Notes

Monitoring program with regard to intense extreme infections together with pandemic possible using a deterministic-stochastic product, the StochCum Method.
When the long head of the biceps tendon is diseased, tenodesis is an appropriate treatment strategy. The specific technique used is dependent on visualization, fixation method and hardware, and tenodesis location. For suprapectoral tenodesis techniques, those that fix the tendon within or below the bicipital groove can be challenging owing to the transverse humeral ligament covering the groove. To accurately identify the biceps tendon in this area, the ligament often requires resection. Ultrasound provides surgeons with a safe and noninvasive tool to visualize the biceps tendon as it exits the bicipital groove, negating the need for unroofing and other pitfalls associated with traditional techniques. This technical note describes an ultrasound-guided suprapectoral biceps tenodesis procedure.Posterior shoulder dislocation is a rare condition. It is easily overlooked and often appears in a chronic locked status, which makes the reduction difficult, even through open procedures. Few reports in the literature have described an isolated arthroscopic reduction because it is difficult to elevate the humeral head to the level of the glenoid surface and obtain anterior-posterior soft-tissue balance. On the basis of an analysis of the mechanisms of the locking of the humeral head and the soft-tissue imbalance, we describe a set of arthroscopic shoulder release and reduction techniques, which include mainly the removal of rotator interval tissue; a thorough subscapularis release from the coracoid, the conjoined tendon, and the glenoid; and a 360° capsule-muscle release from the glenoid and the scapula. The described technique is an effective method to obtain a medial-to-lateral humeral head reduction and anterior-to-posterior soft-tissue balance. The introduction of this technique will provide a practical tool for surgeons to realize an arthroscopic shoulder reduction in the case of a chronic locked posterior shoulder dislocation.Disorders of the acromioclavicular (AC) joint quite often necessitate distal clavicle resection (DCR). Arthroscopic DCR is favored because of it is mini-invasive and convenient to treat concomitant intraarticular or subacromial lesions. In previous reports, arthroscopic DCR was performed through the anterior portal with the patient in beach chair position. NX-1607 cell line However, when the patient is in the lateral decubitus position, it is inconvenient to perform DCR through the anterior portal. Thus, we introduce a special DCR technique through the supraspinatus fossa (SSF) portal. The critical point of this technique is viewing the acromioclavicular joint through the routine posterior portal, creating the SSF portal at the anterior edge of the scapular spine and the same medial-to-lateral level to the AC joint, and enough removal of the posterior edge of the distal clavicle. We believe the introduction of this technique will provide a special technical option when DCR is needed.Biceps tenodesis is a commonly performed procedure. It can be done using a multitude of fixation methods, at multiple locations, and either open or arthroscopic, with little if any clinical differences in the literature. Yet, many techniques have drawbacks in the risk of complications or in the technical ease. Here we present what we have found to be an efficient, simple, reproducible technique KAToB, Knotless All-arthroscopic intraarticular Tenodesis of the Biceps using a knotless anchor at the articular margin. This technique minimizes the risk of nerve injury, infection, and fracture; has good clinical outcomes; and has a low rate of failure.Acromioclavicular (AC) joint injuries are the most common shoulder injuries in the athletic population. The literature is rife with various surgical techniques and implants as well as opinion on proper timing of surgical options. Patient outcomes are generally similar across fixation method. Complications are common following reconstruction, and the specific type of complication may depend on the technique used. Fracture and graft elongation are associated with use of allograft, whereas button cutout and skin irritation can occur with cortical suture-fixation methods. This technical paper describes an arthroscopically assisted acute AC joint reconstruction technique using the Infinity-Lock Button System. This technique provides a minimally invasive, low-profile reconstruction that may minimize risk of clavicle and coracoid fracture as well as overlying skin irritation. Acute reconstruction may permit healing of the native coracoclavicular and AC ligaments and mitigate risk of future AC joint arthritis.Acromioclavicular (AC) joint injuries are extremely common in the athletic population. Although most low-grade injuries can be managed nonoperatively, high-grade injuries often require reconstruction of the AC joint. Various reconstructive options have been described with varying risks and benefits to each. Implant or graft failure with loss of reduction as well as clavicle and coracoid fracture are a few of the more common complications following AC joint reconstruction surgery. Currently, no gold standard exists. This technical paper describes an arthroscopically assisted AC joint reconstruction technique using the Infinity-Lock Button System with hamstring allograft augmentation. This technique provides an anatomic, minimally invasive, low-profile reconstruction that may minimize risk of clavicle and coracoid fracture. It also provides augmented stabilization across the AC joint, which may also help resist naturally occurring horizontal and rotational displacing forces.Recurrent anterior shoulder dislocation is always combined with glenoid and capsule-labrum deficiency. To address all these deficiency in a single operation, we developed a 4-layer structural reconstruction technique at the anterior side of the shoulder, which includes capsule-labrum repair, glenoid bone grafting, and transfer of the long head of the biceps brachii (LHB). This procedure is indicated in patients who need both sling and bone fragment augmentation. The critical steps of this technique are LHB transfer and 2-layer glenoid bone grafting. We believe that this technique will enhance the field of anterior shoulder reconstruction for complicated anterior shoulder dislocation.
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