Preoperative Factors Affecting the Patient-Reported Outcome Measures following Total Knee Replacement: Socioeconomic Factors and Preoperative OKS Have a Clinically Meaningful Effect
J Knee Surg DOI: 10.1055/s-0040-1721089The Oxford Knee Score (OKS) is a patient-reported outcome questionnaire typically used to assess function and pain in patients undergoing total knee replacement (TKR). However, research is inconclusive as to which preoperative factors are important in explaining variation in outcome following TKR. The operative records of 12,709 patients who underwent primary TKR over a 9-year period were analyzed. The following variables were collected for each patient: age, sex, body mass index (BMI), Index of Multiple Deprivation decile rank, side of operation, diagnosis, the American Society of An...
Source: Journal of Knee Surgery - January 15, 2021 Category: Orthopaedics Authors: Demetriou, Charis Webb, Jeremy Sedgwick, Philip Afzal, Irrum Field, Richard Kader, Deiary Tags: Original Article Source Type: research

Tibial Cut Accuracy in Mechanically Aligned Total Knee Arthroplasty Using Extensor Hallucis Longus Tendon to Determine Extramedullary Tibial Guide Position
This study aimed to determine the tibial cut (TC) accuracy using extensor hallucis longus (EHL) tendon as an anatomical landmark to position the total knee arthroplasty (TKA) extramedullary tibial guide (EMTG), and its impact on the TKA mechanical alignment (MA). We retrospectively studied 96 TKA, performed by a single surgeon, using a femoral tailored intramedullary guide technique. Seventeen were prior to the use of the EHL and 79 used the EHL tendon to position the EMTG. We analyzed preoperative and postoperative standing total lower extremity radiographs to determine the tibial component angle (TCA) and the correction ...
Source: Journal of Knee Surgery - January 15, 2021 Category: Orthopaedics Authors: Besa, Pablo Vega, Rafael Ledermann, Gerardo Calvo, Claudio Angulo, Manuela Lira, Mar ía Jesús Vidal, Catalina Orrego, Mario Irribarra, Luis Espinosa, Julio Vial, Raimundo Irarr ázaval, Sebastián Tags: Original Article Source Type: research

Evaluation of Knee Kinematics and Moments during Active Deep Flexion Activity after Oxford Mobile-Bearing Medial UKA —A Two-Year Follow-Up Study
J Knee Surg DOI: 10.1055/s-0040-1721033Few studies have assessed knee range of motion (ROM) and moments of patients with mobile-bearing unicompartmental knee arthroplasty (MB UKA) during active deep flexion activities. We analyze knee kinematic and kinetic parameters during postoperative squatting-standing activity, aiming to evaluate the efficacy of MB UKA and postoperative rehabilitation progress. This was a clinical cohort study. We followed up with 37 patients diagnosed with medial knee osteoarthritis (OA) with primary UKA. After screening 31 patients were recruited to take gait tests. Squatting-standing activities wer...
Source: Journal of Knee Surgery - January 5, 2021 Category: Orthopaedics Authors: Yue, Li Lamontagne, Mario Xiong, Zhao Zhengfei, Zhu Run, Tian Zhe, Li Ning, Kong Chunsheng, Wang Pei, Yang Kunzheng, Wang Tags: Original Article Source Type: research

Does Treatment with Dexmedetomidine Intra-articularly Improve Postoperative Pain and Rehabilitation after Anterior Cruciate Ligament Reconstruction?
This study aims to evaluate the analgesic efficacy of dexmedetomidine added to levobupivacaine following anterior cruciate ligament (ACL) surgery. Fifty patients undergoing ACL reconstruction were included. Group DL (dexmedetomidin-levobupivacaine) received 20 mL 0.5% levobupivacaine plus 1 mL (100 μg) dexmedetomidine. Group L (levobupivacaine) patients received 20 mL 0.5% levobupivacaine plus 1 mL saline 10 minutes before tourniquet release. A patient-controlled analgesia (PCA) pump was then connected, delivering 0.5 mg at every 10 minutes and 1-mg morphine and 75...
Source: Journal of Knee Surgery - January 3, 2021 Category: Orthopaedics Authors: Ülgey, Ayşe Bayram, Adnan Aksu, Recep Altunta ş, Resul G üney, Ahmet G üler, Gülen Tags: Original Article Source Type: research

Adoption of Robotic-Arm-Assisted Total Knee Arthroplasty Is Associated with Decreased Use of Articular Constraint and Manipulation under Anesthesia Compared to a Manual Approach
J Knee Surg DOI: 10.1055/s-0040-1721123Haptic robotic-arm-assisted total knee arthroplasty (RATKA) seeks to leverage three-dimensional planning, intraoperative assessment of ligament laxity, and guided bone preparation to establish and achieve patient-specific targets for implant position. We sought to compare (1) operative details, (2) knee alignment, (3) recovery of knee function, and (4) complications during adoption of this technique to our experience with manual TKA. We compared 120 RATKAs performed between December 2016 and July 2018 to 120 consecutive manual TKAs performed between May 2015 and January 2017. Operativ...
Source: Journal of Knee Surgery - January 3, 2021 Category: Orthopaedics Authors: Zhang, Jenny Matzko, Chelsea N. Sawires, Andrew Ehiorobo, Joseph O. Mont, Michael A. Hepinstall, Matthew S. Tags: Original Article Source Type: research

