Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA
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Knee Surg Sports Traumatol Arthrosc · Jan 2009
A new tourniquet system that determines pressures in synchrony with systolic blood pressure in knee surgery.
This study reports the results of the clinical use of a new tourniquet system for surgery related to knee joint that can determine tourniquet pressure in synchrony with systolic blood pressure (SBP). We prospectively applied additional pressure of 100 mmHg based on the SBP recorded just before infiltration of tourniquet in 163 consecutive procedures, which consisted of 73 TKA related surgeries, 42 arthroscopic related surgeries, 20 ACL reconstructed surgeries, 15 ORIF, and 13 other surgeries. After the infiltration, the tourniquet pressure was automatically synchronized with the SBP. ⋯ All cases kept a good operative field without measurable bleeding and there were no postoperative complications. Sixty-eight (42%) cases had a lower intra-operative SBP than the initial value. Since a tourniquet should be applied at the lowest pressure, and for the shortest amount of time possible, the new system appears to be practical and reasonable for maintaining a bloodless surgical field, as compared to conventional tourniquets, which maintain the initial pressure between 300 and 350 mmHg.
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Knee Surg Sports Traumatol Arthrosc · Jan 2009
Arthroscopic reconstruction of chronic AC joint dislocations by transposition of the coracoacromial ligament augmented by the Tight Rope device: a technical note.
We present a new arthroscopic technique for chronic AC joint dislocations with coracoacromial ligament transposition and augmentation by the Tight Rope device (Arthrex, Naples, USA). First the glenohumeral joint is visualised to repair concomitant lesions, such as SLAP lesions, if needed. Once the rotator interval is opened and the coracoid is identified, the arthroscope is moved to an additional anterolateral portal. ⋯ The CA ligament is armed with a strong braided suture using a Lasso stitch and dissected from the undersurface of the acromion. It is then reattached to the distal part of the clavicle by transosseous suture fixation after abrasion of its undersurface. Although this combined arthroscopic procedure of AC joint augmentation with a Tight Rope combined with a ligament transposition is technically demanding, it is a safe method to reconstruct the coracoclavicular ligaments and achieve a sufficient reduction of the clavicle without the need of further implant removal or autologous tendon transplantation.