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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Total Knee Arthroplasty versus Osteochondral Allograft: Prevalence and Risk Factors following Tibial Plateau Fractures
J Knee Surg DOI: 10.1055/s-0038-1641593Orthopaedic surgeons commonly have the misconception that patients with tibial plateau fractures will likely go on to posttraumatic knee arthritis requiring total knee arthroplasty (TKA). In younger patients, osteochondral allograft (OCA) transplantation is an alternative method to address posttraumatic knee arthritis. The purpose of this study was (1) to identify our institutional failure rate following tibial plateau open reduction and internal fixation (ORIF) (failure was defined as conversion to TKA or OCA); (2) to determine if there are patient- or injury-related risk factors pre...
Source: Journal of Knee Surgery - April 18, 2018 Category: Orthopaedics Authors: Oladeji, Lasun O. Dreger, Tina K. Pratte, Eli L. Baumann, Charles A. Stannard, James P. Volgas, David A. Rocca, Gregory J. Della Crist, Brett D. Tags: Original Article Source Type: research

Pediatric Knee Sports Injuries
J Knee Surg 2018; 31: 373-373 DOI: 10.1055/s-0038-1639373 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 - April 18, 2018 Category: Orthopaedics Authors: Fanelli, Gregory C. Tags: Special Focus Section Source Type: research

Revision Anterior Cruciate Ligament Reconstruction Outcomes at a Minimum of 5-Year Follow-Up: A Systematic Review
J Knee Surg DOI: 10.1055/s-0038-1641137Revision anterior cruciate ligament (ACL) reconstruction typically has worse outcomes than primary reconstructions. Minimal long-term data exist regarding 5-year results. We chose to perform a systematic review to evaluate midterm (5-year) revision ACL reconstruction outcomes (patient-reported outcomes, reoperation, stability, arthritis) in comparison to primary ACL reconstructions at similar time points. Embase, Cochrane, and PubMed databases were queried, and four studies met the inclusion criteria. Two authors reviewed and performed data extraction. All were level 4 studies. Review...
Source: Journal of Knee Surgery - April 13, 2018 Category: Orthopaedics Authors: Wright, Rick W. Johnson, Lea Brophy, Robert H. Bogunovic, Ljiljana Matava, Matthew J. Smith, Matthew V. Tags: Original Article Source Type: research

Effect of the Distal Femoral Joint Line on Ligament Tensions in Flexion with Cruciate-Retaining Total Knee Prostheses
J Knee Surg DOI: 10.1055/s-0038-1641730Proper ligament tension in knee flexion within cruciate-retaining (CR) total knee arthroplasty has long been associated with clinical success; however, traditional balancing principles have assumed that the distal femoral joint line (DFJL) affects only extension. The purpose of this study was to determine the effect DFJL may have on ligament strains and tibiofemoral kinematics of CR knee designs in flexion. A computational analysis was performed using a musculoskeletal modeling system for two different knee implants, the high-flex CR (HFCR) and guided-motion CR (GMCR). Tibiofemoral ki...
Source: Journal of Knee Surgery - April 13, 2018 Category: Orthopaedics Authors: Narayanan, Rajkishen Lenz, Nathaniel Werner, Jordan Alexander Cross, Michael B. Hughes, Dean Laster, Scott Schwarzkopf, Ran Tags: Original Article Source Type: research

The Role of Clinical Examination in Predicting Relevant MRI Findings in Acute Knee Injuries: A Retrospective Study
The objective of this study was to delineate the usefulness of clinical examination and magnetic resonance imaging (MRI) in acute knee injuries. We aim to establish whether the time period post acute knee injury is related to the diagnostic accuracy of clinical examination and to investigate the strength of specific clinical examination findings in predicting a clinically relevant MRI abnormality. Seventy patients were referred to fracture clinic with an acute knee injury who subsequently went on to be investigated with MRI over 12 months. These patients were retrospectively analyzed looking at the time period they were re...
Source: Journal of Knee Surgery - April 13, 2018 Category: Orthopaedics Authors: Makki, Daoud Mastan, Saleem Ness, Daniel Thonse, Raghuram Tags: Original Article Source Type: research

