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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

    “Triple Package” Modified SpeedBridge Rotator Cuff Repair Technique

    Arthroscopy Techniques
    Vol. 12Issue 2e279–e284Published online: January 18, 2023
    • Tim Kelley
    • Joel Walthall
    • Kade Lyman
    • Sarah D. Lang
    • Brian B. Gilmer
    • Dan Guttmann
    Cited in Scopus: 0
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    Treatment of full-thickness rotator cuff repairs vary in surgical technique depending on many factors including tear geometry, delamination of soft tissue, tissue quality, and rotator cuff retraction. The described technique presents a reproducible method of addressing tear patterns where the tear may be larger laterally, but the medial footprint exposure is small. This can be addressed with a single medial anchor combined with a knotless lateral-row technique to provide compression for small tears or two medial row anchors for moderate to large tears.
    “Triple Package” Modified SpeedBridge Rotator Cuff Repair Technique
  • Technical Note
    Open Access

    Arthroscopic Pectoralis Minor Release

    Arthroscopy Techniques
    Vol. 7Issue 6e589–e594Published online: May 7, 2018
    • S. Tal Hendrix
    • Matt Hoyle
    • John M. Tokish
    Cited in Scopus: 10
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    The scapula has long been recognized as a key component in shoulder motion and a crucial part of the kinetic chain connecting the body's core and upper extremity. The pectoralis minor (PM) has garnered increasing attention as we better understand scapular kinematics and its role in shoulder pain and dysfunction. This is particularly important in patients with scapular dyskinesis and especially in overhead throwing athletes. The most of these patients achieve their recovery goals through nonoperative management, stretching, and strengthening protocols; however, some patients do not respond to nonoperative modalities.
    Arthroscopic Pectoralis Minor Release
  • Technical Note
    Open Access

    Arthroscopic Anterior and Posterior Glenoid Bone Augmentation With Capsular Plication for Ehlers-Danlos Syndrome With Multidirectional Instability

    Arthroscopy Techniques
    Vol. 7Issue 5e541–e545Published online: April 23, 2018
    • Mitchel D. Armstrong
    • Benjamin Smith
    • Catherine Coady
    • Ivan H. Wong
    Cited in Scopus: 10
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    Recurrent multidirectional shoulder instability is a difficult clinical problem. This can be compounded in patients with connective tissue diseases such as Ehlers-Danlos syndrome. We present an all-arthroscopic technique involving extra-articular anterior and posterior glenoid bone grafting to augment a capsular repair in a patient with Ehlers-Danlos syndrome and recurrent multidirectional shoulder instability. Graft options include either distal tibial allograft or iliac crest autograft. Anterior graft placement uses a dilated far medial portal using an inside-out technique.
    Arthroscopic Anterior and Posterior Glenoid Bone Augmentation With Capsular Plication for Ehlers-Danlos Syndrome With Multidirectional Instability
  • Technical Note
    Open Access

    Arthroscopic Coracoclavicular Ligament Reconstruction Using Graft Augmentation and Titanium Implants

    Arthroscopy Techniques
    Vol. 7Issue 5e465–e471Published online: April 9, 2018
    • Juha O. Ranne
    • Terho U. Kainonen
    • Jussi A. Kosola
    • Lasse L. Lempainen
    • Kari J. Kanto
    • Janne T. Lehtinen
    Cited in Scopus: 3
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    Several techniques have been introduced to treat acromioclavicular separation with coracoclavicular ligament reconstruction using graft augmentation. A modified arthroscopic technique for coracoclavicular ligament reconstruction was used based on a previous technique where the supportive device and tendon graft share the clavicular and coracoid drill holes. A notable problem with the previous technique was large protruding suture knots on the washer and clavicle, which could predispose to wound infection.
    Arthroscopic Coracoclavicular Ligament Reconstruction Using Graft Augmentation and Titanium Implants
  • Technical Note
    Open Access

    Technique for Arthroscopic Long Head of Biceps Tenodesis Using Anchor With Fork Tip Eyelet

