Failed Reverse Shoulder Arthroplasty and Recommendations for Revision
AbstractPurpose of ReviewThe most common complications warranting revision consideration in reverse shoulder arthroplasty (RSA) include instability and its associated causes: infection, periprosthetic fracture, and glenoid baseplate loosening. Management of complications can be challenging and the nuances of treatment are still being elucidated. The focus of this paper is to review the treatment of the failed RSA and discuss evidence-based recommendations for revision.Recent FindingsThe most common complications requiring revision RSA are instability and infection. The causes for instability can be subdivided into three ma...
Source: Current Reviews in Musculoskeletal Medicine - January 20, 2020 Category: Orthopaedics Source Type: research

Failure of Surgery for Osteochondral Injuries of the Elbow in the Pediatric and Adolescent Population
AbstractPurpose of ReviewWith an increase in single-sport specialization, elbow injuries have become increasingly common in the pediatric and adolescent population. Osteochondritis dissecans (OCD) of the capitellum frequently requires intervention yet can be difficult to treat given high patient activity demands. The purpose of this paper is to review treatment options, understand failure rates, and provide strategies for successful revision surgery.Recent FindingsPatients at high risk for the development of this condition are involved in high-demand upper extremity activity such as baseball or gymnastics. Treatment option...
Source: Current Reviews in Musculoskeletal Medicine - January 16, 2020 Category: Orthopaedics Source Type: research

Dry Needling as a Treatment Modality for Tendinopathy: a Narrative Review
AbstractPurpose of ReviewTendinopathy describes a combination of pain, swelling, and impaired performance of the tendon and around structures. There are various treatment options for tendinopathy with unclear efficacy. Dry needling involves inserting needles into the affected tendon, and it is thought to disrupt the chronic degenerative process and encourage localized bleeding and fibroblastic proliferation. The purpose of this review is to review the use of dry needling as a treatment modality for tendinopathy.Recent FindingsThe effectiveness of dry needling for treatment of tendinopathy has been evaluated in 3 systematic...
Source: Current Reviews in Musculoskeletal Medicine - January 15, 2020 Category: Orthopaedics Source Type: research

Osteoarthritis and ACL Reconstruction —Myths and Risks
AbstractPurpose of ReviewAnterior cruciate ligament (ACL) injury is one of the most common ligamentous injuries suffered by athletes participating in cutting sports. A common misperception is that ACL reconstruction can prevent osteoarthritis (OA). The goal of this paper is to review and discuss the contributing factors for the development of OA following ACL injury.Recent FindingsThere has been interesting new research related to ACL reconstruction. As understanding of knee biomechanics following ACL injury and reconstruction has changed over time, many surgeons have changed their surgical techniques to low anterior drill...
Source: Current Reviews in Musculoskeletal Medicine - January 2, 2020 Category: Orthopaedics Source Type: research

Advances and Update on Reverse Total Shoulder Arthroplasty
AbstractPurpose of ReviewReverse total shoulder arthroplasty (RTSA) is a procedure that has been increasingly utilized since its inception over 20 years ago. The purpose of this review is to present the most up to date practice and advances to the RTSA literature from the last 5 years.Recent FindingsRecent literature on RTSA has focused on identifying complications, maximizing outcomes, and determining its cost-effectiveness. RTSA has become a valuable tool in the treatment of various shoulder pathologies from fractures to massive-irreparable rotator cuff tears. Maximizing outcomes, proper patient counseling, and limiting ...
Source: Current Reviews in Musculoskeletal Medicine - December 28, 2019 Category: Orthopaedics Source Type: research

ACL and Posterolateral Corner Injuries
AbstractPurpose of ReviewThe importance of the posterolateral corner (PLC) with respect to knee stability, particularly in the setting of anterior cruciate ligament (ACL) deficiency, has become more apparent in recent years. The purposes of this article are to review the current concepts of PLC injuries and to address their role in the ACL-deficient and ACL-reconstructed knee.Recent FindingsRecent literature demonstrates that a single staged, combined reconstruction is optimal. Studies further provide more thorough insight into avoidance of tunnel collision during the multiligament reconstruction. In total, reconstruction ...
Source: Current Reviews in Musculoskeletal Medicine - December 28, 2019 Category: Orthopaedics Source Type: research

