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Table of Contents
doi : 10.1016/S0749-8063(21)00938-5
Volume 37, Issue 12, December 2021, Pages A9-A12
Cover Image & Video Link
doi : 10.1016/S0749-8063(21)00939-7
Volume 37, Issue 12, December 2021, Page A12
Instructions for Authors
doi : 10.1016/S0749-8063(21)00944-0
Volume 37, Issue 12, December 2021, Page A33
The Imprimatur of Peer Review
James H.LubowitzM.D.Jefferson C.BrandM.D.Michael J.RossiM.D.
doi : 10.1016/j.arthro.2021.10.005
Volume 37, Issue 12, December 2021, Pages 3387-3388
Regarding “Mobilized Peripheral Blood Stem Cells are Pluripotent and Can be Safely Harvested and Stored for Cartilage Repair”
Konstantinos I.PapadopoulosM.D., Ph.D.MantanaPaisanB.Sc.WarachayaSutheesophonM.D.ThanaTurajaneM.D.
doi : 10.1016/j.arthro.2021.09.019
Volume 37, Issue 12, December 2021, Pages 3389-3390
Regarding “Intra-Articular Mesenchymal Stromal Cell Injections Are No Different From Placebo in the Treatment of Knee Osteoarthritis: A Systematic Review and Meta-analysis of Randomized Controlled Trials”
ZhanWangM.D.XingwenHanM.D.WenjiWangM.D.
doi : 10.1016/j.arthro.2021.10.003
Volume 37, Issue 12, December 2021, Pages 3390-3391
Author Reply to “Regarding 'Intra-articular Mesenchymal Stromal Cell Injections Are No Different From Placebo in the Treatment of Knee Osteoarthritis: A Systematic Review and Meta-analysis of Randomized Controlled Trials’”
WenliDaiM.D.XiLengM.D.YingfangAoM.D., Ph.D.
doi : 10.1016/j.arthro.2021.10.004
Volume 37, Issue 12, December 2021, Pages 3391-3392
Surgical Treatment for Osteochondral Lesions of the Talus
Robert T.PowersD.O.aThomas C.DowdM.D.aEricGizaM.D.b
doi : 10.1016/j.arthro.2021.10.002
Volume 37, Issue 12, December 2021, Pages 3393-3396
Osteochondral lesions of the talus (OLT) are often associated with ankle pain and dysfunction. They can occur after ankle trauma, such as sprains or fractures, but they usually present as a continued ankle pain after the initial injury has resolved. Chronic ankle ligament instability and subsequent microtrauma may lead to insidious development of an OLT. Medial-sided lesions are more common (67%) than lateral-sided lesions. For acute lesions that are nondisplaced, nonoperative management is initially performed, with a 4-6 week period of immobilization and protected weight bearing. Symptomatic improvement results in more than 50% of patients by 3 months. Acute osteochondral talus fractures, which have a bone fragment thickness greater than 3 mm with displacement will benefit from early surgical intervention. These injuries should undergo primary repair via internal fixation with bioabsorbable compression screws 3.0 mm or smaller using at least 2 points of fixation. Acute lesions that are too small for fixation can be treated with morselization and reimplantation of the cartilage fragments. If OLTs are persistently symptomatic following an appropriate course of nonoperative treatment, various reparative and restorative surgical options may be considered on the basis of diameter, surface area, depth, and location of the lesion.
National Trends Show Declining Use of Arthroscopic Subacromial Decompression Without Rotator Cuff Repair
Daniel M.CurtisM.D.aAlexander T.BradleyM.D.bYeLinB.S.cHayden P.BakerM.D.bLewis L.ShiM.D.bJason A.StrelzowM.D.bAravindAthivirahamM.D.b
doi : 10.1016/j.arthro.2021.05.019
Volume 37, Issue 12, December 2021, Pages 3397-3404
Editorial Commentary: Denial of Payment Limits Patient Access to Musculoskeletal Procedures: What Can Willie Sutton Teach Us About the Decreasing Incidence of Acromioplasty?
