Optimization of the racking hitch knot: how many half hitches and which suture material provide the greatest security?

Background: Reliable methods of fixation of soft tissue and bone are of utmost importance in reconstructive shoulder surgery and in many orthopaedic applications. Current methods of securing lesser tuberosity osteotomies performed during shoulder arthroplasty and tuberosity fixation performed during repair of proximal humeral fractures often rely on alternating half hitches or surgeon's knots regardless of the suture configuration used passing through the tissue (eg, Mason-Allen, Krackow). The racking hitch knot in contrast to half hitches allows sequential tightening, even under tension, with minimal risk of knot slippage or premature locking.

Biologic resurfacing of the glenoid with meniscal allograft: long-term results with minimum 2-year follow-up.

Background: There is a lack of consensus in treating glenohumeral arthritis in younger patients. Hemiarthroplasty has historically been favored because of complications associated with total shoulder arthroplasty. Biologic resurfacing of the glenoid has been investigated as a potential treatment that would decrease glenoid erosion and pain, the major complications of hemiarthroplasty.

The influence of arm and shoulder position on the bear-hug, belly-press, and lift-off tests: an electromyographic study.

Background: Clinical testing for the integrity of the subscapularis muscle includes the belly-press, lift-off, and bear-hug examinations. While these tests have been widely applied in clinical practice, there is considerable variation in arm positioning within each clinical examination.

Hypothesis: To determine the ideal arm and shoulder positions for isolating the subscapularis muscle while performing the bear-hug, belly-press, and lift-off tests.

Arthroscopic rotator cuff repair: scientific rationale, surgical technique, and early clinical and functional results of a knotless self-reinforcing double-row rotator cuff repair system.

Background: Rotator cuff repair has shown to improve shoulder function and reduce pain experienced by patients. Successful repairs should have high fixation strength, allow minimal gap formation, maintain stability, and restore normal anatomy and function of the supraspinatus footprint. The purpose of this study is to describe our preferred method for rotator cuff repair using a knotless self-reinforcing double-row system, and to cite biomechanical data rationalizing its use.

The influence of the acromioclavicular joint degeneration on supraspinatus outlet impingement and the acromion shape.

Purpose: To assess the anatomic association of acromioclavicular joint degeneration to supraspinatus outlet impingement and the acromion shape.

Methods: Sagittal oblique magnetic resonance images of 49 shoulders in 49 patients were reviewed. 29 of them (mean age, 59 years) underwent surgery for impingement with or without rotator cuff tear (group 1), whereas the 20 controls (mean age, 27 years) were treated for shoulder instability without rotator cuff disease or acromioclavicular joint derangement (group 2).

New techniques in allograft tissue processing.

With the increasing reliance on tissue allografts in orthopedic reconstructive and sports surgery, there is a realistic concern on behalf of both the surgeon and the patient as to the safety of these implanted tissues and the possibility of disease transmission. New Food and Drug Administration guidelines in association with independent agency scrutiny have served to decrease this risk in light of recent publicized reports of infection transmission associated with allograft use. In addition, tissue banks are constantly developing new proprietary techniques for allograft processing and sterilization.

The relationship between main elbow flexion skin crease and osseous anatomy of the elbow joint.

Background: Studies that investigate the relationships between the main elbow flexion crease and the underlying osseous anatomy are lacking.

Methods: The relationship between the flexion skin crease and osseous anatomy of the elbow joint was studied. Markers were placed along the main flexion skin crease of both elbows in 50 healthy volunteers.

How safe is the operative treatment of Gartland type 2 supracondylar humerus fractures in children?

Unlabelled: Whereas operative treatment of supracondylar fractures is now standard of care for Gartland type 3 supracondylar humerus fractures in children, the treatment of type 2 fractures remains somewhat controversial. The purpose of this article was to examine the safety and efficacy of closed reduction and pinning of type 2 supracondylar humerus fractures in children.

Methods: We performed a retrospective review of 189 type 2 supracondylar humerus fractures operatively treated at one tertiary care children's hospital from 2000 to 2006.

Computed tomography study of radial head morphology.

Computed tomography scans of 22 cadaveric adult elbows were obtained in 3 forearm positions: full supination, neutral, and full pronation. The radial head dimensions, the radiocapitellar joints, and the proximal radioulnar joints were measured. Multivariate analysis of variance was used to determine which portions of each articulation were the most congruent.

Position of the distal fibular fragment in pronation and supination ankle fractures: a CT evaluation.

Background: Although classically the fibula has been reported to be in external rotation after supination-external rotation (SER) or pronation-external rotation (PER) ankle fractures, a previous CT study demonstrated that what had traditionally been interpreted as external rotation of the distal fibular fracture fragment is actually internal rotation of the proximal fibular fragment. The purpose of this study was to evaluate a series of CT scans in patients who have suffered type IV SER or PER ankle fractures to assess the rotational deformity of the fibular fragment.

Materials And Methods: CT scans of the injured and uninjured extremities were performed on 30 extremities which had sustained either SER (21) or PER (9) injuries.