Females Experience Higher Rates of Recurrent Dislocation Following Medial Patellofemoral Ligament Reconstruction: A Systematic Review.

Purpose: To perform a systematic review to investigate and summarize the literature regarding the influence of sex on postoperative outcomes following primary medial patellofemoral ligament (MPFL) reconstruction, with a primary focus on MPFL failure and recurrent dislocation, and a secondary analysis of postoperative patient-reported outcome measures (PROMs).

Methods: A literature review was performed using the PubMed, Scopus, and Web of Science databases. Included were randomized controlled trials or cohort studies that provided sex-stratified, quantitative analysis of MPFL reconstruction outcomes.

Large Tenosynovial Giant Cell Tumor Treated with Hip Arthroscopy in the Setting of Osteoarthritis: 13-Year Outcomes with Annual MRI Surveillance: A Case Report.

Case: A 21-year-old man presented with a ∼1.5-year history of atraumatic left hip pain and imaging suspicious for a diffuse tenosynovial giant cell tumor (TSGCT) with signs of osteoarthritis. Hip arthroscopy for tumor debulking and treatment of associated pathology were recommended given his age and activity level.

Multiligament knee injury patients with limited access to post-operative rehabilitation exhibit similar patient-reported outcomes: A retrospective cohort study.

Purpose: Multiligament knee injuries (MLKI) are typically high-energy traumatic injuries requiring surgical reconstruction and extensive post-operative rehabilitation. This study aimed to examine differences in outcomes of patients with different access to post-operative rehabilitation following multiligament knee reconstruction (MLKR). We hypothesize that patients with limited access to rehabilitation will demonstrate worse outcomes.

Interscalene nerve block with plain bupivacaine versus liposomal bupivacaine for arthroscopic rotator cuff repair: A randomized controlled trial.

Background: Although single injections with anesthetics are commonly administered given their safety, their short-acting nature limits pain control. Liposomal bupivacaine represents a promising alternative to plain bupivacaine in interscalene nerve blocks. The goal of our study was to determine whether an interscalene block with liposomal bupivacaine provides superior analgesia and reduces opioid requirements compared to plain bupivacaine in patients undergoing arthroscopic rotator cuff repair (ARCR).

Commercial Insurance Payer Coverage Criteria for Meniscal Allograft Transplantation Poorly Reflect Modern Indications for the Procedure.

ObjectiveTo investigate whether insurance coverage criteria for meniscal allograft transplantation (MAT) are sufficiently supported in the policy documentation and whether these criteria represent current research and expert consensus on indications for the procedure.DesignThe top 11 United States (US)-based national commercial health insurance payers for MAT were identified. A Google search was performed to identify payer coverage policies.

Orthopedic Patients Are Highly Amenable to Cannabis-Based Products for the Treatment of Musculoskeletal Pain.

Background: Tetrahydrocannabinol (THC)-based and cannabidiol (CBD)-based products are increasing in popularity for the management of pain. Cannabis-based products may serve as a valuable alternative to traditional analgesics such as opioids for pain management among orthopedic patients. The purpose of this study was to investigate the perspective of orthopedic sports medicine patients regarding the use of THC- and CBD-based products for the management of musculoskeletal pain.

Most Athletes Who Fail to Return to Sport After Latarjet Procedure Cite Psychological Factors: A Systematic Review.

Purpose: To identify the return-to-sport (RTS) rate in athletes undergoing a Latarjet procedure while outlining the specific reasons for failure to RTS.

Methods: An electronic literature search was conducted (PubMed/MEDLINE, Scopus, Web of Science). Studies in peer-reviewed journals with Latarjet procedures performed on athletes that reported rates and reasons for failure to RTS were included.

The Relationship Between Surgeon Volume and Major Surgical Complications After Total Shoulder Arthroplasty: An Evaluation of 3177 US Orthopedic Surgeons.

Background: Total shoulder arthroplasty (TSA), which includes anatomic total shoulder arthroplasty (aTSA) and reverse total shoulder arthroplasty (rTSA), is a technically demanding procedure and limited data exist on the relationship between case volume and complications. We sought to identify volume thresholds for TSA, aTSA, and rTSA at which risk of a major surgical complication decreased and to compare complications of patients treated by high-volume surgeons with those of patients treated by low-volume surgeons.

Materials And Methods: Primary, elective TSAs (aTSA and rTSA) from January 1, 2016, to December 31, 2019, were identified in the Premier Healthcare Database.

Commercial Insurance Coverage Criteria for Autologous Chondrocyte Implantation Poorly Reflect Current Research.

