Medial-Sided Injuries in the Multiple Ligament Knee Injury
J Knee Surg DOI: 10.1055/s-0039-3402768Multiligament knee injuries (MLKI) are complex and challenging to treat. The posteromedial corner (PMC) structures are commonly torn in MLKI. A thorough and systematic evaluation is imperative to avoid a missed diagnosis and for planning treatment. With several structures injured, the treatment method (operative vs. nonoperative, repair vs. reconstruction), availability of allografts, timing of surgery, and rehabilitation are some of the factors that have to be considered in the decision-making. Persistent valgus instability because of untreated or not healed medial collateral ligamen...
Source: Journal of Knee Surgery - February 19, 2020 Category: Orthopaedics Authors: Moatshe, Gilbert Vap, Alexander R. Getgood, Alan LaPrade, Robert F. Engebretsen, Lars Tags: Special Focus Section Source Type: research

Association between Type of Anesthesia and Risk of Blood Transfusion Events in Primary Unilateral Total Knee Arthroplasty: A Secondary Analysis Based on a Cohort Study in Singapore
This study evaluated whether the type of anesthesia independently related to risk of blood transfusion events in patients undergoing total knee arthroplasty (TKA) after adjusting for other covariates. This was a secondary analysis of a retrospective cohort study of patients undergoing primary unilateral TKA in Singapore. The independent variable was the type of anesthesia and the dependent variable was blood transfusion events. A multivariable logistic regression analysis was performed adjusting for variables that might affect the choice of anesthesia or blood transfusion events. Additional analyses examined this associati...
Source: Journal of Knee Surgery - February 19, 2020 Category: Orthopaedics Authors: Zhu, Zhongxin Tong, Peijian Tags: Original Article Source Type: research

Surgical Wound Complications after Knee Cruciate Ligament Reconstruction in Patients with Atopic Dermatitis
This study aimed to report four patients with AD who developed foreign body reactions to FiberWire sutures with or without surgical wound infection (SSI) after knee cruciate ligament reconstruction (CLR). The mean age was 19.8 (range, 16–25) years, and patients 1 and 3 underwent reconstructions of the posterior and anterior cruciate ligament, respectively. At a mean of 7.5 (range, 4–10) weeks postoperatively, discharge from the surgical wound at the tibial side of the fixed graft was identified. All patients were treated with continuous saline lavage and antibiotics; however, their wounds did not heal. Second-l...
Source: Journal of Knee Surgery - February 19, 2020 Category: Orthopaedics Authors: Yokoe, Takuji Tajima, Takuya Yamaguchi, Nami Morita, Yudai Chosa, Etsuo Tags: Original Article Source Type: research

Aseptic Loosening of Porous Metaphyseal Sleeves and Tantalum Cones in Revision Total Knee Arthroplasty: A Systematic Review
J Knee Surg DOI: 10.1055/s-0040-1701434Bone loss often complicates revision total knee arthroplasty (TKA). Management of metaphyseal defects varies, with no clearly superior technique. Two commonly utilized options for metaphyseal defect management include porous-coated metaphyseal sleeves and tantalum cones. A systematic review was conducted according to the international Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We combined search terms “Total knee arthroplasty” AND/OR “Sleeve,” “Cone” as either keywords or medical subject heading (MeSH) te...
Source: Journal of Knee Surgery - February 19, 2020 Category: Orthopaedics Authors: Roach, Ryan P. Clair, Andrew J. Behery, Omar A. Thakkar, Savyasachi C. Iorio, Richard Deshmukh, Ajit J. Tags: Original Article Source Type: research

Association of Lumbar Degenerative Disease and Revision Rate following Total Knee Arthroplasty
J Knee Surg DOI: 10.1055/s-0040-1701651Recently, a variety of studies have analyzed the potential correlation between lumbar degenerative disease (LDD) and inferior clinical outcomes after total hip arthroplasty. However, there has been limited data concerning the role of LDD as a risk factor for failure after total knee arthroplasty (TKA). The aim of our study was to determine: (1) what is the association of LDDs with TKA failure (all-cause revision) within 2 years of index arthroplasty and (2) if patients with LDD and lumbar fusion are at increased risk of TKA revision within 2 years compared with LDD patients without fu...
Source: Journal of Knee Surgery - February 19, 2020 Category: Orthopaedics Authors: Malahias, Michael-Alexander Gu, Alex Richardson, Shawn S. De Martino, Ivan Mayman, David J. Sculco, Thomas P. Sculco, Peter K. Tags: Original Article Source Type: research

