Which Osteochondritis Dissecans Lesions Will Heal Nonoperatively? An Application of Machine Learning to the ROCK Prospective Cohort.

Background: There are limited evidence-based guidelines to predict which osteochondritis dissecans (OCD) lesions will heal with nonoperative treatment.

Purpose: To train a set of classification algorithms to predict nonoperative OCD healing while identifying new clinically meaningful predictors.

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

A Simple Clinical Predictive Model for Arthroscopic Mobility of Osteochondritis Dissecans Lesions of the Knee.

Background: Osteochondritis dissecans (OCD) of the knee is a focal idiopathic alteration of subchondral bone and/or its precursor with risk for instability and disruption of adjacent cartilage. Treatment options focused on preventing premature osteoarthritis vary depending on multiple patient and lesion characteristics, including lesion mobility.

Purpose: To differentiate lesion mobility before arthroscopy using a multivariable model that includes patient demographic characteristics and physical examination findings.

Biceps Tenodesis for the Treatment of Type II Superior Labral Anterior Posterior (SLAP) Tears in Overhead Athletes Under the Age of 35: A Case Series.

Background: The best treatment for type II superior labral anterior posterior (SLAP) tears in overhead athletes is not well defined.

Questions/purpose: The purpose of this study was to examine post-surgical outcomes in overhead athletes under the age of 35 who underwent primary biceps tenodesis for an isolated type II SLAP tear. We hypothesized that these patients would have high rates of return to play, as well as recovery of range of motion (ROM) and strength after surgery.

Guided Growth for Correction of Elevated Tibial Posterior Slope in Pediatric ACL Deficiency: A Case Report.

Case: Fourteen-year-old boy, history of autism presented with bilateral knee instability. Imaging revealed bilateral anterior cruciate ligament (ACL) insufficiency, 20° of posterior tibial slope (PTS) on the right and 18° on the left. A guided growth technique using anterior placed tension band plates was used to correct the PTS.

Advanced Neuromuscular Training Differentially Changes Performance on Visuomotor Reaction Tests and Single-leg Hop Tests in Patients with ACL Reconstruction.

Background: Advanced neuromuscular training prepares patients with anterior cruciate ligament reconstruction (ACLR) for sport participation. Return-to-sport testing often includes single-leg hop tests, yet combining motor and cognitive tasks (i.e.

Tibial derotational osteotomy for idiopathic tibial torsion: A systematic review of surgical indications based on clinical presentation and measurement technique.

Purpose: The aim of this systematic review was to identify the surgical indications of tibial derotational osteotomy (TDO) in patients with idiopathic external tibial torsion (ETT) and identify common measurement thresholds for surgical correction.

Methods: A systematic search of MEDLINE and Embase via Ovid, Cochrane Library via Wiley, Web of Science, Scopus, SPORTDiscus via EBSCOhost, ClinicalTrials.gov, WHO ICTRP and Global Index Medicus databases was performed with search terms reflecting the concepts of idiopathic tibial torsion, TDOs, and surgical indications.

Functional testing following isolated meniscus repair may help to identify patients who need additional physical therapy prior to a return to activity.

Objectives: Functional testing (FT), commonly used to evaluate dynamic knee function and provide objective information about how well a patient, has progressed in rehabilitation following an anterior cruciate ligament (ACL) reconstruction. The purpose of the study was to determine whether a functional test could be used as an assessment tool for return to activity following isolated meniscus repair.

Methods: The results of FT completed between 80 and 150 days post-operation (representing 4-months post-operative) in isolated meniscal repair patients were analysed for the involved limb, uninvolved limb, and limb symmetry index (LSI).

Improved Patient-reported Outcomes in Patients Aged 16 and Younger at Two Years After Anterior Cruciate Ligament Reconstruction Despite Relatively High Rates of Reinjury and Repeat Surgery.

Background: Anterior cruciate ligament reconstruction (ACLR) in adolescent patients, particularly those aged 16 and under, are increasingly common procedure that lacks robust clinical and patient-reported outcome (PRO) data. The purpose of this study was to report 2-year PROs of patients receiving ACLR aged 16 or younger using the single assessment numerical evaluation (SANE) and knee injury and osteoarthritis outcome score (KOOS). Secondary aims included characterizing treatment characteristics, return to sport (RTS), and clinical outcomes.

Changes in tissue sodium concentration and sodium relaxation times during the maturation of human knee cartilage: Ex vivo Na MRI study at 10.5 T.

Purpose: To evaluate the influence of skeletal maturation on sodium ( Na) MRI relaxation parameters and the accuracy of tissue sodium concentration (TSC) quantification in human knee cartilage.

Methods: Twelve pediatric knee specimens were imaged with whole-body 10.5 T MRI using a density-adapted 3D radial projection sequence to evaluate Na parameters: B , T , biexponential , and TSC.

Cell Count and Cell Density Decrease as Age Increases in Cadaveric Pediatric Medial Menisci.

Purpose: To examine the histologic changes in terms of cellularity, cell density, and nuclear shape in medial meniscal cellularity during skeletal development using pediatric cadaver specimens.

