Acromial morphology is not associated with rotator cuff tearing or repair healing.

Background: The purposes of this study were to determine whether acromial morphology (1) could be measured accurately on magnetic resonance images (MRIs) as compared to computed tomographs (CTs) as a gold standard, (2) could be measured reliably on MRIs, (3) differed between patients with rotator cuff tears (RCTs) and those without evidence of RCTs or glenohumeral osteoarthritis, and (4) differed between patients with rotator cuff repairs (RCRs) that healed and those that did not.

Methods: This is a retrospective comparative study. We measured coronal, axial, and sagittal acromial tilt; acromial width, acromial anterior and posterior coverage, and glenoid version and inclination on MRI corrected into the plane of the glenoid.

Arthroscopic Reduction and Fixation of a Lesser Trochanter Avulsion Nonunion.

Identifying and treating avulsion fractures of the pelvis and proximal femur in adolescent athletes has become increasingly more important as the rate of competitive sports participation has grown. The majority of these fractures can be treated conservatively, with most returning to full activity. Surgical treatment of these injuries has been traditionally indicated for >2 cm displacement, painful nonunion, symptomatic exostosis formation, or persistent pain and symptoms.

Surgical Treatment for FAI: Arthroscopic and Open Techniques for Osteoplasty.

Purpose Of Review: To review the relevant literature and techniques regarding arthroscopic and open treatment of femoroacetabular impingement (FAI). To discuss both the senior authors' preferred method of arthroscopic and open treatment of FAI.

Recent Findings: Routine treatment of FAI has moved away from open techniques and is more focused arthroscopic methods.

Blinded Ultrasound Examination of the Subscapularis Following Anatomic Shoulder Arthroplasty.

Background: The subscapularis tendon is commonly released during shoulder arthroplasty, and its integrity and repair postoperatively have been shown important to help maximize patient function. However, diagnosing subscapular tendon failure can be difficult with magnetic resonance imaging secondary to metal artifact as well as very costly.

Purpose: The purpose of this study was to assess the utility of ultrasound imaging in evaluating subscapularis integrity at specific time points following shoulder arthroplasty, in a blinded fashion.

Biomechanical Comparison of Olecranon Sled Versus Intramedullary Screw Tension Banding for Olecranon Osteotomies.

Background: Olecranon osteotomies are frequently performed to gain access to the distal humeral articular surface. Repair of the osteotomy or fixation of a simple 2-part olecranon fracture with traditional tension band construct is often plagued by complication. Proximal migration and irritation attributed to hardware are common complications of the standard construct of an intramedullary screw with tension band and are causes for reoperation.

Biomechanical Comparison of Epiphyseal Anterior Cruciate Ligament Fixation Using a Cortical Button Construct Versus an Interference Screw and Sheath Construct in Skeletally Immature Cadaveric Specimens.

Background: Anterior cruciate ligament (ACL) ruptures have become increasingly common in pediatric and adolescent athletes. While multiple methods exist, all-epiphyseal ACL reconstruction is a popular technique in the skeletally immature patient. Given the high rate of reruptures in this population and the increasing number of commercially available fixation devices, biomechanical testing is crucial to understand the performance of these devices in pediatric epiphyseal bone.

A Biomechanical Analysis of Different Clavicular Tunnel Diameters in Anatomic Acromioclavicular Ligament Reconstruction.

Purpose: To evaluate the biomechanical stability of a tendon-to-clavicle bone interface fixation of a graft in revision acromioclavicular reconstruction.

Methods: Fifteen fresh-frozen cadaveric shoulders were used. All specimens underwent bone density evaluation.

Systemic Administration of Sclerostin Antibody Enhances Bone Morphogenetic Protein-Induced Femoral Defect Repair in a Rat Model.

Background: Recombinant human bone morphogenetic protein (rhBMP)-2 is a potent osteoinductive agent; however, its clinical use has been reduced because of safety and efficacy concerns. In preclinical studies involving a critical-sized defect in a rat model, sclerostin antibody (Scl-Ab) treatment increased bone formation within the defect but did not result in reliable healing. The purpose of the current study was to evaluate bone repair of a critical-sized femoral defect in a rat model with use of local implantation of rhBMP-2 combined with systemic administration of Scl-Ab.

