Effectiveness of Concurrent Ankle Arthroscopy During Open Reduction and Internal Fixation of Malleolar Fractures in Prevention of Common Short-Term Complications

Rotational malleolar fractures result in a high prevalence of intra-articular pathologies; therefore, routine arthroscopic assessment may be beneficial in the surgical treatment of ankle fractures. However, the clinical studies regarding the effectiveness of arthroscopy thus far have mixed results. We investigated the efficacy of concurrent arthroscopy during the treatment of malleolar fractures using a large U.S. healthcare data set. Those who had arthroscopy were compared with those who did not, during the surgical treatment of malleolar fractures, while adjusting for covariates of clinical relevance. The analysis showed that concurrent arthroscopy is protective against postoperative repeat surgery (OR = 0.13, 95CI = 0.02-0.41) and wound dehiscence (OR = 0.18, 95CI = 0.03-0.56). The number of added arthroscopy cases needed to avoid one repeat surgery was 74, while that of wound dehiscence was 52. Further studies are needed to determine if routine use of arthroscopy is justifiable in the surgical treatment of malleolar fractures, given the additional costs and time to the healthcare system.

Platelet rich plasma combined with arthroscopic microfracture versus arthroscopic microfracture alone for the treatment of knee cartilage injury

OBJECTIVE

To investigate the clinical efficacy of platelet-rich plasma (PRP) injection combined with arthroscopic microfracture technique in treating knee cartilage injury.

METHODS

The clinical data of 120 patients with knee cartilage injuries treated in Jiangnan University Medical Center from October 2019 to December 2021 were analyzed retrospectively. Among them, 55 cases underwent the arthroscopic microfracture technique alone (control group), and the other 65 cases underwent PRP combined with the arthroscopic microfracture technique (observation group). The visual analogue scale (VAS) score, Lysholm knee joint score, MRI image indexes, the incidence of adverse events, and patient satisfaction during treatment were compared between groups before and after surgery.

RESULTS

Before surgery and at 3, 6, and 12 months after surgery, VAS scores in both groups showed a decreasing trend with time (F = 40.780, P<0.001); VAS scores in the observation group were lower than those in the control group (F = 302.300, P<0.001); there was an interaction between grouping and time (F = 10.350, P<0.001); Lysholm score in both groups showed an increasing trend with time (F = 153.500, P<0.001); Lysholm scores in the observation group were higher than those in the control group (F = 488.000, P<0.001); there was an interaction between grouping and time (F = 25.570, P<0.001). At 12 months after surgery, the subchondral bone marrow oedema volumes and bone marrow defect areas in the observation group were smaller than those in the control group; while repaired cartilage thicknesses of the observation group were more significant than those of the control group (all P<0.05). Patient satisfaction in the observation group was higher than that the control group (95.38% VS 80%, P<0.05). There was no statistical difference in the incidence of adverse events between the control group and the observation group (7.27% VS 3.64%). The clinical efficacy was judged to be effective in 81 cases and markedly effective in 39 patients. Logistic regression analysis showed that age and body mass index (BMI) were independent factors affecting the treatment efficacy.

CONCLUSION

PRP combined with the arthroscopic microfracture technique has high safety in treating knee cartilage injuries. Compared with the arthroscopic microfracture alone, PRP combined with arthroscopic microfracture technique can effectively relieve pain, promote the repair of defective cartilage, improve knee joint function, and increase patient satisfaction. It is worthy of clinical promotion.

Effective Skill Transfer From Fundamentals of Arthroscopic Surgery Training to Shoulder Arthroscopic Simulator in Novices

PURPOSE

To investigate whether novices could improve performance on a shoulder arthroscopic simulator (high-fidelity) through short-term training on a Fundamentals of Arthroscopic Surgery Training (FAST) simulator (low-fidelity).

METHODS

Twenty-eight novices with no experience in arthroscopy were recruited to perform a pre-test on a shoulder arthroscopic simulator. Then they were randomized into two groups: the experimental group practiced five modules on the FAST simulator three times, and the control group did nothing. The experimental group performed a post-test immediately after FAST simulator practice. Control group rested for 70 minutes after experiencing pre-test before performing post-test. All parameters were recorded by the simulator.

RESULTS

The experimental group outperformed the control group in terms of total score, procedure time, camera path length, and grasper path length. However, there was no statistical difference in scratching of humerus cartilage or glenoid cartilage. Significant differences were found in the improvement of both groups in total score, procedure time, and camera path length.

