Publications by authors named "Ron Gilat"

Over the past decade, hip-preservation strategies have gained momentum, resulting in a notable increase in the use of hip arthroscopy for diagnostic and therapeutic interventions in hip-related pathology. In this 3-part series, the authors will aim to comprehensively review the fundamentals of hip arthroscopy in the setting of femoroacetabular impingement. This Technical Note will thoroughly review the senior authors' approach to managing the central compartment of the hip in the context of femoroacetabular impingement.

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Over the past decade, hip-preservation strategies have gained momentum, resulting in a notable increase in the use of hip arthroscopy for diagnostic and therapeutic interventions in hip-related pathology. In this 3-part series, the authors will aim to comprehensively review the fundamentals of hip arthroscopy in the setting of femoroacetabular impingement. While considering the advantages and disadvantages of post versus postless hip arthroscopy, this Technical Note will review the preferred patient and portal positioning approach used by the senior authors.

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Over the past decade, hip preservation strategies have gained momentum, resulting in a notable increase in the use of hip arthroscopy for diagnostic and therapeutic interventions for hip-related pathology. In this 3-part series, we aim to comprehensively review the fundamentals of hip arthroscopy in the setting of femoroacetabular impingement. This Technical Note will thoroughly review the senior authors' approach to managing the peripheral compartment of the hip in the context of femoroacetabular impingement.

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Background: Impaired sleep quality often drives patients with rotator cuff tears (RCT) to seek surgical intervention. This meta-analysis reviews the impact of arthroscopic rotator cuff repair (ARCR) on sleep quality beyond six months and identifies influencing factors, primarily narcotics, on sleep quality.

Methods: The search spanned PubMed, Google Scholar, Embase, and the Cochrane Central Register, targeting articles evaluating rotator cuff injury and sleep quality.

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Article Synopsis
  • The study investigates the link between weakness or dysfunction of the vastus medialis oblique muscle (VMO) and patellar instability, emphasizing that while VMO issues are known in patellofemoral pain syndrome, their role in lateral patellar instability is less clear.
  • Researchers analyzed VMO characteristics in 204 participants, using MRI to measure features like muscle elevation, cross-sectional area (CSA), and fiber angulation, finding that those with patellar instability showed significant differences in these measurements compared to controls.
  • Results indicated that patients with patellar instability had increased muscle elevation and fiber angulation, reduced CSA, and a lower CSA-to-thigh circumference ratio, with recurrent instability showing even more pronounced V
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Background: Clinically significant outcome (CSO) thresholds are invaluable to the interpretation of patient-reported outcomes (PROs). The Patient-Reported Outcomes Measurement Information System (PROMIS) is gaining popularity among the orthopaedic community; however, CSO thresholds for PROMIS are yet to be defined for outcomes after gluteus medius and/or minimus (GM) repair.

Purpose: To (1) define CSO thresholds for PROMIS-Pain Interference (PROMIS-PI) and PROMIS-Physical Function (PROMIS-PF) after GM repair, (2) correlate these PROMIS scores with legacy hip-specific PROs, and (3) quantify their floor and ceiling effects.

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Purpose: To compare the differences between men and women who receive primary osteochondral allograft transplantation of the knee with regard to preoperative disease presentation, failures and reoperations.

Methods: A retrospective review of patients ≥18 years old who underwent primary osteochondral allograft transplantation between 2002 and 2020 by a single surgeon with a minimum of 2-year follow-up was performed. Demographic, preoperative, intraoperative and postoperative data were collected for all included patients.

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Objective: To evaluate the prevalence and types of injuries incurred during kiteboarding (1), along with treatment approaches (2). In addition, the time to return to kiteboarding following injury (3) and factors associated with the rate and type of injury were analyzed (4).

Setting: Recreational kiteboarding.

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Background: Previous studies have shown that short-term outcomes after hip arthroscopy for femoroacetabular impingement syndrome (FAIS) predict midterm outcomes, but a limited number of studies have evaluated whether short-term outcomes predict long-term outcomes and survivorship.

Purpose: To evaluate whether achieving clinically significant outcomes at 2 years after hip arthroscopy for FAIS can predict patient-reported outcomes (PROs) and survivorship at 10 years.

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

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Purpose: To assess patient-reported outcomes (PROs), clinically significant outcomes (CSOs), and survivorship after staged hip arthroscopy with labral repair, femoroplasty, and capsular plication followed by periacetabular osteotomy (PAO) for the management of femoroacetabular impingement syndrome and hip dysplasia (lateral center-edge angle ≤25°).

Methods: A prospectively maintained database was queried to retrospectively identify patients who underwent staged primary hip arthroscopy and PAO between January 2018 and October 2021 and had a minimum 2-year follow-up. PROs collected included Hip Outcome Score Activities of Daily Living/Sports Subscale, international Hip Outcome Tool-12 item questionnaire, and visual analog scale for pain.

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Patellar instability is a complex orthopaedic condition, occurring at an incidence of 23.2 per 100,000 person-years and resulting from a combination of osseous and soft-tissue factors. Osseous abnormalities associated with patellar instability include trochlear dysplasia and a lateralized tibial tubercle.

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Purpose: To assess the current scientific literature on the microbiome's relation with knee osteoarthritis (OA), with specific focuses on the gut microbiome-joint axis and joint microbiome-joint axis.

