There seems to be a "law of diminishing returns" with repeated lengthenings of dual growing rods. Repeated lengthenings still result in a net T1-S1 increase; however, this gain tends to decrease with each subsequent lengthening and over time. This phenomenon may be due to autofusion of the spine from prolonged immobilization by a rigid device.

When performing a medial opening wedge proximal tibial osteotomy, the surgeon should consider the negative effects of increased patellofemoral peak pressure.

This novel intramedullary AC ligament reconstruction may be considered when seeking to improve horizontal stability in an anatomical CC ligament reconstruction.