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

Background:If an increased posterior tibial slope (PTS) and concomitant unicompartmental osteoarthritis are present, a simultaneous sagittal (slope) and coronal correcting high tibial osteotomy has been recommended. However, no study has investigated the accuracy of such combined high tibial slope correction osteotomies.Purpose:(1) To report the accuracy of navigated high tibial slope correction osteotomies

Background:The microvasculature of the human meniscus has been previously described by Arnoczky and Warren. However, to date, the qualitative and quantitative extra-articular vascular anatomy of the medial meniscus has not been characterized.Purposes:To perform a qualitative and quantitative anatomic study of the extra-articular medial meniscal vasculature and to introduce the novel “medial meniscal

Background:There may be an association between repetitive stress on the elbow and capitellar osteochondritis dissecans (COCD). The influence of activity on the characteristics or specific location of the lesion within a capitellar zone of propensity remains unclear.Purpose/Hypothesis:The purpose of this study was to evaluate COCD in gymnasts and baseball players compared with a non–upper extremity

Background:The insufficient regeneration of fibrocartilage at the tendon enthesis is the primary cause of retearing after surgical reattachment of the rotator cuff. Exosomes derived from bone marrow–derived mesenchymal stem cells (BMSC-Exos) and kartogenin (KGN) have been demonstrated to induce fibrocartilage formation. Loading drugs into exosomes may lead to a synergistic effect, significantly enhancing

Background:The utilization of lateral extra-articular tenodesis (LET) augmentation for anterior cruciate ligament reconstruction has increased. Various fixation points have been recommended based on tactile and anatomic landmarks; however, there is limited reporting of the accuracy or precision of these techniques in clinical practice.Purpose/Hypothesis:The purpose of this study was to evaluate whether

Background:Anterior cruciate ligament (ACL) injury is one of the most severe injuries for athletes. It is important to identify risk factors because a better understanding of injury causation can help inform athletes about risk and increase their understanding of and motivation for injury prevention.Purpose:To investigate the relationship between anatomic factors and risk for future noncontact ACL

Background:Despite the clinical benefits over nonoperative treatment or meniscectomy, the clinical outcomes of surgical repair for medial meniscus posterior root tear (MMRT) remain suboptimal, which may be attributed to the insufficient restoration of meniscal hoop tension during surgery.Purpose:To analyze the clinical outcomes of surgical repair of MMRT based on the appearance of the meniscal tension

Background:Sleep disturbance is commonly reported by patients wearing an abduction brace after arthroscopic rotator cuff repair (ARCR). Although a sling has been proven noninferior to an abduction brace for function and repair integrity, there is no evidence-based medical support for the advantage of the sling in improving sleep quality compared with a brace.Purpose/Hypothesis:This study aimed to compare

Background:The open Latarjet procedure yields excellent results as a treatment for anterior shoulder instability. The position of the bony fragment and the insertion angle of the screw (the alpha angle) are critical factors for a successful procedure. The alpha angle is considered overangulated at >25°, which is associated with poor bone fixation and healing.Purpose:To assess preoperative patient anatomic

Background:Treatment for osteochondritis dissecans (OCD) of the humeral capitellum has been predominantly guided by fragment stability and articular cartilage integrity. Nonoperative management is recommended for stable lesions, whereas surgical intervention is indicated for unstable lesions and those that fail nonoperative care. Several surgical options may be considered, although limited information

Background:Shoulder stabilization surgery has evolved over time, and bony augmentation procedures on the glenoid side are being performed more often. The Latarjet procedure modifies subscapularis anatomy because the conjoined tendon divides the subscapularis muscle fibers through a split/takedown, which has structural and functional implications. Arthroscopic anatomic glenoid reconstruction (AAGR)

Background:Latissimus dorsi tendon transfer (LDTT) leads to good clinical outcomes and recovery of function. A previous study have evaluated the outcomes of LDTT at a minimum 10-year follow-up and found durable improvements in shoulder function and pain relief but observed that shoulders with fatty infiltration of the teres minor muscle and insufficiency of the subscapularis muscle tended to have inferior

Background:Previous studies have examined the relationship between patient resilience and functional outcome scores after anterior cruciate ligament reconstruction (ACLR). However, past studies have failed to explore the longitudinal relationship between preoperative resilience and functional outcomes 2 years after ACLR.Purpose:To evaluate the relationship between preoperative patient resilience and

Background:Detection of meniscal ramp lesions concomitant with anterior cruciate ligament (ACL) injury using conventional magnetic resonance imaging (MRI) has low sensitivity, and these lesions are currently difficult to diagnose preoperatively.Purpose/Hypothesis:The purpose of this study was to assess the accuracy of MRI in detecting the presence of meniscal ramp lesions in the 120° flexed-knee position

