Lateral Opening Distal Femoral Osteotomy with Concomitant MPFL Reconstruction is Efficacious in Addressing Patellar Instability.

Purpose: To describe the clinical and radiographic outcomes of patients undergoing a lateral opening distal femur osteotomy (DFO) to address valgus alignment and restore patellar stability.

Methods: A retrospective review of patients who underwent lateral opening DFO for recurrent patellar instability in the setting of valgus leg alignment at a single academic institution between January 2016 to December 2021 was performed. Patients without a minimum 24-month postoperative follow-up were excluded.

Tibial Tubercle Osteotomies Performed in an Outpatient Setting Have a Low Rate of Early Complications.

Purpose: To characterize the early postoperative complications following outpatient tibial tubercle osteotomy (TTO) to determine its safety in this setting.

Methods: Patients undergoing TTO by a single surgeon between July 2017 and August 2022 for patellar instability or patellofemoral chondromalacia and achieving a minimum of 3 months of clinical and radiographic follow-up were evaluated for inclusion. Although an inclusion criterion was a minimum follow-up of 3 months, if evidence of a healed osteotomy was observed sooner, final follow-up was accepted at 2 months.

Distal femoral osteotomies improves recurrent patellar instability in patients with genu valgum: A systematic review.

Importance: Coronal plane malalignment can contribute to recurrent patellar instability, a common knee pathology, particularly in adolescents that can negatively impact knee function and stability.

Objective: To systematically review the literature in order to summarize the clinical and radiologic outcomes of the surgical treatment of recurrent lateral patellar instability in patients with genu valgum using varus-producing distal femoral osteotomies (DFOs).

Evidence Review: A systematic review was conducted using PubMed, Cochrane Library, and OVID Medline databases from 1990 to present.

Thick-shell sulcus-deepening trochleoplasty for recurrent patellar dislocation leads to clinically meaningful improvements and high patient satisfaction in adolescents with open physes.

Objectives: To evaluate clinical and radiological outcomes of thick-shell, sulcus-deepening trochleoplasty in patients with open distal femoral physes and less than two years of growth remaining. We hypothesized that patients would have clinical and radiographic improvements in addition to high patient-reported outcomes following thick-shell, sulcus-deepening trochleoplasty.

Methods: Bone age was determined on preoperative magnetic resonance imaging (MRI) using the Pennock Knee Bone Age Atlas.

Osteochondral Allograft Transplantation to the Capitellum: Technical Considerations of a Mega Osteochondritis Dissecans Technique.

Osteochondritis dissecans of the elbow is a rare but debilitating pathology typically found in the adolescent repetitive overhead athlete. In the setting of unstable lesions, mechanical symptoms, or deteriorating function despite appropriate conservative management, surgical osteochondral allograft transplantation of the capitellum is a viable option for even large lesions (>10 mm), with minimal morbidity and good return of function. We describe a technique for performing a large osteochondral allograft transplantation of the capitellum.

The effect of factors from different time points on psychological readiness following ACL reconstruction.

Objective: The purpose of this study was to examine factors correlated with psychological readiness to return to activity after ACLR.

Design: cross sectional study.

Setting: controlled laboratory.

Evaluation of Differences in Patellar Height After Patellar Stabilization Procedures Not Intended to Address Patella Alta: A Multicenter Study.

Background: Recent studies have reported conflicting results as to whether isolated medial patellofemoral ligament reconstruction (MPFLr) leads to decreased patellar height.

Purpose: To investigate if patellar stabilization surgery not intended to address patella alta influences patellar height.

Study Design: Cohort study; Level of evidence, 3.

Trends for Diversity in Orthopedic Sports Medicine.

Despite the increasingly diverse population of the United States, orthopedic surgery continues to lag other medical specialties in terms of diversity. It remains the specialty with the lowest percentage of women, and White physicians dominate the field, especially in leadership positions. Although the trends are slowly moving in the right direction, additional efforts must be taken to further diversify the field.

