The Oblique Mattress Lasso-Loop Stitch for Arthroscopic Capsulolabral Repair.

Arthroscopic capsulolabral repair during shoulder stabilization surgery requires the use of suture anchors. Several arthroscopic suturing techniques for capsulolabral repair have been described, and each carries very specific advantages and disadvantages with regard to risk, patient satisfaction, and functional outcomes. The purpose of this report is to describe the oblique mattress lasso-loop stitch. This stitch (1) provides strong initial fixation of the labrum, (2) establishes labral height and allows for larger capsular plication if needed, (3) prevents the suture from cutting through the radial fibers of the glenoid labrum, (4) prevents knot migration to the articular side and loosening of the knot, and (5) requires fewer implants and preserves glenoid bone stock by increasing the amount of labrum and capsule that can be reattached to the glenoid with a single-loaded suture anchor.

The Combined "Double-Pulley" Simple Knot Technique for Arthroscopic Transtendon Fixation of Partial Articular-Sided Tear of the Subscapularis Tendon.

Subscapularis tendon tears occur more frequently than previously suspected. Most subscapularis tendon tears are partial tears that have the potential to progress to complete tears. Repairs of partial tears of the tendon are performed to preserve normal shoulder function. This report describes a combined transtendon double-pulley and simple knot technique for repair of partial articular tears of the subscapularis tendon. This technique incorporates the advantages of transtendon repair, the double-pulley technique, and simple knot fixation.

The Combined "Double Pulley"-Simple Knot Technique for Arthroscopic Shoulder Posterior Labral Repair and Capsular Shift.

Posterior shoulder instability is more prevalent than traditionally believed. Surgical repairs of posterior shoulder instability have overall good success rates. However, in elite overhead and throwing athletes, a low rate of return to the preinjury level of play after repair remains a challenge. The 2 goals of posterior shoulder stabilization surgery are secure fixation of the labrum to the glenoid and retensioning of the posterior capsulolabral complex. Recent studies have shown significant advantages of arthroscopic anatomic repair over open nonanatomic techniques. We report a combined double pulley-simple knot technique for arthroscopic fixation of posterior labral tears and capsular shift. The technique incorporates several advantages of this hybrid fixation method.

Spread of virulent group A Streptococcus type emm59 from Montana to Wyoming, USA.

Full-genome sequencing showed that a recently emerged and hypervirulent clone of group A Streptococcus type emm59 active in Canada and parts of the United States has now caused severe invasive infections in rural northeastern Wyoming. Phylogenetic analysis of genome data indicated that the strain was likely introduced from Montana.

Massive rotator cuff tears: arthroscopy to arthroplasty.

The understanding of rotator cuff disease has increased exponentially since Codman drew attention to this pathology in the early 1900s. Although challenging, the surgical treatment of massive rotator cuff tears is rational, with treatment decisions based on physical examination, imaging, biologic, and patient factors. Arthroscopy can be used to treat ancillary pain generators, débride necrotic tissue, and possibly restore balance to the force couples about the shoulder. Tendon transfers may be effective in restoring functional strength to irreparable, ineffectual muscle units. Arthroplasty is both a primary treatment and a salvage option.