Sage Orthopaedics

To determine the return-to-work, pain relief, and perioperative complication rates in a high-demand athletic cohort undergoing patellofemoral ACI. For patellofemoral chondral defects without a failed primary procedure, second-generation ACI successfully returned to work 78% of patients of moderate to very heavy occupational demand with significantly decreased patient-reported knee pain. Risk factors after ACI for patellofemoral articular lesions for overall failure were age

Five articles from the October 2018 issue summarized in five minutes, with the addition of a brief editorial commentary. The 5-in-5 feature is designed to give readers an overview of articles that may pique their interest and encourage more detailed reading. It may also be used by busy readers who would prefer a brief audio summary in order to select the articles they want to read in full. The featured articles for this month are, "Histological Evaluation of Early-Phase Changes in the Osteochondral Unit After Microfracture in a Full-Thickness Cartilage Defect Rat Model", "Is There a Pathological Gait Associated With Common Soft Tissue Running Injuries?" ,"Effect of Smoking on Healing Failure After Rotator Cuff Repair" ,and "Reduced Time to Surgery Improves Patient-Reported Outcome After Achilles Tendon Rupture"   Click here to read the articles.

Anterolateral complex injuries are becoming more recognized. While these are known to affect tibiofemoral mechanics, it is not known how they affect patellofemoral joint behavior. This work did not find that an anterolateral injury altered patellofemoral mechanics or kinematics, but adding a lateral tenodesis can elevate lateral contact pressures and induce lateral patellar tilting if the tibia is pulled into external rotation by the tenodesis. Although these in vitro changes were small and might not be relevant in a fully loaded knee, controlling the position of the tibia at graft fixation is effective in avoiding overconstraint at time zero in a lateral tenodesis.   Click here to read the article.  

Five articles from the September 2018 issue summarized in five minutes, with the addition of a brief editorial commentary. The 5-in-5 feature is designed to give readers an overview of articles that may pique their interest and encourage more detailed reading. It may also be used by busy readers who would prefer a brief audio summary in order to select the articles they want to read in full. The featured articles for this month are "Comparative Outcomes of Radial and Bucket-Handle Meniscal Tear Repair: A Propensity- Matched Analysis", "Biomechanical Deficits at the Hip in Anterior Cruciate Ligament-Reconstructed Athletes are Ameliorated with Neuromuscular Training", "Career Length and Performance Among Professional Baseball Players Returning to Play After Hip Arthroscopy", "Stabilization of Acute High-Grade Acromioclavicular Joint Separation: A Prospective Assessment of the Clavicular Hook Plate Versus the Double Double-Button Suture Procedure", and "The Effect of Suture Absorbability on Rotator Cuff Healing

Recent literature correlated anterior cruciate ligament (ACL) reconstruction failure to smaller diameter of the harvested hamstring (HS) autograft. However, this approach may be a simplification, as relation of graft size to native ACL size is not typically assessed and oversized grafts may impart their own complications. In conclusion, ACL insertion size and the CSAs of 3 commonly used grafts vary greatly for each patient and are not correlated with one another. Thus, if the reconstructed ACL size is determined by the harvested autograft size alone, native ACL size may not be adequately restored. PT grafts tended to undersize the native ACL, while QT might oversize it.   Click here to read the article.

Five articles from the August 2018 issue summarized in five minutes, with the addition of a brief editorial commentary. The 5-in-5 feature is designed to give readers an overview of articles that may pique their interest and encourage more detailed reading. It may also be used by busy readers who would prefer a brief audio summary in order to select the articles they want to read in full. The featured articles for this month are "Integrity of the Untorn Articular-Sided Tendon in Bursal-Sided Partial-Thickness Rotator Cuff Tear: A Comparative Study of Apoptotic Activity in Torn and Untorn Layers", "No difference in the KOOS Quality of Life, between anatomic Double-bundle and anatomic Single-bundle Anterior Cruciate Ligament reconstruction of the knee; a Prospective, Randomized, Controlled Trial with 2 years’ follow-up", "In Vitro Repair of Meniscus Radial Tear Using Hydrogels Seeded with Adipose Stem Cells and TGF-β3"," Septic Arthritis After Anterior Cruciate Ligament Reconstruction - How Important is Graft S

