Arthroscopic Core Decompression for Avascular Necrosis of the Femoral Head Using Multiple Small-Diameter Tunnels.

Avascular necrosis of the femoral head (AVNFH) is a debilitating disease that requires early intervention to prevent subchondral collapse and irreversible damage leading to premature hip replacement. Patients presenting with AVNFH can have concomitant intra-articular pathology, including femoroacetabular impingement (FAI), that contributes to their hip pain and dysfunction. It is important to restore the native hip anatomy in addition to providing revascularization of necrotic areas to reduce pain, improve function, and maximize efforts to preserve the joint.

Biomechanical Evaluation of 4 Suture Techniques for Hip Capsular Closure.

Background: The most reliable suture technique for capsular closure after a capsulotomy remains unknown.

Purpose: To determine which suture technique best restores native stability after a 5-cm interportal capsulotomy.

Study Design: Controlled laboratory study.

Optimal Tibial Tunnel Placement for Medial and Lateral Meniscus Root Repair on the Anteromedial Tibia in the Setting of Anterior and Posterior Cruciate Ligament Reconstruction of the Knee.

Background: Although the risk of tibial tunnel convergence in the setting of multiligamentous reconstruction has been reported in the literature, the risk of tunnel convergence in the setting of posterior cruciate ligament (PCL), anterior cruciate ligament (ACL) reconstruction and medial and lateral meniscus root repair has not been defined.

Purpose: To examine the risk of tunnel convergence and to determine optimal tunnel placement for ACL and PCL reconstruction performed in conjunction with posterior medial and lateral meniscus root repairs on the anteromedial proximal tibia.

Study Design: Descriptive laboratory study.

Cotyloid Fossa Coverage Percentages May Be Associated With Alpha Angle, Labral Tear, and Clinical Outcomes in Patients With Femoroacetabular Impingement.

Background: Within the hip joint, the anatomy of the acetabulum and cotyloid fossa is well established. There is little literature describing the association between the size of the cotyloid fossa relative to the acetabulum and characteristics of patients with femoroacetabular impingement (FAI).

Purpose/hypothesis: The purpose was to calculate the cotyloid fossa coverage percentage in the acetabulum and determine its association with patient characteristics, radiographic parameters, intra-articular findings, and preoperative patient-reported outcomes in patients with FAI.

Arthroscopic Treatment of Femoroacetabular Impingement in Patients With and Without Borderline Developmental Dysplasia of the Hip: A Systematic Review and Meta-analysis.

Background: Based on previous studies, it is difficult to discern whether patients who have femoroacetabular impingement (FAI) with borderline developmental dysplasia of the hip (BDDH) would benefit from arthroscopy when compared with patients without BDDH.

Purpose: To evaluate the existing comparative literature on arthroscopic findings, procedures, patient-reported outcomes (PROs), and failures in patients who have FAI with BDDH compared with those without BDDH.

Study Design: Systematic review; Level of evidence, 3.

Comparison Between Hip Arthroscopic Surgery and Periacetabular Osteotomy for the Treatment of Patients With Borderline Developmental Dysplasia of the Hip: A Systematic Review.

Background: The treatment for borderline developmental dysplasia of the hip (BDDH) has historically been arthroscopic surgery or periacetabular osteotomy (PAO). As orthopaedic surgery is constantly evolving, a lack of comparison of outcomes for these 2 treatment methods could potentially be stalling the progression of treatment for patients with BDDH.

Purpose: To evaluate the existing literature on patient characteristics, procedures, clinical outcomes, and failure rates for patients with BDDH and to determine whether PAO or hip arthroscopic surgery is a better treatment method for patients with BDDH.

A biomechanical analysis of ischiofemoral impingement in a cadaver model.

Ischiofemoral impingement (IFI) occurs due to the diminishing of space between the ischium and lesser trochanter. During a robotic hip study, one hip presented with indications of IFI, an opportunity to explore the pathophysiology and treatment strategies for this unusual condition. This specimen underwent kinematic tests in two states: (i) native lesser trochanter and (ii) resected lesser trochanter.

Differentiation Potential of Synovial Mesenchymal Stem Cells Isolated From Hip Joints Affected by Femoroacetabular Impingement Syndrome Versus Osteoarthritis.

Purpose: To establish the characteristics of synovium-derived mesenchymal stem cells (MSCs) from the hip joints of patients with femoroacetabular impingement syndrome (FAIS) and osteoarthritis (OA), particularly their proliferation and differentiation potentials. We further investigated their functional differences.

Methods: Synovium samples were harvested from 21 patients with FAIS who underwent hip arthroscopic surgery and from 14 patients with OA who underwent total hip arthroplasty.

Percutaneous Lengthening of a Regenerated Semitendinosus Tendon for Medial Hamstring Snapping.

In this surgical technique article, the authors describe a percutaneous tendon lengthening technique for surgical treatment of a regenerated semitendinosus tendon in snapping syndrome. Snapping syndromes are caused by 2 adjacent anatomic structures having a frictional catching, which may be associated with an audible pop. At the knee, they may have an intra- or extra-articular origin.

Posterior Glenohumeral Instability: Evidence-based Treatment.

Posterior glenohumeral instability is an increasingly important clinical finding in athletic patients. Over the last decade, basic and clinical research has improved our understanding of the pathoanatomy and biomechanics of this challenging disorder, as well as our ability to diagnose and appropriately treat it. Although recurrent posterior shoulder instability is not as common as anterior instability, it is prevalent among specific populations, including football and rugby players, and may be overlooked by clinicians who are unaware of the typical physical examination and radiographic findings.

Arthroscopically Assisted Anatomic Coracoclavicular Ligament Reconstruction Technique Using Coracoclavicular Fixation and Soft-Tissue Grafts.

Acromioclavicular joint injuries are common and are often seen in contact athletes. Good to excellent clinical results have been reported using soft-tissue grafts to reconstruct the coracoclavicular ligaments; however, complications remain. Some complications are unique to the surgical technique, particularly clavicle and coracoid fractures that are associated with drilling large or multiple bone tunnels.