Interobserver and intraobserver reliability of radiographic classification of acromioclavicular joint dislocations.

Hypothesis And Background: The classification and treatment of acromioclavicular (AC) joint dislocations remain controversial. The purpose of this study was to determine the interobserver and intraobserver reliability of the Rockwood classification system. We hypothesized poor interobserver and intraobserver reliability, limiting the role of the Rockwood classification system in determining severity of AC joint dislocations and accurately guiding treatment decisions.

A Concise and Comprehensive Description of Shoulder Pathology and Procedures: The 4D Code System.

Background. We introduce a novel description system of shoulder pathoanatomy. Its goal is to provide a comprehensive three-dimensional picture, with an additional component of time; thus, we call it the 4D code.

Does the literature confirm superior clinical results in radiographically healed rotator cuffs after rotator cuff repair?

Purpose: Because recurrent or persistent defects in the rotator cuff after repair are common, we sought to clarify the correlation between structural integrity of the rotator cuff and clinical outcomes through a systematic review of relevant studies.

Methods: Medline, CINAHL (Cumulative Index to Nursing and Allied Health Literature), and the Cochrane Central Register of Controlled Trials were searched for all literature published from January 1966 to December 2008 that used the key words shoulder, rotator cuff, rotator cuff tear, rotator cuff repair, arthroscopic, integrity, healed, magnetic resonance imaging (MRI), computed tomography arthrography (CTA), and ultrasound. The inclusion criteria were studies (Levels I to IV) that reported outcomes after arthroscopic rotator cuff repair in healed and nonhealed repairs based on ultrasound, CTA, and/or MRI.

Does the literature support double-row suture anchor fixation for arthroscopic rotator cuff repair? A systematic review comparing double-row and single-row suture anchor configuration.

Purpose: The purpose of this study was to compare the clinical outcome of single-row (SR) and double-row (DR) suture anchor fixation in arthroscopic rotator cuff repair with a systematic review of the published literature.

Methods: We searched all published literature from January 1966 to December 2008 using Medline, CINAHL (Cumulative Index to Nursing and Allied Health Literature), and the Cochrane Central Register of Controlled Trials for the following key words: shoulder, rotator cuff, rotator cuff tear, rotator cuff repair, arthroscopic, arthroscopic-assisted, single row, double row, and transosseous equivalent. The inclusion criteria were cohort studies (Levels I to III) that compared SR and DR suture anchor configuration for the arthroscopic treatment of full-thickness rotator cuff tears.

Revision tibiotalar arthrodesis.

Background: Contemporary recommendations for primary and revision ankle arthrodesis favor internal compression techniques involving the use of screw and/or plate fixation. While tibiotalocalcaneal arthrodesis with internal fixation may be a suitable method of salvage for the treatment of a failed tibiotalar arthrodesis in selected patients, ring external fixation has been reported as an alternative. We reviewed our experience with revision tibiotalar arthrodesis, with a focus on ring external fixation.

Management of bone loss in revision total knee arthroplasty.

Bone deficiencies around the knee can present a substantial challenge during revision total knee arthroplasty. Bone loss occurs from stress shielding, osteolysis, chronic infection, and bone removed during implant extraction. Smaller defects have traditionally been treated with cement filling or allograft bone chips.

Spinal injuries in contact sports.

Contact and collision sports such as American football expose the athlete to a wide array of potential injuries. Knee injuries garner much of the attention, but spinal injuries are potentially catastrophic and all levels of medical coverage of football must be knowledgeable and prepared to attend to an athlete with a neck injury. Of the other possible spinal conditions, some resolve on their own, others might require conservative therapy, and still others might require surgical intervention.