The Presence of a Trochlear Bump and Patella Alta May Predict the Risk of Recurrent Instability After Isolated Medial Patellofemoral Ligament Reconstruction: A Systematic Review and Meta-analysis.

Background: Medial patellofemoral ligament reconstruction (MPFLR) is an excellent surgical option for patients with recurrent patellar instability. This technique has demonstrated significant improvements in patient-reported outcomes, high rates of return to sport, and low rates of failure. However, there is debate regarding the use of isolated MPFLR in the setting of concomitant pathoanatomic features such as patella alta, trochlear dysplasia, or a lateralized tibial tubercle.

No Association Between Donor Variables and Clinically Significant Outcomes, Reoperations, and Failure After Osteochondral Allograft Transplantation.

Background: Mismatch between osteochondral allograft (OCA) donor and recipient sex has been shown to negatively affect outcomes. This study accounts for additional donor variables and clinically relevant outcomes.

Purpose: To evaluate whether donor sex, age, donor-recipient sex mismatch, and duration of graft storage affect clinical outcomes and failure rates after knee OCA transplantation.

Patellofemoral Cartilage Injury and Treatment.

Osteochondral and chondral injuries of the patellofemoral joint are common in active patients, and effective management requires a thorough physical and imaging evaluation, a detailed understanding of the unique anatomic and biomechanical joint properties contributing to these injuries, and an appropriate selection of treatment modality. Diagnosis of patellofemoral chondral injuries can be challenging, and differentiating between various causes of anterior knee pain is crucial to successful outcomes. Once identified, nonsurgical treatments including physical therapy, bracing, and injections are a mainstay of initial management.

iPhone-Based Cartilage Topography Scanning Yields Similar Results to Computed Tomography Scanning.

Purpose: To investigate the feasibility and accuracy of 3-dimensional (3D) iPhone scans using commercially available applications compared with computed tomography (CT) for mapping chondral surface topography of the knee.

Methods: Ten cadaveric dysplastic trochleae, 16 patellae, and 24 distal femoral condyles (DFCs) underwent CT scans and 3D scans using 3 separate optical scanning applications on an iPhone X. The 3D surface models were compared by measuring surface-to-surface least distance distribution of overlapped models using a validated 3D-3D registration volume merge method.

Comparison of Patient-Reported Outcomes for Immediate Unrestricted Weightbearing Versus Restricted Rehabilitation Protocols After Osteochondral Allograft Transplantation to the Distal Femur.

Background: There is no standardized rehabilitation protocol after osteochondral allograft (OCA) transplantation surgery to the distal femur. The spectrum of recommendations includes restrictions to toe-touch weightbearing (TTWB) for 6 weeks and immediate weightbearing as tolerated (WBAT).

Purpose/hypothesis: The purpose of this study was to compare outcomes for immediate unrestricted WBAT to restricted TTWB after OCA transplantation to the distal femur.

Osteochondral Allograft Reaming Significantly Affects Chondrocyte Viability.

Background: Chondrocyte viability is associated with the clinical success of osteochondral allograft (OCA) transplantation.

Purpose: To investigate the effect of distal femoral OCA plug harvest and recipient site preparation on regional cell viability using traditional handheld saline irrigation versus saline submersion.

Study Design: Controlled laboratory study.

Greater Postoperative Biceps Tendon Migration After Arthroscopic Suprapectoral or Open Subpectoral Biceps Tenodesis Correlates With Lower Patient-Reported Outcome Scores.

Purpose: To assess the relation between tendon migration, as measured by radiostereometric analysis, and patient-reported outcome measures (PROMs) after biceps tenodesis (BT); to determine the likelihood of achieving clinically significant outcomes (CSOs) after BT; and to identify factors that impact CSO achievement.

Methods: Patients undergoing arthroscopic suprapectoral or open subpectoral BT at a single, high-volume academic medical center were prospectively enrolled. A tantalum bead sutured to the tenodesis construct was used as a radiopaque marker.

