Purpose: The purpose of this study is to verify the safety of a new technique for a posterior arthroscopic approach to the ankle. This technique was recently described in literature. The technique uses a modified posteromedial portal, a different way of introducing the instruments into the portal, and the tendon of the flexor hallucis longus (FHL) as a landmark to work in the posterior compartment.
Type Of Study: Anatomic study.
Methods: The technique was performed on 10 (4 fresh and 6 fresh-frozen) below-knee amputation specimens, which were then dissected. The instruments were left in place, and anatomic dissections were performed to determine the relationship to the surrounding neurovascular structures. Then the instruments were removed, and the distance of the neurovascular structures from the posteromedial portal was recorded. Another medial portal, 1 cm more proximal, was also created to measure the distance of this latter portal from the nervous structures.
Results: None of the anatomic dissections showed injuries to the neurovascular bundle either during penetration of the instruments or during procedures in the posterior compartment laterally to the tendon of the FHL. This latter is the landmark to prevent damage to the more medially located nerves and vessels. The new posteromedial portal is located, on average, 13.3 mm (range, 11 to 17 mm) from the posterior tibial nerve, 14.7 mm (range, 8 to 20) from the calcaneal branch (which may be single or multiple, and may vary as needed the height of bifurcation from the posterior tibial nerve), and 17.3 mm (range, 15 to 21 mm) from the posterior tibial artery. A posteromedial portal located 1 cm more proximally is on average 2.9 mm closer to the nervous structures.
Conclusions: Based on these anatomic data, there appears to be relatively little risk to the surrounding neurovascular structures with this new technique. Therefore, this technique appears to be relatively safe in the treatment of intra-articular and extra-articular pathology.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1053/jars.2003.50003 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Medial Meniscus Ramp Tears: State of the Art.
J ISAKOS
December 2024
Twin Cities Orthopedics, Edina, Minnesota, USA. Electronic address:
Medial meniscus ramp tears are tears of the posteromedial capsule or peripheral rim of the posteromedial meniscus that frequently occur with anterior cruciate ligament (ACL) tears. The incidence and prevalence of medial meniscus ramp tears has been increasing in the recent literature due to the increased understanding of the anatomy and diagnosis of these tears. When a patient presents with an ACL tear, a medial meniscus ramp tear should be suspected if the patient has a grade 3+ Lachman or pivot shift exam, a vertical line of increased signal intensity in the posterior capsule or peripheral meniscus on magnetic resonance imagining (MRI), or posteromedial tibial plateau bone bruising on MRI.
View Article and Find Full Text PDF[Characteristics of posterior coronal banana-shaped fragments and its research progress in treatment of intertrochanteric femoral fracture with cephalomedullary nail].
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi
December 2024
Department of Orthopedics, Yangpu Hospital, Tongji University, Shanghai, 200090, P. R. China.
Objective: To summarize the characteristics of posterior coronal banana-shaped fragments and its research progress in treatment of intertrochanteric femoral fracture with cephalomedullary nail, provide valuable reference for clinical practice.
Methods: Relevant domestic and foreign literature was extensively reviewed to summarize the history, anatomical structure of posterior coronal banana-shaped fragments, and the need for reduction and fixation, the influence on the stability of cephalomedullary nail, and the remedies.
Results: The posterior coronal banana-shaped fragments refers to the second level fracture line of the intertrochanteric femoral fracture, involving four anatomical structures, namely, the posterior part of the greater trochanter, the intertrochanteric crest, the lesser trochanter, and the posteromedial cortex.
Biomechanical Comparison of Suture-Relay All-Suture Anchors and Conventional Suture Anchors for Posterior Medial Meniscus Root Repair in Porcine Models.
Orthop J Sports Med
October 2024
Chakri Naruebodindra Medical Institute, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Samut Prakan, Thailand.
Background: Posterior medial meniscus root (PMMR) tears (PMMRTs) can be repaired using various techniques to promote healing. However, the biomechanical properties of suture-relay all-suture anchor (ASA) versus conventional suture anchor (CSA) and loop-locking transtibial pullout (TTP) have not been well established.
Purpose: To compare the biomechanical properties of PMMR repairs using suture-relay ASA, CSA, and loop-locking TTP.
Survivorship and Outcomes of Meniscal Ramp Lesions Repaired Through a Posteromedial Portal During Anterior Cruciate Ligament Reconstruction: Outcome Study With a Minimum 10-Year Follow-up.
Am J Sports Med
November 2024
Centre Orthopédique Santy, FIFA Medical Center of Excellence, Hôpital Privé Jean Mermoz, Groupe GDS-Ramsay, Lyon, France.
Background: Several studies have demonstrated suture repair of ramp lesions of the medial meniscus via a posteromedial approach was associated with a significantly lower rate of secondary meniscectomy. However, these studies are not long-term and highlight the need for extended follow-up research to better understand the outcomes over a more extended period.
Purpose: To evaluate the long-term results and reoperation rate for the failure of arthroscopic all-inside suture repair of ramp lesions of the medial meniscus via a posteromedial approach during anterior cruciate ligament (ACL) reconstruction.
Inside-Out Repair of Medial Meniscal Ramp Lesions in Patients Undergoing Anterior Cruciate Ligament Reconstruction.
JBJS Essent Surg Tech
October 2024
Twin Cities Orthopedics, Minneapolis, Minnesota.
Article Synopsis
- Medial meniscal ramp lesions occur at the junctions of the medial meniscus and are often found in up to 42% of ACL tears, but commonly go undetected due to limitations in MRI and physical examinations.
- Proper arthroscopic evaluation, including modified techniques, is necessary for effective diagnosis and treatment of these lesions to prevent increased knee instability and potential ACL graft failure.
- The video article outlines a systematic approach to identify and assess ramp lesions, demonstrating an innovative mini-open repair technique during ACL reconstruction surgery.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!