Arthroscopy News

Recently published results showed no statistically significant differences in re-rupture and clinical outcomes among the use of the 5-strand hamstring autograft the quadruple autograft larger than 8 mm in ACL reconstruction.

Results of this level 2 study showed the lever test resulted in high sensitivity, specificity and overall accuracy in the detection of ACL tears.

The best delivery method into the shoulder for mesenchymal stem cells (MSCs), PRP or other substances is based on the injection technique. The injection approach and accuracy has significant therapeutic effects when addressing pathology in joints or tendons. With reference to the shoulder, success depends on the placement of the needle into the joint space (glenohumeral or acromioclavicular) if addressing arthritis; or into the abnormality of the tendon (biceps and/or rotator cuff) for tendinosis or partial tears. Anatomic palpation to identify injection sites is helpful, but imaging leads to more precise placement of the injectate.

Injuries to the ACL are among the most common and functionally disabling conditions in orthopedics and sports medicine. The incidence in the United States has increased dramatically in the past 20 years. About 200,000 people sustain an ACL injury annually. In 1994, an estimated 86,687 surgeries for these injuries were performed. By 2013, the yearly number of procedures to treat ACL injuries increased by 58% to 148,714. By far, the female high school athlete is the patient demographic that is undergoing the greatest increase in ACL surgeries annually.

In results of a study of 130 patients scheduled to undergo arthroscopic rotator cuff tear repair surgery, the supine Napoleon test was superior to the lift-off, bear-hug and Napoleon tests when used to diagnose subscapularis tendon tears.

It is widely known and reported in the literature that shoulder injuries, including rotator cuff tears, tend to heal slowly and the management of glenoid labral tears, subacromial impingement and the degenerative, arthritic shoulder may be challenging. Therefore, research into biologic treatments for these conditions is underway. This includes exploring the effect in the laboratory and the OR of various types of stem cells on healing when injected or used to augment arthroscopic or open surgery.

Recently published results showed women undergoing ACL reconstruction with doubled semitendinosus-gracilis graft constructs were more likely to receive grafts with diameters of less than 8 mm.

Recently published results showed patients with a degenerative meniscal tear who underwent arthroscopic partial meniscectomy had no significant benefit over placebo surgery.

DENVER —Benjamin G. Domb, MD, discussed a study that evaluated the outcomes of transtendinous repair of partial thickness tears of the gluteus medius. He said investigators saw significant improvements in patient-reported outcomes at final follow-up. Domb said transtendinous repair was an effective procedure for the treatment of pain and instability in patients with partial thickness tears of the gluteus medius who had failed conservative treatment for a minimum of 3 months.

DENVER — At the Arthroscopy Association of North America Annual Meeting, Benjamin G. Domb, MD, discussed a study that compared capsular repair with unrepaired capsulotomy in patients who underwent hip arthroscopy.  He said patients who were repaired saw improvements at the 2-year and 5-year follow-up; however, the unrepaired group saw a decrease in their patient-reported outcomes. At the minimum 5-year follow-up, the repaired group had a survivorship of around 90%, whereas those who were not repaired had a survivorship of less than 82%.