Endoscopic Versus Open Carpal Tunnel Release
AbstractPurpose of ReviewCarpal tunnel syndrome is the most common compressive neuropathy encountered by hand and upper extremity surgeons. The predominant presentation includes symptomatic paresthesias in the median nerve distribution of the affected hand, frequently causing nocturnal disturbances. Surgical treatment requires division of the transverse carpal ligament, which can be performed through open and endoscopic means. Endoscopic techniques have evolved significantly since they were first introduced in the late 1980s. This manuscript reviews the literature to summarize the current state of carpal tunnel surgery.Rec...
Source: Current Reviews in Musculoskeletal Medicine - November 26, 2019 Category: Orthopaedics Source Type: research

Update of Risk Factors, Diagnosis, and Management of Patellofemoral Pain
AbstractPurpose of ReviewPatellofemoral pain is the most common cause of anterior knee pain. The purpose of this review is to examine the latest research on risk factors, physical examination, and treatment of patellofemoral pain to improve accuracy of diagnosis and increase use of efficacious treatment modalities.Recent FindingsThe latest research suggests patellofemoral pain pathophysiology is a combination of biomechanical, behavioral, and psychological factors. Research into targeted exercise therapy and other conservative therapy modalities have shown efficacy especially when used in combination. New techniques such a...
Source: Current Reviews in Musculoskeletal Medicine - November 26, 2019 Category: Orthopaedics Source Type: research

Reverse Total Shoulder Arthroplasty: Biomechanics and Indications
AbstractPurpose of ReviewOver the past decade, our understanding of the biomechanics of the reverse total shoulder arthroplasty (RTSA) has advanced, resulting in design adjustments, improved outcomes, and expanding indications. The purpose of this review is to summarize recent literature regarding the biomechanics of RTSA and the evolving indications for its use.Recent FindingsWhile Grammont ’s principles of RTSA biomechanics remain pillars of contemporary designs, a number of modifications have been proposed and trialed in later generations to address complications such as impingement and glenoid failure. Clinical a...
Source: Current Reviews in Musculoskeletal Medicine - November 26, 2019 Category: Orthopaedics Source Type: research

Cartilage Restoration in the Adolescent Knee: a Systematic Review
AbstractPurpose of ReviewThe purpose of this systematic review was to assess the outcomes and complications of described cartilage restoration techniques for cartilage defects (grades I to IV) in the adolescent knee.Recent Findings Eleven studies satisfied the inclusion criteria comprising 307 patients with a mean follow-up of 4.6 years (range 1–18.9 years). Study patients were treated with autologous chondrocyte implantation (ACI) (n = 98, mean age 16.0), microfracture (MFx) (n = 36, mean age 15.4), internal fixation (n = 71, mean age 13.1), osteochondral allograf...
Source: Current Reviews in Musculoskeletal Medicine - November 26, 2019 Category: Orthopaedics Source Type: research

The Relationship Between Forward Head Posture and Neck Pain: a Systematic Review and Meta-Analysis
AbstractPurpose of ReviewForward head posture (FHP) is the most common cervical postural fault in the sagittal plane that is found with different severity levels in almost all populations. Despite claims that FHP may be related to neck pain, this relation seems to be controversial. Thus, our purpose is to determine whether FHP differs between asymptomatic subjects and those with neck pain and to investigate if there is a relationship between head posture and neck pain.Recent FindingsA total of 15 cross-sectional studies were eligible for inclusion for this systematic review and meta-analysis. Ten studies compared FHP betwe...
Source: Current Reviews in Musculoskeletal Medicine - November 26, 2019 Category: Orthopaedics Source Type: research

Anterior Cruciate Ligament Injury and the Anterolateral Complex of the Knee —Importance in Rotatory Knee Instability?
AbstractPurpose of ReviewIn the setting of rotatory knee instability following anterior cruciate ligament (ACL) reconstruction, there has been a resurgence of interest in knee ’s anterolateral complex (ALC). Reconstruction or augmentation of the ALC with procedures such as a lateral extra-articular tenodesis (LET) has been proposed to reduce rotatory knee instability in conjunction with ACL reconstruction. The current review investigates the recent literature surroundin g the role of the ALC in preventing rotatory knee instability.Recent FindingsThe knee ’s anterolateral complex (ALC) is a complex structure com...
Source: Current Reviews in Musculoskeletal Medicine - November 26, 2019 Category: Orthopaedics Source Type: research

