Video journal of sports medicine最新文献

{"title":"Posterior Bony Bankart Bridge and Reverse Remplissage in an Elite Contact Athlete.","authors":"Ayham Jaber, Tyler J Uppstrom, Michael Nocek, Colin P Murphy, Taylor K Calibo, Peter J Millett","doi":"10.1177/26350254251389134","DOIUrl":"10.1177/26350254251389134","url":null,"abstract":"<p><strong>Background: </strong>Posterior or multidirectional shoulder instability are common among athletes subjected to repetitive posterior loading. Posterior glenohumeral dislocation can result in a posterior bony Bankart lesion, which presents a unique challenge in arthroscopic repair.</p><p><strong>Indications: </strong>Surgical repair is considered for patients with high physical demands and for those with instability refractory to nonoperative treatment, as observed in this 21-year-old professional hockey player. In select cases of elite contact athletes, even a modest reverse Hill-Sachs lesion (rHSL) and posterior bone loss may justify augmentation with a posterior bony Bankart bridge and reverse remplissage, as these techniques aim to minimize the risk of recurrence and optimize return to play.</p><p><strong>Technique description: </strong>The patient is positioned in the beach-chair position. The rHSL is gently debrided. A straight crescent suture lasso is used to pierce the lateral subscapularis from anterior to posterior, and a 1.3-mm SutureTape is shuttled. Both suture limbs are retrieved and loaded into a 4.75-mm SwiveLock anchor. The anchor is placed in the rHSL, securing the tendon into the defect under individual limb tensioning. To repair the posterior bony Bankart lesion, a posteroinferior portal is created. The bony lesion is debrided and elevated. Two 1.8-mm knotless FiberTak anchors are placed to repair the posterior labrum inferiorly and superiorly to stabilize the bony fragment to the glenoid and aid in repair. A 2.4-mm SutureTak anchor is then placed at the glenoid neck medial to the lesion, and its sutures are inserted into a 2.9-mm PushLock anchor at the glenoid margin between 2 previously placed anchors, creating a \"bony Bankart bridge\" for compression. Capsular closure is performed with a polydioxanone suture, which is passed through the posterior capsule using a lasso from the posterior portal and tied down with Weston knots to close the deep capsule and maintain tension. When the anchor trajectory is challenging, curved guides may be substituted for straight guides. The posterior bony Bankart fragment is carefully exposed and debrided before fixation to ensure optimal healing.</p><p><strong>Results: </strong>Published outcomes of the posterior bony Bankart bridge demonstrate excellent stability with high return-to-sport rates. Similarly, while most literature focuses on anterior remplissage, the principles and outcomes of reverse remplissage are consistent with low recurrence rates in patients with rHSLs. Even small rHSLs and modest posterior bone loss may warrant augmentation in elite collision athletes, as recurrent instability can have career-threatening consequences. Further research should focus on long-term durability and comparative effectiveness of this combined strategy.</p><p><strong>Discussion/conclusion: </strong>Appropriate portal placement and meticulous technique execution are integral to avoiding po","PeriodicalId":520531,"journal":{"name":"Video journal of sports medicine","volume":"6 4","pages":"26350254251389134"},"PeriodicalIF":0.0,"publicationDate":"2026-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13458100/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148715251","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":"Focalplasty for Resurfacing of Focal Articular Lesions of the Medial Femoral Condyle.","authors":"Napatpong Thamrongskulsiri, Andres Valdivia San Roman, Logan D Moews, Tomas F Vega, Felipe Casanova, Jacob T Morgan, Tanner Nishioka, Jorge Chahla","doi":"10.1177/26350254261429887","DOIUrl":"10.1177/26350254261429887","url":null,"abstract":"<p><strong>Background: </strong>Focal osteochondral defects of the knee are difficult to manage, as untreated lesions may progress to early osteoarthritis. The OvertureTi Knee Resurfacing System is designed to treat focal defects while preserving native bone, cartilage, and soft tissue.</p><p><strong>Indications: </strong>Focalplasty is indicated in patients with compartmentalized cartilage lesions, preserved ligamentous stability, and meniscal integrity or repairable tears. Appropriate alignment, joint space preservation, and minimal osteophyte formation are required.</p><p><strong>Technique description: </strong>The procedure began with arthroscopic repair of the medial meniscus root using a transtibial pull-out technique. Following this, an open approach was performed to expose the medial femoral condyle. The chondral defect was sized, and appropriate instrumentation was used to prepare the site. Cartilage scoring and sequential reaming were performed to achieve the desired depth and contour. Trial components were confirmed to fit and position, after which peg holes were drilled and filled with bone cement. Finally, the oblong OvertureTi femoral implant was seated flush with the surrounding cartilage surface, and standard wound closure was completed.