33 research outputs found

    A multicenter study investigating factors that influence initiation of return to sport functional testing following ACL reconstruction

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    Despite advances in surgical technique and rehabilitation following anterior cruciate ligament (ACL) reconstruction, re-injury rates after return to play (RTP) are high. There remains controversy over the most effective criteria utilized to initiate RTP functional testing following ACL reconstruction. The purpose of this study is to investigate factors that influence provider decision to initiate RTP functional testing

    Treatment of Glenoid Chondral Defect Using Micronized Allogeneic Cartilage Matrix Implantation

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    Abstract: Focal chondral lesions of the glenohumeral joint, though less common than chondral defects in the knee or ankle, can be a significant source of pain in an active population. For patients in whom nonsurgical management fails, promising results have been reported after arthroscopic microfracture surgery to treat such lesions. However, microfracture leads to growth of fibrocartilage tissue and is biomechanically less durable than native hyaline cartilage. Recently, augmentation of the microfractured defect with micronized allogeneic cartilage and platelet-rich plasma has been described to restore hyaline-like cartilage and potentially protect the subchondral bone from postsurgical fracture biology within the base of the defect. We present a simple arthroscopic technique of implanting dehydrated, micronized allogeneic cartilage scaffold to treat an isolated chondral lesion of the glenoid. C artilage injury in the shoulder may be caused by trauma, shoulder instability, osteonecrosis, infection, chondrolysis, osteochondritis dissecans, inflammatory arthritis, rotator cuff arthropathy, and osteoarthritis. Although symptomatic glenohumeral chondral lesions in elderly and less active patients can be successfully treated with shoulder arthroplasty, focal chondral lesions in the younger, active patient population demand alternative treatment strategies that preserve the joint because of the high rate of glenoid component failure and need for revision surgery in younger patients treated with shoulder arthroplasty

    Arthroscopic Saucerization and All-Inside Repair of a Delaminated Discoid Lateral Meniscus

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    Preservation of the meniscus has been shown to influence the progression of degenerative changes of the knee. As more meniscus is preserved, the propensity for development of osteoarthritis is lessened. Surgical treatment of a torn discoid meniscus has typically been a subtotal meniscectomy or partial meniscectomy. Similar to tears of a normal meniscus, partial meniscectomy compared with subtotal meniscectomy of the discoid meniscus confers better long-term results. With the abnormal morphology predisposing the discoid meniscus to tearing, several characteristic tear patterns can be observed—the horizontal tear being commonly encountered. We present a technique that not only creates a more normal morphology of a discoid meniscus but also preserves the tissue by using an all-inside, intrameniscal repair technique. This technique restores the central rim of the meniscus in the setting of a horizontal cleavage plane, thus restoring a more normal meniscus morphology

    Single-Bundle Augmentation for a Partial Tear of the Anterior Cruciate Ligament

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    Given the prevalence of anterior cruciate ligament (ACL) tears in young athletes, it is essential to elucidate and illustrate surgical interventions that return the most favorable outcomes. Although most ACL injuries are full-thickness tears, occasionally either the anteromedial (AM) or posterolateral (PL) bundle is torn in isolation, allowing consideration of an ACL reconstruction or augmentation. Because the ACL-deficient knee has been shown to exhibit less proprioceptive feedback, the preservation of the intact bundle may offer an inherent component of stability. After arthroscopy has confirmed a partial ACL tear, the decision to augment the intact bundle can be made. The technique is adapted from principles of the double-bundle reconstruction such that the graft follows the path of either the native AM bundle or the native PL bundle, depending on the location of the partial tear. We present our surgical technique for ACL AM bundle augmentation with PL bundle reconstruction using a semitendinosus tendon autograft
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