Normal Shoulder 2009 Chicago
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This document discusses techniques for shoulder arthroscopy including portals, common findings, and complications. It provides tips for avoiding complications and describes approaches to addressing the biceps tendon including tenotomy, tenodesis, and transfer. Debate remains around the optimal management of the biceps and whether to release or stabilize it. Lateral decubitus and beach chair positions each have advantages and disadvantages for different procedures.
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Posterior Instability
This document provides information on posterior instability of the shoulder. It discusses the mechanism of injury, incidence, diagnosis through x-rays, keys to success including portal placement and fixation options. Positioning for repair in beach chair position is described along with portals for posterior stabilization and techniques for suture passing and fixation using suture anchors, suture lassos, and knots. Additional stabilization techniques and potential complications are briefly touched upon.
Positioning for shoulder arthroscopy
Christopher M. Aland MD discusses shoulder arthroscopy procedures and positions. Shoulder arthroscopy can be performed in either the beach chair or lateral decubitus position, with recent modifications to both. The lateral decubitus position involves using a standard table with supports for the axilla, head, and sides. The beach chair position uses a standard table with back support and mechanical or manual leg support and head positioning, allowing for conversion to an open procedure or posterior inferior access if needed.
Beachchair final 2013
This document discusses positioning options for shoulder arthroscopy procedures. It describes the lateral decubitus and beach chair positions. The lateral position involves using a suspension device to support the arm while visualizing from the side. The beach chair position uses a standard table with back support and leg support to position the patient upright. Both positions have advantages like visualization and working space, and disadvantages like difficulty converting to an open procedure or risks of nerve injury or hypotension. In the end, the document notes that most procedures can be done from either position with specialized equipment, and common complications can be avoided by paying attention to details.
Noon extern (1)
This document describes the case of a 19-year-old Thai female who was in a motorcycle accident where she injured her left arm. She was found to have a spiral fracture of the distal third of her left humerus. Humeral shaft fractures most commonly occur in young patients from high-energy trauma or elderly patients from low-energy injuries. Treatment options include splinting or surgery depending on the severity of the injury. Complications can include nonunion, malunion, or radial nerve palsy.
Acetabular Fractures
Acetabular fractures are serious orthopedic injuries that occur when the femoral head is driven through the acetabulum, sometimes resulting in hip dislocation. They require rapid treatment and often surgery due to difficult access and proximity to blood vessels and nerves. Patients typically experience intense pain, swelling, deformity, and limited range of motion. While traction and immobilization are initial treatments, most patients need open reduction and internal fixation surgery to precisely realign the bones and prevent long-term issues. Major post-operative concerns include blood clots, infections, and avascular necrosis of the femoral head. Extensive physical therapy focuses on range of motion, strength, and mobility exercises to aid recovery.
Neurologic examination of upper limbs
The document provides instructions for performing a neurologic examination of the upper limbs, including planning, introducing oneself to the patient, inspecting the arms for deformities or wasting, testing sensations and motor function, and checking reflexes at the biceps, triceps, and brachioradialis using a tendon hammer, cotton wool, and tuning fork. The examination is designed to assess the C5-T1 nerve roots and includes inspection, sensory testing, assessing muscle power and tone, and reflex testing.
Ortho con
1) A 14-year-old boy was in a motorcycle accident where his left hip hit the ground, causing left hip pain and deformity.
2) Examination and x-rays revealed a posterior dislocation of the left hip.
3) The patient was taken to the operating room for closed reduction of the hip dislocation under general anesthesia with skeletal traction.
Hip dislocate mew
- The patient is a 53-year-old Thai man who fell 3 meters from his home after drinking alcohol, landing on his right hip. He has pain and inability to move his right leg. X-rays show an anterior dislocation of the right hip.
- In the emergency room, doctors were unable to perform a closed reduction of the dislocation. The patient was taken to the operating room for a closed reduction under general anesthesia with skeletal traction.
