Microfracture versus Enhanced Microfracture Techniques in Knee Cartilage Restoration: A Systematic Review and Meta-Analysis
This study aimed to compare the efficacy and safety of the microfracture (MFx) and microfracture augmented (MFx + ) techniques for the treatment of cartilage defects of the knee. The PubMed and EMBASE databases were searched from 1 January, 1950 to 1 May, 2019. RevMan5.3 was used to perform statistical analysis. Relative risk was calculated for binary variables, and weighted mean difference and standardized mean difference (SMD) were measured for continuous variables. The 95% confidence interval (CI) of each variable was assessed. Thirteen trials with 635 patients were included. There was a significant differ...
Source: Journal of Knee Surgery - September 20, 2020 Category: Orthopaedics Authors: Wen, Hong-Jie Yuan, Li-Bo Tan, Hong-Bo Xu, Yong-Qing Tags: Original Article Source Type: research

Predictors of Staphylococcus Aureus Nasal Colonization in Joint Arthroplasty Patients
J Knee Surg DOI: 10.1055/s-0040-1716503Early identification and treatment of Staphylococcus aureus (S. aureus) nasal colonization can reduce the risk of prosthetic joint infection. The purpose of this study was to evaluate patient-specific predictors for S. aureus nasal colonization in total joint arthroplasty patients to aid in preoperative screening protocols. A total of 2,147 arthroplasty patients who were preoperatively screened for S. aureus nasal colonization were retrospectively reviewed. Factors analyzed consisted of procedure type, primary diagnosis, gender, ethnicity, body mass index, the presence of chronic obst...
Source: Journal of Knee Surgery - September 17, 2020 Category: Orthopaedics Authors: Stapleton, Erik J. Petrone, Brandon Zois, Theofanis Papas, Vivian Frane, Nicholas Green, Evan Scuderi, Giles R. Tags: Original Article Source Type: research

Anatomical Risk Factors for Anterior Cruciate Ligament Injury Are Not Important As Patellar Instability Risk Factors in Patients with Acute Knee Injury
J Knee Surg DOI: 10.1055/s-0040-1716504To compare in magnetic resonance imaging the anatomical risk factors for anterior cruciate ligament (ACL) injury and patellar dislocation among patients who suffered acute knee injury, 105 patients with acute knee injury resulting in 38 patellar dislocations (patella group), 35 ACL injuries (ACL group), and 32 meniscus or medial collateral ligament injuries (control group) were included. These groups were compared for risk factors for patellar dislocation (patellar height, trochlear dysplasia, and quadriceps angle of action) and for ACL injury (intercondylar width, posterior inclinati...
Source: Journal of Knee Surgery - September 17, 2020 Category: Orthopaedics Authors: Gobbi, Riccardo Gomes Videira, Livia Dau dos Santos, Anderson Albuquerque Saruhashi, Marcello Barni Lucarini, Bruno Romano Fernandes, Renan Jos é Rodrigues Giglio, Pedro Nogueira P écora, José Ricardo Camanho, Gilberto Luis Hinckel, Betina Bremer Tags: Original Article Source Type: research

Development and Assessment of Novel Multiligament Knee Injury Reconstruction Graft Constructs and Techniques
This study assessed novel graft constructs and surgical implantation and fixation techniques for anterior cruciate ligament (ACL), posterior cruciate ligament (PCL), posterior medial corner (PMC), and posterior lateral corner (PLC) reconstruction. Study objectives were (1) to describe each construct and technique in detail, and (2) to optimize MLKI reconstruction surgical techniques using these constructs so as to consistently implant grafts in correct anatomical locations while preserving bone stock and minimizing overlap. Cadaveric knees (n = 3) were instrumented to perform arthroscopic-assisted and open su...
Source: Journal of Knee Surgery - September 17, 2020 Category: Orthopaedics Authors: Cook, James L. Cook, Cristi R. Bozynski, Chantelle C. Bezold, Will A. Stannard, James P. Tags: Original Article Source Type: research

Depression Is Not Independently Associated with a Clinically Worse Functional Improvement but Associated with a Lower Reported Satisfaction Rate after Total Knee Arthroplasty
J Knee Surg DOI: 10.1055/s-0040-1716669The aim of this study was to assess whether depression had a clinically significant influence on the functional improvement of total knee arthroplasty (TKA) according to the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score, and whether it influences patient satisfaction at 1 year. A retrospective cohort of 3,510 primary TKA was identified from an arthroplasty database. Patient demographics, comorbidities, WOMAC, and Short Form-12 (SF-12) scores were collected preoperatively and 1 year postoperatively. Patient satisfaction (overall, pain relief, return to wo...
Source: Journal of Knee Surgery - September 17, 2020 Category: Orthopaedics Authors: Clement, Nicholas D. Lin, Chung M. A. McCone, Emma Weir, David J. Deehan, David J. Tags: Original Article Source Type: research

Distinguishing Periprosthetic Crystalline Arthropathy from Infection in Total Knee Arthroplasty: A Systematic Review
J Knee Surg DOI: 10.1055/s-0040-1716507Distinguishing periprosthetic crystalline arthropathy from periprosthetic joint infection (PJI) remains a diagnostic challenge as both symptom presentation and diagnostic tests overlap. Accurate differentiation is important as treatment plans vary significantly. We sought to systematically review all cases of total knee arthroplasty (TKA) periprosthetic crystalline arthropathy reported in the literature and summarize clinical, diagnostic, and operative findings in the context of guidelines for diagnosing PJI. The goal of this systematic review is to determine the amount of diagnostic ...
Source: Journal of Knee Surgery - September 17, 2020 Category: Orthopaedics Authors: Bradley, Alexander T. King, Connor A. Lin, Ye Sculco, Peter Balach, Tessa Landy, David C. Tags: Original Article Source Type: research

