Arthroscopy

Is "killing the biceps" during rotator cuff repair a capital crime or a lawful act? One of the most passionately debated topics in shoulder surgery is what to do with the biceps during rotator cuff repair: save, tenotomize, or tenodese. Results of repair are not very successful, and as repair of massive rotator cuff tears shows a 40-57% failure rate, there is renewed interest in sparing the biceps tendon as a humeral head depressor, or so that it may be used as a local graft for revision rotator cuff repair...

No abstract text is available yet for this article.

PURPOSE: The primary purpose of this study was to determine if TXA is safe to administer preoperatively for patients undergoing hip arthroscopy by comparing the rate of VTE and complications between patients who did and did not receive TXA pre-operatively. METHODS: This is a multicenter consecutive cohort series of patients that underwent arthroscopic hip surgery from 2014-2021. The two cohorts were patients who did and did not receive TXA preoperatively (single dose of 1-2g) after a practice change...

It has been reported that use of the Latarjet procedure for anterior shoulder instability from 2008-2019 increased 250%. With the rise in utilization, it is imperative to minimize complications. At present, the majority of the literature focuses on male patients, with scant evidence regarding female patients. Outcomes are similar comparing female to male patients, but female patients have higher emergency department postoperative visits than males, requiring specific attention during the post-operative period...

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

Three-dimensional (3-D) modeling using digital or printed models provides a unique perspective that caters to cognitive spatial ability in a way that can add to our understanding and mental representations of human anatomy. This is particularly useful in the setting of trochlear dysplasia, where the morphology of the groove can exhibit substantial variability and complexity. Using 3-D reformatted images and models, a pragmatic understanding of how morphology influences patellofemoral pathology can be gleaned...

PURPOSE: To investigate a radiographic sign believed to be indicative of hip instability and acetabular suction seal disruption in the native hip, coined the "windshield wiper" (WSW) sign. MATERIALS AND METHODS: A retrospective review was performed for patients who underwent periacetabular osteotomy (PAO) with the senior author between March 2021 and September 2023. A WSW sign was identified on plain films as a concave or flat osteochondral defect on the anterolateral femoral head extending medial to the head-neck junction with resultant loss of femoral head sphericity in the native hip...

PURPOSE: The purpose of this work is to create a metric for evaluating the degree of laterality of the patella's entry into the trochlea, the entry point-trochlear groove (EP-TG) angle, and to evaluate if this laterality is associated with recurrent patella instability. METHODS: The time frame of the study was January 2020 to February 2023. The inclusion criteria were patients treated by the senior author (JPF) (with the exception of two patients who were treated by another provider at the institution who was aware of the study) who have been diagnosed with recurrent atraumatic patellar dislocations...

PURPOSE: To investigate the effects of ramp lesion (RL) and its repair on knee instability in patients with anterior cruciate ligament (ACL) injury by quantitatively assessing anteroposterior and rotational knee instability before and after ACL reconstruction. METHODS: All primary double-bundle ACL reconstruction using hamstring autografts between 2016 and 2021 were evaluated retrospectively. Patients with RLs without other meniscal injuries were included in Group R, whereas those with isolated ACL injuries constituted Group C...

Treatment of acute acromioclavicular (AC) joint separations is dependent on a variety of factors including severity, acuity, patient demographics, activity level, and surgeon preferences. For more severe or unstable separations (Rockwood types IIIB, IV, V, and VI), surgical intervention is typically recommended. Over 160 surgical techniques have been described, but none have emerged as a gold standard. Arthroscopic-assisted or all-arthroscopic fixation of the coracoclavicular (CC) ligaments with suture buttons has become increasingly popular due to lower complication rates compared to more rigid fixation...

PURPOSE: To evaluate the current body of evidence surrounding the diagnosis, management, and clinical outcomes of adhesions developed following hip arthroscopy (HA). METHODS: A systematic search of MEDLINE, Embase, Web of Science, and Cochrane CENTRAL was designed and conducted in accordance with PRISMA guidelines. Eligible studies included patients with confirmed adhesions following HA, with one or more of the following reported: i) diagnostic procedures and criteria employed, ii) indications for and details surrounding surgical management, and iii) clinical outcomes following the operative management of adhesions (e...