- Hip dislocations are usually caused by high-energy trauma and can be anterior or posterior. Treatment involves emergent closed reduction if possible, or open reduction and repair of any fractures. Complications can include post-traumatic arthritis, osteonecrosis, nerve
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This document provides information on posterior instability of the shoulder. It discusses the mechanism of injury, incidence, diagnosis through x-rays, keys to success including portal placement and fixation options. Positioning for repair in beach chair position is described along with portals for posterior stabilization and techniques for suture passing and fixation using suture anchors, suture lassos, and knots. Additional stabilization techniques and potential complications are briefly touched upon.
Positioning for shoulder arthroscopy
Christopher M. Aland MD discusses shoulder arthroscopy procedures and positions. Shoulder arthroscopy can be performed in either the beach chair or lateral decubitus position, with recent modifications to both. The lateral decubitus position involves using a standard table with supports for the axilla, head, and sides. The beach chair position uses a standard table with back support and mechanical or manual leg support and head positioning, allowing for conversion to an open procedure or posterior inferior access if needed.
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This document discusses positioning options for shoulder arthroscopy procedures. It describes the lateral decubitus and beach chair positions. The lateral position involves using a suspension device to support the arm while visualizing from the side. The beach chair position uses a standard table with back support and leg support to position the patient upright. Both positions have advantages like visualization and working space, and disadvantages like difficulty converting to an open procedure or risks of nerve injury or hypotension. In the end, the document notes that most procedures can be done from either position with specialized equipment, and common complications can be avoided by paying attention to details.
Noon extern (1)
This document describes the case of a 19-year-old Thai female who was in a motorcycle accident where she injured her left arm. She was found to have a spiral fracture of the distal third of her left humerus. Humeral shaft fractures most commonly occur in young patients from high-energy trauma or elderly patients from low-energy injuries. Treatment options include splinting or surgery depending on the severity of the injury. Complications can include nonunion, malunion, or radial nerve palsy.
Acetabular Fractures
Acetabular fractures are serious orthopedic injuries that occur when the femoral head is driven through the acetabulum, sometimes resulting in hip dislocation. They require rapid treatment and often surgery due to difficult access and proximity to blood vessels and nerves. Patients typically experience intense pain, swelling, deformity, and limited range of motion. While traction and immobilization are initial treatments, most patients need open reduction and internal fixation surgery to precisely realign the bones and prevent long-term issues. Major post-operative concerns include blood clots, infections, and avascular necrosis of the femoral head. Extensive physical therapy focuses on range of motion, strength, and mobility exercises to aid recovery.
Neurologic examination of upper limbs
The document provides instructions for performing a neurologic examination of the upper limbs, including planning, introducing oneself to the patient, inspecting the arms for deformities or wasting, testing sensations and motor function, and checking reflexes at the biceps, triceps, and brachioradialis using a tendon hammer, cotton wool, and tuning fork. The examination is designed to assess the C5-T1 nerve roots and includes inspection, sensory testing, assessing muscle power and tone, and reflex testing.
Ortho con
1) A 14-year-old boy was in a motorcycle accident where his left hip hit the ground, causing left hip pain and deformity.
2) Examination and x-rays revealed a posterior dislocation of the left hip.
3) The patient was taken to the operating room for closed reduction of the hip dislocation under general anesthesia with skeletal traction.
Hip dislocate mew
- The patient is a 53-year-old Thai man who fell 3 meters from his home after drinking alcohol, landing on his right hip. He has pain and inability to move his right leg. X-rays show an anterior dislocation of the right hip.
- In the emergency room, doctors were unable to perform a closed reduction of the dislocation. The patient was taken to the operating room for a closed reduction under general anesthesia with skeletal traction.
- Hip dislocations are usually caused by high-energy trauma and can be anterior or posterior. Treatment involves emergent closed reduction if possible, or open reduction and repair of any fractures. Complications can include post-traumatic arthritis, osteonecrosis, nerve
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1. The document discusses making diagnoses for various causes of wrist pain through thorough history taking and physical examination.