Navigation Improves the Survival Rate of Mobile-Bearing Total Knee Arthroplasty by Severe Preoperative Coronal Deformity: A Propensity Matched Case –Control Comparative Study
J Knee Surg DOI: 10.1055/s-0040-1701441The primary hypothesis of this study was that the survival rate over 10 years of total knee arthroplasties (TKAs) implanted with a navigation system was superior to that of TKAs implanted with a conventional technique. The secondary hypothesis was that the severity of the initial coronal deformity had a negative influence on the survival rate. A national, multicentric, retrospective study was performed in France, including eight university or private centers with high volumes in knee surgery. Cases operated on with either a conventional (control group) or a navigated (study group) tec...
Source: Journal of Knee Surgery - February 19, 2020 Category: Orthopaedics Authors: Jenny, Jean-Yves Saragaglia, Dominique Bercovy, Michel Cazenave, Alain Gaillard, Thierry Ch âtain, Frédéric Jolles-Haeberli, Brigitte Rouvillain, Jean-Louis Tags: Original Article Source Type: research

Can Computer-Assisted Total Knee Arthroplasty Support the Prediction of Postoperative Three-Dimensional Kinematics of the Tibiofemoral and Patellofemoral Joints at the Replaced Knee?
J Knee Surg DOI: 10.1055/s-0040-1701265The aim of this study was to analyze the extent to which postoperative patellofemoral joint (PFJ) kinematics assessed at 6-month follow-up after total knee arthroplasty (TKA) mimics the intraoperative kinematics after final component implantation. The study hypothesis, already proved in terms of tibiofemoral joint (TFJ) kinematics, is that the intraoperative assessment of PFJ kinematics after component implantation is also capable of predicting postoperative knee kinematics during activities of daily living. Twenty patients selected for TKA with patellar resurfacing were implanted usi...
Source: Journal of Knee Surgery - February 19, 2020 Category: Orthopaedics Authors: Belvedere, Claudio Tamarri, Silvia Ensini, Andrea Durante, Stefano Ortolani, Maurizio Leardini, Alberto Tags: Original Article Source Type: research

The Effects of Tourniquet Application in Total Knee Arthroplasty on the Recovery of Thigh Muscle Strength and Clinical Outcomes
J Knee Surg DOI: 10.1055/s-0040-1701454The present randomized controlled study aims to evaluate whether tourniquet application during total knee arthroplasty (TKA) has an effect on (1) thigh muscle strength (quadriceps and hamstring muscle strength) and (2) clinical outcomes (postoperative knee range of motion [ROM], postoperative pain level, and Knee Society Score [KSS]). The effects of tourniquet application during TKA were investigated in 65 patients randomly allocated to one of two groups: TKA with a tourniquet and TKA without a tourniquet. Patients in both groups were comparable in terms of the demographic and clinica...
Source: Journal of Knee Surgery - February 19, 2020 Category: Orthopaedics Authors: Ayik, Omer Demirel, Mehmet Birisik, Fevzi Ersen, Ali Balci, Halil I. Sahinkaya, Turker Batibay, Sefa Giray Ozturk, Irfan Tags: Original Article Source Type: research

Medial Meniscus Scaffold Implantation in Combination with Concentrated Bone Marrow Aspirate Injection: Minimum 3-Year Follow-up
The objective of this study is to show the short-term clinical and radiological outcomes of concentrated bone marrow aspirate (CBMA) injection administered in combination with medial meniscus scaffold implantation. Twenty-three patients who received intra-articular CBMA injection in combination with polyurethane-based medial meniscus scaffold implantation were evaluated within the scope of this study. The International Knee Documentation Committee (IKDC) questionnaire and the Knee injury and Osteoarthritis Outcome Score (KOOS) were used to evaluate the results, and the visual analog scale was used to assess the pain scores...
Source: Journal of Knee Surgery - February 10, 2020 Category: Orthopaedics Authors: Akkaya, Mustafa Şimşek, Mehmet Emin G ürsoy, Safa Çay, Nurdan Bozkurt, Murat Tags: Original Article Source Type: research

Periprosthetic Joint Infections in Total Knee Arthroplasty
J Knee Surg 2020; 33: 099-099 DOI: 10.1055/s-0040-1701248 Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of contents  |  Full text (Source: Journal of Knee Surgery)
Source: Journal of Knee Surgery - February 6, 2020 Category: Orthopaedics Authors: Higuera-Rueda, Carlos A. Tags: Foreword Source Type: research

