Physeal fusion status and lesion size are more important than patient age for healing of juvenile osteochodritis dessicans lesions of the distal femur.

Purpose: The purpose of the study was to evaluate the effect of skeletal age and lesion size, location, and grade on the success of nonoperative treatment for juvenile osteochondritis dissecans (OCD). It is hypothesized that skeletal maturity, including a combination of maturation phenotypes, correlates with nonoperative lesion healing.

Methods: The clinical and radiographic data on 52 patients aged 7-20 years treated for OCD of the distal femur between 2010 and 2019 were retrospectively reviewed.

Common and Consequential Fractures That Should Not Be Missed in Children.

Missed or delayed diagnosis of fractures in children is not uncommon owing to their immature skeletons, unique fracture patterns, and distinctive radiologic findings. The term occult is used to describe radiographically subtle fractures. Some of these fractures can be associated with excellent outcomes despite the pitfalls of delayed diagnosis.

Revision Anterior Cruciate Ligament Reconstruction after Surgical Management of Multiligament Knee Injury.

The purpose of this study is to determine factors associated with the need for revision anterior cruciate ligament reconstruction (ACLR) after multiligament knee injury (MLKI) and to report outcomes for patients undergoing revision ACLR after MLKI. This involves a retrospective review of 231 MLKIs in 225 patients treated over a 12-year period, with institutional review board approval. Patients with two or more injured knee ligaments requiring surgical reconstruction, including the ACL, were included for analyses.

Computed tomography guided radio-frequency ablation of osteoid osteomas in atypical locations.

Purpose: Percutaneous radio-frequency ablation is a minimally invasive treatment option for osteoid osteomas. The ablation process is straightforward in the more common locations like the femur/tibia. Surgery has historically been the gold standard, but is currently used in lesions, that may not be effectively and safely ablated, i.

MRI findings of Stener-like lesion of the knee: A case series with surgical correlation.

Purpose: To describe the MRI findings of the "Stener-like" lesion of the knee and its distinction from simple medial collateral ligament (MCL) tear. A "Stener-like" lesion of the superficial medial collateral ligament is a tear involving the distal fibers, where the torn fibers become displaced superficial to the pes anserinus fibers, a displacement which can prevent healing.

Methods: Nine cases of Stener-like lesion were prospectively diagnosed on MRI.

Incidence of Concurrent Peroneal Nerve Injury in Multiligament Knee Injuries and Outcomes after Knee Reconstruction.

The purpose of this study was to determine incidence of concurrent peroneal nerve injury and to compare outcomes in patients with and without peroneal nerve injury after surgical treatment for multiligament knee injuries (MLKIs). A retrospective study of 357 MLKIs was conducted. Patients with two or more knee ligaments requiring surgical reconstruction were included.

Subchondroplasty for the treatment of post-traumatic bone marrow lesions of the medial femoral condyle in a pre-clinical canine model.

This study characterizes long-term outcomes associated with subchondroplasty (SCP) treatment for impact-induced subchondral bone marrow lesions (BML) using a validated pre-clinical canine model. With IACUC approval, purpose-bred research hounds (n = 16) underwent arthroscopic impact injury (40N) to both medial femoral condyles. At 3 months, functional assessments, arthroscopy, and MRI were performed and knees (n = 32) were randomly assigned to SCP (3 ml fluoroscopically guided percutaneous injection of AccuFill BSM into BML bone defects) or sham injection (Control).

Current Concepts in Rehabilitation for Traumatic Anterior Shoulder Instability.

Purpose Of Review: The objectives of this review are to evaluate the current evidence-based literature and concepts surrounding rehabilitation in patients with anterior shoulder instability injuries and surgical repair.

Recent Findings: The current literature evidence for shoulder rehabilitation for anterior shoulder instability and labral repair is limited. As a result, there are variations among surgeons and physical therapists in rehabilitation protocols after anterior shoulder instability injuries and repair.

Rivaroxaban Use for Thrombosis Prophylaxis Is Associated With Early Periprosthetic Joint Infection.

Background: Periprosthetic joint infection is a disastrous complication after total hip arthroplasty (THA) and total knee arthroplasty (TKA). The use of certain agents to prevent deep vein thrombosis after arthroplasty has been linked to an increased risk of adverse effects including wound drainage and infection. Adverse effects of one alternative, rivaroxaban, was studied in a single community hospital.

Irrigation and Debridement Before a 2-Stage Revision Total Knee Arthroplasty Does Not Increase Risk of Failure.

Background: Studies have suggested that the success of 2-stage revision total knee arthroplasty (rTKA) may be compromised by a prior failed irrigation and debridement (I&D). The purpose of this study was to use 2 large state inpatient databases to compare the 2-stage rTKA failure rates for those patients with and without a prior I&D.

Methods: This retrospective, longitudinal study used inpatient discharge data from the State Inpatient Database of 2 states (California and New York) from 2005 to 2011.

Development of a Novel Canine Model for Posttraumatic Osteoarthritis of the Knee.

Translational models of posttraumatic osteoarthritis (PTOA) that accurately represent clinical pathology need to be developed. This study assessed a novel canine model for PTOA using impact injury. Impacts were delivered to the medial femoral condyle of dogs using a custom-designed impactor at 20, 40, or 60 MPa.

Dynamic Locked Plating of Distal Femur Fractures.

Objectives: Nonunion after locked bridge plating of comminuted distal femur fractures is not uncommon. "Dynamic" locked plating may create an improved mechanical environment, thereby achieving higher union rates than standard locked plating constructs.

Setting: Academic Level 1 Trauma Center.

Definitive plates overlapping provisional external fixator pin sites: is the infection risk increased?

Objectives: The purpose of this study was to compare the infection risk when internal fixation plates either overlap or did not overlap previous external fixator pin sites in patients with bicondylar tibial plateau fractures and pilon fractures treated with a 2-staged protocol of acute spanning external fixation and later definitive internal fixation.

Design: Retrospective comparison study.

Setting: Two level I trauma centers.

Incidence of wrong-site surgery among foot and ankle surgeons.

In 1998, the American Academy of Orthopaedic Surgeons initiated the "sign your site" campaign to address the issue of wrong-site surgery (WSS). Using a confidential online survey sent to 1094 active members of the American Academy of Foot and Ankle Surgeons, the authors assessed participation in the "sign your site" campaign and the occurrence of WSS encountered during their careers. A total of 319 responses were received (response rate = 29.

Rat tibial osteotomy model providing a range of normal to impaired healing.

The purpose of this study was to develop an inexpensive and easily implemented rat tibial osteotomy model capable of producing a range of healing outcomes. A saw blade was used to create a transverse osteotomy of the tibia in 89 Sprague-Dawley rats. A 0.

Epidemiology and outcomes of Achilles tendon ruptures in the National Football League.

The purpose of this study is to document the epidemiology of Achilles tendon ruptures in the National Football League (NFL) and to quantify the impact of these injuries on player performance. A retrospective review of several online NFL player registries identified 31 Achilles tendon ruptures in NFL players between 1997 and 2002. Nineteen percent of injuries occurred during preseason play, while another 18% occurred during the first month of the official season.

Pseudoaneurysm as a complication of ankle arthroscopy.

We present a case of a pseudoaneurysm of the anterior tibial artery following ankle arthroscopy with synovectomy, an extremely rare complication when standard anteromedial and anterolateral portals are used. The patient was diagnosed and treated with appropriate interventions which led to an uneventful recovery. Nevertheless, the potential sequelae of delayed diagnosis or misdiagnosis of the complication are dangerous; therefore, a high index of suspicion for a pseudoaneurysm must be maintained in the postoperative period.