2. Key aspects to examine include palpating the wrist to identify sources of tenderness, and performing stress radiographs and MRI to diagnose ligament injuries or fractures when initial radiographs are inconclusive.
3. Treatment options are discussed for various conditions, including cast immobilization for most scaphoid fractures and surgical fixation for displaced fractures, as well as joint leveling procedures for Kienbock's disease and salvage procedures for advanced cases.
Ultrasound - Shoulder
This document provides information on using ultrasound to examine the shoulder, including:
1) It describes the anatomy that can be visualized with ultrasound and how it compares to MRI, outlines the ultrasound technique for examining various shoulder structures like the biceps tendon, rotator cuff muscles, and joints.
2) It explains the diagnostic and therapeutic uses of ultrasound for the shoulder, such as guiding injections and assessing tears, injuries, or other soft tissue abnormalities.
3) Examples of ultrasound images are provided to illustrate normal anatomy as well as various pathologies that may be detected like tears, tendonitis, fractures.
Extern conference ortho
1. A 41-year-old Thai man fell from a 10-wheel truck while unloading goods and his right leg struck the ground.
2. His right leg was deformed, swollen, and painful around the shin and he could not bear weight. There were no other injuries.
3. X-rays showed a fracture of the right tibia shaft.
The document describes a case of a 41-year-old man who fell from a truck, injuring his right leg. His leg was swollen, deformed and painful around the shin. X-rays confirmed a fracture of the right tibia shaft. The document then provides information on tibia shaft fractures, including mechanisms of injury
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1. Arthroscopic stabilization has become the standard treatment for anterior shoulder instability with indications including post-traumatic unidirectional instability with a discrete Bankart lesion and good tissue quality.
2. Contraindications for arthroscopic stabilization include HAGL lesions, poor quality capsulolabral tissue, intra-capsular IGHL rupture, revision surgery, significant glenoid or bony Bankart pathology, engaging Hill-Sachs lesions, and involvement in contact/collision sports.
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This document provides information on the anatomy and physical exam of the shoulder. It begins with objectives to review pertinent anatomy and the physical exam. It then details various anatomical views of the shoulder that can be seen on x-ray, MRI, and ultrasound. The document outlines the steps for physically examining the shoulder, including inspection, palpation, range of motion testing, and specific provocative tests for conditions like impingement, rotator cuff tears, and instability. It concludes with providing sensitivity and specificity data for some physical exam maneuvers and differential diagnoses for shoulder pain.
Extern conference ortho
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Nof # final (1)
NOF FRACTURE EASIEST SLIDE, EASY TO KNOW THE RECENT ADVANCES IN THE FIELD OF NOF, INCLUDING THE CASE WHICH WAS MANAGED IN DHULIKHEL HOSPITAL AND ASSOCIATED COMPLICATION THAT HAS ARISED ALONG WITH THE MANAGEMENT OF THE COMPLICATION
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The document discusses shoulder instability, including its definition, causes, clinical presentation, evaluation, and treatment options. Static factors like bony anatomy and ligaments contribute to stability, while dynamic factors include muscle forces. Pathologies include labral tears and capsular injuries. Treatment depends on factors like age, activity level, and pathology. Non-operative options include immobilization, while surgery repairs tissues like the labrum or tightens the capsule. Rehabilitation progresses from rest to strengthening and sport-specific training.
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Spine examination
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Neck Of femur fracture.pptx
- Fractures of the femoral neck are common and serious injuries that are increasing in incidence. They can occur from low or high-energy mechanisms.
- Treatment depends on patient age and fracture characteristics. Younger patients generally undergo open reduction and internal fixation while elderly patients may be treated with hemiarthroplasty or total hip arthroplasty.
- Factors like time to surgery, quality of reduction, and implant positioning influence outcomes like avascular necrosis and nonunion. Special considerations exist for stress fractures and nonunions.
