7,067 results match your criteria Arthroscopy[Journal]


Subacromial Spacer Implantation for the Treatment of Massive Irreparable Rotator Cuff Tears: A Systematic Review.

Arthroscopy 2018 Dec 10. Epub 2018 Dec 10.

Department of Orthopaedics, The University of Alabama at Birmingham, Birmingham, Alabama, U.S.A.. Electronic address:

Purpose: To synthesize and report the early clinical and radiographic outcomes associated with subacromial spacer use in patients with massive irreparable rotator cuff tears.

Methods: A systematic search on MEDLINE, Embase, and Cochrane Library databases was performed during February 2018. Included studies were evaluated regarding the level of evidence and quality using the methodological index for nonrandomized studies. Read More

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December 2018

Morphologic Factors Related to Repair Outcomes for Delaminated Rotator Cuff Tears: A Minimum 2-Year Retrospective Comparison Study.

Arthroscopy 2018 Dec 3. Epub 2018 Dec 3.

Department of Orthopaedic Surgery, Gil Medical Center, Gachon University College of Medicine, Incheon, Republic of Korea.

Purpose: To evaluate clinical outcomes and repair integrity after en masse transosseous-equivalent suture bridge repair for delaminated rotator cuff tears and to analyze the morphologic factors related to clinical outcomes and repair integrity.

Methods: This study included 99 patients who underwent the technique of en masse transosseous-equivalent suture bridge repair for delaminated rotator cuff tears. Morphologic factors were estimated using magnetic resonance imaging, and clinical outcomes were evaluated using the University of California, Los Angeles score; American Shoulder and Elbow Surgeons score; and Constant shoulder score. Read More

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December 2018

The Subacromial Balloon Spacer Versus Superior Capsular Reconstruction in the Treatment of Irreparable Rotator Cuff Tears: A Biomechanical Assessment.

Arthroscopy 2018 Dec 4. Epub 2018 Dec 4.

Hand and Upper Limb Centre, University of Western Ontario, London, Ontario, Canada. Electronic address:

Purpose: To compare the subacromial balloon spacer with superior capsular reconstruction (SCR) for the treatment of massive irreparable rotator cuff tears.

Methods: Eight male cadaveric shoulders were mounted on a custom shoulder simulator that permitted quasistatic deltoid and rotator cuff muscle loading. Four shoulder conditions were tested: intact, irreparable rotator cuff tear (torn), subacromial balloon spacer, and SCR. Read More

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December 2018

Research Pearls: Expert Consensus Based Evidence Using the Delphi Method.

Arthroscopy 2018 Dec;34(12):3278-3282

Alexandria, Virginia, U.S.A.

The evolution of a systematic approach to assessing pertinent investigations is known as evidence-based medicine (EBM). EBM is defined as the conscientious and judicious use of current best evidence from clinical care research and integration of clinical expertise in the management of individual patients. There is no doubt that EBM is important but may not give clinically meaningful guidance on topics with clinical equipoise for individual patient care. Read More

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December 2018
4 Reads

Research Pearls: How Do We Establish the Level of Evidence?

Arthroscopy 2018 Dec;34(12):3271-3277

Heartland Orthopedic Associates, Alexandria, Minnesota, U.S.A.

Evidence-based medicine (EBM) guidelines were first introduced in 1986 and were defined as the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients. The practice of EBM means integrating individual clinical expertise with the best available external clinical evidence from systematic research. Level of evidence (LOE) stratifies publications from Level I to Level V and provides the foundation for EBM. Read More

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December 2018

Editorial Commentary: Lateral Hinge Fracture After Opening Wedge High Tibial Osteotomy With Long Locking Plate Use.

Authors:
Jae Gyoon Kim

Arthroscopy 2018 Dec;34(12):3256-3257

Korea University College of Medicine.

Lateral hinge fracture (LHF) is a common complication after opening wedge high tibial osteotomy. Such a fracture can be caused by many factors such as osteotomy level, amount of opening, hinge position, and kind of plate. In particular, long locking plates have superior biomechanical stability in cases of LHF compared with short plates. Read More

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December 2018

Editorial Commentary: Unraveling Gordian's Knot: Opioids in Arthroscopy Pain Management.

