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Arthroscopy Techniques
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    • Cover Image - Arthroscopy Techniques, Volume 12, Issue 2
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  • Technical Note
    Open Access

    Joystick of the Talus for Correcting Malalignment During Arthroscopic Ankle Arthrodesis: A Surgical Tip

    Arthroscopy Techniques
    Vol. 7Issue 5e517–e522Published online: April 23, 2018
    • Alessio Bernasconi
    • Nazim Mehdi
    • Julien Laborde
    • Cesar de Cesar Netto
    • Louis Dagneaux
    • François Lintz
    Cited in Scopus: 6
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    Ankle arthrodesis has been widely reported as an effective solution in treating tibiotalar joint osteoarthritis. The arthroscopic tibiotalar approach for arthrodesis has also been proven to give excellent results in terms of bone fusion rates and reduction of wound-related pain and complications. Historically, ankle malalignment has represented one of the main contraindications for the arthroscopic procedure, but interestingly some investigators have shown that the coronal joint deformity may be addressed arthroscopically as well.
    Joystick of the Talus for Correcting Malalignment During Arthroscopic Ankle Arthrodesis: A Surgical Tip
  • Technical Note
    Open Access

    Treatment of Osteochondral Lesions of the Talus With Cell-free Polymer-based Scaffold in Single-Step Arthroscopic Surgery

    Arthroscopy Techniques
    Vol. 6Issue 5e1727–e1734Published online: October 2, 2017
    • Ulunay Kanatlı
    • Ali Eren
    • Toygun K. Eren
    • Abdurrahman Vural
    Cited in Scopus: 2
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    Arthroscopic techniques have recently gained popularity for the treatment of osteochondral defects of the talus. The microfracture procedure is the most commonly applied arthroscopic technique. However, it is not effective for the treatment of larger lesions. Tissue-engineered scaffolds have been used for cartilage regeneration arthroscopically, and promising results have been reported. We treated larger osteochondral lesions of the talus with polyglycolic acid-hyaluronan scaffold biomaterial (Chondrotissue, BioTissue AG, Zurich, Switzerland) in a single-step arthroscopic surgery.
    Treatment of Osteochondral Lesions of the Talus With Cell-free Polymer-based Scaffold in Single-Step Arthroscopic Surgery
  • Technical Note
    Open Access

    Fibular Intra-articular Resection During Arthroscopic Ankle Arthrodesis: The Surgical Technique

    Arthroscopy Techniques
    Vol. 6Issue 5e1865–e1870Published online: October 16, 2017
    • Alessio Bernasconi
    • Nazim Mehdi
    • François Lintz
    Cited in Scopus: 5
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    Ankle arthrodesis is still considered the gold standard in the treatment of advanced painful ankle osteoarthritis. More than 3 decades ago, it was performed under arthroscopy; thereafter, many authors have reported excellent results and a low complication rate. Despite the significant improvements in surgical techniques, nonunion remains a problematic and relatively frequent event. This is one of the reasons the research is constantly active in this field. Ten years ago, a fibular resection during ankle arthrodesis was, for the first time, described in the literature as a means to correct malalignment in varus cases.
    Fibular Intra-articular Resection During Arthroscopic Ankle Arthrodesis: The Surgical Technique
  • Technical Note
    Open Access

    Anterolateral Arthroscopic Posterior Subtalar Arthrodesis: The Surgical Technique

    Arthroscopy Techniques
    Vol. 6Issue 4e1183–e1188Published online: July 31, 2017
    • Alessio Bernasconi
    • Claude Guillard
    • François Lintz
    Cited in Scopus: 6
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    • Video
    The effectiveness of subtalar arthrodesis has been well documented in treating degenerative subtalar joint disease. The arthroscopic subtalar approach for arthrodesis has also been proved to give excellent results in terms of bone fusion rates and reduction of wound-related pain and complications. To date, the main concerns about arthroscopy have regarded incision-related neurologic complications such as lesions of the tibial, fibular, and sural nerves. In this context, we present a 2-portal lateral (anterior and middle) approach to arthroscopic subtalar arthrodesis, recently documented in the literature, that provides similar excellent access to the joint with a lower risk of nerve damage.
    Anterolateral Arthroscopic Posterior Subtalar Arthrodesis: The Surgical Technique
  • Technical Note
    Open Access