Final, normal anatomy 2013
The document provides an overview of arthroscopic shoulder anatomy and highlights important structures to identify during a shoulder arthroscopy. It describes establishing portals and systematically inspecting the subscapularis, ligaments, labrum, articular surface, recesses, tendons, and bursa. Common anatomic variants are also noted that should not be treated as pathology. The goal is to follow a consistent routine to allow reproducible visualization of shoulder anatomy.
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- Surgical approaches include posterior, anterior, or combined based on the fracture type and neurological status. Proper classification guides treatment to decompress the spine and restore stability.
- Complications include problems from immobilization as well as implant failure and infection. Careful consideration of fracture morphology, neurological findings, and ligamentous integrity directs optimal treatment.
Noon conference
- The patient is a 54-year-old female who was in a motorcycle accident 4 hours prior where her motorcycle was hit on the side causing her to fall and injure her left leg.
- On examination, she had swelling and deformity of her left knee and thigh with tenderness and limited range of motion. X-rays showed a posterolateral dislocation of the left knee.
- She underwent closed reduction of the knee dislocation. A CTA showed no evidence of vascular injury. She was diagnosed with a posterolateral left knee dislocation and given splinting and pain management.
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Ortho
This document summarizes a case of a 9 year old female who presented with right leg pain for 2 hours after a bicycle accident. On examination, she had deformity, swelling and tenderness of the right ankle with limited range of motion due to pain. X-rays showed close transverse fractures of the right distal tibia and fibula with minimal displacement. The diagnosis was close fractures of both bones of the right leg. Management included pain control, possible closed reduction, application of a long leg posterior splint, and monitoring for compartment syndrome. The document then reviews general knowledge of tibia and fibula fractures including mechanisms of injury, signs and symptoms, radiological findings, and treatment options such as cast immobilization or surgery.
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This document discusses the anatomy, pathology, clinical evaluation, diagnosis, and treatment of biceps brachii tendinopathy. Specifically:
- The long head of the biceps brachii originates from the supraglenoid tubercle and inserts into the radial tuberosity. It passes through the bicipital groove in the humerus.
- Tendinopathy of the long head biceps brachii can be inflammatory, degenerative, or due to overuse/trauma. It commonly causes anterior shoulder pain and may occur with other shoulder issues like impingement or rotator cuff tears.
- Clinical evaluation involves assessing for tenderness over the b
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The document discusses shoulder injuries in sports. It provides guidance on what information is important to understand from MRI reports for rotator cuff tears, including the size and location of the tear and the extent of muscle atrophy. It emphasizes the importance of collaboration between surgeons and radiologists for accurate diagnoses. The treatment approach for sports injuries depends on factors like the patient's age, type of sport played, and time since injury.
Wrist pain: making the diagnosis
1. The document discusses making diagnoses for various causes of wrist pain through thorough history taking and physical examination.
2. Key aspects to examine include palpating the wrist to identify sources of tenderness, and performing stress radiographs and MRI to diagnose ligament injuries or fractures when initial radiographs are inconclusive.
3. Treatment options are discussed for various conditions, including cast immobilization for most scaphoid fractures and surgical fixation for displaced fractures, as well as joint leveling procedures for Kienbock's disease and salvage procedures for advanced cases.
Ultrasound - Shoulder
This document provides information on using ultrasound to examine the shoulder, including:
1) It describes the anatomy that can be visualized with ultrasound and how it compares to MRI, outlines the ultrasound technique for examining various shoulder structures like the biceps tendon, rotator cuff muscles, and joints.
2) It explains the diagnostic and therapeutic uses of ultrasound for the shoulder, such as guiding injections and assessing tears, injuries, or other soft tissue abnormalities.
3) Examples of ultrasound images are provided to illustrate normal anatomy as well as various pathologies that may be detected like tears, tendonitis, fractures.
Extern conference ortho
1. A 41-year-old Thai man fell from a 10-wheel truck while unloading goods and his right leg struck the ground.
2. His right leg was deformed, swollen, and painful around the shin and he could not bear weight. There were no other injuries.
