Video journal of sports medicine最新文献

{"title":"Lateral Extra-articular Tenodesis Using a Double-Knotless, All-Suture Anchor for Onlay Fixation.","authors":"Thomas E Moran, Katherine Kessler, William M Pullen, Travis G Maak, Harris S Slone","doi":"10.1177/26350254261429886","DOIUrl":"10.1177/26350254261429886","url":null,"abstract":"<p><strong>Background: </strong>Lateral extra-articular augmentation procedures, including lateral extra-articular tenodesis (LET), are advocated in high-risk patients undergoing anterior cruciate ligament reconstruction (ACLR) to provide improved rotational stability and reduce rates of graft rupture postoperatively.</p><p><strong>Indications: </strong>Indications for performing a LET concomitantly with ACLR continue to evolve, but are recommended for patients with certain demographics and in the presence of anatomic risk factors for graft rupture.</p><p><strong>Technique description: </strong>After the ACL femoral tunnel is reamed, a lateral approach to the knee is performed, and an 8 cm long by 1 cm wide strip of the posterior iliotibial band is harvested and passed retrograde, deep to the lateral collateral ligament. While \"tunneloscopy\" is performed to confirm the absence of tunnel interference, a double-knotless, all-suture anchor is placed just proximal and posterior to the lateral epicondyle. After the ACL graft is passed and fixated, the limb is positioned in 30° of knee flexion and neutral tibial rotation. The double-knotless mechanism is then employed to achieve surface fixation of the LET graft.</p><p><strong>Results: </strong>The literature suggests that performing a LET with ACLR improves rotational stability and reduces the rate of graft rupture postoperatively in high-risk patients, without deviating from standard ACLR postoperative protocols or causing additional morbidity at short- or midterm follow-up.</p><p><strong>Discussion/conclusion: </strong>This article demonstrates a safe and reproducible method of performing a LET concomitantly with ACLR using a quadriceps autograft in appropriately indicated patients. Ongoing research continues to refine the indications and techniques for performing a LET with ACLR.</p><p><strong>Patient consent disclosure statement: </strong>The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.</p>","PeriodicalId":520531,"journal":{"name":"Video journal of sports medicine","volume":"6 5","pages":"26350254261429886"},"PeriodicalIF":0.0,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13583260/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148993516","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patellar Tendon Reconstruction After Failed Patellar Tendon Repair With a Concomitant Double-Bundle Posterior Cruciate Ligament Reconstruction and Medial Collateral Ligament Reconstruction.","authors":"Nicholas K Retzer, Rylan A Behnke, Benjiman J Wilebski, Luke V Tollefson, Matthew T Rasmussen, Dustin R Lee, Robert F LaPrade","doi":"10.1177/26350254251408437","DOIUrl":"10.1177/26350254251408437","url":null,"abstract":"<p><strong>Background: </strong>Patellar tendon ruptures are a relatively uncommon injury that results from a contraction of the quadriceps against a fixed eccentric load during partial knee flexion. The medial collateral ligament (MCL) and posterior cruciate ligament (PCL) are frequently injured together, and their reconstitution should follow anatomic reconstruction techniques.</p><p><strong>Indications: </strong>In a previously failed patellar tendon repair, a reconstruction with an allograft is indicated due to poor tissue quality. The failed patellar tendon repair was further complicated by a chronic PCL tear and a chronic high-grade MCL sprain, confirmed through a physical examination and imaging. A double-bundle PCL reconstruction and MCL reconstruction were performed during the revision of the patellar tendon reconstruction to further stabilize the knee.</p><p><strong>Technique description: </strong>The technique described was for a patellar tendon reconstruction with a concomitant double-bundle PCL reconstruction and MCL reconstruction after a failed patellar tendon repair in the presence of chronic PCL and MCL tears. First, hamstring autografts were harvested for anatomic MCL reconstruction and subsequently fixated distally. Next, tunnels were created through the tibial tubercle and the patella for patellar tendon reconstruction using a hamstring allograft. Then, femoral tunnels for both bundles of the PCL and the correlating tibial tunnel were prepared. After an arthroscopic assessment of the knee joint, the double-bundle PCL allografts were passed and fixed in their respective tunnels. Lastly, the proximal MCL autograft was fixed in a femoral tunnel, and the patellar tendon reconstruction grafts were passed and secured.</p><p><strong>Results: </strong>Recent literature has supported the use of a patellar tendon reconstruction in the setting of a failed repair and chronic patellar tendon rupture. Outcomes are favorable among metrics, including knee range of motion, extension lag, and modified Cincinnati and Kujala scores.