Posterior shoulder instability in the athletic population: Variations in assessment, clinical outcomes, and return to sport.

Posterior instability of the shoulder is becoming an increasingly recognized shoulder injury in the athletic population. Diagnostic elements, such as etiology, directionality, and degree of instability are essential factors to assess in the unstable athletic shoulder. Concomitant injuries and associated pathologic lesions continue to be a significant challenge in the surgical management of posterior shoulder instability.

Sternoclavicular Reconstruction in the Young Active Patient: Risk Factor Analysis and Clinical Outcomes at Short-Term Follow-up.

Objective: To determine the functional outcomes in young, active individuals after sternoclavicular (SC) joint reconstruction.

Design: Level IV, case series.

Setting: United States military hospitals, 2008-2012.

Surgical Techniques for the Reconstruction of Medial Collateral Ligament and Posteromedial Corner Injuries of the Knee: A Systematic Review.

Purpose: To systematically review reconstruction techniques of the medial collateral ligament (MCL) and associated medial structures of the knee (e.g., posterior oblique ligament).

Surgical Repair of Medial Collateral Ligament and Posteromedial Corner Injuries of the Knee: A Systematic Review.

Purpose: To systematically evaluate surgical techniques and objective clinical outcomes of primary repair of the medial collateral ligament (MCL) and posteromedial corner of the knee.

Methods: A systematic review of the PubMed/Medline Database (1966 to August 2014) was performed to identify all clinical studies describing MCL and other medial-based repairs of the knee. Exclusion criteria were applied to reconstruction techniques, animal models, and non-English publications.

Posterior Instability of the Shoulder: A Systematic Review and Meta-analysis of Clinical Outcomes.

Background: To date, there are no reports in the literature of a systematic review and meta-analysis for posterior instability of the shoulder.

Purpose: The primary objective was to systematically capture, critically evaluate, and perform a meta-analysis of all available literature on arthroscopic clinical outcomes to provide insight and clinical recommendations for unilateral posterior shoulder instability. The secondary objective was to use the same means to assess clinical outcome literature for open treatment, of which a subset of highly reported outcome measures were used to determine superiority of arthroscopic versus open procedures for unilateral posterior shoulder.

Knot Strength Varies Widely Among Expert Arthroscopists.

Background: While most surgeons can tie visually appealing knots under an arthroscope, few surgeons have undergone an objective evaluation of their ability to consistently tie knots with maximum loop and knot security.

Purpose/hypotheses: The purpose of this study was to evaluate and compare variations in ultimate load to failure, 3-mm displacement (clinical failure), and knot stack height of arthroscopic suture knots tied by 73 independent expert orthopaedic arthroscopists. The hypotheses were (1) that skilled arthroscopic surgeons would be able to routinely tie arthroscopic knots of similar strength, (2) that surgeons with <10 years of clinical practice would tie stronger and more consistent knots, and (3) that surgeons who performed >200 arthroscopic shoulder cases per year would produce stronger and more consistent knots than would surgeons who performed fewer cases.

Outcome instruments for the shoulder.

Outcome surveys may play a vital role in the future of orthopaedics. Institutions may increasingly look toward determining the effectiveness of treatment options, but different validation studies often yield different results. There is a clear need for consistency when reporting patient-reported outcome scores.

Intra-articular psoas tendon release alters fluid flow during hip arthroscopy.

While not proven definitively, the hypothesis that intra-articular psoas tendon release allows fluid to track into the retroperitoneal space has been widely accepted. This study attempts to identify the path through which fluid enters the pelvis and retroperitoneal space. Six hemi-pelvis human cadaveric specimens were utilized for this study.

Platelet-rich plasma: the PAW classification system.

Platelet-rich plasma (PRP) has been the subject of hundreds of publications in recent years. Reports of its effects in tissue, both positive and negative, have generated great interest in the orthopaedic community. Protocols for PRP preparation vary widely between authors and are often not well documented in the literature, making results difficult to compare or replicate.