A novel technique for managing symptomatic spinal cysts using epiduroscopic neural laser decompression: technical note and preliminary results.

Background: Benign spinal cysts are relatively common, but can cause significant pain. However, consensus regarding the best method for treating these cysts has not been established. We aimed to examine the usefulness of epiduroscopic neural laser decompression (ENLD), a novel percutaneous treatment, for treating lumbo-sacral cysts.

Delayed femoral fracture through a tracker pin site after navigated total knee arthroplasty.

Femoral shaft fractures through a tracker pin site after computer navigated total knee arthroplasty are being increasingly reported. All previously reported fractures have occurred within 3 months of surgery, and thus, any patient with an unexpected thigh pain during the early postoperative period should be carefully monitored for a potential fracture and receive appropriate follow-up care. However, unlike these fractures, we encountered a navigation pin-associated delayed femoral shaft fracture during the late postoperative period (at 12 months postoperatively), which we believe, might be associated with transcortical drilling marks.

A modified keyhole technique for minimizing size mismatches during a smaller than optimal lateral meniscal allograft transplantation: surgical technique.

Despite careful preoperative and intraoperative sizing of lateral menisci in recipient knees, size mismatches between allografts and recipient menisci are often encountered. To minimize size mismatches during the transplantation of smaller than expected lateral meniscal allografts, we devised a modified keyhole technique by dividing the central bone bridge into 2 bony fragments. The fragments are attached to the anterior and posterior horns.

Arthroscopic repair of the posterior horn of the medial meniscus with opening wedge high tibial osteotomy: surgical technique.

Simultaneous repair of a radial tear at the tibial attachment site of the posterior horn of the medial meniscus under special circumstances requiring tibial valgus osteotomy is technically difficult. First, most patients who need an osteotomy have a narrowed medial tibiofemoral joint space. In such a situation, the pull-out suture technique is more difficult to perform than in a normal joint space.

Arthrodesis of the knee using computer navigation in failed total knee arthroplasty.

Arthrodesis is used most commonly as a salvage procedure for failed total knee arthroplasty (TKA). For successful arthrodesis, a stable fusion technique and acceptable limb mechanical alignment are needed. Although the use of TKA intramedullary alignment rods may be helpful in terms of achieving an acceptable limb mechanical axis, fat embolism and intramedullary dissemination of an infection or reactivation of latent infection may occur in failed TKA cases with an active infection or a past history of infections.

ACL injury while jumping rope in a patient with an unintended increase in the tibial slope after an opening wedge high tibial osteotomy.

High tibial osteotomy (HTO) is an accepted surgical technique for the treatment of medial compartmental arthrosis of the knee in younger patients. Compared to total knee arthroplasty, HTO may be a good choice in patients who wish to continue with heavy labor and/or impact sports. Based on the rehabilitation protocol after HTO, impact sports, such as running, jumping rope, and full sports activities, are generally permitted 6 months postoperatively.

Lateral meniscus and lateral femoral condyle cartilage injury by retained cement after medial unicondylar knee arthroplasty.

The authors experienced an unusual case of a patient with a complex tear of the lateral meniscus and adjacent lateral femoral condyle cartilage injury in the contralateral compartment by retained cement, possibly located at the posteromedial side of the medial tibial component after unicondylar knee arthroplasty. Arthroscopic partial meniscectomy and cartilage microfracture were successfully performed. Two small cement fragments were removed from the posterolateral compartment.

'Fine-tuned' correction of tibial slope with a temporary external fixator in opening wedge high-tibial osteotomy.

The authors describe a surgical procedure to 'fine-tune' the tibial slope during high-tibial osteotomy. Fifteen consecutive patients were treated for medial compartment osteoarthritis of the knee using a temporary unilateral external fixator and accompanying internal fixator composed of two plates (with different sized space). All 15 patients were evaluated by measuring femoro-tibial angles (FTAs) in the frontal plane, and using the proximal tibial anatomical axis (PTAA) and the posterior tibial cortex (PTC) methods to assess tibial slope in the sagittal plane.

Arthroscopic double bundle ACL reconstruction using a bone patellar tendon bone-gracilis tendon composite autograft: a technical note.

The authors devised an alternative arthroscopic double bundle ACL reconstruction technique using a bone patellar tendon bone (BPTB)-gracilis tendon composite autograft. One tibial and two femoral tunnels were used to reconstruct two bundles of anterior cruciate ligaments (ACL) [an anteromedial bundle (AM) and a post-erolateral bundle (PL)]. BTBB was fixed in the tunnels produced on the isometric points of the tibia and femur using the conventional technique.

Treatment of persistent extraarticular infection using a temporary cement spacer on the tibia after ACL reconstruction.

Postoperative infection after anterior cruciate ligament (ACL) reconstruction is an uncommon but serious complication. Although several treatments for intraarticular infection have been reported, no report has been recorded on the treatment of persistent extraarticular infections. The authors experienced reconstructed graft removal due to a refractory extraarticular infection on tibia.

Trochlear deformity occurring after distal humeral fractures: magnetic resonance imaging and its natural progression.

Eighteen children (mean age 50.7 months) with trochlear deformities occurring after and related to distal humeral fractures (12 Salter-Harris type 2, 5 supracondylar, 1 Salter-Harris type 4) were evaluated with serial radiographs. The carrying angle and range of motion were measured throughout the follow-up period (up to 13 years after trauma) after definitive treatment.