</p><p><strong>Results: </strong>At 2 weeks, radiographs confirmed proper implant positioning. Long-term outcomes of the Overture prosthesis are not yet available. However, studies on similar implants, such as the HemiCAP, have reported improved function and survivorship at mid- to long-term follow-up.</p><p><strong>Discussion/conclusions: </strong>The Overture prosthesis offers advantages over arthroplasty and biologic resurfacing, including lower cost, off-the-shelf availability, preservation of native tissues, and bone conservation for future arthroplasty. Larger prospective studies are required to determine its long-term clinical 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 4","pages":"26350254261429887"},"PeriodicalIF":0.0,"publicationDate":"2026-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13451671/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148698758","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 4-Compartment Fasciotomy for Chronic Exertional Compartment Syndrome of the Lower Extremity.","authors":"Tomás F Vega, Thomas E Moran, Napatpong Thamrongskulsiri, Gabriel Octavio Pérez Lloveras, Felipe Casanova, Jacob T Morgan, Logan D Moews, Jorge Chahla","doi":"10.1177/26350254261421940","DOIUrl":"10.1177/26350254261421940","url":null,"abstract":"<p><strong>Background: </strong>Chronic exertional compartment syndrome (CECS) is an underrecognized cause of lower extremity dysfunction in athletes. Open 4-compartment fasciotomy remains the gold standard for surgical management.</p><p><strong>Indications: </strong>Operative intervention is indicated for patients with clinically and objectively confirmed CECS who fail to respond to conservative management. Contraindications include inadequate nonoperative treatment or unaddressed medical comorbidities. Proper diagnosis requires exclusion of vascular or neurologic causes that can mimic CECS symptoms.</p><p><strong>Technique description: </strong>A 2-incision, 4-compartment fasciotomy is performed with the patient supine and a thigh tourniquet applied. Two lateral incisions-1 distal (7 cm, 11 cm from the lateral malleolus) and 1 proximal (3 cm, at the fibular head)-allow decompression of the anterior and lateral compartments under direct visualization. The superficial peroneal nerve is identified and protected throughout. Medially, a 7-cm incision is made 2 cm posterior to the tibial border to decompress the superficial and deep posterior compartments. The saphenous vein and nerve are mobilized anteriorly, and the deep posterior compartment is released by detaching the soleal bridge along the posteromedial tibia.</p><p><strong>Results: </strong>Postoperative protocols emphasize early range-of-motion exercises and progressive gait retraining, with return to sports typically at 12 weeks. Recent studies demonstrate that 4-compartment fasciotomy allows 64% to 96% of patients to return to function, although recurrence rates approach 45% and revision rates up to 25% have been reported. Wound complications occur in 15% to 25% of cases but are mitigated by meticulous dissection and neurovascular protection.</p><p><strong>Discussion/conclusion: </strong>Four-compartment fasciotomy remains the most reliable treatment for CECS refractory to conservative care. Success depends on comprehensive compartment release and precise identification of neurovascular structures to minimize complications. While most patients achieve meaningful symptom relief and functional recovery, recurrence underscores the importance of surgical precision and postoperative rehabilitation to ensure durable 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":"26350254261421940"},"PeriodicalIF":0.0,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13443247/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148687470","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 (Arthro) Delivery of MACI (Autologous Cultured Chondrocytes on a Porcine Collagen Membrane) for Defects on MFC and Trochlea With concomitant TTO.","authors":"Michael A Kuhn","doi":"10.1177/26350254261429890","DOIUrl":"10.1177/26350254261429890","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Chondral pathology of the knee-specifically involving the femoral condyles and trochlea-is commonly observed during knee arthroscopies. This condition may necessitate supplementary interventions, such as a concomitant tibial tuberosity osteotomy (TTO). Approaching this patient population with a straightforward, less invasive arthroscopic technique may offer an advanced solution.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Indications: &lt;/strong&gt;Arthro matrix-induced autologous chondrocyte implantation (MACI; autologous cultured chondrocytes on a porcine collagen membrane) targets symptomatic chondral lesions in the knee that are consistent with magnetic resonance imaging findings, which range in size from 2 to 4 cm&lt;sup&gt;2&lt;/sup&gt;, are contained within a stable rim, and are classified as grade 3 to 4a according to the International Cartilage Repair Society.