A Nationwide Analysis of Preoperative Planning on Operative Times and Postoperative Complications in Total Knee Arthroplasty
J Knee Surg DOI: 10.1055/s-0039-1677790Compared with nonelective total knee arthroplasties (TKAs), elective procedures have more time for preoperative planning, which allows for potentially improved patient optimization, risk factor modification, and patient education. The purpose of this study was to (1) determine nationwide trends in operative times and (2) evaluate associations between surgery type, elective or nonelective, with respect to (a) operative times, (b) length of stay (LOS), (c) discharge dispositions, (d) 30-day postoperative complications, (e) reoperations, and (f) readmissions. The American College of Surg...
Source: Journal of Knee Surgery - February 20, 2019 Category: Orthopaedics Authors: Sodhi, Nipun Anis, Hiba K. Coste, Marine Ehiorobo, Joseph O. Chee, Alexander Freund, Benjamin Sultan, Assem A. Moskal, Joseph T. Scuderi, Giles R. Mont, Michael A. Tags: Special Focus Section Source Type: research

The Who, What, and Where of Primary TKAs: An Analysis of HCUP Data from 2009 to 2015
J Knee Surg DOI: 10.1055/s-0039-1677857The aim of this study was to assess (1) temporal trends, (2) primary indication, (3) patient-level demographics (age, race, gender, health status, and median income quartile), and (4) region and hospital type for all patients receiving primary total knee arthroplasty (TKA) between 2009 and the third quarter of 2015. The National Inpatient Sample Database (NIS) was used to identify all patients who underwent a TKA between 2009 and the third quarter of 2015. Regression analysis was utilized to assess trends. Chi-square analysis was used to explore categorical variables whereas Kruskal&n...
Source: Journal of Knee Surgery - February 15, 2019 Category: Orthopaedics Authors: Gwam, Chukwuweike Rosas, Samuel Sullivan, Rashad Luo, T. David Emory, Cynthia L. Plate, Johannes F. Tags: Original Article Source Type: research

The Posterolateral Corner-Locked Technique Is Applicable in a Chinese Population Regarding the Tibial Component Rotation Alignment in Total Knee Arthroplasty
This study aims to assess the applicability of this technique in a Chinese population. Forty normal Chinese volunteers were recruited and underwent computed tomography (CT) of the lower limbs. Knee model reconstructions and simulated standard tibial osteotomy were conducted digitally. The transepicondylar axis (TEA), the Akagi line, and the line connecting the medial third of the tibial tubercle with the midpoint of the posterior cruciate ligament (PCL) were projected to the tibial cross-section and marked. The PLCL technique was applied using either symmetrical or asymmetrical tibial tray templates, and the anteroposterio...
Source: Journal of Knee Surgery - February 14, 2019 Category: Orthopaedics Authors: Fang, Chao-Hua Cheng, Cheng-Kung Qu, Tie-Bing Zhang, Jun-Hui Zhang, Bo Hua, Qun Yan, Shi-Gui Tags: Original Article Source Type: research

Tranexamic Acid Reduces Postoperative Blood Loss in Distal Femoral Osteotomy
J Knee Surg DOI: 10.1055/s-0039-1678540Blood loss remains a significant source of morbidity and mortality in orthopaedic surgery, with transfusions associated with an increased risk of infection, length of stay, delayed rehabilitation, and significantly increased hospitalization costs. The purpose of this study was to assess whether the use of tranexamic acid (TXA) is effective in reducing postoperative blood loss in patients undergoing distal femoral osteotomy (DFO). A retrospective review was performed of all patients undergoing DFO by a single surgeon from 2010 to 2017, with a change in protocol occurring in 2014, after...
Source: Journal of Knee Surgery - February 12, 2019 Category: Orthopaedics Authors: Steinhaus, Michael E. Buksbaum, Joshua Eisenman, Avraham Kohli, Monal Fragomen, Austin T. Rozbruch, S. Robert Tags: Original Article Source Type: research

Postoperative Infection in Cementless and Cemented Total Knee Arthroplasty: A Propensity Score Matched Analysis
J Knee Surg DOI: 10.1055/s-0039-1678678The ongoing debate on fixation in total knee arthroplasty (TKA) has become increasingly relevant with its increased use in a younger patient population and the advent of novel cementless prostheses. Recent literature suggests modern cementless implants are comparable to their cemented counterparts in terms of survivorship and functional outcomes. What has not been well-assessed is whether the two modalities differ with respect to infection rates which was the purpose of this study. Specifically, a propensity score matched study population was used to compare: (1) overall infection; (2...
Source: Journal of Knee Surgery - February 12, 2019 Category: Orthopaedics Authors: Anis, Hiba K. Ramanathan, Deepak Sodhi, Nipun Klika, Alison K. Piuzzi, Nicolas S. Mont, Michael A. Higuera, Carlos A. Molloy, Robert M. Tags: Original Article Source Type: research