Patient-Specific Distal Femoral Guides Optimize Cartilage Topography Matching in Osteochondral Allograft Transplantations.

Background: Osteochondral allograft (OCA) transplantation is an important surgical technique for full-thickness chondral defects in the knee. For patients undergoing this procedure, topography matching between the donor and recipient sites is essential to limit premature wear of the OCA. Currently, there is no standardized process of donor and recipient graft matching.

Chondrocyte Response to Fresh Autologous Conditioned Serum Versus Freeze-Dried Allogenic Conditioned Serum.

Objective: To investigate the cytokine release profile and histological response of human cartilage after exposure to autologous conditioned serum (ACS) and freeze-dried allogenic conditioned serum (FD-CS).

Design: Cartilage explants were collected from 6 patients undergoing total knee arthroplasty. ACS and FD-CS were created from patient serum samples.

Fatty Infiltration, Tear Size, and Retraction Size Are Significant Risk Factors for Retear After Arthroscopic Rotator Cuff Repair: A Systematic Review.

Purpose: To assess the consistency and quality of risk factor reporting for rotator cuff repair (RCR) retear and identify risk factors most frequently associated with retear.

Methods: A systematic review was performed according to Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Of the initial 3,158 studies, a total of 31 met the following inclusion criteria: (1) clinical studies regarding RCR failure, (2) arthroscopic procedures involving RCR, (3) reporting of clinical outcomes, (4) publication within the past 5 years, and (5) studies investigating preoperative risk factors for retear.

Sport-specific Differences in Cartilage Treatment.

Articular cartilage defects in the knee are common in athletes who have a variety of loading demands across the knee. Athletes of different sports may have different baseline risk of injury. The most studied sports in terms of prevalence and treatment of cartilage injuries include soccer (football), American football, and basketball.

Long-Term Clinical and Radiographic Outcomes of Meniscus Allograft Transplant.

Purpose Of Review: To reduce pain, improve function and possibly mitigate the risk for development of osteoarthritis in patients with functionally deficient meniscus pathology, meniscal allograft transplantation (MAT) can be used to restore native joint biomechanics and increase knee joint longevity. This review explores the senior author's preferred bridge-in-slot technique and recently published long-term clinical and radiographic outcomes following MAT.

Recent Findings: Recent literature demonstrates MAT to be a safe and largely successful procedure for patients with functional meniscus deficiency.

Editorial Commentary: The Entry Point-Trochlear Groove Angle Measures Lateralization of the Proximal Trochlear Entry Point in Patients With Patellar Instability.

Patellar instability is a complex orthopaedic condition, occurring at an incidence of 23.2 per 100,000 person-years and resulting from a combination of osseous and soft-tissue factors. Osseous abnormalities associated with patellar instability include trochlear dysplasia and a lateralized tibial tubercle.

Biomechanical Properties and Kinematics of Medial Patellofemoral Ligament Reconstruction: A Systematic Review.

Background: While the biomechanical properties of the native medial patellofemoral ligament (MPFL) have been well studied, there is no comprehensive summary of the biomechanics of MPFL reconstruction (MPFLR). An accurate understanding of the kinematic properties and functional behavior of current techniques used in MPFLR is imperative to restoring native biomechanics and improving outcomes.

Purpose: To provide a comprehensive review of the biomechanical effects of variations in MPFLR, specifically to determine the effect of graft choice and reconstruction technique.

Isolated Medial Patellofemoral Ligament Reconstruction Results in Lower Failure and Complication Rates Than Isolated Trochleoplasty and Tibial Tubercle Osteotomy: A Systematic Review.

Purpose: To evaluate outcomes and complications of isolated medial patellofemoral ligament reconstruction (MPFLR), tibial tubercle osteotomy (TTO), and trochleoplasty for management of patellar instability.

Methods: A query of Scopus, PubMed, Google Scholar, Cochrane CENTRAL Register of Controlled Trials, and the Cochrane Database of Systematic Reviews was performed in accordance with 2020 Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Included studies reported clinical outcome data after isolated MPFLR, TTO, or trochleoplasty for patellar instability with a minimum 12-month follow-up.

