To compare the clinical outcome of patients treated with and without platelet-rich plasma (PRP) injection while undergoing arthroscopic labral repair and femoral neck osteoplasty for femoral acetabular impingement. Patients were randomized at the time of surgery to receive either an intra-articular injection of 5 cc of PRP, or an equal volume of 0.9% normal saline. All patients underwent arthroscopic labral repair and osteoplasty of the femoral neck and, at the conclusion of the case, received the injection. One week following surgery, thigh circumference (measured 10 cm distal to the tip of the greater trochanter) and the presence of ecchymosis of the thigh were recorded. Clinical outcome scores, including Non-Arthritic Hip Score, Modified Harris Hip Score and Hip Outcome Score were collected prior to surgery at 1, 3, 6 and a minimum of 12 months post-operatively. Thirty-five patients were enrolled into this study. Twenty patients received a PRP injection and 15 received a saline injection. Thigh circumference was compared pre-operatively and 1 week post-operatively. There was no significant difference between the two groups. Ecchymosis was compared between the two groups at 1 week post-operatively. Four of the 20 patients in the PRP group and 10 of the 15 in the placebo group demonstrated bruising on the lateral thigh. This was compared with a Chi-Square test and found to be statistically significant (P = 0.005). There was no significant difference in any of the outcome scores between the two groups. An intra-articular injection of PRP after labral repair did not improve the clinical outcome up to 1 year post-operatively in patients undergoing arthroscopic labral repair and osteoplasty of the femoral neck. Level of evidence is level I study.

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Background: The Patient Reported Outcomes Information System (PROMIS) is an efficient metric able to detect changes in global health. Purpose: To assess the responsiveness, convergent validity, and clinically important difference (CID) of PROMIS compared with disease-specific scales after knee arthroscopy.

A massive rotator cuff tear is defined as a tear involving .2 tendons or .5 cm of retraction.» Superior capsular reconstruction is done with either a folded fascia lata autograft (6 to 8 mm in thickness) or acellular dermal allograft (3 to 4 mm in thickness). The graft is secured arthroscopically with anchors on the superior glenoid rim and multiple anchors on the humeral head with use of a transosseous-equivalent repair technique.» Superior capsular reconstruction is indicated for younger patients with massive and irreparable rotator cuff tears involving the supraspinatus and infraspinatus with minimal arthritis, intact subscapularis, and a functional deltoid. Contraindications include bone defects, stiffness, and moderate to severe arthropathy.» Arthroscopic superior capsular reconstruction with fascia lata autograft or humeral dermal allograft is a surgical option, with multiple studies showing statistically significant improvement in short-term outcomes for both pain and function among younger patients with massive irreparable rotator cuff tears. The long-term clinical effectiveness and value have yet to be determined. » Biomechanical data suggest improved restoration of superior glenohumeral stability with decreased subacromial contact pressures in association with the use of the 8-mm fascia lata graft as compared with the 4-mm acellular humeral dermal allograft. In addition, fascia lata graft has shown less elongation and thinning than humeral dermal graft.» Either fascia lata autograft or humeral dermal allograft may be used clinically for arthroscopic superior capsular reconstruction; however, a graft thickness of at least 3 mm is recommended to decrease the risk of radiographic and clinical failure.» No comprehensive quality-of-life or cost-comparison analyses are available to compare superior capsular reconstruction, reverse total shoulder arthroplasty (rTSA), tendon transfer, and partial rotator cuff repair for the treatment of massive irreparable rotator cuff tears. However, the potential higher cost of superior capsular reconstruction and the lack of long-term clinical outcomes or revision data suggest Disclosure: The authors indicated that no external funding was received for any aspect of this work. On the Disclosure of Potential Conflicts of Interest forms, which are provided with the online version of the article, one or more of the authors checked "yes" to indicate that the author had a relevant financial relationship in the biomedical arena outside the submitted work (http://links.lww.com/ JBJSREV/A465).

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