Faculty Bibliography

PURPOSE: To review the results of 34 patients who underwent radiofrequency thermal shrinkage (RFTS) for treatment of anterior cruciate ligament (ACL) laxity in the attenuated and partially torn ACL. TYPE OF STUDY: Retrospective cross-sectional survey performed at least 6 months after treatment. METHODS: Patients with recurrent instability after attenuation of ACL autografts and partially torn ACLs were treated with RFTS. Follow-up included subjective questionnaires (International Knee Documentation Committee [IKDC], Tegner, and Lysholm) and objective clinical tests (IKDC, KT-1000, pivot-shift, Lachman, single-leg hop). RESULTS: Mean follow-up was 21.4 months. Based on IKDC and subjective evaluation, 18 of 20 (90%) partially torn ACLs and 10 of 14 reconstructed ACLs (71%) treated with RTFS were judged to have good or excellent knee function (overall 82%). ACL laxity based on KT-1000 was less successful, with 15 of 20 (75%) partially torn ACLs and 8 of 12 (66%) reconstructed ACLs considered successful. CONCLUSIONS: With no major complications in this study, we conclude that RFTS for treatment of ACL laxity is a well-tolerated procedure with success rates around 71% to 90% in selected patients. RFTS may be offered as a less-extensive alternative to patients being considered for ACL reconstruction who have either attenuated or partially torn ligaments, especially in the athletically low-demand population. LEVEL OF EVIDENCE: Level IV, case series

The simultaneous diagnosis of ipsilateral patellar tendon rupture and anterior cruciate ligament tear is rare. Surgical repair is complicated by different rehabilitation regimens as well as anterior cruciate ligament graft choices. We present a case where at the same operative setting, the patellar tendon was repaired, and the anterior cruciate ligament reconstructed with autologous hamstring graft

Suprascapular neuropathy secondary to cyst compression in the spinoglenoid notch may occur in association with SLAP tears. Arthroscopic techniques may be employed for both cyst excision and repair of labral pathology. We describe 3 cases in which preoperative and postoperative electromyograms and magnetic resonance imaging documented cyst resolution and return of suprascapular nerve function after arthroscopic spinoglenoid cyst excision and labral repair

BACKGROUND: Professional dancers experience high rates of musculoskeletal injuries. OBJECTIVE: To analyze the effect of comprehensive management (case management and intervention) on injury incidence, time loss, and patterns of musculoskeletal injury in a modern dance organization. STUDY DESIGN: Retrospective/prospective cohort study. METHODS: Injury data were analyzed over a 5-year period, 2 years without intervention and 3 years with intervention, in a modern dance organization (42 dancers). The number of workers' compensation cases and number of dance days missed because of injury were compared across a 5-year period in a factorial design. RESULTS: Comprehensive management significantly reduced the annual number of new workers' compensation cases from a high of 81% to a low of 17% and decreased the number of days lost from work by 60%. The majority of new injuries occurred in younger dancers before the implementation of this program. Most injuries involved overuse of the lower extremity, similar to patterns reported in ballet companies. Benefits of comprehensive management included early and effective management of overuse problems before they became serious injuries and triage to prevent overutilization of medical services. CONCLUSIONS: This comprehensive management program effectively decreased the incidence of new cases and lost time. Both dancers and management strongly support its continuance

In this article, we report the case of a healthy young woman who sustained an anterior hip dislocation while participating in a noncontact activity (ballet dancing). The patient's atraumatic dislocation failed closed reduction secondary to interposition of anterior capsule and rectus femoris muscle. Open reduction using a Smith-Petersen approach was concentric and stable. Postinjury femoral nerve neuropraxia resolved within 6 weeks. At 2-year follow-up, the patient was without complications of the injury-including avascular necrosis and posttraumatic arthritis. She returned to dancing and is now asymptomatic

Ochronotic arthropathy is a progressive joint disorder resulting from the deposition of a derivative of homogentisic acid into connective tissues, especially meniscal and articular cartilage. Patients may present with symptoms, physical examination results, and radiographic changes consistent with degenerative joint disease. We present a case in which an operative arthroscopy of the knee was highly suggestive of ochronotic arthropathy. The definitive diagnosis of ochronosis was subsequently confirmed by laboratory and pathologic evaluation

Intra-articular lipoma is an exceedingly rare diagnosis. There have been less than 15 documented cases of an intra-articular lipoma of the knee joint. This report presents the first description of an intra-articular knee lipoma treated entirely by arthroscopic methods. Preoperative history, examination, and imaging studies are reviewed. Intraoperative findings, treatment, and postoperative evaluation are discussed as well. Symptomatic intra-articular lipoma of the knee joint can be successfully treated by arthroscopic resection. Differentiating intra-articular lipoma from lipoma arborescens, a similar but more common condition, is important with regards to optimal treatment

Synovial chondromatosis is an uncommon disorder with rare occurrence in the elbow. Case reports in the literature for elbow synovial chondromatosis have described presenting symptoms secondary to peripheral nerve compressions or localized bursitis. We discuss a case of synovial chondromatosis of the elbow that presented as an isolated soft-tissue mass over the radial head-more suggestive of a soft-tissue tumor than of synovial chondromatosis

A case of arthroscopic removal of a bullet fragment from the subtalar joint and the calcaneus is presented. The bullet fragments impinged on the fibula, limiting eversion and causing pain. The fragments were removed both arthroscopically and through open incision. The patient noted complete relief of pain and improved range of motion within 1 week, and complete recovery soon thereafter