When the lateral collateral ligament (LCL) complex falters in supporting the radiocapitellar and ulnohumeral joints during advanced stages of deficiency, the consequence is posterolateral rotatory instability (PLRI) for the patient. Employing a ligament graft for open repair of the lateral ulnar collateral ligament constitutes the standard treatment for PLRI. This procedure, while showing promising clinical stability figures, is characterized by substantial lateral soft-tissue dissection and an extended recovery time. To increase stability, one can arthroscopically imbricate the LCL at its humeral insertion point. The senior author implemented revisions to the technique. Using a passer, the LCL complex, the lateral capsule, and the anconeus can be woven with a single (doubled) suture that's secured with a Nice knot. In patients with grade I and II PLRI, the strategically layered approach of the LCL complex may lead to improved stability, pain reduction, and functional advancement.

Management of patellofemoral instability in patients with severe trochlear dysplasia has been addressed through the implementation of a trochleoplasty procedure, emphasizing the deepening of the sulcus. This document outlines the improved Lyon sulcus deepening trochleoplasty method. Through a methodical and stepwise approach, the trochlea is prepared, subchondral bone is removed, the articular surface is osteotomized, and the facets are fixed with three anchors while minimizing the risk of any complications.

Anterior cruciate ligament (ACL) tears, among other common injuries, can induce both anterior and rotational knee instability. A method of arthroscopic anterior cruciate ligament reconstruction (ACLR) has demonstrated effectiveness in restoring anterior translation stability, yet subsequent rotational instability, including persistent pivot shifts or recurring instability episodes, may still arise. Lateral extraarticular tenodesis (LET), an alternative technique, has been suggested as a method for addressing persistent rotational instability after anterior cruciate ligament reconstruction (ACLR). This article details a case study involving a lateral extra-articular tenodesis (LET) procedure. An autologous graft derived from the central portion of the iliotibial band was employed, secured to the femur via a 18-mm knotless suture anchor.

Injuries to the meniscus, a common component of the knee joint, often require the precise repair provided by arthroscopic surgery. At the present time, the methods of meniscus repair are principally composed of inside-out, outside-in, and all-inside procedures. All-inside technology's superior results have made it a favored choice among clinicians. We introduce a continuous sewing machine-like suture technique as a way to address the imperfections of all-inclusive technology. Our technique facilitates the creation of a continuous meniscus suture, enhancing its flexibility, and increasing the stability of the suture knot through a method of multiple punctures. Utilizing our technology for complex meniscus injuries can substantially reduce the overall cost of surgical intervention.

Acetabular labral repair seeks to reinstate consistent contact between the labrum and acetabulum, preserving the structural integrity of the suction seal. Ensuring the labrum's precise, native-positioned contact with the femoral head presents a significant hurdle during labral repair. This technique paper describes a repair strategy, enabling the labrum to invert better, aiding in an anatomical repair process. The anchor-first technique of our modified toggle suture technique presents several demonstrably superior technical advantages. We detail a vendor-independent and effective method to facilitate the use of both straight and curved guides. Analogously, anchors can be designed as either entirely sutured or hard-anchored, with the latter enabling suture adjustment. To prevent knot displacement towards the femoral head or joint area, this technique leverages a self-retaining hand-tied knot configuration.

Often, a tear in the anterior horn of the lateral meniscus, accompanied by local parameniscal cysts, necessitates cyst removal and meniscus repair using the outside-in technique. Cyst removal would unfortunately create a pronounced gap between the meniscus and the anterior capsule, complicating OIT closure. Knee pain might arise from the OIT, specifically from overly tight knots. Accordingly, we formulated a procedure for anchor repair. After the cysts were removed, the anterior horn of the lateral meniscus (AHLM) was fixed to the anterolateral tibial plateau using a suture anchor, followed by suturing the AHLM to the surrounding synovial tissue for optimal healing. This technique is presented as an alternative method for the repair of AHLM tears, which may also include local parameniscal cysts.