Clinical Results of Combined ACL and Anterolateral Ligament Reconstruction: A Narrative Review from the SANTI Study Group
J Knee Surg DOI: 10.1055/s-0040-1701220Lateral extraarticular procedures (LEAPs) in the anterior cruciate ligament (ACL)-injured knee were widely abandoned in the 1990s but have seen a recent resurgence. The aim of this review was to demonstrate that anterolateral ligament reconstruction (ALLR) is associated with evidence of significant advantages and no evidence of historical concerns. A narrative review of the literature was performed. Combined ACL + ALLR is associated with improved outcomes when compared against isolated ACL reconstruction, including a significantly lower risk of ACL graft rupture (hazard ...
Source: Journal of Knee Surgery - February 5, 2020 Category: Orthopaedics Authors: Saithna, Adnan Daggett, Matt Helito, Camilo Partezani Monaco, Edoardo Franck, Florent Vieira, Thais Dutra Pioger, Charles Kim, Jin Goo Sonnery-Cottet, Bertrand Tags: Original Article Source Type: research

Higher Component Malposition Rates with Patient-Specific Cruciate Retaining TKA than Contemporary Posterior Stabilized TKA
J Knee Surg DOI: 10.1055/s-0040-1701453Customized individually manufactured total knee arthroplasty (CIM-TKA) was developed to improve kinematic total knee arthroplasty (TKA) performance. Component placement accuracy may influence the success of CIM-TKA designs. We performed this study to compare radiographic component alignment and revision rates of a cruciate retaining (CR) CIM-TKA and a contemporary posterior stabilized TKA (PS-TKA). After obtaining Institutional Review Board approval, we identified 94 CR CIM-TKAs (76 patients) and 91 PS-TKAs (82 patients) performed between July 1, 2013 and December 31, 2014 with a mini...
Source: Journal of Knee Surgery - February 4, 2020 Category: Orthopaedics Authors: Kumar, Prakrit Elfrink, Jacob Daniels, James P. Aggarwal, Ajay Keeney, James A. Tags: Original Article Source Type: research

Extramedullary Guide Alignment Is not Affected by Obesity in Primary Total Knee Arthroplasty
J Knee Surg DOI: 10.1055/s-0040-1701438Coronal alignment of the tibial implant correlates with survivorship of total knee arthroplasty (TKA), especially in obese patients. The purpose of this study was to determine if obesity affects coronal plane alignment of the tibial component when utilizing standard extramedullary tibial guide instrumentation during primary TKA. A retrospective review from June 2017 to February 2018 identified 142 patients (162 primary TKAs). There were 88 patients (100 knees) with body mass index (BMI) 
Source: Journal of Knee Surgery - February 4, 2020 Category: Orthopaedics Authors: Compton, Jocelyn Owens, Jessell Otero, Jesse Noiseux, Nicolas Brown, Timothy Tags: Original Article Source Type: research

Robotic-Assisted versus Manual Unicompartmental Knee Arthroplasty: Contemporary Systematic Review and Meta-analysis of Early Functional Outcomes
J Knee Surg DOI: 10.1055/s-0040-1701455Robotic-assisted unicompartmental knee arthroplasty (RA-UKA) aims to improve accuracy of component placement. Studies have shown improvement in radiographic positioning/alignment with RA-UKA but have not addressed clinical outcome measures (COMs). The purpose of this study was to determine if RA-UKA is associated with improved early revision rates and functional outcome scores (FOS) compared with manual UKA. A systematic review of all English language articles from 1999 to 2019 on RA-UKA using Medline, EMBASE, Scopus, and Web of Science databases identified 277 studies. Seven (three r...
Source: Journal of Knee Surgery - January 30, 2020 Category: Orthopaedics Authors: Gaudiani, Michael A. Samuel, Linsen T. Kamath, Atul F. Courtney, P. Maxwell Lee, Gwo-Chin Tags: Original Article Source Type: research

Vascular Injuries following Knee Dislocation
J Knee Surg DOI: 10.1055/s-0040-1701210Knee dislocations (KDs) are frequently found in high-energy impact injuries, ranging from automobile accidents to contact sports. KDs require careful examination due to the limb-threatening nature of these injuries. A key examination in any KD comprises a proper assessment of the vascular status. The risk of popliteal artery injury with a KD has varied from 7 to 40%, with more contemporary studies reporting injury in the range of 7 to 15%. The notion of mandatory emergent arteriography was challenged in the trauma literature as several small retrospective studies suggested that select...
Source: Journal of Knee Surgery - January 27, 2020 Category: Orthopaedics Authors: Stannard, James P. Schreiner, Anna J. Tags: Special Focus Section Source Type: research

