Julia Retzky, MD

All Publications

• Revision Tibial Tubercle Osteotomy for Nonhealing: A Single-center Case Series. The journal of knee surgery ElNemer, W., Retzky, J. S., Barth, K., Klinger, C., Bilodeau, R., Ricci, W., Fabricant, P., Helfet, D., Fragomen, A. T., Strickland, S. M. 2026

  Abstract

  The tibial tubercle osteotomy (TTO) is a versatile surgical approach for patellofemoral joint conditions, with nonunion, fracture, and recurrent instability as common indications for revision. This case series describes the management and outcomes of revision TTOs performed for these complications. A retrospective review of 20 patients undergoing revision TTO was conducted. Patients were included if they underwent revision for nonunion, delayed union, or fracture after primary TTO. Data collected included patient demographics, primary and revision TTO details, concurrent procedures, biological adjuncts, fixation methods, and clinical outcomes. Outcomes measured were union rates, time to healing, and subsequent revision. The mean age of the cohort was 26.8 ± 11.7 years, with a mean follow-up of 2.6 ± 2.7 years. Indications for revision were nonunion (70%), fracture (15%), and recurrent instability (15%). Biological augmentation, including bone marrow aspirate concentrate (BMAC), was used in 80% of revisions. Following revision TTO, 65% achieved union at a mean time of 14.6 ± 5.0 weeks, 15% had delayed union (mean time to union 11.9 ± 6.7 weeks), and 15% required a second revision for nonunion, achieving union at a mean time of 15.2 ± 12.7 weeks. Patients with delayed union were older (38 ± 12 years, p = 0.049) and had higher rates of vitamin D deficiency. Revision TTO is effective in addressing nonunion, delayed union, and fractures, with a majority achieving union after revision or re-revision. Strategies such as robust fixation, biological augmentation (e.g., BMAC), and management of comorbidities, including vitamin D deficiency, play a critical role in optimizing outcomes. Further research is needed to standardize protocols and improve union rates in high-risk populations. What are the new findings: This 20-patient case series focuses specifically on revision TTO, reporting granular management and outcomes-65% union after revision, union after all re-revisions, 80% use of biologic augmentation, and an observed association of delayed union with older age and vitamin D deficiency. This adds actionable details on biologic use and fixation escalation and spotlights potentially modifiable risk factors in the revision setting.

  View details for DOI 10.1055/a-2908-2504

  View details for PubMedID 42480553

• Simulated wrist fractures displace in well molded casts and splints under fall simulation forces: A cadaveric study. Clinical biomechanics (Bristol, Avon) Bram, J. T., Retzky, J. S., Meyers, K. N., Tracey, O. C., Pascual-Leone, N., Levine, K. R., Darko, M. V., Nichols, E., Dodwell, E. R. 2026; 133: 106752

  Abstract

  Distal radius fractures are commonly treated with cast/splint immobilization, but variations exist in activity restrictions.Fractures of the distal radius/ulna were created in cadaveric forearms. A force was applied through the long axis of the forearm simulating a ground-level fall. Each sample underwent testing in a short-arm well-molded fiberglass cast and a commercial fracture splint. Initial and final position lateral radiographs at 0 N and 400 N of force and dynamic fluoroscopy were taken for calculation of the primary outcome, change in volar tilt. Secondary outcomes were change in radial height and inclination, with comparison of these parameters between cast and splint testing. Statistical analysis employed paired t-tests.Ten adult cadaveric forearms (6 female, mean age 58.5 ± 17.4 years, BMI 25.7 ± 5.9) were included. Mean overall change in volar tilt, radial height, and radial inclination was 13.3°, 6.3 mm, and 0.5°, respectively. Alignment was similar pre-and-post testing between casted and splinted specimens across all forces. Change in dorsal angulation of fractures from 0 to 400 N of force was comparable when casted and splinted (13.3 ± 9.2° vs 13.2 ± 8.7°, P = 0.945). Fracture displacement reached >10° of dorsal tilt in both groups at 29.2% and 40.8% of idealized adult (70 kg) and adolescent (50 kg) body weights, respectively.Mean change in volar tilt suggests immobilized fractures in cast or splint may displace with ground-level fall mechanisms. Fracture displacement was similar between short-arm casts and wrist splints. Clinical practice guidelines should be developed for patients with cast-immobilized healing fractures.

  View details for DOI 10.1016/j.clinbiomech.2026.106752

  View details for PubMedID 41610638

• Early Anterior Cruciate Ligament Reconstruction Mitigates the Development of Posttraumatic Osteoarthritis in a Murine Anterior Cruciate Ligament Rupture Model. The American journal of sports medicine Retzky, J. S., Carballo, C., Simonian, L., Li, T. M., Suzuki, Y., Okazaki, Y., Hammad, M., Ranga, S., Trinh, P. M., Aydin, E., Covello, M., Eliasberg, C. D., Lu, T. T., Rodeo, S. A. 2026; 54 (1): 17-26

  Abstract

  Up to 60% of patients develop posttraumatic osteoarthritis (PTOA) 10 to 25 years after anterior cruciate ligament reconstruction (ACLR). While some studies suggest that early ACLR may mitigate PTOA, other studies, by contrast, have found no difference in the timing of ACLR on the development of PTOA. Therefore, the optimal timing of ACLR for the mitigation of PTOA has yet to be fully elucidated in the literature.To evaluate the effect of timing of ACLR on the development of PTOA using a murine noninvasive (closed) anterior cruciate ligament (ACL) rupture model, as well as on pain-related gait behaviors, peripheral and central immune and inflammatory response, knee range of motion (ROM), and proximal tibial epiphyseal and distal femoral epiphyseal bone volume.Controlled laboratory study.A total of 55 male C57BL/6 mice, 11 to 12 weeks of age, were randomized to 1 of 3 conditions: ACL rupture only, ACL rupture followed by immediate ACLR, or ACL rupture followed by delayed ACLR (7 days after injury). Normal, uninjured animals served as controls. Mice in the immediate and delayed ACLR groups were sacrificed at 28 days postoperatively, and those in the ACL rupture group were sacrificed at 28 days postinjury. The primary outcome measure was histological evaluation using the Osteoarthritis Research Society International (OARSI) score. The secondary outcomes included ROM testing, flow cytometry (from ipsilateral iliac lymph node [iLN] and spleen), gait analysis, and micro-computed tomography (µCT) analysis.The ACL rupture and delayed ACLR groups had higher femoral OARSI scores, consistent with a greater degree of osteoarthritic changes, compared with the control (P < .0001 and P < .0001, respectively) and immediate ACLR (P < .001 and P < .0001, respectively) groups. In addition, the ACL rupture and delayed ACLR groups had higher tibial OARSI scores compared with the control (P < .0001 and P < .001, respectively) and immediate ACLR (P < .01 and P < .01, respectively) groups. There were no differences between groups with respect to ROM or pain-related gait behaviors. There was an increase in total ipsilateral iLN cellularity in the surgical cohorts compared with the ACL rupture and control cohorts. The delayed ACLR group had decreased bone volume in both the proximal tibial epiphysis and distal femoral epiphysis on µCT imaging compared with the immediate ACLR group (P < .001 and P < .01, respectively).The authors found that immediate ACLR mitigates the development of PTOA in a murine closed ACL rupture model.PTOA is common after ACL injury and surgery. The authors found that early ACLR mitigates PTOA in a murine noninvasive ACL rupture model.

