Arthroscopic single anchor repair techniques for upper third subscapularis tears provide sufficient biomechanical stability

Author(s):  
Paul Borbas ◽  
Sara Cammarata ◽  
Rafael Loucas ◽  
Simon Hofstede ◽  
Florian B. Imhoff ◽  
...  
1991 ◽  
Vol 20 (2) ◽  
pp. 85-90 ◽  
Author(s):  
RUSSELL H. PATTERSON ◽  
GAIL K. SMITH ◽  
THOMAS P. GREGOR ◽  
CHARLES D. NEWTON

Hand Surgery ◽  
2015 ◽  
Vol 20 (03) ◽  
pp. 369-379 ◽  
Author(s):  
Tim Sebastian Peltz ◽  
Roger Haddad ◽  
Peter James Scougall ◽  
Sean Nicklin ◽  
Mark Peter Gianoutsos ◽  
...  

Background: This study investigated the exact failure mechanisms of the most commonly used conventional tendon repair techniques. A new method, radiographing repair constructs in antero-posterior and lateral projections before and after tensioning was used. This allowed to precisely analyse failure mechanisms in regards to geometrical changes in all three dimensions. Additionally the biomechanical stability focusing on gapping was tested. Methods: Sheep fore limb deep flexor tendons were harvested and divided in eight groups of ten tendons. Three common variants of the Kessler repair method and four common 4-strand repair techniques were tested. Additionally a new modification of the Adelaide repair was tested. Results: Biomechanical testing showed no significant differences in gapping for the three tested 2-strand Kessler repair groups. Once a double Kessler or 4-strand Kessler repair was performed the stability of the repair improved significantly. Further significant improvements in biomechanical stability could be achieved by using cross locks in the repair like in the Adelaide repair method. Qualitative analysis using radiographs showed that all Kessler repair variants unfolded via rotations around the transverse suturing component, no matter which variant was used. Conclusions: Additional to the commonly described constriction of the repair construct, the rotating deformation is the main reason for repair site gapping in Kessler tendon repair methods. The term “locking” in a Kessler repair is misleading. The cruciate repairs tended to loose grip and drag (cheese-wire) through the tendon and therefore lead to gapping. The most stable repair constructs in all three dimensions were the Adelaide repair and its interlocking modification. This is due to the superior anchoring qualities of its cross locks and three dimensional stability.


Author(s):  
W.R. Jones ◽  
S. Coombs ◽  
J. Janssen

The lateral line system of the mottled sculpin, like that of most bony fish, has both canal (CNM) and superficial (SNM) sensory end organs, neuromasts, which are distributed on the head and trunk in discrete, readily identifiable groupings (Fig. 1). CNM and SNM differ grossly in location and in overall size and shape. The former are located in subdermal canals and are larger and asymmetric in shape, The latter are located directly on the surface of the skin and are much smaller and more symmetrical It has been suggested that the two may differ at a more fundamental level in such functionally related parameters as extent of myelination of innervating fibers and the absence of efferent innervation in SNM. The present study addresses the validity of these last two features as distinguishing criteria by examining the structure of those SNM populations indicated in Fig. 1 at both the light and electron microscopic levels.All of the populations of SNM examined conform in general to previously published descriptions, consisting of a neuroepithelium composed of sensory hair cells, support cells and mantle cells, Several significant differences from these accounts have, however, emerged. Firstly, the structural composition of the innervating fibers is heterogeneous with respect to the extent of myelination. All SNM groups, with the possible exception of the TRrs and CFLs, possess both myelinated and unmyelinated fibers within the neuroepithelium proper (Fig. 2), just as do CNM. The extent of myelina- tion is quite variable, with some fibers sheath terminating just before crossing the neuroepithelial basal lamina, some just after and a few retaining their myelination all the way to the base of the hair cells in the upper third of the neuroepithelium. Secondly, all SNMs possess fibers that may, on the basis of ultrastructural criteria, be identified as efferent. Such fibers contained numerous cytoplasmic vesicles, both clear and with dense cores. In regions where such fibers closely apposed hair cells, subsynaptic cisternae were observed in the hair cell (Fig. 3).