    Ankle Arthroscopy With Microfracture for Osteochondral Defects of the Talus

    Arthroscopy Techniques
    Vol. 6Issue 1e167–e174Published online: February 6, 2017
    • Suman Medda
    • Ian M. Al'Khafaji
    • Aaron T. Scott
    Cited in Scopus: 4
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    Therapeutic arthroscopy with microfracture leads to fibrocartilaginous repair and is an effective treatment of osteochondral lesions of the talus. A full diagnostic arthroscopy is performed, and then attention is turned to the osteochondral defect. We describe in detail patient positioning, ankle distraction, portal placement, steps of the diagnostic arthroscopy, and the technique of microfracture. We then discuss the special considerations to be taken regarding the use of a distractor, protection of neurovascular structures, and the indications for microfracture.
    Ankle Arthroscopy With Microfracture for Osteochondral Defects of the Talus
  • Technical Note
    Open Access

    Arthroscopic Interpositional Arthroplasty of the Second Metatarsophalangeal Joint

    Arthroscopy Techniques
    Vol. 5Issue 6e1333–e1338Published online: November 21, 2016
    • Tun Hing Lui
    Cited in Scopus: 9
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    Painful degenerative diseases of the second metatarsophalangeal joint are frequently progressive and difficult to treat. Surgical options for the degenerated second metatarsophalangeal joint include joint debridement and synovectomy, drilling and microfracture, core decompression, dorsal closing-wedge metatarsal osteotomies, joint arthroplasty (implant or interpositional), elevation of the depressed articular fragment and bone graft, distraction arthroplasty, osteochondral plug transplantation, osteochondral distal metatarsal allograft reconstruction, and resection arthroplasty (phalangeal base or metatarsal head).
    Arthroscopic Interpositional Arthroplasty of the Second Metatarsophalangeal Joint
  • Technical Note
    Open Access

    Posterior Ankle Arthroscopic Reduction With Internal Fixation

    Arthroscopy Techniques
    Vol. 5Issue 6e1261–e1265Published online: November 7, 2016
    • Kevin D. Martin
    • Alicia M. Unangst
    • Cody R. Englert
    Cited in Scopus: 3
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    Current surgical techniques in ankle fracture management now include arthroscopic-assisted reduction and internal fixation. The need for minimally invasive fracture reduction techniques, which preserve soft tissue envelops and assists in overall anatomic reduction, can be refined and improved. The ankle is an ideal anatomic location for arthroscopic-assisted reduction and internal fixation due to the high incidence of intra-articular pathology and the poor long-term sequela of nonanatomic reduction.
    Posterior Ankle Arthroscopic Reduction With Internal Fixation
  • Technical Note
    Open Access

    Simplified Setup to Achieve Distraction for Toe Arthroscopy

    Arthroscopy Techniques
    Vol. 5Issue 4e815–e819Published online: August 1, 2016
    • Cody R. Englert
    • Alicia M. Unangst
    • Kevin D. Martin
    Cited in Scopus: 2
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    Toe arthroscopy has historically had limited applications but is beginning to emerge as a viable treatment option for select toe pathologies, and continues to have expanding indications as technology and techniques improve. Toe arthroscopy has used a multitude of distraction techniques to perform the procedures but all have had limited success. Thus, we propose a simple toe arthroscopy distraction technique that uses an external positioning arm to allow the surgeon to apply manual traction in multiple positions without the use of an assistant, external weights, or any reprocessed sterile equipment.
    Simplified Setup to Achieve Distraction for Toe Arthroscopy
  • Technical Note
    Open Access

