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Tibial Sagittal Slope in Anterior Cruciate Ligament Injury and Treatment


Published on: 01.13.2022

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Patient Positionning and Navigation
Creator:
Duration: 5:37
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Labral Preparation
Creator:
Duration: 2:51
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Patient Positionning and Navigation
Creator:
Duration: 5:37
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Syndesmosis Injury from Diagnosis to Repair
Creator:
Duration: 8:10
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Anterior "Shuck" Test Anterior instability
Creator:
Duration: 0:40
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Latarjet-Patte Procedure
Creator:
Duration: 0:26
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Pediatric Phalanx Fractures
Creator:
Duration: 0:14
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Stay Out of Trouble_Reverse Shoulder Arthroplasty
Creator: Enrico Bellato, MD
Duration: 00:26
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We discuss the key steps the surgeon should follow to perform a safe, successful primary reverse shoulder replacement. Proper patient selection, preoperative evaluation, and surgical technique are essential. CT is used to evaluate for glenoid version and possible glenoid bone defects, and in planning patient-specific instrumentation. Proper patient positioning is essential to avoid intraoperative patient shifting and neck stretching and to allow free shoulder range of motion. The deltopectoral or anterolateral approach can be used.
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Anterior Cervical Diskectomy_Fusion_Myeloradiculopathy
Creator: Gianluca Vadala, MD
Duration: 00:25
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The aim of this video is to show the surgical operative technique of anterior cervical diskectomy and fusion (ACDF) in a 45-year-old man affected by C5-C6 disc herniation with myeloradiculopathy, who suffered from brachialgia, pectoral fasciculation, and weakness at the inferior limbs associated to ambulation impairment.
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Upper Thoracic Vertebral Column Resection
Creator: Kartik Shenoy, MD
Duration: 00:26
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Vertebral column resection (VCR) is the most powerful tool in the spine surgeon’s armamentarium for deformity correction. In patients with severe, rigid spinal deformity, in which traditional osteotomies cannot achieve adequate correction without complication, VCR may be indicated. The posterior technique was popularized by Suk in 2002. We present a unique case in which proximal junctional kyphosis developed after a T4 VCR and T1-T10 instrumented fusion and the patient subsequently underwent a second VCR at T2 with extension of the fusion construct to restore sagittal alignment.
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Medial Malleolar Osteotomy Fresh Osteochondral Allograft
Creator: Michael A. Zacchilli, MD
Duration: 0:25
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Osteochondral allograft implantation has emerged as a promising treatment option for large osteochondral lesions of the talus (OLTs) because it provides both structural support as well as self-sustaining, viable chondrocytes. However, adequate access to the talar dome is critical for allograft implantation. Medial malleolar osteotomy has emerged as a reliable and safe method for exposure of the talar dome and shoulder region. We demonstrate a technique for fresh osteochondral allograft implantation of a large OLT through a medial malleolar osteotomy. Implantation often requires adequate exposure afforded by a medial malleolar osteotomy. Results are contingent on careful and consistent technique.
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Kocher Approach or Kaplan Approach to the Lateral Elbow
Creator: Davide Blonna, MD
Duration: 0:27
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The purpose of this educational video is to report our findings regarding the real anatomy of the lateral collateral ligament of the elbow and discuss how these findings affect our decision making regarding the best surgical approach to the lateral elbow.
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Ultrasound Guided Gastrocnemius Lengthening
Creator: Manuel Villanueva, MD, PhD
Duration: 0:27
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Ultrasound-guided proximal lengthening in patients with less marked gastrocnemius contracture demonstrated excellent preliminary results in most patients. The main indications for the surgical procedures were gastrocnemius contracture, noninsertional Achilles tendinopathy, equinus foot, plantar fasciitis, metatarsalgia, and tarsal tunnel syndrome. Pain and function improved significantly in all patients. There are few complications and contraindications. Bilateral procedures may be performed alone or in combination with other ultrasound-guided surgical techniques in an outpatient setting, with proximal or distal ultrasound-guided procedures. The procedure carries a steep learning curve.
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Total Femur Arthroplasty for Complex Periprosthetic Fracture
Creator: Amy Wasterlain, MD
Duration: 0:30
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Although total femur arthroplasty (TFA) has traditionally been thought of as a treatment for bone tumors of the thigh, it is becoming a versatile and effective technique in the management of complex periprosthetic femur fractures. Adult reconstruction indications include periprosthetic fractures with severe bone loss or comminution that precludes plate fixation and as a two-stage salvage procedure for persistent periprosthetic infection. The major complications associated with TFA include infection, hip or knee dislocation, limb-length discrepancy, fracture or failure of the prosthesis, and abductor muscle failure. TFA can be a useful salvage technique for the management of complex periprosthetic femur fractures.
