Probing Isosteric Replacement for Immunoadjuvant Design: Bis-Aryl Triazole Trehalolipids are Mincle Agonists.

Herein, we report the modular synthesis and immunological activity of seven bis-aryl triazole trehalolipids (-) as Brartemicin analogs. The compounds comprised one or two octyloxy (C8) alkyl chains and were synthesized using the venerable CuAAc reaction between the respective aryl acetylenes and a trehalose diazide. A Mincle reporter cell assay revealed that all lipidated analogs activated Mincle.

Biomechanical Analysis Evaluating Meniscal Extrusion After Knotless Suture Anchor Fixation for Segmental Medial Meniscal Allograft Transplantation.

Background: Segmental medial meniscal allograft transplantation (MAT) has been shown to restore knee biomechanics; however, stable fixation of the transplantation is critical to avoid extrusion and maximize healing.

Purpose: To evaluate the degree of meniscal extrusion and biomechanical function of segmental medial MAT performed with meniscocapsular sutures versus repair augmentation with knotless suture anchors.

Study Design: Controlled laboratory study.

Inflammatory and Immunologic Contributions in Femoroacetabular Impingement Syndrome.

Femoroacetabular impingement (FAI) is one of the most common causes of labral and early cartilage damage in the nondysplastic hip. FAI is increasingly recognized as a cause for hip and groin pain in the young, active patient, and the surgical treatment of FAI with hip arthroscopy has risen exponentially. Although our understanding of FAI and the progression to degenerative osteoarthritis of the hip has historically been considered a mechanical "wear-and-tear" disease of an imperfectly shaped, aspherical, femoral head within a deep or overcovering acetabulum leading to cartilage injury, our understanding of the intrinsic pathophysiologic mechanisms underlying the development of FAI and joint degeneration of the hip remains poor.

Use of Computed Tomography in the Evaluation of Anterior Shoulder Instability: Possible Effect on Surgical Management.

Background: Glenoid bone loss is a critical factor in the management of anterior shoulder instability (ASI). Computed tomography (CT) is often considered the gold standard to evaluate glenoid bone loss, but it is associated with negative factors such as radiation. Thus, interest exists as to when orthopaedic surgeons need a CT scan to guide decision-making when treating ASI.

Long-Term Visual Outcomes in Neovascular Age-Related Macular Degeneration Eyes With Baseline Macular Atrophy on Anti-Vascular Endothelial Growth Factor Treatment.

Background And Objective: This study explores the connection between macular atrophy (MA) status at baseline and best visual acuity (BVA) after 5 to 7 years of anti-vascular endothelial growth factor (anti-VEGF) injections on eyes with neovascular age-related macular degeneration (nAMD).

Patients And Methods: This retrospective study included patients with neovascular age-related macular degeneration receiving anti-VEGF injections at least twice-yearly for 5+ years at Cole Eye Institute. Analyses of variance and linear regressions explored the connection between MA status, baseline MA intensity, and 5-year BVA change.

Sub-ppm gas phase Raman spectroscopy in an anti-resonant hollow core fiber.

We demonstrate recent progress in the development of a Raman gas sensor using a single cladding ring anti-resonant hollow core micro-structured optical fiber (HC-ARF) and a low power pump source. The HC-ARF was designed specifically for low attenuation and wide bandwidth in the visible spectral region and provided low loss at both the pump wavelength (532 nm) and Stokes wavelengths up to a Raman shift of 5000 cm. A novel selective core pressurization scheme was also implemented to further reduce the confinement loss, improving the Raman signal enhancement by a factor of 1.

Anterior Closing-Wedge High Tibial Slope-Correcting Osteotomy Using Patient-Specific Preoperative Planning Software for Failed Anterior Cruciate Ligament Reconstruction.

Failure of anterior cruciate ligament reconstruction (ACLR) remains a challenging problem. Recently, the effect of increased posterior tibial slope has been identified as a risk factor for ACLR failure. In cases with increased posterior tibial slope, an anterior closing wedge, slope-correcting high tibial osteotomy can be used as a robust adjunct to revision ACLR.

Arthroscopic Treatment of Snapping Scapula Syndrome With Scapulothoracic Bursectomy and Partial Scapulectomy.

Snapping scapula syndrome (SSS) is a painful and debilitating condition that occurs as a result of disruption of normal scapulothoracic articulation and inflammation of numerous soft tissue and bursal structures that function to facilitate scapulothoracic motion. Historically, when nonoperative management of SSS failed, patients progressed to open surgical management. However, as arthroscopic techniques have evolved, the condition has been increasingly treated arthroscopically because of the minimally invasive nature, periscapular muscle-preserving approach with decreased risk to surrounding neurovascular structures, better intraoperative visualization, and quicker patient recovery and rehabilitation.

Response Bias for Press Ganey Ambulatory Surgery Surveys after Knee Surgery.

