This technique's core objective is to reproduce the structure and function of the native ligaments supporting the AC joint, thereby improving both clinical and functional outcomes.

Patients with anterior shoulder instability often require surgical intervention on the shoulder joint. An anterior arthroscopic approach, facilitated by the beach-chair position, is employed to present a modified technique for treating anterior shoulder instability, focusing on the rotator interval. The technique for opening the rotator interval increases its workable space, allowing work to proceed without the use of cannulae. Employing this method, we can thoroughly address all injuries and, when required, transition to other arthroscopic procedures for instability, including arthroscopic Latarjet procedures or anterior ligament reconstructions.

Clinicians are encountering an increasing prevalence of meniscal root tears. An enhanced understanding of the biomechanical interaction between the meniscus and tibiofemoral joint surface makes timely identification and repair of these injuries crucial. The tibiofemoral compartment's force can rise up to 25% as a result of root tears, potentially advancing degenerative changes visually detectable on radiographs, which consequently impacts favorable patient outcomes. Multiple repair techniques for meniscal roots, along with a description of their anatomical footprint, have been documented, the most prominent being the arthroscopic-assisted transtibial pullout technique for posterior meniscal root repair. The application of tensioning, with its various approaches, is a surgical element prone to errors during the operation's progression. Our transtibial procedure utilizes a modified approach to suture fixation and tensioning. First, two doubled sutures are inserted through the root, producing a looped end and a twin-tailed end. A locking, tensionable, and potentially reversible Nice knot is applied to the anterior tibial cortex, secured over a button. When a suture button is tied over the anterior tibia with stable suture fixation to the root, the root repair benefits from controlled and accurate tension.

Orthopaedic injuries frequently include rotator cuff tears, a common occurrence. Biolistic-mediated transformation Untreated, these conditions can lead to a substantial, irreversible tear due to tendon retraction and muscle wasting. In their 2012 research, Mihata et al. presented a description of superior capsular reconstruction (SCR) utilizing an autograft from the fascia lata. This method of treating irreparable massive rotator cuff tears has consistently proven to be both acceptable and effective, according to clinical observation. Employing an arthroscopic approach, this superior capsular reconstruction (ASCR) method utilizes solely soft tissue anchors to preserve bone and reduce possible hardware-related complications. The ease of reproduction of the technique is further facilitated by the use of knotless anchors for lateral fixation.

Massive, non-repairable rotator cuff tears create a considerable difficulty for both the attending orthopedic surgeon and their patient. Treatment for extensive rotator cuff tears may include arthroscopic debridement, biceps tenotomy or tenodesis, arthroscopic rotator cuff repair, partial rotator cuff repair, cuff augmentation, tendon transfers, superior capsular reconstruction, the insertion of subacromial balloon spacers, and ultimately, reverse shoulder arthroplasty as a last resort. A summary of these treatment options, coupled with a procedural description of the subacromial balloon spacer placement surgery, will be presented in this investigation.

The arthroscopic approach to large rotator cuff tears, while demanding from a technical perspective, is frequently attainable. Adequate releases are vital to the success of tendon mobility, preventing excessive tension in the final repair stage and thus recreating the native anatomy and biomechanics. This technical note details a step-by-step method for the release and mobilization of substantial rotator cuff tears, aligning them with or close to the anatomical tendon footprints.

The incidence of postoperative retears following arthroscopic rotator cuff repair remains constant, notwithstanding advancements in suture techniques and anchor implant technology. Rotator cuff tears, frequently degenerative, pose a risk of tissue damage. To bolster rotator cuff repair, numerous biological strategies have been formulated, including a diverse range of autologous, allogeneic, and xenogeneic augmentation methods. The biceps smash, a novel arthroscopic augmentation procedure for rotator cuff reconstruction in the posterosuperior area, uses an autograft from the long head of the biceps tendon, as detailed in this article.

When scapholunate instability reaches its most severe form, whether characterized by dynamic or static symptoms, classical arthroscopic repair becomes extremely problematic. The technical complexity of ligamentoplasties and other open surgical procedures is further complicated by frequent operative complications and the potential for stiffness. Thus, the management of these complex cases of advanced scapholunate instability hinges on the necessity of therapeutic simplification. For a minimally invasive, reliable, and easily reproducible solution, little equipment beyond arthroscopic material is required.