Evaluation of Graft Tensioning Effects in Anterior Cruciate Ligament Reconstruction between Hamstring and Bone –Patellar Tendon Bone Autografts
This article investigates the clinical, functional, and radiographic outcomes in anterior cruciate ligament (ACL) reconstruction patients over 7 years to determine the effects of initial graft tension on outcomes when using patellar tendon (bone–tendon–bone [BTB]) and hamstring tendon (HS) autografts. Ninety patients, reconstructed with BTB or HS, were randomized using two initial graft tension protocols: (1) normal anteroposterior (AP) laxity (“low-tension”; n = 46) and (2) AP laxity overconstrained by 2 mm (“high-tension”; n = 44). Seventy-two patient...
Source: Journal of Knee Surgery - January 21, 2020 Category: Orthopaedics Authors: DeFroda, Steven F. Karamchedu, Naga Padmini Budacki, Ross Wiley, Taylor Fadale, Paul D. Hulstyn, Michael J. Shalvoy, Robert M. Badger, Gary J. Fleming, Braden C. Owens, Brett D. Tags: Original Article Source Type: research

Effectiveness of High Tibial Osteotomy with or without Other Procedures for Medial Compartment Osteoarthritis of Knee: An Update Meta-Analysis
J Knee Surg DOI: 10.1055/s-0039-1700978To improve the long-term outcomes of high tibial osteotomy (HTO) for gonarthritis, many cartilage repair procedures appeared, but their effects were controversial. To evaluate the efficacy of cartilage repair procedures during HTO for gonarthritis, we performed this update meta-analysis. We performed the system retrieval for clinical trials using various databases and then pooled the outcomes of the included studies. Fifteen studies were involved. The pooled results indicated that there were no significant differences in Kellgren and Lawrence (KL) scale (mean difference [MD] =&...
Source: Journal of Knee Surgery - January 17, 2020 Category: Orthopaedics Authors: Yao, Ru-Zhan Liu, Wei-Qiang Sun, Liang-Zhi Yu, Ming-Dong Wang, Guang-Lin Tags: Original Article Source Type: research

The Comparison of Intrathecal Ropivacaine with Bupivacaine for Knee Arthroscopy: A Meta-analysis of Randomized Controlled Trials
J Knee Surg DOI: 10.1055/s-0039-3402795The comparison of intrathecal ropivacaine with bupivacaine for knee arthroscopy remains controversial. We conduct a systematic review and meta-analysis to explore the efficacy of intrathecal ropivacaine versus bupivacaine for knee arthroscopy. We search PubMed, EMbase, Web of science, EBSCO, and Cochrane library databases through August 2019 for randomized controlled trials (RCTs) assessing the effect of intrathecal ropivacaine versus bupivacaine for knee arthroscopy. This meta-analysis is performed using the random effects model. Five RCTs are included in the meta-analysis. Overall, ...
Source: Journal of Knee Surgery - January 17, 2020 Category: Orthopaedics Authors: Xie, Zhiwei Nie, Xiaoying Pan, Linlin Zhang, Na Xue, Huiqin Tags: Original Article Source Type: research

Simultaneous Bilateral Total Knee Arthroplasty Becomes Safer after Institution of Optimal Perioperative Management: A Longitudinal Cohort Study
This study aimed to evaluate whether optimal perioperative management could improve the safety of SBTKA. From 2005 to 2017, 1,166 cases of SBTKA were identified from 14,209 TKA procedures. We retrospectively examined the SBTKA patients' demographics, comorbidity profiles, procedure-related complications, and perioperative management during two time periods. Optimal perioperative workup for managing SBTKA significantly decreased the incidences of major complication from 6.2 to 2.4% (p = 0.001) and minor complications from 28.9 to 21.5% (p = 0.004) during period I and period II, respectively. The ...
Source: Journal of Knee Surgery - January 17, 2020 Category: Orthopaedics Authors: Chen, Shih-Hao Chen, Jen-Yuh Wong, Tze-Hong Buechel, Frederick Wu, Meng-Huang Tags: Original Article Source Type: research

Biofilms in Periprosthetic Joint Infections: A Review of Diagnostic Modalities, Current Treatments, and Future Directions
J Knee Surg DOI: 10.1055/s-0040-1701214As the number of total joint arthroplasties continues to rise, periprosthetic joint infection (PJI), a significant and devastating complication of total joint arthroplasty, may also increase. In PJI, bacterial biofilms are formed by causative pathogens surrounded by extracellular matrix with relatively dormant cells that can persist, resulting in a barrier against the host immune system and antibiotics. These biofilms not only contribute to the pathogenesis of PJI but also result in diagnostic challenges, antibiotic resistance, and PJI treatment failure. This review discusses the deve...
Source: Journal of Knee Surgery - January 14, 2020 Category: Orthopaedics Authors: Shoji, Monica M. Chen, Antonia F. Tags: Special Focus Section Source Type: research