  View details for DOI 10.1177/03635465251390541

  View details for PubMedID 41476416

• Smaller ischiofemoral space measurements are associated with proximal hamstring injuries Arthroscopy, Sports Medicine, and Rehabilitation Itthipanichpong, T., Retzky, J. S., Curran, P., Menta, S. V., Ranawat, A. S. 2026
• Time Is of the Essence. The American journal of sports medicine Owens, B. D. 2026; 54 (1): 15-16

  View details for DOI 10.1177/03635465251399638

  View details for PubMedID 41476418

• The Effect of Capsular Repair Location on Humeral Head Position and Translation After Distal Tibial Allograft Reconstruction: A Cadaveric Study. The American journal of sports medicine Fury, M. S., Cirino, C. M., Jahandar, A., Retzky, J. S., Brusalis, C. M., Rauck, R. C., Gulotta, L. V., Blaine, T. A., Fu, M. C., Warren, R. F., Kontaxis, A., Taylor, S. A. 2026; 54 (1): 128-134

  Abstract

  Distal tibial allograft (DTA) reconstruction has emerged as an effective option for the treatment of recurrent shoulder instability with glenoid bone loss (GBL). However, the ideal location for capsular repair during the procedure remains undetermined.To evaluate the effect of capsular repair location on humeral head positioning and anterior translation after DTA.Controlled laboratory study.Nine human cadaveric specimens (mean age, 62.2 years [range, 52-69 years]) underwent biomechanical testing in a simulated bone loss model. The rotator cuff tendons were loaded, and anterior stability testing was performed using a Kuka robot with the shoulder in 90° of abduction and neutral external rotation. A motion capture system recorded humeral head position and anterior translation. GBL (mean, 32%) was created, and a DTA graft was prepared to restore 100% of the native glenoid width. The following conditions were tested: intact, soft tissue Bankart lesion, DTA without capsular repair (DTA), DTA with capsule repaired to the graft (intra-articular), and DTA with capsule repaired to the glenoid (extra-articular). A repeated measures analysis of variance was performed to compare the translation and humeral head resting position between the five capsulolabral conditions.There was no difference in anterior translation when comparing DTA without capsular repair and the DTA with the capsule repaired to the graft (5.1 vs 5.3 mm; P > .999), and there was no difference in anterior translation between either of these conditions and the intact state (P > .999 for both). However, capsular repair to the glenoid demonstrated a significantly decreased anterior translation (0.7 vs 7 mm; P < .001) as well as a statistically significant posterior shift in the resting position (-2.5 vs 1.8 mm; P = .004) when compared with the intact state.When performing a DTA reconstruction for large GBL, capsular repair to the native glenoid results in a more posterior resting humeral head position and less maximum anterior translation of the humeral head during time-zero biomechanical testing in cadaveric specimens. DTA without capsular repair and DTA with capsular repair to the graft restore glenohumeral position and motion closer to the native state.Capsular repair to the native glenoid may overconstrain the glenohumeral joint when performing distal tibial allograft reconstruction in the setting of large glenoid bone loss, but further study is required to determine the impact on patient-reported outcomes or long-term arthritis risk.

  View details for DOI 10.1177/03635465251389964

  View details for PubMedID 41476406

• 6-Month Postoperative Magnetic Resonance Imaging Appearance of Osteochondral Allografts With Bone Marrow Aspirate Augmentation From Either the Proximal Tibia or Iliac Crest ORTHOPAEDIC JOURNAL OF SPORTS MEDICINE Retzky, J. S., Palhares, G. M., Khilnani, T. K., Davie, R., Xu, A., Neijna, A. G., Rizy, M. E., Gracitelli, G. C., Terry, H. L., Strickland, S. M., Gomoll, A. H. 2026; 14 (1)

  View details for DOI 10.1177/23259671251408729

  View details for Web of Science ID 001671377800001

• Comparison of preoperative mechanical axis alignment in pediatric and adolescent patients with anterior cruciate ligament rupture and patellofemoral instability. The Knee Pascual-Leone, N., Chipman, D. E., Retzky, J., Lijesen, E., Gross, P. W., Ammerman, B., Widmann, R. F., Fabricant, P. D., Green, D. W. 2025; 57: 396-400

  Abstract

  The primary aim of this study was to examine mechanical axis alignment and its association with ACLR and PFI in pediatric and adolescent patients. The authors hypothesized that there would be differences in mechanical axis alignment between patients with ACLR, PFI, and a control cohort.Patients aged 8-21 years at a single institution who sustained an ACLR or PFI injury and underwent operative treatment. Patients with scoliosis with a Cobb angle less than 20° served as controls (Controls). One-way ANOVA was used to compare mechanical axis alignment between all cohorts (ACLR, PFI, Controls), and independent samples t-tests were analyzed to compare the individual differences between the cohorts.Of the patients identified, 197 met final inclusion and exclusion criteria (60 ACLR, 92 PFI, 45 Controls). The mean age at time of imaging was 14.4 ± 2.2 years and 50.8 % were female. The mean mechanical axis was 0.067 ± 2.5° for the ACLR cohort, 0.937 ± 2.4° for PFI, and -0.073 ± 2.6° for the Control cohort (p = 0.032) (positive = valgus, negative = varus). The PFI cohort was in significantly more valgus than the ACL cohort (p = 0.032) and the Control cohort (p = 0.026).Mechanical axis alignment was found to be significantly different in preoperative weightbearing radiographs between patients with ACLR, PFI, and a control cohort, demonstrating that static valgus alignment may be associated with PFI in pediatric and adolescent patients, while static alignment may not be associated with ACLR.Level III.

  View details for DOI 10.1016/j.knee.2025.09.006

  View details for PubMedID 41108836

• Tendon-Bone Interface Healing Improvement by Moderate Treadmill Exercise After Anterior Cruciate Ligament Reconstruction in a Murine Model ORTHOPAEDIC JOURNAL OF SPORTS MEDICINE Okazaki, Y., Takata, Y., Piacentini, A., Morita, W., Retzky, J., Suzuki, Y., Sanchez, L., Chen, T., Rodeo, S. A., Carballo, C. B. 2025; 13 (12)

  View details for DOI 10.1177/23259671251394028

  View details for Web of Science ID 001637756000001

• Combined Unicompartmental Knee Arthroplasty and Trochlear Porous Calcium Carbonate Scaffold Implantation: Surgical Technique ARTHROSCOPY TECHNIQUES Terry, H. L., Retzky, J. S., Neijna, A. G., Gomoll, A. H., Strickland, S. M. 2025; 14 (10)

  View details for DOI 10.1016/j.eats.2025.103719

  View details for Web of Science ID 001626871200032

• Increased Lateral Posterior Tibial Slope Is Associated With a Greater Rate of Lateral Meniscal Injury in Acute Noncontact Anterior Cruciate Ligament Ruptures. Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association Thacher, R. R., Retzky, J. S., Hsu, J., Arnone, P. G., Nguyen, J. T., Greditzer, H. G., Nawabi, D. H., Marx, R. G. 2025; 41 (10): 4069-4078

