Video journal of sports medicine最新文献

{"title":"How to Use Full-Length Standing Radiographs to Measure Posterior Tibial Slope and Anterior Tibial Translation.","authors":"Abid M Khan, Adam V Daniel, Alexander K Bishop, Mario Hevesi, Aaron J Krych, Adam J Tagliero, Bruce A Levy","doi":"10.1177/26350254261419139","DOIUrl":"10.1177/26350254261419139","url":null,"abstract":"<p><strong>Background: </strong>Increased posterior tibial slope (PTS) and anterior tibial translation (ATT) result in a higher risk of anterior cruciate ligament reconstruction failure. Accurate measurement of PTS and ATT is essential to guide surgical planning in these patients. Full-length weightbearing lateral tibial radiographs yield the most accurate measurement of PTS and ATT compared with short-film tibial radiographs, computed tomography scans, and magnetic resonance imaging.</p><p><strong>Indications: </strong>We aim to demonstrate a validated, reproducible technique in a stepwise fashion to accurately measure PTS and ATT using full-length weightbearing lateral tibial radiographs. This presentation adds to the field by offering a precise measurement technique for surgical planning purposes.</p><p><strong>Technique description: </strong>To precisely measure PTS using a full-length weightbearing lateral tibial radiograph, first, perpendicular lines are drawn 5 cm proximal to the ankle joint and 5 cm distal to the knee joint. A line is then extended proximally from the center of the perpendicular line near the ankle through the center of the perpendicular line near the knee, and then extended up to the tibial articular surface. Next, a line is drawn along the medial tibial plateau. The angle measured between these 2 lines is subtracted from 90° to yield the PTS.To precisely measure ATT, a line is drawn along the diaphysis of the tibia and approximated to the posterior aspect of the proximal tibia. Then, another parallel line is drawn and approximated to the posterior aspect of the distal femur. The distance between these lines is measured to yield anterior tibial translation.</p><p><strong>Results: </strong>We measured a PTS of 14.2° and an ATT of 12.6 mm using the technique described in this presentation.</p><p><strong>Discussion/conclusion: </strong>This technique demonstrates an accurate and reproducible method to precisely measure PTS and ATT using full-length weightbearing lateral tibial radiographs. This technique yields greater accuracy in PTS and ATT than other imaging modalities. As a result, there is a direct benefit for surgical planning when using this technique.</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":"26350254261419139"},"PeriodicalIF":0.0,"publicationDate":"2026-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13376453/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148582038","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":"Isolated Proximal Tibiofibular Joint Reconstruction With Semitendinosus Tendon Autograft in a Collegiate Athlete.","authors":"Romir Patel, Luke V Tollefson, Benjiman J Wilebski, Dustin R Lee, Matthew T Rasmussen, Robert F LaPrade","doi":"10.1177/26350254251408438","DOIUrl":"10.1177/26350254251408438","url":null,"abstract":"<p><strong>Background: </strong>Proximal tibiofibular joint (PTFJ) instability is a rare and often underrecognized cause of lateral knee pain and dysfunction, most commonly presenting as anterolateral subluxation of the fibular head after trauma. While conservative management is first-line, persistent instability may require operative intervention.</p><p><strong>Indications: </strong>We present the case of a 20-year-old male athlete who sustained a PTFJ injury during sport and noted instability. After a successful PTFJ diagnostic taping trial, he elected for surgical reconstruction after completing his competitive season. Imaging confirmed an isolated PTFJ pathology without intra-articular knee injury.</p><p><strong>Technique description: </strong>The reconstruction was performed using an ipsilateral semitendinosus tendon autograft. After a standard semitendinosus tendon harvest, a posterolateral approach to the fibular head was performed. A common peroneal nerve neurolysis was performed. The fibular head and proximal lateral tibial tunnels were reamed to reproduce the anatomic attachments of the native ligaments. The graft was passed from anterior to posterior through the fibular tunnel and secured with a bioabsorbable screw. The remaining graft was then passed from posterior to anterior through the tibia and secured using a bioabsorbable interference screw at 70° of knee flexion.</p><p><strong>Results: </strong>Isolated anatomic reconstruction of the PTFJ using a semitendinosus tendon autograft provides excellent restoration of joint stability in cases of chronic anterolateral instability. Postoperative assessment consistently demonstrates elimination of symptomatic subluxation and restoration of fibular head stability under clinical examination. These outcomes align with findings in the limited published literature, which report high rates of return to activity and symptom resolution after anatomic PTFJ reconstruction using autograft techniques.