The Role of High Tibial Osteotomy in ACL Reconstruction in Knees with Coronal and Sagittal Plane Deformity
AbstractPurpose of ReviewCoronal and sagittal malalignment in the setting of anterior cruciate ligament (ACL) deficiency alters knee biomechanics and is shown to increase stress and strain on the native ACL and on the ACL graft during reconstruction. The purpose of this review was to determine the role and indications of high tibial osteotomy to correct coronal and/or sagittal plane malalignment with ACL reconstruction.Recent FindingsRecent literature illustrates that an increase in varus malalignment and increased posterior tibial slope increases the biomechanical stress that is seen in a native or reconstructed ACL graft...
Source: Current Reviews in Musculoskeletal Medicine - November 23, 2019 Category: Orthopaedics Source Type: research

Evaluation and Management of Scapular Dyskinesis in Overhead Athletes
AbstractPurpose of ReviewThis review will outline scapular function in throwing, discuss scapular dyskinesis as an impairment of function that can be associated with throwing injuries and altered performance, and present an algorithm that encompasses guidelines for evaluation and can serve as a basis for treatment.Recent FindingsOptimal scapular function is integral to optimal shoulder function. Multiple roles of the scapula in arm function and throwing have been identified while scapular dysfunction continues to be associated with various shoulder pathologies. Although scapular motion alterations may be common in overhead...
Source: Current Reviews in Musculoskeletal Medicine - November 23, 2019 Category: Orthopaedics Source Type: research

UCL Injury in the Non-throwing Athlete
AbstractPurpose of ReviewPrimarily reported in the overhead throwing athlete, ulnar collateral ligament (UCL) injuries have been extensively studied since Dr. Frank Jobe first described his technique for ulnar collateral ligament reconstruction on professional baseball pitcher Tommy John. While the framework for our understanding of UCL injury was initially established studying the repetitive valgus loading of the throwers ’ elbow, other sport-related activities in non-throwing athletes can impart similar valgus stress on the medial elbow placing the UCL at risk for injury. The purpose of this review is to evaluate t...
Source: Current Reviews in Musculoskeletal Medicine - November 21, 2019 Category: Orthopaedics Source Type: research

Bone Marrow Mesenchymal Stem Cell Therapy and Related Bone Marrow-Derived Orthobiologic Therapeutics
AbstractPurpose of ReviewThe purpose of the current article is to review the available literature related to bone marrow-derived mesenchymal stem cell therapy in the management of musculoskeletal pathologies and demonstrate the critical need for additional well-designed clinical studies.Recent FindingsIn recent years, there has been a rapid increase in interest regarding the use of bone marrow-derived mesenchymal stem cells in the treatment of musculoskeletal injury and disease. The clinical use of BM-MSCs and other forms of stem cell therapy has far outpaced the basic and translational science evidence required to elucida...
Source: Current Reviews in Musculoskeletal Medicine - November 20, 2019 Category: Orthopaedics Source Type: research

Ultrasound-Guided Ankle Lateral Ligament Stabilization
AbstractPurpose of ReviewUltrasound (US) is an increasingly popular imaging modality currently used both in clinics and operating rooms. The purpose of this review is to appraise literature describing traditional lateral ankle stabilization techniques and discuss potential advantages of US-guided ankle lateral ligament stabilization. In addition, albeit limited, we will describe our experiences in perfecting this technique.Recent FindingsTo date, the modified open Brostr öm-Gould technique remains as the gold standard surgical treatment for chronic ankle instability (CAI). In the past decade, modifications of this tec...
Source: Current Reviews in Musculoskeletal Medicine - November 20, 2019 Category: Orthopaedics Source Type: research

Outcomes Following ACL Reconstruction Based on Graft Type: Are all Grafts Equivalent?
AbstractPurpose of ReviewAnterior cruciate ligament reconstruction is one of the most common orthopedic procedures performed, accounting for over 200,000 cases annually. Despite the high prevalence, there is still much debate as to the optimal graft choice. The purpose of this review is to evaluate the current literature and discuss the reported outcomes for the most common graft choices.Recent FindingsThe most common autografts being used include bone-patellar tendon-bone (BPTB), hamstring tendon (HT), and quadriceps tendon (QT). Hamstring tendon might have a slightly higher re-tear rate when compared with BPTB (2.84 vers...
Source: Current Reviews in Musculoskeletal Medicine - November 16, 2019 Category: Orthopaedics Source Type: research

