Single-Portal Arthroscopic Posterior Capsulorrhaphy for Recurrent Shoulder Capsule Laxity and Instability.

Arthroscopic stabilization for posterior shoulder instability is well documented in the literature, offering good to excellent clinical outcomes after injury with favorable return-to-sport and patient satisfaction rates. Posterior capsulorrhaphy addresses recurrent laxity by decreasing the size of the posterior capsule through arthroscopic placement of sutures, in addition to addressing posterior labral tears and any intra-articular pathology within the joint. This technical note describes an arthroscopic posterior capsulorrhaphy for recurrent posterior shoulder capsule laxity and instability in an active patient. This technique uses a single posterior working portal and 2 suture anchors to tighten the posterior capsule onto the intact labrum.

Arthroscopic Reduction of Bicruciate Tibial Avulsion Fractures: Lever Push Technique.

Combined anterior cruciate ligament and posterior cruciate ligament tibial avulsion fractures are rare knee injuries that are primarily seen in adults. Prompt surgical intervention is indicated for displaced fractures to restore knee stability. Arthroscopic techniques are now the preferred method for treating anterior tibial spine avulsion fractures with posterior cruciate ligament tibial avulsion fractures being treated arthroscopically or with open reduction and internal fixation methods. This Technical Note and accompanying video demonstrate an arthroscopically assisted repair of bicruciate tibial avulsion fractures using an arthroscopic lever push technique. Two sutures are passed through the anterior cruciate ligament and pulled down through two bone tunnels placed within the tibial fracture bed, and one suture is passed around the posterior cruciate ligament and pulled down through one bone tunnel passing from the anterior tibia to the tibial fracture bed. Our technique is simple and effective in reducing bicruciate tibial avulsion fractures to anatomic position.

Double-Row Rotator Cuff Repair Technique With Dermal Allograft Augmentation.

Rotator cuff tears are common and debilitating injuries in the orthopaedic patient population. Although arthroscopic repair of the rotator cuff generally leads to satisfactory outcomes, some tears would benefit from augmentation with allograft to supplement the native tissue. This biological augmentation has been shown to decrease retear rates and can be beneficial in certain cases based on the size of the tear, amount of retraction, age of the patient, and chronicity. In this technical note, we describe a simple and effective technique for arthroscopic rotator cuff repair with biological augmentation.

Adult Bado type I Monteggia fracture dislocation: A case report.

INTRODUCTION: Fractures of the proximal ulnar shaft accompanied by dislocation of the radial head have been described as "Monteggia fracture-dislocations," since the early nineteenth century. In 1967 Bado further classified these Monteggia fractures into four subtypes, based largely on the direction of the radial head dislocation (Bado, 1967). Despite being frequently discussed in the literature, Monteggia fracture dislocations are rare and represent only 0.7% of elbow fracture-dislocations in adults (Papaioannou et al., 2018). In adults, Bado type I lesions, where the radial head is displaced anteriorly are rarer still, and few cases have been reported in the literature (Papaioannou et al., 2018; Suarez et al., 2016; Egol et al., 2005; Saidi et al., 2018; Wong et al., 2015). CASE PRESENTATION: We present here the case of a 55-year-old male presenting with a Bado type I Monteggia fracture dislocation, resulting from direct trauma to the posterior ulnar surface of his arm. He was treated with ORIF five days after the injury, and by hospital discharge had had 75% active range of motion of his elbow to flexion and extension. CONCLUSION: We present this case of a rare adult fracture subtype with a unique mechanism to add to a paucity of existing literature on such cases and the approach to their care. These fracture-dislocations can be easy to miss because the radial dislocation can be subtle and overshadowed by the more obvious ulnar fracture. This case report hopes to contribute to the expedient recognition of this fracture dislocation syndrome, which is crucial to the preservation of range of motion and arm function for these patients.