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Technique description: &lt;/strong&gt;This technique for the arthroscopic delivery of MACI for defects located on the trochlea and femoral condyles has been developed as a progressive advancement in the evolution of autologous chondrocyte implantation technology. The described technique addresses these defect locations by utilizing the same arthroscopic approach for both cartilage defect locations and a separate incision for TTO. The instruments used include 3 varieties of curettes, an arthroscopic cutter to score the cartilage, and the V-shuttle membrane delivery device. Furthermore, attention is dedicated to the medial and lateral approaches, patellar elevation for trochlear access, meticulous defect preparation, hemostasis and fluid management, and implant delivery. Arthroscopic surgical procedures generally result in reduced postoperative pain, necessitating a decreased analgesic requirement, an earlier and enhanced joint mobility, less postoperative muscle inhibition, and expedited recovery. Moreover, an arthroscopic approach may reduce the length of the surgical incision for patients concerned about cosmetic outcomes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;In contrast to various other arthroscopic procedures related to knee ligaments or meniscal injuries, the implementation of arthroscopic delivery of MACI for defects on the trochlea and femoral condyles of the knee offers a persuasive and readily executable alternative for a proficient surgeon, even when performed in conjunction with TTO.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Discussion/conclusion: &lt;/strong&gt;This arthroscopic technique for the delivery of the MACI implant can effectively treat multiple knee chondral lesions in different compartments when paired with TTO. Advantages of this approach include minimal surgical disruption, the ability to perform combined knee arthroscopic procedures, a more desirable cosmetic appearance, and improved early postoperative 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 patient(s) appearing in this publication. If the individual may be i","PeriodicalId":520531,"journal":{"name":"Video journal of sports medicine","volume":"6 4","pages":"26350254261429890"},"PeriodicalIF":0.0,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13434179/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148674930","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":"On-lay Anatomical Reconstruction of the Superficial and Deep MCL and POL With Hamstrings Tendons Autograft.","authors":"Silvia Cardarelli, Valerio Nasso, Alessandro Carrozzo, Veronica Giuliani, Edoardo Monaco","doi":"10.1177/26350254261421937","DOIUrl":"10.1177/26350254261421937","url":null,"abstract":"<p><strong>Background: </strong>Injuries to the medial collateral ligament (MCL) and the posterior oblique ligament (POL), isolated or associated with cruciate ligament tear, are common in cases of knee sprains and often cause valgus instability. Although there are many surgical techniques for MCL reconstruction, not all are anatomical, and not all involve reconstruction of the deep and superficial bundles of the MCL and POL with an autologous autograft.</p><p><strong>Indications: </strong>We propose this technique in cases of chronic anterior cruciate ligament (ACL) tear associated with POL and MCL injury grade III according to the Hughston-Eilers classification.</p><p><strong>Technique description: </strong>This technique involves an on-lay anatomical reconstruction of the superficial and deep bundles of the MCL and POL using hamstring tendons. The patient is in a supine position with the knee flexed at 90°. An incision is made in the medial compartment of the knee, at the level of the medial collateral ligament, after which the hamstring tendons are harvested with an open tendon stripper so that they can be left inserted at their tibial insertion. Three soft tissue self-punching anchors are positioned at the anatomical insertion of the MCL and POL bundles. Care must be taken not to involve the joint surface, which is easily visible through a needle. The tendons are secured using the previously positioned anchors to reconstruct the MCL and POL.</p><p><strong>Results: </strong>After 5 months, the patient returned to her daily activities, fully recovered knee range of motion, and achieved good recovery of muscle strength without discomfort or functional limitations.</p><p><strong>Discussion/conclusion: </strong>This technique provides an anatomical reconstruction of the MCL and POL using on-lay all suture anchors for chronic lesions. Hastring autografts are used for MCL and POL reconstruction, leaving other autografts available for ACL reconstruction. There is no need for an additional tunnel for MCL and POL reconstruction, thus avoiding tunnel convergence in multiligament reconstructions.