Radiographic Evaluation of Medial Opening-Wedge High Tibial Osteotomy Using a New Internal Fixator with a Wedge-Shaped Spacer Block
J Knee Surg DOI: 10.1055/s-0039-1700977We developed a new internal fixator: a rigid T-shaped plate with locking screws and wedge-shaped spacer block for high tibial osteotomy. The purpose of the present study was to evaluate the radiographic outcome of opening-wedge high tibial osteotomy (OWHTO) using this new internal fixator. Sixty OWHTOs were performed in patients with medial compartment osteoarthritis and varus deformity (28 males and 23 females). Patients' mean age was 60.4 years. Preoperative and postoperative radiographs were obtained. The paired t-test was used to evaluate the differences over time with respect to ...
Source: Journal of Knee Surgery - January 13, 2020 Category: Orthopaedics Authors: Okimura, Shinichiro Teramoto, Atsushi Watanabe, Kota Nuka, Satoshi Kamiya, Tomoaki Yamashita, Toshihiko Tags: Original Article Source Type: research

Do We Need Chemoprophylaxis to Prevent Venous Thromboembolism following Medial Open-Wedge High Tibial Osteotomy?
J Knee Surg DOI: 10.1055/s-0039-1700976The aim of this study was to investigate the overall incidence of venous thromboembolism (VTE) and to assess the efficacy of chemoprophylaxis to prevent VTE following medial open-wedge high tibial osteotomy (MOWHTO) in Asian patients. A total of 133 patients who consecutively underwent MOWHTO for the treatment of knee osteoarthritis with varus deformity were enrolled. All patients underwent preoperative ultrasonography and computed tomography venography on postoperative day 5 to detect deep vein thrombosis (DVT). Patients were divided into two groups: chemoprophylaxis group included p...
Source: Journal of Knee Surgery - January 13, 2020 Category: Orthopaedics Authors: Kim, Kang-Il Kim, Gi Beom Lee, Myeong Gu Song, Sang Jun Tags: Original Article Source Type: research

Impact of Medial Meniscotibial Ligament Disruption Compared to Peripheral Medial Meniscal Tear on Knee Biomechanics
J Knee Surg DOI: 10.1055/s-0039-3402483Medial meniscotibial ligament (MTL) lesions may go unrecognized and untreated and have detrimental impact on knee biomechanics and joint pathology. Therefore, this study was designed to compare the biomechanical impact of midbody MTL disruption to corresponding peripheral medial meniscal (PMM) tears in anterior cruciate ligament (ACL) intact and ACL-deficient cadaveric knees. Cadaveric knees (n = 12; 6 matched pairs) were tested for laxity and ACL strain under anterior, valgus, and external rotation loading at 0, 30, and 90 degree of flexion. Knees were randomly assigned...
Source: Journal of Knee Surgery - January 8, 2020 Category: Orthopaedics Authors: Smith, Patrick A. Humpherys, Joseph L. Stannard, James P. Cook, James L. Tags: Original Article Source Type: research

Different Patellar Indices and Their Role in Decision-Making: An MRI-Based Study
J Knee Surg DOI: 10.1055/s-0039-3402045Magnetic resonance imaging (MRI) of knee has become the integral part of knee evaluation, hence any MRI based study adds more value if it helps in the decision-making process, especially for surgery in treating patellofemoral pain. We tried to determine normal patellar indices using knee MR images and the correlation between them and also compared the results with different ethnic population. We analyzed the prospectively collected MR images of 117 knees/patients, and Insall–Salvati (IS) index, modified IS index, patellotrochlear (PT) index, and patellophyseal (PP) index were ca...
Source: Journal of Knee Surgery - January 8, 2020 Category: Orthopaedics Authors: Raju, Sivashanmugam Chinnakkannu, Karthikeyan Balakumar, Balasubramanian Sundareyan, Ramanivas Kaliappan, Saravanakumar P. Puttaswamy, Mohan K. Tags: Original Article Source Type: research

Erratum to: The Irreducible Knee Dislocation
J Knee Surg DOI: 10.1055/s-0039-3402743 Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of contents  |  Full text (Source: Journal of Knee Surgery)
Source: Journal of Knee Surgery - January 7, 2020 Category: Orthopaedics Authors: Malik, Shahbaz S. MacDonald, Peter B. Tags: Erratum Source Type: research

