Good Morning.

The dreaded ACL rupture is one of the greatest fears for any athlete -- recreational or professional.

ACL reconstruction methods have come a long way, including the development of lateral extra-articular procedures like LET. But do they help?

Find out below in this week's edition of The Pulse!

In today's edition:

🏥 Should we perform LEAPs prior to ACL reconstruction?

📰 Ortho & the NHL

🎙️ Microagressions in the OR, with Dr Saroo Sharda

Up to 25% of patients undergoing ACL reconstruction continue to experience rotatory instability or graft failure.

Lateral extra-articular procedures (LEAPs), including LET, have been proposed as a way to improve rotational control, but their impact on overall outcomes has remained uncertain.

A systematic review and meta-analysis of 10 randomized trials compared ACL reconstruction with and without a LEAP procedure, evaluating rotatory instability, graft rupture, pain, and patient-reported outcomes.

One consistent signal: Adding a LEAP reduced rotatory instability and graft rupture rates at follow-up.

At the same time, early recovery may not be straightforward — with increased postoperative pain reported at 6 months in the LEAP group, before differences resolve over time.

How these competing effects balance out — and whether this should change when you add a LEAP in practice — becomes clearer when you look at the full dataset. 

Read the full ACE Report on this study here.

In the National Hockey League (NHL), injuries are a weekly occurrence. However, there are professional and economic consequences for being injured: each injury carries a mean loss of around $283,100 in player salary.

In the 2025-2026 season, as of November 2025, there are currently almost 100 injury reports across the NHL. Of these injuries, many are undisclosed; however, of the ones that are reported, many of them tend to be lower body. In fact, over 20% of injuries in the NHL tend to be lower body (Mueller, 2016). 

So what exactly is causing so many injuries, and what can players do to avoid them?

Read the full Original on Injuries in the NHL here.

What happens when a passing comment, a glance, or a casual joke carries more weight than intended? 

In this episode of OrthoJoe, Marc and Mo sit down with Dr Saroo Sharda, Associate Dean of Equity and Inclusion in the Faculty of Health Sciences at McMaster University, for a conversation about microaggressions in medicine.

A central theme is that harm can be real even without malicious intent, with repeated experiences contributing to isolation, burnout, and broader health consequences. The discussion also turns practical, emphasizing recognition, attention to hierarchy and power, thoughtful responses in the moment, follow-up support afterward, and the need to treat inclusive communication as a skill that must be practiced deliberately.

Watch the full podcast here.

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AAOS 2026: Novel Digital Therapeutic for Treatment of Patellofemoral Pain – In patients with chronic patellofemoral pain, does a mobile app–based digital therapeutic program combining exercise therapy and cognitive behavioral therapy compared with standard exercise education and self-directed exercises improve pain and functional outcomes? (Read)

Thanks for reading!

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