Decreasing Posterior Femoral Condyle Offset Improves Intraoperative Correction of Flexion Contracture in Total Knee Arthroplasty
J Knee Surg DOI: 10.1055/s-0040-1716415Multiple intraoperative strategies are described to achieve full extension in total knee arthroplasty, but only a few studies have assessed the effect of the flexion gap on intraoperative improvement in flexion contracture. The aim of this study was to determine whether posterior condylar offset, in isolation, independently affects extension at the time of total knee arthroplasty.Two hundred and seventy-eight patients who underwent total knee arthroplasty for knee osteoarthritis and flexion contracture ≥ 5 degrees between January 2008 and July 2018 were included in th...
Source: Journal of Knee Surgery - September 14, 2020 Category: Orthopaedics Authors: Leie, Murilo Anderson Klasan, Antonio Yeo, Wei Wang Misso, Dylan Coolican, Myles Tags: Original Article Source Type: research

Differences in Trochlear Morphology from Native Using a Femoral Component Interfaced with an Anatomical Patellar Prosthesis in Kinematic Alignment and Mechanical Alignment
J Knee Surg DOI: 10.1055/s-0040-1716413Patellofemoral complications following total knee arthroplasty can be traced in part to alignment of the femoral component. Kinematic alignment (KA) and mechanical alignment (MA) use the same femoral component but align the component differently. Our objective was to determine differences in trochlear morphology from native for a femoral component interfaced with an anatomical patellar prosthesis in KA and MA. Ten three-dimensional femur-cartilage models were created by combining computed tomography and laser scans of native human cadaveric femurs free of skeletal abnormalities. The f...
Source: Journal of Knee Surgery - September 14, 2020 Category: Orthopaedics Authors: Hull, Maury L. Howell, Stephen M. Tags: Original Article Source Type: research

Kinematically Aligned Total Knee Arthroplasty Did Not Show Superior Patient-Reported Outcome Measures: An Updated Meta-analysis of Randomized Controlled Trials with at Least 2-Year Follow-up
J Knee Surg DOI: 10.1055/s-0040-1716494Kinematically aligned total knee arthroplasty (KATKA) was developed to improve the anatomical alignment of knee prostheses, assisting in restoring the native alignment of the knee and promoting physiological kinematics. Early clinical results were encouraging, showing better functional outcomes than with mechanically aligned total knee arthroplasty (MATKA). However, there have been concerns about implant survival, and follow-up at 10 years or more has not been reported. In addition, randomized controlled trials (RCTs) comparing KATKA with MATKA have reported inconsistent results. The ...
Source: Journal of Knee Surgery - September 14, 2020 Category: Orthopaedics Authors: Hiyama, Shuhei Takahashi, Tsuneari Takeshita, Katsushi Tags: Original Article Source Type: research

Measuring Outcomes in Knee Articular Cartilage Pathology
J Knee Surg DOI: 10.1055/s-0040-1716362Measuring outcomes following treatment of knee articular cartilage lesions is crucial to determine the natural history of disease and the efficacy of treatments. Outcome assessments for articular cartilage treatments can be clinical (based on failure, lack of healing, reoperation, need for arthroplasty), radiographic (X-ray, MRI), histologic, or patient reported and functional. The purpose of this review is to discuss the application and properties of patient-reported outcomes (PROs) with a focus on articular cartilage injuries and surgery in the knee. The most frequently used and val...
Source: Journal of Knee Surgery - September 9, 2020 Category: Orthopaedics Authors: Oak, Sameer R. Spindler, Kurt P. Tags: Special Focus Section Source Type: research

How Does Robotic-Arm Assisted Technology Influence Total Knee Arthroplasty Implant Placement for Surgeons in Fellowship Training?
J Knee Surg DOI: 10.1055/s-0040-1716983Implant malalignment during total knee arthroplasty (TKA) may lead to suboptimal postoperative outcomes. Accuracy studies are typically performed with experienced surgeons; however, it is important to study less experienced surgeons when considering teaching hospitals where younger surgeons operate. Therefore, this study assessed whether robotic-arm assisted TKA (RATKA) allowed for more accurate and precise implant position to plan when compared with manual techniques when the surgery is performed by in-training orthopaedic surgical fellows. Two surgeons, currently in their fellowship...
Source: Journal of Knee Surgery - September 9, 2020 Category: Orthopaedics Authors: Scholl, Laura Y. Hampp, Emily L. de Souza, Kevin M. Chang, Ta-Cheng Deren, Matthew Yenna, Zachary C. Sodhi, Nipun Mont, Michael A Westrich, Geoffrey H. Tags: Original Article Source Type: research

Preoperative Emergency Department Visits Are Predictive of 90-Day Postoperative Emergency Department Visits and Discharge Disposition in Total Knee Arthroplasty Patients
J Knee Surg DOI: 10.1055/s-0040-1716414The increasing number of patients undergoing total knee arthroplasty (TKA) has resulted in efforts to better understand patient utilization of healthcare services in the 90-day postoperative period. The primary purpose of this study was to examine whether emergency department (ED) visits in the year prior to elective TKA were predictive of postoperative ED visits in the 90-day global period following surgery. A retrospective chart review was performed for all patients undergoing TKA from June 1, 2011 to December 31, 2015 at a Veterans Affairs hospital. Total number of ED visits in the...
Source: Journal of Knee Surgery - September 9, 2020 Category: Orthopaedics Authors: Kiskaddon, Eric M. Soehnlen, Neil T. Erb, Eric Froehle, Andrew W. Green, Uthona Krishnamurthy, Anil Tags: Original Article Source Type: research