    First Metatarsophalangeal Joint Arthroscopy for Osteochondral Lesions

    Arthroscopy Techniques
    Vol. 5Issue 3e513–e518Published online: May 23, 2016
    • Thomas I. Sherman
    • Michael Kern
    • John Marcel
    • Alexander Butler
    • Francis X. McGuigan
    Cited in Scopus: 7
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    • Video
    Small-joint arthroscopy has supplanted open procedures because it offers the potential for improvement in joint visualization, reduced scarring, and accelerated recovery. Despite these advantages, arthroscopy of the first metatarsophalangeal joint is not commonly performed and reports of its use are lacking. The reason for this is not clear but may be because of perceived technical complexity and poorly defined indications. In our experience, however, arthroscopy of the first metatarsophalangeal joint is a versatile procedure that facilitates treatment of many different pathologic processes through a minimally invasive approach with few complications.
    First Metatarsophalangeal Joint Arthroscopy for Osteochondral Lesions
  • Technical Note
    Open Access

    Arthroscopic Excision of Juxta-articular Osteoid Osteoma of the Calcaneum

    Arthroscopy Techniques
    Vol. 5Issue 1e11–e15Published online: January 4, 2016
    • Mohammed Tauheed
    • Ravi Jacob Korula
    • Sriram Shankarnarayanan
    Cited in Scopus: 3
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    Osteoid osteoma of the foot is a rare condition particularly of the calcaneum. This condition is difficult to diagnose and is more difficult to treat particularly if it involves deeper part of the joints. We present an arthroscopic technique to deal with a case of juxta-articular osteoid osteoma of the calcaneum using two portals: the anterolateral portal for instrumentation and the anterior anterolateral portal for visualization of the subtalar joint. Because this approach is minimally invasive, it offers early recovery and reduced morbidity compared with the conventional techniques.
    Arthroscopic Excision of Juxta-articular Osteoid Osteoma of the Calcaneum
  • Technical Note
    Open Access

    Simple 1-Step Ankle Arthroscopy Distraction

    Arthroscopy Techniques
    Vol. 4Issue 6e873–e876Published online: December 28, 2015
    • Alicia Unangst
    • Kevin D. Martin
    Cited in Scopus: 8
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    • Video
    Ankle arthroscopy has emerged as a viable treatment option for multiple ankle pathologies and continues to have expanding indications as technology and techniques improve. Historically, ankle arthroscopy used skeletal traction, and it has transitioned to noninvasive soft-tissue distraction because of high rates of iatrogenic complications. Although soft-tissue distraction has decreased complications, it continues to be both cumbersome and time-consuming. Thus we propose a 1-step simple ankle arthroscopy distraction technique that uses an external positioning arm to allow the surgeon to apply manual traction in multiple positions without the use of any reprocessed sterile equipment.
    Simple 1-Step Ankle Arthroscopy Distraction
  • Technical Note
    Open Access

    Treatment of Osteochondral Lesions of the Talus With Bone Marrow Stimulation and Chitosan–Glycerol Phosphate/Blood Implants (BST-CarGel)

    Arthroscopy Techniques
    Vol. 4Issue 6e663–e667Published online: November 9, 2015
    • Jesús Vilá y Rico
    • Antonio Dalmau
    • Francisco Javier Chaqués
    • Jordi Asunción
    Cited in Scopus: 15
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    • Video
    Bone marrow stimulation (BMS) techniques represent the first-line treatment for unstable osteochondral lesions of the talus or after conservative treatment failure. These techniques are intended to penetrate the subchondral bone to elicit bleeding and allow precursor cells and cytokines from bone marrow to populate the lesion. However, the fibrocartilaginous repair tissue arising after marrow stimulation confers inferior mechanical and biological properties compared with the original hyaline cartilage.
    Treatment of Osteochondral Lesions of the Talus With Bone Marrow Stimulation and Chitosan–Glycerol Phosphate/Blood Implants (BST-CarGel)
  • Technical Note
    Open Access

    Arthroscopic Treatment of Chondral and Osteochondral Defects in the Ankle Using the Autologous Matrix-Induced Chondrogenesis Technique

