Enhancing knot security by heat treatment of knot ears.

Heat treatment of the ears of knotted sutures markedly enhances knot security. Using coated polyester sutures commonly used in arthroscopic surgery, heat treatment of the knot ears allows secure knot construction to be achieved with a two throw granny (1 x 1) or square (1 = 1) knot. A heat source is being designed for secure knot construction in arthroscopic surgery.

Innovative techniques in arthroscopic meniscal repair.

Advanced techniques for arthroscopic repair of meniscal tears offer new ways to repair the meniscus and reduce the rate of long-term arthrosis. The new all-inside technique reduces complications, morbidity, and surgical time as compared to the inside-out or outside-in methods of repair. Application of biomaterial technology to new implants used for all-inside arthroscopy show early promising clinical results. The purpose of this report is to describe new biomaterials and techniques being used successfully in arthroscopic surgery on the meniscus.

Modern concepts in arthroscopic Bankart repair.

The purpose of this report is to review recent advances in Bankart repair that allow it to be performed arthroscopically. Metallic implants in the form of staples, screws, or rivets were used initially, but problems with loosening of implants has prompted development of alternative devices and techniques. A modified form of the transglenoid suturing technique used in open Bankart repair has been used successfully but is associated with an increased risk of soft tissue complications. The use of absorbable tacks avoids some of the complications associated with this approach, but the ability to advance the capsule to reduce the volume is limited. Recently, the use of suture anchors has been described for arthroscopic Bankart lesion repair. However, the ability of these anchoring systems to advance and reduce the capsular volume is limited, and the arthroscopic techniques are technically demanding. One particularly innovative suture anchor system uses a bioabsorbable suture anchor with an integrated suture passing system. This self-contained implant allows multiple passes with suture through the capsule, followed by attachment to the glenoid with the bioabsorbable anchor. This procedure allows the capsule to be advanced by passing suture through before it is anchored to the glenoid, thereby reducing capsular volume to help restore shoulder stability.

Traumatic chronic TMJ dislocation: report of an unusual case and discussion of management.

Dislocation of the temporomandibular joint (TMJ) is most often spontaneous, but it can be associated with direct or indirect head and neck trauma. The disorder may be treated in general by simple closed techniques, if managed acutely. If the dislocation becomes chronic, however, open reduction is usually required. The article discusses various methods for an open surgical approach described in the literature. A case of a prolonged TMJ dislocation is presented, involving a severe bilateral mandibular dislocation with the condyles displaced into the infratemporal fossa and the lateral poles of the condyles articulating on the inner aspect of the zygomatic arch. An open approach, involving masseter, temporalis, and the medial pterygoid muscles, was utilized, followed by the use of scissors mouth props, Erich arch bars, and postoperative elastic traction.