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Disparities in ACL Reconstruction: the Influence of Gender and Race on Incidence, Treatment, and Outcomes
AbstractPurpose of ReviewAnterior cruciate ligament (ACL) rupture is a common injury that has important clinical and economic implications. We aimed to review the literature to identify gender, racial and ethnic disparities in incidence, treatment, and outcomes of ACL injury.Recent FindingsFemales are at increased risk for ACL injury compared to males. Intrinsic differences such as increased quadriceps angle and increased posterior tibial slope may be contributing factors. Despite lower rates of injury, males undergo ACL reconstruction (ACLR) more frequently. There is conflicting evidence regarding gender differences in gr...
Source: Current Reviews in Musculoskeletal Medicine - December 31, 2021 Category: Orthopaedics Source Type: research

Total Knee Arthroplasty and Intra-Articular Pressure Sensors: Can They Assist Surgeons with Intra-Operative Decisions?
AbstractPurpose of ReviewSoft tissue imbalance, presenting as instability or stiffness, is an important cause of revision total knee arthroplasty (TKA). Traditional methods of determining soft tissue balance of the knee lack precision and are not reliable between operators. Use of intra-operative pressure sensors offers the potential to identify and avoid soft tissue imbalance following TKA. This review aims to summarise the literature supporting the clinical indication for the use of intra-articular pressure sensors during TKA.Recent FindingsAnalytical validation studies suggest that intra-operative pressure sensors demon...
Source: Current Reviews in Musculoskeletal Medicine - December 28, 2021 Category: Orthopaedics Source Type: research

Managing Bone Loss in Shoulder Instability —Techniques and Outcomes: a Scoping Review
AbstractPurpose of ReviewThe aim of this scoping review is to provide an overview of the literature published over the past 5 years related to the management of bone loss in anterior shoulder instability.Recent FindingsDuring recent years, there has been a focus on patients at high risk for failure following soft tissue anterior stabilization (Bankart repair). A growing body of evidence suggests that anterior capsulolabral repair is insufficient in the setting of subcritical glenoid bone loss with an off-track Hill Sachs lesion. In such cases, the addition of a remplissage procedure to a Bankart repair or a bone-block augm...
Source: Current Reviews in Musculoskeletal Medicine - December 28, 2021 Category: Orthopaedics Source Type: research

Hamate Body Fractures: a Comprehensive Review of the Literature
AbstractPurpose of ReviewDue to the rarity and often discrete nature of hamate body fractures, timely diagnosis requires a high level of suspicion on the part of the clinician. Here, the authors have compiled the findings from 6 cohort studies and 33 case reports describing hamate body fractures in order to summarize the natural history, management, and outcomes of these infrequent injuries.Recent FindingsFractures of the hamate body typically occur in the coronal plane through axial loading of the metacarpals or loading in the transverse plane by a compressive force. Standard radiographs of the wrist frequently miss hamat...
Source: Current Reviews in Musculoskeletal Medicine - December 21, 2021 Category: Orthopaedics Source Type: research

Current Concepts in Anterior Tibial Closing Wedge Osteotomies for Anterior Cruciate Ligament Deficient Knees
AbstractPurpose of ReviewAnterior closing wedge osteotomies (ACWO) are utilized to better restore knee stability and in situ forces on anterior cruciate ligament (ACL) grafts during ACL revision reconstruction while reducing the risk of retearing and subsequent revision procedures. However, clinical outcomes following ACWO for patients undergoing ACL reconstruction remains largely limited. The purpose of this review was to provide a concise overview of the current literature on indication, techniques, and outcomes following ACWO in ACL-deficient patients undergoing primary or revision ACL reconstruction while discussing th...
Source: Current Reviews in Musculoskeletal Medicine - December 15, 2021 Category: Orthopaedics Source Type: research

Medial Patellofemoral Ligament Reconstruction Techniques and Outcomes: a Scoping Review
AbstractPurpose of ReviewThe purpose of this scoping literature review was to summarize the current evidence on techniques and outcomes following MPFL reconstruction including sources of evidence, key concepts, and gaps in the literature.Recent FindingsA thorough electronic database search included studies published from 2016 to April 26, 2021, identified a total of 144 peer reviewed articles. Of the 144 identified clinical papers, 80 (56%) were of level IV evidence, 49 (34%) were of level III evidence, 11 (8%) were level II evidence, and 4 (3%) were level I evidence. Overall, 10,710 patients (11,466 knees) were included w...
Source: Current Reviews in Musculoskeletal Medicine - December 11, 2021 Category: Orthopaedics Source Type: research

Hip Labral Reconstruction: Techniques and Outcomes
AbstractPurpose of ReviewWith increased understanding of the biomechanical function of the acetabular labrum, more attention has been directed towards surgical techniques that preserve or restore normal joint anatomy. While labral repair has been shown to produce superior outcomes to labral debridement, repair is not always possible in the setting of severe labral intrasubstance tearing or deficiency. These patients were previously left without suitable arthroscopic treatment options.Recent FindingsLabral reconstruction is an emerging procedure that has been shown to offer promising outcomes for traditionally difficult-to-...
Source: Current Reviews in Musculoskeletal Medicine - November 20, 2021 Category: Orthopaedics Source Type: research

