Video journal of sports medicine最新文献

{"title":"Handheld Ultrasound for Personalized All-Soft-Tissue Quadriceps Tendon Anterior Cruciate Ligament Reconstruction.","authors":"Constance R Chu, Leina'ala Song, Jade He, Eugene Roh","doi":"10.1177/26350254251408068","DOIUrl":"10.1177/26350254251408068","url":null,"abstract":"<p><strong>Background: </strong>The use of quadriceps tendon autograft for anterior cruciate ligament (ACL) reconstruction (ACLR) has substantially increased in popularity. Advantages include similar clinical outcomes to other autografts and greater intra-articular tendon volume. However, injury to the quadriceps muscle during graft harvest may compromise quadriceps recovery, which reduces clinical outcomes. Females have been identified as being at higher risk of poor quadriceps recovery after all soft tissue quadriceps tendon ACLR, with 61% of females reported to be unable to achieve terminal extension 6 weeks after surgery.</p><p><strong>Indications: </strong>To allow for 15 to 20 mm of graft-to-bone tunnel healing, autografts 65 to 70 mm long and 10 mm wide have been recommended for adults. A 3-dimensional magnetic resonance imaging study showed that quadriceps tendon length correlates with height and that 90% of patients 5'6\" or taller had a quadriceps tendon length >70 mm. However, the Centers for Disease Control and Prevention (CDC) data show that 80% of adult females and 18% of adult males are shorter than 5'6\" tall. This means that, for about half of adults and the vast majority of females, the quadriceps tendon may not support the harvest of a 70 mm all-soft-tissue graft without potentially injuring muscle tissue.</p><p><strong>Technique description: </strong>Quadriceps tendon length and morphology can be readily assessed by ultrasound. This video demonstrates an easy new method for measuring quadriceps tendon morphology using handheld ultrasound devices that takes <1 minute.</p><p><strong>Results: </strong>This information provides surgeons with knowledge and tools to customize graft harvest to avoid quadriceps muscle injury.</p><p><strong>Discussion/conclusion: </strong>Avoiding the removal of the quadriceps muscle during graft harvest reduces the role that donor-site morbidity can play in compromising quadriceps recovery after ACLR.</p><p><strong>Patient consent disclosure statement: </strong>The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.</p>","PeriodicalId":520531,"journal":{"name":"Video journal of sports medicine","volume":"6 3","pages":"26350254251408068"},"PeriodicalIF":0.0,"publicationDate":"2026-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13167307/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147944556","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Forum <i>Video Journal of Sports Medicine</i> Special Edition.","authors":"","doi":"10.1177/26350254261448126","DOIUrl":"10.1177/26350254261448126","url":null,"abstract":"<p><p>Graphical AbstractThis is a visual representation of the abstract.</p>","PeriodicalId":520531,"journal":{"name":"Video journal of sports medicine","volume":"6 3","pages":"26350254261448126"},"PeriodicalIF":0.0,"publicationDate":"2026-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13167348/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147944532","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":"Rectus Femoris Tendon Harvesting: Step-by-Step Open Technique.","authors":"Juan Esteban Osorio Salas, Juan Felipe Fernández Lopera, John Byron Álzate Arboleda, Daniel Vanegas Isaza, Ruben Dario Arias Perez","doi":"10.1177/26350254261419146","DOIUrl":"10.1177/26350254261419146","url":null,"abstract":"<p><strong>Background: </strong>The rectus femoris tendon autograft has emerged as a reliable alternative to hamstring and patellar tendon grafts, providing a thick, robust structure with low donor-site morbidity. Its consistent anatomy allows predictable graft dimensions while potentially minimizing postoperative quadriceps weakness. Owing to its length, uniform thickness, and high tensile strength, the rectus femoris tendon represents a versatile option for ligament reconstructions requiring substantial graft integrity.</p><p><strong>Indication: </strong>This technique is indicated for primary or revision ligament reconstructions that require a long, strong autograft-including combined anterior cruciate ligament (ACL) and anterolateral ligament (ALL) reconstructions. It may also be applied in selected multiligament knee reconstruction scenarios.