Why Does Hip Arthroscopy Fail? Indications and PEARLS for Revision Success
The surgical treatment of femoroacetabular impingement has been shown to have successful early and mid-term clinical outcomes. Despite these favorable clinical outcomes that have been published in the literature, there is a subgroup of patients that present with continued or recurrent symptoms after surgical treatment. Not only has there been an increase in the number of hip arthroscopy procedures, but also there has been a corresponding increase in the number of revision hip arthroscopy and hip preservation surgeries. Previous studies have reported residual deformity to be the most common reason for revision hip arthrosco...
Source: Sports Medicine and Arthroscopy Review - January 2, 2021 Category: Sports Medicine Tags: Review Articles Source Type: research

Acetabular Rim Disorders/Pincer-type Femoroacetabular Impingement and Hip Arthroscopy
Femoroacetabular impingement (FAI) can lead to acetabular impaction, chondral injury, and labral pathology secondary to deformities of the proximal femur (CAM-type FAI), acetabulum (pincer-type FAI), or with combined FAI. While the majority of cases are of the combined type, this paper focuses on acetabular overcoverage/pincer-type deformities. Various pincer subtypes include focal anterior overcoverage, global retroversion, global overcoverage/profunda, protrusio, subspine impingement, and os acetabuli/rim fracture variants. A thorough history and physical examination, plain radiographs, magnetic resonance imaging, 3-dime...
Source: Sports Medicine and Arthroscopy Review - January 2, 2021 Category: Sports Medicine Tags: Review Articles Source Type: research

Femoral Version in Hip Arthroscopy: Does it Matter?
Femoral version is extremely variable between patients presenting with femoroacetabular impingement (FAI). Careful and routine measurement of femoral anteversion is essential in comprehensive preoperative planning. In general, low degrees of femoral version can lead to anterior impingement (especially on the subspine and distal medial femoral neck). High degrees of anteversion can be seen in the setting of acetabular dysplasia and can lead to anterior hip instability and or posterior impingement. In this article, the authors will discuss the role of routine femoral version management for optimal outcomes after hip arthrosc...
Source: Sports Medicine and Arthroscopy Review - January 2, 2021 Category: Sports Medicine Tags: Review Articles Source Type: research

Surgical Treatment of Labral Tears: Debridement, Repair, and Reconstruction
Advances in hip preservation surgery have to lead to increased utilization of hip arthroscopy. With this, there has also been a growth in the understanding of various hip conditions, therefore, leading to an increase in hip conditions amenable to arthroscopic intervention. The acetabular hip labrum has been at the forefront of arthroscopic advances in the hip. The labrum is important for hip stability, provision of the suction seal, and joint proprioception. Given the labrum’s central role in hip biomechanics, there is increasing emphasis on labral preservation in the form of debridement and repair. In revision setti...
Source: Sports Medicine and Arthroscopy Review - January 2, 2021 Category: Sports Medicine Tags: Review Article: Digital Exclusive Source Type: research

Capsular Management Techniques and Hip Arthroscopy
There has been an increased emphasis on capsular management during hip arthroscopy in the literature in recent years. The capsule plays a significant role in the hip joint stability and studies have demonstrated that capsular closure can restore the biomechanics of the hip back to the native state. Capsular management also affects functional outcomes with capsular repair resulting in better clinical outcomes in some studies. Management of the capsule has evolved in recent years with more surgeons performing routine capsular closure. Management techniques and degree of capsular closure, however, can be quite variable betwee...
Source: Sports Medicine and Arthroscopy Review - January 2, 2021 Category: Sports Medicine Tags: Review Articles Source Type: research

Decision-making in the Borderline Hip
Borderline acetabular dysplasia represents a “transitional acetabular coverage” pattern between more classic acetabular dysplasia and normal acetabular coverage. Borderline dysplasia is typically defined as a lateral center-edge angle of 20 to 25 degrees. This definition of borderline dysplasia identifies a relatively narrow range of lateral acetabular coverage patterns, but anterior and posterior coverage patterns are highly variable and require careful assessment radiographically, in addition to other patient factors. Treatment decisions between isolated hip arthroscopy (addressing labral pathology, femoroace...
Source: Sports Medicine and Arthroscopy Review - January 2, 2021 Category: Sports Medicine Tags: Review Articles Source Type: research

