Video journal of sports medicine最新文献

{"title":"Associated Reconstruction Of Acl And Lcl Tears Plus Proximal Tibiofibular Joint Instability With Asymmetric Hamstring Graft.","authors":"Alejandro Espejo-Reina, Giovanni Fruner, María Josefa Espejo-Reina, Maximiano Lombardo-Torre, Enrique Sevillano-Pérez, Alejandro Espejo-Baena","doi":"10.1177/26350254261442524","DOIUrl":"10.1177/26350254261442524","url":null,"abstract":"<p><strong>Background: </strong>Proximal tibiofibular joint (PTFJ) dislocation is a rare injury, and if missed or misdiagnosed, it can lead to chronic PTFJ instability, especially in the case of a multiligamentous knee injury. Optimal treatment is poorly understood and includes a vast arsenal of surgical techniques.</p><p><strong>Indications: </strong>Surgical treatment is indicated in cases of PTFJ dislocations that are irreducible by closed means, chronic symptomatic dislocations/instability, and first-time dislocations with bony fracture. Risk of persistent symptoms has been reported to be higher than acceptable with conservative management. Anatomical reconstruction is necessary to restore the optimal PTFJ biomechanics and to improve clinical outcomes. The case of a patient with an uncommon set of multiligamentous knee injuries, that is, PTFJ dislocation, anterior cruciate ligament (ACL), and lateral collateral ligament (LCL) tear, is presented, along with a surgical approach not previously described in the literature.</p><p><strong>Study design: </strong>Case report and a surgical technique; Level of evidence, 4.</p><p><strong>Technique description: </strong>A surgical technique is described for the combined reconstruction of ACL, LCL, and PTFJ injuries using asymmetrically prepared hamstring autografts. The procedure includes an extra-articular lateral reinforcement through a modified Lemaire procedure, utilizing a single femoral tunnel. Fixation is achieved with a tibial suspension device for ACL reconstruction, a shared femoral fixation for both the ACL and LCL grafts, and a combined tibial fixation for the LCL and PTFJ reconstruction.</p><p><strong>Results: </strong>The present technique provides a suitable option for the rare combined injury involving ACL and LCL tears along with PTFJ disruption, using a single hamstring graft, a modified Lemaire procedure, and only 3 fixation points for the reconstruction.</p><p><strong>Discussion/conclusion: </strong>The reconstruction of multiligament knee injuries often requires multiple grafts-including allografts-along with a high risk of tunnel convergence and loss of bone stock. The present technique offers a safe and feasible alternative that preserves bone stock and avoids the need for allografts.</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":"26350254261442524"},"PeriodicalIF":0.0,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13525249/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148858007","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 Treatment of Tenosynovial Giant Cell Tumor of the Hip With Concomitant Femoracetabular Impingement Syndrome.","authors":"Joseph C Brinkman, Chandler A Sparks, Ty L Monty, Shane J Nho","doi":"10.1177/26350254261422410","DOIUrl":"10.1177/26350254261422410","url":null,"abstract":"<p><strong>Background: </strong>Tenosynovial giant cell tumor (TGCT) is a benign but locally aggressive proliferative disorder of the synovium. TGCT of the hip is destructive to the joint and is a risk factor for early total hip arthroplasty (THA). Open synovectomy has previously been the gold-standard treatment. However, hip arthroscopy has emerged as a less invasive approach for the management of TGCT of the hip.</p><p><strong>Indications: </strong>Arthroscopic management of TGCT of the hip is indicated when there is either confirmed TCGT on biopsy or strong suspicion for TCGT based on clinical and radiologic findings, minimal-to-no arthritis, a lesion that is accessible and resectable arthroscopically, and an available trained hip arthroscopist.</p><p><strong>Technique description: </strong>The patient is positioned supine on a post- or postless traction table. Anterolateral and mid-anterior portals are created in standard fashion. An interportal capsulotomy is created sharply between the 2 portals, and traction sutures are placed for improved visualization. Defects of the central compartment are addressed, then an arthroscopic scalpel is used to extend the vertical limb of the capsulotomy for creation of a T-type capsulotomy. An arthroscopic grasper is used to mobilize the TGCT lesion. The concomitant CAM-type deformity is then resected using a high-speed burr. The remaining TGCT lesion is then resected, followed by meticulous synovectomy using a shaver and electrocautery. The capsule is then plicated using high-molecular-weight sutures.