Bicondylar tibial plateau fracture after posterior cruciate ligament reconstruction.

The authors present a report of a bicondylar tibial plateau fracture in an adolescent athlete after posterior cruciate ligament (PCL) reconstruction. The procedure was performed via arthroscopic transtibial PCL reconstruction with quadrupled semi-tendinosus and gracilis autograft. The patient recovered uneventfully postoperatively and was able to participate in high-level sports activity, such as baseball and track, with no limitations, no subjective complaints, and no episodes of instability.

Recurrent instability after revision anterior shoulder stabilization surgery.

Purpose: The purpose of this study was to perform a systematic review of the literature to compare outcomes of revision anterior stabilization surgeries based on technique. This study also sought to compare the impact of bone defects on outcomes.

Methods: A systematic review of the electronic databases PubMed, Cochrane Central Register of Controlled Trials, and Scopus was performed in July 2012 and March 2013.

Continuous passive motion following cartilage surgery: does a common protocol exist?

Continuous passive motion (CPM) devices have the potential to improve the histological content as well as the rate and volume of chondrogenesis in repair tissue following chondral injury. However, clinical evidence is lacking to support broad implementation of CPM following cartilage restoration procedures. We searched PubMed, CINAHL, SPORTDiscus, and Cochrane for such terms as knee, continuous passive motion, CPM, ACI, ACT, autologous chondrocyte implantation, autologous chondrocyte transplantation, microfracture, marrow-stimulation technique, mosaicplasty, osteochondral autograft, and osteochondral allograft.

Treatment of avascular necrosis of the femoral head utilising free vascularised fibular graft: a systematic review.

We conducted a systematic review to determine whether the literature supports the use of free vascularised fibular graft (FVFG) over other salvage procedures for the treatment of avascular necrosis (AVN) of the femoral head, and if there are patient-specific and defect-specific factors that may predict better outcomes after FVFG. Fifteen total studies were identified for inclusion. Three comparative studies showed an overall statistically significant superiority of FVFG over NVFG; two comparative studies demonstrated FVFG better than core decompression.

The basic science of continuous passive motion in promoting knee health: a systematic review of studies in a rabbit model.

Purpose: To determine whether the basic science evidence supports the use of continuous passive motion (CPM) after articular cartilage injury in the knee.

Methods: A systematic review was performed identifying and evaluating studies in animal models that focused on the basic science of CPM of the knee. Databases included in this review were PubMed, Biosis Previews, SPORTDiscus, PEDro, and EMBASE.

Outcomes after injury to the thumb ulnar collateral ligament--a systematic review.

Objectives: Rupture of the ulnar collateral ligament (UCL) is a frequent injury of the hand. When untreated, this injury may lead to decreased pinch strength, pain, instability, and osteoarthritis. There is currently no consensus on treatment of acute or chronic UCL injuries.

Complications and re-operations after Bristow-Latarjet shoulder stabilization: a systematic review.

Background: Various methods of bony stabilization, including modifications of Bristow and Latarjet procedures, are considered gold-standard treatment for recurrent anterior shoulder instability but are associated with unique complications and risk of reoperation. The purpose of this study was to identify the prevalence of these complications. We hypothesized that the Bristow-Latarjet procedure would be a successful technique for treatment of shoulder instability but associated with a risk of recurrent postoperative instability, reoperation, and other complications.

Operative management of capitellar fractures: a systematic review.

Purpose: This study was conducted to evaluate reports of clinical outcomes of isolated capitellar fractures.

Materials And Methods: We conducted a systematic review of medical databases reporting clinical outcomes of patients undergoing nonoperative and operative management of isolated capitellar fractures.

Results: We identified 28 studies for inclusion comprising 174 patients.

Lower-extremity soft tissue infections with intra-abdominal sources.

This article describes a series of 3 patients who presented with lower-extremity soft tissue infections. Each patient was treated with prompt debridement by an orthopedic surgeon (J.F.

Assessment of musculoskeletal physical examination skills and attitudes of orthopaedic residents.

Background: Although the musculoskeletal physical examination is an essential part of patient encounters, we believe that it is underemphasized in residency education and that residents' physical examination skills may be lacking. We sought to assess attitudes regarding teaching of the physical examination in orthopaedic residencies, to assess physical examination knowledge and skills among residents, and to develop a method to track the skill level of residents in order to improve our physical examination curriculum.

