A Single-Surgeon 35-Year Experience With ACL Reconstruction Using Patellar Tendon Auto- and Allografts With the Transtibial Technique.

Background: Long-term follow-up for anterior cruciate ligament reconstruction (ACLR) is limited due to heterogeneity in the number of techniques utilized, the number of surgeons included, and attrition bias.

Purpose: To analyze a single surgeon's 35-year experience with ACLR using the transtibial technique, with an emphasis on temporal trends in graft selection and subanalyses on rates of revision surgery, contralateral ACLR, and nonrevision reoperation among different demographic cohorts of patients.

Study Design: Case series; Level of evidence, 4.

The Prevalence of Cam Morphology: A Cross-Sectional Evaluation of 3,558 Cadaveric Femora.

We sought to determine (1) the prevalence of cam deformity in the population and that of bilateral cam deformity, (2) the typical location of a cam lesion, and (3) the typical size of a cam lesion by direct visualization in cadaveric femora. Two observers inspected 3,558 human cadaveric femora from the Hamann-Todd Osteological Collection from the Cleveland Museum of Natural History. Any asphericity >2 mm from the anterior femoral neck line was classified as a cam lesion.

Mirror Image Modeling of Acetabular Rim Thickness Differences in Patients With Unilateral Femoroacetabular Impingement Syndrome.

Purpose: To use mirror imaging to identify the location and magnitude of difference in acetabular rim morphology between the symptomatic and unaffected acetabula in patients with symptomatic unilateral pincer-type or mixed femoroacetabular impingement syndrome (FAIS) using 1-dimensional models created with computed tomography (CT).

Methods: CT scans of bilateral hips in 33 patients diagnosed with unilateral pincer-type or mixed FAIS were obtained. Three-dimensional bilateral hip models were constructed, and the unaffected hemipelvis was superimposed onto the symptomatic side to compare acetabular thickness.

Autologous Chondrocyte Implantation and Osteochondral Allograft Transplantation Render Comparable Outcomes in the Setting of Failed Marrow Stimulation.

Background: Marrow stimulation techniques (MSTs) such as subchondral drilling and microfracture are often chosen as first-line treatment options for symptomatic cartilage defects of the knee. When an MST fails, many cartilage restoration techniques are employed, including autologous chondrocyte implantation (ACI) and osteochondral allograft (OCA). However, a few series in the literature suggest that ACI after a failed MST results in inferior outcomes as compared with primary ACI.

Surface Mapping of the Musculotendinous Attachments at the Pubic Symphysis in Cadaveric Specimens: Implications for the Treatment of Core Muscle Injury.

Purpose: To characterize the 3-dimensional muscular, musculotendinous, and neurovascular anatomy about the pubic symphysis relevant to core muscle injury (CMI).

Methods: Ten cadaveric hips were dissected to characterize the musculotendinous insertion of the rectus abdominis and inguinal ligament, origins of the adductor longus and adductor brevis, and the pubic cartilage plate. A 3-dimensional coordinate measuring system and data acquisition software were used to calculate structure cross-sectional area, and the landmark anatomical relationships to 1 another and relevant neurovascular structures.

Systematic Review of Hip Arthroscopy for Femoroacetabular Impingement: The Importance of Labral Repair and Capsular Closure.

Purpose: To evaluate the safety and efficacy of hip arthroscopy for femoroacetabular impingement syndrome by assessing complications, comprehensive procedure survivorship, and the influence of labral and capsular management on procedure survivorship.

Methods: A systematic review of multiple medical databases was performed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and checklist. All clinical outcome studies that reported on the presence or absence of reoperation after hip arthroscopy for femoroacetabular impingement syndrome were eligible for inclusion.

Open vs Percutaneous vs Arthroscopic Surgical Treatment of Lateral Epicondylitis: An Updated Systematic Review.

This study was performed to compare outcomes of open, arthroscopic, and percutaneous surgical techniques for lateral epicondylitis. We searched PubMed (MEDLINE) for literature published between January 1, 2004 and May 23, 2015 using these key words: lateral epicondylitis AND (surgery OR operative OR surgical OR open OR arthroscopic OR percutaneous). Meta-analyses were performed for outcomes reported in 3 studies using 2-sample and 2-proportion Z-tests.

High Rate of Return to High-Intensity Interval Training After Arthroscopic Management of Femoroacetabular Impingement Syndrome.

Background: Since the inception of CrossFit in 2000, the popularity of high-intensity interval training (HIIT) in the United States has risen dramatically. While HIIT is a highly efficient exercise for weight loss and improved conditioning, some literature reports injuries in up to 34% of HIIT participants. We sought to evaluate the functional and sports-specific results of hip arthroscopic surgery in recreational HIIT participants.

Trends in Shoulder Stabilization Techniques Used in the United States Based on a Large Private-Payer Database.

Background: Arthroscopic stabilization is the most broadly used surgical procedure in the United States for management of recurrent shoulder instability. Latarjet coracoid transfer has been considered a salvage surgical procedure for failed arthroscopic repairs or cases of significant glenoid bone loss; however, with recent literature suggesting reduced risk of recurrent instability with Latarjet, several surgeons have advocated its broader utilization as a primary operation for treatment of shoulder instability.

Purpose: To determine trends in shoulder stabilization techniques used in the United States.

Thirty-Year Experience With ACL Reconstruction Using Patellar Tendon: A Critical Evaluation of Revision and Reoperation.

Background: During the preoperative discussion prior to anterior cruciate ligament reconstruction (ACLR), patients are often interested in data regarding rates of revision reconstruction, reoperation, concomitant pathologic changes, and future contralateral ACL injury.

Purpose: To analyze a single surgeon's experience with primary and revision ACLR over a 30-year interval, focusing on incidence and risk factors for revision and reoperation.

