Shows a modified Latarjet technique using two lag screws with a two-hole plate to provide uniform compression and load distribution between the coracoid and anterior neck of the scapula.

A methodical sequence of examination-one that progresses from one part of the joint cavity to another in each operative case?is paramount to effective diagnostic arthroscopy. Unfortunately, a consistent routine for diagnostic hip arthroscopy has not yet been published. To fill this gap, Drs. Bond and Guanche offer a 23-point arthroscopic examination to increase accuracy and reproducibility within the evolving field of hip arthroscopy. Their DVD-video details the basic operating room setup for hip arthroscopy and describes the normal anatomy encountered from the anterior, anterolateral, and posterolateral portals of the central compartment as well as the common arthroscopic structures of the peripheral compartment. Their 23-point arthroscopic exam has been used for numerous procedures and helps to differentiate normal structures from pathologic counterparts. The goal of this exam is to allow orthopaedic surgeons to correlate their arthroscopic findings with clinical presentations, enhancing their diagnostic abilities and potentially providing better clinical studies.

A triple arthrodesis is frequently indicated for the treatment of a painful or fixed deformity of the hindfoot secondary to inflammatory, degenerative, or post-traumatic arthritis. This procedure effectively realigns the foot and offers long-term pain relief to the patient. However, a triple arthrodesis is contraindicated in the presence of peripheral vascular insufficiency, an active infection, and unresolved Charcot osteoarthropathy. In this video, Drs. Olson and Toolan demonstrate how to perform a triple arthrodesis through medial and lateral incisions employing internal fixation with compression screws. Several tips, tricks, and pearls are offered to facilitate exposure, preparation, and positioning of the joint surfaces for fusion. The video concludes with a protocol detailing the postoperative management.

Rotator cuff repair is a common operation, but the treatment of massive rotator cuff tears remains challenging. Dr. Krishnan details the technique of latissimus dorsi tendon transfer using minimally invasive surgical incisions for repairing massive rotator cuff injury. Technical pearls and pitfalls associated with successful latissimus dorsi tendon transfers are included.

Metal-on-metal hip resurfacing is a new total hip arthroplasty technique that is rapidly gaining popularity worldwide particularly for the young, active patient. This video presents the historical perspective and rationale for this arthroplasty and reviews the results for the author's first 500 cases.

Like other alternative bearing total hip arthroplasty options, the clinical data available to date are short term and should be interpreted with caution. However, this bone-conservative procedure only minimally impacts future arthroplasty options. It is technically more difficult than stemmed total hip arthroplasty and should only be attempted by experienced hip surgeons. A detailed step-by-step technique is demonstrated for reliably accomplishing this procedure through a minimally invasive, four-inch posterior approach.

Drs. Nord and Gothelf present a retrospective review of 200 consecutive SLAP lesions. Each was categorized using the Maffet and Nord's modification of Snyder's classification system. 129 of the SLAP tears were found to have a posterior component as well as isolated posterior Bankart tears or posterior instability. Drs. Nord and Gothelf introduce the additional portals or instruments that are needed to repair these posterior labral tears and demonstrate their techniques for repairing posterior labral lesions.

Drs. Stubbs, Briggs, and Philippon present an operative set-up and surgical approach for hip arthroscopy. Their presentation is intended for orthopaedic surgeons who are beginning a practice of hip arthroscopy as well as for those who want a more comprehensive understanding of the procedure. The demonstration covers the procedure from the induction of anesthesia to the establishment of the two main intraarticular working portals. Patient positioning, surgeon-directed traction, intra-operative fluoroscopy, preparation of the surgical site, and the anatomically guided placement of portal sites are included. Risks associated with each stage of the operative set-up and approach to hip arthroscopy are highlighted.

Drs. Dobbs, Greis, and Burks outline the background, indications, and contraindications for medial patellofemoral ligament reconstruction as a treatment for recurrent patellofemoral instability. They show the anatomy of the medial patellofemoral ligament on a cadaveric specimen and carefully demonstrate their current technique of medial patellofemoral ligament reconstruction using a gracilis tendon graft in one case example along with cadaveric and alternate case examples. They also point out the arthroscopic and gross anatomy before and after reconstruction and discuss the post-operative rehabilitation and the potential complications of the procedure

While the merits of two-incision, minimally invasive THA continue to be debated, Drs. Hozack, Nogler, Parvizi, Mayr, and Martin have been performing THA using a minimally invasive, single incision anterior approach that exploits the interval between tensor fasciae latae and rectus femoris muscle and avoids disrupting the abductor or posterior musculature. In this program, the doctors demonstrate the surgical technique using a single incision (6-8 cm in length) to perform acetabular as well as femoral preparation and component implantation. The procedure is shown on both a cadaver and a live patient. The program includes a description of the necessary instruments and their correct placement and usage, the anatomic structures that are either used as landmarks or are at risk, patient handling, the intraoperative placement of personnel, and how to use a regular operating table instead of a fracture table to perform the procedure. In conclusion, the doctors discuss their clinical experience with the procedure and cover possible complications and salvage procedures.