  Abstract

  To determine whether there is an association between increasing posterior tibial slope and meniscal tears in a group of patients with isolated, noncontact and acute anterior cruciate ligament (ACL) ruptures from a large ACL registry.Our institution's ACL Registry was consulted to identify patients between the age of 18 and 45 years who underwent primary ACL reconstruction between January 2019 and July 2022 for acute, noncontact ACL rupture. Patients with pre-existing meniscal pathology, chronic ACL reconstructions, revisions, and multiligament knee injuries were excluded. Preoperative magnetic resonance imaging scans were used to measure lateral and medial posterior tibial slope. Meniscal injuries seen during arthroscopy were recorded on the basis of operative reports. Independent cohorts were created on the basis of the presence or absence of a meniscal tear. Two-tailed Student t tests were used to compare average medial and lateral posterior tibial slopes between groups. Separate analyses were performed for the presence of isolated lateral meniscal tears, isolated medial meniscal tears, and both medial and lateral meniscal tears. Multivariable logistic regression models were generated to evaluate other potential risk factors for each tear outcome, including age, sex, and body mass index (BMI). Receiver operating characteristic curve analysis was conducted to explore the potential of identifying an optimal threshold for predicting the presence of a meniscal tear based on lateral posterior tibial slope.In total, 1,056 patients ultimately met inclusion criteria. There were 498 (47%) patients with any meniscal tear, 346 (33%) patients with lateral meniscus tears, 245 (23%) patients with medial meniscus tears, and 93 (9%) patients with both medial and lateral tears. The average lateral and medial posterior tibial slopes were 5.5° (-4.2° to 13.4°) and 5.7° (0° to 15.7°), respectively. Increased lateral tibial slope was associated with a statistically significant increase in rate of any meniscal tear (adjusted odds ratio 1.10, 95% confidence interval 1.04-1.16, P < .001) and lateral meniscal tear, specifically (adjusted odds ratio 1.11, 95% confidence interval 1.04-1.18, P < .001). In regression analysis, male sex and body mass index ≥35 were found to increase the risk of all meniscal tear types. With a receiver operating characteristic curve analysis identifying lateral posterior tibial slope threshold values that resulted area under the curve ranges from 0.55 to 0.57, we were unable to identify an optimal threshold for posterior tibial slope in predicting meniscal tears.In this single-institution, registry-based study, increasing lateral posterior tibial slope was associated with a greater rate of meniscus injury in acute ACL ruptures, whereas medial tibial slope demonstrated no correlation. No optimal threshold of posterior slope could be identified above which the odds of a meniscal tear were significantly elevated. Regression analysis identified BMI ≥35 and male sex as independent risk factors for meniscal tear in this select population.Level III, comparative retrospective case series.

  View details for DOI 10.1016/j.arthro.2025.03.011

  View details for PubMedID 40090529

• Incidence, indications, and risk factors for revision tibial tubercle osteotomy: A national database study JOURNAL OF EXPERIMENTAL ORTHOPAEDICS Retzky, J. S., Elnemer, W., Varady, N. H., Suhardi, V. J., Strickland, S. M. 2025; 12 (3)

  View details for DOI 10.1002/jeo2.70339

  View details for Web of Science ID 001534537100001

• Surgical Management of Humeral Avulsion of the Glenohumeral Ligament Injuries: Indications, Treatment Strategies, and Outcomes. Current reviews in musculoskeletal medicine Varady, N. H., Retzky, J., Reddy, R. P., Greditzer, H. G., Tagliero, A. J., Dines, J. S. 2025; 18 (7): 281-288

  Abstract

  This review aims to synthesize current knowledge on humeral avulsion of the glenohumeral ligament (HAGL) lesions, emphasizing clinical presentation, operative indications, and surgical outcomes.HAGL lesions play an important role in shoulder instability, occurring in 7.5%-9.4% of surgically treated cases, with a high propensity to cause recurrent instability if left untreated. The sensitivity of magnetic resonance imaging for detecting HAGL lesions remains imperfect (50%- 83%), making arthroscopy the diagnostic gold-standard. Primary instability is the most common surgical indication (up to 82% of cases). Surgical repair, whether open or arthroscopic, yields excellent outcomes, with return to sport (RTS) rates of 81%- 100% and recurrent instability rates as low as 0%- 5.6%. Athletes may not always RTS at the same level (44%- 80%), however, and recurrent instability rates are higher in collision athletes (up to 21%). Limited data suggest a high incidence of recurrent instability in nonoperatively managed cases (up to 90%), although data on ideal indications for nonoperative management are lacking. HAGL lesions are an important yet often under-recognized cause of shoulder instability. Surgery is indicated in most cases due to its positive results, though comparative data between arthroscopic and open approaches are limited. Future research should refine imaging accuracy, directly compare arthroscopic versus open approaches, and enhance rehabilitation to improve pre-injury RTS rates.

  View details for DOI 10.1007/s12178-025-09963-w

  View details for PubMedID 40183916

  View details for PubMedCentralID PMC12185840

• Patellofemoral Joint Chondral Defects Treated With Third-Generation Matrix-Induced Autologous Chondrocyte Implantation on Porcine Collagen Membrane: Minimum 2-Year Follow-up ORTHOPAEDIC JOURNAL OF SPORTS MEDICINE Palhares, G. M., Retzky, J. S., Coxe, F., Hinkley, P., Rizy, M. E., Neijna, A. G., Gomoll, A. H., Strickland, S. M. 2025; 13 (5)

  View details for DOI 10.1177/23259671251341474

  View details for Web of Science ID 001498996600001

• Efficacy of Transection-Free Patellar Tendon Imbrication Technique for the Correction of Patella Alta ORTHOPAEDIC JOURNAL OF SPORTS MEDICINE Retzky, J. S., Jahandar, A. S., Gould, H. P., Inclan, P. M., Rizy, M., Bram, J. T., Strickland, S. M. 2025; 13 (4)

  View details for DOI 10.1177/23259671251325752

  View details for Web of Science ID 001464530000001

• Indications, Techniques, and Outcomes of Bridge-Enhanced ACL Restoration (BEAR). Current reviews in musculoskeletal medicine Shah, A. K., Neijna, A. G., Retzky, J. S., Gomoll, A. H., Strickland, S. M. 2025; 18 (4): 140-148

  Abstract

  The current landscape of treating anterior cruciate ligament (ACL) tears is rapidly evolving with the advent of the bridge-enhanced ACL restoration (BEAR). BEAR is a novel approach to restore the ACL in lieu of conventional reconstruction. BEAR has recently been approved for post-market use by all orthopaedic surgeons for midsubstance or proximal ACL tears. This article provides a review of the indications and outcomes of BEAR, graduating from the Trial 1 stage to the post-market stage, current operative techniques, and the postoperative rehabilitation protocol for BEAR.Current research demonstrates similar postoperative patient-reported outcome measures and functional outcomes following BEAR compared to ACL reconstruction in clinical trials. Combining all three BEAR trials, there was an aggregate re-tear rate of 15%. Our post-market published BEAR data shows non-inferior short-term postoperative PROMs and functional outcomes as well as zero re-tears. The early- and mid-term results of BEAR show that it is a potential alternative to ACLR for specific patient groups.