</p><p><strong>Discussion/conclusion: </strong>Recent literature has demonstrated improved functional outcomes with anatomic reconstructions of the patellar tendon, MCL, and PCL. A patellar tendon reconstruction after a failed repair with a concomitant double-bundle PCL reconstruction and MCL reconstruction is described, along with technical considerations, to improve chances of favorable outcomes and minimize the risks of complications.</p><p><strong>Patient consent disclosure statement: </strong>The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.</p>","PeriodicalId":520531,"journal":{"name":"Video journal of sports medicine","volume":"6 5","pages":"26350254251408437"},"PeriodicalIF":0.0,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13570008/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148957837","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lateral Meniscoplasty With Semitendinosus Tendon Combined With Capsulodesis.","authors":"Juan D Ayala, Bruno Carriero, Juan C Martín","doi":"10.1177/26350254261433512","DOIUrl":"10.1177/26350254261433512","url":null,"abstract":"<p><strong>Background: </strong>Subtotal lateral meniscectomy may lead to increased tibiofemoral contact pressures and early degenerative changes. Meniscal reconstruction using autograft tissue has been shown to restore load distribution and joint stability. This video demonstrates an arthroscopic technique for lateral meniscoplasty using a doubled semitendinosus tendon, combined with capsulodesis, to limit the meniscal extrusion rate.</p><p><strong>Indications: </strong>Patients with postmeniscectomy syndrome and a sufficient residual meniscal rim who present with lateral compartment pain and preserved articular cartilage.</p><p><strong>Technique description: </strong>The patient is positioned supine with the leg hanging freely in a leg holder. Standard anteromedial and anterolateral portals are established. Capsulodesis is performed using two 3-mm PEEK implants placed on the lateral tibial plateau margin, creating shuttle sutures that secure the capsule. The semitendinosus tendon is harvested, doubled, and prepared as a 12 to 15 cm graft. Posterior and anterior tibial tunnels are drilled using a meniscal root guide and shuttle sutures are passed. The graft is introduced sequentially through these tunnels and positioned arthroscopically. Central fixation is achieved using all-inside sutures, with outside-in sutures securing the anterior horn. The tibial fixation is completed using PEEK interference screws.</p><p><strong>Results: </strong>The final arthroscopic inspection confirms anatomic graft positioning and congruent adaptation of the new graft to the lateral tibial plateau, restoring the meniscal contour.</p><p><strong>Discussion/conclusion: </strong>Lateral meniscoplasty using a semitendinosus autograft combined with capsulodesis represents a biologic reconstructive option to restore the lateral meniscal rim and improve load transmission. Early biomechanical and clinical studies have demonstrated that semitendinosus autografts can function as viable meniscal substitutes, restore kinematics and improve joint contact pressures.</p><p><strong>Patient consent disclosure statement: </strong>The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.</p>","PeriodicalId":520531,"journal":{"name":"Video journal of sports medicine","volume":"6 5","pages":"26350254261433512"},"PeriodicalIF":0.0,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13558944/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148932446","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Arthroscopic Bony Bankart Fixation Using Single-Row Technique with Knotless Suture Anchors.","authors":"George F Matta, Benjamin Brej, Samuel Taylor, Gregory L Cvetanovich, Jennifer Kurowicki, Ryan C Rauck","doi":"10.1177/26350254261460907","DOIUrl":"10.1177/26350254261460907","url":null,"abstract":"<p><strong>Background: </strong>Bony Bankart lesions involve detachment of the anteroinferior labrum with an associated glenoid rim fracture after traumatic anterior shoulder instability. Compared with isolated soft-tissue Bankart lesions, osseous involvement increases the risk of recurrent instability and progressive glenoid bone loss. Arthroscopic fixation techniques have evolved as minimally invasive alternatives to open repair and bone augmentation in appropriately selected cases.</p><p><strong>Indications: </strong>Arthroscopic single-row fixation is indicated for reducible bony Bankart lesions involving small to moderate fragments, typically <25% of the glenoid surface, with adequate fragment viability and an intact capsulolabral sleeve. Larger defects or irreducible fragments may require open fixation or bone augmentation procedures.