</p><p><strong>Technique description: </strong>With the patient in the supine position and the knee flexed to 80° to 90°, a 3 to 4 cm vertical incision is made over the lateral third of the quadriceps tendon, just proximal to the patella. After subcutaneous dissection, the fascia is incised longitudinally to expose the glistening rectus femoris tendon. The lateral border of the rectus femoris is identified and separated from the vastus lateralis, preserving a 2-mm rim for closure. A 10 mm-wide, full-thickness strip is marked and dissected from the underlying vastus intermedius. The tendon is released distally toward the patella to maximize length, then harvested proximally with a closed tendon stripper, yielding a 30 to 35 cm graft.</p><p><strong>Results: </strong>This approach consistently provides grafts of adequate diameter and length for single- or double-bundle reconstructions. We applied this technique in 25 patients undergoing combined ACL and ALL reconstruction, with no graft-harvesting-related complications. Isokinetic dynamometry demonstrated no clinically relevant quadriceps strength deficit at 6 months postoperatively compared with the contralateral limb.</p><p><strong>Discussion/conclusion: </strong>This technique allows a safe and reproducible technique that provides high-quality autografts while preserving quadriceps strength. The proximal incision enhances identification of the rectus and vastus lateralis while minimizing the risk of arthrotomy. Careful distal and proximal dissection ensures optimal graft length and prevents rupture. The favorable structural characteristics and absence of measurable functional deficits support its use as a dependable option for both primary and revision ligament 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 2","pages":"26350254261419146"},"PeriodicalIF":0.0,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13150120/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147871303","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, Retensionable, Onlay Double-Bundle Medial Collateral Ligament Reconstruction.","authors":"Adam W Anz, Garrett Waller, Mark Callanan","doi":"10.1177/26350254251408067","DOIUrl":"10.1177/26350254251408067","url":null,"abstract":"<p><strong>Background: </strong>The superficial medial collateral ligament (sMCL) is the most injured knee ligament, and the most commonly coinjured ligament in anterior cruciate ligament tears. The technique's goal is to be less invasive while maintaining the hamstrings' function.</p><p><strong>Indications: </strong>Surgical indications for this technique include isolated grade 3 injuries that fail nonoperative management and multiligament knee injuries that include the MCL.</p><p><strong>Technique description: </strong>Items needed for the double-bundle reconstruction technique include an anterior tibialis graft > 270 mm, C-Arm for visualization of radiographic landmarks, 2 knotless all-suture anchors, and an adjustable-loop suspensory fixation device. First, create a 3-4-cm incision over the distal tibial insertion of the sMCL, approximately 6 cm from the joint line. Then, split the hamstring fascia and identify the distal tibial insertion of the sMCL. Create a bleeding bed of bone at the anterior and posterior aspects of the distal tibial insertion of the sMCL. Place a knotless suture anchor at the anterior aspect of the distal tibial insertion of the sMCL and a knotless suture anchor at the posterior aspect of the distal tibial insertion of the sMCL. Proximally, identify LaPrade's radiographic femoral landmark for the origin of the sMCL. Make a 1-cm incision over this radiographic landmark. Then, place a spade-tip guide pin through the radiographic landmark, the femur, and the lateral cortex. This creates a femoral reconstruction socket. Then, shuttle the allograft into position from distal to proximal. Pull it into the femoral socket with the loop suspensory device. Then, secure it distally with 2 knotless suture anchors. Final tension is performed with the suspensory loop device with the assistance of arthroscopic viewing of the medial compartment.</p><p><strong>Results: </strong>This technique has been performed clinically by the senior author for the past 7 years. No reoperations nor revision surgeries have been required in the senior author's practice.</p><p><strong>Discussion/conclusion: </strong>This minimally-invasive, retensionable, onlay double-bundle MCL reconstruction technique effectively restores medial knee stability and does not compromise the hamstrings' function to provide medial dynamic knee stability.