthroscopy Techniques","volume":"14 2","pages":"Article 103187"},"PeriodicalIF":1.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143387085","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}
An Van Duy Ho M.Sc., M.D., Khoa Dinh Le M.Sc., M.D., Thanh Nhat Le M.Sc., M.D., Vu Anh Tran M.Sc., M.D., Anh Ha Nam Tang Ph.D., M.D.
{"title":"Remnant Preservation Anterior Cruciate Ligament Reconstruction: Modified All-Inside Technique With Appendiceal Tibial Tunnel","authors":"An Van Duy Ho M.Sc., M.D., Khoa Dinh Le M.Sc., M.D., Thanh Nhat Le M.Sc., M.D., Vu Anh Tran M.Sc., M.D., Anh Ha Nam Tang Ph.D., M.D.","doi":"10.1016/j.eats.2024.103217","DOIUrl":"10.1016/j.eats.2024.103217","url":null,"abstract":"<div><div>The number of anterior cruciate ligament (ACL) ruptures treated arthroscopically has increased. In most cases, the rupture of the ligament occurs in the femoral attachment, leaving a robust stump attached to the tibia. ACL reconstruction with stump preservation might have some advantages: rapid reinnervation and revascularization of the graft. Most techniques have used an interference screw in tibial fixation, which could be more difficult to achieve the graft diameter within 8 to 10 mm in most situations. Therefore, we describe a technique for modified “all-inside” ACL reconstruction with remnant preservation using an appendiceal tibial tunnel to optimize the graft size. After tunnel drilling in anatomic positions, the ACL stump is bored centrally up to the diameter of the graft to be passed. After passing the graft from the tibial tunnel to the remnant to the femoral tunnel, adjustable loops are used to fix the femoral side and the tibial side by an appendiceal tibial tunnel.</div></div>","PeriodicalId":47827,"journal":{"name":"Arthroscopy Techniques","volume":"14 2","pages":"Article 103217"},"PeriodicalIF":1.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143387171","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":"Acromioclavicular Joint Reconstruction With Acromioclavicular Ligament Augmentation Using a Knotless, All-Suture Anchor Construct","authors":"Charles C. White IV M.D., Brandon A. Cincere M.D.","doi":"10.1016/j.eats.2024.103226","DOIUrl":"10.1016/j.eats.2024.103226","url":null,"abstract":"<div><div>Many techniques and combinations of procedures exist for reconstruction of an injured acromioclavicular (AC) joint. Recently, there has been a focus on controlling anterior and posterior translation of the AC joint after the reduction of superior translation and coracoclavicular (CC) ligament stabilization. Diagnosis and treatment of anterior and posterior instability of the AC joint is critical, yet when AC/CC ligament reconstruction fails, this is often the result of recurrent superior migration of the clavicle relative to the acromion. We present a technique using knotless, all-suture anchor technology intended for higher-grade, operative AC joint injuries in “high-risk” patients, i.e., those returning to a collision sport such as football, rugby, hockey, or wrestling. Consideration also could be given to those performing a high-demand occupation, such as overhead work or manual labor. In addition, this technique could be employed in patients at risk for delayed or nonhealing, such as those with diabetes or who are smokers, those at risk of noncompliance, and revision cases. The all-suture anchor, knotless “suture staple” technique can be implemented easily to provide backup fixation of the AC joint directly as an augmentation to CC reconstruction, preferably arthroscopic-assisted reduction, and fixation with a cortical button and, when indicated, concomitant allograft reconstruction.</div></div>","PeriodicalId":47827,"journal":{"name":"Arthroscopy Techniques","volume":"14 2","pages":"Article 103226"},"PeriodicalIF":1.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143387176","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}
Thibault Lafosse M.D. , José Carlos Garcia Ph.D. , Laurent Lafosse M.D. , Michael Kimmeyer M.D.
