Once the most popular graft choice for ACL reconstruction surgery, hamstring autograft has recently fallen out of favor for a variety of concerns including a higher graft rupture rate in younger athletes and concerns over graft diameters that tend to run smaller. However, what does the best level evidence actually say about hamstring autograft’s long-term performance versus the current gold-standard, patellar tendon autograft? Dr. Derrick Knapick, MD joins us from Washington University School of...
Jun 19, 2025•19 min
ACL surgery has come a long way since the early days of acute open repair to modern-day ACL reconstruction. Still, in spite of our advancements in knowledge, technique, and technology, graft rupture as well as contralateral ACL injury remain a concern for patients and their Sports Medicine providers. Well-renowned for her body of work in ACL research, Dr. Kate Webster, PhD from La Trobe University joins us to discuss her team’s recent study on the long-term survival of ACL autografts and contral...
May 15, 2025•22 min
Hamstring autograft has been a widely used graft option for ACL reconstruction surgery for years. Data over the last decade, however, has called into question its performance versus other autograft options particularly when it comes to the rate of re-tear. One potential reason for a higher rate of re-tear may be that hamstring grafts tend to be smaller in diameter compared to patellar tendon autografts, for example. Historically, a hamstring graft diameter of 8 mm has been considered a critical ...
Apr 17, 2025•16 min
Chronic tendinopathies whether it be at the shoulder, elbow, knee, or ankle continue to perplex the Sports Medicine community. These nagging conditions have no easy fix to them which can be frustrating for both the patient and treatment team. Data in most cases does not support surgery as the answer. Thus, we continue to search for non-surgical treatments that can solve tendinopathies as quickly and effectively as possible. Unfortunately, the best answer for these conditions remains elusive. Com...
Mar 13, 2025•23 min
The evolution of all-inside meniscal repair technology has given sports medicine surgeons an efficient, less invasive, yet more costly option to address meniscus tears. How does it compare in the long-run against the classic inside-out technique? Dr. Aaron Krych, MD and his team at Mayo Clinic examine this question specifically for bucket-handle tears , a situation that can typically be addressed with either an all-inside or an inside-out approach. He joins us to discuss the results of their stu...
Feb 12, 2025•14 min
Meniscus tears have historically been treated with arthroscopy. However, compelling data has shown that this surgery does not work for degenerative meniscus tears. Physical therapy, conversely, has been shown to be a more effective measure for the degenerative meniscus tear, and is a more reasonable first-line measure compared to arthroscopic menisectomy. Still, the public's perception, guided by decades of advice from Sports Medicine Specialists that arthroscopy is the answer for all meniscus t...
Dec 11, 2024•25 min
The Medial Meniscus is a known secondary stabilizer to the ACL in terms of anterior tibial translation in the knee. So what happens after ACL reconstruction if the medial meniscus is deficient? Dr. Andrew Fithian, MD joins us to discuss his study addressing this very question . Coming to us from Kaiser Permanente San Diego, Dr. Fithian and his team investigated postoperative anterior tibial translation in autograft ACL patients with an intact medial meniscus, a repaired medial meniscus, or a par...
Nov 13, 2024•23 min
As another exciting NFL season kicks off, Sports Medicine community members and fans alike continue to ponder whether the risk of lower extremity injury is higher on artificial turf versus grass. We welcome UCSF’s Chief of Sports Medicine & Shoulder Surgery and host of the podcast 6-8 Weeks: Perspectives on Sports Medicine , Dr. Brian Feeley, MD to discuss his team’s recent publication in OJSM examining this very question....
Oct 16, 2024•18 min
Historically, ACL repair resulted in poor outcomes and this procedure fell out of favor while ACL reconstruction became the gold-standard surgical approach for a torn ACL. Recently, thanks in part to the advent of more modern techniques, ACL repair has regained interest in the Sports Medicine community as a potentially viable option in certain situations that may provide advantages in comparison to ACL reconstruction. To this point, the literature comparing these two surgeries with modern techni...
Sep 18, 2024•19 min
One of the long-standing assumptions in Sports Medicine is that anterosuperior labral variants including the Buford Complex and Sublabral Foramen are non-pathologic, normal anatomic variants of the shoulder joint. But is this true? Dr. Eric Edmonds from Rady Children’s Hospital in San Diego challenges this assumption and our accepted practice of ignoring these findings when observed arthroscopically.
Aug 14, 2024•12 min
Failure of shoulder stabilization surgery continues to plague contact athletes. Football players are thus at high risk of a repeat shoulder dislocation even after a well-done surgery to stabilize that joint. Such is the nature of a sport with violent and unpredictable collisions. Dr. Andrew Pennock, MD and his team at Rady Children’s in San Diego investigated the outcomes for high school football players who underwent arthroscopic stabilization surgery . They anticipated finding that the younger...