    Arthroscopy Techniques
    Vol. 7Issue 4e299–e305Published online: March 5, 2018
    • Jack Daoud
    • Dany Aouad
    • Hisham Abdelnour
    • Robert Hanna
    • Georges El Rassi
    Cited in Scopus: 2
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    This article describes a method of arthroscopic subscapular tenodesis of the long head of the biceps tendon using a single anterolateral portal, making it a minimally invasive procedure. This method is done by using the Swivelock tenodesis anchor with forked tip PEEK Eyelet from Arthrex, which enables anatomically stable fixation of the biceps tendon with a relatively decreased rate of complications.
    Technique for Arthroscopic Long Head of Biceps Tenodesis Using Anchor With Fork Tip Eyelet
  • Technical Note
    Open Access

    Modified Semilateral Decubitus Position for Shoulder Arthroscopy and Its Application for Open Surgery of the Shoulder (One Setting for All Shoulder Procedures)

    Arthroscopy Techniques
    Vol. 7Issue 4e307–e312Published online: March 5, 2018
    • Ekavit Keyurapan
    • Chaiwat Chuaychoosakoon
    Cited in Scopus: 5
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    Two standard patient positions for shoulder arthroscopy are the beach-chair and lateral decubitus positions. Both positions have advantages and disadvantages in many aspects. Surgeons choose the position based on their preferences, mainly the orientation of the anatomy. If an operation needs to be converted to an open procedure, a patient who is placed in the lateral decubitus position might need to undergo repositioning and re-draping, which result in extending the operative time and increasing the risk of infection.
    Modified Semilateral Decubitus Position for Shoulder Arthroscopy and Its Application for Open Surgery of the Shoulder (One Setting for All Shoulder Procedures)
  • Technical Note
    Open Access

    Arthroscopic and Endoscopic Technique for Subcoracoid Synovial Chondromatosis of the Shoulder Through a Medial Transpectoral Portal

    Arthroscopy Techniques
    Vol. 7Issue 3e279–e283Published online: February 26, 2018
    • Mikel Aramberri
    • Giovanni Tiso
    • David L. Haeni
    Cited in Scopus: 4
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    Synovial chondromatosis of the shoulder is a rare disorder characterized by metaplastic synovial proliferation, causing multiple loose bodies usually localized intra-articularly. Surgical treatment with open techniques through a deltopectoral approach has been commonly used. The evolution of arthroscopy has allowed a complete joint assessment and the extraction of intra-articular loose bodies with less morbidity than open techniques. Nevertheless, this pathology occurs less frequently in the subcoracoid bursa.
    Arthroscopic and Endoscopic Technique for Subcoracoid Synovial Chondromatosis of the Shoulder Through a Medial Transpectoral Portal
  • Technical Note
    Open Access

    Arthroscopic Coracohumeral Ligament Release for Patients With Frozen Shoulder

    Arthroscopy Techniques
    Vol. 7Issue 1e1–e5Published online: December 4, 2017
    • Yoshihiro Hagiwara
    • Akira Ando
    • Kenji Kanazawa
    • Masashi Koide
    • Takuya Sekiguchi
    • Junichiro Hamada
    • and others
    Cited in Scopus: 22
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    Arthroscopic pancapsular release has been recommended for recalcitrant frozen shoulder, but regaining range of motion has not been sufficient compared with the unaffected side. There is no consensus about the reasons for these remaining restrictions in range of motion, but residual capsular or connective tissue must be considered a candidate. A thickened coracohumeral ligament at the rotator interval has been reported as one of the most specific manifestations of frozen shoulder. It covers wider portions of the subscapularis tendon, supraspinatus tendon, and infraspinatus tendon than previously reported.
    Arthroscopic Coracohumeral Ligament Release for Patients With Frozen Shoulder
  • Technical Note
    Open Access

