Arthroscopic suprapectoral biceps tenodesis utilizing the subacromial locking stitch anchor (SALSA) technique.

Biceps tenodesis is an accepted treatment option for various pathologies of the long head of the biceps tendon and labrum. Many techniques have been published, both arthroscopic and open, that utilize various fixation techniques and locations of the tenodesis, yet none has been proven to be superior. We introduce a novel method, the SALSA (subacromial locking stitch anchor), an all-arthroscopic suprapectoral biceps tenodesis utilizing a running locking stitch from a double-loaded biocomposite anchor.

Challenges of Medical Care Delivery in Professional Sports: Lessons From Professional Baseball.

Team medical management for professional sports teams is a demanding and high-risk activity. Every different sport has unique features and the stresses athletes place on themselves, be it from collisions or repetitive stress, result in specific challenges for the medical team and team organization in general. Injuries in professional sports are costly both to the player and organization.

Isolated loss of active external rotation: a distinct entity and results of L'Episcopo tendon transfer.

Background: The purpose of this study was to characterize a subgroup of cuff-deficient patients with isolated loss of active external rotation (ILER) but preserved active elevation and to evaluate the outcomes of the L'Episcopo procedure to restore horizontal muscle balance.

Methods: During a 10-year period, 26 patients (14 men, 12 women) were identified with ILER in the setting of massive irreparable posterosuperior cuff tears. A modified L'Episcopo tendon transfer was performed to restore active external rotation and to improve shoulder function.

Restorative Tissue Transplantation Options for Osteochondral Lesions of the Talus: A Review.

Symptomatic osteochondral lesions of the talus remain a challenging problem due to inability for cartilage lesions to heal. Numerous treatment options exist, including nonoperative management, marrow stimulating techniques, and autograft-allograft. Arthroscopic marrow stimulation forms fibrocartilage that has been shown to be biomechanically weaker than hyaline cartilage.

The Effects of Delays in Diagnosis and Surgical Reconstruction of ACL Tears in Skeletally Immature Individuals on Subsequent Meniscal and Chondral Injury.

Background: Although studies have shown increased rates of chondral injury with delayed surgical treatment of pediatric anterior cruciate ligament (ACL) injuries, it is unknown if this is related to a delay in diagnosis and appropriate activity restrictions. The purpose of this study was to determine if the time from injury to diagnosis, time from diagnosis to reconstruction, and preoperative activity level correlate with the degree of cartilage injury seen intraoperatively.

Methods: A retrospective review of skeletally immature patients who underwent ACL reconstruction was performed.

Anthropometric Computed Tomography Reconstruction Identifies Risk Factors for Cortical Perforation in Revision Total Hip Arthroplasty.

Background: The incidence of revision hip arthroplasty is increasing with nearly 100,000 annual procedures expected in the near future. Many surgeons use straight modular tapered stems in revisions; however, complications of periprosthetic fracture and cortical perforation occur, resulting in poor outcomes. Our objective was to identify patient demographics and femoral characteristics that predispose patients to cortical perforation when using the straight modular stems.

Early radiographic and clinical results of Salto total ankle arthroplasty as a fixed-bearing device.

Background: Total ankle replacement has increased in popularity in the management of severe tibiotalar arthritis. Most previous clinical reports focused on mobile-bearing designs. This study evaluates early radiographic and clinical results of the Salto fixed bearing design.

Orthopedic uses of stem cell therapy.

The treatment of musculoskeletal disorders is gaining importance as the population ages. In addition to the complications brought on by prolonged life expectancy, the growing epidemic of obesity is contributing to joint degradation. Cell-based tissue engineering has the potential to advance the current treatment for musculoskeletal disorders.

Interfragmentary suture fixation for displaced acute type II distal clavicle fractures.

Objectives: Stable fixation of displaced type II distal clavicle fractures presents a challenge to the surgeon because of distal fragment comminution and the large deforming forces created by the weight of the arm. We hypothesized that suture fixation around the coracoid and interfragmentary suture fixation would adequately counteract these forces and lead to a high rate of union and restoration of function.

Design: This is a retrospective study of 20 sequential patients treated between 1997 and 2009.

The clinical results of arthroscopic transtendinous repair of grade III partial articular-sided supraspinatus tendon tears.

Purpose: The purpose of this study was to evaluate the clinical results of arthroscopic transtendinous repair of deep partial articular-sided rotator cuff tears.

Methods: We retrospectively evaluated the results of 53 patients who underwent arthroscopic transtendinous repair for Ellman grade III articular-sided rotator cuff tears (>50% of the thickness of the rotator cuff). The intact bursal side of the cuff was not detached, and all associated pathology was treated.

The results of ORIF of displaced unstable proximal humeral fractures using a locking plate.

Background/hypothesis: Surgical management of displaced unstable proximal humerus fracture remains a challenge due to poor proximal bone quality and significant deforming forces. We hypothesized that the technique of application and mechanical properties of the proximal humeral locking plate would allow successful treatment of unstable and displaced proximal humeral fractures even in the face of osteoporotic bone.

Method: We evaluated prospectively the results of open reduction internal fixation of 22 displaced unstable proximal humerus fractures in 22 patients utilizing a proximal humeral locking plate.

Mini-open rotator cuff repair via an anterosuperior approach.

We retrospectively reviewed the results of arthroscopically assisted rotator cuff repairs done with an anterosuperior approach in 41 patients (average age, 55 years; range, 38-73). Average follow-up was 39 months (range, 24-57 months). There were 2 massive, 8 large 2-tendon, 9 medium-sized, 19 small, and 6 deep partial thickness rotator cuff tears.

Ketorolac use for postoperative pain management following lumbar decompression surgery: a prospective, randomized, double-blinded, placebo-controlled trial.

Study Design: Prospective randomized double-blind placebo-controlled study.

Objective: The objective of this study was to assess the efficacy of Ketorolac in reducing postoperative pain and morphine requirements following primary multilevel lumbar decompression surgery.

Summary Of Background Data: The use of opioid medications following surgical interventions can be complicated by related side effects such as respiratory depression, somnolence, urinary retention, and delayed time to oral intake.