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Visual inertia of rotating 3-D objects.

Five experiments were designed to determine whether a rotating, transparent 3-D cloud of dots (simulated sphere) could influence the perceived direction of rotation of a subsequent sphere. Experiment 1 established conditions under which the direction of rotation of a virtual sphere was perceived unambiguously. When a near-far luminance difference and perspective depth cues were present, observers consistently saw the sphere rotate in the intended direction. In Experiment 2, a near-far luminance difference was used to create an unambiguous rotation sequence that was followed by a directionally ambiguous rotation sequence that lacked both the near-far luminance cue and the perspective cue. Observers consistently saw the second sequence as rotating in the same direction as the first, indicating the presence of 3-D visual inertia. Experiment 3 showed that 3-D visual inertia was sufficiently powerful to bias the perceived direction of a rotation sequence made unambiguous by a near-far luminance cue. Experiment 5 showed that 3-D visual inertia could be obtained using an occlusion depth cue to create an unambiguous inertia-inducing sequence. Finally, Experiments 2, 4, and 5 all revealed a fast-decay phase of inertia that lasted for approximately 800 msec, followed by an asymptotic phase that lasted for periods as long as 1,600 msec. The implications of these findings are examined with respect to motion mechanisms of 3-D visual inertia.

Contrast Sensitivity↗

Are some subjects better taught in block rotation? A geriatric experience.

BACKGROUND AND OBJECTIVES: This study characterizes the progress in and effectiveness of learning geriatric medicine during longitudinal and block phases of a family practice residency program. METHODS: A structured second-year geriatric block rotation was added to a residency longitudinal curriculum. To assess learning, a Geriatric Assessment Instrument (GAI) consisting of 50 multiple choice questions was administered to three classes offamily practice residents (n=33)five times during training: entry into the program, beginning of the second year, pre- andpost-geriatric block rotation, and at graduation. Improvement between individual residentfirst- and third-year in-training exam scores in geriatrics of the intervention classes were compared with the four classes that preceded the introduction of the block rotation (n=38). RESULTS: Scores on the GAI improved significantly before and after the rotation but not during any other interval of training during the residency. In-training exam scores improved significantlyfor the classes taught with the block rotation over those without it. CONCLUSIONS: Most of the geriatric learning occurred during the 1-month geriatric block rotation during the residency. In-training geriatric exam scores improved significantly with a geriatric block rotation. The use of structured repetitive learning experiences during the rotation to emphasize the common clinical issues and the skewed exposure to geriatric patients in the random nature of residency clinic and inpatient encounters accountfor this result.

Aged↗

Relationship of pasture rotation to acquisition of gastrointestinal nematodes by sheep.

In a study of the relationship between pasture rotation in Illinois and acquisition of nematodes (mostly Haemonchus contortus) and body weight gains by lambs grazing with their ewes, 2 pasture rotation systems were tested. (1) Lambs and ewes were rotated through a series of 12 alfalfa-bromegrass-lespedeza pastures, each pasture being grazed for 3 to 4 days and rested for 5.5 weeks; 4 complete rotations were done during a 168-day grazing season. (2) Lambs and ewes were moved every 2 days, and 3 complete rotations of 50, 42, and 54 days, respectively, were done during the 146-day grazing season. The lambs under rotation had more nematodes and gained less weight than nonrotated control lambs, although rotation increased the amount of pasturage. Rotation is not recommended to control nematode parasitism of sheep in Illinois.

Animals↗

Clockwise and counterclockwise rotating shifts: effects on temperature and neuroendocrine measures.

INTRODUCTION: Most researchers suggest that shift rotation in a clockwise (CW) direction produces less disruption of circadian rhythms than rotations in a counterclockwise (CCW) direction. This is based on extrapolation from quasi-experimental studies of shift workers and research on the effects of jet lag that indicate that westward travel results in less disruption of circadian rhythms. METHODS: The effect of direction of rotation on cortisol, melatonin, and rectal temperature was examined in participants randomly assigned to either a CW (n = 14) or CCW (n = 14) shift rotation. RESULTS: Results revealed lower amplitude [F(1,21) = 14.6, p < 0.05] and a delay of the acrophase [F(1,21) = 4.4, p < 0.05] in temperature for the CCW group. Sample time effects for cortisol and melatonin revealed normal circadian variation for both rotations, although melatonin levels on the midnight shift were clearly suppressed relative to baseline melatonin levels. DISCUSSION: The changes observed in the temperature rhythm for the CCW rotation may be related to adaptation or shift-work hardiness; however, it is unclear if these differences indicate beneficial or detrimental changes for the individual. The fact that there were no significant effects of rotation condition for cortisol or melatonin argues against a detrimental effect. These findings are bolstered by performance and sleep data, reported elsewhere from this study, indicating a lack of significant differences as a function of rotation condition.