</p><p><strong>Discussion/conclusion: </strong>Anatomic reconstruction of the PTFJ using a semitendinosus tendon autograft provides a reproducible, biomechanically sound option for stabilizing the joint, avoiding complications associated with fibular head resection or fixation constructs. This case highlights key technical considerations, such as graft tensioning, tunnel positioning, and peroneal nerve protection, which are all essential for successful outcomes in young athletic 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":"26350254251408438"},"PeriodicalIF":0.0,"publicationDate":"2026-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13369362/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148458364","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 Reduction and Suspensory Button Fixation of Bony Bankart Lesion.","authors":"Nicholas Sciarretti, Rebecca Haley, Cole Johnson, Joseph S Tramer","doi":"10.1177/26350254251408434","DOIUrl":"10.1177/26350254251408434","url":null,"abstract":"<p><strong>Background: </strong>Bony Bankart lesions (anteroinferior glenoid avulsion fractures) often occur after anterior shoulder dislocations, with an incidence up to 33% in first-time dislocaters. Detachment of the labrum and underlying glenoid bone piece can lead to recurrent instability, especially with increasing glenoid bone loss. Treatment is generally arthroscopic bony Bankart repair in acute injuries with viable bone fragments and minimal glenoid bone loss (<13.5%). However, there is no gold standard for arthroscopic fixation.</p><p><strong>Indications: </strong>Given the acuity of the lesion with a sizeable bony Bankart fracture, a reducible fragment, and the patient's high activity level, arthroscopic reduction and fixation were indicated.</p><p><strong>Technique description: </strong>A high posterolateral viewing portal was created, with the remainder of the portals created under direct visualization. The fracture hematoma was debrided with a shaver. The anterior glenoid fracture was identified with the labrum still attached, and a radial tear of the superior labrum was noted. A combination of instruments was used to release and mobilize the fracture fragment. Two traction stitches were placed into the superior and inferior ends of the fragment to control it during reduction. A hooked guide was used to reduce the fracture back to its origin. A cannulated drill was used to drill through the posterior glenoid through the fracture fragment. The suture and the button were passed anterior to posterior to secure the fragment, tensioned to 100 N, and the fragment was stable in an anatomic position. A luggage tag suture was placed into the capsular-labral complex at the superior aspect of the bony Bankart lesion, and this was impacted just superior to the end of the fracture fragment to secure the labrum back in place.</p><p><strong>Results: </strong>The patient was immobilized in a sling for weeks 0 to 4, progressed in range of motion from weeks 5 to 12, and began strengthening at 12 weeks. At the final follow-up, the patient was back to his usual activities without complaints of pain or apprehension.</p><p><strong>Discussion/conclusion: </strong>Arthroscopic reduction and suspensory button fixation of bony Bankart lesions is a viable option for reducing and fixing these injuries to prevent future development of recurrent instability.</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":"26350254251408434"},"PeriodicalIF":0.0,"publicationDate":"2026-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13354876/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148428402","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":"Endoscopic Iliopsoas Tendon Lengthening and Iliac Fossa Debridement After Total Hip Arthroplasty: A Surgical Technique.","authors":"Dan Cohen, Tyler M Hauer, Michelle A Milgrub, Margaret E Oberst, Robert Apgar, Craig S Mauro","doi":"10.1177/26350254261421942","DOIUrl":"10.1177/26350254261421942","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Iliopsoas tendinopathy is an established cause of persistent anterior groin pain after total hip arthroplasty (THA), with an incidence of 2% to 6%. Although frequently attributed to acetabular component malposition and anterior prominence, symptomatic iliopsoas irritation can also occur in cases with appropriately positioned implants. Ultrasound-guided corticosteroid injection targeted to the iliopsoas tendon can be diagnostic; however, a subset of patients remains refractory to nonoperative management. In these cases, arthroscopic intervention may be indicated. We present a case highlighting the role of iliac fossa osteophyte formation as a source of iliopsoas impingement after THA and demonstrate an arthroscopic technique to address both tendinopathy and osseous impingement.