Impact of Tourniquet Strategy on Perioperative Results of Modern TKA
J Knee Surg DOI: 10.1055/s-0039-1688919Recent changes in perioperative management of total knee patients including tranexamic acid, multimodal pain management, and periarticular injection make previous data on tourniquet use during total knee arthroplasty (TKA) less relevant. The purpose of this study was to evaluate the effect of tourniquet use on short-term postoperative outcomes in the era of modern TKA. Our institutional database was utilized to retrospectively identify three cohorts (long, short, and no tourniquet) of consecutive patients after unilateral TKA with a single surgeon. These three groups were compared usi...
Source: Journal of Knee Surgery - May 20, 2019 Category: Orthopaedics Authors: Rames, Richard D. Haynes, Jacob Hellman, Michael Barrack, Toby Barrack, Robert Tags: Original Article Source Type: research

Incidence of Femoral Component Malrotation Using Posterior Condylar Referencing in Total Knee Arthroplasty
J Knee Surg DOI: 10.1055/s-0039-1688931Proper femoral component rotation in total knee arthroplasty (TKA) is important, given the prognostic impact of a poorly positioned component. The purpose of this observational study was to determine the incidence of femoral component malrotation using posterior condylar axis (PCA) referencing. A total of 100 knees in 92 patients with varus gonarthritis of the knee undergoing primary TKA using a standard medial parapatellar approach were evaluated intraoperatively. After distal femoral resection, the standard femoral sizing guide referencing the posterior condylar axis was used to set...
Source: Journal of Knee Surgery - May 20, 2019 Category: Orthopaedics Authors: Lee, Diana K. Grosso, Matthew J. Trofa, David P. Sonnenfeld, Julian J. Cooper, H. John Shah, Roshan P. Geller, Jeffrey A. Tags: Original Article Source Type: research

Barbed Sutures in Total Knee Arthroplasty: Are They Really Useful? A Randomized Controlled Trial
J Knee Surg DOI: 10.1055/s-0039-1688922Bidirectional barbed sutures (BBSs) have recently been investigated in total knee arthroplasty (TKA). The contrasting results from the scarce literature suggest that BBSs are safe, save time and money, and give results comparable to traditional sutures. The purpose of the study is to test the real effect of BBSs on closure time in TKA and assess the functional results as well as the complications related to them. It was a randomized controlled trial. Eighty-five patients undergoing primary TKA were assigned to receive traditional closure with Vicryl (V-group) or with BBSs (Q-group). T...
Source: Journal of Knee Surgery - May 20, 2019 Category: Orthopaedics Authors: Gamba, Carlo Hinarejos, Pedro Serrano-Chinchilla, Paula Leal-Blanquet, Joan Torres-Claramunt, Raul S ánchez-Soler, Juan Monllau, Joan Carles Tags: Original Article Source Type: research

Evaluation of Preoperative Pain Using PROMIS Pain Interference in Knee Surgery Patients
The objectives of this cross-sectional analytical study were to (1) compare how the Patient-Reported Outcomes Measurement Information System (PROMIS) pain interference (PI) computer adaptive test (CT) performs against the Numeric Pain Scale (NPS) measure in evaluating pain, and (2) to determine demographic, clinical, and psychosocial correlates of PI in an urban population undergoing a variety of knee surgeries. We hypothesized that there would be a strong correlation between PI and NPS, with minimal floor and ceiling effects; and that a worse PI score would be associated with a worse general health profile. The sample con...
Source: Journal of Knee Surgery - May 16, 2019 Category: Orthopaedics Authors: Nadarajah, Vidushan Glazier, Elizabeth Miller, Kenneth Jauregui, Julio J. Smuda, Michael P. Bennett, Craig H. Packer, Jonathan D. Henn, R Frank Tags: Original Article Source Type: research

PROMIS Physical Function Correlates with KOOS, JR in Patients with Knee Pain
J Knee Surg DOI: 10.1055/s-0039-1688780Using Patient-Reported Outcomes Measurement Information System Physical Function (PROMIS PF) computerized adaptive test instead of the Knee injury and Osteoarthritis Outcome Score for Joint Replacement (KOOS, JR) could reduce question burden for patients with knee pain. We aimed to prospectively determine the correlation between PROMIS PF and KOOS, JR to assess whether PROMIS PF could be a useful alternative measure for both research and clinical care of patients with knee pain. This was a cross-sectional study of 88 patients. We assessed the correlation between PROMIS PF and KOOS, JR...
Source: Journal of Knee Surgery - May 15, 2019 Category: Orthopaedics Authors: Kortlever, Joost T. P. Leyton-Mange, Andrea Keulen, Mark H. F. Liu, Tiffany C. Janssen, Stein J. Bozic, Kevin J. Schultz, W. Randall Koenig, Karl M. Tags: Original Article Source Type: research

Surgical and Medical Costs for Fibromyalgia Patients Undergoing Total Knee Arthroplasty
J Knee Surg DOI: 10.1055/s-0039-1688839The potential added costs of managing fibromyalgia patients after total knee arthroplasty (TKA) have not been assessed. Therefore, the purpose of this study was to perform a cost analysis of fibromyalgia versus nonfibromyalgia patients who underwent TKA. Specifically, we evaluated the following episodes of care: (1) readmission rates, (2) total costs, (3) total reimbursements, and (4) net losses for surgical and medical complications. Patients who underwent TKAs between 2005 and 2014 from the Medicare Standard Analytical Files of the PearlDiver supercomputer were propensity score matc...
Source: Journal of Knee Surgery - May 14, 2019 Category: Orthopaedics Authors: Moore, Tara Sodhi, Nipun Cohen-Levy, Wayne B. Ehiorobo, Joseph Kalsi, Angad Anis, Hiba K. Dushaj, Kristina Pappas, Vivian Vakharia, Rushabh M. Hepinstall, Matthew S. Roche, Martin W. Mont, Michael A. Tags: Special Focus Section Source Type: research

