The arthroscopic treatment of anterior shoulder instability with glenoid bone loss shows similar clinical results after Latarjet procedure and iliac crest autograft transfer.

Purpose: Recurrent anterior shoulder instability caused by critical bone loss of the glenoid is a challenging condition for shoulder surgeons. The purpose of this prospective multicenter trial was to compare the arthroscopic transfer of the coracoid process (Latarjet procedure) with the arthroscopic reconstruction of the glenoid using iliac crest autografts.

Methods: A prospective multi-center trial was performed in nine orthopaedic centres in Austria, Germany and Switzerland between July 2015 and August 2021.

Results of Arthroscopic Revision Rotator Cuff Repair for Failed Open or Arthroscopic Repair: A Prospective Multicenter Study on 100 Cases.

Background: Retears after rotator cuff repair (RCR) have been associated with poor clinical results. Meaningful data regarding the role of arthroscopic revision RCR are sparse thus far.

Purpose/hypothesis: To investigate results after arthroscopic revision RCR.

Functional improvements in active elevation, external rotation, and internal rotation after reverse total shoulder arthroplasty with isolated latissimus dorsi transfer: surgical technique and midterm follow-up.

Hypothesis: This study investigated the hypothesis that reverse total shoulder arthroplasty (RSA) in combination with an isolated latissimus dorsi tendon (LDT) transfer in patients with pseudoparalysis of abduction and external rotation (combined loss of active elevation and external rotation [CLEER] syndrome) would demonstrate improved postoperative functional results.

Methods: This study was a retrospective single-surgeon case series of 13 consecutive patients with CLEER who underwent RSA without subscapularis repair and combined with an isolated LDT transfer. We reviewed 10 patients (77%), at a minimum of 2 years, with 3 cases lost to follow-up.

Subacromial spacer implantation for massive rotator cuff tears: Clinical outcome of arthroscopically treated patients.

Background: Massive rotator cuff tears (MRCT) can be treated arthroscopically by partial reconstruction, tenotomy/tenodesis of the long head of the biceps, and debridement. A new treatment option is the additional implantation of a biodegradable spacer (InSpace Balloon®; ISB) into the subacromial space, which reduces subacromial shear forces to keep the humeral head centered in the glenoid. The aim of this study is to investigate the clinical outcome of patients with MRCT who were treated arthroscopically with or without an additional ISB.

Arthroscopic Technique for Stabilization of Chronic Acromioclavicular Joint Instability With Coracoclavicular and Acromioclavicular Ligament Reconstruction Using a Gracilis Tendon Graft.

We present an arthroscopic technique for stabilization of chronic acromioclavicular (AC) joint instability using a transclavicular-transcoracoidal button technique, combined with a coracoclavicular and AC ligament reconstruction using the gracilis tendon. This arthroscopic technique achieves an anatomic reduction of the clavicle without further implant removal. It ensures vertical and horizontal stabilization of the AC joint.

The use of a modular system to convert an anatomical total shoulder arthroplasty to a reverse shoulder arthroplasty: Clinical and radiological results.

If a modular convertible total shoulder system is used as a primary implant for an anatomical total shoulder arthroplasty, failure of the prosthesis or the rotator cuff can be addressed by converting it to a reverse shoulder arthroplasty (RSA), with retention of the humeral stem and glenoid baseplate. This has the potential to reduce morbidity and improve the results. In a retrospective study of 14 patients (15 shoulders) with a mean age of 70 years (47 to 83) we reviewed the clinical and radiological outcome of converting an anatomical shoulder arthroplasty (ASA) to a RSA using a convertible prosthetic system (SMR system, Lima, San Daniele, Italy).

Biomechanical testing of distal femur osteotomy plate fixation techniques: the role of simulated physiological loading.

Background: Implants for fracture and/or osteotomy fixation are often tested according to basic mechanical test models such as open gap tests or 4-point-bending tests. These may be suitable to test and compare different implants for safety and clinical approval, but are not always representative of the post-operative situation, which is decisive when it comes to bone healing. In the current study the Knee Expert Group of the Association for the Study of Internal Fixation has compared the available open gap test results of the latest version of the TomoFix Medial Distal Femoral Plate and the antecedent plate design, with the test results of a more physiological and life-like test model.

[Osteotomy around the knee vs. unicondylar knee replacement].

Background: Osteotomy around the knee and unicondylar knee replacement can both produce excellent results in unilateral knee osteoarthritis. The indications for these procedures differ significantly and are discussed in this article.

Methods: A weight-bearing long-leg radiograph, clinical stability tests and varus-valgus-stress radiographs are mandatory for a preoperative analysis.

[Transfer of the coracoid process in recurrent anterior instability of the shoulder joint. The arthroscopic Latarjet procedure].

Objective: Full arthroscopic treatment of severe anterior shoulder instability due to glenoid bone loss, Hill-Sachs lesion and irreparable ligament damage.

Indications: Recurrent anterior dislocations or subluxations, previously failed Bankart repairs; patients with anterior glenoid bone loss, Hill-Sachs defect; patients with irreparable damage to soft tissues of labrum, capsule and ligaments; patients with chronic humeral avulsion of glenohumeral ligament (HAGL lesion); combinations of lesions above; young contact sport athletes, where Bankart repairs have high failure rates.

Contraindications: Presence of (arthroscopically confirmed) good preconditions for Bankart repair: good quality of labrum, capsule and ligament, labrum still present, no or minimal bone loss of glenoid, no engaging Hill-Sachs.

[Arthroscopic nerve release and decompression of ganglion cysts around the shoulder joint].