Management of complications of periarticular fractures of the distal interphalangeal, proximal interphalangeal, metacarpophalangeal, and carpometacarpal joints.

Fractures involving the bones of the hand are among the most common injuries in the United States. A significant portion of these fractures are periarticular. Although the great majority of these fractures are treated successfully by nonoperative means, complications arise.

Combination therapy with PTH and DBM cannot heal a critical sized murine femoral defect.

Orthopaedic surgeons continue to search for cost-effective bone graft substitutes to enhance bone repair. Teriparatide (PTH 1-34) and demineralized bone matrix (DBM) have been used in patients to promote bone healing. We evaluated the efficacy of PTH and DBM in healing a critical sized femoral defect in three lineage-specific transgenic mice expressing Col3.

The role of transduced bone marrow cells overexpressing BMP-2 in healing critical-sized defects in a mouse femur.

The role that transduced mouse bone marrow stromal cells (mBMSCs) engineered to overexpress human bone morphogenetic protein 2 (BMP-2) play in healing critical-sized skeletal defects is largely unknown. We evaluated the interaction between host osteoprogenitor cells and donor mBMSCs transduced with either a lentiviral (LV) vector-expressing red fluorescent protein (RFP) with or without BMP-2 that were implanted into a critical-sized femoral defect. Radiographs taken at the time of killing were evaluated using a five-point scaled scoring system.

Biofunctionalizing devitalized bone allografts through polymer-mediated short and long term growth factor delivery.

According to 5- and 10-year clinical follow-up studies large-scale bone allografts have a high failure rate, largely due to poor allograft incorporation with adjacent bone and subsequent poor remodeling. The goal of this study was to develop a methodology to deliver growth factors from large-scale bone allografts in a temporally controlled manner. Intact long bone allografts were coated with a micron-scale thick layer of degradable polymer that maintained inherent pore structures and acted as a delivery vehicle for bone morphogenetic protein-2 and vascular endothelial growth factor.

Evaluation of osteogenic cell differentiation in response to bone morphogenetic protein or demineralized bone matrix in a critical sized defect model using GFP reporter mice.

We evaluated the osteoprogenitor response to rhBMP-2 and DBM in a transgenic mouse critical sized defect. The mice expressed Col3.6GFPtopaz (a pre-osteoblastic marker), Col2.

Advances in wrist arthroscopy.

Since its introduction more than three decades ago, wrist arthroscopy has continually evolved. The procedure has a wide list of indications, including diagnostic and management applications. The scope of practice for the wrist arthroscopic surgeon includes management of triangulofibrocartilage complex pathology, evaluation and management of carpal instability, assistance in fracture reduction of the radius and scaphoid, treatment of trapeziometacarpal synovitis and arthritis, distal ulnar and carpal bone excisions, and salvage procedures.

Sternoclavicular joint reconstruction--a systematic review.

Background: Dislocation of the sternoclavicular joint is a rare injury that has a low incidence of signifcant long-term symptoms. Surgical reconstruction of the joint is indicated in patients with symptomatic, chronic anterior instability or with irreducible or recurrent posterior instability. There have been many reported techniques for stabilization of the joint, but few investigators have reported more than several cases.

Prediction of hypocalcemia after using 1- to 6-hour postoperative parathyroid hormone and calcium levels: an analysis of pooled individual patient data from 3 observational studies.

Background: Parathyroid hormone (PTH) levels up to 6 hours postthyroidectomy have been shown to have excellent predictive power in determining hypocalcemia. In this study, we investigate the usefulness of combining calcium and PTH to increase the predictive power.

Methods: Individual patient data were obtained from 3 studies (152 patients) that fulfilled our criteria (using PTH assay within hours postthyroidectomy to predict symptomatic hypocalcemia).