Authors:
Mustafa Karahan

Arthroscopy 2018 Dec;34(12):3244-3245

Pain management is crucial for a successful result after various knee surgeries. Opioids may be included in the postoperative pain management protocol but may be abused if not controlled. Following knee arthroscopy and related surgery, adolescent and young adult patients are commonly overprescribed opioids. Read More

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December 2018

Editorial Commentary: More Evidence That Anterior Cruciate Ligament Deficiency Contributes to Knee Arthritis-In Search of an Optimal Biomechanical Model.

Authors:
Andrew G Geeslin

Arthroscopy 2018 Dec;34(12):3234-3235

Patients with anterior cruciate ligament (ACL) tears have a greater incidence of knee arthritis than the general population. Acute chondral injury, acute or delayed meniscal pathology, and altered contact mechanics have all been implicated in the development of arthritis. Dynamic models (i. Read More

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December 2018

Editorial Commentary: Fresh-Frozen Meniscal Allografts-Cold Does Not Always Cause Shrinkage.

Arthroscopy 2018 Dec;34(12):3224-3225

Loma Linda, California.

Meniscal allograft transplantation is an effective treatment for the symptomatic, young, active patient with meniscal deficiency. Modern graft-preservation techniques may reduce clinical sequelae of meniscal shrinkage after transplantation. We prefer fresh-frozen nonirradiated allografts because of easier processing, lower immunogenicity, and lower cost, and on the basis of a 2-decade clinical experience with fresh-frozen meniscal allograft transplantations, we are pleased with our survivorship results. Read More

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December 2018
2 Reads

Editorial Commentary: Is the Key to Successful Revision Anterior Cruciate Ligament Reconstruction Addressing the Anterolateral Complex With a Lateral Extra-articular Tenodesis?

Arthroscopy 2018 Dec;34(12):3214-3215

University of Kentucky.

As the overall incidence of anterior cruciate ligament (ACL) ruptures continues to rise, the failure rates in reconstructive surgery remain relatively stable. Despite advances in our understanding of graft selection, anatomic reconstruction, addressing concomitant injuries, and the importance of rehabilitation, we continue to see failure rates in primary ACL reconstructions of up to 15%. Thus as the number of primary ACL reconstructions rises, so too does the number of revision ACL surgeries. Read More

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December 2018

Editorial Commentary: Is Back Pain Killing Your Hip Arthroscopy Outcomes?

Arthroscopy 2018 Dec;34(12):3202-3203

The identification of factors associated with inferior postoperative outcomes after hip arthroscopy is critical as we try to further clarify indications for hip arthroscopy. Recent arthroplasty studies have shown worse outcomes after hip and knee replacement in patients with comorbid joint and spine pain. Recent evidence has shown this to be true in patients undergoing hip arthroscopy as well. Read More

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December 2018
3 Reads

Editorial Commentary: When Your Golf Game Is Handicapped by Your Hip.

Authors:
Scott C Faucett

Arthroscopy 2018 Dec;34(12):3194-3195

Golf is a common recreational and competitive sport that requires full hip rotation to allow for a smooth and effective swing. Therefore hip impingement and hip osteoarthritis, by limiting rotation, could cause pain in golfers and even encourage them to discontinue the sport. In my opinion, the lead hip in golfers is likely what generally drives the symptoms in the hip, back, or knee. Read More

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December 2018
1 Read

Editorial Commentary: Dealer's Choice for Arthroscopic Versus Open Lateral Epicondylitis Release? It's Not That Simple.

Authors:
Larry D Field

Arthroscopy 2018 Dec;34(12):3185-3186

Jackson, Mississippi.

The most efficacious treatment for patients with persistent lateral epicondylitis who have not adequately improved despite undergoing extended nonoperative measures may be arthroscopic. One advantage is the capability of the surgeon to fully assess the elbow intra-articularly. Second, the incision is often considered less appealing to both patients and surgeons than portal-site incisions. Read More

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December 2018
2 Reads

Arthroscopic Versus Open Lateral Release for the Treatment of Lateral Epicondylitis: A Prospective Randomized Controlled Trial.

Arthroscopy 2018 Dec;34(12):3177-3184

Pan Am Clinic, Winnipeg, Canada.

Purpose: The purpose of this randomized clinical trial was to determine whether quality of life and function, as measured using subjective questionnaires and clinical assessment, are different after open versus arthroscopic debridement of the pathologic extensor carpi radialis brevis origin in the treatment of lateral epicondylitis at 1 year postoperatively.

