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Background: Iliopsoas fractional lengthening (IFL) continues to be a controversial procedure in hip arthroscopy. Hypothesis: Patients who underwent arthroscopic surgery for femoroacetabular impingement (FAI) and a labral tear either with or without IFL would experience favorable outcomes, and there would be no difference in postoperative patient-reported outcomes (PROs) between the 2 groups at minimum 2-year follow-up. Study Design: Cohort study; Level of evidence, 3. Methods: Data from July 2009 and April 2015 were retrospectively reviewed. Patients were eligible if they had hip arthroscopy for both FAI and labral tear treatment with IFL and without IFL. IFL was indicated for painful internal snapping. Minimum postoperative follow-up was set to 2 years. The authors calculated the modified Harris Hip Score, International Hip Outcome Tool–12, Hip Outcome Score–Activity of Daily Living Score, Hip Outcome Score–Sports Specific Subscale, Non-Arthritic Hip Score, visual analog scale for pain, patient satisfaction, minimal clinically important difference (MCID), and the percentage of patients who achieved patient acceptable symptomatic state (PASS). Revision surgeries and conversions to total hip arthroplasty (THA) were documented. Results: 351 hips (307 patients) met the necessary inclusion criteria in the IFL cohort, with a mean ± SD follow-up time of 42.5 ± 18.1 months. For the control cohort, 392 hips (354 patients) were included, with a mean ± SD follow-up time of 43.9 ± 19.6 months. Both groups showed significant postoperative improvement in 2-year follow-up PROs. The group with iliopsoas lengthening showed comparable results to the control group with respect to PRO improvement, MCID, PASS, and rates of revision or THA conversion. Conclusion: This comparative cohort study demonstrated that treatment of painful internal snapping syndrome with arthroscopic IFL, in the setting of FAI and a labral tear, is a safe procedure with good short- to mid-term follow-up results and associated improvement in PROs. Patients who underwent IFL showed similar outcomes compared with a control group treated for FAI and labral tear without IFL. In appropriately selected patients, arthroscopic IFL did not adversely affect clinical outcomes compared with patients who did not need IFL. [ABSTRACT FROM AUTHOR]

Background: Osteochondral allograft transplantation (OCA) is often performed with concomitant meniscus allograft transplantation (MAT) as a strategy for knee joint preservation, although to date, the effect of concomitant MAT on outcomes and failure rates after OCA has not been assessed. Purpose: To determine clinical outcomes for patients undergoing OCA with MAT as compared with a matched cohort of patients undergoing isolated OCA. Study Design: Control study; Level of evidence, 3. Methods: Patients who underwent OCA of the medial or lateral femoral condyle without concomitant MAT by a single surgeon were compared with a matched group of patients who underwent OCA with concomitant MAT (ipsilateral compartment). The patients were matched per age, sex, body mass index, and number of previous ipsilateral knee operations ±1. Patient-reported outcomes, complications, reoperations, and survival rates were compared between groups. Results: One hundred patients undergoing OCA (50 isolated, 50 with MAT) with a mean ± SD follow-up of 4.9 ± 2.7 years (minimum, 2 years) were included (age, 31.7 ± 9.8 years; 52% male). Significantly more patients underwent OCA to the medial femoral condyle (n = 59) than the lateral femoral condyle (n = 41, P < .0001). Patients underwent 2.7 ± 1.7 operations on the ipsilateral knee before OCA. There were no significant differences between the groups regarding reoperation rate (n = 18 for OCA with MAT, n = 17 for OCA without MAT, P = .834), time to reoperation (2.2 ± 2.4 years for OCA with MAT, 3.4 ± 2.7 years for OCA without MAT, P = .149), or failure rates (n = 7 [14%] for OCA with MAT, n = 7 [14%] for OCA without MAT, P > .999). There were no significant differences in patient-reported clinical outcome scores between the groups at final follow-up. There was no significant difference in failure rates between patients undergoing medial femoral condyle OCA (n = 12, 15.3%) and lateral femoral condyle OCA (n = 5, 12.2%, P = .665). Conclusion: These results imply that with appropriate surgical indications to address meniscus deficiency in patients otherwise indicated for OCA and despite the added surgical time and complexity of concomitant MAT, outcomes are favorable, with an 86% OCA graft survivorship at 5 years. This information can be used to counsel patients undergoing OCA with concomitant MAT as part of a knee joint preservation strategy. [ABSTRACT FROM AUTHOR]

