Purpose: To perform a systematic review of biomechanical and clinical outcomes following lateral meniscus posterior root (LMPR) repair with concomitant anterior cruciate ligament reconstruction (ACLR).
Methods: A literature search was performed systematically using PubMed, Embase, and Medline databases in April 2022. The search included the following terms combined with Boolean operators: 'Meniscus repairs', 'Meniscal Repair', 'Posterior Horn', 'Root', 'Radial'.
➢: Certain anatomic factors, such as patella alta, increased tibial tubercle-trochlear groove distance, rotational deformity, and trochlear dysplasia, are associated with an increased risk of recurrent patellar instability.
➢: The presence of a preoperative J-sign is predictive of recurrent instability after operative management.
➢: Isolated medial patellofemoral ligament reconstruction may be considered on an individualized basis, considering whether the patient has anatomic abnormalities such as valgus malalignment, trochlear dysplasia, or patella alta in addition to the patient activity level.
Background: The contribution of anterior cruciate ligament (ACL) injury to lateral instability under varus stress, particularly compared with posterolateral structures, is not well known.
Purpose: To investigate the effect of sectioning the ACL and posterolateral knee structures on lateral compartment gapping under varus stress.
Study Design: Controlled laboratory study.
Background: Patellar fracture after quadriceps tendon (QT) autograft harvest for anterior cruciate ligament reconstruction (ACLR) has been reported in up to 8.8% of patients.
Purpose: To determine the thickness of the remaining patellar bone across the QT graft harvest location while providing clinical guidance for safely harvesting a patellar bone block when using a QT graft in ACLR.
Purpose: To analyze the impact of professional social media (SM) presence, activity level, and physician practice-specific variables on online ratings and rating frequency for hip arthroscopists across 3 leading physician review websites (PRWs).
Methods: The Arthroscopy Association of North America and American Orthopaedic Society of Sports Medicine directories were queried to identify practicing hip arthroscopists. Physicians included were residency-trained surgeons practicing within the United States.
Background: Anterior cruciate ligament (ACL) tears are often associated with other ligamentous injuries. The side-to-side difference in heel height can represent a valuable diagnostic tool in the setting of multiligamentous injuries.
Purpose: To assess in a cadaveric model how sequential sectioning of the static stabilizing structures of the knee (ACL, fibular collateral ligament [FCL], popliteus tendon [PLT], popliteofibular ligament [PFL], and medial collateral ligament [MCL]) influences heel-height measurements when comparing groups undergoing initial transection of the ACL versus FCL and to assess posterior tibial slope after sequential sectioning.
»: Anterior cruciate ligament (ACL) injuries remain common among athletes; these injuries require reconstruction to restore stability and enable successful return to sport.
»: The role of postoperative dynamic knee bracing following ACL reconstruction in protecting graft integrity and promoting return to sport remains largely unknown.
»: Limited biomechanical studies on functional bracing have reported decreased strain across the ACL with increasing anterior shear loading.
Background: Medial meniscus posterior root (MMPR) injuries accelerate the progression of osteoarthritis. While partial meniscectomy was once considered the gold standard for treatment, meniscus root repair has become increasingly utilized with reported improvements in clinical and biomechanical outcomes.
Purpose: To perform a systematic review of biomechanical outcomes and a meta-analysis of clinical and radiographic outcomes after MMPR repair.
Background: Individual contributions of the rotator cuff (RC) and superior capsule (SC) to prevent superior translation of the humerus are not well understood.
Purpose: To evaluate the relative contributions of the SC and RC to normal and pathologic shoulder biomechanics by determining their independent effects on superior humeral translation.
Study Design: Controlled laboratory study.
Apophyseal avulsion fractures of the ischial tuberosity (AFIT) in pediatric athletes are relatively uncommon injuries with treatment and return to sport (RTS) outcomes being largely unknown. The purpose of this review is to perform a systematic review analyzing RTS and predictors of successful RTS for pediatric athletes sustaining AFIT. Studies reporting on athletes strictly under the age of 18 years sustaining an AFIT with reported RTS status were included.
View Article and Find Full Text PDFBackground: Although the risk of tibial tunnel convergence in the setting of multiligamentous reconstruction has been reported in the literature, the risk of tunnel convergence in the setting of posterior cruciate ligament (PCL), anterior cruciate ligament (ACL) reconstruction and medial and lateral meniscus root repair has not been defined.
Purpose: To examine the risk of tunnel convergence and to determine optimal tunnel placement for ACL and PCL reconstruction performed in conjunction with posterior medial and lateral meniscus root repairs on the anteromedial proximal tibia.
Study Design: Descriptive laboratory study.
Persistent pain after hip arthroscopy may be due to residual impingement, hip dysplasia, osteoarthritis progression, labral injury, or insufficient capsular closure. A patient's history, physical examination findings, and imaging studies should be used to determine whether revision hip arthroscopy is indicated. If surgical management is chosen, careful preoperative planning is essential.
