Endoscopic Retrofibular Groove Deepening for Management of Type A Intrasheath Peroneal Tendon Subluxation.

In intrasheath peroneal tendon subluxation, the peroneal tendons subluxate on each other within the retrofibular peroneal tendon sheath. Two subtypes can be distinguished: type A, in which the tendons are normal, and type B, in which the peroneus brevis tendon has an associated longitudinal split and the peroneus longus tendon subluxates through this tendon split. The purpose of this technical note is to describe the details of endoscopic retrofibular groove deepening for management of type A intrasheath peroneal tendon subluxation.

Endoscopic Resection of Sustentaculum Tali Bone Spur.

The flexor hallucis longus tendon is susceptible to impingement, longitudinal tears, or ruptures throughout the whole course of the tendon. The most frequently affected site is the fibro-osseous tunnel from posterior talus to under the sustentculum tali, followed by the master knot of Henry and intersesamoid ligament. The purpose of this Technical Note is to describe the details of endoscopic resection of a sustentaculum tali bone spur that entraps the flexor hallucis longus tendon.

iTRAQ proteomic analysis of exosomes derived from synovial fluid reveals disease patterns and potential biomarkers of Osteoarthritis.

Exosomes extracted from synovial fluid (SF-exo) reflect the status of their originating cells. The proteomic profiles of SF-exo are important for the diagnosis of osteoarthritis (OA). To delineate the proteomic differences between SF-exo from OA patients and healthy individuals, a quantitative proteomic study based on iTRAQ technology was performed.

Surgeon-Administered Ultrasound-Guided Regional Anesthesia in Fixation of Distal Fibula Fracture.

Distal fibula fracture is a common injury of the lower limb. Significantly displaced distal fibula fracture is treated with surgical fixation under general, spinal, or regional anesthesia. We present a case of displaced distal fibula fracture with both the regional anesthesia and operation performed by the same attending orthopedic surgeon.

Endoscopic En Bloc Resection of Giant Cell Tumor of Tendon Sheath of Anterior Ankle.

Giant cell tumor of the tendon sheath (GCTTS) originates from the synovial cells of the tendon sheath. It is one of the most common benign soft-tissue tumors of the foot and ankle affecting the joints, bursae, and tendon sheaths and can behave in a locally aggressive manner. Complete surgical resection with long-term follow-up is the preferred treatment.

Endoscopic Resection of Horseshoe Ganglion of the Great Toe.

Twelve percent of the foot ganglion cysts occur on the toes, and they are often symptomatic and recurrent. When conservative treatment failed, surgical excision is recommended, which is classically an open resection of the ganglion cyst. However, communicating lesions between ganglion cysts and the interphalangeal joint or tendon sheath make it difficult to prevent a recurrence.

Lesser Metatarsophalangeal Joint Instability: Arthroscopic Treatment Alternatives.

Instability of the lesser toes metatarsophalangeal (MTP) joints is a common forefoot problem and can present as metatarsalgia, synovitis, and lesser toe deformities. The plantar plate contributes to MTP joint stability through its interaction with the plantar aponeurosis, and plantar plate insufficiency is the primary cause of MTP joint instability. Conservative treatment options, including the use of nonsteroidal anti-inflammatory medications, intra-articular steroid injections, orthosis, and accommodative shoe modifications, generally provide only temporary relief and do not effectively halt the progression of deformity in most cases.

ICON 2023: International Scientific Tendinopathy Symposium Consensus - the core outcome set for Achilles tendinopathy (COS-AT) using a systematic review and a Delphi study of professional participants and patients.

To develop a core outcome set for Achilles tendinopathy (COS-AT) for use in clinical trials we performed a five-step process including (1) a systematic review of available outcome measurement instruments, (2) an online survey on truth and feasibility of the available measurement instruments, (3) an assessment of the methodological quality of the selected outcome measurement instruments, (4) an online survey on the outcome measurement instruments as COS and (5) a consensus in-person meeting. Both surveys were completed by healthcare professionals and patients. The Outcome Measures in Rheumatology guidelines with a 70% threshold for consensus were followed.

Arthroscopic Management of Dysplasia Epiphysealis Hemimelica (Trevor Disease) of the Ankle.

Dysplasia epiphysealis hemimelica (Trevor disease) is a rare skeletal development disorder of childhood, characterized by irregular ossification centers, which may develop together or individually, leading to asymmetric epiphyseal cartilage overgrowth, affecting 1 side of the epiphyses or the epiphyses equivalents (the medial side being affected twice as often as the lateral), until skeletal maturity is reached. Trevor disease around the ankle is locally aggressive with a poor outcome, especially in tumors involving the articular surface. The purpose of this Technical Note is to describe the details of arthroscopic management of dysplasia epiphysealis hemimelica (Trevor disease) of the ankle.

Endoscopic Resection of Horseshoe Ganglion of the Lateral Midfoot.

A ganglion is the most common soft-tissue mass in the foot and can cause pain, paresthesia, or footwear problems. A ganglion can extend from the dorsum into the plantar compartment of the foot in the form of a horseshoe at the borders of the foot or in the form of an hourglass through the intermetatarsal space. Initial conservative management of a ganglion may entail observation and the use of padding for comfort, manual rupture, aspiration of the cyst contents, and steroid injection or sclerotherapy into the cyst.

Arthroscopic Talonavicular Arthrodesis for the Management of Talonavicular Osteoarthritis.

The talonavicular joint is a common site for osteoarthritis of the foot. Talonavicular arthrodesis is the surgical treatment for symptomatic talonavicular osteoarthritis. Classically, this is performed via an open approach and is associated with a rate of nonunion that ranges from 3% to 37%.

