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Table of Contents
doi : 10.1016/S0749-8063(20)31304-9
Volume 37, Issue 2, February 2021, Pages A9-A12, A14, A16
Instructions for Authors
doi : 10.1016/S0749-8063(20)31310-4
Volume 37, Issue 2, February 2021, Page A43
What Happens to a Published Article if a Cited Article Is Corrected?
James H.LubowitzM.D.Jefferson C.BrandM.D.Michael J.RossiM.D., M.S.
doi : 10.1016/j.arthro.2020.12.196
Volume 37, Issue 2, February 2021, Pages 425-426
When one considers that as many as 2.5 million scientific articles are published each year, it is likely that more than a few contain errors. Probably, most go undetected. In theory, scientific literature is self-correcting, and the truth will eventually be revealed. However, to maintain the integrity of our literature, it is best to correct errors. Fortunately, when it comes to an errant citation, most scientific citations provide background, and errors in background citations should not change the conclusion of a study. However, for systematic reviews that quantitatively synthesize published research findings in a meta-analysis, an error in (or retraction of) an included citation will affect the study results. Such errors require correction, revision of the meta-analysis, and electronic attachment of the notation to the publication.
Regarding “Intra-Articular Injections of Hyaluronic Acid or Steroid Associated With Better Outcomes Than Platelet-Rich Plasma, Adipose Mesenchymal Stromal Cell, or Placebo in Knee Osteoarthritis: A Network Meta-analysis”
BerardoDi MatteoM.D.DiegoDelgadoPh.D.MikelS?nchezM.D.Brian J.ColeM.D.Scott A.RodeoM.D.ElizavetaKonM.D.
doi : 10.1016/j.arthro.2020.05.054
Volume 37, Issue 2, February 2021, Pages 427-429
Regarding “Intra-Articular Injections of Hyaluronic Acid or Steroid Associated With Better Outcomes Than Platelet-Rich Plasma, Adipose Mesenchymal Stromal Cell, or Placebo in Knee Osteoarthritis: A Network Meta-analysis”
Eoghan T.HurleyM.B., B.Ch., M.Ch.Kirk A.CampbellM.D.
doi : 10.1016/j.arthro.2020.05.052
Volume 37, Issue 2, February 2021, Pages 430-432
Accurate Assessment of the Hill-Sachs Lesion: There Is No Information About the Accuracy of Quantification of These Lesions
Lukas P.E.VerweijB.Sc.Derek F.P.van DeurzenM.D.Michel P.J.van den BekeromM.D., Ph.D.
doi : 10.1016/j.arthro.2020.10.021
Volume 37, Issue 2, February 2021, Pages 432-433
Author Reply to “Accurate Assessment of the Hill-Sachs Lesion: There Is No Information About the Accuracy of Quantification of These Lesions”
Matthew L.VopatM.D.Liam A.PeeblesB.A.IsaakCironeB.S.TrevorMcBrideB.A.DanielleRiderB.A.Matthew T.ProvencherM.D., C.A.P.T., M.C., U.S.N.R
doi : 10.1016/j.arthro.2020.10.041
Volume 37, Issue 2, February 2021, Pages 433-434
Proximal Hamstring Tendon Injuries: Diagnosis and Management
Andrew J.SheeanM.D.aJustin W.ArnerM.D.bJames P.BradleyM.D.b
doi : 10.1016/j.arthro.2020.12.201
Volume 37, Issue 2, February 2021, Pages 435-437
Abstract: Proximal hamstring tendon injuries are common among active and athletic populations and exist on a spectrum ranging from proximal tendinopathy to partial tears to complete avulsions. Imaging should include plain radiography as bony avulsions have been observed in skeletally immature patients. Magnetic resonance imaging is diagnostic in the setting of both partial tears and complete tears. A high-intensity (on T2-weighted images), crescent-shaped signal at the tendon-bone interface (“sickle sign”) is indicative of a partial-thickness tear of the proximal hamstring tendons. In the setting of complete avulsions, magnetic resonance imaging is also useful in demonstrating the extent of tendon avulsion and quantifying the number of tendons torn. Nonoperative treatment for proximal tendinopathy, acute partial tears, and complete tears with minimal tendon retraction includes activity modification, eccentric stretching and strengthening, and potentially platelet rich plasma injections. Surgical repair should be considered for partial tears refractory to nonoperative management, acute tears with greater than 2 cm of distal retraction, and/or chronic retracted tears. The surgical approach is generally made through a transverse incision within the gluteal crease, which can be extended distally in a “T” configuration in the setting of chronic retracted tears. In the setting of chronic retracted tears, a sciatic nerve neurolysis may be required owing to scarring. Following the surgical procedure, a graduated rehabilitation protocol is commenced with the expectation for a return to full, unrestricted activities by 6 months postoperative, and excellent outcomes can be anticipated. Compared with repair of chronic tears, acute repairs have improved functional outcomes and lower re-tear rates.
The Ratio of the Transverse to Longitudinal Diameter of the Glenoid Projection Is of Good Predictive Value for Defining the Reliability of Critical Shoulder Angle in Nonstandard Anteroposterior Radiographs
JingyiHouFangqiLiXiangZhangYuanhaoZhangYapingYangYiyongTangRuiYang
doi : 10.1016/j.arthro.2020.08.036
Volume 37, Issue 2, February 2021, Pages 438-446
To investigate (1) whether measurement of the critical shoulder angle (CSA) is still reliable in some nonstandard anteroposterior radiographs; and (2) whether the ratio of the transverse to longitudinal diameter of the glenoid projection (RTL) could be used to determine the reliability of the CSA in nonstandard anteroposterior radiographs.
Editorial Commentary: Is Your Critical Shoulder Angle Accurate? Only If You Can Verify That You Have the Correct Images
Heath B.HenningerPh.D.aThomasSuterM.D.aPeter N.ChalmersM.D.a
doi : 10.1016/j.arthro.2020.11.021
Volume 37, Issue 2, February 2021, Pages 447-449
The critical shoulder angle (CSA) has been the focus of significant research related to the etiology and prognosis of rotator cuff tears in recent years, but the accuracy of CSA measurements on plain anteroposterior (Grashey) radiographs has been questioned. Research to better understand what qualifies as a “tolerable” radiograph for reliable measurement of the CSA can inform best practices for obtaining plain radiographs. Optimal measurements rely on optimal images, and knowing how much room for error there is regarding malrotation provides surgeons with unbiased criteria to rule out inadequate images.
Does an “Off-Track” Hill-Sachs Lesion That Is Misclassified as “Non-Engaging” Affect Outcomes From Bankart Repair Alone Compared With Bankart Repair Combined With Remplissage?
