Does the Robotic Arm and Preoperative CT Planning Help with 3D Intraoperative Total Knee Arthroplasty Planning?
J Knee Surg DOI: 10.1055/s-0038-1668122Although several studies highlight the advantages of robotic arm-assisted total knee arthroplasty (RA-TKA), few investigate its intraoperative outcome. Therefore, the purpose of this study was to analyze the RA-TKA's ability to assist with intraoperative correction of: (1) flexion and (2) extension gaps, as well as its ability to (3) accurately predict implant sizes. Additionally, in this RA-TKA cohort, length of stay, complications, and readmissions were assessed. A total of 335 patients who underwent RA-TKA were included. The robotic software virtually measured the intraoperative pr...
Source: Journal of Knee Surgery - August 15, 2018 Category: Orthopaedics Authors: Marchand, Robert C. Sodhi, Nipun Bhowmik-Stoker, Manoshi Scholl, Laura Condrey, Caitlin Khlopas, Anton Sultan, Assem A. Newman, Jared M. Mont, Michael A. Tags: Original Article Source Type: research

Pie Crust Technique of the Deep Medial Collateral Ligament in Knee Arthroscopy: Ultrasound and Anatomic Study
This article determines compartment opening of the medial articular space of the knee after pie crust (PC) technique of the medial collateral ligament (MCL) by ultrasound measurements and anatomic dissection. This is a cadaveric study of 12 specimens. Four anatomic references were marked on the skin. Distances between the femur and tibia in the internal compartment at 30 degrees of flexion were obtained with ultrasound measurements in four situations: with and without applying valgus force both prior and after the PC technique. Ultrasound measurements of the medial articular compartment were made twice and mean value was c...
Source: Journal of Knee Surgery - August 15, 2018 Category: Orthopaedics Authors: Claret-Garcia, Guillem Monta ñana-Burillo, Jordi Tornero-Dacasa, Eduard Llus á-Pérez, Manel Popescu, Dragos Combalia-Aleu, Andreu Sastre-Solsona, Sergi Tags: Original Article Source Type: research

Clinical Outcomes of Closing- and Opening-Wedge High Tibial Osteotomy for Treatment of Anteromedial Unicompartmental Knee Osteoarthritis
This study included 79 patients who underwent high tibial osteotomy (HTO) between 2002 and 2008. Pre- and postoperative radiography and computed tomography were used to evaluate the posterior tibial slope, the patellar height, the tibiofemoral angle, and the lateral and medial tibiofemoral joint space. Pre- and postoperative severity of arthritis was assessed with the Kellgren–Lawrence grading system. Pre- and postoperative American Knee Society (AKS) score and Lysholm Knee Score (LKS) were determined to evaluate functional outcomes. The duration of follow-up was 86.1 ± 6.2 months. Postoperativel...
Source: Journal of Knee Surgery - August 13, 2018 Category: Orthopaedics Authors: Lu, Jiangfeng Tang, Shiyu Wang, Yanru Li, Yao Liu, Chang Niu, Yingzhen Cao, Pengkai Wang, Fei Tags: Original Article Source Type: research

Similar Outcome, but Different Surgical Requirement in Conversion Total Knee Arthroplasty following High Tibial Osteotomy and Unicompartmental Knee Arthroplasty: A Meta-Analysis
J Knee Surg DOI: 10.1055/s-0038-1666999The present systematic review and meta-analysis were conducted to find out how effective any subsequent conversion total knee arthroplasty (TKA) would be after unicompartmental knee arthroplasty (UKA) and high tibial osteotomy (HTO) and which is better in outcomes. A rigorous and systematic approach was used. Each of the selected studies was evaluated for methodological quality. Data were extracted by the following standardized protocol: study design, level of evidence, cases enrolled, age, sex ratio, follow-up, kind of index surgery, type of index surgery, average time to failure, mo...
Source: Journal of Knee Surgery - August 6, 2018 Category: Orthopaedics Authors: Lee, Yong Seuk Kim, Hyun Jung Mok, Su Jung Lee, O-Sung Tags: Original Article Source Type: research

Response to: Reliability of Roentgenographic Knee Alignment Measurements in Gonarthrosis: Methodological Issues to Avoid Misinterpretation
J Knee Surg DOI: 10.1055/s-0038-1660842 Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of contents  |  Full text (Source: Journal of Knee Surgery)
Source: Journal of Knee Surgery - August 6, 2018 Category: Orthopaedics Authors: Wu, Chang-Chin Tags: Letter to the Editor Source Type: research

Gender Differences in Intra-articular and Extra-articular Injuries Associated with Acute Anterior Cruciate Ligament Ruptures
In conclusion, males and females have similar rates of associated intra-articular and extra-articular injuries after ACL rupture in the acute setting. These include associated collateral ligament injuries, meniscal injuries, chondral injuries, and bone contusions. The level of evidence is Level II. [...] Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of contents  |  Abstract  |  Full text (Source: Journal of Knee Surgery)
Source: Journal of Knee Surgery - August 1, 2018 Category: Orthopaedics Authors: Sharon Tan, Si Heng Kripesh, Aishwarya Chan, Chloe Xiaoyun Krishna, Lingaraj Tags: Original Article Source Type: research

