Effects of General Anesthesia Plus Multimodal Analgesia on Immediate Perioperative Outcomes of Hamstring Tendon Autograft ACL Reconstruction: A Randomized, Double-Blinded, Placebo-Controlled Trial.

Unlabelled: Anterior cruciate ligament reconstruction with hamstring tendon autograft (H-ACLR) is a standard ambulatory procedure with the potential for considerable postoperative pain. We hypothesized that general anesthesia combined with a multimodal analgesia regimen would reduce postoperative opioid use associated with H-ACLR.

Methods: This study was a single-center, surgeon-stratified, double-blinded, placebo-controlled, randomized clinical trial.

Clinical Outcomes After Revision Distal Biceps Tendon Surgery.

Background: Little is known about the clinical indications of performing a revision distal biceps tendon repair/reconstruction, and there is even less data available on the clinical outcomes of patients after revision surgery.

Purpose: To determine the clinical outcomes of patients undergoing revision distal biceps tendon repair/reconstruction and evaluate the causes of primary repair failure.

Study Design: Case series; Level of evidence, 4.

The Impact of Unguided Trauma Simulation Practice on Novice Performance: A Randomized Controlled Trial.

Introduction: The purpose of this investigation was to determine the impact of simulator practice on task completion time, radiation use, success rate, and overall quality in a simulation of placing a distal locking screw.

Methods: This was a prospective, randomized control trial with one-to-one randomization and parallel group design. Twenty-eight volunteer novice trainees (medical and premedical students) participated.

Impact of Simulation Training on Diagnostic Arthroscopy Performance: A Randomized Controlled Trial.

Purpose: To determine the impact of training on a virtual reality arthroscopy simulator on both simulator and cadaveric performance in novice trainees.

Methods: A randomized controlled trial of 28 participants without prior arthroscopic experience was conducted. All participants received a demonstration of how to use the ArthroVision Virtual Reality Simulator and were then randomized to receive either no training (control group, n = 14) or a fixed protocol of simulation training (n = 14).

Novel 3-dimensionally printed patient-specific guide improves accuracy compared with standard total shoulder arthroplasty guide: a cadaveric study.

Background: Patient-specific instrumentation (PSI) systems for total shoulder arthroplasty (TSA) can improve glenoid component placement, but may involve considerable expense and production delays. The purpose of this study was to evaluate a novel technique for in-house production of 3-dimensionally printed, patient-specific glenoid guides. We hypothesized that our PSI guide would improve the accuracy of glenoid guide pin placement compared with a standard TSA guide.

Biomechanical Analysis of All-Suture Suture Anchor Fixation Compared With Conventional Suture Anchors and Interference Screws for Biceps Tenodesis.

Purpose: To compare the biomechanical properties of all-suture suture anchors (ASSAs) with conventional interference screws (CISs) and conventional suture anchors (CSAs) for long head of the biceps tendon fixation during proximal biceps tenodesis (BT).

Methods: We randomized 21 fresh-frozen human cadaveric shoulders into 3 subpectoral BT treatment groups: ASSA, CSA, and CIS. Each construct was cyclically loaded from 5 to 70 N for 500 cycles (1 Hz).

Biomechanical Analysis of Medial-Row All-Suture Suture Anchor Fixation for Rotator Cuff Repair in a Pair-Matched Cadaveric Model.

Purpose: To compare the biomechanical properties of all-suture suture anchors (ASSAs) with conventional suture anchors (CSAs) for double-row rotator cuff repair (RCR).

Methods: Fourteen fresh-frozen human cadaveric shoulders were randomized into 2 RCR treatment groups: ASSA and CSA. All constructs received a double-row repair, with the lateral-row implants consisting of two 5.

Surgical technique for arthroscopic onlay suprapectoral biceps tenodesis with an all-suture anchor.

The long head of the biceps is a frequent pain generator in the shoulder. Tendinopathy of the long head of the biceps may be treated with biceps tenodesis. There has been great debate about the optimal technique for biceps tenodesis, without a clear distinction between different techniques.

Ninety-day complications following the Latarjet procedure.

Background: The purpose of this study was to describe the rate and type of complications occurring within 90 days following the Latarjet procedure for anterior glenohumeral instability.

Methods: Consecutive patients undergoing the Latarjet procedure by fellowship-trained surgeons from a single institution between 2007 and 2016 were included for analysis. Indications for the Latarjet procedure included primary or recurrent anterior instability with clinically significant anterior glenoid bone loss and/or failed prior arthroscopic stabilization.

Variability in the Contour of Cadaveric Anterior and Posterior Glenoids Based on Ipsilateral 3-Dimensional Computed Tomography Reconstructions: Implications for Clinical Estimation of Bone Loss.