A lateral patellar dislocation (LPD) is the most common traumatic knee injury with hemarthrosis in children. The redislocation rate is high. Varying operative and nonoperative treatments have been advocated with no consensus on the best treatment. Operative repair of an MPFL injury in the acute phase in skeletally immature children with a primary traumatic LPD significantly reduced the redislocation rate but did not improve subjective or objective knee function compared with a knee brace without repair. The majority of the patients in both groups were satisfied with their knee function. There was a high representation of APIFs, which needs to be considered when evaluating the risk of redislocations.   Click here to read the article.

Five articles from the July 2018 issue summarized in five minutes, with the addition of a brief editorial commentary. The 5-in-5 feature is designed to give readers an overview of articles that may pique their interest and encourage more detailed reading. It may also be used by busy readers who would prefer a brief audio summary in order to select the articles they want to read in full. The featured articles for this month are "Anterolateral Ligament Reconstruction Protects the Repaired Medial Meniscus: A Comparative Study of 383 Anterior Cruciate Ligament Reconstructions From the SANTI Study Group With Minimum Follow-up of 2 Years", "How Variable Are Achilles Allografts Used for Anterior Cruciate Ligament Reconstruction? A Biomechanical Study", "Bone Marrow Stimulation Technique Augmented by an Ultrapurified Alginate Gel Enhances Cartilage Repair in a Canine Model", "Getting Hit by Pitch in Professional Baseball: Analysis of Injury Patterns, Risk Factors, Concussions, and Days Missed for Batters", and "Retur

Current practice patterns for the management of anterior cruciate ligament (ACL) injury favor surgical reconstruction. However, long-term outcomes may not differ between patients completing operative and nonoperative treatment of ACL injury. Differences in outcomes between operative and nonoperative treatment of patients in the United States is largely unknown, as are outcomes in long-term strength and performance measures. The current findings indicate that favorable outcomes can occur after both operative and nonoperative management approaches with the use of progressive criterion-based rehabilitation. Further study is needed to determine clinical algorithms for identifying the best candidates for surgical versus nonoperative care after ACL injury. These findings provide an opportunity to improve the educational process between patients and clinicians regarding the expected clinical course and long-term outcomes of operative and nonoperative treatment of ACL injuries.   Click here to read the article.

Five articles from the June 2018 issue summarized in five minutes, with the addition of a brief editorial commentary. The 5-in-5 feature is designed to give readers an overview of articles that may pique their interest and encourage more detailed reading. It may also be used by busy readers who would prefer a brief audio summary in order to select the articles they want to read in full. The featured articles for this month are "Low 1-Year Return-to-Sport Rate After Anterior Cruciate Ligament Reconstruction Regardless of Patient and Surgical Factors: A Prospective Cohort Study of 272 Patients", "Higher Gene Expression of Healing Factors in Anterior Cruciate Ligament Remnant in Acute Anterior Cruciate Ligament Tear", "Does Greater Trochanter Decortication Affect Suture Anchor Pullout Strength in Abductor Tendon Repairs? A Biomechanical Study", "Metal Resurfacing Inlay Implant for Osteochondral Talar Defects After Failed Previous Surgery: A Midterm Prospective Follow-up Study", and "Influences of Mental Illness,

The incidence of anterior cruciate ligament (ACL) ruptures is 2 to 4 times higher in female athletes as compared with their male counterparts. As a result, a number of recent studies have addressed the hypothesis that female and male patients sustain ACL injuries via different mechanisms. The efficacy of prevention programs may be improved by a better understanding of whether there are differences in the injury mechanism between sexes. No statistically significant differences between male and female patients were detected in the position of injury with regard to knee flexion (P = .66), valgus (P = .87), internal tibial rotation (P = .26), or anterior tibial translation (P = .18). These findings suggest that a similar mechanism results in an ACL rupture in both male and female athletes with this pattern of bone bruising.   Click here to read the article.