Methods: A systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines; the PubMed, Embase, and Cochrane databases were searched for relevant English-language clinical studies on the gut and/or joint microbiomes' association with knee OA in humans. Bias was evaluated using the Methodological Index for Non-randomized Studies score.

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Purpose: To define the time to achievement of clinically significant outcomes (CSOs) after primary gluteus medius and/or minimus (GM) repair and to identify factors associated with delayed CSO achievement.

Methods: Patients who underwent primary GM repair between January 2012 and June 2021 with complete preoperative, 6-month, 1-year, and 2-year Hip Outcome Score-Activities of Daily Living (HOS-ADL) were retrospectively identified. Cohort-specific minimal clinically important difference (MCID) and patient acceptable symptom state (PASS) were calculated.

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Background: Meniscal allograft transplantation (MAT) has been shown to provide clinical benefits in patients with symptomatic meniscal deficiency in the short term and midterm. There is, however, a paucity of data regarding long-term outcomes after MAT using fresh-frozen allografts and the bridge-in-slot technique.

Purpose: To report clinical outcomes and revision rates after primary MAT with fresh-frozen allografts and the bridge-in-slot technique in a large case series of patients at a 10-year minimum follow-up.

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Article Synopsis
  • The study reports on the outcomes of subacromial balloon spacer implantation (SBSI) over a minimum of 5 years, focusing on survivorship, pain reduction, functional improvements, complications, and the need for reoperations.
  • Out of 36 patients who underwent SBSI, 29 had follow-up data, showing significant improvements in patient-reported scores for pain, strength, and overall satisfaction.
  • The results indicate that pain and function improvements are maintained over time, with a 13.79% conversion rate to reverse total shoulder arthroplasty.
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Introduction: Patient-Reported Outcome Measurement Information System (PROMIS) was developed as a uniform and generalizable PROM system using item response theory and computer adaptive testing. We aimed to assess the utilization of PROMIS for clinically significant outcomes (CSOs) measurements and provide insights into its use in orthopaedic research.

Materials And Methods: We reviewed PROMIS CSO reports for orthopaedic procedures via PubMed, Cochrane Library, Embase, CINAHL, and Web of Science from inception to 2022, excluding abstracts and missing measurements.

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Article Synopsis
  • The study aimed to evaluate the mid-term outcomes of patients who underwent revision meniscal allograft transplantation (RMAT) and compare their results with those who had primary meniscal allograft transplantation (PMAT).
  • A total of 22 RMAT procedures were performed, with a follow-up of around 9.9 years, and patient-reported outcome measures (PROMs) were collected to assess the success and satisfaction of the surgeries.
  • Results showed that 31% of RMAT patients needed further operations within an average of 4.7 years, and various scores indicated differing levels of patient satisfaction, highlighting the ongoing impact of their knee conditions despite surgery.
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Introduction: The meniscotibial ligament (MTL) limits extrusion of the medial meniscus (MM). While meniscal extrusion may be detrimental to knee joint biomechanics, the role of the MTL in meniscal extrusion is debatable. We sought to perform a systematic review and meta-analysis to evaluate the role of the MTL and surgical techniques for MTL repair.

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Purpose: To determine the improvements in patient-reported outcome measures (PROMs) necessary to achieve minimal clinically important difference (MCID), patient-acceptable symptomatic state (PASS), and substantial clinical benefit (SCB) after primary meniscal allograft transplantation (MAT) at a minimum of 5-year follow-up, while identifying variables predictive of achieving clinically significant outcomes (CSOs).

Methods: A retrospective review was performed to identify patients undergoing primary MAT at a single institution from 1999 to 2016. Lysholm, International Knee Documentation Committee (IKDC), and Knee Injury and Osteoarthritis Outcome Score (KOOS) subscales were collected before surgery and at a minimum of 5-year follow-up.

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Background: Atrial Fibrillation (AF) is the most common sustained tachi-arrhythmia. Thrombus formation in the left atrial appendage (LAA) increases the risk of stroke and systemic embolism in patients with AF.

Objectives: The aim of this study was to compare thrombin generation in the LAA to the LA among patients with AF.

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Background: Immediate postoperative pain relief following arthroscopic partial meniscectomy remains a critical contributor to improved patient experience, early recovery of range of motion, and enhanced rehabilitation.

Purpose: To evaluate the effect of intra-articular versus extra-articular bupivacaine on pain intensity and analgesic intake after arthroscopic partial meniscectomy.

Study Design: Randomized controlled trial; Level of evidence, 1.

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Posterior root-tear of the medial meniscus and accompanied meniscal extrusion can lead to functional loss of the meniscus. The aim of this study is to assess medial meniscus extrusion at increasing varus forces utilizing magnetic resonance imaging (MRI), in order to evaluate the contribution of the adduction moment of the knee during gait. We prospectively enrolled 19 patients (38 knees).

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Background: Hip arthroscopy is an increasingly common procedure; however, recommendations for safely returning to driving after hip arthroscopy vary among surgeons.

Purpose: To systematically review and analyze the current available evidence on the optimal time to safely return to driving after hip arthroscopy.

Study Design: Systematic review; Level of evidence, 3.

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Acute septic arthritis of the knee joint is an orthopedic emergency, potentially devastating, which can lead to high morbidity and may even be life-threatening. While any synovial joint can be infected, the knee is the most often affected joint and is involved in about 50 % of the cases. The infection is usually caused by a gram-positive bacteria.

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