The arthroscopic treatment of anterior shoulder instability with glenoid bone loss shows similar clinical results after Latarjet procedure and iliac crest autograft transfer.

Purpose: Recurrent anterior shoulder instability caused by critical bone loss of the glenoid is a challenging condition for shoulder surgeons. The purpose of this prospective multicenter trial was to compare the arthroscopic transfer of the coracoid process (Latarjet procedure) with the arthroscopic reconstruction of the glenoid using iliac crest autografts.

Methods: A prospective multi-center trial was performed in nine orthopaedic centres in Austria, Germany and Switzerland between July 2015 and August 2021.

[MCL tear with intra-articular dislocation].

A 48-year-old male patient presented with inner skin retraction after a sports accident involving the knee. In a multi-ligament injury it must be assumed that knee dislocation has occurred. Inner skin retraction after knee distortion can result from an intra-articular dislocation of the ruptured medial collateral ligament.

Sonographic Measurement of Dynamic Horizontal Instability in Acromioclavicular Joint Instability: Description of a Simple Technique and Correlation to Radiographic Parameters.

Objective: Dynamic horizontal instability is considered to be the main reason for poor outcome after treatment for acromioclavicular (AC) joint instability. In this study, we describe a simple technique to quantify this pathology via sonography.

Methods: Thirty-six shoulders from 18 patients with ac joint instabilities were examined using modified Alexander views and a standardized sonographic examination.

The lack of retropatellar resurfacing at index surgery is significantly associated with failure in patients following patellofemoral inlay arthroplasty: a multi-center study of more than 260 patients.

Purpose: To evaluate the clinical outcomes of patients with a minimum 2-year follow-up following contemporary patellofemoral inlay arthroplasty (PFIA) and to identify potential risk factors for failure in a multi-center study.

Methods: All patients who underwent implantation of PFIA between 09/2009 and 11/2016 at 11 specialized orthopedic referral centers were enrolled in the study and were evaluated retrospectively at a minimum 2-year follow-up. Clinical outcomes included the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score, the Knee Injury and Osteoarthritis Outcome Score (KOOS), the Tegner Scale, the visual analogue scale (VAS) for pain, and subjective patient satisfaction.

Elective shoulder surgery during the coronavirus disease 2019 pandemic in Germany: the patients' perspective.

Background: The coronavirus disease 2019 (COVID-19) pandemic has impeded the treatment of elective shoulder patients all over the world. Owing to the constraints in personnel and operation theater capacities, many patients who should undergo planned surgeries could not receive medical care. In our study, we examined the status quo of elective shoulder arthroscopy during the pandemic in Germany.

Planning Results for High Tibial Osteotomies in Degenerative Varus Osteoarthritis Using Standing and Supine Whole Leg Radiographs.

Objective: In this study, we hypothesized that standing and supine X-rays lead to different preoperative planning results.

Methods: The present study included 168 pictures from 81 patients who were treated surgically with high tibial osteotomy (HTO) for varus deformity between January 2017 and February 2018. Each patient underwent whole leg X-ray examinations in both standing and supine position.

Effects of focal metallic implants on opposing cartilage - an in-vitro study with an abrasion test machine.

Background: For focal cartilage defects, biological repair might be ineffective in patients over 45 years. A focal metallic implant (FMI) (Hemi-CAP Arthrosurface Inc., Franklin, MA, USA) was designed to reduce symptoms.

Pullout strength and failure mode of industrially manufactured and self-made all-suture anchors: a biomechanical analysis.

Background: This study presents a new technique for assembling an all-suture anchor from existing medical products. The biomechanical characteristics of this self-made anchor (SMA) are compared with those of an industrially manufactured all-suture anchor.

Methods: The SMAs were made from established medical products (FiberWire #2 and 2-mm FiberTape; Arthrex, Naples, FL, USA).

All-arthroscopic glenoid reconstruction by iliac crest bone graft transfer does not affect structural integrity and 3-dimensional volume of the subscapularis muscle.

Aim: The subscapularis muscle is an important active stabilizer of the glenohumeral joint. For this radiological study, we investigated if its radiological integrity is affected after arthroscopic glenoid reconstruction. In the technique used, an autologous iliac crest graft is transported through the rotator interval, and the graft is fixed via an antero-inferior portal with compression screws.

The Diagnosis and Treatment of Acute Dislocation of the Acromioclavicular Joint.

Background: The acromioclavicular joint (ACJ) is one of the more common sites of shoulder girdle injury, accounting for 4-12% of all such injuries, with an incidence of 3-4 cases per 100 000 persons per year in the general population. Current topics of debate include the proper standard diagnostic evaluation, the indications for surgery, and the best operative method.

Methods: This review is based on publications retrieved by a selective literature search.

Influence of Sutures on Cartilage Integrity: Do Meniscus Sutures Harm Cartilage? An Experimental Animal Study.

Purpose: To evaluate whether different suture materials in meniscal repair may harm cartilage.

Methods: A preloaded linear friction testing setup including porcine knees with porcine cartilage, porcine meniscus, and different suture materials (braided nonabsorbable, absorbable monofilament) was used. Five groups with different tribological pairs were tested: cartilage on meniscus (control), cartilage on cartilage (control No.

Anatomic considerations for arthroscopic glenoid reconstruction using iliac crest grafts: a radiologic study.

Background: Arthroscopic glenoid reconstruction using autografts is an advanced procedure that requires experience and preparation. Knowledge about anatomic pitfalls is therefore important to establish well-positioned portals and prevent neurovascular damage.

Methods: We included 43 computed tomography scans from 43 patients.

Mid-term clinical results of an arthroscopic glenoid rim reconstruction technique for recurrent anterior shoulder instability.