Minimally invasive-or minimal incision-total knee arthroplasty has garnered substantial interest from both the orthopaedic community and their patients. However, given the steep learning curve and limited visualization throughout the procedure, most surgeons recommend limiting minimal incision approaches to patients without significant flexion contracture, angular deformity, obesity, or poor bone stock.

Dr. Remia demonstrates a subvastus technique for total knee replacement that allows for complete lateralization of the patellofemoral mechanism without violating the quadriceps mechanism or requiring patellar eversion. The exposure is typically performed through a 4- to 5-inch incision and can be applied to most patients, except those with severe deformity or those requiring revision surgeries.

The program begins with pre-operative planning followed by operative video of the minimal incision subvastus technique, including anatomical landmarks and marking the skin incision, the technique for the subvastus exposure, and the total knee arthroplasty. Dr. Remia shows that the subvastus technique provides excellent visualization without violating the quadriceps mechanism and discusses how to identify appropriate candidates for minimal incision total knee arthroplasty.

Drs. Kim and Park present a technique for posterolateral instability (PLI) of the knee using a tibialis posterior tendon allograft that reconstructs the lateral collateral ligament and the popliteal tendon with its attachment to the tendon. This technique helps to prevent external rotary instability and improves varus instability.

Drs. Yu and Bugbee present their operative technique of fresh osteochondral allografting in the treatment of osteochondritis dissecans of the femoral condyle. Their video includes preoperative imaging, surgical approach, preparing the defect, graft harvesting, graft fixation, and their results from a study of sixty-nine knees in 66 patients. The program shows that allografting of lesions due to OCD successfully relieved pain and restored function in over 80% of individuals.

Drs. Johnson, Zuckerman, Wright, Flurin, Angibaud, and Beng describe the anatomic basis for a new proximal humeral implant designed specifically for fracture treatment. The surgical technique details the tuberosity reattachment, which is designed to minimize associated complications--specifically tuberosity detachment and migration. A step-by-step video animation demonstrates a simple stable suture technique for tuberosity fixation.

In this video, Dr. Levy covers all stages of bicondylar tibial plateau fracture treatment, especially dual-incision (posteromedial, anterolateral) approaches and fracture reduction maneuvers. The posteromedial approach (Burks et al, 1990) uses a plane between the medial head of the gastroc and the semimembranosus tendon. The approach is extensile, free from the neurovascular bundle, and gives excellent exposure to the posterior tibial plateau. The anterolateral approach that Dr. Levy shows in the video is a standard IT band-splitting, submeniscal approach that gives excellent visualization of the lateral tibial plateau. This dual-incision technique has a low patient morbidity and provides excellent range of motion (Barei et al, 2004).

Dr. Levy also demonstrates the surgical technique for a polyaxial locked plating system and points out its advantages, including the ability to direct locking screws with up to 30° of freedom. He also discusses submuscular locking plates and the plethora of questions the surgeon faces when choosing plates and screws.

Dr. Bindra uses cadaveric dissection to highlight the relevant surgical anatomy of stenosing tenosynovitis including the digital flexor sheath and the structures that are at risk during surgery. He demonstrates his preferred technique of steroid injection into the flexor sheath, his technique of open surgical release of the A1 pulley both in a digit and in a thumb under local anesthesia, and a safe technique for release and confirming adequate release. He also discusses postoperative protocol and avoidable complications.

In this video, Drs. Leadbetter, Mont, Ragland, and Delanois emphasize the importance of patient selection, surgical technique, and the potential complications associated with patellofemoral arthroplasty. It includes intra-operative commentary that describes technical pearls, problems, and pitfalls as well as a review of Dr. Leadbetter's experience with these devices. A literature search of indications, contraindications, and reported outcomes is discussed and combined with operative experience to develop a list of factors that the surgeon should consider to avoid less than optimal results when choosing to do a patellofemoral arthroplasty.