Louis F.McIntyreM.D.
doi : 10.1016/j.arthro.2021.07.008
Volume 37, Issue 12, December 2021, Pages 3405-3407
Arthroscopic acromioplasty is one of the most commonly performed orthopedic surgical procedures. The indication for performing an acromioplasty has traditionally been based on the mechanical theory of impingement of the coracoacromial arch on the soft tissues of the rotator cuff footprint. Orthopedic surgeons have recommended surgically decompressing this phenomenon for six decades to eliminate shoulder pain and restore function. Recent high-level studies have cast doubt on the value of acromioplasty compared to other nonoperative treatment modalities. There is also an increased recognition and awareness that rotator cuff disease is as much a degenerative and senescent process as it is a mechanical one. There is now good evidence that the incidence of acromioplasty is falling significantly, especially in treatment scenarios that involve an intact rotator cuff. The cause of this decrease must be understood as multifactorial and related to both the clinical evidence and the economics and reimbursement policy concerning acromioplasty. Like many other high-volume and elective orthopedic surgical procedures, third-party reimbursement policy dictates patient access to treatments. Yet, current and future literature and clinical expertise determine proper indications for acromioplasty. Doctors are in the best position to indicate proper patient care.
Patients With Preoperative Clinical Depression Symptomology Experience Significant Improvements in Postoperative Pain, Function, and Depressive Symptoms Following Rotator Cuff Repair
Luke T.HessburgB.A.Alexander C.ZiedasB.S.Austin G.CrossB.S.KareemElhageB.S.Eric W.GuoB.S.NikhilYedullaB.S.DylanKoolmeesB.S.Stephanie J.MuhM.D.VasiliosMoutzourosM.D.Eric C.MakhniM.D., M.B.A.
doi : 10.1016/j.arthro.2021.05.020
Volume 37, Issue 12, December 2021, Pages 3408-3413
Anchor Arthropathy of the Shoulder Joint After Instability Repair: Outcomes Improve With Revision Surgery
Joseph J.RuzbarskyM.D.abCDRRobert A.WaltzM.D., MC, USNabAnnalise M.PeeblesB.A.bJeffrey E.WongM.D.cPetarGolijaninM.D., M.B.A.dJustin W.ArnerM.D.abLiam A.PeeblesB.A.eJonathan A.GodinM.D., M.B.A.abPeter J.MillettM.D.abMatthew T.ProvencherM.B.A., CAPT, MC, USNRab
doi : 10.1016/j.arthro.2021.05.024
Volume 37, Issue 12, December 2021, Pages 3414-3420
Editorial Commentary: Early Detection and Treatment Improves Short-Term Outcomes After Shoulder Anchor Arthropathy, but an Ounce of Prevention Is Worth a Pound of Cure
AmanDhawanM.D.(Associate Editor)
doi : 10.1016/j.arthro.2021.07.014
Volume 37, Issue 12, December 2021, Pages 3421-3422
Anchor arthropathy is a rare, but devastating, complication after arthroscopic labral repair and shoulder stabilization. Early recognition and treatment in the form of removal of anchor and suture material, loose bodies, and potential revision stabilization significantly improve short-term outcomes. The entity of anchor arthropathy may be difficult to diagnose, and a high index of suspicion is needed when a patient presents postoperatively with pain and stiffness beyond atypical for their time in rehab. In the end, while early treatment can be favorable, prevention with meticulous attention to detail on anchor placement, position, and potential use of knotless anchors is strongly recommended.