Preoperative CT-Based Three-Dimensional Templating in Robot-Assisted Total Knee Arthroplasty More Accurately Predicts Implant Sizes than Two-Dimensional Templating
J Knee Surg DOI: 10.1055/s-0038-1666829Patient dissatisfaction after total knee arthroplasty (TKA) is a concern. Surgical error is a common, avoidable cause of failed TKA. Correct femoral and tibial component sizing improves implant longevity, clinical outcomes, knee balance, and pain scores. We hypothesized that preoperative three-dimensional (3D) templating for robot-assisted TKA (RA-TKA) is more accurate than two-dimensional (2D) digital templating. Prospectively collected data from 31 RA-TKAs were assessed to determine accuracy pertaining to implant sizing and positioning. All cases undergoing RA-TKA undergo preoperati...
Source: Journal of Knee Surgery - August 1, 2018 Category: Orthopaedics Authors: Pietrzak, J. R. T. Rowan, F. E. Kayani, B. Donaldson, M. J. Huq, S. S. Haddad, F. S. Tags: Original Article Source Type: research

Perioperative Care of the TKA Patient
J Knee Surg 2018; 31: 593-593 DOI: 10.1055/s-0038-1641748 Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of contents  |  Full text (Source: Journal of Knee Surgery)
Source: Journal of Knee Surgery - July 17, 2018 Category: Orthopaedics Authors: Friedman, Richard J. Tags: Special Focus Section Source Type: research

Isolated Tibial Component Failure in Total Knee Arthroplasty: A Case Series Evaluating Inflammatory Response versus Mechanical Failure
J Knee Surg DOI: 10.1055/s-0038-1666831Total knee prostheses are routinely redesigned to improve performance, longevity, and to closer mimic the native kinematics of the knee. Despite continued improvements, all knee implants, even those with proven design features, have failures. We identified a cohort of patients with isolated tibial component failures that occurred in a popular and successful knee system. Our purpose was to (1) characterize the observed radiographic failure pattern; (2) investigate the biologic response that may have contributed to the failure; and (3) to determine if the failure mechanism was of a biol...
Source: Journal of Knee Surgery - July 10, 2018 Category: Orthopaedics Authors: Yokhana, Sanar S. Bergum, Christopher Ren, Weiping Markel, David C. Tags: Original Article Source Type: research

Predicting the Outcome of Total Knee Arthroplasty Using the WOMAC Score: A Review of the Literature
J Knee Surg DOI: 10.1055/s-0038-1666866It is estimated that up to a third of recipients of total knee arthroplasty (TKA) experience chronic pain postoperatively. However, there are no clear indications within the literature that predict which patients are at higher risk of being dissatisfied with their TKA. The Western Ontario and McMaster University Osteoarthritis Index (WOMAC) is one of the most commonly used, patient-reported outcome measures in patients with lower limb osteoarthritis. This review discusses the available evidence surrounding the predictability of the outcome of TKA using the WOMAC score as well as consi...
Source: Journal of Knee Surgery - July 10, 2018 Category: Orthopaedics Authors: Walker, Lucy Camilla Clement, Nick D. Deehan, David J. Tags: Original Article Source Type: research

The Pellegrini –Stieda Lesion of the Knee: An Anatomical and Radiological Review
J Knee Surg DOI: 10.1055/s-0038-1666867The Pellegrini–Stieda lesion is a calcification on the medial side of the knee. The origin of this tissue is controversial. The purpose of our study is to investigate the origin of the Pellegrini–Stieda lesion using conventional radiography as to recreate the circumstances in which Pellegrini and Stieda had to study this pathology. Six nonpaired fresh-frozen cadaveric knees were used. A surgical approach to the medial side of the knee was performed using the layered approach. The origin of the gastrocnemius muscle (GM) (n = 3) or the superficial medial collat...
Source: Journal of Knee Surgery - July 10, 2018 Category: Orthopaedics Authors: Somford, M. P. Janssen, R. P. A. Meijer, D. Roeling, T. A. P. Brown, C. Eygendaal, D. Tags: Original Article Source Type: research

Primary Allograft ACL Reconstruction in Skeletally Immature Patients —A Systematic Review of Surgical Techniques, Outcomes, and Complications
J Knee Surg DOI: 10.1055/s-0038-1666833The purpose of this systematic review is to ascertain the risk profile of allografts in primary anterior cruciate ligament reconstruction (ACLR) of skeletally immature patients. Three databases (PubMed, EMBASE, and MEDLINE) were searched for articles addressing primary ACLR in skeletally immature patients (i.e., open femoral and tibial physes). Inclusion criteria encompassed the use of allograft tissue with available postoperative outcomes data. The methodological index for non-randomized studies (MINORS) was used to assess all studies. Descriptive statistics such as means, 95% confid...
Source: Journal of Knee Surgery - July 10, 2018 Category: Orthopaedics Authors: Shanmugaraj, Ajaykumar de SA, Darren Skelly, Matthew M. Duong, Andrew Simunovic, Nicole Musahl, Volker Peterson, Devin C. Ayeni, Olufemi R. Tags: Original Article Source Type: research