Higher Axial Tibiofemoral Rotation and Functional Outcomes with Mobile-Bearing Compared with Fixed-Bearing Total Knee Arthroplasty at 1- but Not at 2-Year Follow-Up – A Randomized Clinical Trial
The objective of this study was to determine in vivo knee kinematics and clinical outcomes of patients who underwent fixed- and mobile-bearing total knee arthroplasty (TKA) at 1- and 2-year follow-up. This prospective double-blinded randomized controlled trial was performed from November 2011 to December 2012. A total of 64 patients were randomized to fixed- and mobile-bearing TKA groups (32 patients in each group). All patients were evaluated with the following: three-dimensional in vivo knee kinematics analysis during gait, stepping up and stepping down stair steps, and getting up from and sitting on a chair; and knee ra...
Source: Journal of Knee Surgery - February 12, 2019 Category: Orthopaedics Authors: Amaro, Joicemar Tarouco Novaretti, Jo ão Victor Astur, Diego Costa Cavalcante, Elton Luiz Batista Rodrigues Junior, Adilson G óes Debieux, Pedro Kaleka, Camila Cohen Cohen, Mois és Tags: Original Article Source Type: research

Preoperative Chronic Opioid Use and Its Effects on Total Knee Arthroplasty Outcomes
J Knee Surg DOI: 10.1055/s-0039-1678538Unsafe opioid distribution remains a major concern among the total knee arthroplasty (TKA) population. Perioperative opioid use has been shown to be associated with poorer outcomes in patients undergoing TKA including longer length of stay (LOS) and discharges to extended care facilities. The current study aims to detail perioperative opioid use patterns and investigate the effects of preoperative chronic opioid use on perioperative quality outcomes in TKA patients. A retrospective analysis was performed on 338 consecutive TKAs conducted at our institution. Two cohorts were compared i...
Source: Journal of Knee Surgery - February 11, 2019 Category: Orthopaedics Authors: Kim, Kelvin Chen, Kevin Anoushiravani, Afshin A. Roof, Mackenzie Long, William J. Schwarzkopf, Ran Tags: Original Article Source Type: research

Cemented versus Cementless Stems in Revision Total Knee Arthroplasty
J Knee Surg DOI: 10.1055/s-0039-1678686Successful arthroplasty of the knee requires a stable foundation for implant placement, adequate mechanical alignment, and durable fixation. In the revision setting, the later may be difficult to obtain, especially in the setting of significant bone loss. While augments, cones, and sleeves have greatly enhanced the modern knee surgeon's ability to gain fixation in metaphyseal bone, stems continue to be a cornerstone tool in revision arthroplasty to bypass deficient or damaged bone surfaces to enhance structural stability of a revision construct. When placing a revision construct, ther...
Source: Journal of Knee Surgery - February 8, 2019 Category: Orthopaedics Authors: Driesman, Adam S. Macaulay, William Schwarzkopf, Ran Tags: Special Focus Section Source Type: research

Torsional Osteotomy
This article provides an overview of symptomatic torsional deformities of the lower extremity, and operative treatment techniques are described in detail. A definition of torsion versus rotation as well as information to physical examination and the relevance of radiological evaluation is given. Based on current literature and the own personal experience of the authors in osteotomies, surgical techniques at the proximal and at the distal femur, as well as at the tibia are presented. [...] Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of contents  | &...
Source: Journal of Knee Surgery - February 8, 2019 Category: Orthopaedics Authors: Schr öter, Steffen Nakayama, Hiroshi Ihle, Christoph Ateschrang, Atesch Maiotti, Marco Harrer, J örg Dickschas, J örg Tags: Original Article Source Type: research

Survivorship and Functional Outcomes of Cementless versus Cemented Total Knee Arthroplasty: A Meta-Analysis
J Knee Surg DOI: 10.1055/s-0039-1678525The purpose of this meta-analysis was to assess the evidence supporting the use of cementless versus cemented total knee arthroplasties (TKAs). Specifically, we evaluated (1) all-cause survivorship, (2) aseptic survivorship, and (3) functional outcomes (Knee Society Scores [KSS], Oxford Knee Scores, Western Ontario and McMaster Universities Osteoarthritis Index [WOMAC] scores, and ranges of motion [ROMs]). A literature search was performed for studies that evaluated cementless versus cemented TKAs published between 2000 and 2017. Selected studies included three randomized controlled t...
Source: Journal of Knee Surgery - February 8, 2019 Category: Orthopaedics Authors: Newman, Jared M. Sodhi, Nipun Dekis, Joanne C. Khlopas, Anton Piuzzi, Nicolas S. Sultan, Assem A. Levin, Jay M. Mont, Michael A. Tags: Original Article Source Type: research

Highly Satisfied Total Knee Arthroplasty Patients Display a Wide Range of Soft Tissue Balance
We examined a range of postoperative coronal plane laxity parameters and the correlation between preoperative and postoperative laxity. Total postoperative coronal laxity arcs at maximum extension and 20 degrees of flexion varied between 2 and 12 and 3 and 13 degrees, respectively. Depending on the position of measurement, medial laxity was between 0.5 and 9.5 degrees and lateral laxity between 1 and 12 degrees. The change in laxity between maximum extension and 90 degrees of flexion demonstrated a range of 7 degrees medially and 12 degrees laterally. The total coronal arc of movement did not affect functional outcomes. A ...
Source: Journal of Knee Surgery - February 8, 2019 Category: Orthopaedics Authors: McAuliffe, Michael J. O'Connor, Patrick B. Major, Lisa J. Garg, Gautam Whitehouse, Sarah L. Crawford, Ross W. Tags: Original Article Source Type: research