Background:Nonoperative management of posterior shoulder instability is common. However, limited data are available to assess the pathomorphologic factors associated with its failure.Purpose/Hypothesis:The purpose of this study was 2-fold: (1) to determine glenohumeral pathomorphologic features predictive of nonoperative management failure of posterior instability; and (2) to determine the relationship

Background:Both high body mass index (BMI) and anterior cruciate ligament reconstruction (ACLR) independently influence knee osteoarthritis risk. Preliminary evidence shows the combination of these risk factors leads to poorer recovery and altered biomechanical outcomes after ACLR, but few studies have directly evaluated early changes in cartilage health between normal-BMI and high-BMI groups in this

Background:Repair of rotator cuff tear is not always feasible, depending on the severity. Although several studies have investigated factors related to reparability and various methods to predict it, inconsistent scoring methods and a lack of validation have hindered the utility of these methods.Purpose:To develop machine learning models to predict the reparability of rotator cuff tears, compare them

Background:One-step cell-based techniques of cartilage repair that lead to restoration of durable chondral tissue and long-term maintenance of joint function are cost-effective and ideal for routine use.Purposes:To examine the long-term clinical outcomes, after a mean follow-up duration of 14 years, of cartilage repair in the knee using a hyaluronic acid–based scaffold in association with bone marrow

Background:Microfracture is one surgical treatment strategy for osteochondral lesions of the talus (OLTs) but results in fibrocartilage repair tissue, which has inferior mechanical properties to native hyaline cartilage. Biological regulation of microfracture has been suggested to improve the quality of cartilage repair in patients.Purpose:To determine if administration of losartan, fisetin, or losartan

Background:Previous studies have revealed that early postoperative rehabilitation of chronic lateral ankle instability is just as crucial as surgical intervention. Immediate weightbearing has yielded good clinical results; however, randomized controlled studies have been limited.Purpose:To compare the clinical outcomes of patients with immediate weightbearing after lateral ankle ligament repair with

BACKGROUND Revision anterior cruciate ligament (ACL) reconstruction has been documented to have inferior outcomes compared with primary ACL reconstruction. The reasons why remain unknown. PURPOSE To determine whether surgical factors performed at the time of revision ACL reconstruction can influence a patient's outcome at 6-year follow-up. STUDY DESIGN Cohort study; Level of evidence, 2. METHODS Patients

Background:The critical shoulder angle (CSA) has become an important topic of study in patients with rotator cuff tears (RCTs). However, there are conflicting data on whether the CSA can differentiate between patients with normal shoulder pathology and full-thickness RCTs on shoulder radiographs.Purpose/Hypothesis:The purpose of this study was to define the relationship between full-thickness RCTs

Background:Short-term results after arthroscopic/endoscopic lateral ligament repair for chronic lateral ankle instability have been satisfactory, although medium- to longer-term results are lacking.Purpose/Hypothesis:The purpose of this study was to report the medium-term results of an all-inside endoscopic classic Bröstrom-Gould procedure where both the both lateral ligaments and the inferior extensor

Background:Paralabral cysts at the spinoglenoid notch are rare disorders that can potentially lead to compressive suprascapular neuropathy. Given their infrequency, a standard treatment protocol has not yet been established.Hypothesis/Purpose:This study aimed to assess changes in the infraspinatus muscle using magnetic resonance imaging (MRI) and to compare the outcomes of 2 different surgical methods

Background:There is concern that physiologic knee hyperextension may be associated with inferior outcomes after anterior cruciate ligament reconstruction (ACLR) using hamstring tendon (HT) autografts.Purpose:To assess whether there is an association between contralateral passive preoperative knee hyperextension (≤−5°) and postoperative anterior knee laxity, subjective knee function, or revision surgery

Background:The essential component of managing femoroacetabular impingement involves restoration of the original labral function. Circumferential labral reconstruction (CLR) has shown positive results. However, biomechanical studies of CLR are limited and have not established the efficacy of the modern knotless all-suture anchor (ASA) pull-through technique.Hypotheses:(1) CLR with knotless ASA fixation

Background:Several studies have demonstrated suture repair of ramp lesions of the medial meniscus via a posteromedial approach was associated with a significantly lower rate of secondary meniscectomy. However, these studies are not long-term and highlight the need for extended follow-up research to better understand the outcomes over a more extended period.Purpose:To evaluate the long-term results

Background:The long-term prognosis of jumper's knee and whether structural changes in the patellar tendon persist is unknown.Purpose:To investigate whether limitations in knee function and structural changes persisted beyond the athletic career of young elite volleyball players.Study Design:Cohort study; Level of evidence, 2.Methods:Volleyball players (mean ± SD age, 18 ± 0.8 years) enrolled in 2006-2011

Background:Studies to date of superior capsular reconstruction (SCR) comparing outcomes of healed grafts versus torn grafts do not separate graft tears based on location of the tear, rather they combine and report all tears as a single group.Purpose/Hypothesis:The purpose of this study was to correlate functional outcome with graft integrity and graft tear location after SCR with a dermal allograft

