Men and women sustained a significant number of UE injuries playing collegiate ice hockey during the period studied, with acromioclavicular joint sprain being the most common UE injury and the one that most frequently led to significant time loss. These data may provide insight for future injury prevention and guide improvements in training.

Background: Medial ulnar collateral ligament (mUCL) repair is growing in popularity as a treatment for younger athletes with mUCL tears. One of the most recent techniques utilizes a collagen-coated suture tape to augment the repair. The most popular repair technique uses a screw for proximal fixation in the humerus. We present an alternative technique that uses suspensory fixation in the proximal humerus. Purpose: To biomechanically compare elbow valgus stability and load to failure of a novel alternative repair technique with suspensory fixation to an mUCL reconstruction. Study Design: Controlled laboratory study. Methods: Eighteen fresh-frozen cadaveric elbows were dissected to expose the mUCL. Medial elbow stability was tested with the mUCL in an intact, deficient—either repaired or reconstructed—state. The repair technique used a suspensory fixation with suture augmentation, and the docking technique was used on all reconstructions. A 3-N·m valgus torque was applied to the elbow, and valgus rotation of the ulna was recorded via motion tracking cameras as the elbow was cycled through a full range of motion. After kinematic testing, specimens were loaded to failure at 70° of elbow flexion. Results: Both ulnar collateral ligament reconstruction and repair restored valgus stability to levels that were not statistically different from intact at all angles of flexion. There was no significant difference in the ultimate torque to failure between repaired and reconstructed mUCLs. Conclusion: There was no significant difference in the valgus strength between the mUCL repair with suspensory fixation and the mUCL reconstruction. Clinical Relevance: Suspensory fixation is an alternative method for proximal fixation in the mUCL without compromising the strength of the construct.

Anterior knee pain and patella fracture are 2 potential complications of bone-patellar-bone autograft anterior cruciate ligament reconstruction. Techniques have been developed to minimize the risk of these complications, including filling the defects with autologous bone fragments and augmenting with biologic agents. We have developed a technique that uses a graft collection device to collect the autologous bone graft generated during surgery. This graft augments the larger bone graft derived from the bone plugs. This autologous augmentation provides a complete biologic strategy to potentially reduce the risk of anterior knee pain and potential patella fracture.

Purpose The purpose of this study is to determine the effects of temperature or 0.25% bupivacaine treatment in combination to supraphysiological temperatures on chondrocyte viability. Methods Bovine articular chondrocytes in suspension culture were treated with phosphate- buffered saline (PBS) at 20, 37, 40, 42, 45, 47, and 50° C for 15, 30 and 60 minutes; or with PBS at 37, 45, and 50° C for 30 and 60 minutes followed by 0.25% bupivacaine at 20° C for 60 minutes. Chondrocyte viability was analyzed by flow cytometry using the LIVE/DEAD Viability/Cytotoxicity Kit. Annexin-V and ethidium double- staining determined whether apoptosis or necrosis occurred. Results Temperatures from 20° C to 42° C did not cause chondrocyte death. Temperatures at or above 45° C caused significant chondrocyte death, particularly at 50° C for 60 minutes, compared to 37° C at 60 minutes (P < 0.01). When the chondrocytes were incubated at 50° C, subsequent exposure to bupivacaine significantly increased chondrocyte death, compared to the saline-treated control group (P < 0.001). There were additive cytotoxic effects when bupivacaine was combined with supraphysiological temperatures. It was also found that bupivacaine at supraphysiological temperatures caused necrosis of articular chondrocytes. Conclusions Temperatures at or above 45° C caused significant chondrocyte death. Bupivacaine treatment in the presence of 45° C and 50° C temperatures significantly increased necrosis of bovine articular chondrocytes in this in-vitro study. Clinical Relevance Immediate intra-articular injection of bupivacaine after heat-generating procedures may cause damage to the cartilage due to the additive cytotoxic effects of bupivacaine and elevated temperature.

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