CONCLUSIONS

Arthroscopic skills gained after short-term training on FAST simulator could be transferred to the shoulder arthroscopic simulator. This research provides important evidence of the benefits of FAST simulator in shoulder arthroscopy training program.

Is Wrist Arthroscopy Safer with the Nanoscope?

Background  Nanoscope, given its smaller size, may be safer when establishing dorsal wrist arthroscopy portals compared with the traditional 2.7 mm arthroscope. Case Description  Ten fresh frozen cadaver specimens were utilized. Dorsal radiocarpal portals were established with the Nanoscope and calipers were used to measure the distance between the portals and the surrounding anatomical structures. The only structure that was pierced during portal placement was the dorsal sensory branch of the ulnar nerve (DSUN) in one specimen when establishing the 6U portal. Our study did not note any tendon injuries. Literature Review  Traditional wrist arthroscopy may be performed with a 2.7 mm arthroscope. With its larger outer sheath cannula, this may place adjacent anatomical structures at risk of injury. Clinical Relevance  During wrist arthroscopy, the Nanoscope may be safer when creating portals to underlying structures. Level of Evidence  This is a Level IV study.

Arthroscopic Anterior Cruciate Ligament Repair Versus Autograft Anterior Cruciate Ligament Reconstruction: A Meta-Analysis of Comparative Studies

Purpose

To compare the clinical outcomes of arthroscopic anterior cruciate ligament (ACL) repair and autograft ACL reconstruction for ACL ruptures.

Methods

PubMed, EMBASE, Scopus, Web of Science and The Cochrane Library were searched for relevant studies from 1 January 1990 to 21 March 2022. Two evaluators independently screened the literature, extracted data and assessed the methodological quality of the enrolled studies. Meta-analysis was conducted using RevMan 5.4 software.

Results

Ten studies with mean follow-up periods from 12 to 36 months were included. For 638 patients with ACL ruptures, arthroscopic ACL repair showed statistically comparable outcomes of failure (p = 0.18), complications (p = 0.29), reoperation other than revision (p = 0.78), Lysholm score (p = 0.78), Tegner score (p = 0.70), and satisfaction (p = 0.45) when compared with autograft ACL reconstruction. A significantly higher rate of hardware removal (p = 0.0008) but greater International Knee Documentation Committee (IKDC) score (p = 0.009) were found in the ACL repair group. The heterogeneity of the side-to-side difference of anterior tibial translation (ΔATT) was high (I²= 80%). After the sensitivity analysis, the I² decreased dramatically (I²= 32%), and the knees with ACL repair showed significantly greater ΔATT (P = 0.04).

Conclusion

For proximal ACL ruptures, arthroscopic ACL repair showed similar clinical outcomes, and even better functional performance when compared to autograft ACL reconstruction. ACL repair has a higher rate of hardware removal, and might be related to greater asymptomatic knee laxity. More high-quality prospective trials are needed to confirm our findings.

Risk Factor Analysis for Infection after Medial Open Wedge High Tibial Osteotomy

Background: Medial open wedge high tibial osteotomy (MOWHTO) is a well-established treatment for osteoarthritis of the medial tibiofemoral compartment. Surgical site infection (SSI) after MOWHTO is a devastating complication that may require further surgery. In this study, we aimed to identify the risk factors for infection after MOWHTO over 1 to 4 years of follow-up. Methods: Fifty-nine patients who underwent MOWHTO combined with knee arthroscopic surgery were included in this prospective study. Artificial bone grafts were used in all cases. Possible risk factors, including sex, age, body mass index (BMI), underlying disease, hospitalization length, correction angle, and surgery time, were recorded. Both univariate and multivariate analysis were used. Results: A total of 59 patients who underwent 61 operations were included. Eleven patients (18.0%) were reported to have SSI. Univariate analysis showed that smoking and diabetes mellitus were positively associated with SSI. Multivariate analysis showed that smoking and age were positively associated with SSI. Three patients (4.9%) were reported to suffer from deep SSI, requiring surgical debridement, all of whom were male smokers. Conclusion: Smoking, diabetes mellitus, and old age were identified to be possible risk factors of SSI after MOWHTO. These findings are common risk factors of SSI after orthopedic surgery according to the literature. Patient selection should be performed cautiously, and postoperative prognosis for MOWHTO should be carefully explained to patients who smoke.