Methods: Patients older than 16 years with a minimum of 6 months of nonoperative management for lateral epicondylitis were recruited into this prospective, single-blinded randomized clinical trial. Patients were randomized intraoperatively to undergo open or arthroscopic release. Read More

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December 2018
2 Reads

Editorial Commentary: When Less Is More-The Benefits of Limiting Bursectomy in Arthroscopic Rotator Cuff Repair.

Arthroscopy 2018 Dec;34(12):3175-3176

Although the exact function of the subacromial bursa as it relates to rotator cuff repair is still debatable, most surgeons would agree that the more invasive the procedure, the more likely there will be scarring and/or adhesions, which can lead to decreased motion. So, when performing subacromial bursectomy during rotator cuff repair, "Observe due measure, moderation is best in all things [subacromial]." Read More

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December 2018
1 Read

Editorial Commentary: Buyer Beware-Throwers Undergoing Type VIII SLAP Repair Should Do So With Very Reasonable Expectations.

Authors:
Eric C Makhni

Arthroscopy 2018 Dec;34(12):3165-3166

West Bloomfield, Michigan.

SLAP repair in throwing athletes should be approached with caution. Surgery may help improve symptoms but may not guarantee a return to the preinjury level of competition. Even in the most expert of hands, the rate of return to the preinjury level of performance ranges from 38% to 60% and is as low as 10% for pitchers. Read More

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December 2018
1 Read

Editorial Commentary: Restoration of Rotator Cuff Footprint Anatomy Is All That Matters, No Matter How We Get There.

Authors:
Darius Moezzi

Arthroscopy 2018 Dec;34(12):3157-3158

Delamination of rotator cuff tears presents a challenge to shoulder arthroscopists. Tear pattern recognition and an understanding of anatomy as it relates to the superior capsule guide treatment strategies. The key to management of a delaminated rotator cuff tear is to recognize differential retraction of respective layers. Read More

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December 2018
1 Read

Editorial Commentary: Measurement of Glenoid Bone Loss With Computed Tomography Scan Versus Magnetic Resonance Imaging.

Authors:
John M Tokish

Arthroscopy 2018 Dec;34(12):3148-3149

Phoenix, Arizona.

Glenoid bone loss remains the largest risk factor for failure after arthroscopic Bankart reconstruction, and its measurement has been called for in all cases of patients undergoing stabilization. Accurate measurements of glenoid bone loss are of the utmost importance, because just 4 mm of "subcritical" loss can separate surgical success from failure. The computed tomography scan is a standard for bone loss measurement, but patients also typically require magnetic resonance imaging for other reasons. Read More

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December 2018

Editorial Commentary: To Pump or Not to Pump? Gravity Versus Fluid Pumps for Shoulder and Knee Arthroscopy.

Authors:
Hugh S West

Arthroscopy 2018 Dec;34(12):3139-3140

Murray, Utah.

Recent studies and our clinical experience have supported the safety and efficacy of various arthroscopic pumps for use in practice. Different pump designs are to be used in different ways. Although gravity flow can lead to constant low pressure in a cadaveric knee or shoulder, it may not provide optimal visualization or performance to best complete your surgical procedure. Read More

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December 2018

Reviews Pooling Heterogeneous, Low-Evidence, High-Bias Data Result in Incorrect Conclusions: But Heterogeneity is an Opportunity to Explore.

Arthroscopy 2018 Dec;34(12):3126-3128

Systematic Review submissions to our journal commonly pool heterogeneous studies of low levels of evidence and a high risk of bias. Pooling, or quantitative synthesis, of such study data regularly results in incorrect conclusions. We reject these submissions without peer-review (desk rejection), and typically invite authors to submit a new, subjective synthesis without pooling and to report ranges of the results of included studies rather than pooled values. Read More

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December 2018

Tools to Improve Scientific Research.

Arthroscopy 2018 Dec;34(12):3113-3114

The mission of Arthroscopy is to provide authoritative, current, peer-reviewed clinical and basic science information regarding arthroscopic and related surgery. In addition, with a goal of improving the quality of the scientific research published in our journal and others, we develop and publish research pearls, statistical guides, article checklists and templates, and related tools. In sum, this effort allows our cadre of editors, reviewers, authors, and readers to strive to improve in our ability to create and critically analyze medical literature of the greatest merit. Read More

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December 2018

Management of Chondral Lesions of the Knee: Analysis of Trends and Short-Term Complications Using the National Surgical Quality Improvement Program Database.

Arthroscopy 2018 Nov 22. Epub 2018 Nov 22.

