Mid-term outcomes of temporary medial distal femoral hemiepiphysiodesis with and without medial patellofemoral ligament repair for recurrent patellar instability in skeletally immature patients with genu valgum.

Genu valgum contributes to patellar instability, though outcomes following temporary hemiepiphysiodesis via eight plating are less understood. The purpose of this study was to evaluate the outcomes and need for additional procedures following temporary hemiepiphysiodesis for the treatment of pediatric genu valgum and patellar instability, as well as evaluating the utility of a concurrent medial patellofemoral ligament (MPFL) repair. Patients who underwent medial distal femoral epiphysiodesis for the treatment of genu valgum and recurrent patellar instability were identified.

Medial Patellofemoral Ligament Reconstruction in the Pediatric Population: Skeletal Immaturity Does Not Affect Functional Outcomes but Demonstrates Increased Rate of Subsequent Knee Injury.

Purpose: To evaluate short- to mid-term-outcomes, including instability rates, following medial patellofemoral ligament (MPFL) reconstruction in skeletally immature versus mature pediatric patients.

Methods: Patients younger than age 18 with recurrent patellar instability who underwent primary allograft MPFL reconstruction by a single surgeon from 2013 to 2019 were identified. Skeletally immature patients underwent all-epiphyseal drilling and mature patients underwent metaphyseal drilling at the Schöttle's point.

Female Patients and Decreased Hip Capsular Thickness on Magnetic Resonance Imaging Associated With Increased Axial Distraction Distance on Examination Under Anesthesia: An In Vivo Study.

Purpose: To investigate the relation of hip capsular thickness as measured on preoperative magnetic resonance imaging (MRI) and intraoperative hip joint axial distraction distance on an examination under anesthesia.

Methods: A retrospective review of primary arthroscopic hip procedures performed between November 2018 and June 2021 was conducted. The inclusion criteria included a diagnosis of femoroacetabular impingement syndrome and preoperative radiographic imaging and MRI.

Magnetic Resonance Arthrogram Improves Visualization of Hip Capsular Defects in Patients Undergoing Previous Hip Arthroscopy.

Purpose: To compare magnetic resonance imaging (MRI) with magnetic resonance arthrogram (MRA) in the identification of hip capsular defects in patients who previously underwent hip arthroscopy.

Methods: Patients who underwent revision hip arthroscopy for capsular insufficiency by a single surgeon between March 2014 and December 2019 were identified by Current Procedural Terminology code. Patients with arthroscopically confirmed capsular defects treated surgically who underwent both MRI and MRA between their primary and revision surgeries were identified.

Tape Augmentation Does Not Affect Mid-Term Outcomes of Medial Patellofemoral Ligament Reconstruction in Skeletally Mature Adolescent Patients.

Purpose: To evaluate mid-term outcomes after medial patellofemoral ligament (MPFL) reconstruction with and without tape augmentation in the skeletally mature adolescent population.

Methods: All patients under age 18 with recurrent patellar instability treated with surgery at a single institution by a single surgeon from January 2013 through June 2017 were identified by current procedural terminology codes. Inclusion criteria were (1) primary MPFL reconstruction, (2) minimum 3 years' follow-up, (3) skeletal maturity.

Osteoid osteoma of the femoral neck mistaken as a synovial herniation pit.

A 36-year-old man presented with 1 year of atraumatic left lateral thigh, groin, and hip pain, and imaging consistent with the diagnosis of femoroacetabular impingement and a labral tear. Imaging concurrently demonstrated a synovial herniation pit. The patient underwent hip arthroscopy, which included femoroplasty, acetabuloplasty, labral debridement, and synovectomy.

Previous Arthroscopic Hip Surgery Increases Axial Distractibility Compared to the Native Contralateral Hip and May Suggest Instability.

Purpose: To compare intraoperative hip joint distractibility between hips that previously underwent arthroscopic surgery and the contralateral hip with no history of surgical manipulation.

Methods: Patients undergoing revision hip arthroscopy between April 2019 and December 2020, who previously underwent arthroscopic hip surgery for femoroacetabular impingement syndrome, were prospectively enrolled. Exclusion criteria were any contralateral hip surgery.