Poor Outcome of Above-Knee Amputation after Septic Failure of Revision Total Knee Arthroplasty
J Knee Surg DOI: 10.1055/s-0040-1716416Persistent periprosthetic infection following total knee arthroplasty is one of the most dreaded complications of orthopaedic surgery. Treatment strategies include arthrodesis of the knee joint, stable fistula, long-lasting antibiotic therapy, or above-knee amputation. The advantage of amputation in comparison to other treatment options is the possible cure of infection, because the source of infection is removed and no foreign material left in situ. The aim of the study is to examine whether a septic amputation of the femur in case of persistent periprosthetic infection at the knee j...
Source: Journal of Knee Surgery - September 9, 2020 Category: Orthopaedics Authors: B öhle, Sabrina Rohe, Sebastian Kirschberg, Julia Brinkmann, Olaf Seeger, J örn Zippelius, Timo Matziolis, Georg R öhner, Eric Tags: Original Article Source Type: research

Articular Cartilage Repair in the Knee: Postoperative Imaging
This article focuses on how specific morphologic features identified on MRI can be utilized to evaluate patients following the most commonly performed cartilage repair surgeries of 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 - September 8, 2020 Category: Orthopaedics Authors: Yang, Brian W. Brusalis, Christopher M. Fabricant, Peter D. Greditzer, Harry G. Tags: Special Focus Section Source Type: research

Small Cartilage Defect Management
J Knee Surg DOI: 10.1055/s-0040-1716359Cartilage defects in the knee are common resulting in significant pain and morbidity over time. These defects can arise in isolation or concurrently with other associated injuries to the knee. The treatment of small (
Source: Journal of Knee Surgery - September 8, 2020 Category: Orthopaedics Authors: Hacken, Brittney A. LaPrade, Matthew D. Stuart, Michael J. Saris, Daniel B. F. Camp, Christopher L. Krych, Aaron J. Tags: Special Focus Section Source Type: research

Low-Dose Aspirin is Safe and Effective for Venous Thromboembolism Prevention in Patients Undergoing Revision Total Knee Arthroplasty: A Retrospective Cohort Study
J Knee Surg DOI: 10.1055/s-0040-1716377Venous thromboembolism (VTE) events are rare, but serious complications of total joint replacement affect patients and health care systems due to the morbidity, mortality, and associated cost of its complications. There is currently no established universal standard of care for prophylaxis against VTE in patients undergoing revision total knee arthroplasty (rTKA). The aim of this study was to determine whether a protocol of 81-mg aspirin (ASA) bis in die (BID) is safe and/or sufficient in preventing VTE in patients undergoing rTKAs versus 325-mg ASA BID. In 2017, our institution adopt...
Source: Journal of Knee Surgery - September 8, 2020 Category: Orthopaedics Authors: Tang, Alex Zak, Stephen G. Waren, Daniel Iorio, Richard Slover, James D. Bosco, Joseph A. Schwarzkopf, Ran Tags: Original Article Source Type: research

Cartilage and Meniscus Injuries Are More Common in Patients Undergoing Delayed Multiligament Reconstruction
J Knee Surg DOI: 10.1055/s-0040-1716378The purpose of this study was to describe the pattern of meniscus and cartilage pathology in multiligament knee injuries (MLKIs) and determine the relationship between surgical timing and injury mechanism with degree of intra-articular injury. Patients with surgically treated MLKIs over a 15-year period were retrospectively reviewed and grouped based on surgical intervention, time to intervention, and injury mechanism. The presence or absence of meniscus and chondral injury were recorded at the time of surgery. Surgical intervention within 6 weeks of injury was deemed acute, while sur...
Source: Journal of Knee Surgery - September 8, 2020 Category: Orthopaedics Authors: Shamrock, Alan G. Hall, James R. Hajewski, Christina J. An, Qiang Duchman, Kyle R. Tags: Original Article Source Type: research

Central Transpatellar Tendon Portal Is Safe When Used for Anterior Cruciate Ligament Reconstruction
J Knee Surg DOI: 10.1055/s-0040-1716380Central transpatellar tendon portal (CTP) was suggested first for complex meniscal lesion and subsequently for a better femoral footprint view during reconstruction of anterior cruciate ligament (ACL). A comprehensive evaluation of possible consequences of using the CTP performing an ACL reconstruction does not exist. Our hypothesis was that the use of CTP for ACL reconstruction does not lead to a higher rate of complications or clinically evident radiological abnormalities. In total, 141 patients were prospectively evaluated, 69 underwent ACL reconstruction using a standard high medi...
Source: Journal of Knee Surgery - September 8, 2020 Category: Orthopaedics Authors: Perelli, Simone Erquicia, Juan Ignacio Morales Marin, Carlos Bracamonte Salgado, William Teodoro Masferrer-Pino, Angel Perez-Prieto, Daniel Monllau, Juan Carlos Tags: Original Article Source Type: research