Yun-JaeLeeM.D.ChulKimM.D.Sung-JaeKimM.D., Ph.D.Tae-HwanYoonM.D.Jae-YongChoM.D.Yong-MinChunM.D., Ph.D.
doi : 10.1016/j.arthro.2020.09.037
Volume 37, Issue 2, February 2021, Pages 450-456
To determine how intraoperative assessment (engagement test) may affect recurrent dislocation rate and to compare the clinical outcomes, recurrence rates, and presence of on-/off-track conditions between cases that received arthroscopic Bankart repair alone (nonengaged Hill-Sachs lesion) and Bankart repair with remplissage (engaged Hill-Sachs lesion).
Editorial Commentary: Preoperative 3-Dimensional Imaging for Shoulder Instability Is Vital for Determination of Off-Track Lesions and May Indicate Bankart Repair Plus Remplissage
CAPTMatthew T.ProvencherM.D., M.C., U.S.N.R., Editorial BoardAnnalise M.PeeblesB.A.
doi : 10.1016/j.arthro.2020.11.019
Volume 37, Issue 2, February 2021, Pages 457-459
The on- and off-track concept is gaining momentum for surgeons who treat patients with anterior shoulder instability. Preoperative imaging is critical for improving our outcomes. Determination of an off-track lesion prior to surgery using 3-dimensional computed tomography allows for improvement in outcomes by indicating remplissage. Intraoperative determination with the patient under anesthesia is not as good or as accurate. However, although Bankart repair plus remplissage shows good outcomes, bony procedures such as Latarjet, distal tibia allograft, and iliac crest or other bone graft procedures are preferred for large defects. Still, perhaps it is time to truly look at posterior adjuncts to anterior instability such as remplissage in patients who have off-track lesions, even with notable bipolar bone loss.
Patient Factors Associated With Clinical Failure Following Arthroscopic Superior Capsular Reconstruction
RonGilatM.D.abEric D.HaunschildB.S.aBrady T.WilliamsM.D.aMichael C.FuM.D.aGrant E.GarriguesM.D.aAnthony A.RomeoM.D.aNikhil N.VermaM.D.aBrian J.ColeM.D., M.B.A.a
doi : 10.1016/j.arthro.2020.09.038
Volume 37, Issue 2, February 2021, Pages 460-467
To identify demographic, clinical, and radiographic factors associated with failure after superior capsular reconstruction (SCR).
Editorial Commentary: Optimizing Indications for Shoulder Superior Capsular Reconstruction: Choose the Right Patient at the Right Time!
ChristopherGibbsM.D.BrianGodshawM.D.BrysonLesniakM.D.
doi : 10.1016/j.arthro.2020.12.178
Volume 37, Issue 2, February 2021, Pages 468-469
Superior capsular reconstruction has gained popularity for the management of massive, irreparable rotator cuff tears in young patients with minimal glenohumeral arthritis. Short-term outcomes show significant improvements in pain and function. However, the failure rate has been reported to range from 3% to 36%, with higher failure rates in women and patients with subscapularis tears, a greater body mass index, lower preoperative forward flexion, a lower preoperative acromiohumeral distance, subscapularis atrophy, and advanced rotator cuff arthropathy. Inadequate restoration of the acromiohumeral distance and poor integrity of posterior remnant tissue postoperatively have also been associated with an increased risk of retear. Currently accepted indications include younger patients (aged < 65-70 years) with irreparable, massive rotator cuff tears involving the supraspinatus and infraspinatus with minimal arthritis, an intact or repairable subscapularis, and a functional deltoid without bony deficiency, stiffness, or advanced arthropathy.
The Shoulder Trans-pectoralis Arthroscopic Portal Is a Safe Approach to the Arthroscopic Latarjet Procedure: A Cadaveric Analysis
Albert S.M.DunnD.O.abStephanie C.PettersonM.P.T., Ph.D.aKevin D.PlancherM.D., M.P.H., M.S.ac
doi : 10.1016/j.arthro.2020.09.044
Volume 37, Issue 2, February 2021, Pages 470-476
To assess the proximity of neurovascular structures in a layered approach during medial portal placement and determine standardized measurements for establishing a portal medial to the coracoid used in arthroscopic Latarjet-type procedures.
Editorial Commentary: The Shoulder Transpectoralis Portal for Arthroscopic Latarjet: Medial to the Coracoid Can Also Be a Safe Side!
PascalBoileauM.D., Ph.D.aDevin B.LemmexM.D., F.R.C.S(C).b
doi : 10.1016/j.arthro.2020.12.177
Volume 37, Issue 2, February 2021, Pages 477-479
The all-arthroscopic Latarjet is gaining popularity among shoulder surgeons, although the procedure is technically demanding and potentially dangerous, placing the brachial plexus and axillary vessels at risk when using screws for fixation of the bone block from the front. Matsen once wrote that “lateral to the coracoid is the safe side, while medial to the coracoid is the suicide.” However, creation of a portal medial to the coracoid during arthroscopic reconstruction of the glenoid is needed to permit accurate positioning of the screws (parallel to the glenoid surface) and coracoid bone block (flush to the glenoid surface). Our own clinical experience with the arthroscopic Latarjet over the last decade has shown us that the safety of the arthroscopic medial transpectoralis portal depends on 3 technical considerations: (1) the portal should always be established in an outside-in fashion from anterior to posterior; (2) passing through the pectoralis major muscle with a relatively superficial trajectory, using a switching stick oriented with a 45° orientation toward the tip of the coracoid; and (3) under visual control of the anterior extra-articular subdeltoid space to end up lateral to the coracoid process. If these conditions are respected, surgeons should not worry: medial to the coracoid can also be a safe side! An inside-out technique (introducing a switching stick from posterior to anterior) is forbidden, as this would end up piercing the neurovascular structures. Once the coracoid has been osteotomized and the conjoint tendon retracted distally, all instruments passing though the transpectoral portal are directly in contact with the neurovascular structures. This is why working through the medial transpectoralis portal should be done only with the help of a cannula or half-pipe. Ideally, the transpectoral portal should not be used as a “working portal” but as a “protecting portal” instead, placing a stick or spreader to protect the neurovascular structures. To avoid working through the anterior medial portal, we have proposed a much safer alternative that consists of drilling the glenoid from posterior to anterior (using a guide and remaining inside the glenohumeral joint) and using cortical-buttons (instead of screws) for coracoid fixation. In this modern technique, the transpectoral portal makes the arthroscopic safe as it allows the introduction of a spreader to retract the subscapularis muscle and protect the neurovascular structures during transfer and fixation of the coracoid bone block.