Reverse Total Shoulder Arthroplasty: Implant Design Considerations
AbstractPurpose of ReviewOur understanding of the reverse total shoulder arthroplasty (RTSA) has grown exponentially since Grammont first introduced his design in 1985. There are a multitude of implant-related variables to consider when performing RTSA. The purpose of this article is to provide a review of these design considerations.Recent FindingsCurrent literature demonstrates that the traditional Grammont prosthesis has over 90% survivorship at 10 years. Despite these promising results, there have been concerns raised over the significant rate of scapular notching observed. As a result, the traditional RTSA design has ...
Source: Current Reviews in Musculoskeletal Medicine - November 13, 2019 Category: Orthopaedics Source Type: research

Computer Navigation in Minimally Invasive Spine Surgery
AbstractPurpose of ReviewThe goal of the review is to discuss the common general applications of navigation in the context of minimally invasive spine surgery and assess its value in the published literature comparing against non-navigated or navigated techniques.Recent FindingsThere is increasing utilization of computer navigation in minimally invasive spine surgery. There is synergy between navigation and minimally invasive technologies, such that one enhances or facilitates the other, thus leading to wider applications for both. Specifically, navigation has been shown to improve performance of percutaneous pedicle screw...
Source: Current Reviews in Musculoskeletal Medicine - November 7, 2019 Category: Orthopaedics Source Type: research

Cell Therapy —a Basic Science Primer for the Sports Medicine Clinician
AbstractPurpose of ReviewThe emergence of cell-based therapies has brought much excitement to the field of orthopedic sports medicine. However, the significant inconsistency of reporting has led to the poor understanding, misinformation, and false expectations for patients and clinicians alike. In this paper, we aim to clarify the available cell-therapy treatments and summarize some of the latest research.Recent FindingsAlthough this technology is in early development, our understanding of cell biology has grown significantly over the last decade. Furthermore, it is becoming evident that tissue specificity may play a signi...
Source: Current Reviews in Musculoskeletal Medicine - November 4, 2019 Category: Orthopaedics Source Type: research

Three-Dimensional Printing in Minimally Invasive Spine Surgery
AbstractPurpose of ReviewTo summarize the recent advances in 3D printing technology as it relates to spine surgery and how it can be applied to minimally invasive spine surgery.Recent FindingsMost early literature about 3D printing in spine surgery was focused on reconstructing biomodels based on patient imaging. These biomodels were used to simulate complex pathology preoperatively. The focus has shifted to guides, templates, and implants that can be used during surgery and are specific to patient anatomy. However, there continues to be a lack of long-term outcomes or cost-effectiveness analyses. 3D printing also has the ...
Source: Current Reviews in Musculoskeletal Medicine - October 26, 2019 Category: Orthopaedics Source Type: research

Postoperative Pain Management Strategies in Hip Arthroscopy
AbstractPurpose of ReviewHip arthroscopy is a rapidly growing field due to its significant diagnostic and therapeutic value in the management of numerous hip disorders. Adequate control of postoperative pain in patients undergoing hip arthroscopy continues to be a challenging and evolving area in orthopedics. In the absence of standardized protocols for pain management in these patients, a variety of different approaches have been utilized in an effort to find a regimen that is effective at reducing postoperative pain, narcotic consumption, and cost to the patient and healthcare system. The purpose of this article, therefo...
Source: Current Reviews in Musculoskeletal Medicine - October 24, 2019 Category: Orthopaedics Source Type: research

Stem Cell Treatment for Ligament Repair and Reconstruction
AbstractPurpose of ReviewWith the rapid and ongoing evolution of regenerative and sports medicine, the use of stem/stromal cells in ligament repair and reconstruction continues to be investigated and grow. The purpose of this review was to assess available methods and formulations for stem/stromal cell augmentation as well as review early pre-clinical and clinical outcomes for these recently emerging techniques.Recent FindingsRecent literature demonstrates promising outcomes of stem/stromal cell augmentation for ligament repair and reconstruction. Multiple groups have published animal models suggesting improved healing for...
Source: Current Reviews in Musculoskeletal Medicine - October 17, 2019 Category: Orthopaedics Source Type: research

Surgical Treatment of Labral Tears: Debridement, Repair, Reconstruction
AbstractPurpose of ReviewWith the rapid growth of hip arthroscopy over the past decade, new treatment paradigms as well as recognition of new disease states have sprung forth. The ability to perform complex arthroscopic procedures of the hip such as labral augmentation and reconstruction is essential for hip arthroscopists in the revision setting, with patient selection and indications for various labral treatments the key driver for improved short- and mid-term clinical outcomes.Recent FindingsCurrent techniques have been developed to address disease states where the labrum is either unstable, torn, deficient, or otherwis...
Source: Current Reviews in Musculoskeletal Medicine - July 26, 2019 Category: Orthopaedics Source Type: research