Tibial Spine Repair in the Pediatric Population: Outcomes and Subsequent Injury Rates.

Purpose: To evaluate short- to mid-term outcomes after arthroscopic operative fixation of tibial spine fractures in pediatric patients, to determine the incidence of further ipsilateral and contralateral knee injuries, and to describe associated meniscal pathology and intraoperative findings at the time of tibial spine repair.

Methods: All patients under age 18 with a tibial spine fracture treated arthroscopically at 1 institution by 2 surgeons from 2008 through 2019 were identified by Current Procedural Terminology codes. Patients at least 1 year from their date of surgery were contacted to complete a questionnaire, which included the International Knee Documentation Committee (IKDC) form.

Capsular Repair During Hip Arthroscopy Demonstrates Restoration of Axial Distraction Resistance in an in Vivo Intraoperative Testing Model.

Background: Cadaveric models demonstrate that failure of hip capsular repair is dependent on the robustness of the repair construct. In vivo data on capsular repair construct efficacy are limited. We investigated the effect of a figure-of-8 capsular repair on hip distraction resistance relative to native and post-capsulotomy states.

Chondrosarcoma Arising in Synovial Chondromatosis of the Hip: A Case Report.

Case: Synovial chondromatosis (SC) is a rare condition involving the proliferation of cartilage within the synovial membrane secondary to subsynovial connective tissue metaplasia. Malignant transformation to chondrosarcoma is rare. We cite a case of SC of the hip refractory to arthroscopic debridement, found to have secondary chondrosarcoma on aborted total hip arthroplasty, in which curative treatment was ultimately obtained with external hemipelvectomy.

Arthroscopic Hip Capsule Reconstruction for Anterior Hip Capsule Insufficiency in the Revision Setting.

Iatrogenic hip instability is increasingly recognized as a cause of persistent pain and disability after hip arthroscopy. Many authors currently advocate capsular repair to reduce postoperative instability. However, anatomic deficiencies in the anterosuperior capsule can prevent a functional capsular repair, particularly in the revision setting.

Overgrowth After Pediatric Tibial Spine Repair with Symptomatic Leg Length Discrepancy: A Case Report.

Case: A 12-year-old girl sustained a right-sided tibial spine fracture while jumping on a trampoline. Postoperative course was complicated initially by arthrofibrosis requiring manipulation under anesthesia and subsequent leg length discrepancy attributed to posttraumatic overgrowth necessitating femoral epiphysiodesis. Ten years after initial injury, she reported her knee to be 63% of normal and an International Knee Documentation Committee score of 63.

Ischial osteoid osteoma: A cause of persistent hip pain in an adolescent patient with bilateral femoroacetabular impingement.

A 15-year-old boy presented with left-sided hip pain and imaging consistent with the diagnosis of femoroacetabular impingement. Following hip arthroscopy, which included an osteochondroplasty, labral repair, and capsular repair, the patient's anterior hip pain improved. However, his deep aching hip pain persisted until an ischial osteoid osteoma was identified and treated with radiofrequency ablation.

Joint Venting Prior to Hip Distraction Minimizes Traction Forces During Hip Arthroscopy.

Purpose: This study evaluates the effect of venting on distraction of the hip during arthroscopy on a post-free traction table for fixed traction forces ranging from 0 to 100 pounds (lbs).

Methods: Patients underwent surgery by the senior author (S.K.

HRAS-driven cancer cells are vulnerable to TRPML1 inhibition.

By serving as intermediaries between cellular metabolism and the bioenergetic demands of proliferation, endolysosomes allow cancer cells to thrive under normally detrimental conditions. Here, we show that an endolysosomal TRP channel, TRPML1, is necessary for the proliferation of cancer cells that bear activating mutations in Expression of , which encodes TRPML1, is significantly elevated in -positive tumors and inversely correlated with patient prognosis. Concordantly, knockdown or TRPML1 inhibition selectively reduces the proliferation of cancer cells that express oncogenic, but not wild-type, Mechanistically, TRPML1 maintains oncogenic HRAS in signaling-competent nanoclusters at the plasma membrane by mediating cholesterol de-esterification and transport.