Outcomes following open acetabular labrum reconstruction: Comparing fresh-frozen tendon with fresh meniscus allograft transplantation.

Background: Symptomatic acetabular labral insufficiency in young, active patients is often treated with labral repair or reconstruction using fresh-frozen allografts. However, fresh-frozen tendon allografts do not have tissue or material properties that closely mimic acetabular labral fibrocartilage. Recent studies suggest meniscal allografts may be a better biomechanical, geometric, and material alternative for acetabular labrum reconstruction (ALR).

Review of Extensor Mechanism Injuries in the Dislocated Knee.

Knee dislocations, aka multiligamentous injuries, are uncommon but devastating injuries often following high-energy trauma. Tears of the major knee stabilizers are well documented; however, injuries of the knee extensor mechanism are less commonly reported. The extensor mechanism is comprised of the patella, patellar tendon, and quadriceps tendons.

Friction Syndromes of the Knee.

The knee is a complex joint with many fascial and ligamentous interactions. The movement in multiple planes makes the knee a prime site for friction syndromes, especially in active individuals. The most common friction syndrome is the iliotibial band friction syndrome.

The Lateral Knee Radiograph: A Detailed Review.

Initial imaging evaluation for a variety of knee pathologies often begins with a radiographic series. Depending on the specific indication, this will include at least two different projections of the knee. In most cases, these are the anteroposterior and lateral radiographs of the affected knee, and sometimes with the contralateral knee for comparison.

Imaging of Noncontact Anterior Cruciate Ligament Injuries and Associated Bone Marrow Contusion Patterns.

Anterior cruciate ligament (ACL) tears are commonly associated with bone contusions. Bone contusions can lend important insight into increased risk for more subtle concurrent injuries based on common injury mechanisms and patterns, as higher energy trauma has been tied to patterns of specific bone contusions and concomitant injuries. Lateral compartment contusions are most common and occur in pivot shift injuries.

Initial Validation of a Modified MRI Scoring System for Assessing Outcomes after Single-Surface Osteochondral Shell Allograft Transplantation in the Knee.

The Osteochondral Allograft Magnetic Resonance Imaging Scoring System (OCAMRISS) provides a reproducible method for imaging-based grading for osteochondral allograft (OCA) transplants. However, the OCAMRISS does not account for larger whole-surface OCA shell grafts, and has not been validated for assessing outcomes after shell OCA transplantation. Therefore, the objective of this study was to evaluate a modified OCAMRISS for assessing single-surface shell OCAs in the knee based on strength of correlations for a modified OCAMRISS score with graft success and patient-reported outcomes for pain and function.

Imaging Review of the Posterior Cruciate Ligament.

Posterior cruciate ligament (PCL) injuries can often be missed on physical examination, especially in multiligament knee injuries. Therefore, a comprehensive approach to imaging the PCL should be implemented whenever history and examination findings indicate relative risk. Radiography, including a posterior-stress view, and magnetic resonance imaging, when available, provide consistently accurate diagnosis of PCL pathology and common knee comorbidities.

Systematic Review of Osteochondral Allograft Transplant Immunology: How We Can Further Optimize Outcomes.

Despite the growing success for osteochondral allograft (OCA) transplantation in treating large articular cartilage lesions in multiple joints, associated revision and failure rates are still higher than desired. While immunorejection responses have not been documented, the effects of the host's immune responses on OCA transplantation failures have not been thoroughly characterized. The objective of this study was to systematically review clinically relevant peer-reviewed evidence pertaining to the immunology of OCAs to elucidate theragnostic strategies for improving functional graft survival and outcomes for patients undergoing OCA transplantation.

The deep medial femoral sulcus sign: does it exist?

Objective: To determine the normal depth of the medial femoral sulcus on lateral radiographs of the knee and determine if abnormal deepening of the medial femoral sulcus exists as a radiographic indicator of intra-articular knee abnormalities.

Materials And Methods: A retrospective search was performed over a period of 10 years to identify all individuals with a bone contusion of the anterior medial femoral condyle at MR imaging. Study patients had documented acute knee injuries and radiographs 6 weeks or less prior to their MR.

Friction Syndromes of the Knee: The Iliotibial Band and Anterior Fat Pads.

As participation in sporting activities increases among the general population, the incidence of overuse injuries continues to rise. Friction syndromes of the knee are common and are often clinically diagnosed without the need for imaging. However, clinical symptoms may overlap with other joint abnormalities, and physical examination may be limited in individuals with excessive pain.

Superolateral Hoffa's Fat Pad Edema in Collegiate Volleyball Players.

Objective: Superolateral Hoffa's fat pad (SHFP) edema is a previously described magnetic resonance (MR) finding located between the patellar tendon and the lateral femoral condyle. The purpose of our study was to determine the prevalence and clinical significance of SHFP edema in female collegiate volleyball players.

