• Recent Meta-Analysis Shows Hamstring Grafts equally as stable as patellar tendon grafts but with significantly fewer complications

    The authors analyzed all prospective randomized studies comparing hamstring and patellar tendon grafts to come to the above conclusion. Here is how the authors stated their findings: “Contemporary 4-strand HT ACL reconstruction is comparable with the PT technique in terms of clinical stability and postoperative functional status across most parameters studied. The HT technique carries lower risk of postoperative complications such as anterior knee pain, kneeling discomfort, and extension deficit. Primary ACL reconstruction using the 4-strand HT technique achieves clinical results that are comparable with the PT technique with significantly less postoperative complications.”

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  • Is There Any Benefit in Anterior Cruciate Ligament Reconstruction in Patients Older Than 60 Years?

    When I began my Orthopaedic Sportsmedicine practice in 1985 ACL reconstruction was generally reserved for young athletes. Over the years the acceptable age for reconstruction has gradually increased. Several studies have shown good outcomes in patients in their 50s. But what about even older individuals? There has been very little data in patients over 60 years of age. However a recent European study looked at a cohort of a dozen patients between 60 and 63 years of age with no significant arthritic changes in their knee at presentation. All patients had restoration of knee stability by ACLR, with no major complications. 10 of 12 patients resumed their prior sports activities. Follow-up was 2-6 years and there was no significant progression of arthritis. Ratings were greatly improved overall. While all patients in their 60s are not candidates this study shows that for a selected group in this age range ACL reconstruction is beneficial.

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    As the above picture shows the long head of the biceps tendon attaches directly into the shoulder joint. The rotator cuff tendons are located very nearby. While it is controversial, many surgeons will cut the biceps tendon if it has damage and then implant it into the top of the humerus or arm bone: a procedure called biceps tenodesis. The rationale is that cutting the biceps eliminates a potential pain generator after surgery. But now a new study shows that there may be a price to be paid in some by doing so.

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    Total knee and hip replacement are wonderful restorative procedures - except when they aren’t. While it is well known that pulmonary embolism, heart attack, stroke and death occur at surgery in a small percentage of patients, it is less well known that infection of a total joint replacement can equally be, or more, devastating. Infections occur in about 2% of patients. At a recent symposium of the American Academy of Orthopaedic Surgeons, new research showed that THE FIVE YEAR MORTALITY RATE OF PATIENTS WITH AN INFECTED TOTAL JOINT REPLACEMENT IS HIGHER THAN FOUR OF THE FIVE MOST COMMON CANCERS. Repeat surgery and intensive antibiotic therapy is required in nearly all cases, but resistant antibiotics prevent eradication of the infection in some. And the physical and emotional stress of the treatment over a period of years takes a heavy toll on the patient.

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  • Shoulder Specialist Chicago | Is Empty Stomach Before Surgery is All Wrong?

    For my 31 years of Orthopaedic Surgery practice and ten years of training before that, EVERYONE followed the axiom that an empty stomach before surgery was absolutely essential to avoid potentially fatal aspiration. But now it appears that may be completely wrong.

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