    Bipolar Acromioclavicular Joint Resection

    Arthroscopy Techniques
    Vol. 6Issue 6e2229–e2233Published online: November 20, 2017
    • Julien Gaillard
    • Michel Calò
    • Geoffroy Nourissat
    Cited in Scopus: 4
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    Acromioclavicular (AC) joint arthropathy remains one of the most common causes of shoulder pain. In the case of AC joint arthropathy resistant to conservative treatment, most authors have recognized distal clavicle resection as the gold-standard treatment. However, some challenges remain to be solved. One is the difficulty in visualization of the superior and posterior part of the distal clavicle from the midlateral portal, causing an incomplete resection of the distal clavicle. This could potentially lead to unresolved pain and therefore surgical failure.
    Bipolar Acromioclavicular Joint Resection
  • Technical Note
    Open Access

    Arthroscopic Management of Posterior Instability due to “Floating” Posterior Inferior Glenohumeral Ligament Lesions

    Arthroscopy Techniques
    Vol. 6Issue 6e2249–e2254Published online: November 20, 2017
    • Lawrence O'Malley II
    • Eric D. Field
    • Larry D. Field
    Cited in Scopus: 0
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    The “floating” posterior inferior glenohumeral ligament (floating PIGHL) is an uncommon cause of posterior shoulder instability. This pathologic lesion, defined as detachment of both the origin of the PIGHL (posterior Bankart lesion) and insertion of the of the PIGHL from its humeral head insertion site, often results in significant and persistent shoulder instability symptoms. An effective surgical technique for arthroscopic repair of a floating PIGHL lesion is described and demonstrated.
    Arthroscopic Management of Posterior Instability due to “Floating” Posterior Inferior Glenohumeral Ligament Lesions
  • Technical Note
    Open Access

    Middle Glenohumeral Ligament Abrasion Causing Upper Subscapularis Tear

    Arthroscopy Techniques
    Vol. 6Issue 6e2151–e2154Published online: November 13, 2017
    • Paul C. Brady
    • Heather Grubbs
    • Alexandre Lädermann
    • Christopher R. Adams
    Cited in Scopus: 4
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    The middle glenohumeral ligament (MGHL) typically contributes partially to the anterior stability of the shoulder. In a very limited number of cases, the MGHL can cause abrasion on the upper edge of the subscapularis causing persistent pain symptoms for patients. The condition is exacerbated by internal rotation of the arm. In this Technical Note, we describe this entity and call it the SAM lesion (Subscapularis Abrasion from the MGHL). We present a technique of addressing this lesion.
    Middle Glenohumeral Ligament Abrasion Causing Upper Subscapularis Tear
  • Technical Note
    Open Access

    Anatomic Acromioclavicular Joint Reconstruction With Semitendinosus Allograft: Surgical Technique

    Arthroscopy Techniques
    Vol. 6Issue 5e1721–e1726Published online: October 2, 2017
    • Rachel M. Frank
    • Eamon D. Bernardoni
    • Eric J. Cotter
    • Nikhil N. Verma
    Cited in Scopus: 7
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    Acromioclavicular joint separations are common shoulder injuries in the active patient population. Nonoperative management is recommended for Rockwood type I and II injuries, whereas surgical reconstruction is recommended for type IV and VI separations. The management for type III and V injuries is more controversial and is determined on a case-by-case basis. A multitude of surgical reconstruction techniques exist, and there is little evidence to support one technique over another. The anatomic technique aims at reconstructing the coracoclavicular ligaments and bringing the clavicle back into its anatomic position.
    Anatomic Acromioclavicular Joint Reconstruction With Semitendinosus Allograft: Surgical Technique
  • Technical Note
    Open Access

    Figure-of-8 Reconstruction Technique for Chronic Posterior Sternoclavicular Joint Dislocation