Effect of Geometry on the Fixation Strength of Anterior Cruciate Ligament Reconstruction Using BASHTI Technique
J Knee Surg DOI: 10.1055/s-0040-1716371The goal of this study is to investigate the effects of tendon and cannulated drill bit diameter on the strength of the bone and site hold tendon inside (BASHTI) fixation technique for an anterior cruciate ligament (ACL) reconstruction. Bovine digital tendons and Sawbones blocks were used to mimic the ACL reconstruction. Mechanical strength of the specimens was measured using a cyclic loading continued by a single cycle pullout load until failure to simulate the real postsurgical loading conditions. Finally, failure modes of specimens and ultimate failure load were recorded. The maxim...
Source: Journal of Knee Surgery - September 8, 2020 Category: Orthopaedics Authors: Moeinnia, Hadi Nourani, Amir Borjali, Amirhossein Mohseni, Mahdi Ghias, Narges Korani, Hossein Chizari, Mahmoud Tags: Original Article Source Type: research

Computed Tomography-Based Patient-Specific Instrumentation Loses Accuracy with Significant Varus Preoperative Misalignment
J Knee Surg DOI: 10.1055/s-0040-1716381Patient-specific instrumentation (PSI) has been introduced to simplify and make total knee arthroplasty (TKA) surgery more precise, effective, and efficient. We performed this study to determine whether the postoperative coronal alignment is related to preoperative deformity when computed tomography (CT)-based PSI is used for TKA surgery, and how the PSI approach compares with deformity correction obtained with conventional instrumentation. We analyzed pre-and post-operative full length standing hip-knee-ankle (HKA) X-rays of the lower limb in both groups using a convention> 180 de...
Source: Journal of Knee Surgery - September 8, 2020 Category: Orthopaedics Authors: Le ón-Muñoz, Vicente Jesús L ópez-López, Mirian Lis ón-Almagro, Alonso José Mart ínez-Martínez, Francisco Santonja-Medina, Fernando Tags: Original Article Source Type: research

Predictors of PROMIS Physical Function at 2 Years following Knee Surgery
J Knee Surg DOI: 10.1055/s-0040-1716360The purpose of this study was to evaluate Patient-Reported Outcomes Measurement Information System physical function (PROMIS PF) 2 years following knee surgery, and identify preoperative factors associated with postoperative PROMIS PF. Three hundred and sixty-five patients, age 17 years and older, undergoing knee surgery at one institution were studied. Patients completed multiple questionnaires prior to surgery and again 2 years postoperatively including PROMIS PF, International Knee Documentation Committee (IKDC), joint and body numeric pain scales (NPS), Tegner's activity scale (TA...
Source: Journal of Knee Surgery - September 8, 2020 Category: Orthopaedics Authors: Hunt, Darius Zhang, Tina Koenig, Scott Aneizi, Ali Perraut, Gregory Shasti, Keyan Wahl, Alexander J. Meredith, Sean J. Henn, R. Frank Tags: Original Article Source Type: research

Comparison of Acorn and Fluted Reamers on Tibial Tunnel Outer Aperture Dimensions in Anterior Cruciate Ligament Reconstruction
J Knee Surg DOI: 10.1055/s-0040-1716372The aim of this study was to determine if the type of reamer used in tibial tunnel creation during anterior cruciate ligament (ACL) reconstruction influences the dimensions of the tunnel's outer aperture. Tibial tunnels were created in tibial saw bones by reaming over a guidewire using an 8 mm acorn or fluted reamer in an antegrade manner. Reaming was aimed either in line with the guidewire, or with 10-degree inferior/superior deviation in relation to the wire. The shape and size of the outer aperture of the tibial tunnel were compared between the two reamers. When using the ac...
Source: Journal of Knee Surgery - September 8, 2020 Category: Orthopaedics Authors: Gerrard, Adam D. Jump, Chris M. Sutton, Paul Charalambous, Charalambos P. Tags: Original Article Source Type: research

Risk Factors for New Meniscal Tears following Anterior Cruciate Ligament Reconstruction
This study aims to compare the rate of meniscal tears after anterior cruciate ligament (ACL) reconstruction in patients who have undergone concomitant meniscal repair during the index procedure with that in patients who have not undergone such surgery. It also evaluates other risk factors, such as age, gender, race, body mass index (BMI), site of concomitant meniscal surgery, and ACL graft failure. This is a retrospective study conducted at a large tertiary public hospital. Patients who underwent primary anterior cruciate ligament reconstruction (ACLR) surgery with or without concomitant meniscal repair from 2011 to 2016 w...
Source: Journal of Knee Surgery - September 8, 2020 Category: Orthopaedics Authors: Chan, Chloe Xiaoyun Silas, Christian Ifran, Nadia Nastassia Mok, Ying Ren Krishna, Lingaraj Tags: Original Article Source Type: research

Increased Risk of Short-Term Complications in Smokers Undergoing Primary Unicompartmental Knee Arthroplasty
J Knee Surg DOI: 10.1055/s-0040-1716373The effects of smoking on unicompartmental knee arthroplasty (UKA) are unknown. The purpose of this study was to evaluate the effects of smoking on short-term outcomes following primary UKA. A query of the National Surgical Quality Improvement Project (NSQIP) database was used to identify cases of primary UKA performed during years 2006 to 2017. Patient demographics, operative times, and postoperative complications were compared between smoking and nonsmoking cohorts. Descriptive statistics, univariate analyses, and multivariate analyses were conducted to evaluate the effects of smoki...
Source: Journal of Knee Surgery - September 8, 2020 Category: Orthopaedics Authors: Carender, Christopher N. DeMik, David E. Bedard, Nicholas A. Glass, Natalie A. Brown, Timothy S. Tags: Original Article Source Type: research

