Overuse of Magnetic Resonance Imaging in the Diagnosis and Treatment of Moderate to Severe Osteoarthritis.

Background: MRI in the evaluation of end-stage knee joint osteoarthritis (OA) is usually unnecessary when radiographic and clinical evidence of gonarthrosis is clear. The purpose of this study was to assess the prevalence of MRI scans ordered in patients with radiographically obvious gonarthrosis and to examine the characteristics of health care providers who ordered these imaging studies.

Methods: We retrospectively identified 164 patients diagnosed with moderate to severe OA who were referred for total knee replacement (TKA) over a one-year period.

Safety and efficacy of hyperosmolar irrigation solution in shoulder arthroscopy.

Background: A hyperosmolar irrigation solution has been reported to be safe and have potential benefits for use during shoulder arthroscopy in an animal model study. In this study, the clinical effects of a hyperosmolar solution were compared with a standard isotonic solution when used for shoulder arthroscopy.

Methods: A prospective, double-blind, randomized controlled trial was performed to compare isotonic (273 mOsm/L) and hyperosmolar (593 mOsm/L) irrigation solutions used for arthroscopic rotator cuff repair.

Osteochondral Allografts in Shoulder Surgical Procedures.

The use of fresh osteochondral allografts has become popular in many joint-preserving orthopaedic procedures and shows early promising results within the shoulder. Distal tibial allograft contains a stout cartilaginous layer that appears to have highly congruent curvature and concavity to the glenoid, which makes for an optimal allograft option for instability. In the setting of large Hill-Sachs lesions, the use of a humeral-head osteochondral allograft is essential to restore geometry, stability, and mechanics of the native glenohumeral joint.

Hyperosmolar irrigation compared with a standard solution in a canine shoulder arthroscopy model.

Background: A hyperosmolar irrigation solution may decrease fluid extravasation during arthroscopic procedures. Demonstrating the safety of a hyperosmolar irrigation solution with respect to chondrocyte viability and cartilage water content was deemed necessary before designing a clinical efficacy study.

Methods: We designed a translational animal model study in which hyperosmolar arthroscopy irrigation fluid (1.