1
|
Cvetanovich GL, Leroux TS, Bernardoni ED, Hamamoto JT, Saltzman BM, Verma NN, Romeo AA. Clinical Outcomes of Arthroscopic 360° Capsular Release for Idiopathic Adhesive Capsulitis in the Lateral Decubitus Position. Arthroscopy 2018; 34:764-770. [PMID: 29100771 DOI: 10.1016/j.arthro.2017.08.249] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2016] [Revised: 08/09/2017] [Accepted: 08/09/2017] [Indexed: 02/02/2023]
Abstract
PURPOSE To report outcomes after arthroscopic 360° capsular release in the lateral decubitus position for idiopathic glenohumeral adhesive capsulitis without manipulation under anesthesia. METHODS A retrospective case series of patients who underwent arthroscopic capsular release in the lateral decubitus position for idiopathic adhesive capsulitis with minimum 2-year follow-up was conducted. Patient demographics, preoperative range of motion (ROM), postoperative ROM, and the postoperative outcome scores, visual analog scale for pain, Single Assessment Numeric Evaluation, Simple Shoulder Test, and American Shoulder and Elbow Surgeons scores, were recorded. Complications and reoperations were recorded. Paired t-tests were used to compare preoperative and postoperative ROM, with P < .05. RESULTS Overall, 43 patients were identified, of whom 10 were excluded because of post-traumatic etiology. Of the remaining 33 patients, 27 (81.8%) completed a minimum follow-up of 2 years. The mean age was 54.8 with a standard deviation of 7.4 years and 78% were female, with the duration of symptoms of 16.2 ± 21.0 (range, 3-125) months. Hypothyroidism was present in 7% and diabetes present in 30%. Active forward flexion improved from 115.0° ± 21.9° to 156.2° ± 16.1° at the final follow-up (mean difference, 41.2; 95% confidence interval [33.7, 48.7]; P < .001). Active external rotation with the arm adducted improved from 28.1° ± 16.3° preoperatively to 56.8° ± 15.7° at the final follow-up (mean difference, 27.7; 95% confidence interval [19.1, 36.3]; P < .001). Significant ROM improvements were seen even as early as 2 weeks postoperatively (P < .001). Two patients (7%) had manipulation under anesthesia postoperatively due to early recurrent stiffness 4 to 6 weeks after arthroscopic capsular release. There were no revision surgeries or complications. CONCLUSIONS Arthroscopic 360° capsular release in the lateral decubitus position for idiopathic adhesive capsulitis results in a significant early and lasting improvement in ROM, excellent functional outcomes, and low revision and complication rates. LEVEL OF EVIDENCE Level IV, retrospective case series.
Collapse
Affiliation(s)
- Gregory L Cvetanovich
- Section of Sports Medicine, Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois, U.S.A
| | - Timothy S Leroux
- Department of Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Eamon D Bernardoni
- Section of Sports Medicine, Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois, U.S.A
| | - Jason T Hamamoto
- Section of Sports Medicine, Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois, U.S.A
| | - Bryan M Saltzman
- Section of Sports Medicine, Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois, U.S.A
| | - Nikhil N Verma
- Section of Sports Medicine, Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois, U.S.A..
| | - Anthony A Romeo
- Section of Sports Medicine, Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois, U.S.A
| |
Collapse
|
2
|
Makhni EC, Higgins JD, Hamamoto JT, Cole BJ, Romeo AA, Verma NN. Patient Compliance With Electronic Patient Reported Outcomes Following Shoulder Arthroscopy. Arthroscopy 2017; 33:1940-1946. [PMID: 28958797 DOI: 10.1016/j.arthro.2017.06.016] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2016] [Revised: 04/12/2017] [Accepted: 06/02/2017] [Indexed: 02/02/2023]
Abstract
PURPOSE To determine the patient compliance in completing electronically administered patient-reported outcome (PRO) scores following shoulder arthroscopy, and to determine if dedicated research assistants improve patient compliance. METHODS Patients undergoing arthroscopic shoulder surgery from January 1, 2014, to December 31, 2014, were prospectively enrolled into an electronic data collection system with retrospective review of compliance data. A total of 143 patients were included in this study; 406 patients were excluded (for any or all of the following reasons, such as incomplete follow-up, inaccessibility to the order sets, and inability to complete the order sets). All patients were assigned an order set of PROs through an electronic reporting system, with order sets to be completed prior to surgery, as well as 6 and 12 months postoperatively. Compliance rates of form completion were documented. Patients who underwent arthroscopic anterior and/or posterior stabilization were excluded. RESULTS The average age of the patients was 53.1 years, ranging from 20 to 83. Compliance of form completion was highest preoperatively (76%), and then dropped subsequently at 6 months postoperatively (57%) and 12 months postoperatively (45%). Use of research assistants improved compliance by approximately 20% at each time point. No differences were found according to patient gender and age group. Of those completing forms, a majority completed forms at home or elsewhere prior to returning to the office for the clinic visit. CONCLUSIONS Electronic administration of PRO may decrease the amount of time required in the office setting for PRO completion by patients. This may be mutually beneficial to providers and patients. It is unclear if an electronic system improves patient compliance in voluntary completion PRO. Compliance rates at final follow-up remain a concern if data are to be used for establishing quality or outcome metrics. LEVEL OF EVIDENCE Level IV, case series.