Femoroacetabular Impingement and Core Muscle Injury in Athletes: Diagnosis and Algorithms for Success
Athletic hip injuries account for a substantial portion of missed time from sports in high-level athletes. For both femoroacetabular impingement (FAI) and core muscles injuries, a thorough history and physical examination are paramount to guide the treatment. While advanced imaging including computed tomography and magnetic resonance imaging are frequently obtained, a wealth of information can be ascertained from standard radiographs alone. For patients with isolated or combined FAI and core muscle injuries (CMIs), the initial treatment is often nonoperative and consists of rest, activity modification, and physical therapy...
Source: Sports Medicine and Arthroscopy Review - January 2, 2021 Category: Sports Medicine Tags: Review Articles Source Type: research

Make the Right Diagnosis: My Pearls for Working Up Hip-related Pain
The origin of pain around the hip is commonly more elusive than other joints; often obscured by compensatory disorders. Hip problems tend to be multifactorial and require a multidisciplinary approach in the evaluation. The best strategy is to team with a capable physical therapist to unveil the layers of problems. Ultrasonography and imaging/ultrasound-guided injections can be the most valuable adjunct to the history and physical examination. Plain radiographs are an essential element in the workup. Magnetic resonance imaging can underestimate damage in the joint, but positive findings can sometimes be the normal consequen...
Source: Sports Medicine and Arthroscopy Review - January 2, 2021 Category: Sports Medicine Tags: Review Articles Source Type: research

Hip Arthroscopy, Editorial
No abstract available (Source: Sports Medicine and Arthroscopy Review)
Source: Sports Medicine and Arthroscopy Review - January 2, 2021 Category: Sports Medicine Tags: Editorial Source Type: research

Subject Index
No abstract available (Source: Sports Medicine and Arthroscopy Review)
Source: Sports Medicine and Arthroscopy Review - December 1, 2020 Category: Sports Medicine Tags: Subject Index Source Type: research

Author Index
No abstract available (Source: Sports Medicine and Arthroscopy Review)
Source: Sports Medicine and Arthroscopy Review - December 1, 2020 Category: Sports Medicine Tags: Author Index Source Type: research

Rehabilitation After Shoulder Instability Surgery: Keys for Optimizing Recovery
The specific approach to rehabilitation after surgical management of the unstable shoulder is dependent on the severity and chronicity of the instability. Establishing dynamic stability throughout the athlete’s functional range of movement is critical to a successful outcome. The pace progression is guided by surgical (technique, injury pattern, and strength of repair) and patient factors (healing potential, prior health status, and psychosocial factors). The primary goal of treatment is to restore function and return the athlete to sport. The process should be guided by surpassing functional criteria for progression...
Source: Sports Medicine and Arthroscopy Review - December 1, 2020 Category: Sports Medicine Tags: Review Articles Source Type: research

Chapter 6: Attritional Glenoid Bone Loss in the Shoulder: Operative Considerations
Patients with recurrent anterior shoulder instability often have glenoid bone loss present in addition to soft tissue pathologies. It is known that patients with significant glenoid bone loss are best treated with a boney augmentation procedure as opposed to a soft tissue Bankart repair because of the high rate of recurrent instability that results from a Bankart repair. Although the Latarjet technique has been the gold-standard treatment for patients with glenoid bone loss because of the low incidence of recurrent instability, it has a high complication rate and a steep learning curve. Herein, the authors present the tech...
Source: Sports Medicine and Arthroscopy Review - December 1, 2020 Category: Sports Medicine Tags: Review Articles Source Type: research

Measuring Bone Loss in the Unstable Shoulder: Understanding and Applying the Track Concept
An interesting international debate has been developed over the past 10 years (the last decade) surrounding the surgical procedure for recurrent anteroinferior instability and a definitive consensus is lacking on the factors which favor one technique over another, especially when bone loss is present (soft tissue vs. bone block). Glenoid bone loss is commonly observed in the shoulder with anterior instability, and it is difficult to evaluate the shape of the glenoid using plain radiograph, therefore, computed tomography or intraoperative observation is recommended for accurate assessment of glenoid bone loss and Hill-Sachs...
Source: Sports Medicine and Arthroscopy Review - December 1, 2020 Category: Sports Medicine Tags: Review Articles Source Type: research

