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Editorial| Volume 30, ISSUE 2, P151-152, February 2014

Knee, Shoulder, Ankle Features, Level I Shoulder Evidence, and Ultrasonography Expert Opinion

      February is the shortest month, so we encourage readers not to waste time: book now for the AANA Annual Meeting, to be held May 1-3 in Hollywood, Florida. When we look at the calendar, we find it difficult to argue with those who decry that “There are too many meetings.” While we can't disagree, we can share that it pays to be selective, and the AANA Annual Meeting is one we always select for an unparalleled combination of education, innovation, collaboration, and camaraderie. With our very own Matt Provencher serving as Program Chairman, and Associate Editor Emeritus Thomas Byrd serving as the President of AANA, we feel certain that those who attend will not be disappointed, while those who miss the meeting risk regret.
      In this issue, we are proud to share a dynamic compilation of “features.”
      • Lubowitz J.H.
      • Poehling G.G.
      The features: HAGL, thumb CMC, and meniscus repair.
      • Lubowitz J.H.
      • Poehling G.G.
      Extra! Extra! Read all about it: The features—Shoulder stiffness, humerus greater tuberosity fractures, and hip arthroscopy.
      Regarding the knee, Noyes and Barber-Westin review the potential for neuromuscular retraining programs to reduce noncontact ACL injury rates in the population most at risk for ACL tear, the adolescent female athlete.
      • Noyes F.R.
      • Barber-Westin S.D.
      Neuromuscular retraining intervention programs: Do they reduce noncontact anterior cruciate ligament injury rates in adolescent female athletes?.
      As active surgeons, we also wonder if training can reduce ACL graft reinjury after reconstructive surgery. In addition, Khan, Rothrauff, Merali, Musahl, Peterson, and Ayeni address management of contaminated ACL grafts.
      • Khan M.
      • Rothrauff B.B.
      • Merali F.
      • Musahl V.
      • Peterson D.
      • Ayeni O.R.
      Management of the contaminated anterior cruciate ligament graft.
      It is possible that many high-volume ACL surgeons have or will suffer that most traumatic moment of indignity when the ACL graft inadvertently makes contact with the operating room floor. While this is a moment best avoided, it does occur, so if we fail to plan, we plan to fail.
      Concerning the shoulder, Bhatia, Frank, Ghodadra, Hsu, Romeo, Bach, Boileau, and Provencher review the outcomes and surgical techniques of the Latarjet procedure.
      • Bhatia S.
      • Frank R.M.
      • Ghodadra N.S.
      • et al.
      The outcomes and surgical techniques of the Latarjet procedure.
      Additionally, on the shoulder, we once again are fortunate to share another consensus statement from the very productive ISAKOS Upper Extremity Committee.
      • Lubowitz J.H.
      • Provencher M.T.
      • Poehling G.G.
      ISAKOS Upper Extremity Committee shoulder rotator cuff consensus, plus chondrocyte implantation and ACL systematic reviews.
      • Arce G.
      • Bain G.
      • Bak K.
      • et al.
      Management of disorders of the rotator cuff: Proceedings of the ISAKOS Upper Extremity Committee consensus meeting.
      This one, by Beitzel, Mazzocca, Bak, Itoi, Kibler, Mirzayan, Imhoff, Calvo, Arce, and Shea, focuses on the need for diversification of the Rockwood classification for AC joint injuries.
      • Beitzel K.
      • Mazzocca A.D.
      • Bak K.
      • et al.
      Upper Extremity Committee of ISAKOS
      ISAKOS Upper Extremity Committee consensus statement on the need for diversification of the Rockwood Classification for acromioclavicular joint injuries.
      Regarding the ankle, Simonson and Roukis review “Safety of Ankle Arthroscopy for the Treatment of Anterolateral Soft-Tissue Impingement.”
      • Simonson D.C.
      • Roukis T.S.
      Safety of ankle arthroscopy for the treatment of anterolateral soft-tissue impingement.
      In our experience, this is a very effective procedure, when performed for the proper indications, and a procedure that may be underused. However, absent safety, the risks may outweigh the benefits, so arthroscopic and related surgeons, and sports medicine specialists, should carefully review this article because anterolateral ankle soft-tissue pathology may be common and, as above, underdiagnosed.
      Finally, Lesniak, Loveland, Jose, Selley, Jacobson, and Bedi review “Use of Ultrasonography as a Diagnostic and Therapeutic Tool in Sports Medicine.”
      • Lesniak B.P.
      • Loveland D.
      • Jose J.
      • Selley R.
      • Jacobson J.A.
      • Bedi A.
      Use of ultrasonography as a diagnostic and therapeutic tool in sports medicine.
      Your editors acknowledge all of the authors of this Level V evidence expert opinion review, with a special nod to Asheesh Bedi, who is well known to be one of the most productive and most cited arthroscopic authors of the 21st century.
      Among the original scientific articles, we note a Level I evidence study by Oh, Kim, Chung, Park, Kim, Kim, and Yun: “Warmed Irrigation Fluid Does Not Decrease Perioperative Hypothermia During Arthroscopic Shoulder Surgery.”
      • Oh J.H.
      • Kim J.Y.
      • Chung S.W.
      • et al.
      Warmed irrigation fluid does not decrease perioperative hypothermia during arthroscopic shoulder surgery.
      Yet we ask, is hypothermia common? Is it a clinical problem? Is hypothermia associated with higher complication rates, including sepsis? We encourage readers, as ever, to send us letters to the editor about these questions and any topic of interest to you.
      We hope to see you all at the AANA Annual Meeting in Hollywood, Florida. Until then, enjoy your green journal, and our electronic versions at www.arthroscopyjournal.org and www.arthroscopytechniques.org. And, please do send your letters.

