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Biomedical subjects

R Thal

Publications and source records attributed to R Thal.

9 recordsLinked to original sources
PubMed2001

A Knotless Suture Anchor: Technique for use in arthroscopic Bankart repair.

Arthroscopic Bankart repair performed using suture anchors most closely mimics open repair techniques. One of the challenges with the arthroscopic technique is tying consistent, good-quality arthroscopic knots. The unique Knotless Suture Anchor (Mitek Products, Westwood, MA) and method of use for arthroscopic Bankart repair is described. The Knotless Suture Anchor has a short loop of suture secured to the tail end of the anchor. A channel is located at the tip of the anchor that functions to capture the loop of suture after it has been passed through the ligament. The ligament is tensioned as the anchor is inserted into bone to the appropriate depth. The doubled suture configuration that is created with the loop increases the suture strength in the Knotless Suture Anchor compared with standard suture anchors with the same size suture. To my knowledge, this article describes the first knotless suture anchor. A secure, low-profile repair can be created without arthroscopic knot tying.

Acromion↗
PubMed2001

Knotless suture anchor: arthroscopic bankart repair without tying knots.

Arthroscopic Bankart repair done using suture anchors most closely mimics open repair techniques. The challenge with the arthroscopic technique is tying consistent, good quality arthroscopic knots. A unique knotless suture anchor and method of use for arthroscopic Bankart repair is described. The Knotless Suture Anchor has a short loop of suture secured to the tail end of the anchor. A channel is located at the tip of the anchor that functions to capture the loop of suture after it has been passed through the ligament. The ligament is tensioned as the anchor is inserted into bone to the appropriate depth. Mechanical testing showed increased suture strength in the Knotless Suture Anchor compared with standard suture anchors. This is attributable to the doubled suture configuration that is created with the Knotless Suture Anchor loop. To the author's knowledge, the current study describes the first knotless suture anchor. A secure, low-profile repair can be created without arthroscopic knot tying.

Arthroscopy↗
PubMed1996

Delayed articular cartilage slough: two cases resulting from holmium:YAG laser damage to normal articular cartilage and a review of the literature.

We present two cases referred from other physicians with chondral damage and cartilage slough secondary to use of the holmium:YAG laser during knee arthroscopy. The first patient had a partial lateral meniscectomy, which was done with a 20-W Ho:YAG laser. The patient never fully recovered and underwent a second arthroscopy that revealed full-thickness cartilage defects of the lateral femoral condyle. The second patient had debridement of Outerbridge grade III changes of the lateral tibial plateau and patella, as well as a partial lateral meniscectomy using a Ho:YAG laser. The patient developed recurrent symptoms, and when a second arthroscopy was performed, new degenerative changes to the lateral femoral condyle were noted with large areas of cartilage loss. A careful look needs to be taken at the limited use of lasers until further randomized prospective studies are carried out comparing patient outcomes, cost, and long-term complications.

Adult↗
PubMed1995

Redislocation with a bony bankart lesion after arthroscopic Bankart repair.

This case report presents a traumatic dislocation after an arthroscopic Bankart repair in which the repair site was intact and failure occurred through a new bony interval. The new bony Bankart lesion was identified 3 years after the initial arthroscopic repair. This highlights the issue of whether a traumatic redislocation after a surgical repair for recurrent shoulder instability represents a failure of repair or a reinjury.

Adult↗
PubMed1993

A technique for arthroscopic mattress suture placement.

Many techniques and instrument systems have been developed for performing arthroscopic Bankart repair and arthroscopic rotator cuff repair. These procedures often use multiple simple sutures placed in the repaired tissue. The use of a mattress suture design allows for inversion or eversion of the repaired tissue, greater repair strength, and provides a greater area of soft tissue apposition to bone. Described is a technique for arthroscopic mattress suture placement. We have used this technique primarily for arthroscopic Bankart repair and arthroscopic rotator cuff repair. Suture material of any type may be used with this technique.

Arthroscopes↗
PubMed1992

A technique for arthroscopic subacromial decompression.

The control of bleeding and the determination of the appropriate amount of bone to resect are two common technical difficulties in performing arthroscopic subacromial decompression. We describe a technique that simplifies the procedure while providing more precise bone resection and contouring. First, the coracoacromial ligament is released by sectioning the anterior margin of the acromion. Bleeding is minimized with this technique because the coracoacromial ligament itself is not being cut, but rather its bony attachment is resected. An acromioplasty is then performed with the arthroscope in the lateral portal and the burr in the posterior portal. The shank of the cutter is rested against the posterior lip of the acromion, which acts as a fulcrum. The tip of the burr is placed at the deepest point of the concavity of the acromion. Bone is resected by sweeping the cutter from lateral to medial and progressing anteriorly while maintaining the angle of the burr, using the angle of the posterior acromion as a guide. In this way the appropriate amount of bone is automatically resected, resulting in a flat acromion which is tapered anteriorly and has a smooth transition to normal bone posteriorly.

Acromioclavicular Joint↗
PubMed1992

Locked patellar dislocation with vertical axis rotation. A case report.

Whereas traumatic lateral dislocation of the patella is a well-described clinical entity, other types of patellar dislocations, specifically those that involve patellar rotation, are unusual. These rare types also present a therapeutic problem in which reduction often requires a general anesthetic and, possibly, an open procedure. A 16-year-old boy sustained a laterally directed blow to his knee, resulting in dislocation of the patella. The patella had rotated 90 degrees in the vertical plane and became wedged against the lateral femoral condyle. Initial attempts at closed reduction in the emergency room and under general anesthesia in the operating room were unsuccessful, and the patient required open reduction. A similar type of dislocation has been described; however, the patella is usually intercondylar. The tear along the medial side was extensive enough to allow the patella to dislocate lateral to the lateral femoral condyle, making this a unique case. In these instances of rare patellar dislocation, the surgeon should be prepared to perform an open reduction, because attempts at closed reduction even with a general anesthetic may be unsuccessful.

Adolescent↗
PubMedDate not supplied

A knotless suture anchor. Design, function, and biomechanical testing.

The development of a unique Knotless suture anchor for soft tissue repair to bone is described. This device allows for soft tissue repair to bone using a suture anchor without the need for knot tying. This provides a particular advantage for arthroscopic repairs, where knot tying can be difficult. The Knotless suture anchor has a short loop of suture secured to the tail end of the anchor. A channel located at the tip of the anchor functions to capture the loop of suture after it has been passed through the soft tissue. The soft tissue is tensioned as the anchor is inserted into bone to the appropriate depth. Biomechanical testing demonstrated increased suture strength in the Knotless suture anchor compared with standard suture anchors. This is because of the doubled-suture configuration that is created with the Knotless suture anchor loop. To the author's knowledge, this paper describes the first knotless suture anchor. A secure, low-profile repair can be created without knot tying.

Animals↗