Impact of Preoperative Opioid Use on 2-Year Patient-Reported Outcomes in Knee Surgery Patients
The objectives of this study are to assess perioperative opioid use in patients undergoing knee surgery and to examine the relationship between preoperative opioid use and 2-year postoperative patient-reported outcomes (PROs). We hypothesized that preoperative opioid use and, more specifically, higher quantities of preoperative opioid use would be associated with worse PROs in knee surgery patients. We studied 192 patients undergoing knee surgery at a single urban institution. Patients completed multiple PRO measures preoperatively and 2-year postoperatively, including six patient-reported outcomes measurement information ...
Source: Journal of Knee Surgery - September 8, 2020 Category: Orthopaedics Authors: Aneizi, Ali Sajak, Patrick M. J. Alqazzaz, Aymen Weir, Tristan Burt, Cameran I. Ventimiglia, Dominic J. Leong, Natalie L. Packer, Jonathan D. Henn, R. Frank Tags: Original Article Source Type: research

Cementless Total Knee Arthroplasty
J Knee Surg 2020; 33: 847-847 DOI: 10.1055/s-0040-1714419 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 - September 1, 2020 Category: Orthopaedics Authors: Sodhi, Nipun Salem, Hytham Tarazi, John Ehiorobo, Joseph O. Harwin, Steven F. Mont, Michael A. Tags: Foreword Source Type: research

Patellofemoral Arthroplasty Improves Patellofemoral Alignment in Patients with Patellofemoral Osteoarthritis with Trochlear Dysplasia
J Knee Surg DOI: 10.1055/s-0040-1715099The impact of trochlear dysplasia on patellofemoral arthroplasty (PFA) has rarely been reported in the literature. The purpose of this study was to explore the effectiveness of PFA in patients with patellofemoral osteoarthritis (PFOA) associated with trochlear dysplasia. From January 2014 to March 2018, 35 patients with PFOA and trochlear dysplasia (29 females and 6 males), underwent PFA, were included in the present retrospective study. Radiological measurements including the patellar tilt (PT), congruence angle (CA), Blackburne–Peel ratio (BPR), tibial tuberosity–trochle...
Source: Journal of Knee Surgery - August 31, 2020 Category: Orthopaedics Authors: Yang, Guangmin Wang, Jue Dai, Yike Lin, Wei Niu, Jinghui Wang, Fei Tags: Original Article Source Type: research

In-hospital Mortality after Septic Revision TKA: Analysis of the New York and Florida State Inpatient Databases
In this study, 3,531 septic rTKA patients were identified; 105 (3%) patients suffered in-hospital mortality, compared with the control aseptic rTKA (n = 178; 1.7%; p 
Source: Journal of Knee Surgery - August 31, 2020 Category: Orthopaedics Authors: Samuel, Linsen T. Sultan, Assem A. Zhou, Guangjin Navale, Suparna Kamath, Atul F. Klika, Alison Piuzzi, Nicolas S. Koroukian, Siran M. Higuera-Rueda, Carlos A. Tags: Original Article Source Type: research

Incidence of Venous Thromboembolism following Knee Arthroscopy: Effectiveness of a Risk-Based Stratified Chemoprophylaxis Protocol
This study found that a chemoprophylaxis protocol with preferential use of aspirin or low–molecular weight heparin based on risk factors reduced the VTE incidence below to 2.0%, which is lower than most historical controls. [...] 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 31, 2020 Category: Orthopaedics Authors: Reynolds, Alan W. Garay, Mariano Lynch, Scott Black, Kevin P. Gallo, Robert A. Tags: Original Article Source Type: research

Improved Component Placement Accuracy with Robotic-Arm Assisted Total Knee Arthroplasty
J Knee Surg DOI: 10.1055/s-0040-1715571Component position of total knee arthroplasty (TKA) has been shown to influence prosthetic survivorships and clinical outcomes. Our objective was to compare the three-dimensional accuracy to plan of robotic-arm assisted TKA (RATKA) with conventional TKA for component position. We conducted a nonrandomized, prospective study comparing 143 RATKA with 86 conventional TKA operated at four U.S. centers between July 2016 and October 2018. Computed tomography (CT) scans obtained approximately 6 weeks postoperatively were analyzed using anatomical landmarks. Absolute deviation from surgical p...
Source: Journal of Knee Surgery - August 31, 2020 Category: Orthopaedics Authors: Mahoney, Ormonde Kinsey, Tracey Sodhi, Nipun Mont, Michael A. Chen, Antonia F. Orozco, Fabio Hozack, William Tags: Original Article Source Type: research

Effect of Local Infiltration Analgesia on Functional Outcomes in Total Knee Arthroplasty: A Randomized, Placebo-Controlled, Double-Blind Clinical Trial
J Knee Surg DOI: 10.1055/s-0040-1715103Local infiltration analgesia (LIA) is a simple, surgeon-administered technique for the treatment of postoperative pain after total knee arthroplasty (TKA). The aim of the study was to investigate the efficacy of LIA and its effects on functional outcomes in TKA. A total of 135 patients with primary TKA were recruited and randomized either to receive LIA or to receive placebo injection (PI). Pain, active range of motion (ROM), knee function score, functional activities, and hospital length of stay (LOS) were assessed before surgery and from postoperative day (POD) 1 to at discharge. Lo...
Source: Journal of Knee Surgery - August 24, 2020 Category: Orthopaedics Authors: Unver, Bayram Yuksel, Ertugrul Eymir, Musa Maltepe, Fikret Karatosun, Vasfi Tags: Original Article Source Type: research