Background:Although there has been some amount of research into the use of platelet-rich plasma (PRP) after arthroscopic rotator cuff repair, most studies have not fully demonstrated its benefits. In addition, PRP formulations containing different concentrations of leukocytes have not been directly compared for rotator cuff repair.Purpose/Hypothesis:The purpose of this article was to determine whether

Background:Arthroscopic meniscectomy is one of the most performed surgical procedures in orthopaedics. Different approaches have been proposed to improve patient recovery but with unsatisfactory results. Platelet-rich plasma (PRP) augmentation has been proposed as a strategy to improve the recovery after meniscectomy.Purpose:To investigate the clinical benefits of an intra-articular PRP injection after

Background:Participation in recreational and competitive sports can predispose people to musculoskeletal injuries. Chronic overuse with insufficient recovery, overloading, and direct contact can result in acute primary tendon ruptures. There is scarce literature regarding the epidemiology of sports-related acute primary tendon ruptures in the United States (US).Purpose:To identify the incidence rate

Background:Osteochondral allograft transplantation (OCAT) has become a standard-of-care treatment option for patients with large symptomatic articular defects. Recent advances in allograft science and OCAT protocols have been reported to result in consistently robust outcomes after OCAT in the knee. However, only short-term comparisons have been reported, and analyses are lacking for treatment failure

Background:High tibial osteotomy (HTO) modifies the mechanics of the affected knee but can also affect the nonoperated knee. However, no research has reported on the prognosis and risk factors related to the nonoperated knee after unilateral HTO.Purpose:To assess the radiological parameters associated with osteoarthritis (OA) progression and the need for surgery in the nonoperated knee after unilateral

Background:Recent studies utilizing magnetic resonance imaging (MRI) for the evaluation of symptomatic lumbar spondylolysis in pediatric and adolescent athletes have indicated that upper level lumbar involvement has a higher incidence than previously reported. There has been a paucity of literature evaluating sport-specific patterns of lumbar spondylolysis, specifically upper versus lower level involvement

Background:The effectiveness and safety of matrix-associated autologous chondrocyte implantation with an autologous periosteal flap (pMACI) remain unclear. The Japanese Ministry of Health, Labor, and Welfare requires postmarketing surveillance of all patients undergoing pMACI using the tissue-engineered product JACC.Purpose:To evaluate the effectiveness and safety of pMACI for large articular cartilage

Background:Platelet-rich plasma (PRP) is one of the most frequently used orthobiologic products for the injection treatment of patients affected by knee osteoarthritis (OA). Some preliminary evidence supports the influence of platelet concentration on patients’ clinical outcomes.Purpose:To analyze if platelet concentration can influence the safety and clinical efficacy of PRP injections for the treatment

Background:Distal femoral varus osteotomy (DFVO) is an established surgical procedure for addressing valgus malalignment across various knee conditions. However, the effect of DFVO on stress distribution within the femorotibial joint has not been explored through in vivo studies.Purpose:To (1) explore the distribution pattern of subchondral bone density across the proximal tibia in nonarthritic knees

Background:Value-based decision-making regarding nonoperative management versus early surgical stabilization for first-time anterior shoulder instability (ASI) events remains understudied.Purpose:To perform (1) a systematic review of the current literature and (2) a Markov model–based cost-effectiveness analysis comparing an initial trial of nonoperative management to arthroscopic Bankart repair (ABR)

Background:Platelet-rich plasma (PRP) is increasingly used for the injection treatment of knee osteoarthritis (OA). However, the role of leukocytes contained in PRP is controversial, with some preclinical studies suggesting detrimental effects and others emphasizing their contribution in secreting bioactive molecules.Purpose:To compare the safety and effectiveness of leukocyte-rich PRP (LR-PRP) and

Background:Increased tibial slope has been shown to lead to higher rates of anterior cruciate ligament graft failure. A slope-decreasing osteotomy can reduce in situ anterior cruciate ligament force and may mitigate this risk. However, how this procedure may affect the length change behavior of the medial ligamentous structures is unknown.Purpose/Hypothesis:The purpose of this study was to examine

Background:Rotator cuff repair augmentation using biological materials has become popular in clinical practice to reduce the high retear rates associated with traditional repair techniques. Tissue engineering approaches, such as engineered tendon-fibrocartilage-bone composite (TFBC), have shown promise in enhancing the biological healing of rotator cuff tears in animals. However, previous studies have

Background:Injuries to the glenoid labrum have been recognized as a source of joint pain and discomfort, which may be associated with the inflammatory responses that lead to the deterioration of labral tissue. However, it is unclear whether the torn labrum prompts mast cell (MC) activation, resulting in synovial inflammatory responses that lead to labral tissue degeneration.Purpose:To determine the