Three-dimensional analysis of age and sex differences in femoral head asphericity in asymptomatic hips in the United States.

Background: The sphericity of the femoral head is a metric used to evaluate hip pathologies and is associated with the development of osteoarthritis and femoral-acetabular impingement.

Aim: To analyze the three-dimensional asphericity of the femoral head of asymptomatic pediatric hips. We hypothesized that femoral head asphericity will vary significantly between male and female pediatric hips and increase with age in both sexes.

Methods for Biomechanical Testing of Posterior Malleolar Fractures in Ankle Fractures: A Scoping Review.

Background: The treatment of posterior malleolar fractures (PMFs) is debated, including the need for surgery and method of fixation. Recent literature has suggested that fracture pattern, rather than fragment size, may be an important predictor for ankle biomechanics and functional outcome. Biomechanical studies have been conducted to provide evidence-based treatment on the effects of fracture and fixation on contact pressure and stability.

In situ repair of segmental loss posterior lateral meniscal root tears outperforms meniscofemoral ligament imbrication in the ACL reconstructed knee.

Purpose: The purpose of this study was to compare the biomechanical effect of in-situ repair of posterior lateral meniscal root (PLMR) tear with segmental meniscal loss, with and without meniscofemoral ligament (MFL) imbrication, on anterior cruciate ligament (ACL) graft force and knee joint kinematics.

Methods: Ten fresh-frozen cadaveric knee specimens underwent kinematic evaluation in five states: 1) Native, 2) ACLR, 3) Segmental PLMR loss, 4) In-situ PLMR repair, and 5) MFL augmentation. Kinematic evaluation consisted of five tests, each performed at full extension and at 30° of flexion: 1) Anterior drawer, 2) Internal Rotation, 3) External Rotation, 4) Varus, and 5) Valgus.

Outcomes and complications after open reduction and internal fixation of distal humeral fractures with precontoured locking plates.

Objectives: The aim of this study was to evaluate functional and radiographic results after open reduction and internal fixation of distal humeral fractures using precontoured locking plates. Our main hypothesis was that patients older than 65 years have inferior outcomes compared with younger patients.

Methods: All patients treated for a distal humeral fracture with precontoured locking plates between 2006 and 2017 at a level 1 trauma center were identified.

Qualitative and Quantitative Anatomy of the Humeral Attachment of the Pectoralis Major Muscle and Structures at Risk: A Cadaveric Study.

Background: Surgical pectoralis major (PM) repair can offer improved functional outcomes over nonoperative treatment. However, there is a lack of literature on consensus of the anatomical site of the humeral attachment.

Purpose: To provide qualitative and quantitative anatomic analysis of the PM by focusing on humeral insertion and relevant structures at risk.

Biomechanical Evaluation of 4 Suture Techniques for Hip Capsular Closure.

Background: The most reliable suture technique for capsular closure after a capsulotomy remains unknown.

Purpose: To determine which suture technique best restores native stability after a 5-cm interportal capsulotomy.

Study Design: Controlled laboratory study.

Neurovascular Anatomic Locations and Surgical Safe Zones When Approaching the Posterior Glenoid and Scapula: A Quantitative and Qualitative Cadaveric Anatomy Study.

Purpose: To characterize the qualitative anatomy of posterior scapula structures encountered with the Judet approach and to perform a quantitative evaluation of these structures' anatomic locations, including their relationships to osseus landmarks to identify safe zones.

Methods: Twelve fresh-frozen cadaveric shoulders (mean age, 55.2 years; range 41-64 years; 5 left, 7 right) were dissected.

Glenoid Bone Loss Directly Affects Hill-Sachs Morphology: An Advanced 3-Dimensional Analysis.

Background: While the glenoid track concept presents a useful prediction for recurrent glenohumeral instability, little is known about the humeral head bony architecture as it relates to glenoid erosion in the setting of bipolar bone loss.

Purpose: To (1) qualitatively and quantitatively analyze the interplay between glenoid bone loss (GBL) and Hill-Sachs lesions (HSLs) in a cohort of patients with anterior instability using 3-dimensional imaging software and (2) assess the relationships between GBL and HSL characteristics.

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

Anatomic safe zones for arthroscopic snapping scapula surgery: quantitative anatomy of the superomedial scapula and associated neurovascular structures and the effects of arm positioning on safety.

Background: Neurovascular anatomy has not been previously quantified for the arthroscopic snapping scapula approach with the patient in the most frequent patient position ("chicken-wing" position). The purposes of this study were (1) to determine anatomic relationships of the superomedial scapula and neurovascular structures at risk during arthroscopic surgical treatment of snapping scapula syndrome (SSS), (2) to compare these measurements between the arm in the neutral position and the arm in the chicken-wing position, and (3) to establish safe zones for arthroscopic treatment of SSS.

Methods: Eight fresh-frozen cadaveric hemi-torsos (mean age, 55.

Anterior Inferior Tibiofibular Ligament Suture Tape Augmentation for Isolated Syndesmotic Injuries.

Background: The best operative construct and technique for treatment of isolated syndesmotic injuries is highly debated. The purpose of this study was to determine whether the addition of anterior inferior tibiofibular ligament (AITFL) suture repair or suture tape (ST) augmentation provides any biomechanical advantage to the operative repair of an isolated syndesmotic injury.