{"title":"Comprehensive Endoscopic Brachial Plexus Release for Neurogenic Thoracic Outlet Syndrome Including Suprascapular Nerve Release and Scalenotomy","authors":"Thibault Lafosse M.D. , José Carlos Garcia Ph.D. , Laurent Lafosse M.D. , Michael Kimmeyer M.D.","doi":"10.1016/j.eats.2024.103237","DOIUrl":"10.1016/j.eats.2024.103237","url":null,"abstract":"<div><div>Thoracic outlet syndrome is characterized by compression of neurovascular structures including the brachial plexus. Endoscopic techniques for brachial plexus neurolysis are emerging as treatment options when properly indicated. This technical note presents an updated comprehensive endoscopic technique for infraclavicular and supraclavicular brachial plexus neurolysis, including release of the suprascapular nerve via the anterior approach and release of the brachial plexus at the level of the interscalene triangle.</div></div>","PeriodicalId":47827,"journal":{"name":"Arthroscopy Techniques","volume":"14 2","pages":"Article 103237"},"PeriodicalIF":1.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143387178","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":"Quantitative Technique to Precisely Fix the Tibia With a Locking Compression Plate at the Preoperatively Planned Correction Angle While Applying High Compression to the Osteotomy Site in Inverted V–Shaped High Tibial Osteotomy","authors":"Takuma Kaibara M.D., Ph.D. , Kazunori Yasuda M.D., Ph.D. , Eiji Kondo M.D., Ph.D. , Koji Yabuuchi M.D. , Jun Onodera M.D., Ph.D. , Norimasa Iwasaki M.D., Ph.D. , Tomonori Yagi M.D., Ph.D.","doi":"10.1016/j.eats.2024.103229","DOIUrl":"10.1016/j.eats.2024.103229","url":null,"abstract":"<div><div>In high tibial osteotomy (HTO) fixed with a locking compression plate (LCP), overcorrection or under-correction of knee alignment frequently occurs because the LCP applies not only proximal displacement but also valgus rotation to the distal tibia. We have developed a quantitative technique to precisely fix the tibia with the LCP at the preoperatively planned correction angle in inverted V–shaped HTO. Preoperatively, simulation of the HTO using the LCP is performed with a radiograph, and the distance of the most proximal locking screw from the articular surface is measured. During surgery, a marker wire is precisely inserted into the proximal tibia at the preoperatively planned position of the most proximal locking screw. By inserting the first screw along this marker wire, the LCP is precisely installed on the proximal tibia at the planned position. Then, a compression screw is inserted into the distal tibia through the LCP. This screw pulls the distal tibia toward the distal part of the LCP while applying proximal displacement and valgus rotation. Thus, the tibia is precisely fixed at the planned correction angle.</div></div>","PeriodicalId":47827,"journal":{"name":"Arthroscopy Techniques","volume":"14 2","pages":"Article 103229"},"PeriodicalIF":1.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143388335","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}
Vincent H. Key M.D., Austin A. Cole M.D., Matthew H. Freeman M.D.
{"title":"Ulnar Collateral Ligament Reconstruction Utilizing a 3-Strand Palmaris Tendon Autograft With a Hybrid Linear Construct","authors":"Vincent H. Key M.D., Austin A. Cole M.D., Matthew H. Freeman M.D.","doi":"10.1016/j.eats.2024.103215","DOIUrl":"10.1016/j.eats.2024.103215","url":null,"abstract":"<div><div>The integrity of the medial ulnar collateral ligament (UCL) of the elbow is vital for the throwing athlete. Although newer techniques exist, reconstruction remains the gold standard for full-thickness UCL tears. An increase in throwing velocity, inadequate recovery, and early sports specialization have contributed to increased rates of UCL injury. As increasing numbers of athletes undergo UCL reconstruction, we continue to search for the optimal technique to return athletes to the same level of competition. We present a UCL reconstruction utilizing a 3-stranded palmaris longus tendon autograft with an inlay linear construct.</div></div>","PeriodicalId":47827,"journal":{"name":"Arthroscopy Techniques","volume":"14 2","pages":"Article 103215"},"PeriodicalIF":1.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143387183","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}
Di Jia M.D. , Rongqian Ni M.B.B.S. , Yi Zhang M.B.B.S. , Dewei Liu M.B.B.S. , Kun Wang M.D.
{"title":"Posterior Labral Suture of Hip Joint by a 2-Step Camera Rotation Switching for Establishment of Bird’s-Eye View","authors":"Di Jia M.D. , Rongqian Ni M.B.B.S. , Yi Zhang M.B.B.S. , Dewei Liu M.B.B.S. , Kun Wang M.D.","doi":"10.1016/j.eats.2024.103210","DOIUrl":"10.1016/j.eats.2024.103210","url":null,"abstract":"<div><div>Labral tear of the hip joint is an important factor causing joint pain and locking, as well as mobility disturbance. Although femoroacetabular impingement syndrome often results in anterior labral tears, posterior labral tears are present in a subset of patients, especially those with a history of posterior hip dislocation. Posterior labral repair under arthroscopy usually requires switching between the viewing approach and the operating approach, but this undoubtedly increases the operative time and the destruction of soft tissue. This article introduces a technique for rapid posterior labral suture by rotating the arthroscopic camera without switching the surgical approach.</div></div>","PeriodicalId":47827,"journal":{"name":"Arthroscopy Techniques","volume":"14 2","pages":"Article 103210"},"PeriodicalIF":1.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143387185","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}
Milind V. Pimprikar M.S.D. Ortho. , Hitendra G. Patil M.B.B.S., D.N.B. Ortho.
