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ABSTRACTS 365 the 6- or 12-month groups. Cells below the laser lesions appeared viable when compared with con- trois. In each group studied, no histologic evidence of healing or fibrous covering was found in the super- ficial or deep laser lesions. No adverse clinical ef- fects (synovitis, infection) were found with the laser system, and the laser permitted excellent depth control during vaporization. This study cautions the surgeon against lasing articular cartilage during sur- gery. Conclusion: No histologic evidence of healing was present up to 1 year later in any articular lesions made by the CO2 laser. The Healing Effect of the Neodymium:YAG Laser on Meniscal Repairs in the Avascular Zone of the Menis- cus. C. Thomas Vangsness, Jr., Younis Akl, June Marshall, and Bill Subin. Los Angeles, California, U.S.A. Thirty mature New White rabbits were divided into four surgical groups. Group I, with three rab- bits, underwent an iatrogenic, full-thickness menis- cal tear 3-4 mm long in the avascular central area of the medial meniscus without lasering or suturing. Group II, with three rabbits, had the same lesion with 8.0 ethibond suturing of the tear. Group III, with 12 rabbits, was given four different doses with the neodymium:YAG laser and no suturing. Group IV, with 12 rabbits, underwent meniscal suturing followed by the same four different laser doses. The animals were killed at 2, 4, and 6 weeks; one animal from each groups in I and II, and from sub- groups of groups III and IV. Hematoxylin and eosin staining was used to evaluate the healing responses by group and time. The overall results showed no healing of this me- niscal tear in the avascular zone. Suturing generally showed increased cellular infiltration. The varying doses of the neodymium:YAG lasing demonstrated no overall gradient effect, and no "welding" of me- nisci was noted. The maximum cellular inflamma- tory response was noted in the sutured and lased menisci, implicating the importance of a stable en- vironment for maximum healing ability. Arthroscopic "Mini-Open" Technique in the Treat- ment of Ruptures of the Long Head of the Biceps. Stephen C. Weber. Sacramento, California, U.S.A. Rupture of the long head of the biceps is a com- mon injury, usually associated with the natural pro- gression of impingement syndrome. Many patients tolerate the deformity, mild elbow flexion, and su- pination weakness well, but other patients appear to have problems related either to the weakness and pain, or to the residual stump. Traditional tech- niques involving open repair usually involve a del- topectoral approach, and either ignore the stump or involve an arthrotomy; both techniques carry the risk of significant patient morbidity. Presented here are 25 patients with partial or complete biceps rup- tures treated with a "mini-open" technique as de- scribed by Caspari. Five were partial ruptures iden- tified arthroscopically as >50% torn; the remainder were complete. Mean age was 42.4 years, reflecting the younger patients who selected surgical repair. All patients had standard shoulder arthroscopy to exclude coexistent rotator cuff tear. The residual biceps stump and damaged superior labrum were then excised, and if preoperative examination or bursoscopy suggested impingement, arthroscopic acromioplasty was performed. After completing the arthroscopy with the patient in the same position, a 2-cm axillary incision was made. Dissection was bluntly performed between the pectoralis major and conjoined tendon, and the distal rupture was iden- tiffed and tenodesed using a screw and ligament washer at the distal bicipital groove. Follow-up av- eraged 23.6 months. All procedures were performed on an outpatient basis with oral medications. One superficial infection cleared with oral antibiotics, and one temporary neuropraxia of the lateral ante- brachial cutaneous nerve occurred. Eighty-five per- cent of patients were pain free at follow-up, with normal cosmesis and strength confirmed by isoki- netic testing. Miniopen biceps repair appears to be a reasonable alternative to open repair or neglect in the younger active patient with a biceps rupture. "Mini-Open" Versus Traditional Open Repair in the Management of Small and Moderate Size Tears of the Rotator Cuff. Stephen C. Weber and Randall Schaefer. Sacramento, California, U.S.A. Traditional open rotator cuff repair as described by Neer and others has been an acceptable proce- dure with good or excellent results in -85% of pa- tients. However, the perioperative morbidity is per- ceived by many patients as high, and recovery to full function lengthy. Recently "mini-open" re- pair--preserving the deltoid attachment by per- forming the acromioplasty arthroscopically fol- Arthroscopy, Vol. 9, No. 3, 1993

Arthroscopic “mini-open” technique in the treatment of ruptures of the long head of the biceps

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ABSTRACTS 365

the 6- or 12-month groups. Cells below the laser lesions appeared viable when compared with con- trois.

