Median Nerve Mononeuropathy and Meralgia Paresthetica After Prone Positioning in a Patient with COVID-19 ARDS: A Case Report.

Case: Throughout the COVID-19 pandemic, prone positioning has decreased mortality in patients with severe acute respiratory distress syndrome. We present the unique case of a patient who developed left median nerve mononeuropathy and bilateral meralgia paresthetica after prone positioning while afflicted with COVID-19. These nerve injuries have been rarely reported in the literature and never before in the same patient.

Return to Work After Distal Femoral Varus Osteotomy.

Background: Distal femoral varus osteotomy (DFVO) is a well-described procedure to address valgus deformity of the knee. There is a paucity of information available regarding patients' ability to return to work (RTW) after DFVO.

Purpose: To report the objective findings for RTW rates and times for patients receiving a DFVO for lateral compartment osteoarthritis secondary to valgus deformity of the knee.

Topographic Analysis of Lateral Versus Medial Femoral Condyle Donor Sites for Oblong Medial Femoral Condyle Lesions.

Purpose: To analyze the topographic matching of oblong osteochondral allografts to treat large oval medial femoral condyle (MFC) lesions using computer simulation models. The secondary objective was to determine whether lateral femoral condyle (LFC) grafts would have a similar surface matching when compared with MFC grafts in this setting.

Methods: Human femoral hemicondyles (10 MFCs, 7 LFCs) underwent 3-dimensional computed tomography.

Return to Sport Following High Tibial Osteotomy With Concomitant Osteochondral Allograft Transplantation.

Background: Young patients with symptomatic chondral defects in the medial compartment with varus malalignment may undergo opening wedge high tibial osteotomy (HTO) with concomitant osteochondral allograft transplantation (OCA) (HTO + OCA). Although patients have demonstrated favorable outcomes after HTO + OCA, limited information is available regarding return to sporting activities after this procedure.

Purpose: To evaluate (1) the timeline to return to sports (RTS), (2) patient satisfaction, and (3) reasons for discontinuing sporting activity after HTO + OCA, and to identify predictive factors of RTS.

Return to Sport and Patient Satisfaction After Meniscal Allograft Transplantation.

Purpose: To investigate patient return to sport and satisfaction after meniscal allograft transplantation (MAT).

Methods: Patients undergoing MAT using a bone bridge technique between 2013 and 2015 with minimum 2-year follow-up were retrospectively reviewed. They completed a survey regarding return to sport, satisfaction, and subsequent surgery in addition to patient-reported outcome measures.

The Effect of Triangulation Simulator Training on Arthroscopy Skills: A Prospective Randomized Controlled Trial.

Purpose: To prospectively evaluate the transferability of skills acquired on a low-cost, at-home, nonanatomic triangulation simulation system to cadaveric models.

Methods: We randomized 28 medical students into either a simulator-training group (n = 14) or group with no training (control, n = 14). All subjects were pretested using a standardized checklist of arthroscopic skills on cadaveric knees and shoulders.

Effect of Patella Alta on the Native Anatomometricity of the Medial Patellofemoral Complex: A Cadaveric Study.

Background: Patella alta has been identified as an important risk factor for lateral patellar instability and medial patellofemoral complex (MPFC) reconstruction failure.

Purpose: To evaluate the length changes of the MPFC at multiple possible reconstruction locations along the extensor mechanism in varying degrees of patella alta throughout knee motion.

Study Design: Controlled laboratory study.

The Biomechanical Effects of Limited Lateral Retinacular and Capsular Release on Lateral Patellar Translation at Various Flexion Angles in Cadaveric Specimens.

Purpose: To determine the biomechanical effect of limited lateral retinacular and capsular release on lateral patellar translation as a function of constant force at various knee flexion angles.

Methods: Six pairs of bilateral cadaveric knee specimens (12 knees) were obtained from a tissue bank, dissected, and potted in a perfect lateral position based on fluoroscopy. A direct lateral force was applied to the patella through an eye screw in the midpoint of the lateral patella, and each knee underwent testing in the intact state and after lateral retinacular and capsular release.

Differential Contributions of the Quadriceps and Patellar Attachments of the Proximal Medial Patellar Restraints to Resisting Lateral Patellar Translation.

