Medial meniscus posterior root tear is one of the underestimated knee injuries in terms of incidence. Despite its grave sequelae, using simple but effective technique can maintain the native knee joint longevity. In the current note, a 2-simple-suture pullout technique was used to effectively reduce the meniscus posterior root to its anatomic position. The success of the technique depended on proper tool selection as well as tibial tunnel direction that allowed easier root suturing and better suture tensioning, without inducing any iatrogenic articular cartilage injury or meniscal tissue loss. Using anterior knee arthroscopy portals, anterolateral as a viewing portal and anteromedial as a working portal, a 7-mm tibial tunnel starting at Gerdy tubercle and ending at the medial meniscus posterior root bed was created. The 2 simple sutures were retrieved through the tunnel and tensioned and secured over a 12-mm-diameter washer at the tibial tunnel outer orifice. Anatomic reduction of the medial meniscus posterior root tear was confirmed arthroscopically intraoperatively and radiologically by postoperative magnetic resonance imaging.

This study aims to determine the mean posterior condylar angle (PCA) in the included population and its relation to coronal alignment; and to know the clinical importance of the use of preoperative computed tomography (CT) scan in total knee arthroplasty (TKA). We randomized 50 patients with primary knee osteoarthritis into 2 groups. We used CT scan axial images to measure the PCA. In the first group we followed the CT scan plan (group 1), but in the second we did not follow the plan and adjusted rotation to the standard three degrees (group 2). The mean age of the included patients was 63 years. The radiological data of the included patients showed 5 patients with valgus deformity and 45 patients with varus deformity with the mean coronal alignment of 7.5 degrees. CT scan showed the mean PCA of 3.7 degrees (1.3 degrees). The axial knee postoperative X-ray showed the mean patellar tilt angle of 2.1 degrees (0.5 degrees) and 1.9 degrees (0.5 degrees) in groups 1 and 2, respectively. The congruence angle was 4 degrees (2.6 degrees) in group 1 and 5.5 degrees (3.2 degrees) in group 2. The median Knee Society functional score in group 1 was 85 (12), while it was 84 (7.5) in group 2. The median postoperative Western Ontario and McMaster Universities Arthritis Index score in group 1 was 84 (18.6) whereas 80.2 (13.6) in group 2. The median postoperative Bartlett score in group 1 was 30 (5), while it was 30 (6) in group 2. The use of preoperative CT scan did not improve the patient functional scores after TKA.

Rotator cuff tears are one of the most common shoulder problems and the incidence of this condition is increasing along with an aging population. Despite satisfactory results for rotator cuff repair the quality and speed of healing remain problematic. Several studies have demonstrated that native tendon-bone insertions were not restored after tendon to bone repair. Healing of repaired tendons occurred via fibrous scar tissue formation rather than via the regeneration of a histologically normal insertion, and thus repaired tendons have inferior mechanical properties and are more susceptible to retear. Presumably, this is the most significant reason that account for tendon repair failure. Despite recent biomechanical advances in fixation, rates of retear are still high. Tendons consume little energy, and as a consequence healing is slow after injury. Increasing the speed of healing would allow earlier return to work, sport, and activities of daily living, which would be helpful for both the elite athlete and general public. Platelet rich plasma was first popularized in maxillofacial and plastic surgery, but now is thought to enhance and accelerate the repair and regeneration of a variety of tissues, such as bone, cartilage, tendon, ligament, and muscle. This systematic review reporting the effect of PRP after arthroscopic rotator cuff repair.

We report a 68-year-old end-stage renal disease female patient on dialysis for 15 years. She sustained consecutive fractures starting with left-sided femoral neck fracture, followed 16 months later by a right-sided one. On her recovery from her right hip injury she sustained a stress type subtrochanteric fracture at the entry site of the fixation implants and an ipsilateral humeral shaft fracture. Cementless total hip replacement was done for the left femoral neck, and osteosynthesis was done for her undisplaced right femoral neck fracture. Revision fixation was done for her right subtrochanteric fracture with a long Gamma nail that was statically locked. The humeral fracture was fixed with an interlocking nail in a closed manner. This case highlights the fact that sequential hip fractures is an ominous event which is likely to be followed by a quick cascade of bone injuries with trivial trauma and a high rate of unexpected complications. Our treatment approach is explained here, stressing the unexpected complications and challenges met.

To report and compare patient outcomes (PROs) (IKDC score, Lysholm Score) and knee laxity using Lachmeter -The digital Rolimeter ® - among patients who underwent hamstrings autograft anterior cruciate ligament reconstruction (ACLR) with and without internal tape augmentation. Randomized trial of 41 patients in which 21 patients underwent all-inside ACLR with internal suture augmentation (Group I, Brace group) and 20 patients underwent all-inside ACLR without internal suture augmentation (Group II, non-brace group). Primary outcomes Lachmeter examinations and PROs were analyzed at 3,6,9 months postoperative. Secondary outcomes were graft failure, synovitis, and infection. Mean follow-up duration was 18 months ± 3.4. Date was expressed as Mean±SD for quantitative parametric data or number and percentage for categorized data. Delta change (dC) principle was used to test the actual mathematical change in the outcomes between 0-9 months and 3-9 months intervals postoperative. Lysholm score at 9-months was significant and better in brace group mean: 94 (92.4-96.5), p<0.005. Postoperative Lachmeter at 3,9 months was significant with less laxity in brace group mean: 1.98 (1.89- 2.07), 2.14 (2.06-2.22) p<0.005. dC Lachmeter in both intervals was significant with less laxity in brace group mean: .09 (.06-.11) p<0.001. dC IKDC score was significant in 3-9 months interval mean: .31 (.28-.35) p<0.001. dC Lysholm score was significant in 0-9 months interval mean: .86 (.72-.99) p<0.001. Both scores were better in brace-group. One graft failure was reported in Group II and one case of synovitis in Group I. All-inside ACLR with brace showed better laxity measures and lower failure rate at 9-months postoperative. However, the subjective functional outcomes did not show clear evidence of superiority in the suture tape augmentation group.