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Correction of Varus Deformity in TKA With Pie Crusting
Creator: Han-Jun Lee, MD
Duration: 0:25
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Several methods exist for correcting severe varus deformity during total knee arthroplasty (TKA). Tibial subperiosteal stripping of the superficial medial collateral ligament (MCL) can lead to excessive release, as can traditional pie-crusting of the superficial MCL using a blade. We performed selective and sequential medial release using the pie-crusting method with multiple needle punctures and investigated the effectiveness and safety of the technique during primary TKA. There were no complications, that is, no hematoma formation, conversion to a constrained implant, or late instability. The technique was safe, reproducible, and effective in treating severe varus deformity during primary TKA.
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Pediatric Ankle Instability_Modified Brostrom Procedure
Creator: Kathleen Rickert, MD
Duration: 00:32
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The video shows the modified Broström technique of direct, anatomic repair to manage chronic lateral ankle instability in the immature athlete.
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Pemberton Pericapsular Osteotomy for DDH and Hip Dislocation
Creator: Luca Labianca, MD
Duration: 00:28
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The Pemberton pericapsular osteotomy is performed to manage acetabular deficiency in patients with developmental dysplasia of the hip. The video shows step by step the timeline of the procedure, beginning from the incision (ie, bikini incision) made just distal and parallel to the anterior superior iliac spine. Key points, as the LFCN isolation or the correct use of Cobb elevators to expose the anterior inferior iliac spine, are clearly shown. Moreover, we show how fluoroscopic imaging aids in determining the osteotomy cut, in addition to a wide and clear explanation, with several different views of the osteotomy itself.
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The Modified Stoppa Approach for Fractures of the Acetabulum
Creator: Michael T. Archdeacon, MD
Duration: 12:01
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The modified Stoppa, or anterior intrapelvic, approach to the acetabulum provides straightforward anatomic exposure that can be used for direct access to the pelvic brim, posterior column of the acetabulum, and the quadrilateral surface. The improved visualization provided by this approach facilitates fracture reduction and stabilization. This approach does not require surgical dissection of the inguinal canal and femoral neurovascular bundle. A traditional lateral window may be incorporated to facilitate reduction and stabilization of anterior column fracture. This anterior intrapelvic approach is contraindicated in fractures with posterior-only patterns that exit below the ischial spine.
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Closed Reduction and External Fixation of Proximal Humeral Fractures
Creator: Davide Blonna, MD
Duration: 0:27
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Our technique was developed to use the advantages of traditional percutaneous pinning (eg, temporary fixation, preservation of the soft tissues, better cosmesis) and improve its limitations, in particular, the weak fixation in osteoporotic bone. The main modifications are the use of long threaded pins to achieve purchase in good-quality bone beneath the articular surface of the humeral head and in the lateral cortex of the metaphysis, which helps to obtain strong bicortical fixation, as well as the use of a dedicated external fixator to further increase pin stability.
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Surgical Correction of Drop Foot by Posterior Tibialis Transfer
Creator: Cesare Faldini, MD
Duration: 0:26
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Retrospective evaluation of 13 patients (mean age, 34.8 years) treated with tibialis posterior tendon transfer to manage foot drop deformity secondary to insufficiency of the muscles of the anterior compartment of the leg. The tibialis posterior tendon was transferred onto the intermediate or lateral cuneiform, then pulled out through a transosseous tunnel and fixed at the plantar surface. Seven patients underwent Achilles tendon lengthening before tibialis posterior transfer. Results were excellent in five patients, good in five, fair in two, and poor in one based on the Stanmore scale (0 to 100). No major complications occurred.
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Use of the 95 Degree Angled Blade Plate for Proximal Femur Fracture
Creator: Braden E. Hartline, MD
Duration: 0:31
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This video shows a technique of using a fixed-angle blade plate to treat a proximal femur fracture.
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Scaphoid Nonunion - Vascularized Bone Graft
Creator: Thanapong Waitayawinyu, MD
Duration: 2:05
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Demonstrates a vascularized bone graft for scaphoid nonunion.