Purpose: To define the contributions of the of the medial patellofemoral ligament (MPFL) and medial quadriceps tendon femoral ligament (MQTFL) to lateral patellar translation as the knee moves through a 90° arc of motion.

Methods: Six pairs of bilateral cadaveric knee specimens (12 knees) were dissected and potted in perfect lateral position using fluoroscopy. An eye screw was placed in the midpoint on the lateral aspect of the patella.

Lack of standardization among clinical trials of injection therapies for knee osteoarthritis: a systematic review.

: Osteoarthritis (OA) of the knee is a debilitating, expensive, and prevalent disease, and interest in the non-surgical management of knee OA has grown recently. Our objective was to systematically assess the level of heterogeneity among all clinical trials and published studies regarding injections for knee osteoarthritis, in terms of treatment of interest, outcomes evaluated, and time points of outcome assessment. : The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were utilized to review all published studies and publically available clinical trials from 1 January 2013 to 3 May 2019evaluating intra-articular injections to treat knee OA.

Use of Allografts in Orthopaedic Surgery: Safety, Procurement, Storage, and Outcomes.

The use of allografts has become a vital option for orthopaedic surgeons in the treatment of a variety of musculoskeletal lesions, ranging from osteochondral defects in the glenohumeral joint to meniscal deficiency in the young athlete. Nevertheless, barriers to treating a patient with an allograft-based procedure may arise from concerns over disease transmission, the navigation of tissue banks that supply allografts, the process of obtaining insurance approval, or optimal storage methods. This review serves to support orthopaedic surgeons in the incorporation of allografts into their practice by quelling these potential concerns.

Return to Work Following High Tibial Osteotomy With Concomitant Osteochondral Allograft Transplantation.

Purpose: To assess the timeline of return to work (RTW) following opening-wedge high tibial osteotomy (HTO) with concomitant osteochondral allograft transplantation (OCA) of the medial femoral condyle.

Methods: Consecutive patients undergoing HTO + OCA due to focal chondral deficiency and varus deformity were retrospectively identified and reviewed at a minimum of 2 years following surgery. Patients completed a subjective work questionnaire, a visual analog scale for pain, Single Assessment Numerical Evaluation, and a satisfaction questionnaire.

Return to Sport and Outcomes After Concomitant Lateral Meniscal Allograft Transplant and Distal Femoral Varus Osteotomy.

Purpose: To evaluate the time and rate of return to sport (RTS), as well as outcomes, in young and active patients receiving concomitant lateral meniscal allograft transplantation (MAT) and distal femoral varus osteotomy (DFVO) for lateral meniscal deficiency and valgus malalignment.

Methods: This was a retrospective study of consecutive patients who underwent concomitant MAT and DFVO by a single surgeon. The exclusion criteria were any concomitant procedures other than cartilage restoration procedures for focal full-thickness cartilage defects of the lateral femoral condyle and less than 2 years of follow-up.

Return to Work Following Isolated Opening Wedge High Tibial Osteotomy.

Purpose: Patients with isolated medial compartment osteoarthritis and varus deformity may undergo high tibial osteotomy (HTO) to reduce the contact pressure in the medial compartment. The purpose of this investigation is (1) examine the timeline of return to work (RTW) following HTO and (2) evaluate RTW stratified by occupational intensity.

Methods: Consecutive patients undergoing HTO were reviewed retrospectively at a minimum of 2-years postoperatively.

Return to sport following isolated opening wedge high tibial osteotomy.

Background: The purposes of the study are as follows: (1) examine the timeline of return to sport (RTS) following isolated high tibial osteotomy (HTO), (2) evaluate the degree of participation and function upon RTS and (3) identify reasons that patients do not return or discontinue participation in sport activity.

Methods: Patients undergoing isolated HTO were reviewed retrospectively at a minimum of two years post-operatively. Patients completed a subjective sports questionnaire, a visual analog scale for pain, Single Assessment Numerical Evaluation, and a satisfaction questionnaire.

Midlevel Providers in Orthopaedic Surgery: The Patient's Perspective.

Background: Midlevel providers (i.e. physician assistants [PAs] and nurse practitioners [NPs]) are being integrated into systems of care due to the exponentially increasing demand for orthopaedic care.

Establishing Clinically Significant Outcomes After Meniscal Allograft Transplantation.