Necessary Factors to Achieve Deep Flexion for Asian Populations after Oxford Unicompartmental Knee Arthroplasty
The objective of this study was to clarify the relationship between outcomes and the postoperative maximum flexion angle and reveal the necessary factors for maximum flexion angle ≥ 140 degrees which is considered necessary for Asian populations. We categorized 212 UKA patients into the following three groups based on the postoperative maximum flexion angle: group 1 had flexion angle ≥ 140 degrees in 80 patients (38%), group 2 had 130 degrees ≤ flexion angle 
Source: Journal of Knee Surgery - February 8, 2019 Category: Orthopaedics Authors: Inui, Hiroshi Taketomi, Shuji Yamagami, Ryota Kawaguchi, Kohei Nakazato, Keiu Tanaka, Sakae Tags: Original Article Source Type: research

The Effect of Implant Design on Sagittal Plane Stability: A Randomized Trial of Medial- versus Posterior-Stabilized Total Knee Arthroplasty
J Knee Surg DOI: 10.1055/s-0039-1678524Up to 20% of total knee arthroplasty (TKA) patients report dissatisfaction with their outcome, especially with weight-bearing in flexion (WBiF) activities. Sagittal plane instability may contribute to dissatisfaction following TKA. We assessed the impact of implant design on TKA sagittal plane stability and clinical satisfaction. We randomized patients to receive one of two TKA implant designs: medial-stabilized (MS) or posterior-stabilized (PS). Sagittal stability was assessed using a KT-1000 arthrometer. Patient-reported outcome measures, including a custom bank of questions targeti...
Source: Journal of Knee Surgery - February 8, 2019 Category: Orthopaedics Authors: Edelstein, Adam I. Bhatt, Surabhi Wright-Chisem, Josh Sullivan, Ryan Beal, Matt Manning, David W. Tags: Original Article Source Type: research

Is Intraoperative Fluoroscopy Necessary to Confirm Device Position for Femoral-Sided Cortical Suspensory Fixation during Anterior Cruciate Ligament Reconstruction?
This study evaluates the benefit of intraoperative fluoroscopy to confirm device position on the femur during ACL reconstruction using cortical suspensory fixation. One hundred consecutive patients who underwent soft tissue ACL reconstruction using a suspensory cortical device for femoral fixation were retrospectively evaluated. Patients were split into two groups: Group A utilized anteromedial portal visualization and had intraoperative fluoroscopic imaging performed at the time of ACL graft fixation to confirm femoral device placement on the lateral femoral metaphyseal cortex. Group B utilized anteromedial portal visuali...
Source: Journal of Knee Surgery - February 8, 2019 Category: Orthopaedics Authors: Balldin, B. Christian Nuelle, Clayton W. DeBerardino, Thomas D. Tags: Original Article Source Type: research

Are Subchondral Intraosseous Injections Effective and Safe for the Treatment of Knee Osteoarthritis? A Systematic Review
J Knee Surg DOI: 10.1055/s-0039-1677792Knee osteoarthritis (OA) is a highly prevalent disease and treatment options for early stages of OA are needed. Intraosseous injections of bone substitute and biologic materials have been proposed to expand the therapeutic arsenal by potentially halting OA progression and delaying the need for knee arthroplasty in patients with early/moderate-stage disease. Therefore, the goal of this study was assessed the efficacy and safety of subchondral intraosseous injection for the treatment of knee OA. A systematic review was performed on PubMed-Medline, and the Cochrane Database of systematic...
Source: Journal of Knee Surgery - February 6, 2019 Category: Orthopaedics Authors: Sundaram, Kavin Vargas-Hern ández, Juan S. Sanchez, Tomas Roca Moreu, Nestor Moreno Mont, Michael A. Higuera, Carlos A. Piuzzi, Nicolas S. Tags: Special Focus Section Source Type: research

Biomechanical Properties of Bioabsorbable Fixation for Osteochondral Shell Allografts
This study compares bioabsorbable nail to metal screw fixation of shell osteochondral allograft (OCAs) for compression and shear strength. Cadaveric distal femurs (n = 5) yielding six 1.5 cm shell grafts (n = 30) were used. Three different fixation methods (2.0 and 2.4 mm headed screws, and copolymer absorbable nail) were compared for statistically significant differences (p 
Source: Journal of Knee Surgery - February 6, 2019 Category: Orthopaedics Authors: Thomas, Dimitri M. Stannard, James P. Pfeiffer, Ferris M. Cook, James L. Tags: Original Article Source Type: research

Cementless 3D Printed Highly Porous Titanium-Coated Baseplate Total Knee Arthroplasty: Survivorship and Outcomes at 2-Year Minimum Follow-Up
J Knee Surg DOI: 10.1055/s-0039-1677842Newer generation cementless total knee arthroplasty (TKA) implants continue to develop with demonstrated clinical success in multiple recent reports. The purpose of this study was to investigate (1) survivorship, (2) complications, and (3) clinical outcomes of a newer generation cementless and highly porous titanium-coated base plate manufactured using three-dimensional (3D) printing technology. We reviewed a single-surgeon, longitudinally maintained database of patients who underwent primary TKA using cementless, highly porous titanium-coated base plate implants from July 1, 2013 to ...
Source: Journal of Knee Surgery - February 6, 2019 Category: Orthopaedics Authors: Sultan, Assem A. Mahmood, Bilal Samuel, Linsen T. Stearns, Kim L. Molloy, Robert M. Moskal, Joseph T. Krebs, Viktor E. Harwin, Steven F. Mont, Michael A. Tags: Original Article Source Type: research

