Nathan K. Endres

Lacerations in alpine ski racers caused by the sharp metal edge of the ski are potentially severe and even life-threatening injuries. To date, there has been little published on these injuries. This case series reports on 5 cases of severe lacerations in alpine ski racers and details slope side management, initial evaluation, and definitive treatment. By publishing this case series, it is hoped to promote further investigation into the mechanism of these injuries and strategies for prevention. Study Design: Case series. Level of evidence: Level 4C.

Context: This article reviews the epidemiology of alpine ski racing–related injuries, risk factors, mechanisms of injury, and injury prevention strategies. Evidence Acquisition: Pertinent literature from peer-reviewed publications from 1976 through 2018. Study Design: Clinical review. Level of Evidence: Level 5. Results: The rate of injury in alpine ski racing is high. In general, knee injuries are the most common, with anterior cruciate ligament (ACL) disruptions being the most significant in terms of time loss from sport. Three specific mechanisms of ACL injury in alpine ski racers have recently been described (slip-catch, dynamic snowplow, and landing back-weighted). In contrast to other sports, female ski racers are not clearly at greater risk for ACL injury, especially at the highest level of competition. A high percentage of ski racers are able to return to their previous level of competition after ACL injury. Risk factors for injury and methods of injury prevention have been proposed; however, the rate of injury, particularly ACL injuries, has not decreased significantly. Conclusion: Alpine ski racing has a high injury rate. ACL injuries in particular remain problematic. Further study is needed to identify modifiable risk factors and implementation of injury prevention strategies.

Context: Alpine skiing is a popular sport worldwide but has significant risk for injury. The epidemiology of skiing-related injuries has been described, which has led to the identification of risk factors for specific types of injuries. Evidence Acquisition: Pertinent literature from peer-reviewed publications was reviewed. Study Design: Clinical review. Level of Evidence: Level 5. Results: The adoption of international standards for ski-boot-binding systems has changed the profile of skiing-related injuries over time, as has the widespread use of helmets. An understanding of mechanisms of injury, risk factors, and preventative measures may decrease the incidence of skiing-related injuries. Conclusion: Advances in standards for skiing equipment have been effective at decreasing both the frequency and severity of skiing-related injuries, but additional efforts are required to improve the safety of the sport.

Purpose of Review Trochlear dysplasia is a well-described risk factor for patellar instability. Trochleoplasty has emerged as a procedure within the surgical armamentarium for patellar instability, yet its role is unclear. A variety of trochleoplasty procedures have emerged. The purpose of this review is to clarify indications for trochleoplasty, outline the technical steps involved in performing common trochleoplasties and report the published outcomes and potential complications of these procedures. Recent Findings Patellar instability with severe trochlear dysplasia is the main indication for trochleoplasty. Three types of trochleoplasty have emerged: (1) lateral facet elevation; (2) sulcus deepening; and (3) recession wedge. Deepening and recession wedge trochleoplasties are the most commonly performed. Summary Trochleoplasty is a surgical option for addressing patellar instability in patients with severe trochlear dysplasia. Deepening and recession wedge trochleoplasties that address Dejour B and D dysplastic trochleas are the most studied, with both short- and midterm outcomes reported. Long-term outcomes are lacking and comparative studies are needed.

The goal of this paper is to review the biomechanical and clinical rationale for single-bundle versus double-bundle posterior cruciate ligament (PCL) reconstruction. The primary question is whether there has been demonstrated any clear biomechanical or clinical superiority of a double-bundle reconstruction over a single-bundle reconstruction.