Examination under Anesthesia in Patients with Recurrent Patellar Dislocation: Prognostic Study
J Knee Surg DOI: 10.1055/s-0038-1641174Surgical management of patellar instability is a matter of wide debate. While some authors believe that isolated medial patellofemoral ligament (MPFL) reconstruction is sufficient, others advocate procedures to treat the underlying pathology, namely, patella alta and trochlear dysplasia. Radiological studies have been traditionally used as a determinant of these pathologies and to determine the need for an additional procedure. The value of examination under anesthesia (EUA) in formulating a treatment plan remains unknown. Our aim is to assess the prognostic value of EUA in assessing ...
Source: Journal of Knee Surgery - April 13, 2018 Category: Orthopaedics Authors: Fathalla, Ismail Holton, James Ashraf, Tanweer Tags: Original Article Source Type: research

Expression of LOXs and MMP-1, 2, 3 by ACL Fibroblasts and Synoviocytes Impact of Coculture and TNF- α
This study aims to confirm the effects of synoviocytes (SCs) on regulating lysyl oxidases (LOXs) and matrix metalloproteinase (MMP)-1, 2, 3 in the normal and injured anterior cruciate ligament (ACL) fibroblasts response to tumor necrosis factor-α(TNF-α). The gene and protein expression levels of LOXs and MMP-1, 2, 3 in SCs cocultured ACL fibroblasts (ACLfs) induced by TNF-α and mechanical injury were analyzed by real-time polymerase chain reaction (PCR) and western bolting; the MMP-2 activity were analyzed by zymography. The results exhibited that TNF-α alone slightly downregulated the expressions o...
Source: Journal of Knee Surgery - April 10, 2018 Category: Orthopaedics Authors: Wang, Chunli Chi, Qingjia Xu, Chunming Xu, Kang Zhang, Yanjun Liu, Yan Yang, Li Sung, K. L. Paul Tags: Original Article Source Type: research

Achieving Minimum Clinically Important Difference in Oxford Knee Score and Short Form-36 Physical Component Summary Is Less Likely with Single-Radius Compared with Multiradius Total Knee Arthroplasty in Asians
In conclusion, there are no significant differences in the absolute PROMs between SR-TKA and MR-TKA at 2 years following TKA in Asians. However, SR-TKA has significantly lower odds of achieving the MCID for OKS and SF-36 PCS. [...] 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 - April 10, 2018 Category: Orthopaedics Authors: Lee, Wu Chean Bin Abd Razak, Hamid Rahmatullah Allen, John Carson Chong, Hwei Chi Tan, Hwee Chye Andrew Tags: Original Article Source Type: research

Ten-Year Results of the Press Fit Condylar Sigma Cobalt –Chrome Total Knee Replacement
J Knee Surg DOI: 10.1055/s-0038-1641138Total knee arthroplasty (TKA) is reliant on safe and effective implants. The Press Fit Condylar Sigma Cobalt–Chrome (PFCSCC) was introduced in 2006, but no reports have examined long-term failure rates and patient-reported outcome measures (PROMs). The primary aim of this study was to assess survival outcomes of the PFCSCC at 10 years after implantation. Prospective data collection was performed on all patients undergoing primary TKA in one orthopaedic department using this prosthesis exclusively from February 1, 2006, to January 31, 2007. Follow-up was at 10 years. Survival ana...
Source: Journal of Knee Surgery - April 10, 2018 Category: Orthopaedics Authors: Keenan, Oisin Brenkel, Ivan Walmsley, Phil Tags: Original Article Source Type: research

Tension Band Wire Fixation Technique for Anterior Cruciate Ligament Tibial Avulsion Fracture: A New Fixation Technique
This study evaluated clinical results of tension band wire fixation technique in the arthroscopic treatment of anterior cruciate ligament (ACL) tibial avulsion fracture. This study included 148 cases of ACL tibial avulsion fracture treated using arthroscopic tension band wire fixation technique. Patients were followed up for 25 to 36 months with an average of 27 months and evaluated in accordance with the International Knee Documentation Committee (IKDC) and Lysholm knee scoring scale. Fractures were united within 3 months after surgery in all cases. During the last follow-up, the anterior drawer, Lachman, and pivot shift ...
Source: Journal of Knee Surgery - April 10, 2018 Category: Orthopaedics Authors: Ding, Jing Wan, Lianping Hou, Xiaosheng Gan, Yudong Tags: Original Article Source Type: research

