Evaluation of Rotator Cuff Augmentation of Proximal Humerus Fracture Fixation.

Proximal humerus fractures represent one of the most common fractures in the elderly, and are increasingly treated with surgical fixation. Suture augmentation attaching the rotator cuff to the plate has been advocated to combat varus collapse and other associated complications. The objective of this study was to evaluate the contribution of rotator cuff augmentation to stability of proximal humerus fracture fixation.

Prevalence of femoroacetabular impingement in younger patients undergoing total hip arthroplasty.

The pathogenesis of hip arthrosis is complex with many risk factors. Femoroacetabular impingement abnormalities are thought to be a factor. To determine the prevalence of femoroacetabular impingement in younger patients who had undergone hip arthroplasty, the authors reviewed preoperative radiographs to determine radiographic indices of femoroacetabular impingement in 142 patients (92 men and 50 women) younger than 50 years old and who had undergone hip replacement.

Normal anatomy and biomechanics of the knee.

Functionally, the knee comprises 2 articulations-the patellofemoral and tibiofemoral. Stability of the joint is governed by a combination of static ligaments, dynamic muscular forces, meniscocapsular aponeurosis, bony topography, and joint load. The surgeon is ill equipped to undertake surgical treatment of a dislocated knee without a sound footing in the anatomic complexities of this joint.

Evaluation and treatment of acute and chronic injuries to the capsular ligaments of the knee.

Injury to the capsular ligaments of the knee commonly occurs in conjunction with cruciate ligament injury. An untreated grade III sprain can lead to recurrent meniscal injury, failure of cruciate ligament reconstruction, and arthrosis. Careful clinical examination is necessary to identify injuries to discrete ligaments and estimate the severity of injuries not discernable on imaging studies.

Surgical treatment of chronic posterolateral rotatory instability of the knee using capsular procedures.

Chronic posterolateral rotatory instability of the knee was introduced as a diagnostic classification by Hughston and associates in the early 1970s and occurs as a result of dysfunctional healing of a strained arcuate complex, causing a patulous posterolateral capsuloligamentous complex to exist. This capsular redundancy allows varying degrees of recurvatum and adduction instability during single-limb stance. Eradication of the redundant pouch with a capsular shift-type reconstruction has been shown to eliminate the instability and hold up under long-term follow-up studies.