Comparison of Revision and Redislocation Rates After First-Time Anterior Shoulder Instability Between Subluxators and Dislocators: A Midterm Outcome Study.

Background: Anterior shoulder instability is a common pathology seen especially in young men and highly active patient populations. Subluxation is a commonly encountered clinical issue, yet little is known about the effects of first-time subluxation compared with dislocation on shoulder stability and clinical outcomes after surgical stabilization.

Purpose: To compare revision and redislocation rates as well as patient-reported outcomes (PROs) between subluxators and dislocators after a first-time anterior shoulder instability event.

Primary Anterior Cruciate Ligament Injury: Extrinsic and Intrinsic Risk Factors.

Anterior cruciate ligament (ACL) injuries continue to increase in incidence despite extensive research into prevention strategies. Many extrinsic and intrinsic risk factors for sustaining ACL injuries have been identified and continue to be investigated. Extrinsic risk factors for ACL injury relate to the athlete's environment, such as the shoe-surface interaction, weather conditions, and sport played.

Surgical Parameters During Reverse Shoulder Arthroplasty Predict Post-Surgical Kinematics During the Hand-to-Head Motion.

Purpose: This study aimed to identify surgical parameters during reverse shoulder arthroplasty (RSA) that predict post-surgical kinematics during the hand-to-head motion (H2H) and to identify associations between kinematics and outcomes. We hypothesized that greater humeral retroversion and lateralization predict kinematics, and that more scapular upward rotation is associated with better PROs and more range of motion (ROM).

Methods: Thirty-five post-RSA patients consented to participate.

Increased rate of surgery for loss of motion following anterior cruciate ligament reconstruction during COVID-19.

Objectives: To investigate the incidence and risk factors associated with loss of motion after anterior cruciate ligament reconstruction (ACLR) during the coronavirus disease 2019 pandemic (COVID-19).

Methods: A retrospective review of patients undergoing primary ACLR between March 2017 and November 2022 by a senior high-volume orthopaedic surgeon was performed. Exclusion criteria included revision ACLR, multiligamentous knee surgery, and age <14 years.

Association of Smaller Intercondylar Notch Size With Graft Failure After Anterior Cruciate Ligament Reconstruction.

Background: Smaller intercondylar notch sizes have been consistently associated with a predisposition for primary anterior cruciate ligament tears.

Purpose: To evaluate the association between intercondylar notch size, graft size, and postoperative complications, including knee stiffness and return to the operating room, after primary anatomic anterior cruciate ligament reconstruction (ACLR).

Study Design: Case-control study; Level of evidence, 3.

Outcomes After Anterior Cruciate Ligament Reconstruction With Quadriceps Tendon in Adolescent Athletes at Mean Follow-up of 4 Years.

Background: Despite increasing use of quadriceps tendon (QT) autograft in anterior cruciate ligament (ACL) reconstruction (ACLR), limited data exist regarding its outcomes in high-risk adolescent athletes.

Purpose: To (1) report the outcomes after QT ACLR in adolescent athletes and (2) identify patient-related and surgery-related factors that may influence failure rates after QT ACLR.

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

Slope Osteotomies in the Setting of Anterior Cruciate Ligament Deficiency.

➤ Posterior tibial slope (PTS) of ≥12° represents an important risk factor for both anterior cruciate ligament (ACL) injury and ACL reconstruction failure.➤ PTS measurements can significantly differ on the basis of the imaging modality and the measurement technique used. PTS should be measured on strictly lateral radiographs, with a recommended proximal tibial length of 15 cm in the image.

Methodological considerations in assessing countermovement jumps with handheld accentuated eccentric loading.

This study aimed to compare the agreement between three-dimensional motion capture and vertical ground reaction force (vGRF) in identifying the point of dumbbell (DB) release during a countermovement jump with accentuated eccentric loading (CMJ), and to examine the influence of the vGRF analysis method on the reliability and magnitude of CMJ variables. Twenty participants (10 male, 10 female) completed five maximal effort CMJ at 20% and 30% of body mass (CMJ and CMJ, respectively) using DBs. There was large variability between methods in both loading conditions, as indicated by the wide limits of agreement (CMJ = -0.

Total Shoulder Arthroplasty is associated With Less Pain and Better Functional Outcomes, but Humeral Head Resurfacing may be Preferred in Younger, Higher Demand Patients: A Short-Term Outcomes Study in Patients with Glenohumeral Osteoarthritis.

Objectives: This study aimed to compare short-term outcomes following Total Shoulder Arthroplasty (TSA) and Humeral Head Resurfacing (HHR) in patients with glenohumeral osteoarthritis (GHOA).

Methods: A retrospective analysis included patients who had undergone either TSA or HHR for GHOA at a single institution. Baseline demographics, complications, range of motion (active forward flexion, FF and active external rotation, ER), visual analog scores (VAS), and Subjective Shoulder Values (SSV) were collected.