The Latarjet coracoid transfer procedure provides a "triple blocking" effect in the treatment of anterior shoulder instability. In this video, Drs. Edwards, Gartsman, and Elkousy illustrate the Latarjet procedure in detail in a patient with recurrent anterior glenohumeral instability and anterior inferior glenoid bone loss.

Dr. Krishnan details the surgical approach and technique for hemiarthroplasty for proximal humeral fractures. He uses a unique prosthetic stem and a reproducible method of tuberosity osteosynthesis to restore the gothic arch of the shoulder girdle. The goal of this video is to aid orthopaedic surgeons in the operative management of this difficult, yet commonplace, surgical procedure.

Arthroscopic reattachment of the superior glenoid labrum is the primary treatment for Type II SLAP (Superior labrum anterior posterior) lesions and is also utilized in Types III through X to various degrees. Once the suture anchors are inserted in the glenoid rim, SLAP repair requires successful passing of the sutures through the labrum.

Drs. Nord, Masterson, and Mauck demonstrate how they use a penetrating suture through a Neviaser portal. They explain that using the Neviaser portal for SLAP repair is a safe and easy technique for SLAP repair, because it allows easy passage of suture through the labrum with less trauma to the labrum.

Adhesive capsulitis is a fairly common and challenging shoulder problem. In this video, Dr. Shaffer presents an overview of the evaluations and management strategies for treating adhesive capsulitis. Specifically reviewed treatment alternatives include non-operative management, manipulation under anesthesia, and surgical release. Indications, the technique of arthroscopic capsular release, post-operative rehabilitation, and outcomes are also presented.

Drs, Labib, Kimmerly, and Karas present a case study of 21-year-old athletic man with continuing lateral ankle instability that failed adequate conservative treatment. The video documents his intra-operative stress X-rays, the ankle arthroscopy used to evaluate and treat concomitant intraarticular ankle synovitis and talar chondromalacia, a modified Brostrom-Gould repair technique, and their standard post-operative rehabilitation program.

Drs. Stubbs, Briggs, and Philippon present the arthroscopic approach and technique used by the senior author for the management of femoroacetabular impingement. The video demonstrates the hip arthroscopy procedure from the establishment of the two intraarticular working portals and the single peripheral compartment working portal to the surgical treatment of both CAM and pincer impingement. Also included are the features of anatomically directed portal placement, the importance of intraoperative arthroscopic dynamic examination, the hallmarks of pathology along the acetabular rim and femoral neck, and the minimally invasive arthroscopic techniques employed to treat the identified impingement pathology. The authors discuss the rational and the risks associated with each stage of the arthroscopic technique used to relieve femoroacetabular impingement lesions.

Dr. Ashcroft, Harold, and Duncan demonstrate a modified lateral approach to the hip that allows for the insertion of the Birmingham Surface Hip Replacement. The approach has been in regular use in the Department of Orthopaedics in Aberdeen, Scotland, since 1992 as an alternative to traditional posterior access. The DVD shows how this surgical approach allows the clear visualisation of both the acetabulum and femoral head. It also includes a detailed description of the technique and equipment used to prepare the acetabulum and femoral head.

Drs. Albritton and Ferkel illustrate a 21-point exam of the anterior, posterior, and central ankle joint that has been developed to increase the accuracy and reproducibility of the arthroscopic examination. The exam allows the surgeon to reproduce the findings and to diagnose any intraarticular pathology. In addition, it guarantees that all areas of the ankle joint are carefully inspected and provides a complete videotape record that can be reviewed in the future for both patient care and clinical studies of ankle arthroscopy.

Drs. Bonutti, Mont, Seyler, and Plate describe and demonstrate a mini-subvastus approach using a posterior referencing instrumentation system.

Demonstrates the anatomy of the distal biceps tendon, outline the treatment algorithm for injuries to the tendon, and demonstrate biceps tendon endoscopy. This technique allows debridement of synovitis and partial tears. Tears of the tendon complex that are greater than 50% require surgical reattachment. They also demonstrate the Endobutton technique of distal biceps tendon repair, which provides strong fixation through a single anterior incision and allows immediate mobilization. Retracted chronic complete tears are managed with autologous hamstring tendon grafts.