Retracted Rotator Cuff Repairs Heal With Disorganized Fibrogenesis Without Affecting Biomechanical Properties: A Comparative Animal Model Study
Sung-MinRheeM.D.aSeung-MinYounF.R.A.C.S.bYoung WanKoM.D.aTae YoonKwonM.D.aYong-KooParkM.D.cYong GirlRheeM.D.b
doi : 10.1016/j.arthro.2021.06.025
Volume 37, Issue 12, December 2021, Pages 3423-3431
Editorial Commentary: Repairing Retracted Rotator Cuff Tears: Histologically Different, but Success Still Achievable With “Failure in Continuity”
Matthew R.AkelmanM.D.Mark C.HowardM.D.Brian R.WatermanM.D., Associate Editor
doi : 10.1016/j.arthro.2021.09.004
Volume 37, Issue 12, December 2021, Pages 3432-3433
Failure after rotator cuff repair continues to occur despite advances in our understanding of the native tendon enthesis. Recurrent postoperative tendon defects are common, and the impact of nonhealing on postoperative outcomes remains controversial. Rotator cuff tears (RCT) of all patterns commonly present with some degree of retraction, and it is, therefore, critical to understand and examine the biology and biomechanics of the retracted RCT to address why a repaired tendon may fail. An article in this issue reports on retracted tears forming more disorganized fibrous tissue with similar biomechanical properties compared to nonretracted tear tissue. It provides insight into what lies “beneath the surface” after retracted rotator cuff repair, but it is unclear whether the fibrous tissue formed after their acute partial tendon excision adequately reflects the tissue found in more chronic, retracted human rotator cuff tears, particularly with varying degrees of retraction. Facilitating a more favorable “scar-forming” environment and optimizing this postoperative fibrous tissue may be crucial to improving rotator cuff repairs in the future.
Repeat Revision Hip Arthroscopy Outcomes Match That of Initial Revision But Not That of Primary Surgery for Femoroacetabular Impingement Syndrome
Robert B.BrowningM.D.aIan M.ClappM.S.aLaura M.KrivicichB.S.aBenedict U.NwachukwuM.D., M.B.A.bJorgeChahlaM.D., Ph.D.aShane J.NhoM.D., M.S.a
doi : 10.1016/j.arthro.2021.04.031
Volume 37, Issue 12, December 2021, Pages 3434-3441
Editorial Commentary: Repeat Revision Hip Arthroscopy: Unaddressed Femoroacetabular Impingement, Labral Damage, and Capsular Deficiency Are Commonly Encountered
F. WinstonGwathmeyM.D.
doi : 10.1016/j.arthro.2021.05.055
Volume 37, Issue 12, December 2021, Pages 3442-3444
The increasing use of hip arthroscopy has been accompanied by an associated increase in revision hip arthroscopy. The results of revision surgery are generally inferior to primary hip arthroscopy. When revision hip arthroscopy fails, repeat revision hip arthroscopy may be indicated. Addressing the etiology of failure of the primary and first revision surgery is fundamental to achieving optimal outcomes in repeat revision cases. Unfortunately, poorly executed previous surgery is the leading etiology of failure, with unaddressed femoroacetabular impingement, labral damage, and capsular deficiency most commonly encountered during repeat revision surgery. Complex secondary soft-tissue procedures may be required to address capsular and labral deficiency from previous surgery. Despite clinically significant improvement in repeat revision cases, results are inferior to those after primary hip arthroscopy. The best opportunity for a patient to achieve an optimal outcome is a well-executed primary surgery.
Hip Arthroscopy Volume and Reoperations in a Large Cross-Sectional Population: High Rate of Subsequent Revision Hip Arthroscopy in Young Patients and Total Hip Arthroplasty in Older Patients
NicolasCevallosB.S.Kylen K.J.SorianoB.S.Sergio E.FloresM.D.Stephanie E.WongM.D.Drew A.LansdownM.D.Alan L.ZhangM.D.
doi : 10.1016/j.arthro.2021.04.017
Volume 37, Issue 12, December 2021, Pages 3445-3454.e1
Improved Functional Outcome Scores Associated with Greater Reduction in Cam Height Using the Femoroacetabular Impingement Resection Arc During Hip Arthroscopy
Daniel J.KaplanM.D.aBogdan A.MatacheM.D. C.M., F.R.C.S.C.aJordanFriedB.M.aChristopherBurkeM.D.bMohammadSamimM.D.bThomasYoumM.D.a
doi : 10.1016/j.arthro.2021.05.014
Volume 37, Issue 12, December 2021, Pages 3455-3465
Editorial Commentary: Not Yet Convinced That the Femoroacetabular Impingement Resection (Fair) Arc Measurement Provides a “Fair” Assessment of Cam Resection Principles
Allan K.MetzB.S.Stephen K.AokiM.D.
