Assessing Residual Moisture After Sterilization as an Overlooked Source of Intraoperative Bacterial Contamination in Knee Intra-articular Reconstructions: Evaluating the Reliability of Routine Procedures and Tests.

Background: Contamination of sterilized surgical instruments is not a typically suspected source of increased infection rate, especially if no abnormalities in the sterilization process are detected.

Purpose/hypothesis: The purpose of this study was to report increased infection rates after knee ligament reconstructions due to undetectable sterilization process errors leading to residual moisture, not limited to a specific surgical tool. It was hypothesized that (1) residual moisture on surgical tools due to autoclave overloading would not be detected by autoclave self-diagnostics, chemical and biological tests, or organoleptic assessment and (2) this kind of contamination may elevate infection rates, especially in knee intra-articular reconstruction procedures.

Adequate Failure Loads for Modified Lemaire Lateral Extra-articular Tenodesis Are Achieved With an Interference Screw, Staple, and Suture Anchor: A Biomechanical Study of Structural Properties.

Background: A lateral extra-articular tenodesis (LET) is increasingly being utilized to augment an anterior cruciate ligament reconstruction because it has been shown to reduce the risk of postreconstruction graft failure or recurrent rotatory instability. Various femoral fixation techniques are available, including the use of an interference screw, staple, or suture anchor.

Purpose: To determine and compare the biomechanical properties of an LET graft when using an interference screw, staple, or suture anchor for the femoral fixation for a modified Lemaire LET.

Posterior Medial Meniscus Root Tears: Clinical Implications, Surgical Management, and Post-operative Rehabilitation Considerations.

Tears of the posterior medial meniscus root (PMMR) are common in older patients and reportedly contribute to rapid joint degeneration over time. Recognition of these tear types and the appropriate diagnosis through clinical exam and diagnostic imaging have improved significantly in recent years, as have surgical techniques to address them. Standardized post-operative rehabilitation protocols specific to PMMR repair have not been established or well understood in the scientific literature.

Correlation of Increased Lateral Tibial Slope With Baseline Tibial Position in Intact Knees and Side-to-Side Anterior Tibial Translation for Knees With ACL Tears.

Background: Anterior cruciate ligament (ACL) stress techniques-including single-leg stress radiographs, Telos, and KT-1000 arthrometer-are highly accessible and can provide additional diagnostic information to assess ACL and ACL graft integrity. The degree of anterior tibial translation (ATT) may be useful in guiding treatment when a diagnosis on magnetic resonance imaging is not conclusive or for judging if additional treatments, such as anterolateral complex augmentation, may be necessary.

Purpose/hypothesis: The purpose of this study was to evaluate the effect of increasing posterior tibial slope (PTS) on baseline tibial position (BTP) and side-to-side differences (SSD) in ATT.

Medial Meniscus Ramp Tears: State of the Art.

Medial meniscus ramp tears are tears of the posteromedial capsule or peripheral rim of the posteromedial meniscus that frequently occur with anterior cruciate ligament (ACL) tears. The incidence and prevalence of medial meniscus ramp tears has been increasing in the recent literature due to the increased understanding of the anatomy and diagnosis of these tears. When a patient presents with an ACL tear, a medial meniscus ramp tear should be suspected if the patient has a grade 3+ Lachman or pivot shift exam, a vertical line of increased signal intensity in the posterior capsule or peripheral meniscus on magnetic resonance imagining (MRI), or posteromedial tibial plateau bone bruising on MRI.