Medial meniscal root tears are biomechanically similar to a total meniscectomy. Repair is clinically indicated and supported by evidence. Increased contact pressures can result in cartilage degeneration and early onset of osteoarthritis. Once diffuse grade 3 or 4 osteoarthritis has settled in, repair may not be indicated anymore. Combining medial meniscal root repair with a high tibial osteotomy for grade 3 or 4 medial-compartment osteoarthritis is not beneficial, and osteotomy alone provides very similar clinical outcomes at 2 years. Meniscal healing was observed in only 18% of patients, and the rate of “cartilage recovery” during second-look arthroscopy was between 8% and 24%. The low sample size, short follow-up, and historical control group limit the validity and generalizability of these conclusions.Despite its overall good results, meniscal allograft transplantation is considered a salvage procedure, and abstention from sport practice is considered a valid solution to preserve the transplanted meniscus as long as possible. However, many patients want to return to sport, and this is often beneficial for them. Therefore, we should know how meniscal allograft transplantation performs in terms of return to sport to better counsel our patients. It is thus of primary importance to discuss general and sport-related expectations with each patient, whom should be informed of the potential short- and long-term risks of strenuous or light sport activities. In particular, the high risk of reoperation, the long recovery time, and the potentially deleterious effect of sporting activity on graft survival should be quite clear to both surgeons and patients because, when it comes to return-to-sport decisions, “It takes two to tango”!The compensatory labrum needs to considered in patients with mechanical hip pain. It is no longer adequate to broadly characterize patients with femoracetabular impingement as either cam or pincher patients. Effective treatment of the syndrome requires in-depth assessment version, head-neck offset, subspine, and capsule-labral morphology, especially in patients with borderline dysplasia. A larger acetabular labrum is associated with hip dysplasia, and labral length correlates with lateral center-edge angle and acetabular roof obliquity. Symptomatic hips show larger labra. Labral size and acetabular undercoverage are part of the spectrum in patients with borderline dysplasia and evidence of impingement. Quantitative and advanced 3-dimensional imaging is a critical evaluation tool.The surgical treatment of labral deficiency has generated a tremendous amount of discussion and controversy among hip arthroscopists. The surgical reconstruction of the labrum has been viewed as the natural next step, after debridement and repair, in the advancement of our ability to treat patients with hip labral pathology. However, the indications for labral replacement and the profile of patients who would benefit from this complex intervention are still under debate. Every hip arthroscopist must have the technical ability to perform reconstruction when indicated. Repair or debridement does not always achieve best patient outcome.When choosing the best treatment option for patients with tears of the triangular fibrocartilage complex, there are multiple patient factors that should be carefully considered. The role of ulnar variance is often overemphasized when attempting to predict the success of arthroscopic repair. In practice, variables such as the age of the patient and location and nature of the tear as traumatic or degenerative should primarily drive the decision between arthroscopic repair and primary ulnar-shortening osteotomy. Arthroscopic repair should generally be avoided in favor of ulnar-shortening osteotomy in patients with degenerative tears and evidence of ulnar impaction syndrome. However, for acute, traumatic, ulnar-sided tears in young patients, arthroscopic repair remains an effective treatment option regardless of ulnar variance.Cell therapies hold great promise as primary and adjuvant treatments for a range of musculoskeletal conditions. Bone marrow harvested from the iliac crest represents the gold-standard source of progenitor cells with a recognized ability to release trophic factors, modulate local immune environments, and differentiate into multiple musculoskeletal cell types in vitro. Identifying accessible locations that limit donor-site morbidity while increasing efficiency during aspiration of bone marrow is essential. There is increasing evidence to suggest that the number of progenitor cells present in bone marrow aspirated from multiple sites, including the proximal humerus and ilium, is at least equivalent to that from the iliac crest. PF-04965842 Because many of these sources lie within the surgical field, the requirement for iliac crest harvest and the risks associated with secondary harvest sites can be mitigated. Although there is a clear need for further studies evaluating the biological attributes and clinical benefit of bone marrow aspirate concentrate in a range of clinical settings, the use of local harvesting sites is likely to reduce morbidity and improve the experience for patients.Glenoid bone loss must be recognized when treating patients with shoulder instability to appropriately determine surgical treatment with either a soft-tissue stabilization or bony augmentation procedure. Three-dimensional reconstructions from computed tomography scans currently are the clinical gold standard for accurately evaluating glenoid bone loss. Novel advances in magnetic resonance imaging sequences and processing may allow for obtaining complete bony information from a single preoperative imaging study.A national database in the United States was used to identify increasing age, male sex, smoking, obesity, hyperlipidemia, and vitamin D deficiency as significant independent patient-specific risk factors for rotator cuff repair failure requiring revision repair. Understanding risks for repair failure can help counsel patients, inform treatment strategies, and consider treatment alternatives for patients with symptomatic rotator cuff tears.