The Bony Bankart: Clinical and Technical Considerations
This article aims to provide an overview focusing on clinical and technical considerations in the diagnosis and treatment of bony Bankart lesions. (Source: Sports Medicine and Arthroscopy Review)
Source: Sports Medicine and Arthroscopy Review - December 1, 2020 Category: Sports Medicine Tags: Review Articles Source Type: research

The Role of Remplissage in the Setting of Shoulder Instability
Recurrent anterior shoulder instability is a multifactorial problem for which many solutions exist. Often, the bony surface area of the humeral head and the glenoid needs to be addressed surgically. For large, engaging humeral head defects associated with (Source: Sports Medicine and Arthroscopy Review)
Source: Sports Medicine and Arthroscopy Review - December 1, 2020 Category: Sports Medicine Tags: Review Articles Source Type: research

The Arthroscopic Bankart Repair: State of the Art in 2020: Decision-making and Operative Technique
Traumatic anterior shoulder instability is prevalent among young athletes, and recurrent dislocations can result in compromised upper extremity function, increasing glenohumeral bone loss, and ultimately, posttraumatic arthritis. Although management algorithms have evolved in response to contemporary data and technical innovation, the arthroscopic Bankart repair continues to be a mainstay for the primary surgical management of first-time or recurrent anterior shoulder instability with marginal attritional glenoid bone loss (ie, (Source: Sports Medicine and Arthroscopy Review)
Source: Sports Medicine and Arthroscopy Review - December 1, 2020 Category: Sports Medicine Tags: Digital Exclusive Source Type: research

In-Season Management of Anterior Shoulder Instability
Anterior shoulder instability commonly occurs in young and active individuals, particularly those participating in contact or collision sports. At the intercollegiate level, rates of anterior instability have been reported to be 0.12 events per 1000 athlete exposures. The treatment of in-season athletes with anterior instability presents a challenge for the team physician. The desire to return to play within the same season with nonoperative management must be weighed against the increased risk of recurrence as well as athlete and team specific demands. The purpose of this chapter is to discuss the key considerations for t...
Source: Sports Medicine and Arthroscopy Review - December 1, 2020 Category: Sports Medicine Tags: Review Articles Source Type: research

First-time Glenohumeral Dislocations: Current Evidence and Considerations in Clinical Decision Making
The decision to manage first-time shoulder dislocations conservatively or operatively has become increasingly complex because of conflicting literature. Although shoulder dislocations have traditionally been managed with reduction and immobilization, recent evidence has suggested high rates of subsequent recurrence. Surgical intervention is thought to better restore stability and decrease recurrence rates; however, it also has the potential for additional morbidity and financial cost. As such, recent literature has sought to better define patient risk profiles to identify optimal candidates for both conservative and operat...
Source: Sports Medicine and Arthroscopy Review - December 1, 2020 Category: Sports Medicine Tags: Review Articles Source Type: research

Shoulder Instability
No abstract available (Source: Sports Medicine and Arthroscopy Review)
Source: Sports Medicine and Arthroscopy Review - December 1, 2020 Category: Sports Medicine Tags: Editorial Source Type: research

Results of Treatment of the Multiple Ligament Injured (Dislocated) Knee
Knee dislocations leading to multiligament knee injuries are associated with a wide variety of bony, ligamentous, soft tissue, and neurovascular injury patterns. Numerous management strategies have been proposed including nonoperative treatment and surgical repair or reconstruction. In recent years, an emphasis has been placed on anatomic repair and reconstruction principles, which have shown superior outcomes compared with older techniques. However, despite these advances, clinical outcomes continue to vary widely, with many patients experiencing chronic pain, stiffness, loss of range of motion, instability, and failure t...
Source: Sports Medicine and Arthroscopy Review - August 1, 2020 Category: Sports Medicine Tags: Review Articles Source Type: research

Knee Dislocations in the Morbidly Obese Patient
Ultra-low-velocity knee dislocations are historically rare but increasingly common events. They occur most frequently in obese, morbidly obese, and super obese patients during everyday activities, but they can be as severe or more severe than high-velocity knee dislocations. Ultra-low-velocity knee dislocations frequently are associated with neurovascular injury and other complications. Diagnosis, early reduction, and identification and treatment of vascular injuries are critical to reducing the risk of limb ischemia and possibly amputation. Given the size of the limb, maintenance of reduction in these patients almost alwa...
Source: Sports Medicine and Arthroscopy Review - August 1, 2020 Category: Sports Medicine Tags: Review Articles Source Type: research

