Superior labrum anterior posterior (SLAP) injury is a major challenge for orthopedic surgeons, due to the poor healing ability of the injured labrum. Although arthroscopic surgery is the gold standard for the treatment of SLAP injury, there are still disputes about the adaptation of different surgical techniques, the choice of anchors during operation, knotted or knotless anchors, and fixation methods. The authors believe that arthroscopic repair of SLAP lesions is effective for young patients with intact glenoid labrum(<35 years old) or with extensive activity, where single and knotless anchor is preferred. For the older patients(≥35 years old) with degeneration and wear of glenoid labrum, biceps tenodesis is more preferable, and interference screw fixation technique is recommended. As for patients with failed SLAP repair, biceps tenodesis can achieve a high success rate as a revision surgery. By review of the relevant literature in recent years, this paper summarizes the adaptation of different surgical methods of arthroscopic treatment of SLAP injury, intraoperative anchoring techniques, fixation methods and other improved surgical techniques.
Humans ; Adult ; Shoulder Joint/surgery* ; Arthroscopy/methods* ; Tendon Injuries/surgery* ; Shoulder Injuries/surgery* ; Tenodesis/methods*

Stiffness and pain are major causes of failed superior labral anterior to posterior (SLAP) repair. The term, ‘failed SLAP repair’, can be defined as stiffness or pain without rotator cuff tears, acromio-clavicular pathology, arthritis, impingement syndrome, and other shoulder diseases. Moreover, it does not respond to conservative management. Generally, for failed SLAP repair, the initial conservative management includes physical therapy, strengthening exercise, oral medications, and injections. In addition, with failed conservative treatment, surgical intervention can be carried out. Surgical indications must be in consideration with patients' age, mechanism of injury, stability of the lesion, activity, former history of sports activity, and types of sports. Surgical treatments include debridement, SLAP repair, biceps tenodesis and tenotomy. However, each type of surgical method is controversial on both indications and prognosis. Surgical treatment on SLAP lesion is increasing, and studies on failed SLAP repair are expanding. The recommended first line therapy for failed SLAP lesion is conservative management, and with limited and thorough indications, surgical treatment yields good results, depending on concurrent lesions. However, authors recommend that it is important to seek for adjacent lesions prior to the initial SLAP repair to decrease failed SLAP repair.
Arthritis ; Debridement ; Methods ; Pathology ; Problem Solving* ; Prognosis ; Rotator Cuff ; Shoulder ; Sports ; Tears ; Tenodesis ; Tenotomy

Chronic anteromedial rotatory instability has not been demonstrated to have a satisfactory solution and we have experienced recurrence of the instability after operations. So the authors devised a new operative technique for the TCL (Tibial collateral ligament), that is, burying of the torn end of the ligament beneath the “ㄷ” shaped bony flap. It would better be called advancement and bony reinsertion operation. And we performed modifed MacIntosh tenodesis for the torn anterior cruciate ligament. The results were as follows: l. Of six knees, four (66.6%) rated “good”, two (33.3%) “fair”, and none (O%) “poor” (follow-up period; at least 6 months). 2. The technical problem of the advancement and bony reinsertion operation was discussed.
Anterior Cruciate Ligament ; Knee ; Ligaments ; Medial Collateral Ligament, Knee ; Methods ; Recurrence ; Tenodesis

The finger flexor injuries are very difficult to treat satisfactorily. It is usually said that the earlier the treatment performed, the better result obtained. But the delicasy of the hand anatomy and its function as well as the absence of the hand surgeon in the first aid care make the problem more complex. Even if we made the primary treatment to the flexor tendon injuries, some disabilities are often remained. We have treated fifty eight cases of old flexor tendon injuries in forty eight patients, the results can be summarized as follows. 1. The cause of the tendon damage is due to the laceration injury in the majorities of the cases. T,he tendon injuries are especially common between the late second and the early third decade. 2. In the injury of the Zone II with pulley distortion, the pulley reconstruction using palmaris longus or fascia from other sites will prevent bowstring and help the tendon function. 3. The Zone II can be subdivided into two subspecific areas. The proximal area is from the distal palmar crease to the midoprtion of porximal phalanx and the distal one is from the midportion of the proximal phalanx to the insertion of the sublimis tendon. In the proximal area one can repair the injured tendon directly after removal of the A1 and about proximal half of the A2 pulley without any subsequent bowstring if the tendon and its tunnel is relatively well preserved. Thus one can convert this proximal portion of Zone II to Zone III. So the proximal area of the Zone II should be differentiated from the remaining distal part of the Zone II. 4. At six months after the operation the result of the operation was analyzed by the percentage of the recovery, which was calculated by the postoperative active range of the interphalangeal joints divided by one hundred seventy five degrees that means the available total range of motion of normal interphalangeal joints. Excluding the cases with the tenodesis or arthrodesis, the total result revealed good or excellent in about ninty percentages with this method. 5. There were two fingers that showed a postoperative lumbrical plus state in Zone II, which were recovered spontaneously within three to four months postoperatively. So it is considered that the relative shortening of the lumbrical muscles can be treated and overcome conservatively by the active use of the fingers, and there is no need to perform an lumbrical tenotomy to correct this kind of muscle imbalance.
Arthrodesis ; Fascia ; Fingers ; First Aid ; Hand ; Humans ; Joints ; Lacerations ; Methods ; Muscles ; Patella ; Patellar Ligament ; Range of Motion, Articular ; Tendon Injuries ; Tendons ; Tenodesis ; Tenotomy ; Tibia

OBJECTIVETo investigate the techniques and therapeutic effects of suture anchors for the reconstruction of distal tendo achillis rupture.

METHODSThe clinical data of 16 patients of distal tendo achillis rupture repaired with suture anchors from June 2005 to August 2008 were retrospectively analyzed. Among them, there were 13 males and 3 females with a mean age of 33.5 years (ranged from 17 to 46 years). The postoperative rehabilitation was conducted for every patient. The operation time, position of suture anchor and complications of the surgery were analyzed. The healing of stendo achillis and functional recovery were assessed by Arner-Lindholm standard.

RESULTSAll the patients were followed up for an average of 13.2 months. There were no complications of foreign-body reaction or re-rupture. The average operation time was 35.5 minute. There was no intraoperative injuries of blood vessels, nerves or tendons. A total of 19 suture anchors were used, and only 1 anchor was displaced. The functional recovery of tendo achillis was rated as excellent in 13 cases,good in 2 cases, bad in 1 case. All patients were satisfied with the effects on their current work and life. And no displacement of anchors was found in radiographic films.

CONCLUSIONRepairing of the distal tendo achillis rupture with suture anchors can make operation simple and quick, rigid fixation, less complications, and provide good therapeutic effects.

Adolescent ; Adult ; Female ; Foreign-Body Reaction ; etiology ; Humans ; Male ; Middle Aged ; Reconstructive Surgical Procedures ; instrumentation ; methods ; Retrospective Studies ; Suture Anchors ; Tendon Injuries ; complications ; immunology ; surgery ; Tenodesis ; instrumentation ; methods ; Treatment Outcome ; Young Adult