3. X-rays showed a fracture of the right tibia shaft.
The document describes a case of a 41-year-old man who fell from a truck, injuring his right leg. His leg was swollen, deformed and painful around the shin. X-rays confirmed a fracture of the right tibia shaft. The document then provides information on tibia shaft fractures, including mechanisms of injury
Case report of thoracic spine fractures from ied blast in armoured vehicle Y...
This document summarizes three cases of thoracic spine fractures in soldiers from a vehicle IED strike in Afghanistan. All three soldiers were seated and wearing body armor at the time of the blast. Two soldiers had compression fractures of T12 that were not initially suspected based on examination alone. CT scans revealed the fractures. Both were treated non-operatively. The third soldier had a burst fracture of T12 also seen on CT scan. A literature review found that spine fractures are common in IED strikes and physical exams can miss injuries. CT scans are recommended to evaluate all back pain cases from IED attacks. Future research on seat design, restraints, and protection from flexion injuries from body armor is discussed.
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1. Arthroscopic stabilization has become the standard treatment for anterior shoulder instability with indications including post-traumatic unidirectional instability with a discrete Bankart lesion and good tissue quality.
2. Contraindications for arthroscopic stabilization include HAGL lesions, poor quality capsulolabral tissue, intra-capsular IGHL rupture, revision surgery, significant glenoid or bony Bankart pathology, engaging Hill-Sachs lesions, and involvement in contact/collision sports.
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This document provides information on the anatomy and physical exam of the shoulder. It begins with objectives to review pertinent anatomy and the physical exam. It then details various anatomical views of the shoulder that can be seen on x-ray, MRI, and ultrasound. The document outlines the steps for physically examining the shoulder, including inspection, palpation, range of motion testing, and specific provocative tests for conditions like impingement, rotator cuff tears, and instability. It concludes with providing sensitivity and specificity data for some physical exam maneuvers and differential diagnoses for shoulder pain.
Extern conference ortho
This document describes the case of a 69-year-old Thai man who presented to the emergency department with right thigh pain after falling 1.5 meters from the roof of his house. On examination, he had swelling and tenderness of the left thigh with limited range of motion. Radiographs revealed an intertrochanteric fracture of the left femur. Intertrochanteric fractures occur between the greater and lesser trochanters and are common in elderly patients, often resulting from low-energy falls. Treatment depends on the stability of the fracture but may involve internal fixation with screws or cephalomedullary nails. Complications can include malunion, nonunion, and loss of fixation.
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Spine examination
The orthopaedic examination involves looking at the patient's spine for any deformities, imbalance, swelling or wasting, feeling the spine for tenderness at spinous processes and paraspinal muscles as well as temperature and step off, moving the spine through its ranges of motion including special tests like the straight leg raise test to detect problems like herniated discs, and performing a full neurological exam. The exam must be tailored based on clinical suspicions and involve assessing both positive and negative findings to prove or rule out diagnoses.
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- Treatment depends on patient age and fracture characteristics. Younger patients generally undergo open reduction and internal fixation while elderly patients may be treated with hemiarthroplasty or total hip arthroplasty.
- Factors like time to surgery, quality of reduction, and implant positioning influence outcomes like avascular necrosis and nonunion. Special considerations exist for stress fractures and nonunions.
Final, normal anatomy 2013
The document provides an overview of arthroscopic shoulder anatomy and highlights important structures to identify during a shoulder arthroscopy. It describes establishing portals and systematically inspecting the subscapularis, ligaments, labrum, articular surface, recesses, tendons, and bursa. Common anatomic variants are also noted that should not be treated as pathology. The goal is to follow a consistent routine to allow reproducible visualization of shoulder anatomy.
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- Surgical approaches include posterior, anterior, or combined based on the fracture type and neurological status. Proper classification guides treatment to decompress the spine and restore stability.