In each group studied, no histologic evidence of healing or fibrous covering was found in the super- ficial or deep laser lesions. No adverse clinical ef- fects (synovitis, infection) were found with the laser system, and the laser permitted excellent depth control during vaporization. This study cautions the surgeon against lasing articular cartilage during sur- gery.

Conclusion: No histologic evidence of healing was present up to 1 year later in any articular lesions made by the CO2 laser.

The Healing Effect of the Neodymium:YAG Laser on Meniscal Repairs in the Avascular Zone of the Menis- cus. C. Thomas Vangsness, Jr., Younis Akl, June Marshall, and Bill Subin. Los Angeles, California, U.S.A.

Thirty mature New White rabbits were divided into four surgical groups. Group I, with three rab- bits, underwent an iatrogenic, full-thickness menis- cal tear 3-4 mm long in the avascular central area of the medial meniscus without lasering or suturing. Group II, with three rabbits, had the same lesion with 8.0 ethibond suturing of the tear. Group III, with 12 rabbits, was given four different doses with the neodymium:YAG laser and no suturing. Group IV, with 12 rabbits, underwent meniscal suturing followed by the same four different laser doses.

The animals were killed at 2, 4, and 6 weeks; one animal from each groups in I and II, and from sub- groups of groups III and IV. Hematoxylin and eosin staining was used to evaluate the healing responses by group and time.

The overall results showed no healing of this me- niscal tear in the avascular zone. Suturing generally showed increased cellular infiltration. The varying doses of the neodymium:YAG lasing demonstrated no overall gradient effect, and no "welding" of me- nisci was noted. The maximum cellular inflamma- tory response was noted in the sutured and lased menisci, implicating the importance of a stable en- vironment for maximum healing ability.

Arthroscopic "Mini-Open" Technique in the Treat- ment of Ruptures of the Long Head of the Biceps. Stephen C. Weber. Sacramento, California, U.S.A.

Rupture of the long head of the biceps is a com- mon injury, usually associated with the natural pro-

gression of impingement syndrome. Many patients tolerate the deformity, mild elbow flexion, and su- pination weakness well, but other patients appear to have problems related either to the weakness and pain, or to the residual stump. Traditional tech- niques involving open repair usually involve a del- topectoral approach, and either ignore the stump or involve an arthrotomy; both techniques carry the risk of significant patient morbidity. Presented here are 25 patients with partial or complete biceps rup- tures treated with a "mini-open" technique as de- scribed by Caspari. Five were partial ruptures iden- tified arthroscopically as >50% torn; the remainder were complete. Mean age was 42.4 years, reflecting the younger patients who selected surgical repair. All patients had standard shoulder arthroscopy to exclude coexistent rotator cuff tear. The residual biceps stump and damaged superior labrum were then excised, and if preoperative examination or bursoscopy suggested impingement, arthroscopic acromioplasty was performed. After completing the arthroscopy with the patient in the same position, a 2-cm axillary incision was made. Dissection was bluntly performed between the pectoralis major and conjoined tendon, and the distal rupture was iden- tiffed and tenodesed using a screw and ligament washer at the distal bicipital groove. Follow-up av- eraged 23.6 months. All procedures were performed on an outpatient basis with oral medications. One superficial infection cleared with oral antibiotics, and one temporary neuropraxia of the lateral ante- brachial cutaneous nerve occurred. Eighty-five per- cent of patients were pain free at follow-up, with normal cosmesis and strength confirmed by isoki- netic testing. Miniopen biceps repair appears to be a reasonable alternative to open repair or neglect in the younger active patient with a biceps rupture.

"Mini-Open" Versus Traditional Open Repair in the Management of Small and Moderate Size Tears of the Rotator Cuff. Stephen C. Weber and Randall Schaefer. Sacramento, California, U.S.A.

Traditional open rotator cuff repair as described by Neer and others has been an acceptable proce- dure with good or excellent results in -85% of pa- tients. However, the perioperative morbidity is per- ceived by many patients as high, and recovery to full function lengthy. Recently "mini-open" re- pair--preserving the deltoid attachment by per- forming the acromioplasty arthroscopically fol-

Arthroscopy, Vol. 9, No. 3, 1993