Applications of Vascular Imaging and Interventional Radiology Modalities in the Upper Extremity: A Review.

Hand and upper extremity (HUE) vascular disorders are encountered frequently by hand surgeons in clinical practice. A wide array of imaging and vascular interventional radiology modalities exists for the diagnosis and treatment of HUE vascular disorders, some of which may not be familiar to the HUE surgeons. In this review article, we summarize the vascular imaging and vascular interventional radiology modalities and their relative advantages, disadvantages, and indications with respect to HUE pathology.

Evaluation of rotator cuff abduction moment arms for superior capsular reconstruction and reverse total shoulder arthroplasty.

Purpose: The rotator cuff (RC) muscles contribute to dynamic stability and rotational actions of the glenohumeral joint. Moment arm can be used to demonstrate the potential work a muscle contributes to a musculoskeletal joint rotation. This study aimed to understand the moment arm contributions of the RC muscles and explore changes following a complete supraspinatus tear treated with either superior capsular reconstruction (SCR) or reverse total shoulder arthroplasty (rTSA).

Biomechanics in an Incomplete Versus Complete Supraspinatus Tear: A Cadaveric Study.

Background: Degenerative and traumatic changes to the rotator cuff can result in massive and irreparable rotator cuff tears (RCTs).

Purpose/hypothesis: The study objective was to conduct a biomechanical comparison between a small, incomplete RCT and a large, complete RCT. We hypothesized that the incomplete supraspinatus (SS) tear would lead to an incremental loss of abduction force and preserve vertical position of the humeral head, while a complete SS tear would cause superior humeral migration, decrease functional deltoid abduction force, and increase passive range of motion (ROM).

Solutions for the Unstable and Arthritic Elbow Joint.

An unstable, arthritic elbow presents a therapeutic challenge. Patients may have painful, limited range of motion, often due to trauma or progressive joint destruction from rheumatologic disease. The options for management may be particularly challenging when treating young, active patients.

Biomechanical effects of superior capsular reconstruction in a rotator cuff-deficient shoulder: a cadaveric study.

Background: Superior capsular reconstruction (SCR) has been gaining popularity as a treatment for irreparable rotator cuff tears (RCTs), especially in younger patients. This biomechanical study aimed to investigate how SCR affects functional abduction force, humeral head migration, and passive range of motion following an irreparable RCT. We hypothesized that SCR will restore these parameters to nearly intact shoulder levels.

The biomechanics of the supraspinatus-deficient shoulder treated with superior capsular reconstruction vs. reverse total shoulder arthroplasty-experimental study.

Aim Of The Study: Our objective was to compare biomechanical effects of superior capsular reconstruction (SCR) and reverse total shoulder arthroplasty (rTSA) on shoulder motion, in the setting of an irreparable supraspinatus (SS) tear. We hypothesized that rTSA would produce greater improvement in abduction force and shift the humerus inferiorly, while SCR would produce greater range of motion (ROM) and prevent superior migration of the humerus during abduction.

Methods: Six cadaveric shoulders were evaluated using a custom biomechanical apparatus.

Hip Arthroscopy: extra-articular Procedures.

Hip preservation is one of the fastest growing fields in orthopaedics and indications of intra-articular procedures are well established. In the last decade, extra-articular procedures have gained momentum and arthroscopic solutions to peri-articular hip pathologies have been offered. It should be noted that many of these pathologies are well-treated conservatively and only those who fail conservative management should be treated operatively.

Arthroscopic Reconstruction of the Irreparable Acetabular Labrum: A Match-controlled Study.

Purpose: To report clinical outcomes of arthroscopic labral reconstruction in the hip at minimum 2-year follow-up in comparison to a pair-matched labral repair group.

Methods: Patients were included in this study if they underwent labral reconstruction during hip arthroscopy and had minimum 2-year follow-up data available. Exclusion criteria were active workers' compensation claims or previous ipsilateral hip surgery or conditions.

In Revision Hip Arthroscopy, Labral Reconstruction Can Address a Deficient Labrum, but Labral Repair Retains Its Role for the Reparable Labrum: A Matched Control Study.

Background: Revision hip arthroscopy is increasingly common and often addresses acetabular labrum pathology. There is a lack of consensus on indications or outcomes of revision labral repair versus reconstruction.

Purpose: To report clinical outcomes of labral reconstruction during revision hip arthroscopy at minimum 2-year follow-up as compared with pair-matched labral repair during revision hip arthroscopy (control group) and to suggest a decision-making algorithm for labral treatment in revision hip arthroscopy.

Recent National Trends and Outcomes in Total Ankle Arthroplasty in the United States.

Total ankle arthroplasty (TAA) is an evolving option for treating ankle arthritis. We assessed the national trends in usage and perioperative outcomes of TAA in the United States. International Classification of Diseases, 9th revision (ICD-9), codes were used to search the National Hospital Discharge Survey database for TAA from 1997 to 2010.

Minimum Five-Year Outcomes of Hip Arthroscopy for the Treatment of Femoroacetabular Impingement and Labral Tears in Patients with Obesity: A Match-Controlled Study.

Background: Obesity is a negative prognostic factor for various surgical procedures. The purpose of this study was to compare patients with obesity who underwent hip arthroscopy for femoroacetabular impingement and labral tears with a match-controlled group of normal-weight patients.

Methods: Data were prospectively collected and retrospectively reviewed for patients who underwent arthroscopy between February 2008 and December 2011.

Acetabular microfracture in hip arthroscopy: clinical outcomes with minimum 5-year follow-up.

Introduction: There is a paucity in the literature regarding mid-term results of microfracture in hip arthroscopy. We aim to assess 5-year outcomes of patients who underwent acetabular microfracture for full-thickness chondral lesions as a part of hip arthroscopy.

Methods: Between August 2008 and September 2011, data were prospectively gathered for patients undergoing acetabular microfracture during hip arthroscopy with minimum 5-year follow-up.

Outcomes of Hip Arthroscopic Surgery in Patients With Tönnis Grade 1 Osteoarthritis at a Minimum 5-Year Follow-up: A Matched-Pair Comparison With a Tönnis Grade 0 Control Group.

Background: Studies on midterm outcomes of the arthroscopic treatment of femoroacetabular impingement (FAI) and labral tears with mild osteoarthritis (OA) are limited.

Purpose: To evaluate outcomes of the arthroscopic treatment of FAI and labral tears in patients with mild preoperative OA (Tönnis grade 1) at a minimum 5-year follow-up, and to perform a matched-pair comparison to a control group with Tönnis grade 0.

Study Design: Cohort study; Level of evidence, 3.

Arthroscopic Acetabular Microfracture With the Use of Flexible Drills: A Technique Guide.

Chondral injuries of the hip joint are often symptomatic and affect patient activity level. Several procedures are available for addressing chondral injuries, including microfracture. Microfracture is a marrow-stimulating procedure, which creates subchondral perforation in the bone, allowing pluripotent mesenchymal stem cells to migrate from the marrow into the chondral defect and form fibrocartilaginous tissue.