{"title":"Physeal-Sparing Medial Patellofemoral Ligament Reconstruction With Quadriceps Turndown and Patellar Tendon Transfer","authors":"Patrick England, Bryce Maxwell, Neeraj Patel","doi":"10.1016/j.otsm.2025.151162","DOIUrl":"10.1016/j.otsm.2025.151162","url":null,"abstract":"<div><div>Patellar instability is a common problem in the pediatric population. When surgery is indicated, skeletal immaturity poses unique challenges due to the risk of deformity or limb length discrepancy if the physis are injured. Therefore, the optimal combination of procedures in prepubescent patients with patellar instability remains unclear. Several stabilization procedures have been described for the treatment of patellar instability. The medial patellofemoral ligament (MPFL) or similar structures are commonly reconstructed, as they function as the primary restraint to lateral translation in early flexion and are commonly incompetent after lateral patellar dislocations. Traditional MPFL reconstruction can pose a risk to the distal femoral physis in skeletally immature patients because of the proximity of the insertion of the MPFL to the physis. Therefore, modified techniques are necessary. Distal realignment procedures have been used as accessory operations and, when necessary, must consider the presence of the proximal tibial physis. This article describes physeal-sparing MPFL reconstruction with quadriceps autograft and patellar tendon transfer for the management of patellofemoral instability in the skeletally immature patient.</div></div>","PeriodicalId":54678,"journal":{"name":"Operative Techniques in Sports Medicine","volume":"33 1","pages":"Article 151162"},"PeriodicalIF":0.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143855392","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Treatment of Failed Anterior Instability Repair With DTA","authors":"Christiaan Sonke , Ivan Wong","doi":"10.1016/j.otsm.2024.151137","DOIUrl":"10.1016/j.otsm.2024.151137","url":null,"abstract":"<div><div>This chapter explores the use of distal tibia allograft (DTA) for addressing glenoid bone deficiencies in revision surgery for anterior glenohumeral instability. Traditional approaches have often overlooked glenoid bone loss, which can negatively impact functional outcomes of a shoulder instability repair. The DTA offers a promising solution, effectively reconstructing the glenoid vault while minimizing damage to surrounding tissues when performed arthroscopically. This approach not only simplifies the surgical technique but also enhances stability when combined with soft tissue procedures. By allowing for personalized graft sizing, the DTA presents an adaptable option for various patients facing revision surgeries for anterior instability, making it a leading consideration in modern orthopaedic practice for the management of shoulder instability repair.</div></div>","PeriodicalId":54678,"journal":{"name":"Operative Techniques in Sports Medicine","volume":"32 4","pages":"Article 151137"},"PeriodicalIF":0.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143156822","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Treatment of Failed Arthroscopic Multidirectional Instability Repair: Next Options?","authors":"Patrick Luchini, Thomas Spears, Lance E. LeClere","doi":"10.1016/j.otsm.2024.151140","DOIUrl":"10.1016/j.otsm.2024.151140","url":null,"abstract":"<div><div>Multidirectional instability (MDI) of the shoulder presents a unique challenge in orthopedics due to its complex etiology and varied patient profiles. MDI can arise from congenital ligamentous laxity, atraumatic repetitive microtrauma, or traumatic events. The pathophysiology involves an imbalance between shoulder mobility and stability, with significant contributions from both static and dynamic stabilizers. Initial management focuses on conservative treatments, emphasizing physical therapy to strengthen the dynamic stabilizers of the glenohumeral joint. Surgical options, primarily open inferior capsular shift and arthroscopic capsular plication, have shown comparable success rates. However, revision surgery outcomes remain poorly defined, with limited literature indicating low success rates and a need for tailored approaches based on individual pathology. This chapter outlines the treatment of failed MDI surgeries and optimized return-to-sport outcomes for affected individuals.</div></div>","PeriodicalId":54678,"journal":{"name":"Operative Techniques in Sports Medicine","volume":"32 4","pages":"Article 151140"},"PeriodicalIF":0.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143100182","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Elizabeth Carpenter , Emily Whicker , Ryan J. Whalen , Nate J. Dickinson , Matthew T. Provencher
