Editorial Commentary: Prevention and Treatment of Hip Adhesions Associated With Hip Arthroscopy Shows Positive Outcomes.

Adhesions are known to occur following arthroscopic as well as open surgery of multiple joints, including after hip arthroscopy, resulting in pain, stiffness, and dysfunction. Adhesions of the labrum to the overlying hip capsule can lead to eversion of the labrum and potentially compromise the suction seal, leading to microinstability and pain. Generally, patient-reported outcomes improve after surgical lysis of adhesions, with or without concurrent correction of labral, chondral, or bony pathology.

Editorial Commentary: Earlier Hip Arthroscopy May Result in Improved Outcomes for Femoroacetabular Impingement Syndrome in Symptomatic Athletes: No Time Like the Present Could Mean Better Luck Next Year.

Hip arthroscopy is an effective tool to address hip pain and dysfunction related to femoroacetabular impingement syndrome (FAIS), and an increasing volume of evidence suggests improved outcomes of these procedures if they are done closer to the onset of symptoms. Although this same relationship is observed in competitive athletes, these patients often have competing priorities when deciding if and when to proceed with surgical management of FAIS, including the desire to complete a competitive season, scouting and scholarship considerations, and financial incentives. Despite these incentives, consideration may be given to earlier surgical management, given the improved outcome potential and high rates of return to play.

Self-Reported Cannabis Use Is Not Associated With Increased Opioid Use or Costs After Hip Arthroscopy.

Purpose: Our purpose is to determine the difference in cost, opioid use, and complication rates following hip arthroscopy with or without perioperative cannabis use.

Methods: Data were collected from a large commercial insurance database (PearlDiver) between the years 2010 and 2019. Patients who underwent hip arthroscopy with reported cannabis use were identified using Common Procedural Terminology codes and the appropriate International Classification of Diseases codes.

Editorial Commentary: Lumbosacral Anatomy and Mechanics Influence Femoroacetabular Impingement Syndrome and Surgical Outcomes: The Hip Bone Is Connected to the Back Bone.

The hip joint in general and femoroacetabular impingement (FAI) in particular do not exist in a vacuum. Impingement kinematics are very closely tied to the relationship between spinopelvic motion and posture, and that of the hip joint itself. While the relationship of lumbar degenerative disease, fusion, and sagittal balance to hip arthroplasty has been well studied, there is a paucity of data on the analogous relationship of the stiff spine with hip arthroscopy and FAI.

Editorial Commentary: Third-Generation Autologous Chondrocyte Implantation-Are Cells Seeded Onto the Scaffold Itself in It for the Long Run?

Autologous chondrocyte implantation (ACI) is an increasingly performed procedure, with rapidly evolving technology. First-generation ACI used a periosteal patch, leading to the second generation, in which a type I-type III collagen membrane is used to cover the autologous chondrocytes, and ultimately the third generation, in which autologous chondrocytes are seeded onto the scaffold itself. As third-generation, scaffold-based ACI techniques are becoming more widely available, interest in the long-term clinical and radiographic outcomes continues to grow, especially given the high costs associated with these procedures.

Editorial Commentary: Predicting the Size of the Labrum: We Have the Technology, Should We Put it to Use?

The size of the labrum of the hip found at the time of arthroscopy can be predicted by measuring the labrum on preoperative magnetic resonance imaging/magnetic resonance arthrography, which may lead to consideration of using this measurement for preoperative planning. While normal labral anatomy is becoming better understood and our ability to preoperatively evaluate this improves, more evaluation is warranted to determine if, and at what point, labral width should influence treatment decisions, including labral repair techniques or the decision to reconstruct the labrum with allograft or autograft.

Complications of biceps tenodesis based on location, fixation, and indication: a review of 1526 shoulders.

Background: Long head of the biceps tendon (LHBT) tenodesis is predominantly performed for 2 reasons: anterior shoulder pain (ASP) or structural reasons (partial tear, dislocation).

Methods: Between 2006 and 2014, all cases of primary LHBT tenodesis performed at an integrated health care system were retrospectively reviewed. Complications were analyzed by tenodesis location (below or out of the groove [OOG] vs leaving tendon in the groove [ITG]), fixation method (soft tissue vs implant), and indication (preoperative ASP vs structural).

Quadratus lumborum block provides improved immediate postoperative analgesia and decreased opioid use compared with a multimodal pain regimen following hip arthroscopy.

The purpose of our study was to evaluate the effect on immediate patient outcomes following hip arthroscopy with use of a preoperative, single shot quadratus lumborum (QL) block. We retrospectively reviewed patients who underwent hip arthroscopy following a preoperative QL block. These patients were matched by age and gender to patients who had not received a block.

Return to Play After PRP and Rehabilitation of 3 Elite Ice Hockey Players With Ulnar Collateral Ligament Injuries of the Elbow.

Background: Ulnar collateral ligament (UCL) injury is a well-described etiology of pain and decreased performance for the overhead athlete. Despite a growing volume of literature regarding the treatment of these injuries for overhead athletes, there is a paucity of such data regarding stickhandling collision sport athletes, such as ice hockey players.

Purpose/hypothesis: The purpose of this study was to characterize this injury among 3 elite ice hockey players and to describe the ability of these athletes to return to play, as well as to review the unique sport-specific implications of this injury, evaluation, nonsurgical management, and considerations for return to play.

Arthroscopic Anterior Ankle Decompression Is Successful in National Football League Players.

Anterior ankle impingement is a frequent cause of pain and disability in athletes with impingement of soft-tissue or osseous structures along the anterior margin of the tibiotalar joint during dorsiflexion. In this study, we hypothesized that arthroscopic decompression of anterior ankle impingement would result in significant, reliable, and durable improvement in pain and range of motion (ROM), and would allow National Football League (NFL) players to return to their preoperative level of play. We reviewed 29 arthroscopic ankle débridements performed by a single surgeon.

Significant Chondrocyte Viability Is Present in Acetabular Chondral Flaps Associated With Femoroacetabular Impingement.

Background: Patients presenting with cam deformity of the femoral head and neck sustain repeated trauma to the articular cartilage of the superior acetabulum, with chondral delamination injuries found during hip arthroscopy. Two previous studies reveal conflicting chondrocyte viability data in these traumatic cartilage injuries. The full-thickness nature of flaps may suggest that chondrocytes residing in the cartilage flap matrix in the joint environment would remain viable despite shear trauma.

In Vivo Analysis of Biceps Tendon Characteristics in Subpectoral Tenodesis.

Purpose: To report the in vivo characteristics of the long head of the biceps tendon (LHBT); to evaluate the relation of age, gender, height, weight, and body mass index to the length and sutured and tubularized diameter of the LHBT; and to determine the smallest possible tunnel diameter for a subpectoral biceps tenodesis (SPBT) that can accommodate most patients.

Methods: The study included 66 patients (33 men and 33 women) with an average age of 54 years (range, 29-73 years) undergoing SPBT. After tenotomy, the length from the biceps musculotendinous junction to the released end was measured.

Postmeniscectomy Meniscus Growth With Stem Cells: Where Are We Now?

Arthroscopic meniscal repair and debridement are some of the most common procedures performed in the field of orthopedic surgery. Further, recent research has suggested poor long-term outcomes for patients with meniscectomies with increased incidence of osteoarthritis, leaving a need to develop technology to regenerate meniscal tissue following meniscectomy. Mesenchymal stem cells, are cells that can be harvested from multiple organs and retain the ability to differentiate into a variety of tissues, including osteoblasts, adipocytes, and chondroblasts.