Reconstruction of the acetabular labrum with autologous capsule via arthroscopic assisted direct anterior mini open approach

Author(s):  
Marco Ezechieli
Author(s):  
Antonia F. Chen ◽  
Patrick O’Toole ◽  
Joshua Minori ◽  
Javad Parvizi
Keyword(s):  

2019 ◽  
Vol 130 ◽  
pp. e467-e474 ◽  
Author(s):  
Yamaan S. Saadeh ◽  
Clay M. Elswick ◽  
Jibran A. Fateh ◽  
Brandon W. Smith ◽  
Jacob R. Joseph ◽  
...  

2019 ◽  
Vol 4 (4) ◽  
pp. 2473011419S0023
Author(s):  
James Rush Jones ◽  
Haley McKissack ◽  
Aaradhana J. Jha ◽  
Leonardo V. M. Moraes ◽  
Jun Kit He ◽  
...  

Category: Sports Introduction/Purpose: Surgical repair of the Achilles tendon is a commonly-performed procedure in cases of acute tendon rupture. Open Achilles tendon surgery with traditional extensile approach is most often performed with the patient in prone position, but this can interfere with airway access, put increased pressure on the abdomen, and subject to increase perioperative period and comorbidities. Mini-open approach in supine repair may potentially avoid the risks of the prone position, but the safety and utility of this approach have not been established. The purpose of this study is to compare perioperative outcomes between patients undergoing acute Achilles rupture repair with mini-open approach in the supine position versus traditional approach in the prone position. Methods: Patients who underwent surgical repair of acute Achilles rupture between the years 2011 and 2018 at a single institution were retrospectively identified using CPT code 27650. Patients who underwent concurrent procedures for additional injuries were excluded. Charts of included patients were retrospectively reviewed for demographic information, intraoperative characteristics, and postoperative outcomes. Statistical analysis was conducted and p-values =0.05 were considered significant. Results: A total of 81 patients were included for analysis, 26 supine and 55 prone. Baseline characteristics were statistically similar between the two groups. Average total time in the operating room was significantly greater among patients in the prone position (118.7 minutes) than those in the supine position (100 minutes) (p = 0.0011). Average surgery time, blood loss, and time in PACU were greater among the prone group than the supine group, although these differences were not statistically significant. Average postoperative pain score, infection rate, dehiscence rate, sepsis rate, and DVT rate were also similar between the two groups. Conclusion: The mini open approach in supine position may be advantageous in repair of acute Achilles rupture in that it significantly reduces total time in the operating room while maintaining positive patient outcomes. Prospective clinical studies are warranted to validate these assessments.


2019 ◽  
Vol 4 (4) ◽  
pp. 2473011419S0013
Author(s):  
Karthikeyan Chinnakkannu ◽  
Haley McKissack ◽  
Gean C. Viner ◽  
Jun Kit He ◽  
Leonardo V. M. Moraes ◽  
...  

Category: Ankle, Ankle Arthritis, Arthroscopy, Basic Sciences/Biologics Introduction/Purpose: Ankle arthrodesis is a gold standard for end-stage ankle arthritis after conservative managements fail. It may be done through direct anterior, lateral, arthroscopic or mini open approaches. Joint preparation, apposition of joint surfaces and stable fixation are very important for successful outcomes. Ankle arthrodesis maybe associated with infection, chronic pain and nonunion - of these, nonunion is the most common complication reported. Achieving union is of utmost importance while minimizing complications associated with the procedure. Regardless of approach or fixation method, preparation of articular surface is of paramount importance for successful union and may be limited by the approach used. Our study aims to evaluate the difference between direct lateral and dual mini-open approaches (extended arthroscopic portals) in terms of joint preparation. Methods: We used 10 below knee fresh-frozen cadaver legs for this cadaveric study. Ankle joints of five specimens were prepared through the lateral approach, while the remaining five ankles were prepared using dual mini incisions. After the completion of preparation, all ankles were dissected to open, photographic images of tibial plafond and talar articular were taken. Surface areas of each articular facet and unprepared cartilage of the talus, distal tibia, and distal fibula were measured and analyzed using ImageJ software. Results: Significantly greater amount of total surface area was prepared among specimens using mini-open approach compared to those with trans-fibular approach. The percentage of total articulating surface area prepared (including talus and tibia/fibula), talus, tibia and fibula in trans-fibular approach were 76.9%, 77.7% and 75% respectively. The percentages were 90.9%, 92.9%, and 88.6% in mini-open approach. While the medial gutter was well prepared with mini incision technique (unprepared surface 44 .64% vs 91.08%), lateral gutter was well prepared in trans-fibular technique (88.82vs 82.04 square cm). There is no difference in the amount of unprepared surface of talar dome between the two approaches. When excluding the medial gutter, there was no significant difference between trans-fibular and mini open techniques (83.94 vs 90.85, p=0.1412). Conclusion: Joint preparation using the mini-open approach (extended arthroscopic portal) is equally as efficacious as the transfibular approach for preparation of the tibiotalar joint. When including preparation of the medial gutter, the mini-open approach provides superior joint preparation. This may be advantageous with decreased rate of nonunion and less complications. But many surgeons fuse only tibiotalar surface, considering that, both approaches yield equal amount of joint preparation. But it needs to be confirmed with clinical studies.