Materials And Methods: Sixteen female collegiate volleyball players were consented for bilateral knee evaluations which consisted of history, physical examination and MR imaging.

Long term anticoagulation (4-16 years) stops progression of idiopathic hip osteonecrosis associated with familial thrombophilia.

In 6 patients with familial thrombophilia (5 Factor V (FV) Leiden heterozygotes, 1 with resistance to activated protein C (RAPC)), we prospectively assessed whether continuous longterm (4-16 years) anticoagulation would prevent progression of idiopathic osteonecrosis (ON), ameliorate pain, and facilitate functional recovery. Four men and 2 women (9 hips, 8 Ficat stage II, 1 stage I) were anticoagulated with enoxaparin (60 mg/day) for 3 months and subsequently with Coumadin, Xarelto, or Pradaxa, warranted by ≥2 prior thrombotic events. Anticoagulation was continued for 4, 4, 9, 13, 13, and 16 years, with serial clinical and X-ray follow-up.

Cysts of the anterior horn lateral meniscus and the ACL: is there a relationship?

Objective: Parameniscal cysts have a very high association with meniscal tears in all locations except the anterior horn lateral meniscus (AHLM). The common insertion of the anterior cruciate ligament (ACL) and the AHLM root may provide a pathway for disease. The purpose of our study was to determine if cysts of the ACL are the origin of cysts adjacent to the AHLM.

The anteromedial tibial rim sign: an indicator of patellotibial impaction in acute anterior cruciate ligament tears.

Objective: We have encountered unexplained anteromedial tibial rim edema in acute anterior cruciate ligament (ACL) tears. Our goal was to determine the incidence, internal derangements, and mechanism of injury in patients with anteromedial tibial rim edema (rim sign).

Materials And Methods: A retrospective review of ACL tears diagnosed by magnetic resonance imaging over 7 years was performed.

The role of imaging in diagnosing diseases of the distal radioulnar joint, triangular fibrocartilage complex, and distal ulna.

Objective: The purpose of this article is to review the anatomy, biomechanics, and multimodality imaging findings of common and uncommon distal radioulnar joint (DRUJ), triangular fibrocartilage complex, and distal ulna abnormalities.

Conclusion: The DRUJ is a common site for acute and chronic injuries and is frequently imaged to evaluate chronic wrist pain, forearm dysfunction, and traumatic forearm injury. Given the complex anatomy of the wrist, the radiologist plays a vital role in the diagnosis of wrist pain and dysfunction.

Stress injury of the rib in a swimmer.

Rib stress injuries are uncommonly reported but have been documented among athletes, most notably rowers. There have only been two prior case reports of rib stress injuries in swimmers, both of which were young females. Magnetic resonance (MR) imaging was either not obtained or the imaging characteristics were incompletely described.

The trochlear cleft: initial experience in elite athletes.

Objective: The trochlear cleft is a recently described vertically oriented, low-signal cartilage lesion centered in the trough of the trochlear cartilage. The purpose of our study was to determine the incidence of clefts in an at-risk group of athletes and correlate these findings with clinical and physical examination results.

Materials And Methods: Sixteen female collegiate volleyball players consented to bilateral knee evaluations, which consisted of history, physical examination, and magnetic resonance (MR) imaging.

Patellotibial contusions: a rare cruciate ligament injury pattern.

Objective: Patellotibial contusions are a recently described contusion pattern in anterior cruciate ligament (ACL) tears. The purposes or our study were to determine if patellotibial contusions are specific to ACL injuries, determine the internal derangements in patients demonstrating this contusion, and suggest a mechanism of injury.

Materials And Methods: We conducted a retrospective search of radiology reports over a 6-year period to identify patients with patellar edema described on magnetic resonance (MR) imaging.

Patellotibial contusions in anterior cruciate ligament tears.

Bone contusions are an important ancillary finding of many knee injuries. Not only are they a source of pain, they may suggest a mechanism of injury or a specific derangement of the knee joint. We have encountered a small number of patients being evaluated for anterior cruciate ligament (ACL) tears with unexplained patellar and tibial edema at magnetic resonance (MR) imaging.

The next accreditation system in radiology: a report from the APDR residency structure committee.

In a move to emphasize the educational outcomes of training programs, the ACGME has created the Next Accreditation System (NAS). The stated goals of NAS include aiding the ACGME in the accreditation of programs based on educational outcome measures, decreasing program burdens associated with the conventional process-based approach to ACGME accreditation, allowing good programs to innovate while enabling struggling programs to steadily improve, and providing public accountability for outcomes. Diagnostic radiology is among the first group of specialties to undergo NAS implementation and began operating under the NAS in July 2013.