</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 2","pages":"26350254251408067"},"PeriodicalIF":0.0,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13135655/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147848935","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":"Axillary Nerve Decompression for Neurogenic Quandrangular Space Syndrome in a Volleyball Player: 2-Dimensional Operative Video.","authors":"Michael N Saunders, Alex C Donaghy, Yamaan S Saadeh","doi":"10.1177/26350254251404953","DOIUrl":"10.1177/26350254251404953","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Quadrangular space syndrome (QSS) is a rare condition involving compression of the axillary nerve and/or posterior circumflex humeral artery within the quadrangular space. Neurogenic QSS is caused by entrapment of the axillary nerve due to fibrotic bands, paralabral cysts, trauma, or space-occupying lesions, leading to shoulder pain, weakness, and deltoid atrophy, which is frequently observed in athletes performing overhead activities.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Indications: &lt;/strong&gt;A 21-year-old female competitive volleyball player presented with a 5-year history of progressive right arm weakness and shoulder pain, worsened by shoulder activity. The patient's symptoms persisted despite conservative treatments. On examination, she had visible right anterolateral deltoid atrophy and 4/5 weakness with right shoulder forward flexion. Electromyography showed denervation of all 3 deltoid heads with severely decreased motor units, while magnetic resonance imaging demonstrated compression of the right axillary nerve within the quadrangular space and denervation changes of the deltoid muscle. Given the failure of nonsurgical interventions, ongoing symptom progression, and examination findings, axillary nerve decompression was recommended.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Technique description: &lt;/strong&gt;A posterior surgical approach was used for axillary nerve decompression using microsurgical techniques. The patient was positioned supine; a posterior arm incision was made, and the deltoid muscle and the long head of the triceps brachii were exposed and retracted to access the quadrangular space. The teres major fascia was opened to visualize and divide a compressive fibrotic band, completing the nerve decompression.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The surgery was successful, with significant postoperative improvements. The patient began rehabilitation at 4 weeks postoperatively and experienced restored deltoid muscle mass and strength by the 6-month follow-up, and durable relief at 2 years postoperatively. She achieved a full return to sports.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Discussion/conclusion: &lt;/strong&gt;Axillary nerve decompression proved effective for treating neurogenic quadrangular space syndrome in this case, especially after conservative management had failed. The procedure preserved shoulder function without the need for additional surgical interventions. Return to sports was achievable without complications by 6 months postoperatively. At 2 years postoperatively, the patient continued to have durable relief. The treatment and outcome in this case were consistent with existing literature on this topic, which is Level 4 evidence in the form of case reports and case series.&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 th","PeriodicalId":520531,"journal":{"name":"Video journal of sports medicine","volume":"6 2","pages":"26350254251404953"},"PeriodicalIF":0.0,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13121903/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147794215","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anatomic Multiligament Knee Reconstruction With a Medial Meniscal Repair in the Setting of a Valgus Hyperextension Injury.","authors":"Daisy L Lang, Riley T Kramer, Benjiman J Wilebski, Luke V Tollefson, Dustin R Lee, Matthew T Rasmussen, Robert F LaPrade","doi":"10.1177/26350254251404950","DOIUrl":"10.1177/26350254251404950","url":null,"abstract":"<p><strong>Background: </strong>Simultaneous anterior cruciate ligament (ACL), posterior cruciate ligament (PCL), and medial collateral ligament (MCL) tears represent a severe form of multiligament knee injury (MLKI). This combination of injuries often results from high-energy trauma and leads to gross instability, impaired joint biomechanics, and long-term degenerative changes if not addressed appropriately. Untreated or improperly treated MLKIs may result in chronic pain, instability, and early onset osteoarthritis.</p><p><strong>Indications: </strong>Combined ACL, PCL, and MCL reconstruction is indicated in patients with complete tears of all 3 ligaments confirmed on physical examination, stress radiography, and magnetic resonance imaging, typically presenting with marked instability in both the anterior-posterior plane and to valgus stress. Early surgical intervention is often recommended in active individuals and in cases of knee dislocation, where spontaneous reduction may obscure the extent of concomitant ligament tears.