</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":"26350254261421937"},"PeriodicalIF":0.0,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13428139/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148655652","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 Gluteus Reconstruction with Inlay Enthesis Allograft and Onlay Acellular Dermal Allograft.","authors":"Ty L Monty, Chandler A Sparks, Kristen I Barton, Shane J Nho","doi":"10.1177/26350254261421938","DOIUrl":"10.1177/26350254261421938","url":null,"abstract":"<p><strong>Background: </strong>Gluteus medius/minimus tears are common, especially in older women. These can occur acutely due to trauma or chronically from degeneration. Treatment options vary depending on the extent of the tear. In cases with poor tendon quality or retracted tears, allograft augmentation is a promising surgical option that may enhance repair strength and healing potential.</p><p><strong>Indications: </strong>Open gluteus medius/minimus repair with allograft augmentation is indicated for patients with large, chronic tears that are unlikely to heal due to factors such as age, tissue degeneration, or prior failed repairs. Specifically, allograft augmentation is used in chronic tears, massive tears with fatty atrophy, and revision surgeries.</p><p><strong>Technique description: </strong>The patient is secured in the lateral decubitus position. An incision is made directly over the greater trochanter to expose the gluteus medius and minimus tendons. The tendons are mobilized and reduced to their footprint, allowing identification and decortication. The enthesis biphasic inlay allograft is added to a slightly excavated area on the trochanteric footprint. The glute tendon is then sewn superficially, above the inlay enthesis graft, in a secure manner. Proximal anchors are placed, and the onlay human dermal allograft is cut to appropriate dimensions for fixation to the torn tendon, with sutures placed both anteriorly and posteriorly. Anchor sutures are then passed through the graft-tendon-graft construct and in mattress fashion, forming the proximal row. One suture limb from each mattress is then loaded into a double-row anchor to form the distal row.</p><p><strong>Results: </strong>There are case series in the literature describing outcomes after gluteal reconstruction; however, this is the first demonstration of the use of biphasic enthesis allograft for gluteal reconstruction. Open gluteal reconstructions have shown improvements in patient-reported outcomes, pain, and hip functionality.</p><p><strong>Discussion/conclusion: </strong>Open gluteus medius/minimus reconstruction with inlay biphasic enthesis allograft and onlay acellular dermal allograft provides an immediate scaffold for strength and support. The allograft augmentation should be considered particularly for cases of retracted tears and fatty infiltrated musculature. The enthesis graft has been used successfully in rotator cuff repairs, and its benefits are applicable to the hip for significant tears with poor repair quality.</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":"26350254261421938"},"PeriodicalIF":0.0,"publicationDate":"2026-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13424792/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148655578","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 Rotator Cable Reconstruction With Dermal Allograft Tuberoplasty Augmentation for an Irreparable Massive Rotator Cuff Tear.","authors":"Alexander R Markes, James P Bradley","doi":"10.1177/26350254261419140","DOIUrl":"10.1177/26350254261419140","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Massive irreparable rotator cuff tears present significant management challenges, particularly with nonarthroplasty options. The combination of rotator cable reconstruction with dermal allograft tuberoplasty represents a technique designed to partially restore biomechanical function while addressing persistent pain through biologic augmentation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Indications: &lt;/strong&gt;This technique is indicated for patients with massive rotator cuff tears involving multiple tendons with significant retraction where complete repair is not possible, particularly when patients experience persistent pain and functional limitations despite conservative management.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Technique description: &lt;/strong&gt;The procedure involves 2 primary components performed arthroscopically. First, rotator cable reconstruction is performed using nonabsorbable ultrahigh molecular weight polyethylene suture placed in a running nonlocking fashion along the free edge of the rotator cuff from anterior to posterior, with locking stitches at endpoints. The cable is secured at the anterior and posterior margins of the greater tuberosity with a knotless 4.75-mm biocomposite suture anchor. Second, tuberoplasty is performed using power instrumentation to create a smooth acromiohumeral articulation, followed by dermal allograft augmentation. The dermal allograft patch is secured medially using the knotless suture in the previously placed medial anchors and laterally with 5.5-mm biocomposite anchors. Key technical considerations include using accessory percutaneous portals, rolling the graft for insertion through a cannula, and selecting appropriate anchors based on bone quality.