The American journal of sports medicine
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An acute infection after arthroscopic shoulder surgery is a rare but serious complication. Previous studies estimating the incidence of infections after arthroscopic surgery have been conducted, but the majority of these had either relatively small study groups or were not specific to shoulder arthroscopic surgery. ⋯ The overall infection rate for all arthroscopic shoulder procedures was 0.27%. The incidence was highest in elderly patients, in the South, and for rotator cuff repair. The incidence was lowest in young patients, in the Midwest, and for capsulorrhaphy. In general, shoulder arthroscopic surgery in this study population had a low rate of reoperation in the acute period.
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An autograft has traditionally been the gold standard for anterior cruciate ligament reconstruction (ACLR), but the use of allograft tissue has increased in recent years. While numerous studies have demonstrated that irradiated allografts are associated with increased failure rates, some report excellent results after ACLR with nonirradiated allografts. The purpose of this systematic review was to determine whether the use of nonirradiated allograft tissue is associated with poorer outcomes when compared with autografts. ⋯ No significant differences were found in graft failure rate, postoperative laxity, or patient-reported outcome scores when comparing ACLR with autografts to nonirradiated allografts in this systematic review. These findings apply to patients in their late 20s and early 30s. Caution is advised when considering extrapolation of these findings to younger, more active cohorts.
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The choice of graft for anterior cruciate ligament reconstruction (ACLR) remains controversial, and despite numerous studies, there is still an ongoing debate on this topic. The 2 most widely used grafts are the hamstring tendon and patellar tendon. ⋯ In this population-based study, the use of hamstring tendon grafts in ACLR was associated with an increased risk of revision compared with patellar tendon grafts, in particular during the first year after surgery. These results demonstrate that both hamstring and patellar tendon grafts reveal good results after ACLR and suggest that graft selection should be based on an individual evaluation of patient demands and graft morbidity.
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Randomized Controlled Trial Multicenter Study
Efficacy of platelet-rich plasma for chronic tennis elbow: a double-blind, prospective, multicenter, randomized controlled trial of 230 patients.
Elbow tenderness and pain with resisted wrist extension are common manifestations of lateral epicondylar tendinopathy, also known as tennis elbow. Previous studies have suggested platelet-rich plasma (PRP) to be a safe and effective therapy for tennis elbow. ⋯ No significant differences were found at 12 weeks in this study. At 24 weeks, however, clinically meaningful improvements were found in patients treated with leukocyte-enriched PRP compared with an active control group.
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In recent years, significantly more attention has been focused on the role of the medial patellofemoral ligament (MPFL) in patellar stability, and MPFL reconstruction has become a mainstay of surgical treatment of episodic patellar dislocations. Although previously described in detail after reconstruction of the anterior cruciate ligament, tunnel enlargement has not been investigated after MPFL reconstruction. ⋯ Femoral tunnel enlargement after MPFL reconstruction is common, with patients with patella alta at an increased risk. The influence of tunnel malposition and trochlear dysplasia on this condition requires further research. Recurrent instability and patient-reported outcome scores are not affected by tunnel enlargement.