</p><p><strong>Technique description: </strong>The technique described was used to surgically reconstruct the ACL, PCL, and MCL, and repair the medial meniscus. A central-third bone-patellar tendon-bone autograft was used for the arthroscopic ACL reconstruction, and a double bundle PCL reconstruction used Achilles and tibialis anterior tendon allografts. The medial meniscal repair was also performed arthroscopically. The MCL was reconstructed open using autografts of the semitendinosus and gracilis tendons.</p><p><strong>Results: </strong>Clinical outcomes after simultaneous reconstruction of the ACL, PCL, and MCL have demonstrated significant improvements in subjective stability, return to sports, and pain reduction. Patients with multiligament injuries treated within 3 weeks have been reported to have improved outcomes compared with those who delay surgery.</p><p><strong>Discussion: </strong>Anatomic reconstruction of concomitant ACL, PCL, and MCL tears is an effective technique for restoring knee stability and function in the setting of multiligament knee trauma. Early diagnosis and treatment are critical for optimal outcomes. Single-stage reconstruction allows for efficient restoration of native biomechanics while minimizing the risk of instability, osteoarthritis, and chronic pain.</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 2","pages":"26350254251404950"},"PeriodicalIF":0.0,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13111824/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147794918","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":"Bucket Handle, Inside-Out Medial Meniscal Repair: A Technique Video.","authors":"Camden Bohn, Matthew Varano, Henry Eilen, Catherine Hand, Joshua Chang, Thomas Moran, Brian Forsythe","doi":"10.1177/26350254251395686","DOIUrl":"10.1177/26350254251395686","url":null,"abstract":"<p><strong>Background: </strong>Bucket-handle medial meniscal tears represent a common subset of meniscal injuries, particularly among younger athletes. In cases requiring operative intervention, the inside-out technique for medial meniscal repair remains the gold standard.</p><p><strong>Indications: </strong>We present a technique video for the repair of a bucket-handle medial meniscal tear in a young athlete who sustained a meniscal injury while playing soccer, resulting in mechanical symptoms. The tear was noted to remain within the peripheral vascular zone of the meniscus, making him a favorable candidate for operative repair.</p><p><strong>Technique description: </strong>The bucket-handle medial meniscal injury was confirmed with a diagnostic arthroscopy. The identified tear was subsequently reduced, debrided, and repaired via an inside-out technique using a mechanized suture passer. After appropriate repair, a femoral notch microfracture-a marrow stimulation procedure-was performed.</p><p><strong>Results: </strong>After the operation, the patient was expected to recover without complications and achieve return to sports and full recovery within 4 to 6 months. Surgical intervention was anticipated to result in symptom resolution, improved functional outcomes, and high patient satisfaction.</p><p><strong>Discussion/conclusion: </strong>While the inside-out technique remains the gold standard for medial meniscal repair, the documented relative rate of failure for this procedure is not insignificant in high-level athletes. This technique video addresses some potential pearls and pitfalls to maximize the likelihood of success. It is imperative to accurately assess the extent of the injury during diagnostic arthroscopy and to strongly consider the regenerative capacity of the meniscus in establishing the appropriate treatment plan. Passing vertical mattress sutures with a mechanized device may obviate the need for a second surgical assistant. When finalizing the repair, sutures should be tied in full extension with the assistance of an arthroscopic knot pusher; direct visualization should be maintained to ensure adequate meniscal reduction and appropriate tension of both the knots tied and the tissues secured. Lastly, we advocate a femoral notch microfracture procedure to introduce marrow elements, platelets, growth factors, and cells into the articular space to provide a biologically favorable healing environment.