</p><p><strong>Results: </strong>Numerous case series have supported the arthroscopic management of TGCT of the hip, showing improved and excellent patient reported outcomes, low rates of THA conversion, low rates of recurrence, and low complication rates.</p><p><strong>Discussion/conclusion: </strong>Hip arthroscopy can be an effective, minimally invasive surgical technique for the arthroscopic management of TGCT of the hip.</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":"26350254261422410"},"PeriodicalIF":0.0,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13525300/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148858010","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":"Habitual Patellar Dislocation of the Adult: Surgical Technique and Case Report.","authors":"Santiago Pache, Nicolás Morales, Ricardo Pereyra, Luke V Tollefson, Robert F LaPrade","doi":"10.1177/26350254261442523","DOIUrl":"10.1177/26350254261442523","url":null,"abstract":"<p><strong>Background: </strong>Habitual patellar dislocation (HPD) is a rare patellar instability knee condition. Although it is more common in children, it can also be observed in adults. This is an extremely debilitating condition in which the patella is reduced in full extension and dislocates with every flexion movement, typically at 30° of knee flexion. There is typically a significant contracture of the iliotibial band, lateral retinaculum, vastus lateralis, and even the quadriceps muscle/tendon unit, as well as potentially bony alterations. Given the unique pathogenic behavior of this condition, compared with classic patellar instability, the surgical technique is unique and must be well recognized. We present the surgical technique of an HPD of the left knee of an adult male patient.</p><p><strong>Indications: </strong>After failure of physical therapy, surgical treatment is indicated.</p><p><strong>Technique description: </strong>We performed a 4-in-1 procedure through a medial patellofemoral ligament (MPFL) reconstruction using a tenodesis of the quadriceps tendon, tibial tubercle osteotomy for anteromedialization, lateral retinaculum lengthening with vastus lateralis release, and quadriceps tendon lengthening.</p><p><strong>Results: </strong>Range of motion (ROM) exercises are encouraged from day 1 to prevent recurrent contracture of the lateral soft tissues. After 26 months of follow-up, the patient had almost no pain, full ROM, a stable patella, and Kujala and Single Assessment Numeric Evaluation scores of 80 and 77, respectively. Although he returned to recreational activities, he decided not to resume playing soccer.</p><p><strong>Discussion/conclusion: </strong>HPD of the adult is a rare entity, in which a meticulous surgical procedure on a step-by-step basis should be performed. Anatomic reconstruction of the MPFL and management of the soft-tissue structures are key to allowing for a safe early ROM and better outcomes. Although different surgical techniques have been described, larger case series are needed.</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":"26350254261442523"},"PeriodicalIF":0.0,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13525299/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148858013","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":"Proximal Medial Patella Restraint Reconstruction: Medial Patellofemoral Ligament and Medial Quadriceps Tendon-Femoral Ligament Reconstruction.","authors":"Nicholas L Newcomb, Ryan C Price, Jordan A Buttner, Dustin J Richter, Christopher L Shultz, Andrew J Veitch, Gehron P Treme","doi":"10.1177/26350254261429891","DOIUrl":"10.1177/26350254261429891","url":null,"abstract":"<p><strong>Background: </strong>The proximal medial patella restraints (PMPR) are comprised of the medial patellofemoral ligament (MPFL) and the medial quadriceps tendon femoral ligament (MQTFL) and serve as the principal patellar stabilizers in early to mid-flexion of the knee.</p><p><strong>Indications: </strong>PMPR reconstruction is an ideal stabilization technique for recurrent patellar instability or after a first-time dislocation associated with an osteochondral fracture requiring surgical treatment.</p><p><strong>Technique description: </strong>A single 3 to 4 cm longitudinal incision is made at the midpoint between the medial patella and medial epicondyle. A single hamstring allograft is used. This graft is passed through a slit in the medial aspect of the quadriceps tendon deep to the vastus medialis toward the origin on the femur to create the MQTFL limb. The remaining MPFL limb is anchored to its inferior insertion site on the patella, then laid into a trough along the medial patella. The 2 limbs are then passed through a femoral socket and anchored with a PEEK tenodesis screw at 45° of flexion.