Methods: Medial menisci from 26 pediatric cadavers, 11 female and 15 male (total 36 menisci), were obtained from tissue bank. Mean age of female donors was 34 months (1-108 months) and of male donors was 52 months (1-132 months).

Screws or Sutures? A Pediatric Cadaveric Study of Tibial Spine Fracture Repairs.

Background: Tibial spine fractures are common in the pediatric population because of the biomechanical properties of children's subchondral epiphyseal bone. Most studies in porcine or adult human bone suggest that suture fixation performs better than screw fixation, but these tissues may be poor surrogates for pediatric bone. No previous study has evaluated fixation methods in human pediatric knees.

Pediatric meniscus morphology varies with age: a cadaveric study.

Purpose: In adolescent patients, meniscal tear injury can occur either in isolation (e.g., discoid lateral meniscus tears) or in association with other traumatic injuries including tibial eminence fracture or ACL tear.

An MCL internal brace can withstand cyclic fatigue loading and produce a valgus load to failure similar to that of intact knees.

Purpose: The purpose of this study is to report on the biomechanical durability and strength of an MCL internal brace construct. The null hypothesis is that there will be no difference between this construct and the intact MCL in terms of deflection during fatigue testing and the ultimate failure load.

Methods: Eight cadaver knees were used.

MCL internal brace does not fully recapitulate normal MCL function in valgus stress.

Purpose: The null hypothesis is that there would be no difference in medial gapping under valgus load between the intact MCL and the ruptured MCL with an internal brace in place.

Methods: Eight pairs of cadaver knees were used (16 knees). Alternating sides, one knee from each pair was used for one of two "internal brace" constructs.

Rising incidence of stair-related upper extremity fractures among older adults in the United States: a 10-year nationwide analysis.

Unlabelled: Upper extremity (UE) fractures are prevalent age-related fractures, and stair-associated falls are a common mechanism for these injuries. Our study has identified an increasing incidence of stair-related UE fractures and associated hospitalization rates among the older United States population between 2012-2021. Targeted prevention efforts should be implemented by health systems.

Sofa and bed-related pediatric trauma injuries treated in United States emergency departments.

Introduction: Children under the age of 5 years suffer from the highest rates of fall-related injuries. Caretakers often leave young children on sofas and beds, however, falling and rolling off these fixtures can lead to serious injury. We investigated the epidemiologic characteristics and trends of bed and sofa-related injuries among children aged <5 years treated in US emergency departments (EDs).

Open Glenoid Augmentation With Scapular Spine Autograft for Recurrent Shoulder Instability: A Report of Two Cases.

Optimal treatment for patients with significant glenoid bone loss after severe shoulder dislocation remains a topic of discussion, as there are many autograft and allograft techniques for glenoid augmentation. Several studies have identified scapular spine autograft to be a potential option for restoring glenohumeral stability, however, there is limited clinical data for this procedure. We present two cases in which patients suffered from anterior glenoid bone loss and recurrent shoulder instability who underwent open glenoid augmentation with scapular spine autograft.

Evaluation of lesion and overlying articular cartilage in patients with juvenile osteochondritis dissecans of the knee using quantitative diffusion MRI.

Current clinical MRI of patients with juvenile osteochondritis dissecans (JOCD) is limited by the low reproducibility of lesion instability evaluation and inability to predict which lesions will heal after nonoperative treatment and which will later require surgery. The aim of this study is to verify the ability of apparent diffusion coefficient (ADC) to detect differences in lesion microstructure between different JOCD stages, treatment groups, and healthy, unaffected contralateral knees. Pediatric patients with JOCD received quantitative diffusion MRI between January 2016 and September 2020 in this prospective research study.

Rotational Osteotomy for Femoral Version/Tibial Torsion.

Purpose Of Review: The purpose of this review is to discuss the current state of knowledge regarding axial plane deformities in patellofemoral instability, indications and techniques for treatment of those deformities, and outcomes following treatment.

Recent Findings: There is opportunity for more information in the literature on all aspects of axial plane deformities in patellofemoral instability. This includes how to assess axial plane deformities on imaging, what is normal and what is an appropriate goal for correction, what techniques are best used depending on the deformity or concomitant pathology, and larger and more discriminating studies on outcomes.

Cost and Cost Driver Analysis of Anterior Cruciate Ligament Reconstruction Using Time-Driven Activity-Based Costing: Bone-Tendon-Bone Autograft Versus Hamstring Autograft.

Unlabelled: As health care transitions toward value-based care, orthopaedics has started to implement time-driven activity-based costing (TDABC) to understand costs and cost drivers. TDABC has not previously been used to study cost drivers in anterior cruciate ligament reconstruction (ACLR). The purpose of this study was to use TDABC to (1) calculate bone-tendon-bone (BTB) and hamstring ACLR total costs of care and (2) evaluate the impact of graft choice and other factors on ACLR costs.

Osteochondritis Dissecans of the Knee in Young Athletes.

Osteochondritis dissecans of the knee is a relatively rare disorder in young athletes that can lead to premature osteoarthritis. It may be caused by multiple factors, including repetitive stress, local ischemia, aberrant endochondral ossification of the subarticular physis, and hereditary disposition. Nonoperative treatment is typically attempted for patients with open physes, stable lesions, and minimal symptoms.