The Role of Surgical Closure Position in Total Knee Arthroplasty: Flexion versus Extension —A Randomized Prospective Study
J Knee Surg DOI: 10.1055/s-0038-1666865We aimed to investigate the effect of the knee position during the surgical closure on isokinetic muscle strength, clinical score, and range of motion in total knee arthroplasty. Seventy-five eligible patients were enrolled in the study and randomly divided into two groups; wound closure was performed with the knee flexed at 90° in group 1 and knee extended in group 2. All the surgeries were performed by the same surgeon and by the same prosthesis type. All the patients received the same rehabilitation program postoperatively. The primary outcomes were the knee flexion degrees and...
Source: Journal of Knee Surgery - July 10, 2018 Category: Orthopaedics Authors: Pepe, Murad Calisal, Emre Kocadal, Onur Bicer, Eren Taskin, Suhan Aktekin, Cem Nuri Tags: Original Article Source Type: research

Preoperative Opioid Use in Knee Surgery Patients
The objectives of the study were to determine the demographic, diagnostic, and psychologic factors associated with opioid use; and to determine the clinical correlates of opioid use. We hypothesized that preoperative opioid use would be associated with worse patient-reported outcome (PRO) measures. The sample consisted of 383 patients undergoing knee surgery. The patients were classified as either opioid or nonopioid users on the basis of medical record review. All participants completed a battery of clinical assessments, including the Patient-Reported Outcomes Measurement Information System computer adaptive testing in si...
Source: Journal of Knee Surgery - July 10, 2018 Category: Orthopaedics Authors: Meredith, Sean J. Nadarajah, Vidushan Jauregui, Julio J. Smuda, Michael P. Medina, Shaun H. Bennett, Craig H. Packer, Jonathan D. Henn, R. Frank Tags: Original Article Source Type: research

Value of Preoperative MRI and Examination under Anesthesia for Differentiating Complete from Partial Anterior Cruciate Ligament Tears
J Knee Surg DOI: 10.1055/s-0038-1666827Partial tears of the anterior cruciate ligament (ACL) recently regained attention due to a better understanding of the two distinct bundles of the ligament and the possibility of single-bundle reconstruction procedures. An accurate diagnosis is important as it influences treatment options and patient prognosis. The aim of this study was to evaluate the value of examination under anesthesia (EUA) and magnetic resonance imaging (MRI) for differentiating partial from complete ACL tears. For this purpose, this prospective case series included 95 consecutive patients undergoing primary ACL...
Source: Journal of Knee Surgery - July 10, 2018 Category: Orthopaedics Authors: Cavinatto, Leonardo Gupta, Sunny Morgan, Craig Bartolozzi, Arthur R. Tags: Original Article Source Type: research

Posterolateral Rotatory Knee Instability —MRI Evaluation of Anatomic Landmarks for Tibial Drill Tunnel Placement in Open and Arthroscopic Popliteus Tendon Reconstruction
J Knee Surg DOI: 10.1055/s-0038-1666832Anatomic reconstruction of the popliteus tendon and arcuate complex results in superior functional and a biomechanically more stable outcome compared with extra-anatomic techniques in posterolateral rotatory knee instability. Although specific characteristics of the femoral and fibular footprint of the anatomic posterolateral reconstruction have been described, data for tibial tunnel placement while popliteus tendon reconstruction do not exist. The purpose of this study was to quantify reasonable parameters, which could be used in arthroscopy, fluoroscopy, or open surgery to determine...
Source: Journal of Knee Surgery - July 6, 2018 Category: Orthopaedics Authors: Krause, Matthias Akoto, Ralph Drenck, Tobias Claus Frosch, Karl-Heinz Preiss, Achim Tags: Original Article Source Type: research

Can Preoperative Magnetic Resonance Imaging Predict Intraoperative Autograft Size for Anterior Cruciate Ligament Reconstruction? A Systematic Review
J Knee Surg DOI: 10.1055/s-0038-1666830This systematic review explored the utility of preoperative magnetic resonance imaging (MRI) as a tool for predicting intraoperative graft size for anterior cruciate ligament (ACL) reconstruction. Three databases (EMBASE, PubMed, and MEDLINE) were searched in November 2017 for English-language studies of all levels of evidence that aimed to correlate preoperative MRI measurements of common primary ACL autograft sources to intraoperative measurements of the harvested graft. Two reviewers applied predetermined inclusion/exclusion criteria to independently complete title, abstract, and f...
Source: Journal of Knee Surgery - July 6, 2018 Category: Orthopaedics Authors: Agarwal, Suhail de SA, Darren Peterson, Devin C. Parmar, Daniel Simunovic, Nicole Ogilvie, Rick Musahl, Volker Ayeni, Olufemi R. Tags: Original Article Source Type: research

Right TKR Patients Treated with Enhanced Pain and Rehabilitation Protocols Can Drive at 2 Weeks
J Knee Surg DOI: 10.1055/s-0038-1660478An important milestone in the recovery following total knee replacement (TKR) is the ability to return to driving. With advances in pain control and the widespread introduction of rapid rehab programs, we hypothesized that the ability to drive would also return sooner than had been traditionally observed. In our group of consecutive right TKR patients, using a driving simulator, we showed that at the 2-week mark, 36 of the 40 patients tested had returned to their preoperative driving capabilities and the other 4 had reached baseline at 3 weeks. While the eventual decision to return to...
Source: Journal of Knee Surgery - June 20, 2018 Category: Orthopaedics Authors: Dalury, David F. Chapman, Danielle M. Tags: Original Article Source Type: research