Combined ACL-PCL-Medial and Lateral Side Injuries (Global Laxity)
The multiple ligament injured knee is a complex problem in orthopedic surgery. These injuries may or may not present as acute knee dislocations, and careful assessment of the extremity vascular and neurological status is essential because of the possibility of arterial and/or venous compromise, and nerve injury. These complex injuries require a systematic approach to evaluation and treatment. Physical examination and imaging studies enable the surgeon to make a correct diagnosis and formulate a treatment plan. Knee stability is improved postoperatively when evaluated with knee ligament rating scales, arthrometer testing, a...
Source: Sports Medicine and Arthroscopy Review - August 1, 2020 Category: Sports Medicine Tags: Review Articles Source Type: research

Surgical Treatment of Combined ACL, PCL, and Lateral Side Injuries
A knee dislocation that involves at least 2 of the 4 major ligament groups—such as the anterior cruciate ligament, the posterior cruciate ligament, or the posterolateral corner—is a catastrophic event for an athlete or trauma patient. Careful evaluation of these patients is needed to avoid disastrous outcomes. Surgeons must be cognizant of a number of key treatment concerns—such as tunnel crowding, controversies over graft fixation methods, and sparsity of level I clinical data—to make proper ligament repair decisions. This manuscript will review treatment principles that govern high-quality care of...
Source: Sports Medicine and Arthroscopy Review - August 1, 2020 Category: Sports Medicine Tags: Review Articles Source Type: research

Surgical Treatment of Combined ACL PCL Medial Side Injuries
The multiple ligament knee injury involving the medial collateral ligament, anterior cruciate ligament, and posterior cruciate ligament is typically the result of a high-energy trauma or knee dislocation event. Optimal treatment strategies are debated, specifically in regard to timing of surgery, reconstruction/repair techniques, and postoperative protocols. This review details the stepwise treatment of these complex patients from diagnosis to postoperative rehabilitation and summarizes the current literature. (Source: Sports Medicine and Arthroscopy Review)
Source: Sports Medicine and Arthroscopy Review - August 1, 2020 Category: Sports Medicine Tags: Digital Exclusive Source Type: research

Initial Evaluation and Classification of Knee Dislocations
The traumatic knee dislocation (KD) is a complex condition resulting in injury to>1 ligament or ligament complexes about the knee, termed multiligament knee injuries. Typically, KDs result in injury to both cruciate ligaments with variable injury to collateral ligament complexes. Very rarely, KD may occur with single cruciate injuries combined with collateral involvement but it is important to understand that not all multiligament knee injuries are KDs. Patients can present in a wide spectrum of severity; from frank dislocation of the tibiofemoral joint to a spontaneously reduced KD, either with or without neurovascular...
Source: Sports Medicine and Arthroscopy Review - August 1, 2020 Category: Sports Medicine Tags: Review Articles Source Type: research

Knee Ligament Anatomy and Biomechanics
An understanding of knee ligament anatomy and biomechanics is foundational for physicians treating knee injuries, especially the more rare and morbid multiligamentous knee injuries. This chapter examines the roles that the cruciate and collateral anatomy and morphology play in their kinematics. Additionally, the biomechanics of the ACL, PCL, MCL, and LCL are discussed as they have surgical and reconstructive implications. (Source: Sports Medicine and Arthroscopy Review)
Source: Sports Medicine and Arthroscopy Review - August 1, 2020 Category: Sports Medicine Tags: Review Articles Source Type: research

Knee Dislocation
No abstract available (Source: Sports Medicine and Arthroscopy Review)
Source: Sports Medicine and Arthroscopy Review - August 1, 2020 Category: Sports Medicine Tags: Editorial Source Type: research

Chapter 5: Techniques For ACL Revision Reconstruction
Anterior cruciate ligament (ACL) reconstruction is a commonly performed procedure, with an increasing frequency leading to an increased number of revision procedures. Etiologies for graft rupture are varied and can include technical issues, repeat trauma, and graft choice. The preoperative evaluation before a revision ACL reconstruction should include a detailed history and physical exam, as well as radiographs, magnetic resonance imaging to evaluate graft integrity and for concomitant injuries, as well as computed tomography to measure for bone tunnel osteolysis. Surgical techniques for revision ACL reconstruction include...
Source: Sports Medicine and Arthroscopy Review - April 30, 2020 Category: Sports Medicine Tags: Digital Exclusive Source Type: research

