The Condition of the Meniscus and Cartilage of the Injured Knee on Preoperative Magnetic Resonance Imaging Is a Prognostic Factor Affecting Postoperative Outcomes Following Knee Cartilage Restoration Surgery.

Purpose: To evaluate the relationship between preoperative whole-joint imaging evaluation of the knee with patient-reported outcome (PRO) measures after cartilage restoration surgery (mosaicplasty, osteochondral allograft transplantation, matrix autologous chondrocyte implantation).

Methods: We retrospectively evaluated patients who underwent knee articular cartilage restoration at our institution from 2014 to 2020. The patients' knee magnetic resonance imaging (MRI) was evaluated with the Whole-Organ Magnetic Resonance Imaging Score (WORMS) and semiquantitative synovial inflammation imaging biomarkers of the preoperative MRI.

Combined Medial Patellofemoral Ligament Reconstruction and Tibial Tubercle Osteotomy Has a Lower Risk of Recurrent Instability Requiring Revision Stabilization at 2 Years Than Either Procedure Alone.

Purpose: To use a large nationwide administrative database to directly compare usage, complications, and need for revision stabilization surgery after medial patellofemoral ligament reconstruction (MPLFR), tibial tubercle osteotomy (TTO), and combined MPFLR and TTO (MPFLRTTO).

Methods: The PearlDiver Mariner database was queried for all reported cases of MPLFR, TTO, and combined MPFLRTTO performed between 2010 and 2020 using Current Procedural Terminology codes. Subsets from those cohorts with laterality-specific , , codes for patellar instability were used to evaluate 2-year incidence of infection, stiffness, fracture, and revision stabilization with MPFLR and/or TTO.

Patellofemoral Cartilage Injury and Treatment.

Osteochondral and chondral injuries of the patellofemoral joint are common in active patients, and effective management requires a thorough physical and imaging evaluation, a detailed understanding of the unique anatomic and biomechanical joint properties contributing to these injuries, and an appropriate selection of treatment modality. Diagnosis of patellofemoral chondral injuries can be challenging, and differentiating between various causes of anterior knee pain is crucial to successful outcomes. Once identified, nonsurgical treatments including physical therapy, bracing, and injections are a mainstay of initial management.

Longitudinal Changes in Medial Meniscal Extrusion After ACL Injury and Reconstruction and Its Relationship With Cartilage Degeneration Assessed Using MRI-Based T1ρ and T2 Analysis.

Background: Anterior cruciate ligament (ACL) injury often leads to posttraumatic osteoarthritis (PTOA), despite ACL reconstruction (ACLR). Medial meniscal extrusion (MME) is implicated in PTOA progression but remains understudied after ACL injury and ACLR.

Hypothesis/purpose: It was hypothesized that MME would increase longitudinally after ACL injury and ACLR, with greater changes in the ipsilateral knee compared with the contralateral knee, leading to cartilage degeneration.

COVID-19 Diagnosis Within 6 Weeks of Arthroscopic Knee Surgery Leads to Higher Risk for Postoperative Venous Thromboembolism.

Purpose: To determine if preoperative infection with COVID-19 increased risk for postoperative venous thromboembolism (VTE) in patients undergoing arthroscopic knee surgery.

Methods: PearlDiver Mariner 165 database was queried for patients undergoing knee arthroscopy between 2010 and October 2022. Patients were categorized by history of COVID-19 diagnosis and timing in relation to surgery.

Endoprosthetic Reconstruction for Proximal Humerus Tumors.

Purpose Of The Review: Anatomic and reverse endoprosthetic reconstruction are two common surgical options used after tumor resection of the proximal humerus. The purpose of this article is to provide an overview of the functional outcomes and complications of modern anatomic and reverse endoprostheses.

Recent Findings: The anatomic endoprosthesis has traditionally been a successful reconstructive technique as it provided a stable platform upon which the hand and elbow could function.

Association Between Tibiofemoral Bone Shape Features and Retears After Anterior Cruciate Ligament Reconstruction.

Background: A retear after anterior cruciate ligament (ACL) reconstruction remains a common and devastating complication. Knee bone morphology is associated with the risk of ACL injuries, ACL retears, and osteoarthritis, and a combination of tools that derive bone shape from clinical imaging, such as magnetic resonance imaging (MRI) and statistical shape modeling, could identify patients at risk of developing these joint conditions.

