Arthroscopy News

ORLANDO — In a presentation at the Arthroscopy Association of North America Annual Meeting, Hannan Mullett, MCh, FRCSI (Tr&Orth), noted that the open Latarjet technique may lead to better outcomes and lower complications in collision athletes compared with an arthroscopic Latarjet technique.

Shown are the steps for completion of a transtibial pullout technique with a tensionable anchor for repair of meniscal root tears. The technique involves reaming a 5-mm bone socket using a 6-mm FlipCutter (Arthrex). Sutures are then shuttled with a Firstpass Mini suture passer (Smith & Nephew) through various tunnels. The repair construct is ultimately tensioned under direct arthroscopic visualization.

After National Football League players underwent hip arthroscopy for femoroacetabular impingement, the return-to-sport rate was high, according to recently published results.

Changes in MRI-based features progressed in patients with meniscal tears and osteoarthritis regardless of whether they underwent arthroscopic partial meniscectomy or were treated nonoperatively and underwent physical therapy, according to published research.

Controversial in the patellofemoral surgery world are indications for trochleoplasty. David Dejour, MD, and Philip Schoettle, MD, PhD, continuing the landmark trochlea classification work of Henri Dejour, MD, have studied and recommended trochleoplasty in the treatment of select patients with patella instability. Several surgeons, mostly in Europe, report good results.

Keeping patients safe during and after orthopedic outpatient surgery of all types — arthroscopy, joint replacement, hand, spine and other procedures —will be of ongoing concern as the frequency with which these procedures are performed increases and anesthesia and surgical protocols evolve. The American Academy of Orthopaedic Surgeons stated in a position statement that with the continued advancement of medical technology comes more opportunities for outpatient surgery to be utilized. However, lingering concerns about the safety of outpatient orthopedic surgery remain.

Superior capsule reconstruction is a new treatment option for massive, irreparable posterosuperior rotator cuff tears (Figure 1). The treatment goals for massive tears are to reduce pain, restore shoulder function and delay the development of cuff tear arthropathy. Superior capsule reconstruction is an exciting and promising new procedure that can achieve these goals. Moreover, superior capsule reconstruction can be performed arthroscopically, which minimizes the complication risk. Superior capsule reconstruction uses a bridging graft that is attached at the superior glenoid and at the greater tuberosity to re-stabilize and re-center the humeral head. Teruhisa Mihata, MD, who is credited with inventing the procedure, recently reported on 100 patients who underwent superior capsule reconstruction with fascia lata autografts at a minimum of 2-years follow-­up. In that series, the American Shoulder and Elbow Surgeons score improved significantly from 36 preoperatively to 92 postoperatively and MRI follow-up showed 95% of patients had intact capsule reconstructions.

Use of chloroprocaine may provide adequate anesthesia with quick recovery of sensory and motor functions for patients undergoing knee arthroscopy in the ambulatory setting, according to results presented at the Regional Anesthesiology and Acute Pain Medicine Meeting.

EFORT Open Reviews is the new open access journal from EFORT and Bone & Joint Publishing. All articles are free to read online with no subscription required.

LAS VEGAS — At the American Academy of Orthopaedic Surgeons Annual Meeting, James Gladstone, MD, chief of the orthopedic sports medicine service in the department of orthopedic surgery at the Mount Sinai Health System and associate professor of orthopedic surgery at the Icahn School of Medicine at Mount Sinai, spoke about patient education on postoperative pain management for arthroscopic meniscectomy.