[Clinical observation of arthroscopic all-inside combined with outside-in "suture loop" repair for meniscus bucket-handle tear]

OBJECTIVE

To investigate the effectiveness of arthroscopic all-inside combined with outside-in "suture loop" repair for meniscus bucket-handle tear (BHT).

METHODS

Between August 2016 and May 2019, 44 case of meniscus BHT were treated with arthroscopic all-inside combined outside-in "suture loop". There were 29 males and 15 females with an average age of 26.6 years (range, 18-42 years). The causes of injury included sports injury in 31 cases, falling injury in 7 cases, and sprain in 6 cases. There were 32 cases of medial meniscus posterior horn tears and 12 cases of lateral meniscus posterior horn tears. The disease duration ranged from 6 weeks to 3 months. Thirty-three cases were complicated with anterior cruciate ligament rupture. All patients had normal lower limb alignment. The preoperative Lysholm score was 42.1±9.1. According to the evaluation criteria of MRI and Barrett et al., the healing of meniscus was evaluated, and the effectiveness was evaluated by Lysholm score.

RESULTS

All the 44 patients were followed up 8-36 months with an average of 16.8 months. At last follow-up, according to the evaluation criteria of Barrett et al., 39 cases were clinically healed, 5 cases were not healed, the clinical healing rate was 88.6%; according to MRI evaluation, 32 cases were completely healed, 7 cases were partially healed, and 5 cases were not healed, the total healing rate was 88.6%, and the complete healing rate was 72.7%. Lysholm score was 87.8±4.8, which was significantly different from that before operation ( t=31.060, P=0.000).

CONCLUSION

Arthroscopic all-inside combined with outside-in "suture loop" repair is a reliable and effective method for the meniscus BHT, which can obtain good joint function.

[Application of internal and external lysis combined with Ilizarov external fixation technology for severe knee pathological flexion contracture deformity in children]

OBJECTIVE

To investigate the effectiveness of internal and external lysis combined with Ilizarov external fixation technology for severe knee pathological flexion contracture deformity in children.

METHODS

A retrospective analysis was made on 12 children (12 knees) with severe knee pathological flexion contracture deformity who were treated with internal and external lysis and Ilizarov external fixation between August 2012 and January 2017. There were 9 boys and 3 girls with an age of 3-12 years (mean, 8.4 years). There were 8 cases of tuberculosis, 3 cases of haemophilia A, and 1 case of residual deformity after extensive hemangioma drug injection. The disease duration ranged from 5 months to 4 years, with an average of 20.3 months. The degree of knee contracture was (67.42±23.30)°, and the range of motion of knee was (38.33±14.98)°. The preoperative Western Ontario and McMaster University Osteoarthritis Index (WOMAC) score was 78.42±15.57. The complication was observed after operation, and the degree of knee contracture, range of motion, and WOMAC score at 3 months and 1 year after operation were recorded and compared with those before operation.

RESULTS

The operations completed successfully in all children. All the 12 cases were followed up 9-24 months (mean, 14.5 months). All incisions healed by first intention after operation. The knee function of all children improved significantly and the weight-bearing walking function of the lower limbs restored. The degree of knee contracture, range of motion, and WOMAC score were significantly improved at 3 months and 1 year after operation (P<0.05), but there was no significant difference between 3 months and 1 year after operation (P>0.05).

CONCLUSION

For severe knee pathological flexion contracture deformity in children, application of internal and external lysis combined with Ilizarov external fixation has advantages, such as small trauma, rapid recovery, and early postoperative knee function training, and good effectiveness.

Arthroscopic Lengthening of the Flexor Hallucis Longus Tendon to Correct Hallux Flexion Deformity

Contracture of the flexor hallucis longus (FHL) tendon is one of the most common factors leading to hallux flexion deformity. Few cases treated by arthroscopic technology have been reported. In this article, we perform a new method to lengthen the FHL tendon under an arthroscope. We present a case of 1 patient treated with this technique and followed for 2 years. The appearance of his halluces remarkably improved at the follow-up visits, and movement was refined simultaneously. From the satisfactory effect of this operation, lengthening the FHL tendon under arthroscope is an effective method to correct flexion deformity of the hallux with minimal incisions. This technique also provides an innovative application of minimally invasive surgeries to treat clinically infrequent diseases.