A Meta-Analysis Comparing Liposomal Bupivacaine and Traditional Periarticular Injection for Pain Control after Total Knee Arthroplasty
J Knee Surg DOI: 10.1055/s-0038-1641141Liposomal bupivacaine is a novel method for pain control after total knee arthroplasty (TKA), but recent studies showed no advantage for patients undergoing TKA compared with traditional periarticular injection (PAI). The purpose of this analysis was to compare the clinical outcomes between liposomal bupivacaine treatment and traditional PAI. We retrospectively reviewed data from 16 clinical trials in published databases from their inception to June 2017. The primary outcome was postoperative Visual Analogue Scale (VAS) score and secondary outcomes included opiate usage, narcotic cons...
Source: Journal of Knee Surgery - April 4, 2018 Category: Orthopaedics Authors: Sun, Hao Huang, Zhiyu Zhang, Zhiqi Liao, Weiming Tags: Original Article Source Type: research

Ankle and Hindfoot Symptoms after Medial Open Wedge High Tibial Osteotomy
J Knee Surg DOI: 10.1055/s-0038-1641143Medial open wedge high tibial osteotomy (MOWHTO) is a commonly performed procedure for symptomatic medial compartment osteoarthritis (OA). However, little is known about its effects on ipsilateral ankle or hindfoot. The aim of our study was to determine the incidence of ankle or hindfoot problems after MOWHTO and examine its association with radiological indices. Thirty-five knees (32 patients) undergoing navigated MOWHTO were evaluated for the presence of new-onset ankle or hindfoot symptoms after surgery. Pre- and postoperative hip-knee-ankle (HKA) angle, medial proximal tibial angl...
Source: Journal of Knee Surgery - April 4, 2018 Category: Orthopaedics Authors: Shah, Siddharth Mahesh Roberts, Jason Picard, Frederic Tags: Original Article Source Type: research

Previous History of Breast Cancer Increases Rates of Pulmonary Embolism and Costs after Total Knee Arthroplasty: An Evaluation of 185,114 Matched Patients
J Knee Surg DOI: 10.1055/s-0038-1641155Risk factors for adverse events after total knee arthroplasty (TKA) relating to malignancy have not been well studied. Thus, the purpose of this study was to conduct a retrospective case–control outcome and cost analysis after TKA in this population. Patients with a history of breast cancer (BrCa) were identified based on the International Classification of Disease 9th revision codes. An age- and sex-matched cohort was also identified of patients without a history of BrCa. Complications, length of stay, comorbidity burden, and reimbursements were tracked at 90 days. Each cohort ...
Source: Journal of Knee Surgery - April 4, 2018 Category: Orthopaedics Authors: Rosas, Samuel Luo, T. David Jinnah, Alexander H. Marquez-Lara, Alejandro Roche, Martin W. Emory, Cynthia L. Tags: Original Article Source Type: research

Where is the Target Point to Prevent Cortical Hinge Fracture in Medial Closing-Wedge Distal Femoral Varus Osteotomy?
This study showed a significantly higher incidence of lateral cortical hinge fracture and instability in group A than in group B during closure of the osteotomy gap. [...] 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 - April 4, 2018 Category: Orthopaedics Authors: Nha, Kyung-Wook Chang, Yong Suk Shon, Oog-Jin Shim, Bum-Jin Lee, Jong Seong Song, Jun Seop Bae, Ji-Hoon Tags: Original Article Source Type: research

