Molly Claire Meadows

All Publications

• Comparative Analysis of Iliotibial Band Graft Length in Pediatric Anterior Cruciate Ligament Reconstruction: MacIntosh Versus All-Epiphyseal Femoral Drilling Technique. The American journal of sports medicine Duru, N. O., Stoner, A. J., Alayleh, A. M., Lind, D. R., Schultz, C., Pham, N. S., Ellis, H. B., Schmitz, M. R., Yen, Y. M., Tompkins, M. A., Ganley, T., Meadows, M. C., Chan, C., Shea, K. G. 2025: 3635465251371321

  Abstract

  Iliotibial band (ITB) grafts yield excellent outcomes for anterior cruciate ligament reconstruction (ACLR) in skeletally immature patients. Because closure of the ITB harvest interval is often not feasible, techniques that allow for shorter ITB grafts may be beneficial.That the all-epiphyseal femur ITB graft would be significantly shorter than the over-the-top ITB graft.Controlled laboratory study.Six fresh-frozen pediatric knees (mean age, 9.7 years; range, 9-11 years) were used. Surgeons simulated the modified MacIntosh and all-epiphyseal ITB ACLRs using No. 2 suture as a proxy for the ITB graft. A suture was attached at the ITB origin on the Gerdy tubercle and then passed over-the-top on the femur, under the transverse meniscal ligament, and to the metaphyseal anchor point. The length of the suture was measured. The suture was then placed through the all-epiphyseal femoral drill hole, under the transverse meniscal ligament to the same tibial metaphyseal anchor point. Femoral condyle width was recorded, and the relationship between graft length and technique was analyzed using analysis of covariance to adjust for femoral condyle widths.Graft length for the all-epiphyseal ITB ACLR was significantly shorter than that for the modified MacIntosh ITB ACLR, with a mean difference of 26.0 ± 6.0 mm (P < .001). Across both groups, each additional millimeter of condyle width was associated with an increase in graft length by 2.3 mm (P < .001). Mean graft lengths for the modified MacIntosh and all-epiphyseal femur were 173.3 ± 16.5 mm and 147.3 ± 16.0 mm, respectively.The all-epiphyseal femoral technique requires a significantly shorter ITB graft length compared with the modified MacIntosh technique. A nomogram was developed to estimate graft length differences adjusted for condyle width. Future pediatric studies should continue to explore the biomechanics of both graft techniques, as they may provide lateral extra-articular stabilization and reduce ACL reinjury rates.Shortened ITB autograft length may reduce symptoms associated with muscle herniation.

  View details for DOI 10.1177/03635465251371321

  View details for PubMedID 40971308

• Commentary to Quality Improvement Case Series: Iatrogenic Physeal Fracture Sustained During Manipulation for Arthrofibrosis of the Knee. Journal of the Pediatric Orthopaedic Society of North America Ellis, H. B., Meadows, M. C., Justin Mistovich, R., Beck, J. J. 2025; 12: 100245

  View details for DOI 10.1016/j.jposna.2025.100245

  View details for PubMedID 40791968

  View details for PubMedCentralID PMC12337176

• Biomechanical simulation of radial head subluxation in cadaveric pediatric elbows. Journal of the Pediatric Orthopaedic Society of North America Meadows, M., Vuong, B., Storaci, H., Tam, K., Shea, K. 2024; 7: 100036

  Abstract

  Radial head subluxation, known as pulled elbow or nursemaid's elbow, is a common pediatric condition that occurs when a longitudinal traction force is applied to an extended elbow. The purpose of our study was to demonstrate and quantify the axial traction force required to produce a nursemaid's elbow in a pediatric cadaver specimen and to review the current relevant literature.We performed a literature search to identify relevant articles describing the nursemaid's elbow injury, as well as relevant biomechanical studies of the radiocapitellar joint. For the biomechanical model, 2 fresh-frozen cadaveric elbows from a single 3-year-old male donor were dissected by a fellowship-trained orthopedic surgeon. An Instron 5,944 testing machine with a 2 kN load cell was used to perform uniaxial testing. The radius and humerus were mounted to the Instron machine and loaded in the axial direction with the elbow in full extension. Loading occurred at a rate of 10 mm/second for 4 seconds, during which the force and actuator displacement were continuously recorded. The local instantaneous load and extension displacement at the time of subluxation were recorded.The load to failure required to produce the nursemaid's elbow injury in our first specimen was 31 N, with a failure displacement of 4.6 mm. The second specimen demonstrated a load to failure of 26 N, with a failure displacement of 4.6 mm. After subluxation, we reduced the annular ligament from the first specimen. The elbow was then retested and demonstrated a load to failure of 20 N, with a failure displacement of 2.6 mm.Axial traction applied to a pediatric elbow results in subluxation of the annular ligament into the radiocapitellar joint, at relatively low loads. We demonstrated a mean load to failure in a pediatric cadaveric model of 28.5 N, and a lower load to failure was required to produce a recurrent subluxation in a previously injured specimen.(1)Radial head subluxation, known as pulled elbow or nursemaid's elbow, is a common pediatric condition that occurs when a longitudinal traction force is applied to an extended elbow.(2)This study is the first to demonstrate and quantify the axial traction force required to produce a nursemaid's elbow in a pediatric cadaver specimen.(3)Axial traction applied to a pediatric cadaver specimen results in subluxation of the annular ligament into the radiocapitellar joint.(4)The mean load to failure is 28.5 N, and a lower load to failure is required to produce a recurrent subluxation in a previously injured specimen.(5)Literature supports that the nursemaid's elbow injury is a result of subluxation of the annular ligament into the radiocapitellar joint, though this may involve a spectrum of injury to the annular ligament itself.