Arthroscopic Repair of Anterior Talofibular Ligament Using the Pull-Out Technique for Chronic Ankle Instability: Case Report

Arthroscopic repair of the lateral ankle ligament using the anchor system has been increasingly reported. We treated a 39-year-old woman who suffered from pain and instability in her left ankle joint. She was diagnosed with chronic ankle instability and an osteochondral lesion of the talar dome. For this patient, arthroscopic repair of the anterior talofibular ligament (ATFL) was performed. Standard anteromedial and anterolateral portals were placed, and excision of the osteochondral fragment and microfracture were performed. Then, an accessory anterolateral (AAL) portal was placed. No. 2 nylon sutures were inserted into the ATFL remnant through the AAL portal. Two bone tunnels were created at the footprint of the fibula attachment toward the posterior edge of the lateral malleolus using a passing pin, and nylon sutures anchored in the ATFL were retrieved toward the posterior fibula. The foot was held in neutral position with eversion, and nylon sutures were tied at the posterior fibula. At 1 year after surgery, the Japanese Society for Surgery of the Foot scale was improved from the preoperative value of 48 points to a postoperative value of 100 points. Stress radiography showed no difference of talar tilt angle between the involved and noninvolved ankles. Joint position sense was also improved at 3 and 6 months after surgery. This arthroscopic repair of the ATFL using the pull-out technique enabled achievement of an improved clinical score and stability of the ankle and proprioception, and there was no concern about complications of the anchor system.

[Arthroscopic treatment of anterior cruciate ligament tibial eminence avulsion fracture with double heads compressive cannulated screw fixation in adolescents]

Objective

To discuss the effectiveness of arthroscopic treatment of anterior cruciate ligament (ACL) tibial eminence avulsion fracture in adolescents by using double heads compressive cannulated screw fixation.

Methods

Twenty-four patients with ACL tibial eminence avulsion fractures were treated by arthroscopic reduction and internal fixation with double heads compressive cannulated screw fixation between June 2014 and June 2017. There were 15 males and 9 females with an average age of 12.3 years (range, 5-18 years). The body mass index was 19.3-26.4 kg/m ² (mean, 23.3 kg/m ²). The injury causes included traffic accident injury in 10 cases, sports injury in 8 cases, and falling injury in 6 cases. According to the Meyers-McKeever classification, there were 19 cases of type Ⅱ and 5 cases of type Ⅲa. All patients’ drawer test and pivot shift test were positive. The interval between injury and operation was 3-14 days (mean, 6.2 days). During the follow-up period, the fracture healing condition of patients were determined by X-ray examination; Lysholm score, International Knee literature Committee (IKDC) score, and Tegner score were used to evaluate the knee function.

Results

Primary healing of incision was obtained in all patients after operation. All the 24 patients were followed up 6-32 months (mean, 16.4 months). At 6 weeks after operation, 3 patients had difficulty in knee flexion. After the release of the knee joint by manipulation, the knee joint function recovered normally at 6 months after operation. At last follow-up, the X-ray films showed that all the fractures healed and no epiphyseal dysplasia, knee joint deformity, or leg length discrepancy occurred. The Lysholm score, IKDC score, and Tegner score were improved from preoperative 44.3±5.4, 43.7±4.4, and 3.0±1.3 to postoperative 93.1±4.3, 94.6±3.3, and 8.1±1.2, the differences were all significant ( t=25.152, P=0.000; t=28.634, P=0.000; t=13.226, P=0.000).

Conclusion

The arthroscopic reduction and internal fixation with double heads compressive cannulated screw in treatment of ACL tibial avulsion fracture (Meyers-McKeever type Ⅱ and Ⅲ) in adolescents has so many advantages, such as minimal trauma, simple operation, firm fixation, little effect on the epiphyseal plate, and has a good joint function recovery.