Total Knee Arthroplasty: Fitness, Heart Disease Risk, and Quality of Life
We examined cardiovascular fitness, CHD risk factors, and quality of life in patients for 1 year after TKA compared with matched controls who did not undergo surgery. A total of 14 patients, 7 surgery patients and 7 matched controls, were tested for measurements of body composition, knee range of motion, resting blood pressure, strength testing, a maximal exercise test, quality-of-life questionnaires (Medical Outcomes Study Short Form-36 and Knee Osteoarthritis Outcome Score [KOOS]), and activity monitoring, fasting blood glucose, and lipids at 0, 3, 6, and 12 months after surgery or baseline testing. Comparison bet...
Source: Journal of Knee Surgery - May 14, 2019 Category: Orthopaedics Authors: Casazza, Gretchen A. Lum, Zachary C. Giordani, Mauro Meehan, John P. Tags: Original Article Source Type: research

Treatment of Chronic Patellar Tendon Rupture with Hamstrings Tendon Autograft
We describe a new simple reconstruction for neglected chronic ruptures of patellar tendon using ipsilateral hamstrings tendon autograft. This has been validated in thirteen patients with mean follow up six years resulting in favorable outcome. Thirteen patients with mean age 58.2 years (range 30–64 years) presented with chronic patellar tendon rupture. They all underwent patellar tendon reconstruction using ipsilateral hamstrings tendon autograft. The average time from injury was 10 months (range 3–20 months). The cause of rupture was fall from height or after TKA and the preoperative Lysholm score was 65 (rang...
Source: Journal of Knee Surgery - May 8, 2019 Category: Orthopaedics Authors: Valianatos, Panagiotis Papadakou, Evgenia Erginoussakis, Dimitrios Kampras, Dimitrios Schizas, Nikitas Kouzoupis, Anastasios Tags: Original Article Source Type: research

Simultaneous Bilateral Extensor Mechanism Disruptions: More Than Double the Trouble?
J Knee Surg DOI: 10.1055/s-0039-1688779Simultaneous bilateral extensor mechanism disruption (BEMD) is a rare condition, for which the relationship between comorbid conditions, complications, and clinical outcomes has not been well defined. We hypothesized that patients with BEMD would have more comorbidities, more repair failures, and worse clinical outcomes compared with patients with unilateral extensor mechanism disruption (UEMD). We performed a retrospective review of all adult patients seen at our institution for either a quadriceps or patellar tendon rupture between 2012 and 2017. Statistical analysis was conducted u...
Source: Journal of Knee Surgery - May 8, 2019 Category: Orthopaedics Authors: Seifert, Christina Vokes, Jordan Roberts, Aaron Gorczyca, John Judd, Kyle Tags: Original Article Source Type: research

Evaluation of the PROMIS Physical Function Computer Adaptive Test in Patients Undergoing Knee Surgery
The objectives of the study were to (1) compare how the Patient-Reported Outcomes Measurement Information System physical function (PROMIS PF) computer adaptive test performs against the International Knee Documentation Committee (IKDC) Subjective Knee Form in evaluating functional status, and (2) to determine demographic, clinical, and psychosocial correlates of each outcome measure in an urban population undergoing a variety of knee surgeries. We hypothesized that there would be a strong correlation between PROMIS PF and IKDC, with minimal floor and ceiling effects, and similar clinical correlates. The sample consisted o...
Source: Journal of Knee Surgery - May 8, 2019 Category: Orthopaedics Authors: Miles, Megan Nadarajah, Vidushan Jauregui, Julio J. Dubina, Andrew G. Smuda, Michael P. Bennett, Craig H. Packer, Jonathan D. Henn, R. Frank Tags: Original Article Source Type: research

Intraoperative Soft Tissue Balance/Kinematics and Clinical Evaluation of Modified Kinematically versus Mechanically Aligned Total Knee Arthroplasty
J Knee Surg DOI: 10.1055/s-0039-1688504Recently, kinematically aligned total knee arthroplasty has been found to achieve better clinical outcomes than mechanically aligned TKA. Despite the good clinical outcomes that are reported at short- to mid-term follow-up, intraoperative variables that are associated with a better outcome have not been measured. Therefore, this study was conducted to compare intraoperative kinematics/soft tissue balance and the clinical outcomes of patients who underwent modified kinematically (restricted tibial cut) or mechanically aligned total knee arthroplasty. Sixty cruciate-retaining total knee...
Source: Journal of Knee Surgery - May 8, 2019 Category: Orthopaedics Authors: Matsumoto, Tomoyuki Takayama, Koji Ishida, Kazunari Kuroda, Yuichi Tsubosaka, Masanori Muratsu, Hirotsugu Hayashi, Shinya Hashimoto, Shingo Matsushita, Takehiko Niikura, Takahiro Kuroda, Ryosuke Tags: Original Article Source Type: research