{"title":"Imaging Pearls and Findings After Prior Shoulder Stabilization","authors":"Elizabeth Carpenter , Emily Whicker , Ryan J. Whalen , Nate J. Dickinson , Matthew T. Provencher","doi":"10.1016/j.otsm.2024.151133","DOIUrl":"10.1016/j.otsm.2024.151133","url":null,"abstract":"<div><div>This chapter emphasizes the significance of advanced imaging techniques, particularly MRI, in diagnosing the underlying causes of failed stabilization, such as recurrent labral tears, capsular deficiency, and glenoid bone loss. Key criteria for evaluating labral integrity postsurgery are discussed, alongside the importance of assessing the capsule and inferior glenohumeral ligament for signs of laxity or tears. Advanced MRI methodologies enable precise assessment of bony structures, while the interplay of imaging findings with history informs clinical decisions regarding revision surgery. Ultimately, integrating advanced imaging examination and surgical expertise can enhance patient outcomes and contribute to long-term shoulder functionality.</div></div>","PeriodicalId":54678,"journal":{"name":"Operative Techniques in Sports Medicine","volume":"32 4","pages":"Article 151133"},"PeriodicalIF":0.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143099740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Table of Contents (pick up from previous issue w/updates)","authors":"","doi":"10.1053/S1060-1872(24)00088-1","DOIUrl":"10.1053/S1060-1872(24)00088-1","url":null,"abstract":"","PeriodicalId":54678,"journal":{"name":"Operative Techniques in Sports Medicine","volume":"32 4","pages":"Article 151146"},"PeriodicalIF":0.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143099743","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Phob Ganokroj , Marco Adriani , Ryan J. Whalen , Nate J. Dickinson , Eddie Afetse , CAPT Matthew T. Provencher
{"title":"What Is a Failed Shoulder Instability...It Includes More Than Recurrent Dislocation","authors":"Phob Ganokroj , Marco Adriani , Ryan J. Whalen , Nate J. Dickinson , Eddie Afetse , CAPT Matthew T. Provencher","doi":"10.1053/j.otsm.2024.151132","DOIUrl":"10.1053/j.otsm.2024.151132","url":null,"abstract":"<div><div>Shoulder instability, particularly prevalent among athletes and military personnel, poses significant challenges in both diagnosis and treatment. This chapter explores the multifaceted nature of shoulder instability, distinguishing between dislocation and subluxation, and highlights the critical role of careful patient selection in achieving successful surgical outcomes. Risk factors contributing to failed shoulder stabilization, including patient-related factors, pathoanatomical conditions, and technical errors, are analyzed. Furthermore, this chapter reviews clinical outcomes for various revision procedures, such as arthroscopic and open Bankart repairs, Latarjet procedures, and bone block procedures, emphasizing the importance of addressing underlying risk factors to optimize recovery and return-to-play rates. Overall, effective management of failed shoulder instability repairs requires a comprehensive understanding of the factors influencing recurrence and a tailored approach to each patient's unique situation.</div></div>","PeriodicalId":54678,"journal":{"name":"Operative Techniques in Sports Medicine","volume":"32 4","pages":"Article 151132"},"PeriodicalIF":0.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143156821","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Bryant P. Elrick, Daniel J. Stokes, Abdulaziz F. Ahmed, Rachel M. Frank
{"title":"Treatment of the Failed Latarjet With Distal Tibia Allograft","authors":"Bryant P. Elrick, Daniel J. Stokes, Abdulaziz F. Ahmed, Rachel M. Frank","doi":"10.1016/j.otsm.2024.151138","DOIUrl":"10.1016/j.otsm.2024.151138","url":null,"abstract":"<div><div>The Latarjet procedure is commonly performed in patients with recurrent shoulder instability and critical glenoid bone loss. While the success rate of the Latarjet procedure is high, failures do occur. Revision surgery can be challenging, and options are limited. Glenoid reconstruction using a distal tibial allograft (DTA) is a viable option to revise a failed Latarjet. Using a DTA bone block technique provides an osteochondral surface with an articular congruency similar to the native glenoid, which effectively restores glenohumeral joint stability and biomechanics. The bony composition, along with technical execution, allows for excellent graft integration with minimal resorption. In this paper, we describe our preferred surgical technique for glenoid reconstruction using a fresh DTA bone block in the setting of a failed Latarjet.</div></div>","PeriodicalId":54678,"journal":{"name":"Operative Techniques in Sports Medicine","volume":"32 4","pages":"Article 151138"},"PeriodicalIF":0.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143100181","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abigail N. Boduch, Stephen E. Marcaccio, Albert Lin, Justin W. Arner