A Case of Posterior Tibial Nerve Injury After Arthroscopic Calcaneoplasty

We report the first case of distal posterior tibial nerve injury after arthroscopic calcaneoplasty. A 59-year-old male had undergone right arthroscopic calcaneoplasty to treat retrocalcaneal bursitis secondary to a Haglund's deformity. The patient complained of numbness in his right foot immediately after the procedure. Two years later and after numerous assessments and investigations, a lateral plantar nerve and medial calcaneal nerve lesion was diagnosed. In the operating room, the presence of an iatrogenic lesion to the distal right lateral plantar nerve (neuroma incontinuity involving 20% of the nerve) and the medial calcaneal nerve (complete avulsion) was confirmed. The tarsal tunnel was decompressed, and both the medial and the lateral plantar nerve were neurolyzed under magnification. To the best of our knowledge, our case report is the first to describe iatrogenic posterior tibial nerve injury after arthroscopic calcaneoplasty. It is significant because this complication can hopefully be avoided in the future with careful planning and creation of arthroscopic ports and treated appropriately with early referral to a nerve specialist if the patient's symptoms do not improve within 3 months.

Arthroscopic Deltoid Repair: A Technical Tip

Deltoid ligament repair can be challenging, and implementation of an arthroscopic method can be useful in terms of minimizing morbidity associated with open dissection, as long as the repair is effective and durable. In this brief report, we describe a method of arthroscopic deltoid ligament repair that we have found to be useful.

Using a 70° Scope Facilitates Pick up Rates of Subscapularis Tears

INTRODUCTION

Subscapularis tendon plays an important role in shoulder stability and functions. There has been much interest recently in the prevalence of subscapularis tears and outcomes following repair of subscapularis tears. We aimed to assess whether there is an increase in pick up rate of subscapularis tears in patients who underwent arthroscopic rotator cuff repair following routine additional use of a 70° arthroscope during shoulder arthroscopy.

MATERIALS AND METHODS

A retrospective review of a single surgeons practice was performed to assess the frequency of identifying and repairing subscapularis tears among a cohort of 58 consecutive arthroscopic rotator cuff tears performed over a 12 months period. The patients' had an age ranged between 42 and 71 years (mean 54.4). The case mix was a combination of degenerative and traumatic tears. All-arthroscopic procedures had an additional assessment with a 70° arthroscope, in addition to routine assessment with a 30° arthroscope. The follow-up ranged from 30 to 120 days. The prevalence of subscapularis tendon tears was noted intraoperatively. This was compared to the pre-operative incidence as determined by the various clinical examination and radiological techniques.

RESULTS

Of the 58 arthroscopic rotator cuff repairs, subscapularis tear was identified in 25 patients (43.1%). Among the imaging modalities used pre-operative magnetic resonance imaging scanning reported a subscapularis tear in 71.4% and pre-operative ultrasound scanning reported a tear in 78.6.

CONCLUSION

The use of a 70° arthroscope can facilitate the recognition and management of subscapularis tears which may not be recognized with a routine 30° shoulder arthroscope. A combination of high index of suspicion, judicious use of pre-operative imaging and careful arthroscopic assessment aids identification of subscapularis tendon tears.

Development of an arthroscopically compatible polymer additive layer manufacture technique

This article describes a proof of concept study designed to evaluate the potential of an in vivo three-dimensional printing route to support minimally invasive repair of the musculoskeletal system. The study uses a photocurable material to additively manufacture in situ a model implant and demonstrates that this can be achieved effectively within a clinically relevant timescale. The approach has the potential to be applied with a wide range of light-curable materials and with development could be applied to create functionally gradient structures in vivo.

Effects of arthroscopic-assisted surgery on irreducible developmental dislocation of hip by mid-term follow-up: An observational study

The purpose of this study was to investigate the indications, surgical technique, and the clinical effects of arthroscopic-assisted treatment of irreducible developmental dislocation of the hip by mid-term follow-up. Arthroscopic-assisted surgeries were performed on 40 children (52 hips) between January 2005 and December 2009. Anterior and antero-superior greater trochanter portals were used in these treatments. Spica cast and abduction splint were applied for 3 months postoperatively. The follow-up was conducted on every 3 months postoperatively. During 12-month follow-up, a secondary treatment such as acetabuloplasty and/or femoral osteotomy (shortening, varus, and derotation) was applied if the acetabular angle was greater than 25°. The pelvic acetabular angle, Mckay and Severin score were evaluated every 6 months in all children. With 36 to 96 months (average 71 months) follow-up, 35 children (44 hips) were successfully followed up with complete case data while 5 children unsuccessfully. According to Tönnis classification, there were 5 grade 1 hips, 14 grade 2 hips, 14 grade 3 hips, 11 grade 4 hips, in which 3 children (4 hips) were failed in arthroscopic reduction and femoral head avascular necrosis occurred in 2 children (4 hips). According to Mckay standard, the good rate is 100%. According to Severin standard, the good rate is 84.1%. Arthroscopic assisted treatment is an effective way of reduction of the irreducible hip. Compared with the open reduction, arthroscopic treatment combined with acetabuloplasty and/or femoral osteotomy has advantages of less trauma and better function preservation.