</p><p><strong>Technical description: </strong>The patient is positioned in the beach-chair position, and standard posterior, anterior, and anterosuperior portals are established. A systematic diagnostic arthroscopy is performed. The capsulolabral complex and attached osseous fragment are thoroughly mobilized using an elevator to achieve anatomic reducibility. The native anterior glenoid rim is lightly decorticated to create a bleeding bone bed while preserving fragment integrity. Fixation proceeds from inferior to superior. A knotless suture anchor is placed at the 5:30 position, and the suture is passed through the anteroinferior labrum at the base of the fragment, restoring inferior glenohumeral ligament tension. A second anchor is placed at the 3:00 position to secure the superior portion of the fragment. Knotless fixation permits incremental tensioning and retensioning to optimize reduction while minimizing fragment malrotation. Final probing confirms stable anatomic reduction.</p><p><strong>Results: </strong>Stable fixation with restoration of the anterior-inferior labral bumper and glenoid contour was achieved arthroscopically. Early follow-up demonstrated maintained stability, minimal pain, and progressive return of range of motion.</p><p><strong>Discussion/conclusion: </strong>Arthroscopic single-row fixation using knotless anchors provides a reproducible, minimally invasive technique for selected bony Bankart lesions. Key technical principles include complete mobilization, preparation of the native glenoid bed, inferior-to-superior fixation, and controlled tensioning. When applied appropriately, this technique restores stability while preserving bone stock and avoiding the morbidity of open procedures.</p><p><strong>Patient consent disclosure statement: </strong>The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.</p>","PeriodicalId":520531,"journal":{"name":"Video journal of sports medicine","volume":"6 5","pages":"26350254261460907"},"PeriodicalIF":0.0,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13542546/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148898863","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medial Patellofemoral Reconstruction with a Hamstring Allograft and Proximal Trochlear Bumpectomy.","authors":"Yining Lu, Nicholas Lemme, Jay S Amin, Cade C Smelley, Zachary R Oppenheim, Adam B Yanke","doi":"10.1177/26350254261452725","DOIUrl":"10.1177/26350254261452725","url":null,"abstract":"<p><strong>Background: </strong>Patellar instability is a common condition in adolescents and young adults, often associated with trochlear dysplasia, patella alta, and increased tibial tubercle-trochlear groove distance. While medial patellofemoral ligament (MPFL) reconstruction (MPFLR) is the most common surgical intervention for recurrent instability, patients with high-grade dysplasia and supratrochlear spurs may require adjunctive procedures to restore stability.</p><p><strong>Indications: </strong>Recurrent lateral patellar instability for MPFLR and Dejour type B or D trochlear dysplasia with a trochlear bump height of ≥5 mm and a positive jumping J-sign on physical examination for adjunct bumpectomy.</p><p><strong>Technique description: </strong>MPFLR using a hamstring allograft, combined with a proximal trochlear bumpectomy, is demonstrated. A superomedial patellar incision was made, and fixation was achieved using 2 knotless PEEK anchors, with a patellar trough created. The Schöttle point was identified fluoroscopically for femoral tunnel placement. The proximal trochlear prominence was resected arthroscopically using a scalpel and a bur under fluoroscopic guidance. The graft was tensioned and fixed with an interference screw, with stability confirmed throughout a full range of motion.</p><p><strong>Results: </strong>MPFLR with hamstring allograft is successful for the majority of patients, with low rates of recurrent instability, apprehension, and reoperation reported in the literature. Proximal trochlear bumpectomy has been described as an alternative to trochleoplasty in cases of high-grade dysplasia with a prominent trochlear spur, with early data suggesting lower recurrence rates and comparable functional outcomes.</p><p><strong>Discussion/conclusion: </strong>MPFLR with allograft combined with proximal trochlear bumpectomy is a viable technique for patients with recurrent patellofemoral instability and a prominent trochlear spur. Further long-term studies are warranted to establish durability and comparative efficacy.</p><p><strong>Patient consent disclosure statement: </strong>The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.</p>","PeriodicalId":520531,"journal":{"name":"Video journal of sports medicine","volume":"6 5","pages":"26350254261452725"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13535050/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148883340","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Open Excision of Snapping Scapula.","authors":"Roger V Ostrander, Mark Goss","doi":"10.1177/26350254261443647","DOIUrl":"10.1177/26350254261443647","url":null,"abstract":"<p><strong>Background: </strong>Snapping scapula syndrome is characterized as an audible crepitus or snapping sensation during scapular motion that can cause pain or discomfort.