Jul 10, 2024•14 min
Second ACL injuries, whether it be a tear of the ipsilateral ACL graft or the native contralateral ACL, continue to be of great concern to patients and sports medicine practitioners particularly during the first 1-2 years after surgery. Sending a patient back too early to play is widely considered a major risk factor for this 2nd injury. As health care providers, we take pride in the joy and confidence a patient expresses as he/she advances through a rehab process towards his/her goals. However,...
Jun 12, 2024•16 min
The right surgery for recurrent patellofemoral instability remains a topic of controversy. While medial patellofemoral ligament reconstruction (MPFLr) is the standby surgical procedure for this condition, many adjuncts including tibial tubercle osteotomy (TTO) are performed concurrently with the hope of improving the chances of success. Historically, a tibial tubercle-trochlear groove (TT-TG) distance greater than 20 mm has triggered surgeons to perform TTO, however recent evidence suggests this...
Apr 17, 2024•16 min
Despite our technological advances in ACL surgery, the rehabilitation period remains challenging, particularly when it comes to lingering quadriceps weakness. Blood Flow Restriction (BFR) Therapy has been introduced as a potential means to speed up the return of quad function. We welcome Dr. Kelechi Okoroha from the Mayo Clinic to discuss his high-level study, “ Effects of Perioperative Blood Flow Restriction Therapy Program on Early Quadriceps Strength and Patient-Reported Outcomes After Anteri...
Mar 13, 2024•12 min
Proper treatment of Type III AC Joint Separations has been a topic of ongoing debate. In OJSM’s August edition, Drs. Mark Tauber, Phillipp Moroder and their team from the German Shoulder Center in Munich, Germany, published, “ Prospective Multicenter Randomized Controlled Trial of Surgical Versus Nonsurgical Treatment of Acute Rockwood Type 3 Acromioclavicular Injury ,” a high-level study that showed no difference in outcomes between surgical and nonsurgical management of this injury. We are joi...
Feb 14, 2024•24 min
Once an exotic procedure, hip arthroscopy is now a commonplace surgery with an expanding footprint in Sports Medicine. One of the basic steps of hip arthroscopy is a capsulotomy to allow adequate access to the hip joint. Closure of the capsule, however, has been a point of controversy. While expert opinion has long touted the benefits of capsular closure, the technical difficulty of this step and the fact that it comes at the end of a time-sensitive surgery may explain why it is not performed un...
Jan 17, 2024•13 min
Meniscal root tears are a problem. They can occur without trauma, they can only be diagnosed on MRI but occur commonly in a patient population where MRI is not routinely utilized, they don’t respond reliably to partial menisectomy, and they result in rapid degeneration of the knee joint. What we don’t know is how rapid is that arthritic progression. Dr. Caitlin Chambers from the University of Minnesota and her team address this question with their study, “ Association of Medial Meniscus Root Tea...
Dec 13, 2023•19 min
Platelet-Rich Plasma (PRP) remains a topic of controversy in Sports Medicine. One of the limitations surrounding this therapy is the paucity of high-quality data to support or refute its efficacy. We welcome Dr. Dean Wang, MD from UC Irvine to discuss his study looking at the fragility of the highest quality data we have on PRP. A fragile study is one in which the study’s conclusion would change with the reversal of only a few outcomes. Our medical community holds randomized-controlled trials in...
Nov 15, 2023•15 min
The correct surgical approach for a skeletally immature athlete with an ACL tear remains controversial. Transphyseal ACL reconstruction with a soft tissue autograft is a popular choice that most resembles the technique performed in adults. However, crossing an open growth plate comes with risk of growth arrest, though the frequency and magnitude of that risk is not well known. We thank Drs. Alexander Seeto, MD and Ivan Astori, MBBS for their discussing their findings with us....
Oct 18, 2023•14 min
We welcome Drs. Adam Daniel, MD and Patrick Smith, MD from Columbia Orthopaedic Group to discuss their study “ Reduced Incidence of Revision Anterior Cruciate Ligament Reconstruction with Internal Brace Augmentation ." Though a proprietary orthopaedic implant, the term “Internal Brace” has become a household name in Sports Medicine and Orthopaedic Surgery in general. It’s application in the realm of ACL reconstruction has been theorized, however due to poor performance of prior augmentation effo...