From Rush University Medical Center, Chicago, Illinois, U.S.A.

Purpose: To provide updated surgical trends of cartilage procedures differentiated by the classic groups of palliative, repair, and restorative modalities.

Methods: The American College of Surgeons National Surgical Quality Improvement Program database was queried from 2010-2016 for the following cartilage procedures: chondroplasty, microfracture, arthroscopic osteochondral autograft or allograft transplantation, open osteochondral autograft or allograft transplantation, and autologous chondrocyte implantation. Demographic variables and short-term (30-day) complications were analyzed with 1-way analysis of variance and post hoc analysis. Read More

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November 2018

Knotless Anchors in Acetabular Labral Repair: A Biomechanical Comparison.

Arthroscopy 2018 Nov 22. Epub 2018 Nov 22.

Department of Orthopedic Surgery, Clinica Las Condes, Santiago, Chile; Hip Surgery Unit, Hospital Militar, Santiago, Chile.

Purpose: To analyze the failure mechanism, stiffness, and pullout strength of acetabular knotless suture anchors.

Methods: Seven suture anchors were tested in high-density (0.48 g/cc) synthetic blocks. Read More

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November 2018
3 Reads

Abnormal Biomechanics at 6 Months Are Associated With Cartilage Degeneration at 3 Years After Anterior Cruciate Ligament Reconstruction.

Arthroscopy 2018 Nov 22. Epub 2018 Nov 22.

Department of Orthopaedic Surgery, University of California, San Francisco, San Francisco, California, U.S.A.. Electronic address:

Purpose: To investigate the changes in landing biomechanics over a 3-year period and their correlation with cartilage degenerative changes in the medial tibiofemoral joint of the knee after anterior cruciate ligament reconstruction (ACLR) using magnetic resonance T1ρ mapping.

Methods: Thirty-one anterior cruciate ligament-injured patients underwent magnetic resonance imaging of the injured knee before ACLR and 3 years after ACLR, as well as biomechanical analysis of a drop-landing task at 6 months and 3 years after ACLR. Sixteen healthy individuals were recruited and underwent knee magnetic resonance imaging and biomechanical assessment during a drop-landing task. Read More

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November 2018
4 Reads

Determination of Threshold Scores for Treatment Success After Arthroscopic Rotator Cuff Repair Using Oxford, Constant, and University of California, Los Angeles Shoulder Scores.

Arthroscopy 2018 Nov 22. Epub 2018 Nov 22.

Department of Orthopedic Surgery, Singapore General Hospital, Singapore.

Purpose: To determine the threshold scores for the Constant-Murley score (CMS); University of California, Los Angeles (UCLA) shoulder score; and Oxford Shoulder Score (OSS) that determine treatment success after arthroscopic rotator cuff (RC) repair.

Methods: Patients who underwent unilateral arthroscopic double-row RC repair by a single surgeon between 2010 and 2015 were prospectively followed up and assessed preoperatively and at 6, 12, and 24 months postoperatively. Perceived pain was measured with a visual analog scale, and functional outcome was assessed by the CMS, UCLA score, and OSS. Read More

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November 2018
6 Reads

Return to Sports After in Situ Arthroscopic Repair of Partial Rotator Cuff Tears.

Arthroscopy 2018 Nov 22. Epub 2018 Nov 22.

Hospital Italiano de Buenos Aires, Buenos Aires City, Argentina.

Purpose: To evaluate return to sport, clinical outcomes, and complications in a series of athletes with painful partial-thickness rotator cuff tears treated with the arthroscopic in situ repair with a minimum 2-year follow-up.

Methods: Retrospective case series. Seventy-two patients who had undergone an arthroscopic in situ repair for partial-thickness rotator cuff tears were evaluated. Read More

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November 2018
1 Read

Increasing Numbers of Shoulder Corticosteroid Injections Within a Year Preoperatively May Be Associated With a Higher Rate of Subsequent Revision Rotator Cuff Surgery.

Arthroscopy 2018 Nov 22. Epub 2018 Nov 22.

Department of Orthopedic Surgery, University of Virginia, Charlottesville, Virginia, U.S.A.. Electronic address:

Purpose: To identify any dose-dependent association between the use of subacromial corticosteroid injections within a year before rotator cuff repair (RCR) and subsequent need for revision rotator cuff surgery.

