The anterior cruciate ligament (ACL) is the most common ligamentous knee injury in pivoting sports. There are multiple techniques described for ACL reconstruction; however, still there is an ongoing debate regarding the optimal technique with minimal residual laxity and least risk of rerupture. All-inside ACL reconstruction with suture tape augmentation (InternalBrace) is a newly developed method of ACL reconstruction to help address these issues. Suture tape protects the graft during ligamentization process. The aim of this article is to describe a modified all-inside ACL reconstruction technique with suture tape augmentation in which the internal brace is tied distally over the distal TightRope button without an extra method of fixation.

Background: Large and massive rotator cuff repairs constitute a true challenge for arthroscopic shoulder surgeons. Retear rates as high as 20% have been reported after arthroscopic double-row and suture-bridge techniques used for these tears. Hypothesis: A modified triple-row repair will provide satisfactory clinical results with lower risk for retear. Study Design: Case series; Level of evidence, 4. Methods: Between March 2016 and August 2017, a total of 52 patients with large and massive rotator cuff tears received a modified triple-row cuff repair. A middle repositioning anchor was inserted between the medial and the lateral rows. The middle anchor sutures were loaded to lateral knotless anchors in a star-shaped configuration. Functional evaluation was performed using the American Shoulder and Elbow Surgeons score, University of California, Los Angeles score, Constant-Murley score, and Simple Shoulder Test. Subjective evaluation was carried out using a visual analog scale for pain and a subjective shoulder value score. Health-related as well as disease-specific quality-of-life scores were also used. Retear rates were assessed by means of musculoskeletal ultrasonography. Patients were evaluated for a minimum of 24 months. Results: This study included 34 female and 18 male patients with a mean age of 57.17 ± 6.7 years. There were 35 patients (67.3%) with large tears and 17 patients (32.7%) with massive tears. Significant improvement from preoperative values was seen in all functional and subjective scores ( P < .001). The mean forward flexion was 163° ± 9.7°, and the mean lateral abduction was 159.4° ± 9.4°. All patients had excellent scores on the general health-related and disease-specific quality-of-life scales. No retears were reported at the end of the follow-up period. Conclusion: The star-shaped, modified triple-row cuff repair is a valid and effective solution for surgical management of large and massive rotator cuff tears, providing excellent results and low risk for retears.

Calcific rotator cuff tendinitis is a common cause of shoulder pain. It is thought to be an active cell-mediated process although the exact pathophysiology remains unclear. It commonly affects the supraspinatus tendon. The condition is generally self-limiting and can be managed with appropriate nonoperative treatment; however, some cases may need surgical excision. Complete removal of the calcific deposits may result in large significant defects. Infraspinatus calcific deposits were seldomly described. This report illustrates a double-row suture bridge technique with margin convergence of a large cuff defect after excision of calcific deposits within the infraspinatus tendon.

Recently, many arthroscopic techniques have been described to improve the outcomes in rotator cuff repair of large and massive tears; these include conventional double-row, suture bridge, and triple-row techniques, in an effort to optimally reconstruct the rotator cuff footprint and improve fixation. This report describes a modified triple-row repair technique that links the double-row and suture-bridge techniques in one construct, merging the advantages of both to maximize the footprint contact area and contact pressure, which may lead to better healing and faster rehabilitation.

Introduction Traumatic anterior shoulder instability is a rare occurrence in the childhood. While glenoid labrum articular disruption itself is an uncommon condition that accompanies shoulder instability in the contact athletes, the occurrence of such lesion in a child is of extreme rarity. To the best of our knowledge, this case is the first to be reported at such a young age. Case presentation A six-year-old female child is presented to the clinic with a painful left shoulder and limited range of motion after a fall which was abruptly prevented by the father; hence, the child was grabbed by the arm, leaving the body to pivot around the shoulder at full force in an abduction external rotation position. Radiological studies revealed anteroinferior osteochondral fragment and a matching glenoid defect. Open surgery was performed, and the osteochondral fragment with the attached labrum was fixed using smooth K-wires. Conclusions Although rare, shear fractures of the anterior glenoid associated with chondral damage are possible in early childhood. However, it demands a forceful burst of abduction external rotation force which could have been avoided if the child was left to fall. The use of two K-wires via an open deltopectoral approach achieved excellent results with minimum cartilage damage.