Different Strategies in Making Transseptal Portal for the Different Purposes
J Knee Surg DOI: 10.1055/s-0039-1688557The purpose of this study was to find the most suitable and safe position of the transseptal portal in anatomic anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) reconstructions. The hypothesis of this study was that area and position of the transseptal portal are different between ACL and PCL reconstructions for the observation of native footprint. A matched-pair comparison study was conducted on the arthroscopic images of 100 consecutive patients who underwent ACL reconstruction and 50 consecutive patients who underwent PCL reconstruction. The transseptum was di...
Source: Journal of Knee Surgery - May 8, 2019 Category: Orthopaedics Authors: Lee, Yong Seuk Kim, Tae Woo Lee, Eui Soo Lee, Kyoung Hwan Lee, Seung Hoon Tags: Original Article Source Type: research

Reconstruction with Custom Unicondylar Hemiarthroplasty following Tumor Resection: A Case Series and Review of the Literature
J Knee Surg DOI: 10.1055/s-0039-1688556For patients with tumors of the distal femur, options for limb salvage include tumor resection followed by reconstruction. While reconstruction commonly involves a distal femoral replacement, careful selection of patients with tumor involvement limited to a single condyle may be candidates for reconstruction with distal femur hemiarthroplasty. In these procedures, resection spares considerably more native anatomy. Three consecutive patients who underwent resection and reconstruction at the distal femur with custom unicondylar hemiarthroplasty are presented in this case series at a mea...
Source: Journal of Knee Surgery - May 8, 2019 Category: Orthopaedics Authors: Ippolito, Joseph A. Campbell, Megan L. Siracuse, Brianna L. Benevenia, Joseph Tags: Original Article Source Type: research

Do Individual Differences in Physical Therapists' Skills Affect Postoperative Results of Total Knee Arthroplasty?
J Knee Surg DOI: 10.1055/s-0039-1688690We investigated variations in postoperative outcomes of total knee arthroplasty which were dependent on the physical therapist (PT) who performed rehabilitation while keeping other parameters as uniform as possible. Seventy-nine among 690 knees were selected based on strict inclusion and exclusion criteria. Patients were randomly assigned to five PTs, who had from 2 to 21 years of experience. Range of motion (ROM) on postoperative days (PODs) 1, 3, 7, and 14 and at postoperative months 3, 6, and 12, results of timed up and go (TUG) test on POD 14, time to walking with a single cane, a...
Source: Journal of Knee Surgery - May 8, 2019 Category: Orthopaedics Authors: Fujii, Tadashi Nishio, Naoyuki Bandou, Minenari Kitano, Shuji Noboru, Marehoshi Seko, Munehito Inagaki, Yusuke Tanaka, Yasuhito Tags: Original Article Source Type: research

Midterm Outcomes following Acute Repair of Grade III Distal MCL Avulsions in Multiligamentous Knee Injuries
This study aims to determine outcomes of a series of patients with grade III distal MCL injuries managed with acute surgical repair. Patients with grade III, distal MCL injuries, with or without multiligament involvement were identified. Demographic, clinical examination, and midterm patient-reported outcomes (PRO) data were collected. Clinical follow-up included physical examination and ligamentous stress testing at a minimum of 6 months. PROs included Lysholm's knee scoring scale, Tegner's activity score, and subjective International Knee Documentation Committee (IKDC) scores at minimum of 2 years follow-up. Of the 24 el...
Source: Journal of Knee Surgery - May 8, 2019 Category: Orthopaedics Authors: Desai, Vishal S. Wu, Isabella T. Camp, Christopher L. Levy, Bruce A. Stuart, Michael J. Krych, Aaron J. Tags: Original Article Source Type: research

Traumatic Patellar Tendon Rupture Repair using Synthetic Ligament Augmentation
In this study, we propose the augmentation of patellar tendon repair using an artificial ligament. The questions to be assessed in this study are as follows: (1) measurement of functional results 1 year after surgery using the Lysholm score and (2) the incidence of both rerupture, and surgical complications within the first year postsurgery, the median knee range of motion at 3 months and 1-year postsurgery, patient satisfaction, and postsurgery patellar height, measured using the Caton–Deschamps Index. In our center, we performed 30 suture repairs of traumatic patellar tendon ruptures between 2015 and 2016. T...
Source: Journal of Knee Surgery - May 8, 2019 Category: Orthopaedics Authors: Core, Maxime Anract, Philippe Raffin, Juliette Biau, David Jean Tags: Original Article Source Type: research

Total Knee Arthroplasty Using a Medial Pivot or Posterior Cruciate-Stabilizing Prosthesis in Chinese Patients
In conclusion, there were no significant differences in midterm outcomes in Chinese patients receiving an MP implant or a PS prosthesis for unilateral TKA. These data suggest that the MP and PCL substitution design are safe and effective for unilateral TKA in China. [...] 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 7, 2019 Category: Orthopaedics Authors: Yuan, Ding Zhang, Quan-San Zhang, Kun Cao, Yan-Wei Chen, Guan-Hong Ling, Zong-Zhun Xu, Hui Tags: Original Article Source Type: research

Is It Better to Routinely Use Tourniquet for Knee Arthroscopic Surgery: A Systematic Review and Meta-analysis
J Knee Surg DOI: 10.1055/s-0039-1688555The use of tourniquet in knee arthroscopic surgery is a routine technique and provides convenience for the operation. However, the adverse effects caused by tourniquet during the operation are noticed by more and more researchers. The purpose of our study was to perform a systematic review and meta-analysis to assess the effects of tourniquet use in knee arthroscopy. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines, we searched databases like PubMed, Cochrane library, EMBASE, and Web of Science from inception of the database up to November 20...
Source: Journal of Knee Surgery - May 7, 2019 Category: Orthopaedics Authors: Wang, Jinyou Xu, Wennan Lv, Jiayin Tags: Original Article Source Type: research