Current Concepts in the Evaluation of the Pediatric Patient with Concussion
AbstractPurpose of the ReviewA concussion is a mild traumatic brain injury (mTBI) that results in a change in how a person feels or functions after a force transmitted to the head. Nearly 10% of all sports-related injuries are mild traumatic brain injuries. Concussion/mTBIs have accounted for more than 3 million emergency department visits between 2005 and 2009 and present as an important public health concern.Recent FindingsPhysical, cognitive, and psychological functioning are known to be affected by concussion/mTBI, and various tools are readily available to guide clinicians through the initial evaluation.SummaryEvaluat...
Source: Current Reviews in Musculoskeletal Medicine - July 24, 2019 Category: Orthopaedics Source Type: research

Innovative Approaches in the Management of Shoulder Instability: Current Concept Review
This article summarises the latest innovations and concepts in the management of shoulder instability associated with glenoid bone loss.Recent FindingsThe management of shoulder instability has undergone significant evolution in the last century with rapid strides being made in the last few decades due to the transition from open to arthroscopic techniques allowing management of pathological entities which were previously untreatable. However, there is no consensus on treatment methods, especially in the presence of glenoid bone loss. The complication profile associated with non-anatomic glenoid bony reconstruction procedu...
Source: Current Reviews in Musculoskeletal Medicine - July 23, 2019 Category: Orthopaedics Source Type: research

The Current State of Minimally Invasive Approaches to Adult Spinal Deformity
AbstractPurpose of ReviewMinimally invasive approaches to adult spinal deformity (ASD) surgery have seen a large increase in popularity over the last decade, largely because these techniques are viewed as a potential improvement to the lengthy recovery and high complication rates observed after traditional open surgery for this pathology. The purpose of this review is to present a summary of the latest minimally invasive techniques used in adult spinal deformity surgery, examine whether MIS surgery can accomplish the goals of ASD surgery, and investigate whether MIS surgery is safer than traditional approaches.Recent Findi...
Source: Current Reviews in Musculoskeletal Medicine - July 16, 2019 Category: Orthopaedics Source Type: research

A Systematic Review of Complications Following Minimally Invasive Spine Surgery Including Transforaminal Lumbar Interbody Fusion
AbstractPurpose of ReviewTo assess complications after minimally invasive spinal surgeries including transforaminal lumbar interbody fusion (MI-TLIF) by reviewing the most recent literature.Recent FindingsCurrent literature demonstrates that minimally invasive surgery (MIS) in spine has improved clinical outcomes and reduced complications when compared with open spinal procedures. Recent studies describing MI-TLIF primarily for degenerative disk disease, spondylolisthesis, and vertebral canal stenosis cite over 89 discrete complications, with the most common being radiculitis (ranging from 2.8 to 57.1%), screw malposition ...
Source: Current Reviews in Musculoskeletal Medicine - July 13, 2019 Category: Orthopaedics Source Type: research

Management of High Energy Distal Radius Injuries
AbstractPurpose of ReviewHigh energy distal radius are commonly multi-fragmentary with significant comminution and/or bone loss. They can also be associated with ligamentous and soft tissue injury and neurovascular compromise. As such, reconstruction of these injuries can be challenging. This paper will review the relevant anatomy, different methods of fixation, and present techniques for difficult fractures.Recent FindingsVolar locked plating is a successful, very common method of treatment for distal radius fractures, but dorsal plating, fragment specific fixation, spanning bridge plating, and external fixation are somet...
Source: Current Reviews in Musculoskeletal Medicine - July 13, 2019 Category: Orthopaedics Source Type: research

Outcomes for Surgical Treatment of Femoroacetabular Impingement in Adults
AbstractPurpose of reviewTo assess the outcomes of modern techniques for arthroscopic surgery in the treatment of femoroacetabular impingement.Recent findingsWhile initially approached by means of open surgical hip dislocation, recent literature has shown generally good outcomes of arthroscopic treatment for femoroacetabular impingement. Modern advances in hip arthroscopy technique and implants now allow for labral repair or reconstruction when indicated.SummaryArthroscopic treatment of femoroacetabular impingement results in significant improvements in patient pain and function, with low complication rates and high patien...
Source: Current Reviews in Musculoskeletal Medicine - July 10, 2019 Category: Orthopaedics Source Type: research