Methods: Twelve lower leg specimens underwent biomechanical testing in 6 states: (1) intact, (2) AITFL suture repair, (3) AITFL suture repair + transsyndesmotic suture button (SB), (4) AITFL suture repair + ST augmentation + SB, (5) AITFL suture repair + ST augmentation, and (6) complete syndesmotic injury.

Biomechanical Analysis of Segmental Medial Meniscal Transplantation in a Human Cadaveric Model.

Background: Meniscal deficiency has been reported to increase contact pressures in the affected tibiofemoral joint, possibly leading to degenerative changes. Current surgical options include meniscal allograft transplantation and insertion of segmental meniscal scaffolds. Little is known about segmental meniscal allograft transplantation.

Biomechanical Evaluation of Achilles Tendon Midsubstance Repair: The Effects of Anchor Angle and Position.

Background: The percutaneous knotless repair technique for Achilles tendon ruptures utilizes a Percutaneous Achilles Repair System (PARS) device for suturing the proximal tendon and 2 suture anchors for fixing the sutures into the calcaneus. Determining the best position of the suture anchors may optimize the strength of this repair.

Methods: Twelve pairs of human ankle cadaveric specimens were randomly assigned to receive suture anchors placed at 45°, 90°, or 135° from the sagittal plane.

Pullout Strength of All-Suture and Metallic Anchors in Repair of Lateral Collateral Ligament Injuries of the Elbow.

Purpose: To compare the biomechanical properties of metallic anchor (MA) and all-suture anchor (ASA) constructs in the anatomic reattachment of the lateral ulnar collateral ligament complex to its humeral insertion.

Methods: Twenty paired male human cadaveric elbows with a mean age of 46.3 years (range: 33-58 years) were used in this study.

Advanced 3-Dimensional Characterization of Hill-Sachs Lesions in 100 Anterior Shoulder Instability Patients.

Purpose: We sought to qualitatively and quantitatively describe characteristics of Hill-Sachs lesions (HSL) in a cohort of anterior shoulder instability patients using advanced 3-dimensional (3-D) modeling software and assess the impact of various HSL parameters on the HSL volume, location, and orientation in patients with anterior shoulder instability.

Methods: A total of 100 recurrent anterior instability patients with evidence of HSL with a mean age of 27.2 years (range = 18 to 43 years) were evaluated.

Accessibility and Thickness of Medial and Lateral Talar Body Cartilage for Treatment of Ankle and Foot Osteochondral Lesions.

Background: The purposes of this study were to determine (1) if cartilage thicknesses on the talar dome and medial/lateral surfaces of the talus were similar, (2) whether there was sufficient donor cartilage surface area on the medial and lateral talar surfaces to repair talar dome cartilage injuries of the talus, and (3) whether the cartilage surface could be increased following anterior talofibular ligament (ATFL) and sectioning of the tibionavicular and tibiospring portion of the anterior deltoid.

Methods: Medial and lateral approaches were utilized in 8 cadaveric ankles to identify the accessible medial, lateral, and talar dome cartilage surfaces in 3 conditions: (1) intact, (2) ATFL release, and (3) superficial anterior deltoid ligament release. The talus was explanted, and the cartilage areas were digitized with a coordinate measuring machine.

The Effect of Torque Differences for All-Suture Anchor Fixation Strength: A Biomechanical Analysis.

Purpose: To investigate the biomechanical influence of differential loading of suture strands (torque) on the fixation strength of knotted and knotless all-suture anchors.

Methods: The biomechanical strength of 48 all-suture anchors was evaluated for 4 conditions in polyurethane foam blocks: (1) 12 knotted all-suture anchors loaded proportionately, (2) 12 knotted all-suture anchors with 1 suture strand bearing 50% of total force (partial torque), (3) 12 knotted all-suture anchors with 1 strand fixated and the other loaded (full torque), and (4) 12 knotless all-suture anchors with the loop kept open via a fixed rod. Force for 1 mm and 2 mm of displacement and ultimate failure load were assessed.

Quantitative and Qualitative Surgical Anatomy of the Acromioclavicular Joint Capsule and Ligament: A Cadaveric Study.

Background: The acromioclavicular (AC) capsule and ligament have been found to play a major role in maintaining horizontal stability. To reconstruct the AC capsule and ligament, precise knowledge of their anatomy is essential.

Purpose/hypothesis: The purposes of this study were (1) to determine the angle of the posterosuperior ligament in regard to the axis of the clavicle, (2) to determine the width of the attachment (footprint) of the AC capsule and ligament on the acromion and clavicle, (3) to determine the distance to the AC capsule from the cartilage border of the acromion and clavicle, and (4) to develop a clockface model of the insertion of the posterosuperior ligament on the acromion and clavicle.

Accuracy of MRI-Based Talar Cartilage Thickness Measurement and Talus Bone and Cartilage Modeling: Comparison with Ground-Truth Laser Scan Measurements.

Objective: The purpose of this work was to compare measurements of talar cartilage thickness and cartilage and bone surface geometry from clinically feasible magnetic resonance imaging (MRI) against high-accuracy laser scan models. Measurement of talar bone and cartilage geometry from MRI would provide useful information for evaluating cartilage changes, selecting osteochondral graft sources or creating patient-specific joint models.

Design: Three-dimensional (3D) bone and cartilage models of 7 cadaver tali were created using (1) manual segmentation of high-resolution volumetric sequence 3T MR images and (2) laser scans.