Subacromial Balloon Spacer for Massive, Irreparable Rotator Cuff Tears Is Associated With Improved Shoulder Function and High Patient Satisfaction
FilippoFamiliariM.D.aSuresh K.NayarM.D.bRaffaellaRussoM.D.cMarcoDe GoriM.D.dFrancescoRanuccioM.D.aValerioMastroianniM.D.aErmesGiuzioM.D.aOlimpioGalassoM.D.cGiorgioGaspariniM.D.cEdward G.McFarlandM.D.bUmaSrikumaranM.D., M.B.A.b
doi : 10.1016/j.arthro.2020.09.048
Volume 37, Issue 2, February 2021, Pages 480-486
To investigate associations between clinical and demographic parameters and Constant-Murley (CM) scores after subacromial balloon placement for massive, irreparable rotator cuff tears and to evaluate implant survival, shoulder function, and patient satisfaction.
Editorial Commentary: Balloons for Rotator Cuff Tears: A Viable Treatment or Just a Bunch of Hot Air?
Benjamin G.GuevaraM.D.(Editorial Board)
doi : 10.1016/j.arthro.2020.11.018
Volume 37, Issue 2, February 2021, Pages 487-488
Rotator cuff tears are very common. They can be either traumatic or degenerative in nature. Many tears can be successfully treated nonoperatively with physical therapy or home exercises. For patients in whom conservative measures fail, there are a variety of ways to repair the rotator cuff. Despite our advances in knowledge about rotator cuff tears, improved technology, and advanced repair techniques, failure rates after surgery are still high. Large tears that are deemed irreparable can be treated with partial repair, debridement, tendon transfers such as a latissimus dorsi transfer or lower trapezius transfer, biceps tenotomy or tenodesis, superior capsular reconstruction, bridge grafting, or even arthroplasty options such as a hemiarthroplasty or reverse total shoulder arthroplasty. No technique has proved vastly superior to another, and there are many advantages and disadvantages of each surgical procedure. Add balloon spacer implantation to that list. A surgeon can now place a subacromial balloon spacer to help improve functional outcomes and reduce pain in patients with irreparable rotator cuff tears. Studies have shown promising results, with improvements in strength and range of motion, as well as reductions in pain. Outcomes have only been studied in the short term, so much is still unknown about the full effects of this treatment. More studies are needed to find out whether the results persist into the long term and to confirm that complications do not arise that may complicate future procedures such as a reverse total shoulder arthroplasty.
Superior Capsular Reconstruction Using Dermal Allograft Is a Safe and Effective Treatment for Massive Irreparable Rotator Cuff Tears: 2-Year Clinical Outcomes
Troy D.PashuckM.D.aAlan M.HiraharaM.D.dJames L.CookD.V.M., Ph.D.abcCristi R.CookD.V.M., M.S.abcWyatt J.AndersenM.S.H.S., A.T.C.dMatthew J.SmithM.D.abc
doi : 10.1016/j.arthro.2020.10.014
Volume 37, Issue 2, February 2021, Pages 489-496.e1
To evaluate functional, symptomatic, and diagnostic imaging outcomes after arthroscopic superior capsular reconstruction (SCR) using dermal allograft in patients with massive irreparable rotator cuff tears.
Editorial Commentary: Shoulder Superior Capsular Reconstruction With Dermal Allograft Is Useful for Active Patients With Massive Irreparable Rotator Cuff Tear
Adri?nCuéllarM.D.(Editorial Board)RicardoCuéllarM.D., Ph.D.
doi : 10.1016/j.arthro.2020.12.182
Volume 37, Issue 2, February 2021, Pages 497-498
Shoulder superior capsular reconstruction (SCR) with dermal allograft improves clinical outcomes in active patients with massive irreparable rotator cuff tear. SCR functions to restore the glenohumeral joint position, including humeral head depression, thus improving contact pressures. SCR is best indicated in patients with lower grades of rotator cuff arthropathy (Hamada grades 1 and 2) who are <65 years old and without pseudoparalysis. However, SCR can be indicated in very active patients older than 65. In our experience, ?70% of the times that a SCR surgery has been indicated, a direct complete repair of the supraspinatus tendon can be achieved during surgery. Thus, indications are narrow. Finally, optimal SCR graft tensioning is a complicated but a very important consideration. If the graft is unstressed, it won’t function, and if it is too tight, it will tear.
Clinical Outcomes of Arthroscopic Suprascapular Nerve Decompression for Suprascapular Neuropathy
Philip C.NolteM.D., M.A.abThomas E.WoolsonB.S.aBryant P.ElrickM.Sc.aAnna-KatharinaTrossM.D.acMarilee P.HoranM.P.H.aJonathan A.GodinM.D., M.B.A.dPeter J.MillettM.D., M.Sc.d
doi : 10.1016/j.arthro.2020.10.020
Volume 37, Issue 2, February 2021, Pages 499-507
To report clinical outcomes following arthroscopic suprascapular nerve (SSN) decompression for suprascapular neuropathy at the suprascapular and/or spinoglenoid notch in the absence of major concomitant pathology.
Editorial Commentary: Suprascapular Nerve Decompression Can Be Effective, But Should You Have the Nerve to Do It?
Sean J.MeredithM.D.Michael J.FosterM.D.R. FrankHennIIIM.D.
doi : 10.1016/j.arthro.2020.12.192
Volume 37, Issue 2, February 2021, Pages 508-509
Isolated suprascapular neuropathy that requires surgical decompression is rare. Arthroscopic suprascapular nerve decompression is an effective treatment for correctly indicated patients, but identifying which patients would benefit from decompression is challenging. While good outcomes and low complication rates after arthroscopic suprascapular nerve decompression have been reported by expert surgeons, this procedure has potential for neurovascular injury in inexperienced hands. Given the rarity of the condition, the difficulty with accurate diagnosis, and the potential risks from surgical intervention, we believe that these patients are best treated in a tertiary referral practice.
Platelet-Rich Plasma in Patients With Partial-Thickness Rotator Cuff Tears or Tendinopathy Leads to Significantly Improved Short-Term Pain Relief and Function Compared With Corticosteroid Injection: A Double-Blind Randomized Controlled Trial
Cory A.KwongM.D., FRCSCaJarret M.WoodmassM.D., FRCSCbEva M.GusnowskiM.D., M.Sc., FRCSCaAaron J.BoisM.D., M.Sc., FRCSCcJustinLeblancM.D., M.Sc., FRCSCcKristie D.MoreM.Sc.dIan K.Y.LoM.D., FRCSCc
doi : 10.1016/j.arthro.2020.10.037
Volume 37, Issue 2, February 2021, Pages 510-517
To perform a randomized controlled trial comparing platelet-rich plasma (PRP) with standard corticosteroid (CS) injection in providing pain relief and improved function in patients with rotator cuff tendinopathy and partial-thickness rotator cuff tears (PTRCTs).