Medium- to Long-Term Results of the Nexgen Legacy Posterior Stabilized Fixed-Bearing Knee Replacement
This study revealed excellent mid- to long-term results with the NexGen LPS prosthesis. [...] Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of contents  |  Abstract  |  Full text (Source: Journal of Knee Surgery)
Source: Journal of Knee Surgery - June 20, 2018 Category: Orthopaedics Authors: Arikupurathu, Oommen Mathew Johnston, Linda MacInnes, Alasdair Nicol, Graeme Nassif, Manhal Tags: Original Article Source Type: research

Pediatric Knee Trauma
J Knee Surg 2018; 31: 485-485 DOI: 10.1055/s-0038-1637019 Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of contents  |  Full text (Source: Journal of Knee Surgery)
Source: Journal of Knee Surgery - June 19, 2018 Category: Orthopaedics Authors: Schmidt, Andrew H. Tags: Special Focus Section Source Type: research

Incidence of Concurrent Peroneal Nerve Injury in Multiligament Knee Injuries and Outcomes after Knee Reconstruction
This study contributes to our understanding of patient outcomes in patients with concurrent MLKI and peroneal nerve injury, with a focus on the patient's ability to return to work and sporting activity. [...] Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of contents  |  Abstract  |  Full text (Source: Journal of Knee Surgery)
Source: Journal of Knee Surgery - June 13, 2018 Category: Orthopaedics Authors: Worley, John R. Brimmo, Olubusola Nuelle, Clayton W. Cook, James L. Stannard, James P. Tags: Original Article Source Type: research

The Effect of Remnant Tissue Preservation in Anatomic Double-Bundle ACL Reconstruction on Knee Stability and Graft Maturation
This article evaluates the effectiveness of RTP in ACLR on knee stability and graft maturation. In total, 75 patients with unilateral ACL injury who had undergone anatomic double-bundle ACLR using autografted hamstring tendon either with RTP (Group P, n = 43) or without (Group N, n = 32) were enrolled. Clinical scores, pre- and postoperative side-to-side differences (SSDs) obtained using Telos, radiological evaluations of the grafted tendon using the signal/noise quotient (SNQ) measured using magnetic resonance imaging, and arthroscopic evaluations of the grafted tendon were retrospectively comp...
Source: Journal of Knee Surgery - June 13, 2018 Category: Orthopaedics Authors: Takahashi, Tsuneari Kimura, Masashi Hagiwara, Keiichi Ohsawa, Takashi Takeshita, Katsushi Tags: Original Article Source Type: research

Mucoid Degeneration of the Anterior Cruciate Ligament: Characterization of Natural History, Femoral Notch Width Index, and Patient Reported Outcome Measures
J Knee Surg DOI: 10.1055/s-0038-1660514The presentation and clinical course of mucoid degeneration of the anterior cruciate ligament (MD-ACL) are poorly documented within the literature. Subsequently, it is under-diagnosed and the optimal management strategy remains ill-defined. Here, we characterize the syndrome associated with MD-ACL and compare the natural clinical course with the outcomes of arthroscopic management. Thirty-one patients with radiological features of MD-ACL over a 2-year period had their clinical notes retrospectively reviewed. Seven patients underwent arthroscopic debridement of the ACL for MD. These we...
Source: Journal of Knee Surgery - June 13, 2018 Category: Orthopaedics Authors: Hotchen, Andrew J. Demetriou, Charis Edwards, Dennis Melton, Joel T. K. Tags: Original Article Source Type: research

Arthroscopic and 3D CT Scan Evaluation of Femoral Footprint of the Anterior Cruciate Ligament in Chronic ACL Deficient Knees
J Knee Surg DOI: 10.1055/s-0038-1660515The outcome of single-bundle anterior cruciate ligament (ACL) reconstruction depends largely on the anatomic placement of bone tunnel. The lateral intercondylar ridge (LIR) and bifurcate ridge (BR) are useful bony landmarks for femoral tunnel placement. The purpose of our study was to compare the bony landmarks of ACL footprint on femur by three-dimensional computed tomography (3D CT) scan and arthroscopy in chronic ACL-deficient knees. Fifty patients above 18 years of age who were diagnosed of having ACL tear were selected for the study. All the cases were more than 6 months old sinc...
Source: Journal of Knee Surgery - June 13, 2018 Category: Orthopaedics Authors: Das, Anupam Yadav, C. S. Gamanagatti, Shivanand Pandey, R. M. Mittal, Ravi Tags: Original Article Source Type: research

Reliability of Roentgenographic Knee Alignment Measurements in Gonarthrosis: Methodological Issues to Avoid Misinterpretation
J Knee Surg DOI: 10.1055/s-0038-1660840 Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of contents  |  Full text (Source: Journal of Knee Surgery)
Source: Journal of Knee Surgery - June 13, 2018 Category: Orthopaedics Authors: Sabour, Siamak Tags: Letter to the Editor Source Type: research

Erratum to: Gender Disparity between Absolute versus Relative Size of Condylar Chondral Defects: An MRI Analysis
J Knee Surg DOI: 10.1055/s-0038-1656512 Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of contents  |  Full text (Source: Journal of Knee Surgery)
Source: Journal of Knee Surgery - June 5, 2018 Category: Orthopaedics Authors: Berman, Daniel Rogers, Kelly Griffin, Justin Bonner, Kevin Tags: Erratum Source Type: research

