Nearly half the multiligamentous knee injuries involved the anterior cruciate ligament, posterior cruciate ligament, and posterolateral corner; one-fourth had associated ipsilateral tibial plateau fractures. The incidence of peroneal nerve injury (25%) was higher than previously reported (20%), whereas the incidence of arterial injury (21%) was comparable to previous reports (19%). Posterolateral corner injuries were more prevalent than previously reported and were highly associated with peroneal nerve injury. We found a substantial incidence of associated morbidities of the whole body. Multiligamentous knee injuries are a marker of concomitant trauma and should be closely evaluated at presentation and during the hospital course to allow for early intervention for life- or limb-threatening comorbidities.

This observed decline may have significant ramifications on long-term graft survival following stored-allograft implantation.

1) Lethal cytomegalovirus enteritis can arise in patient populations not typically identified as being at risk for this disorder, including normal individuals. 2) Mortality in cytomegalovirus enteritis is adversely associated with age older than 65 years and increased time to institution of therapy but is not affected by anatomic site of infection or particular form of treatment. Paradoxically, in this study, normal patients had the highest mortality, which we attribute to a low index of suspicion and relatively late institution of therapy.

No abstract

No abstract

No abstract

Objectives:The suprascapular nerve is potentially at risk during superior labrum repair. We compared risk of injury to the suprascapular nerve during suture anchor placement through an anterosuperior versus a rotator interval portal. Our hypothesis was that the rotator interval portal provides a safer and more reproducible method for repair of Type-II SLAP tears. Methods: Each pair of ten bilateral fresh human cadaveric shoulders was randomized to suture anchor placement through an anterosuperior portal on one shoulder and a rotator interval portal on the contralateral shoulder. Suture anchors were placed into the glenoid rim (one o'clock, eleven o'clock, and ten o'clock positions for right shoulder; eleven o'clock, one o'clock, and two o'clock for left shoulder). Standard 3 × 14 mm suture anchors were placed, and the suprascapular nerve was carefully dissected. When glenoid perforation occurred, the distance from the suture anchor tip to the suprascapular nerve was measured. The anchors were removed, and the distance from the glenoid rim to the suprascapular nerve and drill hole depth at each suture anchor entry site was recorded. Results: All far posterior suture anchors (ten o'clock anchor for right shoulders, two o'clock anchor for left shoulders) perforated the glenoid rim using the anterosuperior or rotator interval portal. For the far posterior anchor, distance from anchor tip to suprascapular nerve averaged 8.02 mm (range, 3.4 to 14 mm) using the anterosuperior portal and 2.1 mm (range, 0 to 5.5 mm) using the rotator interval portal, a statistically significant difference of 5.92 mm (95% confidence interval [CI]: −7.81 to −4.04; p ≤ 0.001). Conclusion: Using an anterosuperior or rotator interval portal results in consistent penetration of one o'clock and two o'clock posterior suture anchors and may place the suprascapular nerve at risk of iatrogenic injury. Based on the high likelihood of glenoid perforation and closer proximity of the suture anchor tip to the suprascapular nerve, the risk of injury is significantly greater with a rotator interval portal for superior labrum anterior and posterior repair. Clinical Relevance: It is important to recognize the high rate of glenoid perforation and risk of injury to the suprascapular nerve when placing anchors in the posterior glenoid from either portal.

Posterior cruciate ligament (PCL) injuries can be debilitating knee injuries, having involvement in up to 44% of traumatic knee injuries. However, isolated PCL injuries are relatively infrequent. Therefore, effective evidence-based rehabilitation protocols have proven to be elusive. This systematic review aims to summarize the latest evidence on postoperative rehabilitation protocols for patients undergoing PCL reconstruction. Studies included in this paper included those published from 1991 to 2019 with a grade 1 to 5 level of evidence discussing the postoperative PCL rehabilitation. A multidatabase search using largely PubMed and Ovid was conducted using relevant keywords such as "PCL," "postoperative," and "rehabilitation," initially leading to 955 papers, which were narrowed by relevance to 12 final published studies used in the analysis. Through careful review of the evidence, crucial principles of rehabilitation, such as an initial focus on protecting the graft during strengthening, as well as an optimized PCL reconstruction protocol are presented here. Rehabilitation following PCL reconstruction continues to be limited by a lack of high-quality evidencebased publications.