By Trong B. Nguyen, Peter R. Kurzweil (auth.), Robert J. Meislin, Jeffrey Halbrecht (eds.)
Any surgical intervention has power hazards and problems. a few problems are avoidable and a few will not be. Arthrofibrosis or stiffness may possibly ensue within the better of palms, and an infection may well floor postoperatively even within the such a lot sterile working room. How one offers with issues actually assessments the ability of the physician. conserving calm and focussed at the concerns in the middle of an intraoperative problem should be facilitated through having an algorithmic approach.
Complications in Knee and Shoulder surgical procedure is designed as a reference software and a roadmap for the activities medication orthopedist to reduce problems in knee and shoulder surgical procedure. by means of realizing the useful anatomy in danger, right surgical organize, right apparatus, and correct sufferer choice, a preventative method of problems might be instituted.
The authors of those chapters are leaders in orthopedic activities drugs and exhibit their options for facing intraoperative issues, expanding the surgeon’s understanding of power problems and supplying suggestion to prevent and deal with those difficulties successfully and swiftly may still they arise.
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Additional info for Complications in Knee and Shoulder Surgery: Management and Treatment Options for the Sports Medicine Orthopedist
Capsular abrasion with a meniscal repair device or whisker shaver may be helpful to obtain a bleeding surface at the menisco-capsular junction. Fixation for bone plug allografts is accomplished by shuttling sutures at the bone-meniscal root out of the reamed tunnels and tying over a bone-bridge. Alternatively, allograft dovetail or slot grafts with poor fixation may have their press-fit improved with the use of an interference anterior-to-posterior screw placed over a guide-wire. Meniscal transplant fixation is best achieved with an inside-out technique using a cannulated needle delivery system.
Unfortunately, such co-linear placement is often unachievable through a conventional anterolateral arthrotomy because of impingement by the patellar tendon’s lateral margin. Variability in the patellar tendon’s tibial tubercle attachment and tendon width make the exact line of placement different for each patient. 2. Use a spinal needle percutaneously to confirm co-linear placement of the intended slot. The anterolateral incision/artrotomy should be made directly over this site, which is often over the lateral to midthird of the patella tendon.
Difficulty in medial meniscus graft passage using the bone plug technique has led to the development of a slot or dovetail technique similar to that used laterally. Careful templating of the bone block is necessary during this step to ensure subsequent passage and seating. The primary disadvantage of using a bone bridge or slot technique medially is that it requires placement through some of the ACL footprint (Fig. 8). When performing a concomitant ACL reconstruction, this strategy has merit. But in isolated medial transplanatation, undermining the medial ACL footprint for graft placement seems unwise.