Revision hip arthroscopy is increasingly common and most often performed to treat residual femoroacetabular impingement caused by cam under-resection. Unfortunately, other pathologies encountered during revision hip arthroscopy are more difficult to treat, including capsular deficiency, labral deficiency, adhesion formation, and/or cam over-resection. When encountered, these various pathologies should be comprehensibly corrected with the goals of restoring anatomy, re-establishing the hip fluid seal, and ensuring impingement-free motion. Labral deficiency can successfully be treated with labral augmentation or reconstruction. Capsular deficiency is best managed with primary repair or capsular reconstruction. Cam over-resection is a difficult problem, but there is growing evidence for a soft-tissue remplissage used to fill the defect with soft tissue. The combination of these problems can be considered a salvage scenario but can be treated comprehensively with these techniques with improved outcomes and acceptable survivorship.

The purpose of this study is to compare postoperative healthcare utilization, prescriptions, and shoulder surgery between patients with an acute depressive episode (ADE) and those without an acute depressive episode (NADE) within 3 months before arthroscopic rotator cuff repair.

The purpose of this study was to evaluate sex-based disparities in outcomes following surgery for anterior shoulder instability and to assess the quality of the current literature on this topic.

To provide an aggregate review of literature on 1) outcomes related to the quality of intercourse (frequency, postoperative pain during intercourse, postoperative sexual dysfunction) after hip arthroscopy and 2) patient-reported outcomes regarding postoperative sexual function after hip arthroscopy.

The purpose of this study was to compare the surgical outcomes of anterior cruciate ligament (ACL) reconstruction using hamstrings autograft (HA) plus lateral extra-articular tenodesis (LET), isolated all-soft-tissue quadriceps autograft (QA), and isolated HA.

The Latarjet procedure is a successful treatment for anterior shoulder instability, with fewer than 5% of patients having redislocations-revision surgery and prior surgery having been shown to be significant risk factors for recurrence. Approximately 90% of athletes return to play after the Latarjet procedure, comparable to arthroscopic Bankart repair. Patients may be physically unable to return to play, which may be due to persistent pain, apprehension, or weakness. Pain may be common after the Latarjet procedure and may be attributable to issues with hardware or graft placement, and it may be best evaluated with computed tomography scans. If screw fixation is not parallel to the joint and too posterior, then it may irritate the suprascapular nerve. Weakness due to nerve injury occurs in fewer than 1% of patients. Graft issues may be difficult to manage if due to nonunion, malunion, malpositioning, or graft fracture. All of these may also contribute to apprehension, as could incomplete rehabilitation or psychological reasons. Psychological reasons for not returning to play are the greatest contributor to athletes being unable to return to play after the Latarjet procedure and may be an area where improvements could be made in early screening and intervention. Improvements in the rehabilitation process could address psychological issues, and perhaps patients with kinesiophobia should be rehabilitated differently from those with concerns over their ability to perform for other reasons, such as retirement from sport. Finally, it is important to report why athletes are not returning to sport.

To compare arthroscopic Bankart repair versus the open Latarjet procedure at a minimum of a 10-year follow-up evaluating recurrence and arthropathy development rates.

We have carefully reviewed the article entitled "The incidence of Popeye Deformity after Soft Tissue Biceps Tenodesis is Comparable to Biceps Anchor Tenodesis and Lower than Biceps Tenotomy During Arthroscopic Rotator Cuff Repair" by Hyun Gon Kim et al. and found it very interesting. While we appreciate the authors' efforts, we have some questions about certain aspects of the study methodology that we hope they can address.

Thank you for your deep interest in our article entitled "The incidence of Popeye Deformity after Soft Tissue Biceps Tenodesis is Comparable to Biceps Anchor Tenodesis and Lower than Biceps Tenotomy During Arthroscopic Rotator Cuff Repair". We'll do our best to answer your questions.

