Objective quantification of trochlear dysplasia: Assessment of the difference in morphology between control and chronic patellofemoral instability patients.

Background: Trochlear dysplasia is an important risk factor associated with patellofemoral instability, but it remains difficult to classify with consistency. Currently there is no objective way to quantify the dysplasia. The purpose of this study is to define and quantify objectively the trochlear morphology by volume and length via computed tomography (CT).

Medial patellofemoral ligament reconstruction: indications and technique.

Lateral instability of the patella is a common problem that often requires reconstruction of the proximal soft tissue restraints. The medial patellofemoral ligament (MPFL) has been demonstrated to be the major soft tissue stabilizer to prevent abnormal lateral displacement of the patella. In this chapter we will discuss the anatomy, biomechanics, indications, and technique for surgical reconstruction of the medial patellofemoral ligament.

Arthroscopic versus open acromioplasty: a meta-analysis.

Background: To address persisting controversy in the literature concerning the efficacy of arthroscopic compared to open acromioplasty, a meta-analysis was performed to evaluate the treatment effect after both approaches.

Hypothesis: The final clinical outcomes will be the same after both open and arthroscopic acromioplasty. However, the arthroscopic technique results in faster recovery and less postoperative morbidity as reflected by faster return to work and decreased hospital stays.

Prospective comparison of auto and allograft hamstring tendon constructs for ACL reconstruction.

Unlabelled: Although allograft use for primary anterior cruciate ligament reconstruction has continued to increase during the last 10 years, concerns remain regarding the long-term function of allografts (primarily that they may stretch with time) and clinical efficacy compared with autograft tendons. We attempted to address these issues by prospectively comparing identical quadrupled hamstring autografts with allograft constructs for primary anterior cruciate ligament reconstruction in patients with a minimum followup of 3 years. Eighty-four patients (37 with autografts and 47 with allografts) were enrolled; the mean followup was 52 +/- 11 months for the autograft group and 48 +/- 8 months for the allograft group.

Posterior shoulder instability: comprehensive analysis of open and arthroscopic approaches.

Whether open surgery and arthroscopic repair of posterior shoulder instability have similar success rates remains unknown, but the literature suggests that arthroscopic soft-tissue stabilization procedures equal open surgery in managing posterior shoulder instability. A comprehensive PubMed computer search of the English-language literature from 1988 to 2004 was performed using the key phrase posterior shoulder instability. Studies included in our analysis addressed the surgical treatment of recurrent posterior instability and multidirectional instability with primarily a posterior component of instability; studies were excluded if their minimum follow-up was less than 1 year, if their patients had a history of habitual posterior shoulder instability, or if their patients had either bony procedures or thermal capsulorrhaphy.

How effective is a saline arthrogram for wounds around the knee?

Unlabelled: Traumatic arthrotomies may predispose patients to subsequent septic arthritis and therefore are regarded as serious injuries requiring emergent treatment. The saline arthrogram is a commonly used test to determine if a patient has a traumatic arthrotomy. We determined the sensitivity of the saline arthrogram to identify known intraarticular wounds in 78 patients (80 knees) undergoing elective arthroscopic procedures.

Arthroscopic distal clavicle resection in athletes: a prospective comparison of the direct and indirect approach.

Background: The clinical success of arthroscopic distal clavicle resection for athletes has been well documented. There are, however, no published studies that prospectively compare the recovery rates in athletes as well as the outcomes of the indirect versus direct approaches.

Hypothesis: Both procedures are equally successful; however, the direct approach affords faster return to sports.

Revision surgery for exertional anterior compartment syndrome of the lower leg: technique, findings, and results.

Background: Recurrent symptoms or failure after fasciotomy for exertional anterior compartment syndrome is not uncommon.

Hypothesis: Symptoms from high compartment pressures can be secondary to involvement of the entire compartment or to localized constrictions from postsurgical fibrosis, as well as to entrapment of the superficial peroneal nerve.

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

Meniscal repair using the FasT-Fix all-inside meniscal repair device.

Purpose: We performed a prospective study of meniscal repair using a new all-inside suture meniscal repair device to evaluate its clinical efficacy.

Type Of Study: Prospective case series.

Methods: The results of 42 meniscal tears in 37 patients who underwent meniscal repair using the FasT-Fix device (Smith & Nephew, Andover, MA) were prospectively evaluated.

Achilles tendon disorders in athletes.

Achilles tendon disorders are among the more common maladies seen by sports medicine physicians. Understanding the anatomy and biomechanics of the Achilles tendon and contiguous structures is essential to the diagnosis and treatment of Achilles tendon overuse injuries. Posterior heel pain is multifactorial and includes paratenonitis, tendinosis, tendinosis with partial rupture, insertional tendinitis, retrocalcaneal bursitis, and subcutaneous tendo-Achilles bursitis.

Two-year follow-up of meniscal repair using a bioabsorbable arrow.

Purpose: The value of meniscal repair is well established. Several all-inside arthroscopic techniques have become available to achieve this goal. One such technique involves the use of a biodegradable polylactic acid tack, which has made repair technically easier to perform.