Adult↗

[Radiographic analysis of rotational malalignment between tibial component and femoral component in total knee arthroplasty].

OBJECTIVE: To identify possible reasons of rotational mismatch between tibial component and femoral component in total knee arthroplasty and choose a right reference axis for placing the components in the operation and to decrease the complications. METHODS: Forty normal Chinese knees were studied. There were 20 men and 20 women, and average age was 34 years (range, 18 - 42 years). The images of cross sections of the distal femur were obtained by spiral CT scanning (0.5 mm thickness). Scan direction was aligned to be in the plane perpendicular to the mechanical axis of the tibia. On the images of the distal femur and the proximal tibia, three baselines for the anteroposterior axis of the femoral component were drawn based on the clinical epicondylar axis and the surgical epicondylar axis and 3 degrees lateral rotated to the posterior condylar surfaces of the femur separately, and a baseline for the anteroposterior axis of the tibial component was drawn based on the medial 1/3 of the tibial tuberosity. The rotational mismatch angles were measured between each component by using the Autocad software. RESULTS: The mean rotational mismatch angle between tibial component and femoral component is 2.94 degrees for the clinical epicondylar axis, 6.50 degrees for the surgical epicondylar axis and 6.83 degrees for 3 degrees lateral rotation of the femoral component referenced to the posterior condylar axis separately. CONCLUSIONS: Landmarks of each bone were the intrinsic cause of the rotational mismatch in total knee arthroplasty. The clinical epicondylar axis can be chosen for the ideal reference to rotational alignment of the femoral component because of its minimal rotational mismatch between each component.

Adolescent↗

[A new blockout instrument for the construction of rotational path removable partial dentures. A case report].

This article introduces a new blockout device for rotational path removable partial dentures. The concept of rotation axis is discussed, from which a more convenient tool for clinical use is derived. The blockout instrument can be divided into three parts: the acrylic block, the rotation axis and the functional part. In the case of tilted mandibular molars, distal and lingual surfaces of anterior abutments should be blocked out according to the rotational path of insertion. In the blockout procedures, the blockout instrument is mounted between the two rotation centers on the two distal abutments with dental stone, so as to coincide the rotation axis of the instrument and that of the denture to be constructed. After the areas below the survey line of the anterior abutments are aproned with wax, Duralay resin is applied onto the areas above the survey line, and extended to join the functional parts of the blockout instrument. After setting, Duralay resin is removed and the portion above the survey line is trimmed to form a knife edge which corresponds to the survey line. Thereafter, the blockout areas are determined by the rotation movement of the knife-edge shaped Duralay resin along the rotation axis of the blockout instrument. This blockout method is more easily performed compared to the method mentioned by Firtell and Jacobson. In addition to the function of blockout, it can also be assisted in analyzing undercut and diagnosis.

Denture, Partial, Removable↗

[Experiences with rotation atherotomy and atherectomy].

In addition to currently available, low risk procedures for reestablishment of patency in arteriosclerotic vascular segments with bougier techniques as described by Dotter and the balloon dilatation modification according to Grüntzig, as necessary together with local thrombolysis, important new developments based on mechanical principles are the atherectomy according to Simpson as well as the rotation atherotomy with a flexible catheter and slowly rotating milling head or rapidly rotating head as used by Kensey. To provide a larger lumen of recanalization, we developed an atherotomy lathing catheter with a rapidly rotating head and various diameters which is now available for intraoperative use. The thrombendarterectomy as described by Vollmar with the "ring stripper" is used only intraoperatively and can only be performed retrograde. The effect of laser systems encompasses disintegration and ablation of occlusive material. The rotation atherotomy is based on the capability of discrimination between hard occlusive material and elastic vascular wall through suitable construction of the lathe head (Figures 1 a to 1 e). Since, in passive catheters, the capability of lathing at the tip is associated with a high risk of perforation and a lateral possibility for lathing is not achievable, the lathing performance should be small, at the center of rotation and orthogonal to the axis of rotation at the outer radius. Through combination with a spherical disc face perpendicular to the axis of rotation, which protrudes only slightly from the hemispherical catheter tip, with a maximum at the center and minimum at the lateral borders, the lathing head has only a slight risk of perforation and no undesired sheering forces (Figures 2a to 2d).(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗

[The rotator cuff syndrome--a frequent disease caused by loading].

