Delacruzcoley4212
Instability of the proximal tibiofibular joint (PTFJ) is a rare injury pattern than can affect high-demand athletes involved in twisting or pivoting movements on a flexed knee. Instability may produce painful subluxations during provocative activity and occasional neuritic symptoms from tethering of the common peroneal nerve at the fibular neck. There are several reports of reconstruction for symptomatic PTFJ instability; however, no optimal treatment has been elucidated in the literature. Use of a cortical button suspensory device for fixation of the PTFJ offers the advantage of stabilizing the joint without need for free graft harvest or rigid screw fixation. The present technical report illustrates the operative technique and the advantages, disadvantages, pearls, and pitfalls associated with this operation.The posterolateral corner (PLC) is an important stabilizer of the knee. This complex of ligaments and tendons functions as the primary restraint to varus and posterolateral rotation of the knee. Injury to the PLC can result in chronic instability, a varus-thrust gait, and early arthrosis of the medial compartment of the knee if left untreated. Several techniques have been designed to address injuries of the PLC. Over the last 30 years, our understanding of the posterolateral corner as well as its operative reconstruction evolved. This evolution has attempted to refine what is an "anatomic" reconstruction. With more improved techniques and new, innovative fixation devices, we hope to make a more favorable repair for recreating the native stability of the posterolateral corner.The Latarjet technique is a widely used technique for anterior shoulder instability with glenoid bone defects, irreparable capsuloligamentous lesion, or in patients at greater risk of recurrence. The use of this technique has been reported to obtain satisfactory clinical and biomechanical results. Although other methods exist, the coracoid process is typically fixed with 2 metal screws. Complications related to metal fixation are very frequently reported. #link# In EPZ004777 cell line to avoid these complications, we developed this arthroscopically assisted metal-free Latarjet technique in which we fix a coracoid graft using four cerclage tapes to achieve a strong, stable fixation, thus mimicking a plate.The presence of an intra-articular air bubble adjacent to the rotator cuff at the time of diagnostic shoulder arthroscopy will confirm an intact rotator cuff and is helpful in ambiguous cases. After the introduction of the arthroscope, air is pulled owing to negative air pressure in the joint cavity. Fluid inflow is then started after the inflow has been properly flushed of all air. This creates an intra-articular air bubble, which can be found at the top of the capsular-supraspinatus attachment site in cases with an intact rotator cuff. Secondary subacromial positioning of the arthroscope is used to confirm the intact rotator cuff from the bursal side.In knee arthroscopy, a posteromedial portal is used for various indications including arthroscopic posterior cruciate ligament reconstruction, posterior cruciate ligament avulsion fracture fixation, posterior medial meniscal repair, medial ramp lesion repair, and synovectomy. Making the posteromedial portal is challenging for young and even experienced surgeons. Creating the posteromedial portal in knee arthroscopy is challenging and technically demanding for surgeons because of the thick muscular cover, proximity of the neurovascular bundle, tenacious tough capsule, and excessive fat deposition in the posteromedial knee and thigh region. Access for viewing the posteromedial compartment during different procedures is made simple, safe, and replicable with this technique of creating the posteromedial portal. This article describes a simple way to create the posteromedial portal using a radiofrequency device by a modified outside-in surgical technique.Subchondral acetabular edema and cysts, as a consequence of degenerative changes of the hip, are associated with disability, pain, and worsened function in this joint. The arthroscopic treatment of intra-articular pathologies, such as femoroacetabular impingement syndrome and labral tears, when associated with those alterations, has been suggested to provide inferior outcomes to those in patients without subchondral changes. Yet, the direct treatment of subchondral pathology has been limited. Recently, a technique for insufflating bone substitute into the bone marrow lesions of the knee, Subchondroplasty (Zimmer Knee Creations, Exton, PA), has led to promising results. Subchondroplasty has raised attention as a possible minimally invasive procedure to treat cystic changes in the acetabulum in patients who are not yet candidates for hip replacement. We present the technique of acetabular Subchondroplasty, in which a bone substitute material is injected into subchondral acetabular cysts under fluoroscopic guidance. In this technique, hip arthroscopy is used in conjunction with fluoroscopic guidance to address intra-articular pathologies and assess for possible intra-articular extravasation of the injectable material.Stiffness is a well-known complication after reverse shoulder arthroplasty. Although multiple factors may be involved, the main cause for stiffness is rarely identified. Imaging studies frequently are inconclusive in ruling out mechanical or biological causes. Periprosthetic infection should be always suspected, but the absence of major clinical signs and accurate diagnostic tests is frequent. A lack of objective criteria establishing a diagnosis and when to proceed with revision surgery is often present in such cases. Moreover, additional surgical procedures should be carefully evaluated, as they can represent a point of no return. Shoulder arthroscopy plays an increasingly important role in these cases, either as a diagnostic or therapeutic tool. There are no reports about arthroscopy on stiffness after reverse shoulder arthroplasty. In this Technical Note, we describe an arthroscopic technique aimed to identify potential causes of reverse shoulder arthroplasty stiffness. Subsequent circumferential release is described and discussed.