Editorial Commentary: Platelet-Rich Plasma Has Advantages Over Corticosteroid for Nonoperative Treatment of Rotator Cuff Pathology: Another Step in the Right Direction
Andrew J.SheeanM.D.(Associate Editor)
doi : 10.1016/j.arthro.2020.12.194
Volume 37, Issue 2, February 2021, Pages 518-520
Lack of high-quality evidence has limited the widespread acceptance of platelet-rich plasma, bone marrow aspirate, and other therapeutics, collectively referred to as “orthobiologics,” for partial-thickness rotator cuff tears and associated tendinopathies. The existing literature is limited, among other things, by underpowered studies and imprecise descriptions of the administration and/or formulation of the platelet-rich plasma being investigated. However, recent research favors platelet-rich plasma over corticosteroid injections in the nonoperative treatment of rotator cuff pathology. In light of evidence showing a deleterious effect of corticosteroids on subsequent surgical interventions, surgeons should continue to be wary of subacromial corticosteroid injections if alternatives such as platelet-rich plasma exist. A corticosteroid injection may have been the “go-to” nonoperative intervention in the past, but platelet-rich plasma may be a more effective arrow in our quiver. Of course, the conspicuous cost differential between these 2 different injections remains a very real consideration. However, this should be weighed against the increased risk (and cost) of a revision repair in the event that a surgical repair is performed subsequent to a corticosteroid injection.
Orthopaedic Surgery Sports Medicine Fellows See Substantial Increase in Hip Arthroscopy Procedural Volume With High Variability From 2011 to 2016
Adam M.GordonB.S.David C.FlaniganM.D.Azeem TariqMalikM.B.B.S.WilliamVasileffM.D.
doi : 10.1016/j.arthro.2020.09.043
Volume 37, Issue 2, February 2021, Pages 521-527
To analyze the trends in operative experience, specifically procedures of the shoulder, hip and knee, of fellows graduating from Accreditation Council for Graduate Medical Education orthopaedic sports medicine fellowships between 2011 and 2016.
Editorial Commentary: Expansion of Hip Arthroscopy in Sports Medicine Fellowship Training: The Good, Bad, and Ugly
Dean K.MatsudaM.D.
doi : 10.1016/j.arthro.2020.10.047
Volume 37, Issue 2, February 2021, Pages 528-529
Orthopaedic sports medicine fellowship experience in hip arthroscopy is increasing rapidly (2.6-fold from 2011 to 2016), although the case numbers vary quite widely (64-fold) depending on the program. Orthopaedic providers are now able to refine diagnoses and refer or render indicated less-invasive hip treatment options, many of which yield outcomes equaling or surpassing those of open equivalents. Patients benefit. Our profession benefits. However, advanced hip arthroscopy procedures are technically challenging, and complications can be significant in inexperienced hands. For those who choose to perform hip arthroscopy after fellowship training, continuing hip arthroscopy education and skill development is essential.
Effect of Acetaminophen on Postoperative Percocet Use In Hip Arthroscopy: A Randomized Controlled Trial
David A.BloomB.A.David J.KirbyM.D.KamaliThompsonB.S.Samuel L.BaronB.S.CristCheeB.A.ThomasYoumM.D.
doi : 10.1016/j.arthro.2020.09.046
Volume 37, Issue 2, February 2021, Pages 530-536
To determine whether postoperative acetaminophen reduced narcotic consumption following hip arthroscopy for femoroacetabular impingement.
Editorial Commentary: Hip Arthroscopists Can Reduce Postoperative Opioid Use
AshleyDisantisP.T., O.C.S.aRobRoyMartinP.T., Ph.D., C.S.C.S.ab
doi : 10.1016/j.arthro.2020.11.035
Volume 37, Issue 2, February 2021, Pages 537-540
Despite the harrowing opioid crisis in the United States, the use of opioids to combat musculoskeletal pain continues to be widespread. In the setting of hip arthroscopy, approximately one-third of patients are on opioids while awaiting surgery to address the pain that results from femoracetabular impingement syndrome. In addition, the use of opioids to address pain postoperatively is common practice. With the rapid rise of hip arthroscopy in the United States, it is paramount that other modes of pain relief are promoted by surgeons in conjunction with allied health professionals, such as physical therapists. In fact, early physical therapy has been shown to decrease the use of postoperative opioids by 10%. The use of complementary and alternative therapies should be common practice in the in the orthopaedic setting to assist in reducing the number of opioids used for both pre and postoperative pain management. While this may be a small piece of the opioid crisis puzzle, it is up to all of us in the medical community to do our part and change the direction of the current opioid crisis.
Midterm Follow-Up and Assessment of Cartilage Thickness by Arthro-Magnetic Resonance Imaging After Arthroscopic Cam Resection, Labral Repair, and Rim Trimming Without Labral Detachment
CsabaForster-Horv?thM.D., Ph.D.aUlrichUnterreithmeierbSimonFriesM.D.bSimonGanalM.D.bJensGütlerM.D.bcNicoleVogelaRichard F.HerzogM.D.b
doi : 10.1016/j.arthro.2020.10.012
Volume 37, Issue 2, February 2021, Pages 541-551
To evaluate the clinical and radiological outcome, sum of acetabular and femoral cartilage thickness, and rate of failure in the midterm after arthroscopic treatment of femoroacetabular impingement (FAI) syndrome with femoral osteoplasty, labral repair, and rim trimming without labral detachment.
Editorial Commentary: Reach Over the Top and Preserve the Hip Labrum
Pablo A.SlullitelM.D.CeciliaPascual-GarridoM.D., Ph.D.(Editorial Board)
doi : 10.1016/j.arthro.2020.12.198
Volume 37, Issue 2, February 2021, Pages 552-553
There is increasing interest in fine tuning of hip arthroscopy to improve the long-term outcomes of femoroacetabular impingement (FAI) surgery. Recently, some advocated for rim trimming and labral refixation without taking down the labrum, using a so-called over-the-top technique. Although some studies have already reported on the outcomes of this procedure, very few have focused on how maintaining an unharmed chondrolabral junction may decrease cartilage wear over time. Preserving labral attachment should be the standard of care in the treatment of FAI, to keep the suction seal working normally.
Treatment of Labral Calcification in the Setting of Femoroacetabular Impingement Syndrome With Arthroscopic Calcification Excision, Labral Repair, and Osteoplasty Improves Outcomes
Kylen K.J.SorianoB.S.Sergio E.FloresM.D.Mya S.AungB.A.Thu QuynhNguyenB.S.Alan L.ZhangM.D.
doi : 10.1016/j.arthro.2020.10.033
Volume 37, Issue 2, February 2021, Pages 554-563
To describe the diagnosis and 2-year outcomes of arthroscopic treatment for labral calcification in the setting of femoroacetabular impingement syndrome (FAIS).