Meniscus Graft Augmentation for a Midsubstance Tear of the Medial Collateral Ligament during Total Knee Arthroplasty
The objective of the study is to confirm the clinical effectiveness of meniscus transfer for treatment of iatrogenic MCL midsubstance transection in which remaining MCL is of poor quality, and there is a persistent gap between both ligament ends during TKA. From January 2015 to November 2019, we treated 11 patients with MCL injuries of 882 primary TKAs by meniscus transfer. Another 24 primary TKAs were recruited as a control group. The two groups of patients were comparable for age, gender, body mass index (BMI), Knee Society scoring (KSS), knee function score (KFS), and type of prosthesis comparison without significant di...
Source: Journal of Knee Surgery - August 24, 2020 Category: Orthopaedics Authors: Sun, Changjiao Rong, Wei Du, Ruiyong Wu, Sha Liu, Pu Zhang, Wei Cai, Xu Tags: Original Article Source Type: research

Various Types of Medial Tibial Bone Resorption after Total Knee Arthroplasty Using a Thick Cobalt Chromium Tibial Baseplate
J Knee Surg DOI: 10.1055/s-0040-1715085Recent literature has implicated a thick cobalt chromium baseplate as a potential source of stress shielding and medial tibial bone resorption after total knee arthroplasty (TKA) in a Western population. The purpose was to calculate the incidence of various types and severity of medial tibial bone resorption utilizing a novel classification system after TKA with a thick cobalt chromium baseplate in Asian patients. Five hundred TKAs using Attune prostheses with mean follow-up of 3.4 years were evaluated, using the prospective radiographic data. The mean age was 71.3 years. The preopera...
Source: Journal of Knee Surgery - August 24, 2020 Category: Orthopaedics Authors: Song, Sang Jun Lee, Hyun Woo Kang, Se Gu Bae, Dae Kyung Park, Cheol Hee Tags: Original Article Source Type: research

Gout As a Predictor of Total Knee Arthroplasty Outcomes and Costs
J Knee Surg DOI: 10.1055/s-0040-1715098Gout is the most common inflammatory arthritis and affects approximately 4% of the U.S. population. As the prevalence of gout and the number of total knee arthroplasties (TKAs) performed continue to increase, the literature on TKA in patients with gout remains scant. The purpose of this study was to evaluate the outcomes of patients with gout following TKA at a population level, that is, how patient with gout fair after TKA. We hypothesized that patients with gout have higher rates of complications and higher costs compared with controls. A case–control study was designed to eva...
Source: Journal of Knee Surgery - August 24, 2020 Category: Orthopaedics Authors: Rosas, Samuel Zuskov, Andrey Luo, Tianyi David Roche, Martin W. Emory, Cynthia L. Plate, Johannes F. Tags: Original Article Source Type: research

Preoperative Meniscal Extrusion Predicts Unsatisfactory Clinical Outcomes and Progression of Osteoarthritis after Isolated Partial Medial Meniscectomy: A 5-Year Follow-Up Study
The objective of this study was to examine the association between preoperative meniscal extrusion of patients undergoing partial medial meniscectomy with clinical outcomes and progression of osteoarthritis and to determine the extent of meniscal extrusion associated with unsatisfactory clinical outcomes and progression of osteoarthritis. Ninety-five patients who underwent partial medial meniscectomy with a minimum follow-up of 5 years were retrospectively reviewed. Preoperative meniscal extrusion was evaluated with magnetic resonance imaging. Patients were assessed preoperatively and postoperatively with Lysholm and Inter...
Source: Journal of Knee Surgery - August 24, 2020 Category: Orthopaedics Authors: Novaretti, Jo ão V. Astur, Diego C. Cavalcante, Elton L.B. Kaleka, Camila C. Amaro, Joicemar T. Cohen, Mois és Tags: Original Article Source Type: research

Anthropometric Comparison between Indian and Arabian Knees with Respect to Total Knee Replacement
In this study, the knee anthropometry of the Indian and Arabian patients was compared. They were operated with implants which were not ethnic-specific designs. Since the consequences associated with implant misfit apply equally to both the Indian and Arabian population, it is essential to compare the knee anthropometry of these two populations. Anthropometric measurements of the distal femur and proximal tibia of the Indian and Arabian knees were obtained intraoperatively using a Vernier caliper. Their respective aspect ratios (ARs) were calculated and statistically compared. It was found that the ARs of both tibia and fem...
Source: Journal of Knee Surgery - August 24, 2020 Category: Orthopaedics Authors: Nair, Vijayamohan Sreedharan Radhamony, Niranj Ganeshan Padmalayam, Arjun Govindan, Nijith O. Tags: Original Article Source Type: research

Learning Curve of Robotic-Assisted Total Knee Arthroplasty for a High-Volume Surgeon
J Knee Surg DOI: 10.1055/s-0040-1715126The learning curve has been established for robotic-assisted total knee arthroplasty (RATKA) during the first month of use; however, there have been no studies evaluating this on a longer term. Therefore, the purpose of this study was to compare operative times for three cohorts during the first year following adoption of RATKA (initial, 6 months, and 1 year) and a prior cohort of manual TKA. We investigated both mean operative times and the variability of operative time in each cohort. This is a learning curve study comparing a single surgeon's experience using RAKTA. The study group...
Source: Journal of Knee Surgery - August 24, 2020 Category: Orthopaedics Authors: Marchand, Kevin B. Ehiorobo, Joseph Mathew, Kevin K. Marchand, Robert C. Mont, Michael A. Tags: Original Article Source Type: research