The rotator cuff syndrome is defined as a cronical pain syndrome, originating from the rotator cuff with characteristic pain and referred pain. Disorders evolving from the rotator cuff and the rotator muscles comprise between 70 og 90% of the shoulder disorders. The rotator cuff syndrome may be of occupational origin, particularly in heavy work with tasks at or above shoulder level, e.g. shipyard welders and plate workers. Biomecanically surveys show that continuous blood flow in the rotator muscles ceases at about 30 degrees of flexion or abduction of the upper arm. Electromyographic examinations have shown high muscle tension in the same muscles in assembly plant employees. High prevalences of shoulder pain have been shown in these groups and it is considered that the workers are actually suffering from disorders in the rotator cuff and its muscles. The rotator cuff syndrome is on the list of occupational disorders in the Danish Workers' Compensation Act but, in the authors' experience knowledge on etiology, examination and treatment is insufficient. Diagnostic criteria are proposed with the object of improving clinical practice and medical insurance declarations.

Female↗

Biomechanical analysis by chiropractic radiography: Part II. Effects of X-ray projectional distortion on apparent vertebral rotation.

Projectional distortion in an X-ray image can produce artifacts that cause error in the measurement of vertebral rotation. By means of a stereotaxic positioning device, the effect of varying object-film distance, vertical and horizontal off-centering, rotation, and lateral flexion on the amount of distortion in the image of a third lumbar vertebra was determined. Mathematical analysis of the results revealed that projectional distortion due to vertical off-centering does not affect the apparent rotation of the vertebra measurably; that there is a linear relationship between apparent vertebral rotation and horizontal off-centering; for the object-film distances of 35.64 + 0.12 cm and 19.48 + 0.08 cm, the vertebra displayed 1 mm of apparent rotation for every 2 to 3 cm of lateral off-centering regardless of whether the vertebra is rotated or laterally flexed; and that as long as a given osseous segment is compared to its adjacent segment (as in analysis for subluxation), the apparent vertebral rotation may be regarded as a sufficiently accurate representation of the actual rotation of the vertebra.

Biomechanical Phenomena↗

Neural pathway constraints in the motor innervation of the chick hindlimb following dorsoventral rotations of distal limb segments.

Several studies have demonstrated that motor axons can discriminate between dorsally and ventrally derived muscles. In this paper we present evidence that (1) the pathway axons take in the limb constrain their access to either dorsally or ventrally derived muscles, and therefore (2) the axon's ability to discriminate between dorsal and ventral is expressed already at the level of pathway selection into the limb. Surgically manipulated hindlimbs were produced consisting of a normal host thigh connected to a dorsoventrally rotated calf or to rotated and duplicated donor limb segments. The limb rotations were done distal to the level at which axons select a dorsally or ventrally destined pathway through the limb, such that at the level of the rotation, axons in each nerve were confronted with the opposite-from-normal set of muscles. In this situation, the relative influence of pathway availability versus dorsal/ventral muscle recognition could be assessed. The innervation of rotated limb segments was, in all cases, opposite from normal. Motoneurons which normally innervate dorsal muscles innervated ventrally derived muscles that had been rotated into a dorsal position. Likewise, normally ventrally destined axons served dorsal muscles in the rotated segments. Thus, motor axons did not alter their distal path to reach their normal set of muscles. While these results do not rule out intrinsic dorsal/ventral differences between muscles, they do demonstrate that muscle surface recognition is not necessary to account for dorsal/ventral discrimination in the innervation of normal, supernumerary, or duplicated limbs, nor is it sufficient to account for the innervation of rotated limb segments. These results also indicate that pathway guidance cues are an important influence on innervation patterns.