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Technique description: &lt;/strong&gt;The procedure is performed supine on a traction table without traction, utilizing an outside-in extracapsular approach. An anterolateral portal is localized fluoroscopically superficial to the femoral head implant. After arthroscopic insertion, a mid-anterior portal is established. Significant tendinopathy within the iliopsoas tendon and associated bursal/pericapsular inflammation are debrided with an arthroscopic shaver and radiofrequency ablation. The iliac fossa is then exposed, and the osteophyte formation is systematically burred back to eliminate contact between the tendon and the prominent iliac fossa bone. After osteoplasty, a fractional lengthening is performed at the myotendinous junction, incising only the tendinous fibers to reduce tension while preserving muscle to minimize postoperative weakness.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Previous endoscopic iliopsoas lengthening studies after THA demonstrate consistent improvement in patient-reported outcomes with high rates of minimal clinically important difference achievement and low complication rates. Functional hip range of motion is preserved, and a mild reduction in hip flexor strength (approximately 15%-20%) is not clinically limiting in most patients. Comparative analyses also demonstrate lower complication rates for iliopsoas tendon lengthening versus acetabular component revision.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Discussion/conclusion: &lt;/strong&gt;In patients with persistent iliopsoas-related pain after THA with well-positioned implants, iliac fossa osteophytes are an under-recognized source of mechanical irritation. Arthroscopic iliopsoas fractional lengthening, combined with targeted iliac fossa osteophyte debridement, represents a reproducible minimally invasive strategy that relieves tendon overload, restores appropriate tension, preserves implant integrity, and avoids revision arthroplasty.&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","PeriodicalId":520531,"journal":{"name":"Video journal of sports medicine","volume":"6 4","pages":"26350254261421942"},"PeriodicalIF":0.0,"publicationDate":"2026-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13346708/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148428434","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 Posterior Capsular Releases for Recalcitrant Arthrofibrosis.","authors":"Adam V Daniel, Griffin R Rechter, Lindsay E Barrera, Mario Hevesi, Adam J Tagliero, Kelechi R Okoroha, Aaron J Krych, Bruce A Levy","doi":"10.1177/26350254261416547","DOIUrl":"10.1177/26350254261416547","url":null,"abstract":"<p><strong>Background: </strong>The origin of arthrofibrosis of the knee is multifactorial; however, it is more commonly seen in patients with arthritis, prolonged immobility, or a history of trauma or surgery to the knee. Arthrofibrosis that results in a flexion contracture of the knee is commonly attributable to scarring and shortening of the posterior joint capsule as seen in the setting of operative intervention, such as anterior cruciate ligament reconstruction (ACLR).</p><p><strong>Indications: </strong>Arthroscopic posterior capsular releases of the knee are indicated in patients with recalcitrant arthrofibrosis who have (1) failed nonoperative management and (2) a flexion contracture of ≥10°.</p><p><strong>Technique description: </strong>This arthroscopic technique utilizes posteromedial and posterolateral portals in addition to the standard anteromedial and anterolateral portals. A transpatellar tendon portal may also be used to create the posterolateral portal. Both a 30° and a 70° arthroscope are used to better visualize the posteromedial and posterolateral inferior and superior releases. In addition to releases of the capsule both inferiorly and posteriorly, the medial and lateral gastrocnemius tendons can be partially released from the femur to allow for a more adequate release. The 70° arthroscope is necessary to access the capsule posterior to the posterior cruciate ligament to ensure complete release.</p><p><strong>Results: </strong>This procedure is typically reserved for patients who have failed conservative management with extension splinting, physical therapy, and the use of corticosteroids. Persistent arthrofibrosis with flexion contracture can occur after ACLR, with an incidence as high as 38% in some series. The specific technique described in this video has documented patient-reported outcomes of achieving full extension in >90% of patients after an arthroscopic posterior capsular release at final follow-up.</p><p><strong>Discussion/conclusion: </strong>Recalcitrant arthrofibrosis leading to a persisting extension deficit can be devastating for a patient, as it results in increased pain and stiffness, as well as a significant decrease in functionality. Performing a posterior capsular release in addition to the standard manipulation under anesthesia and lysis of adhesions/synovectomy will allow for greater knee range of motion, particularly greater knee extension.