Effects of the Graft Type Used for Anterior Cruciate Ligament Reconstruction on Isokinetic Muscle Strength and Quality of Life
In this study, it was aimed to compare the quality of life, knee functions, and isokinetic muscle strength of patients who underwent ACL reconstruction with hamstring tendon (HT) and bone–tendon–bone (BTB) autografts. Total 40 patients with ACL reconstruction (20 in HT group and 20 in BTB group), at least 1 year after the operation, all injured during sports activity were included in this study. Flexor and extensor muscle groups of both affected and unaffected knees at angular velocities of 60 and 180 degrees/s were recorded. Lysholm knee score questionnaire and Short Form (SF)-36 were administered to all patie...
Source: Journal of Knee Surgery - January 3, 2021 Category: Orthopaedics Authors: Yapali, G ökmen K ürklü, Galip Bilen Tags: Original Article Source Type: research

The Ratio of the Distal Femur Width to the Tibial Plateau Width with Advancing Age
In conclusion, the articular tibial plateau width and the articular distal femoral width are nearly equal across ages 20 to 80 years. An absolute articular width value by age cannot be assigned because articular widths change with aging. [...] Thieme Medical Publishers, Inc. 333 Seventh Avenue, 18th Floor, New York, NY 10001, USAArticle in Thieme eJournals: Table of contents  |  Abstract  |  Full text (Source: Journal of Knee Surgery)
Source: Journal of Knee Surgery - January 3, 2021 Category: Orthopaedics Authors: Schlatterer, Daniel Robert Kessler, Raymond Donahue, Jeffrey Amersi, Arish Robinson, Weston Khakharia, Saurabh Tags: Original Article Source Type: research

National Decline in Knee Fusions Performed for Salvage of Chronic Periprosthetic Total Knee Infections
J Knee Surg DOI: 10.1055/s-0040-1721126The primary purpose of this study was to study and compare rates of two salvage operations for patients with chronically infected total knee arthroplasties: (1) knee arthrodesis and (2) above knee amputation (AKA). An analysis was performed comparing the inpatient hospital characteristics and complications between the two procedures. Secondarily, we presented rates of all surgically treated periprosthetic total knee infections over a 6-year period. Using the Nationwide Inpatient Sample, we identified all patients with a periprosthetic infection (International Classification of Disease...
Source: Journal of Knee Surgery - January 3, 2021 Category: Orthopaedics Authors: Rajaee, Sean S. Kavolus, Joseph J. Hayden, Brett L. Estok, Daniel M. Tags: Original Article Source Type: research

The Functional Outcomes of Delayed Surgical Reconstruction in Nonsport-Induced Multiligament Knee Injuries: A Retrospective Cohort Study
J Knee Surg DOI: 10.1055/s-0040-1721788Multiligament knee injuries (MLKIs) are among the most detrimental injuries, which can cause significant compromise of joint stability and function. Our aim was to investigate the functional outcomes of nonsport-induced MLKIs who presented late after injury and underwent delayed arthroscopic reconstruction. In a retrospective cohort of 18 MLKI patients (19 knees, January 2012–2018) who had undergone arthroscopic reconstruction, we assessed the knee range of motion, return to work/sport, International Knee Documentation Committee (IKDC), Knee Injury and Osteoarthritis Outcome Sco...
Source: Journal of Knee Surgery - January 3, 2021 Category: Orthopaedics Authors: Mortazavi, S. M. Javad Kaseb, M. H. Maleki, R. G. Razzaghof, M. Noori, A. Rezaee, R. Tags: Original Article Source Type: research

Delayed Surgery, Low Presurgery Activity, and Poor Preoperative IKDC Scores Are Correlated with Lower Rates of Return to Sports after ACL Reconstruction in an Asian Population
J Knee Surg DOI: 10.1055/s-0040-1721789There is limited literature regarding the early postsurgical outcomes of anterior cruciate ligament (ACL) reconstruction in Asian populations, particularly in the rates of return to sports. We aimed to quantify early clinical outcomes for ACL reconstruction, determine the predictive value of surgeon- and patient-reported outcomes on the rate of return to sports in the early postoperative period, and identify factors predictive of return to sports. We analyzed the data of 55 patients who underwent ACL reconstruction at our tertiary medical center from 2015 to 2016. All patients underwe...
Source: Journal of Knee Surgery - January 3, 2021 Category: Orthopaedics Authors: Lim, Dominic G. W. Chou, Andrew C. C. Chang, Paul C. C. Tan, Edwin T. S. Lie, Denny T. T. Tags: Original Article Source Type: research

Intra-Articular Corticosteroid or Hyaluronic Acid Injections Are Not Associated with Periprosthetic Joint Infection Risk following Total Knee Arthroplasty
This study evaluated whether the preoperative use and timing of the use of hyaluronic acid (HA) and/or corticosteroid (CS) injections were associated with an increased risk of periprosthetic joint infections (PJIs) following primary total knee arthroplasty (TKA). We tested the hypothesis that preoperative injection of HA or CS within 3 months prior to primary TKA was associated with an increased risk of PJI by specifically evaluating the association between PJI risk and (1) injection type; (2) timing; (3) patient demographic factors; and (4) surgery-related factors, such as surgeon injection volume, knee arthroscopy (pre- ...
Source: Journal of Knee Surgery - January 3, 2021 Category: Orthopaedics Authors: Kurtz, Steven M. Mont, Michael A. Chen, Antonia F. Valle, Craig Della Sodhi, Nipun Lau, Edmund Ong, Kevin L. Tags: Original Article Source Type: research

Return-to-Sport Review for Current Cartilage Treatments
This article will focus on the most common current knee cartilage treatments including microfracture, autologous chondrocyte implantation, osteochondral autograft transplant, and osteochondral allograft transplantation. [...] Thieme Medical Publishers, Inc. 333 Seventh Avenue, 18th Floor, New York, NY 10001, USAArticle in Thieme eJournals: Table of contents  |  Abstract  |  Full text (Source: Journal of Knee Surgery)
Source: Journal of Knee Surgery - January 3, 2021 Category: Orthopaedics Authors: Skelley, Nathan W. Kurtenbach, Chad Kimber, Kristofer Piatt, Bruce Noonan, Benjamin Tags: Special Focus Section Source Type: research

