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

    Endoscopic Superior Peroneal Retinaculum Reconstruction Using Q-FIX MINI Suture Anchor

    Arthroscopy Techniques
    Vol. 12Issue 2e233–e240Published online: January 18, 2023
    • Tun Hing Lui
    • Charles Churk Hang Li
    Cited in Scopus: 0
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    Post-traumatic peroneal tendon subluxation or dislocation is most commonly caused by injury to the superior peroneal retinaculum. Classic open surgeries usually require extensive soft-tissue dissection and have potential risks of peritendinous fibrous adhesions, sural nerve injury, limited range of movement, recurrent or persistent peroneal tendon instability, and tendon irritation. The purpose of this Technical Note is to describe the details of endoscopic superior peroneal retinaculum reconstruction using Q-FIX MINI suture anchor.
    Endoscopic Superior Peroneal Retinaculum Reconstruction Using Q-FIX MINI Suture Anchor
  • Technical Note
    Open Access

    Arthroscopic Synovectomy of the Interphalangeal Joint of the Great Toe

    Arthroscopy Techniques
    Vol. 7Issue 6e657–e660Published online: May 21, 2018
    • Cheung Hong Lee
    • Tun Hing Lui
    Cited in Scopus: 0
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    Synovitis of the interphalangeal joint of the great toe can occur in patients with rheumatoid arthritis, seronegative arthritides, or gouty arthritis or after a penetrating injury to the joint. Complete synovectomy of the joint usually requires a lengthy incision and extensive soft-tissue dissection. The purpose of this Technical Note is to describe the surgical details of arthroscopic synovectomy of the hallucal interphalangeal joint, which can reduce the surgical trauma.
    Arthroscopic Synovectomy of the Interphalangeal Joint of the Great Toe
  • Technical Note
    Open Access

    Peroneus Longus Tendoscopy at the Sole

    Arthroscopy Techniques
    Vol. 7Issue 5e479–e483Published online: April 9, 2018
    • Tun Hing Lui
    • Wilson Wai Shun Hau
    Cited in Scopus: 3
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    Different pathologies can occur in the peroneus longus tendon at the sole. Many of them can be dealt with by peroneus longus tendoscopy of the sole. The purpose of this Technical Note is to describe the details of this minimally invasive approach to the peroneus longus tendon of the sole. This has the advantages of better cosmesis, less soft tissue dissection, less postoperative pain, and less peritendinous fibrosis.
    Peroneus Longus Tendoscopy at the Sole
  • Technical Note
    Open Access

    Naviculocuneiform Arthroscopy

    Arthroscopy Techniques
    Vol. 7Issue 5e437–e442Published online: April 2, 2018
    • Tun Hing Lui
    • Cho Yau Lo
    Cited in Scopus: 3
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    • Video
    Surgical interventions at the naviculocuneiform joint are not uncommon to deal with various pathologies of the joint and correction of different foot deformities. To minimize the soft tissue dissection, naviculocuneiform arthroscopy has been described. The purpose of this Technical Note is to report the details of this arthroscopic approach.
    Naviculocuneiform Arthroscopy
  • Technical Note
    Open Access

    Bone Marrow Aspirate Concentrate and Microfracture Technique for Talar Osteochondral Lesions of the Ankle

    Arthroscopy Techniques
    Vol. 7Issue 4e391–e396Published online: March 26, 2018
    • Evelyn P. Murphy
    • Christopher Fenelon
    • Niall P. McGoldrick
    • Stephen R. Kearns
    Cited in Scopus: 5
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    Osteochondral lesions of the talus refer to a chondral or subchondral defect of the articular cartilage and potentially the underlying bone. Ankle sprains are an extremely common injury; approximately 27,000 ankle sprains occur per day in America. Fifty percent of these can lead to a cartilage injury to the ankle. There has been a high quoted rate of failure with conservative measures of up to 45% in some series. Surgical options are largely broken down into 2 groups, namely, reparative or regenerative treatments.
    Bone Marrow Aspirate Concentrate and Microfracture Technique for Talar Osteochondral Lesions of the Ankle
  • Technical Note
    Open Access

    Treatment of Malunited Calcaneal Fracture With Posttraumatic Subtalar Osteoarthritis Using Lateral Endoscopic Calcaneoplasty With Posterior Arthroscopic Subtalar Arthrodesis