A free-floating disc shaped polycarbonate-urethane ultra-high molecular weight polyethylene fiber reinforced medial compartment implant is designed for symptomatic postmedial meniscectomy syndrome. Because it is not sutured into place, an intact 2mm meniscus rim with intact anterior and posterior meniscal horns are required. In a recent 24-month follow-up study, only 64% of the original implants were retained. The differences between the 12-month data and the 24-month data are striking, and underscore the importance of adequate follow-up, especially for new devices. While about 95% of the patients retained this synthetic medial joint implant at 12 months, only 64% did so at 24 months follow-up. Positive prognostic factors include increasing patient age (especially 56 and older) and a higher BMI (at least 27.5). Those retaining the initial implant or having revision implant replacement reported improved pain and function. This data casts doubt on the effectiveness of the current design and technique for this implant.

To review patients with recurrent patellar dislocation surgically treated with robot-assisted medial patellofemoral ligament (MPFL) reconstruction compared with patients who underwent surgery using the traditional freehand technique.

To determine the effectiveness of administering intravenous (IV) tranexamic acid (TXA) on altering visual field clarity (VFC) during arthroscopic hip preservation surgery for patients with femoroacetabular impingement syndrome (FAIS).

As surgeons, we strive to recognize and correct any mistakes that may occur before completing an operation, and importantly, do our best to avoid irreversible mistakes. Over-resection of the femoral cam lesion in patients having hip arthroscopy for femoroacetabular impingement syndrome has been considered irreversible. While cam under-resection is a technical complication of femoroacetabular impingement surgery to be avoided, avoiding this at the expense of over-resection of the proximal femur is of great concern. Despite the quest to avoid leaving the operating room before the ideal surgical plan has been executed and errors corrected, we must anticipate a certain rate of both over- and under-resection of the cam deformity in the post-surgical patient population. The solution for under-resection is straightforward; additional resection. The same cannot be said for over-resection. Over-resection can result in femoral neck fracture or loss of the hip suction seal. A potential solution is placing a soft tissue allograft in the over-resection defect ("remplissage" of the femoral resection lesion). This may address the suction seal for too proximal resection. In contrast, for too deep a resection in the femoral neck, when fracture is a risk, internal fixation and/or bone grafting may be considered.

The pathophysiology of rotator cuff disease is complex, involving intrinsic and extrinsic factors that contribute to mechanical alterations, inflammation, apoptosis, and neovascularization. These changes result in structural and cellular disruptions, including inflammatory cell infiltration and collagen disorganization. Macrophages recently have gained attention as critical mediators of tissue repair and regeneration. M1 macrophages traditionally have been associated with proinflammatory cytokines involved in the acute inflammatory process after injury, whereas M2 macrophages are thought to play a role in resolution of inflammation and tissue healing. Therefore, achieving a balance between M1 and M2 macrophage phenotypes may be crucial in influencing tendon healing outcomes. Strategies have ranged from mediating circulating macrophage recruitment with CCR2 inhibition to promoting M2 macrophage polarization, increasing secretion of transforming growth factor-β1 from M2 macrophages, and subsequently enhancing chondrogenesis of mesenchymal progenitor cells to improve tendon-to-bone healing. Modulating macrophage activity to favor the M2 phenotype also has been hypothesized to not only enhance healing but also to reduce adhesion formation, making it an attractive potential therapeutic strategy for tendon injuries. However, inflammation is complex and multifactorial, and identifying the optimal targets to modulate and at what time points in the healing process can be difficult. In addition, although preclinical models of tendon disorders can be helpful in identifying promising cellular and molecular targets, recapitulating the human disease process, which often consists of chronic, degenerative tendinopathies, remains challenging. Many studies use young, healthy small animal models with acute injuries, which do not fully recreate the chronic degenerative conditions commonly seen in human rotator cuff injuries. In addition, recent studies have used aged mice (∼18 to 20 months), which, although expensive, are likely closer in biological age relative to human patients and thus more representative of the changes in microstructure and composition seen in degenerative rotator cuff pathology.

This systematic review aimed to assess the impact of prior or concurrent cervical spine pathology on clinical outcomes following shoulder surgery.

