Editorial Commentary: A Revisit of an Old Clinical Dilemma-To Operate or Not to Operate on Acute Knee Anterior Cruciate Ligament Injuries.

There is a feeling among knee surgeons that operating on an acute anterior cruciate ligament injury will increase the incidence of arthrofibrosis. A recent systematic review and meta-analysis of 7 recent articles compared early versus delayed anterior cruciate ligament reconstruction. The conclusions were that the clinical and stability results were comparable in both groups.

Initial evaluation of posterior cruciate ligament injuries: history, physical examination, imaging studies, surgical and nonsurgical indications.

Compared with anterior cruciate ligament injuries, posterior cruciate ligament injuries are a rare event. The mechanisms are predictable and a thorough physical examination is mandatory to rule out or define combined injury patterns. Stress radiography and magnetic resonance imaging studies are very helpful adjuncts.

The use of platelet-rich plasma in arthroscopy and sports medicine: optimizing the healing environment.

Platelet-rich plasma (PRP) is a new technology focused on enhancing the healing response after injury of different tissue types. PRP is prepared by withdrawal of patients' peripheral blood and centrifugation to obtain a highly concentrated sample of platelets, which undergo degranulation to release growth factors with healing properties. It also contains plasma, cytokines, thrombin, and other growth factors that are implicated in wound healing and have inherent biological and adhesive properties.

Controversies in soft-tissue anterior cruciate ligament reconstruction: grafts, bundles, tunnels, fixation, and harvest.

Increased stability has been reported with both autografts and allografts for anterior cruciate ligament (ACL) reconstruction. However, meta-analysis has shown significantly lower overall knee stability rates and more than double the abnormal stability rate with allografts. Some issues surrounding allograft sterilization (ie, risk of disease transmission) are unresolved, and cost is also a concern.

High failure rate for electrothermal shrinkage of the lax anterior cruciate ligament: a multicenter follow-up past 2 years.

Purpose: The purpose of this study was to prospectively evaluate the midterm results (beyond 2 years) of thermal shrinkage on both lax native anterior cruciate ligament (ACL) and lax reconstructions and determine the effectiveness of this procedure.

Methods: This is a multicenter study in which 64 patients from 2 sites underwent electrothermal shrinkage for a lax ACL, both native and previous reconstructions. They were followed up past 2 years with KT-1000 measurements (MEDmetric, San Diego, CA).

Arthroscopic meniscal repair using the BioStinger.

Purpose: Biodegradable devices are available for all-inside meniscal repairs. One device, the BioStinger (Linvatec, Largo, FL), is made of molded poly-L-lactic acid. The purpose of this study was to evaluate the effectiveness of and any adverse events associated with meniscus repair using this device.

A review of ski injuries resulting in combined injury to the anterior cruciate ligament and medial collateral ligaments.

Alpine skiing is a global winter recreational sport with 15 million participants in the United States alone, and an overall injury rate of 2.5 per 1,000 ski person-days. Isolated injury to the anterior cruciate ligament (ACL) or the medial collateral ligament (MCL) is common among ski injuries; however, combined injury to these structures is rare.

Basic science in digital imaging: storage and retrieval.

This practical discussion reviews the current methods available for digital image storage and retrieval. The organization of digital images is important to allow easy retrieval of the data in the future. Examples of several software programs that will catalogue and retrieve the images are demonstrated.