the making of the posterior arthroscopic portal to the hip joint must be done with careful marking of the trochanter massive; should there be difficult to find it, a small surgical access is recommended. The access point to the portal should not exceed two centimeters towards the posterior superior aspect of the greater trochanter, and must be made with the limb in internal rotation of 15 degrees.

A greater understanding of the deleterious consequences that a meniscal root tear brings to the knee joint and how its surgical repair can be advantageous over the previously used treatment strategies brings the need for the development of surgical techniques that make the procedure less complex and more reproducible. When meniscal root rupture occurs, a mechanical overload occurs in the affected compartment similar to a total meniscectomy. Several authors have concluded that meniscal root reinsertion significantly improves postoperative outcomes and patient satisfaction, regardless of age or laterality of the meniscal injury. The Meniscus 4 A-II device (Rio de Janeiro, Brazil) allows stitching at the root of the medial and lateral menisci. In this article, we describe the surgical repair technique for posteriormedial and-lateral meniscal root tears using this meniscal suture device. This technique is fast and effective.

The meniscus is largely responsible for the health and longevity of the knee. It has diverse functions, being fundamental in load absorption and distribution and even in joint stability. To preserve meniscal functions and prevent the occurrence of osteoarthritis after meniscectomy, several meniscal repair techniques have been developed. To perform meniscal repair in anterior horn, the outside-in technique is the most used. There are few devices for performing them, with most of the surgical techniques described using needles. Our group uses a device capable of performing meniscal repair in different ways. Our objective is to describe a continuous outside-in meniscal repair technique, especially indicated for anterior horn and meniscus body tears, with the “Meniscus 4-All suture device.” The continuous outside-in meniscal suture technique using this device is easy to perform, inexpensive, fast, and reproducible, minimizing the risk of soft-tissue entrapment. In addition, it allows the surgeon to perform meniscal repair in the posterior horn in extensive injuries with the same repair device, just switching to inside-out technique.

No abstract

The human hip (acetabulofemoral joint) is amongst the most complex joints for arthroscopic surgery. This is due to the many inviolable structures that are in direct contact, proximity, or surround the hip joint, notably: the femoral neurovascular bundle, anteriorly; the lateral cutaneous nerve of the thigh, in the anterolateral aspect; and gluteal vessels and the sciatic nerve (SN) in the posterior region. Arthroscopic access of the hip joint involves the opening of cutaneous entry portals. We here discuss the posterior portal (PP), placed at 1cm proximal and 1cm posterior to the palpable apex of the great trochanter, where its anterior and posterior edges merge superiorly, in neutral position or slight interior rotation of the hip (Aprato et al. Muscles, Ligaments and Tendons Journal. 2016). The PP offers a good view of the posterior aspect of the articular capsule of hip, but involves risk of injury to the SN and anatomical variations should be considered. This study evaluates the types of anatomic variations of the SN and assesses the risk of nerve injury by measuring the distance between the nerve and the PP in 40 cadaveric hip joints (17 males and 3 females). We used a millimeter caliper to obtained the measurements and the standard Beaton's and Anson's criteria (Anat Rec. 1937) as a reference to classify the anatomic variations. From our sample, 35 specimens presented with variation type I: SN emerging below the piriformis muscle (PM) in a single bundle; and 5 specimens presented with variation type II, common peroneal nerve running through the PM and the tibial nerve emerging below the PM. The average distance from the sciatic nerve to the PP was 3.06cm for type I variation group, 2.46cm for the type II variation group (p<0.05, Wilcoxon and t test). In the cases presenting with type II variation, the SN is closer to the region of access via PP and the risk of injury is higher. We recommend a careful analysis of the MRI, prior to the surgery, with attention to the anatomical variations of the SN, and a maximum distance of 2.0cm from the cutaneous PP in order to increase the surgical safety of posterior arthroscopic approaches of the human hip joint.Support or Funding InformationIn conjunction with the Building Bridges initiativesThis abstract is from the Experimental Biology 2018 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.