Arthroscopic Visualization Is a Reliable Method of Confirming Femoral Button Placement During Anterior Cruciate Ligament Reconstruction.

Purpose: To compare arthroscopic visualization with intraoperative fluoroscopy for confirming proper femoral button placement during ACLR.

Methods: Fifty consecutive patients undergoing soft-tissue ACLR between March 2021 and February 2022 were evaluated for inclusion in this study. Both primary and revision ACLR cases using suspensory fixation were included.

Opioid Consumption After Knee Arthroscopy.

Purpose: To prospectively observe opioid consumption in patients undergoing knee arthroscopy and to create an evidence-based guideline for opioid prescription.

Methods: This prospective multicenter observational study enrolled patients undergoing outpatient knee arthroscopy for meniscal repair, meniscectomy, or chondroplasty. Patients were provided with a pain journal to record postoperative opioid consumption, Numeric Pain Rating Scale (NPRS) pain scores, and Likert scale satisfaction scores for 1 week postoperatively.

Biceps Tenodesis: A Comparison of Tendon-to-Bone and Tendon-to-Tendon Healing in a Rat Model.

In this article, we report on the differences in the healing biology of biceps tenodesis performed on either bone or soft tissue in a rat model. This work provides further insight into what may be the optimal strategy for managing biceps-labrum complex disease.

Tibial and Femoral Tunnel Changes After ACL Reconstruction: A Prospective 2-Year Longitudinal MRI Study.

Background: Tunnel widening after anterior cruciate ligament reconstruction (ACL-R) is a well-accepted and frequent phenomenon, yet little is known regarding its origin or natural history.

Purpose: To prospectively evaluate the cross-sectional area (CSA) changes in tibial and femoral bone tunnels after ACL-R with serial MRI.

Study Design: Case series; Level of evidence, 4.

The effect of platelet-rich plasma on muscle contusion healing in a rat model.

Background: Current therapy for muscle contusions is usually limited to nonsteroidal anti-inflammatory drugs and/or use of the RICE principle (rest, ice, compression, elevation); thus, other forms of treatment that can potentially accelerate the rate of healing are desirable.

Hypotheses: A local injection of platelet-rich plasma (PRP) would lead to accelerated healing rates compared with controls; also, delayed administration of PRP would lead to a blunted response compared with immediate treatment.

Study Design: Controlled laboratory study.

Anterior shoulder capsular tears in professional baseball players.

Background: Tearing of the anterior capsule of the shoulder is a rare but debilitating injury for throwing athletes. However, there is very little in the literature to guide its diagnosis and treatment. In this case series, we outline our experience with anterior capsular tears of the shoulder in professional baseball players.

Arthroscopic subscapularis bankart technique as a salvage procedure for failed anterior shoulder stabilization.

Background: Shoulder instability is a relatively common problem. Even with contemporary surgical techniques, instability can recur following both open and arthroscopic fixation. Surgical management of capsular insufficiency in anterior shoulder stabilization represents a significant challenge, particularly in young, active patients.

Muscle injuries in athletes: enhancing recovery through scientific understanding and novel therapies.

Context: Muscle injuries are extremely common in athletes and often produce pain, dysfunction, and the inability to return to practice or competition. Appropriate diagnosis and management can optimize recovery and minimize time to return to play.

Evidence Acquisition: Contemporary papers, both basic science and clinical medicine, that investigate muscle healing were reviewed.

Successful Fusion of the Proximal Tibiofibular Joint with Osteogenic Protein-1 (OP-1) Augmentation.

Proximal tibiofibular joint (PTFJ) instability is rare, but when encountered can be difficult to manage. Previously reported forms of treatment, including cast immobilization, soft tissue repairs and reconstructions, and fibular head resection have met with limited success. Another option is PTFJ arthrodesis-however, fusion can be difficult and ankle pain after surgery is not uncommon.

Passive anterior tibial subluxation in anterior cruciate ligament-deficient knees.

Background: Abnormal anterior-posterior and rotational motion secondary to anterior cruciate ligament (ACL) insufficiency is typically described in terms of dynamic laxity. An original description of the abnormal tibiofemoral relationship in the setting of ACL insufficiency has highlighted the presence of a fixed anterior tibial subluxation in this population of failed ACL reconstruction (ACLR); however, no study has quantified the degree of tibial subluxation in both the medial and lateral compartments.

Purpose: To measure and compare the amount of anterior tibial subluxation among various states of ACL competency, including (1) intact ACL, (2) acute ACL disruption, and (3) failed ACLR (ie, patients requiring revision ACLR).