Gender Disparity between Donor Sites of the Trochlea Used for Autologous Osteoarticular Transfer: An MRI Analysis
J Knee Surg DOI: 10.1055/s-0039-1677813The purpose of this study was to assess potential gender differences in size of the lateral and medial trochlea of the male and female knee as well as the variation within gender of potential osteochondral autograft transfer (OAT) donor site area. Two hundred and twelve skeletally mature patients, 106 males and 106 females, who underwent a 3T magnetic resonance imaging of the knee for a variety of indications were utilized for analysis. Exclusion criteria included degenerative arthritis, trochlear dysplasia, and poor image quality. Medial and lateral femoral trochlear cartilage width ...
Source: Journal of Knee Surgery - February 6, 2019 Category: Orthopaedics Authors: Rogers, Kelly M. Berman, Daniel C. Griffin, Justin W. Bonner, Kevin F. Tags: Original Article Source Type: research

Risk Factors for Tibial Component Oversizing in Total Knee Arthroplasty among African Americans
J Knee Surg DOI: 10.1055/s-0039-1677817Incidences and risk factors for tibial component oversizing in total knee arthroplasty (TKA) have been well described, predominantly in Caucasian samples. Component oversizing has been linked to variations in proximal tibial shape and morphology, which has been found to be objectively different in African Americans compared with Caucasians. These anthropometric differences may affect the conformity of modern TKA systems to the anatomy of African Americans undergoing TKA. We sought to investigate the incidence and risk factors for tibial baseplate oversizing in an exclusively African A...
Source: Journal of Knee Surgery - February 6, 2019 Category: Orthopaedics Authors: Padmanabha, Anand Li, Michael T. Tybor, David J. Smith, Eric L. Tags: Original Article Source Type: research

Total Knee Arthroplasty for Fixed Valgus Deformity Correction Using a Modified Lateral Parapatellar Approach
We present a case series of a single institution's experience with use of a modified LPA using a Z-capsuloplasty for 35 primary TKA cases in 30 patients with osteoarthritis and Ranawat's type-II fixed valgus deformity with attenuation of medial soft tissues. The mean age of patients was 64.8 years (range: 42–78 years). Follow-up duration was a mean of 47.3 months (range: 3–130 months). The patients were assessed pre- and postoperatively using radiographic measurement of the anatomic femorotibial angle (FTA) and clinical measurement of range of motion (ROM) and the Chinese knee society score (KSS). Complications...
Source: Journal of Knee Surgery - February 6, 2019 Category: Orthopaedics Authors: Li, Hu Ponzio, Danielle Y. Ong, Alvin Wei, Wei Wang, Baicheng Li, Zhichang Zhou, Diange Tags: Original Article Source Type: research

Revision Single-Stage Anterior Cruciate Ligament Reconstruction Using an Anterolateral Tibial Tunnel
This study showed that ACL revision surgery with ALTT can reliably restore stability and provide fair functional outcomes in patients with ACL retear. One could expect acceptable lateral tibial tunnel length compared with medial tibial tunnel in classic ACL revision, intact bony surround, and good graft fixation. This technique is clinically relevant in that making an anterolateral tunnel in one-stage ACL revision surgery had a good subjective result with low complication rate in midterm follow-up. [...] Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of contents&nbs...
Source: Journal of Knee Surgery - February 6, 2019 Category: Orthopaedics Authors: Keyhani, Sohrab Hanafizadeh, Behzad Verdonk, Ren é Sajjadi, Mohammadreza Minator Soleymanha, Mehran Tags: Original Article Source Type: research

Kinematic Alignment in Cruciate Retaining Implants Improves the Biomechanical Function in Total Knee Arthroplasty during Gait and Deep Knee Bend
J Knee Surg DOI: 10.1055/s-0039-1677846Kinematic alignment (KA), which co-aligns the rotational axes of the components with three kinematic axes of the knee by aligning the components to the prearthritic joint lines, has been a recently introduced surgical technique. However, whether KA and cruciate retaining (CR) implants provide better biomechanical function during activities than mechanical alignment (MA) in posterior stabilized (PS) implants is unclear. We evaluated the biomechanical functions during the stance phase gait and deep knee bend, with a computer simulation and measured forces in the medial and lateral colla...
Source: Journal of Knee Surgery - February 6, 2019 Category: Orthopaedics Authors: Kang, Kyoung-Tak Koh, Yong-Gon Nam, Ji Hoon Kwon, Sae Kwang Park, Kwan Kyu Tags: Original Article Source Type: research

The Impact of Gender on Postoperative Complications after Revision Total Knee Arthroplasty
This study included 9,914 patients who underwent revision TKA (females = 5,728 [57.8%]; males = 4 186 [42.2%]). Male patients were shown to be at greater risk for developing 7 of 17 complications compared with female patients, and female patients were shown to be at greater risk for urinary tract infection (UTI) development. Multivariate analysis showed males as an independent risk factor for four complications and females as an independent risk factor for UTI development. Male patients were more likely to develop more complications postoperatively than female patients. Although the possibility ...
Source: Journal of Knee Surgery - February 6, 2019 Category: Orthopaedics Authors: Gu, Alex Wei, Chapman Bernstein, Simone A. Nguyen, Nam Tran T. Sobrio, Shane A. Liu, Jiabin Sculco, Peter K. Tags: Original Article Source Type: research