Systematic Review of Osteochondral Allograft Transplant Immunology: How We Can Further Optimize Outcomes
The objective of this study was to systematically review clinically relevant peer-reviewed evidence pertaining to the immunology of OCAs to elucidate theragnostic strategies for improving functional graft survival and outcomes for patients undergoing OCA transplantation. This systematic review of Cochrane Central Register of Controlled Trials, the Cochrane Database of Systematic Reviews, MEDLINE, PubMed, and EMBASE suggests that host immune responses play key roles in incorporation and functional survival of OCA transplants. OCA rejection has not been reported; however, graft integration through creeping substitution is re...
Source: Journal of Knee Surgery - January 3, 2021 Category: Orthopaedics Authors: Luk, Josephine Stoker, Aaron M. Teixeiro, Emma Kuroki, Keiichi Schreiner, Anna J. Stannard, James P. Wissman, Robert Cook, James L. Tags: Special Focus Section Source Type: research

Articular Cartilage Lesions in the Knee
J Knee Surg 2021; 34: 001-001 DOI: 10.1055/s-0040-1721129 Thieme Medical Publishers, Inc. 333 Seventh Avenue, 18th Floor, New York, NY 10001, USAArticle in Thieme eJournals: Table of contents  |  Full text (Source: Journal of Knee Surgery)
Source: Journal of Knee Surgery - January 3, 2021 Category: Orthopaedics Authors: Cook, James L. Tags: Foreword Source Type: research

Comparison between Single- and Multi-Radius Prostheses Used in Modified Kinematically Aligned Cruciate-Retaining Total Knee Arthroplasty
In conclusion, modified kinematically aligned TKAs using a SR or MR prosthesis showed no significant differences in clinical outcomes or patellar tracking when appropriate lateral retinacular release was performed. [...] Thieme Medical Publishers, Inc. 333 Seventh Avenue, 18th Floor, New York, NY 10001, USAArticle in Thieme eJournals: Table of contents  |  Abstract  |  Full text (Source: Journal of Knee Surgery)
Source: Journal of Knee Surgery - December 23, 2020 Category: Orthopaedics Authors: Matsumoto, Tomoyuki Takashima, Yoshinori Takayama, Koji Ishida, Kazunari Nakano, Naoki Kuroda, Yuichi Tsubosaka, Masanori Kamenaga, Tomoyuki Matsushita, Takehiko Niikura, Takahiro Hayashi, Shinya Kuroda, Ryosuke Tags: Original Article Source Type: research

Management of Large Focal Chondral and Osteochondral Defects in the Knee
J Knee Surg 2020; 33: 1187-1200 DOI: 10.1055/s-0040-1721053Large, focal articular cartilage defects of the knee (> 4 cm2) can be a source of significant morbidity and often require surgical intervention. Patient- and lesion-specific factors must be identified when evaluating a patient with an articular cartilage defect. In the management of large cartilage defects, the two classically utilized cartilage restoration procedures are osteochondral allograft (OCA) transplantation and cell therapy, or autologous chondrocyte implantation (ACI). Alternative techniques that are available or currently in clinical trials in...
Source: Journal of Knee Surgery - December 1, 2020 Category: Orthopaedics Authors: Calcei, Jacob G. Ray, Taylor Sherman, Seth L. Farr, Jack Tags: Special Focus Section Source Type: research

Articular Cartilage Lesions in the Knee
J Knee Surg 2020; 33: 1163-1163 DOI: 10.1055/s-0040-1720959 Thieme Medical Publishers, Inc. 333 Seventh Avenue, 18th Floor, New York, NY 10001, USAArticle in Thieme eJournals: Table of contents  |  Full text (Source: Journal of Knee Surgery)
Source: Journal of Knee Surgery - December 1, 2020 Category: Orthopaedics Authors: Cook, James L. Tags: Foreword Source Type: research

Total Knee Arthroplasty after Anterior Cruciate Ligament Reconstruction
J Knee Surg DOI: 10.1055/s-0040-1721423The incidence of anterior cruciate ligament (ACL) reconstruction is increasing in the United States, particularly in the older athlete. Patients who undergo ACL reconstruction are at higher risk for undergoing total knee arthroplasty (TKA) later in life. TKA in patients with prior ACL reconstruction has been associated with longer operative time due in-part to difficulty with exposure and retained hardware. Outcomes after TKA in patients with prior ACL reconstruction are not well defined, with some reports showing increased rate of complications and higher risk of reoperation compared...
Source: Journal of Knee Surgery - November 26, 2020 Category: Orthopaedics Authors: Best, Matthew J. Amin, Raj M. Raad, Micheal Kreulen, R. Timothy Musharbash, Farah Valaik, Daniel Wilckens, John H. Tags: Original Article Source Type: research

Prosthetic Accuracy Depends on the Design of Patient-Specific Instrumentation: Results of a Retrospective Study Using Three-Dimensional Imaging
J Knee Surg DOI: 10.1055/s-0040-1721127To determine accuracy of patient-specific instrumentation (PSI), the preoperative three-dimensional (3D) plan should be superimposed on the postoperative 3D image to compare prosthetic alignment. We aimed to compare prosthetic alignment on a preoperative 3D computed tomography (CT) plan and postoperative 3D-CT image, and evaluate the accuracy of PSI during total knee arthroplasty (TKA). Thirty consecutive knees (30 patients) who underwent TKA using PSI were retrospectively evaluated. The preoperative plan was prepared using 3D CT acquisitions of the hip, knee, and ankle joints. The po...
Source: Journal of Knee Surgery - November 25, 2020 Category: Orthopaedics Authors: Yamamura, Kazumasa Inori, Fumiaki Konishi, Sadahiko Tags: Original Article Source Type: research