The combination of hip arthroscopy and periacetabular osteotomy (PAO) has been proven safe and effective for addressing symptoms in patients with developmental dysplasia of the hip. As not every patient with dysplasia will require a hip arthroscopy to obtain desired clinical improvement in the setting of PAO, a challenge is identifying which patients require adjacent procedures (either via arthroscopic or open) to fully treat their hip pathology. Even though labral repair is the most reported arthroscopic procedure in cases of hip dysplasia, I would suggest that labral treatment is the least likely helpful component of hip arthroscopy in these cases. Not all patients with hip dysplasia will have restoration of their suction seal after arthroscopic repair or debridement of the labrum. On the basis of numerous studies demonstrating the effectiveness of PAO for hip dysplasia, labral pathology has unknown importance for either mechanical stability or for the long-term survivorship of the dysplastic hip and thus must be examined instead as a significant pain generator. Reorientation of the labrum out of the zone of injury, and/or desensitization of the labrum during labral stabilization, may alleviate pain generated from labral pathology in the setting of PAO for dysplasia. I find hip arthroscopy to be most helpful as a tool to assess articular cartilage and address femoroacetabular impingement in the most common forms of subspine or true femoral cam morphology, when present. One may argue that the best evaluation of femoroacetabular impingement only exists after PAO correction is achieved. In cases in which I am concerned about iatrogenic impingement from reorientation, particularly in the subspine area, I have intentionally delayed capsule closure to be able to assess and address residual impingement after PAO. Despite the fact that combining hip arthroscopy and PAO in a single stage is safe, we should approach hip arthroscopy and capsulotomy with trepidation, as capsular adhesions, iatrogenic articular cartilage damage, and disruption of capsular integrity are all risks best avoided if capsule violation is not necessary. Clearer definitions for labral pathology and indications for repair or debridement are required.

To compare the patient-reported outcome improvements and cartilage status of trochlear cartilage defects (TCDs) after additional arthroscopic microdrilling versus no treatment for TCDs during medial open-wedge high tibial osteotomy(MOWHTO) METHODS: Patients who underwent MOWHTO with either microdrilling (Group M) or no treatment (Group N) for near full-thickness TCDs (International Cartilage Repair Society[ICRS] grade≥3B) from March 2010 to September 2022 were retrospectively reviewed, with a minimum 2-year follow-up. 1:1 Propensity score matched-Group N was created. Comparative analyses were conducted using patient-reported outcomes(PROs) and minimal clinically important difference (MCID). Trochlear cartilage status was visually assessed via second-look arthroscopy 1 year postoperatively and categorized as deteriorated, maintained, or improved.

The long head of the biceps tendon is a common source of anterior shoulder pain, frequently addressed during rotator cuff repairs. Surgical management typically involves either tenotomy or tenodesis, each offering distinct advantages and disadvantages. Tenotomy, a straightforward procedure with a short rehabilitation period, is well suited for low-demand patients but carries a higher risk of Popeye deformity and cramping pain. In contrast, tenodesis, which reattaches the long head of the biceps tendon, minimizes these risks and is preferred for younger, active patients. Randomized controlled trials have shown equivalent functional outcomes for both techniques, with tenotomy associated with a higher risk of cosmetic deformity. The choice of a specific technique often reflects patient age, activity demands, and cosmetic concerns. Surgeons are more likely to select tenodesis for younger, male patients. Thus, nonrandomized studies introduce confounding variables and selection bias that can obscure clear recommendations based on the literature.

Current surgical treatment options for ulnar collateral ligament injury of the elbow include both reconstruction and repair. A growing amount of research has evaluated the outcomes of these various techniques in a variety of study designs. Large national database assessment indicates that overall failure rates are low and complication rates are similar between UCL reconstruction and UCL repair techniques. And, though the incidence of revision UCL surgery is low, UCL repair is associated with a significantly higher risk of revision than UCL reconstruction. This information is important in counseling our patients, and urges us to perform higher level, comparative research of these two surgical techniques in order to more precisely sculpt the optimal treatment algorithm for UCL injury. In my experience, preoperative advanced imaging including MRI, MRA, and stress ultrasound are invaluable in determining the location and degree of UCL injury and, equally importantly, the status of the remaining ligament. These are key factors in deciding if a particular patient is appropriate for UCL reconstruction or repair according to the indications defined by Dugas (with suture tape augmentation): "complete or partial avulsion of the UCL from either the sublime tubercle or medial epicondyle, without evidence of poor tissue quality of the ligament."