</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":"26350254261416547"},"PeriodicalIF":0.0,"publicationDate":"2026-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13338505/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148407492","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":"Osteochondral Fragment Repair Using Knotless All-Suture Anchor Technique Within Patellofemoral Joint.","authors":"Brett P Salazar, Ravi Krishnan, Brent R Sanderson, Sarah Lander","doi":"10.1177/26350254251408070","DOIUrl":"10.1177/26350254251408070","url":null,"abstract":"<p><strong>Background: </strong>The optimal technique for fixation of osteochondral fragments sustained after traumatic patellar dislocations remains controversial, with several described techniques in the literature-including screws, pins, anchors, and suture-based techniques. All-suture anchor fixation utilizes a small-caliber unicortical drill hole, minimizing the creation of bony defects and the disruption of healthy cartilage by the fixation construct.</p><p><strong>Indications: </strong>In this study, we present a male patient with a history of acute left knee pain after a patellar dislocation who was found to have a large osteochondral fragment within the patellofemoral joint. After extensive discussion regarding the treatment options, the patient was indicated for knee arthroscopy with loose-body removal, open osteochondral fragment repair, and medial patellofemoral ligament reconstruction. For this video, we focus on the open osteochondral fragment repair portion of the procedure.</p><p><strong>Technique description: </strong>The procedure begins by preparing both the fragment and the chondral defect for repair by debridement of fibrous tissue. The periphery is trimmed to stable cartilage edges of matching size and shape. The repair surface is roughened to promote bleeding of the subchondral bone and facilitate healing. All-suture anchors are placed around the periphery of the repair. The osteochondral fragment is secured within the defect using sutures tensioned between the anchors. A layer of fibrin glue is used to finalize the repair.</p><p><strong>Results: </strong>Open osteochondral repair using an all-suture fixation is a viable technique for stable cartilage repair. Although outcomes data are sparse, studies have demonstrated chondral healing with modern repair techniques similar to the one described in this demonstration.</p><p><strong>Discussion/conclusion: </strong>Many fixation techniques are possible for osteochondral fragments after traumatic patellar dislocations. We demonstrate a novel technique using an all-suture fixation construct with stable fragment fixation, focusing on technical tips and outlining a postoperative rehabilitation protocol.</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":"26350254251408070"},"PeriodicalIF":0.0,"publicationDate":"2026-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13328987/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148393312","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 Fixation of a Distal Fibula Fracture With an Intramedullary Nail.","authors":"Jothi Murali-Larson","doi":"10.1177/26350254261452269","DOIUrl":"10.1177/26350254261452269","url":null,"abstract":"<p><strong>Background: </strong>Advantages of using an intramedullary (IM) nail over a lateral plate for fixation of distal fibula fractures include the ability to allow for earlier weightbearing and return to sport, smaller incisions, and decreased hardware prominence. When comparing a fibular nail with an IM screw, the nail allows for syndesmosis fixation through the device and imparts rotational stability. Long-term studies support the viability and clinical outcomes of using an IM nail. In this technique video, a case is presented to illustrate the use of an IM nail for fixation of a distal fibula fracture.</p><p><strong>Indications: </strong>Distal fibula fractures should be treated operatively in the following cases: open fractures, bimalleolar fractures, or lateral malleolar fractures with medial clear space widening, displacement >3 mm, or decreased tib-fib overlap, increased talocrural angle, any talar displacement, fracture-dislocation, or nonunion. When treating these fractures operatively, it is crucial to get an anatomic reduction, as this will lead to a satisfactory outcome. By restoring the anatomy, the talar shift is decreased, and a normal tibiotalar contact area is approached.</p><p><strong>Technique description: </strong>Percutaneous incisions are made around the fracture to place a clamp and hold anatomic reduction. Once reduced, a small incision is made 1cm distal to the fibular tip and in line with its axis. The start point is checked with the K-wire on anteroposterior and lateral views. An opening reamer is used, followed by a flexible guidewire and then a proximal reamer. Talons are deployed once the appropriate position is confirmed, and interlocking screws are placed through the guide. Syndesmosis fixation is added if necessary.</p><p><strong>Results: </strong>The success rate for achieving good outcomes is high at 90%. Patients should be counseled that their braking time while driving is normal at around 9 weeks and that overall recovery is about 2 years.