Arthroscopic arthritis options are on the horizon

Editorial Commentary: Increase in Posterior Slope in High Tibial Osteotomy Is Preventable

Increase in the posterior tibial slope after open-wedge high tibial osteotomy can be prevented by appropriate uniplanar and biplanar osteotomy with careful attention to osteotomy length and dimension of distraction.

The Expectation Game: Patient Comprehension Is a Determinant of Outcome

Patient comprehension of orthopaedic procedures is low and their expectations for successful outcomes are often unrealistic. Surgeons need to understand this and guide patients toward sensible expectations.

Editorial Commentary: Shoulder Arthroscopy, Shoulder Hemiarthroplasty, and Total Shoulder Arthroplasty for Glenohumeral Osteoarthritis

Shoulder arthroscopy offers a safe, effective, and less invasive alternative to arthroplasty in patients under 60 years of age with glenohumeral arthritis. However, indications include joint space of greater than 2 mm. For patients who do not meet arthroscopic indications, total shoulder arthroplasty is more effective than hemiarthroplasty. Performance and publication bias may effect generalizability of these findings. Biologic treatment options seem on the horizon.

Arthroscopic microfracture may not be superior to arthroscopic debridement, but abrasion arthroplasty results are good, although not great

Microfracture is nonanatomic because microfracture destroys the gross structure and the complex microscopic infrastructure of the subchondral plate, and may promote subchondral cyst formation. In consideration of the destruction of subchondral anatomy, it may be time to abandon the arthroscopic microfracture procedure. However, arthroscopic abrasion arthroplasty results in a positive outcome in 66% of patients, and may still merit consideration as a salvage procedure.