Purpose: To identify bone shape features before primary ACL reconstruction in patients with an eventual retear compared to those with a known intact ACL graft.

Higher Posterior Tibial Slope and Lower Medial Proximal Tibial Angle of the Knee Are Associated With Delayed Graft Maturation After Anterior Cruciate Ligament Reconstruction Surgery With Hamstring Autograft.

Purpose: To relate bone shape with anterior cruciate ligament (ACL) graft maturation, as evaluated by quantitative magnetic resonance imaging.

Methods: We retrospectively evaluated patients aged 18 to 60 years who underwent ACL reconstruction with a hamstring autograft with doubled semitendinosus and gracilis at our institution between 2018 and 2020 with isolated ACL injuries. All patients had a minimum follow-up period of 2 years.

Low-Volume and Early-Career Surgeons Have Higher Risk for Reoperation and Complications Following Anterior Cruciate Ligament Reconstruction.

Purpose: To characterize the population of surgeons performing anterior cruciate ligament reconstructions (ACLRs) in the United States and investigate the relationships between surgeon volume, career duration, and practice setting on surgical outcomes.

Methods: A large nationwide insurance database was queried for patients undergoing primary ACLR. Provider gender, degree type (allopathic vs osteopathic), practice setting (academic vs private as defined by ACGME affiliation), surgeon volume per year, and career duration were obtained.

Prognostic Factors on Preoperative MRI for Patient-Reported Outcomes After Posterior Medial Meniscus Root Repair.

Background: Repair of posterior medial meniscus root (PMMR) tears has demonstrated favorable outcomes and may prevent rapid progression of knee osteoarthritis; however, there is a paucity of data regarding prognostic factors affecting postoperative outcomes.

Purpose/hypothesis: The purpose of this study was to identify factors on preoperative magnetic resonance imaging (MRI) that predict postoperative outcomes after PMMR repair. It was hypothesized that patients with increasing levels of degenerative changes as evaluated through semiquantitative preoperative MRI scans would have worse postoperative patient-reported outcome (PRO) scores.

Effect of Obesity on Short- and Long-Term Complications After Ankle Fracture Fixation.

Objectives: This study evaluated the relationship between obesity and postoperative complications in patients undergoing ankle open reduction internal fixation (ORIF).

Design: Retrospective cohort study.

Setting: PearlDiver-Mariner All-Payor Database.

Association of Preoperative Shoulder Osteoarthritis Severity Score With Change in American Shoulder and Elbow Surgeons Score at 2 Years After Rotator Cuff Repair.

Background: The impact of early glenohumeral osteoarthritis (GHOA) on clinical outcomes after rotator cuff repair (RCR) remains unclear. The magnetic resonance imaging (MRI)-based Shoulder Osteoarthritis Severity (SOAS) score is a comprehensive approach to quantifying glenohumeral degeneration.

Purpose: To investigate the association between SOAS scores and changes in American Shoulder and Elbow Surgeons (ASES) scores in patients who underwent RCR.

Impact of surgeon volume, experience, and training on outcomes after arthroscopic rotator cuff repair: a nationwide analysis of 1489 surgeons.

Background: Given the complexity of arthroscopic rotator cuff repair (ARCR) and increasing prevalence, there is a need for comprehensive, large-scale studies that investigate potential correlations between surgeon-specific factors and postoperative outcomes after ARCR. This study examines how surgeon-specific factors including case volume, career length, fellowship training, practice setting, and regional practice impact two-year reoperation rates, conversion to total shoulder arthroplasty (anatomic or reverse), and 90-day post-ARCR hospitalization.

Methods: The PearlDiver Mariner database was used to collect surgeon-specific variables and query patients who underwent ARCR from 2015 to 2018.

Degenerative medial and lateral menisci root tears: demographics, clinical presentation, imaging features, and associated findings.

Purpose: (I) Characterize the demographics and clinical features of patients with meniscal root tears (MRT); (II) analyze the morphology, extent, and grade of MRT on MRI; (III) evaluate associated abnormalities on imaging; and (IV) evaluate the associations between imaging findings, demographics, clinical features, and joint structural abnormalities.

Material And Methods: A search was performed to identify meniscal root tears. Age, sex, BMI, and pain were recorded.

