Outpatient Shoulder Arthroplasty-A Systematic Review.

Objective: Recent reports have shown that outpatient shoulder arthroplasty (SA) may be a safe alternative to inpatient management in appropriately selected patients. The purpose was to review the literature reporting on outpatient SA.

Methods: A systematic review of publications on outpatient SA was performed.

Patellar tendon reconstruction with hamstring autograft for the treatment of chronic irreparable patellar tendon injuries.

Background: Patellar tendon injuries not amenable to primary repair present a challenging problem for surgeons and patients alike. No standard surgical technique exists for these injuries and few studies report outcomes after surgical treatment.

Methods: A retrospective analysis was conducted for patients undergoing surgical treatment for irreparable patellar tendon tears.

Measurement of the coracohumeral distance on magnetic resonance imaging in a large patient cohort.

Background: Coracoid impingement syndrome is an increasingly recognized etiology of anterior shoulder pain. Numerus studies have documented the coracohumeral distance (CHD) as a primary or secondary measurement in symptomatic individuals, but there lacks an evaluation of CHD in a large cohort of asymptomatic individuals. The purpose of this study was to quantify a normative distribution of the CHD in a large cohort of healthy, asymptomatic subjects with no history of impingement or shoulder instability.

Platelet-Rich Plasma, Bone Morphogenetic Protein, and Stem Cell Therapies.

The frequency of use of "biologics," including platelet-rich plasma (PRP), bone morphogenetic protein (BMP), and stem cell therapies in the treatment of orthopaedic conditions has significantly increased over the past few decades. The use of PRP and stem cells has been proposed for a wide variety of conditions including knee and hip osteoarthritis (OA), tendon strains and tendinopathies, muscle strains, and acute and chronic soft-tissue injuries. It has also been proposed for use in the enhancement of healing during surgical treatments.

Meniscus Form and Function.

The menisci are 2 fibrocartilaginous crescents anchored via bony and ligamentous attachments to surrounding structures. Their biochemical composition and multilayered structure make them ideal for converting compressive forces to tensile forces in addition to improving joint congruity and providing shock absorption to weight bearing. The medial meniscus maintains more attachments at both the horns and the midbody than the lateral meniscus, making it more susceptible to injury.

Comparison of three fixation techniques for arcuate fractures.

Purpose: Proximal fibula avulsion fractures, or "arcuate fractures", are an often discussed but poorly defined injury pattern which represent a destabilizing injury to the posterolateral corner of the knee. Historical and recent literature discussing reconstruction and repair techniques exist, but there has been little biomechanical evaluation of repair techniques. The purpose of this study was to evaluate the strength of three type of fixation techniques for arcuate fractures: bone tunnels, a screw and washer, and a novel suture anchor technique.

Tibial Tubercle Osteotomy and Medial Patellofemoral Ligament Imbrication for Patellar Instability Due to Trochlear Dysplasia.

Background: The treatment of patellar instability in the setting of trochlear dysplasia is challenging.

Purpose/hypothesis: The purpose of this study was to evaluate outcomes for the treatment of recurrent patellar dislocations due to trochlear dysplasia using anteromedialization tibial tubercle osteotomy combined with medial patellofemoral ligament (MPFL) imbrication. We hypothesized that the treatment of patellar instability with tibial tubercle osteotomy and MPFL imbrication would result in improved patient satisfaction and decrease patellar instability events in patients with prior instability and trochlear dysplasia.

Use of Air Arthrograms to Aid in Joint Distraction During Hip Arthroscopic Surgery Decreases Postoperative Pain and Opioid Requirements.

Background: Positive-pressure air arthrography and venting of the hip capsule are techniques used to decrease the traction forces needed for joint distraction during hip arthroscopic surgery. Little is known about the effects that these techniques have on postoperative pain.

Hypothesis: Positive-pressure air arthrography and venting during hip arthroscopic surgery will decrease patient-reported pain and narcotic requirements in the acute postoperative setting.

Factors Affecting Return to Play After Primary Achilles Tendon Tear: A Cohort of NFL Players.