Animals↗

Order of rotation in third-year clerkships. Influence on academic performance.

OBJECTIVE: To determine if student performance during the third-year clerkship is influenced by the order of departmental rotation. STUDY DESIGN: In this retrospective, descriptive study, the National Board of Medical Examiners (NBME) scores, departmental examination grade (DE) and final block grade (FG) were stratified into six segments based on the order of block time in obstetrics-gynecology, pediatrics, psychiatry, internal medicine, surgery and family medicine. Consistency was validated by comparing these performance criteria from 1988 to 1992. RESULTS: When all six clerkships were assessed by year, there was no uniform trend of improved performance over time. In the obstetrics-gynecology block, however, NBME scores and FGs were highest for students assigned to the fifth and sixth rotation as compared to the first two groups (P < .02). No such trend was noted with the departmental written examination. In surgery, DE and FG were always lower in the first rotation (P = .0001). Psychiatry DE scores were significantly higher on the second or third blocks as compared to the fifth and sixth rotation positions (P < .001). Students had a higher FG in pediatrics when the sixth position was compared to the second block (P = .02), but the DE grades and NBME scores were not altered by rotational schema. In family medicine and internal medicine, no effect of rotation was noted. CONCLUSION: Third-year clerks tended to have higher NBME scores and FGs in obstetrics-gynecology if they selected this rotation later in the academic year. Surgery DEs and FGs were lowest if selected first in the academic year. There was no similar trend in other nonsurgical specialties. These data suggest that prior clinical rotations positively influence student performance in obstetrics-gynecology.

Clinical Clerkship↗

[High frequency rotational angioplasty].

High-speed rotational coronary atherectomy is an alternative method to treat complex, especially calcified coronary stenoses. A rotating burr tip removes the occlusive plaque tissue. The applied rotating frequency is between 160 000 to 190 000 rpm. The primary technical success-rate for high frequency rotational atherectomy alone yields between 50 to 60% on average. Associated with consecutive additional balloon angioplasty, the success rate is between 80 and 95% when treating complex type B II or C stenoses. Today, the usage of a single burr tip size with adjunctive balloon angioplasty has become a standard procedure. The occurrence of serious complications such as extensive dissections or thrombotic vessel occlusion is a rare phenomenon after high-speed rotational atherectomy compared to coronary balloon angioplasty, whereas coronary spasm is more common after high-speed rotational atherectomy. According to the actual results, high-speed rotational angioplasty did not lower the rate of long-term restenosis, compared to the results achieved by balloon angioplasty alone. The rate of long-term restenosis is reported to be between 40 to 50% after highspeed rotational angioplasty with or without adjunctive balloon angioplasty.

Atherectomy, Coronary↗

The senior SHO rotation in Wales--a basis for BST training.

Between 1969-1992 there was a successful surgical registrar rotation in South Wales (1). This was a three-year rotation comprising two years general surgery, six months trauma and orthopaedics and six months surgical specialty. The rotation was aimed at those doctors who had completed senior house officer (SHO) posts in accident and emergency, 6-12 months general surgery and had already obtained the primary FRCS. However, with the recent recommendations of the Calman Report concerning general surgical training (2) changes to this rotation have become necessary, namely to reduce the number of surgical registrars in order to achieve a balance in numbers entering higher surgical training and to shorten the period of training to seven years with two years Basic Surgical Training (BST) and five years Higher Surgical Training (HST). A modified rotation was therefore designed and implemented in South Wales since July 1992. The previous registrar rotation was shortened to two years instead of three ensuring the pre-requirements for entry into HST and eligibility to sit the second part FRCS. The aim of this study was to assess whether the new senior SHO/BST rotation in South Wales is providing adequate training for our surgical trainees to enter into HST. We present our data as a potential basis for setting up a formal BST rotation.

Attitude of Health Personnel↗

Quantitative assessment of transient regional ischemia during rotational atherectomy.

