Quadriceps tendons rupture

Revision anterior cruciate ligament (ACL) reconstruction is a challenge due to the unfavorable condition of the knee and the lack of autogenous graft tissue. Anterolateral structure (ALS) reconstruction of the knee has been proved effective to address the unfavorable condition in revision cases, and lateral extra-articular tenodesis (LET) is a special technique that can enhance anterolateral stability of the knee without graft tissue. We introduce a procedure that combines ACL and ALS reconstruction, as well as LET for failed ACL reconstruction. The critical point of this technique is using the anterior half of the iliotibial band to realize LET and to partially reconstruct the ACL. Our clinical experience indicates this technique is extremely useful in revision ACL reconstruction without enough free graft tissue. This technique will provide a reasonable choice in revision ACL reconstruction.
Various methods have been described for the treatment of anterior shoulder instability with glenoid bone loss. The incidence of recurrent dislocations following surgical intervention is high and, therefore, necessitates a reliable and replicable revision procedure. The purpose of this Technical Note is to describe a method of arthroscopic anatomic glenoid reconstruction using a distal tibial allograft and screw fixation in the setting of a failed Latarjet procedure with significant glenoid bone loss.
We describe in detail patient positioning, portal placement, steps of the diagnostic arthroscopy, and graft preparation using imaging and a detailed intraoperative arthroscopic technique.
Level 1, Shoulder; Level 2, Instability.
Level 1, Shoulder; Level 2, Instability.Proximal tibiofibular joint (PTFJ) instability is a rare knee injury, accounting for less than 1% of knee injuries. It causes significant lateral sided knee pain and functional deficits and can be associated with up to 9% of multiligament knee injuries. Concurrent surgical treatment of posterolateral corner (PLC) and PTFJ instability poses technical challenges due to the limited working space of the fibula head and inherent risk of collision between grafts, bone tunnels, and implants. In this Technical Note, we detail our senior author's technique for PTFJ reconstruction without the use of additional bone tunnels or implants in the fibula head, to reduce the risk of overcrowding and tunnel collision.
Level I knee; Level II other, proximal tibiofibular joint.
Level I knee; Level II other, proximal tibiofibular joint.Repair of meniscus injuries always posed a significant problem, especially in relatively avascular zones. Selleckchem Rosuvastatin Several methods to augment the repair were devised, but only a few had convincing results. Fibrin clot augmentation is one of the augmentation procedures that shows good promise in this premise. The major hurdle to it is difficulty in delivering into the meniscus tear under constant irrigation during arthroscopic procedures. This article presents a simple and unique way to prepare and transfer a fibrin clot into a meniscal tear in a step-by-step manner.Hallux varus deformity most commonly occurs as a complication of bunion surgery. Surgical option depends on the underlying cause, flexibility of the deformity, and presence of osteoarthritis of the first metatarsophalangeal joint. Joint-preserving surgery including medial soft tissue release, metatarsal osteotomy, and tendon transfer can be considered in flexible deformity without degeneration of the first metatarsophalangeal joint. First metatarsophalangeal arthrodesis is indicated in cases of inflammatory arthritis, avascular necrosis, osteoarthritis, neuromuscular disorder, or failed previous hallux varus corrective surgery. The purpose of this technical note is to describe the technique of arthroscopic arthrodesis of the first metatarsophalangeal joint to correct hallux varus deformity. It has the potential advantages of less surgical trauma, preservation of blood supply, less postoperative pain, and better cosmetic results.The Achilles tendon is the largest and strongest tendon in the human body. It is the tendon that most often suffers injury and accounts for 20% of all tendon ruptures. These types of ruptures often occur 2 to 6 cm proximal to the stumps in an area of reduced vascularity. One such injury, the distal acute Achilles tendon rupture, is quite uncommon. For distal repairs, there have been studies that used a pullout technique, a button technique, and the use of local tendons for open-fashion augmentation. Although percutaneous repair and endoscopic flexor hallucis longus (FHL) tendon transfer techniques have been described for both acute midportion and chronic Achilles tendon rupture repair, there are no studies that describe the use of percutaneous sutures and biological augmentation with FHL transfer as a treatment option for acute distal injuries. The purpose of this Technical Note is to describe a novel approach to repair. It combines arthroscopic FHL tendon transfer with a percutaneous Achilles tendon repair technique for traumatic distal ruptures.Anterior cruciate ligament (ACL) rupture is a common injury of the knee. Arthroscopic ACL reconstruction is a standard treatment for this condition. All-inside ACL reconstruction has many advantages compared with conventional techniques. However, there are still concerns regarding graft elongation and stability with all-inside ACL reconstruction. Here, we propose an arthroscopic technique using the shortening strands of a flexible suspensory button as an internal brace. This method provides the advantages of increased stability and ACL graft protection while using the same implant as the all-inside ACL reconstruction technique.High tibial osteotomy is a common procedure to address unicompartment knee osteoarthritis and other conditions. Regarding the specific surgical methods, medial open wedge osteotomy and lateral close wedge osteotomy are the most used. Both methods have a common disadvantage in that they are not so suitable to correct a severe