Background: Achilles tendon tears are potentially career-ending injuries for professional athletes. For players in the National Football League (NFL), return requires not only surgery and extensive rehabilitation but also the ability to compete in a market with limited positions that annually introduces new recruits.

Purpose/hypothesis: We authors sought to evaluate factors related to return to play (RTP) and changes in performance following a primary Achilles tear.

Osteochondral Allograft Transplantation: Identifying the Biomechanical Impact of Using Shorter Grafts and Pulsatile Lavage on Graft Stability.

This study seeks to identify the ability of shorter osteochondral allografts (OCAs) to resist displacement/failure. Additionally, this study seeks to evaluate the effect of pulsatile lavage (PL) on the biomechanical stability of the OCA. Fifteen-millimeter diameter, human cadaveric, OCAs of 4, 7, and 10 mm in depth were harvested for comparison of resistance to compressive and tensile loads.

The arcuate fracture: A descriptive radiographic study.

Purpose: To assess plain radiographic morphology of arcuate fractures in order to identify patterns and help shape treatment algorithm for proximal fibula fracture.

Methods: A search of radiographic reports at a level 1 trauma center from 2014 to 2016 using MONTAGE search software for the phrases "arcuate fracture", "fibular head avulsion", or "fibular head fracture" was conducted. Descriptive measurements were obtained including dimensions of the fragment, the displacement of the fragment from its anatomic position, and the orientation of the primary fracture line relative to the axis of the fibular diaphysis in both the sagittal and coronal plane.

Biomechanical Assessment of Locking Plate Fixation of Comminuted Proximal Olecranon Fractures.

Objectives: To determine if mean ultimate strength or failure mechanism differed between comminuted olecranon fractures created at the proximal 25% or 50% of the trochlear notch and fixed with precontoured posterior locking plates (PLPs).

Methods: Comminuted osteotomies were created in 10 matched pairs of cadaveric upper extremities at either the proximal 25% or 50% of the trochlear notch after quantitative computed tomography scans were performed to evaluate bone mineral density. Variable-angle olecranon PLPs were fixed to the specimens.

Tibial Eminence Fracture Repair With Double Hewson Suture Passer Technique.

Displaced tibial eminence fractures are commonly encountered in pediatric patients and are often considered to be functionally equivalent to an anterior cruciate ligament (ACL) rupture. While a variety of techniques are available for fixation of this injury, we describe an anchorless technique relying on suture fixation tied over a bone bridge. This technique also relies on two intra-articular Hewson suture passers to quickly and effectively pass and shuttle sutures through the ACL and tibial bone tunnels in order to reduce and fix the fracture fragment.

National Football League Skilled and Unskilled Positions Vary in Opportunity and Yield in Return to Play After an Anterior Cruciate Ligament Injury.

Background: Anterior cruciate ligament (ACL) injuries pose a significant risk to the careers of players in the National Football League (NFL). The relationships between draft round and position on return to play (RTP) among NFL players are not well understood, and the ability to return to preinjury performance levels remains unknown for most positions.

Purpose: To test for differences in RTP rates and changes in performance after an ACL injury by position and draft round.

Orthopaedic Resident Preparation and Confidence in Treating On-Field Injuries.

Background: Orthopaedic surgery residents may cover athletic events, although the training provided to prepare residents for this role and oversight from attending physicians during these activities is not well understood.

Purpose: To survey orthopaedic residents about the training provided by their residency program for on-field athletic coverage and to understand their levels of preparation for this role and confidence in treating commonly encountered on-field conditions.

Study Design: Descriptive epidemiology study.

An Anatomic Evaluation of Arthroscopic Access to the Radial Head.

Purpose: To determine the area of the radial head accessible for visualization and screw placement from the standard anteromedial and anterolateral portals used in elbow arthroscopy.

Methods: Five cadaveric elbows were arthroscopically evaluated using standard anteromedial and anterolateral portals. Markers (pins) were placed into the accessible portions of the radial head at maximal pronation and supination.

Readability of Online Sources Regarding Meniscal Tears.

Meniscal injuries are extremely common, with an incidence of 8.3 per 1,000 person/years in young, active individuals. Patients often turn to the internet to glean information about their injuries, and even to guide decision making about treatment.