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Adam Prep > Hip and Shoulder Instability > Flashcards

Hip and Shoulder Instability Flashcards

1
Q

What is a Bankart’s Lesion?

A

3 to 6 o’clock
(Anterior Labrum)

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2
Q

What is a Reverse Bankart’s Lesion?

A

6 to 11o’clock
(Posterior Labrum)

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3
Q

What is Bony Bankart’s / Reverse Bony Bankart’s Lesion?

A

Avulsion of Labrum Anteriorly (Bank) or Posteriorly (Rev Bank) with some loss of Glenoid bone.
Treated with Laterjet or Bone Block transfer

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4
Q

What is a SLAP tear?

A

11 to 1 o’clock
Superior Labral tear from Anterior to Posterior

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5
Q

What is a Hill-Sach’s lesion?

A

Posterior part of Humeral Head is forced onto anterior glenoid causing defect

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6
Q

What is an ALPSA lesion?

A

Anterior
Labroligamentous
Periosteal
Sleeve
Avulsion

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7
Q

What is a HAGL lesion?

A

Humeral
Avulsion
Glenohumeral
Ligament

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8
Q

Instability Classifications (x4)

A
  1. Anterior (Unidirectional)
  2. Posterior (Unidirectional)
  3. Bidirectional (A+P)
  4. Multidirectional (A+P+Inf)
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9
Q

Q-Fix for Instability
Size?
Material?
Knotted or Knotless?
Bone prep?
Sutures?

A

1.8mm
Magnumwire
Knotted - All suture
Drill with 1.8 disposable kit
1 x Magnumwire

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10
Q

SutureFix
Size?
Material?
Knotted or Knotless?
Bone prep?
Sutures?

A

1.7 and 1.9mm
Durabraid &
1 x #2 UB (1.7mm)
2 x #1 UB (1.9mm)
Knotted - All suture
Size Specific disposable kit

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11
Q

Speedlock
Size?
Material?
Knotted or Knotless?
Bone prep?
Sutures?

A

3.0 and 3.4mm
PEEK
Knotless
Speedlock Drill
Holds 1 suture

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12
Q

Microraptor Knotless
Size?
Material?
Knotted or Knotless?
Bone prep?
Sutures?

A

2.4/2.75mm
PEEK & RG
Knotless
2.2 drill Shoulder
2.6 drill Hip
Tip, Tension, Tap, Lock off
Holds 1 suture / Minitape

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13
Q

Accupass features (4)

A

Single Handed
Precise Control
7 configs of tip
Spare Monofilament

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14
Q

Speedstitch Features (3)

A

Simple stitch in <5s
Targeted
Single working portal repair

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15
Q

Microraptor Knotless features (x5)

A

Off axis insertion
Less volume
Greater fixation strength
Full length inserter
RG - replaced by bone 24m

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16
Q

Microraptor Technique

A
  1. Pass Suture through tissue and into anchor
  2. Drill guide & Obturator
  3. Obt out & Drill bone
  4. Advance Anchor
  5. Tip in hole, tension to reduce labrum, tap to laser line
  6. Rotate knob to deploy anchor, and pull out
17
Q

Hip Bony Anatomy

A

Greater Trochanter
Lesser Trochanter
Femoral Head
Neck of Femur

18
Q

Hip Soft Tissue & Ligaments

A

Acetabulum
Labrum
Pubofemoral Ligament
Ischiofemoral Ligament
Iliofemoral Ligament
Ligamentum Teres

19
Q

Hip Pathology

A
  1. Femoroacetabular Impingement
    - CAM lesion - on neck
    - Pincer Lesion - on acetabular rim
  2. Labral Tears
20
Q

Basic steps of Hip Arthroscopy

A
  1. Position & Mark Landmarks
  2. Apply traction
  3. Central Compartment
  4. Release traction
  5. Peripheral Compartment
21
Q

Patient Positioner features (x4)

A
  1. Active Heel Technology (Conforms to patient, secure)
  2. Military Grade buckles & straps (Easy to secure & release)
  3. Fits both left & right feet (No double checking correct boots)
  4. Quick disconnect (Quick, Easy, can load foot into boot prior to positioning)
22
Q

Hip Portals - marking

A

Find ASIS, mark midline down leg (suicide line)
1. ALP - Find & palpate GT, portal = 2cm Superior and Anterior to GT.
2. AP - Follow ALP towards suicide line, go back 2 cm
3. PLP - 2cm Superior and Lateral to GT
4. Mid Anterior Portal - 45 degree from ALP to suicide line. Anywhere within triangle.

23
Q

Hip Positioner Technique

A
  1. Attach using 4 clamps
  2. Blue cushion - Perineal post hole on op leg side
    3 Attach well leg & distractor leg
  3. Attach Traction boots (Active Heel on OP leg) & white clip to lock
  4. Patient boots on
  5. Patient into traction boots
  6. Perineal post and pad, and smooth down
  7. Gentle traction on well leg
  8. Loosen orange knob & ball joint and pull for gross traction
  9. Fine traction & xray. (2hrs max in traction)
24
Q

Steps using Crosstrac

A

Traction, mark skin
1. 17 gauge spinal needle in ALP. Xray/needle/xray/needle
2. 40cc saline into joint
3. Guidewire down needle, remove needle
4. Scalpel, Insert 4.5mm (G) Arthrogarde Cannula plus Delrin Handle Obt over guidewire
5. Remove Obt and guidewire
6. Attach scope and irrigation extender
7. Attach Crosstrac
8. Black top obt into Crosstrac to AP mark
9. Push to skin, incision, insert, XL needle, guidewire
10. Remove all aprt from guidewire
11. Put in switching stick & Viktor OR 2 nd Arthrogarde

25
Q

Burrs used in Hip

A

High Vis Flat Top
High Vis Abrader
Barrel

Adam Prep (5 decks)

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