A Simple Clinical Predictive Model for Arthroscopic Mobility of Osteochondritis Dissecans Lesions of the Knee.

Background: Osteochondritis dissecans (OCD) of the knee is a focal idiopathic alteration of subchondral bone and/or its precursor with risk for instability and disruption of adjacent cartilage. Treatment options focused on preventing premature osteoarthritis vary depending on multiple patient and lesion characteristics, including lesion mobility.

Purpose: To differentiate lesion mobility before arthroscopy using a multivariable model that includes patient demographic characteristics and physical examination findings.

MRI Features That Contribute to Decision-Making for Treatment of Capitellar OCD Lesions: An Expert Consensus Using the Delphi Method.

Background: Most healthcare providers utilize magnetic resonance imaging (MRI) to assist in diagnosing and treating osteochondritis dissecans (OCD) of the capitellum. However, consensus on imaging features that portend clinically relevant information in the care of these lesions has not been determined.

Purpose: To conduct a survey on the MRI features of a capitellar OCD that are salient for clinical decision-making using a classic Delphi protocol.

Transarticular Versus Retroarticular Drilling of Stable Osteochondritis Dissecans of the Knee: A Prospective Multicenter Randomized Controlled Trial by the ROCK Group.

Background: When stable osteochondritis dissecans (OCD) lesions of the femoral condyle in a skeletally immature patient fail to heal with nonoperative methods, the standard of care treatment is condylar OCD drilling. Two primary OCD drilling techniques have been described, but no prospective studies have compared their relative effectiveness.

Purpose/hypothesis: The purpose of this study was to compare the healing and function after transarticular drilling (TAD) with that after retroarticular drilling (RAD).

Descriptive Epidemiology From the Research in Osteochondritis Dissecans of the Knee (ROCK) Prospective Cohort.

Background: Osteochondritis dissecans (OCD) occurs most commonly in the knees of young individuals. This condition is known to cause pain and discomfort in the knee and can lead to disability and early knee osteoarthritis. The cause is not well understood, and treatment plans are not well delineated.

Metrics of OsteoChondral Allografts (MOCA) Group Consensus Statements on the Use of Viable Osteochondral Allograft.

Background: Osteochondral allograft (OCA) transplantation has evolved into a first-line treatment for large chondral and osteochondral defects, aided by advancements in storage protocols and a growing body of clinical evidence supporting successful clinical outcomes and long-term survivorship. Despite the body of literature supporting OCAs, there still remains controversy and debate in the surgical application of OCA, especially where high-level evidence is lacking.

Purpose: To develop consensus among an expert group with extensive clinical and scientific experience in OCA, addressing controversies in the treatment of chondral and osteochondral defects with OCA transplantation.

Association Between Concussion History and Factors Relating to Cognitive, Behavioral, and Emotional Health Among American High School Athletes: A Cross-sectional Analysis.

Background: The cognitive, behavioral, and emotional deficits that may be associated with sports-related concussions among adolescents are unclear.

Purpose: To examine the association between reported concussion history and factors relating to cognitive, behavioral, and emotional health among a population-based sample of US high school-aged adolescents.

Study Design: Cross-sectional study; Level of evidence, 3.

Osteochondritis Dissecans of the Knee: An Interrater Reliability Study of Magnetic Resonance Imaging Characteristics.

Background: Imaging characteristics of osteochondritis dissecans (OCD) lesions quantified by magnetic resonance imaging (MRI) are often used to inform treatment and prognosis. However, the interrater reliability of clinician-driven MRI-based assessment of OCD lesions is not well documented.

Purpose: To determine the interrater reliability of several historical and novel MRI-derived characteristics of OCD of the knee in children.

Pediatric Type II Tibial Spine Fractures: Addressing the Treatment Controversy With a Mixed-Effects Model.

Background: Tibial spine fractures, although relatively rare, account for a substantial proportion of pediatric knee injuries with effusions and can have significant complications. Meyers and McKeever type II fractures are displaced anteriorly with an intact posterior hinge. Whether this subtype of pediatric tibial spine fracture should be treated operatively or nonoperatively remains controversial.

Anatomic Dissection and CT Imaging of the Anterior Cruciate and Medial Collateral Ligament Footprint Anatomy in Skeletally Immature Cadaver Knees.

Background: Anterior cruciate ligament (ACL) and medial collateral ligament (MCL) injuries in skeletally immature patients are increasingly recognized and surgically treated. However, the relationship between the footprint anatomy and the physes are not clearly defined. The purpose of this study was to identify the origin and insertion of the ACL and MCL, and define the footprint anatomy in relation to the physes in skeletally immature knees.

All-Epiphyseal Anterior Cruciate Ligament Femoral Tunnel Drilling: Avoiding Injury to the Physis, Lateral Collateral Ligament, Anterolateral Ligament, and Popliteus-A 3-Dimensional Computed Tomography Study.

Purpose: To investigate the relation of the at-risk structures (distal femoral physis, lateral collateral ligament, anterolateral ligament, popliteus, and articular cartilage) during all-epiphyseal femoral tunnel drilling. A second purpose was 2-fold: (1) to develop recommendations for tunnel placement and orientation that anatomically reconstruct the anterior cruciate ligament (ACL) while minimizing the risk of injury to these at-risk structures, and (2) to allow for maximal tunnel length to increase the amount of graft in the socket to facilitate healing.

