Three Hundred Periprosthetic Tibial Fractures Around a Total Knee Replacement: Classification and Outcomes from a Single Institution.

Background: Periprosthetic tibial fractures around a total knee replacement (TKR) remain challenging to manage, with little published information for guidance. The purpose of this study was to review the types, management techniques, and outcomes of periprosthetic tibial fractures in the largest series to date.

Methods: We identified 300 periprosthetic tibial fractures (285 patients) around a TKR (43% in primary TKRs and 57% in revision TKRs) sustained between 1996 and 2020.

Highly Porous Acetabular Cup and Augment Constructs in Complex Revision Total Hip Arthroplasty: What Predicts 10-Year Implant Survivorship?

Background: Porous tantalum acetabular cup and augment constructs have demonstrated favorable outcomes up to 5 years postsurgery despite severe bone loss during revision total hip arthroplasty (THA). Prior literature lacks long-term studies with substantial case numbers. This study aims to assess long-term clinical and radiographic outcomes 10 years postsurgery in patients undergoing revision THA with porous tantalum acetabular cup-augment constructs and determine factors associated with long-term survivorship.

3.0T magnetic resonance imaging-based hip bone models for femoroacetabular impingement syndrome are equivalent to computed tomography-based models.

This study aimed to compare three-dimensional (3D) proximal femoral and acetabular surface models generated from 3.0T magnetic resonance imaging (MRI) to the clinical gold standard of computed tomography (CT). Ten intact fresh-frozen cadaveric hips underwent CT and 3.

Hip and Pelvis Movement Patterns in Patients With Femoroacetabular Impingement Syndrome Differ From Controls and Change After Hip Arthroscopy During a Step-Down Pivot-Turn Task.

Background: Alterations in hip kinematics during functional tasks occur in positions that cause anterior impingement in patients with femoroacetabular impingement (FAI) syndrome. However, tasks that do not promote motions of symptomatic hip impingement remain understudied.

Purpose: To compare movement patterns of the hip and pelvis during a step-down pivot-turn task between patients with FAI and controls as well as in patients with FAI before and after hip arthroscopy.

Effect of Differing Orientation and Magnitude of Femoral Torsion on Outcomes and Achievement of the MCID and PASS at 5 Years After Hip Arthroscopy for Femoroacetabular Impingement Syndrome.

Background: Femoral torsion measurements and outcomes are variable throughout the literature and have focused on short-term follow-up. However, there is a paucity of literature investigating clinically meaningful outcomes at midterm follow-up after hip arthroscopy for femoroacetabular impingement syndrome (FAIS).

Purpose: To quantify femoral version using computed tomography imaging in patients with FAIS and to explore the relationship between version abnormalities and 5-year outcomes after hip arthroscopy.

Isolated, Full-Thickness Proximal Rectus Femoris Injury in Competitive Athletes: A Systematic Review of Injury Characteristics and Return to Play.

Background: Characteristics regarding mechanism of injury, management, and return-to-play (RTP) rate and timing are important when treating and counseling athletes with rectus femoris tears.

Purpose: To systematically review the literature to better understand the prevalence, sporting activity, injury mechanisms, and treatment of patients with rectus femoris injury and to provide prognostic information regarding the rate and timing of RTP.

Study Design: Systematic review; Level of evidence, 4.

Noninvasive shape-fitting method quantifies cam morphology in femoroacetabular impingement syndrome: Implications for diagnosis and surgical planning.

There are considerable limitations associated with the standard 2D imaging currently used for the diagnosis and surgical planning of cam-type femoroacetabular impingement syndrome (FAIS). The aim of this study was to determine the accuracy of a new patient-specific shape-fitting method that quantifies cam morphology in 3D based solely on preoperative MRI imaging. Preoperative and postoperative 1.

Defining the Minimal Clinically Important Difference and Patient Acceptable Symptom State After Endoscopic Gluteus Medius or Minimus Repair With or Without Labral Treatment and Routine Capsular Closure at Minimum 5-Year Follow-up.

Background: There is a paucity of information in the literature on midterm outcomes of endoscopic gluteus medius and/or minimus repair with concomitant labral treatment using only modern surgical techniques.

Purpose: To define the minimal clinically important difference (MCID) and Patient Acceptable Symptom State (PASS) at a minimum of 5 years postoperatively for patients undergoing endoscopic hip abductor repair with routine capsular closure.

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

Hip Arthroscopy for the Treatment of Femoroacetabular Impingement Syndrome in Hips With Mild Osteoarthritis (Tönnis Grade 1): A Matched Comparative Cohort Analysis at Minimum 5-Year Follow-up.

