Incidence of Early Adverse Events Following Medial Patellofemoral Ligament Reconstruction.

The current literature lacks data regarding perioperative complications after medial patellofemoral ligament reconstruction (MPFLr). The objective of this study was to identify the incidence and predictors of adverse events in the first 90 days after MPFLr. Patients undergoing primary MPFLr between January 1, 2010, and December 31, 2019, were included.

Preoperative Computed Tomography Scan in Distal Radius Fractures and the Effect on Preoperative Planning.

Purpose: It is unclear whether computed tomography (CT) scans alter the surgical plan when ordered before surgery for fixation of intra-articular distal radius fractures (DRFs). The purpose of this study was to determine whether a preoperative CT scan alters the planned approach (PA) or planned fixation strategy (PFS) for open reduction internal fixation of intra-articular DRFs.

Methods: Radiology records were retrospectively reviewed by one trauma surgeon and two hand surgeons for 33 intra-articular DRFs that met the inclusion criteria and previously underwent open reduction internal fixation.

A modified Delphi consensus statement on patellar instability: part I.

Aims: The aim of this study was to establish consensus statements on the diagnosis, nonoperative management, and indications, if any, for medial patellofemoral complex (MPFC) repair in patients with patellar instability, using the modified Delphi approach.

Methods: A total of 60 surgeons from 11 countries were invited to develop consensus statements based on their expertise in this area. They were assigned to one of seven working groups defined by subtopics of interest within patellar instability.

A modified Delphi consensus statement on patellar instability: part II.

Aims: The aim of this study was to establish consensus statements on medial patellofemoral ligament (MPFL) reconstruction, anteromedialization tibial tubercle osteotomy, trochleoplasty, and rehabilitation and return to sporting activity in patients with patellar instability, using the modified Delphi process.

Methods: This was the second part of a study dealing with these aspects of management in these patients. As in part I, a total of 60 surgeons from 11 countries contributed to the development of consensus statements based on their expertise in this area.

Improved perioperative narcotic usage patterns in patients undergoing robotic-assisted compared to manual total hip arthroplasty.

Background: Robot-assisted total hip arthroplasty (RA-THA) improves accuracy in achieving the planned acetabular cup positioning compared to conventional manual THA (mTHA), but optimal dosage for peri-RA-THA and mTHA pain relief remains unclear. This study aimed to compare pain control with opioids between patients undergoing direct anterior approach THA with the use of a novel, fluoroscopic-assisted RA-THA system compared to opioid consumption associated with fluoroscopic-assisted, manual technique.

Methods: Retrospective cohort analysis was performed on a consecutive series of patients who received mTHA and fluoroscopy-based RA-THA.

Eponyms of Upper Extremity Surgical Approaches: A Historical Perspective.

Numerous eponymous surgical approaches are used in the treatment of upper extremity pathology, especially in the trauma setting. Knowledge of anatomy and planes is critical to maximize visualization, achieve anatomic reduction, and avoid iatrogenic injury to critical neurovascular structures. Understanding the history of these commonly used eponymous upper extremity approaches (Kaplan, Kocher, Boyd, Thompson, and Henry) provides a humanistic perspective of each of these surgeons' narratives, which shaped their description of anatomic approaches that have forever changed the course of hand and upper extremity surgeries, providing greater means and possibilities to treat our patients.

Lack of race/ethnic minority representation in ulnar collateral ligament reconstruction in baseball athletes: a systematic review.

Objectives: To assess the reporting and representation of ethnic and racial minorities in comparative studies of ulnar collateral ligament (UCL) injuries and treatment in baseball athletes.

Methods: A systematic review of the literature was conducted using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) reporting guidelines. The literature search was conducted by two independent reviewers using the PubMed, Scopus, and Cochrane Library databases.

Factors Associated With Pain and Function Before Medial Patellofemoral Ligament Reconstruction.

Background: Medial patellofemoral ligament (MPFL) reconstruction is performed to treat recurrent patellar instability. Measurement of joint pain and function at the time of surgery has been demonstrated to be a predictor of the final outcomes in many surgical procedures.

