Editorial Commentary: Biologic Stimulation Using Marrow Venting for Meniscus Repair is Cost Effective and Recommended.

Current literature offers little guidance on the most cost-effective approach to intraoperative biologic stimulation in the setting of arthroscopic meniscus repair. Combining data from robust systematic reviews into a Markov Decision Making Model reveal the ideal strategy: Strong consideration should be given to biologic stimulation for all meniscal repairs, and the most cost effective technique is marrow stimulation.

Harvest of All-Soft Tissue Quadriceps Tendon Autograft for Anterior Cruciate Ligament Reconstruction With or Without Closure of Resulting Defect Has No Effect on Patellar Height.

Purpose: To evaluate the radiographic effect of quadriceps tendon harvest on patellar height and to determine whether closure of a quadriceps graft harvest defect resulted in a significant change in patellar height compared to nonclosure.

Methods: We conducted a retrospective review of prospectively enrolled patients. The institutional database was queried and all patients who underwent quadriceps autograft anterior cruciate ligament reconstruction between 2015 and March 2020 were included.

Editorial Commentary: First They Came for My Examination Skills: Diagnostic Injections of the Biceps Sheath Are No Substitute for a Careful Collaboration of History, Examination, and Clinical Acumen.

Diagnostic injections have been used in the workup of many musculoskeletal complaints, especially when a good history and physical examination don't point to a concrete diagnosis. However, the accuracy of blind injections, especially in locations like the biceps sheath, has been called into question. This has led to the use of image guidance to improve injection accuracy, usually with great success.

Editorial Commentary: To Boldy Go…to the Back of the Glenoid: Bone is the Key to Success.

Risk factors of failure after arthroscopic posterior shoulder stabilization are not well understood. Careful attention to anatomy may be the key to helping patients understand their risk of failure after surgery. Posterior stabilization may be even more sensitive to small amounts of bone loss than is anterior stabilization.

Editorial Commentary: Morton Forks a Knee: Magnetic Resonance Imaging Versus Needles Arthroscopy for Knee Meniscus Tears.

Recent literature tells us that knee arthroscopy in the setting of osteoarthritis is no better than placebo, but arthroscopy for isolated, nondegenerative meniscus tears is both helpful to patients and cost-effective. Since most patients with osteoarthritis have meniscus pathology, we need an accurate way to rule out degenerative disease in patients who are otherwise good candidates for arthroscopic partial meniscectomy. Magnetic resonance imaging can be misleading.

Editorial Commentary: The Ever-changing Landscape of Health Care Economics-"The Future Ain't What It Used to Be".

Payment models for orthopaedic services are constantly changing. Rather than have changes dictated to us, it is our responsibility as experts in arthroscopic surgery to advocate for patients and offer our unique insight to governmental agencies and payers. Before we can begin to understand this complex landscape, we need to start at the beginning and master the fundamentals of health care economics: cost-effectiveness analysis, cost minimization, cost benefit, and the like.

Anatomic All-Inside Anterior Cruciate Ligament Reconstruction Using Quadriceps Tendon Autograft.

All-inside anterior cruciate ligament reconstruction has recently gained popularity, in part because of its bone-sparing socket preparation and reported lower pain levels after surgery. However, because this technique uses suture loops and cortical suspension buttons for graft fixation, it has mostly been limited to looped graft constructs (e.g.

Knotless Arthroscopic Repair of Subscapularis Tendon Tears Using Looped Suture.

Subscapularis tendon tears present a technical challenge because both diagnosis and arthroscopic treatment can be difficult. One difficulty is the limited visualization and working space of the anterior shoulder. Although most tears of the subscapularis are partial- or full-thickness tears of the upper third of the tendon, occasionally, larger or more retracted tears are encountered.

Cost-effectiveness analysis of primary arthroscopic stabilization versus nonoperative treatment for first-time anterior glenohumeral dislocations.

Purpose: The purpose of this study was to compare the cost-effectiveness of initial observation versus surgery for first-time anterior shoulder dislocation.

Methods: The clinical scenario of first-time anterior glenohumeral dislocation was simulated using a Markov model (where variables change over time depending on previous states). Nonoperative outcomes include success (no recurrence) and recurrence; surgical outcomes include success, recurrence, and complications of infection or stiffness.

Operative versus nonoperative treatment after primary traumatic anterior glenohumeral dislocation: expected-value decision analysis.

Background: The optimal management strategy for primary traumatic anterior glenohumeral dislocation remains controversial. Patients have traditionally been managed nonoperatively, but high recurrence rates in certain populations have led to increased interest in early operative stabilization. The purpose of this study was to use expected-value decision analysis to determine the optimal management strategy--nonoperative treatment or arthroscopic stabilization--for a first-time traumatic anterior shoulder dislocation.

The diagnostic effect of various needle tip positions in selective lumbar nerve blocks: an analysis of 1202 injections.

Study Design: Retrospective chart review.

Objective: To determine the effect of various needle tip positions on immediate postinjection pain in selective lumbar nerve blocks.

Summary Of Background Data: To our knowledge, no large study has examined the effect of various needle tip positions within or adjacent to the intervertebral foramen on immediate pain outcome.

Influence of needle-tip position on the incidence of immediate complications in 2,217 selective lumbar nerve root blocks.

Background Context: Selective lumbar nerve blocks (SLNBs) are a popular, minimally invasive treatment and diagnostic tool for lumbar radiculopathy. It is therefore relevant to determine the complication rate for SLNBs, as well as examine the association between needle-tip position and complication rates in order to improve safety.

Purpose: The purposes of the present study are to determine the overall rate of immediate, postprocedural complications in a large cohort of patients who received SLNBs and determine if certain needle-tip positions are less likely to cause complications.