Methods: We created a thirty-question multiple-choice musculoskeletal physical examination test and administered it to our residents.

Infrapatellar branch of saphenous neurectomy for painful neuroma: a case report.

We present the case of an 18-year-old woman who was healthy other than a history of multiple arthroscopic right knee surgeries culminating in subtotal lateral meniscectomy in a valgus knee. The patient was referred to our office for evaluation for realignment osteotomy and meniscal transplantation. Her diagnosed case of neuroma of the infrapatellar branch of the saphenous nerve was managed with neurectomy, which produced prompt and complete resolution of pain.

Effectiveness of ultraporous β-tricalcium phosphate (vitoss) as bone graft substitute for cavitary defects in benign and low-grade malignant bone tumors.

We retrospectively evaluated healing with ultraporous β-tricalcium phosphate (β-TCP [Vitoss; Orthovida, Malvern, Pennsylvania]) bone graft in patients who underwent surgical excision or curettage of benign bone lesions subsequently filled with bone void filler. Twentynine patients were treated with curettage and ultraporous β-TCP morsels. Radiologic defect size at initial postoperative presentation and subsequent visits (minimum follow-up, 6 months) was evaluated.

Implementation of an objective structured clinical exam (OSCE) into orthopedic surgery residency training.

Objective: While the musculoskeletal (MSK) physical examination (PE) is an essential part of a patient encounter, we believe it is an underemphasized component of orthopedic residency education and that resident PE skills may be lacking. The purpose of this investigation was to (1) assess the attitudes regarding PE teaching in orthopedic residencies today; (2) develop an MSK objective structured clinical examination (OSCE) to assess the MSK PE knowledge and skills of our orthopedic residents.

Design: Prospective, uncontrolled, observational.

Intramuscular synovial cyst of the shoulder.

In this article, we report a case of intramuscular synovial cyst of the rotator cuff musculature with associated supraspinatus and infraspinatus tears. The patient was treated arthroscopically with cyst decompression and inside-out rotator cuff repair. We also present a review of the current literature on intramuscular synovial cysts of the rotator cuff.

Prediction of coracoid thickness using a glenoid width-based model: implications for bone reconstruction procedures in chronic anterior shoulder instability.

Background: Chronic anterior shoulder instability with glenoid bone loss can be a very challenging clinical problem. Significant bone loss is commonly managed with the Latarjet procedure. However, in some cases with severe glenoid bone loss, iliac crest bone grafting is required to obtain a graft of adequate size.

Internal and external hemipelvectomy or flail hip in patients with sarcomas: quality-of-life and functional outcomes.

Objective: We evaluated the quality-of-life of patients who have had an internal hemipelvectomy with and without (flail hip) prosthetic reconstruction and external hemipelvectomy.

Design: We reviewed the cases of 15 patients who had undergone either internal or external hemipelvectomy for tumor. Fifteen patients who were previously treated operatively with either a type II periacetabular internal (n = 5) or external (n = 10) hemipelvectomy were evaluated using the Toronto Extremity Salvage Score (TESS), Musculoskeletal Tumor Society (MSTS), and the 36-item Short-Form Health Survey.

Chondroblastoma: a rare cause of femoral neck fracture in a teenager.

Chondroblastomas usually present in the epiphyseal region of bones in skeletally immature patients. These uncommon, benign tumors are usually treated with curettage and use of a bone-void filler. Here we report a case of a hip fracture secondary to an underlying chondroblastoma in a 19-year-old woman.

Treatment of adhesive capsulitis with intra-articular hyaluronate: A systematic review.

Sodium hyaluronate injection into the glenohumeral joint is a treatment option in the management of adhesive capsulitis of the shoulder. We hypothesized that a systematic review would demonstrate that intra-articular sodium hyaluronate injections would result in significant improvements in passive range-of-motion, shoulder and general clinical outcome measures, and pain scales at short- and mid-term follow-up. Multiple medical databases were searched for levels I-IV evidence with a priori defined specific inclusion and exclusion study criteria.

Synovial chondromatosis of the elbow causing a mechanical block to range of motion: a case report and review of the literature.

We report a unique case of elbow synovial chondromatosis with sudden onset of severe loss of elbow extension and flexion range of motion caused by mechanical block from deposition of chondral fragments in the olecranon and coronoid fossae, respectively. We performed successful arthroscopic surgical treatment of synovial chondromatosis of the elbow. Arthroscopy examination revealed an acutely evolving synovial chondromatosis.