View Article and Find Full Text PDFDespite advances in techniques designed to make arthroscopic sports medicine procedures simple, complications still arise in the operating room; even in the most trained hands. However, what marks a skilled surgeon is not just the ability to steer the ship amidst smooth seas, but a knack for getting out of trouble once things deviate from the set course. Each surgical case presents a unique challenge, and no 2 are the same.
View Article and Find Full Text PDFPurpose: To establish a better understanding of the variations in pain management protocols and prescribing patterns for pediatric patients undergoing anterior cruciate ligament (ACL) reconstruction or repair.
Methods: A 20-question multiple-choice survey was distributed to 3 professional orthopaedic societies to assess the pre-emptive and postoperative pain management prescribing patterns for pediatric patients undergoing ACL reconstruction or repair. Clinical agreement (defined as agreement between >80% of participants) and general agreement (defined as agreement between >60% of participants) were calculated based on responses as previously reported.
Purpose: To establish an infection rate following primary arthroscopic rotator cuff repair (ARCR) from a single institutional database and to ascertain whether there is a relationship between the use of preoperative corticosteroid injection (CSI) and the risk of postoperative infection.
Methods: All medical records at a single institution were retrospectively reviewed to identify patients who had undergone arthroscopic repair from January 2016 to December 2018. Patient charts were reviewed for CSI treatment within 6 months of surgery, superficial or deep infection within 2 months postoperatively, and specific treatment of the infection.
Curr Rev Musculoskelet Med
December 2021
Purpose Of Review: Anterior closing wedge osteotomies (ACWO) are utilized to better restore knee stability and in situ forces on anterior cruciate ligament (ACL) grafts during ACL revision reconstruction while reducing the risk of retearing and subsequent revision procedures. However, clinical outcomes following ACWO for patients undergoing ACL reconstruction remains largely limited. The purpose of this review was to provide a concise overview of the current literature on indication, techniques, and outcomes following ACWO in ACL-deficient patients undergoing primary or revision ACL reconstruction while discussing the authors' preferred technique to ACWO during a staged ACL revision reconstruction.
View Article and Find Full Text PDFCapsular management, from the initial capsulotomy to capsule closure is essential to success in hip arthroscopy to achieve optimal outcomes. Although an interportal capsulotomy is typically sufficient for resection of proximal cam lesions and for performing central compartment procedures, T-capsulotomy is usually performed when large cam deformity needs to be addressed because it provides a broader field of view. The purpose of this Technical Note is to summarize each step of capsule management and to define a traction-assisted T-capsulotomy technique that allows for accurate placement of the T-capsulotomy while also avoiding damage to the articular cartilage.
View Article and Find Full Text PDFBackground: In younger patients and those without severe degenerative changes, the efficacy of intra-articular (IA) injections as a nonoperative modality for treating symptomatic knee osteoarthritis (OA)-related pain while maintaining function has become a subject of increasing interest.
Purpose: To assess and compare the efficacy of different IA injections used for the treatment of knee OA, including hyaluronic acid (HA), corticosteroids (CS), platelet-rich plasma (PRP), and plasma rich in growth factors (PRGF), with a minimum 6-month patient follow-up.
Study Design: Meta-analysis of randomized controlled trials; Level of evidence, 1.
Hip arthroscopy is an increasingly popular procedure used to treat femoroacetabular impingement. However, the procedure is technically challenging with a steep learning curve. To prevent complications and to optimize patient outcomes, proper patient positioning, correct portal placement, and adequate capsular closure are necessary.
View Article and Find Full Text PDFThe hip suction seal plays a key role in distractive stability and maintenance of intra-articular fluid pressure of the hip. Preservation of the suction seal relies on the acetabular labrum and the congruence between the labrum and the femoral head-neck junction. During the treatment of cam-type impingement, iatrogenic over-resection in the femoral head-neck junction or labrum deficiency can cause loss of this suction seal.
View Article and Find Full Text PDFDistraction is essential during hip arthroscopy to allow for adequate working space during central and peripheral compartment procedures. Pudendal posts are frequently used with traction boots to achieve distraction, but use of these posts is believed to be associated with the iatrogenic pudendal area and perineal nerve injuries seen with hip arthroscopy. Current post-free distraction tables are costly and cumbersome.
View Article and Find Full Text PDFThe Bennett lesion is an extra-articular ossification at the posteroinferior glenoid rim that is common among overhead-throwing athletes. While the majority of these exostoses are asymptomatic, some may cause posterior shoulder pain during throwing motion and frequently have concomitant posterior labral tears. Multiple approaches to Bennett lesion resection have been described, and there is debate regarding the need for capsulotomy, posterior labral repair, and capsular repair.
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