Outcomes and Return to Sport After Knee Osteochondral Allograft Transplant in Professional Athletes.

Background: Limited data are available on the outcomes and return-to-sport rates after osteochondral allograft transplant in professional athletes.

Purpose: To evaluate the experience of a single senior surgeon in treating professional athletes with osteochondral allograft transplant, including analyzing clinical outcomes and return to sport.

Study Design: Case series; Level of evidence, 4.

Bioabsorbable Screw Fixation Provides Good Results With Low Failure Rates at Mid-term Follow-up of Stable Osteochondritis Dissecans Lesions That Do Not Improve With Initial Conservative Treatment.

Purpose: To evaluate the clinical and radiographic outcomes of patients who have undergone bioabsorbable screw fixation for intact, stable grade I and II osteochondritis dissecans (OCD) lesions for which at least 6 months of conservative management has failed.

Methods: A retrospective review of prospectively collected data from a single institution was performed to identify patients who underwent internal fixation of stable grade I and II OCD lesions (according to the Guhl classification) between January 2010 and January 2020. Patients were included regardless of the presence of concomitant procedures.

Revision and Conversion to Arthroplasty Are Low Among Adolescents Undergoing Meniscal Allograft Transplantation Using the Bridge-In-Slot Technique at Midterm Follow-Up.

Purpose: To report midterm outcomes after primary medial and lateral meniscal allograft transplantation (MAT) with fresh-frozen allografts implanted with the bridge-in-slot technique in the adolescent patient population.

Methods: Adolescent patients less than 18 years old at the time of primary MAT from 1999 to 2016 were retrospectively identified. International Knee Documentation Committee (IKDC) subjective form, Lysholm, and Knee Injury and Osteoarthritis Outcome Score (KOOS) subscales scores were collected before surgery and at 1-year, 2-year, and a minimum 5-year follow-up.

One to Two Days of Rest Is Recommended Before Returning to Sport After Intra-Articular Corticosteroid Injection in the High-Level Athlete.

Unlabelled: Return to sport following a corticosteroid injection is a complex decision. Multiple considerations should be taken into account, including steroid dose and formulation, involvement of the affected joint in the activity, and intensity of the activity. Research investigating the adverse effects of corticosteroid injections with early initiation of high-intensity activity is limited and has produced mixed results.

Orthopaedic Musculoskeletal Biologics Research Impacts Patient Care: The First Annual Arthroscopy Orthobiologics Virtual Special Issue.

Orthobiologics can modify symptoms and improve healing in a variety of musculoskeletal conditions as a part of office-based care or as an adjunct to surgery. Orthobiologics harness the benefits of naturally derived blood components, autologous tissue, and growth factors to reduce inflammation and optimize the host-healing environment. The Arthroscopy family of journals seeks to positively influence evidence-based clinical decision-making by publishing peer-reviewed biologics research.

The Effect of Locking Screws on Distal Component Fixation in Total Wrist Arthroplasty Using a Cadaver Model.

Purpose: The advent of total wrist arthroplasty has allowed for motion-sparing surgical treatment for wrist arthritis. The Integra Freedom Total Wrist Arthroplasty recently incorporated locking caps into its distal component fixation to minimize implant micromotion and improve osseous integration. The purpose of this study was to assess the kinematic effect of locking caps in a cadaveric model.

Editorial Commentary: Rotator Cuff Repair: Graft Augmentation Provides Promising Clinical Outcomes.

Rotator cuff repair has benefitted from many technologic advances including the advent of arthroscopy, improved implant materials, and refined repair techniques. Despite our efforts to improve the science of rotator cuff repair, clinical advances have lagged far behind. Graft augmentation of rotator cuff repairs is an emerging and heterogeneous field that has significantly improved both healing rates and patient-reported metrics in initial data reporting.

Moderate Return to Play and Previous Performance After SLAP Repairs in Competitive Overhead Athletes: A Systematic Review.

Purpose: To perform a systematic review of return to play (RTP) and return to previous level of performance (RPP) in competitive overhead athletes after SLAP repair to identify factors associated with failure to RTP.

Methods: Systematic review was conducted according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Review was registered with PROSPERO International prospective register of systematic reviews (CRD42020215488).

New Approaches to the Diagnosis and Management of Periprosthetic Joint Infection of the Shoulder.

