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: Medial Patellofemoral Ligament Reconstruction for Knee Patellar Instability: When Are Soft Tissue Procedures Not Enough?
Medial patellofemoral ligament reconstruction is commonly performed to treat patellofemoral instability by recreating the static soft tissue restraint to lateral patellar translation. Concurrent tibial tuberosity osteotomy can be indicated in the setting of bony malalignment, such as a lateralized tuberosity or patella alta; however, the exact indications for this have been difficult to define due to the multifactorial nature of this problem. Understanding the role of tuberosity lateralization and patella alta on the function of medial patellofemoral ligament grafts can help to identify the interplay of some factors that contribute to patellar stability and improve our understanding of when and how concurrent tibial tuberosity osteotomy may be indicated.
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Editorial Comment
Editorial Commentary: Three-Dimensional Printing and Stem Cells May Be a Game Changer for Recovery After Anterior Cruciate Ligament Reconstruction.
Placing stem cells at the tendon-bone interface of a soft tissue anterior cruciate ligament (ACL) reconstruction in an animal model accelerates graft incorporation at 12 weeks. A 3D-printed scaffold used to deliver the stem cells completely degraded at 12 weeks. Future clinical application of similar technology may improve outcomes after ACL reconstruction.
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Editorial
Editorial Commentary: Arthroscopic Simulation Training Need Not Be Expensive to Be Effective.
In a randomized controlled trial of arthroscopic training tools, the low-cost/low-fidelity Cigar Box Arthroscopy Trainer demonstrated equivalent efficacy to the validated, and more expensive, Anatomic Knee Arthroscopy Trainer (AKAT) in the training of novice arthroscopists using a validated scoring system, the Basic Arthroscopic Knee Skill Scoring System. As simulation training and formal surgical skills training is now mandatory, residency and fellowship programs are required to incorporate training modules and equipment to maximize learning while minimizing potential for patient harm. Low-cost, low-fidelity simulation tools such as this may provide a solution to do so while minimizing costs and maximizing educational returns on investment. The value in simulation training will be in its synergistic ability to augment the traditional apprenticeship model of resident and fellow training.
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Editorial Comment
Editorial Commentary: Biomechanics of Cutting Studies-Knowledge and Deficiencies: Knee Joint Stability and the Posterolateral Corner.
Injury to the posterolateral corner of the knee is a difficult condition to treat. We know a lot about the anatomy and different methods with which we can reconstruct this complex area of the knee. Despite these advances, injuries to this area still do not lead to great surgical outcomes.
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Editorial
Editorial Commentary: Ankle Arthroscopy: Correct Portals and Distraction Are the Keys to Success.
Access to all areas of the ankle during arthroscopy is always problematic. The use of the correct portals and distraction increases access in both the supine and prone positions. Noninvasive distraction up to 30 pounds is safe and effective to perform arthroscopy in the supine position, and avoids the potential complications of pin distraction.