doi : 10.1016/j.arthro.2021.07.013
Volume 37, Issue 12, December 2021, Pages 3466-3468
Trochlear Dysplasia as Shown by Increased Sulcus Angle Is Associated With Osteochondral Damage in Patients With Patellar Instability
LilahFonesB.A.aAndrew E.JimenezM.D.bChrisChengM.D.aNicoleChevalierP.A.-C.cMichael B.BrimacombePh.D.dAndrewCohenM.S.cJ. LeePaceM.D.bc
doi : 10.1016/j.arthro.2021.04.054
Volume 37, Issue 12, December 2021, Pages 3469-3476
Editorial Commentary: Stabilize the Patella to Achieve Functional Gain but Don’t Neglect the Cartilage That May Cause Long-Term Pain! Trochlear Dysplasia Plays a Role in Both
John A.GrantM.D., Ph.D., F.R.C.S.C., Dip. Sport Med.
doi : 10.1016/j.arthro.2021.06.015
Volume 37, Issue 12, December 2021, Pages 3477-3478
While trochlear dysplasia is commonly discussed as a major risk factor for recurrent patellar instability, it also has a strong relationship with the development of patellofemoral cartilage lesions. Patellofemoral instability frequently occurs in teens and young adults, and the high prevalence of associated cartilage damage unfortunately sets patients up for the progression of degenerative changes of the patellofemoral joint at an early age. The judicious use of magnetic resonance imaging can help identify the presence of chondral lesions, allowing for urgent management of associated osteochondral fractures or open discussions and patient education about the possibility of performing a cartilage restoration procedure concurrently with patellar stabilization surgery. The location and presence of patellofemoral chondral lesions should be considered when contemplating the concurrent use of tibial tubercle osteotomy as part of the patellar stabilization procedure.
Establishing the Minimal Clinically Important Difference and Patient-Acceptable Symptomatic State After Arthroscopic Meniscal Repair and Associated Variables for Achievement
BhargaviMaheshwerB.S.aStephanie E.WongM.D.bEvan M.PolceB.S.cKatlynnPauldBrianForsytheM.D.eCharlesBush-JosephM.D.eBernard R.BachM.D.eAdam B.YankeM.D., PhD.eBrian J.ColeM.D., MBAeNikhil N.VermaM.D.eJorgeChahlaM.D., Ph.D.e
doi : 10.1016/j.arthro.2021.04.058
Volume 37, Issue 12, December 2021, Pages 3479-3486
Bone Marrow Lesions on Preoperative Magnetic Resonance Imaging Correlate With Outcomes Following Isolated Osteochondral Allograft Transplantation
Hailey P.HuddlestonM.D.Stephanie E.WongM.D.William M.CregarM.D.Eric D.HaunschildB.S.Mohamad M.AlzeinB.S.Brian J.ColeM.D., M.B.A.Adam B.YankeM.D., Ph.D.
doi : 10.1016/j.arthro.2021.04.056
Volume 37, Issue 12, December 2021, Pages 3487-3497
Editorial Commentary: Bone Marrow Lesion as a Prognostic Factor for Osteochondral Allograft Transplantation of Cartilage Defects in the Knee Joint
Peter E.MüllerThomas R.Niethammer
doi : 10.1016/j.arthro.2021.07.027
Volume 37, Issue 12, December 2021, Pages 3498-3499
Bone marrow lesions (BML) can be categorized as ischemic, mechanical, or reactive. BML are associated with cartilage loss and can be interpreted as a “stress-related bone marrow edema,” and are a consequence of subchondral overload due to lack of cartilaginous cushioning and load distribution. The prevalence, depth, and cross-sectional area of BML increase with the degree cartilage defect. There is a risk that bone marrow edema will progress to subchondral cysts, and cysts are a point of no return of a BML. Thus, successful treatment of cartilage damage requires causally addressing the bone marrow edema, and it is also crucial for the therapy of the BML that cartilage damage is completely treated. A postoperative BML is associated with incomplete defect coverage due to incomplete ingrowth of the osteochondral allograft with missing closure of the cartilage surface, or insufficient containment. Ideal treatment for a circumscribed subchondral BML is a single cylinder replacing the damaged cartilage and the entire BML with an osteochondral allograft. In the case of larger defects or larger BML, successful treatment of the cartilage defect is the critical point.
