Fostering Mentorship.

This article delves into the critical role of mentorship in the field of sports medicine, particularly for those embarking on a career in orthopedic surgery. It underscores mentorship as an essential element for professional development, offering insights into the dynamics of effective mentor-mentee relationships. This article highlights the mutual benefits of these relationships, where both parties gain valuable knowledge and experience.

All-Onlay Anterolateral Ligament Reconstruction Technique of the Knee.

The anterolateral ligament has gained attention as a secondary stabilizer of anterolateral rotatory stability of the knee. This has had implications among sports medicine specialists as an adjunct procedure with anterior cruciate ligament reconstruction to improve stability. As indications have evolved for its use as an anterior cruciate ligament reconstruction augment, so have the techniques for reconstruction.

Classification of Distal Clavicle Fractures and Indications for Conservative Treatment.

Management of distal clavicle fractures depends on a clear understanding of the injury's proximity to the ligamentous attachments joining the clavicle and scapula. Various classification systems have been proposed to guide treatment. Despite this, controversy between operative and nonoperative management remains for certain fracture patterns.

Stiffness and Instability After MPFL Reconstruction Using a Fluoroscopic Versus Open Technique to Localize the Femoral Attachment Site: A Systematic Review and Meta-analysis.

Background: Open and fluoroscopic techniques have been described for localization of the femoral attachment site in medial patellofemoral ligament (MPFL) reconstruction. No study to date has evaluated if one technique is superior to another in terms of complications.

Purpose: To review the literature comparing clinical outcomes of MPFL reconstruction using the fluoroscopic versus open technique to localize the site of femoral graft placement.

Approximately One Half of Patients Greater Than 40 Years Old Achieve Patient Acceptable Symptomatic State 6 Months After Arthroscopic Partial Meniscectomy.

Purpose: The purposes of this study were to 1) calculate the minimal clinically important difference (MCID) in a population of patients undergoing arthroscopic partial meniscectomy (APM) based on Knee Injury and Osteoarthritis Outcomes Scores (KOOS), 2) quantify the difference between the proportion of patients reaching MCID based on KOOS versus the proportion who considered surgery to be successful based on a "yes" answer to a patient acceptable symptom state (PASS) question, and 3) calculate the percentage of patients experiencing treatment failure (TF).

Methods: A large, single-institution clinical database was queried for patients undergoing isolated APM (>40 years of age). Data were collected at regular time intervals, including KOOS and PASS outcome measures.

Subacromial Bursal Tissue and Surrounding Matrix of Patients Undergoing Rotator Cuff Repair Contains Progenitor Cells.

Purpose: To build upon previous literature to identify a complete analysis of cellular contents of subacromial bursal tissue as well as the matrix surrounding the rotator cuff.

Methods: Samples of subacromial bursal tissue and surrounding matrix milieu from above the rotator cuff tendon and above the rotator cuff muscle bellies were obtained from 10 patients undergoing arthroscopic rotator cuff repair. Samples were analyzed using fluorescent-activated cell sorting and histologic analysis with staining protocols (Oil Red O, Alcian Blue, and Picro-Sirius Red), for identification of matrix components, including fat, proteoglycans, and collagen.

Relationship Between Patellar Morphology and Known Anatomic Risk Factors for Patellofemoral Instability.

Background: Patellar instability (PI) is a common problem among pediatric, adolescent, and young adult patients. Recent literature has shown a correlation between pathoanatomy and PI.

Purpose/hypothesis: The purpose of this study was to determine if there is any difference in patellar shape in patients with and without PI and if there is any association between the shape of the patella and the shape of the trochlea.

The Original Mini-Open Technique for Repair of Humeral Avulsion of the Glenohumeral Ligament.

Anterior shoulder dislocations commonly occur in the young, athletic population. The mechanism of dislocation occurs when the shoulder is placed in an abducted, externally rotated position while a forceful anterior moment is applied to the humerus. This position, combined with the force applied, results in an anterior and inferiorly directed dislocation of the humeral head away from the glenoid.

Use of a Superolateral Portal and 70° Arthroscope to Optimize Visualization of Patellofemoral Tracking and Osteochondral Lesions in Patients With Recurrent Patellar Instability.

Surgical treatment of patellofemoral instability and associated cartilaginous lesions can be technically challenging. Visualization of patellar tracking and underlying osteochondral lesions is paramount to operative success. To treat these conditions effectively, a comprehensive arthroscopic assessment of the patellofemoral joint as well as dynamic visualization of patella tracking must be achieved.

The interaction between human rotator cuff tendon and subacromial bursal tissue in co-culture.

Background: The role of subacromial bursa in rotator cuff pathology is unclear. Along with recognized inflammatory potential, current data demonstrate the presence of mesenchymal stem cells and potential regenerative properties of the bursa. The purpose of this study was to (1) approximate an in vitro co-culture model that represents interaction between torn rotator cuff tendon and subacromial bursa, (2) quantify the cellular activity of tendon and bursa and their interactions, (3) use this model to induce a state of inflammation present with rotator cuff pathology.

Telerounding Offers High Patient Satisfaction After Total Joint Arthroplasty.

Background: Research in surgical fields other than orthopedics has demonstrated high patient satisfaction with non-traditional telerounding modalities.

Questions/purposes: We sought to determine patient satisfaction and Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores of patients who experienced telerounding in the post-operative period after undergoing total joint arthroplasty (TJA).

Methods: Fifty consecutive TJA patients were prospectively enrolled to receive telerounding.

Analysis of Time to Form Colony Units for Connective Tissue Progenitor Cells (Stem Cells) Harvested From Concentrated Bone Marrow Aspirate and Subacromial Bursa Tissue in Patients Undergoing Rotator Cuff Repair.