</p><p><strong>Results: </strong>The patient's patellar stability was markedly improved with normal physiologic translation, and she was able to return to competitive softball without further dislocation events. Studies evaluating similar combined MPFL/MQTFL reconstructions have reported improvements in recurrent instability.</p><p><strong>Discussion/conclusion: </strong>This technique for PMPR reconstruction may provide more anatomic and physiologic medial patellar stabilization in cases of patellar instability without increasing time, cost, or complexity of the procedure or recovery.</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":"26350254261429891"},"PeriodicalIF":0.0,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13519177/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148842234","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":"Minimally Invasive Approach to Multiligament Knee Reconstruction: Arthroscopic PCL and PLC With Percutaneous LCL Reconstruction.","authors":"Corentin Philippe, Ali Alayane, Stefano Jacotti, Victor Sonnery-Cottet, Dany Mouarbes, Regis Pailhe, Etienne Cavaignac","doi":"10.1177/26350254261416544","DOIUrl":"10.1177/26350254261416544","url":null,"abstract":"<p><strong>Background: </strong>Multiligament knee injuries involving the posterior cruciate ligament (PCL), posterolateral corner (PLC), and lateral collateral ligament (LCL) are rare but complex pathologies. Historically managed with open surgery, these injuries are increasingly being addressed using minimally invasive techniques, which provide anatomical reconstruction and less surgical morbidity.</p><p><strong>Indications: </strong>We report the case of a 24-year-old male farmer who sustained a high-energy multiligament knee injury after a motorcycle accident. Six months after the accident, he presented with persistent daily instability affecting his work and recreational activities. Clinical and radiological evaluation confirmed chronic injuries to the PCL, PLC, and LCL.</p><p><strong>Technique description: </strong>A 1-stage, all-arthroscopic and percutaneous reconstruction was performed. The PCL was reconstructed using a pedicled semitendinosus autograft with tibial tunnel placement via a trans-septal portal for direct visualization. The PLC was addressed arthroscopically by placing a knotless anchor for femoral fixation of the reconstructed popliteus tendon, using an extensor hallucis longus allograft. The LCL was reconstructed using a gracilis autograft via a percutaneous technique, minimizing soft-tissue dissection and avoiding tunnel convergence. This minimally invasive strategy enabled anatomical graft placement with reduced risk of neurovascular injury and greater potential for accelerated recovery.</p><p><strong>Results: </strong>Postoperatively, the patient wore a hinged PCL dynamic brace for 3 months with no weightbearing for the first 6 weeks. Physical therapy was initiated immediately after surgery with a focus on a controlled range of motion and progressive strengthening. The aim was to allow him to safely return to manual labor and sports activities 6 to 9 months after the surgery.</p><p><strong>Discussion/conclusion: </strong>This case highlights the feasibility and effectiveness of a 1-stage, all-arthroscopic, percutaneous reconstruction of chronic PCL, PLC, and LCL injuries. This technique provides reliable anatomical restoration with minimal surgical morbidity and promising early clinical outcomes, particularly in physically demanding patients.</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":"26350254261416544"},"PeriodicalIF":0.0,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13504089/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148820914","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":"Chronic Acromioclavicular Joint Reconstruction With Semitendinosus Allograft: The X's Technique.","authors":"Andrew S Bi, Jacob T Morgan, Tomas F Vega, Logan D Moews, Enrico M Forlenza, Nikhil N Verma","doi":"10.1177/26350254261442526","DOIUrl":"10.1177/26350254261442526","url":null,"abstract":"<p><strong>Background: </strong>The acromioclavicular (AC) and coracoclavicular (CC) joints provide anteroposterior and superoinferior stability, respectively, of the scapula in relation to the lateral clavicle. Chronic or high-grade (≥IIIB) AC dislocations should be treated with a structured rehabilitation program, and if symptoms persist, they typically require reconstruction to restore alignment, relieve pain, and improve scapular function.