Comparison of the Leg-Length Change between Opening- and Closing-Wedge High Tibial Osteotomy: A Systematic Review and Meta-Analysis
J Knee Surg DOI: 10.1055/s-0038-1641176The aim of this meta-analysis was to compare the effects of closing-wedge (CW) and opening-wedge (OW) high tibial osteotomies (HTOs) on the change in leg length. Our hypotheses were that leg length will increase after OW HTO and decrease after CW HTO, and the magnitude of the change in leg length would be negligible in both techniques. Multiple databases including MEDLINE, Embase, and Cochrane were searched for studies comparing the change in leg length after HTO with that before HTO. After testing for publication bias and heterogeneity, we aggregated variables by using the random-eff...
Source: Journal of Knee Surgery - April 4, 2018 Category: Orthopaedics Authors: Lee, O-Sung Ahn, Soyeon Lee, Yong Seuk Tags: Original Article Source Type: research

Reliability of Intraoperative Knee Range of Motion Measurements by Goniometer Compared with Robot-Assisted Arthroplasty
J Knee Surg DOI: 10.1055/s-0038-1641140Accurate measurement of knee range of motion (ROM) is critical to predict the outcomes of knee surgery and prognosis. We investigated the reliability of knee ROM measurements by goniometer compared with robotic system. Fifty-three patients with medial osteoarthritis who were planning to undergo unicompartmental knee arthroplasty (UKA) with robotic UKA were prospectively enrolled. During the operation, knee ROM measurement was performed in both flexion and extension before and after insertion of the implant using both a goniometer and robotic system. The intraclass correlation coeffici...
Source: Journal of Knee Surgery - April 4, 2018 Category: Orthopaedics Authors: Kwon, Hyuck Min Yang, Ick-Hwan Lee, Woo-Suk Yu, Alvin Ray L. Oh, Sang Yun Park, Kwan Kyu Tags: Original Article Source Type: research

Five-Strand Hamstring Autograft in Primary Anterior Cruciate Ligament Reconstruction
J Knee Surg DOI: 10.1055/s-0038-1641175The purpose of this study was to describe our surgical technique of using five-strand hamstring autograft with interference screw fixation in primary anterior cruciate ligament (ACL) reconstruction and to report the early postoperative outcomes of this technique. Patients who underwent primary ACL reconstruction using five-strand hamstring autografts with interference screw fixation between December 2014 and June 2016 were included in this study. The five-strand configuration was used in these patients because the four-strand configuration produced a graft diameter of less than 8 mm. ...
Source: Journal of Knee Surgery - April 4, 2018 Category: Orthopaedics Authors: Krishna, Lingaraj Tan, Xin Yang Thangaraja, Acksen Wong, Francis K. L. Tags: Original Article Source Type: research

Efficacy and Safety of Hylan versus Hyaluronic Acid in the Treatment of Knee Osteoarthritis
J Knee Surg DOI: 10.1055/s-0038-1641142The purpose of this study was to use meta-analytic approach to compare the efficacy and safety of intraarticular hylan and hyaluronic acid (HA) for knee osteoarthritis (OA) treatment. We searched PubMed, Embase, and the Cochrane databases through July 2017 to identify Level I randomized controlled trials (RCTs) that evaluated clinical efficacy and safety of hylan compared with HA for knee OA. The primary outcomes were Visual Analogue Scale (VAS) for pain and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain, and WOMAC function scores. In each study and for th...
Source: Journal of Knee Surgery - April 4, 2018 Category: Orthopaedics Authors: Dai, Wen-Li Lin, Ze-Ming Guo, Dong-Hong Shi, Zhan-Jun Wang, Jian Tags: Original Article Source Type: research

Preoperative Hyponatremia Is Associated with Reoperation and Prolonged Length of Hospital Stay following Total Knee Arthroplasty
J Knee Surg DOI: 10.1055/s-0038-1641156Hyponatremia is a risk factor for adverse surgical outcomes, but limited information is available on the prognosis of hyponatremic patients who undergo total knee arthroplasty (TKA). The purpose of this investigation was to compare the incidence of major morbidity (MM), 30-day readmission, 30-day reoperation, and length of hospital stay (LOS) between normonatremic and hypontremic TKA patients.The American College of Surgeons National Surgical Quality Improvement Program database was used to identify all primary TKA procedures. Hyponatremia was defined as 145 mEq/L) were excluded. Mult...
Source: Journal of Knee Surgery - April 4, 2018 Category: Orthopaedics Authors: Abola, Matthew V. Tanenbaum, Joseph E. Bomberger, Thomas T. Knapik, Derrick M. Fitzgerald, Steven J. Wera, Glenn D. Tags: Original Article Source Type: research