Reconstruction of the anterior cruciate ligament in the skeletally immature athlete: a review of current concepts: AAOS exhibit selection.

Intrasubstance tears of the anterior cruciate ligament (ACL) were once considered a rare injury in skeletally immature athletes but are now observed with increasing frequency. Treatment strategies have evolved as recent studies have identified unique considerations specific to the skeletally immature patient. The current literature now supports the trend toward early operative treatment to restore knee stability and prevent progressive meniscal and/or articular cartilage damage, but the optimal approach to ACL reconstruction in this age group remains controversial.

Nonoperative treatment for anterior cruciate ligament injury in recreational alpine skiers.

Purpose: The purpose of this study was to test whether low-grade Lachman test (i.e. Grade 0-1+) and a negative pivot shift at 6-12 weeks post-ACL rupture in recreational alpine skiers can be used to predict good function and normal knee laxity in nonoperated patients at minimum 2 years after the injury.

Venous thrombosis after arthroscopic shoulder surgery: pacemaker leads as a possible cause: pacemaker leads as a possible cause.

Deep venous thrombosis is extremely rare after arthroscopic shoulder surgery. In this report, we describe one such case in a patient with a history of cardiac pacemaker placement. He presented with complaints of pain and swelling in the operated extremity several days after rotator cuff surgery and underwent ultrasound evaluation that confirmed thrombosis of the axillary vein with extension into the brachial and basilic veins, down to the level of the elbow.

Peripheral nerve injuries in sports-related surgery: presentation, evaluation, and management: AAOS exhibit selection.

Peripheral nerve injuries during sports-related operative interventions are rare complications, but the associated morbidity can be substantial. Early diagnosis, efficient and effective evaluation, and appropriate management are crucial to maximizing the prognosis, and a clear and structured algorithm is therefore required. We describe the surgical conditions and interventions that are commonly associated with intraoperative peripheral nerve injuries.

The effect of platelet-rich fibrin matrix on rotator cuff tendon healing: a prospective, randomized clinical study.

Background: There is a strong need for methods to improve the biological potential of rotator cuff tendon healing. Platelet-rich fibrin matrix (PRFM) allows delivery of autologous cytokines to healing tissue, and limited evidence suggests a positive effect of platelet-rich plasma on tendon biology.

Purpose: To evaluate the effect of platelet-rich fibrin matrix on rotator cuff tendon healing.

Enhancing meniscal repair through biology: platelet-rich plasma as an alternative strategy.

Meniscal tears are common orthopaedic injuries that can manifest with significant pain and mechanical symptoms. The treatment of meniscal tears has evolved from total meniscectomy to partial meniscectomy and meniscal repair. Preserving the meniscus is ideal because the loss of any portion of the meniscus can lead to significantly increased articular cartilage contact stresses compared with the intact state.

Biomechanical and biologic augmentation for the treatment of massive rotator cuff tears.

Recent studies have reported that massive rotator cuff tears do not heal as predictably as, and may have diminished clinical outcomes compared with, smaller rotator cuff tears. An improved understanding of the biologic degeneration and the biomechanical alterations of massive rotator cuff tears should provide better strategies to optimize outcomes. The approach to patients with massive rotator cuff tears requires careful assessment of the patient and the extent of rotator cuff degeneration to determine the appropriate treatment.

The effects of RANKL inhibition on fracture healing and bone strength in a mouse model of osteogenesis imperfecta.

Currently, the standard treatment for osteogenesis imperfecta (OI) is bisphosphonate therapy. Recent studies, however, have shown delayed healing of osteotomies in a subset of OI patients treated with such agents. The current study sought to determine the effects of another therapy, RANKL inhibition, on bone healing and bone strength in the growing oim/oim mouse, a model of moderate to severe OI.

Abnormal mineral-matrix interactions are a significant contributor to fragility in oim/oim bone.

The presence of abnormal type I collagen underlies the tissue fragility in the heritable disease osteogenesis imperfecta (OI), though the specific mechanism remains ill-defined. The current study addressed the question of how an abnormal collagen-based matrix contributes to reduced bone strength in OI by comparing the material properties of mineralized and demineralized bone from the oim/oim mouse, a model of OI that contains homotrimeric (alpha1(3)(I)) type I collagen, with the properties of bone from wildtype (+/+) mice. Femoral three-point bend tests combined with geometric analyses were conducted on intact (mineralized) 14-week-old oim/oim and +/+ mice.