Purpose/hypothesis: The purpose of this study was to evaluate the relationship between baseline patient characteristics, mental health, and intraoperative findings and patient-reported knee pain and function at the time of MPFL reconstruction.

Opioid Use After Simple Arthroscopic Knee Surgery.

Background: Evidence-based prescribing guidelines are lacking for opioids after most orthopaedic surgical procedures.

Hypothesis: Opioids are commonly overprescribed after simple knee arthroscopy.

Study Design: Case-control study; Level of evidence, 3.

Forward and reverse degradomics defines the proteolytic landscape of human knee osteoarthritic cartilage and the role of the serine protease HtrA1.

Objectives: Proteolytic destruction of articular cartilage, a major pathogenic mechanism in osteoarthritis (OA), was not previously investigated by terminomics strategies. We defined the degradome of human knee OA cartilage and the contribution therein of the protease HtrA1 using Terminal Amine Isotopic Labeling of Substrates (TAILS).

Design: Proteins from OA cartilage taken at knee arthroplasty (n = 6) or separately, from healthy cartilage incubated in triplicate with/without active HtrA1, were labeled at natural and proteolytically cleaved N-termini by reductive dimethylation, followed by trypsin digestion, enrichment of N-terminally labeled/blocked peptides, tandem mass spectrometry and positional peptide annotation to identify cleavage sites.

Patellar Tendon Imbrication for Patella Alta.

Patella alta is a significant contributor to patellar instability. Historically, distalizing tibial tubercle osteotomy has been recommended for this problem; however, complications such as nonunion, fracture and hardware irritation are concerning. Additionally, the procedure cannot be performed on skeletally immature patients without violation of the proximal tibial physis.

Patient-Reported Outcomes After a Modified Albee Procedure.

Background: Trochlear dysplasia (TD) is a recognized condition that can become a risk factor for patellofemoral instability. A modified Albee osteotomy procedure using a trapezoidal-shaped wedge to elevate the lateral wall of the trochlea can be used with the goal of preventing further dislocation. However, outcomes studies are lacking, and scores on patient-reported outcome measures (PROMs) are largely unknown.

Assessment of Skeletal Maturity and Postoperative Growth Disturbance After Anterior Cruciate Ligament Reconstruction in Skeletally Immature Patients: A Systematic Review.

Background: Growth disturbance is an uncommon but potentially serious complication after anterior cruciate ligament (ACL) reconstruction in skeletally immature patients.

Purpose: To describe how the pediatric ACL literature has assessed preoperative skeletal maturity and the amount of growth remaining and to comprehensively review the incidence, reporting, and monitoring of postoperative growth disturbance.

Study Design: Systematic review; Level of evidence, 4.

The Evaluation of Trochlear Osseous Morphology: An Epidemiologic Study.

Background: The femoral trochlea is considered the most significant osseous factor affecting stability in the patellofemoral joint. The true prevalence of trochlear dysplasia in the general population is largely unknown.

Purpose/hypothesis: To investigate the prevalence of trochlear dysplasia in the general population.

Preoperative Hyponatremia and Perioperative Complications in Cervical Spinal Fusion.

Objective: Preoperative patient optimization is increasingly recognized as key to good surgical outcomes. Preoperative hyponatremia is a modifiable risk factor linked to poorer postoperative outcomes in other surgical fields. We provide the first investigation of the association of preoperative hyponatremia with morbidity and mortality in patients undergoing cervical spine surgery.

Arthroplasty studies with greater than 1000 participants: analysis of follow-up methods.

Background: The use of patient-reported outcome measures (PROMs) has become a mainstay of orthopedic joint arthroplasty research. Large studies with >1000 participants are vital to orthopedic research, as they allow for comprehensive multivariable analysis. Achieving high follow-up rates minimizes potential response bias.

Alpine Ski Racing Injuries.

Context: This article reviews the epidemiology of alpine ski racing-related injuries, risk factors, mechanisms of injury, and injury prevention strategies.

Evidence Acquisition: Pertinent literature from peer-reviewed publications from 1976 through 2018.