Background: Traditionally, the primary outcome in meniscal allograft transplantation (MAT) has been long-term survivorship; however, short-term clinically significant outcomes are necessary to fully evaluate patient improvement after surgery.

Purpose: To (1) establish the minimal clinically important difference (MCID) and patient acceptable symptomatic state (PASS) with respect to patient-reported outcome measures (PROMs) and (2) evaluate preoperative and intraoperative variables correlated with achieving these threshold values.

Study Design: Cohort study (diagnosis); Level of evidence, 2.

Articular Cartilage Injuries of the Knee: Patient Health Literacy, Expectations for Management, and Clinical Outcomes.

Objective: The purpose of this article is to review the orthopedic literature regarding patient understanding of articular cartilage disease, interpret literature reporting patient expectations for surgical management of articular cartilage injuries of the knee, and review patient-reported outcomes and patient satisfaction with management of these injuries.

Design: A retrospective review of the current literature using the PubMed database (1980-current) was performed on July 15, 2017. The search terms used were "patient understanding knee cartilage," "patient satisfaction knee cartilage," "patient expectation knee cartilage," and "patient reported outcomes knee cartilage.

Management of Chondral Lesions of the Knee: Analysis of Trends and Short-Term Complications Using the National Surgical Quality Improvement Program Database.

Purpose: To provide updated surgical trends of cartilage procedures differentiated by the classic groups of palliative, repair, and restorative modalities.

Methods: The American College of Surgeons National Surgical Quality Improvement Program database was queried from 2010-2016 for the following cartilage procedures: chondroplasty, microfracture, arthroscopic osteochondral autograft or allograft transplantation, open osteochondral autograft or allograft transplantation, and autologous chondrocyte implantation. Demographic variables and short-term (30-day) complications were analyzed with 1-way analysis of variance and post hoc analysis.

Preservation of Knee Articular Cartilage.

Hyaline articular cartilage is critical for the normal functioning of the knee joint. Untreated focal cartilage defects have the potential to rapidly progress to diffuse osteoarthritis. Over the last several decades, a variety of interventions aiming at preserving articular cartilage and preventing osteoarthritis have been investigated.

Wide Variation in Methodology in Level I and II Studies on Cartilage Repair: A Systematic Review of Available Clinical Trials Comparing Patient Demographics, Treatment Means, and Outcomes Reporting.

Background: The management of complex cartilage pathology in young, otherwise healthy patients can be difficult.

Purpose: To determine the nature of the design, endpoints chosen, and rate at which the endpoints were met in published studies and ongoing clinical trials that investigate cartilage repair and restoration procedures.

Study Design: Systematic review.

Patient Perspectives of Midlevel Providers in Orthopaedic Sports Medicine.

Background: Midlevel providers (eg, nurse practitioners and physician assistants) have been integrated into orthopaedic systems of care in response to the increasing demand for musculoskeletal care. Few studies have examined patient perspectives toward midlevel providers in orthopaedic sports medicine.

Purpose: To identify perspectives of orthopaedic sports medicine patients regarding midlevel providers, including optimal scope of practice, reimbursement equity with physicians, and importance of the physician's midlevel provider to patients when initially selecting a physician.

Cartilage Restoration: Microfracture and Osteochondral Autograft Transplantation.

The treatment of patellofemoral cartilage defects presents several distinct challenges when compared with cartilage restoration techniques used for other compartments of the knee due to the unique anatomy and distribution of forces. The etiologies of patellofemoral articular cartilage lesions include acute traumatic instability injuries, such as dislocation and subluxation, osteochondritis dissecans, and chronic degenerative changes. Regardless of the etiology, untreated patellofemoral cartilage lesions can contribute to activity-limiting anterior knee pain.

Meniscal Allograft Transplantation With Concomitant Osteochondral Allograft Transplantation.

Surgical strategies for knee joint preservation are numerous, with the procedure(s) of choice for a given patient dependent on the status of the articular cartilage, meniscus, overall alignment, and ligamentous stability. For patients with large, isolated, osteochondral defects of the articular cartilage of the femoral condyle, osteochondral allograft transplantation (OCA) is often performed in an effort to reduce pain and improve function. Similarly, for appropriately indicated patients with symptomatic meniscus deficiency, meniscus allograft transplantation (MAT) is an excellent surgical solution.