Lateral Extra-Articular Tenodesis (LET) has become an accepted adjunct to standard anterior cruciate ligament reconstruction to help provide additional rotational stability to the knee and lower the risk of re-tears. The classic situation to perform this surgery would be at the same time as an ACL reconstruction in a patient with a high degree of rotational instability or in a patient who has already had ACL surgery and re-torn. However, might there be a role for LET performed as a standalone procedure? A subset of patients following ACL surgery will have a knee that is very stable in the anterior-to-posterior (front-to-back) direction but continues to demonstrate some degree of rotational instability. Could an LET performed in isolation provide these patients with that additional rotational stability and thus lower their risk of another injury, or is that a crazy idea?

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The importance of the mind-body connection in Sports Medicine is well-established and continues to be a hot topic of study and conversation. This connection between psychological and physical is especially noted with ACL injuries, surgery, and rehabilitation. Dr. Brian M. Devitt, MD, PhD from UPMC Sports Surgery Clinic in Dublin, Ireland joins us to discuss his team's work examining psychological readiness and return to play rates in elite versus nonelite athletes. One might assume that the elite athlete, perhaps with more personal athletic identity and rehab resources would outperform the nonelite athlete, but does that actually play out?

The correct treatment for rotator cuff tears remains a matter of debate. The varying characteristics of cuff tears – symptomatic versus asymptomatic, tear size, tendon quality, the presence of fatty atrophy, etc. – makes generalizations about the best treatment approach difficult. One thing shoulder specialists agree on is that tear enlargement is problematic. A cuff tear that enlarges may turn a once fixable tear into an unfixable one. Predicting which tears will enlarge and the rate at which they will is not an exact science. We welcome Dr. James Irrgang, PT, PhD, FAPTA & Dr. Luke Mattar, PhD from the University of Pittsburgh to discuss their study looking at tear propagation trends in patients with a symptomatic, isolated supraspinatus tears after 3 month of an initial trial of physical therapy.