    Arthroscopy Techniques
    Vol. 6Issue 5e1749–e1753Published online: October 2, 2017
    • Dean Wang
    • Christopher L. Camp
    • Brian C. Werner
    • Joshua S. Dines
    • David W. Altchek
    Cited in Scopus: 8
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    Dislocation of the sternoclavicular joint is a rare injury and typically requires high-energy forces applied through the joint. Initial treatment is dependent on the direction of dislocation, with acute reduction indicated for posterior dislocations presenting with signs of tracheal, esophageal, or neurovascular compression. Although most patients do well with conservative treatment after the initial trauma, some can have persistent pain and scapular dyskinesia due to instability or locked dislocation of the sternoclavicular joint.
    Figure-of-8 Reconstruction Technique for Chronic Posterior Sternoclavicular Joint Dislocation
  • Technical Note
    Open Access

    Split Pectoralis Major Transfer for Chronic Medial Scapular Winging

    Arthroscopy Techniques
    Vol. 6Issue 5e1781–e1788Published online: October 2, 2017
    • W. Stephen Choate
    • Adam Kwapisz
    • John M. Tokish
    Cited in Scopus: 2
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    Scapular winging can be a significant source of chronic pain, weakness, and disability of the shoulder. Isolated serratus anterior palsy from long thoracic nerve injury, which is the most common cause of this condition, produces prominent winging and medial malpositioning of the inferior angle of the scapula. In the case of persistent symptoms despite conservative care, treatment options primarily include scapulothoracic fusion and pectoralis major transfer. Outcomes of scapulothoracic fusion are notable for a high complication rate and limited functional improvements.
    Split Pectoralis Major Transfer for Chronic Medial Scapular Winging
  • Technical Note
    Open Access

    Arthroscopic Intramuscular Side-to-Side Repair of an Isolated Infraspinatus Tear

    Arthroscopy Techniques
    Vol. 6Issue 5e1743–e1748Published online: October 2, 2017
    • Rachel M. Frank
    • Eric J. Cotter
    • David Savin
    • Eamon Bernardoni
    • Anthony A. Romeo
    Cited in Scopus: 2
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    Intramuscular, full-thickness rotator cuff tears are uncommon and present a challenging clinical scenario for repair because traditional suture anchor or transosseous repair techniques are less feasible. The goal of repair is to achieve a tension-free reduction of both ends of the muscle to allow for adequate healing over time. Intramuscular tears of the infraspinatus specifically have rarely been reported. The clinical presentation of these patients can be challenging to interpret, and other causes of rotator cuff dysfunction, including compression to the suprascapular nerve, must be ruled out.
    Arthroscopic Intramuscular Side-to-Side Repair of an Isolated Infraspinatus Tear
  • Technical Note
    Open Access

    Arthroscopic Intra-articular Spinoglenoid Cyst Resection Following SLAP Repair

    Arthroscopy Techniques
    Vol. 6Issue 5e1795–e1799Published online: October 9, 2017
    • Sreehari C.K.
    • Ankit Varshney
    • Yon-Sik Yoo
    • Seung-Jin Lee
    Cited in Scopus: 4
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    Spinoglenoid cyst (SGC) is a ganglion arising in the spinoglenoid notch and is thought to be related to SLAP lesion. This cyst often compresses the suprascapular nerve in the spinoglenoid notch. Symptomatic cysts require surgical treatment when conservative treatment fails. In particular, arthroscopic decompression through the torn labral tissue when the cyst is extending into the joint cavity is easy and convenient. However, if the cyst is confined to the spinoglenoid notch, arthroscopic approach through the torn labral tissue is challenging.
    Arthroscopic Intra-articular Spinoglenoid Cyst Resection Following SLAP Repair
  • Technical Note
    Open Access

    Graft Transfer Technique in Arthroscopic Posterior Glenoid Reconstruction With Distal Tibia Allograft

    Arthroscopy Techniques
    Vol. 6Issue 5e1891–e1895Published online: October 16, 2017
    • Stephen A. Parada
    • K. Aaron Shaw
    Cited in Scopus: 4
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    Posterior glenoid reconstruction using distal tibia allograft is an available technique for the treatment of posterior shoulder instability with glenoid bone loss. A key aspect to this procedure relies on maintaining complete control of the graft during insertion and securement to the posterior glenoid. Although there are commercially available products to aid with graft control, we describe a novel graft transfer technique that is compatible with all cannulated systems for maintaining positive graft control.
    Graft Transfer Technique in Arthroscopic Posterior Glenoid Reconstruction With Distal Tibia Allograft
  • Technical Note
    Open Access