Total Knee Arthroplasty after Previous Ipsilateral Hip Arthroplasty Showed Lower Clinical Outcomes and Higher Leg Length Discrepancy Perception
J Knee Surg DOI: 10.1055/s-0040-1715447The purpose of this study is to compare perception of leg length discrepancy (LLD) and clinical results of total knee arthroplasties (TKA) in patients with or without previous ipsilateral hip arthroplasty. Between 2008 and 2015, navigation-assisted TKA was performed in 43 patients with previous hip arthroplasty after hip fracture. After 1:3 propensity score matching was performed, 108 patients of primary navigation-assisted TKA (group 1) and 36 patients with hip arthroplasty (group 2) were included. Knee Society (KS) scores, Western Ontario and McMaster Universities Index (WOMAC) scor...
Source: Journal of Knee Surgery - August 24, 2020 Category: Orthopaedics Authors: Lee, Han-Jun Kim, Seong Hwan Pujol, Nicolas Park, Yong-Beom Tags: Original Article Source Type: research

Unicompartmental Knee Arthroplasty in Octogenarians versus Younger Patients: A Comparison of 30-Day Outcomes
J Knee Surg DOI: 10.1055/s-0040-1715110As the United States' octogenarian population (persons 80–89 years of age) continues to grow, understanding the risk profile of surgical procedures in elderly patients becomes increasingly important. The purpose of this study was to compare 30-day outcomes following unicompartmental knee arthroplasty (UKA) in octogenarians with those in younger patients. The American College of Surgeons National Surgical Quality Improvement Program database was queried. All patients, aged 60 to 89 years, who underwent UKA from 2005 to 2016 were included. Patients were stratified by age: 60 to 69...
Source: Journal of Knee Surgery - August 24, 2020 Category: Orthopaedics Authors: Kavanagh, Michael D. Abola, Matthew V. Tanenbaum, Joseph E. Knapik, Derrick M. Fitzgerald, Steven J. Wera, Glenn D. Tags: Original Article Source Type: research

Enhanced Recovery after Surgery for Knee Arthroplasty in the Era of COVID-19
J Knee Surg DOI: 10.1055/s-0040-1715125Enhanced recovery after surgery (ERAS) represents a paradigm shift in perioperative care, aimed at achieving early recovery for surgical patients, reducing length of hospital stay, and complications. The purpose of this study was to provide an insight of the impact of the COVID-19 on ERAS protocols for knee arthroplasty patients in a tertiary hospital and potential strategy changes for postpandemic practice. We retrospectively reviewed all cases that underwent surgery utilizing ERAS protocols in the quarter prior to the pandemic (fourth quarter of 2019) and during the first quarter of...
Source: Journal of Knee Surgery - August 24, 2020 Category: Orthopaedics Authors: Ding, Benjamin Tze Keong Ng, Jensen Tan, Kelvin Guoping Tags: Original Article Source Type: research

Clinical Outcomes, Health Care Costs and Prognostic Factors for Total Knee Arthroplasty: A Multilevel Analysis of a National Cohort Study Using Administrative Claims Data
J Knee Surg DOI: 10.1055/s-0040-1715097Total knee arthroplasty (TKA) is one of the most frequent orthopaedic surgeries. The purpose of this study was to determine the 30-day postoperative mortality rate, total episode-of-care costs, and prognostic factors associated with these outcomes, for adult patients who underwent TKA in Colombia's contributory health care system. A retrospective cohort study of all adult patients enrolled in Colombia's contributory health system, who underwent TKA between January 1, 2012 and November 30, 2015 was performed. Thirty-day postoperative mortality rates, 30-day ICU admissions rates, 30-day...
Source: Journal of Knee Surgery - August 24, 2020 Category: Orthopaedics Authors: Buitrago, Giancarlo Ortiz, Jorge R. Camacho, Felipe Tags: Original Article Source Type: research

Isokinetic Evaluation of Knee Strength and Endurance in Hemodialysis Patients Treated with the Transpatellar Tunnel Technique for Bilateral Spontaneous Quadriceps Tendon Ruptures
J Knee Surg DOI: 10.1055/s-0040-1715100There are numerous surgical techniques described for treating acute quadriceps tendon rupture. We aim to evaluate the strength of the quadriceps tendon using isokinetic tests in hemodialysis patients treated with the transpatellar tunnel technique for bilateral spontaneous quadriceps tendon ruptures. Additionally, functional and clinical results were investigated and compared with hemodialysis patients without a history of quadriceps tendon rupture. We retrospectively reviewed hemodialysis patients diagnosed with quadriceps tendon rupture who were operated between 2005 and 2015 at our...
Source: Journal of Knee Surgery - August 24, 2020 Category: Orthopaedics Authors: Biri şik, Fevzi Ekinci, Mehmet Bayram, Serkan Şahinkaya, Türker Ergin, Ömer Naci Er şen, Ali A şık, Mehmet Tags: Original Article Source Type: research

Comment on “Robot-Assisted versus Conventional Total and Unicompartmental Knee Arthroplasty: A Meta-analysis of Radiological and Functional Outcomes”
J Knee Surg DOI: 10.1055/s-0040-1715131 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 24, 2020 Category: Orthopaedics Authors: Lei, Kai Feng, Qing Tags: Letter to the Editor Source Type: research

Fresh Osteochondral Allograft Transplants in the Knee: Bipolar and Beyond
This article documents our own institutional OCA journey since 2016 through enhanced graft preservation techniques (the Missouri Osteochondral Preservation System, or MOPS), technical improvements in surgical techniques, use of bone marrow aspirate concentrate, bioabsorbable pins and nails, and prescribed and monitored patient-specific rehabilitation protocols. Further follow-up with documentation of long-term outcomes will provide insight for continued optimization for future applications for OCA transplantation, potentially including a broader spectrum of patients appropriate for this treatment. Ongoing translational res...
Source: Journal of Knee Surgery - July 20, 2020 Category: Orthopaedics Authors: Stannard, James P. Stannard, James T. Schreiner, Anna J. Tags: Special Focus Section Source Type: research