Methods: Two large administrative databases were queried for patients undergoing arthroscopic RCR. A minimum of 1 year of preoperative database exposure and 2 years of postoperative database follow-up were required for inclusion. Read More

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November 2018

Factors Affecting the Cost and Profitability of Arthroscopic Rotator Cuff Repair.

Arthroscopy 2018 Nov 22. Epub 2018 Nov 22.

Department of Orthopaedic Surgery, Beaumont Health System, U.S.A.

Purpose: To examine the cost metrics and profitability of rotator cuff repairs (RCRs) in a large health care system.

Methods: A retrospective study was performed using value analysis team data from 2 hospitals within a large metropolitan health system from 2010 to 2014. Cost and profit metrics were collected and compared against surgeon volume, surgeon subspecialty training, implant costs, Current Procedural Terminology (CPT) coding, length of stay, and hospital site. Read More

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November 2018

Full-Thickness Rotator Cuff Tears: What Is the Rate of Tear Progression? A Systematic Review.

Arthroscopy 2018 Nov 21. Epub 2018 Nov 21.

Department of Surgery, Section of Orthopedic Surgery, McCaig Institute for Bone and Joint Health, University of Calgary, Calgary, Alberta, Canada.

Purpose: To systematically review the literature and determine the rate of radiographic tear progression of nonoperatively treated full-thickness rotator cuff tears.

Methods: The PubMed, Embase, and Cochrane Library databases were systematically reviewed to identify all articles related to nonoperatively treated rotator cuff tears. English-language studies of Level I through IV evidence examining chronic, full-thickness rotator cuff tears in adults were included. Read More

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November 2018
9 Reads

The Influence of Naproxen on Biological Factors in Leukocyte-Rich Platelet-Rich Plasma: A Prospective Comparative Study.

Arthroscopy 2018 Nov 21. Epub 2018 Nov 21.

Center of Regenerative Sports Medicine, Steadman Philippon Research Institute, Vail, Colorado, U.S.A.; The Steadman Clinic, Vail, Colorado, U.S.A.. Electronic address:

Purpose: To quantify and compare normative catabolic and anabolic factor concentrations in leukocyte-rich platelet-rich plasma (LR-PRP) at various time points, including baseline, 1 week after initiating naproxen use, and after a 1-week washout period.

Methods: Asymptomatic healthy donors aged between 18 and 70 years were recruited (average age, 36.6 years; range, 25-64 years). Read More

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November 2018
3 Reads

The Clinical Evidence Behind Biologic Therapies Promoted at Annual Orthopaedic Meetings: A Systematic Review.

Arthroscopy 2018 Nov 16. Epub 2018 Nov 16.

Rothman Institute, Philadelphia, Pennsylvania, U.S.A.. Electronic address:

Purpose: The purpose of this study is to systematically evaluate the available clinical data for biologic therapies promoted for articular cartilage defects and osteoarthritis of the knee at the 2016 American Orthopaedic Society for Sports Medicine Meeting (AOSSM) and the 2017 Arthroscopy Association of North America meeting (AANA).

Methods: Our sample included all exhibitors at the 2016 AOSSM meeting and 2017 AANA meeting. All biologic products marketed at each conference were identified by reviewing exhibition booths and company websites. Read More

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November 2018

Arthroscopic Coracoclavicular Fixation Using Multiple Low-Profile Devices in Acute Acromioclavicular Joint Dislocation.

Arthroscopy 2018 Nov 16. Epub 2018 Nov 16.

Department of Orthopedic Surgery, Hallym University Dongtan Sacred Heart Hospital, Medical College of Hallym University, Hwaseong, Republic of Korea.

Purpose: To introduce an arthroscopically assisted coracoclavicular (CC) fixation technique using multiple low-profile devices to evaluate the clinical and radiologic outcomes in patients with acute high-grade acromioclavicular (AC) joint dislocation.

Methods: Between July 2014 and September 2015, cases of AC joint dislocation that were treated with arthroscopic CC fixation using multiple low-profile devices with a minimum follow-up of 24 months were included. We measured the vertical coracoclavicular distance (CCD) on the anteroposterior view and the horizontal acromioclavicular distance on 3-dimensional computed tomography images to evaluate the changes in radiologic outcomes before and after surgery. Read More

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November 2018
5 Reads

Intra-articular Mesenchymal Stem Cells in Osteoarthritis of the Knee: A Systematic Review of Clinical Outcomes and Evidence of Cartilage Repair.