Distraction arthroplasty with arthroscopic microfracture in a patient with rheumatoid arthritis of the ankle joint

We treated a 39-year-old female who had experienced destruction of her ankle joint owing to rheumatoid arthritis. This relatively young patient wished to avoid ankle fusion and joint replacement. Therefore, distraction arthroplasty with arthroscopic microfracture was performed to improve her symptoms and preserve motion. A microfracture procedure specifically for cartilage defects of the tibial plafond and talar dome was performed with the arthroscope, after which a hinged external fixator was applied to distract the ankle joint. The ankle joint space was enlarged by the external device and joint movement allowed. After 3 months, removal of the external device and repeat arthroscopy revealed newly formed fibrocartilage on the surfaces of both the tibia and the talus. At 2 years after the surgery, a radiograph showed that the joint space enlargement of the ankle had been maintained. The American Orthopaedic Foot and Ankle Society score improved from 37 points preoperatively to 82 points at 2 years postoperatively. Our findings suggest that good clinical results can be achieved with distraction arthroplasty and arthroscopic microfracture in a relatively young patient with rheumatoid arthritis.

Minimally invasive thumb carpometacarpal joint arthrodesis with headless screws and arthroscopic assistance

We describe a minimally invasive arthrodesis technique using an arthroscope and fixation with headless screws. From February 2007 to March 2010, we treated 11 thumbs in 11 patients with posttraumatic carpometacarpal joint osteoarthritis. All patients reported pain at the thumb carpometacarpal joint. Preoperatively, mean grip and pinch strength was 38 and 5.9 kg, respectively. At a mean time of 9 weeks, all patients achieved complete union at the fusion site. Mean follow-up was 46 months. At the final follow-up, mean grip and pinch strength was 47 and 7.7 kg, respectively. Based on the Kapandji opposition score (full scored = 10), the mean thumb opposition score was 7. All patients had pain relief. There were 6 excellent, 3 good, and 2 fair results.

Arthroscopic ankle arthrodesis with intra-articular distraction

Arthroscopic ankle arthrodesis has shown high rates of union comparable to those with open arthrodesis but with substantially less postoperative morbidity, shorter operative times, less blood loss, and shorter hospital stays. To easily perform arthroscopic resection of the articular cartilage, sufficient distraction of the joint is necessary to insert the arthroscope and instruments. However, sometimes, standard noninvasive ankle distraction will not be sufficient in post-traumatic ankle arthritis, with the development of arthrofibrosis and joint contracture after severe ankle trauma. In the present report, we describe a technique to distract the ankle joint by inserting a 4.6-mm stainless steel cannula with a blunt trocar inside the joint. The cannula allowed sufficient intra-articular distraction, and, at the same time, a 4.0-mm arthroscope can be inserted through the cannula to view the joint. Screws can be inserted to fix the joint under fluoroscopic guidance without changing the patient's position or removing the noninvasive distraction device and leg holder, which are often necessary during standard arthroscopic arthrodesis with noninvasive distraction.

The laser-assisted capsular shift procedure on an intercollegiate volleyball player: a case report

OBJECTIVE

To present a new arthroscopic technique, the laser-assisted capsular shift (LACS), which decreases glenohumeral instability and reduces recovery time over traditional surgical procedures.

BACKGROUND

A student-athlete hyperabducted her right shoulder while diving for a ball during a volleyball match. She complained of pain, weakness, and inability to raise her arm above shoulder height in any plane.

DIFFERENTIAL DIAGNOSIS

Capsular sprain, subluxation, rotator cuff strain, glenoid labral lesion.

TREATMENT

The student-athlete was unable to play due to pain and dysfunction and so elected to have the LACS procedure performed.

UNIQUENESS

The LACS procedure is a relatively new procedure for tightening the capsule and decreasing glenohumeral instability. Immobilization and recovery time are reduced when compared with traditional treatment methods.

CONCLUSIONS

The LACS procedure appears to be a good alternative to some of the traditional methods used to treat glenohumeral instability.