Editorial Commentary: Labral Calcification in the Setting of Femoroacetabular Impingement Syndrome: The Gratification of Eradication and Treatment of the Problem
Timothy J.JacksonM.D.(Associate Editor)
doi : 10.1016/j.arthro.2020.12.195
Volume 37, Issue 2, February 2021, Pages 564-565
Acetabular labral calcifications are occasionally encountered during hip arthroscopy for labral tears and femoroacetabular impingement. Clinical outcomes after removal of this calcification and repair of labral tearing have been shown to be good. Since these are found in asymptomatic patients, the labral repair and treatment of femoroacetabular impingement seem to be more important than removal of the calcification. However, amorphous calcium deposits need to be distinguished from the more serious conditions of labral ossification or rim fractures, which require significant preoperative planning and patient counseling. Labral reconstruction or rim fixation will alter the surgical procedure and potentially the postoperative rehabilitation.
Chronic Hip Injury Has a Negative Emotional Impact on the Male Athlete With Femoroacetabular Impingement
DavidFilanM.Sc.PatrickCartonM.D., F.R.C.S (Orth), F.F.S.E.M.
doi : 10.1016/j.arthro.2020.10.035
Volume 37, Issue 2, February 2021, Pages 566-576
To evaluate the impact of hip arthroscopy for femoroacetabular impingement (FAI) on both the physical and mental components of the 36-Item Short Form (SF-36) and assess how changes in health status compare with improvements in physical function and ability to continue to play (CTP) 2 years after surgery.
Editorial Commentary: Hip Femoroacetabular Impingement Emotional Impact and Mental Health: An Arthroscope Can’t Fix Everything
Davidson A.SacolickM.D.Scott C.FaucettM.D., M.S.(Editorial Board)
doi : 10.1016/j.arthro.2020.12.193
Volume 37, Issue 2, February 2021, Pages 577-578
Arthroscopic treatment of femoroacetabular impingement is increasingly common with established clinical success. As with other chronic injuries, there is an emotional impact that can affect recovery, particularly in competitive athletes. As this emotional aspect of injury is more recognized, it will be important to determine comprehensive means of treating both an athlete’s physical and mental health. It is important to establish preoperative expectations. For certain patients, psychological evaluation and treatment is indicated early in the diagnosis and recovery to ensure mental fitness, and this may be especially true for adolescents. A comprehensive and personalized approach to injury recovery is optimal.
Five-Strand Versus Four-Strand Hamstring Autografts in Anterior Cruciate Ligament Reconstruction—A Prospective Randomized Controlled Study
LingarajKrishnaM.B.B.S., M.Med. (Orth), M.R.C.S. (Edin), F.R.C.S.Ed. (Orth)aChloe XiaoyunChanM.B.B.S. (Spore), M.R.C.S. (Ire)aLakshmipathiLokaiahB.P.T.bDuraimuruganChinnasamyM.P.T., Cert.Adv Sports RehabbSaumitraGoyalM.B.B.S., M.R.C.S. (Ire), M.S. (Ortho)aMingchangWangM.B.B.S. (Spore), M.Med. (Family Medicine), F.C.F.P. (Spore)aAmritpalSinghM.B.B.S. (Spore), M.R.C.S. (Edin), M.Med. (Ortho Surg), F.R.C.S.Ed. (Orth)c
doi : 10.1016/j.arthro.2020.08.012
Volume 37, Issue 2, February 2021, Pages 579-585
To compare the clinical outcomes of the routine use of 5-strand hamstring grafts (where possible) with those of 4-strand grafts in primary anterior cruciate ligament (ACL) reconstruction.
Editorial Commentary: Multiple-Strand Hamstring Autografts for Anterior Cruciate Ligament Reconstruction: If Graft Diameter Is at Least 8 Millimeters, Bigger May Not Be Better
OrrinShermanM.D.
doi : 10.1016/j.arthro.2020.10.010
Volume 37, Issue 2, February 2021, Pages 586-587
Anterior cruciate ligament graft diameter is of concern to every orthopaedic surgeon who’s ever performed an anterior cruciate ligament reconstruction. The current standard is to obtain a graft of at least 8 mm in diameter. The 5-bundle construct is an option to increase the graft diameter in the situation in which a smaller diameter 4-strand hamstring autograft is encountered. The question is whether bigger is better once one obtains an 8-mm diameter graft.
Pseudotear Sign of the Anterior Horn of the Meniscus
Cheng-weiKangM.D.aLi-xueWuM.D.bXiao-bingPuM.D.aGangTanM.D.aChang-chaoDongM.D.aZhao-kuiYanM.D.aLeiLiuM.D., Ph.D.c
doi : 10.1016/j.arthro.2020.08.024
Volume 37, Issue 2, February 2021, Pages 588-597
To observe the morphology of the transverse geniculate ligament of the knee (TGL) by magnetic resonance imaging (MRI) and to analyze the cause of the pseudotear sign of the anterior horn of the meniscus caused by the TGL.
Editorial Commentary: False-Positive Meniscus Pseudotear on Magnetic Resonance Imaging: A False Sign That Rings True
Peter R.KurzweilM.D.
doi : 10.1016/j.arthro.2020.10.011
Volume 37, Issue 2, February 2021, Pages 598-599
The false-positive finding of anterior horn meniscus (pseudo)tear on magnetic resonance imaging (MRI) is an important finding of which to be aware. We have recently seen awareness similarly raised regarding root tears of the meniscus, which, if overlooked, could have detrimental consequences. Manifestations of the MRI finding of meniscus pseudotear arise from the variability of the insertion of the transverse geniculate ligament into the anterior horn of the lateral meniscus. Bearing in mind that anterior knee pain is a common reason that patients present for an orthopaedic and sports medicine evaluation, the understanding that this MRI finding does not represent a true meniscus tear may save patients from unnecessary arthroscopic surgery.
The Patient Acceptable Symptomatic State in Primary Anterior Cruciate Ligament Reconstruction: Predictors of Achievement
AlexanderBeletskyB.A.aEdmundNaamiB.A.bYiningLuB.A.bEvan M.PolceB.S.aBenedict U.NwachukwuM.D., M.B.A.cKelechi R.OkorohaM.D.aJorgeChahlaM.D., Ph.D.aAdam B.YankeM.D., Ph.D.aBrianForsytheM.D.aBrian J.ColeM.D., M.B.A.aNikhil N.VermaM.D.a
doi : 10.1016/j.arthro.2020.08.029
Volume 37, Issue 2, February 2021, Pages 600-605
To identify thresholds for patient acceptable symptomatic state (PASS) achievement in a cohort of primary anterior cruciate ligament reconstruction (ACLR) recipients, and to identify factors predictive of PASS achievement.