Collapse
Affiliation(s)
- Eric C Makhni
- Department of Orthopedics, Henry Ford Health System, Detroit, Michigan, U.S.A..
| | - John D Higgins
- Department of Sports Medicine, Rush University Medical Center, Chicago, Illinois, U.S.A
| | - Jason T Hamamoto
- Department of Sports Medicine, Rush University Medical Center, Chicago, Illinois, U.S.A
| | - Brian J Cole
- Department of Sports Medicine, Rush University Medical Center, Chicago, Illinois, U.S.A
| | - Anthony A Romeo
- Department of Sports Medicine, Rush University Medical Center, Chicago, Illinois, U.S.A
| | - Nikhil N Verma
- Department of Sports Medicine, Rush University Medical Center, Chicago, Illinois, U.S.A
| |
Collapse
|
3
|
Frank RM, Hamamoto JT, Bernardoni E, Cvetanovich G, Bach BR, Verma NN, Bush-Joseph CA. ACL Reconstruction Basics: Quadruple (4-Strand) Hamstring Autograft Harvest. Arthrosc Tech 2017; 6:e1309-e1313. [PMID: 29354434 PMCID: PMC5622412 DOI: 10.1016/j.eats.2017.05.024] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2017] [Accepted: 05/11/2017] [Indexed: 02/03/2023] Open
Abstract
Hamstring tendon autograft remains a popular graft choice for anterior cruciate ligament (ACL) reconstruction. Although there are a variety of autograft and allograft options available for ACL reconstruction, advantages of hamstring tendon autografts include decreased postoperative knee pain and an overall easier surgical recovery compared with bone patellar tendon bone autograft. In addition, 4-stranded (quadruple) hamstring grafts are among the strongest grafts biomechanically (at time equals zero). Although the technique of hamstring autograft harvest is relatively straightforward, it is critical to pay attention to several technical steps to avoid iatrogenic neurovascular damage as well as to avoid premature amputation of the graft while using a tendon stripper. In this Technical Note, we describe a technique of hamstring autograft harvest for ACL reconstruction for a quadruple (4-strand) hamstring graft using the gracilis and semitendinosus tendons.
Collapse
Affiliation(s)
- Rachel M. Frank
- Address correspondence to Rachel M. Frank, M.D., CU Sports Medicine, Department of Orthopedics, University of Colorado School of Medicine, 2150 Stadium Drive, Boulder, CO 80309, U.S.A.CU Sports MedicineDepartment of Orthopedics, University of Colorado School of Medicine2150 Stadium DriveBoulderCO80309U.S.A.
| | | | | | | | | | | | | |
Collapse
|
4
|
Hamamoto JT, Frank RM, Higgins JD, Provencher MT, Romeo AA, Verma NN. Shoulder Arthroscopy in the Lateral Decubitus Position. Arthrosc Tech 2017; 6:e1169-e1175. [PMID: 29354413 PMCID: PMC5621971 DOI: 10.1016/j.eats.2017.04.004] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2016] [Accepted: 04/11/2017] [Indexed: 02/03/2023] Open
Abstract
Arthroscopic shoulder surgery can be performed in both the beach chair and lateral decubitus positions. The lateral decubitus position allows for excellent exposure to all aspects of the glenohumeral joint and is therefore frequently employed in procedures such as stabilization, in which extensive visualization of the inferior and posterior aspects of the joint is required. Improved visualization is imparted due to applied lateral and axial traction on the operative arm, which increases the glenohumeral joint space. To perform arthroscopy surgery in the lateral decubitus position successfully, meticulous care during patient positioning and setup must be taken. In this Technical Note, we describe the steps required to safely, efficiently, and reproducibly perform arthroscopic shoulder surgery in the lateral decubitus position.
