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Three-dimensional (3D) modeling and printing are increasingly used in the field of orthopaedic surgery for both research and patient care. One area where they are particularly helpful is in improving our understanding of the patellofemoral (PF) joint. Heretofore, morphological studies that use 3D models of the PF joint have primarily been based on computed tomography imaging data and thus do not incorporate articular cartilage. Here, we describe a method for creating 3D models of the articular surfaces of the PF joint based on magnetic resonance imaging. Models created using this technique can be used to improve our understanding of the morphology of the articular surfaces of the PF joint and its relationship to joint pathologies. Of particular interest is our finding of articular congruity in printed articular cartilage surfaces of dysplastic PF joints of recurrent patella dislocators., (© 2023 The Authors.)

Patellofemoral instability may be attributed to a variety of soft tissue and osseous factors, of which dysplasia of the femoral trochlea significantly predisposes patients to recurrent instability events. Surgical planning and decision-making remain wholly predicated upon two-dimensional imaging-derived measurements and classification systems, although aberrant patellar tracking in the setting of trochlea dysplasia is a three-dimensional (3-D) complexity. 3-D reconstructions of the patellofemoral joint (PFJ) may be considered to better comprehend the complex anatomy of patients with recurrent patella dislocation and/or trochlea dysplasia. We describe a classification and integrated interpretation system by which these 3-D reproductions of the PFJ may be analyzed to enhance surgical decision making in the treatment of this condition to achieve optimal joint stability and long-term preservation., (© 2023 The Authors.)

Trochlear dysplasia is a major contributor to patellofemoral instability and subsequent failure of isolated soft tissue reconstruction procedures in the treatment of recurrent patellar dislocation and/or subluxation. Trochleoplasty procedures aim to address abnormal osseous trochlear morphologic factors that contribute to patellar maltracking. However, teaching these techniques is limited by the lack of reliable training models for trochlear dysplasia and trochleoplasty simulation. Although a cadaveric knee model of trochlear dysplasia for trochleoplasty simulation has been recently described, cadaveric knees are less amenable for use in trochleoplasty planning and surgeon training because of the absence of reliable, natural dysplastic anatomic relationships, such as suprapatellar spurs due to the rarity of dysplastic cadavers and the high cost of cadaveric specimens. Furthermore, readily available sawbone models represent "normal" osseous trochlear morphology and are difficult to modify and bend due to their material composition. Given this, we have developed a cost-effective, reliable, and anatomically accurate three-dimensional (3D) knee model of trochlear dysplasia for trochleoplasty simulation and trainee education., (© 2023 The Authors.)

Three-dimensional (3D) modeling and printing comprise an important tool for orthopaedic surgeons. One area in which 3D modeling has the potential to dramatically improve our understanding of biomechanical kinematics is pathologies of the patellofemoral joint, in particular trochlear dysplasia. We describe a method for creating 3D printed models of the patellofemoral joint, including computed tomography image acquisition, image segmentation, model creation, and 3D printing. The models created can help surgeons understand and plan surgery for recurrent patellar dislocations., (© 2022 The Authors.)

Medial quadriceps tendon-femoral ligament (MQTFL) reconstruction for prevention of recurrent patella dislocation is an alternative to medial patellofemoral ligament (MPFL) reconstruction. Because the reconstruction graft attaches to the quadriceps tendon, no patella drill hole is required, thereby eliminating iatrogenic fracture risk. The procedure remains anatomically accurate and early results are comparable to MPFL reconstruction for preventing patella dislocation. The MQTFL reconstruction graft is brought up under the vastus medialis obliquus distal to the patella apex, such that its orientation is directed toward the medial patellofemoral complex (MPFC) midpoint, also known as Tanaka's point. The graft is then secured by looping it around the vastus medialis and rectus femoris tendons, after which optimal graft length is easily established by cycling the knee, after which it is sutured securely into the deep quadriceps tendon precisely at the anatomic midpoint of the MPFC. Anatomic reconstruction of the MQTFL-in which graft orientation is crucial-confers reliable patellofemoral joint stability in the surgical treatment of patients with recurrent patella dislocations., (© 2021 The Authors.)

Objective: Healthcare hackathons are fast-paced, mentored events that bring together individuals with diverse skillsets to identify clinical needs and propose solutions. Traditionally geared toward device development and workflow optimization, platforms that address women and minorities in surgery are rare. We aimed to expand the traditional healthcare hackathon model to include a novel workforce development (WD) track to address concerns faced by surgeons and trainees., Design: The WD track was created as part of the first surgical hackathon at our academic institution. In a single-day event, participants identified concerns (pain points) of diversity and sustainability in surgery, formed interdisciplinary teams, and pitched solutions. Pain points, project themes, and postevent survey results were analyzed and compared between WD and other tracks., Setting: Participants were surveyed at Yale School of Medicine, an academic medical tertiary center, in September 2018., Participants: Thirty-one total participants. Twenty-five (80.6%) responded to the survey., Results: Of 57 problem pitches, 23 (40.4%) were related to WD. Issues highlighted 5 themes: training and career exploration, leadership and communication of skills, mental health and burnout prevention, surgeon discrimination and harassment, and work-life balance. Participants formed 6 groups, with 1 focused on WD. There was no difference between participants in the WD track and non-WD track counterparts with regard to excitement for continuing their project beyond the hackathon (4.00, standard deviation [SD] 0.89, vs. 3.63, SD 1.12, p = 0.43), and in their perception of the mentorship they received (4.00, SD 1.00, vs. 4.11, SD 0.78, p = 0.84). The project presented within the WD track, on culturally sensitive scrub wear, was 1 of 3 prize-winners., Conclusions: The first WD track at a healthcare hackathon identified 5 themes of unmet workforce needs. The pilot demonstrated that WD tracks can be implemented in hackathons with similar results to traditional tracks and create innovative and sustainable solutions to surgical workforce concerns., (Copyright © 2020 Association of Program Directors in Surgery. All rights reserved.)