Stable Lateral Meniscal Posterior Root Tears Left In Situ at Time of Anterior Cruciate Ligament Reconstruction Are of Minimal Long-Term Clinical Detriment
Sarah J.ShumborskiB.Sc., M.B.B.S.(Hons.)aLucy J.SalmonB.App.Sci.(Physio.), Ph.D.abClaire I.MonkB.App.Sci.(Exercise Physiology)aLeo A.PinczewskiM.B.B.S., F.R.A.C.S.ab
doi : 10.1016/j.arthro.2021.04.075
Volume 37, Issue 12, December 2021, Pages 3500-3506
Editorial Commentary: Meniscus Tears Seen at the Time of Anterior Cruciate Ligament Reconstruction Are Overtreated
K. DonaldShelbourneM.D.
doi : 10.1016/j.arthro.2021.06.016
Volume 37, Issue 12, December 2021, Pages 3507-3509
Meniscus tears seen at the time of anterior cruciate ligament reconstruction are usually asymptomatic, and treatment varies greatly between surgeons, with meniscus repair being used for tears that could be left in situ. Recent outcome studies of most types of lateral meniscus tears show that leaving the tears in situ can give equal or superior results. Meniscus repair being performed for degenerative medial meniscus tears does not give better results than removing the tears. As an alternative to repair, trephination through the meniscus into the peripheral capsule can create many bloody channels to promote healing. Long-term follow-up of meniscus treatment with anterior cruciate ligament reconstruction can help us understand outcomes and prevent us from overtreating tears.
Public Opinion and Expectations of Stem Cell Therapies in Orthopaedics
Richard N.PuzzitielloM.D.abJeremyDubinB.A.cMariano E.MenendezM.D.abMichael A.MovermanM.D.abNicholas R.PaganiM.D.abJustinDragerM.D.aMatthew J.SalzlerMDa
doi : 10.1016/j.arthro.2021.05.058
Volume 37, Issue 12, December 2021, Pages 3510-3517.e2
All-Cause Failure Rates Increase With Time Following Meniscal Repair Despite Favorable Outcomes: A Systematic Review and Meta-analysis
Zachariah Gene WingOwaMichelle Shi NiLawbCheng HanNgaAaron J.KrychM.D.cDaniel B.F.SarisM.D., Ph.D.cPedroDebieuxM.D., Ph.D.deKeng LinWongF.R.C.S.Ed.(Orth)afgHeng AnLinF.R.C.S.Ed.(Orth)f
doi : 10.1016/j.arthro.2021.05.033
Volume 37, Issue 12, December 2021, Pages 3518-3528
Clinical Outcomes of Revision Biceps Tenodesis for Failed Long Head of Biceps Surgery: A Systematic Review
Samuel S.RudisillB.S.Matthew J.BestM.D.Evan A.O’DonnellM.D.
doi : 10.1016/j.arthro.2021.04.063
Volume 37, Issue 12, December 2021, Pages 3529-3536
Lack of Conclusive Evidence of the Benefit of Biologic Augmentation in Core Decompression for Nontraumatic Osteonecrosis of the Femoral Head: A Systematic Review
OctavianAndronicaCesar A.HincapiébcMarco D.BurkhardaRafaelLoucasaMariosLoucasaEmanuelRiedaStefanRahmaPatrick O.Zingga
doi : 10.1016/j.arthro.2021.04.062
Volume 37, Issue 12, December 2021, Pages 3537-3551.e3
