The American journal of sports medicine
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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.
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The graft choice for anterior cruciate ligament reconstruction (ACLR) is controversial. Hamstring tendon (HT) autografts and patellar tendon (PT) autografts are the most common grafts used and have shown similar subjective and objective outcomes. ⋯ Patients with HT grafts had twice the risk of revision compared with patients with PT grafts. Younger age was the most important risk factor for revision, and no effect was seen for sex. Further studies should be conducted to identify the cause of the increased revision rate found for HT grafts.
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Epidemiology of primary anterior shoulder dislocation requiring closed reduction in Ontario, Canada.
There is a lack of high-quality population-based literature describing the epidemiology of primary anterior shoulder dislocation. ⋯ Young male patients have the highest incidence of primary anterior shoulder dislocation requiring CR and the greatest risk of repeat shoulder CR. Patient, provider, and injury factors all influence repeat shoulder CR risk. A comprehensive understanding of the epidemiology of primary anterior shoulder dislocation will aid management decisions and injury prevention initiatives.
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An incorrect femoral tunnel position or inappropriate graft tensioning during medial patellofemoral ligament (MPFL) reconstruction may cause altered patellofemoral joint kinematics and contact mechanics, potentially resulting in pain and joint degeneration. ⋯ A malpositioned femoral tunnel or overtensioned graft during MPFL reconstruction resulted in increased medial contact pressures and patellar tilting. This may lead to adverse outcomes such as early degenerative joint changes or pain if occurring in a clinical population.
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Comparative Study
Repair integrity and functional outcome after arthroscopic conversion to a full-thickness rotator cuff tear: articular- versus bursal-side partial tears.
A few studies have compared high-grade partial-thickness articular- and bursal-side rotator cuff tears postoperatively. ⋯ The arthroscopic repair of partial-thickness bursal-side tears resulted in comparable or superior postoperative functional outcomes compared with that of articular-side tears. However, the postoperative retear rate did not differ significantly between the 2 groups.