Charles A. Bush-Joseph, MD

WAIKOLOA, Hawaii — In this video from Orthopedics Today Hawaii 2022, Charles A. Bush-Joseph, MD, spoke on the operative approach for young patients with ligament injury, graft choice and rehabilitation for return to sport.

A healthy 18-year-old men sustained a left knee dislocation while snowboarding 4 days prior to presentation to our office. He was seen immediately following the injury at an outside hospital where the knee was reduced, vascular work-up and CT angiogram were negative and he was placed into a hinged knee brace.

A 44-year-old woman with a history of hypothyroidism and dyslipidemia presented to our office with right knee pain and instability. She reported a history of an ACL tear 4 years prior to presentation, which was managed with an ACL reconstruction using hamstring autograft at an outside hospital. She did well after ACL reconstruction for approximately 1 year, at which time she noticed a sensation of looseness and instability within the knee. She underwent an MRI at that time, which was relatively unremarkable and showed an intact ACL graft.

The role of the capsule in arthroscopic hip surgery has recently received a great deal of attention. Capsulotomy is necessary to navigate the joint for both diagnostic and therapeutic purposes. However, many authors now contend that iatrogenic instability may result if the capsulotomy is not closed (Figure 1). As the number of hip arthroscopies has dramatically increased up to 18-fold during the past decade, warranted concern has been emphasized about the size and type of capsulotomy performed and its routine closure, as Joshua D. Harris, MD, and colleagues noted in their 2013 article in Arthroscopy Techniques .

A 33-year-old right-handed minor league baseball pitcher who has been with four minor league organizations in his career presented after experiencing sudden onset medial elbow pain while pitching in a game. When the injury occurred, he felt a sharp “pop” while pitching in the early acceleration phase, tingling in the ulnar nerve distribution of his hand and an immediate inability to throw.

The proximal hamstring is a common location of athletic injuries. Athletes participating in sports that require sprinting, jumping, acceleration and deceleration are at increased risk.