Influence of Graft Type and Meniscal Involvement on Short-Term Outcomes Following Anterior Cruciate Ligament Reconstruction.

Context: The purpose of this study was to compare short-term clinical outcomes between meniscus procedures performed with anterior cruciate ligament reconstruction (ACLR), ACLR (ACLR-only), ACLR with meniscectomy/resection (ACLR-resect), and ACLR with meniscal repair (ACLR-repair) for bone patellar tendon bone grafts (BPTB) and hamstring tendon grafts, separately.

Design: This was a cross-sectional study conducted in a controlled laboratory setting as part of a large point-of-care collaborative research program.

Methods: This study included 314 participants (168 females; mean [SD]: age, 19.

Atraumatic Calcific Tendinitis in Medial Collateral Ligament: A Case Report.

Introduction: Calcific tendinitis is a commonly treated in the shoulder and wrist, but it is rarely seen in the medial collateral ligament (MCL). There is not satisfactory orthopedic literature for diagnosis and treatment of this condition.

Case Report: A healthy 50-year-old woman presented with medial sided right knee pain.

No Deficits in Functional Outcomes of the Contralateral Limb Are Seen When the Hamstring Is Harvested for Augmentation of Small Diameter Ipsilateral Hamstring Autograft.

Purpose: To evaluate clinical outcomes of the contralateral, nonoperative limb in patients undergoing contralateral hamstring (HS) autograft harvest compared with patients undergoing ipsilateral HS autograft harvest alone.

Methods: This study included 96 patients who underwent isolated anterior cruciate ligament reconstruction (ACLR) using 4-stranded HS autograft (n = 85) or 4-stranded HS autograft augmented with contralateral HS (n = 13) due to inclusion of ipsilateral graft diameter <8 mm. Isokinetic flexion and extension strength and dynamic performance of the ipsilateral and contralateral limbs and limb symmetry index (LSI) were evaluated at 6 months' postoperatively.

Knee extensor torque-velocity relationships following anterior cruciate ligament reconstruction.

Background: The inherent nature of the torque-velocity relationship is the inverse nature between the velocity of muscle contraction and torque production and is an indication of muscle function. The purpose of this study was to characterize the torque-velocity relationship in the quadriceps following anterior cruciate ligament reconstruction compared to healthy limbs.

Methods: 681 participants were included, 493 of which were patients at least four months following anterior cruciate ligament reconstruction (23.

Hip Strength Recovery After Anterior Cruciate Ligament Reconstruction.

Background: Return-to-play (RTP) assessment after anterior cruciate ligament reconstruction (ACLR) rarely includes hip strength.

Hypothesis: It was hypothesized that (1) patients after ACLR will have weaker hip abduction (AB) and adduction (AD) strength compared with the contralateral limb, with larger deficits in women, (2) there will be a correlation between hip and thigh strength ratios and patient-reported outcomes (PROs), and (3) hip AB and AD strength will improve over time.

Study Design: Descriptive laboratory study.

The "N+10 Rule" to Avoid Graft-Tunnel Mismatch in Bone-Patellar Tendon-Bone ACL Reconstruction Using Independent Femoral Tunnel Drilling.

Background: Graft-tunnel mismatch (GTM) is a common problem in anterior cruciate ligament (ACL) reconstruction (ACLR) using bone-patellar tendon-bone (BPTB) grafts.

Hypothesis: Application of the "N+10 rule" in endoscopic ACLR with BPTB grafts will result in acceptable tibial tunnel length (TTL), minimizing GTM.

Study Design: Controlled laboratory study.

Comparison of Patient-Reported Outcomes, Strength, and Functional Performance in Primary Versus Revision Anterior Cruciate Ligament Reconstruction.

Background: Clinical outcomes after revision anterior cruciate ligament reconstruction (ACLR) are not well understood.

Hypothesis: Patients undergoing revision ACLR would demonstrate worse patient-reported outcomes and worse limb symmetry compared with a cohort undergoing primary ACLR.