Lateral Extra-articular Tenodesis in Anterior Cruciate Ligament Reconstruction
A subset of patients have residual rotational laxity following anterior cruciate ligament reconstruction (ACLR) despite the evolution of ACLR techniques. In recent years, there has been increased interest in addressing residual laxity because it is associated with poor outcomes after ACLR. There is an expanding body of knowledge on the anatomy and biomechanics of the anterolateral soft tissue restraints in regard to their rotational control of the knee and this has reignited an interest in extra-articular reconstruction techniques for augmenting ACLR. Reconstruction techniques currently used can be broadly categorized as e...
Source: Sports Medicine and Arthroscopy Review - April 30, 2020 Category: Sports Medicine Tags: Review Articles Source Type: research

Readiness to Return to Sport After ACL Reconstruction: A Combination of Physical and Psychological Factors
Although the incidence of anterior cruciate ligament injuries continues to rise, return to sport (RTS) rates remain low and risk of the second injury remains high. No gold-standard criteria exist for medical clearance to RTS after anterior cruciate ligament reconstruction. The lack of consensus may be driven by the multifactorial nature of the clinical decision that includes a combination of physical and psychological factors. Tools such as the Quality of Movement Assessment, which identifies physical deficits and faulty movement patterns to provide targeted recommendations for safe RTS, and the Anterior Cruciate Ligament ...
Source: Sports Medicine and Arthroscopy Review - April 30, 2020 Category: Sports Medicine Tags: Review Articles Source Type: research

Techniques for Femoral Socket Creation in ACL Reconstruction
Anterior cruciate ligament (ACL) injury is common and affects a wide variety of individuals. An ACL reconstruction is the treatment of choice for patients with subjective and objective symptoms of instability and is of particular importance to cutting or pivoting athletes. With many variables involved in ACL reconstruction, femoral tunnel placement has been found to affect clinical outcomes with nonanatomic placement being identified as the most common technical error. Traditionally the femoral tunnel was created through the tibial tunnel or transtibial with the use of a guide and a rigid reaming system. Because of proxima...
Source: Sports Medicine and Arthroscopy Review - April 30, 2020 Category: Sports Medicine Tags: Review Articles Source Type: research

Biological Augmentation of ACL Repair and Reconstruction: Current Status and Future Perspective
Historically, anterior cruciate ligament (ACL) suture repair mostly resulted in failure because of intra-articular hypovascularity and poor intrinsic healing capacity of ACL. ACL reconstruction was therefore deemed the gold standard with a high success rate because of more evolved surgical technique. There are, however, clinical and subclinical disadvantages of reconstruction; low rate in full recovery to sports, donor harvest morbidity, tunnel enlargement, and incomplete microscopic healing of the graft. Recent experimental and clinical studies on biological augmentation of mesenchymal stem cells, platelet-rich plasma, or...
Source: Sports Medicine and Arthroscopy Review - April 30, 2020 Category: Sports Medicine Tags: Review Articles Source Type: research

Graft Selection in Anterior Cruciate Ligament Reconstruction
Surgical reconstruction of the anterior cruciate ligament (ACL) is often indicated to restore functional stability and prevent early degeneration of the knee joint, as there is little biological healing capacity of the native ACL. Although a reconstructed ACL does not fully restore the original structure or biomechanics properties of the native ACL, the graft used for reconstruction must not only have structural and mechanical properties that closely resemble those of the native ligament, it must also have minimal antigenicity and enough biological potential to incorporate into host bone. There are several considerations i...
Source: Sports Medicine and Arthroscopy Review - April 30, 2020 Category: Sports Medicine Tags: Review Articles Source Type: research

Objectifying the Pivot Shift Test
The pivot shift test is utilized for assessment of rotatory instability in the anterior cruciate ligament (ACL) deficient knee. There are multiple reports of the pivot shift maneuver, and there is a lack of consensus among clinicians as to a standardized maneuver. Measurement devices are a feasible option to evaluate rotatory knee instability, objectively or quantitatively. Traditionally, measurement systems have been invasive systems. More recently, electromagnetic system, inertial sensor, or imaging analysis systems, specifically with the utilization of a tablet computer, have emerged as noninvasive, and more importantly...
Source: Sports Medicine and Arthroscopy Review - April 30, 2020 Category: Sports Medicine Tags: Review Articles Source Type: research