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Pyrolytic Carbon Proximal Interphalangeal Joint Arthroplasty Technique
Creator: Marco Rizzo, MD
Duration: 19:01
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Because of the limitations of silicone spacers, a new generation of implants, composed of more durable materials, has been introduced. These recent prostheses are of two kinds: a nonconstrained surface replacement and a more constrained hinge-type design. Nonconstrained implants tend to be more commonly used in the United States, whereas both joint types are used in Europe. The procedure of implanting these prostheses is similar, with slight differences and nuances. Here we discuss implanting the pyrolytic carbon prosthesis.
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Hindfoot Arthrodesis
Creator: Justin Greisberg, MD
Duration: 0:16
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The authors demonstrate the restoration of subtalar alignment in hindfoot arthrodesis.
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Scaphoid Nonunion - Palmar Approach
Creator: Thanapong Waitayawinyu, MD
Duration: 1:38
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Demonstrates the palmar approach for scaphoid nonunion.
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Locked Plating for Proximal Humeral Fractures
Creator: Brian L. Badman, MD
Duration: 16:59
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Proximal humerus fractures are relatively common, accounting for 5% to 9% of all fractures. Additional investigation is necessary, but early results with locked plate fixation for the treatment of proximal humerus fractures have been encouraging. It is anticipated that this technique will provide another potentially viable alternative to prosthetic replacement for the treatment of these difficult injuries.
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Distal Biceps Tendon Repair
Creator: Jeffrey King, MD
Duration: 18:23
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Although initially developed for fixation of an anterior cruciate ligament graft, EndoButton (Acufex Microsurgical, Mansfield, MA) repair of distal biceps tendon ruptures provides strong fixation to allow early motion, lessens technical difficulty in securing fixation, and utilizes a bone socket to maximize tendon healing.
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Chronic Distal Radioulnar Joint Instability
Creator: Brian D. Adams, MD
Duration: 3:30
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Demonstrates reconstruction of the distal radioulnar joint.
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Arthroscopic Rotator Cuff Repair
Creator: Joseph P. Burns, MD
Duration: 21:20
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Arthroscopic repair is used as a first-line technique for repairing even large and massive rotator cuff tears. An all-arthroscopic technique is less damaging to the overlying deltoid muscle than are open or mini-open techniques. All-arthroscopic technique provides greater versatility in terms of characterizing, accessing, mobilizing, and fixing the torn rotator cuff tendon. Arthroscopic repair allows complete evaluation of the intra-articular and bursal anatomy while causing minimal morbidity in terms of postoperative pain and scarring. We report our stepwise technique for arthroscopic repair of full-thickness rotator cuff tears (using triple-loaded suture anchors) and key steps for maximizing efficiency and reproducibility.
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Lumbar Spinal Stenosis - Laminectomy
Creator: Kern Singh, MD
Duration: 0:23
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Demonstrates laminectomy for lumbar spinal stenosis, including exposure, laminectomy site preparation, laminectomy/decompression, herniated disk, closure.
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Osteochondral Lesions of the Talus
Creator: Mark E. Easley, MD
Duration: 33:12
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Several procedures of varying complexity have been used to manage symptomatic osteochondral lesions of the talus. Arthroscopic procedures rely on marrow stimulation to fill the osteochondral defect with fibrocartilage that is less durable than the native hyaline cartilage. These relatively simple and inexpensive procedures introduce no donor site morbidity and do not preclude subsequent open reconstructive salvage. Open reconstruction, which fills the defect with near-normal hyaline cartilage, is technically demanding, requires extensive exposure, and carries a risk of donor site morbidity or disease transmission. Open techniques are generally indicated for larger lesions or as secondary procedures after failed arthroscopic management.
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Management of Displaced Proximal Humerus Fractures
Creator: Eric T. Ricchetti, MD
Duration: 3:57
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Locked plating for proximal humerus fractures is becoming more common; precise knowledge of and experience with the surgical technique is required to maximize clinical outcomes.
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Safe Surgical Dislocation for Femoral Head Fractures
Creator: Ashok Sunil Gavaskar Kumaresan, MS
Duration: 0:24
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Surgical treatment of femoral head fractures is recommended in cases of incongruent or unstable hip joint after closed reduction. Safe surgical dislocation provides circumferential exposure of the femoral head and acetabulum to address fractures and labral injuries without additional risk of osteonecrosis of the femoral head. Sound knowledge of the vascular supply to the femoral head, meticulous posterior soft-tissue dissection, and a precise osteotomy technique are imperative to avoid iatrogenic injury to the femoral head blood supply. Explanation of the anatomic basis, key landmarks, and techniques in safe surgical dislocation for a Pipkin type II fracture-dislocation.