Editorial Commentary: Preoperative Exercise, Workers’ Compensation, Diabetes, Lateral Extra-Articular Tenodesis, and Return to Sport Determine Patient Satisfaction After Anterior Cruciate Ligament Reconstruction
James P.LeonardM.D.(Editorial Board)
doi : 10.1016/j.arthro.2020.11.057
Volume 37, Issue 2, February 2021, Pages 606-608
Patient-reported outcome measures (PROMs) have been developed and used as the primary determinant of successful patient-centered results. The patient acceptable symptomatic state delineates an absolute value for PROMs indicating that patients are satisfied with their outcome. When this metric is used for anterior cruciate ligament reconstruction, patients reach a satisfactory outcome at between 6 and 8 months postoperatively, and more than 90% reach a satisfactory outcome at 12 months. Preoperative variables such as preoperative exercise, Workers’ Compensation, and diabetes impact patient outcomes, whereas preoperative PROMs and use of the anteromedial portal technique for femoral tunnel drilling have a limited impact on satisfaction. Iliotibial band tenodesis shows a large impact on satisfactory outcomes; however, this result may be affected by patient demographic issues (selection bias). Ultimately, a “satisfactory” outcome is a very general term and may not necessarily apply to active athletes desiring a return to competitive sport. Thus, the patient acceptable symptomatic state should be interpreted in combination with a surgeon’s experience. Ultimately, the success of a surgical procedure could be determined, in large part, based on the patient’s individual preoperative expectations.
Hamstring Autograft Anterior Cruciate Ligament Reconstruction Using an All-Inside Technique With and Without Independent Suture Tape Reinforcement
Chad W.ParkesM.D.Devin P.LelandM.D.Bruce A.LevyM.D.Michael J.StuartM.D.Christopher L.CampM.D.Daniel B.F.SarisM.D., Ph.D.Aaron J.KrychM.D.
doi : 10.1016/j.arthro.2020.09.002
Volume 37, Issue 2, February 2021, Pages 609-616
To compare the (1) rates of complications and reoperations, (2) rate of anterior cruciate ligament (ACL) graft failure, and (3) patient-reported outcomes (PROs) among patients after hamstring autograft ACL reconstruction (ACLR) with and without independent suture tape reinforcement at a minimum 2-year clinical follow-up.
Editorial Commentary: Independent Suture Tape Reinforcement Could Be a Part of the Holy Anterior Cruciate Ligament Grail Puzzle?
Christiaan H.W.HeusdensM.D.
doi : 10.1016/j.arthro.2020.11.013
Volume 37, Issue 2, February 2021, Pages 617-618
The quest for improvement of anterior cruciate ligament (ACL) reconstruction results is a continuous struggle as we endeavor different technique adjustments that could form a missing piece of the holy ACL grail puzzle. Independent suture tape reinforcement (ISTR) is a small addition to the familiar ACL reconstruction technique with the potential to improve reconstruction results. Biomechanical studies show a decreased graft elongation and increased ultimate load to failure with ISTR. Clinical studies are scarce. In contrast to the ACL augmentation results in the 1980s, 2 retrospective comparative studies do not report negative results, which would support further research. Larger clinical trials will have to prove whether this small addition to ACL reconstruction will have a positive impact on ACL reconstruction results. For now, it is promising to note that no “red flags” have been described for ACL reconstruction with ISTR.
Pharmacologic Thromboprophylaxis Other Than Aspirin Is Associated With Increased Risk for Procedural Intervention for Arthrofibrosis After Anterior Cruciate Ligament Reconstruction
CharlesQinM.D.aMia M.QinM.D.bHaydenBakerM.D.aLewis L.ShiM.D.aJasonStrelzowaAravindAthivirahamM.D.a
doi : 10.1016/j.arthro.2020.09.019
Volume 37, Issue 2, February 2021, Pages 619-623
To compare rates of procedural intervention for arthrofibrosis following anterior cruciate ligament reconstruction (ACLR) among patients who were not prescribed any pharmacologic thromboprophylaxis compared with patients who were prescribed aspirin and to patients who were prescribed other agents.
Cost-Effectiveness Analysis of Nonoperative Management Versus Early Drilling for Stable Osteochondritis Dissecans Lesions of the Knee in Skeletally Immature Patients
Drake G.LeBrunM.D., M.P.H.aChristopher J.DeFrancescoM.D.aPeter D.FabricantM.D., M.P.H.bJohn T.R.LawrenceM.D., Ph.D.c
doi : 10.1016/j.arthro.2020.09.020
Volume 37, Issue 2, February 2021, Pages 624-634.e2
To evaluate the cost-effectiveness of a trial of nonoperative management versus early drilling in the treatment of skeletally immature patients with stable osteochondritis dissecans (OCD) of the knee.
Editorial Commentary: Early Operative Management of “Stable” Osteochondritis Dissecans Lesions Confers Greater Value in Skeletally Immature Patients
Brian R.WatermanM.D.(Associate Editor)
doi : 10.1016/j.arthro.2020.11.036
Volume 37, Issue 2, February 2021, Pages 635-637
The ideal treatment of juvenile osteochondritis dissecans (OCD) varies according to the chronicity of symptoms and radiographic classification. Traditionally, “stable” OCD lesions of the knee are managed conservatively with limited weight bearing and nonoperative care. However, this can require up to 6 to 12 months of observation, and success rates are estimated at only 59%. By contrast, recent data suggest that early subchondral drilling of OCD lesions may more consistently facilitate new vascular channels and remodeling of the compromised osteochondral unit. When considering overarching health care costs and probabilistic modeling, contemporary treatment paradigms may preferentially suggest early surgical treatment of OCD lesions for greater cost-effectiveness and an optimized timeline for a return to full activity. Additionally, surgery may be prioritized for larger lesions, atypical locations, closing physes, and/or the presence of mechanical symptoms.
Clinicoradiologic Outcomes of Medial Open-Wedge High-Tibial Osteotomy Are Equivalent in Bone-on-Bone and Non–Bone-on-Bone Medial Osteoarthritis
Bum-SikLeeM.D., Ph.D.aTae-HyukKimM.D.abSeong-IlBinM.D., Ph.D.aJong-MinKimM.D., Ph.D.aHanwookKimM.D.ac
doi : 10.1016/j.arthro.2020.09.033
Volume 37, Issue 2, February 2021, Pages 638-644
(1) To investigate whether patients with bone-on-bone (BOB) medial OA (Ahlback grade 2) had comparable clinical improvement to those with non-BOB arthritis with remaining joint space (Ahlback grades 0/1) after medial open-wedge high tibial osteotomy (MOWHTO); (2) to determine whether the radiological results differ between these 2 groups from 1 month postoperatively to last follow-up ?2 years later.
Editorial Commentary: High Tibial Osteotomy Is Effective, Even in Patients With Severe Osteoarthritis: Contradiction of Another Dogma From the Past
PhilippSchusterM.D.abJoergRichterM.D.a
doi : 10.1016/j.arthro.2020.11.025
Volume 37, Issue 2, February 2021, Pages 645-646
High tibial osteotomy is a widespread treatment option and has been performed in the treatment of osteoarthritis long before joint replacements started their triumphant era in the last third of the last century. However, osteotomies have again gained increased interest and popularity within the last 2 decades. Historically, osteotomies have mainly been recommended for early osteoarthritis and contraindicated for advanced osteoarthritis. However, over time, some historic but widespread dogmas have already been contradicted regarding high tibial osteotomy. Osteotomies are very well possible and can yield excellent outcomes, even in patients with severe osteoarthritis. Thus, another dogma from the past is contradicted.
