Anterior Cruciate Ligament Reconstruction Graft Options.

Anterior cruciate ligament reconstruction is one of the most common orthopaedic sports medicine surgeries. Its prevalence in the sports medicine sphere is matched by the numerous options of different techniques. Chief among these is graft selection, which most commonly falls into 1 of 4 options: bone-patellar tendon-bone (BPTB) autograft, hamstring tendon autograft (HT), quadriceps tendon autograft, and allografts.

Management of Sideline Medical Emergencies.

Sideline medical care is typically provided by musculoskeletal specialists and orthopaedic surgeons with varying levels of training and experience. While the most common sports injuries are often benign, the potential for catastrophic injury is omnipresent. Prompt recognition of sideline emergencies and expeditious medical management are necessary to minimize the risk of calamitous events.

Analysis of Changing Practice Trends in Anterior Cruciate Ligament Reconstruction: A Multicenter, Single-Institution Database Analysis.

Purpose: To identify trends in anterior cruciate ligament reconstruction (ACLR), including graft choice, femoral tunnel drilling techniques, and augmentation techniques, and to assess how various surgeon factors impact these trends.

Methods: A retrospective review of primary ACLRs performed between 2014 and 2022 was completed using a multicenter institutional database. Patient demographic characteristics, graft type, femoral drilling technique, use of extra-articular tenodesis, and use of suture augmentation were recorded from the medical record.

Capsular Repair, Labral Repair, and Femoroplasty With Postless Traction Are Increasingly Performed for the Arthroscopic Treatment of Femoroacetabular Impingement Syndrome.

Purpose: To provide an updated assessment of hip arthroscopy use by using an institutional database that is specific to the treatment of femoroacetabular impingement syndrome (FAIS).

Methods: All patients undergoing hip arthroscopy for the treatment of FAIS were retrospectively identified between the years 2014 and 2022 via Current Procedural Terminology coding in a multi-institutional, single health system database. A longitudinal analysis was performed to identify trends in the use of arthroscopic techniques including capsular and labral treatment, osteoplasty, and traction set-up.

Seventy Percent of Abstracts Presented at the AANA Annual Meeting Are Later Published.

Purpose: To assess the future publication rates of abstracts presented at AANA annual meetings between 2015 and 2019.

Methods: Abstracts presented at the 2015-2019 AANA annual meetings were identified. The PubMed and Google Scholar databases were searched for a corresponding manuscript for each abstract using the name of the first author, abstract title, and keywords.

Regulatory and Ethical Aspects of Orthobiologic Therapies.

Orthobiologic therapies show significant promise to improve outcomes for patients with musculoskeletal pathology. There are considerable research efforts to develop strategies that seek to modulate the biological environment to promote tissue regeneration and healing and/or provide symptomatic relief. However, the regulatory pathways overseeing the clinical translation of these therapies are complex, with considerable worldwide variation.

Exosomes Derived from Non-Classic Sources for Treatment of Post-Traumatic Osteoarthritis and Cartilage Injury of the Knee: In Vivo Review.

Osteoarthritis of the knee is one of the most common chronic, debilitating musculoskeletal conditions. Current conservative treatment modalities such as weight loss, non-steroidal anti-inflammatory drugs, and intra-articular steroid injections often only provide temporary pain relief and are unsatisfactory for long-term management. Though end stage osteoarthritis of the knee can be managed with total knee arthroplasty (TKA), finding alternative non-surgical options to delay or prevent the need for TKA are needed due to the increased healthcare costs and expenditures associated with TKA.

A Novel Strategy to Enhance Microfracture Treatment With Stromal Cell-Derived Factor-1 in a Rat Model.

Background: Microfracture is one of the most widely used techniques for the repair of articular cartilage. However, microfracture often results in filling of the chondral defect with fibrocartilage, which exhibits poor durability and sub-optimal mechanical properties. Stromal cell-derived factor-1 (SDF-1) is a potent chemoattractant for mesenchymal stem cells (MSCs) and is expressed at high levels in bone marrow adjacent to developing cartilage during endochondral bone formation.

COVID-19 and Orthopaedics: Recovery After the Pandemic Surge.

The novel Coronavirus (COVID-19) pandemic has placed an immense strain on health care systems and orthopedic surgeons across the world. To limit the spread, federal and state governments mandated the cancellation of all nonurgent surgical cases to address surging hospital admissions and manage workforce and resource reallocation. During the pandemic surge, thousands of surgical cancellations have been required.

The Effect of the COVID-19 Pandemic on Orthopedic Practices in New York.

The SARS-CoV-2 (COVID-19) crisis has strained hospitals and health systems across the world. In the United States, New York City has faced a surge of cases as the epicenter of the North American outbreak. Northwell Health, as the largest regional health system in New York City, has implemented various practices and policies to adapt to the evolving situation and prepare for future global events.