</p><p><strong>Indications: </strong>This technique is indicated for chronic AC joint dislocations that are Rockwood grade IIIB-VI injuries that have failed conservative management. Patients should demonstrate both horizontal and vertical AC instability to use this technique.</p><p><strong>Technique description: </strong>The senior author's \"X's\" technique for AC joint reconstruction using semitendinosus (ST) allograft is detailed here. This arthroscopically assisted open approach uses diagnostic arthroscopy first to identify joint landmarks. The undersurface of the acromion is identified, and a brief bursectomy is performed. A tensionable button construct (TightRope and DogBone) is utilized to reduce the AC joint. Four all-suture anchors are used to form an X configuration and stabilize the AC joint. The ST allograft is passed through the anterolateral portal, looped around the coracoid, and secured over the top of the clavicle for additional fixation of the joint.</p><p><strong>Results: </strong>This technique does not yet have specific outcome data; however, similar techniques have demonstrated that ST allograft and autograft augmentation improve patient-reported outcomes and load resistance. Additionally, reconstructing the AC joint, in addition to the CC joint, improves patient horizontal instability. Allograft and autograft reconstruction techniques have low failure rates and help patients return to sport at their preinjury level.</p><p><strong>Discussion/conclusion: </strong>AC joint reconstruction with an ST allograft using the \"X's\" technique is a novel method of AC and CC joint treatment for patients with chronic AC joint dislocations that are Rockwood grade IIIB-VI, providing improved patient vertical and horizontal fixation via the 3 \"X\" constructs: the tensionable button construct, \"X\" of the all-suture anchors across the AC joint, the \"X\" of the ST graft around the coracoid and clavicle, and an optional \"X\" across the AC joint with the ST graft.</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":"26350254261442526"},"PeriodicalIF":0.0,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13498800/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148805029","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 Shell Osteochondral Allograft Transplantation for Full-Thickness Patellar Cartilage Lesions.","authors":"Patrick M Ryan, Garrett R Jackson, Caleb J Bischoff, Samuel Gieg, James L Cook, James P Stannard, Clayton W Nuelle","doi":"10.1177/26350254261429889","DOIUrl":"https://doi.org/10.1177/26350254261429889","url":null,"abstract":"<p><strong>Background: </strong>Large cartilage defects of the patella in young, active patients present a significant treatment challenge, with a risk of progression to patellofemoral arthritis. Shell osteochondral allografts are a treatment option for large, irregular, or uncontained lesions, particularly in cases involving subchondral bone pathology or the failure of previous cartilage repair surgeries.</p><p><strong>Case presentation: </strong>We present the case of a 24-year-old female with persistent anterior knee pain and mechanical symptoms after 5 previous knee surgeries. Preoperative imaging confirmed diffuse, full-thickness chondral lesions with subchondral bone involvement.</p><p><strong>Operative technique: </strong>The patient underwent a patellar shell osteochondral allograft transplantation. The procedure involved resection of a 7-mm patellar shell, creation of a superior bony shelf with a step cut osteotomy in the native patella, and fixation of a precisely matched shell allograft. The step-cut osteotomy of the native patella and the corresponding bony shelf created on the graft creates added stability to the graft, with the shelf secured with superior bioabsorbable polylactic acid (PLA) bone fixation nails and the inferior aspect of the graft secured with antirotation bioabsorbable PLA pins.</p><p><strong>Results: </strong>Postoperative imaging at 3 months demonstrated excellent graft incorporation while maintaining the native patellar thickness. The patient progressed through a 5-phase rehabilitation protocol designed for a 9-to-16-month recovery and return to play.</p><p><strong>Discussion/conclusion: </strong>A review of the literature supports the efficacy of patellar osteochondral allograft transplantation, with reported graft survival rates of approximately 88% at 5 years and 77% at 10 years. Studies also show high rates of return to sport (75%-87%) and patient satisfaction. Shell osteochondral allografting is a viable and effective treatment for complex patellar chondral defects, providing durable outcomes and a reliable return to activity for young patients. In this video, we describe a novel technique for allograft fixation to enhance the stability of the shell allograft, allowing earlier postoperative weightbearing and range of motion activities.