Return to Sport After ACL Reconstruction With Meniscal Allograft Transplantation Versus Isolated ACL Reconstruction: A Matched-Cohort Study.

Background: Meniscal allograft transplantation (MAT) is indicated in the setting of anterior cruciate ligament (ACL) reconstruction to restore proper arthrokinematics and load distribution for the meniscus-deficient knee. Objective outcomes after ACL reconstruction with concomitant MAT in athletic populations are scarcely reported and highly variable.

Purpose: To compare patient outcomes using an objective functional performance battery, self-reported outcome measures, and return-to-sport rates between individuals undergoing ACL reconstruction with concomitant MAT and a matched group undergoing isolated ACL reconstruction.

Variability Between Full-Length Lateral Radiographs and Standard Short Knee Radiographs When Evaluating Posterior Tibial Slope in Revision ACL Patients.

Background: Increased posterior tibial slope (PTS) has been identified as a risk factor for failure after anterior cruciate ligament (ACL) reconstruction. Correction of PTS may improve outcomes after revision ACL reconstruction. There are conflicting reports demonstrating the measurement of the PTS on standard short knee (SSK) radiographs versus full-length lateral (FLL) radiographs including the entire tibia.

Single-Strand "Short Isometric Construct" Medial Collateral Ligament Reconstruction Restores Valgus and Rotational Stability While Isolated Deep MCL and Superficial MCL Reconstruction Do Not.

Background: Historical MCL (medial collateral ligament) reconstruction (MCLR) techniques have focused on the superficial MCL (sMCL) to restore valgus stability while frequently ignoring the importance of the deep MCL (dMCL) in controlling tibial external rotation. The recent recognition of the medial ligament complex importance has multiple studies revisiting medial anatomy and questioning contemporary MCLR techniques.

Purpose: To assess whether (1) an isolated sMCL reconstruction (sMCLR), (2) an isolated dMCL reconstruction (dMCLR), or (3) a novel single-strand short isometric construct (SIC) would restore translational and rotational stability to a knee with a dMCL and sMCL injury.

Audit of animal-related injuries at UK veterinary schools between 2009 and 2018.

Background: Animal-related injuries pose a significant risk to the veterinary profession. This study aimed to describe the incidence, demographics, context and consequences of animal-related injuries at UK veterinary schools.

Methods: A multicentre audit of accident records (2009-2018) across five UK veterinary schools was performed.

Comparison of Psychological Readiness to Return to Sport After Primary Versus Revision Anterior Cruciate Ligament Reconstruction.

Background: Rates of return to preinjury level of play after anterior cruciate ligament (ACL) reconstruction (ACLR) remain unsatisfactory, particularly for patients who undergo revision surgery. Psychological readiness is associated with successful return to sport (RTS) and self-perceived preinjury sport performance.

Purpose: To compare psychological readiness at RTS between patients who underwent revision ACL autograft reconstruction and matched controls who underwent primary ACL autograft reconstruction.

Utilizing Hip Abduction Strength to Body-Weight Ratios in Return to Sport Decision-Making After ACL Reconstruction.

Background: Despite the association between hip abduction weakness and non-contact anterior cruciate ligament (ACL) injury, hip abduction strength is rarely considered in return to sport decision-making following ACL reconstruction (ACLR).

Hypothesis/purpose: The purpose of this study was to compare self-reported function, objective functional test performance, and re-injury rates in patients with high (≥33%) versus low (<33% ) isometric hip abduction strength to body weight (BW) ratios when returning to activity following ACLR.

Study Design: Cohort study.

Platelet-Rich Plasma Augmentation of Meniscal Repair in the Setting of Anterior Cruciate Ligament Reconstruction.

Background: The increasing incidence of anterior cruciate ligament (ACL) and meniscal injuries has led to strong interest in discovering new methods to enhance the biological healing response of these tissues. Platelet-rich plasma (PRP) contains various growth factors associated with a positive healing response, but few existing clinical studies are available to determine the risks and benefits of these therapies.

Purpose: To determine the effects of intraoperative PRP on postoperative knee function and complications at 2 years after ACL reconstruction with meniscal repair.

The Beneficial Effect of an Intra-articular Injection of Losartan on Microfracture-Mediated Cartilage Repair Is Dose Dependent.

Background: A previous publication demonstrated that the oral intake of losartan promoted microfracture-mediated hyaline-like cartilage repair in osteochondral defects of a rabbit knee model. However, an intra-articular (IA) injection of losartan may have direct beneficial effects on cartilage repair and has not been studied.

Purpose: To determine the dosage and beneficial effects of an IA injection of losartan on microfracture-mediated cartilage repair and normal cartilage homeostasis.

Intra-articular Injection of Bevacizumab Enhances Bone Marrow Stimulation-Mediated Cartilage Repair in a Rabbit Osteochondral Defect Model.

Background: Bone marrow stimulation (BMS) via microfracture historically has been a first-line treatment for articular cartilage lesions. However, BMS has become less favorable because of resulting fibrocartilage formation. Previous studies have shown that angiogenesis blockade promotes cartilage repair.

The Influence of Mode-of-Injury on Psychological Readiness for Return-To-Sport Following Anterior Cruciate Ligament Reconstruction: A Matched-Controlled Study.

Background: Self-efficacy and fear of re-injury have been documented as factors related to an athlete's ability to return-to-sport after anterior cruciate ligament (ACL) reconstruction. The purpose of this study was to compare psychological readiness between athletes injured in their primary mode of sport versus those injured outside of their primary sport following ACL reconstruction.

Hypothesis: Athletes sustaining 'in-sport' injuries will demonstrate poorer psychological readiness when compared their matched counterparts injured outside of their primary sport.