      References

        • Lubowitz J.H.
        • Poehling G.G.
        The features: HAGL, thumb CMC, and meniscus repair.
        Arthroscopy. 2010; 26: 1270
        • Lubowitz J.H.
        • Poehling G.G.
        Extra! Extra! Read all about it: The features—Shoulder stiffness, humerus greater tuberosity fractures, and hip arthroscopy.
        Arthroscopy. 2008; 24: 857-858
        • Noyes F.R.
        • Barber-Westin S.D.
        Neuromuscular retraining intervention programs: Do they reduce noncontact anterior cruciate ligament injury rates in adolescent female athletes?.
        Arthroscopy. 2014; 30: 245-255
        • Khan M.
        • Rothrauff B.B.
        • Merali F.
        • Musahl V.
        • Peterson D.
        • Ayeni O.R.
        Management of the contaminated anterior cruciate ligament graft.
        Arthroscopy. 2014; 30: 236-244
        • Bhatia S.
        • Frank R.M.
        • Ghodadra N.S.
        • et al.
        The outcomes and surgical techniques of the Latarjet procedure.
        Arthroscopy. 2014; 30: 227-235
        • Lubowitz J.H.
        • Provencher M.T.
        • Poehling G.G.
        ISAKOS Upper Extremity Committee shoulder rotator cuff consensus, plus chondrocyte implantation and ACL systematic reviews.
        Arthroscopy. 2013; 29: 1733-1734
        • Arce G.
        • Bain G.
        • Bak K.
        • et al.
        Management of disorders of the rotator cuff: Proceedings of the ISAKOS Upper Extremity Committee consensus meeting.
        Arthroscopy. 2013; 29: 1840-1850
        • Beitzel K.
        • Mazzocca A.D.
        • Bak K.
        • et al.
        • Upper Extremity Committee of ISAKOS
        ISAKOS Upper Extremity Committee consensus statement on the need for diversification of the Rockwood Classification for acromioclavicular joint injuries.
        Arthroscopy. 2014; 30: 271-278
        • Simonson D.C.
        • Roukis T.S.
        Safety of ankle arthroscopy for the treatment of anterolateral soft-tissue impingement.
        Arthroscopy. 2014; 30: 256-259
        • Lesniak B.P.
        • Loveland D.
        • Jose J.
        • Selley R.
        • Jacobson J.A.
        • Bedi A.
        Use of ultrasonography as a diagnostic and therapeutic tool in sports medicine.
        Arthroscopy. 2014; 30: 260-270
        • Oh J.H.
        • Kim J.Y.
        • Chung S.W.
        • et al.
        Warmed irrigation fluid does not decrease perioperative hypothermia during arthroscopic shoulder surgery.
        Arthroscopy. 2014; 30: 159-164