Outcome After Anterior Cruciate Ligament Revision
AbstractPurpose of ReviewTo describe the current literature related to anterior cruciate ligament (ACL) revision in terms of surgical aspects, graft choices, concomitant injuries, patient-reported outcome, return to sport, and objective measurement outcome.Recent FindingsAn ACL rupture is a common knee injury, and the number of primary ACL reconstructions is increasing, implying a subsequent increase of ACL revisions in the future. It is widely accepted that an ACL revision is surgically challenging with a myriad of graft options to choose from. In many cases, simultaneous injuries to the index limb including meniscal and ...
Source: Current Reviews in Musculoskeletal Medicine - July 8, 2019 Category: Orthopaedics Source Type: research

Contemporary Management of the Hip Capsule During Arthroscopic Hip Preservation Surgery
AbstractPurpose of ReviewThe importance of the hip capsule and its effect on hip biomechanics, functional outcomes, and hip arthroscopy success rates has been demonstrated in recent studies. These results have led to a shift in management of the hip capsule, where an increasing number of surgeons routinely perform complete capsular closure. The purpose of this review is to highlight recent studies evaluating the hip capsule and describe contemporary capsular management and repair.Recent FindingsBiomechanical studies using cadaveric models have demonstrated that complete capsular closure restores hip distraction, rotation, ...
Source: Current Reviews in Musculoskeletal Medicine - July 5, 2019 Category: Orthopaedics Source Type: research

Etiology and Pathomechanics of Femoroacetabular Impingement
AbstractPurpose of reviewFemoroacetabular impingement is a common cause of hip pain in young patients and has been shown to progress to osteoarthritis. The purpose of this review is to better understand the development of femoroacetabular impingement.Recent findingsRecent literature shows little genetic transmission of FAI. However, molecular studies show strong similarities with the cartilage in osteoarthritis. The development of cam lesions has a strong association with sports participation, particularly at the time of physeal closure suggesting abnormal development. Lumbar, pelvis, and femoral biomechanics may also play...
Source: Current Reviews in Musculoskeletal Medicine - July 5, 2019 Category: Orthopaedics Source Type: research

Review of Shoulder Range of Motion in the Throwing Athlete: Distinguishing Normal Adaptations from Pathologic Deficits
AbstractPurpose of ReviewOverhand (OH) throwers demonstrate a unique motion profile of the shoulder joint complex. This manuscript reviews normal adaptations in the OH thrower and contrast findings with pathologic motion deficits.Recent FindingsMultiple adaptations in range of motion have been associated with increased risk for arm injury. The use of a more conservative cutoff value for glenohumeral internal rotation deficit and horizontal adduction in younger throwers may help reduce injury risk. Deficits in glenohumeral internal rotation, total range of motion, shoulder flexion, and external rotation insufficiency have a...
Source: Current Reviews in Musculoskeletal Medicine - July 1, 2019 Category: Orthopaedics Source Type: research

Surgical Treatment for FAI: Arthroscopic and Open Techniques for Osteoplasty
AbstractPurpose of ReviewTo review the relevant literature and techniques regarding arthroscopic and open treatment of femoroacetabular impingement (FAI). To discuss both the senior authors ’ preferred method of arthroscopic and open treatment of FAI.Recent FindingsRoutine treatment of FAI has moved away from open techniques and is more focused arthroscopic methods. Arthroscopic treatment of FAI has more recently focused on differing techniques of hip access and capsular management. Open techniques still have a role in FAI, but indications for open management are focused on cases with more severe pathology.SummaryWhi...
Source: Current Reviews in Musculoskeletal Medicine - July 1, 2019 Category: Orthopaedics Source Type: research

The Clinical Use of Biologics in the Knee Lesions: Does the Patient Benefit?
AbstractPurpose of ReviewOverview the outcomes of the latest use of platelet-rich plasma (PRP) for the treatment of knee lesions in the clinics and discuss the challenges and limitations.Recent FindingsRecent clinical studies mainly indicate there may be benefit of PRP usage for the treatment of knee lesions. As an autologous source of bioactive components, PRP has been shown to be typically safe, free of major adverse outcomes. The use of PRP has been continuously increasing, and some well-designed, double-blinded, placebo-controlled clinical trials have been published.SummaryClinical outcomes relating to PRP usage are mu...
Source: Current Reviews in Musculoskeletal Medicine - June 28, 2019 Category: Orthopaedics Source Type: research