</p><p><strong>Indications: </strong>It is initially treated nonoperatively, but after failed conservative treatment, it can be treated with open or arthroscopic resection of the symptomatic portion of the scapula.</p><p><strong>Technique description: </strong>The technique in this video is the open resection of the symptomatic superomedial angle of the scapula for treatment of snapping scapula syndrome.</p><p><strong>Results: </strong>The expected result of this procedure is complete resolution of pain and elimination of the snapping or crepitus with scapular motion.</p><p><strong>Discussion/conclusion: </strong>Open excision for snapping scapula syndrome is a safe and easy procedure to perform with good clinical outcomes for persistent symptomatic patients who have failed conservative treatment.</p><p><strong>Patient consent disclosure statement: </strong>The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.</p>","PeriodicalId":520531,"journal":{"name":"Video journal of sports medicine","volume":"6 4","pages":"26350254261443647"},"PeriodicalIF":0.0,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13525301/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148858070","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medial Meniscal Transplant Allograft Using A Hybrid Root Fixation Technique.","authors":"Romed P Vieider, Vince Morgan, Sahil Dadoo, Robert E Bilodeau, Shohei Yamauchi, Seth L Sherman, Volker Musahl","doi":"10.1177/26350254261443649","DOIUrl":"10.1177/26350254261443649","url":null,"abstract":"<p><strong>Background: </strong>High rates of osteoarthritis have been reported after partial and total meniscectomy, attributed to increased joint contact stresses in meniscus-deficient knees. Meniscal allograft transplantation (MAT) with hybrid root fixation has emerged as a treatment for meniscal deficiency, combining the advantages of bony and all-soft-tissue techniques.</p><p><strong>Indications: </strong>MAT is best suited for patients <55 years with symptomatic meniscal deficiency and may require correction of modifiable factors, such as obesity, malalignment, instability, or cartilage loss, before the procedure.</p><p><strong>Technique description: </strong>A size-matched fresh-frozen meniscal allograft is prepared with meticulous preservation of 1 to 2 mm bony wafers at the anterior and posterior roots to maintain meniscal length and enhance fixation. Diagnostic arthroscopy was performed to debride residual tissue and prepare a bleeding cancellous bed for graft integration. Posterior and anterior root tunnels were created using an anterior cruciate ligament tibial guide, enabling precise shuttle and anatomic graft positioning. All inside sutures are used to fixate the meniscus. Final fixation was achieved by tensioning the wafer-root sutures through transtibial tunnels and securing them over cortical buttons at 60° of knee flexion to optimize graft stability.</p><p><strong>Results: </strong>Long-term outcomes of MAT are favorable, with a systematic review of 688 cases (mean age, 33 years) reporting 74% survivorship at 10 years and 60% at 15 years, improved postoperative International Knee Documentation Committee (IKDC) scores, and similar results between bony (53.8%) and suture-only (46.2%) fixation techniques. A recent meta-analysis of 25 studies found graft extrusion to be common but generally comparable between fixation methods, with some evidence suggesting slightly less extrusion with bony fixation.</p><p><strong>Discussion/conclusion: </strong>Hybrid root fixation for medial meniscal allograft transplantation provides increased fixation flexibility with the advantages of bone-to-bone healing.</p><p><strong>Patient consent disclosure statement: </strong>The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.</p>","PeriodicalId":520531,"journal":{"name":"Video journal of sports medicine","volume":"6 4","pages":"26350254261443649"},"PeriodicalIF":0.0,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13525311/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148858054","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The \"Make and Use\" All-Suture Suture Anchor in an Open Hip Abductor Repair.","authors":"Andrew S Bi, Ty L Monty, Chandler A Sparks, Shane J Nho","doi":"10.1177/26350254261443648","DOIUrl":"10.1177/26350254261443648","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;All-suture anchors have gained widespread adoption in the past decade because of their small diameter profile, which permits smaller drill holes, preservation of bone stock, and the ability to place multiple fixation points. Despite these advantages, commercially available all-suture anchors may be cost-prohibitive in certain health care environments. The make-and-use (MAU) all-suture anchor technique is presented as a low-cost alternative.