Medium-Term Results after Surgical Treatment of High-Energy Tibial Plateau Fractures
J Knee Surg DOI: 10.1055/s-0039-1677822The aim of the article is to present the medium-term results of surgical treatment of Schatzker's IV, V, and VI tibial plateau fractures, in a retrospective study of 22 patients at a level-1 trauma center. Twenty-two of 34 patients with Schatzker's IV–VI fractures completed follow-up at a mean of 56 months (range: 7–103 months). Patients' mean age was 47.6 years (range: 18–76 years). Open reduction and internal fixation were performed in 16 patients, while external fixators were used in the remaining six patents. Patients were assessed radiologically for the presence...
Source: Journal of Knee Surgery - February 6, 2019 Category: Orthopaedics Authors: Evangelopoulos, Dimitrios Chalikias, Stavros Michalos, Mihail Vasilakos, Dimitrios Pappa, Eleni Zisis, Konstantinos Koundis, George Kokoroghiannis, Constantine Tags: Original Article Source Type: research

Knee Injuries in the Military
J Knee Surg 2019; 32: 117-117 DOI: 10.1055/s-0038-1677014 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 - February 5, 2019 Category: Orthopaedics Authors: Haley, Chad A. Posner, Matthew A. Tags: Special Focus Section Source Type: research

The Correlation of Shoe Size and Component Size of Primary Total Knee Arthroplasty
J Knee Surg DOI: 10.1055/s-0039-1677841Preoperative planning is an important phase of total joint arthroplasty. Current template programs and methods only provide moderate accuracy for implant size prediction. Recently, a relationship between shoe size and implant size was found. We hypothesized that shoe size shows a high percentage of agreement for implant size of both femoral and tibial component size in primary total knee arthroplasty (TKA). The aim of this study was to investigate the correlation and agreement between shoe size and TKA implant size. We performed a retrospective cohort study. Of all patients, who under...
Source: Journal of Knee Surgery - February 4, 2019 Category: Orthopaedics Authors: van Egmond, Jeroen Cornelis Verburg, Hennie Hesseling, Brechtje Mathijssen, Nina Maria Cornelia Tags: Original Article Source Type: research

Total Articular Knee Replacement Using Polyurethane
This study reviewed the early use of polyurethane for total knee resurfacing, the long-term results of polycarbonate urethane (PCU) for total knee replacement and conducted wear simulator testing of PCU. In 1959 and 1960, 10 patients underwent total articular polyurethane knee replacement (polyethylene was not available). The polyurethane was placed on the articular surface of the femur with metal surfaces on the tibia and patella. In 1996 and 1997, four patients received a newer PCU tibial insert in revision procedures; all had well-fixed prostheses, but no revision polyethylene implants were available. In addition, this ...
Source: Journal of Knee Surgery - February 4, 2019 Category: Orthopaedics Authors: Pritchett, James W. Tags: Original Article Source Type: research

Body Mass Index Classification Is Independently Associated with Health-Related Quality of Life after Primary Total Knee Arthroplasty: An Institutional Registry-Based Study
J Knee Surg DOI: 10.1055/s-0039-1677811The purpose of this study was to compare the health-related quality of life (HRQoL) before and after successful total knee arthroplasty (TKA) across World Health Organization (WHO) body mass index (BMI) classifications. Through an institutional registry, patients with end-stage knee osteoarthritis who received elective primary unilateral TKA were identified and categorized based on WHO BMI classification. Age, gender, laterality, year of surgery, and Charlson–Deyo comorbidity index were recorded. The primary outcome was the EQ-5D-3L index and visual analog scale (VAS) at 2 years...
Source: Journal of Knee Surgery - February 1, 2019 Category: Orthopaedics Authors: Steinhaus, Michael E. Buller, Leonard T. Romero, Jose A. Lee, Yuo-Yu Figgie, Mark P. McLawhorn, Alexander S. Tags: Original Article Source Type: research

A New Total Knee Arthroplasty Design Has Significantly Better Early Implant Survivorship than a Previous Gold-Standard Design —A Retrospective Analysis of 1,000 Cases
This study examined whether a new total knee arthroplasty (TKA) prosthesis improved implant survivorship and reoperation rates compared with a gold-standard, established TKA. A retrospective analysis of the first 500 consecutive new TKAs was compared with a consecutive series of the last 500 currently available TKAs performed by a single senior surgeon in one center. The primary outcome measure was revision of the femoral, tibial, or patellar component. A secondary outcome was reoperation for any reason. The new-TKA group had a significantly reduced revision rate at up to 5 years follow-up (p = 0.02). Reopera...
Source: Journal of Knee Surgery - February 1, 2019 Category: Orthopaedics Authors: Bloch, Benjamin V. Palan, Jeya Shahid, Mohammad James, Peter J. Tags: Original Article Source Type: research

Autologous Patellar Tendon Reconstruction after Total Knee Arthroplasty Infection with Skin Loss: Anatomical Study and Case Report
J Knee Surg DOI: 10.1055/s-0038-1677498Disruption of patellar tendon after total knee arthroplasty (TKA) is a devastating complication. If associated with infection or soft tissue defect, knee arthrodesis is usually indicated. The purpose of this study is to analyze, by means of an anatomical study, the feasibility of our novel technique for reconstruction of extensor apparatus after TKA infections with skin defects, combining gracilis (G) and semitendinosus (ST) tendon autografts and chimeric medial gastrocnemius-sural artery perforator (SAP) flap. In addition, to report on the use of this reconstruction, we described an ...
Source: Journal of Knee Surgery - January 29, 2019 Category: Orthopaedics Authors: P érez-García, Alberto Esteban-Vico, Juan Ramon Garc ía-Sánchez, Jose María Baeza, Jos é Soriano, Francisco Mart ínez Valverde Navarro, Alfonso Amador Garc ía-Granero, Álvaro Sim ón-Sanz, Eduardo Tags: Original Article Source Type: research