Sonographic Evaluation of the Anterolateral Ligament of the Knee: A Cadaveric Study
This study evaluated the effectiveness of high-resolution ultrasound (US) examination to detect the ALL. We studied 8 cadaveric knees (8 ALLs). On each knee, high-resolution real-time ultrasonography examination was performed by an experienced musculoskeletal radiologist before and after the procedure, with the surgeons blind to the results of the scan both before and after dissection. The ALL was identified in each cadaver limb by the musculoskeletal radiologist. US is a useful imaging modality to identify and evaluate the ALL. The ability of US to fully evaluate injuries involving the ALL still needs to be demonstrated i...
Source: Journal of Knee Surgery - May 31, 2018 Category: Orthopaedics Authors: Zappia, Marcello Oliva, Francesco Chianca, Vito Di Pietto, Francesco Maffulli, Nicola Tags: Original Article Source Type: research

Trends in Anterior Cruciate Ligament Reconstruction in the Last Decade: A Web-Based Analysis
J Knee Surg DOI: 10.1055/s-0038-1655764Anterior cruciate ligament (ACL) injury is known to be one of the most common knee joint injuries. ACL reconstruction can be similar to the native ACL in respect of graft morphology, tension, position, and orientation. ACL reconstruction can be applied with different surgery techniques, graft and fixation devices, and rehabilitation as ACL reconstruction is just as important as surgery. Although commonly known as a sports injury, ACL injuries are increasingly seen in the general population. The aim of this study was to investigate the trends in ACL injury treatment in the last decade ...
Source: Journal of Knee Surgery - May 31, 2018 Category: Orthopaedics Authors: Yucens, Mehmet Aydemir, Ahmet Nadir Tags: Original Article Source Type: research

Quality and Variability of Online Physical Therapy Protocols for Isolated Meniscal Repairs
J Knee Surg DOI: 10.1055/s-0038-1655742The ideal meniscal repair postoperative rehabilitation protocol has yet to be determined. Further, patients are attempting to access health care content online at a precipitously increasing rate given the efficiency of modern search engines. The purpose of this investigation was to assess the quality and variability of meniscal repair rehabilitation protocols published online with the hypothesis that there would be a high degree of variability found across available protocols. To this end, Web-based meniscal repair physical therapy protocols from U.S. academic orthopaedic programs as ...
Source: Journal of Knee Surgery - May 31, 2018 Category: Orthopaedics Authors: Trofa, David P. Parisien, Robert L. Noticewala, Manish S. Noback, Peter C. Ahmad, Christopher S. Moutzouros, Vasilios Makhni, Eric C. Tags: Original Article Source Type: research

Intra-Articular Biocompatibility of Multistranded, Long-Chain Polyethylene Suture Tape in a Canine ACL Model
J Knee Surg DOI: 10.1055/s-0038-1655765The purpose of this study was to assess intra-articular use of a nonabsorbable braided suture tape for its biocompatibility when implanted adjacent to the native anterior cruciate ligament (ACL) in a canine model. Establishing biocompatibility of suture tape in the knee is an important foundational step for clinicians considering use of suture tape augmentation for ACL reconstruction or repair. The study hypothesis was that a nonabsorbable braided suture tape would be biocompatible in the knee with no resultant adverse functional consequences, and no significant intra-articular synovi...
Source: Journal of Knee Surgery - May 31, 2018 Category: Orthopaedics Authors: Smith, Patrick A. Bozynski, Chantelle C. Kuroki, Keiichi Henrich, Sarah M. Wijdicks, Coen A. Cook, James L. Tags: Original Article Source Type: research

Reconstruction of Knee Defects Using Pedicled Gastrocnemius Muscle Flap with Split-Thickness Skin Grafting: A Single Surgeon's Experience with 21 Patients
J Knee Surg DOI: 10.1055/s-0038-1653965Generally, reconstruction of knee defects with exposed bone, joint, tendon, and/or hardware requires a vascularized muscle flap for coverage. Although there are several surgical options for a knee defect reconstruction, the pedicled gastrocnemius muscle still remains the workhorse flap. Although this flap is commonly used for knee defect reconstruction and the technique is described very well, there is an absence of information in the literature detailing the technique of harvesting and insetting of the gastrocnemius flap step by step with illustrations. The purpose of this article is...
Source: Journal of Knee Surgery - May 31, 2018 Category: Orthopaedics Authors: Kilic, Ali Denney, Brad de la Torre, Jorge Tags: Original Article Source Type: research

Predictors of Knee Arthrofibrosis and Outcomes after Arthroscopic Lysis of Adhesions following Ligamentous Reconstruction: A Retrospective Case –Control Study with Over Two Years' Average Follow-Up
J Knee Surg DOI: 10.1055/s-0038-1655741Arthrofibrosis can be a devastating complication after ligamentous knee reconstruction. Beyond early range of motion (ROM), manipulation under anesthesia (MUA) and arthroscopic lysis of adhesions (LOAs) are the most frequently employed interventions for the condition. There is a paucity of data regarding predictive factors of arthrofibrosis requiring MUA and LOA, and even less data regarding changes in validated patient-reported outcome measures following the procedure. A retrospective case–control study was performed at an academic, urban Level I trauma center of patients that ...
Source: Journal of Knee Surgery - May 31, 2018 Category: Orthopaedics Authors: Bodendorfer, Blake M. Keeling, Laura E. Michaelson, Evan M. Shu, Henry T. Apseloff, Nicholas A. Spratt, James D. Malone, Patrick S. Argintar, Evan H. Tags: Original Article Source Type: research