Methods: Three-dimensional models of 6 skeletally immature knees (aged 7-11 years) were reconstructed from computed tomography and used to simulate all-epiphyseal femoral tunnels.

Variation in the Medial Patellofemoral Ligament Origin in the Skeletally Immature Knee: An Anatomic Study.

Background: The medial patellofemoral ligament (MPFL) is frequently reconstructed to treat recurrent patellar instability. The femoral origin of the MPFL is well described in adults but not in the skeletally immature knee.

Purpose: To identify a radiographic landmark for the femoral MPFL attachment in the skeletally immature knee and study its relationship to the distal femoral physis.

Epidemiology of Shoulder and Elbow Injuries Among United States High School Baseball Players: School Years 2005-2006 Through 2014-2015.

Background: Shoulder and elbow injuries are common in young athletes, especially high school baseball players. Understanding the risk factors associated with baseball injuries is an essential first step in the development of injury prevention strategies.

Purpose: To provide a comprehensive understanding of the epidemiology of shoulder and elbow injuries among high school baseball players in the United States.

Management of Osteochondritis Dissecans Lesions of the Knee, Elbow and Ankle.

Although osteochondritis dissecans (OCD) has been a recognized condition for more than 100 years, our understanding of the etiology, natural history, and treatment remains poorly characterized. OCD most commonly affects the knee, followed by the elbow and ankle. Adolescents and young adults are most commonly affected.

The Reliability of Assessing Radiographic Healing of Osteochondritis Dissecans of the Knee.

Background: The reliability of assessing healing on plain radiographs has not been well-established for knee osteochondritis dissecans (OCD).

Purpose: To determine the inter- and intrarater reliability of specific radiographic criteria in judging healing of femoral condyle OCD.

Study Design: Cohort study (Diagnosis); Level of evidence, 3.

Lateral Radiographic Landmarks for ACL and LCL Footprint Origins During All-Epiphyseal Femoral Drilling in Skeletally Immature Knees.

Background: This study was conducted to evaluate the spatial relationship of the anterior cruciate ligament (ACL) and lateral collateral ligament (LCL) femoral footprint origins in knee specimens from skeletally immature donors as viewed on lateral radiographs.

Methods: Fourteen cadaver specimens of skeletally immature knees from children between 7 and 11 years old at the time of death were examined through gross dissection. Metallic pins were placed at the center of the ACL and LCL femoral footprints, and computed tomography (CT) scans were performed.

Anterolateral Ligament of the Knee Shows Variable Anatomy in Pediatric Specimens.

Background: Anterior cruciate ligament (ACL) reconstruction failure rates are highest in youth athletes. The role of the anterolateral ligament in rotational knee stability is of increasing interest, and several centers are exploring combined ACL and anterolateral ligament reconstruction for these young patients. Literature on the anterolateral ligament of the knee is sparse in regard to the pediatric population.

The Relationship of the Femoral Physis and the Medial Patellofemoral Ligament in Children: A Cadaveric Study.

Background: Young athletes sustain patellar dislocations in a variety of sports. The medial patellofemoral ligament (MPFL) is a critical structure that functions as an anatomic checkrein to help prevent lateral patellar dislocation. Reconstruction of this ligament is challenging in patients with open physes because of concerns about iatrogenic damage to the femoral physis.

The Anterolateral Ligament of the Knee: An Inconsistent Finding in Pediatric Cadaveric Specimens.

Background: The anterolateral ligament (ALL) of the knee has been identified as a structure that limits internal rotation, and thus, affects the pivot shift mechanism. It has previously been reported in a high percentage of adult subjects. The purpose of the current study was to evaluate whether the ALL could be identified on pediatric cadaveric knee specimens and compare these findings to previously published reports.

The patellar insertion of the medial patellofemoral ligament in children: a cadaveric study.

Background: The purpose of this study was to evaluate the medial patellofemoral ligament (MPFL) patellar insertion in skeletally immature anatomic specimens.

Methods: Nine pediatric cadaveric knee specimens were examined through gross dissection. Metallic markers were placed at the MPFL patellar insertion footprint.

Novel radiographic feature classification of knee osteochondritis dissecans: a multicenter reliability study.

Background: Osteochondritis dissecans (OCD) is a vexing condition for patients, parents, and physicians because of the frequent slow healing and nonhealing that leads to prolonged treatment. Several features on plain radiographs have been identified as predictors of healing, but the reliability of their measurement has not been established.

Purpose: To determine the inter- and intrarater reliability of several radiographic features used in the diagnosis, treatment, and prognosis of OCD femoral condyle lesions.

The relationship of the femoral physis and the medial patellofemoral ligament in children: a cadaveric study.

Background: Patellar dislocations are common in skeletally immature athletes, and the medial patellofemoral ligament (MPFL) is an important primary restraint to lateral patellar translation. The relationship between the MPFL femoral origin footprint and femoral physis is unclear. The purpose of this study was to evaluate the MPFL femoral origin footprint and its relationship to the femoral physis in skeletally immature anatomic specimens.

Comparison of allograft versus autograft anterior cruciate ligament reconstruction graft survival in an active adolescent cohort.

Background: Graft selection for anterior cruciate ligament (ACL) reconstructive surgery is a controversial topic. Few studies have compared graft outcomes in adolescents.

Purpose: To identify factors related to ACL graft failure in an adolescent cohort.