Association Between Anteromedial Portal Versus Tibial Tunnel Drilling and Meniscal Reoperation Risk Following Anterior Cruciate Ligament Reconstruction: A Cohort Study.

Background: Anterior cruciate ligament reconstruction (ACLR) provides functional stability to an injured knee. While multiple techniques can be used to drill the femoral tunnel during ACLR, a single technique has yet to be proven as clinically superior. One marker of postoperative functional stability is subsequent meniscal tears; a lower risk of subsequent meniscal surgery could be expected with improved knee stability.

Femoral Tunnel Drilling Method: Risk of Reoperation and Revision After Anterior Cruciate Ligament Reconstruction.

Background: The femoral tunnel in anterior cruciate ligament reconstruction (ACLR) can be created by the transtibial (TT) or tibial-independent (TI) methods. An anatomically located femoral tunnel can be more consistently achieved by TI methods, which include the anteromedial portal and lateral (outside-in, retrodrill) techniques. Nonanatomic graft placement in ACLR can result in postoperative instability and meniscal or chondral injury.

Revision Risk After Allograft Anterior Cruciate Ligament Reconstruction: Association With Graft Processing Techniques, Patient Characteristics, and Graft Type.

Background: Allograft tissue is a common graft choice for anterior cruciate ligament reconstruction (ACLR). Allograft sterilization methods vary widely across numerous commercial tissue vendors. Multiple studies, despite being limited in sample size, have suggested a higher rate of clinical failure associated with the use of allograft tissue in ACLR when compared with autograft.

Arthroscopic capsulolabral reconstruction for posterior instability of the shoulder: a prospective study of 200 shoulders.

Background: There are few reports in the literature detailing the arthroscopic treatment of unidirectional posterior shoulder instability.

Hypothesis: Arthroscopic capsulolabral reconstruction is effective in restoring stability and function and alleviating pain in athletes with symptomatic unidirectional posterior instability.

Study Design: Cohort study; Level of evidence, 2.

All-inside patellar tendon anterior cruciate ligament reconstruction.

In the continued evolution of arthroscopic surgery for anterior cruciate ligament (ACL) reconstruction, the "All-Inside" technique has been developed in an attempt to further decrease surgical trauma. By replicating standard anatomic ACL reconstruction techniques, the RetroConstruction System (Arthrex, Naples, FL) eliminates tibial tunnels by creating "Retrodrilled" sockets. This All-Inside technique reduces the size and number of incisions and associated soft-tissue trauma, while eliminating the violation of distal cortices, thereby potentially decreasing patient morbidity, facilitating rehabilitation, and improving cosmesis.

Arthroscopic capsulolabral repair for posterior shoulder instability in throwing athletes compared with nonthrowing athletes.

Background: There are limited studies evaluating arthroscopic treatment of unidirectional posterior shoulder instability in overhead-throwing athletes.

Hypothesis: Arthroscopic capsulolabral repair for unidirectional posterior shoulder instability will yield equivalent stability and functional outcomes in the overhead-throwing athlete and nonthrowers.

Study Design: Cohort study; Level of evidence, 2.

Soft tissue allograft and double-bundle reconstruction.

The anterior cruciate ligament (ACL) is composed of two functional bundles, the anteromedial and posterolateral. Multiple biomechanical and clinical studies have demonstrated that the posterolateral bundle plays a critical role in rotatory stability of the knee. Anatomic double-bundle reconstruction of the ACL best restores knee function and kinematics when the ACL is ruptured.

Arthroscopic capsulolabral reconstruction of the type VIII superior labrum anterior posterior lesion: mean 2-year follow-up on 13 shoulders.

Background: A type VIII superior labrum anterior posterior lesion represents pathologic posteroinferior extension of a type II superior labrum anterior posterior lesion with injury to the insertion of the posterior band of the inferior glenohumeral ligament. No reports in the literature describe arthroscopic treatment of a type VIII superior labrum anterior posterior lesion and its associated glenohumeral instability.

Hypothesis: Arthroscopic capsulolabral reconstruction is effective in alleviating pain and restoring stability and function in athletes with glenohumeral instability due to the type VIII superior labrum anterior posterior lesion.

