Meniscal injuries are becoming increasingly common in the pediatric population. During arthroscopic evaluation, pediatric patients typically have pristine articular cartilage and tight medial joint spaces. Therefore, when an arthroscope enters the medial compartment, iatrogenic damage to the articular cartilage may occur. Additionally, proper visualization of the medial meniscus (posterior horn or meniscocapsular junction) can prove to be difficult, and potential pathology may be missed. Proposed methods of increasing medial compartment visualization include the use of a 70° arthroscope placed through the intercondylar notch (Gillquist maneuver), creation of a posteromedial portal, or relaxation of the deep medial collateral ligament (MCL). Similar techniques have been described for use in adults for partial meniscectomy, but not in the pediatric population. The purpose of this Technical Note is to describe the steps to successfully perform the relaxation technique for meniscal repairs in pediatric patients, using an extra-articular outside-in percutaneous method.
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http://dx.doi.org/10.1016/j.eats.2019.07.010 | DOI Listing |
Arthrosc Tech
December 2024
Department for Orthopedics and Trauma Surgery, Martin Luther Hospital Berlin, Berlin, Germany.
Indication for this hemi-wedge high tibial osteotomy is the combination of medial osteoarthritis or cartilage damage, varus deformity of >10°, and medial proximal tibial angle of <80°. The proximal lateral tibia is exposed via a skin incision of approximately 10 cm length between the tibial tuberosity and the head of the fibula. After detachment of the anterior tibial muscle, a first oblique guidewire marks the main osteotomy plane and a second guidewire marks the hemi-wedge.
View Article and Find Full Text PDFArthrosc Tech
December 2024
Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, U.S.A.
The medial patellofemoral complex provides the primary static restraint to lateral patellar translation and is composed of the medial patellofemoral ligament and medial quadriceps tendon femoral ligament. Multiple techniques including medial patellofemoral ligament and/or medial quadriceps tendon femoral ligament reconstruction have demonstrated good results; however, modification of the femoral fixation technique is required for skeletally immature patients or revision cases in which anatomic bony fixation on the femur is not possible. This technique describes an all-soft-tissue procedure for single-bundle medial patellofemoral complex reconstruction in which the graft is fixed on the adductor tendon while using the medial collateral ligament as a distalizing pulley, for anatomic and isometric recreation of the native ligament.
View Article and Find Full Text PDFArthrosc Tech
December 2024
Orlin & Cohen Orthopedic Group, Smithtown, New York, U.S.A.
Direct repair of ulnar collateral ligament (UCL) injuries with suture augmentation has been successful in properly selected patients lacking chronic attritional wear of the medial elbow. Described is a Speed-Fix technique for direct UCL repair using SutureTape, with Brace augmentation. The Speed-Fix repair technique uses an inverted mattress knotless repair with a knotless SwiveLock anchor and FiberTape suture, which allows for theoretical compression at the repair site.
View Article and Find Full Text PDFZhongguo Zhen Jiu
January 2025
Department of Rehabilitation Medicine, General Hospital of Ningxia Medical University, Yinchuan 750004, China; Key Laboratory of Ningxia Ethomedicine Modernization, Ministry of Education, Yinchuan 750004.
Objective: To observe the clinical effect of internal heat acupuncture therapy for knee osteoarthritis of early to middle stages, and explore its influence on cartilage thickness.
Methods: A total of 44 patients with knee osteoarthritis of early to middle stages were treated with internal heat acupuncture therapy at points (most of them are located at the subpatellar fat pad, both sides of the patellar ligament, the tendon of the quadriceps and the attachment of the medial and lateral collateral ligaments), once a week, a total of 4 weeks of treatment. Before and after treatment, after 3 months of treatment completion (in the follow-up), the visual analogue scale (VAS) score, Western Ontario and McMaster Universities osteoarthritis index (WOMAC) score, frequency of 30-second chair stand test (30sCST), cartilage thickness of femoral intercondylar and knee joint ultrasound score were compared, and the clinical effect was evaluated.
Foot Ankle Spec
January 2025
Trauma Unit, Department of Surgery, Amsterdam UMC (Location AMC), University of Amsterdam, Amsterdam, The Netherlands.
Background: It remains unclear whether repairing the deltoid ligament (DL) is beneficial in acute ankle fractures. The aim of this review is to critically review the developments in deltoid ligament repair (DLR) in ankle fractures over the course of 44 years.
Method: An electronic search was conducted on the PubMed and Embase database including comparative studies evaluating the effect of performing DLR in adults suffering from a closed acute ankle fracture with suspected rupture of the DL.
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