Blood Management in Total Knee Arthroplasty: A Nationwide Analysis from 2011 to 2018
J Knee Surg DOI: 10.1055/s-0040-1721414Both advances in perioperative blood management, anesthesia, and surgical technique have improved transfusion rates following primary total knee arthroplasty (TKA), and have driven substantial change in preoperative blood ordering protocols. Therefore, blood management in TKA has seen substantial changes with the implementation of preoperative screening, patient optimization, and intra- and postoperative advances. Thus, the purpose of this study was to examine changes in blood management in primary TKA, a nationwide sample, to assess gaps and opportunities. The American College of Sur...
Source: Journal of Knee Surgery - November 25, 2020 Category: Orthopaedics Authors: Warren, Jared A. McLaughlin, John P. Molloy, Robert M. Higuera, Carlos A. Schaffer, Jonathan L. Piuzzi, Nicolas S. Tags: Original Article Source Type: research

Discontinued Use of Outpatient Portable Intermittent Pneumatic Compression Devices May Be Safe for Venous Thromboembolism Prophylaxis in Primary Total Knee Arthroplasty Using Low-Dose Aspirin
J Knee Surg DOI: 10.1055/s-0040-1721092Venous thromboembolism (VTE) is a rare, but serious complication following total knee arthroplasty (TKA). Current VTE guidelines recommend pharmacologic agents with or without intermittent pneumatic compression devices (IPCDs). At our institution, both 81-mg aspirin (ASA) twice a day (BID) and portable IPCDs were previously prescribed to TKA patients at standard risk for VTE, but the IPCDs were discontinued and patients were treated with ASA alone going forward. The aim of this study is to determine if discontinued use of outpatient IPCDs is safe and does not increase the rate of VTE ...
Source: Journal of Knee Surgery - November 25, 2020 Category: Orthopaedics Authors: Tang, Alex Zak, Stephen Lygrisse, Katherine Slover, James Meftah, Morteza Lajam, Claudette Schwarzkopf, Ran Macaulay, William Tags: Original Article Source Type: research

Immediate Postoperative Improvement in Gait Parameters following Primary Total Knee Arthroplasty Can Be Measured with an Insole Sensor Device
In this study an insole sensor device was used to quantify parameters of gait. The purpose of this study was to evaluate the ability of a wearable insole sensor device to measure immediate postoperative gait parameters at 2 weeks and 6 weeks following primary TKA and to determine if the device was suitable and sensitive enough to identify and measure potentially subtle changes in these measures at these early postoperative time periods. Twenty-nine patients with unilateral TKA, without contralateral knee pain, and aid-free walking before surgery were evaluated. An insole force sensor measured the postoperative parameters w...
Source: Journal of Knee Surgery - November 25, 2020 Category: Orthopaedics Authors: Pfeufer, Daniel Monteiro, Priscila Gililland, Jeremy Anderson, Mike B. B öcker, Wolfgang Stagg, Marissa Kammerlander, Christian Neuerburg, Carl Pelt, Christopher Tags: Original Article Source Type: research

Short-Term Effects of Isometric Quadriceps Muscle Exercise with Auditory and Visual Feedback on Pain, Physical Function, and Performance after Total Knee Arthroplasty: A Randomized Controlled Trial
J Knee Surg DOI: 10.1055/s-0040-1721035Severe acute pain after total knee arthroplasty (TKA) may cause delay in muscle strength and functional recovery, and it is a risk factor for chronic postoperative pain. Although pharmacological approaches are the typical firstline to treat acute pain; recently, nonpharmacological approaches such as exercise have been increasingly applied. The purpose of this investigation was to evaluate the effects of a rehabilitation program involving isometric quadriceps exercise with auditory and visual feedback to improve the short-term outcome after TKA. Sixty-two patients, planning a primary u...
Source: Journal of Knee Surgery - November 25, 2020 Category: Orthopaedics Authors: Kondo, Yasutaka Yoshida, Yoshihiro Iioka, Takashi Kataoka, Hideki Sakamoto, Junya Hirase, Tatsuya Honda, Yuichiro Nawata, Atsushi Okita, Minoru Tags: Original Article Source Type: research

Treatment of Posterior Cruciate Ligament Tibial Avulsion: A New Modified Open Direct Lateral Posterior Approach
This study was aimed to evaluate the postoperative outcomes and complications if any after an open direct, posterolateral approach using cannulated cancellous screw fixation of a PCL tibial avulsion. From January 2016 to June 2018, 17 patients (14 males and 3 females) with PCL avulsion fraction treatment—who underwent open reduction and internal fixation using cannulated cancellous screws—were included in this prospective study. A direct posterolateral approach in the prone position was used in all cases. The Lysholm's knee score and International Knee Documentation Committee (IKDC) score were assessed preopera...
Source: Journal of Knee Surgery - November 25, 2020 Category: Orthopaedics Authors: Keyhani, Sohrab Soleymanha, Mehran Salari, Amir Tags: Original Article Source Type: research

Isolated Liner Revision for Total Knee Arthroplasty Instability: A Road That Should Remain Less Taken
J Knee Surg DOI: 10.1055/s-0040-1721091Isolated polyethylene liner exchange (IPLE) is infrequently selected as a treatment approach for patients with primary total knee arthroplasty (TKA) prosthetic joint instability. Potential advantages of less immediate surgical morbidity, faster recovery, and lower procedural cost need to be measured against reoperation and re-revision risk. Few published studies have directly compared IPLE with combined tibial and femoral component revision to treat patients with primary TKA instability. After obtaining institutional review board (IRB) approval, we performed a retrospective comparison...
Source: Journal of Knee Surgery - November 23, 2020 Category: Orthopaedics Authors: Tegethoff, Jason D. Walker-Santiago, Rafael Ralston, William M. Keeney, James A. Tags: Original Article Source Type: research