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Indications: &lt;/strong&gt;This technique is particularly suited for soft-tissue repair in resource-limited health care systems or settings with limited implant availability. Contraindications include short diaphyseal canals, where a bottoming-out effect may compromise fixation, and endoscopic/arthroscopic implantation, as direct visualization is recommended to ensure adequate anchor deployment and purchase.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Technique description: &lt;/strong&gt;Two high-tensile strength, nonabsorbable sutures are secured using sequential half-hitch knots to create a compact \"suture ball\" construct. When inserted into a prepared intramedullary bone socket, the construct expands and functions analogously to commercially available all-suture anchors by generating cortical engagement and interference fixation. In this video, the anchor is utilized to achieve double-row fixation of the gluteal tendons to their native footprint on the greater trochanter during an open repair.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;All-suture anchors have demonstrated comparable or superior biomechanical properties relative to other anchor designs, while their low-profile configuration may better preserve bone stock. The MAU anchor allows the fabrication of an all-suture anchor using readily available high-tensile-strength suture material and a low-cost nonabsorbable suture (eg, Ethibond). This construct can be produced at a fraction of the cost of commercially available all-suture anchors. In this technical demonstration, the anchor provided stable fixation during open gluteal tendon repair.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Discussion/conclusion: &lt;/strong&gt;The MAU all-suture anchor is a low-cost alternative for soft-tissue fixation, particularly in economically/resource-constrained environments or when standard implants are unavailable. While indications mirror those of commercially available all-suture anchors, potential limitations include increased operative time and technical demand associated with appropriate construct sizing and deployment. Further biomechanical evaluation and long-term clinical outcomes are warranted to determine the durability and reproducibility of this technique.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Patient consent disclosure statement: &lt;/strong&gt;The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publicatio","PeriodicalId":520531,"journal":{"name":"Video journal of sports medicine","volume":"6 4","pages":"26350254261443648"},"PeriodicalIF":0.0,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13525309/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148858062","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anatomic Total Shoulder Arthroplasty Using Lesser Tuberosity Osteotomy: Technical Considerations.","authors":"Ayham Jaber, Colin P Murphy, Tyler J Uppstrom, Michael Nocek, Eric Piatt, Christopher J Hawryluk, Peter J Millett","doi":"10.1177/26350254261421943","DOIUrl":"10.1177/26350254261421943","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Glenohumeral osteoarthritis (GHO) is a common cause of shoulder pain and dysfunction in middle-aged and older adults. Anatomic total shoulder arthroplasty (aTSA) is the preferred surgical treatment for patients with an intact rotator cuff. This video focuses on technical considerations in aTSA using a lesser tuberosity osteotomy (LTO).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Indications: &lt;/strong&gt;aTSA is indicated in patients with advanced GHO who experience persistent pain, mechanical symptoms, and functional limitations despite prolonged conservative treatment. The rotator cuff should be intact.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Technique description: &lt;/strong&gt;The patient is positioned in the beach-chair position. A standard deltopectoral approach is used. The clavipectoral fascia is incised lateral to the biceps tendon. The anterior circumflex vessels are cauterized, and the superior pectoralis tendon is released for exposure. The biceps tendon is tenodesed after sheath release. An oscillating saw and curved osteotome are used to osteotomize the lesser tuberosity with a ~4 mm thick bone block. The lesser tuberosity and subscapularis are tagged. A \"double hammock\" inferior capsular release is performed to protect the axillary nerve. The humeral head is osteotomized. Glenoid exposure is achieved with retractors and labrum and biceps stump excision. Preoperative planning software is used to correct glenoid version and inclination. A glenoid component is cemented after concentric/eccentric reaming. The humerus is broached sequentially. A press-fit stem is implanted and secured with locking screws if needed. A trial head confirms soft tissue balance before final implantation. The lesser tuberosity is repaired with cerclage sutures. The rotator interval is closed in external rotation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Postoperative anteroposterior and axillary radiographs confirm proper implant positioning and soft tissue balance. Patients are placed in a sling for 3 weeks for comfort, with immediate full passive range of motion except limiting external rotation to 30° for the first 3 weeks to protect the osteotomy. Active and active-assisted range of motion begins at 4 weeks. Initial resistance strengthening begins at 5 weeks, with advanced resistance at 8 weeks.