Objective: Arthroscopic visualisation and release of nerves around the shoulder, decompression of ganglion cysts.

Indications: Arthroscopic treatment of nerve entrapment syndromes around the shoulder (suprascapular nerve, axillary nerve). Arthroscopic visualisation and release of osseous or ligamentous structures causing nerve entrapment.

Biomechanical comparison of open and arthroscopic Latarjet procedures.

Purpose: To biomechanically compare the effectiveness of the standard open and arthroscopic techniques of the Latarjet procedure to address a critical anterior glenoid defect in combination with a capsular insufficiency.

Methods: Translation testing of 12 human cadaveric shoulder specimens was performed in a robot-assisted setup under 3 different conditions: (1) intact/vented shoulder joint, (2) combined anterior glenoid bone and capsular defect, and (3) open and arthroscopic Latarjet procedures. Testing was performed for each condition in 2 test positions: 60° of glenohumeral abduction with neutral rotation (ABD position) and 60° of abduction and external rotation (ABER position).

Biomechanical investigation of the stabilization principle of the Latarjet procedure.

Purpose: The purpose of the study was to determine the biomechanical status of the different components of the Latarjet procedure. The anterior capsule reconstruction with the transferred coracoacromial ligament (CAL) and the necessity of an intact subscapularis tendon were of particular interest. We hypothesized that the anterior capsule reconstruction will have a significant effect and that the Latarjet procedure will lose its stabilizing effect if the subscapularis tendon is torn.

[Arthroscopic coracoid transfer : Indications, technique and initial results].

Recurrent anterior shoulder instability is a frequent and severe problem for patients. The Bankart operation with reconstruction of the labrum, capsule and ligament is the established treatment method, which is usually performed arthroscopically. However, the results of the Bankart operation deteriorate if there is significant bone loss at the glenoid or humerus and also when there is structural damage to the anteroinferior glenohumeral ligament and labrum.

Axial and torsional stability of supracondylar femur osteotomies: biomechanical comparison of the stability of five different plate and osteotomy configurations.

Purpose: Little is known regarding the biomechanical stability and stiffness of implants and techniques used in supracondylar femur osteotomies (SCO). Therefore, fixation stability and stiffness of implants to bone was investigated under simulated physiological loading conditions using a composite femur model and a 3D motion-analysis system.

Methods: Five osteotomy configurations were investigated: (1) oblique medial closing-wedge fixated with an angle-stable implant; (2) oblique and (3) perpendicular medial closing-wedge, both fixated with an angled blade plate; and lateral opening-wedge fixated with (4) a spacer plate and (5) an angle-stable lateral implant.

Osteotomies around the knee: patient selection, stability of fixation and bone healing in high tibial osteotomies.

New developments in osteotomy techniques and methods of fixation have caused a revival of interest of osteotomies around the knee. The current consensus on the indications, patient selection and the factors influencing the outcome after high tibial osteotomy is presented. This paper highlights recent research aimed at joint pressure redistribution, fixation stability and bone healing that has led to improved surgical techniques and a decrease of post-operative time to full weight-bearing.

Arthroscopic reconstruction of chronic AC joint dislocations by transposition of the coracoacromial ligament augmented by the Tight Rope device: a technical note.

We present a new arthroscopic technique for chronic AC joint dislocations with coracoacromial ligament transposition and augmentation by the Tight Rope device (Arthrex, Naples, USA). First the glenohumeral joint is visualised to repair concomitant lesions, such as SLAP lesions, if needed. Once the rotator interval is opened and the coracoid is identified, the arthroscope is moved to an additional anterolateral portal.

Arthroscopic release of the superior transverse ligament and SLAP refixation in a case of suprascapular nerve entrapment.

We report a case of suprascapular nerve entrapment at the suprascapular notch combined with a type II SLAP lesion resulting in supraspinatus and infraspinatus muscle weakness and shoulder pain in a 27-year-old female professional handball player. The magnetic resonance imaging scan showed significant atrophy of the supraspinatus and infraspinatus muscles. Electromyography revealed an isolated proximal lesion of the suprascapular nerve.

[Arthroscopic treatment of posterior shoulder instability: technique and results].

Posterior shoulder instability occurs in approximately 2-5% of all cases of shoulder instability and treatment is still challenging. Open capsular plication procedures are described, but significant complications and risks have been reported in the literature. Arthroscopy has led to a better understanding of the pathoanatomy of posterior shoulder instability in recent years.

The effects of valgus medial opening wedge high tibial osteotomy on articular cartilage pressure of the knee: a biomechanical study.

Purpose: The objective of this study was to quantify the effect of different loading axes and of a valgus opening wedge high tibial osteotomy (HTO) on tibiofemoral cartilage pressure.

Methods: Six human knee specimens were tested with a load of 1000N in extension in a materials testing machine using a specially designed fixture. Pressure in the medial and lateral joint compartment was recorded using pressure-sensitive films.

Spreading of platelets: a morphological marker for platelet reactivity in peripheral arterial occlusive disease.

Platelet-surface contact is the first step in thrombus formation. Platelet spreading makes this initial contact irreversible. On the other hand plasma lipids and fibrinogen have been described to activate platelets or promote adhesion.

[Arthroscopic capsular release in the management of refractory adhesive capsulitis. Technique and results].

Idiopathic adhesive capsulitis can severely restrict the comfort and function of the entire extremity, often resulting in prolonged, substantial disability. Some studies have demonstrated long-term residual pain and limitation of motion in most patients after conservative treatment such as physical therapy or corticoid injection. Closed manipulation is associated with severe complications.