Five articles from the May 2018 issue summarized in five minutes, with the addition of a brief editorial commentary. The 5-in-5 feature is designed to give readers an overview of articles that may pique their interest and encourage more detailed reading. It may also be used by busy readers who would prefer a brief audio summary in order to select the articles they want to read in full. The featured articles for this month are "Operative Management of Acute Triceps Tendon Ruptures: Review of 184 Cases", "Ten-Year Results of Medial Open-Wedge High Tibial Osteotomy and Chondral Resurfacing in Severe Medial Osteoarthritis and Varus Malalignment", "The Integrity of the Acromioclavicular Capsule Ensures Physiological Centering of the Acromioclavicular Joint Under Rotational Loading", "Does Capsular Laxity Lead to Microinstability of the Native Hip?", and "Arthroscopic Surgery or Physical Therapy for Patients With Femoroacetabular Impingement Syndrome: A Randomized Controlled Trial With 2-Year Follow-up."   Click he

Matrix-based cell therapy improves surgical handling, increases patient comfort, and allows for expanded indications with better reliability within the knee joint. Five-year efficacy and safety of autologous cultured chondrocytes on porcine collagen membrane (MACI) versus microfracture for treating cartilage defects have not yet been reported from any randomized controlled clinical trial. The purpose of this study is to examine the clinical efficacy and safety results at 5 years after treatment with MACI and compare these with the efficacy and safety of microfracture treatment for symptomatic cartilage defects of the knee. Symptomatic cartilage knee defects 3 cm2 or larger treated with MACI were clinically and statistically significantly improved at 5 years compared with microfracture treatment. No remarkable adverse events or safety issues were noted in this heterogeneous patient population.   Click here to read the article.

Five articles from the April 2018 issue summarized in five minutes, with the addition of a brief editorial commentary. The 5-in-5 feature is designed to give readers an overview of articles that may pique their interest and encourage more detailed reading. It may also be used by busy readers who would prefer a brief audio summary in order to select the articles they want to read in full. The featured articles for this month are "Distal Clavicular Osteochondral Autograft Augmentation for Glenoid Bone Loss: A Comparison of Radius of Restoration Versus Latarjet Graft", "Biomechanical Evaluation of a Single- Versus Double-Tunnel Coracoclavicular Ligament Reconstruction With Acromioclavicular Stabilization for Acromioclavicular Joint Injuries", "Descriptive Epidemiology of the MOON Shoulder Instability Cohort", "Patellar Tendon Repair Augmentation With a Knotless Suture Anchor Internal Brace: A Biomechanical Cadaveric Study", and "Subacromial Local Anesthetics Do Not Interfere With Rotator Cuff Healing After Arthr

The association between preoperative tibial subchondral bone marrow lesion (BML) patterns and outcomes after isolated meniscus allograft transplantation (MAT) are unknown. The purpose of this study was to determine (1) if a superior classification means exists (ie, high interrater reliability [IRR]) for grading tibial subchondral BML before isolated MAT and (2) whether quality and/or severity of preoperative tibial subchondral BML patterns was associated with clinical outcomes and/or failure rates after isolated MAT. Nearly two-thirds of patients who undergo isolated MAT have subchondral BML on preoperative MRI. Our findings suggest that increasing BML size (Welsch et al) is correlated with worse postoperative pain measures (KOOS pain, WOMAC pain) and worse activity ratings (Marx Activity Rating Scale). Additionally, increasing disruption or depression of the normal contour of the cortical surface, with or without lesion contiguity with the subjacent articular surface (Costa-Paz et al), is correlated with gr

