Distally Based Patella Tendon Shortening With Medial Patellotibial Ligament Reconstruction.

Patella alta is a common pathoanatomic contributor to various knee pathologies, including patella instability, fat pad impingement, and patellar tendinopathy. The 2 most common surgical techniques used to treat patella alta include a distalizing tibial tubercle osteotomy and patella tendon imbrication. Although these 2 surgical techniques are effective, they are associated with significant surgical morbidity and a limiting postoperative course with prolonged rehabilitation.

All-soft tissue quadriceps tendon autograft and bone-patellar tendon-bone autograft demonstrate no significant ACL tunnel widening: An MRI comparison.

Purpose: This study sought to quantify the tunnel widening associated with quadriceps tendon (QT) autograft after anterior cruciate ligament reconstruction (ACLR) and compare it to bone-patellar tendon-bone (BTB) autografts.

Methods: A retrospective review of each ACLR performed at a single academic institution from 2011 to 2021 were reviewed. Subjects with repeat ipsilateral knee magnetic resonance imaging (MRI) studies performed after ACLR were included.

Snapping Complication After Partial-Thickness Quadriceps Tendon Autograft Anterior Cruciate Ligament Reconstruction: A Report of 2 Cases.

Case: A 14-year-old adolescent girl and 18-year-old man underwent right anterior cruciate ligament (ACL) reconstruction using quadriceps tendon (QT) autografts via partial-thickness harvest. While both patients initially recovered well, later they experienced a painful snapping in their knee localized to the lateral QT, just proximal to the patella. Surgical completion of the previous partial-thickness defect with imbrication provided resolution of symptoms at 4 and 9 months postoperatively, respectively.

Evaluation of a Military Global Health Engagement Mission for Critical Wartime Surgical Specialty Readiness.

Introduction: Surgical volume at Military Treatment Facilities (MTFs) has been gradually decreasing for roughly the past 2 decades. The Knowledge, Skills, and Abilities (KSA) Clinical Readiness Program linked surgical volume and readiness using a tool known as the KSA metric. However, the extent to which military medical missions contribute to the readiness of critical wartime specialties has not been evaluated using this metric.

Distinct risk profiles for short-term surgical complications and venous thromboembolism exist among extensor mechanism repair procedures.

Purpose: Extensor mechanism injuries, which comprise patella fractures, patella tendon tears and quadriceps tendon tears, are severely debilitating injuries and a common cause of traumatic knee pathology that requires surgical intervention. Risk factors for short-term surgical complications and venous thromboembolism (VTE) in this population have not been well characterised. The aim of this study was to identify perioperative risk factors associated with these short-term complications.

High accuracy of intra-articular needle position during anterior landmark guided glenohumeral injections.

Objectives: Image-guided ultrasound or fluoroscopic glenohumeral injections have high accuracy rates but require training, equipment, cost, and radiation exposure (fluoroscopy). In contrast, landmark-guided glenohumeral injections do not require additional subspecialist referrals or equipment. An optimal technique would be safe and accurate and have few barriers to implementation.

Most Publications Regarding Platelet-Rich Plasma Use in the Knee Are From Asia, Investigate Injection for Osteoarthritis, and Show Outcome Improvement: A Scoping Review.

Purpose: To evaluate and synthesize the available literature related to platelet-rich plasma (PRP) treatment of knee pathologies and to provide recommendations to inform future research in the field.

Methods: PubMed, CINAHL, and Scopus databases were queried on October 6, 2023. All identified citations were collated and uploaded into Covidence for screening and data extraction.

Viable Vitreous Grafts of Whole Porcine Menisci for Transplant in the Knee and Temporomandibular Joints.

The shortage of suitable donor meniscus grafts from the knee and temporomandibular joint (TMJ) impedes treatments for millions of patients. Vitrification offers a promising solution by transitioning these tissues into a vitreous state at cryogenic temperatures, protecting them from ice crystal damage using high concentrations of cryoprotectant agents (CPAs). However, vitrification's success is hindered for larger tissues (>3 mL) due to challenges in CPA penetration.

High Tibial Osteotomy in Knee Reconstruction and Joint Preservation.

High tibial osteotomy is a dynamic operation, used as an effective procedure in both joint preservation and knee stability. Applications and indications are expanding, with good results in the treatment of malalignment associated with arthrosis, knee instability, meniscus deficiency or transplants, and/or cartilage restoration. Appropriate patient selection and preoperative planning are critical to achieving good outcomes after surgery.

MRI Does Not Improve Inter- or Intrarater Reliability for Hip Arthritis Grading Systems.

Background: Magnetic resonance imaging (MRI) scans and radiographs are often utilized in assessing for preoperative osteoarthritis in patients undergoing hip preservation surgery.

Purpose: To determine if MRI scans improve inter- or intrarater reliabilities over radiographs for findings of hip arthritis.

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

Gadolinium injected concurrently with anesthetic can result in false-negative diagnostic intra-articular hip injections.

Purpose: The purpose of this paper was to evaluate the response to intra-articular hip injections with and without concurrent gadolinium administration. Our secondary outcome was to compare post-operative outcomes between patients with an initial false-negative gadolinium-containing injection and a matched control group.