- Complications include problems from immobilization as well as implant failure and infection. Careful consideration of fracture morphology, neurological findings, and ligamentous integrity directs optimal treatment.
Noon conference
- The patient is a 54-year-old female who was in a motorcycle accident 4 hours prior where her motorcycle was hit on the side causing her to fall and injure her left leg.
- On examination, she had swelling and deformity of her left knee and thigh with tenderness and limited range of motion. X-rays showed a posterolateral dislocation of the left knee.
- She underwent closed reduction of the knee dislocation. A CTA showed no evidence of vascular injury. She was diagnosed with a posterolateral left knee dislocation and given splinting and pain management.
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The presentation includes new insight to rotator cuff anatomy, rotator cable, concept of force couple, different classifications of rotator cuff tear, signs and symptoms, special tests, non operative and operative management of rotator cuff tear, comparison of recent surgical modalities, management of irreparable cuff tears, post operative rehabilitation protocols, SLAP lesion, Parsonage Turner Syndrome
Ortho
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Biceps - Melbourne Arm Clinic
This document discusses the anatomy, pathology, clinical evaluation, diagnosis, and treatment of biceps brachii tendinopathy. Specifically:
- The long head of the biceps brachii originates from the supraglenoid tubercle and inserts into the radial tuberosity. It passes through the bicipital groove in the humerus.
- Tendinopathy of the long head biceps brachii can be inflammatory, degenerative, or due to overuse/trauma. It commonly causes anterior shoulder pain and may occur with other shoulder issues like impingement or rotator cuff tears.
- Clinical evaluation involves assessing for tenderness over the b
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2. Different imaging modalities have advantages and disadvantages for evaluating various shoulder conditions. Plain radiographs are useful initial tests but MRI, ultrasound, CT and arthrography provide additional information in certain cases.
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This document summarizes the Version 8 upgrade to the SRS software. Version 8 provides upgraded features required for meaningful use, including the ability to select dates of service and view multiple providers in chart lists. It also integrates pharmacy and appointment data into the clinical summary. A referring provider field was removed from the summary screen but remains accessible elsewhere. The upgrade goes live on April 23, 2012 across the Rothman Institute.
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The document summarizes potential complications that can arise from shoulder arthroscopy surgery. It lists complications as equipment related, technique related, patient related, and general. Equipment related complications include those from hand instruments, power instruments, and pumps/fluids. Technique related complications involve vascular, neurological, and bone injuries. Patient related risks are from obesity and MRSA. General complications encompass those from anesthesia, common to all surgeries like infection, and issues involving implants.
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This document discusses options for treating shoulder injuries, specifically tenotomy and tenodesis procedures. It notes that while anatomy, pathology, and treatment options are known, the reasons for pain, best locations for pain, and definitively best treatments are still unknown. It provides an overview of tenotomy and tenodesis procedures, highlighting the use of various devices and methods, importance of not leaving behind surgical remnants ("stumps"), and pre-operative planning. Effectiveness is noted to vary depending on a patient's age, activity level, and studies have found most options do not differ greatly in results.
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Normal Shoulder 2009 Chicago
- 1. Normal Shoulder Exam Variants and What not to Fix Christopher M Aland MD Bucks County, PA sportdoc@comcast.net
- 2. Presenter disclosure information Normal Shoulder Exam Disclosure information The following relationships exist Arthrex, Conformis, Opus,
- 3. Standard • Posterior: through soft spot • Anterior: through rotator interval • Mid lateral: locate with needle
- 4. Arthroscopic Portals • Proper placement of portals is key • Standard • Supplemental
- 5. Mark the skin first
- 6. Anterior view Scope Posterior • Biceps labrum • Subscapularis tendon complex • Subscapularis recess • Biceps tendon • Middle GH ligament • Biceps hiatus • Anterior labrum • Anterior articular surface • Anterior inferior GH • Superior GH ligament • Inferior labrum • Rotator interval • Inferior capsule
- 7. VIEW ANTERIOR BICEPS HIATUS KNOW NORMAL !
