Long-Term Clinical and Radiographic Outcomes of Meniscus Allograft Transplant.

Purpose Of Review: To reduce pain, improve function and possibly mitigate the risk for development of osteoarthritis in patients with functionally deficient meniscus pathology, meniscal allograft transplantation (MAT) can be used to restore native joint biomechanics and increase knee joint longevity. This review explores the senior author's preferred bridge-in-slot technique and recently published long-term clinical and radiographic outcomes following MAT.

Recent Findings: Recent literature demonstrates MAT to be a safe and largely successful procedure for patients with functional meniscus deficiency.

Editorial Commentary: The Entry Point-Trochlear Groove Angle Measures Lateralization of the Proximal Trochlear Entry Point in Patients With Patellar Instability.

Patellar instability is a complex orthopaedic condition, occurring at an incidence of 23.2 per 100,000 person-years and resulting from a combination of osseous and soft-tissue factors. Osseous abnormalities associated with patellar instability include trochlear dysplasia and a lateralized tibial tubercle.

Isolated Medial Patellofemoral Ligament Reconstruction Results in Lower Failure and Complication Rates Than Isolated Trochleoplasty and Tibial Tubercle Osteotomy: A Systematic Review.

Purpose: To evaluate outcomes and complications of isolated medial patellofemoral ligament reconstruction (MPFLR), tibial tubercle osteotomy (TTO), and trochleoplasty for management of patellar instability.

Methods: A query of Scopus, PubMed, Google Scholar, Cochrane CENTRAL Register of Controlled Trials, and the Cochrane Database of Systematic Reviews was performed in accordance with 2020 Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Included studies reported clinical outcome data after isolated MPFLR, TTO, or trochleoplasty for patellar instability with a minimum 12-month follow-up.

Lateral Opening-Wedge Distal Femoral Osteotomy Made Easy: Tips and Tricks.

A lateral opening-wedge distal femoral osteotomy is useful to offload the lateral tibiofemoral compartment for focal chondral defects or isolated lateral compartment arthritis. Although beneficial for these lateral compartment disorders, a distal femoral osteotomy requires careful forethought to optimize correction accuracy and safety. We recommend the following for effective execution of a distal femoral osteotomy: (1) Plan the desired correction preoperatively while accounting for an individual patient's anatomy and femoral width.

Osteochondral Allografts: Pearls to Maximize Biologic Healing and Clinical Success.

We present an evidence-based approach to optimize the biologic incorporation of osteochondral allografts: (1) The donor graft is gradually rewarmed to room temperature to reverse the metabolic suppression from cold storage. (2) The graft is harvested while submerged in saline to limit thermal necrosis. (3) Subchondral bone depth is preferred at 4 to 6 mm depth (total plug depth ∼5-8 mm including articular cartilage) to reduce graft immunogenicity and to promote incorporation.

Landmarks Used in Medial Patellofemoral Ligament Reconstruction Have Variable Topography.

Purpose: To describe the morphology of the adductor tubercle (AT), medial epicondyle (ME), and gastrocnemius tubercle (GT); to quantify their relationships to the medial patellofemoral ligament (MPFL) footprint location; and to classify the reliability of each landmark based on measurement variability.

Methods: Eight cadaveric specimens were dissected to expose the following landmarks on the femur: MPFL footprint, AT, ME, and GT. Using the MicroScribe 3D digitizer, each landmark was projected into a 3-dimensional coordinate system and reconstructed into a complex, closed polygon.