Arthroscopic Remnant Preserving 3-Portal Posterior Cruciate Ligament Reconstruction With Reverse Passage of the Graft.

The posterior cruciate ligament (PCL) is the largest and strongest ligament of the knee, with a tremendous role as the primary posterior stabilizer of the knee. Surgical management of PCL injuries is very demanding, due to the fact that the PCL tear usually is a part of multiligamentous knee injury. Moreover, PCL anatomy, especially its course and attachment points to femur and tibia, makes reconstruction of the PCL technically challenging. The main pitfall is the sharp angle between created during reconstruction surgery bony tunnels, which forms so called "killer turn". The authors present a technique of the remnant-preserving PCL arthroscopic reconstruction that simplifies the procedure and uses the method of reverse passage of the PCL graft to overcome the killer turn.

Knee Osteochondral Defect Reconstruction With Autologous Bone Grafting and Mesenchymal Cell Transplantation.

Osteochondral defects of the knee are common in orthopaedic patients. They are challenging to treat, especially in young, highly demanding patients who do not qualify for arthroplasty. Among the many possibilities to treat osteochondral lesions presented so far, none is ideal. Because of the poor healing potential of cartilage, treatment outcomes significantly worsen with larger lesions. The treatment of large defects usually requires expensive solutions, sometimes including second-stage surgery. Using mesenchymal stem cell transplantation and cancellous bone autografts, the technique presented here for osteochondral lesion reconstruction can be effectively used to treat large osteochondral lesions in a single-stage procedure.

Arthroscopic Posterolateral Corner Stabilization With Popliteus Tenodesis.

The injuries of the posterolateral corner (PLC) of the knee often remain misdiagnosed. Because most structures in this anatomical region have low potential to heal, the posterolateral rotational instability results in a deterioration in patient quality of life, impaired biomechanics of the knee, and increased tension on other ligaments and the meniscus. Many open and a few arthroscopic techniques have been developed to repair or reconstruct the damaged structures of the PLC. Creating an additional midlateral arthroscopic portal on the lateral side of the knee was the key to developing the technique to recreate a static stabilizer against external rotational instability of the PLC by fixing the popliteus tendon as a native, vascularized material to the tibia.

Long Head Biceps Tendon-Natural Patch for Massive Irreparable Rotator Cuff Tears.

Despite the development in shoulder surgery, massive irreparable rotator cuff tears still remain challenging for orthopaedic surgeons. Many surgical methods are addressed to this kind of pathology, but each of them has its own limitations. We decided to fuse the ideas of superior capsular reconstruction, "GraftJacket" technique, and partial rotator cuff repair. In this way, the technique using the long head biceps tendon simultaneously as a vascularized bridge between rotator cuff remnants and greater tubercle and as a depressor for the humeral head was created. This Technical Note describes the technique.