    Arthroscopy Techniques
    Vol. 4Issue 5e463–e469Published online: September 21, 2015
    • Tomasz Piontek
    • Paweł Bąkowski
    • Kinga Ciemniewska-Gorzela
    • Jakub Naczk
    Cited in Scopus: 3
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    One of the greatest challenges nowadays facing orthopaedic surgeons around the world is the problem of articular cartilage defects and their treatment. The autologous matrix-induced chondrogenesis technique is based on 2 elements—drilling into bones and matrix application. The purpose of this article is to present the surgical technique of arthroscopic treatment of chondral or osteochondral defects in the ankle using the autologous matrix-induced chondrogenesis technique.
    Arthroscopic Treatment of Chondral and Osteochondral Defects in the Ankle Using the Autologous Matrix-Induced Chondrogenesis Technique
  • Technical Note
    Open Access

    Use of a Pneumatic Limb Positioner for Invasive Skeletal Traction in Posterior Hindfoot Arthroscopy

    Arthroscopy Techniques
    Vol. 4Issue 5e417–e422Published online: September 7, 2015
    • Bryan G. Vopat
    • Craig R. Lareau
    • Rohit B. Sangal
    • Amanda J. Fantry
    • Brad D. Blankenhorn
    Cited in Scopus: 1
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    • Video
    Posterior hindfoot arthroscopy is a useful tool to treat a variety of foot and ankle pathologies. Skeletal distraction of the hindfoot to increase visualization in posterior ankle arthroscopy has been described in previous studies, but the described distractor is not readily available in most operating rooms. We describe a case of posterior hindfoot distraction in the prone position using a pneumatic limb positioner and other readily available Food and Drug Administration–approved equipment to apply tension to a transcalcaneal wire.
    Use of a Pneumatic Limb Positioner for Invasive Skeletal Traction in Posterior Hindfoot Arthroscopy
  • Technical Note
    Open Access

    All-Arthroscopic Autologous Matrix-Induced Chondrogenesis for the Treatment of Osteochondral Lesions of the Talus

    Arthroscopy Techniques
    Vol. 4Issue 3e255–e259Published online: June 8, 2015
    • Federico Giuseppe Usuelli
    • Laura de Girolamo
    • Miriam Grassi
    • Riccardo D'Ambrosi
    • Umberto Alfieri Montrasio
    • Michele Boga
    Cited in Scopus: 34
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    Several surgical techniques have been described for the treatment of talar chondral lesions. Among them, microfracture is well established. Autologous matrix-induced chondrogenesis (AMIC), using microfracture and biomaterials, has shown promising results for the treatment of knee osteochondral lesions and has been proposed for the ankle as an open technique. We describe an all-arthroscopic AMIC technique. The benefits of an all-arthroscopic procedure include smaller incisions with less soft-tissue dissection, better visualization of the joint, and a quicker recovery compared with open surgery.
    All-Arthroscopic Autologous Matrix-Induced Chondrogenesis for the Treatment of Osteochondral Lesions of the Talus
  • Technical Note
    Open Access

    Arthroscopic Allograft Cartilage Transfer for Osteochondral Defects of the Talus

    Arthroscopy Techniques
    Vol. 4Issue 2e175–e178Published online: April 20, 2015
    • Kyong S. Min
    • Paul M. Ryan
    Cited in Scopus: 6
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    Arthroscopic treatment of osteochondral defects is well established but has had mixed results in larger lesions and revision operations. Particulated allograft cartilage transfer may provide an arthroscopic option for lesions that would otherwise have been treated through open approaches or osteotomies. The procedure is performed under noninvasive distraction with standard arthroscopic portals.
    Arthroscopic Allograft Cartilage Transfer for Osteochondral Defects of the Talus
  • Technical Note
    Open Access

    Ankle Arthroscopy for Ankle Fractures

    Arthroscopy Techniques
    Vol. 4Issue 1e75–e79Published online: February 16, 2015
    • Thomas I. Sherman
    • Nick Casscells
    • Joe Rabe
    • Francis X. McGuigan
    Cited in Scopus: 13
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    In many patients who undergo open reduction–internal fixation of ankle fractures, there is a failure to achieve good clinical outcomes despite radiographic evidence of anatomic reduction. One possible reason for this is the high incidence of concomitant intra-articular pathology associated with ankle fractures that may go unrecognized using traditional open approaches. Arthroscopy in the setting of acute operative management of ankle fractures provides a means to completely assess intra-articular pathology, as well as provide direct therapeutic intervention in many instances.
    Ankle Arthroscopy for Ankle Fractures
  • Technical Note
    Open Access

