Over 850,000 surgeries are performed to treat meniscal injuries each year in the United States. Even with repair, patients are likely to develop osteoarthritis (OA) within the next two decades. There is a pressing clinical need to improve meniscal repair procedures to restore tissue function and prevent joint degeneration later in life.
View Article and Find Full Text PDFObjective: Gymnasts and baseball players have different mechanisms of loading their elbows, and there is little data comparing osteochondritis dissecans (OCD) lesions between these 2 sports. Our objective is to compare the clinical and imaging characteristics of elbow OCD lesions between weight-bearing and throwing athletes.
Design: Review from 2015 to 2022.
Background: There has been increased interest in lateral extra-articular procedures, such as anterolateral ligament reconstruction (ALLR) or lateral extra-articular tenodesis (LET), to reduce anterolateral rotation instability of the knee after anterior cruciate ligament reconstruction (ACLR). Despite promising surgical outcomes with these techniques, their impact on knee strength recovery is unknown.
Hypothesis: Patients undergoing lateral extra-articular procedures at the time of ACLR would have impaired thigh muscle strength at 6 to 9 months after surgery.
Blood flow restriction training (BFRT) is increasing in popularity in the rehabilitation setting due to its believed impact on mitigating muscle atrophy, maintaining muscle mass and improving muscle function after musculoskeletal injury. This intervention has shown to be an effective option for addressing muscle strength and atrophy during earlier phases of rehabilitation when higher loads are not tolerated after injury. Although this intervention appears to be a safe and effective approach in sports medicine environments, there is limited information on the young athlete population.
View Article and Find Full Text PDFBackground: Most healthcare providers utilize magnetic resonance imaging (MRI) to assist in diagnosing and treating osteochondritis dissecans (OCD) of the capitellum. However, consensus on imaging features that portend clinically relevant information in the care of these lesions has not been determined.
Purpose: To conduct a survey on the MRI features of a capitellar OCD that are salient for clinical decision-making using a classic Delphi protocol.
Background: Surgical treatment options of discoid lateral meniscus in pediatric patients consist of saucerization with or without meniscal repair, meniscocapular stabilization, and, less often, subtotal meniscectomy.
Purpose: To describe a large, prospectively collected multicenter cohort of discoid menisci undergoing surgical intervention, and further investigate corresponding treatment of discoid menisci.
Study Design: Cohort study; Level of evidence, 3.
Background: The incidence of meniscus tears and ACL tears in pediatric patients continues to rise, bringing to question the risk factors associated with these injuries. As meniscus tears are commonly repaired in pediatric populations, the epidemiology of repairable meniscus tears is an important for consideration for surgeons evaluating treatment options.
Purpose: To describe meniscal tear patterns in pediatric and adolescent patients who underwent meniscal repair across multiple institutions and surgeons, as well as to evaluate the relationship between age, sex, and body mass index (BMI) and their effect on the prevalence, type, and displacement of repaired pediatric meniscal tears.
Unlabelled: Little consensus exists on the best method for evaluation and management of pediatric medial epicondyle fractures because of an inability to reliably evaluate fracture displacement with standard imaging techniques. This study aimed to determine the performance of various radiographic views in evaluating displaced medial epicondyle fractures when using a standardized measurement methodology.
Methods: Ten fellowship-trained pediatric orthopaedic surgeons assessed fracture displacement in 6 patients with displaced medial epicondyle fractures using radiographic views (anteroposterior, lateral, axial, internal oblique [IO], and external oblique [EO]) and computed tomographic (CT) views (axial, 3-dimensional [3D] horizontal, and 3D vertical).
Bone quality in diabetic patients is compromised, leading to weaker bones and increased fracture risk. However, the mechanism by which this occurs in diabetic bone remains to be fully elucidated. We hypothesized that elevated glucose and glucose variation would affect the function of osteocytes, essential regulators of bone homeostasis and quality.
View Article and Find Full Text PDFBackground: Soccer is an increasingly popular sport for children and adolescents in the United States. Little is known about participation patterns related to sport specialization.
Purpose: To investigate soccer participation levels and sport specialization characteristics among youth soccer athletes.
Extracellular matrix (ECM) "raw materials" such as demineralized bone matrix (DBM) and cartilage matrix have emerged as leading scaffolding materials for osteochondral regeneration owing to their capacity to facilitate progenitor/resident cell recruitment, infiltration, and differentiation without adding growth factors. Scaffolds comprising synthetic polymers are sturdy yet generally lack cues for guiding cell differentiation. We hypothesized that opposing gradients of decellularized cartilage (DCC) and DBM in polymeric microsphere-based scaffolds would provide superior regeneration compared to polymer-only scaffolds in vivo.
View Article and Find Full Text PDFAnterior cruciate ligament (ACL) injuries can present as a ligamentous disruption or avulsion fracture of the tibial spine in pediatric patients. Differences in knee morphometric parameters have been investigated between pediatric cohorts with ACL disruptions and tibial spine avulsion fractures. However, no study to date has compared morphometric parameters in patients with tibial spine avulsion fracture against a control population.
View Article and Find Full Text PDFTo date, many osteochondral regenerative approaches have utilized varied combinations of biocompatible materials and cells to engineer cartilage. Even in cell-based approaches, to date, no study has utilized stem cell aggregates alone for regenerating articular cartilage. Thus, the purpose of this study was to evaluate the performance of a novel stem cell-based aggregate approach in a fibrin carrier to regenerate osteochondral defects in the Sprague-Dawley rat trochlear groove model.
View Article and Find Full Text PDFPurpose: Failure of a reconstructed anterior cruciate ligament (ACL) has significant morbidity in the paediatric and adolescent patient population. Untreated concomitant posterolateral corner (PLC) injury is an identified cause of failed ACL reconstruction; however, the injury pattern has yet to be defined for the paediatric population.
Methods: Magnetic resonance imaging (MRI) studies of the knee performed between 1 January 2009 and 1 January 2013 were retrospectively reviewed.
Study Design: Retrospective, case-control.
Purpose: Knee morphometric risk factors for noncontact anterior cruciate ligament (ACL) injury have been a popular topic with skeletally mature patients. Little research has focused on the skeletally immature, with conflicting conclusions.
An important goal in advancing islet transplantation for the treatment for type 1 diabetes, is to discover transplantation sites that promote long-term islet engraftment. Here, we investigate the bone marrow cavity in rats as a potential site for islet transplantation. Dark agouti streptozotocin diabetic recipients received DA islets to one of three sites: to the renal subcapsular, intrahepatic or bone marrow cavity site.
View Article and Find Full Text PDFTo evaluate the effect of weight-bearing on consolidation of the regenerate in distraction osteogenesis, unilateral femoral lengthenings were performed in two groups of rats. In the first group (n = 19) unrestricted weight-bearing was permitted postoperatively, while in the second (n = 18) weight-bearing was prevented via a through-knee amputation. In both groups the distraction protocol involved a 3-day latency period, four daily 0.
View Article and Find Full Text PDFBone regeneration during fracture healing has been demonstrated repeatedly, yet the regeneration of articular cartilage and joints has not yet been achieved. It has been recognized however that the mechanical environment during fracture healing can be correlated to the contributions of either the endochondral or intramembranous processes of bone formation, and to resultant tissue architecture. Using this information, the goal of this study was to test the hypothesis that induced motion can directly regulate osteogenic and chondrogenic tissue formation in a rat mid-femoral bone defect and thereby influence the anatomical result.
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