The Difference between Computed Tomography and Magnetic Resonance Imaging Measurements of Tibial Tubercle –Trochlear Groove Distance for Patients with or without Patellofemoral Instability: A Systematic Review and Meta-Analysis
J Knee Surg DOI: 10.1055/s-0039-1688563The tibial tubercle–trochlear groove (TT–TG) distance was originally described for computed tomography (CT) but has recently been used on magnetic resonance imaging (MRI) without sufficient evidence demonstrating its validity on MRI. The current review aims to evaluate (1) whether there is a difference in the TT–TG distances measured using CT and MRI, (2) whether both the TT–TG distances measured using CT and MRI could be used to differentiate between patients with or without patellofemoral instability, and (3) whether the same threshold of 15 to 20 mm c...
Source: Journal of Knee Surgery - May 7, 2019 Category: Orthopaedics Authors: Tan, Si Heng Sharon Lim, Beatrice Ying Chng, Kiat Soon Jason Doshi, Chintan Wong, Francis K.L. Lim, Andrew Kean Seng Hui, James Hoipo Tags: Original Article Source Type: research

Does Component Alignment Affect Patient Reported Outcomes following Bicruciate Retaining Total Knee Arthroplasty? An In Vivo Three-Dimensional Analysis
This study aims to determine (1) accurate three-dimensional (3D) component alignment of BCR TKA and (2) whether the component alignment of BCR TKA affects PROMs. The 3D modeling analysis was performed based on computed tomography images from 29 BCR TKAs. Component orientations were quantified for femoral and tibial components in the sagittal, axial, and coronal planes. The knee society scores (KSS) were collected preoperatively and postoperatively at 1-year follow-up. Multiple comparisons were performed to analyze the relationship between component alignment and patient outcomes. High variability was observed in the tibial...
Source: Journal of Knee Surgery - May 7, 2019 Category: Orthopaedics Authors: Peng, Yun Arauz, Paul An, Shuai Limmahakhun, Sakkadech Klemt, Christian Kwon, Young-Min Tags: Original Article Source Type: research

Impact of Tourniquet Use on Systemic Inflammatory Parameters, Functional Physical Recovery, and Cardiovascular Outcomes of Patients Undergoing Knee Arthroplasty: A case-control study
J Knee Surg DOI: 10.1055/s-0039-1688565The benefits of tourniquet use during orthopaedic surgery are controversial. We aim to investigate its effects on systemic inflammation, functional physical recovery, and cardiovascular complications of patients undergoing knee arthroplasty. We enrolled 129 consecutive patients (57 treated with tourniquet vs. 72 in the control group) undergoing total unilateral knee arthroplasty, followed by inpatient rehabilitation protocol at our institution. Blood samples were drawn in all patients at baseline and within 24 hours after surgery for complete blood cell count assessment. Neutrophil-to...
Source: Journal of Knee Surgery - May 7, 2019 Category: Orthopaedics Authors: Bressi, Edoardo Longo, Umile Giuseppe Mangiacapra, Fabio Candela, Vincenzo Berton, Alessandra Salvatore, Giuseppe Capuano, Marialessia Proietti, Riccardo Denaro, Vincenzo Tags: Original Article Source Type: research

Extended Postoperative Prophylactic Antibiotics with First-Generation Cephalosporin Do Not Reduce the Risk of Periprosthetic Joint Infection following Aseptic Revision Total Knee Arthroplasty
J Knee Surg DOI: 10.1055/s-0039-1683889Postoperative prophylactic antibiotics administered within 24 hours of primary total knee arthroplasty (TKA) have been documented to prevent periprosthetic joint infection (PJI). However, the effectiveness of this regimen is still unclear in aseptic revision TKA. The purpose of this study was to evaluate whether extended postoperative prophylactic antibiotics would reduce the PJI rate compared with the current 24-hour standard postoperative prophylactic antibiotics after aseptic revision TKA. A retrospective review of 236 patients (46 men, 190 women, 252 knees) who underwent aseptic r...
Source: Journal of Knee Surgery - May 6, 2019 Category: Orthopaedics Authors: Kuo, Feng-Chih Lin, Po-Chun Bell, Kerri L. Ko, Jih-Yang Wang, Ching-Jen Wang, Jun-Wen Tags: Original Article Source Type: research

Periprosthetic Fractures
J Knee Surg 2019; 32: 387-387 DOI: 10.1055/s-0039-1687858 Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of contents  |  Full text (Source: Journal of Knee Surgery)
Source: Journal of Knee Surgery - May 3, 2019 Category: Orthopaedics Authors: Schmidt, Andrew H. Tags: Special Focus Section Source Type: research

The Effect of Ambient Temperature and Implantation Time on the Material Properties of Two Viscosity-Differing Cements Using American Society of Testing and Materials Methodology
J Knee Surg DOI: 10.1055/s-0039-1681090Ambient temperature and time to implantation can affect the material properties of polymethylmethacrylate bone cement, and cement intrusion depth has been shown to affect implant fixation. The purpose of this study was to examine the effects of ambient temperature and time to implantation on depth of intrusion, and the effect of ambient temperature on setting time. Two types of cements were evaluated: cement A (Simplex P,medium Q7 viscosity) and cement B (Palacos R, high viscosity). Dough, working and setting times were determined, as well as intrusion depth, at different temperatures...
Source: Journal of Knee Surgery - May 2, 2019 Category: Orthopaedics Authors: Pytiak, Andrew V. Jove, Nathaniel He, Shulin Korduba-Rodriguez, Laryssa A. Esformes, Marc Markel, David C. Tags: Original Article Source Type: research