Quantitative Assessment of In Vivo Human Anterior Cruciate Ligament Autograft Remodeling: A 3-Dimensional UTE-T2* Imaging Study.

Background: The timing of return to play after anterior cruciate ligament (ACL) reconstruction is still controversial due to uncertainty of true ACL graft state at the time of RTP. Recent work utilizing ultra-short echo T2* (UTE-T2*) magnetic resonance imaging (MRI) as a scanner-independent method to objectively and non-invasively assess the status of in vivo ACL graft remodeling has produced promising results.

Purpose/hypothesis: The purpose of this study was to prospectively and noninvasively investigate longitudinal changes in T2* within ACL autografts at incremental time points up to 12 months after primary ACL reconstruction in human patients.

Biologically Regulated Marrow Stimulation by Blocking TGF-β1 With Losartan Oral Administration Results in Hyaline-like Cartilage Repair: A Rabbit Osteochondral Defect Model.

Background: Microfracture or bone marrow stimulation (BMS) is often the first choice for clinical treatment of cartilage injuries; however, fibrocartilage, not pure hyaline cartilage, has been reported because of the development of fibrosis in the repair tissue. Transforming growth factor β1 (TGF-β1), which can promote fibrosis, can be inhibited by losartan and potentially be used to reduce fibrocartilage.

Hypothesis: Blocking TGF-β1 would improve cartilage healing in a rabbit knee BMS model via decreasing the amount of fibrocartilage and increasing hyaline-like cartilage formation.

Fibrin Clots Maintain the Viability and Proliferative Capacity of Human Mesenchymal Stem Cells: An In Vitro Study.

Background: Augmentation of soft-tissue repairs with an autologous fibrin clot has been used clinically for nearly four decades; however, fibrin clots tend to produce an abundance of scar tissue, which is known to inhibit soft-tissue regeneration. Mesenchymal stem cells (MSCs) embedded in fibrin clots before repair could reduce scar tissue deposition and facilitate soft-tissue regeneration. To our knowledge, no published studies have directly evaluated the viability or bioactivity of MSCs in fresh human fibrin clots over time.

Adductor Canal Nerve Versus Femoral Nerve Blockade for Pain Control and Quadriceps Function Following Anterior Cruciate Ligament Reconstruction With Patellar Tendon Autograft: A Prospective Randomized Trial.

Purpose: To compare femoral nerve blockade (FNB) versus adductor canal nerve blockade (ACB) for postoperative pain control and quadriceps muscle function in patients undergoing anterior cruciate ligament (ACL) reconstruction with patellar tendon autograft.

Methods: A randomized therapeutic trial of 90 patients undergoing ACL reconstruction with patellar tendon autograft was conducted comparing ACB versus FNB at 24 hours, 2 and 4 weeks, and 6 months postsurgery. Early outcome measures included average pain score and morphine equivalent units (milligrams) consumed, quadriceps surface electromyography, straight leg raise, and ability to ambulate without assistive devices.

Potential Usefulness of Losartan as an Antifibrotic Agent and Adjunct to Platelet-Rich Plasma Therapy to Improve Muscle Healing and Cartilage Repair and Prevent Adhesion Formation.

Postoperative tissue fibrosis represents a major complication in orthopedics. Transforming growth factor beta 1 is a key molecule in the development of postoperative fibrosis. High concentrations of transforming growth factor beta 1 have also been implicated in various diseases.

Editorial Commentary: Posterolateral Corner Injuries in Elite Athletes Remain a Challenging Diagnostic Problem.

Posterolateral corner injuries are rare, and the examination to quantitate these injuries is very challenging. Careful examination comparing the involved and uninvolved knees, considering stress radiographs, and combining this with magnetic resonance imaging findings is currently our most accurate way to grade these injuries.

Functional Bracing After Anterior Cruciate Ligament Reconstruction: A Systematic Review.

Introduction: The purpose of this study was to evaluate the current literature on the use of functional knee braces after anterior cruciate ligament (ACL) reconstruction with respect to clinical and in vivo biomechanical data.

Methods: A systematic search of both the PubMed and Embase databases was performed to identify all studies that reported clinical and/or in vivo biomechanical results of functional bracing versus nonbracing after ACL reconstruction. Extracted data included study design, surgical reconstruction techniques, postoperative rehabilitation protocols, objective outcomes, and subjective outcomes scores.

Editorial Commentary: "There, It Fits!"-Justifying Nonsignificant P Values.

The increasing emphasis placed on value-based medicine has become a powerful motivating factor that has driven the performance and publication of more comparative clinical outcome studies. Although these endeavors are well intentioned and significant progress has been made in our field over the past few decades, I believe that we need both to re-emphasize the importance of results derived from meaningful study designs and to avoid the notion that nonsignificant P values represent study failure.

Meniscal Root Tears: Identification and Repair.

Intact menisci are capable of converting the axial load of tibiofemoral contact into hoop stress that protects the knee joint. Total meniscectomy leads to rapid degeneration of the knee. Strong clinical and biomechanical data show meniscal root tears and avulsions are the functional equivalent of total meniscectomy.

STRENGTH & FUNCTIONAL ASSESSMENT OF HEALTHY HIGH SCHOOL FOOTBALL PLAYERS: ANALYSIS OF SKILLED AND NON-SKILLED POSITIONS.

Background/purpose: Identifying an athlete's functional capacity is an important consideration in determining when to allow an athlete to return to competition following injury. Establishing normative data for lower extremity functional assessment is valuable for comparison when making decisions regarding the high school athlete returning to play after injury. Therefore, the purpose of this study was to compare functional performance and strength between American high school football players of both skilled and non-skilled positions.