  View details for DOI 10.1007/s12178-025-09950-1

  View details for PubMedID 39937355

  View details for PubMedCentralID PMC11965036

• Magnetic Resonance Observation of Cartilage Repair Tissue (MOCART) Scores > 55 at 6 Months Postoperative Predict Ability to Achieve Patient Acceptable Symptomatic State at Minimum 1 Year Postoperative Following Autologous Chondrocyte Implantation for Grade IV Chondral Defects About the Patellofemoral Joint. Cartilage Retzky, J. S., Fletcher, C., Rizy, M., Burge, A., Strickland, S. M. 2025; 16 (1): 17-23

  Abstract

  The primary aim is to evaluate the relationship between MOCART scores and patient satisfaction, as evaluated by achievement of (1) the Patient Acceptable Symptomatic State (PASS) and (2) the minimal clinically important difference (MCID) for Knee Injury and Osteoarthritis Score Quality of Life (KOOS QoL), for patients undergoing autologous chondrocyte implantation (ACI) for focal Grade IV patellofemoral chondral defects. The secondary aim is to determine the threshold MOCART score which predicts the ability to meet the PASS and the MCID for KOOS QoL.Patients undergoing ACI for grade IV patellofemoral chondral defects by a single surgeon from 2017 to 2020 were identified by search of the EMR. To determine PASS status, patients were asked, "Do you consider your current level of symptoms to be acceptable?" KOOS QoL scores were also collected. Patients with 6-month postoperative knee MRI, PASS scores, and minimum 2-year follow-up data were included. Paired t tests and Wilcoxon Rank-Sum tests were used to evaluate the relationship between MOCART scores and (1) PASS achievement and (2) achievement of the MCID for KOOS QoL (12.8).Thirty-four patients were included, with a median age of 35.1 years [IQR: 24.6, 37.1], and BMI of 24.0 kg/m2 [IQR: 21.5, 28.1]. The median time to postoperative MRI was 6.7 months [IQR: 5.8, 7.9], and average follow-up time was 3.7 ± 1.2 years. Twenty-five patients (74%) achieved PASS, and 18 patients (out of 27 who had postop KOOS QoL Scores, 67%) achieved the MCID for KOOS QoL. Patients who achieved PASS had higher average MOCART scores (61.8 ± 16.0) than those who did not achieve PASS (45.0 ± 12.8, p=0.011), whereas patients who achieved the MCID for KOOS QoL did not have higher MOCART scores than those who did not achieve the MCID (61.9 ± 18.3 versus 53.3 ± 17.1, P = 0.25). There was no relationship between age, sex, lesion size, and lesion location and ability to achieve PASS or MCID for KOOS QoL (p>0.05). A threshold MOCART value of 55 was associated with the highest AUC on ROC analysis for likelihood of achieving PASS (0.778) and MCID for KOOS QoL (0.667).Higher MOCART scores are associated with an increased likelihood of achieving PASS following patellofemoral ACI. Moreover, MOCART scores > 55 predict the ability to achieve PASS and the MCID for KOOS QoL following patellofemoral ACI.IV.

  View details for DOI 10.1177/19476035241244491

  View details for PubMedID 38613220

  View details for PubMedCentralID PMC11569683

• Novel Noninvasive Imaging Techniques to Assess Structural, Functional, and Material Properties of Tendon, Ligament, and Cartilage: A Narrative Review of Current Concepts ORTHOPAEDIC JOURNAL OF SPORTS MEDICINE Retzky, J. S., Koff, M. F., Nwawka, O. K., Rodeo, S. A. 2025; 13 (2)

  View details for DOI 10.1177/23259671251317223

  View details for Web of Science ID 001423437900001

• No significant differences in patient-reported outcome measures in men versus women following tibial tubercle osteotomy Journal of Cartilage & Joint Preservation Neijna, A. G., Retzky, J. S., Gomoll, A. H., Strickland, S. M. 2025
• A Murine Model of Non-Wear-Particle-Induced Aseptic Loosening BIOMIMETICS Suhardi, V., Oktarina, A., Niu, Y., Sosa, B., Retzky, J., Greenblatt, M., Ivashkiv, L., Bostrom, M., Yang, X. 2024; 9 (11)

  View details for DOI 10.3390/biomimetics9110673

  View details for Web of Science ID 001367687000001

• Injury Patterns, Imaging Findings, and Prognosis for Muscle Strength Recovery in Surgical Infraclavicular Brachial Plexus Injuries. Journal of hand surgery global online Retzky, J. S., Straus, C., Bhatia, A., Sneag, D. B., Nwawka, O. K., Lee, S. K. 2024; 6 (6): 888-893

  Abstract

  Historically, infraclavicular brachial plexus injuries (IBPIs) were considered neuropraxic injuries that would improve with nonsurgical intervention. However, more recent studies suggest that these injuries may benefit from surgical intervention. The aims of this retrospective study were to (1) describe injury patterns and associated injuries of isolated, traumatic IBPIs, (2) evaluate the concordance of preoperative ultrasound and magnetic resonance neurography with surgical findings of patients who underwent surgical intervention for IBPIs, and (3) describe outcomes of surgical intervention for these injuries.A total of 148 patients who underwent surgical intervention for traumatic injury to the IBP by one of three hand/upper-extremity fellowship-trained surgeons from 1995 to 2021 were included. Patients with supraclavicular brachial plexus injuries, stretch injuries, nonsurgical IBPIs, and brachial plexus dysfunction without traumatic injury were excluded.The most common cause of injury was motor vehicle accident (74%). Scapular fractures were associated with IBPI in 22% of patients. Isolated branch injuries were the most common (58.8%), of which isolated musculocutaneous nerve injury was the most frequent (40.6%). Preoperative ultrasound and magnetic resonance neurography were concordant with surgical findings in eight of nine and seven of nine patients, respectively. Nerve transfers were the most common intervention (46%). Muscle strength improved after surgery, with an increase from 1 to 5 points on the Medical Research Council scale at 14-50 months after surgery.Infraclavicular brachial plexus injuries are associated with high-energy trauma and concomitant upper-extremity fractures. Ultrasound and magnetic resonance neurography are mostly concordant with surgical findings in patients undergoing surgical intervention for IBPIs. Prognosis for muscle recovery after surgery is good in patients with IBPIs.Infraclavicular brachial plexus injuries can improve with surgical intervention.

  View details for DOI 10.1016/j.jhsg.2024.08.012

  View details for PubMedID 39703586

  View details for PubMedCentralID PMC11652277

• Initial Outcomes of Single versus Multiple-Plug Osteochondral Allograft Transplantation for Osteochondral Defects of the Knee: A Matched Cohort Analysis. The journal of knee surgery Retzky, J. S., Coxe, F. R., Ammerman, B., Neijna, A. G., Hinkley, P., Gomoll, A. H., Strickland, S. M. 2024; 37 (13): 902-909

  Abstract

  Although several prior studies have described the outcomes of osteochondral allograft (OCA) transplantation for single osteochondral lesions, there is a paucity of comparative data on outcomes of single versus multiple OCA transplants. We aimed to describe the initial outcomes of single-plug versus multiple-plug knee OCA transplants at a minimum of 1 year of follow-up. We hypothesized that there would be no difference in patient-reported outcome measures (PROMs) between patients undergoing single-plug and multiple-plug OCA transplants at a minimum of 1 year of follow-up. We retrospectively reviewed the prospectively collected data of patients undergoing OCA transplantation for large (>2 cm2) osteochondral defects of the knee. Thirty patients who underwent multiple-plug (2 + ) OCA transplants (either single surface using the snowman technique or multi-surface) were 1:1 age, sex, and body mass index (BMI) matched with 30 patients who underwent single-plug OCA transplants. PROMs, including the International Knee Documentation Committee (IKDC) and Knee Injury and Osteoarthritis Outcome Score (KOOS) subscores, were obtained both preoperatively and at a minimum of 1 year postoperatively. Failure was defined as a revision OCA or conversion to unicompartmental knee arthroplasty (UKA) or total knee arthroplasty (TKA). The cohort comprised 30 females (31 affected left knees), with an average age of 37 ± 10.3 years and median follow-up of 2.0 years (interquartile range: 1.7-2.5 years). There was a significant increase in PROMs from the preoperative to the postoperative period for the entire cohort and the single-plug versus multiple-plug subgroups (p < 0.01). There was no difference between the groups with respect to the percentage of patients who achieved the minimal clinically important difference (MCID) for each PROM (p > 0.05). There were two failures, both in the single-plug group, with a mean time to failure of 3.5 years. There was no difference in the initial outcomes between patients undergoing single-plug versus multiple-plug OCA transplant at the short-term follow-up. LEVEL OF EVIDENCE::  Level IV, case series.