Collapse
Affiliation(s)
- Jason T. Hamamoto
- Department of Orthopaedic Surgery, Division of Sports Medicine, Rush University Medical Center/Midwest Orthopaedics at Rush, Chicago, Illinois, U.S.A
| | - Rachel M. Frank
- Department of Orthopaedic Surgery, Division of Sports Medicine, Rush University Medical Center/Midwest Orthopaedics at Rush, Chicago, Illinois, U.S.A
| | - John D. Higgins
- Department of Orthopaedic Surgery, Division of Sports Medicine, Rush University Medical Center/Midwest Orthopaedics at Rush, Chicago, Illinois, U.S.A
| | | | - Anthony A. Romeo
- Department of Orthopaedic Surgery, Division of Sports Medicine, Rush University Medical Center/Midwest Orthopaedics at Rush, Chicago, Illinois, U.S.A
| | - Nikhil N. Verma
- Department of Orthopaedic Surgery, Division of Sports Medicine, Rush University Medical Center/Midwest Orthopaedics at Rush, Chicago, Illinois, U.S.A.,Address correspondence to Nikhil N. Verma, M.D., Department of Orthopaedic Surgery, Division of Sports Medicine, Rush University Medical Center, Midwest Orthopaedics at Rush, 1611 West Harrison Street, Suite 300, Chicago, IL 60612, U.S.A.Department of Orthopaedic SurgeryDivision of Sports MedicineRush University Medical CenterMidwest Orthopaedics at Rush1611 West Harrison StreetSuite 300ChicagoIL60612U.S.A.
| |
Collapse
|
5
|
Makhni EC, Hamamoto JT, Higgins JD, Patterson T, Griffin JW, Romeo AA, Verma NN. How Comprehensive and Efficient Are Patient-Reported Outcomes for Rotator Cuff Tears? Orthop J Sports Med 2017; 5:2325967117693223. [PMID: 28451596 PMCID: PMC5400217 DOI: 10.1177/2325967117693223] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Increasing emphasis is placed on patient-reported outcomes (PROs) after common orthopaedic procedures as a measure of quality. When considering PRO utilization in patients with rotator cuff tears, several different PROs exist with varying levels of accuracy and utilization. HYPOTHESIS/PURPOSE Understanding which disease-specific PRO may be most efficiently administered in patients after rotator cuff repair may assist in promoting increased patient and physician adoption of these useful scores. Using a novel assessment criterion, this study assessed all commonly used rotator cuff PROs. We hypothesize that surveys with fewer numbers of questions may remain comparable (with regard to comprehensiveness) to longer surveys. STUDY DESIGN Systematic review. METHODS Commonly utilized rotator cuff PROs were analyzed with regard to number of survey components, comprehensiveness, and efficiency. Comprehensiveness (maximum score, 11) was scored as the total number of pain (at rest/baseline, night/sleep, activities of daily living [ADLs], sport, and work) and functional (strength, motion/stiffness, and ability to perform ADLs, sport, and work) metrics included, along with inclusion of quality of life/satisfaction metrics. Efficiency was calculated as comprehensiveness divided by the number of survey components. RESULTS Sixteen different PROs were studied. Number of components ranged from 5 (University of California at Los Angeles score [UCLA]) to 36 (Short Form-36 [SF-36], Japanese Orthopaedic Association score [JOA]). The Quality of Life Outcome Measure for Rotator Cuff Disease (RC-QoL) included all 5 pain components, while 7 PROs contained all 5 functional components. Ten PROs included a quality of life/satisfaction component. The most comprehensive scores were the RC-QoL (score, 11) and Penn (score, 10), and the least comprehensive score was the Marx (score, 3). The most efficient PROs were the UCLA, the Quick Disabilities of the Arm, Shoulder, and Hand score (QuickDASH), and Constant scores. The least efficient scores were the JOA and SF-36 scores. CONCLUSION Many commonly utilized PROs for rotator cuff tears are lacking in comprehensiveness and efficiency. Continued critical assessment of PRO quality may help practitioners identify the most comprehensive and efficient PRO to incorporate into daily clinical practice.
