Purpose Knowledge of epidemiologic trends of meniscal injuries in young active populations is limited. Better awareness of injury patterns is a first step to lowering injury rates. Our hypothesis was that meniscal injuries in high school athletes would vary by gender, sport, and type of exposure. Methods During 2007–2013, a large nationally disperse sample of US high schools reported athlete exposure and injury data for 22 sports by having certified athletic trainers complete an internet-based data collection tool. Results 1,082 meniscal injuries were reported during 21,088,365 athlete-exposures for an overall injury rate of 5.1 per 100,000 athlete exposures. The overall rate of injury was higher in competition (11.9) than practice (2.7) (RR = 4.4; 95% CI, 3.9–5.0), and 12/19 sports showed significantly higher injury rates in competition compared to practice. Of all injuries, 68.0% occurred in boys, yet among the gender-comparable sports of soccer, basketball, track and field, lacrosse, and baseball/softball injury rates were higher for girls than boys (5.5 and 2.5, respectively, RR = 2.2; 95% CI, 1.8–2.7). Contact injury represented the most common mechanism (55.9%). Surgery was performed for the majority of injuries (63.8%), and 54.0% of athletes had associated intra-articular knee pathology. Conclusions Meniscal injury patterns among high school athletes vary by gender, sport, and type of exposure. Overall rates are higher for boys, but this is driven by football; however in gender-comparable sports girls may be at higher risk for meniscal injury. Our study is clinically relevant because recognition of distinct differences in these injury patterns will help drive evidence-based, targeted injury prevention strategies and efforts. Level of Evidence Level III

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The purpose of this review was to compile existing knowledge regarding venous thromboembolism (VTE) after arthroscopic knee surgery (AKS). We reviewed the reported incidence, published prophylaxis guidelines, randomized controlled trials (RCT) of prophylaxis, and current prophylaxis practice patterns. In this context we then considered the most appropriate VTE risk assessment model for patients undergoing knee arthroscopy. The existing body of literature regarding VTE and AKS reports a wide range of incidence, often utilizing primary outcome measures with unclear clinical significance: asymptomatic and distal deep vein thrombosis (DVT). Published prophylaxis guidelines provide limited practical guidance and it is unclear how to translate the results of RCTs to clinical practice, as many of the VTE prevented by routine prophylaxis are asymptomatic or distal DVT. Literature regarding actual implementation of pharmacologic prophylaxis following AKS suggests that no consensus exists. Patients undergoing knee arthroscopy would be best managed with the individual model of VTE risk assessment rather than the group model that is applied to hip and knee arthroplasty patients.

Meniscal allograft transplantation has evolved over the years to provide a state-of-the-art technique for the sports medicine surgeon to utilize in preserving contact mechanics and function of the knee in irreparable meniscal pathology. However, this procedure continues to spark considerable debate on proper tissue processing techniques, acceptable indications, methods of implantation, and potential long-term outcomes.

The overall prevalence of isolated meniscal pathology in asymptomatic athletes was 31.1 % (27.2 % with intrasubstance meniscal damage and 3.9 % with a meniscal tear). More studies of age-comparable, non-athletic populations are necessary for direct comparison with these groups.

There is a need for more accurate methods of determining the size of articular cartilage lesions.

Objective Tibial plateau osteochondral allograft transplantation is a promising treatment for symptomatic chondral damage of the proximal tibia due to a variety of etiologies. The purpose of this investigation is to develop an accurate and reproducible algorithm for sizing tibial plateau allografts based on recipient radiographs. Design A cadaveric study was performed in which radiographs of 10 fresh frozen cadaveric knees were compared to measured digital photographs of the disarticulated specimens. By comparing the average distance between standard anatomical landmarks on the radiographs to the gross specimens, a correlation factor was calculated that could be applied to recipient radiograph measurements for more accurate sizing of tibial plateau allografts. Results In the coronal plane there were no differences between the mean radiographic and mean morphologic measurements of either the medial or lateral tibial plateau. However, in the sagittal plane the anatomic specimens of the medial and lateral plateau were 90% and 80%, respectively, of the measurements made from the lateral radiograph. Conclusions This cadaveric investigation is the first to propose a sizing algorithm for tibial plateau osteochondral allografts. Based on the results, an anteroposterior radiograph can reliably measure the width of both the medial and lateral tibial plateau without any correction needed. The average morphological lengths of the medial and lateral tibial plateau, on the other hand, were found to be 90% and 80%, respectively, of the radiographically measured lengths. Without correction, this would lead to the implantation of oversized grafts that may contribute to early failure.

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