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Purpose: To evaluate the incidence of early postoperative complications and revision surgery in patients who underwent primary medial ulnar collateral ligament (MUCL) repair with minimum of 2-year follow-up., Methods: A retrospective review of a national insurance database was conducted to identify patients with MUCL injuries who underwent primary MUCL repair between 2015 to 2020 with minimum 2-year follow-up. Patients >40 years of age and those who had concomitant elbow fractures or dislocations, lateral UCL injures, medial epicondylitis, elbow arthritis, or a history of previous elbow injury/surgery were excluded. The number of patients who underwent a concomitant ulnar nerve procedure (transposition or decompression) during the primary MUCL repair was recorded. Complications within 90 days of surgery and the incidence and timing of subsequent ipsilateral ulnar nerve surgery or revision MUCL surgery were assessed., Results: A total of 313 patients (63.6% male) were included. The mean age was 20.3 ± 6.9 years, and mean follow-up was 3.7 ± 1.3 years. Concomitant ulnar nerve transposition or decompression was performed in 34.2% (N = 107). The early postoperative complication rate was 7.3% (N = 23). The most common complication was ulnar neuropathy (5.8%, N = 18). Wound complications, elbow stiffness, and medial epicondyle fractures were much less common (N = 5). Sixteen of 18 (88.9%) patients with postoperative ulnar neuropathy underwent transposition or decompression at the time of primary repair. Of these 18 patients, 5 (27.8%) underwent a subsequent ulnar nerve surgery (1 primary and 4 secondary), with the majority occurring within 6 months. The incidence of revision MUCL surgery was low (1.0%, N=3), with all 3 patients undergoing MUCL reconstruction., Conclusion: There was a low incidence of early postoperative complications (7.3%) and 2-year revision MUCL surgery (1.0%) in young patients who underwent primary MUCL repair with no additional ligamentous, fracture, and dislocation-related diagnoses. All 3 (1.0%) MUCL revisions underwent reconstruction., Level of Evidence: Level IV, therapeutic case series., Competing Interests: The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: A.J. reports other from Medwest, outside the submitted work. L.V.G. reports personal fees from DePuy/Medical Device Business Services; Exactech, 10.13039/100006338Zimmer Bioment, and Smith & Nephew; and other from Gotham Surgical and Exactech, outside the submitted work. J.D. reports personal fees from 10.13039/100007307Arthrex, Merch Sharp and Dohme, and Trice Medical; and other from 10.13039/100007307Arthrex and Linvatec, outside the submitted work. D.W.A. reports personal fees from Stryker; and other from 10.13039/100008894Stryker and 10.13039/100007307Arthrex, outside the submitted work. Full ICMJE author disclosure forms are available for this article online, as supplementary material., (© 2023 The Authors.)

Purpose: To measure bony morphologic parameters and identify their association with arthroscopic Bankart repair failure., Methods: This was a retrospective comparative study. The inclusion criteria were primary arthroscopic Bankart repair, no prior shoulder surgery, traumatic cause, and had a Bankart (soft tissue and bony) lesion evident on magnetic resonance imaging (MRI). The exclusion criteria were posterior labral pathology, multidirectional instability, connective tissue disorder, rotator cuff pathology, and those who underwent concomitant shoulder procedures. Patients who had a postoperative redislocation (unstable group) were compared with matched patients who did not (stable group). Data were obtained by chart review and from preoperative MRI. Comparisons were made using the Student t test, Fisher exact test, or χ 2 test. Statistical significance was defined as P < .05. Inter-rater reliability was measured between reviewers., Results: A total of 45 patients experienced a postoperative dislocation and were matched to 90 patients without a postoperative dislocation. There were no differences in demographic and radiographic variables. The radius of curvature (ROC) of the glenoid was larger (shallower) in the unstable group (23.6 mm vs 22.6 mm, P  = .05). The humeral head volume (HHV) trended higher in the unstable group (68.9 mL vs 62.9 mL, P  = .06). The glenoid volume was not significantly different. A greater percentage of patients with a glenoid ROC of 24.5 mm or greater (62.1% vs 26.4%, P  = .0003) and an HHV of 80 mm 3 or greater (60.8% vs 28.9%, P  = .003) experienced a redislocation compared with patients without these factors. Patients with a glenoid ROC of 24.5 mm or more and an HHV of 80 mm 3 or more had greater than 4 times the odds of redislocation (odds ratio, 4.56; 95% confidence interval, 1.44-14.43; P  = .0098). Strong inter-rater reliability was found for the HHV, glenoid volume, glenoid ROC, and humeral head ROC measurements ( r  = 0.94, r  = 0.88, r  = 0.89, and r  = 0.95, respectively)., Conclusions: This study shows that large ROC (shallow) glenoids in conjunction with large humeral heads may predispose patients to failure after arthroscopic Bankart repair., Level of Evidence: Level III, retrospective comparative trial., (© 2021 The Author(s). Published by Elsevier Ltd on behalf of Osteoarthritis Research Society International.)