Collapse
Affiliation(s)
- Eric C. Makhni
- Department of Orthopedics, Henry Ford Health System, Detroit, Michigan, USA
- Eric C. Makhni, MD, MBA, Department of Orthopedics, Henry Ford Health System, 6777 West Maple Road, West Bloomfield, MI 48322, USA ()
| | - Jason T. Hamamoto
- Department of Sports Medicine, Rush University Medical Center, Chicago, Illinois, USA
| | - John D. Higgins
- Department of Sports Medicine, Rush University Medical Center, Chicago, Illinois, USA
| | - Taylor Patterson
- Department of Sports Medicine, Rush University Medical Center, Chicago, Illinois, USA
| | - Justin W. Griffin
- Department of Sports Medicine, Rush University Medical Center, Chicago, Illinois, USA
| | - Anthony A. Romeo
- Department of Sports Medicine, Rush University Medical Center, Chicago, Illinois, USA
| | - Nikhil N. Verma
- Department of Sports Medicine, Rush University Medical Center, Chicago, Illinois, USA
| |
Collapse
|
6
|
Makhni EC, Meadows M, Hamamoto JT, Higgins JD, Romeo AA, Verma NN. Patient Reported Outcomes Measurement Information System (PROMIS) in the upper extremity: the future of outcomes reporting? J Shoulder Elbow Surg 2017; 26:352-357. [PMID: 28104094 DOI: 10.1016/j.jse.2016.09.054] [Citation(s) in RCA: 82] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2016] [Revised: 09/18/2016] [Accepted: 09/27/2016] [Indexed: 02/01/2023]
Abstract
Patient reported outcomes (PROs) serve an integral role in clinical research by helping to determine the impact of clinical care as experienced by the patient. With recent initiatives in health care policy and pay for performance, outcome reporting is now recognized as a policy-driven requirement in addition to a clinical research tool. For outcome measures to satisfy these regulatory requirements and provide value in understanding disease outcomes, they must be responsive and efficient. Recent research has uncovered certain concerns regarding traditional PROs in patients with upper extremity disability and injury. These include lack of consensus regarding selection of PROs for a given diagnoses, inconsistent techniques of administration of the same PROs, and the administrative burden to patients and providers of completing these forms. To address these limitations, emphasis has been placed on streamlining the outcomes reporting process, and, as a result, the National Institutes of Health (NIH) created the Patient Reported Outcomes Measurement Information System (PROMIS). PROMIS forms were created to comprehensively and efficiently measure outcomes across multiple disease states, including orthopedics. These tools exist in computer adaptive testing and short forms with the intention of more efficiently measuring outcomes compared with legacy PROs. The goals of this review are to highlight the main components of PROMIS reporting tools and identify recent use of the scores in the upper extremity literature. The review will also highlight the research and health policy potentials and limitations of implementing PROMIS into everyday orthopedic practice.
Collapse
Affiliation(s)
- Eric C Makhni
- Division of Sports Medicine, Department of Orthopaedic Surgery, Henry Ford Hospital, Detroit, MI.
| | - Molly Meadows
- Division of Sports Medicine, Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL
| | - Jason T Hamamoto
- Division of Sports Medicine, Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL
| | - John D Higgins
- Division of Sports Medicine, Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL
| | - Anthony A Romeo
- Division of Sports Medicine, Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL
| | - Nikhil N Verma
- Division of Sports Medicine, Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL
| |
Collapse
|
7
|
Ajiboye RM, Eckardt MA, Hamamoto JT, Plotkin B, Daubs MD, Wang JC. Outcomes of Demineralized Bone Matrix Enriched with Concentrated Bone Marrow Aspirate in Lumbar Fusion. Int J Spine Surg 2016; 10:35. [PMID: 27909656 DOI: 10.14444/3035] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Multiple studies have demonstrated that a significant amount of variability exists in various demineralized bone matrix (DBM) formulations, which casts doubts on its reliability in consistently promoting fusion. Bone marrow aspirate (BMA) is a cellular based graft that contains mesenchymal stem cells (MSCs) and growth factors can confer osteogenic and osteoinductive potential to DBM. The goal of this study was to describe the outcome of DBM enriched with concentrated BMA in patients undergoing combined lumbar interbody and posterolateral fusion. METHODS Eighty patients with a minimum of 12 months of follow-up were evaluated. Fusion and rates of complication were evaluated. Functional outcomes were assessed based on the modified Odom's criteria. Multiple logistic regression analysis was used to examine the effects of independent variables on fusion outcome. RESULTS The overall rate of solid fusion (i.e patients with both solid posterolateral and interbody fusion) was 81.3% (65/80). Specifically, the radiographic evidence of solid posterolateral and interbody fusions were 81.3% (65/80) and 92.5% (74/80), respectively. Seven (8.75%) patients developed hardware-related complications, 2 (2.5%) patients developed a postoperative infection and 2 (2.5%) patients developed clinical pseudarthrosis. Charlson comorbidity index (CCI) scores of 3 and 4 were associated with non-solid unions (CCI-3, p = 0.048; CCI-4, p = 0.03). Excellent or good outcomes were achieved in 58 (72.5%) patients. CONCLUSIONS Patients undergoing lumbar fusion using an enriched bone graft containing concentrated BMA added to DBM can achieve successful fusion with relatively low complications and good functional outcomes. Despite these findings, more studies with higher level of evidence are needed to better understand the efficacy of this promising graft option.