Background: There is a paucity of information in the literature on midterm outcomes from the arthroscopic treatment of femoroacetabular impingement syndrome (FAIS) with concomitant labral treatment in patients with mild osteoarthritis (OA) using modern surgical techniques.

Purpose: To compare outcomes of hip arthroscopy for the treatment of FAIS between patients with mild OA (Tönnis grade 1) and patients without OA (Tönnis grade 0) at minimum 5-year follow-up.

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

Ultrasound Can Determine Joint Distraction During Hip Arthroscopy but Fluoroscopic-Guided Portal Placement Is Superior.

Purpose: To compare joint distraction measured on ultrasound (US) with joint space width (JSW) measured on fluoroscopy in hip arthroscopy and to determine whether ultrasound guidance is as safe and effective as fluoroscopy, the current gold standard, for establishing arthroscopic portals.

Methods: Cadaveric whole-body specimens were positioned supine and subjected to 60 lbs. of unilateral axial traction using a distal femoral Steinman pin.

Outcomes for the Arthroscopic Treatment of Femoroacetabular Impingement Syndrome With Acetabular Retroversion: A 3D Computed Tomography Analysis.

Background: Increased attention has been directed toward the acetabular morphology in the management of patients with femoroacetabular impingement syndrome (FAIS). Whether acetabular version influences patient-reported outcomes remains poorly understood.

Purpose: To use computed tomography (CT)-based 3-dimensional (3D) bone models to (1) quantify acetabular version in patients with FAIS, (2) compare acetabular version on 3D bone models with current plain radiographic parameters, and (3) explore the relationship between the magnitude of acetabular version and minimum 2-year clinical outcomes after hip arthroscopy.

Three-Dimensional Quantification of Cam Resection Using MRI Bone Models: A Comparison of 2 Techniques.

Background: The current clinical standard for the evaluation of cam deformity in femoroacetabular impingement syndrome is based on radiographic measurements, which limit the ability to quantify the complex 3-dimensional (3D) morphology of the proximal femur.

Purpose: To compare magnetic resonance imaging (MRI)-based metrics for the quantification of cam resection as derived using a best-fit sphere alpha angle (BFS-AA) method and using 3D preoperative-postoperative surface model subtraction (PP-SMS).

Study Design: Descriptive laboratory study.

Sex-Based Differences in Femoroacetabular Impingement Syndrome and the Effect of Cam Deformity Location on the Extent of Labral Tearing: A 3-Dimensional Computed Tomography Study.

Background: Sex-specific quantification of cam morphology in patients with femoroacetabular impingement syndrome may improve diagnostics, surgical planning, and outcomes.

Purpose: To (1) examine differences between men and women with symptomatic cam deformities based on deformity location, magnitude, and extent; (2) assess the association between cam deformity and labral pathology; and (3) evaluate the relationship between cam deformity and patient-reported outcome measures after hip arthroscopy.

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

Determining the Roles of the Anterior Cruciate Ligament, Posterolateral Corner, and Medial Collateral Ligament in Knee Hyperextension Using the Heel-Height Test.

Background: Anterior cruciate ligament (ACL) tears are often associated with other ligamentous injuries. The side-to-side difference in heel height can represent a valuable diagnostic tool in the setting of multiligamentous injuries.

Purpose: To assess in a cadaveric model how sequential sectioning of the static stabilizing structures of the knee (ACL, fibular collateral ligament [FCL], popliteus tendon [PLT], popliteofibular ligament [PFL], and medial collateral ligament [MCL]) influences heel-height measurements when comparing groups undergoing initial transection of the ACL versus FCL and to assess posterior tibial slope after sequential sectioning.

Multicenter Outcomes After Hip Arthroscopy: Comparative Analysis of Patients Undergoing Concomitant Labral Repair and Ligamentum Teres Debridement Versus Isolated Labral Repair.

Background: Increased attention has been directed toward the ligamentum teres (LT) and its association with acetabular coverage, labral pathology, and hip microinstability; however, few studies have evaluated whether LT pathology influences the rate of clinically significant outcome improvement after hip arthroscopy.

Purpose: To determine if patients with femoroacetabular impingement syndrome (FAIS) undergoing labral repair and concomitant LT debridement achieve outcomes similar to patients without LT pathology undergoing labral repair.

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

Three-Dimensional Measures of Bony Resection During Femoral Osteochondroplasty Are Related to Alpha Angle Measures: A Cadaveric Study.

