Techniques in Shoulder and Elbow Surgery 
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This is an RSS file. You can use it to subscribe to this data in your favourite RSS reader or to display this data on your own website or blog.Neurovascular Complications in Clavicle Fractures Plating: A Simple Procedure to Avoid Them
Open reduction and internal fixation of clavicle displaced fractures is a well-known procedure in trauma surgery but it is not without risks including injuries to major neurovascular structures. Our goal is to share the simple and effective method to avoid neurovascular complications in clavicle fractures plating used in our center. As part of the surgical planning, we performed a digital measurement of the cephalad-caudad length of fracture fragments. We confirmed our measurement intraoperative with a sterile ruler and we adjusted the length of the drill adding 3 mm to our estimation. Knowing that the closest neurovascula...
Source: Techniques in Shoulder and Elbow Surgery - November 1, 2017 Category: Orthopaedics Tags: Techniques Source Type: research
Single-row Rotator Cuff Repair: SpeedFix and Triple-loaded Anchor
Most surgeons who repair rotator cuff tears arthroscopically do so using either a single-row (SR) or double-row technique. While there is still controversy regarding which technique is superior, most surgeons use both techniques, taking into consideration characteristics of the rotator cuff tear to help them decide which technique to use in a particular patient. This paper describes 2 methods of performing an isolated SR supraspinatus repair. In addition, it provides the authors’ indications for a SR repair and discusses the clinical outcomes available to date comparing SR and double-row rotator cuff repairs. Regardless ...
Source: Techniques in Shoulder and Elbow Surgery - November 1, 2017 Category: Orthopaedics Tags: Techniques Source Type: research
Cell-based Approaches for Augmentation of Tendon Repair
Cell-based approaches are among the principal interventions in orthobiologics to improve tendon and ligament healing and to combat degenerative processes. The number of options available for investigation are expanding rapidly and investigators have an increasing number of cell types to choose from for research purposes. However, in part due to the current regulatory environment, the list of available cells at clinicians’ disposal for therapeutic purposes is still rather limited. In this review, we present an overview of the main cellular categories in current use. Notable recent developments in cell-based approaches inc...
Source: Techniques in Shoulder and Elbow Surgery - August 2, 2017 Category: Orthopaedics Tags: Online Articles Source Type: research
Latissimus Dorsi Tendon Transfer Augmented by Human Dermal Tissue Allograft for Massive Rotator Cuff Tears: Surgical Technique
We describe a latissimus dorsi transfer procedure specifically augmented by an acellular dermal allograft, which serves as a reinforcing onlay on the bursal side of the transferred tendon. At the completion of the reconstruction, the host latissimus tendon is in direct contact with both the native prepared bone on the tuberosity footprint and the surrounding tissues. The goal of this procedure is not only to augment the native latissimus tendon and improve its tensile properties during the healing process, but also to achieve complete superior humeral head coverage with the potential for force couple restoration and increa...
Source: Techniques in Shoulder and Elbow Surgery - August 2, 2017 Category: Orthopaedics Tags: Online Articles Source Type: research
What is the Role of Systemic Conditions and Options for Manipulation of Bone Formation and Bone Resorption in Rotator Cuff Tendon Healing and Repair?
Rotator cuff pathology is a significant cause of shoulder pain. Operative repair of rotator cuff is an established standard of care for these patient, however, failure of the procedure is common. Systemic conditions such as diabetes mellitus, hypocholesteremia, thyroid disease, and smoking significantly affect the outcomes of rotator cuff repair and have significant implications for the management of these patients. Diabetes mellitus has been proposed to damage tendons through nonenzymatic glycosylation of collagen with advanced glycation end-product formation and impaired microcirculation. Hypocholesteremia may lead to fa...
Source: Techniques in Shoulder and Elbow Surgery - August 2, 2017 Category: Orthopaedics Tags: Techniques Source Type: research
An Update on Scaffold Devices for Rotator Cuff Repair
The annual volume of rotator cuff repairs in the United States is roughly 250,000, and failure rates still range from 20% to 70% in most studies despite significant advances in surgical technique and rehabilitation protocols. Even many “healed” repairs continue to have pain, weakness, and dysfunction, a phenomenon that may be explained by “Failure with continuity,” where the healing tendon retracts from the repaired location without a structural defect, leaving interposed scar tissue. To improve clinical outcomes, there is a need to minimize the rate of structural failure and minimize the failure with continuity th...
Source: Techniques in Shoulder and Elbow Surgery - August 2, 2017 Category: Orthopaedics Tags: Techniques Source Type: research
Update on Platelet-rich Plasma for Shoulder and Elbow Tendinopathy
Tendinopathy in upper limb tendons, driven by overuse or understimulation, is very frequent in the general population. Because of the absence of effective treatments, biological approaches are currently being investigated. Platelet-rich plasma (PRP) is injected locally for the conservative management of epicondylar and rotator cuff tendinopathy, or as a biological enhancer in arthroscopic repair of rotator cuff tears. In epicondylar tendinopathy, we have identified 15 randomized clinical studies comparing the efficacy of PRP with other injectable treatments. PRP has been compared with corticosteroids in 8 randomized trials...
Source: Techniques in Shoulder and Elbow Surgery - August 2, 2017 Category: Orthopaedics Tags: Techniques Source Type: research
Targeting Inflammation in Rotator Cuff Tendon Degeneration and Repair
Rotator cuff degeneration is a common affliction that results in pain and disability. Tendinopathy was historically classified with or without the involvement of the immune system. However, technological advancements in screening have shown that the immune system is both present and active in all forms of tendinopathy. During injury and healing, the coordinated effort of numerous immune cell populations work with the resident stromal cells to break down damaged tissues and stimulate remodeling. These cells deploy a wide array of tools, including phagocytosis, enzyme secretion, and chemotactic gradients to direct these proc...