In Vivo Tibial Fit and Rotational Analysis of a Customized, Patient-Specific TKA versus Off-the-Shelf TKA
J Knee Surg DOI: 10.1055/s-0038-1653966In total knee arthroplasty (TKA), surgeons often face the decision of maximizing tibial component fit and achieving correct rotational alignment at the same time. Customized implants (CIMs) address this difficulty by aiming to replicate the anatomical joint structure, utilizing data from patient-specific knee geometry during the manufacturing. We intraoperatively compared component fit in four tibial zones of a CIM to that of three different off-the-shelf (OTS) TKA designs in 44 knees. Additionally, we assessed the rotational alignment of the tibia using computed tomography (CT)-based...
Source: Journal of Knee Surgery - May 25, 2018 Category: Orthopaedics Authors: Schroeder, Lennart Martin, Gregory Tags: Original Article Source Type: research

Erratum to: Total Knee Arthroplasty versus Osteochondral Allograft: Prevalence and Risk Factors following Tibial Plateau Fractures
J Knee Surg DOI: 10.1055/s-0038-1654705 Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of contents  |  Full text (Source: Journal of Knee Surgery)
Source: Journal of Knee Surgery - May 24, 2018 Category: Orthopaedics Authors: Oladeji, Lasun O. Dreger, Tina K. Pratte, Eli L. Baumann, Charles A. Stannard, James P. Volgas, David A. Della Rocca, Gregory J. Crist, Brett D. Tags: Erratum Source Type: research

The Impact of Medical Comorbidities on Primary Total Knee Arthroplasty Reimbursements
In this study, we present and quantify the influence of common medical comorbidities on the cost of care in patients undergoing primary TKA. A retrospective level of evidence III study was performed using the PearlDiver supercomputer to identify patients who underwent primary TKA between 2007 and 2015. Patients were stratified by medical comorbidities and compared using analysis of variance for reimbursements for the day of surgery and over 90 days postoperatively. A cohort of 137,073 US patients was identified as having undergone primary TKA between 2007 and 2015. The mean entire episode-of-care reimbursement was $23,701 ...
Source: Journal of Knee Surgery - May 23, 2018 Category: Orthopaedics Authors: Sabeh, Karim G. Rosas, Samuel Buller, Leonard T. Freiberg, Andrew A. Emory, Cynthia L. Roche, Martin W. Tags: Original Article Source Type: research

Treatment Outcome of Reconstruction for Isolated Posterior Cruciate Injury: Subjective and Objective Evaluations
J Knee Surg DOI: 10.1055/s-0038-1653947There is no consensus regarding the treatment method and outcome of posterior cruciate ligament (PCL) injury. We hypothesized that although the outcome of PCL reconstruction was favorable in terms of knee stability, the outcome was unsatisfactory in terms of patient-based assessments. The purpose of this study is to evaluate the treatment outcomes of knees that underwent reconstruction for PCL injury by subjective and objective assessments, and to analyze the correlation between various assessments. Twenty-three patients who underwent PCL reconstruction were studied. All reconstructio...
Source: Journal of Knee Surgery - May 23, 2018 Category: Orthopaedics Authors: Ochiai, Satoshi Hagino, Tetsuo Senga, Shinya Yamashita, Takashi Haro, Hirotaka Tags: Original Article Source Type: research

Meniscus Repair in Children and Adolescents: A Systematic Review of Treatment Approaches, Meniscal Healing, and Outcomes
In conclusion, meniscal tears in pediatrics are not uncommon. Repairs of this injury were associated with good to excellent outcomes in most patients, regardless of the injury pattern, zone, or technique. Reported complications were minimal; however, higher quality studies are needed to confirm the findings of this systematic review. This is a systematic review study with Level IV. [...] Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of contents  |  Abstract  |  Full text (Source: Journal of Knee Surgery)
Source: Journal of Knee Surgery - May 23, 2018 Category: Orthopaedics Authors: Ferrari, M árcio Balbinotti Murphy, Colin P. Gomes, Jo ão Luiz Ellera Tags: Original Article Source Type: research

Patient-Specific Instrumentation Affects Perioperative Blood Loss in Total Knee Arthroplasty
This study demonstrated that PSI leads to a significant trend in earlier Hb regain. These promising results suggest a beneficial effect of PSI in blood loss reduction. [...] Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of contents  |  Abstract  |  Full text (Source: Journal of Knee Surgery)
Source: Journal of Knee Surgery - May 23, 2018 Category: Orthopaedics Authors: Cucchi, Davide Menon, Alessandra Zanini, Beatrice Compagnoni, Riccardo Ferrua, Paolo Randelli, Pietro Tags: Original Article Source Type: research