  View details for DOI 10.1016/j.jposna.2024.100036

  View details for PubMedID 40433293

  View details for PubMedCentralID PMC12088284

• Radial Width of the Lateral Meniscus at the Popliteal Hiatus: Relevance to Saucerization of Discoid Lateral Menisci. The American journal of sports medicine Gamble, J. G., Abdalla, A. B., Meadows, M. G., Rauer, T., Chan, C. M., Ganley, T. J., Tompkins, M., Shea, K. G., Gamble, J. G. 2021: 3635465211056661

  Abstract

  A discoid lateral meniscus (DLM) is a congenital anomaly of the knee in which the lateral meniscus has an "O" shape and contains irregular, abnormal collagenous tissue. A DLM can cause mechanical symptoms and pain. Treatment of a symptomatic DLM is arthroscopic saucerization to reshape the meniscus to a more normal contour. Enough tissue must be removed to eliminate mechanical symptoms but not too much to create instability. The residual width of the meniscus is crucial at the popliteus hiatus because here the peripheral rim is unattached at the capsule. Reports in the literature recommend a residual width of 6 to 8 mm.The purpose of this research was to determine the width of the lateral meniscus at the popliteal hiatus in normal specimens. Our null hypothesis was that a residual width of 6 to 8 mm will be sufficient to approximate normal anatomy.Cross-sectional study; Level of evidence, 3.We made direct measurements of the radial width of the lateral meniscus from the outer rim at the popliteal hiatus to the inner edge in 19 specimens (age, 2-120 months.) We measured one 4-year-old specimen with a bilateral complete DLM. We also measured 39 digital images of specimens (age, 1-132 months) using ImageJ. Finally, we made direct arthroscopic measurements of 8 skeletally mature specimens.The average width of specimens <3 years old was 5.5 mm. The average width of the 10-year-old specimens was 12 mm. The average width of the skeletally mature specimens was 16 mm. A 4-year-old DLM specimen measured 19 mm.We rejected our null hypothesis. Direct measurements suggest that a residual width of 6 to 8 mm is insufficient for children ≥8 years old. A width of at least a full centimeter approximates the normal for 8-year-olds and at least 15 mm for adolescents.

  View details for DOI 10.1177/03635465211056661

  View details for PubMedID 34780308

• Medial Patellofemoral Ligament Repair OPERATIVE TECHNIQUES IN SPORTS MEDICINE Meadows, M. C., Dragoo, J. L. 2019; 27 (4)

  View details for DOI 10.1016/j.otsm.2019.150687

  View details for Web of Science ID 000502884400006

• The use of biologics for the elbow: a critical analysis review. Journal of shoulder and elbow surgery Dragoo, J. L., Meadows, M. C. 2019

  Abstract

  There is significant interest in biologic treatment options to improve the healing environment and more rapidly decrease symptoms in many conditions around the elbow. Despite fairly widespread use of biologic agents such as platelet-rich plasma (PRP) in the elbow, there is a lack of clear evidence in the literature to support its use. The potential impact of these biologic agents must be evaluated with evidence from high-quality studies, particularly considering the high financial burden these treatments often impose on patients. The aim of this review is to provide an evidence-based summary of the biologic augmentation options available for use by the physician treating painful conditions of the elbow and to identify areas where further research is warranted.

  View details for DOI 10.1016/j.jse.2019.07.024

  View details for PubMedID 31585783