deformity. Thus, we would like to introduce an anterior proximal-to-posterior distal oblique proximal tibial osteotomy technique, which is especially suitable to correct severe tibial deformity. The most critical point of this technique is to create an osteotomy plane from the most proximal posterior site of the tibial tubercle posteriorly and distally to the posterior cortex of the tibia, with each horizontal osteotomy maneuver in the coronal plane. Combined fibular osteotomy is always needed, and better results can be obtained when it is combined with arthroscopic debridement of the knee. We consider the introduction of this technique will provide a useful option when tibial osteotomy is needed to preserve the knee, especially for a great deformity correction.The tibial avulsion fracture of the anterior cruciate ligament (ACL) in skeletally immature patients poses challenges to orthopaedic surgeons due to the necessity of protecting the epiphysial plate during surgical reduction and fixation of the bone fragment. Several epiphysial plate-sparing techniques have been reported. However, the epiphysial plate is still in danger because in most of these techniques the fixation device is approaching the epiphysial plate or passing through it. We would like to introduce a suture fixation technique in which there is no fixation device passing through the fracture interface as well as the epiphysial plate. The critical points of this technique are ligating the ACL, retrieving the fixation suture distally along the anterior surface of the proximal tibia, and tying the fixation suture at an adjustable loop that is set distal to the proximal tibial epiphysial plate. Our clinical experience indicates that this technique is safe and effective. We consider the introduction of this technique will provide more feasible options when surgical treatment is indicated in case of ACL tibial avulsion fracture in skeletally immature patients.Knee osteoarthritis (OA) leads to significant pain and disability, prompting new cell-based injections to lessen the symptoms. Biological therapies such as autologous microfragmented adipose tissue (AMAT) and a stromal vascular fraction (SVF) are a common source for harvesting mesenchymal and progenitor cells. Platelet-rich plasma (PRP) is associated with cytokines and growth factors. Recent studies have reported good clinical outcomes with AMAT, SVF, and PRP in knee osteoarthritis treatment. However, the preparation, processing, and application technique are vital to achieving satisfactory results. Many studies have examined outcomes after AMAT, SVF, or PRP injection, with encouraging results. Still, there is a lack of studies describing a technique that combines both methods, the timing, and the amount of SVF or PRP injected. This technical note's objective was to describe a standardized new technique composed of platelet and adipose stroma to treat knee osteoarthritis (OA) and the processing method.Surgical treatment of anterior glenohumeral joint instability can be challenging and carries the inherent risk of recurrent instability, dislocation arthropathy, and postoperative loss of external rotation. In the current manuscript, a technique for combined reconstruction of anterior labrum and capsule, with concomitant reduction of the humeral head during anterior capsule reconstruction in open Latarjet procedure, is presented. Analogous to other techniques, the coracoid graft is fixed on the anteroinferior part of the glenoid between 3 and 5 o'clock. However, for this technique, reattachment of the labrum is performed between the native glenoid and the bone graft. Additionally, during the reconstruction of the anterior capsule on the coracoacromial ligament, while the operated arm is held in external rotation to avoid the postoperative rotational deficit, the humeral head is reduced posteriorly in the center of the glenoid during adduction, slight anterior forward flexion, and a posterior lever push. By doing so, the inherent theoretical risks of persistent instability and dislocation arthropathy are believed to be decreased. Further studies are needed to clarify the long-term consequences of this surgical technique in the clinical setting.Arthroscopic distal clavicular autograft (DCA) is effective in shoulder instability with glenoid bone loss. The original technique uses an osteochondral autograft, fixed with screws or suture anchors. We developed a modified procedure called "congruent arc DCA" characterized by (1) use of drilling guides to optimize graft positioning and make the all-arthroscopic procedure safer and reproducible; (2) rotation of the DCA of 90° to reach a congruent arc with its undersurface; (3) fixation of the graft with cortical buttons to simplify its intra-articular passage, avoid hardware problems, and facilitate possible revision surgery; and (4) intraoperative use of a suture tensioner to achieve satisfactory compression of the graft and increase its consolidation.Formal interventions are rationalized to be irreplaceable, especially with marginalized communities that are presumed to lack capacity. It is event centric and differ considerably from the community's experience of disaster risk and recovery within the everyday context. Thus, community engagement with multiple formal institutions that often fail to address recovery needs of the most marginalized, is inevitable. These contradictions lead to varied forms of community assertion towards addressing structural inequalities and injustices. In this paper we explore these contradictions by drawing from the work of scholars who recognize the limits of procedural justice and push for distributive justice, especially by focusing on grassroots processes using the lens of the politics of neo-liberalism and ontology of possibilities. Using a multi-sited instrumental case study approach the paper explores community's lived experiences, factors contributing to the persistence of structural inequality and injustice, and the alternate conception of justice and their assertions, in the disaster recovery context.