No Differences in 2-Year Reoperation Rates for Meniscus Allograft Transplant With Concomitant Cartilage Restoration or Osteotomy: A National Database Study.

Purpose: To investigate reoperation rates after meniscus allograft transplant (MAT), comparing rates with and without concomitant articular cartilage and osteotomy procedures using a national insurance claims database.

Methods: We performed a retrospective cohort study of patients who underwent MAT from 2010 to 2021 with a minimum 2-year follow-up using the PearlDiver database. Using Current Procedural Terminology and International Classification of Diseases codes, we identified patients who underwent concomitant procedures including chondroplasty or microfracture, cartilage restoration defined as osteochondral graft or autologous chondrocyte implantation (ACI), or osteotomy.

Clinical and radiologic outcomes in patients with meniscal root tears.

Background: Meniscal root tears can lead to early knee osteoarthritis and pain. This study aimed (1) to compare clinical and radiological outcomes between patients who underwent arthroscopic meniscal root repair after meniscal root tears and those who received non-surgical treatment, and (2) to identify whether baseline MRI findings could be potential predictors for future treatment strategies.

Methods: Patients with meniscal root tears were identified from our picture archiving and communication system from 2016 to 2020.

A Greater Platelet Dose May Yield Better Clinical Outcomes for Platelet-Rich Plasma in the Treatment of Knee Osteoarthritis: A Systematic Review.

Purpose: To determine whether the platelet dose administered during a platelet-rich plasma (PRP) injection for knee osteoarthritis (OA) affects clinical outcomes.

Methods: A systematic review was performed by searching PubMed, Cochrane Library, and Embase for randomized controlled trials with at least 1 study arm using PRP for knee OA. Only studies that provided a platelet count, concentration, or dose with a minimum of 6-month outcome scores were included.

Delayed hip arthroscopy for femoroacetabular impingement syndrome does not increase revision but does increase rates of chronic opiate use.

Introduction: In recent years, the utilization of hip arthroscopy to treat femoroacetabular impingement syndrome (FAIS) has increased due to its low complication rates, positive impact on patient-reported outcomes (PROs), and association with faster rehabilitation. Despite this, there are high rates of revision and conversion to total hip arthroplasty (THA) in some of these patients. It is unclear whether time from initial FAIS diagnosis to surgery is a risk factor for poor outcomes.

Rotator cuff tears.

Rotator cuff tears are the most common upper extremity condition seen by primary care and orthopaedic surgeons, with a spectrum ranging from tendinopathy to full-thickness tears with arthritic change. Some tears are traumatic, but most rotator cuff problems are degenerative. Not all tears are symptomatic and not all progress, and many patients in whom tears become more extensive do not experience symptom worsening.

Total shoulder arthroplasty in patients with dementia or mild cognitive impairment.

Background: Anatomic total shoulder arthroplasty (ATSA) and reverse total shoulder arthroplasty (RTSA) reliably alleviate pain and restore shoulder function for a variety of indications. However, these procedures are not well-studied in patients with neurocognitive impairment. Therefore, the purpose of this study was to investigate whether patients with dementia or mild cognitive impairment (MCI) have increased odds of surgical or medical complications following arthroplasty.

Open Fractures in National Football League Athletes: Analyzing Performance and Return to Sport.

Introduction: Open fractures are potentially devastating injuries for the professional athlete. We sought to compare return to sports (RTS) and performance in National Football League (NFL) athletes sustaining open versus closed fractures.

Methods: NFL athletes with surgically treated open and closed fractures of the forearm, tibial shaft, and ankle from 2009-2018 were identified through publicly available reports and records.

Factors Associated With Humeral Avulsion of Glenohumeral Ligament Lesions in Patients With Anterior Shoulder Instability: An Analysis of the MOON Shoulder Instability Cohort.

Background: Humeral avulsion of the glenohumeral ligament (HAGL) lesions are an uncommon cause of anterior glenohumeral instability and may occur in isolation or combination with other pathologies. As HAGL lesions are difficult to detect via magnetic resonance imaging (MRI) and arthroscopy, they can remain unrecognized and result in continued glenohumeral instability.

Purpose: To compare patients with anterior shoulder instability from a large multicenter cohort with and without a diagnosis of a HAGL lesion and identify preoperative physical examination findings, patient-reported outcomes, imaging findings, and surgical management trends associated with HAGL lesions.