No significant difference in thick versus thin osteochondral flap trochleoplasty in the treatment of trochlear dysplasia: A systematic review.

Purpose: Trochleoplasty has become increasingly utilised to address patellar instability in the setting of severe trochlear dysplasia. There remains a paucity of literature on the outcomes of 'thick'- versus 'thin'-osteochondral flap trochleoplasty. The purpose of this study is to compare clinical and radiographic outcomes between patients with patellar instability with symptomatic trochlear dysplasia treated using a 'thick' versus 'thin' osteochondral flap trochleoplasty.

Lateral Opening-Wedge Distal Femoral Osteotomy Made Easy: Tips and Tricks.

A lateral opening-wedge distal femoral osteotomy is useful to offload the lateral tibiofemoral compartment for focal chondral defects or isolated lateral compartment arthritis. Although beneficial for these lateral compartment disorders, a distal femoral osteotomy requires careful forethought to optimize correction accuracy and safety. We recommend the following for effective execution of a distal femoral osteotomy: (1) Plan the desired correction preoperatively while accounting for an individual patient's anatomy and femoral width.

A Systematic Review and Meta-analysis of Risk Factors for the Increased Incidence of Revision Surgery After Arthroscopic Rotator Cuff Repair.

Background: Approximately 90% of patients who undergo arthroscopic rotator cuff repair (RCR) are satisfied with their pain levels and function after surgery. However, a subset of patients experience continued symptoms that warrant revision surgery. Preoperative risk factors for RCR failure requiring revision surgery have not been clearly defined.

Osteochondral Allografts: Pearls to Maximize Biologic Healing and Clinical Success.

We present an evidence-based approach to optimize the biologic incorporation of osteochondral allografts: (1) The donor graft is gradually rewarmed to room temperature to reverse the metabolic suppression from cold storage. (2) The graft is harvested while submerged in saline to limit thermal necrosis. (3) Subchondral bone depth is preferred at 4 to 6 mm depth (total plug depth ∼5-8 mm including articular cartilage) to reduce graft immunogenicity and to promote incorporation.

Concomitant Treatment of High-Grade Cartilage Lesions Mitigates Risk of Meniscal Allograft Transplant Failure.

Purpose: To identify frequently studied significant preoperative risk factors for meniscal allograft transplantation (MAT) failure.

Methods: Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines were used to conduct this systematic review. The database analysis was performed in May 2022 and included PubMed, Embrace, and Cochrane.

Patient-reported outcomes measurement information system depression psychometrically underperforms compared to legacy measures and is poorly associated with postoperative functional outcomes in shoulder arthroplasty patients.

Background: The purpose of this study was to investigate the associations between each mental health patient-reported outcome measure with postoperative functional outcomes following shoulder arthroplasty, and to compare psychometric properties of patient-reported outcomes measurement information system depression to the legacy (VR-12 Mental) patient-reported outcome measure.

Methods: Patients who underwent primary shoulder arthroplasty from July 2018 to February 2019 were retrospectively reviewed. Patient-reported outcomes measurement information system depression and VR-12 Mental were administered preoperatively; American Shoulder and Elbow Surgeons and Single Assessment Numeric Evaluation were administered at 6-month and 1-year postoperatively.

PROMIS physical function and pain perform poorly psychometrically in patients undergoing medial patellofemoral ligament reconstruction.

Purpose: The purpose of this study was to assess the validity, floor and ceiling effects, and dimensionality of PROMIS Physical Function (PF) and Pain compared to legacy patient reported outcome (PRO) measures in patients undergoing medial patellofemoral ligament (MPFL) reconstruction.

Methods: Patients who underwent MPFL reconstruction between 2018 to 2020 were retrospectively reviewed. Preoperatively, patients completed the IKDC, VR-12, Kujala, SF-12, KOOS JR, PROMIS PF and Pain surveys.