Patellotrochlea Index in Normal Healthy Knees
J Knee Surg DOI: 10.1055/s-0040-1721095Patella alta is a common and significant abnormality responsible for many patellofemoral joint-related conditions. Many methods of patella height measurements are described; however, patellotrochear index (PTI) is the most logical method as it measures the direct relation between patella and trochlea. The aim of this study is to investigate PTI in normal healthy asymptomatic volunteers to understand the patellofemoral relation in normal knees. Twenty-five healthy volunteers underwent magnetic resonance imaging (MRI) scans of both knees. Two observers independently measured PTI on two ...
Source: Journal of Knee Surgery - November 23, 2020 Category: Orthopaedics Authors: Middleton, Simon Bajada, Stefan Powell, Roy Nelson, Adam Mandalia, Vipul Tags: Original Article Source Type: research

Periarticular Injection of Ketorolac Augmenting Intravenous Administration of Ketorolac for Postoperative Pain Control: A Randomized Controlled Trial in Simultaneous Bilateral Total Knee Arthroplasty
J Knee Surg DOI: 10.1055/s-0040-1721088Adequate postoperative pain control with minimal side effects is necessary for patients undergoing total knee arthroplasty (TKA). Ketorolac is a frequently used nonsteroidal anti-inflammatory drug due to its excellent disposition in all administration routes; however, it possesses an “analgesic ceiling,” which means that higher doses of the drug have no additional analgesic effect. Alternatively, increasing the local concentration of ketorolac via periarticular injection may provide additional pain relief to parenteral administration of ketorolac, but evidence demonstratin...
Source: Journal of Knee Surgery - November 23, 2020 Category: Orthopaedics Authors: Laoruengthana, Artit Rattanaprichavej, Piti Mahatthanatrakul, Akaworn Tantimethanon, Thanawat Lohitnavy, Manupat Pongpirul, Krit Tags: Original Article Source Type: research

Clorpactin: An Alternative Irrigation Method for Total Knee Arthroplasty Joint Infection Revisions
J Knee Surg DOI: 10.1055/s-0040-1721087Different combinations of irrigation solutions have been used in attempt to eradicate microorganisms for the prevention and treatment of prosthetic joint infections (PJIs). Clorpactin WCS-90 was evaluated as an alternative irrigation intraoperative technique for the treatment of PJI using both debridement, antibiotics, and implant retention (DAIR) and 2-stage total knee arthroplasty (TKA) procedures. We retrospectively reviewed PJIs irrigated with Clorpactin between January 2015 and January 2020. We found 13 patients who underwent a DAIR procedure for an acutely infected primary TKA, ...
Source: Journal of Knee Surgery - November 23, 2020 Category: Orthopaedics Authors: Kotecki, Keith Bradford, Michael S. Tags: Original Article Source Type: research

High Tibial Osteotomy with a Modern Polyetheretherketone (PEEK) System: Mid-Term Results at a Mean of 6 Years Follow-Up
J Knee Surg DOI: 10.1055/s-0040-1721090The purpose of this study was to determine patient-reported outcomes, hardware removal rates, as well as conversion to arthroplasty at mid-term follow-up following high tibial osteotomy (HTO) with a modern polyetheretherketone (PEEK) system. All PEEK system-based HTOs performed at a single institution between January 2010 and January 2016 with a minimum of 2 years follow-up were reviewed. Rates of postoperative complications, hardware removal and conversion to arthroplasty were calculated. Patient-reported outcomes including visual analog pain scale (VAS), Tegner activity scale, Lysho...
Source: Journal of Knee Surgery - November 23, 2020 Category: Orthopaedics Authors: Keyt, Lucas K. Hevesi, Mario Levy, Bruce A. Krych, Aaron J. Camp, Christopher L. Stuart, Michael J. Tags: Original Article Source Type: research

Return to Sport and Work after Randomization for Knee Distraction versus High Tibial Osteotomy: Is There a Difference?
J Knee Surg DOI: 10.1055/s-0040-1721027Knee joint distraction (KJD) is a novel technique for relatively young knee osteoarthritis (OA) patients. With KJD, an external distraction device creates temporary total absence of contact between cartilage surfaces, which results in pain relief and possibly limits the progression of knee OA. Recently, KJD showed similar clinical outcomes compared with high tibial osteotomy (HTO). Yet, no comparative data exist regarding return to sport (RTS) and return to work (RTW) after KJD. Therefore, our aim was to compare RTS and RTW between KJD and HTO. We performed a cross-sectional follow-up study in patients
Source: Journal of Knee Surgery - November 23, 2020 Category: Orthopaedics Authors: Hoorntje, Alexander Kuijer, P. Paul F. M. Koenraadt, Koen L. M. Waterval-Witjes, Suzanne Kerkhoffs, Gino M. M. J. Mastbergen, Simon C. Marijnissen, Anne C. A. Jansen, Myl ène P. van Geenen, Rutger C. I. Tags: Original Article Source Type: research

The Knee Dislocation Classification System Is Simple, Reproducible, and Allows Communication among Surgeons
J Knee Surg DOI: 10.1055/s-0040-1721036 Thieme Medical Publishers, Inc. 333 Seventh Avenue, 18th Floor, New York, NY 10001, USAArticle in Thieme eJournals: Table of contents  |  Full text (Source: Journal of Knee Surgery)
Source: Journal of Knee Surgery - November 12, 2020 Category: Orthopaedics Authors: Wascher, Daniel C. Schenck, Robert C. Treme, Gehron P. Richter, Dustin L. Tags: Letter to the Editor Source Type: research