Source: Techniques in Shoulder and Elbow Surgery - August 2, 2017 Category: Orthopaedics Tags: Techniques Source Type: research
Adverse Muscle Changes and Possible Therapeutic Targets for Rotator Cuff Muscle Atrophy and Fatty Infiltration
Rotator cuff tears are among the most prevalent musculotendinous injuries treated by orthopedic surgeons. Outcomes following attempted surgical repair are highly dependent on tear size and muscle quality. It is the aim of this review to outline the natural history of rotator cuff muscle degeneration following tendon tears, describe the correlation between muscle pathology and clinical outcomes, and highlight advances in basic-translational research that point toward novel therapeutic approaches for this troublesome injury process. (Source: Techniques in Shoulder and Elbow Surgery)
Source: Techniques in Shoulder and Elbow Surgery - August 2, 2017 Category: Orthopaedics Tags: Techniques Source Type: research
Two-year Clinical and Radiographic Outcomes of Total Shoulder Arthroplasty Using a Hybrid Glenoid Component With a Central Porous Titanium Post
To determine the effectiveness of hybrid glenoid components in reducing the frequency of glenoid component loosening, we evaluated clinical and radiographic outcomes at a minimum 2-year follow-up in 35 shoulders using a system with a central porous titanium post to augment the cemented pegs. Function was evaluated with the American Shoulder and Elbow Society score, QuickDASH disability score, and active shoulder range of motion. Postoperative radiographs were analyzed for radiolucent lines, progressive loosening, and at-risk signs. The average American Shoulder and Elbow Society score improved from 39 to 80 (P (Source: Tec...
Source: Techniques in Shoulder and Elbow Surgery - May 2, 2017 Category: Orthopaedics Tags: Research Article Source Type: research
Quadruple Repair Technique for Acromioclavicular Dislocation
Twenty patients with acute Rockwood type IV (3 cases) and type V (17 cases) acromioclavicular (AC) dislocations were studied. All patients underwent the same surgical technique: arthroscopic release of the coracoacromial ligament, reduction of the dislocated joint, coracoclavicular (CC) fixation with a malleolar screw and metal washer, transfer of the proximal insertion site of the coracoacromial ligament to the clavicle, CC cerclage with 2 No. 5 Ethibond sutures, and deltoid-trapezius imbrication. Clinical and radiographic follow-up was at 1 week, at 2 and 6 months, and at final evaluation (a minimum 2-y follow-up). The s...
Source: Techniques in Shoulder and Elbow Surgery - May 2, 2017 Category: Orthopaedics Tags: Techniques Source Type: research
Medial Ulnar Collateral Ligament Reconstruction: Restoring the Ulnar Footprint
The medial ulnar collateral ligament (MUCL) is commonly injured in the elite overhead throwing athlete. Many techniques have been described to reconstruct the ligament in an effort to return the athlete to play. A recent anatomic study detailed the broad ulnar attachment of the MUCL. Reconstruction of the ligament across the entire ulnar footprint has not previously been described. The senior author’s technique for anatomic MUCL reconstruction recreates the broad ulnar footprint of the native ligament. (Source: Techniques in Shoulder and Elbow Surgery)
Source: Techniques in Shoulder and Elbow Surgery - May 2, 2017 Category: Orthopaedics Tags: Techniques Source Type: research
Management of Recurrent Posterior Shoulder Instability in a Young Contact Athlete Using a Posterior Bone Block Technique With Distal Tibia Osteochondral Allograft
We present the surgical technique and successful long-term follow-up for the use of distal tibial osteochondral allograft for the treatment of posterior glenoid deficiency in a young male athlete after 2 failed soft tissue repairs. Our case and a review of the early results in the literature demonstrate that distal tibial allograft seems to be an effective bone graft option for posterior glenoid reconstruction in the setting of recurrent posterior glenohumeral instability. Further studies involving more subjects with long-term results are needed to guide future surgical indications. (Source: Techniques in Shoulder and Elbow Surgery)
Source: Techniques in Shoulder and Elbow Surgery - May 2, 2017 Category: Orthopaedics Tags: Techniques Source Type: research
The Tensing Technique for Proximal Biceps Tenodesis
The long head of biceps is a frequent source of shoulder pain and is often seen along with different conditions of the shoulder pathology. There are various options including biceps tenotomy or tenodesis. Tenodesis of the long head of biceps can be performed using various techniques including arthroscopic, mini open or open methods. With the traditional open technique using a guide wire there is a risk and concern about axillary nerve injury. (Source: Techniques in Shoulder and Elbow Surgery)
Source: Techniques in Shoulder and Elbow Surgery - May 2, 2017 Category: Orthopaedics Tags: Techniques Source Type: research
Massive Allograft for Shoulder Arthroplasty: A Case Report
We present the case of a 46-year-old man who was referred for the evaluation of longstanding left-shoulder pain in obstetrical plexus palsy. A distal cryopreserved tibia allograft was used and a hemiarthroplasty was performed. Congruity, mechanical stability, significant improvement in the glenoid retroversion, generally excellent clinical results, and incorporation of the graft were achieved and no allograft failed because of early or late infection, nonunion at the graft-host junction, or instability. (Source: Techniques in Shoulder and Elbow Surgery)
Source: Techniques in Shoulder and Elbow Surgery - May 2, 2017 Category: Orthopaedics Tags: Techniques Source Type: research