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Discussion/conclusion: &lt;/strong&gt;We present a reproducible technique using a deltopectoral approach, LTO, capsular releases, and meticulous implant positioning. This implant system accommodates native anatomy with variable offset, inclination, and version. Rigid fixation of the lesser tuberosity allows for reliable healing, which can be assessed on routine postoperative radiographs. Pain-free and improved function can be achieved in patients with an appropriate indication for the procedure.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Patient consent disclosure statement: &lt;/strong&gt;The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, t","PeriodicalId":520531,"journal":{"name":"Video journal of sports medicine","volume":"6 4","pages":"26350254261421943"},"PeriodicalIF":0.0,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13525259/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148858050","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lemon Wedge Humeral Head Allograft Reconstruction Technique for Large Reverse Hill-Sachs Lesion.","authors":"Vijay A Chhabra, Zachary V Braig, Brian C Werner","doi":"10.1177/26350254261442527","DOIUrl":"10.1177/26350254261442527","url":null,"abstract":"<p><strong>Background: </strong>Reverse Hill-Sachs lesions (RHSLs) are compression fractures of the anteromedial humeral head that occur with posterior shoulder dislocations, often contributing to recurrent instability and failure of isolated posterior labral repair. Surgical intervention is indicated for large, engaging lesions to restore bone density and prevent recurrent dislocation.</p><p><strong>Indications: </strong>Lemon wedge humeral head allograft reconstruction is a novel technique used for instances of recurrent posterior shoulder instability resulting in a large RHSL.</p><p><strong>Technique description: </strong>Arthroscopic evaluation is used to verify a detached posterior labrum and a large RHSL of the anteromedial humeral head. Posterior labral repair is performed with mobilization, debridement, and fixation using 3 knotless suture anchors, restoring the capsulolabral complex to achieve stable reattachment. Next, attention is turned to the RHSL. Through a deltopectoral approach, the subscapularis tendon is tenotomized for exposure, and the lesion is excised in a wedge fashion. A fresh humeral head allograft, precisely shaped using a wax mold, is press-fit into the defect and stabilized with headless compression screws buried beneath the articular surface. Finally, the subscapularis is repaired to cover the reconstruction and restore anterior stability, completing the combined arthroscopic labral repair and open humeral head allograft transplantation.</p><p><strong>Results: </strong>Postoperative imaging confirmed congruent reduction and stable allograft fixation. Rehabilitation was staged with progressive motion, strengthening, and functional recovery, with return to activity anticipated after 6 months.</p><p><strong>Discussion/conclusion: </strong>RHSLs associated with recurrent posterior instability require careful surgical management. The lemon-wedge humeral head allograft technique provides anatomic reconstruction of the humeral head and restores posterior stability, offering a joint-preserving alternative to arthroplasty in active patients. While technically demanding and biologically limited by graft availability, this approach represents a viable option for managing large RHSLs. The literature suggests that osteochondral allograft transplantation provides favorable outcomes in terms of stability and function. However, long-term complications such as graft resorption, arthritis, and conversion to arthroplasty remain possible. Further studies with long-term follow-up are needed to refine patient selection and optimize surgical outcomes.</p><p><strong>Patient consent disclosure statement: </strong>The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.</p>","PeriodicalId":520531,"journal":{"name":"Video journal of sports medicine","volume":"6 4","pages":"26350254261442527"},"PeriodicalIF":0.0,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13525248/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148858055","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}