Purpose: To evaluate the time required for colonies to develop from concentrated bone marrow aspirate (cBMA) and subacromial bursal tissue samples.

Methods: Samples of cBMA and subacromial bursa tissue were harvested from patients undergoing rotator cuff repair surgery between November 2014 and December 2019. Samples were analyzed for time to form colonies and number of colonies formed.

Open Anatomic Reconstruction of the Posterolateral Corner: The Arciero Technique.

The posterolateral corner (PLC) is an important stabilizer of the knee. This complex of ligaments and tendons functions as the primary restraint to varus and posterolateral rotation of the knee. Injury to the PLC can result in chronic instability, a varus-thrust gait, and early arthrosis of the medial compartment of the knee if left untreated.

Current Concepts Regarding Patellofemoral Trochlear Dysplasia.

Optimal treatment of patients with patellofemoral trochlear dysplasia and recurrent patellar instability requires in-depth understanding of this complex structural anomaly. An extensive review of the literature suggests that dysplasia occurs as a result of aberrant forces applied to the patellofemoral joint in the majority of cases. Evidence supports surgical stabilization that reconstructs the medial patellofemoral and/or medial quadriceps tendon-femoral ligament without added trochleoplasty in the majority of patients with trochlear dysplasia and recurrent patellar instability.

Demographics and Epidemiology of Discoid Menisci of the Knee: Analysis of a Large Regional Insurance Database.

Background: A discoid meniscus is a morphological variant of normal knee joint meniscus shape and ultrastructure that can lead to traumatic tearing of this tissue and early joint osteoarthritis.

Purpose/hypothesis: The purpose of this study was to determine the prevalence of discoid menisci in a large, ethnically diverse regional cohort and to evaluate possible risk factors. The hypothesis was that there would be no difference in the epidemiological distribution of discoid menisci based on ethnicity or sex.

Traumatic Patellar Dislocations in Childhood and Adolescents.

Patellar instability and associated patellar dislocation can result in significant pain, disability, and associated injuries in young athletes. The patellofemoral joint is a complex articulation with stabilizing restraints, both medially and laterally, that help guide the patella into the corresponding trochlear groove as the knee cycles through an extension-to-flexion arc. In addition to soft tissue injuries, many osseous aberrancies can contribute to patellar instability in young athletes, including trochlear dysplasia, patella alta, and axial and coronal plane abnormalities.

Is there value in the routine practice of discarding the incision scalpel from the surgical field to prevent deep wound contamination with Cutibacterium acnes?

Background: Cutibacterium acnes is found in skin flora of the shoulder and is the most common microbe identified in periprosthetic shoulder infections. The purpose of this study is to determine if there is C acnes present on the incision scalpel in patients undergoing shoulder arthroplasty despite extensive skin preparation techniques to prevent wound contamination.

Methods: The authors collected a consecutive case series of patients meeting inclusion criteria.

When to Abandon the Arthroscopic Bankart Repair: A Systematic Review.

Context: Bone loss is a major factor in determining surgical choice in patients with anterior glenohumeral instability. Although bone loss has been described, there is no consensus on glenoid, humeral head, and bipolar bone loss limits for which arthroscopic-only management with Bankart repair can be performed.

Objective: To provide guidelines for selecting a more complex repair or reconstruction (in lieu of arthroscopic-only Bankart repair) in the setting of glenohumeral instability based on available literature.

Osteotomies for the Management of Medial Compartment Defects of the Knee.

For nearly three-quarters of a century the proximal tibia osteotomy has been used as an effective treatment for cartilage injuries of the knee. Over this same timeframe several advancements have been made in our diagnostic, preoperative planning, and technical execution of this procedure. As such, good-to-excellent short-, mid-, and long-term outcomes have been reported.

Medial Patellofemoral Ligament Reconstruction and Lateral Retinacular Lengthening in the Skeletally Immature Patient.

Patellar instability remains a ubiquitous and troublesome problem in orthopaedics and represents a challenge in the pediatric population. Reconstruction of the medial patellofemoral ligament (MPFL) has become a mainstay of patellar instability management in recent years. As with any procedure at or around the physes, there is concern among surgeons regarding safe placement of hardware and drilled tunnels.

Patient Preferences for Plain Radiographs in the Setting of Atraumatic Shoulder Pain: Which Factors Influence Their Decision?

Introduction: Plain radiographs of the shoulder are routinely obtained for patients presenting with atraumatic shoulder pain, although the diagnostic utility of this imaging modality is unclear. Despite this, patients often prefer to obtain radiographs and may associate them with a more satisfactory visit.

Methods: New patients presenting with atraumatic shoulder pain were provided with information regarding the potential advantages and disadvantages of plain radiographs as part of their visit.

Reducing Lateral Femoral Cutaneous Nerve Palsy in Obese Patients in the Beach Chair Position: Effect of a Standardized Positioning and Padding Protocol.

Introduction: To report on the effectiveness of a standardized patient positioning and padding protocol in reducing lateral femoral cutaneous nerve (LFCN) palsy in obese patients who have undergone shoulder surgery in the beach chair position.

Methods: We retrospectively reviewed the medical records of 400 consecutive patients with a body mass index (BMI) of ≥30 kg/m who underwent either open or arthroscopic shoulder surgery in the beach chair position by a single surgeon. Before June 2013, all patients were placed in standard beach chair positioning with no extra padding.

Routine Plain Radiographs in the Setting of Atraumatic Shoulder Pain: Are They Useful?

Introduction: Plain radiographs of the shoulder are routinely obtained for patients presenting with atraumatic shoulder pain. The diagnostic utility of these radiographs is debatable.

Methods: Patients presenting for the first time to a shoulder clinic with atraumatic shoulder pain received a plain radiographic series.