Methods: Patients receiving a series of two hip diagnostic intra-articular injections (DIAI), the first with gadolinium for concurrent MRA and the second without gadolinium, were retrospectively identified.

The Reliability of the Tönnis Grading System in Patients Undergoing Hip Preservation.

Background: The presence of pre-existing osteoarthritis (OA) has been associated with poor results after hip arthroscopic surgery. There is limited evidence validating the currently available grading systems of hip OA in patients undergoing hip preservation.

Purpose/hypothesis: Our purpose was to evaluate the interobserver and intraobserver reliabilities of 2 grading systems in a group of patients undergoing hip preservation: the Tönnis grading system and a simple 4-choice Likert scale.

Hybrid height and slope figuring method for grazing-incidence reflective optics.

Grazing-incidence reflective optics are commonly used in synchrotron radiation and free-electron laser facilities to transport and focus the emitted X-ray beams. To preserve the imaging capability at the diffraction limit, the fabrication of these optics requires precise control of both the residual height and slope errors. However, all the surface figuring methods are height based, lacking the explicit control of surface slopes.

Repair of Chronic Patellar Tendon Rupture with Extensor Mechanism Allograft Augmentation.

The purpose of this study was to evaluate the effectiveness of our novel chronic patellar tendon repair with allograft augmentation in an active-duty military population. From 2014 to 2018, five patients with chronic patellar tendon ruptures were treated with a primary repair of the patellar tendon augmented with Achilles tendon allograft. All patients were followed for 12 months, and their range of motion, Lysholm scores, and straight leg raise ability were assessed.

Random adaptive tool path for zonal optics fabrication.

Deterministic optics fabrication using sub-aperture tools has been vital for manufacturing precision optical surfaces. The fabrication process requires the tool influence function and the tool path to calculate the dwell time that guides the tool to bring surface quality within tight design tolerances. Widely used spiral and raster paths may leave excess waviness from the tool path, and the unavoidable constant removal layer is added to obtain positive dwell time.

Multi-tool optimization for computer controlled optical surfacing.

With the rapid development of precision technologies, the demand of high-precision optical surfaces has drastically increased. These optical surfaces are mainly fabricated with computer controlled optical surfacing (CCOS). In a CCOS process, a target surface removal profile is achieved by scheduling the dwell time for a set of machine tools.

Central Femoral Head Chondromalacia Is Associated with a Diagnosis of Hip Instability.

Purpose: To compare the locations and patterns of femoral head chondral damage in patients with instability in contrast to those with femoroacetabular impingement (FAI) without instability.

Methods: All consecutive hip arthroscopies were reviewed from 2013 to 2020 from a single surgeon. Intraoperative records were reviewed on all patients identified to have femoral head chondromalacia.

No Difference in Complication Rates or Patient-Reported Outcomes Between Bone-Patella Tendon-Bone and Quadriceps Tendon Autograft for Anterior Cruciate Ligament Reconstruction.

Purpose: To compare subjective outcomes and complications of anterior cruciate ligament reconstruction (ACLR) using either bone-patellar tendon-bone (BPTB) or quadriceps tendon (QT) autograft.

Methods: A retrospective analysis of prospectively collected data identified consecutive cohorts of patients undergoing ACLR with either BPTB or QT autograft. Patients with less than 12-month follow-up and those undergoing concomitant osteotomies, cartilage restoration, and/or other ligament reconstruction procedures were excluded.

Incidence of Symptomatic Femoroacetabular Impingement: A 4-Year Study at a National Collegiate Athletic Association Division I Institution.

Background: Femoroacetabular impingement (FAI) is an increasingly recognized cause of hip pain in young athletes. Although there are multiple studies that describe the radiographic prevalence of FAI in athletes, its true incidence within this population is unknown.

Purpose: To report on the overall and sport-specific incidence of symptomatic FAI in National Collegiate Athletic Association (NCAA) Division I athletes.

Female gender, decreased lateral center edge angle and a positive hyperextension-external rotation test are associated with ease of hip distractability at time of hip arthroscopy.

Purpose: To identify factors associated with ease of hip distraction at the time of hip arthroscopy.

Methods: A retrospective review of patients 17-50 years old undergoing hip arthroscopy with a single high-volume hip arthroscopist was performed from 2014 to 2020. Demographics, clinical history, examination, and imaging findings were collected.

Hip Microinstability: Understanding a Newly Defined Hip Pathology in Young Athletes.

Microinstability is an increasingly recognized diagnosis in young athletes presenting with hip pain. Causes of microinstability may include abnormality of the hip bony anatomy, acetabular labral tears, joint capsule laxity or injury, and muscle dysfunction. Borderline hip dysplasia is an increasingly recognized factor predisposing to microinstability.

Postoperative Infection: Prevention, Diagnosis, and Treatment Guidelines for the Sports Surgeon.

Postoperative infection remains a potentially devastating complication facing the sports medicine surgeon. Infection prevention begins with a thorough history and physical examination to identify patient specific risk factors and aid in risk stratification. Perioperative steroid injections should be used cautiously, with increased time prior to or following surgery being associated with lower infection risk.