Arthroscopy 2018 Nov 16. Epub 2018 Nov 16.

Department of Orthopedic Surgery, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul 06973, Republic of Korea.

Purpose: To provide a systematic review of the clinical literature reporting the efficacy of mesenchymal stem cells (MSCs) in terms of clinical outcomes including pain and function and cartilage repair in patients with osteoarthritis.

Methods: We systematically reviewed any studies investigating clinical outcomes and cartilage repair after the clinical application of cell populations containing MSCs in human subjects with knee osteoarthritis through MEDLINE, EMBASE, the Cochrane Library, CINAHL, Web of Science, and Scopus. Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed. Read More

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November 2018
3 Reads

Patient Positioning in Arthroscopic Management of Posterior-Inferior Shoulder Instability: A Systematic Review Comparing Beach Chair and Lateral Decubitus Approaches.

Arthroscopy 2018 Nov 16. Epub 2018 Nov 16.

UPMC Lemieux Sports Complex (D.V.), Cranberry, Pennsylvania, U.S.A.

Purpose: To analyze the available literature pertaining to clinical outcomes and complications of posterior-inferior shoulder stabilization performed arthroscopically in either the beach chair (BC) or lateral decubitus (LD) position.

Methods: According to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), 3 databases (PubMed, EMBASE, and Medline) were searched up to January 2018 for English-language studies on posterior shoulder instability. Descriptive statistics are presented. Read More

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November 2018
1 Read

Concentrated Bone Marrow Aspirate May Decrease Postoperative Cyst Occurrence Rate in Autologous Osteochondral Transplantation for Osteochondral Lesions of the Talus.

Arthroscopy 2018 Nov 10. Epub 2018 Nov 10.

Hospital for Special Surgery, New York, New York, U.S.A.. Electronic address:

Purpose: To clarify if the use of concentrated bone marrow aspirate (CBMA) would affect both postoperative functional outcomes and magnetic resonance imaging (MRI) outcomes compared with those of autologous osteochondral transplantation (AOT) alone; in addition, to assess the efficacy of CBMA reducing the presence of postoperative cyst formation following AOT in the treatment of osteochondral lesions of the talus.

Methods: Fifty-four (92%) of 59 eligible patients who underwent AOT between 2004 and 2008 were retrospectively assessed at a minimum of 5-year follow-up. Twenty-eight patients were treated with AOT and CBMA (AOT/CBMA group) and 26 patients were treated with AOT alone (AOT-alone group). Read More

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November 2018
5 Reads

Invention Versus Gold Standard: A Hands-On Research Pearl on Study Design and Statistical Concerns.

Arthroscopy 2018 Dec 7;34(12):3266-3270. Epub 2018 Nov 7.

UConn Health, Farmington, Connecticut, U.S.A.

This article points out what is important to consider when planning to perform and analyze a commonly seen study involving a comparison of an innovation with something established. A hands-on guide on how to perform this type of research trial and how to choose proper statistical methods is given. Read More

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December 2018
2 Reads

Femoral Contact Forces in the Anterior Cruciate Ligament Deficient Knee: A Robotic Study.

Arthroscopy 2018 Dec 2;34(12):3226-3233. Epub 2018 Nov 2.

Department of Orthopaedic Surgery, David Geffen School of Medicine at UCLA, Los Angeles, California, U.S.A.

Purpose: To measure contact forces (CFs) at standardized locations representative of clinical articular cartilage defects on the medial and lateral femoral condyles during robotic tests with simulated weightbearing knee flexion.

Methods: Eleven human knees had 20-mm-diameter cylinders of native bone/cartilage cored from both femoral condyles at standardized locations, with each cylinder attached to a custom-built load cell that maintained the plug in its precise anatomic position. A robotic test system was used to flex the knee from 0° to 50° under 200-N tibiofemoral compression without and with a 2 Nm internal tibial torque, 5 Nm external tibial torque, and 45 N anterior tibial force (AF). Read More

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December 2018
5 Reads

Autograft or Allograft? Irradiated or Not? A Contrast Between Autograft and Allograft in Anterior Cruciate Ligament Reconstruction: A Meta-analysis.

Arthroscopy 2018 Dec 2;34(12):3258-3265. Epub 2018 Nov 2.

Center for Sport Medicine, First Affiliated Hospital, College of Medicine Zhejiang University, Hangzhou, China. Electronic address:

Purpose: To compare the clinical outcomes and adverse events associated with irradiated and nonirradiated allografts in anterior cruciate ligament (ACL) reconstruction.