    Consolidated Proximal Biceps Tenodesis and Subscapularis Repair

    Arthroscopy Techniques
    Vol. 6Issue 5e1967–e1971Published online: October 23, 2017
    • Kyle E. Fleck
    • Larry D. Field
    Cited in Scopus: 3
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    Pathologic changes to the biceps tendon including subluxation are frequently encountered in patients with subscapularis tears. Operatively managing these combined lesions can be difficult depending on the status of the subscapularis tendon and the degree of biceps medialization. The presented technique is an effective and relatively simple method that simultaneously and efficiently provides for secure tenodesis of the biceps and fixation of subscapularis tendon detachment.
    Consolidated Proximal Biceps Tenodesis and Subscapularis Repair
  • Technical Note
    Open Access

    Arthroscopic Biceps Tenodesis Using Interference Screw Fixation in the Bicipital Groove

    Arthroscopy Techniques
    Vol. 6Issue 5e1953–e1957Published online: October 23, 2017
    • Thomas Amouyel
    • Yves-Pierre Le Moulec
    • Nicolas Tarissi
    • Mo Saffarini
    • Olivier Courage
    Cited in Scopus: 6
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    Arthroscopic repair of the long head of the biceps (LHB) is performed to treat various biceps pathologies yet the choice between tenotomy or tenodesis remains controversial. Although tenotomy is simpler and quicker, tenodesis results in fewer complications, and there are several techniques available using various fixation devices and sites. This Technical Note describes an all-arthroscopic, suprapectoral tenodesis technique using a bioresorbable interference screw, without motorized devices to create the humeral tunnel in the bicipital groove.
    Arthroscopic Biceps Tenodesis Using Interference Screw Fixation in the Bicipital Groove
  • Technical Note
    Open Access

    Reverse Total Shoulder Arthroplasty With Humeral Head Autograft Fixed Onto Glenoid for Treatment of Severe Glenoid Retroversion

    Arthroscopy Techniques
    Vol. 6Issue 5e1691–e1695Published online: September 25, 2017
    • Zaamin B. Hussain
    • Jonathan A. Godin
    • George Sanchez
    • Nicholas I. Kennedy
    • Mark E. Cinque
    • Márcio B. Ferrari
    • and others
    Cited in Scopus: 1
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    Advanced glenohumeral osteoarthritis can transform glenoid morphology and, in some cases, is found in association with severe glenoid retroversion. The associated glenoid retroversion leads to difficulty in fixation of the glenoid component in reverse total shoulder arthroplasty. In the context of extreme glenoid wear, structural grafts can be used to restore glenoid volume and version in order for the glenoid component of the reverse total shoulder arthroplasty to be more easily implanted. Nevertheless, literature regarding structural grafts remains limited, with optimal graft choice and technique still controversial at best.
    Reverse Total Shoulder Arthroplasty With Humeral Head Autograft Fixed Onto Glenoid for Treatment of Severe Glenoid Retroversion
  • Technical Note
    Open Access

    Arthroscopic Excision of the Sternoclavicular Joint

    Arthroscopy Techniques
    Vol. 6Issue 5e1697–e1702Published online: September 25, 2017
    • Graham Tytherleigh-Strong
    • Lee Van Rensburg
    Cited in Scopus: 3
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    Osteoarthritis changes at the sternoclavicular joint (SCJ) have been shown to be present on computed tomography in more than 90% of people over the age of 60 years. Although usually asymptomatic, when symptoms do occur, they can be very debilitating. Most patients respond favorably to conservative treatment, but there is a small cohort of patients who continue to be symptomatic despite adequate conservative treatment. Surgical management with an open SCJ excision has been shown to give satisfactory results.
    Arthroscopic Excision of the Sternoclavicular Joint
  • Technical Note
    Open Access