Collapse
Affiliation(s)
- Remi M Ajiboye
- UCLA Medical Center, Department of Orthopaedic Surgery, Santa Monica, CA
| | - Mark A Eckardt
- UCLA Medical Center, Department of Orthopaedic Surgery, Santa Monica, CA
| | - Jason T Hamamoto
- UCLA Medical Center, Department of Orthopaedic Surgery, Santa Monica, CA
| | - Benjamin Plotkin
- UCLA Medical Center, Department of Orthopaedic Surgery, Santa Monica, CA
| | - Michael D Daubs
- University of Nevada School of Medicine, Department of Orthopaedic Surgery, Las Vegas, NV
| | - Jeffrey C Wang
- Keck Medicine of USC, Department of Orthopaedic Surgery, Los Angeles, CA
| |
Collapse
|
8
|
Cvetanovich GL, Hamamoto JT, Campbell KJ, McCarthy M, Higgins JD, Verma NN. The Use of Accessory Portals in Bankart Repair With Posterior Extension in the Lateral Decubitus Position. Arthrosc Tech 2016; 5:e1121-e1128. [PMID: 28224066 PMCID: PMC5310186 DOI: 10.1016/j.eats.2016.06.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2016] [Accepted: 06/09/2016] [Indexed: 02/03/2023] Open
Abstract
The Bankart lesion, in which the anteroinferior labrum is detached from the glenoid, is the critical anatomic lesion in the majority of patients with anterior glenohumeral instability. Some patients with anterior glenohumeral instability will have Bankart lesions with posterior extension beyond the 6-o'clock position, and achieving anatomic labral repair in these cases can present a technical challenge. In our experience, the lateral decubitus position and use of accessory portals allow superior visualization of the inferior half of the glenohumeral joint for glenoid and labral preparation, anchor placement, and suture management. The use of double-loaded suture anchors at the inferior glenoid provides multiple points of fixation at this challenging location while limiting the number of anchors required. The purpose of this article is to present a simple and reproducible technique for arthroscopic repair of Bankart lesions with posterior extension, emphasizing the use of accessory 5-o'clock trans-subscapularis and 7-o'clock portals.
Collapse
Affiliation(s)
| | | | | | | | | | - Nikhil N. Verma
- Address correspondence to Nikhil N. Verma, M.D., Department of Orthopaedic Surgery, Division of Sports Medicine, Rush University Medical Center, Midwest Orthopaedics at Rush, 1611 W. Harrison St., Suite 300, Chicago, IL 60612, U.S.A.Department of Orthopaedic SurgeryDivision of Sports MedicineRush University Medical CenterMidwest Orthopaedics at Rush1611 W. Harrison St.Suite 300ChicagoIL60612U.S.A.
| |
Collapse
|
9
|
Cvetanovich GL, Leroux T, Hamamoto JT, Higgins JD, Romeo AA, Verma NN. Arthroscopic 360° Capsular Release for Adhesive Capsulitis in the Lateral Decubitus Position. Arthrosc Tech 2016; 5:e1033-e1038. [PMID: 27909672 PMCID: PMC5124218 DOI: 10.1016/j.eats.2016.05.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2016] [Accepted: 05/17/2016] [Indexed: 02/03/2023] Open
Abstract
Idiopathic adhesive capsulitis of the shoulder is a relatively common condition that results in pain and loss of motion due to capsular thickening and fibrosis. Most cases are successfully treated with conservative management including physical therapy and intra-articular steroid injections. If conservative management fails, arthroscopic capsular release allows precise release of thickened capsular tissue with a lower risk of complications and less soft-tissue trauma than manipulation under anesthesia alone. Arthroscopic capsular release in the beach-chair position typically requires some degree of manipulation to release the inferior capsule, which is often not visualized intraoperatively. In this technique article and video, we describe and demonstrate a technique of arthroscopic capsular release in the lateral decubitus position, providing a clear view of the inferior capsule, which facilitates a complete, 360° capsular release and mitigates the need for any manipulation under anesthesia.