Five articles from the March 2018 issue summarized in five minutes, with the addition of a brief editorial commentary. The 5-in-5 feature is designed to give readers an overview of articles that may pique their interest and encourage more detailed reading. It may also be used by busy readers who would prefer a brief audio summary in order to select the articles they want to read in full. The featured articles for this month are "Use of Platelet-Rich Plasma Immediately After an Injury Did Not Improve Ligament Healing, and Increasing Platelet Concentrations Was Detrimental in an In Vivo Animal Model", "Midterm Clinical Results in Rugby Players Treated with the Bristow Procedure", "Alarmins in Frozen Shoulder: A Molecular Association Between Inflammation and Pain", "The Influence of Graft Fixation Methods on Revision Rates After Primary Anterior Cruciate Ligament Reconstruction", and "20-Year Outcomes of Anterior Cruciate Ligament Reconstruction With Hamstring Tendon Autograft: The Catastrophic Effect of Age and

Degenerative rotator cuff tears (RCTs) are generally thought to originate at the anterior margin of the supraspinatus tendon. However, a recent ultrasonography study suggested that they might originate more posteriorly than originally thought, perhaps even from the isolated infraspinatus (ISP) tendon, and propagate toward the anterior supraspinatus. The mean width of all RCTs was 11.9 ± 4.1 mm, and the mean length was 11.1 ± 5.0 mm. Histograms showed the most common location of origin to be 9 to 10 mm posterior to the biceps tendon. The histograms of groups A and B showed similar tear location distributions, indicating that the region approximately 10 mm posterior to the biceps tendon is the most common site of tear initiation. These results demonstrate that degenerative RCTs most commonly originate from approximately 9 to 10 mm posterior to the biceps tendon.   Click here to read the article.

Five articles from the February 2018 issue summarized in five minutes, with the addition of a brief editorial commentary. The 5-in-5 feature is designed to give readers an overview of articles that may pique their interest and encourage more detailed reading. It may also be used by busy readers who would prefer a brief audio summary in order to select the articles they want to read in full. The featured articles for this month are "Variation in the Medial Patellofemoral Ligament Origin in the Skeletally Immature Knee: An Anatomic Study", "Hypothermia Promotes Cell-Protective and Chondroprotective Effects After Blunt Cartilage Trauma", "Selective Debridement With Labral Preservation Using Narrow Indications in the Hip: Minimum 5-Year Outcomes With a Matched-Pair Labral Repair Control Group", "Men and Women Differ in the Biochemical Composition of Platelet-Rich Plasma", and "Hamstring Graft Incorporation According to the Length of the Graft Inside Tunnels".   Click here to read the articles.

The technique of hip arthroscopic surgery is advancing and becoming more commonly performed. However, most current reported results are limited to short-term follow-up, and therefore, the durability of the procedure is largely unknown. The purpose of this study was to perform a multicenter analysis of mid-term clinical outcomes of arthroscopic hip labral repair and determine the risk factors for patient outcomes. Patients demonstrated significant improvements in VAS, mHHS, and HOS-SSS scores after arthroscopic labral repair. However, those with Tönnis grade 2 changes preoperatively, BMI >30 kg/m2, and age >35 years at the time of surgery demonstrated significantly decreased mHHS and HOS-SSS scores at final follow-up.   Click here to read the article.

Five articles from the January 2018 issue summarized in five minutes, with the addition of a brief editorial commentary. The 5-in-5 feature is designed to give readers an overview of articles that may pique their interest and encourage more detailed reading. It may also be used by busy readers who would prefer a brief audio summary in order to select the articles they want to read in full. The featured articles for this month are "Meniscectomy and Resultant Articular Cartilage Lesions of the Knee Among Prospective National Football League Players: An Imaging and Performance Analysis", "Does the Arthroscopic Latarjet Procedure Effectively Correct “Off-Track” Hill-Sachs Lesions?", "Comparison of 2 Exercise Rehabilitation Programs for Multidirectional Instability of the Glenohumeral Joint: A Randomized Controlled Trial", "Clinical Outcomes of Knee Osteoarthritis Treated With an Autologous Protein Solution Injection: A 1-Year Pilot Double-Blinded Randomized Controlled Trial", and "Do Outcomes of Osteochondral All