    Arthroscopic Particulated Juvenile Cartilage Allograft Transplantation for the Treatment of Osteochondral Lesions of the Talus

    Arthroscopy Techniques
    Vol. 3Issue 4e533–e537Published online: August 25, 2014
    • Samuel B. Adams Jr.
    • Constantine A. Demetracopoulos
    • Selene G. Parekh
    • Mark E. Easley
    • Justin Robbins
    Cited in Scopus: 27
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    Several options exist for the treatment of osteochondral lesions of the talus. Particulated juvenile cartilage allograft transplantation (PJCAT) has become a viable treatment modality for osteochondral lesions of the talus that are not amenable to microfracture or for which microfracture has failed. Arthroscopic placement of this type of graft obviates the need for osteotomy or plafondplasty and does not prevent additional procedures from being performed through an anterior approach. Special instrumentation and setup are not required to perform this procedure.
    Arthroscopic Particulated Juvenile Cartilage Allograft Transplantation for the Treatment of Osteochondral Lesions of the Talus
  • Technical Note
    Open Access

    Arthroscopic Treatment of Talar Body Fractures

    Arthroscopy Techniques
    Vol. 3Issue 2e271–e274Published online: April 10, 2014
    • Nicholas B. Jorgensen
    • Michael Lutz
    Cited in Scopus: 7
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    • Video
    Talar fractures can be severe injuries with complications leading to functional disability. Open reduction–internal fixation remains the treatment of choice for displaced talar fractures. Arthroscopic evaluation of the fracture and articular surfaces can play an important role in the treatment of these fractures. Arthroscopic reduction–internal fixation (ARIF) is increasingly used for certain intra-articular fracture types through the body. The minimally invasive nature of ARIF and high accuracy are enviable attributes of an evolving technique.
    Arthroscopic Treatment of Talar Body Fractures
  • Technical Note
    Open Access

    The “Cup-Shaped” Technique for Uncontained Osteochondral Lesion of the Talus

    Arthroscopy Techniques
    Vol. 2Issue 4e347–e350Published online: September 16, 2013
    • Ichiro Yoshimura
    • Tomonobu Hagio
    • Masatoshi Naito
    Cited in Scopus: 0
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    The arthroscopic bone marrow stimulation technique is defined as the first-line procedure for an osteochondral lesion of the talus. The containment of the lesion has been reported as 1 of the prognostic factors for clinical outcomes of arthroscopic bone marrow stimulation. It was surmised that lesions without a stable rim lose the protective border, thereby making stable formation of fibrocartilage less likely. The purpose of the cup-shaped technique is to improve the stability of blood clots after arthroscopic bone marrow stimulation in an uncontained lesion.
    The “Cup-Shaped” Technique for Uncontained Osteochondral Lesion of the Talus
  • Technical Note
    Open Access

    Improved Visualization of the 70° Arthroscope in the Treatment of Talar Osteochondral Defects

    Arthroscopy Techniques
    Vol. 2Issue 2e129–e133Published online: April 15, 2013
    • Pietro Spennacchio
    • Pietro Randelli
    • Paolo Arrigoni
    • Niek van Dijk
    Cited in Scopus: 3
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    • Video
    Osteochondral defects (OCDs) of the talus are a common cause of residual pain after ankle injuries. When conservative treatment fails, arthroscopic debridement combined with drilling/microfracturing of the lesion (bone marrow stimulation [BMS] procedures) has been shown to provide good to excellent outcomes. Not uncommonly, talar OCDs involve the borders of the talar dome. These uncontained lesions are sometimes difficult to visualize with the 30° arthroscope, with potential negative effect on the clinical outcome of an arthroscopic BMS procedure.
    Improved Visualization of the 70° Arthroscope in the Treatment of Talar Osteochondral Defects
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