Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association
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Editorial Comment
Editorial Commentary: Posterolateral Corner Reconstruction: Is Better (Anatomy) the Enemy of Good?
The negative consequences of neglected posterolateral corner injury (PLC) have led to numerous advancements in the understanding and treatment of these injuries. As anatomic, biomechanical, and clinical knowledge of PLC injury continues to progress, finding the balance between re-creating native anatomy and safely performing PLC reconstruction continues to provide challenges to surgeons managing this complex constellation of injuries.
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Editorial Comment
Editorial Commentary: Shedding Light on the Posterolateral Corner of the Knee: Can We Do it With the Scope? Is There a Real Benefit?
Historically described as the "dark side of the knee," the posterolateral corner of the knee has been a significant focus of anatomic, biomechanical, and clinical outcomes research due to poor treatment outcomes for these injuries before improvements over the past 2 decades. These research efforts have resulted in significant improvements in the understanding, diagnosis, and surgical treatment of these injuries. Perhaps most importantly, improved understanding of the anatomy and biomechanics has led to the development of anatomic-based reconstructions, which have been subsequently validated with both biomechanical and clinical outcomes. ⋯ These anatomic-based techniques have significantly improved the clinical and objective outcomes of the surgical treatment of posterolateral knee injuries. However, as techniques have evolved and the clinical outcomes have improved, clinicians have attempted to develop and employ less-invasive and arthroscopically assisted techniques. Specifically, given the steep learning curve, paucity of clinical outcomes, increased operative time, and the limited view of the anatomy, which may increase the risk of nonanatomic tunnel placement, and injuries to surrounding structures, we cannot support an arthroscopic approach at this time.
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The knee or rib has been used routinely as a donor site for capitellar osteochondral autologous transplantation (osteoarticular transplantation) procedures with promising results. However, donor-site morbidity is a bitter truth that has led surgeons to pursue alternatives to the ipsilateral elbow. The non-articulating radial head and the lateral olecranon tip show acceptable topography and histology. However, size limitations require additional and clinical study.
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Editorial Comment
Editorial Commentary: If You Can't See It, You Can't Treat It: Proper Hip Radiographic Views Are Critical.
Hip arthroscopy has become a common surgical treatment for femoroacetabular impingement syndrome and hip labral tears. In addition to being a complex procedure with a steep learning curve, understanding the required imaging to provide a comprehensive view of femoral cam deformities can be challenging. Because of the 3-dimensional anatomy of the hip joint, 2-dimensional imaging with plain radiographs may miss areas of pathomorphology that are not in the plane of the specific radiographic view.
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Social media has transformed the way we communicate, including truncating the manner in which we converse. A positive result is that we are mindfully succinct as we acclaim our annual research prize winners. Just as investigations have limitations, we are limited in the number of publications that we can recognize. We are excited to celebrate our outstanding papers.