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The literature supports favorable outcomes, with cable reconstruction demonstrating reduced retear rates and improved acromiohumeral distance, with tuberoplasty separately demonstrating improved pain relief in the setting of rotator cuff tears. The combined approach seeks to address both biomechanical restoration and pain relief through biologic interpositional grafting.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Rotator cable reconstruction with dermal allograft tuberoplasty offers a promising nonarthroplasty treatment option for massive irreparable rotator cuff tears. This technique partially restores suspension bridge function while providing biologic augmentation for pain relief and improved acromiohumeral mechanics. The procedure represents an important addition to the surgical armamentarium for managing complex rotator cuff pathology, although further clinical research is needed to establish clinical outcomes and optimal patient selection criteria.&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 pa","PeriodicalId":520531,"journal":{"name":"Video journal of sports medicine","volume":"6 4","pages":"26350254261419140"},"PeriodicalIF":0.0,"publicationDate":"2026-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13408049/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148611913","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":"Ulnar Collateral Ligament Hybrid Reconstruction With Palmaris Longus Autograft, Suture Brace Augmentation, and Ulnar Nerve Transposition.","authors":"Andrew S Bi, Jacob T Morgan, Tomas F Vega, Logan D Moews, Tanner Nishioka, Nikhil N Verma","doi":"10.1177/26350254261419143","DOIUrl":"10.1177/26350254261419143","url":null,"abstract":"<p><strong>Background: </strong>Many overhead athletes, both amateur and professional, experience an increasing number of injuries to the ulnar collateral ligament (UCL) as a result of overuse or trauma. As a result of this increasing frequency, multiple techniques have been developed to reconstruct or repair the UCL with success and faster return to sports (RTS) for athletes who are ideal candidates for a repair. However, a large proportion of UCL tear patients cannot undergo repair due to chronic injury, leading to poor tissue quality, midsubstance tears, or older age, which predispose them to slower healing and a more difficult path to total rehabilitation. The senior author's \"hybrid\" reconstruction combines a palmaris longus autograft for reconstruction with a repair-style suture brace augmentation that allows for increased load-to-failure strength that parallels the native UCL, while allowing for native anatomic motion of the ligament when ranging the elbow.</p><p><strong>Indications: </strong>This technique is indicated for patients with a UCL tear confirmed by magnetic resonance imaging, poor to moderate UCL tissue quality, midsubstance tears, and older patients who have a palmaris longus tendon to harvest and persistent ulnar nerve paresthesias.</p><p><strong>Technique description: </strong>This video demonstrates the senior author's technique of harvesting a palmaris autograft, drilling proximal and distal UCL graft passage tunnels, augmenting the graft with an internal suture brace, fixation of the graft, and finally an ulnar nerve transposition to alleviate ulnar nerve paresthesia.</p><p><strong>Results: </strong>Outcomes of retrospective studies demonstrate good to excellent outcomes of UCL hybrid reconstructions with suture brace augmentation and RTS rates of at least 85%. Complication rates are low, with the most common complication being graft failure (14%) and the next most common being temporary ulnar nerve paresthesia.</p><p><strong>Discussion/conclusion: </strong>Overall, this video demonstrates a highly effective technique at restoring native-like biomechanics and function for patients with UCL tears that are too complex to repair. Patients have good to excellent outcomes and RTS rates, although time to RTS may take 12 months or longer.</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":"26350254261419143"},"PeriodicalIF":0.0,"publicationDate":"2026-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13400932/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148595415","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":"Endosteal Button Fixation for Latissimus Dorsi Tendon Rupture in a Bodybuilding Athlete.","authors":"Jasraj S Raghuwanshi, Jelle P van der List, Nichole M Perry, Alan W Reynolds, Nicholas A Trasolini, Brian R Waterman","doi":"10.1177/26350254261419141","DOIUrl":"10.1177/26350254261419141","url":null,"abstract":"<p><strong>Background: </strong>Bodybuilders are uniquely at risk of shoulder injuries given training intensity, frequency, and heavy overhead loads through a full arc of motion. Latissimus tears are rare injuries that have increased incidence in overhead and weightlifting athletes, following forceful hyperabduction/adduction during sport-specific activities. Humeral avulsions of the latissimus tendon are treated with endosteal button fixation.