</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 2","pages":"26350254251395686"},"PeriodicalIF":0.0,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13103511/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147794432","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":"Paediatric Sternoclavicular Joint Pseudodislocation Fixation Technique.","authors":"Akib M Khan, Megan E Cain, Kemble K Wang","doi":"10.1177/26350254251394391","DOIUrl":"10.1177/26350254251394391","url":null,"abstract":"<p><strong>Background: </strong>Posterior sternoclavicular joint (SCJ) injuries in children are rare and frequently misdiagnosed. Due to the anatomy of the immature medial clavicle, many of these injuries are Salter-Harris type I/II physeal fractures rather than true joint dislocations-termed <i>pseudodislocations</i>. These injuries require careful diagnosis and tailored management to ensure safe and functional outcomes.</p><p><strong>Indications: </strong>Surgical intervention is indicated in paediatric SCJ pseudodislocations with significant posterior displacement of the medial clavicular fragment, particularly when the posterior metaphysis poses a risk to mediastinal structures or functional deficits persist.</p><p><strong>Technique description: </strong>We describe a paediatric SCJ pseudodislocation fixation technique performed at the Royal Children's Hospital in Melbourne. The patient is positioned supine with a bolster behind the shoulders. A curvilinear incision is made, and dissection is performed to identify the clavicular diaphysis and sternum. The fracture is reduced under direct vision with a reduction clamp, blunt periosteal elevator, and axial traction. An anterior-inferior drill hole is made in the medial clavicular metaphysis, and 2 anterior drill holes are created in the sternum. Fibertape is passed in a double figure-of-8 configuration through the posterior clavicle, disc, and posterior sternal cortex, before being tied anteriorly over the sternum and clavicle. This anterior-directed force resists further posterior subluxation. The capsule and strap muscles are repaired to restore soft tissue support.</p><p><strong>Results: </strong>In our internal audit of 30 paediatric posterior SCJ pseudodislocations treated operatively over a decade, this technique consistently resulted in anatomical reduction, full range of motion, and return to sports. Complication rates were low. Computed tomography confirmed the reduction, and rehabilitation was tailored to the biology of physeal injuries, allowing an earlier return to activity compared with soft-tissue dislocations.</p><p><strong>Discussion/conclusion: </strong>Posterior SCJ pseudodislocations can be safely and effectively managed with this transosseous fibertape fixation technique. Restoration of anterior stability using a double figure-of-8 construct provides strong mechanical support while preserving anatomy. Accurate diagnosis, surgical planning, and soft tissue repair are essential. This technique facilitates a reliable return to sports and function, with minimal complications.</p><p><strong>Patient consent disclosure statement: </strong>The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.</p>","PeriodicalId":520531,"journal":{"name":"Video journal of sports medicine","volume":"6 2","pages":"26350254251394391"},"PeriodicalIF":0.0,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13092822/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147794416","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":"Second-Stage Revision Anterior Cruciate Ligament Reconstruction After Three Failures With Anterolateral Ligament Reconstruction, Medial Meniscal Root Repair With Centralization Suture, and Inside-Out Lateral Meniscal Repair.","authors":"Nicholas K Retzer, Rylan A Behnke, Benjiman J Wilebski, Luke V Tollefson, Matthew T Rasmussen, Dustin R Lee, Robert F LaPrade","doi":"10.1177/26350254251404945","DOIUrl":"10.1177/26350254251404945","url":null,"abstract":"<p><strong>Background: </strong>Anterior cruciate ligament (ACL) graft failure is a relatively common occurrence and is even more likely in the presence of medial meniscal deficiency. ACL tears cause significant knee instability, particularly anterolaterally, and are commonly treated with a surgical reconstruction.</p><p><strong>Indications: </strong>During a revision ACL reconstruction (ACLR), clinical studies have demonstrated that correcting medial meniscus pathologies and reconstructing the anterolateral ligament (ALL) improve outcomes. This is the patient's fourth ACLR, complicated by a concomitant extruded medial meniscal root tear, and confirmed on clinical examination and imaging. An ALL reconstruction (ALLR) and medial meniscal root repair with a centralization suture were therefore indicated during the revision ACLR.