Dermal burns associated with bipolar radiofrequency ablation in the subacromial space.

This article presents iatrogenic dermal burn injury as a complication of using a vented bipolar radiofrequency (RF) ablative device in shoulder arthroscopy. We have encountered 4 patients who have sustained second-degree skin burns after shoulder arthroscopy. The burns occurred from arthroscopic shoulder surgeries performed from 2004 to 2008. In each case a vented bipolar RF device was used to help perform a subacromial decompression. The burns appeared to be the result of heated effluent from the outflow tubing of the RF device exposed to the skin of the patients. This case report shows that care should be taken to avoid exposing patients to the elevated temperatures of bipolar RF device effluent to reduce the risk of dermal burn injury.

Anatomic tibial graft fixation using a retrograde bio-interference screw for endoscopic anterior cruciate ligament reconstruction.

The article describes a simple technique for anatomic anterior cruciate ligament (ACL) tibial graft fixation at the level of the intercondylar floor within a standard endoscopic tibial tunnel. Fixation is achieved with a retrograde positioned cannulated bio-interference screw delivered over a No. 5 permanent suture from a standard anteromedial portal. The screw is inserted into the tibial tunnel in an inside-out position, so that the head of the screw is flush with the intra-articular orifice of the tibial tunnel. Recent experimental, animal, and clinical studies have reported that the advantages of this type of anatomic graft fixation over nonanatomic tibial graft fixation include increased fixation strength, a more stable reconstruction through full knee range of motion, absence of postoperative tunnel expansion, and final biologic graft incorporation at or near the native ACL tibial insertion.