- 9. Posterior View Scope Anterior • Posterior glenoid labrum • Posterior capsule • Posterior cuff • Subscapularis recess • MGH ligament • Anterior inferior GH ligament
- 10. POSTERIOR VIEW • Posterior inferior GH ligament • Posterior labrum • Infraspinatus tendon • Posterolateral humeral head
- 11. Sub Acromial Space View Posterior • Acromial Underside • CA ligament • Bursa • Dorsal cuff • AC joint
- 12. View Lateral • Posterior Cuff • Posterior Bursa • Rotator interval
- 13. What not to fix • Sublabral holes • Meniscoid labrum • Buford Complex
- 14. Buford complex • Anatomic variant • May have correlation to SLAP JSES 2009
- 15. Meniscoid labrum • May be Type 1 SLAP • Firm attachment • AB/ER does it move?
- 18. Complications and How to Avoid Them Christopher M Aland MD Bucks County, PA sportdoc@comcast.net
- 19. Presenter disclosure information Complications and How to Avoid Them Disclosure information The following relationships exist Arthrex, Conformis, Opus,
- 20. Shh, don’t say it • Nobody likes them, or likes to talk about them • Rates are low: i.e. infection .015 percent • Can be broken down into Equipment, Technique, Patient related, General, and Off the Wall
- 21. Equipment • Hand Instruments • Power Instruments • Pumps/fluid • Anchors
- 22. Technique • Vascular • Neurologic • Tendon issues
- 23. Patient related • Obesity • MRSA • General tissue condtion
- 24. Off the Wall • Rhabdomyolysis • Air Embolus • RSD • DVT • WTF? 1995: Sadat-Ali M; Al-Habdan I; Marwah S Fire during arthroscopy--an unusual complication. Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA 1995;3(3):178-9.
- 27. A word about stiffness • Preventable complication • Functional activity • Check at surgery
- 28. How to Avoid • This is why you are here • Don’t get in over your head • Stepwise progression • Know when to say when
- 29. BeachChair vs. Lateral Tips and Pointers Christopher M Aland MD Bucks County, PA sportdoc@comcast.net
- 30. Presenter disclosure information BeachChair vs Lateral Disclosure information The following relationships exist Arthrex, Conformis, Opus,
- 31. Lateral Decubitus • Standard table • Bean bag/postioner • Axillary roll • Traction device
- 33. BeachChair • Standard table with back support • Knee support • Optional arm support
- 36. Advantages • Lateral • Traction • Head clearance • Perfusion • BeachChair • Anatomic • Mobility
- 37. Disadvantages • Lateral • Non anatomic • Traction issues • BeachChair • Head in way • Hypotension • Expense of seat
- 38. • Pearls • Caution with weight in lateral • Don’t use saline for ax roll • Clear the scapula • Mark your anatomy • Head position neutral • Work at comfortable level
- 40. • Bottom line: • Advocates typically fall into camps based on their training • Most procedures can be done from either set-up • Peruto, Arthroscopy, 2008
- 41. Biceps Tendon Tenotomy, Tenodesis Christopher M Aland MD Bucks County, PA sportdoc@comcast.net
- 42. Presenter disclosure information Biceps Tendon Disclosure information The following relationships exist Arthrex, Conformis, Opus,
- 43. What to do with the Biceps ? • Kelly, AJSM, 2005 Tenotomy • Yong, Chinese MedJ, 2009 Transfer • Franceschi, BiomedJ, 2008, Tenodesis
- 45. What we do know • Biceps tendon can be source of pain
- 46. What we don’t know • How much function is left • What is best answer
- 47. Tenotomy • Transect back to glenoid rim • Debulk stump • No attempt to control
- 48. Tenodesis • Suture to cuff • Variety of techniques • Usually associated with tenotomy
- 50. Transfer • Stabilize in extra articular position • Variety of anchors • Similar technique • Open v. arthroscopic
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