Erratum to: Gender Differences in Intra-articular and Extra-articular Injuries Associated with Acute Anterior Cruciate Ligament Ruptures
J Knee Surg DOI: 10.1055/s-0039-1678598 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 - January 29, 2019 Category: Orthopaedics Authors: Tan, Si Heng Sharon Kripesh, Aishwarya Chan, Chloe Xiaoyun Krishna, Lingaraj Tags: Erratum Source Type: research

Erratum to: Correlation of Meniscal Tear with Timing of Anterior Cruciate Ligament Reconstruction in Patients without Initially Concurrent Meniscal Tear
J Knee Surg DOI: 10.1055/s-0039-1678599 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 - January 29, 2019 Category: Orthopaedics Authors: Chen, Kun-Hui Chiang, En-Rung Wang, Hsin-Yi Ma, Hsiao-Li Tags: Erratum Source Type: research

The Difference between Cartilaginous and Bony Sulcus Angles for Patients with or without Patellofemoral Instability: A Systematic Review and Meta-analysis
J Knee Surg DOI: 10.1055/s-0038-1677541The cartilaginous sulcus angle and bony sulcus angle have been widely used to evaluate trochlea dysplasia. The current review aims to evaluate (1) whether there is a difference in measurement for cartilaginous and bony sulcus angles, (2) whether both the cartilaginous and bony sulcus angles could be used to differentiate between patients with or without trochlear dysplasia, and (3) whether the same cut-off of 145 degrees, originally used for radiographs, can be applied for the cartilaginous and bony sulcus angles measured on CT and MRI. The review was conducted using the Preferred Rep...
Source: Journal of Knee Surgery - January 24, 2019 Category: Orthopaedics Authors: Tan, Si Heng Sharon Chng, Kiat Soon Jason Lim, Beatrice Ying Wong, Keng Lin Doshi, Chintan Lim, Andrew Kean Seng Hui, James Hoipo Tags: Original Article Source Type: research

VIS-IT: Visualizing the Injured Tibia —A Cadaveric Study of Limb Positioning for Posterolateral Tibial Plateau Fracture Visualization
J Knee Surg DOI: 10.1055/s-0038-1676799Posterolateral tibial plateau (PLTP) fractures are often associated with anterior cruciate ligament (ACL) incompetence, such as tibial eminence fractures. Both occur from a pivot shift like mechanism. Malreductions of the tibial plateau most frequently occur in the posterolateral quadrant. Acquiring adequate intraoperative visualization of the PLTP poses a challenge. We hypothesized that visualization of PLTP could be improved by positioning the knee at 110 degrees of flexion with the addition of a varus anterolateral rotatory vector. This position and maneuver take advantage of both ...
Source: Journal of Knee Surgery - January 24, 2019 Category: Orthopaedics Authors: Kendal, Joseph K. Clark, Damian Longino, David Marion, Travis E. Buckley, Richard Schneider, Prism S. Martin, Ryan Tags: Original Article Source Type: research

The Occurrence of Meniscal and Chondral Injury in Two-Stage Revision Anterior Cruciate Ligament Reconstruction: A Consecutive Case Series
In conclusion, approximately 10% of patients developed a new meniscal tear and no difference in macroscopic chondral injury was observed between the first and second stages. [...] 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 - January 18, 2019 Category: Orthopaedics Authors: van Tol, Floris R. Kernkamp, Willem A. van der Wal, Robert J. P. Swen, Jan-Willem A. Van de Velde, Samuel K. van Arkel, Ewoud R. A. Tags: Original Article Source Type: research

Benign Bone Tumors When They Coexist with Common Orthopaedic Conditions
This article aims to provide general guidelines and management strategies for benign bone tumors when they coincide with common orthopaedic conditions around the knee. [...] 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 - January 16, 2019 Category: Orthopaedics Authors: Hasan, Khalid Nguyen, Duc M. Conway, Sheila A. Tags: Special Focus Section Source Type: research

Residual Mild Varus Alignment and Neutral Mechanical Alignment Have Similar Outcome after Total Knee Arthroplasty for Varus Osteoarthritis in Five-Year Follow-Up
In this study, we compared the midterm clinical and functional outcomes in patients with different residual varus. A retrospective review of 175 patients (219 knees) with varus OA was > 3° for the hip-knee-ankle (HKA) who underwent primary TKA after exclusions and loss to follow-up from 237 patients (281 knees). The mean follow-up period was 5.2 ( ±  1.1) years. Patients were divided into four groups according to the first postoperative HKA angle from weight-bearing full-leg radiographs: “valgus” group (HKA angle > 0°, n = 44), ...
Source: Journal of Knee Surgery - January 16, 2019 Category: Orthopaedics Authors: Zhang, Zhiqi Liu, Can Li, Zhiwen Wu, Peihui Hu, Shu Liao, Weiming Tags: Original Article Source Type: research