Latest Trends in ACL Reconstruction
No abstract available (Source: Sports Medicine and Arthroscopy Review)
Source: Sports Medicine and Arthroscopy Review - April 30, 2020 Category: Sports Medicine Tags: Editorial Source Type: research

Complications in Posterior Cruciate Ligament Injuries and Related Surgery
Posterior cruciate ligament (PCL) injury, especially in isolation, is a less frequent injury than injury to the anterior cruciate ligament and other ligaments of knee. In addition, the complex injury patterns involving the PCL, the technically demanding nature of surgical treatments, the anatomic proximity to vital neurovascular structures and the controversy surrounding optimal management of PCL injuries, make these injuries and their treatment potentially prone to more complications. This chapter will review the common complications of PCL injuries and related surgery. (Source: Sports Medicine and Arthroscopy Review)
Source: Sports Medicine and Arthroscopy Review - December 31, 2019 Category: Sports Medicine Tags: Review Articles Source Type: research

Arthroscopic Posterior Cruciate Ligament Primary Repair
Injury to the posterior cruciate ligament (PCL) is most commonly seen in the setting of a multiligamentous injured knee, and isolated PCL tears are rare. PCL injuries are generally treated either conservatively or by PCL reconstruction using a graft. If a proximal or distal tear is present, the injured ligament can also be treated by primary repair, in which the ligament is reattached to the tibial or femoral insertion. This has the (theoretical) advantages of preserving the native tissue, maintaining proprioception, and can be performed in a less invasive way when compared with reconstruction surgery. In this review, the ...
Source: Sports Medicine and Arthroscopy Review - December 31, 2019 Category: Sports Medicine Tags: Review Articles Source Type: research

Posterior Cruciate Ligament All-Inside Reconstruction
Several techniques for posterior cruciate ligament (PCL) reconstruction have been described. Reported clinical outcomes for the various techniques are often affected by concomitant injuries. Therefore, the optimal surgical technique choice remains controversial. Variations include transtibial versus tibial inlay, single-bundle versus double-bundle, and autograft versus allograft. The all-inside technique has recently been described as a transtibial method that uses adjustable loop suspensory fixation through sockets rather than tunnels on both the femur and tibia. This technique preserves more bone and may decrease the ris...
Source: Sports Medicine and Arthroscopy Review - December 31, 2019 Category: Sports Medicine Tags: Review Articles Source Type: research

Tibial Inlay Posterior Cruciate Ligament Reconstruction
Reconstruction of the posterior cruciate ligament is typically made through either tibial inlay or transtibial methods. Double-bundle reconstruction can be combined with either technique and has clear biomechanical advantages. On the basis of prior evidence and the author’s own surgical experiences, this technique paper provides the reasoning for using these methods. Further evidence and reasoning is given for when to use the inlay technique rather than the transtibial technique for posterior cruciate ligament reconstruction. (Source: Sports Medicine and Arthroscopy Review)
Source: Sports Medicine and Arthroscopy Review - December 31, 2019 Category: Sports Medicine Tags: Review Articles Source Type: research

PCL Transtibial Tunnel Reconstruction
The keys to successful posterior cruciate ligament (PCL) reconstruction are to identify and treat all pathology, use strong graft material, accurately place tunnels in anatomic insertion sites, minimize graft bending, mechanical graft tensioning, secure graft fixation, and the appropriate postoperative rehabilitation program. Adherence to these technical principles results in successful single and double bundle arthroscopic transtibial tunnel PCL reconstruction based upon stress radiography, arthrometer, knee ligament rating scales, and patient satisfaction measurements. The purpose of this article is to describe the arthr...
Source: Sports Medicine and Arthroscopy Review - December 31, 2019 Category: Sports Medicine Tags: Review Articles Source Type: research

