Treatment of chronic recurrent dislocation of temporomandibular joint by autologus blood injection

Aim:The aim of this study was to evaluate the efficacy of autologus blood injection in the management of recurrent temporomandibular joint(TMJ)dislocation.Methods:A total of 11 patients,4 males,7 females,mean age of 58.6 years and suffering from recurrent dislocation of TMJ,were included in the study.In all the patients the procedure included anesthesia-local or sedation,arthrocentesis which was followed by autologous blood injection in the upper joint cavity.The peri-articular tissues were also infiltrated with autologous blood.Post procedure advice included restricted mouth activity and liquid diet for a month.Results:The results indicate that success rate of treatment of recurrent dislocation of TMJ is 72.8%which can be considered as impressive.The recurrence was noticed in 27.2%cases after one year follow up.Conclusion:Autologus blood injection is an effective,simple,non-invasive,and safe procedure for treatment of recurrent dislocation of TMJ and can be performed on outpatient basis.

Complications of Surgical Treatment of Anterior Shoulder Dislocation:A Systematic Review

Introduction: shoulder joint has the greatest range of motion in the human body. The shoulder anatomy promotes high mobility and favors relative sacrifice of articular stability, making it susceptible and more prone to events of instability and dislocation. This review aimed at identifying main complications of surgical treatment of anterior shoulder dislocation. Methodology: This systematic review was conducted according to the International Preferred Reporting Items for Systematic Reviews and Meta-Analyzes (PRISMA) guidelines. Studies which were eligible for this systematic review included: English or Spanish language, studies published from 2000, which mentioned surgical complications of anterior shoulder dislocation in their results, both in open and arthroscopic surgery. Included studies which were required to have at least 1 complication following surgical repair. Only studies from original data were included. Results: We found 228 potentially eligible studies for the survey. Through the inclusion and exclusion criteria and after consensus among reviewers, we chose 9 studies to compose the systematic review. Conclusion: Important information emerges: recurring instability, recurring dislocation, external rotation limitation and arthritis are main surgical complications of anterior shoulder dislocation.

LUtarjet-limit unique coracoid osteotomy Latarjet(With video)

Background:The Latarjet procedure is an effective technique for the treatment of recurrent anterior shoulder dislocation with glenoid bone loss.However,the inevitable destruction of the coracoacromial arch may result in humeral head translation.The aim of the study is to introduce a modified Latarjet technique with coracoacromial arch preservation as well as its short term clinical outcomes.Methods:We propose a novel individualized flexible arthroscopic suture button fixation Latarjet technique called‘LUtarjet’with video.Precise measurements of the coracoid process,glenoid deficiency and osteotomy plane were made preoperatively.Only three arthroscopic portals were needed and limit unique coracoid osteotomy was performed with coracoacromial arch preser-vation.The mini window splitting of the subscapularis was performed from the posterior to the anterior direction and the split window was as small as 8-10 mm in length.Results:A total of 27 patients(25.6±5.4 years)were included in the study.The average surgical durationwas 55.6±6.3 min and the mean follow-up timewas 8.1±1.5 months.The functional score was significantly improved at the last follow-up.Radiologic evidence showed that the bone graft healing was placed in the desired position.No complications were found.Conclusions:We present a fast,easy,accurate,safe arthroscopic‘LUtarjet’technique called FEAST that can simplify the arthroscopic Latarjet process and achieve a satisfactory bone graft position and satisfactory short-term clinical outcomes.Level of evidence:IV,case series.

Reconstruction of the medial patellofemoral ligament with a suture-tie technique of patellar side fixation

Background Medial patellofemoral ligament （MPFL） reconstruction is the preferred operative treatment for recurrent patellar dislocation. The purpose of this study was to report a novel suture-tie technique of patellar side fixation in medial patellofemoral ligament reconstruction for recurrent patellar dislocation, and to evaluate the intermediate-term results. Methods We retrospectively reviewed the results of 22 MPFL reconstructions in 21 patients （6 male and 15 female） with a suture-tie technique performed by a single surgeon between March 2004 and July 2009. All patients had been diagnosed with recurrent patellar dislocation. Outcomes were assessed preoperatively and postoperatively by physical and radiographic examination as well as with Kujala and Lysholm scores. Results At the mean follow-up month 37.5 （range： 24-56 months）, there was no graft failure. Primary healing was achieved in all cases. At the final follow-up, the mean Kujala score improved from 53.9 （range： 46-62 points） to 84.1 （range： 78-90 points） postoperatively （P 〈0.05）, and the mean Lysholm score improved from 47.2 points （range： 37-57 points） to 82.8 points （range： 76-89 points） postoperatively （P 〈0.05）. To date, no patients have reported redislocation or subluxation; however, there is one patient with a positive apprehension test. Conclusion A suture-tie technique in medial patellofemoral ligament reconstruction can restore patella stability without significant complication.