Gentrygadegaard8919

005) and 1 year (92.9 ± 4.9 vs. 88.1 ± 4.6, P less then 0.001), but not at the latest follow-up (P = 0.081). Ankle ROM was markedly improved in the ARPF group unlike in the ORIF group at 6 months (dorsiflexion P = 0.025; plantar flexion P less then 0.001) and 1 year (dorsiflexion and plantar flexion P less then 0.001). The improvement remained present at the latest follow-up in plantar flexion (P = 0.001) but not in dorsiflexion (P = 0.354). CONCLUSIONS Arthroscopy-assisted reduction is a feasible alternative modality with superior short-term outcomes for treating isolated medial malleolar fracture, but its superiority may be attenuated in the intermediate term. PURPOSE To quantify the effects of lateral extra-articular tenodesis (LET) on tibiofemoral compartment contact area and pressures, knee kinematics and forces. METHODS Nine cadaveric knees were tested using a robotic testing system. Two loading conditions, 1) anterior tibial translational load coupled with axial compression and 2) internal tibial torque coupled with axial compression were applied for each knee state at full extension, 30º, 60º and 90º of knee flexion. Kinematic data was recorded for three knee states ALC competent, ALC deficient , and post-LET using a 6-mm semitendinosus graft. In situ force in the ACL was quantified using the principle of superposition by comparing the change in force measured before and after the removal of the ALC. Contact area and pressures in each tibiofemoral compartment was measured by replaying kinematics after soft tissues were removed and pressure sensors inserted. RESULTS In response to an anterior tibial translational load, mean contact area in the medial compartment decreased by 33.1% from the ALC competent to post-LET knee states at 90º of knee flexion (P = .042). No significant differences in the lateral compartment contact pressure were found between knee states. In situ force in the ACL in response to an anterior tibial translational load decreased by 43.4% and 50% from the ALC deficient to post-LET knee states at 60º (P = .02) and 90º (P = .006). No significant difference in kinematics was observed between the ALC competent and post-LET knee states in each of the loading conditions at all knee flexion angles (P > .05). CONCLUSIONS In this in vitro model, LET with a semitendinosus graft did not significantly overconstrain the knee nor increase pressure in the lateral compartment. Additionally, LET reduced the in situ force in the ACL in the setting of ALC injury. PURPOSE The aims of this study are to arthroscopically evaluate the trans-coracoacromial ligament glenohumeral (GH) injection technique by understanding intra-articular needle tip placement and potential misplacement and complications. METHODS The technique relies on the palpation of three bony landmarks the anterolateral corner of the acromion (ACA), superior lateral border of coracoid tip (SLBCT), and the curved depression of distal clavicle (CDDC). The skin entry site lies on the line connecting the CDDC and SLBCT, two-thirds way from the former and one-third way towards the latter. The direction of needle is perpendicular to the triangle formed by the three bony landmarks. The technique is used to insufflate GH joint at the start of shoulder arthroscopy procedures in the beach chair position. Saline was injected, and then the position of needle tip in the GH joint was evaluated arthroscopically. An injection was considered successful if saline could be injected and the needle tip could be visualized intra-articularly. RESULTS 195 patients undergoing shoulder arthroscopy were enrolled in the study. 179 patients (91.8%) had successful needle placement in the GH joint; of these, 122 were placed through the rotator interval, 41were adjacent or through long head of biceps tendon, 13 were through upper subscapularis or anterior supraspinatus, and 3 were through anterior labrum. In the 16 failures (8.2%), three patients' needle position did not allow saline to be injected due to high resistance, and 13 patients' needle tips were not visualized. Needle tip was presumed to rest within the subscapularis muscle/tendon or labrum in 10 failed injections. CONCLUSION The trans-coracoacromial ligament injection technique demonstrated high success rate (91.8%) in anesthetized patients about to undergo arthroscopy, while the failed injections were mainly because the needle inserted into the subscapularis or labrum. This technique can be used for awake patients in multiple settings with different diagnoses. PURPOSE The purpose of this study was to determine if there are significant side to side anthropometric differences between paired glenoids. METHODS Forty-six matched pair cadaver glenoids were harvested and their glenoid heights (GH) and glenoid widths (GW) were measured with digital calipers. The glenoid surface area was calculated utilizing the standard assumption that the inferior two-thirds of the glenoid is a perfect circle. RESULTS There was a statistically significant difference between matched pair glenoid heights of 0.96 mm ± 3.07 mm (P = 0.020) and glenoid widths of 0.46 mm ± 1.64 mm (P = 0.033). There was a significant difference of glenoid cavity area of 20.30 mm2 ± 81.53 mm2 (P = 0.044), or a difference of approximately 3%. A total of four out of 46 (8.6%) pairs of glenoids demonstrated a difference in width greater than three mm. CONCLUSIONS This study demonstrates the fallacy of use of the contralateral glenoid in measuring glenoid bone loss. Although many paired samples exhibited similar side to side glenoid measurements, the number of cadaveric pairs that demonstrated differences of > 3 mm is substantial. Caution should be used when utilizing calculation methods that employ this assumption for surgical decision making, as surface area, GW and GH were all shown to have statistically significant side to side differences in their measurements. read more PURPOSE To determine if arthroscopy is an effective means to diagnose and treat postoperative pain in anatomic total shoulder arthroplasty (TSA) and reverse total shoulder arthroplasty (rTSA) patients. METHODS A two-year retrospective chart review for patients with a painful shoulder arthroplasty was performed. Patients included in the study had a painful shoulder after previous shoulder arthroplasty without gross signs of infection, severely elevated laboratory markers, implant loosening, or glenoid arthrosis following hemiarthroplasty. VAS scores, physical exam findings, laboratory studies, culture results, pathology reports, operative records and postoperative treatment data were collected. RESULTS The study cohort included six males and seven females. Seven TSA and six rTSA patients underwent arthroscopic debridement of adhesions and synovitis with tissue biopsy for culture and fresh frozen section between 2016 - 2018. We arthroscopically treated adhesive capsulitis, subacromial impingement and AC joint arthritis in three patients.