Knee Meniscus Posterior Root Repair with FiberTak.

Repair of medial meniscal root tear is nowadays a validated procedure in order to restore knee biomechanics and to prevent early development of arthritis. There are various techniques described, without any being considered superior. This article describes a technique with a knotless suture anchor design, using a high posteromedial portal to insert the anchor and a meniscal suture passer device from the anteromedial portal. The technique eliminates the need for transtibial drilling and knot tying, and it certifies a strong reproducible tension.

Ultrasound-Guided Electrocoagulation of Neovessels for Chronic Patellar Tendinopathy.

Chronic patellar tendinopathy remains a challenging problem. The first line of treatment is conservative; when this fails, surgical treatment is indicated. Several open and arthroscopic techniques have been described. We describe an alternative technique using ultrasound-guided electrocoagulation of neovessels that leaves the patellar tendon intact.

Figure-of-4 Cruciate Remnant Objective Assessment Test Reducibility of Anterior Cruciate Ligament Stump for Feasibility of Arthroscopic Primary Anterior Cruciate Ligament Repair.

Suture of the anterior cruciate ligament (ACL) has reemerged as a treatment option for proximal ACL tears. Preoperative imaging can provide insight into the feasibility of performing arthroscopic primary ACL repair, but the final decision is taken only after confirming with arthroscopy that the ACL remnant is reducible. We describe a test called the Figure-of-4 Cruciate Remnant Objective Assessment test that objectively interprets the reducibility of the ACL remnant for arthroscopic primary ACL repair.

Long-Term Follow-Up of Anterior Spinal Fusion for Thoracolumbar/Lumbar Curves in Adolescent Idiopathic Scoliosis.

STUDY DESIGN: Retrospective patient series analysis with update of long-term data. OBJECTIVE: To define the long-term prognosis of the thoracolumbar/lumbar correction after selective anterior spinal fusion (ASF) in adolescent idiopathic scoliosis (AIS). SUMMARY OF BACKGROUND DATA: The ASF is a well-described procedure for the treatment of AIS. The correction reliability over time, the consequences in adjacent spinal levels and patient's quality of life are fundamental for the characterization of AIS treatment. METHODS: One hundred seven patients were submitted to single-rod ASF for thoracolumbar/lumbar (ThL/L) AIS between 1993 and 2016 in a single-surgeon experience. Seventy five were available for final follow-up evaluation 9 years ±4 (2-23) after surgery. A clinical and sequential radiographic evaluations were performed. RESULTS: The mean age at surgery was 16 years ±â€Š2.33 (14-20) and 94 (87%) were females. The mean final follow-up of the 75 patients available was 9 years ±â€Š4 (2-23). Sixty-five patients had a Lenke type 5C curve and 10 had a type 6C curve. The mean values of the Scoliosis Research Society 22 (SRS-22) questionnaire in Lenke 5C was 92 ±â€Š9 (71-109) and in Lenke 6C 90.3 ±â€Š9 (75-107). In Lenke 5C group, the mean preoperative ThL Cobb angle was 38.4°â€Š±â€Š9.3 (21-60) and the postoperative was 5.9°â€Š±â€Š4.5 (0-18; P < 0.001) being similar at the final follow-up (P > 0.05). In Lenke 6C group, the mean preoperative ThL Cobb angle was 58.6°â€Š±â€Š13.9 (40-90) and the postoperative ThL Cobb was 22.6°â€Š±â€Š14.5 (5-48, P < 0.001) being similar at the final follow-up (P > 0.05). The mean preoperative Thoracic (Th) Cobb angle was 39°â€Š±â€Š7.6 (30-50), the postoperative was 30.6°â€Š±â€Š10.1 (14-49, P < 0.008) and in the final follow-up was 29.3°â€Š±â€Š10.7 (11-48, P < 0.011). CONCLUSION: ASF is a safe procedure in the treatment of ThL/L with good long-term results and high rates of satisfaction among patients with AIS Lenke type 5C. The partial correction was frequent in Lenke type 6C despite the absence of progression in the non-instrumented curves. LEVEL OF EVIDENCE: 4.

Lateral Meniscus Repair Using Posterolateral Portal: Suture Hook Technique.

Lateral meniscus lesions result in loss of meniscus hoop stresses and can lead to lateral compartment overload and early degenerative changes. Arthroscopic suture repair provides good long-term results. However, posterior vertical tears in the peripheral area of the meniscus can be technically challenging to resolve. This Technical Note describes the suture hook technique using an accessory posterolateral portal. We believe it is a safe, effective method for repairing full vertical tears of the lateral meniscus.

Anterior Closing-Wedge Osteotomy for Posterior Slope Correction With Tibial Tubercle Preservation.

An excessive posterior tibial slope has been identified as a potential risk factor for anterior cruciate ligament tears. Anterior closing-wedge osteotomy decreases the posterior slope and can eliminate this risk factor in patients with recurrent instability and greater than 12° posterior slope. We will describe an anterior closing-wedge osteotomy technique performed at the tibial tubercle (TT), in which the TT is not detached to preserve the extensor mechanism attachment. A vertical cut is performed in the sagittal plane just posterior to the TT, leaving a distal cortical hinge. Two proximal parallel K-wires and 2 distal parallel K-wires convergent to the proximal ones are inserted from the anterior cortex on both sides of the tubercle toward the tibial posterior cortex at the posterior cruciate ligament's tibial insertion. Proximal and distal cuts are performed to remove the bone wedge. Reduction is achieved by gentle knee extension. Fixation is completed with 2 staples placed medially and laterally to the TT.