Methods: PubMed, Web of Science, and EMBASE were searched for randomized controlled trials from January 1990 to March 2018 to compare autograft with allograft in ACL reconstruction. Both objective and subjective outcomes of the function and adverse events were meta-analyzed. Read More

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December 2018
4 Reads

The Influence of Pain in Other Major Joints and the Spine on 2-Year Outcomes After Hip Arthroscopy.

Arthroscopy 2018 Dec 2;34(12):3196-3201. Epub 2018 Nov 2.

Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois, U.S.A.

Purpose: To determine whether patients who have pain in other major joints or the spine have poorer postsurgical outcomes than patients without comorbid orthopaedic pain.

Methods: We performed a review of a prospectively maintained institutional surgical registry of patients who underwent hip arthroscopy between January 1, 2012, and July 16, 2015, by a single surgeon, with a minimum of 2 years of postoperative follow-up. A musculoskeletal morbidity (MSM) score was assigned to each patient preoperatively based on the presence of pain in other joints and the spine (grade 1, hip only; grade 2, hip and other major joints without spine; grade 3, hip with spine; and grade 4, hip and other major joints with spine). Read More

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December 2018
7 Reads

Extra-articular Lateral Hinge Fracture Does Not Affect the Outcomes in Medial Open-Wedge High Tibial Osteotomy Using a Locked Plate System.

Arthroscopy 2018 Dec 2;34(12):3246-3255. Epub 2018 Nov 2.

Department of Orthopedic Surgery, Kyung Hee University Hospital at Gangdong, Seoul, Republic of Korea; Department of Orthopaedic Surgery, College of Medicine, Kyung Hee University, Seoul, Republic of Korea.

Purpose: To compare the radiologic and clinical outcomes in patients with and without lateral hinge fractures (LHFs) during medial open-wedge high tibial osteotomy (MOWHTO) using a locked plate system, as well as to assess whether LHFs could affect the midterm outcomes.

Methods: From May 2008 to November 2015, 164 knees underwent MOWHTO using a locked plate system for the treatment of knee osteoarthritis. LHFs were recognized by radiographs during or after the high tibial osteotomy and were not additionally treated. Read More

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December 2018
5 Reads

Opioid Overprescription After Knee Arthroscopy and Related Surgery in Adolescents and Young Adults.

Arthroscopy 2018 Dec 2;34(12):3236-3243. Epub 2018 Nov 2.

Department of Orthopaedic Surgery, Division of Sports Medicine, Boston Children's Hospital, Boston, U.S.A.; Harvard Medical School, Boston, Massachusetts, U.S.A.; Harvard T.H. Chan School of Public Health, Boston, MA, U.S.A.. Electronic address:

Purpose: The purpose of this study was to compare the number of opioids prescribed with the amount of pain medication required after knee arthroscopy and related surgery in adolescent and young adult patients to determine the effectiveness of current pain-control practices at a single institution. The secondary purpose was to determine what demographic or surgical factors are associated with increased opioid intake.

Methods: Adolescent and young adult patients who underwent knee arthroscopy and related surgery, including ligament reconstruction or tibial tubercle osteotomy, between May and August 2016 were provided pain-control logbooks in which they were asked to maintain a record of daily pain medication intake. Read More

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December 2018
7 Reads

Measurement of Glenoid Bone Loss With 3-Dimensional Magnetic Resonance Imaging: A Matched Computed Tomography Analysis.

Arthroscopy 2018 Dec 2;34(12):3141-3147. Epub 2018 Nov 2.

Steadman Philippon Research Institute and The Steadman, Vail, Colorado, U.S.A.

Purpose: To compare the measurement of glenoid bone surface area (GBSA) and glenoid bone loss (GBL) between 3-dimensional computed tomography (3D CT) and an autosegmentation approach for 3D magnetic resonance imaging (MRI) of patients with recurrent shoulder instability.

Methods: Eight subjects (2 women and 6 men; age range, 15-72 years [mean, 44 ± 19 years]) were consecutively enrolled who had both CT and MRI of the shoulder for clinical shoulder instability. Inclusion criteria were patients with shoulder instability or other shoulder injury who had both a CT scan and MRI performed of the same shoulder. Read More

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December 2018
4 Reads

Comparison of En Masse Versus Dual-Layer Suture Bridge Procedures for Delaminated Rotator Cuff Tears.

