Arthroscopic Subpectoral Tenodesis of the Long Head of the Biceps Brachii.

The long head of the biceps brachii is a common pain generator in the shoulder that is often managed surgically with tenotomy or tenodesis. The clinical outcomes after tenotomy and tenodesis are comparable. However, tenodesis is preferred in the active population owing to complications associated with tenotomy, including cosmetic deformity, early fatigue, and cramping.

Arthroscopic Technique for Headless Compression Screw Fixation of Large Bony Bankart Fractures in Anterior Shoulder Instability.

A bony Bankart fracture is a common injury pattern in anterior shoulder instability. The fracture fragment size varies and the larger the fragment the more likely recurrent instability will occur. When a large bony Bankart fracture is present, surgical fixation is preferred.

Hip Circumferential Labral Reconstruction Provides Similar Distractive Stability to Labral Repair After Cam Over-Resection in a Biomechanical Model.

Purpose: To evaluate the change in hip distractive stability after a cam over-resection, labral tear, repair, labrectomy, or circumferential 6- or 10-mm labral reconstruction in a biomechanical model.

Methods: Ten fresh-frozen matched-pair human cadaveric hips were analyzed using a materials testing system to measure the force and distance required to disrupt the suction seal of the hip (1) with an intact capsule and labrum; (2) after a capsulectomy and labral repair; (3) after a capsulectomy, 5-mm cam over-resection and labral repair; (4) after a capsulectomy, 5-mm cam over-resection and labral tear; (5) after a capsulectomy, 5-mm cam over-resection and labrectomy; and (6) after a capsulectomy, 5-mm cam over-resection and a 6- or 10-mm circumferential labral reconstruction with iliotibial band (5 hips each). Each specimen was retested at 0° flexion, 45° flexion, and 45° flexion and at 15° internal rotation and analyzed using nonparametric statistical methods.

Excision of Intra-articular Knee Heterotopic Ossification Using a 70° Arthroscope.

Heterotopic ossification is ectopic lamellar bone formation within soft tissue and can result in significant functional limitations. There are multiple underlying etiologies of HO including musculoskeletal trauma and traumatic brain injury. Intra-articular HO of the knee is rare and is typically located within the cruciate ligaments.

Single bundle hamstrings autograft preparation techniques for anterior cruciate ligament reconstruction: current concepts.

Anterior cruciate ligament reconstruction (ACLR) is one of the most common orthopedic procedures, and huge variation exists in the surgical technique. Single bundle hamstrings autograft reconstruction is a common method and has good clinical outcomes. A criticism of the hamstrings autograft is a small graft diameter, often less than 8-mm, which has been associated with increased re-rupture rates.

Hip Labral and Capsular Repair Are Unable to Restore Distractive Stability in a Biomechanical Model.

Purpose: To evaluate the change in hip distractive stability after a capsulotomy, labral tear, and simultaneous repair of both the capsule and the labrum in a biomechanical model.

Methods: Ten fresh-frozen human cadaveric hips were analyzed using a materials testing system to measure the distractive force and distance required to disrupt the hip suction seal under the following conditions: (1) native intact capsule and labrum, (2) 2- or 4-cm interportal capsulotomy (IPC), (3) labral tear, (4) T extension, (5) labral repair, (6) T extension repair, and (7) IPC repair. Each specimen was retested at 0° of flexion, 45° of flexion, and 45° of flexion with 15° of internal rotation.

Not all patient-reported outcome measures are equivalent at two years compared to one year after anterior cruciate ligament reconstruction based on a retrospective analysis.

Objective: This article aims to assess for clinically important differences in patient-reported outcome measures (PROMs) at one and two years post anterior cruciate ligament reconstruction (ACLR).

Methods: A retrospective comparison of prospectively collected PROMs for a single cohort who underwent a primary ACLR with or without associated meniscal surgery from 2016 to 2020 was assessed. Six externally validated PROMs were collected preoperatively and at standardized times postoperatively.

The Contribution of Soft Tissue and Bony Stabilizers to the Hip Suction Seal: A Systematic Review of Biomechanical Studies.

Background: Previous biomechanical studies have identified capsular closure, labral repair or reconstruction, and osteochondroplasty as important surgical interventions to improve hip stability.

Purpose: To investigate the outcome metrics used to quantify hip stability and assess and measure the relative contributions of the labrum, capsule, and bone to hip stability through a quantitative analysis.

Study Design: Systematic review and meta-analysis; Level of evidence, 4.

If at first you don't succeed, should you try again? The efficacy of repeated closed reductions of distal radius fractures.

Introduction: A repeated closed reduction ("re-reduction") of a displaced distal radius fracture is a common procedure performed to obtain satisfactory alignment and avoid surgery when the initial reduction is deemed unsatisfactory. However, the efficacy of re-reduction is unclear. Compared to a single closed reduction, does a re-reduction of a displaced distal radius fracture: (1) improve radiographic alignment at the time of fracture union and, (2) decrease the rate of operative intervention?

Materials And Methods: Retrospective cohort analysis of 99 adults aged 20-99 years with extra-articular or minimally displaced intra-articular, dorsally angulated, displaced distal radius fracture with or without an associated ulnar styloid fracture who underwent a re-reduction, compared against 99 adults matched for age and sex who were managed with a single reduction.

Intra-articular Soft Tissue Pathology of the Postpartum Hip: A Systematic Review.

Purpose Of Review: Pregnancy-related lumbopelvic and hip pain affects over half of postpartum females and has multiple aetiologies. The relative contribution of intra-articular soft tissue pathology to pregnancy-related hip pain is unknown. The current review investigates the available evidence regarding underlying intra-articular soft tissue aetiologies of hip pain in females during pregnancy and in the acute postpartum period.

Near-peer question writing and teaching programme.

Background: Near-peer assisted learning (NPAL) is an increasingly important tool in medical education; however, although numerous published papers discuss its merits, the evidence on the effectiveness and student perception of NPAL is limited. We describe a novel near-peer question writing and teaching programme to assess whether it improves the confidence of first-year medical students for their first In-Course Assessment (ICA) in medical school. The evidence on the effectiveness and student perception of NPAL is limited METHODS: A team of medical students designed a question development procedure and a structured teaching programme.