</p><p><strong>Technique description: </strong>The technique described was used for a revision ACLR after 3 failed reconstructions with a concomitant ALLR and lateral meniscal peripheral and medial meniscal root repair as part of the second stage of a 2-stage surgery. The first stage of surgery included ACL tunnel debridement and bone grafting. The second stage procedure described here included a revision ACLR with bone-patellar tendon-bone autograft and an ALLR using the inferior portion of the iliotibial band, fixated with suture anchors to recreate the anatomic proximal and distal attachment sites. For the menisci, a lateral meniscal posterolateral peripheral tear was repaired using an inside-out technique, and the medial meniscal root tear was repaired with a double transtibial tunnel root repair with a centralization suture to reduce extrusion.</p><p><strong>Results: </strong>Recent literature has demonstrated that rerevision ACLR improved functional outcomes and overall knee stability. Despite these improvements, the overall rate of return to preinjury activity levels was poor, with high inter-study variability.</p><p><strong>Discussion: </strong>A complex revision ACLR with an ALLR and multiple meniscal repairs is described, along with technical considerations to improve long-term outcomes and minimize complication risks.</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 2","pages":"26350254251404945"},"PeriodicalIF":0.0,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13087362/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147725372","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":"Transtibial Pull-Out Repair of a Chronic Medial Meniscal Posterior Root Tear With All-Suture Knotless Centralization.","authors":"Jacob T Morgan, Napatpong Thamrongskulsiri, Gabriel Octavio Lloveras Pérez, Felipe Casanova, Myles A Atkins, Logan D Moews, Tomás F Vega, Jorge Chahla","doi":"10.1177/26350254251404947","DOIUrl":"10.1177/26350254251404947","url":null,"abstract":"<p><strong>Background: </strong>Medial meniscus posterior root tears (MMPRTs) are a common form of meniscal tear and are increasingly recognized as one of the most detrimental insults to knee health. Root repairs have mainly focused on reestablishing the biomechanics of the medial knee compartment and preventing joint deterioration; however, meniscal extrusion persists even after the best root repairs and remains an independent risk factor for knee degeneration. Furthermore, chronic MMPRTs are more likely to be associated with significant extrusion, chondromalacia, and fibrotic changes, which make successful repair more challenging. Careful meniscal mobilization and centralization can provide consistent, repeatable results.</p><p><strong>Indications: </strong>This technique is indicated for patients with chronic MMPRTs, meniscal extrusion of at least 3 mm, minimal arthritic changes, minimal-to-no varus knee alignment, and the ability to be nonweightbearing for 6 weeks postoperatively.</p><p><strong>Technique description: </strong>The following technique demonstrates the senior author's method of repairing a chronic MMPRT in an anatomic fashion using a 2-tunnel transtibial pull-out repair and footbed anchor fixation. An all-outside centralization is performed using 2 all-suture knotless anchors to address meniscal extrusion and reestablish the biomechanics of the meniscotibial ligament by approximating the posteromedial joint capsule with the rim of the tibial plateau.</p><p><strong>Results: </strong>By repairing a chronic root tear and addressing meniscal extrusion, the native biomechanics of the medial compartment are restored, and the meniscus's ability to withstand hoop stress is preserved. Centralization has been shown to lead to favorable improvements in patient-reported and functional outcomes during short-term follow-up and may significantly reduce strain on the root repair construct, thereby improving healing of the meniscal root attachment.</p><p><strong>Discussion/conclusion: </strong>We present our preferred technique for augmenting a chronic MMPRT repair with centralization using all-suture knotless anchors. This method mobilizes fibrotic adhesions and reduces the medial meniscus and peripheral capsule to the rim of the tibial plateau. The advantages include eliminating intra-articular knot-related issues, avoiding the need for an additional tibial tunnel-thereby reducing the risk of tunnel coalition-and offering a streamlined, reproducible approach to minimize meniscal extrusion, with favorable short-term 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 2","pages":"26350254251404947"},"PeriodicalIF":0.0,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13080176/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147701837","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}