Hip Capsular Deficiency —A Cause of Post-surgical Instability in the Revision Setting Following Hip Arthroscopy for Femoroacetabular Impingement
AbstractPurpose of ReviewTo characterize current concepts in capsular repair and hip instability, and examine findings from biomechanical and clinical studies on hip capsular management strategies as they pertain to hip stability, patient outcomes, and hip arthroscopy failure. Further, we discuss the clinical evaluation and treatment of capsular deficiency.Recent FindingsThere remains debate regarding the optimal capsular management strategies in hip arthroscopy, particularly concerning the necessity of routine capsular repair. A variety of capsulotomy techniques exist and may be used to access the hip joint. Additionally,...
Source: Current Reviews in Musculoskeletal Medicine - November 17, 2021 Category: Orthopaedics Source Type: research

Biological Augments for Acetabular Chondral Defects in Hip Arthroscopy —A Scoping Review of the Current Clinical Evidence
AbstractPurpose of ReviewA wide array of joint-preserving surgical techniques exists in the management of acetabular chondral defects (ACDs). The purpose of this review is to summarize the clinical outcomes of the recent biologics used to treat ACDs during hip arthroscopy.Recent FindingsIncreasing evidence is available for different biological solutions used in the hip. Studies have shown promising outcomes with minimal complications when using biologics as augmentation to microfracture (MF), including different scaffolds or stem cells, or to enhance autologous chondrocyte implantation (ACI). However, data so far is scarce...
Source: Current Reviews in Musculoskeletal Medicine - November 15, 2021 Category: Orthopaedics Source Type: research

Quadricep ACL Reconstruction Techniques and Outcomes: an Updated Scoping Review of the Quadricep Tendon
AbstractPurpose of ReviewThe purpose of this review is to provide an up-to-date summary on the most recent literature examining techniques and outcomes in anterior cruciate ligament (ACL) reconstruction using quadriceps tendon (QT) which will enable surgeons to make well informed evidence-based decisions when choosing a particular graft option and technique in ACL reconstruction.Recent FindingsSeveral RCTs and systematic reviews have been published recently on this topic, and overall, there were no differences found between the QT, HT, and BPTB groups in patient-reported outcomes, stability testing, or graft re-rupture rat...
Source: Current Reviews in Musculoskeletal Medicine - November 10, 2021 Category: Orthopaedics Source Type: research

Perioperative Management of Immunosuppressive Medications in Rheumatic Disease Patients Undergoing Arthroscopy
AbstractPurpose of ReviewThis manuscript reviews relevant prior literature regarding management of immunosuppressants in patients with rheumatic diseases around the time of orthopedic surgery, highlighting important considerations specifically regarding arthroscopy.Recent FindingsUtilization rates of arthroscopic surgery in patients with rheumatic diseases are on the rise, as immunosuppressive treatment options enable them to lead more active lives and hence experience more injuries. Physicians regularly manage patients ’ glucocorticoids and conventional synthetic and biologic disease modifying antirheumatic drugs around...
Source: Current Reviews in Musculoskeletal Medicine - November 10, 2021 Category: Orthopaedics Source Type: research

Natural Language Processing and Its Use in Orthopaedic Research
AbstractPurpose of ReviewThis review aims to demonstrate how natural language processing is used in orthopaedic research.Recent FindingsNatural language processing is a form of artificial intelligence that involves encoding human-generated text or speech into a form which can be interpreted by computers to perform a variety of tasks. Natural language processing gathers, processes, and organizes large amounts of free-text data more efficiently than humans. In orthopaedics, it has been utilized for retrospective chart review, automated reporting of electronic health record data, analyzing operative notes and radiology report...
Source: Current Reviews in Musculoskeletal Medicine - November 10, 2021 Category: Orthopaedics Source Type: research

Augmented Reality (AR) in Orthopedics: Current Applications and Future Directions
AbstractPurpose of ReviewImaging technologies (X-ray, CT, MRI, and ultrasound) have revolutionized orthopedic surgery, allowing for the more efficient diagnosis, monitoring, and treatment of musculoskeletal aliments. The current review investigates recent literature surrounding the impact of augmented reality (AR) imaging technologies on orthopedic surgery. In particular, it investigates the impact that AR technologies may have on provider cognitive burden, operative times, occupational radiation exposure, and surgical precision and outcomes.Recent FindingsMany AR technologies have been shown to lower provider cognitive bu...
Source: Current Reviews in Musculoskeletal Medicine - November 9, 2021 Category: Orthopaedics Source Type: research

Smart Technology and Orthopaedic Surgery: Current Concepts Regarding the Impact of Smartphones and Wearable Technology on Our Patients and Practice
AbstractPurpose of ReviewWhile limited to case reports or small case series, emerging evidence advocates the inclusion of smartphone-interfacing mobile platforms and wearable technologies, consisting of internet-powered mobile and wearable devices that interface with smartphones, in the orthopaedic surgery practice. The purpose of this review is to investigate the relevance and impact of this technology in orthopaedic surgery.Recent FindingsSmartphone-interfacing mobile platforms and wearable technologies are capable of improving the patients ’ quality of life as well as the extent of their therapeutic engagement, while ...
Source: Current Reviews in Musculoskeletal Medicine - November 3, 2021 Category: Orthopaedics Source Type: research

Physical Examination and Patellofemoral Pain Syndrome: an Updated Review
AbstractPurpose of ReviewPatellofemoral pain syndrome (PFPS) accounts for 25 to 40% of all knee disorders. Diagnosis of PFPS is primarily based on history and physical examination, but the findings on physical examination are often subtle and do not consistently correlate with symptoms described. Yoon and Fredericson published a review article in 2006 detailing the physical examination maneuvers most frequently used to assist clinicians in the accurate diagnosis and treatment of PFPS, and our aim in this review is to provide an update on this previous article focusing on the literature published over the past 15 years rega...
Source: Current Reviews in Musculoskeletal Medicine - October 29, 2021 Category: Orthopaedics Source Type: research