Meniscal root tears, left untreated, result in accelerated progression of arthritis. Numerous techniques to repair medial meniscus posterior root tears have been presented in the literature. Direct repair of the meniscus to bone without reconstructive tissue may result in a nonanatomic and biologically weak construct with a significant number of structural repair failures. Re-creation of the ligament-like structures that fix the meniscal root to bone is critical to restoring normal knee biomechanics. We present an arthroscopic reconstructive technique using gracilis autograft with suture reinforcement for medial meniscus posterior root tears.
The incidence and treatment of rupture of the canine anterior cruciate ligament are presented from reports over a 3‐month period by members of the Kent Region BSAVA.
Purpose The purpose of this study was to evaluate the relationship between patient-specific factors, preoperative radiographic findings, and the presence and severity of chondrolabral damage identified during hip arthroscopy for femoroacetabular impingement. Methods Between 2014 and 2017, patients who underwent hip arthroscopy for FAI and labral tear were retrospectively reviewed. Patient-specific variables including age, gender, BMI, LCEA, and alpha angle were collected. Surgical reports were reviewed for labral tear position and size, as well as severity of acetabular and femoral chondromalacia. Results There were 205 patients who met inclusion criteria with a mean age of 33 years (range 15-66), BMI 26.5 (range 15.9-44.5), LCEA 32.2° (range 21.0°-56.0°) and alpha angle 59.1° (range 33.0°-86.0°). Greater age (p = 0.023), alpha angle (p = 0.011) and male gender (p < 0.001) significantly correlated with high-grade acetabular chondral damage. Increased LCEA (p < 0.001), increased alpha angle (p = 0.012), and greater age (p = 0.002) were significantly associated with increased labral tear size. Conclusions Greater age, male gender, increased BMI and increased alpha angle were associated with more advanced acetabular chondromalacia. Additionally, greater age, increased LCEA, and increased alpha angle was associated with larger labral tear size. Level of evidence IV.
Background Annually there are an estimated 4.5 million sports- and recreation-related injuries among children and young adults in the United States. The most common sports-related injuries are to the lower extremities, with two-thirds occurring among children and young adults (age range 5-24 years). The objective is to describe the epidemiology of lower leg injuries across 27 high school (HS) sports over a 3-year period. Methods The Datalys Center for Sports Injury Research and Prevention provided lower leg injury data for 27 sports in 147 high schools for 2011-2012 through 2013-2014 academic years from National Athletic Treatment, Injury and Outcomes Network (NATION) HS Surveillance Program. Results The overall rate of lower leg injuries over this 3-year period was 1.70 per 10 000 acute events (AEs) (95% CI, 1.59-1.82). In men, the highest number of lower leg injuries was in football (n=181), but indoor track had the highest rate of injury at 2.80 per 10 000 AEs (95% CI, 2.14-3.58). In women, the highest number of lower leg injuries and the highest rate of injury were in cross-country (n=76) at 3.85 per 10 000 AEs (95% CI, 3.03-4.81). The practice injury rate was 0.91 times the competition injury rate (95% CI, 0.78-1.07). Conclusion An improved understanding of the most common sports in which lower leg injuries are seen may help direct appropriate resource utilization. Our data would suggest efforts toward prevention of these overuse injuries, especially in football, track, and cross-country may have the greatest impact on the health of student athletes. Level of Evidence: Level IV, case series.
Femoroacetabular impingement syndrome (FAIS) is commonly associated with acetabular labral tears. Correction of impingement morphology and suture anchor repair of labral tears have demonstrated successful early and midterm patient-reported outcomes. The purpose of this study was to evaluate the posterior and anterior extent and size of labral tears in patients with FAIS undergoing arthroscopic labral repair, and to evaluate the number of suture anchors required to repair these tears. The design of this study was retrospective case series (Level 4). A single surgeon's operative database was retrospectively reviewed to identify patients undergoing primary arthroscopic hip labral repair between November 2014 and September 2019. Patient-specific factors and radiographic measurements were recorded. Arthroscopic findings including labral tear posterior and anterior extents, and the number of suture anchors utilized for the repair were recorded. Linear regression was performed to identify factors associated with labral tear size. The number of suture anchors used relative to labral tear size was calculated. Three-hundred and thirteen patients were included in the study. The mean posterior and anterior extent for labral tears were 11:22 ± 52 and 2:20 ± 34 minutes, respectively. Mean tear size was 2 hours, 58 minutes ± 45 minutes. The mean number of suture anchors utilized for labral repair was 3.1 ± 0.7. The mean number of anchors per hour of labral tear was 1.1 ± 0.3. Increased age, lateral center edge angle, and α angle were associated with larger labral tears. Our study found that acetabular labral tears associated with FAIS are, on average, 3 hours in size and centered in the anterosuperior quadrant of the acetabulum. Arthroscopic labral repair required 1.1 anchors per hour of tear size, resulting in a mean of 3.1 anchors per repair. Level of Evidence IV
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