    A Shortcut to Arthroscopic Suprascapular Nerve Decompression at the Suprascapular Notch: Arthroscopic Landmarks and Surgical Technique

    Arthroscopy Techniques
    Vol. 6Issue 5e1709–e1713Published online: September 25, 2017
    • Hatem Galal Said
    • Ayman Farouk AbdelKawi
    • Tarek Nabil Fetih
    • Ahmed Wahid Kandil
    Cited in Scopus: 3
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    Arthroscopic suprascapular nerve decompression at the suprascapular notch is a technically demanding surgical procedure with a steep learning curve. The aim of this Technical Note is to describe important pearls for an arthroscopic decompression of the suprascapular nerve relying on the palpation of the coracoclavicular ligaments before starting the arthroscopic visualization. This reduces the time and minimizes the resection of the surrounding fat.
    A Shortcut to Arthroscopic Suprascapular Nerve Decompression at the Suprascapular Notch: Arthroscopic Landmarks and Surgical Technique
  • Technical Note
    Open Access

    Arthroscopic Triple Labral Repair in an Adolescent

    Arthroscopy Techniques
    Vol. 6Issue 5e1587–e1591Published online: September 18, 2017
    • Eric J. Cotter
    • Rachel M. Frank
    • Scott W. Trenhaile
    Cited in Scopus: 1
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    Traumatic glenohumeral dislocations often result in significant injury to the anterior-inferior labrum, most commonly leading to recurrent anterior instability. While in skeletally immature patients, shoulder trauma more commonly results in fracture versus a true dislocation, shoulder instability does occur and can be difficult to manage in the setting of open physes. In any event, the goal of treatment is to reduce the risk of recurrence and allow full participation in activities, including sports.
    Arthroscopic Triple Labral Repair in an Adolescent
  • Technical Note
    Open Access

    Pectoralis Major Transfer for Treatment of Serratus Anterior Dysfunction in the Setting of Long Thoracic Nerve Palsy

    Arthroscopy Techniques
    Vol. 6Issue 4e1347–e1353Published online: August 21, 2017
    • George Sanchez
    • Márcio B. Ferrari
    • Anthony Sanchez
    • Nicholas I. Kennedy
    • Matthew T. Provencher
    Cited in Scopus: 0
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    Symptomatic scapular winging resulting in scapular dyskinesia leads to a wide spectrum of clinical complaints, most notably periscapular pain. The malpositioning of the scapula, termed through use of the acronym SICK (scapular malposition, inferior-medial border prominence, coracoid pain and malposition, and dyskinesia of scapular movement), is due to the irregular activity of one or more of the periscapular muscles. In particular, the serratus anterior, innervated by the long thoracic nerve, is a key muscle that stabilizes the scapula and provides coordinated scapulohumeral rhythm.
    Pectoralis Major Transfer for Treatment of Serratus Anterior Dysfunction in the Setting of Long Thoracic Nerve Palsy
  • Technical Note
    Open Access

    Pectoralis Major Muscle Transfer With the Sternal Head and Hamstring Autograft for Scapular Winging

    Arthroscopy Techniques
    Vol. 6Issue 4e1321–e1327Published online: August 14, 2017
    • Antonio Cusano
    • Nicholas Pagani
    • Xinning Li
    Cited in Scopus: 2
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    Medial scapular winging is often due to dysfunction of the serratus anterior muscle as a result of injury to the long thoracic nerve. Impairment of the serratus anterior muscle may cause uncoordinated scapulohumeral rhythm during shoulder elevation and subsequent subscapular or shoulder pain, subacromial impingement, and glenohumeral joint instability. Although long thoracic nerve injury typically resolves in 12 to 18 months after a physical therapy regimen, surgical intervention is indicated in patients who fail conservative management.
    Pectoralis Major Muscle Transfer With the Sternal Head and Hamstring Autograft for Scapular Winging
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