2009 ◽  
Vol 56 (S 01) ◽  
Author(s):  
W Eichinger ◽  
CC Badiu ◽  
I Hettich ◽  
DJ Ruzicka ◽  
A Hutter ◽  
...  

2020 ◽  
Vol 23 (2) ◽  
pp. 54-58
Author(s):  
ABM Mahbubur Rahman ◽  
Tamjeed Alam ◽  
AHM Shamsul Alam ◽  
Fahim Ferdaus ◽  
Gazi Gias Uddin

Background: Treatment of groin hernias continues to evolve. The emergence of laparoscopic inguinal hernia surgery has challenged the conventional gold standard Lichtenstein’s tension free mesh repair. Laparoscopic technique to achieve surgical correction over groin hernia is increasingly being practiced in our country, and it is imperative to test the overall outcome of this technique in a tertiary care setting. Objectives: Current study was aimed at evaluating the per-operative events, early and late outcomes of laparoscopic groin hernia repair techniques. End points of evaluation were postoperative pain, hospital stay, resumption of normal activities, chronic pain and recurrence. Methods: Within a 2-year period, 45 patients of groin hernias of different clinical types underwent laparoscopic inguinal hernia repair in Bangladesh Medical College Hospital were recruited in this prospective observational study. Preoperative findings, intraoperative course, postoperative and follow-up data were analyzed to evaluate the outcomes. Observations were made regarding operating time, operative hazards, postoperative pain, incidence of early post-operative morbidities, hospital stay, resumption of activities. Total 24 months follow-up was carried out with regards to normal activity, late complications notably chronic groin pain and recurrence. Results: The mean age of 38.1±11.1 years, 27(60%) patients underwent TEP repair whereas, TAPP procedure was carried out in 18 patients (40%). For unilateral hernia repair using TEP technique, mean operative time was 50.3±4.2 mints and 61.7±5.3 mints for direct and indirect variety (D/I), with the corresponding rates for TAPP repair being 65.0±2.2 mints and 72.8±3.2 mints (D/I) respectively. Conversion rate to other operative procedure was 6.67%. The overall surgery related early post-operative morbidity was 7.4% (TEP) and 16.8% (TAPP). 3 out of 45 patients (6.67%) experienced chronic pain in the groin in the study. However, there was no single incidence of recurrence observed during the follow up period. Conclusion: Laparoscopic groin hernia repair techniques are safe and feasible, offers the benefits of minimally invasive surgery and becoming the procedure of choice specially for bilateral and recurrent inguinal hernias. Journal of Surgical Sciences (2019) Vol. 23(2): 54-58


HortScience ◽  
1998 ◽  
Vol 33 (3) ◽  
pp. 468b-468
Author(s):  
Stephen F. Klauer ◽  
J. Scott Cameron ◽  
Chuhe Chen

After promising results were obtained with an open-style split trellis (two top wires) in its initial year, two new trials were established in 1997 in northwest (Lynden) and southwest (Woodland) Washington. For the split trellis, actual yields were 33% (machine-picked 1/2 season) and 17% (hand-picked) greater, respectively, for the two locations compared to the conventional trellis (one top wire). In Woodland, canes from the split trellis had 33% more berries, 55% more laterals, 69% more leaves, and 25% greater leaf area compared with the conventional trellis. Greatest enhancement of these components was in the upper third of the canopy. Laterals were also shorter in this area of the split canopy, but there was no difference in average total length of lateral/cane between trellis types. Total dry weight/cane was 22% greater in the split trellis, but component partitioning/cane was consistent between the two systems with fruit + laterals (43%) having the greatest above-ground biomass, followed by the stem (30% to 33%) and the leaves (21% to 22%). Measurement of canopy width, circumference, and light interception showed that the split-trellis canopy filled in more quickly, and was larger from preanthesis through postharvest. Light interception near the top of the split canopy was 30% greater 1 month before harvest with 98% interception near the top and middle of that canopy. There was no difference between the trellis types in leaf CO2 assimilation, spectra, or fluorescence through the fruiting season, or in total nitrogen of postharvest primocane leaves.


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