Collapse
Affiliation(s)
| | | | | | | | | | - Nikhil N. Verma
- Address correspondence to Nikhil N. Verma, M.D., Department of Orthopaedic Surgery, Division of Sports Medicine, Rush University Medical Center, Midwest Orthopaedics at Rush, 1611 W. Harrison St., Suite 300, Chicago, IL 60612, U.S.A.Department of Orthopaedic SurgeryDivision of Sports MedicineRush University Medical CenterMidwest Orthopaedics at Rush1611 W. Harrison St.Suite 300ChicagoIL60612U.S.A.
| |
Collapse
|
10
|
|
11
|
|
12
|
Hamamoto JT, Leroux T, Chahla J, Bhatia S, Higgins JD, Romeo AA, Yanke AB, Verma NN. Assessment and Evaluation of Glenoid Bone Loss. Arthrosc Tech 2016; 5:e947-e951. [PMID: 27709063 PMCID: PMC5040627 DOI: 10.1016/j.eats.2016.04.027] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2016] [Accepted: 04/20/2016] [Indexed: 02/03/2023] Open
Abstract
The preoperative assessment of anterior glenoid bone loss is a critical step in surgical planning for patients with recurrent anterior glenohumeral instability. The structural integrity of the glenoid has been identified as one of the most important factors influencing the success of operative repair. The currently accepted gold standard for glenoid structural assessment among most orthopaedic surgeons is the use of 3-dimensional reconstructed computed tomography images with the humeral head digitally subtracted, yielding an en face sagittal oblique view of the glenoid. This view allows for evaluation of glenoid morphology and quantitative assessment of glenoid bone loss. In this article, we describe the practical application of ImageJ software (National Institutes of Health, Bethesda, MD) to quantify the amount of glenoid bone loss reported as a percentage of either total surface area or diameter. The following equations are used in this technical note for the diameter-based method and surface area method, respectively: Percent bone loss = (Defect width/Diameter of inferior glenoid circle) × 100% and Percent bone loss = (Defect surface area/Surface area of inferior glenoid circle) × 100%.
Collapse
Affiliation(s)
- Jason T. Hamamoto
- Department of Orthopaedic Surgery, Division of Sports Medicine, Midwest Orthopaedics at Rush, Chicago, Illinois, U.S.A.,Address correspondence to Jason T. Hamamoto, B.S., Department of Orthopaedic Surgery, Midwest Orthopaedics at Rush, 1611 W Harrison St, Ste 300, Chicago, IL 60612, U.S.A.Department of Orthopaedic SurgeryMidwest Orthopaedics at Rush1611 W Harrison StSte 300ChicagoIL60612U.S.A.
| | - Timothy Leroux
- Department of Orthopaedic Surgery, Division of Sports Medicine, Midwest Orthopaedics at Rush, Chicago, Illinois, U.S.A
| | - Jorge Chahla
- Steadman Philippon Research Institute, Vail, Colorado, U.S.A
| | - Sanjeev Bhatia
- Hip Arthroscopy and Joint Preservation Center, Cincinnati Sports Medicine and Orthopaedic Center–Mercy Health, Cincinnati, Ohio, U.S.A
| | - John D. Higgins
- Department of Orthopaedic Surgery, Division of Sports Medicine, Midwest Orthopaedics at Rush, Chicago, Illinois, U.S.A
| | - Anthony A. Romeo
- Department of Orthopaedic Surgery, Division of Sports Medicine, Midwest Orthopaedics at Rush, Chicago, Illinois, U.S.A
| | - Adam B. Yanke
- Department of Orthopaedic Surgery, Division of Sports Medicine, Midwest Orthopaedics at Rush, Chicago, Illinois, U.S.A
| | - Nikhil N. Verma
- Department of Orthopaedic Surgery, Division of Sports Medicine, Midwest Orthopaedics at Rush, Chicago, Illinois, U.S.A
| |
Collapse
|
13
|
Ajiboye RM, Hamamoto JT, Eckardt MA, Wang JC. Clinical and radiographic outcomes of concentrated bone marrow aspirate with allograft and demineralized bone matrix for posterolateral and interbody lumbar fusion in elderly patients. Eur Spine J 2015; 24:2567-72. [DOI: 10.1007/s00586-015-4117-5] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2015] [Revised: 07/08/2015] [Accepted: 07/08/2015] [Indexed: 11/30/2022]
|