Patient- and Procedure-Specific Variables Driving Total Direct Costs of Outpatient Anterior Cruciate Ligament Reconstruction.

Background: Few studies have investigated the influence of patient-specific variables or procedure-specific factors on the overall cost of anterior cruciate ligament reconstruction (ACLR) in an ambulatory surgery setting.

Purpose: To determine patient- and procedure-specific factors influencing the overall direct cost of outpatient arthroscopic ACLR utilizing a unique value-driven outcomes (VDO) tool.

Study Design: Cohort study (economic and decision analysis); Level of evidence, 3.

Is the Lesser Trochanter Profile a Reliable Means of Restoring Anatomic Rotation After Femur Fracture Fixation?

Background: Restoring normal femoral rotation is an important consideration when managing femur fractures. Femoral malrotation after fixation is common and several preventive techniques have been described. Use of the lesser trochanter profile is a simple method to prevent malrotation, because the profile changes with femoral rotation, but the accuracy of this method is unclear.

The critical acromial point: the anatomic location of the lateral acromion in the critical shoulder angle.

Background: Acromioplasty has been proposed as a means of altering elevated critical shoulder angles (CSAs). We aimed to localize the critical acromion point (CAP) responsible for the acromial contribution of the CSA and determine whether resection of the CAP can alter the CSA to a normal range.

Methods: The CAP and 3-dimensional (3D) CSAs were determined on 3D computed tomography reconstructions of 88 cadaveric shoulders and compared with corresponding CSAs on digitally reconstructed radiographs.

Hip Arthroscopy Capsular Closure: The Figure of Eight Technique.

Hip arthroscopy techniques have continued to evolve for femoroacetabular impingement and other intra-articular pathologies. However, there is still debate about the importance and technique of routine capsular closure. We present an efficient and reliable technique for creating a watertight capsular closure to prevent iatrogenic macro and microinstability.

Height, weight, and age predict quadriceps tendon length and thickness in skeletally immature patients.

Background: Quadriceps tendon autografts have been used with success in adults and are becoming a popular graft option in pediatric patients because of size, decreased donor site morbidity, ease of harvest, and favorable biomechanical characteristics. However, little is known about the length and thickness of the quadriceps tendon in pediatric patients.

Purpose: This study aimed to determine whether quadriceps tendon length and thickness follow a predictable pattern of development based on height, weight, age, and body mass index in skeletally immature patients.

Anatomic, Transepiphyseal Anterior Cruciate Ligament Reconstruction.

Introduction: Our technique for physeal-sparing, anatomic anterior cruciate ligament (ACL) reconstruction reliably produces femoral tunnels that are of adequate length and that safely avoid the femoral physis without the addition of time-consuming surgical methods or substantial utilization of fluoroscopy.

Step 1 Preoperative Planning: Obtain radiographs and MRI of the knee as well as an anteroposterior radiograph of the hand (to obtain a bone age).

Step 2 Patient Setup Portal Placement And Graft Harvest: The affected knee must be able to flex at least 90° with the end of the operative table lowered, in order to properly visualize the anatomy of the ACL femoral footprint.

Anatomic landmarks utilized for physeal-sparing, anatomic anterior cruciate ligament reconstruction: an MRI-based study.

Background: Anterior cruciate ligament (ACL) injury and reconstruction in the skeletally immature patient are becoming more common. The purpose of this study was to develop a reproducible anatomic ACL reconstruction technique, based on intra-articular and extra-articular landmarks, that reliably produces a femoral tunnel of adequate length and diameter while avoiding the distal femoral physis.

Methods: Magnetic resonance images (MRIs) of one hundred and eighty-eight children (age range, six to seventeen years) were evaluated.