  View details for DOI 10.1055/a-2368-4253

  View details for PubMedID 39019473

• Management of patellar and trochlear cartilage lesions with matrix-induced autologous chondrocyte implantation in conjunction with patellofemoral realignment procedures improves patient-reported outcomes and magnetic resonance image appearance. Journal of ISAKOS : joint disorders & orthopaedic sports medicine Retzky, J. S., Carey, E. G., Selley, R. S., Fletcher, C., Hartwell, M. J., Burge, A. J., Gomoll, A., Strickland, S. 2024; 9 (5): 100311

  Abstract

  The aim of this study is to evaluate the relationship between the achievement of clinically significant improvement in patient-reported outcome measures (PROMs) and the postoperative magnetic resonance image (MRI) appearance of matrix-associated chondrocyte implantation (MACI), in conjunction with patellofemoral realignment procedures, for the treatment of grade-IV chondral defects about the patellofemoral joint.A retrospective review of patients undergoing MACI for grade-IV chondral defects of the patella or trochlea by a single sports-medicine-fellowship-trained surgeon from 2017 to 2020 was performed. Concomitant realignment procedures, including tibial tubercle osteotomy and medial patellofemoral ligament reconstruction, were also performed as needed. Patients with preoperative and minimum 1-year postoperative PROMs and postoperative knee MRI were included. MRI scans were obtained at 6.3 (interquartile range: 5.8, 7.5) months postoperatively. A fellowship-trained musculoskeletal radiologist assigned a Magnetic Resonance Observation of Cartilage Repair Tissue (MOCART) score (range: 0-100, with 100 equating to complete graft healing) to each MRI. Achievement of the minimal clinically important difference (MCID) for International Knee Documentation Committee (IKDC), Knee Injury and Osteoarthritis Score-Quality of Life, and Kujala scores were determined for each patient. Paired t-tests or Wilcoxon rank-sum tests were used to evaluate for an association between achievement of the MCID for each PROM and MOCART score. The average follow-up time and time from surgery to PROMs were 2.7 ​± ​1.5 years and 1.7 ​± ​0.66 years, respectively.Thirty patients were included. There was a significant improvement in all PROMs from preoperative to postoperative (p ​< ​0.001). More than two-thirds of patients achieved the MCID for each PROM. Patients who achieved the MCID for IKDC had significantly higher MOCART scores (66.5 ​± ​16.2) than those who did not meet the MCID for IKDC (50.6 ​± ​23.6, p ​= ​0.043).MACI for the treatment of patellofemoral chondral injuries is associated with clinically significant improvement in PROMs at short-term follow-up. Clinically significant improvements in IKDC scores are associated with a more mature MRI appearance of the autologous chondrocyte implantation graft on postoperative MRI, as indicated by higher MOCART scores.IV-Case Series.

  View details for DOI 10.1016/j.jisako.2024.100311

  View details for PubMedID 39154863

• Defining the minimal clinically important difference for IKDC and KOOS scores for patients undergoing tibial tubercle osteotomy for patellofemoral pain or instability JOURNAL OF EXPERIMENTAL ORTHOPAEDICS Retzky, J. S., Shah, A. K., Neijna, A. G., Rizy, M. E., Gomoll, A. H., Strickland, S. M. 2024; 11 (3)

  View details for DOI 10.1002/jeo2.12115

  View details for Web of Science ID 001278628300001

• Risk Factors for Atraumatic Medial Patellar Facet Lesions ORTHOPAEDIC JOURNAL OF SPORTS MEDICINE Retzky, J. S., Palhares, G. M., Uppstrom, T. J., Hinkley, P., Fletcher, C., Gomoll, A. H., Strickland, S. M. 2024; 12 (6)

  View details for DOI 10.1177/23259671241255681

  View details for Web of Science ID 001248031100001

• Multi-Surface Cartilage Defects about the Knee Treated with Cartilage Restoration Procedures Show Good Outcomes and Survivorship at Minimum 2-Year Follow-Up. Cartilage Retzky, J. S., Palhares, G. M., Rizy, M., Hinkley, P., Gomoll, A. H., Strickland, S. M. 2024; 15 (2): 77-83

  Abstract

  We aimed to evaluate the outcomes, survivorship, and complications following multi-surface cartilage procedures at minimum 2-year follow-up.Patients with either (1) single-surface osteochondral allograft transplantation (OCAT) with third-generation matrix-induced autologous cultured chondrocyte implantation (MACI) or particulated juvenile cartilage implantation (DeNovo), or (2) multiple-surface OCAT ± associated MACI/DeNovo procedures for grade IV chondral or osteochondral defects about the knee with minimum 2-year follow-up were analyzed. Patient-reported outcome measures (PROMs), including International Knee Documentation Committee (IKDC) and Knee Injury and Osteoarthritis Outcome Score (KOOS) subscales, were obtained preoperatively and at minimum 2 years postoperatively. The percentage of patients who met the minimal clinically important difference (MCID) for each PROM was reported. Failure was defined as revision OCAT, conversion to patellofemoral/total/unicompartmental joint arthroplasty, or Arthrosurface HemiCAP placement.Of 257 patients identified, 35 were included. There was a significant increase in IKDC, KOOS-pain, KOOS-symptom, KOOS-sport, and KOOS-quality of life scores from preoperative to postoperative evaluation (P < 0.03 for all). More than 50% of patients met the MCID for each PROM. There were 2 failures, 1 of the patella and 1 of the medial femoral condyle, at 39.7 and 38.6 months postoperatively, respectively.Multi-surface cartilage procedures are a safe, efficacious treatment option for multifocal cartilage defects about the knee at short-term follow-up.

  View details for DOI 10.1177/19476035231207780

  View details for PubMedID 37853671

  View details for PubMedCentralID PMC11368898

• Simultaneous MPFL reconstruction and guided growth result in low rates of recurrent patellofemoral instability. Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA Bram, J. T., Tracey, O. C., Lijesen, E., Li, D. T., Chipman, D. E., Retzky, J. S., Fabricant, P. D., Green, D. W. 2024; 32 (5): 1105-1112

  Abstract

  Implant-mediated guided growth (IMGG) is used to address coronal plane deformity in skeletally immature patients. Few studies have reported on IMGG and simultaneous medial patellofemoral ligament (MPFL) reconstruction for paediatric patients with concurrent genu valgum and patellofemoral instability (PFI). This study aimed to report on the outcomes of these simultaneous procedures.This was a retrospective review of paediatric patients undergoing simultaneous MPFL reconstruction and IMGG between 2016 and 2023. Mechanical lateral distal femoral angle (mLDFA), hip-knee-ankle angle (HKA) and mechanical axis deviation (MAD) were measured on full-length hip-to-ankle plain radiographs. Measurements were taken preoperatively, prior to implant removal and/or at final follow-up with minimum 1-year clinical follow-up.A total of 25 extremities in 22 patients (10 female) underwent simultaneous IMGG and MPFL reconstruction. The mean age at surgery was 12.6 ± 1.7 years. The mean duration of implant retention was 18.6 ± 11.3 months. Nineteen extremities (76%) underwent implant removal by final follow-up. Preoperative HKA corrected from a mean of 5.8 ± 2.3° to -0.8 ± 4.5° at implant removal or final follow-up (p < 0.001), with mLDFA and MAD similarly improving (both p < 0.001). HKA corrected a mean of 0.7 ± 0.9° per month, while mLDFA and MAD corrected a mean of 0.5 ± 0.6°/month and 2 ± 3 mm/month, respectively. At the time of implant removal or final follow-up, 88% of patients demonstrated alignment within 5° of neutral. Only one extremity experienced subsequent PFI (4%). For 14 patients who underwent implant removal with further imaging at a mean of 7.8 ± 4.9 months, only one patient (7%) had a valgus rebound to an HKA > 5°.Simultaneous MPFL reconstruction and IMGG provided successful correction of lower extremity malalignment with only one recurrence of PFI. This approach is a reliable surgical option for skeletally immature patients with genu valgum and PFI.Level 4 case series.