One-Year Patient Outcomes for Robotic-Arm-Assisted versus Manual Total Knee Arthroplasty
J Knee Surg DOI: 10.1055/s-0039-1683977Although there are many studies on the alignment advantages when using the robotic arm–assisted (RAA) system for total knee arthroplasty (TKA), there have been questions regarding patient-reported outcomes. Therefore, the purpose of this study was to use this index to compare: (1) total, (2) physical function, and (3) pain scores for manual versus RAA patients. We compared 53 consecutive RAA to 53 consecutive manual TKAs. No differences in preoperative scores were found between the cohorts. Patients were administered a modified Western Ontario and McMaster Universities Osteoarth...
Source: Journal of Knee Surgery - April 8, 2019 Category: Orthopaedics Authors: Marchand, Robert C. Sodhi, Nipun Anis, Hiba K. Ehiorobo, Joseph Newman, Jared M. Taylor, Kelly Condrey, Caitlin Hepinstall, Matthew S. Mont, Michael A. Tags: Special Focus Section Source Type: research

Distal Femoral Replacement for Periprosthetic Fractures around Total Knee Arthroplasty: When and How?
We present a review of distal femoral replacement in periprosthetic fractures around the total knee arthroplasty, along with surgical technique, and pearls and pitfalls. [...] 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 8, 2019 Category: Orthopaedics Authors: Khan, Saad Schmidt, Andrew H. Tags: Special Focus Section Source Type: research

All-Polyethylene versus Metal-Backed Tibial Components in Total Knee Arthroplasty
J Knee Surg DOI: 10.1055/s-0039-1683979All-polyethylene tibial (APT) implants were incorporated into the initial design of the first total knee arthroplasty (TKA) systems. Since then, a dynamic shift has taken place and metal-backed tibial (MBT) implants have become the gold standard in TKA. This has mostly been due to the theoretical advantages of intraoperative flexibility and improved biomechanics in addition to the heavy influence of device manufacturers. MBT implant comes not only with a higher cost but also with potential for complications such as osteolysis, backside wear, and thinning of the polyethylene insert, wh...
Source: Journal of Knee Surgery - April 8, 2019 Category: Orthopaedics Authors: AbuMoussa, Samuel White, Charles Cody Eichinger, Josef K. Friedman, Richard J. Tags: Special Focus Section Source Type: research

Effect of Partial Fibula Osteotomy Combined with Arthroscopic Debridement Surgery in the Treatment of Medial Compartment Knee Osteoarthritis
This study aimed to investigate the effect of partial fibula osteotomy combined with arthroscopic debridement surgery on the treatment of medial compartment knee osteoarthritis. From January 2013 to June 2016, 17 patients who suffered from medial compartment knee osteoarthritis were assigned to two groups: groups A (n = 5) and B (n = 12). Group A patients were treated with arthroscopic debridement surgery only, while group B patients received additional fibula osteotomy in addition to arthroscopic debridement operation. Visual analogue score (VAS) and hospital for special surgery (HSS) knee scor...
Source: Journal of Knee Surgery - April 8, 2019 Category: Orthopaedics Authors: Wang, Ying-Ming Zhu, Chen Kong, Rong Yu, De-Wan Zhao, Qi-Chun Tags: Original Article Source Type: research

Efficacy of Portable Accelerometer-Based Navigation Devices versus Conventional Guides in Total Knee Arthroplasty: A Meta-analysis
In conclusion, compared with CON, PAD can help improve the femoral coronal angle as well as decrease the outliers out of ±3 degrees in femoral/tibial coronal angles and overall mechanical alignment. However, PAD did not show significant advantages in tibial and femoral component sagittal angles out of ±3 degrees, various outliers of ±2 degrees, most mean values of component alignments, operative time, and various functional or satisfactory scores. [...] Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of contents  |&...
Source: Journal of Knee Surgery - April 8, 2019 Category: Orthopaedics Authors: Sun, Han Li, Shuxiang Wang, Kun Wu, Guofeng Zhou, Jian Sun, Xiaoliang Tags: Original Article Source Type: research

Outcomes of Total Knee Arthroplasty in Human Immunodeficiency Virus-Positive Patients
This study seeks to provide detailed results of TKA in HIV+ patients and compare them to an HIV-negative (HIV − ) cohort. We performed a multicenter retrospective case–control study comparing 25 HIV+ patients to 25 HIV− patients undergoing TKA. The analysis included a cohort and subgroup stratification based on the presence or absence of postoperative complications. Prior to TKA, all 25 patients had a documented history of HIV infection. No intraoperative complications were reported. Ninety-day postoperative complications included knee contracture (one HIV + , no HIV &mi...
Source: Journal of Knee Surgery - April 8, 2019 Category: Orthopaedics Authors: Roof, Mackenzie A. Anoushiravani, Afshin A. Chen, Kevin K. Moses, Michael J. Wolfson, Theodore Poultsides, Lazaros Schwarzkopf, Ran Tags: Original Article Source Type: research

Decreasing Incidence of Postoperative Ileus Following Total Knee Arthroplasty: A 17-Year Retrospective Review of 38,007 Knee Replacements at One Institution
J Knee Surg DOI: 10.1055/s-0039-1684013Ileus following total knee arthroplasty is a clinically and financially significant postoperative complication that has not been extensively described in the orthopaedic joint literature. Ileus has been found to occur in 0.7 to 4.0% of patients after total joint arthroplasty. In a 17-year period (2001 fiscal year through 2017 fiscal year) at one institution, we found an incidence of 0.500% (190/38,007) following knee arthroplasty. In addition, the incidence of ileus following total knee arthroplasty (TKA) has drastically declined over this 17-year period, from 1.593% (13/816) in 2001 ...
Source: Journal of Knee Surgery - April 8, 2019 Category: Orthopaedics Authors: Nguyen, Bob H. Bono, Olivia J. Bono, James V. Tags: Original Article Source Type: research