Validation of the Macroscopic Anterior Cruciate Ligament Status Using the Oxford Classification System in Relation to Cartilage Defects on the Medial Tibial Plateau in Osteoarthritic Knees
This study evaluated the relationships between anterior cruciate ligament (ACL) grading using the Oxford classification system and cartilage defects on the medial tibial plateau to clarify the validity of the system. We studied the location and size of a full-thickness cartilage defect of the medial tibial plateau in 154 knees (97 patients) treated by unicompartmental (113) or total (41) knee arthroplasty between April 2017 and January 2018, and analyzed their relationship to the anterior cruciate ligament (ACL) grade, Grade 1 (normal), Grade 2 (synovial damage), Grade 3 (longitudinal split), Grade 4 (friable and fragmente...
Source: Journal of Knee Surgery - November 11, 2020 Category: Orthopaedics Authors: Hiranaka, Takafumi Hida, Yuichi Tanaka, Toshikazu Okimura, Kenjiro Fujishiro, Takaaki Okamoto, Koji Tags: Original Article Source Type: research

Posterolateral Fractures of the Tibial Plateau Revisited: A Simplified Treatment Algorithm
J Knee Surg DOI: 10.1055/s-0040-1721026High-energy fractures of the proximal tibia with extensive fragmentation of the posterolateral (PL) quadrant of the tibial plateau are challenging to manage. Herein, we present a review of the literature on the patterns and options of approach and fixation of the PL fragment of the tibial plateau to optimize the treatment of this specific injury pattern. We searched PubMed (1980–May 2020) to identify and summarize the most relevant articles evaluating both the morphology and treatment recommendations, including the choice of approach and fixation strategy, for the PL tibial plat...
Source: Journal of Knee Surgery - November 9, 2020 Category: Orthopaedics Authors: Giordano, Vincenzo Pires, Robinson Esteves Pimenta, Frederico Silva Campos, T úlio Vinícius de Oliveira Andrade, Marco Ant ônio Percope de Giannoudis, Peter V. Tags: Original Article Source Type: research

Earlier Initiation of Postoperative Physical Therapy Decreases Opioid Use after Total Knee Arthroplasty
J Knee Surg DOI: 10.1055/s-0040-1721034For patients with advanced osteoarthritis of the knee, total knee arthroplasty (TKA) has been shown to provide significant pain relief and improved function with consistent, reproducible results. Post-operative physical therapy (PT) plays an important role is restoring muscle strength and range of motion (ROM). Yet, the impact of earlier physical therapy initiation after TKA has not been well defined. We assessed 205 patients that underwent primary TKA including 136 patients who started PT on the first post-operative day (POD1) and a second group that started PT 3 days after surgery (...
Source: Journal of Knee Surgery - November 9, 2020 Category: Orthopaedics Authors: Frenkel Rutenberg, Tal Izchak, Haim Rosenthal, Yoav Barak, Uri Shemesh, Shai Heller, Snir Tags: Original Article Source Type: research

Comment on Medial Meniscus Scaffold Implantation in Combination with Concentrated Bone Marrow Aspirate Injection: Minimum 3-Year Follow-Up
J Knee Surg DOI: 10.1055/s-0040-1721037 Thieme Medical Publishers, Inc. 333 Seventh Avenue, 18th Floor, New York, NY 10001, USAArticle in Thieme eJournals: Table of contents  |  Full text (Source: Journal of Knee Surgery)
Source: Journal of Knee Surgery - November 9, 2020 Category: Orthopaedics Authors: Zhong, Mingjin Lu, Wei Zhu, Weimin Tags: Letter to the Editor Source Type: research

Anterior Tibial Artery and Its Clinical Importance in the Posterolateral Approach to the Tibial Plateau: An Angiographic Study on 219 Lower Limbs
This study aimed to use available lower extremity digital subtraction angiography (DSA) images to determine the distal safe limit of this approach by measuring the distance from the tibial joint line to the ATA where it pierces the interosseous membrane. Tibial plateau mediolateral width (TP-ML-W) and the perpendicular distances from the ATA to the tibial joint line and fibular head were measured on DSA images in 219 lower extremities. To normalize the distances according to the tibial dimensions, each distance was divided by the TP-ML-W, and a ratio was obtained. Popliteal artery branching pattern was categorized accordin...
Source: Journal of Knee Surgery - October 30, 2020 Category: Orthopaedics Authors: May, Hasan Kastan, Ozlem Emre, Tuluhan Yunus Cetin, Mustafa Unal, Melih Kose, Ozkan Tags: Original Article Source Type: research

The Outcome of Posterior-Stabilized, Rotating Platform Total Knee Arthroplasty at a Minimum Ten-Year Follow-up, a Middle East Institution Experience
J Knee Surg DOI: 10.1055/s-0040-1716850Posterior-stabilized, rotating platform knee prosthesis design was aimed to decrease polyethylene wear for the sake of improving implant survivorship. The purpose of the present prospective study was to evaluate the long-term clinical and radiographic results as well as the survival rate after using a rotating platform, posterior-stabilized knee prosthesis at a minimum of 10 years at a Middle East institution. We compared the results with reports in the literature on western populations. From January 2002 to June 2008, 96 patients (106 knees) underwent total knee arthroplasty (TKA) us...
Source: Journal of Knee Surgery - October 30, 2020 Category: Orthopaedics Authors: Khalifa, Ahmed A. Fayez, Mostafa Elkady, Hesham Abdelaal, Ahmed M. Elassal, Maher A. Tags: Original Article Source Type: research