Return to Sport after ACL Surgery: A Comparison between Two Different Reconstructive Techniques
This study compares clinical and imaging data, to evaluate the timing of return to sport, of two populations undergoing ACLR using two different techniques: ACLR with hamstring maintaining tibial insertion (MHG) and an all-inside technique with complete hamstring detachment (DHG). Patients were clinically evaluated with Marx rating scale, International Knee Documentation Committee (IKDC) score, and Tegner activity scale at a minimum follow-up (FU) of 4 years. The two groups have homogeneous characteristics: age, sex, type, and level of sports activity. Since November 2012, 59 patients with unilateral ACL insufficiency unde...
Source: Journal of Knee Surgery - May 23, 2018 Category: Orthopaedics Authors: Baldassarri, Matteo Perazzo, Luca Ghinelli, Diego Ricciarelli, Marco Pilla, Federico Buda, Roberto Tags: Original Article Source Type: research

Tendon Healing in Bone Tunnel after Human Anterior Cruciate Ligament Reconstruction: A Systematic Review of Histological Results
J Knee Surg DOI: 10.1055/s-0038-1653964Most studies concerning to tendon healing and incorporation into bone are mainly based on animal studies due to the invasive nature of the biopsy procedure. The evidence considering tendon graft healing to bone in humans is limited in several case series or case reports, and therefore, it is difficult to understand the healing process. A computerized search using relevant search terms was performed in the PubMed, EMBASE, Scopus, and Cochrane Library databases, as well as a manual search of reference lists. Searches were limited to studies that investigated tendon graft healing to bone...
Source: Journal of Knee Surgery - May 21, 2018 Category: Orthopaedics Authors: Lu, Hongbin Chen, Can Xie, Shanshan Tang, Yifu Qu, Jin Tags: Original Article Source Type: research

Mid-Term Clinical Outcome and Reconstruction of Posterior Tibial Slope after UKA
J Knee Surg DOI: 10.1055/s-0038-1651528Unicompartmental knee arthroplasty (UKA) has gained growing popularity over the last decades. The posterior tibial slope (PTS) has been shown to play a significant role for knee biomechanics and is thought to be crucial for clinical function of the UKA. We evaluated the clinical outcome at mid-term follow-up after UKA. Furthermore, the reconstruction of the individual PTS was analyzed. A total of 91 consecutive patients undergoing medial UKA for osteoarthritis were included. Patients were contacted by telephone for a survival analysis at a minimum of 30 months after surgery. Patient-o...
Source: Journal of Knee Surgery - May 21, 2018 Category: Orthopaedics Authors: Franz, Alois Boese, Christoph Kolja Matthies, Andrej Leffler, J örg Ries, Christian Tags: Original Article Source Type: research

Intravenous Acetaminophen May Be Associated with Reduced Odds of 30-Day Readmission after Total Knee Arthroplasty
J Knee Surg DOI: 10.1055/s-0038-1646927The purpose of this study was (1) to evaluate 30-day readmission rates in total knee arthroplasty (TKA) patients who either received intravenous (IV) or oral (PO) acetaminophen (APAP) perioperatively and (2) to extrapolate the potential annual cost savings on the national level. This was a review of 190,691 TKA recipients between the years 2012 and 2015 who received either IV (n = 56,475) or PO APAP (n = 134,216). All-cause readmissions that occurred between patient discharge and 30 days postdischarge were recorded. Continuous and categorical variables were...
Source: Journal of Knee Surgery - May 7, 2018 Category: Orthopaedics Authors: Mont, Michael A. Lovelace, Belinda Pham, An T. Hansen, Ryan N. Chughtai, Morad Gwam, Chukwuweike U. Khlopas, Anton Barrington, John W. Tags: Original Article Source Type: research

Minimizing Blood Loss and Transfusions in Total Knee Arthroplasty
J Knee Surg DOI: 10.1055/s-0038-1648223Blood loss management is critical to positive outcomes in patients undergoing total knee arthroplasty (TKA). Transfusions are associated with an increased risk of major and minor adverse events, length of hospitalization, and overall cost associated with surgery. Many techniques have been investigated and compared. Tranexamic acid (TXA), an antifibrinolytic drug widely known to reduce blood loss, may be a bridge to the goal of eliminating blood transfusions from TKA. Administration of TXA can be performed intravenously, topically at the knee joint, orally, or in combination. A single ...
Source: Journal of Knee Surgery - May 4, 2018 Category: Orthopaedics Authors: White, Charles Cody Eichinger, Josef K. Friedman, Richard J. Tags: Special Focus Section Source Type: research

A Preclinical Model to Study the Influence of Graft Force on the Healing of the Anterior Cruciate Ligament Graft
In conclusion, we have developed a novel ACL reconstruction model that can reproducibly produce two ACL graft force patterns. This model would permit further research on how ACL graft forces may affect subsequent graft healing, maturation, and function. [...] Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of contents  |  Abstract  |  Full text (Source: Journal of Knee Surgery)
Source: Journal of Knee Surgery - May 4, 2018 Category: Orthopaedics Authors: Ma, Richard Stasiak, Mark Deng, Xiang-Hua Rodeo, Scott A. Tags: Original Article Source Type: research