Magnetic Resonance Imaging T2 Relaxation Times of Articular Cartilage Before and After Arthroscopic Surgery for Discoid Lateral Meniscus
KazuyaNishinoM.D.aYusukeHashimotoM.D., Ph.D.aYoheiNishidaM.D.aShinyaYamasakiM.D., Ph.D.bHiroakiNakamuraM.D., Ph.D.a
doi : 10.1016/j.arthro.2020.09.036
Volume 37, Issue 2, February 2021, Pages 647-654
To quantitatively evaluate degeneration of articular cartilage using magnetic resonance imaging (MRI) T2 mapping before and after arthroscopic surgery for discoid lateral meniscus (DLM).
Editorial Commentary: Saucerization Is Superior to Total Meniscectomy in Patients With Symptomatic Discoid Lateral Meniscus
JungtaeAhnM.D.aSang HakLeeM.D., Ph.D.(Editorial Board)b
doi : 10.1016/j.arthro.2020.11.022
Volume 37, Issue 2, February 2021, Pages 655-656
Current treatment recommendations favor meniscal rim preservation through partial meniscectomy with repair when indicated in patients with symptomatic discoid lateral menisci. Although many studies have shown the importance of meniscal rim preservation, some have shown that suture repair does not yield improved outcomes over partial meniscectomy without repair, considering the cost of repair and lack of available data. However, partial meniscectomy with repair is essential when peripheral instability is seen in patients with symptomatic discoid lateral menisci. Arthroscopic reshaping in young patients can be challenging for an inexperienced surgeon because visualization within the lateral joint space may be limited by a thickened meniscus and the small size of the pediatric knee. To preserve a stable peripheral rim, various meniscal repair methods should be used for stabilizing the reshaped meniscus on the capsule based on repair location, tear type, and surgeon preference.
An Increase in Medial Joint Space Width After Medial Open-Wedge High Tibial Osteotomy Is Associated With an Increase in the Postoperative Weight-Bearing Line Ratio Rather Than With Cartilage Regeneration: Comparative Analysis of Patients Who Underwent Second-Look Arthroscopic Assessment
Hyun-SooMoonM.D.abChong-HyukChoiM.D., Ph.D.bcJe-HyunYooM.D., Ph.D.abMinJungM.D., Ph.D.bcTae-HoLeeM.D.bdJun-WooByunM.D.cSung-HwanKimM.D., Ph.D.bd
doi : 10.1016/j.arthro.2020.09.042
Volume 37, Issue 2, February 2021, Pages 657-668.e4
To investigate relevant factors influencing increases in medial joint space width (JSW) after medial open-wedge high tibial osteotomy (MOWHTO).
Editorial Commentary: Radiographic Measurements of Knee Joint Space Are Inadequate for Demonstrating Chondral Restoration
Jason A.GrassbaughM.D.(Editorial Board)Edward D.ArringtonM.D.
doi : 10.1016/j.arthro.2020.11.012
Volume 37, Issue 2, February 2021, Pages 669-671
Orthopaedic advancements into the 21st century will increasingly focus on chondral restoration to either halt or reverse degenerative processes. Researchers and clinicians will need tools beyond patient-reported outcomes to measure the effectiveness of these treatment efforts. The use of joint space width (JSW) as a surrogate for chondral restoration is inadequate. At a minimum, such observations must standardize load transmission across the joint to be useful. Simple, readily available, standardized, and clinically useful measures of knee chondral restoration would facilitate and accelerate advances in the field. For now, it may be that improvement in JSW after chondral restoration could be attributable to changes in mechanical alignment of the knee and not the chondral restoration. JSW is an inadequate surrogate for chondral restoration, and anyone doing a stress radiograph of a unicompartmental degenerative knee recognizes this point.
A Biomechanical Study of Pivot-Shift and Lachman Translations in Anterior Cruciate Ligament-Sectioned Knees, Anterior Cruciate Ligament-Reconstructed Knees, and Knees With Partial Anterior Cruciate Ligament Graft Slackening: Instrumented Lachman Tests Statistically Correlate and Supplement Subjective Pivot-Shift Tests
Frank R.NoyesM.D.Lauren E.HuserM.Eng.MichaelPalmerM.D.
doi : 10.1016/j.arthro.2020.09.047
Volume 37, Issue 2, February 2021, Pages 672-681
To determine the statistical and predictive correlation between instrumented Lachman and pivot-shift tests with progressive loss of anterior cruciate ligament (ACL) function.
Editorial Commentary: The Pivot Shift and Lachman Examinations: Teammates With Distinct Roles
Andrew D.PearleM.D.aDanyal H.NawabiM.D.aNivMaromM.D.bThomas L.WickiewiczM.D.aCarl W.ImhauserPh.D.a
doi : 10.1016/j.arthro.2020.12.001
Volume 37, Issue 2, February 2021, Pages 682-685
The pivot shift and Lachman examinations are “teammates” with complementary but distinct roles in the successful diagnosis and treatment of anterior cruciate ligament rupture and injury to the surrounding soft-tissue envelope of the knee. The Lachman test measures anterior tibial translation in response to an applied anterior tibial load. This test assesses the integrity of the native or reconstructed anterior cruciate ligament and the secondary medial restraints including the medial meniscus and medial collateral ligament. In contrast, the pivot shift exam creates coupled tibiofemoral motions in response to a complex combination of multiplanar loads. This test assesses the stabilizing role of the native or reconstructed anterior cruciate ligament and the secondary lateral restraints including the lateral meniscus and anterolateral complex. The pivot shift grade depends not only on the soft the tissue stabilizers of the knee but also on the shape of the proximal tibia and the distal femur including lateral tibial slope and femoral condylar offset. Both examinations have unique strengths and weaknesses, but when combined as diagnostic tools, they achieve far more collectively than what each can achieve alone.
Increased Prevalence and Associated Costs of Psychiatric Comorbidities in Patients Undergoing Sports Medicine Operative Procedures
Jacqueline E.BaronM.D.Zain M.KhaziB.S.Kyle R.DuchmanM.D.Brian R.WolfM.D., M.S.Robert W.WestermannM.D.
doi : 10.1016/j.arthro.2020.10.032
Volume 37, Issue 2, February 2021, Pages 686-693.e1
To evaluate the prevalence of preoperatively diagnosed psychiatric comorbidities and the impact of these comorbidities on the healthcare costs of ten common orthopaedic sports medicine procedures.