  View details for DOI 10.1002/ksa.12134

  View details for PubMedID 38469940

  View details for PubMedCentralID PMC11701717

• Team Approach: Neuromuscular Training for Primary and Secondary Prevention of Anterior Cruciate Ligament Injury. JBJS reviews Inclan, P. M., Hicks, J. J., Retzky, J. S., Janosky, J. J., Pearle, A. D. 2024; 12 (4)

  Abstract

  Neuromuscular training is a method of performance optimization-typically combining plyometrics, balancing training, agility, and dynamic stabilization-predicated on improving the efficiency of fundamental movement patterns. Neuromuscular training has consistently been shown to reduce the risk of anterior cruciate ligament injury, particularly for athletes engaged in activities associated with noncontact knee injuries (i.e., women's soccer). Successful implementation of neuromuscular training programs requires input from coaches, physical therapists, athletic trainers, and physicians to generate efficacious programs with high rates of adherence.

  View details for DOI 10.2106/jbjs.rvw.23.00207

  View details for PubMedID 38994007

  View details for PubMedCentralID PMC11236273

• High Rates of Abnormal Patellofemoral Morphology in Adolescents With Anterior Knee Pain: A Retrospective Review HSS JOURNAL Retzky, J. S., Gross, P. W., Doyle, S. M., Strickland, S. M. 2024; 20 (3): 351-358

  View details for DOI 10.1177/15563316241231805

  View details for Web of Science ID 001189809400001

• Impact of Wiberg Patellar Type on Outcomes and Survival Following Cell-Based Cartilage Repair for Patellar Chondral Lesions at Midterm Follow-up. The American journal of sports medicine Retzky, J. S., Thacher, R. R., Palhares, G. H., Gomoll, A. H., Strickland, S. M. 2024; 52 (3): 705-709

  Abstract

  Cell-based cartilage repair procedures of the patellofemoral joint have less reliable outcomes than those of the tibiofemoral joint. No previous studies have evaluated the influence of patellar shape on cell-based cartilage repair outcomes. Patellar dysplasia may predispose patients to worse outcomes after cell-based cartilage repair.The purpose of this study was to evaluate the relationship between Wiberg patellar type and outcomes after cell-based cartilage repair (autologous chondrocyte implantation or particulated juvenile allograft cartilage transplantation) for the treatment of patellar chondral lesions at a minimum 2-year follow-up. It was hypothesized that Wiberg classification of patellar shape would have no effect on patient-reported outcome measures (PROMs) or graft survival.Cohort study; Level of evidence, 3.Patients undergoing autologous chondrocyte implantation or particulated juvenile allograft cartilage transplantation for full-thickness patellar chondral defects between 2016 and 2020 were retrospectively reviewed after institutional review board approval. The change in PROMs, including International Knee Documentation Committee (IKDC), Kujala, and Veterans RAND 12-item Health Survey Mental and Physical scores, from pre- to postoperatively and the percentage of patients who achieved the minimal clinically important difference (MCID) for IKDC and Kujala scores were compared for the Wiberg type A versus Wiberg type B versus Wiberg type C groups. The log-rank test was used to evaluate for differences in survival between subgroups.A total of 59 patients (63 knees) were included, with a mean age of 33.3 ± 8.6 years, median body mass index of 26.0 (IQR, 21.8-30.2), and median follow-up time of 3.5 years (IQR, 2.6-4.2 years). In total, 26 (41%) patellae were Wiberg type A, 29 (46%) were Wiberg type B, and 8 (13%) were Wiberg type C. There were no differences between Wiberg type A versus Wiberg type B versus Wiberg type C groups with respect to change in PROMs from pre- to postoperatively or the percentage of patients who achieved the MCID for IKDC or Kujala scores (P > .05 for all). There were no differences in survival between groups (P = .45).Wiberg patellar type has no effect on patient-reported outcomes or graft survival at midterm follow-up. Patellar dysplasia should not be seen as a contraindication for cell-based cartilage repair procedures.

  View details for DOI 10.1177/03635465231220028

  View details for PubMedID 38243799

  View details for PubMedCentralID PMC11701720

• Association of Lateral Extra-Articular Tenodesis With Improved Graft Maturity on MRI 2 Years After ACL Reconstruction With Quadriceps Tendon Autograft in Skeletally Immature Athletes ORTHOPAEDIC JOURNAL OF SPORTS MEDICINE Retzky, J. S., Chipman, D. E., Mintz, D. N., Cordasco, F. A., Green, D. W. 2024; 12 (1)

  View details for DOI 10.1177/23259671231211885

  View details for Web of Science ID 001136860900001

• Leadership in Orthopaedic Surgery: Creating a Highly Effective Leader. Instructional course lectures Sutton, K., Retzky, J., Bedi, A., Provencher, C. M., Mulcahey, M. K. 2023; 72: 29-37

  Abstract

  Strong leadership is associated with improved outcomes in multiple domains, including orthopaedic surgery. There are multiple leadership styles, including transformational, transactional, and laissez-faire leadership. An effective leader understands the importance of verbal and nonverbal communication, emotional intelligence, preparation, and mindset on team performance. Orthopaedic surgeons serve as leaders in the operating room, in the outpatient setting, and on committees. Leadership skills can be developed through leadership-specific evaluations and training.

  View details for PubMedID 36534844

• Biomechanical properties of suprapectoral biceps tenodesis with double-anchor knotless luggage tag sutures vs. subpectoral biceps tenodesis with single-anchor whipstitch suture using all-suture anchors JSES INTERNATIONAL Nicolay, R. W., Jahandar, A., Retzky, J. S., Kontaxis, A., Verma, N. N., Fu, M. C. 2023; 7 (6): 2393-2399

  View details for DOI 10.1016/j.jseint.2023.07.013

  View details for Web of Science ID 001634917600017

• The Perils of Sleeper Plates in Multiple Hereditary Exostosis: Tibial Deformity Overcorrection Due to Tether at Empty Metaphyseal Hole. Journal of pediatric orthopedics Retzky, J., Pascual-Leone, N., Cirrincione, P., Nichols, E., Blanco, J., Widmann, R., Dodwell, E. 2023; 43 (8): 471-474