UNLABELLED: Sustained myocardial ischemia with angina pectoris, electrocardiographic changes and subsequent non-Q-wave infarctions has been reported during percutaneous transluminal rotational atherectomy of complex coronary lesions. The purpose of this study was to evaluate the effect of rotational atherectomy on regional myocardial perfusion as assessed by serial 99mTc-sestamibi SPECT imaging with semiquantitative tracer uptake analysis. METHODS: Twenty-nine consecutive patients with anginal symptoms, complex coronary lesions (all Type B and Type C) and preserved left ventricular function were studied using resting 99mTc-sestamibi SPECT before rotational atherectomy, during and 2 days after the procedure. For semiquantitative computerized analysis, the left ventricular myocardium was divided into 24 regions, and regional perfusion was expressed as percentage of maximal sestamibi uptake. RESULTS: Visual analysis of scintigraphic images revealed transient perfusion defects corresponding to the revascularized vessel in 26 of 29 patients, whereas three patients had no transient hypoperfusion. During rotational atherectomy, perfusion decreased significantly (>2 s.d. below normal mean) in 3.1 +/- 2.4 regions (range 1-10). Perfusion in the territory of the revascularized vessel was 75% +/- 11% at baseline, decreased to 67% +/- 12% during rotational atherectomy (p < 0.001) and normalized again after rotational atherectomy to 78% +/- 8% (p < 0.001). Similarly, perfusion in the region with the maximal reduction decreased from 74% +/- 15% at baseline to 55% +/- 14% (p < 0.001) during the procedure and returned to 74% +/- 16% (p < 0.001) following the intervention. In calcified stenoses, the extent of perfusion defects was larger as compared to noncalcified (4.2 +/- 2.5 versus 2.3 +/- 2.0 regions/patient, p < 0.05). CONCLUSION: During rotational atherectomy, myocardial hypoperfusion occurs. The transient nature of this perfusion defect can be demonstrated and quantified by serial 99mTc SPECT. This model may prove useful to assess the effects of pharmacological approaches to reducing myocardial hypoperfusion during coronary rotational atherectomy.

Atherectomy, Coronary↗

Humeral head cysts and rotator cuff tears: an MR arthrographic study.

OBJECTIVE: Humeral tuberosity cysts are a common finding, with previous reports suggesting they are related to rotator cuff tear or aging. The aim of this study was to investigate the characteristics of cysts in the tuberosities of the humeral head and their relationship with rotator cuff tear and age. DESIGN AND PATIENTS: Shoulder MR arthrograms were reviewed in 120 consecutive patients-83 males (mean age 38.0, range 19-59 years) and 37 females (mean age 41.2, range 15-59 years). Patients were referred for investigation of a variety of conditions, and instability was suspected in only a minority of cases. MR was performed before and after direct arthrography with 0.01% solution of gadolinium. Cysts were defined as well-demarcated circular/ovoid foci in two planes that demonstrated high signal on pre-arthrographic T2W sequences. Location, size and numbers of cysts and post-arthrographic enhancement were documented, along with the location of rotator cuff tears, if present. RESULTS: Cysts in the tuberosities of the humerus were identified in 84 patients (70%), and were seen seven times more frequently in the posterior aspect of the greater tuberosity than anteriorly. Most cysts (94%) demonstrated communication with the joint post-arthrogram. Rotator cuff tears were present in 36 patients, and 79% of all tears occurred in supraspinatus tendon. There was no significant difference in the occurrence of cysts between patients older or younger than age 40 or between genders, but rotator cuff tears were seen significantly more often in the older age group (p<0.01). Tuberosity cysts and rotator cuff tears did not appear to be related (p=0.55). However, whilst this lack of association was quite obvious posteriorly (p=0.84), the trend in the anterior aspect of the greater tuberosity is not as clear (p=0.14). CONCLUSIONS: Humeral cysts are most often located in the posterior aspect of the greater tuberosity, communicate with the joint space and, in this location, are not related to aging or rotator cuff tear.

Adolescent↗

Arthroscopic repair of large rotator cuff tears using the interval slide technique.

