Return to sport: Does excellent 6-month strength and function following ACL reconstruction predict midterm outcomes?

Purpose: The purpose of this study was to determine whether patients with excellent 6-month functional testing after ACL reconstruction had (1) higher risk of subsequent ACL tears, (2) superior knee function, and (3) increased activity levels compared to those with delayed clearance for return to sports at midterm follow-up.

Methods: A total of 223 patients underwent primary ACL reconstruction by a single surgeon and had functional and isokinetic testing performed 6 months post-operatively between 1998 and 2005. Of the 223 patients, 52 (23 %) made the excellent group and were allowed return to sport at 6 months, and the remaining 171 (77 %) constituted the delayed group.

Incidence and Risk Factor Analysis of Symptomatic Venous Thromboembolism After Knee Arthroscopy.

Purpose: To (1) determine the incidence of symptomatic venous thromboembolic events (VTEs) after knee arthroscopy and arthroscopy-assisted procedures at a single institution and (2) determine associated risk factors for VTEs in these patients.

Methods: The records of patients who underwent knee arthroscopy at a single institution between 1988 and 2008 were reviewed. Chemoprophylaxis was not routinely used.

Are meniscal tears and articular cartilage injury predictive of inferior patient outcome after surgical reconstruction for the dislocated knee?

Purpose: A paucity of data exists on the effects of articular cartilage and meniscal injury in the setting of knee dislocations. The purpose of this study is to determine whether concomitant intra-articular injuries at the time of multiligament reconstruction for knee dislocation are associated with inferior outcomes.

Methods: The records of patients who underwent surgical treatment for multiligament knee injury between 1992 and 2012 were retrospectively reviewed.

Treatment of Patellofemoral Cartilage Lesions in the Young, Active Patient.

Articular cartilage lesions of the patella and trochlea are commonly encountered in the young and active patient. These defects can be classified as chondral or osteochondral, and then further described according to size, location, and etiology. Early surgical intervention is often indicated for traumatic injuries resulting in osteochondral damage, including acute patellofemoral dislocation.

Ice Hockey Summit II: zero tolerance for head hits and fighting.

Objective: To present currently known basic science and on-ice influences of sport-related concussion (SRC) in hockey, building on the Ice Hockey Summit I action plan (2011) to reduce SRC.

Methods: The prior summit proceedings included an action plan intended to reduce SRC. As such, the proceedings from Summit I served as a point of departure, for the science and discussion held during Summit II (Mayo Clinic, Rochester MN, October 2013).

Medial patellofemoral ligament tears in the setting of multiligament knee injuries rarely cause patellar instability.

Background: Multiligament knee injuries (MLKIs) can also involve the medial patellofemoral ligament (MPFL), but there is a paucity of information regarding prevalence and relevance of MPFL involvement in this setting.

Purpose: (1) To identify the prevalence of MPFL injury in MLKIs, (2) to determine whether an MPFL tear results in symptomatic patellar instability, and (3) to report clinical and functional outcomes of patients with and without MPFL tears after MLKI surgical reconstruction.

Study Design: Cohort study; Level of evidence, 3.

Ice hockey summit II: zero tolerance for head hits and fighting.

Objective: To present currently known basic science and on-ice influences of sport related concussion (SRC) in hockey, building upon the Ice Hockey Summit I action plan (2011) to reduce SRC.

Methods: The prior summit proceedings included an action plan intended to reduce SRC. As such, the proceedings from Summit I served as a point of departure, for the science and discussion held during Summit II (Mayo Clinic, Rochester MN, October, 2013).

Ice Hockey Summit II: zero tolerance for head hits and fighting.

This study aimed to present currently known basic science and on-ice influences of sport-related concussion (SRC) in hockey, building upon the Ice Hockey Summit I action plan (2011) to reduce SRC. The prior summit proceedings included an action plan intended to reduce SRC. As such, the proceedings from Summit I served as a point of departure for the science and discussion held during Summit II (Mayo Clinic, Rochester, MN, October 2013).

Advances in posterior cruciate ligament reconstruction.

Current advances in posterior cruciate ligament reconstruction have led to excellent clinical and functional outcomes. It is helpful to review anatomy, cadaver sectioning studies, biomechanical studies, clinical outcome data, and novel surgical techniques for posterior cruciate ligament reconstruction, including all-inside reconstructions. Surgeons also should be aware of current controversies regarding transtibial versus inlay, autograft versus allograft, and single-bundle versus double-bundle reconstructions.

Meniscal tears and articular cartilage damage in the dislocated knee.

Purpose: Knee dislocations can cause significant damage to intra-articular knee structures, but currently there are limited data reporting articular cartilage and meniscal injuries in this setting. The purpose of this study is to (1) report the rate of concomitant intra-articular injuries at the time of multiligament reconstruction for knee dislocation, (2) determine whether the pattern of ligament injury is associated with the presence of chondral and meniscal injuries, and (3) assess the relationship between timing of surgery and incidence of chondral and meniscal injuries.

Methods: The records of patients who sustained a knee dislocation between 1992 and 2013 were retrospectively reviewed.

Fibular head and tibial-based (2-Tailed) posterolateral corner reconstruction.

Two-tailed techniques for reconstruction of the posterolateral corner use grafts that originate on the femur and insert onto both the proximal tibia and the fibular head. Two-tailed reconstruction aims to reconstruct the fibular collateral ligament, popliteus tendon, and popliteofibular ligament with anatomically placed grafts. This article will review the history, indications, and authors' preferred technique for 2-tailed posterolateral corner reconstruction, as well as biomechanical and clinical outcomes of this technique.

Arthroscopic Meniscal Root Repair Using a Ceterix NovoStitch Suture Passer.