The growing prevalence of lateral hip pain is correlated with diagnosed deficiencies in gluteus medius and minimus function, causing abductor impairments. In cases of a failed gluteus medius repair or when tears are irreparable, a transfer of the anterior gluteus maximus muscle is a potential treatment for gluteal abduction insufficiency. Japanese medaka The classic description of the gluteus maximus transfer process explicitly features bone tunnel fixation as the critical element of the procedure. The study presented in this article details a reproducible method of adding a distal row to tendon transfers. This addition may enhance fixation by compressing the tendon transfer against the greater trochanter and providing increased biomechanical robustness to the transfer.

The shoulder's anterior stability is maintained by the subscapularis tendon, which, along with capsulolabral tissues, prevents anterior dislocation, attaching to the lesser tuberosity. Subscapularis tendon tears frequently manifest as anterior shoulder discomfort and internal rotation weakness. Mesoporous nanobioglass Patients with subscapularis tendon partial-thickness tears, unresponsive to conservative management, could benefit from surgical intervention. A transtendon repair of a subscapularis tendon tear, focused on the articular side, similar to a PASTA repair, can potentially cause over-tensioning and bunching of the subscapularis tendon on its bursal aspect. We advocate for an arthroscopic, all-inside, transtendon repair technique for high-grade, partial articular-sided subscapularis tendon tears, avoiding any bursal-sided tendon overtension or bunching.

The problems in bone tunnel expansion, defects, and revision surgery resulting from preferred tibial fixation materials in anterior cruciate ligament procedures have fueled the increasing adoption of the implant-free press-fit tibial fixation technique. Several benefits are associated with employing a patellar tendon-tibial bone autograft for anterior cruciate ligament reconstruction. A description of the tibial tunnel preparation process and the employment of a patellar tendon-bone graft in the implant-free tibial press-fit technique is provided. In this context, the Kocabey press-fit technique refers to this method of operation.

Through a transseptal portal, we delineate a surgical technique for reconstructing the posterior cruciate ligament by harvesting a quadriceps tendon autograft. In preference to the transnotch method, the tibial socket guide is inserted via the posteromedial portal. The transseptal portal facilitates clear visualization during tibial socket drilling, safeguarding the neurovascular bundle and negating the requirement for fluoroscopy. click here The advantage of the posteromedial approach resides in the ease with which the drill guide can be placed, and the ability to pass the graft through both the posteromedial portal and the notch, which streamlines the challenging turn. Within the tibial socket, the bone block, which includes the quad tendon, is secured with screws passing through both the tibial and femoral sides.

Ramp lesions are key factors in maintaining the anteroposterior and rotational stability of the knee joint. The clinical assessment and magnetic resonance imaging examination both pose difficulties in the diagnosis of ramp lesions. A diagnosis of a ramp lesion can be ascertained via arthroscopic identification of the posterior compartment and subsequent probing through the posteromedial portal. Improper management of this lesion will result in undesirable knee movement characteristics, sustained knee instability, and a significantly increased likelihood of the reconstructed anterior cruciate ligament failing. Two posteromedial portals and a knee scorpion suture-passing device are integral to this simple arthroscopic procedure for ramp lesion repair. The final steps involve a 'pass, park, and tie' maneuver.

Due to a heightened recognition of the meniscus's significance in the proper operation and functionality of the knee joint, surgical repair of meniscal tears is becoming the more favored treatment over the historical practice of partial meniscectomy. Meniscal tissue repair employs diverse techniques, encompassing approaches like outside-in, inside-out, and all-inside repair methods. Every technique comes with its strengths and shortcomings. Inside-out and outside-in techniques, leveraging knots situated external to the joint capsule for enhanced repair precision, nevertheless present a potential risk of neurovascular injury and demand additional incision points. Arthroscopic all-inside repair procedures have shown a rise in use, yet the current methods of achieving fixation, either via intra-articular knots or extra-articular implants, can lead to fluctuating outcomes and the possibility of post-operative problems. SuperBall, an all-inside meniscus repair device described in this technical note, offers a completely arthroscopic solution. The method eliminates intra-articular knots and implants, providing surgeon-controlled tensioning of the meniscus repair.

In the context of extensive rotator cuff tears, the rotator cable, an essential biomechanical element of the shoulder, is often affected. Surgical techniques for reconstructing the cable have been refined in tandem with advancements in our comprehension of the structure's biomechanics and anatomical significance.