{"title":"Medial Meniscal Ramp Lesions: An Arthroscopic Classification","authors":"Milind V. Pimprikar M.S.D. Ortho. , Hitendra G. Patil M.B.B.S., D.N.B. Ortho.","doi":"10.1016/j.eats.2024.103203","DOIUrl":"10.1016/j.eats.2024.103203","url":null,"abstract":"<div><div>Medial meniscus ramp lesions are commonly associated with anterior cruciate ligament injuries. These lesions were defined previously as longitudinal tears around the meniscocapsular junction at the level of the posterior horn of the medial meniscus. However, the recent interpretation of the ramp lesions, their causation, anatomical studies, and histologic studies has uncovered a different dimension to these lesions. With recent knowledge of anatomy and soft-tissue attachments around the posterior horn of the medial meniscus, the attachments of the articular capsule, posteromedial capsule, meniscocapsular ligament, meniscotibial ligament, and semimembranosus, there is a need to understand these injuries differently. Because the anatomical structures injured during the ramp lesion will decide the treatment strategy to repair it anatomically, a review of the classification and repair techniques is necessary. The existing classification is descriptive and does not suggest a repair strategy for each classification. Because the ramp lesion, by definition, does not affect the meniscus tissue, it is a peel-off injury of the posteromedial structures. Hence, injury to the meniscus without injury to the meniscocapsular ligament, or meniscotibial ligament, cannot be classified as a ramp lesion. This article proposes an arthroscopic and functional classification.</div></div>","PeriodicalId":47827,"journal":{"name":"Arthroscopy Techniques","volume":"14 2","pages":"Article 103203"},"PeriodicalIF":1.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143387094","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}
Alejandro Jaramillo Quiceno M.D. , Paula Andrea Sarmiento Riveros M.D. , Camilo Partezani Helito M.D., Ph.D. , Andre Giardino Moreira da Silva M.D. , Rubén Darío Arias Pérez M.D., B.S. , Ricardo Londoño García M.D.
{"title":"Combined Anterior Cruciate Ligament and Anterolateral Ligament Reconstruction Using a Flexible Reaming System","authors":"Alejandro Jaramillo Quiceno M.D. , Paula Andrea Sarmiento Riveros M.D. , Camilo Partezani Helito M.D., Ph.D. , Andre Giardino Moreira da Silva M.D. , Rubén Darío Arias Pérez M.D., B.S. , Ricardo Londoño García M.D.","doi":"10.1016/j.eats.2024.103213","DOIUrl":"10.1016/j.eats.2024.103213","url":null,"abstract":"<div><div>The combination of anterior cruciate ligament (ACL) and anterolateral ligament (ALL) reconstruction represents a therapeutic modality that exhibits superior clinical efficacy for certain risk groups when compared with isolated ACL reconstruction. This approach is progressively gaining broader applicability owing to its inherent prospective advantages. Despite the absence of a universally acknowledged gold-standard surgical technique, several methods have been delineated for its implementation. Typically, conventional practice involves the creation of distinct individual tunnels in the femur, followed by graft fixation using interference screws. However, the conventional steps in the technique are not without potential drawbacks. These include tunnel convergence, screw migration, screw irritation, and the risk of lateral collateral ligament injury. The manifestation of such unfavorable outcomes can necessitate a subsequent surgical intervention for effective management. Consequently, adopting a single socket-shaped tunnel strategy for concurrent reconstruction of the ACL and ALL, coupled with femoral fixation using an adjustable-loop button facilitated by a flexible reaming system, presents potential advantages. This alternative approach can mitigate the aforementioned risks by minimizing morbidity and preserving bone stock. The technique is feasible and reproducible, offering a pragmatic avenue for optimizing clinical outcomes in combined ACL and ALL reconstruction.</div></div>","PeriodicalId":47827,"journal":{"name":"Arthroscopy Techniques","volume":"14 2","pages":"Article 103213"},"PeriodicalIF":1.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143387098","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}