Arthroscopic Management of Sinus Tarsi Syndrome.

Sinus tarsi syndrome (STS) is a clinical entity characterized by pain of the lateral hindfoot and a sense of instability especially on uneven surfaces due to chronic inflammation characterized by fibrotic tissue remnants and synovitis of the sinus tarsi, associated with both traumatic and nontraumatic causes. Arthroscopic debridement of the subtalar joint is an effective and safe alternative in the treatment of STS refractory to conservative treatment. The purpose of this Technical Note is to report the details of arthroscopic management of STS.

Metatarsosesamoid Arthroscopy for Management of Plantar Pain of the First Metatarsophalangeal Joint After Surgical Correction of Hallux Valgus Deformity.

Residual pain in the early postoperative phase after hallux valgus surgery is common, but persistent plantar pain of the first metatarsophalangeal joint after surgery is rare. This can be due to intra- or extra-articular causes. Metatarsosesamoid arthroscopy is effective for the management of intra-articular causes of plantar pain.

Endoscopic Release of the Flexor Hallucis Longus Tendon at Posterior Ankle for Management of Checkrein Deformity of the Great Toe, Second Toe, and Third Toe.

Checkrein deformity is rare and involves entrapment or fixed tethering of the flexor hallucis longus (FHL) in the posterior foot, just proximal to the flexor retinaculum of the ankle, and causes the "constant length phenomenon" of FHL. The clinical presentation is a dynamic flexion deformity of the great toe characterized by flexion contracture of the interphalangeal joint with mild extension contracture of the metatarsophalangeal joint, causing difficulty in walking since in the stance phase of gait, the hallux is forced into plantar flexion and impinges onto the ground. Because the FHL tendon has some interconnection to the tendons of the flexor digitorum longus at the master knot of Henry, deformities of the second and third toes are sometimes seen.

Arthroscopic Trapeziectomy Without Traction Tower.

Osteoarthritis in the thumb carpometacarpal joint causes pain, swelling, deformity, instability, loss of motion, and power, which seriously impairs overall hand function. Surgery is indicated if conservative treatment fails to relieve the pain. Trapeziectomy is the most popular surgical treatment choice and yields good range of motion and relieves pain with the fewest complications.

Arthroscopic Release of the First Metatarsophalangeal Joint: The 3-Portal Approach.

Arthrofibrosis of the first metatarsophalangeal joint may cause significant limitation of sport and daily activities. Surgical release is indicated if conservative management fails. Open release may have a high recurrence rate of joint stiffness because the surgical trauma will induce fibrous tissue formation and the presence of lengthy surgical wounds may hinder early joint mobilization.

Endoscopic En-Bloc Resection of Intra-Muscular Lipoma of the Flexor Digitorum Profundus: A Uniportal Technique.

Deep-seated lipomas can be intramuscular, intermuscular, and rarely, parosteal lipomas. Intramuscular lipoma can be divided into infiltrative, well-circumscribed, and mixed types. Marginal excision is the treatment of choice for well-circumscribed intramuscular lipoma, and histopathology eliminates diagnosis of well-differentiated liposarcoma.

Full-Length Endoscopic Adhesiolysis of the Achilles Tendon and Triceps Surae.

Fibrous adhesions of the Achilles tendon and triceps surae can cause calf and heel cord pain, limited ankle dorsiflexion, and even equinus deformity. The purpose of this technical note is to describe the technical details of full-length endoscopic adhesiolysis of the Achilles tendon and triceps surae. This minimally invasive approach has the advantage of allowing immediate postoperative vigorous mobilization and stretching exercise, which can reduce formation of peritendinous adhesions as compared to immobilization.

Endoscopic En-Bloc Resection of Neurilemmoma of the Foot Dorsum.

Neurilemmoma (schwannoma) is a benign, slow-growing, encapsulated tumor originating from the Schwann cells of the peripheral nerve sheath. The purpose of this technical note is to describe the technique of endoscopic en-bloc resection of neurilemmoma of the foot dorsum. This has the advantage of better cosmetic result and less postoperative perineural fibrosis.

Endoscopic En-Bloc Resection of Lipoma of the Tibialis Anterior Tendon.

Lipoma is benign soft-tissue tumor that consists entirely of mature fat and can occur in a superficial or deep location. Lipoma of the foot and ankle can even develop within a tendon sheath or joint. Classically, lipoma is resected via open approach, which may result in a lengthy disfiguring surgical scar.

Endoscopic Resection of Ulnar Bursa of the Palm: 2 Ulnar Portals Technique.

Ulnar bursa of the hand invaginates the flexor digitorum superficialis and flexor digitorum profundus tendons of the little, ring, long, and index fingers. Distension of this bursa can have an inflammatory or infective cause. It can also originate from pathology of another site (e.

Modified Endoscopic Distal Soft Tissue Procedure (mEDSTP) and Arthroscopic Lapidus Arthrodesis for Correction of Severe Hallux Valgus.

Hallux valgus is one of the most common forefoot deformities faced by foot and ankle surgeons. Symptomatic deformity usually needs surgical correction. Endoscopic techniques of hallux valgus correction have been reported that are based on the same principle of the classic distal soft tissue procedure.

Arthroscopic Sesamoidectomy and Plantar Metatarsal Head Bone Shaving in Management of First Metatarsal Head Metatarsalgia After First Metatarsophalangeal Fusion.

First metatarsophalangeal arthrodesis has been used to treat end-stage arthritis of the great toe (e.g., gout, post-traumatic, infection), severe hallux valgus deformity, hallux valgus caused by neuromuscular disorders, rheumatoid forefoot deformity, primary hallux varus, and rigid plantarflexion deformities, as well as a salvage procedure for failed previous operation of the great toe.