technique

Subscapularis Arthroscopic Repair

Technique

- extra-articular

 

Portals

- posterior portal very lateral so can see anterior aspect subacromial space

- port of Wilminton at anterolateral acromion to access SSC

- anterior portal in normal position, slightly more lateral so becomes working portal

 

Platelet Rich Plasma

Definition

 

Platelet rich plasma

 

Concept

 

2 main components

 

1.  Platelets

- contain PDGF, TGF, VEGF

 

2.  Growth factors

- ILGF

- FGF

 

Formed from the separation of whole blood into plasma and RBC

- separation usually achieved with centrifugation

 

Platelet concentration

Principles of Biopsy

Aims

 

1.  Provide representative sample

- to determine whether benign or malignant

- to determine cell line

- to grade lesion

 

2.  Not compromise definitive treatment

 

Timing

 

Last step in evaluation / after staging

 

Don't perform definitive procedure immediately after biopsy unless

- pre-operative & Xray information characteristic

Technique ACDF

Anterior Cervical Discectomy and Fusion

 

ACDF C5 6

 

Position

 

Place the patient in the supine position

- small roll placed under the shoulder blades to drop the shoulders from the field

- exposes the anterior neck

- strap the shoulders at the side with minimal traction 

Mosaicplasty Technique

Harvest site

 

Option 1

- lateral and medial aspect femoral trochlea

 

Option 2

- intercondylar notch

 

Mosaicplasty Harvest Site

 

Option 3

- allograft

- can take larger grafts without donor site risk

 

Size

 

TSR Technique

TSR APTSR Lateral

 

Goal

- head that translates 50% in all directions

- allows 30o ER with arm at side

- stable posteriorly

 

Pre-Op 

- antibiotics

- consider specific Propionobacterium cover

Scarf Osteotomy

Technique

 

A.  Longitudinal Cut

- plantar proximal / dorsal distally

- ends up being parallel to sole

- leave strong plantar portion of head to prevent dorsiflexion

- mark centre of head

- distally to a point 2mm prox and 3mm above the centre of the head

 

B.  Transverse cuts

- plantar proximal / dorsal distal

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