Erratum to: Knee Pain and the Use of Various Types of Footwear —A Review
J Knee Surg DOI: 10.1055/s-0038-1641721 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 - April 4, 2018 Category: Orthopaedics Authors: Chughtai, Morad Newman, Jared M. Akil, Samuel Khlopas, Anton Sultan, Assem A. Sodhi, Nipun Bhave, Anil Harwin, Steven F. Mont, Michael A. Tags: Erratum Source Type: research

The Role of Virtual Rehabilitation in Total and Unicompartmental Knee Arthroplasty
This study evaluated the use of telerehabilitation during the postoperative period for patients who underwent total knee arthroplasty (TKA) or unicompartmental knee arthroplasty (UKA). Specifically, this study evaluated the following: (1) patient compliance and adherence to the program, (2) time spent performing physical therapy exercises, (3) the usability of the virtual rehabilitation platform, and (4) clinical outcome scores in a selected primary knee arthroplasty cohort. A total of 157 consecutive patients underwent TKA (n = 18) or UKA (n = 139). These patients used a telerehabilitation syst...
Source: Journal of Knee Surgery - March 16, 2018 Category: Orthopaedics Authors: Chughtai, Morad Kelly, John J. Newman, Jared M. Sultan, Assem A. Khlopas, Anton Sodhi, Nipun Bhave, Anil Kolczun, Michael C. Mont, Michael A. Tags: Original Article Source Type: research

Multiple Ligament Knee Injuries
This article will discuss multiple ligament knee injury evaluation, treatment, and special considerations in the pediatric and adolescent population. [...] 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 - March 13, 2018 Category: Orthopaedics Authors: Fanelli, Gregory C. Fanelli, David G. Tags: Special Focus Section Source Type: research

Intra-articular Alpha-2 Agonists as an Adjunct to Local Anesthetic in Knee Arthroscopy: A Systematic Review and Meta-Analysis
J Knee Surg DOI: 10.1055/s-0038-1636909The infiltration of local anesthetic has been shown to reduce postoperative pain in knee arthroscopy. Several studies have shown that the addition of agents such as magnesium and nonsteroidal antiinflammatory drugs (NSAIDs) result in an increased time to first analgesia and overall reduction in pain. The aim of this systematic review and meta-analysis was to determine whether the addition of an α-2 agonist (A2A) to intra-articular local anesthetic, results in a reduction in postoperative pain. Four major databases were systematically searched for relevant randomized controlled t...
Source: Journal of Knee Surgery - March 13, 2018 Category: Orthopaedics Authors: Ryan, Thomas James Holyoak, Rhys Vlok, Ruan Melhuish, Thomas Hodge, Anthony Binks, Matthew Hurtado, Glenn White, Leigh Tags: Original Article Source Type: research

Improved Early Postoperative Range of Motion in Total Knee Arthroplasty Using Tranexamic Acid: A Retrospective Analysis
J Knee Surg DOI: 10.1055/s-0038-1636914The use of tranexamic acid (TXA) in total knee arthroplasty (TKA) has become common practice. Recent literature has demonstrated a reduction in postoperative knee swelling and drain output while using TXA. Our purpose is to analyze the range of motion (ROM) following TKA in patients who received TXA compared with a control group. We hypothesize that patients treated with TXA will have improved early postoperative ROM when compared with controls. A retrospective chart review was performed for patients who underwent TKA from 2010 to 2012 performed by a single orthopaedic surgeon. Patien...
Source: Journal of Knee Surgery - March 13, 2018 Category: Orthopaedics Authors: Dorweiler, Matthew A. Boin, Michael A. Froehle, Andrew W. Lawless, Matthew W. May, Jedediah H. Tags: Original Article Source Type: research

Erratum to: Difficult Cases in Robotic Arm-Assisted Total Knee Arthroplasty: A Case Series
J Knee Surg DOI: 10.1055/s-0038-1635083 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 - March 13, 2018 Category: Orthopaedics Authors: Marchand, Robert C. Khlopas, Anton Sodhi, Nipun Condrey, Caitlin Piuzzi, Nicolas S. Patel, Rickesh Delanois, Ronald E. Mont, Michael A. Tags: Erratum Source Type: research