Study Design: Clinical review.

Evaluation of the Schöttle Technique in the Pediatric Knee.

Background: The Schöttle point is commonly used for anatomic femoral tunnel placement during medial patellofemoral ligament (MPFL) reconstruction. This technique has not been previously validated in the skeletally immature patient, in whom femoral tunnel placement may put the distal femoral physis at risk of iatrogenic injury.

Hypothesis: Interobserver reliability for femoral tunnel placement will be higher in adult knees compared with pediatric knees.

Responsiveness Comparison of the EQ-5D, PROMIS Global Health, and VR-12 Questionnaires in Knee Arthroscopy.

Background: The EuroQol 5 dimensions questionnaire (EQ-5D), Patient-Reported Outcomes Measurement Information System (PROMIS) 10 Global Health, and Veterans RAND 12-Item Health Survey (VR-12) are generic patient-reported outcome (PRO) questionnaires that assess a patient's general health. In choosing a PRO to track general health status, it is necessary to consider which measure will be the most responsive to change after treatment. To date, no studies exist comparing responsiveness among the EQ-5D, PROMIS 10 Global Health, and the Veterans Rand 12-Item Health Survey (VR-12).

Utilization of Osseous Landmarks for Anatomic Anterior Cruciate Ligament Femoral Tunnel Placement.

Accurate placement of the femoral tunnel is critical for long-term clinical success following anterior cruciate ligament (ACL) reconstruction. The purpose of the present study is to evaluate the accuracy of femoral tunnel placement when referencing osseous landmarks during ACL reconstruction. We hypothesize that referencing osseous landmarks during ACL reconstruction consistently results in anatomic placement of the ACL femoral tunnel.

Mid-Term Results and Predictors of Patient-Reported Outcomes of Birmingham Hip Resurfacing.

Background: Birmingham hip resurfacing (BHR) is the only Food and Drug Administration approved resurfacing option currently available in the United States. While adequate BHR outcomes are established, there is a paucity of US-based literature demonstrating factors critical to improve patient reported outcomes (PROs). This study answers: (1) What is the implant survivorship in a large US cohort? (2) Which preoperative factors result in higher PRO scores over 5 years postoperatively?

Methods: A retrospective 541 hip single-surgeon cohort with mean of 6.

Long-term outcomes of allograft reconstruction of the anterior cruciate ligament.

Recent studies have found higher rates of failed reconstruction of the anterior cruciate ligament (ACL) with use of allograft when compared with autograft reconstruction. To evaluate the long-term outcomes of allograft ACL reconstruction, we retrospectively reviewed the cases of all patients who underwent allograft (n=99) or autograft (n=24) ACL reconstruction by 2 senior surgeons at a single institution over an 8-year period. Seventeen (17%) of the 99 allograft reconstructions required additional surgery.

Superficial precooling on a 4-week static stretching regimen: a randomized trial.

Background: The influence of superficial precooling on range of motion (ROM) as part of a stretching program has not been extensively studied. It is not clear if the analgesic effect can benefit a stretching program.

Hypotheses: Superficial precooling will result in greater gains in ROM as part of a stretching program, compared with stretching without a precooling intervention.

Early return to function after hip resurfacing: is it better than contemporary total hip arthroplasty?

Our hypothesis was that return of function for young patients undergoing resurfacing total hip arthroplasty (THA) with metal-on-metal bearings or contemporary THA with ceramic bearings would be comparable. Results from 337 unilateral hip resurfacing patients were compared with results from 266 unilateral ceramic-on-ceramic THA patients. Early differences in Harris Hip Scores were observed, but all differences faded by 24 months.

Results and lessons learned from a United States hip resurfacing investigational device exemption trial.

Background: Improvements in metal-on-metal bearings have made hybrid hip surface replacement a potential alternative for the young active patient with end-stage hip disease. Possible advantages include greater hip joint stability, bone preservation, and decreased osteolysis. In this study, we compared the clinical and radiographic results of a new resurfacing device with those in a historical group of standard total hip arthroplasties.