  Abstract

  Hemi-epiphysiodesis is the mainstay of treatment for angular deformities at the knee in children with multiple hereditary exostosis (MHE). Upon deformity correction, the metaphyseal screw may be removed from the hemi-epiphysiodesis plate, the sleeper plate technique, with anticipated reimplantation of the metaphyseal screw should the original deformity recur. The aim of the present study is to compare the incidence of complications with the sleeper plate technique with complete plate removal in an MHE cohort.Patients under the age of 18 with MHE who underwent hemi-epiphysiodesis of the proximal tibia and/or distal femur between February 1, 2016, and February 6, 2022 with a minimum 2-year follow-up or follow-up to skeletal maturity were identified via ICD-10 codes. Patient charts and radiographic images were reviewed to assess for the bone(s) treated, the use of sleeper plates, and whether any complication occurred, including overcorrection from bony ingrowth at the empty holes or deformity recurrence.In 13 patients, 19 knees underwent hemi-epiphysiodesis at 30 sites; 13 distal femoral and 17 proximal tibial. Of 30 plates, 18 (60%) were removed completely upon deformity correction and 3 (10%) did not require removal due to skeletal maturity. Four of 13 (30.8%) femoral plates and 5 of 17 (29.4%) tibial plates were left as sleeper plates. All 5 tibial sleeper plates developed bony ingrowth into the empty metaphyseal screw hole, which led to unintended progressive deformity overcorrection. In the majority of cases, the deformity was addressed by the removal of the plate and exophytic bone and hemi-epiphysiodesis on the other side of the affected proximal tibia with subsequent resolution of the deformity.All tibial sleeper plates developed bony ingrowth into the screwless metaphyseal hole. The bony ingrowth functioned as a tether, resulting in progressive deformity overcorrection. Sleeper plates should be avoided at the proximal tibia in patients with MHE, and extreme caution should be exercised when considering this technique at the distal femur or other sites.Level III-retrospective comparative study.

  View details for DOI 10.1097/BPO.0000000000002458

  View details for PubMedID 37469302

  View details for PubMedCentralID PMC10402878

• Male sex is an independent risk factor for patellar osteochondral fractures following acute patellar dislocation in pediatric patients JOURNAL OF EXPERIMENTAL ORTHOPAEDICS Retzky, J. S., Uppstrom, T. J., Chipman, D. E., Bovonratwet, P., Green, D. W. 2023; 10 (1)

  View details for DOI 10.1186/s40634-023-00646-4

  View details for Web of Science ID 001055117500002

• Current Concepts in the Measurement of Glenohumeral Bone Loss CURRENT REVIEWS IN MUSCULOSKELETAL MEDICINE Thacher, R. R. R., Retzky, J. S. S., Dekhne, M. S. S., Oquendo, Y. A. A., Greditzer, H. G. G. 2023; 16 (9): 419-431

  View details for DOI 10.1007/s12178-023-09852-0

  View details for Web of Science ID 001013743300001

• High Rates of Successful Return to Competitive Athletics After Posterior Spinal Fusion for Adolescent Idiopathic Scoliosis Regardless of Distal Fusion Level: A Prospective Cohort Study. Spine Fabricant, P. D., Pascual-Leone, N., Gross, P. W., Retzky, J. S., Green, D. W., Blanco, J. S., Widmann, R. F. 2023; 48 (11): 737-741

  Abstract

  Prospective cohort.To determine if distal spinal fusion level is associated with postoperative sport participation after posterior spinal fusion (PSF) for adolescent idiopathic scoliosis (AIS).The concept of "saving a level" during PSF for AIS refers to minimizing the distal extent of lumbar fusion to theoretically allow for increased postoperative spinal mobility and a more predictable return to athletic activity, as well as minimizing the risk of degenerative disc disease. There are few prospective studies evaluating the correlation between distal fusion level and timing of return to sports.Adolescent patients undergoing PSF for AIS between 2009 and 2019 were approached at their presurgical visit to participate in this prospective study. Participants were followed for a minimum of 2 years after surgery. Sports participation (classified by sport type and level of competitiveness) and radiographic data were collected at the initial visit. At each postoperative visit, it was noted whether patients returned to the same sport type and level of competitiveness.After an a priori power calculation was performed, a total of 106 participants were included in the analysis with a mean age of 14 ± 2 years. Distal fusion levels ranged from T11 to L4. There was no significant association between distal fusion level and return to the same level of sports participation ( P = 0.192). Of the participants, 93% returned to sports with no significant differences by distal fusion level ( P = 0.081). Distal fusion level demonstrated no difference in return to preoperative sport ( P = 0.486) or return to the same type of sport ( P = 0.247).This study found no association between distal fusion level and postoperative sports participation. Even though many patients may elect to change sports, nearly all patients returned to sports, and the majority of patients returned to the same level of sports competition or higher after PSF for AIS.

  View details for DOI 10.1097/BRS.0000000000004599

  View details for PubMedID 36763834

• Medial collateral ligament in the multiligament knee injury: diagnosis, evaluation, management, and outcomes Knee Arthroscopy and Knee Preservation Surgery Retzky, J., Ibarra, A., Elnemer, W., Marx, R. G. 2023
• Ambulatory Single-level Posterior Cervical Foraminotomy for Cervical Radiculopathy: A Propensity-matched Analysis of Complication Rates. Clinical spine surgery Bovonratwet, P., Retzky, J. S., Chen, A. Z., Ondeck, N. T., Samuel, A. M., Qureshi, S. A., Grauer, J. N., Albert, T. J. 2022; 35 (2): E306-E313

  Abstract

  Retrospective cohort comparison study.The aim was to compare perioperative complications and 30-day readmission between ambulatory and inpatient posterior cervical foraminotomy (PCF) in the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database.Single-level PCF for cervical radiculopathy is increasingly being performed as an ambulatory procedure. Despite this increase, there is a lack of published literature documenting the safety of ambulatory PCF.Patients who underwent PCF (through laminotomy or laminectomy) were identified in the 2005-2018 NSQIP database. Ambulatory procedures were defined as cases that had hospital length of stay=0 days. Inpatient procedures were defined as cases that had length of stay=1-4 days. Patient characteristics, comorbidities, and procedural variables (laminotomy or laminectomy performed) were compared between the 2 cohorts. Propensity score matched comparisons were then performed for postoperative complications and 30-day readmissions between the 2 groups.In total, 795 ambulatory and 1789 inpatient single-level PCF cases were identified. After matching, there were 795 ambulatory and 795 inpatient cases. Statistical analysis after propensity score matching revealed no significant difference in individual complications including 30-day readmission, thromboembolic events, wound complications, and reoperation, or aggregated complications between ambulatory versus matched inpatient procedures. Overall 30-day readmissions after ambulatory single-level PCF were noted for 2.46% of the study population, and the most common reasons were surgical site infections (46%) and pain control (15%).The perioperative outcomes assessed in this study support the conclusion that single-level PCF for cervical radiculopathy can be performed for correctly selected patients in the ambulatory setting without increased rates of 30-day perioperative complications or readmissions compared with inpatient procedures.Level III.