Diagnosing PCL Injuries: History, Physical Examination, Imaging Studies, Arthroscopic Evaluation
Isolated posterior cruciate ligament (PCL) injuries are uncommon and can be easily missed with physical examination. The purpose of this article is to give an overview of the clinical, diagnostic and arthroscopic evaluation of a PCL injured knee. There are some specific injury mechanisms that can cause a PCL including the dashboard direct anterior blow and hyperflexion mechanisms. During the diagnostic process it is important to distinguish between an isolated or multiligament injury and whether the problem is acute or chronic. Physical examination can be difficult in an acutely injured knee because of pain and swelling, b...
Source: Sports Medicine and Arthroscopy Review - December 31, 2019 Category: Sports Medicine Tags: Review Articles Source Type: research

Anatomy and Biomechanics of the Posterior Cruciate Ligament and Their Surgical Implications
Knowledge and understanding of the complex anatomy and biomechanical function of the native posterior cruciate ligament (PCL) is vitally important when evaluating PCL injury and possible reconstruction. The PCL has important relationships with the anterior cruciate ligament, menisci, tibial spines, ligament of Humphrey, ligament of Wrisberg, and the posterior neurovascular structures. Through various experimental designs, the biomechanical role of the PCL has been elucidated. The PCL has its most well-defined role as a primary restraint/stabilizer to posterior stress and it seems this role is greatest at higher degrees of ...
Source: Sports Medicine and Arthroscopy Review - December 31, 2019 Category: Sports Medicine Tags: Digital Exclusive Source Type: research

Posterior Cruciate Ligament
No abstract available (Source: Sports Medicine and Arthroscopy Review)
Source: Sports Medicine and Arthroscopy Review - December 31, 2019 Category: Sports Medicine Tags: Editorial Source Type: research

Subject Index
No abstract available (Source: Sports Medicine and Arthroscopy Review)
Source: Sports Medicine and Arthroscopy Review - November 5, 2019 Category: Sports Medicine Tags: Subject Index: PDF Only Source Type: research

Author Index
No abstract available (Source: Sports Medicine and Arthroscopy Review)
Source: Sports Medicine and Arthroscopy Review - November 5, 2019 Category: Sports Medicine Tags: Author Index: PDF Only Source Type: research

Pediatric Management of Recurrent Patellar Instability
This article discusses various risk factors associated with patellofemoral instability, reconstruction techniques, and a case example. (Source: Sports Medicine and Arthroscopy Review)
Source: Sports Medicine and Arthroscopy Review - November 5, 2019 Category: Sports Medicine Tags: Review Article Source Type: research

When and How I Add Trochleoplasty in the Treatment of Recurrent Patella Instability
Long experience and recent evidence suggest that trochleoplasty is needed in very few patella stabilization surgeries. As trochleoplasty adds risk, this author recommends it only in patients with high degrees of dysplasia, prominent supratrochlear spurs, ligamentous laxity, and more dramatic J signs. (Source: Sports Medicine and Arthroscopy Review)
Source: Sports Medicine and Arthroscopy Review - November 5, 2019 Category: Sports Medicine Tags: Commentary Source Type: research

When is Trochleoplasty a Rational Addition?
Trochlear dysplasia has been recognized as a dominant anatomic risk factor in patients with recurrent patellar instability. Sulcus-deepening trochleoplasty is a very effective and powerful procedure for correcting trochlear dysplasia and, specifically, eliminating the supratrochlear spur. However, it must be emphasized that trochleoplasty is not appropriate for patients with mild trochlear dysplasia or those without a large supratrochlear spur or bump. We discuss the characteristics and classification of trochlear dysplasia and discuss specific indications for sulcusdeepening trochleoplasty. (Source: Sports Medicine and Arthroscopy Review)
Source: Sports Medicine and Arthroscopy Review - November 5, 2019 Category: Sports Medicine Tags: Review Article Source Type: research

When to Add Lateral Soft Tissue Balancing?
Lateral patellofemoral (PF) soft tissue abnormalities range from excessive lateral PF tightness (lateral patellar compression syndrome, lateral patellar instability and arthritis), to excessive laxity (iatrogenic lateral PF soft tissue insufficiency postlateral release). The lateral soft tissue complex is composed of the iliotibial band extension to the patella, the vastus lateralis tendon, the lateral PF ligament, lateral patellotibial ligament, and lateral patellomeniscal ligament, with intimate connections between those structures. To identify lateral retinaculum tightness or insufficiency the most important tests are t...
Source: Sports Medicine and Arthroscopy Review - November 5, 2019 Category: Sports Medicine Tags: Digital Exclusive Source Type: research