Study Design: Cohort study; Level of evidence, 3.

Influence of interim functional assessments on patient outcomes at the time of return to activity following ACL-reconstruction.

Objective: To compare patient outcomes at the time of the return to activity (RTA) progression between those with a prior interim assessment and those without.

Design: Retrospective, Cohort Study.

Setting: Controlled Laboratory.

An implantable shock absorber yields an 85% survival-from-arthroplasty rate through 5 years in working-age patients with medial compartment knee osteoarthritis.

Purpose: To evaluate the 5-year rate of survival without undergoing arthroplasty or high tibial osteotomy (HTO) in subjects with mild-to-moderate medial compartment knee osteoarthritis (OA) who were treated with an implantable shock absorber (ISA) system.

Methods: Three prospective, sequential, multicenter, international, single-arm clinical trials were conducted comprising subjects who received an ISA for symptomatic medial knee OA after failing ≥ 6 months of conservative therapy. Study outcomes were analyzed cumulatively and by enrollment group when all subjects' follow-up data exceeded the 2-year threshold after ISA implantation.

Implantable Shock Absorber Provides Superior Pain Relief and Functional Improvement Compared With High Tibial Osteotomy in Patients with Mild-to-Moderate Medial Knee Osteoarthritis: A 2-Year Report.

Objective: Up to 10 million Americans below the age of 65 years have symptomatic knee osteoarthritis (OA) and may not yet be candidates for arthroplasty. In response, a subcutaneous implantable shock absorber (ISA) that unloads the knee has been developed. The safety and effectiveness of ISA treatment were compared against a surgical unloading control, high tibial osteotomy (HTO).

An analysis of the incidence, risk factors, and timing of development of cyclops lesions after anterior cruciate ligament reconstruction.

Background: Cyclops lesions are a known complication following anterior cruciate ligament reconstruction (ACLR) with a described incidence between 1.9% to 10.9%.

Disagreement in Pass Rates Between Strength and Performance Tests in Patients Recovering From Anterior Cruciate Ligament Reconstruction.

Background: Performance on strength and functional tests is often used to guide postoperative rehabilitation progress and return to activity decisions after anterior cruciate ligament reconstruction (ACLR). Clinicians may have difficulty in determining which criteria to follow if there is disagreement in performance outcomes among the tests.

Purpose/hypothesis: The purpose of this study was to compare pass rates between strength tests and single-leg hop (SLHOP) tests among men and women and between patients with lower and higher preinjury activity levels recovering from ACLR.

Predicting Anterior Cruciate Ligament Reinjury From Return-to-Activity Assessments at 6 Months Postsurgery: A Prospective Cohort Study.

Context: Return-to-activity (RTA) assessments are commonly administered after anterior cruciate ligament reconstruction (ACLR) to manage the patient's postoperative progressions back to activity. To date, few data are available on the clinical utility of these assessments to predict patient outcomes such as secondary anterior cruciate ligament (ACL) injury once the athlete has returned to activity.

Objective: To identify the measures of patient function at 6 months post-ACLR that best predict RTA and second ACL injury at a minimum of 2 years after ACLR.

Reinjury Rates in Adolescent Patients 2 Years Following ACL Reconstruction.

Background: Sports injuries have increased dramatically in the pediatric and adolescent population. Return-to-sport testing and criteria are increasingly utilized, however, the guidelines for return to play in adolescents are unclear. The purpose of this study was to compare strength and function at the time of the return-to-sport progression to those with and without a failed anterior cruciate ligament reconstruction (ACLR).

Medial Patellofemoral Ligament Reconstruction: Tips and Tricks to Get It Right.

Medial patellofemoral ligament reconstruction is used increasingly to treat patellar instability. A number of different techniques have been described to perform this procedure. In this article, we review common pearls and pitfalls to medial patellofemoral ligament reconstruction, as well as tips for troubleshooting the procedure.