</p><p><strong>Discussion/conclusion: </strong>This technique should not be used if the 6.2-mm opening reamer will breach the cortex, and should not be used if a plate will provide superior fixation. Like with any nailing procedure, obtaining and maintaining the reduction is paramount. A proper start point is critical for optimal fixation.</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 3","pages":"26350254261452269"},"PeriodicalIF":0.0,"publicationDate":"2026-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13305480/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148348522","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":"Comprehensive Patellofemoral Cartilage Restoration: Trochlear OCA, Patellar MACI, and TTO.","authors":"Alysala M Malik, Beth G Ashinsky, Lauren H Redler","doi":"10.1177/26350254261452268","DOIUrl":"10.1177/26350254261452268","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Bipolar patellofemoral chondral defects in young, active patients present a challenging clinical problem due to persistent pain, functional limitation, and complex biomechanical contributors. While cartilage restoration procedures such as matrix-induced autologous chondrocyte implantation (MACI), osteochondral allograft (OCA) transplantation, and tibial tubercle osteotomy (TTO) have demonstrated favorable outcomes individually, combined restoration strategies addressing both focal cartilage loss and patellofemoral mechanics are less well described. We performed a single-stage, triple-modality comprehensive patellofemoral cartilage restoration, including a trochlear OCA, a patellar MACI, and TTO to offload and realign the patellofemoral joint.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Indications: &lt;/strong&gt;The described combined procedure was indicated in a healthy, active 37-year-old female with bilateral symptomatic full-thickness bipolar patellofemoral chondral defects refractory to extensive nonoperative treatment. Imaging demonstrated bipolar patellofemoral cartilage lesions consisting of a full-thickness trochlear osteochondral defect and a full-thickness patellar chondral defect with associated lateral patellar subluxation but without instability, abnormal patellar height, or elevated tibial tubercle-trochlear groove distance.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Technique description: &lt;/strong&gt;The patellar defect was prepared with stable vertical walls for MACI implantation while preserving the subchondral bone. The trochlear lesion was sized, reamed, and reconstructed using a size-matched fresh OCA prepared to achieve flush articular congruity. A TTO with approximately 1 cm medialization and anteriorization was performed to reduce patellofemoral contact pressures and protect the cartilage restoration constructs. The MACI graft was then trimmed to match the patellar defect and secured with fibrin glue. Standard layered closure and structured rehabilitation with protected weightbearing and early motion were utilized postoperatively.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;At 5-month follow-up, the patient demonstrated improved pain, full patellar mobility, and range of motion from 0° to 135°, with return to baseline activities. Radiographs demonstrated healed tibial tubercle osteotomies and well-incorporated OCAs bilaterally. These findings are consistent with the existing literature, which demonstrates significant improvements in patient-reported outcomes after combined cartilage restoration and patellofemoral unloading procedures, including high satisfaction and return-to-sport rates after MACI, OCA, and TTO procedures.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Discussion/conclusion: &lt;/strong&gt;This case demonstrates a comprehensive approach to bipolar patellofemoral cartilage disease that simultaneously addresses focal cartilage pathology and the underlying biomechanical environment. The literature supports the use of MACI for isolated chondral defects, OCA for osteochondral lesions with subch","PeriodicalId":520531,"journal":{"name":"Video journal of sports medicine","volume":"6 3","pages":"26350254261452268"},"PeriodicalIF":0.0,"publicationDate":"2026-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13305384/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148348576","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":"Meniscal Root Repair With Centralization.","authors":"Lydia McKeithan, Cassandra A Lee","doi":"10.1177/26350254261451037","DOIUrl":"10.1177/26350254261451037","url":null,"abstract":"<p><strong>Background: </strong>Meniscal root tears compromise hoop stress resistance and lead to elevated tibiofemoral contact pressures, meniscal extrusion, and rapid progression of osteoarthritis. Prompt diagnosis and intervention are essential to prevent further degenerative changes.</p><p><strong>Indications: </strong>Meniscal root repair is indicated in patients with acute traumatic tears or chronic symptomatic root tears without advanced arthritis. Root repair has been shown to be beneficial regardless of the patient's age, even in the setting of early arthritis. Contraindications to root repair are severe osteoarthritis or poor surgical candidacy. Meniscus centralization is an important augment to the repair, particularly in the setting of meniscal extrusion.