Knee Ultrasonography to Determine Risk for Noncontact Injuries in Collegiate American Football Players
J Knee Surg DOI: 10.1055/s-0039-1683953Knee ultrasonography has been used effectively as a screening tool for determining risk for knee injuries in athletes. Ultrasonography may be a valuable screening tool for relative risk of noncontact knee injuries that occur over a typical playing career in collegiate American football players. In this prospective longitudinal study, we evaluated American football players (n = 48) in an academic institution affiliated with the National Collegiate Athletic Association Division I athletic program. Players underwent comprehensive ultrasonography of both knees prior to begin...
Source: Journal of Knee Surgery - April 8, 2019 Category: Orthopaedics Authors: Lewis, Ryan A. Cook, Cristi R. Smith, Patrick A. Stannard, James P. Sharp, Rex L. Blecha, Kyle M. Cook, James L. Tags: Original Article Source Type: research

Patient-Reported Functional and Satisfaction Outcomes after Robotic-Arm-Assisted Total Knee Arthroplasty: Early Results of a Prospective Multicenter Investigation
Conclusion The data indicate RATKA patients to have equal or greater improvements in 9 out of 10 of the Knee Society Scoring System components assessed at 3 months postoperatively, though not all findings were statistically significant. Since this is an early results report, this study will be continued for a longer follow-up, but we are encouraged by these interim results. [...] 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 8, 2019 Category: Orthopaedics Authors: Khlopas, Anton Sodhi, Nipun Hozack, William J. Chen, Antonia F. Mahoney, Ormonde M. Kinsey, Tracy Orozco, Fabio Mont, Michael A. Tags: Original Article Source Type: research

Early Clinical and Radiological Outcomes of the Metaphyseally Fixed Totally Stabilized Knee Prosthesis in Primary Total Knee Arthroplasty
J Knee Surg DOI: 10.1055/s-0039-1683976The use of valgus–varus constrained (VVC) implant designs in primary total knee arthroplasty (TKA) is considered in situations of severe deformities, bone loss, and inadequate soft tissue balance. It is not known whether the use of such prosthesis designs may predispose to reduced function owing to its constraining design. The components are usually implanted with diaphyseal stem extensions to dissipate the increased forces. The totally stabilized (TS) implant is a contemporary VVC design with metaphyseal fixation only. It has a conforming articulation with increased rotational ...
Source: Journal of Knee Surgery - April 8, 2019 Category: Orthopaedics Authors: Hossain, Fahad Konan, Sujith Kayani, Babar Kontoghiorghe, Christina Barrack, Toby Sami Haddad, Fares Tags: Original Article Source Type: research

Dialysis Is Not Associated with Increased Risk of Perioperative Complications in TKA Patients after Adjusting for Pertinent Confounders
This study aims to fill in that void. The present study compares lengths of stay, discharge status, and 30-day outcomes between dialysis-dependent TKA recipients and a matched cohort of nondialysis dependent TKA recipients. The National Surgical Quality Improvement Program database was used to identify the study cohorts. Patients were propensity score matched based on patient-specific demographic variables, preoperative functional status, and preoperative laboratory values. Generalized regression models were conducted to assess the effects of dialysis dependency on perioperative outcomes. Dialysis dependent patients demons...
Source: Journal of Knee Surgery - April 8, 2019 Category: Orthopaedics Authors: Gwam, Chukwuweike U. Sultan, Assem Rosas, Samuel Sullivan, Rashad Seem, Michael Ohanale, Chiemena Plate, Johannes F. Tags: Original Article Source Type: research

Relationship of the Posterior Condylar Line and the Transepicondylar Axis: A CT-Based Evaluation
J Knee Surg DOI: 10.1055/s-0039-1685146Posterior condylar referencing, a common method for determining femoral axial orientation during total knee arthroplasty (TKA), relies upon an assumed consistent relationship between the posterior condylar line (PCL) and the transepicondylar axis (TEA) of 3 degrees rotation. A total of 3,010 computed tomography (CT) scans and three-dimension (3D)-reconstructions for presurgical creation of patient-matched TKA instrumentation were analyzed. Demographic data and five anthropometric measurements (hip–knee angle [HKA], distal femoral angle [DFA], proximal tibial angle [PTA], tibial ...
Source: Journal of Knee Surgery - April 8, 2019 Category: Orthopaedics Authors: Fitz, David W. Johnson, Daniel J. Hartwell, Matthew H. Sullivan, Ryan Keller, Tyler J. Manning, David W. Tags: Original Article Source Type: research

Aperture and Suspensory Fixation Equally Efficacious for Quadriceps Tendon Graft Fixation in Primary ACL Reconstruction: A Systematic Review
J Knee Surg DOI: 10.1055/s-0039-1685160This review is aimed to compare suspensory and aperture quadriceps tendon autograft femoral and tibial fixations in primary anterior cruciate ligament reconstruction (ACL-R), and the clinical outcomes and complication profiles of each fixation method. Greater understanding of the optimal graft fixation technique for quadriceps tendon (QT) autografts may assist surgeons in improving outcomes after ACL-R. PubMed, Embase, and Medline were searched from database inception to September 2017, and again to July 2018, and identified 3,670 articles, 21 studies of which satisfied inclusion/excl...
Source: Journal of Knee Surgery - April 8, 2019 Category: Orthopaedics Authors: Crum, Raphael J. de SA, Darren Kanakamedala, Ajay C. Obioha, Obianuju A. Lesniak, Bryson P. Musahl, Volker Tags: Original Article Source Type: research