Periprosthetic joint infection (PJI) of the shoulder is a potentially devastating complication following shoulder arthroplasty. It is important to review the workup of PJI in the shoulder, including recently developed diagnostic criteria for shoulder PJI, along with detailed examination of the most common causative organism, . Treatment strategies for PJI of the shoulder include antibiotic therapy, surgical options, and what to do with unexpected positive cultures in revision arthroplasty.

Early clinical and radiographic outcomes of anatomic total shoulder arthroplasty with a biconvex posterior augmented glenoid for patients with posterior glenoid erosion: minimum 2-year follow-up.

Background: Glenoid bone loss in anatomic total shoulder arthroplasty (aTSA) remains a controversial and challenging clinical problem. Previous studies have shown high rates of glenoid loosening for aTSA in shoulders with retroversion, posterior bone loss, and posterior humeral head subluxation. This study is the first to present minimum 2-year follow-up data of an all-polyethylene, biconvex augmented anatomic glenoid component for correction of glenoid retroversion and posterior humeral head subluxation.

Rotator Cuff Repair with Graft Augmentation Improves Function, Decreases Revisions, and Is Cost-Effective.

Purpose: The purpose of this study is to evaluate the cost effectiveness of the use of extracellular matrix (ECM) augment at the time of primary rotator cuff repair utilizing a decision tree analysis.

Methods: A decision tree model was created utilizing the existing literature for retear rates with and without dermal graft augmentation. Costs for rotator cuff repair (hospital and surgeon fees) were based on published studies and the cost for graft augmentation was based on institutional data.

A Complicated Case of Postpartum Myasthenic Crisis.

Myasthenia gravis (MG) is the most common autoimmune disorder affecting the neuromuscular junction (NMJ) of voluntary skeletal muscle. This disease is characterized by ptosis, diplopia, facial muscle weakness, bulbar muscle involvement including dysphagia and difficulty chewing, dysarthria, hypophonia, respiratory muscle fatigue, and sometimes generalized weakness. A myasthenic crisis (MC) is a complication of MG.

Comparison of mechanical properties between Nice knot, Modified Nice knot, and surgeon's knot.

Background: The success of surgical repairs rely on the effectiveness and integrity of the surgical knots used to secure the repair. The purpose of this study is to examine and compare the performance of the Nice knot, the modified Nice knot, and a commonly used combination of surgeons' and square knots with respect to cyclic loading and load-to-failure usiflueng a high-strength suture composed of ultra-high molecular weight polyethylene in the hands of experienced surgeons.

Methods: Two experienced surgeons threw 3 different knot types 9 times, consisting of the Nice knot, modified Nice knot, and a surgeon's knot utilizing Ultrabraid #2 sutures.

Racial Disparities Affecting Postoperative Outcomes After Brain Tumor Resection.

Objective: To investigate racial disparities in 30-day postoperative outcomes of craniotomy for glioma resection.

Methods: 2006-2019 American College of Surgeons' National Surgical Quality Improvement Program files were queried for all patients who underwent a craniotomy for a supratentorial glioma resection. Racial disparities in preoperative variables were studied between the demographic cohorts of Asian, African Americans, Hispanics, and Caucasian.

Penetrating Thoracoabdominal Trauma With a Cryptic Diaphragmatic Injury in a 23-Year-Old Male.

Traumatic diaphragmatic injuries are a rare entity and can occur in relation to penetrating thoracic and abdominal trauma. The most common clinical features of diaphragm rupture include chest or abdominal bruising, decreased breath sounds, and signs of bowel obstruction. However, the classic signs and symptoms of diaphragmatic injury are not always present and can be obscured even in the highest resolution imaging.

Jaw Pain and Profound Bradycardia - An Atypical Presentation of Lyme Carditis.

In 2018, 23,558 confirmed cases and 10,108 probable cases of Lyme disease were reported in the United States, with 96% of all cases coming from 14 states. Lyme carditis is well described, occurring in less than 1% of Lyme disease. High-grade heart block is uncommon in early disseminated Lyme disease.

Biomechanical Evaluation of Unilateral Versus Bilateral C1 Lateral Mass-C2 Intralaminar Fixation.

Study Design: Biomechanical, cadaveric study.

Objectives: To compare the relative stiffness of unilateral C1 lateral mass-C2 intralaminar fixation to intact specimens and bilateral C1 lateral mass-C2 intralaminar constructs.