Robotic-Assisted Patellofemoral Replacement —Correlation of Preoperative Planning with Intraoperative Implant Position and Early Clinical Experience: A Minimum 2-Year Follow-up
J Knee Surg DOI: 10.1055/s-0040-1716848Patello-femoral arthroplasty (PFA) is successful in a selected group of patients and yields a good functional outcome. Robotic-assisted knee arthroplasty has been shown to provide better implant positioning and alignment. We aim to report our early outcomes and to compare Mako's (Robotic Arm Interactive Orthopaedic System [RIO]) preoperative implant planning position to our intraoperative PFA implant position. Data for this study was prospectively collected for 23 (two bilateral) patients who underwent robotic-assisted PFA between April 2017 and May 2018. All preoperative implant posi...
Source: Journal of Knee Surgery - October 30, 2020 Category: Orthopaedics Authors: Selvaratnam, Veenesh Cattell, Andrew Eyres, Keith S. Toms, Andrew D. Phillips, Jonathan R. P. Mandalia, Vipul I. Tags: Original Article Source Type: research

Preoperative MRI of Articular Cartilage in the Knee: A Practical Approach
This article discusses the normal MRI appearance of articular cartilage as well as the common MRI abnormalities of knee cartilage that may be considered for operative treatment. This article focuses on a practical approach to preoperative MRI of knee articular cartilage using routine MRI techniques. Current and future directions of knee MRI related to articular cartilage are also discussed. [...] 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 - October 29, 2020 Category: Orthopaedics Authors: Fritz, Russell C. Chaudhari, Akshay S. Boutin, Robert D. Tags: Special Focus Section Source Type: research

Articular Cartilage Lesions in the Knee
J Knee Surg 2020; 33: 1055-1055 DOI: 10.1055/s-0040-1715114 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 - October 29, 2020 Category: Orthopaedics Authors: Cook, James L. Tags: Special Focus Section Source Type: research

Postoperative Management for Articular Cartilage Surgery in the Knee
J Knee Surg DOI: 10.1055/s-0040-1718605The postoperative rehabilitation team plays a crucial role in optimizing outcomes after articular cartilage surgery. A comprehensive approach to postoperative physical therapy that considers the type of surgery, location in the knee, concurrent procedures, and patient-specific factors is imperative. While postoperative rehabilitation protocols should be specific to the patient and type of surgery performed and include phased rehabilitation goals and activities, the key principles for postoperative rehabilitation apply across the spectrum of articular cartilage surgeries and patients. ...
Source: Journal of Knee Surgery - October 27, 2020 Category: Orthopaedics Authors: Crecelius, Cory R. Van Landuyt, Karra J. Schaal, Robert Tags: Special Focus Section Source Type: research

Low-Degree Tibial Slope Angle Prevents Component Overhang by Enlarging the Lateral Plateau Surface Area in Total Knee Arthroplasty
This study aimed to investigate whether overhang or underhang around the tibial component that occurs during the placement of tibial baseplates was affected by different slope angles of the tibial plateau and determine the changes in the lateral and medial plateau diameters while changing the slope angle in total knee arthroplasty. Three-dimensional tibia models were reconstructed using the computed tomography scans of 120 tibial dry bones. Tibial plateau slope cuts were performed with 9, 7, 5, 3, and 0 degrees of slope angles 2-mm below the subchondral bone in the deepest point of the medial plateau. Total, lateral, and m...
Source: Journal of Knee Surgery - October 27, 2020 Category: Orthopaedics Authors: Simsek, Mehmet Emin Akkaya, Mustafa Gursoy, Safa Kaya, Özgür Bozkurt, Murat Tags: Original Article Source Type: research

Evaluation of Safety and Medium-Term Functional Outcomes of a Medial Fixed-Bearing Unicompartmental Knee Arthroplasty with Ultra-Highly Cross-Linked Polyethylene
J Knee Surg DOI: 10.1055/s-0040-1718604The primary objective of this study was to evaluate the in vivo safety of a unicompartmental knee arthroplasty design with sequentially annealed cross-linked polyethylene by evaluating reoperation rate, in particular those related to excessive polyethylene wear or breakage. The secondary objective was to examine functional outcomes via standardized questionnaires. This was a 5-year institutional review board-approved prospective single-surgeon case series of the first 152 consecutive patients with symptomatic medial unicompartmental osteoarthritis implanted with a partial knee replace...
Source: Journal of Knee Surgery - October 27, 2020 Category: Orthopaedics Authors: Richards, Megan Dobransky, Johanna S. Jane, Alanna A. Dervin, Geoffrey F. Tags: Original Article Source Type: research

The Journey Bicruciate Knee Replacement: Design modifications Yield Better Early Functional Results and Reduce Complications
J Knee Surg DOI: 10.1055/s-0040-1718599The Journey-I total knee replacement was designed to improve knee kinematics but had several complications including early dislocation. The Journey-II modification was introduced to reduce these while maintaining high function. To assess whether the modified Journey-II prosthesis has succeeded in its designers aims, we undertook an observational study of prospectively recorded data to analyze and compare the two knees. A total of 217 Journey-I and 129 Journey-II knees were identified from the department's prospectively collated registry and were assessed at 1 year by a comparative sta...
Source: Journal of Knee Surgery - October 27, 2020 Category: Orthopaedics Authors: Oikonomidis, Lazaros Santini, Alasdair J. A. Davidson, John S. Banks, Joanne V. Phillipson, Andrew Pope, Jill Tags: Original Article Source Type: research