ObjectiveThe aim of this study is to both quantify and qualify the way insurance companies justify their coverage policies for autologous chondrocyte implantation (ACI) and determine whether these policies align with recent research on the subject.DesignThe top 11 national commercial health insurance payers for ACI were identified. Coverage policy documents were recovered for 8 payers.

Bilateral patellar tendon repair with suture bridge augmentation: A case report.

We describe the case of a 37-year-old male who presented with simultaneous bilateral patellar tendon rupture without any associated risk factors. Additionally, this is the first reported use of the suture bridge technique with patellar and tibial suture anchors in repairing bilateral proximal patellar tendon rupture. At 12-month follow-up, the patient had normal alignment, no effusion, and symmetric quadriceps strength.

Preoperative Mental Health Disorders Affect Opioid Consumption and Perioperative Complications After Total Shoulder Arthroplasty.

Background: Limited evidence exists regarding the influence of mental health disorders (MHDs) on opioid use and complications after total shoulder arthroplasty (TSA). We aimed to identify the prevalence of common MHDs among patients undergoing anatomic TSA (aTSA) and reverse TSA (rTSA).

Materials And Methods: The Premier Healthcare Database was queried for patients undergoing primary aTSA and rTSA from 2016 to 2020.

The Literature that Commercial Insurance Payers Use to Substantiate Knee Osteochondral Allograft Policies Are of a Low Level of Evidence.

ObjectiveThe purpose of this study is to analyze how the largest insurance companies support their medical necessity policies regarding osteochondral allograft transplantation (OCA) and to determine whether the literature they cite in their policies is of a high level of evidence (LOE).DesignThe 10 largest national health insurance companies were identified. Each payer was contacted via phone or email to obtain their coverage policy regarding OCA.

Studies With Direct Industry Affiliation Are More Likely to Report Positive Results in Randomized Controlled Trials for Platelet-Rich Plasma Use in Rotator Cuff Tears: A Systematic Review.

Purpose: To perform a systematic review to evaluate the effect of industry affiliation on the outcomes of randomized controlled trials for platelet-rich plasma (PRP) injections in rotator cuff tears METHODS: The PubMed, SPORTDiscus, and Scopus databases were searched from 2010 to the present for the terms "rotator cuff" and "platelet-rich plasma." The inclusion criteria were randomized controlled trials comparing PRP with controls for the treatment of rotator cuff tears, and the exclusion criteria were systematic reviews, meta-analyses, case reports, cohort studies, basic science studies, studies of Level III or below, and studies not in English. Degree of industry affiliation was categorized into 3 groups: directly, indirectly, and not affiliated.

Effect of body mass index on complications following total shoulder arthroplasty: a population-wide analysis.

Background: Evidence regarding the effect of body mass index (BMI) on complications following anatomic shoulder arthroplasty (aTSA) and reverse shoulder arthroplasty (rTSA) remains controversial. This high-powered study examines the effect of BMI on surgical and medical complications following aTSA and rTSA.

Methods: This retrospective cohort study was conducted using the Premier Healthcare Database to query all adult patients who underwent primary, elective TSA (aTSA, rTSA) from 2016 to 2020.

Comparative Studies of Bone Graft and Orthobiologics for Foot Ankle Arthrodesis: A Critical Review.

Graft materials available to supplement hindfoot and ankle arthrodesis procedures include autologous (autograft) or allogeneic bone graft (allograft) but also bone graft substitutes such as demineralized bone matrix, calcium sulfate, calcium phosphate, and tricalcium phosphate/hydroxyapatite. In addition, biologic agents, such as recombinant human bone morphogenetic protein-2 or recombinant human platelet derived growth factor-BB (rhPDGF-BB), and preparations, including platelet-rich plasma or concentrated bone marrow aspirate, have been used to facilitate bone healing in ankle or hindfoot arthrodesis. The purpose of this review was to summarize the available clinical evidence surrounding the utilization and efficacy of the above materials and biological agents in ankle or hindfoot arthrodesis procedures, with emphasis on the quality of the existing evidence to facilitate clinical decision making.

Results of Randomized Controlled Trials of Platelet-Rich Plasma in Lower-Extremity Tendinopathy Are Not Influenced by Industry Sponsorship.

Purpose: To determine whether industry affiliation influences the results of randomized controlled trials (RCTs) studying the use of platelet-rich plasma (PRP) for the treatment of patellar or Achilles tendinopathy.

Methods: The PubMed, Scopus, Cochrane, and MEDLINE databases were searched in July 2023 for RCTs investigating PRP for the treatment of patellar or Achilles tendinopathy published between 2009 and July 2023. Industry affiliation was determined by analyzing each study's funding or conflict-of-interest section.

