No Deficits in Functional Outcomes of the Contralateral Limb Are Seen When the Hamstring Is Harvested for Augmentation of Small Diameter Ipsilateral Hamstring Autograft.

Purpose: To evaluate clinical outcomes of the contralateral, nonoperative limb in patients undergoing contralateral hamstring (HS) autograft harvest compared with patients undergoing ipsilateral HS autograft harvest alone. Methods: This study included 96 patients who underwent isolated anterior cruciate ligament reconstruction (ACLR) using 4-stranded HS autograft (n = 85) or 4-stranded HS autograft augmented with contralateral HS (n = 13) due to inclusion of ipsilateral graft diameter <8 mm. Isokinetic flexion and extension strength and dynamic performance of the ipsilateral and contralateral limbs and limb symmetry index (LSI) were evaluated at 6 months' postoperatively. Rates of contralateral native ACL tear at minimum 2 years also were compared. For all comparisons, P < .05 was considered statistically significant. Results: Normalized isokinetic knee flexion and extension strength of the contralateral limb did not differ between cohorts (P = .34; P = .21, respectively). LSI for knee extension peak torque and knee flexion peak torque did not differ between cohorts (P = .44; P = .67, respectively). No difference in LSI was seen for any dynamic performance testing (single leg hop, P = .97; triple leg hop, P = .14; 6-m timed hop, P = .99). No difference was observed in International Knee Documentation Committee (P = .99) or Knee Injury and Osteoarthritis Outcome Score subscale measures (P = .39-.86). No difference in rates of contralateral knee native ACL tears were seen between cohorts (HS autograft + contralateral HS augmentation, n = 2, 15.4%; HS autograft, n = 7, 8.4%; P = .26). Conclusions: In this study, at the time of return to sport, we found no differences in contralateral limb functional performance or limb symmetry measurements between patients undergoing contralateral HS autograft harvest for augmentation of smaller (<8 mm) diameter HS autografts harvested from the injured extremity. Level of Evidence: Level III, retrospective cohort study.

Hip Imaging and Injections.

Athletic injuries of the hip often require radiographs and advanced imaging for diagnosis. Plain radiographs evaluate for osseous injury, provide a structural context behind an athlete's symptoms and examination, and offer a backdrop for interpretation of advanced imaging. An understanding of normal anatomy, imaging findings, and radiographic measurements allows for recognition of pathoanatomy and ability to diagnose accurately. Advanced imaging modalities, including magnetic resonance imaging, computed tomography, and ultrasonography, each play a role in evaluation of the athlete's hip. Although MRI and CT provide high-resolution imaging of the hip, ultrasonography offers the unique ability to perform dynamic imaging and guided injections.

Obesity, morbid obesity and their related medical comorbidities are associated with increased complications and revision rates after unicompartmental knee arthroplasty.

Recent studies have demonstrated clinical success in expanding the indications for unicompartmental knee arthroplasty (UKA) to patients with increased body mass index (BMI). This study utilized national databases to identify 15,770 unique patients who underwent UKA between 2005 and 2011. 18.7% of patients undergoing a UKA were obese or morbidly obese. Univariate analysis demonstrated that obesity and morbid obesity were associated with significantly higher complication rates within 90 days postoperatively compared to non-obese patients. The overall short-term revision rate in obese and morbidly obese patients undergoing UKA was almost twice as high as the revision rate in non-obese patients. Obese and morbidly obese patients being considered for UKA should be counseled preoperatively regarding their increased risk of postoperative complications and revision surgery.