Soft Tissue Reconstruction for Deep Defects over a Complicated Total Knee Arthroplasty: A Systematic Review
J Knee Surg DOI: 10.1055/s-0039-1684012Deep soft tissue defects after complicated primary or revision total knee arthroplasty (TKA) can be devastating to the patient and technically challenging. The purpose of this review was to (1) discuss different methods used to provide coverage for deep defects of the knee following TKA, as well as to (2) report on their success rates. A comprehensive literature search was performed. Reports were only included if they (1) were case series, (2) were level III studies or above (including retrospective cohort studies and meta-analyses), (3) were in English, and (4) discussed the outcome ...
Source: Journal of Knee Surgery - April 8, 2019 Category: Orthopaedics Authors: Coombs, Demetrius M. Churchill, Jessica Cartwright, Paul Chughtai, Morad Sultan, Assem A. Samuel, Linsen T. Moskal, Joseph T. Hendrickson, Mark F. Mont, Michael A. Tags: Original Article Source Type: research

Proprioception following the Anterior Cruciate Ligament Reconstruction with Tibialis Anterior Tendon Allograft
J Knee Surg DOI: 10.1055/s-0039-1684010After the anterior cruciate ligament (ACL) reconstruction, a loss of proprioception is observed and it can continue years after the operation. The aim of this study is to evaluate proprioception in standing position at different knee flexion angles in patients who underwent ACL reconstruction with tibialis anterior tendon allograft. The study included 34 patients who underwent ACL reconstruction with tibialis anterior tendon allograft and 34 healthy individuals. Proprioception was evaluated in standing position at 15°, 30°, 60° flexion angles with the active joint position...
Source: Journal of Knee Surgery - April 8, 2019 Category: Orthopaedics Authors: B üyükafşar, Enes Ba şar, Selda Kanatli, Ulunay Tags: Original Article Source Type: research

Musculoskeletal Oncology and the Knee
J Knee Surg 2019; 32: 295-295 DOI: 10.1055/s-0039-1677752 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 2, 2019 Category: Orthopaedics Authors: Evenski, Andrea J. Tags: Special Focus Section Source Type: research

Inpatient versus Outpatient Total Knee Arthroplasty
J Knee Surg DOI: 10.1055/s-0039-1683935The rise of improved perioperative recovery protocols after total knee arthroplasty (TKA) has led to faster, more streamlined hospital stays for many patients. Combined with the implementation of value-based care and bundled payment initiatives, there has been a paradigm shift toward outpatient TKA surgery. This change to practice has been accelerated by recent policy changes enacted by the Center for Medicaid and Medicare Services regarding the removal of TKA as an inpatient only procedure as well as some insurance companies denying preauthorization for inpatient stays after TKA. Our...
Source: Journal of Knee Surgery - March 28, 2019 Category: Orthopaedics Authors: Edwards, Paul K. Milles, Jeffrey L. Stambough, Jeffrey B. Barnes, C. Lowry Mears, Simon C. Tags: Special Focus Section Source Type: research

Minimally Invasive Plate Osteosynthesis for Periprosthetic and Interprosthetic Fractures Associated with Knee Arthroplasty: Surgical Technique and Review of Current Literature
J Knee Surg DOI: 10.1055/s-0039-1683443With the increasing number of total knee arthroplasties (TKAs) being performed, the incidence of periprosthetic fractures adjacent to a TKA is rising. Minimally invasive plate osteosynthesis (MIPO) has proven to be successful for the biological fixation of many fractures. Advances in surgical instrumentation and techniques made MIPO possible for more complex fractures. Periprosthetic fractures are always complicated by problems of soft tissue incisions, scarring, and, of course, the arthroplasty components. MIPO techniques may be particularly suited to these injuries and may make the ...
Source: Journal of Knee Surgery - March 28, 2019 Category: Orthopaedics Authors: Borade, Amrut Sanchez, Daniela Kempegowda, Harish Maniar, Hemil Pesantez, Rodrigo Fernando Suk, Michael Horwitz, Daniel S. Tags: Special Focus Section Source Type: research

Are Readmissions After Total Knee Arthroplasty Preventable?
J Knee Surg DOI: 10.1055/s-0039-1683890Readmission within 90 days following total joint arthroplasty has become a central quality measure of reimbursement initiatives; however, the validity of readmission rates as a measure of hospital care quality and the proportion of readmissions that are preventable are unknown. The purpose of this study is to determine if readmissions within 30 and 90 days after total knee arthroplasty (TKA) were related to orthopaedic or medical etiology and identify if these readmissions were preventable. We retrospectively reviewed 1,625 elective TKAs performed between 2011 and 2014 at our institut...
Source: Journal of Knee Surgery - March 28, 2019 Category: Orthopaedics Authors: Su, Charles A. Copp, Jonathan A. Weinberg, Douglas S. Kraay, Matthew J. Fitzgerald, Steven J. Wera, Glenn D. Tags: Original Article Source Type: research