Purpose: To compare differences in the contour of the anterior and posterior glenoid in 3-dimensional computed tomography reconstructions as a reason for variability in estimating glenoid bone loss.

Methods: Three reviewers digitally placed 11 points (1 at 6 o'clock, 5 from 3 to 6 o'clock, and 5 from 6 to 9 o'clock) along the inferior half of glenoid 3-dimensional computed tomography reconstructions of 32 cadaveric specimens. A best-fit circle for the whole glenoid was determined from all 11 points.

A simple method to directly evaluate the lateral extension of the acromion: an anatomic study of 128 cadaveric scapulae.

Background: The lateral extension of the acromion from the glenohumeral joint is the critical variable that both the acromial index and critical shoulder angle reflect. The purpose of this study was to establish a simple and reproducible method to directly measure the lateral extension of the acromion that will be independent of patient demographic characteristics, scapular rotation, or other morphologic features of the shoulder.

Methods: This study used 128 unpaired cadaveric scapulae with a mean age of 69.

Arthroscopic Intramuscular Side-to-Side Repair of an Isolated Infraspinatus Tear.

Intramuscular, full-thickness rotator cuff tears are uncommon and present a challenging clinical scenario for repair because traditional suture anchor or transosseous repair techniques are less feasible. The goal of repair is to achieve a tension-free reduction of both ends of the muscle to allow for adequate healing over time. Intramuscular tears of the infraspinatus specifically have rarely been reported.

Anatomic Acromioclavicular Joint Reconstruction With Semitendinosus Allograft: Surgical Technique.

Acromioclavicular joint separations are common shoulder injuries in the active patient population. Nonoperative management is recommended for Rockwood type I and II injuries, whereas surgical reconstruction is recommended for type IV and VI separations. The management for type III and V injuries is more controversial and is determined on a case-by-case basis.

An All-Arthroscopic, Length-Tensioned Suprapectoral Biceps Tenodesis Technique.

Biceps tenodesis remains a popular choice for treating anterior shoulder pain in the setting of primary biceps tendinitis or biceps pain due to concomitant glenohumeral joint pathology. A variety of surgical approaches and fixation construct options are available for biceps tenodesis. The advantages of an all-arthroscopic biceps tenodesis include anatomic maintenance of the length-tension relation with strength preservation and improved cosmetic results.

ACL Reconstruction Basics: Quadruple (4-Strand) Hamstring Autograft Harvest.

Hamstring tendon autograft remains a popular graft choice for anterior cruciate ligament (ACL) reconstruction. Although there are a variety of autograft and allograft options available for ACL reconstruction, advantages of hamstring tendon autografts include decreased postoperative knee pain and an overall easier surgical recovery compared with bone patellar tendon bone autograft. In addition, 4-stranded (quadruple) hamstring grafts are among the strongest grafts biomechanically (at time equals zero).

Anterior Cruciate Ligament Reconstruction Basics: Bone-Patellar Tendon-Bone Autograft Harvest.

Anterior cruciate ligament reconstruction with bone-patellar tendon-bone autograft has long been considered the graft preference for young, active patients with anterior cruciate ligament injuries. The central-third of the native patellar tendon is a reliable graft and is the preferred option for competitive athletes given its excellent track record with high return-to-play rates and low failure rates. Disadvantages to using this graft include donor site morbidity and associated postoperative anterior knee pain, the risk of patellar fracture or patellar tendon tear, and the potential for graft-construct mismatch.

Arthroscopic Anterior Shoulder Stabilization With Incorporation of a Comminuted Bony Bankart Lesion.

Bony Bankart lesions are a common finding in patients with anterior glenohumeral dislocation. Although there are no defined guidelines, small bony Bankart fractures are typically treated arthroscopically with suture anchors. The 2 main techniques used are double- and single-row suture anchor stabilization, with debate over superiority.

Clinical Outcomes of Arthroscopic 360° Capsular Release for Idiopathic Adhesive Capsulitis in the Lateral Decubitus Position.

Purpose: To report outcomes after arthroscopic 360° capsular release in the lateral decubitus position for idiopathic glenohumeral adhesive capsulitis without manipulation under anesthesia.

Methods: A retrospective case series of patients who underwent arthroscopic capsular release in the lateral decubitus position for idiopathic adhesive capsulitis with minimum 2-year follow-up was conducted. Patient demographics, preoperative range of motion (ROM), postoperative ROM, and the postoperative outcome scores, visual analog scale for pain, Single Assessment Numeric Evaluation, Simple Shoulder Test, and American Shoulder and Elbow Surgeons scores, were recorded.