Microfragmented Adipose Tissue Is Equivalent to Platelet-Rich Plasma for Knee Osteoarthritis at 12 Months Posttreatment: A Randomized Controlled Trial.

Background: Platelet-rich plasma (PRP) is an effective treatment for knee osteoarthritis (OA). Microfragmented adipose tissue (MFAT) is another orthobiologic that holds promise, but data supporting its use are limited. Previous studies showed that MFAT created using the Lipogems device was equivalent to PRP created via noncommercial laboratory-based processes.

Subscapularis Repair Augmentation With Bioinductive Implant During Anatomic Total Shoulder Arthroplasty.

Subscapularis management and repair are crucial during total shoulder arthroplasty to maximize outcomes. Bioinductive implants have been used to aid in repair of tendons in a variety of surgical techniques. In this surgical technique, we demonstrate our technique of subscapularis repair augmentation with a bioinductive implant during anatomic total shoulder arthroplasty.

Platelet-Rich Plasma Versus Microfragmented Adipose Tissue for Knee Osteoarthritis: A Randomized Controlled Trial.

Background: Platelet-rich plasma (PRP) has been established as safe and effective for knee osteoarthritis (OA). Another orthobiologic therapy, microfragmented adipose tissue (MFAT), has gained attention because of its heterogeneous cell population (including mesenchymal stem cells). However, prospective comparative data on MFAT are lacking.

The Clinical Radiographic Incidence of Posttraumatic Osteoarthritis 10 Years After Anterior Cruciate Ligament Reconstruction: Data From the MOON Nested Cohort.

Background: The incidence of posttraumatic osteoarthritis (PTOA) based on clinical radiographic grading criteria at 10 years after anterior cruciate ligament (ACL) reconstruction (ACLR) has not been well-defined in a prospective cohort of young athletic patients.

Hypothesis: Among young athletic patients, there is a high incidence of clinical radiographic PTOA at 10 years after ACLR. Additionally, there is a significant difference in clinical radiographic osteoarthritis (OA) changes (joint space narrowing and osteophyte formation) between ACL-reconstructed and contralateral knees at 10 years.

Anterior and Rotational Knee Laxity Does Not Affect Patient-Reported Knee Function 2 Years After Anterior Cruciate Ligament Reconstruction.

Background: While a primary goal of anterior cruciate ligament (ACL) reconstruction is to reduce pathologically increased anterior and rotational knee laxity, the relationship between knee laxity after ACL reconstruction and patient-reported knee function remains unclear.

Hypothesis: There would be no significant correlation between the degree of residual anterior and rotational knee laxity and patient-reported outcomes (PROs) 2 years after primary ACL reconstruction.

Study Design: Cross-sectional study; Level of evidence, 3.

Ten-Year Outcomes and Risk Factors After Anterior Cruciate Ligament Reconstruction: A MOON Longitudinal Prospective Cohort Study.

Background: The long-term prognosis and risk factors for quality of life and disability after anterior cruciate ligament (ACL) reconstruction remain unknown. Hypothesis/Purpose: Our objective was to identify patient-reported outcomes and patient-specific risk factors from a large prospective cohort at a minimum 10-year follow-up after ACL reconstruction. We hypothesized that meniscus and articular cartilage injuries, revision ACL reconstruction, subsequent knee surgery, and certain demographic characteristics would be significant risk factors for inferior outcomes at 10 years.

Epidemiology of mental health conditions in incoming division I collegiate athletes.

Objectives: The purpose of this study is to examine the epidemiology of mental health conditions in incoming American Division I collegiate athletes.

Methods: Pre-participation physical questionnaires from 1118 incoming student athletes at a Division I Institution were collected retrospectively from 2011-2017. Data collected included lifetime history of any mental health condition, musculoskeletal injuries, concussions, and post-concussion depression.

Risk Factors and Predictors of Significant Chondral Surface Change From Primary to Revision Anterior Cruciate Ligament Reconstruction: A MOON and MARS Cohort Study.

Background: Articular cartilage health is an important issue following anterior cruciate ligament (ACL) injury and primary ACL reconstruction. Factors present at the time of primary ACL reconstruction may influence the subsequent progression of articular cartilage damage.

Hypothesis: Larger meniscus resection at primary ACL reconstruction, increased patient age, and increased body mass index (BMI) are associated with increased odds of worsened articular cartilage damage at the time of revision ACL reconstruction.