Posterior cruciate ligament (PCL) reconstruction using arthroscopic techniques, though technically demanding, can be associated with numerous intraoperative and postoperative complications. Iatrogenic popliteal artery injuries, while infrequent, represent a noteworthy intraoperative risk. At our facility, we've devised a straightforward and successful method involving a Foley balloon catheter, ensuring the safety of the procedure and minimizing the risk of neurovascular issues. buy ISA-2011B The inflatable balloon, introduced through a lower posteromedial portal, establishes a protective boundary between the PCL and posterior capsule. This bulb, filled with betadine or methylene blue, provides a clear indicator for balloon ruptures, signaled by the dye leaking into the posterior compartment. The balloon's expansion, mimicking the balloon's diameter, substantially widens the space between the popliteal artery and the PCL by pushing the capsule posteriorly. By incorporating this balloon catheter protection method alongside other techniques, the procedure for anatomical PCL reconstruction will be performed with considerably greater safety.

Arthroscopic fixation procedures for greater tuberosity fractures have seen widespread adoption during the recent years. Although open methodologies show promise, notably in avulsion-type fractures, split fractures are frequently treated with a combination of open reduction and internal fixation procedures. However, employing suture constructs offers a more dependable stabilization approach for treating multifragment or split-type fractures, particularly those in osteoporotic bone. The utilization of arthroscopy in the management of these more complex fractures is currently questionable due to inherent limitations in anatomical restoration and issues with achieving and sustaining structural integrity. A technically simple and reproducible arthroscopic approach, underpinned by anatomical, morphological, and biomechanical principles, is outlined by the authors, yielding advantages over open or double-row arthroscopic techniques in addressing the majority of split-type greater tuberosity fractures.

The utilization of osteochondral allograft transplantation provides a composite of cartilage and subchondral bone, making it applicable to substantial and multifaceted defects where self-tissue procedures are restricted due to donor site morbidity. Failed cartilage repair frequently necessitates osteochondral allograft transplantation, as patients often present with extensive defects impacting both cartilage and the underlying subchondral bone, and the use of multiple, overlapping grafts is a viable approach. Patients with failed osteochondral grafts, young and active, benefit from the reproducible preoperative evaluation and surgical approach described, which is otherwise unsuitable for knee arthroplasty.

Diagnosing a lateral meniscus tear at the popliteal hiatus presents a clinical challenge, complicated by preoperative diagnostic difficulties, the confined surgical space, the absence of robust capsular attachments, and the potential for vascular damage. This article showcases an arthroscopic, single-needle, all-inside repair technique for longitudinal and horizontal tears of the lateral meniscus, specifically within the popliteus tendon hiatus. We consider this technique to be a safe, effective, cost-efficient, and easily reproducible method.

Deep osteochondral lesion management continues to be a subject of significant contention. In spite of various studies and research attempts, a uniform and ideal technique for managing their treatment has yet to be determined. In all available treatments, the main objective lies in preventing the escalation towards early osteoarthritis. Consequently, this paper details a single-stage method for managing osteochondral lesions reaching or exceeding 5mm in depth, involving retrograde subchondral bone grafting to rebuild the subchondral bone, prioritizing the preservation of the subchondral plate, and the implantation of autologous minced cartilage combined with a hyaluronic acid-based scaffold (HyaloFast; Anika Therapeutics) under arthroscopic conditions.

Generalized joint laxity, combined with a desire for an active lifestyle, frequently leads to repeated lateral patellar dislocations affecting a young, athletic population. Killer cell immunoglobulin-like receptor The distal patellotibial complex is now considered crucial, prompting surgeons to target the recreation of native knee anatomy and biomechanics in procedures for medial patellar reconstruction. This study outlines a potentially more stable surgical approach for treating knee instability, specifically targeting patients with subluxation in full extension, patellar instability in deep flexion, genu recurvatum, and generalized hyperlaxity. The approach involves reconstruction of the medial patellotibial ligament (MPTL), medial patella-femoral ligament (MPFL), and medial quadriceps tendon-femoral ligament (MQTFL).