Posterior Cruciate Ligament Reconstruction in the Multiple Ligament Injured Knee
J Knee Surg DOI: 10.1055/s-0039-3402792Multiligamentous knee injuries are challenging to treat and diagnose. Posterior cruciate ligament (PCL) injuries are commonly found in the constellation of injuries included in a multiligamentous knee injury and are caused by a posteriorly directed force on the proximal tibia with relation to the femoral condyles. A thorough history and physical examination should be performed to evaluate for associated neurovascular injuries and associated ligamentous, chondral, or bony injuries. Nonsurgical management is reserved for patients who are critically ill or have very low activity demands....
Source: Journal of Knee Surgery - January 6, 2020 Category: Orthopaedics Authors: Kew, Michelle E. Miller, Mark D. Tags: Special Focus Section Source Type: research

Complications following Suture Button Use for Femoral Graft Fixation in Arthroscopic Anterior Cruciate Ligament Reconstruction: A Systematic Review
J Knee Surg DOI: 10.1055/s-0039-3400753Understanding any potential complications that may occur in relation to the use of a suture button for femoral graft fixation in arthroscopic anterior cruciate ligament reconstruction can help raise awareness among surgeons and improve safety when using such implants. This is a systematic review of suture button related complications. A literature search was conducted using the PubMed, Embase, and CINAHL (Cumulative Index to Nursing and Allied Health Literature) databases from their year of inception until January 3, 2019. We included studies reporting on suture button related complic...
Source: Journal of Knee Surgery - January 6, 2020 Category: Orthopaedics Authors: Yassa, R. Adams, J. R. Charalambous, C. P. Tags: Original Article Source Type: research

Bilateral Hidden Isokinetic Quadriceps Performance before and after MPFL Reconstruction in Pediatric Patients
J Knee Surg DOI: 10.1055/s-0039-3402031We perform prospective study to evaluate the isokinetic performance of quadriceps before and 1 year after medial patella-femoral ligament (MPFL) reconstruction with the adductor magnus tendon in the case of recurrent patellar dislocation. The present study is the first to describe the isokinetic function of the quadriceps of the involved and uninvolved extremity, in such a wide range. The MPFL is a crucial passive stabilizer of patella and, along with the conditions of the anatomical shape of the femoral-patellar joint and the function of quadriceps, influences the overall patellar st...
Source: Journal of Knee Surgery - January 6, 2020 Category: Orthopaedics Authors: Ma łecki, Krzysztof Niedzielski, Kryspin Flont, Pawe ł Fabis-Strobin, Anna Fabis, Jaros ław Tags: Original Article Source Type: research

Use of a Mandatory Clinical Decision Unit Reduces Readmission Rates following Total Joint Arthroplasty
J Knee Surg DOI: 10.1055/s-0039-3402053Readmission penalties have encouraged the implementation of protocols to reduce readmission rates. We hypothesized that by keeping postoperative patients, who return to the emergency department (ED) in a clinical decision unit (CDU) until being evaluated by the orthopaedic team, there would be a reduction in the readmission rate after total joint arthroplasty (TJA) at our institution. Our institution mandated the use of the CDU for all potential orthopaedic TJA readmissions. A retrospective review of prospectively collected data was performed on 365 patients who presented to the ED af...
Source: Journal of Knee Surgery - January 6, 2020 Category: Orthopaedics Authors: Manoli, Arthur Markel, Jacob F. Pizzimenti, Natalie M. Markel, David C. Tags: Original Article Source Type: research

The 90-day Readmission Rate after Single-Bundle ACL Reconstruction Plus LET: Analysis of 2,559 Consecutive Cases from a Single Institution
In conclusion, this technique of arthroscopic ACL reconstruction with LET showed a low readmission rate within 90 days from surgery. However, patients and physicians should be aware of the risk of serious complications, such as deep and superficial infections, mostly in female patients and in cases of concurrent meniscal treatments. This is a Level IV, retrospective case series study. [...] Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of contents  |  Abstract  |  Full text (Source: Journal of Knee Surgery)
Source: Journal of Knee Surgery - January 6, 2020 Category: Orthopaedics Authors: Grassi, Alberto Costa, Giuseppe Gianluca Cialdella, Sergio Lo Presti, Mirco Neri, Maria Pia Zaffagnini, Stefano Tags: Original Article Source Type: research