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Targeted Muscle Reinnervation and Its Role in Acute Management of Above Elbow Amputations
Creator: Mark A. Tait, MD
Duration: 0:23
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Targeted muscle reinnervation (TMR) can result in intuitive myoelectric prosthetic control and prevention of or relief from neuroma-associated pain. TMR involves nerve transfers that increase the number of available surface electromyography (EMG) targets. Early case studies seem to indicate that TMR is successful in prevention of early neuroma formation after amputation and is highly effective for managing painful neuromas. The two patients presented underwent TMR after traumatic transhumeral amputation. Both patients were able to control a myoelectric prosthesis with use of reinnervated muscles using pattern recognition–based myoelectric prosthesis and neither has had painful neuroma formation.
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Creation of 7 o’clock posterolateral accessory portal
Creator: Rachel M. Frank, MD
Duration: 1:42
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Creation of the 7 o’clock posterolateral accessory portal with serial dilators. The technique is shown on a right shoulder in the lateral decubitus position. It is used in the management of posterior glenohumeral instability.
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Femoral Neck Fractures - Open Reduction
Creator: Robert Probe, MD
Duration: 1:11
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Demonstrates open reduction and internal fixation of femoral neck fractures, including incision, intermuscular plane, fracture exposure, fracture reduction, and fracture fixation.
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Femoral Neck Fractures - Closed Reduction
Creator: Robert Probe, MD
Duration: 1:19
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Demonstrates closed reduction and percutaneous pinning for femoral neck fractures, including positioning and reduction, surgical exposure, guidewire placment, screw placement, and screw position confirmation.
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Elbow Valgus Instability in Throwing Athletes - Docking Technique
Creator: Christopher S. Ahmad, MD
Duration: 0:49
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Demonstrates the docking technique in the treatment of elbow valgus instability in throwing athletes, including graft harvest, approach, ulnar tunnels, humeral tunnels, graft passing, and graft tensioning.
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Elbow Arthroscopy - Basic Setup and Portal Placement
Creator: Joseph A. Abboud, MD
Duration: 4:20
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Since the first reports of elbow arthroscopy in the American literature,1,2 advances in arthroscopic technique and equipment have made elbow arthroscopy an effective and safe method for the diagnosis and treatment of a variety of elbow ailments.3 With elbow arthroscopy becoming more common, precise knowledge of the neurovascular anatomy, preferred arthroscopic portals, and considered indications for definitive arthroscopic procedures is required to maximize the success rate and improve the clinical outcome.
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Supracondylar Fractures of the Humerus in Children
Creator: J. Andy Sullivan, MD
Duration: 5:58
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Demonstrates closed reduction and percutaneous pinning of supracondylar fractures of the humerus in children.
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Hip Arthroscopy
Creator: J. W. Thomas Byrd, MD
Duration: 41:11
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Evaluation of patients with hip pain is focused on whether the source of symptoms is intra-articular and thus potentially amenable to arthroscopy. Indications for hip arthroscopy include loose bodies, labral tears, degenerative disease, chondral injuries, femoroacetabular impingement, osteonecrosis, synovial disease, ruptured ligamentum teres, impinging osteophytes, instability, adhesive capsulitis, joint sepsis, and unresolved hip pain. Characteristic features of intra-articular hip joint pathology include relatively well-tolerated straight plane activity, difficulty with torsional/twisting activities, discomfort with prolonged hip flexion (eg, sitting), pain/catching from flexion to extension (eg, rising from a seated position), and greater difficulty on inclines or stairs than on level surfaces.
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Open Reduction and Internal Fixation
Creator:
Duration: 0:41
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Demonstrates open reduction and internal fixation of distal humerus fractures, including preoperative planning, exposure, reduction and provisional fixation, definitive fixation, closure, and verification.
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Quadriceps Active Test
Creator: Asheesh Bedi, MD
Duration: 0:10
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The patient is positioned supine, with the hip flexed to 45 degrees and the knee flexed to 90 degrees and is instructed to slide the foot down the table.
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Dynamic forefoot supination
Creator: Pooya Hosseinzadeh, MD
Duration: 0:19
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Forefoot supination
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Gait with bilateral relapsed clubfoot deformity
Creator: Pooya Hosseinzadeh, MD
Duration: 0:15
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Gait with bilateral relapsed clubfoot deformity
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