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Portals-Anterior Instability

Two anterior portals (superior and inferior) are established using an “outside-in” technique with a spinal needle. These portals function as utility portals for instrument passage, glenoid preparation, suture management, and knot tying. It is important to separate these anterior cannulas widely so cannula crowding in the joint is not a problem.

The second cannula is […]

Biomechanics of Shoulder Stability-Static Stability Factor

The glenohumeral joint is inherently unstable, with the large humeral head articulating with the small and shallow glenoid. Static stability is provided by the orientation of the articular surfaces, the articular conformity of humerus and the glenoid, the glenoid labrum, the negative intra-articular pressure, the adhesion-cohesion of synovial joint fluid, and the glenohumeral joint capsule […]


Understanding the structure of the meniscus and its process of repair has been critical in advancing surgical techniques and increasing healing rates following meniscal repair. Knowledge of the circumferential orientation of the collagen fibers has lead to the preferred position of sutures—vertical mattress.

Increasing knowledge of normal meniscal healing and meniscal vascularity has lead to […]


Histologically, the meniscus is a fibrocartilaginous tissue composed primarily of an interlacing network of collagen fibers interposed with cells. The cells of the meniscus are responsible for synthesizing and maintaining the extracellular matrix. There is still some debate as to whether the cells of the meniscus are fibroblasts, chondrocytes, or a mixture of both and […]


Most recent trends in knee rehabilitation emphasize immediate motion, immediate weightbearing, early closed kinetic chain exercises, strength exercises, and early return to activity. Effective rehabilitation programs require an understanding of any surgical procedures performed, the structure of the knee, and the nature of the injury.

Strengthening should include both closed and open kinetic chain exercises, […]