Economic Value in Minimally Invasive Spine Surgery
AbstractPurpose of ReviewThe field of spine surgery remains a unique target in the transition to value-based care. While spine surgery has benefited from new medical technologies, including minimally invasive surgery (MIS), these technologies may be a key driver in rising US healthcare costs. As such, MIS needs to clear an economic value threshold through a rigorous evaluation of the outcomes they provide and costs they incur. In this article, we review recent MIS surgery literature from the perspective of economic value.Recent FindingsMany studies report modest all-in cost savings and direct procedural cost equivalence fo...
Source: Current Reviews in Musculoskeletal Medicine - June 24, 2019 Category: Orthopaedics Source Type: research

Transforaminal full-endoscopic lumbar discectomy under local anesthesia in awake and aware conditions: the inside-out and outside-in techniques
We described two types of the TELD in this review. Surgeons should be familiar with the inside-out and outside-in techniques for TELD; therefore, we can select appropriate technique for each case. (Source: Current Reviews in Musculoskeletal Medicine)
Source: Current Reviews in Musculoskeletal Medicine - June 24, 2019 Category: Orthopaedics Source Type: research

Emerging Technologies in Distal Radius Fracture Fixation
AbstractPurpose of ReviewTo provide an overview of emerging fixation constructs and materials used in the operative management of distal radius fractures.Recent FindingsThe indications, advantages, and disadvantages of relatively new implants and devices used to treat distal radius fractures are discussed. These include the intramedullary nail, intramedullary cage, radiolucent volar locking plate, distal radius hemiarthroplasty, and bone graft substitutes.SummaryThe spectrum of distal radius fracture patterns may make it impossible to depend on a single device for fixation, and surgeons managing distal radius fractures sho...
Source: Current Reviews in Musculoskeletal Medicine - June 22, 2019 Category: Orthopaedics Source Type: research

Lateral and Oblique Lumbar Interbody Fusion —Current Concepts and a Review of Recent Literature
AbstractPurposeTo review the relevant recent literature regarding minimally invasive, lateral, and oblique approaches to the anterior lumbar spine, with a particular focus on the operative and postoperative complications.MethodsA literature search was performed on Pubmed and Web of Science using combinations of the following keywords and their acronyms: lateral lumbar interbody fusion (LLIF), oblique lateral interbody fusion (OLIF), anterior-to-psoas approach (ATP), direct lateral interbody fusion (DLIF), extreme lateral interbody fusion (XLIF), and minimally invasive surgery (MIS). All results from January 2016 through Ja...
Source: Current Reviews in Musculoskeletal Medicine - June 22, 2019 Category: Orthopaedics Source Type: research

Management of Congenital Pseudoarthrosis of the Tibia and Fibula
AbstractPurpose of ReviewCongenital pseudoarthrosis of the tibia and fibula are rare conditions that share common treatment strategies. The purpose of this review is to provide an overview of the recent developments in treatments for both conditions.Recent FindingsRecent literature has focused on the use of BMP and on gait analysis as a tool for measuring long-term functional outcomes. Recent study has indicated rhBMP-2 may shorten the time to initial healing of pseudoarthroses, but not guarantee bony union. Children with initial fractures before the age of four have been shown to have long-term gait outcomes that may be u...
Source: Current Reviews in Musculoskeletal Medicine - June 22, 2019 Category: Orthopaedics Source Type: research

Outcomes of Meniscus Repair in Children and Adolescents
AbstractPurpose of ReviewThe purpose of this study was to review the clinical and functional outcomes of meniscus repair in children and adolescents.Recent FindingsThe sequel of meniscal tears and the outcome of meniscus repair have been well studied in adults. However, these topics have received less attention in the pediatric population despite the high prevalence and potentially critical effect on long-term knee function in children.SummaryMeniscus repair has a healing rate ranging from 33 to 100% with less than 40% reoperation rate. Several factors have been suggested to play a role in healing, such as concomitant ACL ...
Source: Current Reviews in Musculoskeletal Medicine - May 23, 2019 Category: Orthopaedics Source Type: research

A Clinician ’s Guide to Analysis of the Pitching Motion
AbstractPurpose of reviewThis review examines recent literature regarding analysis of the throwing motion in baseball players and how modern technology may be used to predict or prevent injury.Recent findingsProper throwing technique is vitally important to prevent injury and it is easier to correct poor mechanics prior to foot strike. Recent findings suggest that the inverted-W position may not lead to an increased risk of injury, but incorrect trunk or pelvis rotation does. Three-dimensional motion analysis in a laboratory setting is most commonly used to evaluate the throwing motion, but it does not allow for assessment...
Source: Current Reviews in Musculoskeletal Medicine - May 6, 2019 Category: Orthopaedics Source Type: research