Lifetime prevalence of injuries in incoming division I collegiate football players.

Objectives: The purpose of this study is to determine the lifetime prevalence of past injuries in incoming first year football players in a Division 1 college football team.

Methods: Pre-participation questionnaires from 605 first-year football players over 20 years (1996-2015) were examined to determine the prevalence of concussions, stingers, fractures, and musculoskeletal surgeries sustained before playing at the collegiate level. Players were grouped by position: wide receiver and defensive back (WR/DB), offensive and defensive linemen (OL/DL), all other positions (OP), and unknown (UKN).

Change in Anterior Cruciate Ligament Graft Choice and Outcomes Over Time.

Purpose: To analyze failure rate in 2-year increments to determine if graft choice changed over time and graft failure rate.

Methods: A prospective 2002-2008 database was used to identify risk factors for anterior cruciate ligament (ACL) retear. Subjects who had primary ACL retear with no history of contralateral surgery and 2-year follow-up were included.

Anterior Cruciate Ligament Reconstruction Using a Combination of Autograft and Allograft Tendon: A MOON Cohort Study.

Background: Anterior cruciate ligament (ACL) reconstruction with hamstring autografts less than 8.5 mm in diameter is associated with worse patient-reported outcome scores and increased risk of revision surgery compared with reconstructions performed with larger grafts. One proposed solution to small autograft harvest is to create a hybrid graft by augmenting autografts with allograft tissue to increase graft diameter.

How much hamstring graft needs to be in the femoral tunnel? A MOON cohort study.

Background: Recent evidence that smaller hamstring graft diameter is associated with increased failure risk following anterior cruciate ligament (ACL) reconstruction has increased the popularity of graft configurations that increase graft diameter at the expense of graft length. A key question is how much graft needs to be in contact with the femoral tunnel to ensure that healing occurs. We hypothesize that no difference in two-year patient-reported outcomes or failure risk exists based on the amount of graft in the femoral tunnel.

Risk Factors and Predictors of Subsequent ACL Injury in Either Knee After ACL Reconstruction: Prospective Analysis of 2488 Primary ACL Reconstructions From the MOON Cohort.

Background: Anterior cruciate ligament (ACL) reinjury results in worse outcomes and increases the risk of posttraumatic osteoarthritis.

Purpose: To identify the risk factors for both ipsilateral and contralateral ACL tears after primary ACL reconstruction (ACLR).

Study Design: Cohort study; Level of evidence, 3.

The Impact of the Multicenter Orthopaedic Outcomes Network (MOON) Research on Anterior Cruciate Ligament Reconstruction and Orthopaedic Practice.

With an estimated 200,000 anterior cruciate ligament reconstructions performed annually in the United States, there is an emphasis on determining patient-specific information to help educate patients on expected clinically relevant outcomes. The Multicenter Orthopaedic Outcomes Network consortium was created in 2002 to enroll and longitudinally follow a large population cohort of anterior cruciate ligament reconstructions. The study group has enrolled >4,400 anterior cruciate ligament reconstructions from seven institutions to establish the large level I prospective anterior cruciate ligament reconstruction outcomes cohort.

Intra- and interobserver agreement in the classification and treatment of distal third clavicle fractures.

Background: In treatment of distal third clavicle fractures, the Neer classification system, based on the location of the fracture in relation to the coracoclavicular ligaments, has traditionally been used to determine fracture pattern stability.

Purpose: To determine the intra- and interobserver reliability in the classification of distal third clavicle fractures via standard plain radiographs and the intra- and interobserver agreement in the preferred treatment of these fractures.

Study Design: Cohort study (Diagnosis); Level of evidence, 3.

The hypermobile lateral meniscus: a retrospective review of presentation, imaging, treatment, and results.

Purpose: Hypermobility of the posterior portion of the lateral meniscus has been reported in several recent case reports and small case series. Pathophysiology and optimal treatment have not been fully elucidated. Our purpose was to evaluate results following arthroscopic stabilization.

Medical expenditures in division I collegiate athletics: an analysis by sport and gender.

Objective: Medical expenses for collegiate athletics include providing a training room with its supplies, equipment, personnel costs, and insurance coverage. Additional expenses beyond the training room include imaging, diagnostic testing, specialty consultations, and surgeries. We hypothesized that there would be no difference in average expenses or number of claims between male and female athletes over a 5-year period.