Restoration of Constitutional Alignment in TKA with a Novel Osteotomy Technique
This study provides a novel technique to restore preoperative CA in patients with varus knees and BFLB. It is found that the distal femur should be cut perpendicular to DMA, so the lower limb alignment and soft tissue strains can be restored to the preoperative state, and the knees would be stable and in a natural status after TKA. [...] 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 - January 16, 2019 Category: Orthopaedics Authors: Wang, Zhibing Cheng, Xingwang Zhang, Yuan Zhang, Xia Zhou, Yue Tags: Original Article Source Type: research

Postoperative Complications and Impact of Diabetes Mellitus Severity on Revision Total Knee Arthroplasty
J Knee Surg DOI: 10.1055/s-0038-1677542Total knee arthroplasty (TKA) is a common and effective treatment of knee osteoarthritis. As the amount of TKAs performed increases, so does the number of TKA failures and subsequent revisions. Diabetes mellitus (DM) has been shown to increase complications following orthopaedic procedures. For these reasons, it is important to understand the association between severity of DM and the risk of postoperative adverse events following revision TKA. A retrospective cohort study was conducted using the American College of Surgeons' National Surgical Quality Improvement Program database. Pat...
Source: Journal of Knee Surgery - January 16, 2019 Category: Orthopaedics Authors: Gu, Alex Wei, Chapman Robinson, Hannah N. Sobrio, Shane A. Liu, Jiabin Sculco, Thomas P. Sculco, Peter K. Tags: Original Article Source Type: research

Metal-Backed Tibial Components Do Not Reduce Risk of Early Aseptic Loosening in Unicompartmental Knee Arthroplasty: A Systematic Review and Meta-Analysis
J Knee Surg DOI: 10.1055/s-0038-1677506Long-term results of unicompartmental knee arthroplasty (UKA) have shown a slightly higher revision rate than total knee arthroplasty (TKA), and implant fixation geometry seems to affect prosthetic survivorship. Whether metal-backed tibial component leads to superior performance over the all-polyethylene design is unclear, and a lack of evidence exists in literature. Our purpose was to demonstrate which implant design of UKA (all-polyethylene or metal-backed tibial component) is clinically superior regarding revision rates and clinical functioning, and investigate the role of potentia...
Source: Journal of Knee Surgery - January 16, 2019 Category: Orthopaedics Authors: Costa, Giuseppe Gianluca Lo Presti, Mirco Grassi, Alberto Agr ò, Giuseppe Cialdella, Sergio Mosca, Massimiliano Caravelli, Silvio Zaffagnini, Stefano Tags: Original Article Source Type: research

Management of Chronic Infected Intra-Articular Fractures of the Proximal Tibia with Ilizarov Ring Fixation
This study assessed the outcome of chronic infected intra-articular proximal tibial fractures with and without metaphyseal bone loss managed with the Ilizarov ring fixator. A series of six patients of intra-articular infected nonunion of the tibial plateau and two patients with malunited plateau with metaphyseal nonunion were treated in a tertiary care hospital. Three of these eight patients had a metaphyseal bone loss or bone gap after debridement and underwent internal transport with distal corticotomy to obtain the bone length. The remaining five patients underwent static ring fixation after correction of the articular ...
Source: Journal of Knee Surgery - January 16, 2019 Category: Orthopaedics Authors: Bhowmick, Kaushik Boopalan, P.R.J.V.C. Gunasekeran, Chandrasekaran Livingston, Abel Jepegnanam, Thilak Samuel Tags: Original Article Source Type: research

Knee Cell-Based Cartilage Restoration
J Knee Surg DOI: 10.1055/s-0038-1676378As our patients become more physically active at all ages, the incidence of injuries to articular cartilage is increasing causing significant pain and disability. The intrinsic healing response of articular cartilage is poor because of its limited vascular supply and capacity for chondrocyte division. Nonsurgical management for the focal cartilage lesion is successful in the majority of patients. Those patients who fail conservative management may be candidates for a cartilage reparative or reconstructive procedure. The type of treatment available depends on a multitude of lesion-spec...
Source: Journal of Knee Surgery - January 10, 2019 Category: Orthopaedics Authors: Pickett, Adam M. Hensley, Dana T. Tags: Special Focus Section Source Type: research

Meniscus Injuries in the Military Athlete
J Knee Surg DOI: 10.1055/s-0038-1676959Meniscal injuries in the young, active patient are often challenging injuries for the orthopaedic surgeon whose goal is to provide pain-free return to play/military duty and preserve maximal meniscal integrity. In the U.S. military, the incidence rate of meniscal tears is almost 10 times higher than that of the civilian population; although, the rates of reoperation following meniscal repair are fairly similar. The decision to pursue meniscal debridement versus repair is multifactorial depending on tear characteristics, concomitant injury, patient characteristics, and goals. Meniscal ...
Source: Journal of Knee Surgery - January 10, 2019 Category: Orthopaedics Authors: Donohue, Michael A. Zhou, Liang Haley, Chad A. Tags: Special Focus Section Source Type: research

Thirty-Day Unplanned Readmission after Total Knee Arthroplasty at a Teaching Community Hospital: Rates, Reasons, and Risk Factors
This study identified 7,482 primary TKA procedures of which 210 (2.8%) were unplanned readmissions. Gastrointestinal bleed (9.05%) and periprosthetic infection (8.10%) were the most common causes of readmission. Age 65 and older (odds ratio [OR], 1.64; 95% confidence interval [CI], 1.21–2.21; p = 0.0012), male (OR, 1.37; 95% CI, 1.03–1.83; p = 0.0302), length of stay > 3 days (OR, 2.04; 95% CI, 1.45–2.86; p 
Source: Journal of Knee Surgery - January 10, 2019 Category: Orthopaedics Authors: Workman, Kalain K. Angerett, Nathan Lippe, Ronald Shin, Alex King, Scott Tags: Original Article Source Type: research