</p><p><strong>Technique description: </strong>After diagnostic arthroscopy, visualization of the medial compartment is enhanced via controlled medial collateral ligament pie-crusting. The meniscal root footprint is decorticated, and the meniscotibial ligaments are released to mobilize the meniscus. Two luggage-tag sutures are placed across the tear and shuttled through a transtibial tunnel drilled to the native root footprint. A knotless anchor secures the repair. Centralization is achieved by placing a knotless all-suture anchor at the mid-coronal medial tibial plateau, with sutures passed in a mattress configuration through the meniscocapsular junction, preventing extrusion. Root sutures are then tensioned and fixed with the knee in 90° of flexion.</p><p><strong>Results: </strong>This anatomic transtibial repair with centralization has been shown to restore hoop stresses, reduce meniscal extrusion, and provide superior outcomes compared with meniscectomy or nonoperative management. Patients undergoing root repair report improved pain, function, and activity levels.</p><p><strong>Discussion/conclusion: </strong>Transtibial meniscal root repair with centralization is a reproducible technique that restores meniscal function, minimizes extrusion, and delays the progression of osteoarthritis. The luggage-tag suture configuration mitigates suture cutout, and careful attention to centralization placement and tensioning optimizes outcomes. Postoperative rehabilitation should emphasize progressive weightbearing and strengthening, with return to sport typically achievable by 6 months. This approach provides durable symptom relief and joint preservation when applied to appropriately selected 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 3","pages":"26350254261451037"},"PeriodicalIF":0.0,"publicationDate":"2026-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13287401/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148321593","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":"Retensionable All-Suture Anchor Extensor Mechanism Repair.","authors":"Zachary S Aman, Samuel G Lorentz, Robert T Tisherman, Jocelyn R Wittstein","doi":"10.1177/26350254261416542","DOIUrl":"10.1177/26350254261416542","url":null,"abstract":"<p><strong>Background: </strong>Extensor mechanism tendon ruptures, including the quadriceps and patellar tendons, are devastating injuries that most often require acute surgical repair to restore knee mechanics and function. There are 2 well-described categories of quadriceps repair techniques, including superior pole suture anchor repairs and transosseous repairs, with recent studies reporting similar overall outcomes. However, failure rates have been reported to be as high as 18% and 21%, respectively.</p><p><strong>Indications: </strong>Extensor mechanism ruptures.</p><p><strong>Technique description: </strong>The described technique utilizes 2 transosseous patellar tunnels. Retensionable all-suture anchor loops are then passed from the distal cortex to the near cortex, setting the suture anchors at the distal cortex. A Krakow stitch is passed from proximal to distal along the medial tendon, through the suture loop, and then distal to proximal through the central tendon and tied. This is repeated for the lateral half of the tendon. The suture loops are then tensioned to reduce the quadriceps tendon to the patella. The knee is cycled to remove creep from the Krakow suture, and the anchors are retensioned as needed to avoid gapping. This technique can also be utilized for patellar tendon ruptures in a similar fashion, with passage of the loops from proximal to distal and setting of the all-suture implant at the superior pole.</p><p><strong>Results: </strong>In our experience, patients undergoing extensor mechanism repair with knotless retensionable all-suture anchors have achieved successful outcomes. The transosseous adjustable all-suture anchor has been shown to be biomechanically superior to a traditional transosseous suture repair, with significantly less gap formation, higher load-to-failure, and greater stiffness. Furthermore, the adjustable knotless anchor allows retensioning that may improve compression, minimize laxity both intra- and postoperatively, and allow more aggressive flexion range of motion during the early postoperative course. The all-suture anchor may also potentially limit complications related to hardware irritation when metal buttons are used for bicortical fixation or hard-bodied anchors are utilized at the superior pole.</p><p><strong>Discussion/conclusion: </strong>Transosseous retensionable all-suture anchors offer an alternative high- strength construct for extensor mechanism repairs, with a unique ability to minimize creep within repair constructs intraoperatively.</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 3","pages":"26350254261416542"},"PeriodicalIF":0.0,"publicationDate":"2026-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13272873/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148280639","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}