Needle Arthroscopy Demonstrates High Sensitivity and Specificity for Diagnosing Intra-Articular Shoulder and Knee Pathology.

Introduction:  Needle arthroscopy has been introduced in recent years as an alternative to magnetic resonance imaging (MRI) for the evaluation of knee and shoulder conditions. It has continued to evolve at a rapid rate with newer generation models making in-office integration simple. As MRI can sometimes prove inconclusive, it is worthwhile to consider these alternative options for evaluating musculoskeletal pathology as a primary diagnostic tool.

Axial-Plane Biomechanical Evaluation of 2 Suspensory Cortical Button Fixation Constructs for Acromioclavicular Joint Reconstruction.

Background: Although numerous suture-button fixation techniques for acromioclavicular (AC) joint reconstruction have been validated with biomechanical testing in the superior direction, clinical reports continue to demonstrate high rates of construct slippage and breakage.

Purpose: To compare the stability of a novel closed-loop double Endobutton construct with a commercially available cortical button system in both the axial and superior directions.

Study Design: Controlled laboratory study.

Closed-Loop Double Endobutton Technique for Repair of Unstable Distal Clavicle Fractures.

Background: Displaced fractures of the distal clavicle are inherently unstable and lead to nonunion in a high percentage of cases. The optimal surgical management remains controversial.

Hypothesis: Indirect osteosynthesis with a closed-loop double endobutton construct would result in reliable fracture union and obviate the need for additional surgery.

Inverted Cyclops Lesion without Extension Block: A Case Report and Literature Review.

Cyclops lesion was previously described as a fibrous lesion with a granulation tissue core originating from the tibial insertion of the anterior cruciate ligament (ACL) graft. Recently, two case reports described inverted cyclops lesions, which originated from the femoral aspect of the ACL. Both cyclops and inverted cyclops lesions are usually associated with a block to knee extension.

A biomechanical assessment of a novel double endobutton technique versus a coracoid cerclage sling for acromioclavicular and coracoclavicular injuries.

Purpose: Recently, many acromioclavicular-coracoclavicular (AC-CC) ligament reconstruction techniques address only the CC ligament. However, many of these techniques are costly, time-consuming, and require the use of allogenic grafts, making them prone to creep and failure or novel devices making them challenging for orthopaedic surgeons. The purpose of this study was to compare the biomechanical characteristics of a double endobutton technique using a standard endobutton CL with those of a coracoid cerclage sling (CS) for reconstruction of the CC ligaments.

Anterior internal impingement: An arthroscopic observation.

Purpose: The source of pain in patients with a stable shoulder and clinical signs of impingement is traditionally thought to be subacromial or outlet impingement, as popularized by Neer. This report introduces the concept of anterior internal impingement in patients with signs and symptoms of classic impingement syndrome and arthroscopic evidence of articular-side partial rotator cuff tear. Contact that occurs between the fragmented undersurface of the rotator cuff and the anterosuperior labrum is the apparent source of pain in these patients.

Dynamic assessment of shoulder and patellofemoral pathology using limited-volume gas arthroscopy.

Subtle instability problems of the glenohumeral joint and patellofemoral joint are difficult to assess and accurately diagnose with current methods of preoperative imaging and physical examination. A simple technique is described that provides objective information for diagnosing dynamic problems of the shoulder and patellofemoral joint. Limited-volume gas arthroscopy avoids many of the potential risks and complications of pressure-based gas arthroscopy.

Cemented internal fixation for supracondylar femur fractures in osteoporotic patients.

Seventeen, supracondylar femur fractures in 15 severely osteoporotic patients (average age, 81.9 years) were treated with a 95 degree supracondylar plate and dynamic compression screw supplemented with intramedullary methyl methacrylate and massive cancellous bone graft harvested from the distal femoral metaphysis. Interfragmentary compression and rigid fracture fixation was obtained in all cases with the use of the A-O compression device.

Infected uncemented hip arthroplasty. Preserving the femoral stem with a two-stage revision procedure.

Revision of an infected uncemented hip arthroplasty can be significantly complicated by the presence of extensive bony ingrowth. Although removal of the prosthesis is desirable, technical difficulties in extracting a well anchored prosthesis can be extreme. Femoral windowing or splitting may be necessary.

Solitary (unicameral) bone cyst. The fallen fragment sign revisited.

The fallen fragment sign is a prominent radiologic feature in a minority of cases of unicameral bone cyst (20% in this series). This sign is always associated with pathologic fracture. Intramedullary fracture fragments may be single or multiple and may or may not be entirely dislodged from overlying periosteum.

Replantation of an autoclaved autogenous segment of bone for treatment of chondrosarcoma. Long-term follow up.

Seven patients who had a low-grade chondrosarcoma of the proximal part of the humerus or femur were treated by resection, autoclaving of the excised segment, and reinsertion of that segment with supplementary fresh autogenous grafts. The length of follow-up ranged from fourteen to twenty-four years, and sequential roentgenograms were made during the follow-up period. A biopsy of the autoclaved segments was done in one patient eleven years after the operation, and examination of the specimen showed predominantly live bone; there were very few spicules of dead bone.