PURPOSE: To evaluate the change in hip distractive stability after capsulotomy, labral tear, and simultaneous repair of both structures in a biomechanical model. METHODS: Ten fresh-frozen human cadaveric hips were analyzed using a materials testing system to measure distractive force and distance required to disrupt hip suction seal after (1) native intact capsule and labrum, (2) 2 or 4 cm interportal capsulotomy (IPC), (3) labral tear, (4) T extension, (5) labral repair, (6) T extension repair, and (7) IPC repair...

PURPOSE: To identify the risk of anterior cruciate ligament (ACL) injury in adolescent athletes based on sex, sport, and sport affiliation. METHODS: A literature search was performed using three online databases (PubMed, Cochrane Library, and EMBASE) from database inception to November 2023 per the 2020 Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines. Included studies consisted of level I or II studies reporting on ACL injury exposures in time (hours) or injuries per 1000 athlete-exposures (AE) (1 game or practice) in adolescent athletes...

No abstract text is available yet for this article.

Articular cartilage defects of the hip pose therapeutic challenges. Among patients undergoing hip arthroscopy for femoroacetabular impingement syndrome (FAIS), over 20% may have partial or full thickness chondral damage, and patients with high grade (ICRS Grade 3 or 4) damage who undergo arthroscopic treatment of FAIS have higher rates of re-operation at ten-year follow up. Arthroscopic and open techniques have been developed to translate cartilage restoration options initially developed in the knee for use in the hip...

PURPOSE: To systematically review studies utilizing video analyses to evaluate anterior cruciate ligament (ACL) injury mechanisms in athletes during sport to better understand risk factors and the potential for injury prevention. METHODS: A literature search was conducted in accordance with the 2020 PRISMA guidelines statement using SCOPUS, PubMed, Medline, and the Cochrane Central Register for Controlled Trials from database inception through June 2023. Inclusion criteria including studies reporting on ACL injury mechanisms occurring in athletes based on video analysis...

Shoulder rotator cuff tears are ideally primarily repaired, but large and massive, chronic, and/or retracted tears result in challenges. In response, innovative solutions include superior capsular reconstruction, tendon transfers, subacromial balloon spacer, tuberoplasty, partial repair, and marginal convergence. Recently, an innovation is to use collagen tissue to bridge repair of compromised tendon. Recent research using fascia lata autografts for supraspinatus tendon reconstruction in a rat model shows positive outcomes with structural similarity to normal muscle-tendon interface, decreased fatty infiltration, and increased collagen types I and III, suggesting enhanced mechanical strength...

The field of orthobiologics continues to advance at a rapid pace, and theoretically holds some promise to augment the biologic healing response in rotator cuff repair. However, the clinical evidence for use of substances such as platelet-rich plasma for rotator cuff repair remains inconclusive. Atelocollagen, as a synthetic collagen substitute, has been proposed as another alternative to provide more collagen substrate for healing, but outcomes data with this technique is lacking. As biologic augmentation options continue to push the envelope on indications, due diligence is required to carefully examine options for safety and efficacy...

The significance of psychological factors in orthopaedic surgery has long been underestimated. High psychological resilience plays a significant role in achieving a positive postoperative outcome in terms of mental health, pain, and functional outcomes. This underscores the need for a more holistic approach to patient care, one that considers not only the physical aspects of treatment but also the emotional and psychological well-being of patients. This may involve implementing strategies to enhance resilience, providing support resources for coping with the challenges of surgery and recovery, and fostering open communication between patients and healthcare providers...

PURPOSE: To evaluate the effectiveness and safety of arthroscopic surgery combined with platelet-rich plasma (PRP) compared to arthroscopic surgery alone in the treatment of patients with full-thickness rotator cuff tears (RCT). METHODS: The Cochrane Library, PubMed, Embase, Scopus, EBSCO, Web of Science, CNKI, and Wanfang Database were systematically searched from inception to November 2023. Subject words combined with free words were used to collect randomized controlled trials focusing on arthroscopic surgery combined with platelet-rich plasma (PRP) in the treatment of full-thickness RCT...