    Arthroscopy Techniques
    Vol. 7Issue 3e245–e249Published online: February 19, 2018
    • Chayanin Angthong
    Cited in Scopus: 2
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    Malunion of calcaneal fractures is a common complication after improper nonoperative treatment. It may develop into posttraumatic subtalar osteoarthritis, lateral calcaneal wall prominence, and severe foot deformities. This Technical Note reports the technical aspects of lateral endoscopic calcaneoplasty with posterior arthroscopic subtalar arthrodesis for the treatment of malunited calcaneal fracture with lateral calcaneal wall prominence and posttraumatic subtalar osteoarthritis. This technique was chosen because it can reduce the risk of wound complication compared with a conventional lateral extensile approach.
    Treatment of Malunited Calcaneal Fracture With Posttraumatic Subtalar Osteoarthritis Using Lateral Endoscopic Calcaneoplasty With Posterior Arthroscopic Subtalar Arthrodesis
  • Technical Note
    Open Access

    A Technique for the Reduction of Complications Associated With Anterior Portal Placement During Ankle Arthroscopy Using a Peripheral Vein Illumination Device

    Arthroscopy Techniques
    Vol. 7Issue 2e125–e129Published online: January 15, 2018
    • Yusuke Tsuyuguchi
    • Tomoyuki Nakasa
    • Masakazu Ishikawa
    • Yasunari Ikuta
    • Mikiya Sawa
    • Masahiro Yoshikawa
    • and others
    Cited in Scopus: 2
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    Ankle arthroscopy is a minimally invasive technique for ankle joint treatment. However, injury to the intermediate dorsal cutaneous nerve (IDCN) and the medial dorsal cutaneous nerve (MDCN) is a common complication during anterior portal placement. To prevent injuries, methods such as palpating the nerves topographically and marking the nerves by transilluminating the skin with an arthroscope have been proposed. Easier and more definitive methods of identifying the IDCN and MDCN should result in a reduction of complications.
    A Technique for the Reduction of Complications Associated With Anterior Portal Placement During Ankle Arthroscopy Using a Peripheral Vein Illumination Device
  • Technical Note
    Open Access

    Endoscopic Management of Calcaneofibular Impingement and Posterior Ankle Impingement Syndrome Caused by Malunion of Joint Depressed–Type Calcaneal Fracture

    Arthroscopy Techniques
    Vol. 7Issue 2e71–e76Published online: January 1, 2018
    • Tun Hing Lui
    • Yuk Chuen Siu
    • Wai Kit Ngai
    Cited in Scopus: 5
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    Identification of the correct source of symptoms is the key in formulating the correct treatment plan for heel pain after calcaneal malunion. Calcaneofibular and posterior ankle impingements can occur due to malunion of a joint depressed–type calcaneal fracture. The purpose of this Technical Note is to report the technical details of posterior and lateral decompression through the posteromedial and posterolateral portals using posterior ankle endoscopy.
    Endoscopic Management of Calcaneofibular Impingement and Posterior Ankle Impingement Syndrome Caused by Malunion of Joint Depressed–Type Calcaneal Fracture
  • Technical Note
    Open Access

    Endoscopic Superior Peroneal Retinaculum Reconstruction

    Arthroscopy Techniques
    Vol. 7Issue 1e45–e51Published online: December 18, 2017
    • Wilson Wai Shun Hau
    • Tun Hing Lui
    • Wai Kit Ngai
    Cited in Scopus: 8
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    • Video
    Post-traumatic peroneal tendon subluxation or dislocation is most commonly due to injury to the superior peroneal retinaculum. Acute repair of the retinaculum is an option for active athletes who desire quick return of sport activity. In general, conventional open surgeries require extensive exposure of the injured superficial peroneal retinaculum and have potential risks of scar formation, sural nerve injury, limited range of movement, peroneal tendon re-subluxation, and tendon irritation. The purpose of this Technical Note is to describe the details of endoscopic superior peroneal retinaculum reconstruction.
    Endoscopic Superior Peroneal Retinaculum Reconstruction
  • Technical Note
    Open Access

    Arthroscopic Arthrodesis of the Lesser Ray Tarsometatarsal Joints: 2-Portal Technique