Intraobserver and interobserver agreement in the classification and treatment of midshaft clavicle fractures.

Background: With the recent emphasis on performing open reduction and internal fixation on midshaft clavicle fractures with complete displacement, comminution, and >2 cm of shortening, it is important to determine the reliability of orthopaedic surgeons to assess these variables on standard plain radiographs and to determine the agreement among orthopaedic surgeons in choosing the treatment.

Purpose: To determine the intra- and interobserver reliability in the classification of midshaft clavicle fractures via standard plain radiographs and to determine the intra- and interobserver agreement in the treatment of these fractures.

Study Design: Cohort study (diagnosis); Level of evidence, 3.

Transtibial ACL femoral tunnel preparation increases odds of repeat ipsilateral knee surgery.

Background: Recent efforts to improve the results of anterior cruciate ligament (ACL) reconstruction have focused on placing the femoral tunnel anatomically. Medial portal femoral tunnel techniques facilitate drilling of femoral tunnels that are more anatomic than those made with transtibial techniques. Few studies have compared the clinical outcomes of these two femoral tunnel techniques.

The influence of hamstring autograft size on patient-reported outcomes and risk of revision after anterior cruciate ligament reconstruction: a Multicenter Orthopaedic Outcomes Network (MOON) Cohort Study.

Purpose: The purpose of this study was to evaluate the effect of graft size on patient-reported outcomes and revision risk after anterior cruciate ligament (ACL) reconstruction.

Methods: A retrospective chart review of prospectively collected cohort data was performed, and 263 of 320 consecutive patients (82.2%) undergoing primary ACL reconstruction with hamstring autograft were evaluated.

Fear of reinjury (kinesiophobia) and persistent knee symptoms are common factors for lack of return to sport after anterior cruciate ligament reconstruction.

Purpose: Our purpose was to determine patient-cited reasons for lack of return to sport after anterior cruciate ligament reconstruction.

Methods: All patients who underwent primary or revision anterior cruciate ligament reconstruction by 2 surgeons from 2007 to 2008 (N = 171) were contacted for a telephone interview. Patients who did not return to preinjury levels by self-assessment were then asked to cite contributing factors from a predetermined list.

In vivo degradation characteristics of bioabsorbable cross-pins in anterior cruciate ligament reconstruction.

Background: We evaluated degradation of bioabsorbable femoral cross-pins following anterior cruciate ligament (ACL) reconstruction.

Methods: Four patients underwent ACL reconstruction using hamstring autograft with femoral fixation provided by a polylactic acid/polyglycolic acid copolymer (LactoSorb L15) cross-pin. Serial computed tomography (CT) scans were performed of the reconstructed knees at approximately 6 weeks, 4 months, 1 year and 2 years, postoperatively.

Time from ACL injury to reconstruction and the prevalence of additional intra-articular pathology: is patient age an important factor?

Purpose: Meniscus and cartilage lesions have been reported to be prevalent during delayed reconstruction of anterior cruciate ligament (ACL) injuries. Relatively, little work has been done exploring the influence of patient age on this relationship. The purpose of this study is to determine whether the effect of time from ACL injury to reconstruction on the prevalence of associated meniscal and chondral injury is influenced by patient age.

Platelet rich plasma use in allograft ACL reconstructions: two-year clinical results of a MOON cohort study.

Background: Platelet rich plasma has been promoted as a biologic agent to enhance tissue healing. As a concentration of autologous growth factors, it has gained increased use in musculoskeletal applications.

Methods: The purpose of this study was to evaluate the effect of intra-operative PRP on patient-reported outcomes 2 years after ACL reconstruction with tibialis anterior allograft.

Knowledge of and compliance with pitch count recommendations: a survey of youth baseball coaches.

Background: Pain and injuries suffered by youth pitchers are ongoing concerns that have been addressed through the institution of rules and recommendations regarding pitch counts and rest periods. The aim of our study was to see if coaches of youth baseball pitchers in our region were aware of the recommended guidelines and if they followed them.

Methods: An Internet-based survey consisting of 18 items including demographic information and questions concerning the USA Baseball Medical and Safety Advisory Committee pitching guidelines was sent to coaches affiliated with a local youth league to assess their knowledge of and reported compliance with these recommendations.