Arthroscopic Treatment of Diffuse Pigmented Villonodular Synovitis of the Knee: Complete Synovectomy and Septum Removal —Midterm Results
This study showed that an attentive arthroscopic synovectomy is a safer alternative with better clinical outcomes, with no clinical recurrences. [...] Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of contents  |  Abstract  |  Full text (Source: Journal of Knee Surgery)
Source: Journal of Knee Surgery - May 4, 2018 Category: Orthopaedics Authors: Keyhani, Sohrab Kazemi, Seyyed Morteza Ahn, Jin Hwan Verdonk, Ren é Soleymanha, Mehran Tags: Original Article Source Type: research

Coronal Knee Malalignment in Young Adults and Its Link to Body Measures
J Knee Surg DOI: 10.1055/s-0038-1646928Our aim was to report the prevalence of knee varus-valgus malalignment (KVVM) and its association with body mass index (BMI) and body height in a healthy and fit young adult population. Information on the disability codes associated with KVVM according to the Regulations of Medical Fitness Determination was retrieved from a medical database containing records of 17-year-old males and females before their recruitment into mandatory military service. Logistic regression models assessed the association between the BMI and body height to KVVM. The study cohort included 821,381 subjects (4...
Source: Journal of Knee Surgery - May 4, 2018 Category: Orthopaedics Authors: Hershkovich, Oded Thein, Ran Gordon, Barak Burstein, Gideon Tenenbaum, Shay Derazne, Estela Tzur, Dorit Afek, Arnon Tags: Original Article Source Type: research

Gender Disparity between Absolute versus Relative Size of Condylar Chondral Defects: An MRI Analysis
J Knee Surg DOI: 10.1055/s-0038-1646932Surgical repair of articular cartilage defects in the knee currently utilizes surgical algorithms based on absolute defect size. These algorithms, which have not been validated, are currently utilized not only by surgeons but also by insurance carriers for justification of reimbursement policy. However, current algorithms do not account for morphological differences between individual patients and defect size relative to condylar dimension. We hypothesized that a significant difference in relative defect size compared with condylar dimension may exist between individuals. A 3T magneti...
Source: Journal of Knee Surgery - May 4, 2018 Category: Orthopaedics Authors: Berman, Daniel Rogers, Kelly Bonner, Kevin Griffin, Justin Tags: Original Article Source Type: research

Knee Osteoarthritis after Arthroscopic Partial Meniscectomy: Prevalence and Progression of Radiographic Changes after 5 to 12 Years Compared with Contralateral Knee
J Knee Surg DOI: 10.1055/s-0038-1646926The purpose of this study was to study the clinical and radiographic changes in the knee after arthroscopic partial meniscectomy (APM) at a long-term follow-up compared with the contralateral knee. We assessed 57 patients (38 males and 19 females) with pre- and postoperative weight-bearing radiography with a follow-up ranging from 5.1 to 12.1 years (mean: 8.1) to analyze prevalence and progression of knee osteoarthritis (OA) after APM. We stratified patients according to body mass index (BMI), type of lesion (degenerative vs. traumatic), and side of meniscectomy (medial, lateral, and ...
Source: Journal of Knee Surgery - May 3, 2018 Category: Orthopaedics Authors: Longo, Umile Giuseppe Ciuffreda, Mauro Candela, Vincenzo Rizzello, Giacomo D'Andrea, Valerio Mannering, Nicholas Berton, Alessandra Salvatore, Giuseppe Denaro, Vincenzo Tags: Original Article Source Type: research

Robotic-Arm Assisted Total Knee Arthroplasty Demonstrated Greater Accuracy and Precision to Plan Compared with Manual Techniques
This study determined if robotic-arm assisted total knee arthroplasty (RATKA) allows for more accurate and precise bone cuts and component position to plan compared with manual total knee arthroplasty (MTKA). Specifically, we assessed the following: (1) final bone cuts, (2) final component position, and (3) a potential learning curve for RATKA. On six cadaver specimens (12 knees), a MTKA and RATKA were performed on the left and right knees, respectively. Bone-cut and final-component positioning errors relative to preoperative plans were compared. Median errors and standard deviations (SDs) in the sagittal, coronal, and axi...
Source: Journal of Knee Surgery - May 1, 2018 Category: Orthopaedics Authors: Hampp, Emily L. Chughtai, Morad Scholl, Laura Y. Sodhi, Nipun Bhowmik-Stoker, Manoshi Jacofsky, David J. Mont, Michael A. Tags: Original Article Source Type: research

Evaluation of a Novel Degradable Synthetic Biomaterial Patch for Augmentation of Tendon Healing in a Large Animal Model
J Knee Surg DOI: 10.1055/s-0038-1646930Tendon injury is common in sports. The standard of care (SOC) for tendon repair is surgical treatment. However, restored tendons often lack complete strength and functionality, and surgical repair is often unsuccessful. This controlled laboratory study investigates the healing of an Artelon patch (AP)-augmented tendon versus tendon repair alone in a preclinical canine patellar tendon defect model. Full-thickness proximal and distal flap defects were created in the patella tendons of eight purpose-bred research mongrel dogs. Dogs were randomly allocated into either the AP-augmented rep...
Source: Journal of Knee Surgery - April 27, 2018 Category: Orthopaedics Authors: Gersoff, Wayne K. Bozynski, Chantelle C. Cook, Cristi R. Pfeiffer, Ferris M. Kuroki, Keiichi Cook, James L. Tags: Original Article Source Type: research