While anterior cruciate ligament (ACL) reconstruction is readily offered to athletes, non-athletes are often treated conservatively. We carried out a retrospective, cross-sectional analysis study to compare the incidence of meniscal and cartilage injuries in an athlete and non-athlete population in relation to time of presentation since injury. The results were used to assess the need and relevance of ACL reconstruction in the non-athlete population. The study included 1375 patients who underwent ACL reconstruction between 1998 and 2004. These patients were initially broadly divided into two categories: athletes (575) and non-athletes (800). Each category was then sub-divided into four subgroups based on time elapsed between the injury and presentation at our clinic (Group A, 3 months; Group B, 3-12 months; Group C, 1-3 years; Group D, more than 3 years). Arthroscopic findings were documented for medial and lateral meniscus and cartilage injuries, and comparisons were made between the incidence of associated injuries in the corresponding groups. There was a statistically significant increase in the incidence of meniscal injuries and cartilage injuries after 1 year in both the groups. There was no difference in the incidence of meniscal and cartilage injuries in athletes and non-athletes among the corresponding groups. (chi-square test, p = 0.05). These results demonstrate that both athletes and non-athletes are equally susceptible for long-term meniscal and cartilage injuries if ACL reconstruction is not carried out early.

Background:Medial patellofemoral ligament (MPFL) is one of the major static medial stabilising structures of the patella. MPFL is most often damaged in patients with patellar instability. Reconstruction of MPFL is becoming a common surgical procedure in treating patellar instability. We hypothesised that MPFL reconstruction was adequate to treat patients with patellar instability if the tibial tubercle and the centre of the trochlear groove (TT-TG) value was less than 20 mm and without a dysplastic trochlea.Materials and Methods:30 patients matching our inclusion criteria and operated between April 2009 and May 2011 were included in the study. MPFL reconstruction was performed using gracilis tendon fixed with endobutton on the patellar side and bio absorbable interference screw or staple on the femoral side. Patients were followed up with subjective criteria, Kujala score and Lysholm score.Results:The mean duration of followup was 25 months (range 14-38 months). The mean preoperative Kujala score was 47.5 and Lysholm score was 44.7. The mean postoperative Kujala score was 87 and Lysholm score was 88.06. None of the patients had redislocation.Conclusion:MPFL reconstruction using gracilis tendon gives excellent results in patients with patellar instability with no redislocations. Some patients may have persistence of apprehension.

Purpose There is a lack of consensus regarding need for Venous Thrombo Embolism (VTE) prophylaxis following arthroscopic knee surgery and open soft tissue knee reconstruction. Clear cut guidelines like ones for trauma surgery and arthroplasty do not exist and the published literature is limited to case reports with a few society guidelines. Given this lack of consensus, we conducted a modified Delphi questionnaire of international experts to provide recommendations on this topic. Methods The consensus statements were generated using an anonymised 3 round modified Delphi questionnaire, sent to an international panel of 38 knee surgeons, with an 80% agreement being set as the limit for consensus. The responses were analysed using descriptive statistics with measures like mode, median and box plots. Feedback was provided to all panelists based on responses from the previous rounds to help generate the consensus. Results Six consensus statements were generated after the three rounds of Delphi. Patient factors, prolonged surgery duration and family history of thrombogenic events emerged as the main points to be taken into consideration for prophylaxis. Conclusion It was established through this study, that there exists a select group of patients undergoing arthroscopic surgery that justify the usage of VTE prophylaxis. The expert responses to most of the questions in different scenarios favoured usage of VTE prophylaxis based on patient factors like advanced age, past history of VTE, smoking, oral contraceptive use etc. Level of evidence Level V. Supplementary Information The online version contains supplementary material available at 10.1007/s00167-022-06973-w.

Introduction: Current evidence is controversial about the outcomes after the repair of the delaminated versus nondelaminated rotator cuff tears. The objective of this study was to evaluate the factors affecting delamination of the cuff and clinical and structural outcomes after en masse arthroscopic repair of delaminated versus nondelaminated cuff of varying sizes. Materials and Methods: A total of 233 patients with full-thickness posterosuperior cuff tears were divided in two groups: Group 1: Delaminated tears ( n = 131) and Group 2: Nondelaminated tears ( n = 102) of medium, large, and massive sizes. Both groups were evaluated by clinical scores (Constant–Murley [CM], American shoulder and elbow score [ASES]) and ultrasonography (USG), at a minimum followup of 2 years. Results: The mean followup was 45.47 months. There was a weak but statistically significant linear correlation ( P = 0.02) between the increasing size of tear and delamination, whereas increasing age and duration of symptoms did not correlate with increasing tendency of delamination. Final followup USG analysis revealed that there was no significant difference ( P = 0.55) between healing rates of Group 1 and Group 2. Further taking various tear sizes into account, USG revealed no significant difference between the healing rates of two groups. The mean overall final postoperative CM and ASES scores of two groups did not show any significant difference (CM; P = 0.36, ASES; P = 0.4). However, the clinical outcome was significantly better in the completely healed group as compared to partially healed or retear group. Conclusions: A weak linear correlation between delamination and increasing size of the tear was noted. Although overall structural and clinical outcome is no different between two groups, the clinical outcomes of completely healed tear are better than partially healed ones. Level of Evidence: Level III, Retrospective comparative.