</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":"26350254261429889"},"PeriodicalIF":0.0,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13490812/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148804949","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":"All-Suture Repair of a Posterior Sternoclavicular Fracture Dislocation in an Adolescent Athlete.","authors":"Cole Morrissette, Lauren Redler","doi":"10.1177/26350254261421939","DOIUrl":"https://doi.org/10.1177/26350254261421939","url":null,"abstract":"<p><strong>Background: </strong>Posterior sternoclavicular (SC) physeal separations are rare injuries in adolescents and pose a significant risk of life-threatening complications due to potential compression of vital mediastinal structures. This necessitates prompt diagnosis and stable fixation to ensure safe healing and return to function.</p><p><strong>Indications: </strong>The primary indication for surgery was an acute, unstable, posteriorly displaced physeal fracture of the medial clavicle in a 14-year-old competitive jiu-jitsu athlete. Computed tomography revealed the displaced metaphyseal fragment abutting the junction of the right brachiocephalic vein and superior vena cava, making operative stabilization essential to mitigate the risk of neurovascular compromise.</p><p><strong>Technique description: </strong>The procedure involved an open reduction of the displaced clavicular metaphysis and internal fixation using a physeal-respecting, all-suture repair. High-strength suture tapes were passed through transosseous tunnels created in the medial clavicular epiphysis and the metaphysis, creating a low-profile, robust construct that anatomically reduces the fracture.</p><p><strong>Results: </strong>At 3 months postoperatively, the patient had a well-healed, nontender incision with full, painless range of motion. Radiographs confirmed anatomic union, and the patient was cleared for an unrestricted return to competitive jiu-jitsu.</p><p><strong>Discussion/conclusion: </strong>An all-suture, open reduction and internal fixation is a safe and effective treatment for posterior SC physeal separations in adolescent athletes. This physeal-respecting technique provides the stability necessary for a reliable return to high-impact sports while avoiding implant-related morbidity and preserving the growth potential of the medial clavicle.</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":"26350254261421939"},"PeriodicalIF":0.0,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13482056/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148804993","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 Ulnar Collateral Ligament Reconstruction With Positive Pivot Shift Test.","authors":"Matthew J Schultz, William DiCiurcio, Hunter Smith, Tyler Radack, Luke S Austin","doi":"10.1177/26350254261429892","DOIUrl":"https://doi.org/10.1177/26350254261429892","url":null,"abstract":"<p><strong>Background: </strong>Posterolateral rotatory instability of the elbow (PLRI) results from incompetence of the lateral ulnar collateral ligament (LUCL), part of the lateral elbow ligamentous complex. A pivot shift test is a sensitive and specific intraoperative maneuver to assess for PLRI. While several LUCL repair and reconstruction techniques have been described, ligament reconstruction remains the gold standard treatment.</p><p><strong>Indications: </strong>LUCL reconstruction is indicated for active patients with symptomatic PLRI whose conservative treatment has failed. Patients classically present with pain and mechanical symptoms, often during active elbow extension, supination, and valgus loading, or with maneuvers such as pushing up from a chair. While the pivot shift test has poor sensitivity in awake patients, it is useful as an examination under anesthesia. This case involves a patient with PLRI and a positive pivot shift test under anesthesia.</p><p><strong>Technique: </strong>We present a video-based technique guide of LUCL allograft reconstruction utilizing a docking technique at the humerus with transosseous ulnar tunnels. The patient was positioned supine with the arm on a hand table. The lateral elbow was approached through a Kocher interval. A semi-tendinosis allograft was passed through transosseous ulnar tunnels at the supinator crest, docked into the humerus at the isometric point, and secured over a bone bridge. A postreconstruction pivot shift test confirmed stability of the elbow.</p><p><strong>Results: </strong>LUCL reconstruction with ulnar tunnels reliably improves pain and restores elbow stability. In this case, the pivot-shift test was eliminated after graft fixation, and the patient's symptoms resolved postoperatively. This technique restores native LUCL biomechanics and durable elbow stability.