Purpose: To develop a standardized method of intercondylar notch measurement on preoperative radiographs and magnetic resonance imaging (MRI) and validate that it could predict intraoperative notch measurements., Methods: The charts and imaging of 50 patients undergoing anterior cruciate ligament reconstruction were reviewed. A standardized method of intercondylar notch measurement on radiographs and MRI was used by 3 blinded reviewers. Arthroscopic measurements were made by the surgeon who was blinded to the imaging measurements. Interrater reliability was determined between reviewers and between imaging and arthroscopic measurements using interclass correlation coefficients (r)., Results: The average notch base width was 16.5 (± 2.7) mm on MRI, 19.0 (± 3.4) mm on radiographs, and 15.8 (± 3.0) mm on arthroscopic measurement. The radiographic notch base width measurements were on average 1.2 times greater than the arthroscopic measurements. There was no significant difference between males and females in notch base width (16.7 mm vs 15.3 mm, P  = .19) or area (312.5 mm 2 vs 284.3 mm 2 , P  = .17). Interrater reliability was excellent between the reviewers for notch base width measurement on both MRI (r = 0.91) and radiographs (r = 0.95). Good-to-excellent interrater reliability between notch base width measurements on MRI and arthroscopy (r = 0.78, 0.73, 0.7) and fair-to-good interrater reliability between notch base width measurements on radiographs and arthroscopy were found (r = 0.61, 0.58, 0.55)., Conclusions: This study introduces a reliable method of using preoperative MRI to predict intercondylar notch width during arthroscopy. This data can be used to identify patients with narrow notches preoperatively., Level of Evidence: Level III, diagnostic study., (© 2019 by the Arthroscopy Association of North America. Published by Elsevier Inc.)

Purpose: To validate the accuracy and precision of a novel haploscope for use in investigating the mechanisms underlying normal eye control as well as the mechanisms of cyclovertical strabismus in pediatric and adult subjects. The accuracy and precision represent the device's ability to reproducibly measure true eye positions., Methods: A novel haploscope was developed that allows the measurement of eye positions and movements under specified conditions of vergence, head tilting, and cover testing. Equipped with video oculography, the haploscope can aid in the objective assessment of binocular and adaptive mechanisms that maintain oculomotor alignment. The device's accuracy and precision were assessed using a model eye with 3 axes of rotation. The device was then used to measure ocular torsion during the well-documented phenomenon of ocular counter-roll with head tilt. The eye movements of 6 normal subjects were measured as each subject fixated binocularly on the center of radially symmetric targets during head tilting., Results: The device yielded Pearson correlations with the model eye of R = 1.0, with residual error (re), a measure of accuracy, about all 3 ocular axes peaking at re = 19 +/- 5 arcmin. For human subjects, average positional error was re = 21 +/- 9 arcmin. Ocular counter-roll averaged 5.7 +/- 0.9 degrees for left and right eyes., Conclusions: These results validate the accuracy and precision of this novel haploscope. They support its use in future investigations of the mechanisms of oculomotor control and alignment.