The American journal of sports medicine
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The arthroscopic Bankart repair and open Bristow-Latarjet procedure are the 2 most commonly used techniques to treat recurrent shoulder instability. ⋯ Arthroscopic stabilization using anchors provided better return to sport and subjective perception of the shoulder compared with the open Bristow-Latarjet procedure in the population studied. Recurrence may be higher in the arthroscopic Bankart group; further study is needed on this point.
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Long-term prospective studies of isolated endoscopic anterior cruciate ligament (ACL) reconstruction are limited and may include confounding factors. ⋯ Compared with patients who received the HT graft, patients who received the PT graft had significantly worse outcomes with regard to radiologically detectable osteoarthritis, kneeling pain, and contralateral ACL injury. At 20-year follow-up, both HT and PT autografts continued to provide good subjective outcomes and objective stability. However, further ACL injury is common, particularly in male individuals, younger patients, and those with tunnel malposition.
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Effect of High-Grade Preoperative Knee Laxity on Anterior Cruciate Ligament Reconstruction Outcomes.
Knee laxity in the setting of suspected anterior cruciate ligament (ACL) injury is frequently assessed through physical examination using the Lachman, pivot-shift, and anterior drawer tests. The degree of laxity noted on these examinations may influence treatment decisions and prognosis. ⋯ The presence of high-grade pre-reconstruction knee laxity as assessed by manual physical examination under anesthesia is associated with significantly increased odds of revision ACL surgery but has no association with patient-reported outcome scores at 2 years after ACL reconstruction.
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Articular cartilage injury is frequently encountered, yet treatment options capable of providing durable cartilage repair are limited. ⋯ Repair of chondral injury using a hyaluronic acid-based scaffold with activated bone marrow aspirate concentrate provides better clinical outcomes and more durable cartilage repair at medium-term follow-up compared with microfracture. Positive short-term clinical outcomes can be achieved with either microfracture or HA-BMAC. Cartilage repair using HA-BMAC leads to successful medium-term outcomes independent of age or lesion size.
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Review Meta Analysis
Outcomes After Isolated Medial Patellofemoral Ligament Reconstruction for the Treatment of Recurrent Lateral Patellar Dislocations: A Systematic Review and Meta-analysis.
A patellar dislocation is a common knee injury in the young, athletic patient population. Recent trends indicate that the use of long-term nonoperative treatment is decreasing, and surgical intervention is more commonly recommended for those patients who fail initial nonoperative management with recurrent patellar dislocations. Medial patellofemoral ligament (MPFL) reconstruction has become increasingly utilized in this regard. ⋯ A high percentage of young patients return to sports after isolated MPFL reconstruction for chronic patellar instability, with short-term results demonstrating a low incidence of recurrent instability, postoperative apprehension, and reoperations.