Meniscal root injuries can compromise knee function and lead to early degenerative changes if not appropriately treated. Numerous techniques have been described; however, the technical difficulties in performing these repairs are well known. Furthermore, the relative strengths of various repair techniques have been examined.

Femoral nerve block is associated with persistent strength deficits at 6 months after anterior cruciate ligament reconstruction in pediatric and adolescent patients.

Background: Femoral nerve block (FNB) has become a popular method of postoperative analgesia for anterior cruciate ligament (ACL) reconstruction in pediatric and adolescent patients. Successful rehabilitation after surgery involves return of quadriceps and hamstring strength.

Purpose: To compare knee strength and function 6 months after ACL reconstruction in pediatric and adolescent patients who received FNB versus patients with no nerve block.

Injuries in men's international ice hockey: a 7-year study of the International Ice Hockey Federation Adult World Championship Tournaments and Olympic Winter Games.

Background: Information on ice hockey injuries at the international level is very limited. The aim of the study was to analyse the incidence, type, mechanism and severity of ice hockey injuries in men's international ice hockey tournaments.

Methods: All the injuries in men's International Ice Hockey Federation World Championship tournaments over a 7-year period were analysed using a strict definition of injury, standardised reporting strategies and an injury diagnosis made by a team physician.

Clinically relevant aspects of stem cell technologies: current state of play.

The emergence of stem cell technologies and their potential applications in regenerative medicine have generated immense interest by both the lay public and clinicians. Unproven and unregulated cell-based therapies are commercially available both in Australia and internationally, and reports of patient uptake (stem cell tourism) and associated morbidity are increasingly frequent. Clinicians in all fields will require an enhanced understanding of the basic science principles and current state of play in regenerative medicine in order to effectively counsel patients regarding these therapies in the setting of both commercial ventures and clinical trials.

Snapping popliteus tendon within an osteochondritis dissecans lesion: an unusual case of lateral knee pain.

The popliteus muscle is an important structure in the posterior knee, coursing from the distal lateral femoral condyle to the posterior tibia, and it initiates knee flexion, protects the lateral meniscus, and resists tibial external rotation. Abnormalities in the lateral femoral condyle may result in impaired tracking of the popliteus tendon over the lateral femoral condyle, causing pain and a snapping sensation. We report a case of a snapping popliteus tendon caused by an osteochondral defect of the lateral femoral condyle.

A spoon full of studies helps the comparison go down: a comparative analysis of Tulving's spoon test.

Mental time travel refers to the ability to cast one's mind back in time to re-experience a past event and forward in time to pre-experience events that may occur in the future. Tulving (2005), an authority on mental time travel, holds that this ability is unique to humans. Anticipating that comparative psychologists would challenge this claim, Tulving (2005) proposed his spoon test, a test specifically designed to assess whether non-human animals are capable of mental time travel.

Reconstruction of the posterolateral corner of the knee with achilles tendon allograft.

Posterolateral corner injuries of the knee are relatively rare; however, they can result in significant long-term disability without appropriate treatment. They often occur in the setting of multiligament knee injuries, and as a result, diagnosis and management can be challenging. Severe injuries often require reconstruction, and both anatomic and nonanatomic techniques exist.

Does proximal tibial osteotomy with a novel osteotomy system obtain coronal plane correction without affecting tibial slope and patellar height?

Purpose: To determine changes in tibial slope, patellar height, and coronal plane alignment after medial opening wedge proximal tibial osteotomy (PTO) using a modern osteotomy system.

Methods: Patients undergoing medial opening wedge PTO for any indication with follow-up until radiographic union were identified. Pre- and post-operative tibial slope (referenced off the anterior tibial cortex, proximal tibial anatomic axis, and posterior tibial cortex), patellar height (Caton-Deschamps, Blackburne-Peel, and Insall-Salvati indices), and coronal plane [mechanical axis and weight-bearing line (WBL) ratio] measurements were taken by two observers and compared.

Patellofemoral arthroplasty: outcomes and factors associated with early progression of tibiofemoral arthritis.

Purpose: The purpose of this study was to review the results of patellofemoral arthroplasty (PFA) performed by a single surgeon at a single institution in order to determine factors associated with clinical outcomes and progression of tibiofemoral degenerative joint disease.

Methods: Sixty-one patients with isolated patellofemoral osteoarthritis were treated with a PFA by a single surgeon between 2003 and 2009. Fifty-nine patients were available for analysis with a mean follow-up of 4 years (range 2-6 years).

All-inside anterior cruciate ligament reconstruction.

All-inside anterior cruciate ligament (ACL) reconstruction has undergone a series of modifications over the past 20 years. Current techniques offer the advantages of improved cosmesis, less postoperative pain, decreased bone removal, and gracilis preservation. Few all-inside ACL reconstruction outcome studies are available; therefore, additional research is necessary to compare the results to conventional techniques.

The most cut-resistant neck guard for preventing lacerations to the neck.

Objective: To evaluate the effectiveness of a variety of neck guard brands when contacted by a sharpened hockey skate blade.

Design: Analytic experimental.

Setting: Laboratory.

Arthroscopic preparation and internal fixation of an unstable osteochondritis dissecans lesion of the knee.

We present our arthroscopic technique for fixation of an unstable osteochondritis dissecans (OCD) lesion. This technique includes arthroscopic evaluation of cartilage and bone quality of the OCD fragment, hinging open the lesion, debridement of fibrous nonunion tissue, reducing the fragment, and obtaining multi-point compression screw fixation. This technique avoids the morbidity of an open arthrotomy and should be considered when treating an unstable OCD lesion with adequate bone for fixation.