    Arthroscopy Techniques
    Vol. 6Issue 5e1495–e1499Published online: September 4, 2017
    • Tun Hing Lui
    Cited in Scopus: 1
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    Tarsometatarsal (Lisfranc) destruction of the tarsometatarsal articulation of the lesser rays is most commonly due to midfoot Charcot neuroarthropathy. Tarsometatarsal arthrodesis is indicated when conservative management cannot relieve the symptoms. The purpose of this Technical Note is to describe a minimally invasive approach of arthroscopic arthrodesis of the destructed lesser ray tarsometatarsal joints. The arthroscopic procedure is performed through the lateral and P1-2 Lisfranc portals. It has the advantages of better cosmesis, less wound complication, less bone resection, and more thorough joint debridement.
    Arthroscopic Arthrodesis of the Lesser Ray Tarsometatarsal Joints: 2-Portal Technique
  • Technical Note
    Open Access

    Endoscopic Resection of Peroneal Tubercle

    Arthroscopy Techniques
    Vol. 6Issue 5e1489–e1493Published online: September 4, 2017
    • Tun Hing Lui
    Cited in Scopus: 2
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    Symptomatic hypertrophy of the peroneal tubercle can result in pain, clicking sensation, and limitation of ambulation. Surgical resection is indicated for symptomatic hypertrophied tubercle that is recalcitrant to conservative treatment. The purpose of this Technical Note is to report the details of tendoscopic resection of the hypertrophied peroneal tubercle. This is performed through zone 2 peroneus longus tendoscopy. Any associated hindfoot deformity and peroneal tendon pathology should also be addressed.
    Endoscopic Resection of Peroneal Tubercle
  • Technical Note
    Open Access

    Endoscopic Interdigital Neurectomy of the Foot

    Arthroscopy Techniques
    Vol. 6Issue 4e959–e965Published online: July 10, 2017
    • Tun Hing Lui
    Cited in Scopus: 2
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    Morton's neuroma is a compressive neuropathy resulting in perineural fibrosis rather than a neuroma of the plantar digital nerve. Surgical treatment is indicated for patients with a clear diagnosis of Morton's neuroma and no improvement with nonsurgical treatment. The surgical options include isolated intermetatarsal ligament division, isolated interdigital nerve excision, and interdigital nerve excision with intermetatarsal ligament division, with or without submuscular transposition. This can be performed via dorsal or plantar approach.
    Endoscopic Interdigital Neurectomy of the Foot
  • Technical Note
    Open Access

    Arthroscopic Excision of Osteoid Osteoma of the Talus

    Arthroscopy Techniques
    Vol. 6Issue 3e839–e843Published online: June 19, 2017
    • Iftach Hetsroni
    • Meir Nyska
    • Evgeny Edelshtein
    • Gideon Mann
    • Ezequiel Palmanovich
    Cited in Scopus: 3
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    Osteoid osteoma is a benign tumor that can cause significant pain and disability. Excision of the tumor can be accomplished with open surgery or, as advocated in recent years, with computed tomography (CT)-guided radiofrequency ablation. In this article, a unique arthroscopic approach to excise an osteoid osteoma of the talus is presented. This was possible by relying on a clear intra-articular prominent osteophyte, which was used as a landmark to indicate tumor location in accordance with preoperative CT views.
    Arthroscopic Excision of Osteoid Osteoma of the Talus
  • Technical Note
    Open Access

    Arthroscopic Triple Arthrodesis in Management of Chronic Flatfoot Deformity

    Arthroscopy Techniques
    Vol. 6Issue 3e871–e877Published online: June 26, 2017
    • Tun Hing Lui
    Cited in Scopus: 9
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    Triple arthrodesis has a significant role in the management of hindfoot osteoarthritis and deformity. Traditionally, it is an open procedure with extensive soft tissue dissection. Arthroscopic triple arthrodesis would appear to provide good visualization and preparation of the fusion surfaces while preserving the soft tissue envelope. The purpose of this Technical Note is to describe a minimally invasive approach of triple arthrodesis to correct chronic flatfoot deformity.
    Arthroscopic Triple Arthrodesis in Management of Chronic Flatfoot Deformity
  • Technical Note
    Open Access