Proximal Tibial Fractures in the Pediatric Population
J Knee Surg DOI: 10.1055/s-0038-1636911Injuries about the proximal tibia are quite common in children. Understanding the mechanisms of injury and treatment strategies is imperative for practitioners caring for these patients. Similarly, appreciating the anatomy of the proximal tibia and the adjacent neurovascular structures can assist a practitioner in recognizing the potential associated risks following fracture. Patients with injuries about the proximal tibia require long-term follow-up, and knowledge of the natural history of these fractures is imperative. [...] Thieme Medical Publishers 333 Seventh Avenue, New York, NY...
Source: Journal of Knee Surgery - March 7, 2018 Category: Orthopaedics Authors: Tileston, Kali Frick, Steven Tags: Special Focus Section Source Type: research

Contemporary Perioperative Analgesia in Total Knee Arthroplasty: Multimodal Protocols, Regional Anesthesia, and Peripheral Nerve Blockade
J Knee Surg DOI: 10.1055/s-0038-1636835Perioperative care of the total knee arthroplasty (TKA) patient has evolved considerably over the past decade. Among the changes driving this evolution toward shorter hospitalization and accelerated rehabilitation have been regional anesthesia, peripheral nerve blockade, and multimodal analgesia protocols. These complementary techniques are increasingly supported by scientific evidence, though considerable uncertainty persists regarding the optimal combination of strategies. Continued refinement of technique and critical evaluation is trending toward greater characterization of the co...
Source: Journal of Knee Surgery - March 7, 2018 Category: Orthopaedics Authors: Drew, Jacob M. Neilio, Jonathan Kunze, Lisa Tags: Special Focus Section Source Type: research

Venous Thromboembolism Prophylaxis after Total Knee Arthroplasty
J Knee Surg DOI: 10.1055/s-0038-1636907Venous thromboembolic disease (VTED) is a major cause of morbidity and mortality after total knee arthroplasty (TKA). Current VTED prophylaxis protocols consist of early mobilization, mechanical compression devices, and pharmacologic agents. Venous phasic flow-regulated below-knee devices are generally favored, but the optimal duration and method of mechanical prophylaxis is unknown. Risk stratification models have been developed to guide pharmacologic prophylaxis. For patients with standard VTED risk profile, aspirin has become increasingly popular. Recent studies have validated the ...
Source: Journal of Knee Surgery - March 7, 2018 Category: Orthopaedics Authors: Box, Hayden N. Shahrestani, Sean Huo, Michael H. Tags: Special Focus Section Source Type: research

Tibial Spine Fractures in Children: Evaluation, Management, and Future Directions
J Knee Surg DOI: 10.1055/s-0038-1636544Fractures of the tibial spine are estimated to occur in 3 per 100,000 children annually, but account for 2 to 5% of pediatric knee injuries with effusion. Although these fractures were historically associated with bicycle accidents, the surge of organized youth sports in recent decades has brought renewed attention to this injury. While minimally displaced fractures can be treated nonoperatively, several techniques have been described for fixation of displaced or comminuted fractures. Sequelae of this injury can include arthrofibrosis, knee instability, and nonunion. Future collaborat...
Source: Journal of Knee Surgery - March 7, 2018 Category: Orthopaedics Authors: Adams, Alexander J. Talathi, Nakul S. Gandhi, Jigar S. Patel, Neeraj M. Ganley, Theodore J. Tags: Special Focus Section Source Type: research

Long-Term Clinical Results of Double Bundle Reconstruction of the Medial Patellofemoral Ligament for Patellar Instability
This study aimed to assess the effectiveness of double bundle reconstruction of the MPFL for patellar instability by means of established scores. A total of 68 patients with chronic patellar instability who underwent surgery from May 2005 to February 2010 were included prospectively. Anatomical double reconstruction of the MPFL with the semitendinosus tendon was conducted. Tegner Activity Scale (TAS), Kujala score, Lysholm knee score, and objective physical examination were assessed during follow-up. Median follow-up time for the patients was 8 (range, 6–10) years. Eight patients were lost to follow-up after 2 years....
Source: Journal of Knee Surgery - March 7, 2018 Category: Orthopaedics Authors: Zhang, Lei Li, Zhiyao Tags: Original Article Source Type: research