PURPOSE: In some cases of larger and chronic rotator cuff tears, the supraspinatus tendon may be held in a retracted position by the contracted tissue of the rotator interval and the attached coracohumeral ligament. This study was performed to evaluate the utility and clinical effectiveness of an arthroscopic release of the rotator interval from the supraspinatus tendon combined with repair of the rotator cuff. TYPE OF STUDY: Prospective clinical follow-up study. METHODS: Forty-three arthroscopic rotator cuff repairs were performed and followed up for an average of 32 months. All of these patients had large, contracted tears that could not be adequately mobilized without a rotator interval release. In each case, an arthroscopic rotator interval release and superior capsular release were performed to improve cuff mobility. End-to-bone and side-to-side repair was performed depending on the configuration of the tear. Postoperatively, the patients were evaluated using a modified University of California Los Angeles (UCLA) rating system. RESULTS: Forty-two repairs were available for at least 2-year follow-up. No cases of deltoid morbidity or progressive superior migration of the humeral head were seen. The average overall preoperative score was 17.4 (range, 9-26). The average postoperative score was 36.4 (range, 20-45). We saw 21 excellent, 6 good, 11 fair, and 4 poor results based on prior criteria established for smaller tears. All of the average postoperative scoring categories were improved from preoperative scores. Only 3 patients were not satisfied with their results. CONCLUSIONS: The use of the interval slide technique greatly improves supraspinatus mobility in the case of large retracted tears. Although average improvements were less than in our previous study of smaller tears, complete or partial repair of these tears yields good results and high patient satisfaction.

Aged↗

Arthroscopic repair of massive, contracted, immobile rotator cuff tears using single and double interval slides: technique and preliminary results.

PURPOSE: The purpose of this study is to describe the technique and review the preliminary results of arthroscopic repair of massive, contracted, immobile rotator cuff tears using an interval slide technique. TYPE OF STUDY: Case series. METHODS: From January 1999 to December 2000, the senior author (S.S.B.) performed arthroscopic rotator cuff repair on 94 massive rotator cuff tears. Of these, 9 (9.6%) were massive, severely contracted rotator cuff tears and required repair using an interval slide technique. A single interval slide was used in 6 patients, and a double interval slide was used in 3 patients. All patients were evaluated preoperatively and postoperatively using a modified University of California Los Angeles (UCLA) scoring system. RESULTS: At a mean follow-up time of 17.9 months (range, 10-24 months), 8 of 9 patients were satisfied with the procedure. The mean UCLA score increased from 10.0 preoperatively to 28.3 postoperatively (P <.00001). All patients showed some improvement in active motion, strength, or function. Active forward flexion improved significantly, from a preoperative mean of 108 degrees to a postoperative mean of 146.1 degrees (P =.025). Active external rotation increased significantly from a preoperative mean of 24.4 degrees to a postoperative mean of 35.0 degrees (P =.04). A significant increase in strength grade (2.2 to 3.6; P <.005) and function (2.5 to 7.1; P <.0005) were also seen. We encountered no significant complications to the procedure. CONCLUSIONS: The interval slide technique provides a method of mobilization of massive, severely contracted, immobile rotator cuff tears allowing repair of previously irreparable tears. This technique, in conjunction with arthroscopic rotator cuff repair, may provide patients with improvements in pain, motion, strength, and overall shoulder function. LEVEL OF EVIDENCE: Level IV.

Aged↗

Arthroscopic side-to-side rotator cuff repair.

PURPOSE: To study the results of arthroscopic repair of full-thickness rotator cuff tears using a side-to-side suture technique without fixation to bone. TYPE OF STUDY: Case series study of the long-term results of patients who underwent purely arthroscopic rotator cuff repair with a side-to-side suturing technique. METHODS: A retrospective review was performed of patients who underwent arthroscopic repair of full-thickness rotator cuff defects. Patients with full-thickness rotator cuff tears repaired in a side-to-side fashion without anchoring the repair to bone were selected. Patients were evaluated using a modified UCLA shoulder scoring system. The data collected were analyzed to determine the outcome in patients with a 4- to 10-year follow-up. RESULTS: A total of 105 arthroscopic rotator cuff repairs were performed in 104 patients between February 1990 and February 1996. Forty-two patients had a full-thickness tear of the rotator cuff that was repaired using a purely side-to-side suturing technique. The mean UCLA score of all patients in this group was 33; 23 patients reported excellent results, 18 good results, and 1 poor result according to the UCLA scoring system. CONCLUSIONS: In this series, 98% of patients qualified as a good to excellent result according to the UCLA shoulder score. This study shows that patients with a full-thickness defect of the rotator cuff tendon with anatomy amenable to side-to-side closure may be effectively treated with a purely arthroscopic repair using only a side-to-side suturing technique with excellent long-term clinical results. LEVEL OF EVIDENCE: Level IV.

Arthroscopy↗