George Alexander Rublev

Giant cell tumor of bone is a locally aggressive benign neoplasm with a strong tendency for local recurrence after surgical treatment. Intralesional excision and curettage is preferred in most cases to maximize tumor removal while preserving the affected joint. The present technical note describes Video‐Assisted Intralesional Curettage of Invasive Nonmalignant Giant cell tumors, a technique in which intracavitary 30° arthroscopic visualization is integrated with extended intralesional curettage. After the creation of a cortical window for Campanacci grade 2 lesions or the use of the existing cortical defect for grade 3 lesions, the arthroscope is introduced and rotated through 360° to identify residual pigmented tumor in recesses not visible to the unaided eye. Targeted recurettage, high‐speed burring, and monopolar electrocautery on spray mode are then applied under direct video visualization, followed by pulsed saline lavage and reconstruction with polymethyl methacrylate cementation, with the aim of reducing residual microscopic disease at every step.

Rib bone stress injuries (BSIs) are rare in athletes but have been reported in rotational sports, such as tennis or golf. Scapular dyskinesia is a well‐established risk factor for shoulder injury, but its contribution to rib BSI has not previously been described. This case concerns a 25‐year‐old man with longstanding left scapular dysfunction, who developed progressive pain in the left medial scapular region 6 months after starting intensive golf training. Clinical examination revealed marked scapular dyskinesia, raising suspicion of muscle atrophy or peripheral nerve involvement. Shoulder and chest MRI excluded neuromuscular abnormalities but demonstrated nondisplaced BSI of the left posterior fifth and sixth ribs. This case report is the first to suggest scapular dyskinesia as a potential biomechanical risk factor for rib BSI in golf. It emphasizes the need to consider underlying scapular dysfunction when evaluating athletes with atypical thoracic pain.

Purpose: To evaluate the outcomes of patients who had osteochondral lesions of the talus treated with osteochondral allograft transplants combined with platelet‐rich plasma (PRP) and hyaluronic acid (HA). Methods: We aimed to investigate the outcomes of patients who underwent osteochondral autograft transplantation surgery (OATS) from 2015 to 2022. The inclusion criteria for patients to undergo OATS included a defect size greater than 5 mm and failure of conservative management. The preoperative and postoperative visual analog scale (VAS) and American Orthopaedic Foot & Ankle Society (AOFAS) scores were recorded and subsequently analyzed using a paired t test. We also performed cohort‐specific analyses that included the minimal clinically important difference, patient acceptable symptom state, and substantial clinical benefit. PRP injections were administered at 8 weeks postoperatively and were given every 2 weeks, for 3 total injections. HA was injected once every 6 months for the following 2 years. The minimum follow‐up time was 2 years. Results: At the 12‐month follow‐up, all 19 patients reported a mean increase in the VAS score of 33.40 (95% confidence interval, 30.9‐35.8). The average age was 31 years, and there were 12 male and 7 female patients. Of the 19 patients, 17 reported no restriction of motion, whereas the other 2 patients reported some restriction of dorsiflexion. Ankle function based on the AOFAS scoring system showed good to excellent results in 18 of 19 cases (94%), with no long‐term donor‐site morbidity and a mean increase of 37.49 (95% confidence interval, 34.7‐40). Hardware removal of lag screws was conducted at 12 months after initial surgery; all cases resulted in union of the malleolar osteotomy. The average follow‐up time was 3 years. Conclusions: Combining OATS with PRP‐HA injections can yield promising results for patients with osteochondral lesions of the talus, showing significant improvement in VAS and AOFAS scores postoperatively. Level of Evidence: Level IV, therapeutic case series.

» Identification of malnourished and at-risk patients should be a standardized part of the preoperative evaluation process for every patient. » Malnourishment is defined as a disorder of energy, protein, and nutrients based on the presence of insufficient energy intake, weight loss, muscle atrophy, loss of subcutaneous fat, localized or generalized fluid accumulation, or diminished functional status. » Malnutrition has been associated with worse outcomes postoperatively across a variety of orthopaedic procedures because malnourished patients do not have a robust metabolic reserve available for recovery after surgery. » Screening assessment and basic laboratory studies may indicate patients' nutritional risk; however, laboratory values are often not specific for malnutrition, necessitating the use of prognostic screening tools. » Nutrition consultation and perioperative supplementation with amino acids and micronutrients are 2 readily available interventions that orthopaedic surgeons can select for malnourished patients.

Purpose: To evaluate the experiences and outcomes of arthroscopic partial meniscectomy in symptomatic non‐Wrisberg discoid lateral meniscus in children younger than 12 years old at a single center. Methods: We retrospectively reviewed the medical records of all pediatric patients who were treated for non‐Wrisberg discoid meniscus at our institute between 2013 and 2021. Patients were separated into 2 groups: Patients who underwent partial resection with saucerization (group A) or patients who underwent saucerization, tear repair, and fixation (group B). Clinical outcomes were compared between the 2 groups. Results: A total of 20 patients (22 knees) were treated for non‐Wrisberg discoid meniscus and included in this study. Nine patients underwent partial resection with saucerization (group A) whereas 11 patients underwent saucerization, tear repair, and fixation (group B). The average follow‐up was 3 years (range 2‐10 years). The results showed that 17 of the 20 patients had excellent outcomes whereas the other 3 had good outcomes after a minimum follow‐up of 2 years. The average Knee Injury and Osteoarthritis Outcome Score for Children score was 93. Conclusions: Arthroscopic saucerization of symptomatic non‐Wrisberg discoid lateral meniscus, with additional repair as indicated results in excellent or good outcomes in children younger than 12 years of age. Level of Evidence: Level III, case–control study.