The American journal of sports medicine
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The number of systematic reviews published in the orthopaedic literature has increased, and these reviews can help guide clinical decision making. However, the quality of these reviews can affect the reader's ability to use the data to arrive at accurate conclusions and make clinical decisions. ⋯ Systematic reviews and meta-analyses in orthopaedics sports medicine literature relied on evidence levels 4 and 5 in 53% of studies over the 5-year study period. Overall, PRISMA and AMSTAR scores are high and may be better than those in other disciplines. Readers need to be conscious of potential shortcomings when reading systematic reviews and using them in practice.
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It is not clear whether risk factors for revision anterior cruciate ligament reconstruction (ACLR) are the same throughout patients' lives. ⋯ Age at the time of ACLR surgery is a strong risk factor for revision ACLR. Other risk factors for revision ACLR, such as graft type, sex, race, and BMI, may vary in strength and significance over a patient's life. Understanding the age-related risk factors associated with revision ACLR may help with appropriate patient counseling and optimal graft choice when performing ACLR.
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The Latarjet technique is a reliable treatment option for recurrent anterior shoulder instability. However, the complication rate has been reported to be as high as 30%, with 1.6% of patients suffering a nerve injury. The all-arthroscopic Latarjet procedure has been gaining popularity, even as it has introduced its own challenges. Given that the surgeon is not able to palpate the nerves, their localization and protection can be difficult. Additionally, the use of different instruments can lead to distinct nerve injury mechanisms. ⋯ This study clarifies the location of the nerves relevant to the arthroscopic Latarjet technique and provides anatomic information that could help the surgeon reduce the risk of injuries to the musculocutaneous, axillary, and suprascapular nerves.
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Injury to the posteromedial meniscocapsular junction has been identified after anterior cruciate ligament (ACL) rupture; however, there is a lack of objective evidence investigating how this affects knee kinematics or whether increased laxity can be restored by repair. Such injury is often overlooked at surgery, with possible compromise to results. ⋯ This study suggests that unrepaired posteromedial meniscocapsular lesions will allow abnormal meniscal and tibiofemoral laxity to persist postoperatively, predisposing the knee to meniscal and articular damage.
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Patient-reported outcome instruments are frequently used for assessing clinical outcomes after injury and surgery. Previously reported normative data for the Knee injury and Osteoarthritis Outcome Score (KOOS) are limited to a narrow subset of ages and demographics or have not included patients who do not participate in sporting activities. ⋯ This study provides normative reference values for the KOOS in an 18- to 64-year-old metropolitan United States population. Study findings can aid surgeons in counseling patients and in developing expectations after the treatment of injuries.