    Endoscopic Synovectomy of Peroneal Tendon Sheath

    Arthroscopy Techniques
    Vol. 6Issue 3e887–e892Published online: June 26, 2017
    • Tun Hing Lui
    Cited in Scopus: 2
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    • Video
    Peroneal tenosynovitis usually responds to conservative therapy. Early diagnosis and management are imperative because improper or delayed diagnosis and treatment of peroneal tenosynovitis may lead to progression of the tenosynovitis to peroneal tendon rupture, ultimately limiting the benefit of nonoperative treatment. For refractory cases, endoscopic tenosynovectomy is indicated. The purpose of this Technical Note is to report a minimally invasive approach to perform a synovectomy of zones 1 and 2 of the peroneal tendon sheath.
    Endoscopic Synovectomy of Peroneal Tendon Sheath
  • Technical Note
    Open Access

    Endoscopic Stalk Resection of a Toe Ganglion With Color-aided Visualization

    Arthroscopy Techniques
    Vol. 6Issue 3e673–e678Published online: May 29, 2017
    • Takahisa Ogawa
    • Yasuhiro Seki
    • Shinichi Shirasawa
    Cited in Scopus: 2
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    Ganglion cysts are common cystic lesions filled with a jelly-like substance and originate from a joint capsule or tendon sheath through a stalk. Ganglion cysts mostly occur in the hand region, for which surgical excision usually results in good outcomes. In contrast, toe ganglions are relatively rare, and surgical treatment is associated with a high recurrence rate because of unidentifiable ganglion stalks, requiring large skin incisions. We have treated toe ganglion cysts using endoscopy in the ganglion cyst by injecting methylene blue into the tendon sheath that connects to the ganglion stalk.
    Endoscopic Stalk Resection of a Toe Ganglion With Color-aided Visualization
  • Technical Note
    Open Access

    Flexor Hallucis Longus Tenosynovitis and First Metatarsophalangeal Synovitis After Penetrating Nail Prick Injury: Treated by Zone 3 Flexor Hallucis Longus Tendoscopy and Metatarsosesamoid Arthroscopy

    Arthroscopy Techniques
    Vol. 6Issue 2e427–e433Published online: April 10, 2017
    • Tun Hing Lui
    Cited in Scopus: 3
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    Pedal penetrating nail prick injury around the first metatarsal head can result in persistent synovitis of the first metatarsophalangeal joint and tenosynovitis of the flexor hallucis longus tendon. Exploration and debridement is indicated if the condition does not improve with antibiotics. Open surgery requires extensive dorsal and plantar incisions. The purpose of this Technical Note is to report the combined arthroscopic and tendoscopic approaches to address the first metatarsophalangeal joint and flexor hallucis longus tendon pathologies.
    Flexor Hallucis Longus Tenosynovitis and First Metatarsophalangeal Synovitis After Penetrating Nail Prick Injury: Treated by Zone 3 Flexor Hallucis Longus Tendoscopy and Metatarsosesamoid Arthroscopy
  • Technical Note
    Open Access

    Correction of Recurred Hallux Valgus Deformity by Endoscopic Distal Soft Tissue Procedure

    Arthroscopy Techniques
    Vol. 6Issue 2e435–e440Published online: April 10, 2017
    • Tun Hing Lui
    Cited in Scopus: 2
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    The underlying reason for recurrence of hallux valgus deformity after bunion surgery is multifactorial and includes surgeon-based and patient-based factors as well as original components of deformity initially unaddressed at the index procedure. Surgical treatment of a recurred hallux valgus deformity should be undertaken using the same guidelines for correction of a primary hallux valgus deformity. It requires correction of bony alignment, restoration of joint congruity, and achievement of soft tissue balance.
    Correction of Recurred Hallux Valgus Deformity by Endoscopic Distal Soft Tissue Procedure
  • Technical Note
    Open Access

    Endoscopic Adhesiolysis of Flexor Hallucis Longus Muscle

    Arthroscopy Techniques
    Vol. 6Issue 2e325–e329Published online: March 20, 2017
    • Tun Hing Lui
    Cited in Scopus: 8
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    Adhesion of the flexor hallucis longus (FHL) muscle to the distal tibia can occur after distal tibial fracture, distal fibular fracture, low tibial osteotomy, soft-tissue injury at the posterior ankle, subclinical compartment syndrome of the distal deep posterior compartment of the leg, or Volkmann contracture after deep posterior compartment syndrome of the leg. The purpose of this Technical Note is to report the endoscopic approach of FHL muscle adhesiolysis. It is indicated in patients with symptomatic adhesion of the FHL muscle and contraindicated if there is entrapment of the FHL muscle or tendon in the fracture callus or if there is extensive fibrosis and contracture of the FHL muscle as a result of Volkmann contracture after deep posterior compartment syndrome of the leg.
    Endoscopic Adhesiolysis of Flexor Hallucis Longus Muscle
  • Technical Note
    Open Access