Introduction: Glenoid bone loss in recurrent anterior instability of the shoulder needs to be addressed to restore joint stability. Over the last years, several arthroscopic methods have been described to treat this condition. However, no clinical mid-term results have been presented for arthroscopic iliac crest bone grafting procedures.

Bone grafts used for arthroscopic glenoid reconstruction restore the native glenoid anatomy.

Purpose: Recurrent anterior instability of the glenohumeral joint is a demanding condition, especially in cases of glenoid bone loss. Various treatment options have been described, such as arthroscopic grafting techniques and the Latarjet procedure. In this study, the degree to which an arthroscopically applied iliac crest graft restores the glenoid anatomy was evalutated.

Surgical treatment of patellar instability: clinical and radiological outcome after medial patellofemoral ligament reconstruction and tibial tuberosity medialisation.

Introduction: The aim of this retrospective study was to analyse clinical and radiological outcome after medial patellofemoral ligament reconstruction (MPFLR) and tibial tuberosity medialisation (TTM) in patients with recurrent patellar instability.

Materials And Methods: Thirty-five patients were included between 2008 and 2012. According to defined criteria such as tibial tuberosity-trochlear groove (TTTG) distance, hyperpression on the lateral patella facet and lateral retropatellar cartilage damage either MPFLR (group A) or TTM (group B) was performed: 18 patients underwent TTM, the other 17 patients underwent MPFLR.

Mapping of glenoid bone loss in recurrent anterior shoulder instability: is there a particular deficit pattern?

Background: Glenoid bone loss in recurrent anterior shoulder instability is a challenging problem for shoulder surgeons, and knowledge about the anatomy of glenoid deficits is scarce. In this study, we tried to evaluate the pattern of this pathology.

Methods: Our analysis included 44 shoulders from 44 patients with recurrent anterior shoulder instability accompanied by a clinically relevant glenoid bone loss.

Additional calcar support using a blade device reduces secondary varus displacement following reconstruction of the proximal humerus: a prospective study.

Background: Locking plate fixation of displaced fractures of the proximal humerus is still accompanied by a distinct complication rate, especially in case of osteoporotic bone, short-segment fracture length and comminution of the medial calcar. Secondary loss of reduction leading to varus deformity and screw cutout most frequently lead to surgical revision. The aim of the present study was to evaluate the clinical and radiological outcome of a recently developed polyaxial locking plate that allows for the additional placement of a helical blade device, aiming for support of the medial calcar.

Arthroscopic Removal of a Polyethylene Glenoid Component in Total Shoulder Arthroplasty.

We present a technique for arthroscopic glenoid removal in a case of glenoid loosening after total shoulder arthroplasty (TSA). The presented technique is technically feasible and may be useful if 1-stage surgery with glenoid reimplantation is not indicated. To exclude low-grade infection, the presented technique allows for an intraoperative infection workup such as intraoperative cultures.

Value of additional acromioclavicular cerclage for horizontal stability in complete acromioclavicular separation: a biomechanical study.

Purpose: To evaluate whether isolated anatomical coracoclavicular (CC) ligament reconstruction with two suture-button devices provides equal horizontal acromioclavicular joint (ACJ) stability compared to additional ACJ suture tape cerclage.

Methods: A servohydraulic testing machine was used to assess horizontal ACJ translation in 12 fresh-frozen human shoulders during 5,000 cycles of dynamic anteroposterior directed loading (70 N). Horizontal ACJ stability was assessed for native specimen (n = 6) and compared to specimen with dissected AC ligaments but intact CC ligaments (n = 6).

Evidence of an autoregulatory mechanism of regional bone blood flow at hypotension.

Background: Blood flow in various organs is determined by an autoregulatory mechanism that guarantees constant organ perfusion over a wide range of arterial blood pressure changes. This physiological principle has been proven for the kidney, brain and intestinal tract, but so far not for bone. This study was carried out to determine whether there is an autoregulatory mechanism of bone or not.

Local cooling reduces regional bone blood flow.

Local cooling is very common after bone and joint surgery. Therefore the knowledge of bone blood flow during local cooling is of substantial interest. Previous studies revealed that hypothermia leads to vasoconstriction followed by decreased blood flow levels.

Arthroscopically assisted 2-bundle anatomic reduction of acute acromioclavicular joint separations: 58-month findings.

Background: Currently, no clinical midterm results have been reported on arthroscopically assisted reduction of the acutely dislocated acromioclavicular (AC) joint using suture-button devices for fixation.

Hypothesis: Athroscopically assisted reduction of the acutely dislocated AC joint yields satisfactory clinical outcomes without loss of reduction, clavicle migration, or AC joint degeneration at midterm follow-up evaluation.

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

Practice in rehabilitation after cartilage therapy: an expert survey.

Background: Current cartilage therapy modalities like microfracture, ACT/MACT, AMIC or osteochondral transplantation are important tools to treat symptomatic (osteo)chondral lesions of the knee joint. However, until now there exists no high-level evidence based accepted rehabilitation plan for the postoperative treatment.

Hypothesis/purpose: This survey describes the predominantly used rehabilitation plan as implemented by expert musculoskeletal surgeons for operatively treated (osteo)chondral lesions.

Arthroscopically assisted 2-bundle anatomical reduction of acute acromioclavicular joint separations.

Background: To achieve reduction of an acute acromioclavicular (AC) joint separation, novel procedures aim to provide stability and function by restoring the coracoclavicular anatomy.

Hypothesis: Anatomical reconstruction for acute AC joint disruption using 2 flip-button devices results in satisfactory clinical function and provides a stable fixation.

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