</p><p><strong>Indications: </strong>Endosteal button repair is indicated for acute or chronic latissimus tears up to 2 years after injury, in patients who are unable to return to their desired level of competition or activities of daily living. Retracted tears or repairs under significant tension are often salvageable given the latissimus tendon's ability to stretch, and concurrent teres major injury may be addressed in a similar fashion.</p><p><strong>Technique description: </strong>Latissimus repair entails posterior axillary dissection of the tendinous stump, identification and protection of the radial nerve intersecting the common brachial artery, tagging the tendon with polyethylene suture tape, and reduction to the footprint with endosteal buttons. Key steps of the technique involve protecting the neurovascular bundle and restoring the 90° turn of the tendon before inserting it on the humerus.</p><p><strong>Results: </strong>Latissimus repair has excellent patient-reported outcomes and return to elite competition in 2 prior case series of professional overhead athletes. Our patient was able to return to amateur bodybuilding without persistent pain or strength deficit.</p><p><strong>Discussion/conclusion: </strong>Bodybuilders are at a unique risk of latissimus tendon ruptures given their high-demand training. Here, we present our best practices for endosteal button fixation in this unique population of athletes.</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":"26350254261419141"},"PeriodicalIF":0.0,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13392306/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148581965","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 Graft Harvest: The Bone Transfer Technique.","authors":"Jesper Fritz, Sebastien Parratte, Charles Brown","doi":"10.1177/26350254261421941","DOIUrl":"10.1177/26350254261421941","url":null,"abstract":"<p><strong>Background: </strong>Bone-patellar tendon-bone (BPTB) autograft for anterior cruciate ligament (ACL) reconstruction (ACLR) is strong and has a low failure rate. However, postoperative anterior knee pain remains a concern because of bony defects at the harvest site, which can be reduced with proper bone grafting.</p><p><strong>Indications: </strong>BPTB autograft for ACLR is indicated for professional athletes, patients returning to pivoting sports, patients undergoing revision surgery, and patients with hyperlaxity, increased recurvatum, or increased posterior tibial slope. This technique is indicated for all these patients, except for revision ACLR, as the bone transfer from the tibial tunnel is not recommended because of the previous ACL tunnel.</p><p><strong>Technique description: </strong>A 4-cm vertical anteromedial proximal tibial incision is made medial to the patellar tendon. The skin is mobilized using full-thickness skin flaps, and the paratenon is split longitudinally to expose the patellar tendon. The mid-third of the tendon is harvested, and bone blocks are taken from both ends of the graft, with special consideration taken to harvest a deep tibial bone block to be able to use the deep portion of the tibial bone block to bone graft the patellar defect. A coring reamer is used to create the tibial ACL tunnel, resulting in a bone cylinder to be used to bone graft the tibial tuberosity defect. Finally, the superficial portion of the tendon and the paratenon are closed, and finally, the skin incision is closed in layers.</p><p><strong>Results: </strong>As previously shown, BPTB autograft for ACLR has a low failure rate and a high return to sports rate, especially in young individuals.</p><p><strong>Discussion/conclusion: </strong>Multiple techniques for BPTB harvest have been described, but we believe this technique addresses the major concern of postoperative anterior knee pain. A bony defect from bone block harvest is a crucial cause of postoperative anterior knee pain, but anatomical bone grafting reduces the risk of harvest-site pain. Furthermore, autologous bone graft heals faster than other grafts, and our technique is designed to address all of these factors by using an autologous bone prism for the patella and a bone cylinder for the tibial tuberosity to avoid defects and restore anatomy.</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":"26350254261421941"},"PeriodicalIF":0.0,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13385582/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148551956","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}