Arthroscopy 2018 Dec 2;34(12):3150-3156. Epub 2018 Nov 2.

Department of Orthopedics, Kagawa Saiseikai Hospital, Takamatsu, Japan.

Purpose: To compare clinical outcomes between 2 suturing procedures, conventional en masse suture bridging (EMSB) and dual-layer suture bridging (DLSB), for delaminated rotator cuff tears.

Methods: From January 2011 through December 2015, 98 consecutive cases with delaminated rotator cuff tears were included in this study (52 with EMSB and 46 with DLSB). The mean age was 65. Read More

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December 2018
8 Reads

Outcomes After Limited or Extensive Bursectomy During Rotator Cuff Repair: Randomized Controlled Trial.

Arthroscopy 2018 Dec 2;34(12):3167-3174. Epub 2018 Nov 2.

Department of Orthopedic Surgery, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea. Electronic address:

Purpose: To evaluate the effects of extensive bursectomy (EB) and limited bursectomy (LB) during arthroscopic rotator cuff repair.

Methods: In the EB group (n = 39), subacromial bursae were thoroughly removed from anterior to posterior and lateral to medial. In the LB group (n = 39), bursectomy was minimized to allow torn cuff visualization and tendon repair. Read More

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December 2018
10 Reads

Editorial Commentary: Rotator Interval Closure of the Shoulder Continues to Be a Challenge in Consensus on Treatment.

Arthroscopy 2018 Nov;34(11):3109-3111

Vail, Colorado.

In discussions of repair or plication of rotator interval capsular tissue and the respective surgical techniques, there is great variability in the procedures used to accomplish this, as well as a lack of consensus in defining rotator interval closure and the complex associated anatomy. The concept of rotator interval closure and how it is performed has shown wide variation and numerous definitions. In the future, it is recommended that one truly define what type of closure is performed, what tissues are imbricated, and where these tissues are imbricated, because both medial and lateral imbrications around the joint can have significant differences in terms of rotation, stability, and overall efficacy. Read More

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November 2018
1 Read

Editorial Commentary: What Is the Optimal Management of First and Recurrent Patellar Instability? Patellofemoral Instability Management Continues to Evolve.

Authors:
Jack Farr

Arthroscopy 2018 Nov;34(11):3094-3097

Greenwood, Indiana.

Patellar instability patients may present for evaluation after their first instability episode or after recurrent episodes. Current management differs for these 2 groups. The accepted "common denominator" of patellar instability is the medial patellofemoral ligament, or medial patellar restraints, to be more all-encompassing. Read More

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November 2018
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Editorial Commentary: Lateral Hinge Fracture in High Tibial Osteotomy: Risk or Annex?

Arthroscopy 2018 Nov;34(11):3080-3081

Technical University of Munich.

The basic aim of the medial opening wedge high tibial osteotomy is to use the elasticity of the lateral cortex as a biomechanical stabilizer, whereas the medial opening gap is maintained by a locking plate. This surgical construct tolerates early weight bearing, free range of knee motion, and sufficient bone healing for an acceptable time. We always perform a biplanar osteotomy, which reduces risk of fracture and improves healing potential owing to more bony contact area. Read More

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November 2018
9 Reads

Editorial Commentary: The Search for the Perfect Fixation Method in Anterior Cruciate Ligament Reconstruction Continues.

Authors:
Clayton W Nuelle

Arthroscopy 2018 Nov;34(11):3071-3072

Anterior cruciate ligament reconstruction fixation methods have long been the subject of frequent debate. The ability to optimize tendon-to-bone or bone-to-bone healing with secure graft fixation in a manner that can be performed as minimally invasively as possible is the goal. As we continue to develop and understand various graft fixation methods, our ability to achieve this goal continues to improve. Read More

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November 2018
4 Reads

Editorial Commentary: Bacterial Load and Contamination of Anterior Cruciate Ligament Grafts-Overamplified Dreadful Nuclear Assumption (DNA) or Underestimated Problem?

Authors:
Erik Hohmann

Arthroscopy 2018 Nov;34(11):3053-3054

Bacterial DNA is present in a large percentage in failed anterior cruciate ligament reconstructions. A potential concern is the presence of biofilm on both failed anterior cruciate ligament reconstruction grafts and suture material. Despite the high prevalence of bacterial material observed, microbial cultures are rarely positive. Read More

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November 2018
2 Reads