{"title":"Anchor, Implant, and Post-Traumatic Arthropathy After Instability Repair: How to Diagnose and Manage","authors":"Abigail N. Boduch, Stephen E. Marcaccio, Albert Lin, Justin W. Arner","doi":"10.1016/j.otsm.2024.151141","DOIUrl":"10.1016/j.otsm.2024.151141","url":null,"abstract":"<div><div>Glenohumeral arthritis following shoulder instability surgery can be due to a variety of factors. One of these, termed anchor arthropathy, presents a significant challenge in management. Studies indicate a varied incidence of glenohumeral arthropathy, with risk factors including age at first dislocation, number of dislocations, and the type of surgical approach. Diagnosis is complex, often relying on a combination of patient history, physical examination, and imaging, with a high index of suspicion necessary for early identification of glenohumeral arthropathy after instability repair. Management typically involves early arthroscopic evaluation and removal of any potential, problematic implants, with promising outcomes reported in revision surgeries. This article underscores the importance of early recognition of glenohumeral arthropathy to prevent long-term complications and improve patient outcomes.</div></div>","PeriodicalId":54678,"journal":{"name":"Operative Techniques in Sports Medicine","volume":"32 4","pages":"Article 151141"},"PeriodicalIF":0.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143100183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Editorial Board (pick up from previous issue)","authors":"","doi":"10.1053/S1060-1872(24)00089-3","DOIUrl":"10.1053/S1060-1872(24)00089-3","url":null,"abstract":"","PeriodicalId":54678,"journal":{"name":"Operative Techniques in Sports Medicine","volume":"32 4","pages":"Article 151147"},"PeriodicalIF":0.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143099742","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Alexander C. Weissman, Allen A. Yazdi, Jared M. Rubin, Sarah A. Muth, Fatima A. Bouftas, Jared P. Sachs, Andrew S. Bi, John P. Scanaliato, Nikhil N. Verma, Brian J. Cole
{"title":"Bone Loss of The Glenoid and Humerus: A concern for Failure in the Setting of Glenohumeral Instability","authors":"Alexander C. Weissman, Allen A. Yazdi, Jared M. Rubin, Sarah A. Muth, Fatima A. Bouftas, Jared P. Sachs, Andrew S. Bi, John P. Scanaliato, Nikhil N. Verma, Brian J. Cole","doi":"10.1016/j.otsm.2024.151135","DOIUrl":"10.1016/j.otsm.2024.151135","url":null,"abstract":"<div><div>Glenohumeral instability is often characterized by progressive bipolar bone loss, a clinical phenomenon that not only complicates the management of recurrent shoulder dislocations but portends an increased risk for failure following soft-tissue stabilization procedures. This review synthesizes the history and pathophysiology of humeral and glenoid bone loss, delineates critical and subcritical thresholds, and emphasizes the necessity of a comprehensive diagnostic and surgical approach in the evaluation and treatment of patients with glenoid and/or humeral bone loss. The dynamic nature of bony injury in shoulder instability highlights the importance of tailored interventions to address bipolar bone loss and restore shoulder stability and function. Through an in-depth examination of contemporary strategies for managing glenohumeral instability, including the employment of advanced imaging techniques and refined surgical methods, this chapter offers guidance on an optimal clinical approach. By focusing on improving surgical outcomes and patient function, this review aims to navigate the complexities of shoulder instability, underscoring the importance of an integrated approach to patient care.</div></div>","PeriodicalId":54678,"journal":{"name":"Operative Techniques in Sports Medicine","volume":"32 4","pages":"Article 151135"},"PeriodicalIF":0.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143100179","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}