Purpose: To determine whether 3-dimensional (3D)-reconstructed proximal femoral bone models can be used to quantify femoral osteochondroplasty and to determine whether the 3D-based metrics are related to clinical alpha angle measures.

Methods: Six cadaveric specimens with cam-type morphology underwent open femoral osteochondroplasty. Alpha angles were measured on the oblique axial computed tomography slice before and after femoral osteochondroplasty.

Patient-Reported Outcomes Measurement Information System Test Is Less Responsive Than Legacy Hip-Specific Patient-Reported Outcome Measures in Patients Undergoing Arthroscopy for Femoroacetabular Impingement Syndrome.

Purpose: To evaluate and compare the Patient-Reported Outcomes Measurement Information System (PROMIS) Physical Function (PF) computerized adaptive test and PROMIS Pain Interference (PI) instruments versus legacy patient-reported outcome measures (PROMs) in patients undergoing hip arthroscopy for femoroacetabular impingement syndrome at 1-year follow-up.

Methods: Patients undergoing primary hip arthroscopy for the treatment of femoroacetabular impingement syndrome without concomitant procedures performed by a single surgeon between August 2018 and January 2019 were identified. The PROMIS PF score, PROMIS PI score, Hip Outcome Score-Activities of Daily Living Subscale (HOS-ADL), Hip Outcome Score-Sports Subscale (HOS-SS), modified Harris Hip Score (mHHS), International Hip Outcome Tool 12 (iHOT-12), and visual analog scale (VAS) pain score were obtained preoperatively and at 6 months and 1 year postoperatively.

Assessment of Femoral Torsion on Magnetic Resonance Imaging is More Reliable Using Axial-Oblique Sequences Compared With Standard Axial Slices in Patients With Femoroacetabular Impingement Syndrome.

Purpose: To determine the agreeability of femoral torsion measurements on axial and oblique axial magnetic resonance imaging (MRI) sequences in patients with femoroacetabular impingement syndrome (FAIS).

Methods: Patients who underwent primary hip arthroscopy for FAIS between January 2012 to January 2019 were identified. Inclusion criteria were all patients with an MRI scan containing the pelvis and knee imaging.

Return to Sport in Athletes With Borderline Hip Dysplasia After Hip Arthroscopy for Femoroacetabular Impingement Syndrome.

Background: Data on outcomes in patients with borderline hip dysplasia (BHD) who undergo hip arthroscopy remain limited, particularly in regard to return to sport (RTS).

Purpose: To evaluate outcomes in patients with BHD and their ability to RTS after hip arthroscopy for treatment of femoroacetabular impingement syndrome (FAIS).

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

Quantification of Acetabular Coverage on 3-Dimensional Reconstructed Computed Tomography Scan Bone Models in Patients With Femoroacetabular Impingement Syndrome: A Descriptive Study.

Background: Accurate assessment of osseous morphology is imperative in the evaluation of patients with femoroacetabular impingement syndrome (FAIS) and hip dysplasia. Through use of computed tomography (CT), 3-dimensional (3D) reconstructed hip models may provide a more precise measurement for overcoverage and undercoverage and aid in the interpretation of 2-dimensional radiographs obtained in the clinical setting.

Purpose: To describe new measures of acetabular coverage based on 3D-reconstructed CT scan bone models.

Iliopsoas Bursitis Managed with Endoscopic Bursectomy and Lesser Trochanter Decompression: A Case Report.

Case: A 32-year-old woman presented with worsening right anterior hip pain, reduced hip flexion strength, and passive range of motion during hip flexion. Magnetic resonance imaging of the hip demonstrated a prominent lesser trochanter and localized fluid signal intensity at the iliopsoas bursa. The patient underwent endoscopic iliopsoas bursectomy and lesser trochanterplasty, reporting improvement in all clinical outcome scores at 1-year follow-up.

Patients Require Less Time to Complete Preoperative Patient-Reported Outcomes Measurement Information System (PROMIS) Than Legacy Patient-Reported Outcome Measures.

Purpose: To analyze time to completion of preoperative legacy patient-reported outcomes (PROs) and more recent computer adaptive Patient-Reported Outcomes Measurement Information System (PROMIS) questionnaires in patients with symptomatic femoroacetabular impingement syndrome undergoing primary hip arthroscopy.

Methods: A retrospective analysis was conducted on patients undergoing hip arthroscopy by a single fellowship-trained hip arthroscopist. Inclusion criteria were patients undergoing primary arthroscopic hip surgery and completion of at least 1 legacy PRO or PROMIS questionnaire at the preoperative time point.