Sep 14, 2023•25 min
2023 OJSM William A. Grana Award for Best Research Paper spotlight - Dr. Olufemi Ayeni from McMaster University Medical Centre in Ontario joins us to discuss his award-winning study “ Effect of Osteochondroplasty on Time to Reoperation After Arthroscopic Management of Femoroacetabular Impingement: Analysis of a Randomized Controlled Trial ." As hip arthroscopy continues to grow as a beneficial treatment option in Sports Medicine, high level evidence is needed to support its efficacy. Dr. Ayeni a...
Aug 16, 2023•19 min
We welcome Dr. Gregory Maletis, MD sports medicine surgeon at Kaiser Permanante Baldwin Park and head of the Kaiser Permanente ACL Registry. The KP ACL Registry has generated 55 high-quality, peer-reviewed publications, with huge sample sizes. Dr. Maletis discusses the registry’s inception, history, inner workings, strengths, and weaknesses. We close by looking at this current study , selected as an AOSSM Specialty Day Abstract 2023 and featured in OJSM, as an example of what the registry can do...
Jul 12, 2023•18 min
We welcome Dr. Daniel Whelan, Head of University of Toronto Sports Medicine, to discuss his team’s recent publication “ Assessment of 30 Years of Randomized Controlled Trials in The American Journal of Sports Medicine: 1990-2020 .” This critical look at how our very best clinical studies have changed over a 30-year period is a fascinating reflection of our own evolution as orthopaedic sports medicine specialists. The past informs the present and can teach us lessons on how to be better in the fu...
Jun 21, 2023•20 min
We welcome Dr. Patrick McCulloch, co-program director of The Houston Methodist Sports Medicine Fellowship, and his current fellow, Dr. Matthew Kraeutler to discuss their study “ Effects of Running on the Development of Knee Osteoarthritis: An Updated Systematic Review at Short-Term Follow-up ” published in OJSM in March. The connection between running and osteoarthritic progression in the knee has been a topic of controversy for years. Common sense would say running must be bad for your knees, h...
May 24, 2023•15 min
We welcome back Foot & Ankle Specialist and Residency Director of Loyola University Medical Center, Dr. Adam Schiff, MD to discuss surgical versus nonsurgical management of Achilles tendon ruptures. We review the study “ Operative versus nonoperative treatment of acute Achilles tendon rupture: a propensity score-matched analysis of a large national dataset “ published in OJSM in February coming to us from Duke University. In the study, Dr. Brian Lau and his team found an increased risk of co...
May 03, 2023•25 min
We welcome Foot & Ankle Specialist and Residency Director of Loyola University Medical Center, Dr. Adam Schiff, MD to discuss suture button versus screw fixation for ankle syndesmotic injuries. We review the study “ Comparison of Suture Button and Syndesmotic Screw for Ankle Syndesmotic Injuries: A Meta-Analysis of Randomized Controlled Trials “ published in OJSM in January coming to us from Southwest Hospital of Army Medical University in Chongqing, China. In the study, Dr. Kang-Lai Tang an...
Apr 12, 2023•19 min
Historically, results of direct ACL repair are poor. As such, it has been viewed as a substandard surgical option in comparison to ACL reconstruction, the modern gold-standard approach. However, ACL reconstruction is not without its flaws, and as technology and techniques have advanced, the idea of ACL repair has reemerged. Coming to us from Tripler Army Medical Center, Drs. Christian Cruz and Craig Bottoni share their results with ACL repair in their military population. Like studies from the p...
Mar 22, 2023•19 min
The correct graft choice for ACL reconstruction remains a topic of debate. Dr. Shelbourne and his group have published extensively on the merits of the contralateral patellar tendon autograft. They presented their impressive results in this large-scale study published in OJSM in November and join us in this podcast to discuss their rationale, protocol, experience, and keys for success.
Feb 15, 2023•28 min
The right surgery for an unstable shoulder remains a topic of controversy. What is the right approach? If performing a soft tissue stabilization, is Bankart repair alone sufficient? What is the amount of critical bone loss that would tip the scales towards a Laterjet? World-renowned shoulder specialist Dr. Patrick Denard of the Oregon Shoulder Institute joins us to discuss his recent study, “ Arthroscopic Bankart Repair with Remplissage as an Alternative to Laterjet for Anterior Glenohumeral Ins...
Jan 18, 2023•16 min
Sports Specialization is the focus on a single sport year-round oftentimes at the exclusion of other sports. It is a practice seen increasingly in our youth athlete population that aims to improve an athlete’s competitive advantage but sacrifices rest and has been associated with physical and psychological stress that can lead to attritional musculoskeletal injuries and burnout. We welcome Dr. Nirav Pandya, Pediatric Sports Medicine Surgeon from UCSF, local Sports Medicine authority for the San ...
Dec 21, 2022•21 min