Study Design: Case series; Level of evidence, 4.

What Factors Influence the Biomechanical Properties of Allograft Tissue for ACL Reconstruction? A Systematic Review.

Background: Allograft tissue is used in 22% to 42% of anterior cruciate ligament (ACL) reconstructions. Clinical outcomes have been inconsistent with allograft tissue, with some series reporting no differences in outcomes and others reporting increased risk of failure. There are numerous variations in processing and preparation that may influence the eventual performance of allograft tissue in ACL reconstruction.

Midterm results of osteochondral allograft transplantation to the humeral head.

Background: This study evaluated clinical outcomes of osteochondral allograft (OCA) transplantation for humeral head osteochondral defects. We hypothesized that patients with isolated humeral head disease would achieve favorable results and that patients with bipolar disease would experience inferior outcomes.

Methods: We identified patients who underwent humeral head OCA transplantation.

Acetabular Osteoarticular Allograft After Ewing Sarcoma Resection: A 15-Year Follow-up: A Case Report.

Case: A 4-year-old girl with Ewing sarcoma of the periacetabular region had been treated with neoadjuvant chemotherapy followed by resection and osteoarticular allograft reconstruction with an adult hemipelvis. At 15 years postoperatively, she remained disease-free with remarkable functionality. She had minimal groin pain and could walk an unlimited distance.

A Novel Complication of the Dall-Miles Cable Grip System Mimicking Recurrent Synovial Chondromatosis: A Case Report and Review of the Literature.

Case: A 25-year-old man with synovial chondromatosis of the hip was treated with a synovectomy through a transtrochanteric approach; the repair was made with use of a Dall-Miles cable. Approximately 13 years later, the patient returned with a massive bursal reaction and a cyst containing "rice bodies." Although the physical examination and imaging were suggestive of recurrent synovial chondromatosis, the bursal reaction actually represented a novel complication of the Dall-Miles system.

Epidemiologic Comparison of Pitching Mechanics, Pitch Type, and Pitch Counts Among Healthy Pitchers at Various Levels of Youth Competition.

Purpose: To determine differences among healthy pitchers at various levels of competition regarding pitching history, pitching mechanics, and prevalence of breaking pitches.

Methods: Demographic, anthropometric, pitching history, and kinematic data were collected on healthy youth pitchers using dual orthogonal high-speed video analysis. Players were grouped by maturity level (9 to 12 [prepubescent], 13 to 15 [pubescent], 16 to 17 [mature], and 18 to 22 years [adult]).

Blastomyces Tenosynovitis of the Foot and Ankle: A Case Report and Review of the Literature.

Deep fungal infection localized to the foot is not common, and when it occurs it often affects immunocompromised individuals. In this report, we describe the case of an adult diabetic patient who suffered with with Blastomycosis infection of the flexor digitorum longus and peroneal tendon sheaths. The condition was treated with systemic antifungal therapy and surgical debridement.

Arthroscopic technique for the treatment of pigmented villonodular synovitis of the hip.

Open synovectomy remains the treatment of choice for pigmented villonodular synovitis (PVNS) of the hip but has shown modest results compared with the treatment of other joints. Recent advances in hip arthroscopy permit a thorough evaluation of the joint surfaces, improved access, and decreased postoperative morbidity. We describe an arthroscopic synovectomy technique for PVNS of the hip.

Correlates With History of Injury in Youth and Adolescent Pitchers.

Purpose: To determine the factors within pitcher demographic characteristics, pitching history, and pitch kinematics, including velocity, that correlate with a history of pitching-related injury.

Methods: Demographic and kinematic data were collected on healthy youth and adolescent pitchers aged 9 to 22 years in preseason training during a single preseason using dual orthogonal high-speed video analysis. Pitchers who threw sidearm and those who had transitioned to another position were excluded.

Predictors of throwing velocity in youth and adolescent pitchers.

Background: Shoulder and elbow injuries are a common cause of pain, dysfunction, and inability to play in overhead throwers. Pitch velocity plays an integral part in the etiology of these injuries; however, the demographic and biomechanical correlates with throwing velocity remain poorly understood. We hypothesized that pitchers with higher velocity would have shared demographic and kinematic characteristics.

Operative treatment of femoroacetabular impingement.

Femoroacetabular impingement is a common pathologic disorder of the hip that causes pain and has been implicated in the development of early osteoarthritis in young adults. This disorder includes 2 different subtypes: cam impingement and pincer impingement. When nonsurgical treatment methods fail, surgical options are indicated.

Outcomes and complications of unicondylar arthroplasty.

Unicompartmental knee arthroplasty has experienced resurgence in popularity because of the lower morbidity of the procedure and the proposed benefits over total knee replacement in appropriately selected patients. Improved component designs and advanced surgical techniques have promoted excellent results. Expanded indications to include the very young and the elderly have yielded comparable clinical outcomes.

Operative treatment of FAI: open hip preservation surgery.

Femoroacetabular Impingement (FAI) is characterized by abnormal contact of the hip joint. Many etiologies cause this painful condition, which leads to early osteoarthritis. While hip arthroscopy has become the most prevalent way to surgically correct a hip, some presentations of FAI require open surgical hip preservation techniques to fully address the pathology at hand.

Biomechanical evaluation of bioabsorbable versus metallic screws for posterior cruciate ligament inlay graft fixation: a comparative study.

Background: Although a tibial inlay technique for posterior cruciate ligament reconstruction is advantageous, metallic screw fixation of the bone block is required. This may pose problems for future surgery (eg, osteotomies, total knee replacement).

Hypothesis: There is no significant difference in the biomechanical integrity of bone block fixation using stainless steel versus bioabsorbable screw fixation of the tibial inlay graft in posterior cruciate ligament reconstruction.