The Effect of Combined Anterolateral and Anterior Cruciate Ligament Reconstruction on Reducing Pivot Shift Rate and Clinical Outcomes: A Meta-analysis
CaiqiXuM.D.JieboChenM.D.EunshinaeChoB.M.JinzhongZhaoM.D.
doi : 10.1016/j.arthro.2020.10.017
Volume 37, Issue 2, February 2021, Pages 694-705
To determine whether combined anterior cruciate ligament reconstruction (ACLR) and anterolateral ligament reconstruction (ALLR) result in better knee rotatory stability and postoperative clinical outcomes than ACLR alone.
Arthroscopic Bankart Repair With Remplissage in Comparison to Bone Block Augmentation for Anterior Shoulder Instability With Bipolar Bone Loss: A Systematic Review
KyleGouveiaB.Sc.aSyed KumailAbidiB.Sc.bSaifShamshoonM.D.cChetanGohalM.D.dKimMaddenPh.D.dRyan M.DegenM.D., M.Sc., F.R.C.S.C.eTimothyLerouxM.D., M.Ed., F.R.C.S.C.fBasharAlolabiM.D., M.Sc., F.R.C.S.C.dMoinKhanM.D., M.Sc., F.R.C.S.C.d
doi : 10.1016/j.arthro.2020.08.033
Volume 37, Issue 2, February 2021, Pages 706-717
The purpose of this systematic review is to examine the rates of postoperative recurrence of instability, functional outcomes, and complications after treatment with bone augmentation procedures or arthroscopic Bankart repair with remplissage for recurrent anterior shoulder instability in the setting of subcritical glenoid bone loss.
Editorial Commentary: Augmented Bankart Could Be the Right Option for Subcritical Bone Loss
AlexandreL?dermannM.D.
doi : 10.1016/j.arthro.2020.10.027
Volume 37, Issue 2, February 2021, Pages 718-719
The suitable treatment for recurrent anterior shoulder instability with subcritical glenoid bone loss remains controversial. Although the Latarjet procedure is one of the most successful surgery for shoulder instability, it has been associated with potential complications in my patients with limited bone loss and poor soft-tissue conditions, which motivated me to further investigate Bankart augmentation techniques. A myriad of them have been devised and proposed for this specific group of patients; however, there are no sufficient clinical data reported in the literature to support one of them particularly or clarify in which situation they should be used. Further comparative and prospective studies are therefore needed to build an evidence-based decision tree to help us treating our patients and better match their expectations. That said, current literature and my experience have resulted in a shift in my treatment paradigm undertaken 3 years ago to augmented Bankart in case of subcritical glenoid bone loss.
Superior Capsular Reconstruction: A Systematic Review of Surgical Techniques and Clinical Outcomes
IanGaoM.D.Kyle R.SochackiM.D.Michael T.FreehillM.D.Seth L.ShermanM.D.Geoffrey D.AbramsM.D.
doi : 10.1016/j.arthro.2020.09.016
Volume 37, Issue 2, February 2021, Pages 720-746
To evaluate surgical techniques and clinical outcomes of arthroscopic superior capsular reconstruction (SCR) for the treatment of massive irreparable rotator cuff tears.
A Systematic Review of Arthroscopic Versus Open Debridement of the Arthritic Elbow
Callum Hoy ReidWhiteB.M.B.S., B.Sc.aVinayakRavibJayWatsonM.B.Ch.B., B.Med.Sci(Hons) M.R.C.S.cShreyaBadhrinarayananB.M.B.S.dJoideepPhadnisF.R.C.S. (Tr&Orth)bc
doi : 10.1016/j.arthro.2020.09.005
Volume 37, Issue 2, February 2021, Pages 747-758.e1
To systematically review the available data with regard to clinical and functional outcomes of arthroscopic and open debridement for elbow arthritis to determine the complication rate with transition to arthroscopic surgery.
Editorial Commentary: Arthroscopic Elbow Arthritis Treatment With Osteocapsular Debridement Yields Favorable Results: On Second Thought, the Elbow Isn’t That Unforgiving
S. JoshuaSzaboM.D.(Editorial Board)
doi : 10.1016/j.arthro.2020.10.029
Volume 37, Issue 2, February 2021, Pages 759-760
The elbow has been referred to as the unforgiving joint. Arthroscopy for treating elbow arthritis is both challenging and rewarding. Most joints require arthroplasty for treatment of arthritis, but the elbow is amenable to osteocapsular debridement. This is especially beneficial when elbow arthroplasty options have high complication rates and the need for permanent physical limitations. Thus, when treating arthritis, the elbow is more forgiving than once thought.
Substantial Loss to Follow-Up and Missing Data in National Arthroscopy Registries: A Systematic Review
Thomas E.UelandB.S.aDominic S.CarreiraM.D.aRobRoy L.MartinPh.D., P.T.bc
doi : 10.1016/j.arthro.2020.08.007
Volume 37, Issue 2, February 2021, Pages 761-770.e3
To report follow-up methodologies, compliance, and existing strategies for handling missing data in national arthroscopy registries collecting patient-reported outcome measures (PROMs).
Diagnostic Performance of Artificial Intelligence for Detection of Anterior Cruciate Ligament and Meniscus Tears: A Systematic Review
Kyle N.KunzeM.D.aDavid M.RossiB.S.bGregory M.WhiteM.D.cAditya V.KarhadeM.D., M.B.A.dJieDengPh.D.cBrady T.WilliamsM.D.bJorgeChahlaM.D., Ph.D.b
doi : 10.1016/j.arthro.2020.09.012
Volume 37, Issue 2, February 2021, Pages 771-781
To (1) determine the diagnostic efficacy of artificial intelligence (AI) methods for detecting anterior cruciate ligament (ACL) and meniscus tears and to (2) compare the efficacy to human clinical experts.
Editorial Commentary: Artificial Intelligence in Sports Medicine Diagnosis Needs to Improve
Nikolaos K.PaschosM.D., Ph.D.(Associate Editor)
doi : 10.1016/j.arthro.2020.11.023
Volume 37, Issue 2, February 2021, Pages 782-783
From imaging interpretation and health monitoring to drug development, the role of artificial intelligence (AI) in medicine has increased. But AI is not ready to replace humans when it comes to the diagnosis of sports medicine conditions. Rather, in highly specialized fields such as sports medicine, when it comes to interpretation of diagnostic studies such as magnetic resonance imaging scans (that are more sophisticated than simple radiographs), experts outperform AI systems at present. Key features of clinical practice, such as the physical examination, in-person consultation, and ultimately, decision making, cannot be easily replaced. As every novel “smart” tool is incorporated into our lives, we need to be ready to embrace its use, but we also ought to be critical of its implementation and seek transparency at every step of the process. We cannot afford to see AI as an antagonistic element in our practices but rather as a valuable assistant that could someday improve diagnostic accuracy.