Posterior Condyle Offset and Maximum Knee Flexion Following a Cruciate Retaining Total Knee Arthroplasty
This study investigated the relationship between the postoperative changes of the PCO and the changes of maximal knee flexion after a cruciate retaining (CR) TKA. Nine patients with medial osteoarthritis (OA) in one knee were investigated. Before operation, each index knee was magnetic resonance imaging (MRI) scanned for construction of a three-dimensional (3D) knee model. The patient then performed a maximal weight-bearing (WB) flexion and the index knee flexion was measured using a dual fluoroscopy technique. At an average of 8 months after a CR TKA, all patients performed the same WB knee flexion. The postoperative chan...
Source: Journal of Knee Surgery - March 7, 2018 Category: Orthopaedics Authors: Wang, Wei Yue, Bin Wang, JianHua Bedair, Hany Rubash, Harry Li, Guoan Tags: Original Article Source Type: research

Patient-Specific Instrument Can Improve Functional and Radiographic Results during Learning Curve for Oxford Unicompartmental Knee Arthroplasty
J Knee Surg DOI: 10.1055/s-0038-1636837The true value of use of patient-specific instrumentation (PSI) systems by inexperienced surgeons during their learning curve to improve the clinical and radiographic outcome of unicompartmental knee arthroplasty (UKA) has not been previously studied. Fifty patients with a mean age of 64.3 years undergoing surgery for Oxford UKA were prospectively divided into two groups. Twenty-five patients were operated on by a surgeon with no prior experience in UKA using a PSI system and the other 25 patients by an experienced surgeon using a conventional procedure. Patients were scored using joi...
Source: Journal of Knee Surgery - March 7, 2018 Category: Orthopaedics Authors: Sanz-Ruiz, Pablo Matas-Diez, Jose Antonio Carbo-Laso, Esther Perez-Ma ñanes, Ruben Vaquero-Mart ín, Javier Tags: Original Article Source Type: research

Contemporary Surgical Trends in the Management of Symptomatic Meniscal Tears among United States Military Servicemembers from 2010 to 2015
J Knee Surg DOI: 10.1055/s-0038-1636838The purpose of this investigation is to report on trends over time in the treatment of meniscal pathology among military orthopaedic surgeons, as well as to evaluate the impact of patient demographics and concomitant procedure on the type of meniscal procedure performed. We performed a retrospective analysis of all active-duty United States military servicemembers who underwent a meniscal procedure from 2010 to 2015 within the Military Health System. Patient demographics and surgical variables were extracted from the electronic medical record. Treatments were categorized by location a...
Source: Journal of Knee Surgery - March 7, 2018 Category: Orthopaedics Authors: Pekari, Timothy B. Wang, Kevin C. Cotter, Eric J. Kusnezov, Nicholas Waterman, Brian R. Tags: Original Article Source Type: research

What are the Short-Term Outcomes in Multiple Sclerosis Patients after Total Knee Arthroplasty?
J Knee Surg DOI: 10.1055/s-0038-1636836Due to the paucity of evidence, this study was conducted to evaluate: (1) unique characteristics of multiple sclerosis (MS) patients and (2) short-term clinical outcomes, of primary total knee arthroplasty (TKA) in patients with MS (MS-TKA) compared with matched non-MS patients. MS patients who underwent TKA were identified using the Nationwide Inpatient Sample (NIS) database. The study sample consisted of 10,884 patients with MS and 56,45,227 control cohort. Various patient factors were compared. To control for potential confounders, with the use of propensity scores, MS-TKA patients...
Source: Journal of Knee Surgery - March 7, 2018 Category: Orthopaedics Authors: Newman, Jared M. Sultan, Assem A. Khlopas, Anton Sodhi, Nipun Faour, Mhamad Piuzzi, Nicolas S. Higuera, Carlos A. Mont, Michael A. Tags: Original Article Source Type: research