The Press Ganey Ambulatory Surgery (PGAS) survey is an emerging tool used to capture patient satisfaction after elective surgery. Evaluating patient satisfaction is important; however, quality improvement (QI) surveys used to capture the patient experience may be subject to nonresponse bias. An orthopaedic registry was used to retrospectively identify patients who underwent ambulatory knee surgery from June 2015 to December 2019.

Editorial Commentary: Shoulder Superior Capsular Reconstruction Graft Tensioning Between 30° and 40° of Glenohumeral Abduction Is Recommended: The Balance Beam of Superior Capsular Reconstruction.

Massive irreparable rotator cuff tears in young, active patients pose a challenging treatment dilemma. Since the relatively recent development of the superior capsular reconstruction (SCR) procedure, the technique has been increasingly used to stave off reverse total shoulder arthroplasty in this demographic. As a result of continued output of supportive literature, both biomechanically and clinically, SCR has been adopted by surgeons despite some technical aspects of the procedure not being fully elucidated.

PROMIS Depression and Anxiety in shoulder surgery patients.

Aims: The purpose of this study was to assess the prevalence of depression and anxiety symptoms in patients undergoing shoulder surgery using the National Institutes of Health (NIH) Patient-Reported Outcomes Measurement Information System (PROMIS) Depression and Anxiety computer adaptive tests, and to determine the factors associated with more severe symptoms. Additionally, we sought to determine whether PROMIS Depression and Anxiety were associated with functional outcomes after shoulder surgery.

Methods: This was a retrospective analysis of 293 patients from an urban population who underwent elective shoulder surgery from 2015 to 2018.

Patient Perception of Being "Completely Better" After Anterior Cruciate Ligament Reconstruction.

Background: Contextualizing patient-reported outcomes (PROs) by defining clinically relevant differences is important. Considering that anterior cruciate ligament reconstruction (ACLR) ideally results in the restoration of normal knee function, an assessment of patients' perception of being "completely better" (CB) may be of particular value.

Purpose: The purpose of this study was to assess the prevalence and characteristics of patients who self-report a CB status after ACLR.

Predictors of postoperative pain using PROMIS pain interference two-years following knee surgery.

Introduction: The purpose of this study was to identify preoperative factors associated with worse PROMIS Pain Interference (PI) two years following knee surgery.

Methods: Participants completed surveys preoperatively and two years postoperatively. Data collected included demographics, medical history, and multiple patient-reported outcomes measures, including PROMIS PI.

Opioid Prescribing Habits for Common Arthroscopic Procedures in Opioid Naïve Patients.

Background: With the opioid epidemic and the increasing number of opioid-related deaths, there is growing awareness in the medical community regarding the dangers of opioid overprescription. As a result, there is a willingness among physicians to abandon old norms and adopt new data-driven prescribing practices.

Purpose: To demonstrate patient-reported consumption data of opioid medications after anterior cruciate ligament (ACL) reconstructions (ACLRs), knee arthroscopies, and rotator cuff repairs to provide data-driven guidelines for prescribing opioids after these procedures.

Preoperative opioid use correlates with worse patient-reported outcomes two years after elective shoulder surgery.

Introduction: Prescription opioid consumption in the United States is a well-known public health problem, however, the deleterious effect of opioids may not be fully understood. The purpose of this study was to investigate the relationship between preoperative opioid use and patient-reported outcomes two years after shoulder surgery. We hypothesized preoperative opioid use would be predictive of worse two-year patient reported outcome scores.

Difference in Resident Versus Attending Perspective of Competency and Autonomy During Arthroscopic Rotator Cuff Repairs.

Unlabelled: A noted deficiency in orthopaedic resident education is a lack of intraoperative autonomy; however, no studies exist evaluating this issue. The purpose of this study was to determine whether there is a difference between resident and attending perception of resident competency and autonomy during arthroscopic rotator cuff repairs and whether increased perceived competency leads to more autonomy.

Methods: This study included 21 orthopaedic residents and 7 attendings from a single residency program.

Preoperative tendon retraction, not smoking, is a risk factor for failure with continuity after rotator cuff repair.

Background: Smoking is a poor prognostic factor for healing after rotator cuff repair and is associated with inferior results. We hypothesized that smokers would have higher recurrent tear rates and more postoperative myotendinous junction (MTJ) retraction in healed repairs than nonsmokers three months postoperatively.

Methods: Rotator cuff repairs (RCRs) were retrospectively reviewed over a 2-year period.

Editorial Commentary: Suprascapular Nerve Decompression Can Be Effective, But Should You Have the Nerve to Do It?

Isolated suprascapular neuropathy that requires surgical decompression is rare. Arthroscopic suprascapular nerve decompression is an effective treatment for correctly indicated patients, but identifying which patients would benefit from decompression is challenging. While good outcomes and low complication rates after arthroscopic suprascapular nerve decompression have been reported by expert surgeons, this procedure has potential for neurovascular injury in inexperienced hands.