Three-Dimensional Bioprinting in Orthopaedics.

Three-dimensional (3D)-printing technology has evolved dramatically in the last 30 years, from large machines with poor resolution to those with micron-level capabilities that sit on a desktop. This technology is being utilized in numerous medical applications, particularly in orthopaedic surgery. Over the past decade, technological advances have allowed for the application of this technology to the field of tissue engineering through the process of 3D bioprinting.

Changing trends in the management of proximal humerus fractures in New York State.

Purpose: Reverse shoulder arthroplasty (RSA) as an alternative to hemiarthroplasty (HA) as treatment for proximal humerus fractures has prompted a re-evaluation of utilization trends.

Methods: Operative treatment for proximal humeral fractures were analyzed using a New York State database.

Results: After introduction as an ICD-9 code, RSA increased to 39.

Degenerative Meniscus Lesions: An Expert Consensus Statement Using the Modified Delphi Technique.

Purpose: The purpose of this study was to perform an evidence-based, expert consensus survey using the Delphi panel methodology to develop recommendations for the treatment of degenerative meniscus tears.

Methods: Twenty panel members were asked to respond to 10 open-ended questions in rounds 1 and 2. The results of the first 2 rounds served to develop a Likert-style questionnaire for round 3.

Effect of Combined Leukocyte-Poor Platelet-Rich Plasma and Hyaluronic Acid on Bone Marrow-Derived Mesenchymal Stem Cell and Chondrocyte Metabolism.

Objective: Given the potential applications of combined biologics, the authors sought to evaluate the effect of combined platelet-rich plasma (PRP) and hyaluronic acid (HA) on cellular metabolism.

Design: Bone marrow-derived mesenchymal stem cells (BMSCs) and chondrocytes were obtained from the femurs of Sprague-Dawley rats. An inflammatory model was created by adding 10 ng/mL interleukin-1-beta to culture media.

Editorial Commentary: Shoulder Repair All-Suture Fixators: Anchors Away or Tell Us Why Not?

The current array of shoulder repair anchors, techniques, and constructs vary greatly and offer many choices to optimize soft-tissue healing to bone. The widely used all-suture anchor designs represent an innovative option that allows for versatile delivery and a low-profile anchor construct that minimizes bone drilling and preserves native bone. Various reports of tissue reactions to copolymer and biocomposite materials and now all-suture anchors have been published raising concerns in some cases over safety, adverse events, and clinical performance.

Viscosupplementation for Osteoarthritis of the Knee: A Key Opinion Leader Panel Discussion.

Unlabelled: With a sharp rise in the prevalence of osteoarthritis of the knee (OAK) in a younger population, new management strategies are needed to preserve mobility, improve patients' quality of life, and reduce the effects of potential disease-related comorbidities. Viscosupplementation with the use of hyaluronic acid (HA) injection is a treatment option for OAK that can provide lubrication and elastic shock absorption, leading to potential pain relief, improved function, and reduced stiffness. A key opinion leader (KOL) panel discussion was held December 3, 2016, with the objective of sharing opinions, ideas, information, and trends regarding OAK and the potential treatment and management offered by viscosupplementation.

Employment Contracts: The Good, the Bad, and the Ugly.

Recent trends indicate that a greater number of orthopaedic surgeons who complete their residency and/or fellowship training are accepting employment positions at hospitals. Moreover, established orthopaedic surgeons with successful private practices have begun to consider whether aligning with hospitals and larger health systems can be effectively accomplished. A comprehensive evaluation of institution-based employment opportunities is essential for orthopaedic surgeons considering hospital-based employment.

Biomechanical analysis of an interference screw and a novel twist lock screw design for bone graft fixation.

Background: Malpositioning of an anterior cruciate ligament graft during reconstruction can occur during screw fixation. The purpose of this study is to compare the fixation biomechanics of a conventional interference screw with a novel Twist Lock Screw, a rectangular shaped locking screw that is designed to address limitations of graft positioning and tensioning.

Methods: Synthetic bone (10, 15, 20lb per cubic foot) were used simulating soft, moderate, and dense cancellous bone.

Impact of recent guideline changes on aspirin prescribing after knee arthroplasty.

Background: Prior to 2012, the American Academy of Orthopaedic Surgeons (AAOS) and American College of Chest Physicians (ACCP) differed in their recommendations for postoperative pharmacologic venous thromboembolism prophylaxis (VTEP) after total joint arthroplasty. More specifically, aspirin (ASA) monotherapy was not endorsed by the ACCP as an acceptable prophylaxis. In 2012, the ACCP supported ASA monotherapy compared with no prophylaxis.