UNASSIGNED: Posterior cruciate ligament (PCL) tears in young children are rare and optimal treatment is poorly described. Diagnosis may prove challenging as young children may not be able to verbalize a complete history of injury, may be difficult to examine, and plane film radiographs often appear within normal limits. Surgical treatment carries a risk of physeal arrest, but non-operative treatment may lead to recurrent instability and pain.
UNASSIGNED: We present a case report of a fouryear- old child with a PCL avulsion off the femoral insertion who received an open reduction and internal fixation (ORIF) with combined arthroscopic synovial debridement. We performed a literature review which compared the mechanism, location, concomitant injuries, work up and management of PCL injuries in children under the age of ten compared to adolescents and adults.
UNASSIGNED: Nineteen months following surgery, physical examination revealed full knee range of motion and return to baseline function. Imaging studies confirmed there was no evidence of physeal arrest.
UNASSIGNED: ORIF with arthroscopy can be an effective method to treat PCL avulsions in children under the age of 10 years. This is similar to other case reports which reported positive outcomes with ORIF in this population. Large studies are needed to best understand optimal treatment modalities for PCL injuries in very young children. Level of Evidence: IV.

UNASSIGNED: Pan-labral tears, commonly associated with recurrent shoulder dislocations, are a well-documented pathology. However, circumferential pan-labral tears following a first-time shoulder dislocation represent a rare and scarcely reported entity in the literature. Accurate diagnosis requires a comprehensive clinical history, physical examination, and further evaluation, often involving MRI. Even with advanced imaging, the acute nature of the injury can lead to the oversight of pan-labral tears, necessitating arthroscopic assessment for definitive diagnosis. Repairing such extensive glenoid labral tears presents a challenging task, requiring skilled surgeons to utilize accessory portals and percutaneous techniques for optimal visualization and anchor placement trajectory. To the best of our knowledge, this case report represents the first documentation of a pan-labral tear associated with a 1st-time shoulder dislocation.
UNASSIGNED: A 27-year-old Asian male presented with pain and limited range of motion in the left shoulder following a single episode of anterior shoulder dislocation during cricket. Initial X-rays were unremarkable, but subsequent MRI revealed an anteroinferior labral tear with intact rotator cuffs. Arthroscopic evaluation disclosed a pan-labral tear, prompting meticulous repair under general and locoregional anesthesia. The patient achieved full recovery postoperatively.
UNASSIGNED: While pan-labral tears are typically linked to recurrent dislocations, this case underscores their occurrence in a 1st-time traumatic shoulder dislocation without overt clinical signs or fractures. Arthroscopic repair demands careful intraoperative planning to achieve optimal tensioning and alignment of labral and capsular tissues. This report contributes to the limited literature on pan-labral tears associated with initial shoulder dislocations, emphasizing the importance of arthroscopic evaluation for accurate diagnosis and successful repair.

Primary synovial osteochondromatosis (PSO), a seldom-seen synovial proliferative disease involving chondral metaplasia, presents a unique challenge when affecting the ankle joint. Controversy exists regarding whether a combined posterior-anterior approach with total synovectomy is necessary to avert recurrence or malignancy. An 18-year-old Caucasian male presented to the outpatient clinic with clinical and imaging findings indicative of a stage III PSO. The surgical intervention involved a combined posterior-anterior arthroscopic approach with the removal of multiple loose bodies and complete synovectomy, resulting in complete relief of symptoms without recurrence at the 12-month follow-up. Pathological examination confirmed the diagnosis. The management of PSO in the ankle joint using a combined posterior-anterior arthroscopic approach with complete synovectomy demonstrated effectiveness in this case. Regular follow-ups are essential for monitoring long-term outcomes and detecting potential recurrence or malignant transformation.

The radioscaphocapitate ligament is part of the stabilizatory complex of the scaphoid. Isolated injury resulting in persistent radioscaphoid instability is rarely reported. The authors propose a technique for arthroscopic reinforcement. Magnetic resonance, dynamic fluoroscopy, and wrist arthroscopy will confirm the elongation of radioscaphocapitate ligament. Under arthroscopic control, an anchor can be drilled into the radial aspect of the scaphoid to tension the ligament toward the anchor. An arthroscopic reinforcement of the radioscaphocapitate ligament may resolve a persistent radioscaphoid instability due to elongation.

This report describes a rare case in which double calcifications of the acetabular labrum and rectus femoris occurred concomitantly in a middle-aged female patient who was treated successfully with surgical intervention via hip arthroscopy.
UNASSIGNED: This case highlights the existence of various types of calcifications around the acetabulum, with a proposed new classification system for acetabular and periacetabular rim ossifications.

BACKGROUND: Congenital absence of the menisci is a rare anatomical variation characterized by the absence or underdevelopment of one or both menisci in the knee joint. The menisci are crucial in load distribution, joint stability, and shock absorption. Understanding the clinical presentation, diagnosis, and management of this condition is important for optimal patient care.
METHODS: A 27-year-old male with a long-standing history of knee pain underwent diagnostic arthroscopy, revealing a congenital absence of the meniscus. The patient\'s clinical findings, imaging results, surgical procedures, and pertinent images are detailed. This case presents a unique aspect with the congenital absence of the meniscus, contributing valuable insights to the literature on rare anatomical anomalies.
CONCLUSIONS: This case of congenital absence of the menisci highlights the diagnostic challenges posed by rare anomalies. The diagnostic arthroscopy played a crucial role in identifying the absence of the meniscus and providing an explanation for the patient\'s persistent knee pain. The case underscores the importance of individualized treatment approaches, including physical therapy, for optimal management of rare meniscal anomalies. Further research is warranted to explore effective management strategies for the aforementioned cases and to expand our knowledge of these rare conditions.

