RESUMEN
Acromioclavicular (AC) joint instability is a fairly common and particularly limiting injury that may result in persistent pain and reduced quality of life. In most cases, conservative management is successful. However, in the case of a severe AC joint dislocation, surgical intervention may be warranted. Previous surgical techniques for treatment of AC joint instability include screw fixation between the coracoid and clavicle, coracoacromial ligament transfer from its acromial insertion to the clavicle, and reconstruction of the coracoacromial and/or coracoclavicular ligaments. The purpose of this Technical Note is to describe our preferred technique for the treatment of a high-grade AC dislocation through coracoacromial ligament transfer to the lateral clavicle and nonabsorbable suture fixation between the coracoid process and clavicle.
RESUMEN
An increasing concern has been given to the rotation stability of the knee in the setting of an anterior cruciate ligament (ACL) reconstruction. This growing interest stems from a better understanding of the rotational stability of the knee afforded by the identification of the anterolateral ligament. Previously, a residual abnormal pivot-shift test had been found after an anatomic single-band reconstruction of the ACL because of a lack of rotational stability, which may lead to the development of osteoarthritis. Residual instability affects function, especially in high-demand athletes who perform many flexion-rotation movements during sporting activity. The purpose of this Technical Note is to describe our preferred method of intra-articular ACL reconstruction using a hamstring tendon autograft in combination with an extra-articular iliotibial band tenodesis for reinforcement of rotational stability.
RESUMEN
The loss of knee extension, even if minimal, is disabling and considerably affects the individual's quality of life. This loss of extension can be a consequence of prior surgery, including a previous anterior cruciate ligament reconstruction. Although this loss of extension may be treated through an isolated arthroscopic procedure, a more severe case may warrant an invasive approach. In these cases, a posterior capsulotomy of the knee may be done if all conservative measures have been exhausted. This procedure has been proven to be safe and effective in the re-establishment of full extension in the setting of a minor flexion contracture of the knee. The purpose of this Technical Note was to describe our preferred technique when performing an open posterior capsulotomy of the knee for the treatment of minimal extension deficit.