Demonstrates the SMC knot, showing how the internal locking mechanism flips the post strand by pulling the loop strand, which then converts the loop strand into a new post strand within the initial slip knot. The result is locking of the initial slip knot in situ--without leaving a time or chance to be loose during the additional locking half-hitches.

This video presents a discussion of the technique and rationale for a stand-alone anterior spine fusion construct using dual (paired) proximity cages with bone morphogenetic protein.

This multimedia presentation by Dr. McAllister and Mr. Stepanian demonstrates a minimally invasive technique for total knee replacement. Downsized instruments are combined with modified surgical techniques and an altered sequence of osteotomies. This combination decreases the incision size, eliminates the need to evert the extensor mechanism, and decreases soft tissue stretching and trauma. The technique demonstrated in this program allows knee replacement to be performed with less soft tissue trauma and a less invasive surgical approach compared to traditional knee replacement. In spite of the minimally invasive approach, the knee replacement is precise and accurate.

The docking procedure is the topic of this surgical demonstration. This technique for the surgical reconstruction of the ulnar collateral ligament is becoming a more reliable and reproducible procedure. Because of the docking procedure, combined with an advance in our understanding of the pertinent anatomy and rehabilitation, the insufficiency that previously ended the careers of overhead throwing athletes can now be treated successfully.

Knot tying is a critical component of reconstructive arthroscopic shoulder surgery. This video details an efficient and effective method of tying a surgeon's one-handed knot during arthroscopic surgery. The video covers how to master this technique, including making overhand and underhand throws, switching the post, sliding the throw using an arthroscopic knot-pusher, and past-point tightening to place and tension each half-hitch correctly. It also reviews the general principles of arthroscopic knot tying and compares various types of knots.

Drs. Toolan and Pinzur provide an overview of total contact casting for neuropathic ulceration and Charcot osteoarthropathy in diabetic patients. The video outlines the purpose, indications, and contraindications for the use of total contact casting; it presents a step-by-step method for applying a total contact cast; and it reviews the instructions and precautions for the proper care of a total contact cast.

Treating patients with glenohumeral arthritis and massive, irreparable rotator cuff tears is a challenging clinical problem. The surgical standard of care for these patients has traditionally been hemiarthroplasty, which has typically resulted in pain relief with modest functional gains. Recently, reverse total shoulder arthroplasty has become available in the United States for use in these difficult cases, yielding superior active elevation to hemiarthroplasty. In this video, Dr. Edwards, Gartsman, Elkousy, Hammerman, Warnock, and O'Connor describe a standardized surgical technique for implantation of a reverse total shoulder arthroplasty as a primary procedure in a patient with glenohumeral arthritis and a massive, irreparable rotator cuff tear. Additionally, this video highlights technical points, such as humeral and glenoid component positioning, that will help the orthopaedic surgeon reduce the incidence of postoperative complications.

Dr. Naito presents a modification of the Bernese periacetabular osteotomy that improves on the negative aspects of the procedure and develops a minimally invasive periacetabular osteotomy (MIPO). The incision is small and gluteal muscles are not detached in this osteotomy. The tape shows the surgery on a young woman with grade 1 osteoarthrosis in both hips and reviews the results of 128 hips on 112 patients over 6 years. The video suggests that limiting the dissection prevents the outside of the ilium from being exposed and all iliac osteotomy surfaces have the same curvature. As a result of these advantages and the greater contact among the bony surfaces, stable fixation and solid union of the iliac osteotomy can be accomplished.

This video demonstrates a two-row technique for mini-open rotator cuff repair. Live and cadaveric surgery illustrates the method by which the wide anatomic footprint of the rotator cuff to the greater tuberosity is surgically recreated. The surgical principles, mechanical basis, technical details, and anatomy are all demonstrated. This technique allows for anatomical restoration of the tendinous attachment while providing enhanced mechanical strength.

This video shows the indications and the surgical technique of latissimus dorsi transfer for an irreparable posterosuperior rotator cuff deficiency that Dr. Gerber pioneered. Each step of the operation is explained in such detail that the competent orthopaedic surgeon should be able to reproduce the procedure.

Translaminar facet screw placement is a technique originally described by Magerl in 1984. This was a modification of previously described techniques. This video reviews the history of transfacet screws, the rationale and indications for translaminar facet screws, and the operative technique and clinical results. The anatomy and operative technique are emphasized by showing the operative technique as a 3-D computer animation as well as on a cadaveric specimen. The clinical results, biomechanical studies, and fusion rates from several large studies are also reviewed.