Management of Morel-Lavallee lesion of the knee: twenty-seven cases in the national football league.

Background: The Morel-Lavallee lesion is a closed degloving injury most commonly described in the region of the hip joint after blunt trauma. It also occurs in the knee as a result of shearing trauma during football and is a distinct lesion from prepatellar bursitis and quadriceps contusion.

Purpose: To review the authors' experience with Morel-Lavallee lesion of the knee in the elite contact athlete to construct a diagnostic and treatment algorithm.

Changes in knee laxity and ligament force after sectioning the posteromedial bundle of the posterior cruciate ligament.

Purpose: Our purpose was to evaluate the role of the posteromedial (PM) bundle of the native posterior cruciate ligament (PCL) in restraining posterior tibial translation and the effects of sectioning of the PM bundle on PCL forces.

Methods: The PCL's femoral origin was mechanically isolated by use of a cylindrical coring cutter, and a cap of bone containing the ligament fibers was attached to a load cell that recorded resultant force in the ligament as the knee was passively extended from 120 degrees to 0 degrees without and with simulated tibial loading conditions. Anteroposterior laxity was also measured after load cell installation.

Transient meralgia paresthetica after pediatric posterior spine fusion.

Meralgia paresthetica (MP) rarely occurs during posterior spine surgery. The study goal was to examine risk factors associated with the incidence of MP. A review of 56 consecutive pediatric patients undergoing posterior spine fusion for scoliosis was performed.

Effects of wafer resection and hemiresection from the distal ulna on load-sharing at the wrist: a cadaveric study.

Purpose: Ulnar impaction syndrome is commonly the result of a naturally occurring ulnar-positive condition, distal radius fracture malunion, or collapse of a fractured radial head. The Feldon wafer procedure and the Bowers distal hemiresection procedure are designed to decrease force transmitted through the distal ulna. The purpose of this study was to measure the effects of these procedures on distal ulnar loading with varying degrees of ulnar positivity at the wrist.

Graft reconstruction of the interosseous membrane in conjunction with metallic radial head replacement: a cadaveric study.

Purpose: Longitudinal radioulnar dissociation (Essex-Lopresti injury) occurs when traumatic axial loading through the wrist disrupts the interosseous membrane (IOM) of the forearm and fractures the radial head. Proximal migration of the radius results in an ulnar-positive wrist, which can lead to painful ulnar-sided wrist degeneration and distal radioulnar joint instability. The purpose of this study was to measure the ability of an IOM reconstruction used in combination with a metal prosthetic radial head implant to reduce distal ulnar forces in a cadaveric model.

Reconstruction of the interosseous membrane of the forearm with a graft substitute: a cadaveric study.

Purpose: Longitudinal radioulnar dissociation occurs when traumatic axial loading through the wrist disrupts the interosseous membrane (IOM) of the forearm and fractures the radial head (Essex-Lopresti injury). Proximal migration of the radius results in a wrist with a positive ulnar variance, which leads ultimately to painful ulnar-sided wrist degeneration and wrist pain during grasping activities that involve axial loading or ulnar deviation of the wrist. In theory reconstruction of the IOM with a graft substitute can limit proximal migration of the radius, thereby preserving wrist function.

Subchondral giant-cell tumor of the proximal tibia: arthroscopic treatment for accelerated articular cartilage and meniscal degeneration in two patients.

Giant-cell tumor most commonly occurs in the distal femur and proximal tibia and characteristically involves the subchondral bone. Incomplete resection leads to recurrence rates of up to 50%. Intralesional curettage, adjuvant treatments, and polymethyl methacralate (PMMA) reconstruction is the current mainstay of treatment and has produced recurrence rates of less than 10%.

Load-sharing at the wrist following radial head replacement with a metal implant. A cadaveric study.

Background: Surgical excision of the radial head is frequently required after a comminuted fracture of the radial head. The outcome of this procedure is often unpredictable, with some patients experiencing ulna-sided pain in the wrist secondary to proximal migration of the radius. Insertion of a radial head prosthesis could prevent proximal radial migration and restore normal load-sharing at the wrist.