Effect of Steroid in Local Infiltration Analgesia in One-Stage Bilateral Total Knee Arthroplasty: A Paired-Randomized Controlled Study
This study aims to evaluate the role of steroids in LIA. This is a paired-randomized controlled study involving one-stage bilateral TKA patients. LIA containing ropivacaine, ketorolac, and adrenaline with or without triamcinolone was given. One knee was randomized to receive LIA with steroids, while the other received LIA without steroids. The primary outcome was knee pain in terms of the visual analog scale (VAS). Secondary outcomes were rehabilitation progress, functional scores, and complications. Outcomes were compared between the knees of the same patient and documented up to 1 year. A total of 45 patients (90 TKAs) w...
Source: Journal of Knee Surgery - July 20, 2020 Category: Orthopaedics Authors: Chan, Vincent Wai Kwan Chan, Ping Keung Yan, Chun Hoi Henry, Chun Him Chan, Chi Wing Chiu, Kwong Yuen Tags: Original Article Source Type: research

Classification, Categorization, and Algorithms for Articular Cartilage Defects
J Knee Surg DOI: 10.1055/s-0040-1713778There is a critical unmet need in the clinical implementation of valid preventative and therapeutic strategies for patients with articular cartilage pathology based on the significant gap in understanding of the relationships between diagnostic data, disease progression, patient-related variables, and symptoms. In this article, the current state of classification and categorization for articular cartilage pathology is discussed with particular focus on machine learning methods and the authors propose a bedside–bench–bedside approach with highly quantitative techniques as a...
Source: Journal of Knee Surgery - July 14, 2020 Category: Orthopaedics Authors: Leary, Emily Stoker, Aaron M. Cook, James L. Tags: Special Focus Section Source Type: research

Nonsurgical Management of Cartilage Defects of the Knee: Who, When, Why, and How?
J Knee Surg DOI: 10.1055/s-0040-1713813The nonoperative practitioner managing individuals with cartilage defects should use a patient-centered, multifaceted approach that aims to individualize treatment to provide optimal benefit. These include addressing modifiable risk factors for disease progression and instituting interventions such as weight loss, nutrition, physical activity, and potentially regenerative medicine strategies. This review will focus on these nonoperative treatment strategies with a focus on when treatments are necessary, who will benefit from these approaches, why they are specifically appropriate, and...
Source: Journal of Knee Surgery - July 14, 2020 Category: Orthopaedics Authors: Hanaoka, Chad Fausett, Cameron Jayabalan, Prakash Tags: Special Focus Section Source Type: research

Association of Anesthesia Type with Postoperative Outcome and Complications in Patients Undergoing Revision Total Knee Arthroplasty
J Knee Surg DOI: 10.1055/s-0040-1713776Revision total knee arthroplasty (TKA) is an increasingly common procedure and is effective in treating knee osteoarthritis, but it has higher complication rates than primary TKA. Anesthetic choice poses perioperative risk that has been extensively studied in primary TKA, showing favorable results for regional anesthesia compared with general anesthesia. The impact of anesthetic choice in revision TKAs is not well studied. A retrospective cohort study was conducted using the American College of Surgeons National Surgical Quality Improvement Program database. Patients who underwent rev...
Source: Journal of Knee Surgery - July 14, 2020 Category: Orthopaedics Authors: Wei, Chapman Muthiah, Arun Gu, Alex Quan, Theodore Nguyen, Kenneth T. Fassihi, Safa C. Chen, Aaron Z. Amdur, Richard L. Nunley, Ryan M. Liu, Jiabin Sculco, Peter K. Berger, Jeffrey S. Tags: Original Article Source Type: research

The Effect of Patellar Positioning on Femoral Component Rotation when Performing Flexion Gap Balancing Using a Tensioning Device for Total Knee Arthroplasty
J Knee Surg DOI: 10.1055/s-0040-1713896There is an increasing interest in new devices such as tensiometers for flexion gap balancing during total knee arthroplasty (TKA). The purpose of this study was to determine the influence of patella positioning during flexion gap balancing on femoral component rotation. We prospectively evaluated 32 consecutive knees in 31 patients who underwent primary TKA for degenerative osteoarthritis and where soft tissue balancing was performed using the same tensiometer. Preoperative measurements included valgus/varus deformation, mechanical axis, epicondylar axis, and tibial slope. Intraopera...
Source: Journal of Knee Surgery - July 14, 2020 Category: Orthopaedics Authors: Ernstbrunner, Lukas Andronic, Octavian Grubhofer, Florian Jundt-Ecker, Mich èle Fucentese, Sandro F. Tags: Original Article Source Type: research

Same Day versus Staged Total Knee Arthroplasty: Do Cost Savings Justify the Risk?
J Knee Surg DOI: 10.1055/s-0040-1713734Same-day bilateral total knee arthroplasties (BTKAs) are associated with increased complications compared with staged procedures; however, as complication rates and lengths of stay (LOS) for same-day procedures decrease, they may become attractive alternatives to staged procedures. The void of recent nationwide studies comparing the 30-day total cost and risks of these procedures inspired this propensity matched review. Therefore, we compared 30-day outcomes in staged and same-day BTKAs occurring in 2016 and 2017 using the National Readmission Database (NRD), a nationwide database. Th...
Source: Journal of Knee Surgery - July 13, 2020 Category: Orthopaedics Authors: Wilkie, Wayne Mohamed, Nequesha Remily, Ethan Pastore, Mark Nace, James Delanois, Ronald E. Tags: Original Article Source Type: research