Arthroscopic Glenoid Resurfacing With Meniscal Allograft: A Minimally Invasive Alternative for Treating Glenohumeral Arthritis
The chronically painful arthritic glenohumeral joint recalcitrant to nonsurgical treatment modalities generally has been treated with an open arthroplasty type of procedure. Certain patients may benefit from a less invasive surgical technique in which a meniscal allograft is used to resurface the glenoid, resulting in decreased pain and increased function. We describe an arthroscopic method of glenoid resurfacing with a meniscal allograft to aid in the restoration of function by providing pain relief to patients debilitated by arthritic conditions of the glenohumeral joint.
Available from: Olivier AJ van der Meijden
- "Other authors reported on open  and later arthroscopic  glenoid resurfacing techniques using lateral meniscus allografts. A cadaveric study by Pennington and Bartz showed that lateral meniscus allograft significantly reduced contact forces as compared to the medial meniscus . "
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ABSTRACT: The management of osteoarthritis of the shoulder in young, active patients is a challenge, and the optimal treatment has yet to be completely established. Many of these patients wish to maintain a high level of activity, and arthroplasty may not be a practical treatment option. It is these patients who may be excellent candidates for joint-preservation procedures in an effort to avoid or delay joint replacement. Several palliative and restorative techniques are currently optional. Joint debridement has shown good results and a combination of arthroscopic debridement with a capsular release, humeral osteoplasty, and transcapsular axillary nerve decompression seems promising when humeral osteophytes are present. Currently, microfracture seems the most studied reparative treatment modality available. Other techniques, such as autologous chondrocyte implantation and osteochondral transfers, have reportedly shown potential but are currently mainly still investigational procedures. This paper gives an overview of the currently available joint preserving surgical techniques for glenohumeral osteoarthritis.
03/2012; 2012(16):160923. DOI:10.1155/2012/160923
Available from: Emery C Lin
- "Interpositional grafts may be secured over the glenoid, thereby offering a biologic surface that articulates with the humeral head. The use of a lateral meniscus as a biologic interpositional graft in the glenoid has been described using both open and arthroscopic techniques [36–38]. Studies have shown that the lateral meniscus provides better glenohumeral coverage with reduced peak forces and contact stress compared to the medial meniscus in the shoulder . "
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ABSTRACT: The diagnosis and treatment of symptomatic chondral lesions in young and active middle-aged patients continues to be a challenging issue. Surgeons must differentiate between incidental chondral lesions from symptomatic pathology that is responsible for the patient's pain. A thorough history, physical examination, and imaging work up is necessary and often results in a diagnosis of exclusion that is verified on arthroscopy. Treatment of symptomatic glenohumeral chondral lesions depends on several factors including the patient's age, occupation, comorbidities, activity level, degree of injury and concomitant shoulder pathology. Furthermore, the size, depth, and location of symptomatic cartilaginous injury should be carefully considered. Patients with lower functional demands may experience success with nonoperative measures such as injection or anti-inflammatory pharmacotherapy. When conservative management fails, surgical options are broadly classified into palliative, reparative, restorative, and reconstructive techniques. Patients with lower functional demands and smaller lesions are best suited for simpler, lower morbidity palliative procedures such as debridement (chondroplasty) and cartilage reparative techniques (microfracture). Those with higher functional demands and large glenohumeral defects will usually benefit more from restorative techniques including autograft or allograft osteochondral transfers and autologous chondrocyte implantation (ACI). Reconstructive surgical options are best suited for patients with bipolar lesions.
03/2012; 2012(2090-3464):846843. DOI:10.1155/2012/846843
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ABSTRACT: The off-diagonal Seebeck voltage of oxygen-reduced YBa<sub>2</sub>Cu<sub>3</sub>O<sub>7</sub> and Y<sub>1-x</sub>Pr<sub>x </sub>Ba<sub>2</sub>Cu<sub>3</sub>O<sub>7-δ</sub> thin films epitaxially grown on strontium titanate crystals cut with a tilt angle of 20° between substrate surface and the cubic axis was measured. A temperature gradient perpendicular to the film surface was produced at room temperature by exposing the films to UV radiation pulses. The transverse Seebeck voltage, i.e. the voltage parallel to the film surface, which results from the temperature gradient perpendicular to it, was measured for varying oxygen content and Pr doping of the YBa<sub>2</sub>Cu<sub>3</sub>O<sub>7-δ</sub> thin films. The oxygen content of the YBa<sub>2</sub>Cu<sub>3</sub>O<sub>7-δ</sub> thin films was reduced from δ≃0 to δ≃0.5. It is shown that a reduction of the oxygen content causes a decrease of the off-diagonal Seebeck voltage. The same effect is observed for the Y<sub>1-x</sub>Pr<sub>x</sub>Ba<sub>2</sub>Cu<sub>3</sub>O<sub>7-δ </sub>(x= 0.1, 0.2, 0.3) thin films, i.e. raising the partial substitution of Y by Pr results in a smaller Seebeck voltage. These results suggest that both, oxygen reduction and Pr doping, have the effect of making YBa<sub>2</sub>Cu<sub>3</sub>O<sub>7-δ</sub> less anisotropic with respect to the thermopower. On the other hand, results of resistivity measurements of YBa<sub>2</sub>Cu<sub>3</sub>O<sub>7-δ</sub> with different values of δ suggest that the anisotropy increases when oxygen is removed. A microscopic model for an explanation of the different behaviours of the thermopower and the resistivity is still lacking. We also have measured the transverse Seebeck voltage of YBa<sub>2</sub>Cu<sub>3</sub>O<sub>7-δ</sub>(δ≃0.06 and 0.19) from T<sub>c</sub> to room temperature. From this we can conclude that S<sub>e</sub> of YBa<sub>2</sub>Cu<sub>3</sub>O<sub>7-δ</sub> (δ≃0.06 and 0.19) increases linearly with temperature, i.e. S <sub>c</sub> shows metallic behaviour
Thermoelectrics, 1996., Fifteenth International Conference on; 04/1996
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