Total Knee Arthroplasty Is Safe in Jehovah's Witness Patients —A 12-Year Perspective
J Knee Surg DOI: 10.1055/s-0038-1676372Despite the evolution of blood management protocols, total knee arthroplasty (TKA) occasionally requires allogeneic blood transfusion. This poses a particular challenge for Jehovah's Witnesses (JW) who believe that the Bible strictly prohibits the use of blood products. The aim of this study was to compare JW and a matched-control cohort of non-JW candidates undergoing TKA to assess the safety using modern blood management protocols. Fifty-five JW patients (63 knees) who underwent TKA at our institution between 2005 and 2017 were matched to 63 non-JW patients (63 knees). Patient demog...
Source: Journal of Knee Surgery - January 8, 2019 Category: Orthopaedics Authors: Wolfson, Theodore S. Novikov, David Chen, Kevin K. Kim, Kelvin Y. Anoushiravani, Afshin A. Deshmukh, Ajit J. Lajam, Claudette M. Tags: Original Article Source Type: research

Distribution of the Force in the Knee Joint during Daily Activities after Open Wedge High Tibial Osteotomy: A Rationale for the Proper Postoperative Management
J Knee Surg DOI: 10.1055/s-0038-1676772The present study was conducted to evaluate the force distribution in knee joint during daily activities after open-wedge high tibial osteotomy (OWHTO). A three-dimensional proximal tibial finite element model (FEM) was created using Mimics software to evaluate computed tomography (CT) scans of the tibia after OWHTO. The anterior and posterior gaps were 7.0 and 12.1 mm, respectively, and the target opening angle was 12 degrees. The loading ratio of the medial and lateral tibial plateaus was 6:4. To evaluate force distribution in the knee joint during activities of daily living ...
Source: Journal of Knee Surgery - January 8, 2019 Category: Orthopaedics Authors: Seo, Hansol Lim, Dohyung Jang, Young Woong Kang, Kwan-su Lee, Myung Chul Lee, O-Sung Im, Byeong-Eun Lee, Yong Seuk Tags: Original Article Source Type: research

The Effects of Surgical Technique in Total Knee Arthroplasty for Varus Osteoarthritic Knee on the Rotational Alignment of Femoral Component: Gap Balancing Technique versus Measured Resection Technique
J Knee Surg DOI: 10.1055/s-0038-1676766Few studies have compared the accuracy of femoral component rotation in the measured resection technique according to the preoperative computed tomography (CT) and gap balancing technique. The aim of this study was to evaluate whether there is a difference in accuracy and outlier incidence of femoral component rotation between gap balancing and measured resection techniques with or without preoperative CT and to evaluate the difference in patellofemoral alignment on simple radiographs and clinical outcomes. In this retrospective study, we evaluated femoral component rotation angle on ...
Source: Journal of Knee Surgery - January 8, 2019 Category: Orthopaedics Authors: Kim, Chang-Wan Lee, Chang-Rack Gwak, Heui-Chul Kim, Jung-Han Kwon, Yong-Uk Kim, Doo-Yeol Tags: Original Article Source Type: research

Primary and Posttraumatic Knee Osteoarthritis in the Military
J Knee Surg DOI: 10.1055/s-0038-1676956Osteoarthritis is a particularly burdensome and career-limiting condition for military service members. The daily demands of military service place the service members at a baseline increased risk of developing primary OA as well as increased risk of acute knee injuries that further predispose to developing posttraumatic OA. There are multiple treatment options available for primary and posttraumatic OA from osteotomy to arthroplasty. [...] Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of contents  |  Abstr...
Source: Journal of Knee Surgery - January 4, 2019 Category: Orthopaedics Authors: Rodriguez, Marina J. Garcia, E'Stephan J. Dickens, Jon F. Tags: Special Focus Section Source Type: research

Results of a Phase II Study to Determine the Efficacy and Safety of Genetically Engineered Allogeneic Human Chondrocytes Expressing TGF- β1
J Knee Surg DOI: 10.1055/s-0038-1676803Genetically engineered chondrocytes virally transduced with a transforming growth factor (TGF)-β1 (TG-C [TissueGene-C]) expression vector have been shown to have potential benefits in the nonoperative management of knee osteoarthritis. Previous literature has reported on safe dosages of TG-C. Therefore, the purpose of this study was to evaluate the Phase II results and a 24-month efficacy of this injectable mixture compared with placebo in patients with Kellgren–Lawrence (K–L) grade III knee osteoarthritis. Specifically, we assessed (1) functional outcomes, (2) pain s...
Source: Journal of Knee Surgery - January 4, 2019 Category: Orthopaedics Authors: Lee, Bumsup Parvizi, Javad Bramlet, Dale Romness, David W. Guermazi, Ali Noh, Moon Sodhi, Nipun Khlopas, Anton Mont, Michael A. Tags: Original Article Source Type: research

Alternative Therapies for Knee Pain
J Knee Surg 2019; 32: 001-001 DOI: 10.1055/s-0038-1669910 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 - January 4, 2019 Category: Orthopaedics Authors: Cook, James L. Tags: Special Focus Section Source Type: research