We present a case of a woman in her 30s who visited the rheumatology clinic due to her persistent knee pain for 5 years, which spread to multiple joints. She was diagnosed with seropositive rheumatoid arthritis (RA). While most joints responded well to methotrexate and subsequently etanercept, persistent unilateral knee pain prompted further investigation. Imaging revealed synovitis and joint effusion in her knee, prompting arthroscopy and synovial biopsy, revealing pigmented villonodular synovitis (PVNS). Despite initial success with a tricompartmental synovectomy, her disease recurred. The decision was made to pursue medical therapy, with pexidartinib initiated by the oncology team. Our case report highlights the importance of considering other underlying conditions in patients with RA who do not achieve full clinical improvement despite standard treatment. Physicians should remain vigilant for atypical presentations and imaging features in patients with RA, for early recognition of PVNS can significantly impact treatment decisions and patient outcomes.

BACKGROUND: Osteochondral lesions on the lateral process of the talus involving the subtalar joint are rare; the optimal surgical treatment remains to be clarified as there are few reports. Additionally, bilateral cases are extremely rare. Therefore, the clinical outcomes of the surgical treatment for bilateral osteochondral lesions on the lateral process of the talus involving the subtalar joint have not been fully elucidated.
METHODS: A 16-year-old boy who played soccer presented to our hospital with bilateral hindfoot pain. The symptoms persisted even after 3 months of conservative treatment. The patient and family requested surgical treatment to relieve the symptoms.
METHODS: The patient was diagnosed with bilateral osteochondral lesions on the lateral process of the talus, involving the subtalar joint based on computed tomography and magnetic resonance imaging findings.
METHODS: Arthroscopic debridement and microfracture were performed bilaterally.
RESULTS: Postoperative computed tomography and magnetic resonance imaging of both feet revealed remodeling of the subchondral bone. The patient returned to play at the pre-injury level with no pain.
CONCLUSIONS: This report describes a case of bilateral osteochondral lesions on the lateral process of the talus, involving the subtalar joint. Arthroscopic debridement and microfracture were effective in relieving symptoms and the subchondral bone remodeling. To the best of our knowledge, this is the first report of arthroscopic treatment of osteochondral lesions of the lateral process of the talus involving the subtalar joint.

UNASSIGNED: Satisfactory clinical results of meniscal allograft transplantation (MAT) have been reported in recent years. However, it remains unclear whether the clinical outcomes of MAT when combined with an osteotomy are inferior to those of isolated MAT.
UNASSIGNED: To compare the survival rates and clinical outcomes of patients who received isolated medial MAT with those of patients undergoing medial MAT combined with high tibial osteotomy (HTO).
UNASSIGNED: Cohort study; Level of evidence, 3.
UNASSIGNED: A total of 55 patients underwent arthroscopic medial MAT using the soft tissue technique and HTO (mean age, 41.3 ± 10.4 years; 9 female); after fuzzy case-control matching on demographics, 55 controls who underwent isolated medial MAT were also included. Survival analyses were performed using the Kaplan-Meier method with surgical failure, clinical failure (Lysholm score, <65), and reoperation as endpoints. Subjective clinical scores were collected preoperatively and at the final follow-up.
UNASSIGNED: The mean follow-up time was 5.4 years, up to 8 years. All outcomes significantly improved at the last follow-up (P < .001). No differences were identified between MAT and MAT + HTO groups preoperatively and at the last follow-up (P > .05). At the final follow-up, 8 of 55 (14.5%) of the MAT + HTO patients and 9 of 55 (16.4%) of the MAT patients had a Lysholm score <65 (P = .885). Overall, 90% of the patients declared they would repeat the surgery regardless of the combined procedure. Surgical failure was identified in 6 of 110 (5.5%) patients: 5 of 55 (9.1%) in the MAT + HTO group and 1 of 55 (1.8%) in the MAT group (P = .093). Clinical failure was identified in 19 of 110 (17.3%) patients: 11 of 55 (20%) in the MAT + HTO group and 8 of 55 (14.5%) in the MAT group (P = .447). A significantly lower survivorship from surgical failure was identified in the MAT + HTO group (hazard ratio, 5.1; P = .049), while no differences in survivorship from reoperation and clinical failure were identified (P > .05).
UNASSIGNED: Patients undergoing medial MAT + HTO showed similar clinical results to patients undergoing isolated medial MAT at midterm follow-up, and thus a surgically addressed malalignment does not represent a contraindication for medial MAT. However, the need for a concomitant HTO is associated with a slightly higher failure rate over time.

BACKGROUND: Plicae or synovial folds can be detected in different joints, especially around the knee. Synovial plicae pathologies are rare conditions with difficulty in diagnosis because of various symptoms overlapping with other diseases.
METHODS: We reported a rare case of symptomatic hypertrophic synovial plica in the lateral side of the knee in a 12-year-old boy following a traumatic event almost two years before the surgery. The diagnosis and treatment were conducted by knee arthroscopy, and follow-up of the patients showed significant improvements with no pain or range of motion restrictions.
CONCLUSIONS: The reported case had a significantly lower age of presentations compared to most previously reported cases, and he was diagnosed with lateral knee hypertrophic plicae, while medial knee hypertrophic plicae are more commonly reported, which is considered rare findings. Contrary to previous studies of lateral plica, our case had a history of significant direct trauma, and he was not a professional athlete. Furthermore, based on evidence, hypertrophic synovial plicae are mostly asymptomatic, but in our case, there was a pain in his knee that worsened in flexion.
CONCLUSIONS: Physicians should consider the possibility of synovial hypertrophic plicae, especially in younger patients with histories of direct traumatic events.