The Distance between Tibial Tubercle and Trochlear Groove Correlates with Knee Articular Torsion
This study aims to correlate the tibial tubercle to trochlear groove (TT-TG) distance with knee axial alignment. The hypothesis is that as internal torsion of the distal femur or external torsion of the proximal tibial increases, the TT-TG distance increases. We designed a cross-sectional study approved by our institutional ethics review board. We reviewed 32 computed tomography angiographies of patients that have nonjoint or bone-related symptoms. Distal femoral torsion, proximal tibial torsion, knee articular torsion (AT), and TT-TG distance were measured. A regression analysis between the TT-TG distance and the AT was p...
Source: Journal of Knee Surgery - January 6, 2020 Category: Orthopaedics Authors: Barahona, Maximiliano Guzm án, Mauricio Barrientos, Cristian Zamorano, Álvaro Palet, Miguel Hinzpeter, Jaime Tags: Original Article Source Type: research

Erratum to: A Randomized Controlled Single-Blind Study Demonstrating Superiority of Amniotic Suspension Allograft Injection over Hyaluronic Acid and Saline Control for Modification of Knee Osteoarthritis Symptoms
J Knee Surg 2019; 32: e2-e2 DOI: 10.1055/s-0039-3402742 Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of contents  |  open access Full text (Source: Journal of Knee Surgery)
Source: Journal of Knee Surgery - January 6, 2020 Category: Orthopaedics Authors: Farr, Jack Gomoll, Andreas H. Yanke, Adam B. Strauss, Eric J. Mowry, Katie C. Tags: Erratum Source Type: research

Revision Multiligament Knee Reconstruction Surgery
J Knee Surg DOI: 10.1055/s-0039-3402791Failed multiligament knee reconstruction is a challenging problem due to recurrent pathologic laxity that is often associated with limb malalignment, meniscus deficiency, articular cartilage insufficiency, decreased motion, compromised bone stock, and a paucity of graft sources. Revision surgical indications and techniques require a comprehensive evaluation of the patient, injury and treatment factors along with a focused physical examination and advanced imaging. A stepwise treatment approach can be effective in the evaluation of revision surgery and also in setting realistic patient...
Source: Journal of Knee Surgery - January 2, 2020 Category: Orthopaedics Authors: Stuart, Michael B. Woodmass, Jarret M. Krych, Aaron J. Levy, Bruce A. Stuart, Michael J. Tags: Special Focus Section Source Type: research

Comparison of the Kirschner Wire Tension Band with a Novel Nickel –Titanium Arched Shape–Memory Alloy Connector in Transverse Patellar Fractures: A Retrospective Study
This study aims to compare the clinical outcomes of the nickel–titanium arched shape–memory alloy connector (hereafter referred to as the ASC) and tension band fixation for the treatment of transverse patellar fractures. We retrospectively analyzed a total of 257 patients with transverse patellar fractures who were treated at our emergency orthopaedics department from March 2010 to March 2017. Either an ASC or the Kirschner wire (K-wire) tension band had been used to treat these fractures according to surgeons' experience and preference. We compared operative details, postoperative recovery, and postoperative k...
Source: Journal of Knee Surgery - January 2, 2020 Category: Orthopaedics Authors: Wang, Yang Xia, Demeng Luo, Xi Zhang, Hongyue Wu, Jianghong Zhou, Panyu Xu, Shuogui Tags: Original Article Source Type: research

Insulin-Dependence Predicts Surgical Complications and Hospital Admission Following Knee Arthroscopy
J Knee Surg DOI: 10.1055/s-0039-3402803While prior studies have demonstrated that insulin-dependence is an independent risk factor for postoperative complications, morbidity, and mortality following spine and shoulder, hip, and knee arthroplasty, it has not been evaluated in the setting of knee arthroscopy. Therefore, the purpose of this study is to compare the risk of postoperative complications among patients with insulin-dependent diabetes mellitus and noninsulin-dependent diabetes mellitus (IDDM and NIDDM respectively) with the general population following knee arthroscopy. A retrospective analysis of the National Surg...
Source: Journal of Knee Surgery - January 2, 2020 Category: Orthopaedics Authors: Traven, Sophia A. Reeves, Russell A. Walton, Zeke J. Woolf, Shane K. Slone, Harris S. Tags: Original Article Source Type: research