Methods: The biomechanical integrity of a unilateral C1 lateral mass-C2 intralaminar screw construct was compared to intact specimens and bilateral C1 lateral mass-C2 intralaminar screw constructs.

Anatomic Posterolateral Corner Reconstruction Using a Fibula Cross-Tunnel Technique: A Cadaveric Biomechanical Study.

Purpose: To compare the biomechanical properties of a fibula cross-tunnel technique for posterolateral corner (PLC) reconstruction with those of intact knees.

Methods: Seven fresh-frozen cadaveric knees were tested while intact, after PLC tear, and after reconstruction. Testing of the parameters listed above was performed at 0°, 30°, 60°, and 90° of knee flexion.

The effects of prosthetic humeral head shape on glenohumeral joint kinematics during humeral axial rotation in total shoulder arthroplasty.

Background: A non-spherical humeral head has been shown to influence kinematics and stability of the glenohumeral joint; yet, most prosthetic humeral head components are designed to be a perfect sphere. The effect of humeral head shape on prosthetic joint kinematics after total shoulder arthroplasty is not well understood. We hypothesized that prosthetic joint kinematics during humeral axial rotation is dependent on humeral head shape, regardless of joint conformity.

The effect of long and short head biceps loading on glenohumeral joint rotational range of motion and humeral head position.

Purpose: To evaluate the effect of loading the long and short heads of the biceps on glenohumeral range of motion and humeral head position.

Methods: Eight cadaveric shoulders were tested in 60° abduction in the scapula and coronal plane. Muscle loading was applied based on cross-sectional area ratios.

Biomechanical characteristics of osteochondral defects of the humeral capitellum.

Background: The repetitive, excessive compression forces in the radiocapitellar joint caused by elbow valgus stresses during throwing motions can result in osteochondritis dissecans (OCD) of the humeral capitellum in adolescent athletes.

Purpose: To assess the effect of elbow valgus torque on contact pressure in the radiocapitellar joint and that of central and lateral capitellar osteochondral defects on radiocapitellar joint contact pressure, elbow valgus laxity, and ulnar collateral ligament (UCL) strain.

Study Design: Controlled laboratory study.

Biomechanical comparison of single-row, double-row, and transosseous-equivalent repair techniques after healing in an animal rotator cuff tear model.

The transosseous-equivalent (TOE) rotator cuff repair technique increases failure loads and contact pressure and area between tendon and bone compared to single-row (SR) and double-row (DR) repairs, but no study has investigated if this translates into improved healing in vivo. We hypothesized that a TOE repair in a rabbit chronic rotator cuff tear model would demonstrate a better biomechanical profile than SR and DR repairs after 12 weeks of healing. A two-stage surgical procedure was performed on 21 New Zealand White Rabbits.

The effects of prosthetic humeral head shape on glenohumeral joint kinematics: a comparison of non-spherical and spherical prosthetic heads to the native humeral head.

Background: The purpose of this study was to quantitatively evaluate the effect of the prosthetic humeral head shape on rotational range of motion and glenohumeral joint kinematics.

Methods: Six fresh-frozen cadaveric shoulders were tested in multiple positions under anatomic muscle loading. Specimens were tested for the native head, and then the spherical and non-spherical prosthetic heads were randomly implanted in the same stem to preserve the center of rotation.

Radioscapholunate arthrodesis with excision of the distal scaphoid: comparison of contact characteristics to the intact wrist.

Purpose: To evaluate the midcarpal contact characteristics at the lunocapitate (LC) and scaphotrapezio-trapezoidal (STT) joints in 3 wrist conditions: intact, after simulating a radioscapholunate (RSL) arthrodesis, and after an RSL arthrodesis with distal scaphoid excision (DSE).

Methods: Eight fresh-frozen cadaveric specimens were tested using a custom jig with the wrist in neutral, 15° and 30° flexion and extension, 10° radial deviation, and 20° ulnar deviation. The RSL arthrodesis was performed using 2.

Margin convergence anchorage to bone for reconstruction of the anterior attachment of the rotator cable.

Purpose: The purpose of this study was to compare the biomechanical characteristics of a massive L-shaped retracted rotator cuff tear repaired with either soft-tissue side-to-side sutures or margin convergence anchorage to bone.

Methods: Eight matched pairs of cadaveric shoulders were used. The supraspinatus and infraspinatus were secured in a clamp at 30° of glenohumeral abduction.