Nonanatomic femoral tunnel placement increases the risk of subsequent meniscal surgery after ACLR: Part II-Patients without recurrent ACL injury.

Purpose: The purpose of this study was to identify risk factors for subsequent meniscal surgery following anterior cruciate ligament (ACL) reconstruction (ACLR) in patients without recurrent ACL injury.

Methods: Patients aged ≥14 years who underwent primary ACLR with minimum 1-year follow-up and without recurrent ACL injury were retrospectively reviewed. Patient demographics and surgical data at the time of ACLR were collected.

Revision Anterior Cruciate Ligament Reconstruction and Associated Procedures.

Failure of anterior cruciate ligament reconstruction (ACLR) is a common yet devastating complication due to inferior clinical outcomes associated with revision ACLR. Identifying the cause and associated risk factors for failure is the most important consideration during preoperative planning. Special attention to tunnel quality, concomitant injuries, and modifiable risk factors will help determine the optimal approach and staging for revision ACLR.

Surgical Techniques in Primary ACL Reconstruction: Getting It Right the First Time.

The ideal anterior cruciate ligament reconstruction (ACLR) is an individualized anatomic approach aimed at restoring the native structure and function of the knee. Surgeons are tasked with difficult decisions during operative planning, including the optimal graft choice for the patient and appropriate anatomic tunnel placement. Special considerations should additionally be given for skeletally immature patients and those at high-risk for failure, including younger, active patients participating in pivoting sports.

Higher odds of meniscectomy compared with meniscus repair in a young patient population with increased neighbourhood disadvantage.

Objectives: To investigate the impact of demographic and socioeconomic factors on the management of isolated meniscus tears in young patients and to identify trends in surgical management of meniscus tears based on surgeon volume.

Methods: Data from a large healthcare system on patients aged 14-44 years who underwent isolated meniscus surgery between 2016 and 2022 were analysed. Patient demographics, socioeconomic factors and surgeon volume were recorded.

Conversion to knee arthroplasty is more common after meniscectomy than meniscus repair in patients older than age 40.

Purpose: To describe rates of conversion to unicompartmental or total knee arthroplasty (KA) in patients over the age of 40 years (at initial surgery) after partial meniscectomy (ME) or meniscal repair (MR).

Methods: Patients over the age of 40 undergoing isolated ME or MR between 2016 and 2018 were extracted from a single healthcare provider database. Data on patient characteristics, type of initial surgery, number of returns to the operating room, as well as performed procedures, including conversion to KA, were recorded.

Around-the-knee osteotomies part II: Surgical indications, techniques and outcomes - State of the art.

Recent advances in surgical techniques and planning for knee-based osteotomies have led to improvements in addressing lower extremity malalignment. Part 1 of this review presented the biomechanical and clinical rationale of osteotomies, emphasizing the importance of osteotomies for restoring normal knee kinematics. In Part 2 of this review, indications, surgical technique and outcomes of osteotomies to correct coronal, sagittal and axial plane deformities will be examined.

Factors Associated With Knee Extension Strength Symmetry After Anterior Cruciate Ligament Reconstruction With Quadriceps Tendon Autograft.

Background: Diminished postoperative knee extension strength may occur after anterior cruciate ligament reconstruction (ACLR) with quadriceps tendon (QT) autograft. Factors influencing the restoration of knee extensor strength after ACLR with QT autograft remain undefined.

Purpose: To identify factors that influence knee extensor strength after ACLR with QT autograft.

Bipolar bone loss and distance to dislocation.

Studies have shown that glenoid- and humeral-sided bone loss may be present in up to 73-93% of individuals with recurrent anterior shoulder instability. As such, bone loss must be addressed appropriately, as the amount of bone loss drives surgical decision making and influences outcomes. Methods to describe and measure bone loss have changed over time.

Around-the-knee osteotomies part 1: definitions, rationale and planning-state of the art.

Knee osteotomies are essential orthopedic procedures with the ability to preserve the joint and correct ligament instabilities. Literature supports the correlation between lower limb malalignment and outcomes after knee ligament reconstruction and cartilage procedures. Concepts such as joint line obliquity, posterior tibial slope angle, and intra-articular deformity correction are integral components of both preoperative planning and postoperative evaluations.

Magnetic Resonance Arthrogram Outperforms Standard Magnetic Resonance Imaging 2 Weeks After First Shoulder Dislocation for Labral Tear Diagnosis.

Purpose: To determine the comparative accuracy and precision of routine magnetic resonance imaging (MRI) versus magnetic resonance (MR) arthrogram in measuring labral tear size as a function of time from a shoulder dislocation.

Methods: We retrospectively evaluated consecutive patients who underwent primary arthroscopic stabilization between 2012 and 2021 in a single academic center. All patients completed a preoperative MRI or MR arthrogram of the shoulder within 60 days of injury and subsequently underwent arthroscopic repair within 6 months of imaging.