2011 ◽  
Vol 2011 ◽  
pp. 1-5 ◽  
Author(s):  
Ilse Degreef ◽  
Luc De Smet

In cubarthritis—osteoarthritis of the elbow—surgical procedures may be considered to debride the elbow joint to reduce pain, to increase mobility, and to postpone joint replacement surgery. The ulnohumeral arthroplasty as described by Outerbridge and Kashiwagi was originally introduced to debride both anterior and posterior elbow compartments through a direct posterior mini-open approach. To achieve this, a distal humeral fenestration throughout the humeral fossa is performed. Although with an elbow arthroscopy, a technique that was obviously developed later on, all compartments can be easily visualized. The arthroscopic fenestration of the humerus preserves its advantages, with good clinical results focused on pain relief and gaining mobility. On top, future elbow joint locking based on degenerative loose bodies can be prevented. Therefore, this surgery is often done in young, more active patients and even in sportsmen. These patients, however, need to be prompted to restrict loading on the elbow in the immediate postoperative period, because the elbow is biomechanically weakened and may be prone to a fracture. However, both outcome and postoperative rehabilitation are promising and the arthroscopic Outerbridge procedure is a reliable procedure with an easy rehabilitation. Therefore, the threshold is relatively low in early cubarthritis and recurrent locking of the elbow. In this paper, we present a literature review and the author's experience and own research on the Outerbridge procedure.


2014 ◽  
Vol 96 (5) ◽  
pp. 331-338 ◽  
Author(s):  
RJ MacFarlane ◽  
S Konan ◽  
M El-Huseinny ◽  
FS Haddad

Introduction Femoroacetabular impingement (FAI) resulting from abnormal contact between the acetabulum and femur has been studied extensively in recent years owing to its association with acetabular labrum tears and possible contribution to the development of osteoarthritis. Methods A comprehensive PubMed, MEDLINE® and Embase™ literature search was conducted. Search terms included ‘femoroacetabular impingement’, ‘pathophysiology’, ‘diagnosis’, ‘dGEMRIC’, ‘arthroscopic’, ‘open’, ‘mini-open’ and ‘outcome measure’. Results A range of radiographic features have been described, and computed tomography and magnetic resonance imaging are both commonly used in the diagnosis of the bony abnormalities in FAI. Treatment of FAI is surgical with methods of treatment ranging from open surgical hip dislocation to arthroscopic osteochondroplasty. Conclusions In recent years, a trend towards the use of arthroscopic treatment for FAI has been seen, with promising results from a range of studies. However, only short-term outcome data are available and a range of different outcome measures have been used in studies to date. We present an overview of the outcomes for a range of surgical treatment methods for FAI and discuss the outcome measures used.


10.14444/2054 ◽  
2015 ◽  
Vol 9 ◽  
pp. 54 ◽  
Author(s):  
José Antonio Soriano-Sánchez ◽  
Luis Alberto Ortega-Porcayo ◽  
Carlos Francisco Gutiérrez-Partida ◽  
Luis Rodolfo Ramírez-Barrios ◽  
Ramses Uriel Ortíz-Leyva ◽  
...  

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