Robotic Guidance in Minimally Invasive Spine Surgery: a Review of Recent Literature and Commentary on a Developing Technology
AbstractPurpose of ReviewMinimally invasive spine surgery (MIS) and robotic technology are growing in popularity and are increasing utilized in combination. The purpose of this review is to identify the current successes, potential drawbacks, and future directions of robotic guidance for MIS compared to traditional techniques.Recent FindingsRecent literature highlights successful incorporation of robotic guidance in MIS as a consistently accurate method for pedicle screw placement. With a short learning curve and low complication rates, robot guidance may also reduce the use of fluoroscopy, operative time, and length of ho...
Source: Current Reviews in Musculoskeletal Medicine - April 29, 2019 Category: Orthopaedics Source Type: research

Outcomes Associated with Return to Sports Following Osteochondral Allograft Transplant in the Knee: a Scoping Review
AbstractPurpose of ReviewThe purposes of this review were to report the currently validated outcomes for OCA transplant patients, discuss the benefits and challenges associated with “return to sports” as an outcome measure, and summarize the currently available data on patients’ ability to return to sports after OCA transplant.Recent FindingsCollege athletes may take less time than professionals to return to basketball, but there are many factors that can influence this timeframe. Player productivity is decreased ~  40% and future career length is only 1 to 2 years following return to play. Wh...
Source: Current Reviews in Musculoskeletal Medicine - April 29, 2019 Category: Orthopaedics Source Type: research

Hand and Wrist Injuries in Tennis Players
AbstractPurpose of ReviewThe purpose of this article is to review common hand and wrist injuries experienced by tennis players.Recent FindingsA myriad of different wrist pathologies can be seen in tennis players ranging from metacarpal and carpal stress fractures to triangular fibrocartilage injuries and ulnar impaction. These vary depending upon the nature of the player, stroke mechanics, and time point within the season.SummaryA broad differential should guide work-up and management of wrist pain in tennis players. (Source: Current Reviews in Musculoskeletal Medicine)
Source: Current Reviews in Musculoskeletal Medicine - April 27, 2019 Category: Orthopaedics Source Type: research

ACL Reconstruction with Augmentation: a Scoping Review
AbstractPurpose of ReviewWe reviewed the recent literature to identify and summarize new research surrounding anterior cruciate ligament reconstruction (ACLR) with augmentation in the form of additional soft tissue procedures or biologic augmentation. Specifically, we wanted to review the failure rates of these procedures in both the primary and revision settings.MethodsThe databases Embase, PubMed, and Medline were searched on August 13, 2018, for English-language studies that reported on the use of anterior cruciate ligament reconstruction (primary and revision) in conjunction with either soft tissue or biologic augmenta...
Source: Current Reviews in Musculoskeletal Medicine - April 3, 2019 Category: Orthopaedics Source Type: research

Current concepts in neuromuscular scoliosis
AbstractPurpose of ReviewSpinal deformity is a common issue in pediatric patients with an underlying neurological diagnosis or syndrome. Management of neuromuscular scoliosis (NMS) is a major part of the orthopedic care of such patients, as the deformity is often progressive, and may affect gait, seating and positioning. In addition, untreated large spinal deformities may be associated with pain and/or cardiopulmonary issues over time.Recent FindingsRecent changes in medical management of the underlying disease process appears to alter the natural history of certain neuromuscular conditions, and in the case of patients wit...
Source: Current Reviews in Musculoskeletal Medicine - April 2, 2019 Category: Orthopaedics Source Type: research

Combined Anterior Cruciate Ligament and Medial Collateral Ligament Knee Injuries: Anatomy, Diagnosis, Management Recommendations, and Return to Sport
AbstractPurpose of reviewThe diagnosis and management of combined anterior cruciate ligament (ACL) and medial collateral ligament (MCL) injuries have been a controversial topic for several decades. No single approach has proven optimal for treatment and there is no consensus between most specialists. This review seeks to describe and clarify the current state and the future of management.Recent findingsMost authors agree on reconstructing of the ACL with non-operative management of the MCL in grade I and II injuries, respectively. However, controversy still exists about the optimal method of treating a combined ACL with hi...
Source: Current Reviews in Musculoskeletal Medicine - March 30, 2019 Category: Orthopaedics Source Type: research