Standardizing the Unstandardized: Can We Create a Universal PJI Pathway?

5-Minute Summary: Idiopathic Medial Patellar Instability Treated with Lateral Patellofemoral Ligament Reconstruction Using Semitendinosus Allograft.

Medial patellar instability is a potentially severe ligamentous condition that significantly impairs normal knee function, with most cases due to iatrogenic injury to the lateral soft tissue restraints. Idiopathic causes are exceedingly rare. We present a unique case of a 32-year-old woman with chronic idiopathic medial patellar instability managed with LPFL reconstruction using a semitendinosus allograft. This report contributes to the limited literature on non-iatrogenic medial patellar instability and supports LPFL reconstruction as a viable treatment option.

5-Minute Summary: Emerging Peptide Therapies in Orthopaedics: Evidence, Safety, and Perioperative Implications

Peptide therapies have rapidly entered musculoskeletal and orthopaedic care through direct-to-consumer performance clinics and widespread online promotion. Agents such as BPC-157 and thymosin beta-4 derivatives (TB-500) are increasingly used by patients seeking accelerated recovery, despite uncertain efficacy and limited perioperative safety data. This scoping review aimed to characterize the available evidence regarding commonly used peptide therapies relevant to musculoskeletal pathology and to examine safety considerations and perioperative implications for orthopaedic surgical patients, with emphasis on total joint arthroplasty (TJA).

5-Minute Summary: Shoulder Arthroplasty Outcomes Using Glucagon-Like Peptide-1 Receptor Agonists: A Systematic Review

Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are increasingly prescribed for both glycemic control and weight loss, particularly in patients undergoing total joint arthroplasty. While studies on total hip and knee arthroplasty suggest potential perioperative benefits, the impact of GLP-1 RA use on outcomes following total shoulder arthroplasty (TSA) is unclear. Given the unique biomechanical demands of TSA, rising TSA volumes, and increasing GLP-1 RA use, this systematic review aims to evaluate the current literature on the impact of GLP-1 RA therapy on postoperative outcomes in TSA patients.

5-Minute Summary: Mitigating the Post-operative Swelling Tsunami in Total Knee Arthroplasty: A Call to Action

Total knee arthroplasty (TKA) is a treatment option for individuals with symptomatic osteoarthritis who have failed conservative therapy. In this manuscript the authors describe the pathophysiology of post-operative edema and explore the patient dependent factors potentially contributing to lymphatic dysfunction and thus directly influencing the TKA postoperative course. A proposed multimodal perioperative protocol is presented that focuses on identifying limb edema/lymphedema preoperatively, intraoperative technique changes that may decrease swelling post-TKA.

5-Minute Summary: Image-guided injections versus anatomical-based injections for carpometacarpal (CMC) arthritis: A Systematic Review

Thumb carpometacarpal (tCMC) arthritis is a common and debilitating condition for aging people worldwide. Conservative treatments including activity modification, bracing, anti-inflammatory medications, and steroid injections remain the initial treatment of choice. Given the size of the tCMC joint, intra-articular image-guided injections (IGI) may provide more consistent and superior outcomes with comparison to peri-articular anatomic landmark injections (ALI). This study systematically reviews the accuracy and efficacy of intra-articular IGA versus ALI.