Osteomeniscal Impact Edema (OMIE): Description of a Distinct MRI Finding in Displaced Flap Tears of the Medial Meniscus, with Comparison to Posterior Root Tears
J Knee Surg DOI: 10.1055/s-0039-1683938Bone marrow edema (BME) can be a late finding in osteoarthritis or a sign of subchondral insufficiency. The purpose of this study was to describe the magnetic resonance imaging (MRI) finding we refer to as “osteomeniscal impact edema” (OMIE), or reactive BME adjacent to a displaced meniscus flap tear. In addition, this edema pattern is compared with a control group of medial meniscus posterior root tears (MMPRT) with subchondral insufficiency edema. MRI records from 2000 to 2017 were retrospectively reviewed for studies that showed the presence of a medial meniscus displac...
Source: Journal of Knee Surgery - March 28, 2019 Category: Orthopaedics Authors: Krych, Aaron J. Wu, Isabella T. Desai, Vishal S. Kennedy, Nicholas I. Littrell, Laurel A. Collins, Mark S. Saris, Dani ël B.F. Stuart, Michael J. Tags: Original Article Source Type: research

Nail –Plate Constructs for Periprosthetic Distal Femur Fractures
This article will give the rationale for the use of the NPC as well as a review of the current published literature reviewing its use. [...] 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 27, 2019 Category: Orthopaedics Authors: Mirick Mueller, Gudrun E. Tags: Special Focus Section Source Type: research

A Modified Direct Posterior Midline Approach for the Treatment of Posterior Column Tibial Plateau Fractures
J Knee Surg DOI: 10.1055/s-0039-1683927The purpose of this study was to introduce a modified surgical approach for the treatment of posterior column tibial plateau fractures. Fifteen patients with posterior column fractures with or without other column fractures were included and treated with this approach between July 2015 and June 2016. The patients were followed up for 18 to 24 months (20.9 ± 1.8 months). Outcomes included neural or vascular injuries, wound complications, nonunion, plate loosening or breakage, and Hospital for Special Surgery (HSS) scores. Bone union was observed in all cases, and t...
Source: Journal of Knee Surgery - March 27, 2019 Category: Orthopaedics Authors: Yin, Zhaowei Yang, Wengbo Gu, Yanqing Gu, Qiangrong Xu, Chenyang Yang, Lei Jiang, Chunzhi Liang, Bin Tags: Original Article Source Type: research

Higher Function Scores and Satisfaction in Patients with Anteromedial Osteoarthritis Compared with Other Wear Patterns of the Knee: 2 Years after Both Total and Unicondylar Knee Arthroplasties
In conclusion, patients treated with TKA for AMOA showed better knee-specific function scores and satisfaction scores compared with patients treated with TKA for other wear patterns, and only slight differences were found between both the AMOA groups (TKA for AMOA and UKA). Thus, the radiologic assessment of wear patterns might be useful to take into account the shared decision-making process, when discussing expectations, timing, and outcomes with knee osteoarthritis patients considering knee arthroplasty. When AMOA is present, it might be beneficial to choose UKA over TKA. [...] Thieme Medical Publishers 333 Seventh Aven...
Source: Journal of Knee Surgery - March 27, 2019 Category: Orthopaedics Authors: Witjes, Suzanne Hoorntje, Alexander Koenraadt, Koen L. M. Kerkhoffs, Gino M. M. J. van Geenen, Rutger C. I. Tags: Original Article Source Type: research

Age-Related Variances in Patients with Tibial Plateau Fractures
J Knee Surg DOI: 10.1055/s-0039-1683893Tibial plateau fractures account for approximately 8% of fractures in the elderly population. Treatment strategies in the elderly are similar to those for younger patients; however, practitioners must account for the elevated comorbidity burden in this population. To date, few studies have analyzed age-based outcomes in patients with tibial plateau fractures. Therefore, the purpose of this study was to determine age-related variances in demographics, fracture characteristics, mechanism of injury, and complications. A 10-year retrospective review was conducted to identify patients who ...
Source: Journal of Knee Surgery - March 27, 2019 Category: Orthopaedics Authors: Oladeji, Lasun O. Worley, John R. Crist, Brett D. Tags: Original Article Source Type: research

The “Diagonal” Lesion: A New Type of Combined Injury Pattern Involving the Impingement Fracture of Anteromedial Tibial Plateau and the Injury of Posterior Cruciate Ligament and Posterolateral Corner
In this study, the incidence of the “diagonal” lesions was 9.5%. Patients who had larger fracture size tended to develop subsequent varus deformity of the lower extremity. It was important for us to recognize the PCL/PLC injuries and to fully reduce the large bony fracture during the initial treatment of the “diagonal” lesions to prevent the residual instability and varus deformity. [...] 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 27, 2019 Category: Orthopaedics Authors: Li, Xu Song, Guanyang Li, Yue Liu, Xin Zhang, Hui Feng, Hua Tags: Original Article Source Type: research

Approximately 30% of Functioning Anterior Cruciate Ligaments Are Sacrificed for Knee Arthroplasty
This study aims to evaluate how often functional ACLs are sacrificed in arthroplasty. The type of arthroplasty (TKA or UKA) and condition of the ACL were studied in a total of 1,586 knees in 1,052 patients who underwent knee arthroplasties. Of 1,586 knees, TKA was performed on 653 knees (41%) and UKA on 933 knees (59%). The ACL was functioning in 77% of all knees. Of the TKA knees, the ACL was functioning in 357 knees (55%). Of these, around 30% of the functioning ACLs were sacrificed to perform TKA. To improve postoperative patient satisfaction after knee arthroplasty, further study regarding relationship between ACL pres...
Source: Journal of Knee Surgery - March 25, 2019 Category: Orthopaedics Authors: Hiranaka, Takafumi Hida, Yuichi Fujishiro, Takaaki Kamenaga, Tomoyuki Kikuchi, Kenichi Yoshikawa, Ryo Tachibana, Shotaro Okamoto, Koji Tags: Original Article Source Type: research