Subjective Causes for Failure to Return to Sport After Anterior Cruciate Ligament Reconstruction: A Systematic Review and Meta-analysis.

Context: While current literature has explored the outcomes of athletes who return to sport (RTS) after anterior cruciate ligament (ACL) injuries, less is known about the outcomes of those who are unsuccessful in returning to sport.

Objective: To determine the rate of athletes who did not RTS after primary ACL reconstruction (ACLR) and to identify the specific subjective reasons for failure to RTS.

Data Sources: A comprehensive search of the PubMed/MEDLINE, Scopus, and Web of Science databases was conducted through April 2021.

NCAA football players are at higher risk of upper extremity injury after first-time concussion.

Background: Previous research has demonstrated that concussions increase the risk of subsequent lower extremity musculoskeletal injury in athletes. However, the risk of upper extremity injury in athletes' post-concussion is poorly understood.

Methods: All concussed football players within a National Collegiate Athletic Association (NCAA) Division I conference athletic database were identified between 2017 and 2021.

Patient Reported Clinical Outcomes Following PCL Suture Augmentation in Patients with Multiligamentous Knee Injury: A Retrospective Observational Study.

Purpose: To compare the patient-reported outcomes between patients with posterior cruciate ligament (PCL) reconstruction or repair alone versus PCL reconstruction or repair with internal bracing (IB) in the context of multi-ligament knee injuries (MLKI).

Methods: All patients who underwent surgical management of MLKI at two institutions between 2006 and 2020 were retrospectively identified and offered participation in the study. Patient reported outcomes were measured via three instruments: Lysholm Knee score, Multiligament Quality of Life (ML-QOL), and the Patient-Reported Outcomes Measurement Information System (PROMIS) computer adaptive testing (CAT).

Reporting Bias is Highly Prevalent in Systematic Reviews and Meta-Analyses of Platelet Rich Plasma Injections for Hip Osteoarthritis.

Purpose: To describe the incidence and types of spin in systematic reviews of platelet-rich plasma (PRP) injections for hip osteoarthritis (OA) and to determine whether patterns in study characteristics could be identified among studies with identifiable spin.

Methods: The PubMed, Scopus, and SPORTDiscus databases were queried. Inclusion criteria were systematic reviews or meta-analyses that included an assessment of intra-articular PRP injections as a stand-alone treatment for hip OA.

Evaluation of spin in systematic reviews on the use of tendon transfer for massive irreparable rotator cuff tears.

Purpose: To identify, describe and account for the incidence of spin in systematic reviews and meta-analyses of tendon transfer for the treatment of massive, irreparable rotator cuff tears. The secondary objective was to characterize the studies in which spin was identified and to determine whether identifiable patterns exist among studies with spin.

Methods: This study was conducted per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.

Ten Pearls for Anterior Cruciate Ligament Reconstruction.

Anterior cruciate ligament (ACL) reconstruction is a common orthopaedic procedure that has continued to evolve. Since it is a complex procedure, it carries a risk of a range of complications. To ensure optimal results, there are many important considerations to take such as the choice of graft, tunnel positioning, graft preparation, and many others.

Tissue Augmentation Techniques in the Management of Ligamentous Knee Injuries.

Despite early reports of high failure rates in knee ligament repair techniques resulting in favor of reconstruction, newer advances in surgical technology have shifted the attention back to repair with the addition of various tissue augmentation techniques. Ligament repair preserves proprioceptors in the native ligament and avoids autograft tendon harvest, minimizing the complications associated with donor site ruptures in reconstruction techniques. Tissue augmentation has been successfully used in knee ligamentous and tendon repair procedures, as well as in some upper extremity procedures.

Management of Hand and Wrist Injuries in NCAA Division I Football Players From a Single Institution: Factors Associated With Epidemiology, Surgical Intervention, and Return to Play.

Background: Upper extremity injuries account for approximately 16.9% of football injuries in the National Collegiate Athletic Association (NCAA).

Purpose: To determine the epidemiology, management, and outcomes of hand/wrist injuries in collegiate football athletes so as to identify factors associated with surgical intervention and delayed return to play (RTP).

Harms reporting in randomized controlled trials underpinning the American Academy of Orthopaedic Surgeons clinical practice guidelines for glenohumeral osteoarthritis.

Background: Glenohumeral osteoarthritis is one of the most common causes of shoulder pain. As such, the American Academy of Orthopaedic Surgeons (AAOS) has developed clinical practice guidelines (CPGs) to address the management of glenohumeral osteoarthritis. These CPG recommendations stem from the findings of randomized controlled trials (RCTs), which have been shown to influence clinical decision making and health policy.