A Percutaneous Knotless Technique for Acute Achilles Tendon Ruptures.

Achilles tendon ruptures are a common tendon injury, usually occurring in middle-aged men during recreational sporting activities. Both nonoperative and operative management are employed to treat these injuries. Several operative treatments are described in the literature, including percutaneous Achilles repair, mini-open repair, and open repair.

Quantitative Assessment of the Coracoacromial and the Coracoclavicular Ligaments With 3-Dimensional Mapping of the Coracoid Process Anatomy: A Cadaveric Study of Surgically Relevant Structures.

Purpose: To perform a quantitative anatomic evaluation of the (1) coracoid process, specifically the attachment sites of the conjoint tendon, the pectoralis minor, the coracoacromial ligament (CAL), and the coracoclavicular (CC) ligaments in relation to pertinent osseous and soft tissue landmarks; (2) CC ligaments' attachments on the clavicle; and (3) CAL attachment on the acromion in relation to surgically relevant anatomic landmarks to assist in planning of the Latarjet procedure, acromioclavicular (AC) joint reconstructions, and CAL resection distances avoiding iatrogenic injury to surrounding structures.

Methods: Ten nonpaired fresh-frozen human cadaveric shoulders (mean age 52 years, range 33-64 years) were included in this study. A 3-dimensional coordinate measuring device was used to quantify the location of pertinent bony landmarks and soft tissue attachment areas.

Qualitative and Quantitative Anatomy of the Proximal Humerus Muscle Attachments and the Axillary Nerve: A Cadaveric Study.

Purpose: To provide a quantitative and qualitative anatomic analysis of the pectoralis major, teres major, and latissimus dorsi on the humerus, as well as the deltoid tendinous attachments on the proximal humerus and acromion, and to quantitatively characterize the humeral course of the axillary nerve.

Methods: Ten nonpaired, fresh-frozen human cadaveric shoulders were analyzed. A portable coordinate-measuring device quantified the location of bony landmarks and tendon attachment areas.

A Contact Pressure Analysis Comparing an All-Inside and Inside-Out Surgical Repair Technique for Bucket-Handle Medial Meniscus Tears.

Purpose: To directly compare effectiveness of the inside-out and all-inside medial meniscal repair techniques in restoring native contact area and contact pressure across the medial tibial plateau at multiple knee flexion angles.

Methods: Twelve male, nonpaired (n = 12), fresh-frozen human cadaveric knees underwent a series of 5 consecutive states: (1) intact medial meniscus, (2) MCL tear and repair, (3) simulated bucket-handle longitudinal tear of the medial meniscus, (4) inside-out meniscal repair, and (5) all-inside meniscal repair. Knees were loaded with a 1,000-N axial compressive force at 5 knee flexion angles (0°, 30°, 45°, 60°, 90°), and contact area, mean contact pressure, and peak contact pressure were calculated using thin film pressure sensors.

Multiligament Reconstruction of the Knee in the Setting of Knee Dislocation With a Medial-Sided Injury.

Multiple ligament knee injuries are complex pathologies that often result from traumatic knee dislocations. Both a high level of suspicion and a thorough clinical and radiographic examination are mandatory to diagnose and identify all injured structures. Reconstruction of all injured ligaments is recommended to aid in early mobilization and to avoid joint stiffness or graft failure.

The Proximal Tibiofibular Joint: A Biomechanical Analysis of the Anterior and Posterior Ligamentous Complexes.

Background: Dislocation of the proximal tibiofibular joint is a complex injury that is often overlooked or misdiagnosed. Surgical management is recommended for severe acute or for chronic symptomatic instability of the proximal tibiofibular joint. Although the anterior ligamentous complex has been reported to be stronger than the posterior complex, biomechanical data are lacking.

The forgotten joint: quantifying the anatomy of the proximal tibiofibular joint.

Purpose: Limited objective data exist detailing the quantitative anatomy of the individual bundles of the proximal tibiofibular joint and their relation to surgically pertinent osseous landmarks. The purpose of this study was to qualitatively and quantitatively describe the ligamentous anatomy of the proximal tibiofibular joint and its relation to relevant bony landmarks.

Methods: Ten non-paired, fresh-frozen cadaveric knee specimens were dissected to identify the proximal tibiofibular joint ligament bundles.

A Cadaveric Model Evaluating the Influence of Bony Anatomy and the Effectiveness of Partial Scapulectomy on Decompression of the Scapulothoracic Space in Snapping Scapula Syndrome.

Background: Snapping scapula syndrome (SSS) is caused by bony and/or soft tissue impingement in the scapulothoracic articulation. Surgical resection of the superomedial angle (SMA) plus bursectomy can provide relief in most cases; however, the amount needed to achieve adequate scapulothoracic space decompression (SSD) is unknown.

Purpose: The aim of this study was to evaluate the effectiveness of partial scapulectomy and the influence of bony anatomy on SSD.

Anatomic and Biomechanical Comparison of the Classic and Congruent-Arc Techniques of the Latarjet Procedure.

Background: The Latarjet procedure is commonly performed using either the classic or the congruent-arc technique. Each technique has potential clinical advantages and disadvantages. However, data on the anatomic and biomechanical effects, benefits, and limitations of each technique are limited.

Effect of Suture Caliber and Number of Core Strands on Repair of Acute Achilles Ruptures: A Biomechanical Study.

Background: Controversy exists regarding the ideal Achilles rupture treatment; however, operative treatment is considered for athletes and active patients. The ideal repair construct is evolving, and the effect of suture caliber or number of core strands has not been studied.

Methods: Simulated mid-substance Achilles ruptures were performed in 24 cadavers.

Impact of Arthroscopic Lateral Acromioplasty on the Mechanical and Structural Integrity of the Lateral Deltoid Origin: A Cadaveric Study.

Purpose: To determine whether a 5-mm and/or 10-mm arthroscopic lateral acromioplasty (ALA) would weaken the structural and mechanical integrity of the lateral deltoid.

Methods: The acromion and lateral deltoid origin were harvested from 15 pairs (n = 30) of fresh-frozen human cadaveric shoulder specimens. One side of each specimen pair (left or right) was randomly assigned to either a 5-mm (n = 7) or 10-mm (n = 8) ALA group, and the contralateral sides (n = 15) were used as matched controls.

Biomechanical Comparison of Surgical Techniques for Resection Arthroplasty of the Sternoclavicular Joint.

Background: The optimal location and extent of medial clavicle resection for sternoclavicular (SC) joint resection arthroplasty are unknown.

Hypothesis: Resection of the intra-articular disc alone cannot reliably decompress the SC joint, and a parallel resection technique will decompress the SC joint significantly more compared with the same amount with an oblique resection technique.

Study Design: Controlled laboratory study.