</p><p><strong>Discussion/conclusion: </strong>LUCL reconstruction with ulnar transosseous tunnels is a reproducible technique for addressing posterolateral rotatory instability. The pivot-shift test is a valuable intraoperative tool for assessing PLRI. This case and video may serve as a useful tool for orthopaedic surgeons implementing biomechanically sound allograft reconstruction of the LUCL via transosseous tunnels.</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":"26350254261429892"},"PeriodicalIF":0.0,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13476593/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148763770","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":"Single-Stage Revision Anterior Cruciate Ligament Reconstruction With Concomitant Lateral Extra-articular Tenodesis, High Tibial Osteotomy, and Medial Femoral Condyle Osteochondral Allograft Transplantation.","authors":"Tomás F Vega, Thomas E Moran, Napatpong Thamrongskulsiri, Logan D Moews, Gabriel Octavio Pérez Lloveras, Felipe Casanova, Jacob T Morgan, Jorge Chahla","doi":"10.1177/26350254261442528","DOIUrl":"https://doi.org/10.1177/26350254261442528","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Combined ligamentous insufficiency, malalignment, and focal cartilage lesions in young, active patients represent a complex reconstructive challenge. Recent advances in patient-specific instrumentation, osteotomy planning, and biologic grafting techniques have enabled single-stage surgical solutions that address both instability and joint preservation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Indications: &lt;/strong&gt;The patient presented with grade 2B Lachman and rotational instability after a previous anterior cruciate ligament (ACL) reconstruction (ACLR). Indications for this combined approach included (1) ACL graft insufficiency with persistent rotational instability, treated with revision ACLR and lateral extra-articular tenodesis; (2) a 4 cm&lt;sup&gt;2&lt;/sup&gt; focal chondral defect of the trochlea, treated with osteochondral allograft transplantation (OCA); and (3) 6° varus malalignment in the setting of revision ACLR and cartilage restoration, treated with medial opening wedge high tibial osteotomy (HTO). A concomitant lateral meniscal root tear contributing to rotational instability was managed with root repair.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Technique description: &lt;/strong&gt;Preoperative 3-dimensional computed tomography imaging with patient-specific instrumentation guided the osteotomy and tunnel trajectories to avoid interference between fixation constructs. After graft harvest and diagnostic arthroscopy, the femoral ACL tunnel was reamed, and the tibial tunnel was created through the patient-specific guide. The OCA was sized, harvested, and implanted flush to the trochlea. The medial opening wedge HTO (1° valgus overcorrection) was stabilized with a precontoured plate and tricortical bone wedges. The lateral extra-articular tenodesis graft, harvested as a 10 × 80 mm iliotibial band strip, was passed deep to the lateral collateral ligament and fixed at the proximal Kaplan's fiber region with a 4.75-mm polyetheretherketone suture anchor in 90° of flexion and neutral rotation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Early follow-up demonstrated restored coronal alignment, well-positioned tunnels, and early osteotomy healing. The patient achieved full range of motion by 3 months and progressed with strengthening. The literature supports that combined ACLR, alignment correction, and cartilage restoration procedures restore stability and alignment while preserving native knee function, with 10-year studies reporting durable improvements in patient-reported outcomes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Discussion/conclusion: &lt;/strong&gt;Single-stage revision ACL reconstruction with concomitant LET, medial opening wedge HTO, and osteochondral allograft transplantation is a feasible and effective strategy for young, active patients with combined ligamentous insufficiency, malalignment, and focal cartilage lesions, offering joint preservation with early functional recovery.&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 patie","PeriodicalId":520531,"journal":{"name":"Video journal of sports medicine","volume":"6 4","pages":"26350254261442528"},"PeriodicalIF":0.0,"publicationDate":"2026-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13469564/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148761915","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}