Providing Inpatient Mobilization with a Mobility Technician Constrains Cost in Primary Total Knee Arthroplasty
J Knee Surg DOI: 10.1055/s-0040-1718597Since the 2016 implementation of the comprehensive care for joint replacement (CJR) bundled payment model, our institutions have sought to decrease inpatient physical therapy (PT) costs by piloting a mobility technician program (MTP), where mobility technicians (MTs) ambulate postoperative total knee arthroplasty (TKA) patients under the supervision of nursing staff members. MTs are certified medical assistants given specialized gate and ambulation training by the PT department. The aim of this study was to examine the economic and clinical impact of MTs on the primary TKA postoperati...
Source: Journal of Knee Surgery - October 27, 2020 Category: Orthopaedics Authors: Novack, Thomas A. Mazzei, Christopher J. Patel, Jay N. Poletick, Eileen B. D'Achille, Roberta Wittig, James C. Tags: Original Article Source Type: research

Knee Arthrofibrosis following Tibial Plateau Fracture Treated with Arthroscopic Lysis of Adhesions with Manipulation
J Knee Surg DOI: 10.1055/s-0040-1718679Posttraumatic arthrofibrosis is a common problem encountered in the orthopaedic setting for which there is no agreement on the optimal management strategy. The literature does not optimally describe the efficacy of arthroscopic lysis of adhesions for arthrofibrosis following tibial plateau fracture. The purpose of this study is to quantify the efficacy of arthroscopic lysis of adhesions with manipulation for the treatment of arthrofibrosis of the knee in patients who previously underwent surgical management of tibial plateau fracture. All patients who underwent arthroscopic lysis of a...
Source: Journal of Knee Surgery - October 27, 2020 Category: Orthopaedics Authors: Middleton, Austin H. Perlewitz, Madeline A. Edelstein, Adam I. Vetter, Carole S. Tags: Original Article Source Type: research

T2 Mapping Values in Postmeniscectomy Knee Articular Cartilage after Running: Early Signs of Osteoarthritis?
J Knee Surg DOI: 10.1055/s-0040-1718596Loading on the joints during running may have a deleterious effect on post–partial meniscectomy knee cartilage, leading to osteoarthritis. Utilizing T2-mapping measurements before and after running may enable the observation of changes in the articular cartilage of the postmeniscectomy knees compared with healthy knees. After medial partial meniscectomy, 12 volunteers underwent magnetic resonance imaging (MRI) of the both knees, before and immediately after 30 minutes of running. Quantitative assessment of articular cartilage was performed using a T2-mapping technique. In...
Source: Journal of Knee Surgery - October 27, 2020 Category: Orthopaedics Authors: Lindner, Dror Chechik, Yigal Beer, Yiftah Tal, Sigal Lysyy, Oleg Blumenfeld-Katzir, Tamar Ben-Eliezer, Noam Agar, Gabriel Tags: Original Article Source Type: research

Gait and Knee Flexion In Vivo Kinematics of Asymmetric Tibial Polyethylene Geometry Cruciate Retaining Total Knee Arthroplasty
J Knee Surg DOI: 10.1055/s-0040-1718681The preservation of the posterior cruciate ligament in cruciate retaining (CR) total knee arthroplasty (TKA) designs has the potential to restore healthy knee biomechanics; however, concerns related to kinematic asymmetries during functional activities still exist in unilateral TKA patients. As there is a limited data available regarding the ability of the contemporary CR TKA design with concave medial and convex lateral tibial polyethylene bearing components to restore healthy knee biomechanics, this study aimed to investigate in vivo three-dimensional knee kinematics in CR TKA patie...
Source: Journal of Knee Surgery - October 27, 2020 Category: Orthopaedics Authors: Klemt, Christian Drago, John Oganesyan, Ruben Smith, Evan J. Yeo, Ingwon Kwon, Young-Min Tags: Original Article Source Type: research

Posterior Tibial Slope Increases Anterior Cruciate Ligament Stress in Bi-Cruciate Retaining Total Knee Arthroplasty: In Vivo Kinematic Analysis
This study aimed to investigate the effect of posterior tibial slope (PTS) on stress experienced by the ACL during weight bearing sit-to-stand (STS) and single-leg deep lunge. The ACL elongation patterns were measured in 30 unilateral BCR TKA patients during weight-bearing STS and single-leg deep lunge using a validated dual fluoroscopic tracking technique. The minimum normalized stress within the anteromedial (AM) and posterolateral (PL) bundle of the ACL during weight-bearing STS and single-leg deep lunge was found at a PTS of 3.7 degrees. The maximum AM and PL bundle stresses were observed at a PTS of 8.5 and 9.3 degree...
Source: Journal of Knee Surgery - October 27, 2020 Category: Orthopaedics Authors: Klemt, Christian Bounajem, Georges Tirumala, Venkatsaiakhil Xiong, Liang Oganesyan, Ruben Kwon, Young-Min Tags: Original Article Source Type: research

Matched-Pair Analysis of Magnetic Resonance Images for Location of the Common Peroneal Nerve in Valgus Knees: Comparison with the Varus Knees
This study aimed to assess the distance and angular location of the common peroneal nerve (CPN) on axial magnetic resonance imaging (MRI) in the valgus knees and compare the measurements with those obtained from the control group. We compared the location of the CPN according to the type of alignment by performing a subgroup analysis. From January 2009 to December 2019, we identified 41 knees with preoperative MRI in patients who underwent total knee arthroplasty (TKA) for valgus deformity (valgus group). We performed one-to-two matched-pair analysis to a cohort of patients who underwent MRI but were not candidates for TKA...
Source: Journal of Knee Surgery - October 27, 2020 Category: Orthopaedics Authors: Jung, Kwang Am Shon, Oog-Jin Banday, Mohd Irfan Patil, Abhishek Kim, Gi Beom Tags: Original Article Source Type: research