Background: Pathologic changes of the long head of the biceps tendon are a recognized source of shoulder pain in adults that can be treated with tenotomy or tenodesis when nonoperative measures are not effective. It is not clear whether arthroscopic or open biceps tenodesis has a clinical advantage. Hypothesis: Pain relief and shoulder function after all-arthroscopic suprapectoral biceps tenodesis are similar to outcomes after an open subpectoral tenodesis. Study Design: Cohort study; Level of evidence, 3. Methods: A prospective database was reviewed for patients undergoing an all-arthroscopic suprapectoral or open subpectoral biceps tenodesis. Adult patients with a minimum 18-month follow-up were included. Patients undergoing a concomitant rotator cuff or labral repair were excluded. The groups were matched to age within 3 years, sex, and time to follow-up within 3 months. Pain improvement, development of a ‘‘Popeye’’ deformity, muscle cramping, postoperative American Shoulder and Elbow Surgeons scores, satisfaction scores, and complications were evaluated. Results: Forty-six patients (23 all-arthroscopic, 23 open) with an average age of 57.2 years (range, 45-70 years) were evaluated at a mean follow-up of 30.1 months (range, 21.1-44.9 months). No patients in either group developed a Popeye deformity or complained of arm cramping. There was no significant difference in mean American Shoulder and Elbow Surgeons scores between the open and all-arthroscopic groups (92.3 vs 88.9; P = .42); similarly, there was no significant difference in patient satisfaction scores between the groups (8.9 vs 9.1; P = .73). Eighteen patients (78.3%) in the arthroscopic cohort and 16 (69.6%) in the open cohort fully returned to athletic activity (P = .50). Eight patients (34.8%) in the arthroscopic group and 10 (39.1%) in the open group reported pain at night or with heavy activities. There were no complications in the all-arthroscopic group. There were 2 complications in the open group that resolved by final follow-up. Conclusion: Biceps tenodesis remains a reliable treatment for pathologic abnormality of the long head of the biceps. Patients undergoing an all-arthroscopic suprapectoral tenodesis in the distal aspect or distal to the bicipital groove showed similar pain relief and clinical outcomes as compared with patients undergoing open subpectoral tenodesis. Open subpectoral biceps tenodesis may carry a higher complication risk secondary to a more invasive technique. [ABSTRACT FROM AUTHOR]

The article presents a comparison of using platelet-rich plasma (PRP) and bone morphogenetic protein-13 (BMP13) on healing of rotator cuff injury in a rat. Topics discussed include the pathophysiology of rotator cuff injury healing, the benefits offered by PRP and BMP13 and the results of the tenocyte gene expression analysis conducted by the authors. Also mentioned is the reason behind the effectiveness of the adenoviral delivery of BMP13.

This article discusses a study which evaluated clinical outcomes in a cohort of patients with borderline dysplasia who were treated with arthroscopic labral preservation and capsular plication. Between April 2008 and November 2010, the researchers examined patients who underwent hip arthroscopy for symptomatic intra-articular hip disorders. They learned that patients with borderline dysplasia have often fallen into a gray area between arthroscopy and periacetabular osteotomy.

The article presents a study on hip arthroscopy for labral tears among patients receiving workers' compensation (WC) with those of a matched group not receiving WC. Data were collected on all patients treated with hip arthroscopy in June 2008 to August 2010. Results show patients with WC status had significantly lower preoperative patient-reported outcome (PRO) scores for all measures. The authors say there was no significant difference between visual analog scale (VAS) scores of the groups.

The article reports a study which compared the amount of inadvertent posteriorization of the anterior cruciate ligament (ACL) tibial tunnel anatomy during transtibial ACL femoral reaming with a full femoral reamer versus a half femoral reamer. The results revealed that half-fluted reamers may be more beneficial for femoral tunnel reaming with a more oblique transtibial approach, as they result in less posterior tibial tunnel expansion than full reamers.

The article discusses the study of early outcomes of endoscopic repair of partial and full-thickness gluteus medius tears. It states that gluteus medius tears can transmit functional impairment causing chronic peritrochanteric hip pain. It reveals the satisfactory scores of all hip specific surgery with postoperative improvement. Endoscopic surgical repair performed through fullthickness technique, is an effective treatment of gluteus medius tears of minimum 2 years follow-up is also concluded.

Background: Allograft tissue remains a valuable alternative for anterior cruciate ligament reconstruction. No study to date has correlated the effect of donor age to bone mineral density (BMD) in a large series of irradiated bone—patellar tendon—bone (BPTB) allograft tissue.Hypothesis/Purpose: The authors attempted to correlate donor age with BMD in a large group of BPTB allograft specimens treated with low-dose gamma irradiation (1.0-1.3 Mrad) collected over a 4-year period. They hypothesized there would be no effect of donor age on the BMD of irradiated BPTB allografts.Study Design: Descriptive laboratory study.Methods: A total of 110 BPTB allograft specimens from 44 male and 66 female donors with a mean age of 46 years (range, 21-58 years) were analyzed. Bone mineral density data were obtained from both the patellar and tibial bone plugs of the BPTB complex. Statistical analyses were conducted using linear regression for correlations and 2-tailed Student t tests for comparisons between groups.Results: The mean BMD of the patellar bone plug (0.471 g/cm2) was significantly greater than the mean BMD of the tibial bone plug (0.328 g/cm2) (P < .001). No correlation was identified between donor age and BMD for either the patella or tibial bone plugs (R2 = .014 and .011, respectively). Both patellar and tibial BMD was significantly greater for the male grafts than the female ones.Conclusion: No correlation was found between donor age and BMD for irradiated BPTB allograft tissue. The patellar bone plugs were noted to have a greater BMD than the tibial bone plugs. Allograft tissue from male donors had higher BMD values than that harvested from female donors. [ABSTRACT FROM AUTHOR]