    Endoscopic Resection of Giant Cell Tumor of the Extensor Tendon of the Foot

    Arthroscopy Techniques
    Vol. 6Issue 2e303–e309Published online: March 13, 2017
    • Tun Hing Lui
    Cited in Scopus: 2
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    The localized form of giant cell tumor of the tendon sheath is one of the most common soft tissue tumors of the foot and ankle region. It is characteristically a benign, sharply localized peritendinous fibrous mass in the synovial or tendinous spaces. The purpose of this Technical Note is to present the technical details of endoscopic resection of giant cell tumor of the extensor tendon of the foot with preservation of the tendon. It is indicated in the localized form of giant cell tumor of the extensor tendon at the foot dorsum.
    Endoscopic Resection of Giant Cell Tumor of the Extensor Tendon of the Foot
  • Technical Note
    Open Access

    Endoscopic Fusion of the Accessory Navicular Synchondrosis That Has No Diastasis

    Arthroscopy Techniques
    Vol. 6Issue 2e263–e267Published online: March 6, 2017
    • Tun Hing Lui
    Cited in Scopus: 1
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    Accessory navicular bone is a common accessory ossicle of the foot and is present in 10% to 14% of normal feet. Less than 1% of the accessory navicular bones are symptomatic. Degenerative or traumatic disruption of the accessory navicular synchondrosis is one of the main causes of symptomatic accessory navicular. The disrupted synchondrosis may or may not be associated with diastasis of the synchondrosis. Fusion of the synchondrosis is indicated if the pain fails to respond to conservative measures.
    Endoscopic Fusion of the Accessory Navicular Synchondrosis That Has No Diastasis
  • 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 Repair of Superomedial Spring Ligament by Talonavicular Arthroscopy

    Arthroscopy Techniques
    Vol. 6Issue 1e31–e35Published online: January 9, 2017
    • Tun Hing Lui
    Cited in Scopus: 11
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    • Video
    A spring ligament tear can occur because of failure of the tibialis posterior tendon in adult-acquired flatfoot deformity or as an isolated injury with a normal tibialis posterior tendon. The superomedial spring ligament is the most common site of rupture. Compromise of this ligament is a primary causative factor of peritalar subluxation, and a functioning tibialis posterior tendon cannot prevent or correct a planovalgus foot deformity. Therefore, the spring ligament should be repaired in addition to treatment of tibialis posterior tendon abnormalities.
    Arthroscopic Repair of Superomedial Spring Ligament by Talonavicular Arthroscopy
  • Technical Note
    Open Access

    Endoscopic Resection of Dorsal Boss of the Second and Third Tarsometatarsal Joints

    Arthroscopy Techniques
    Vol. 6Issue 1e1–e5Published online: January 2, 2017
    • Tun Hing Lui
    Cited in Scopus: 3
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    Dorsal boss of the foot also known as “tarsal boss,” “dorsal exostosis,” and “humped bone” is a bone spur that grows from one of the intertarsal or tarsometatarsal joints. It can occur with or without arthritis of the underlying joints. Surgery is indicated if the symptoms do not respond to conservative treatment. Excision of the dorsal boss with or without fusion of the underlying joint is the operative treatment of choice. We report an arthroscopic approach of resection of the dorsal exostosis.
    Endoscopic Resection of Dorsal Boss of the Second and Third Tarsometatarsal Joints
  • Technical Note
    Open Access

    Arthroscopic Curettage and Bone Grafting of Bone Cysts of the Talar Body

    Arthroscopy Techniques
    Vol. 6Issue 1e7–e13Published online: January 2, 2017
    • Tun Hing Lui
    Cited in Scopus: 6
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    Talar bone cysts can develop as a result of osteochondral lesions of the talus. This can be a source of deep ankle pain. Open debridement and bone grafting of the bone cysts requires extensive soft tissue dissection and malleolar osteotomy. Removal of normal cartilage of the talus is frequently required to approach the bone cysts. Alternatively, the cysts can be grafted arthroscopically with minimal disruption of the normal cartilage surface. The key to success is careful preoperative planning with a computed tomogram of the ankle.
    Arthroscopic Curettage and Bone Grafting of Bone Cysts of the Talar Body
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