  View details for DOI 10.1097/BSD.0000000000001252

  View details for PubMedID 34654773

• Return to Play and Player Performance After Meniscal Tear Among Elite-Level European Soccer Players: A Matched Cohort Analysis of Injuries From 2006 to 2016. Orthopaedic journal of sports medicine Lavoie-Gagne, O. Z., Korrapati, A., Retzky, J., Bernstein, D. N., Diaz, C. C., Berlinberg, E. J., Forlenza, E. M., Fury, M. S., Mehta, N., O'Donnell, E. A., Forsythe, B. 2022; 10 (1): 23259671211059541

  Abstract

  Meniscal injuries are extremely common in soccer athletes, and little is known about postrecovery performance.To (1) identify characteristics associated with return to play (RTP) to the same league level and (2) evaluate long-term effects that injury and management approach may have on player performance.Cohort study; Level of evidence, 3.Using publicly available records, we identified athletes who sustained meniscal tears across the 5 major European soccer leagues (English Premier League, Bundesliga, La Liga, Ligue 1, and Serie A) between 2006 and 2016. Injured athletes were matched to controls 1:2 by demographics and performance. Investigations included rate of RTP to the same league level, reinjury, player characteristics associated with RTP within 2 seasons, long-term availability, field time, and performance metrics standardized to 90 minutes of play during the next 4 seasons.A total of 250 players sustaining meniscal tears were included, of which 106 (42%) received surgical management. Median absence was 57.5 days (interquartile range [IQR], 35-92) or 7 games (IQR, 4-12). Rate of RTP was 70%, and the reinjury rate 5% if a player could RTP. Age greater than 30 years was a negative predictor for RTP (odds ratio [OR], 0.62; P = .002), whereas higher preinjury goals per game (OR, 2.80; P = .04) and surgical management (OR, 1.38; P = .002) were positive predictors for RTP. Surgical management was associated with higher long-term availability (P < .01). As compared with the control, there were no significant differences in field time or performance metrics after RTP, either overall or by player position. As compared with nonoperative management, defenders undergoing surgery demonstrated decreased field time. Attackers and midfielders demonstrated similar field time and performance regardless of management.RTP of elite soccer athletes sustaining meniscal tear is contingent on age, preinjury performance, and management approach. Those who RTP to the same league level can be expected to demonstrate equivalent field time, performance, and long-term availability as noninjured athletes.

  View details for DOI 10.1177/23259671211059541

  View details for PubMedID 35047646

  View details for PubMedCentralID PMC8761888

• Return-to-Play Times and Player Performance After Medial Collateral Ligament Injury in Elite-Level European Soccer Players ORTHOPAEDIC JOURNAL OF SPORTS MEDICINE Lavoie-Gagne, O. Z., Retzky, J., Diaz, C. C., Mehta, N., Korrapati, A., Forlenza, E. M., Knapik, D. M., Forsythe, B. 2021; 9 (9)

  View details for DOI 10.1177/23259671211033904

  View details for Web of Science ID 000703127800001

• Morphology at the Distal Radioulnar Joint: Identifying the Prevalence of Reverse Obliquity. Journal of wrist surgery O'Shaughnessy, M. n., Shapiro, L. M., Schultz, B. n., Retzky, J. n., Finlay, A. K., Yao, J. n. 2020; 9 (5): 417–24

  Abstract

  Background  Recent advances in the understanding of ulnar-sided wrist pathologies such as ulnar abutment syndrome (UAS) have brought increased attention to the anatomy of the distal radioulnar joint (DRUJ). Previous work established three anatomical variants of the sigmoid notch (parallel, oblique, and reverse oblique). The reverse oblique DRUJ poses theoretical risk of increased contact forces following ulnar shortening osteotomy, a common method of treating UAS. Purpose  As prevalence of reverse oblique morphology has been under-reported, this study aims to better define the prevalence of reverse oblique morphology in the adult population. Methods  Institutional Review Board-approved review of 1,000 radiographs over a 2-year period was performed. Demographic data and radiographic measurements were recorded (ulnar variance, notch inclination, and presence of arthritis). Correlation tests, a test of proportions, a t -test, and linear and logic regression tests were used to examine associations between ulnar variance, sigmoid inclination, sex, age, and presence of arthritis. Results  One thousand radiographs were analyzed revealing prevalence rates of: parallel-68%, oblique-26%, and reverse oblique-6%. Females were significantly more likely to have reverse inclination. No significant correlation was noted for morphology by age. Ulna positive variance was negatively correlated with reverse inclination. DRUJ arthritis was noted in 14% of patients. Higher sigmoid inclination was associated with higher odds of presence of arthritis, adjusting for sex and age. Higher incidence of arthritis was noted among patients with the oblique (20.8%) or reverse oblique (24.6%) compared with parallel (10.5%) morphology. Conclusion  This series of 1,000 radiographs demonstrates a 6% overall prevalence of reverse obliquity. This large dataset allows for better quantification of the prevalence of DRUJ morphologies and determination of correlations that have clinical implications for patients with ulnar-sided wrist pathology. Level of Evidence  This is a Level IV study.

  View details for DOI 10.1055/s-0040-1713158

  View details for PubMedID 33042645

  View details for PubMedCentralID PMC7540646

• Single Assessment Numeric Evaluation scores correlate positively with American Shoulder and Elbow Surgeons scores postoperatively in patients undergoing rotator cuff repair. Journal of shoulder and elbow surgery Retzky, J. S., Baker, M., Hannan, C. V., Srikumaran, U. 2020; 29 (1): 146-149

  Abstract

  The American Shoulder and Elbow Surgeons (ASES) shoulder score and the Single Assessment Numeric Evaluation (SANE) measure shoulder function. Relative to the ASES questionnaire, the SANE questionnaire is shorter and easier to score. We sought to determine (1) the correlation between ASES and SANE scores preoperatively and at 2 years postoperatively in patients undergoing rotator cuff repair (RCR) or shoulder arthroplasty and (2) the correlation between the change in ASES scores and change in SANE scores.We reviewed the records of 107 patients who underwent RCR (n = 74) or shoulder arthroplasty (n = 33), which included patients undergoing total shoulder arthroplasty (n = 18) and reverse total shoulder arthroplasty (n = 15), at our institution from 2014 to 2015 and who completed the ASES and SANE questionnaires preoperatively and at least 2 years postoperatively. Pearson correlation coefficients were calculated to determine the relationship between SANE and ASES scores in RCR patients and arthroplasty patients (both total shoulder arthroplasty and reverse total shoulder arthroplasty) at each time point.In the RCR group, correlations between SANE and ASES scores were moderately positive preoperatively (r = 0.30) and strongly positive postoperatively (r = 0.86). In the arthroplasty group, correlations between SANE and ASES scores were moderately positive preoperatively (r = 0.46) and strongly positive postoperatively (r = 0.78).SANE scores correlate positively with ASES scores postoperatively in patients undergoing RCR. Therefore, SANE scores, together with clinician-based and combination scores, can be used to assess postoperative shoulder function in these patients.

  View details for DOI 10.1016/j.jse.2019.05.039

  View details for PubMedID 31401127

• Near-Complete Traumatic Amputation of the Forefoot After Motorboat Propeller Injury. Foot & ankle orthopaedics Retzky, J. S., Humbyrd, C. J. 2019; 4 (1): 2473011418822278

  Abstract

  We report a case of a near-complete amputation of the forefoot of a 20-year-old man as a result of a motorboat propeller injury sustained in a saltwater river. He was treated with open reduction, percutaneous pinning, extensor tendon repair, and an extended course of antibiotic prophylaxis. We review the literature regarding motorboat propeller injuries to the foot and ankle.

  View details for DOI 10.1177/2473011418822278

  View details for PubMedID 35097315

  View details for PubMedCentralID PMC8696818

• Epidemiology of Recurrent Anterior Cruciate Ligament Injuries in National Collegiate Athletic Association Sports: The Injury Surveillance Program, 2004-2014 ORTHOPAEDIC JOURNAL OF SPORTS MEDICINE Gans, I., Retzky, J. S., Jones, L. C., Tanaka, M. J. 2018; 6 (6)

  View details for DOI 10.1177/2325967118777823

  View details for Web of Science ID 000435989900001