The Hip - book

Shoulder Arthroscopy – Subacromial Bursectomy:

– Surgical Considerations: (arthroscopic rotator cuff repair / acromioplasty)    – note that the subacromial bursa is an anterior structure; – it is located from anterior 1/2 to 1/3 of acromion to just medial to A-C joint to 1 to 2 cm anterior to acromion & 2.5 cm laterally; – posterior busrsal wall is thick posteriorly (called posterior bursal … Read more

Initial Steps in Arthroscopic Acromioplasty

 Positioning:      – beach chair position is comfortable for both the patient and the surgeon and allows the option of converting to an open procedure (if necessary);     – patients need to be seated with the torso raised to 70 deg with a foled sheet placed on the medial border of the affected scapula … Read more

Shoulder Capsule / Rotator Interval Capsule

– Rotator Interval Capsule:     – rotator interval is a triangular portion of shoulder capsule which lies between the supraspinatus and subscapularis tendons;     – capsular anatomy: (Static Stabilizers / Capsule of the Shoulder)           – interval capsule is reinforced by the superior glenohumeral and coracohumeral ligaments;            – references:                   – Capsular ligaments … Read more

Healing of Rotator Cuff Tears / Repair

– Discussion:  – rotator cuff anatomy – etilogy of tear and frequency of tear – partial rotator cuff tear – how do RTC tears heal?     – arthroscopic vs open rotator cuff repair – biology of tendon healing to bone – references: – Histological evaluation of repair of the rotator cuff in a primate model – Repair integrity and … Read more

RTC Repair: Convergence Repair

– See RTC Repair – References: Modified Margin Convergence Technique Using Suture Anchors for Footprint Reconstruction of Rotator Cuff Tears A novel technique of rotator cuff repair using spinal needle and suture loop Anatomic reduction and next-generation fixation constructs for arthroscopic repair of crescent, L-shaped, and U-shaped rotator cuff tears. Arthroscopic Side-to-Side Rotator Cuff Repair … Read more

Physical Therapy after RTC Repair

   Incidence and treatment of postoperative stiffness following arthroscopic rotator cuff repair. Does slower rehabilitation after arthroscopic rotator cuff repair lead to long-term stiffness? Subacromial pressures vary with simulated sleep positions. Shoulder kinematics during the wall push-up plus exercise.    

Pigmented Villonodular synovitis

Discussion pigmented villonodular synovitis is a slow growing, benign, and locally invasive tumor of the synovium; location: most often involves the knee (also in hip, ankle, elbow, etc.); always consider PVNS in a younger patient with unexplained hip pain; acute episodic attacks of pain and swelling may occur; patients may have mechanical symptoms (locking and … Read more