Accelerometer-Based Portable Navigation System Is Useful for Tibial Bone Cutting in Modified Kinematically Aligned Total Knee Arthroplasty
This study compares an accelerometer-based portable navigation system with a conventional navigation system on tibial bone resection and clinical outcomes in KA-TKA. This study included 60 knees of patients who underwent primary KA-TKA between May 2015 and September 2017. They were randomly assigned to the OrthoPilot and iASSIST groups. A tibial bone cut was performed with 3 degree varus and 7 degree posterior slope in relation to the mechanical axis in all cases. The tibial component angle (TCA) and posterior slope angle (PSA) were evaluated by postoperative radiography, and those that deviated more than 2 degree were set...
Source: Journal of Knee Surgery - December 31, 2019 Category: Orthopaedics Authors: Tsubosaka, Masanori Kamenaga, Tomoyuki Kuroda, Yuichi Takayama, Koji Hashimoto, Shingo Ishida, Kazunati Hayashi, Shinya Kuroda, Ryosuke Matsumoto, Tomoyuki Tags: Original Article Source Type: research

Selective Embolization Is Safe and Effective for Total Knee Arthroplasty-Associated Recurrent Hemarthroses: A Systematic Review and Meta-Analysis
J Knee Surg DOI: 10.1055/s-0039-3402482Total knee arthroplasty (TKA)-associated hemarthroses are infrequent and often respond to nonoperative therapy. Geniculate artery embolization may provide symptomatic relief in cases recalcitrant to needle aspiration, although no meta-analysis exists regarding this therapy. This meta-analysis aims to assess the rate of symptom relief, the number of embolizations needed to achieve relief, and the rate of complications associated with embolization. Public databases were queried from 1998 until 2018 for TKA-associated recurrent hemarthroses treated with embolization. Eight studies met in...
Source: Journal of Knee Surgery - December 31, 2019 Category: Orthopaedics Authors: Sundaram, Kavin Arnold, Nicholas R. Mont, Michael A. Sodhi, Nipun Warren, Jared Kamath, Atul F. Piuzzi, Nicolas S. Tags: Original Article Source Type: research

Gait Analysis 1 Year after Primary TKA: No Difference between Gap Balancing and Measured Resection Technique
J Knee Surg DOI: 10.1055/s-0039-3402079Mechanical alignment in total knee arthroplasty (TKA) can be achieved using dependent bone cuts. The hypothesis is that patients have a better balanced TKA, as a result. The aim of this study was to determine if this technique is superior to an independent bone cut technique in terms of gait parameters, patient-reported outcome measures (PROMs), and satisfaction assessed before surgery and at 1-year follow-up. A total of 58 patients were evaluated before and 1 year following TKA, using the Press Fit Condylar (PFC) Sigma posterior stabilizer (PS) design; 39 (70 ± 8...
Source: Journal of Knee Surgery - December 31, 2019 Category: Orthopaedics Authors: Miozzari, Hermes H. Armand, St éphane Turcot, Katia L übbeke, Anne Bonnefoy-Mazure, Alice Tags: Original Article Source Type: research

Minimally Invasive Inlay Prosthesis Unicompartmental Knee Arthroplasty for the Treatment of Unicompartmental Osteoarthritis: A Prospective Observational Cohort Study with Minimum 2-Year Outcomes and up to 14-Year Survival
J Knee Surg DOI: 10.1055/s-0039-3400536There are limited medium-term outcome data available for the Repicci II device in unicompartmental knee arthroplasty (UKA). The purpose of this study was to report the medium-term (minimum 2 years) patient-reported outcomes and long-term (up to 14 years) procedure survival in a consecutive series of patients undergoing an inlay prosthesis UKA (Repicci II) at an independent orthopaedic clinic. Patients presenting with medially localized unicompartmental knee osteoarthritis and meeting the criteria appropriate for UKA were recruited to a clinical patient registry at the time of presenta...
Source: Journal of Knee Surgery - December 30, 2019 Category: Orthopaedics Authors: Scholes, Corey Ebrahimi, Milad Field, Clarice Farah, Sami Kerr, Dennis Kohan, Lawrence Tags: Original Article Source Type: research

Risk Factors for Requiring a Revision Anterior Cruciate Ligament Reconstruction: A Case-Control Study
J Knee Surg DOI: 10.1055/s-0039-3402075Anterior cruciate ligament (ACL) reconstruction is considered as a successful orthopaedic procedure that attempts to help patients return to their preinjury level of activity. However, some patients may need to undergo revision surgery, and this potentially may be associated with certain surgery-specific or patient risk factors. Therefore, the purpose of this study was to assess the potential role of (1) demographics, (2) family history, (3) graft choice, (4) sport, and (5) mechanism of injury (contact vs. noncontact) in the risk for needing a revision ACL for improved clinical outcom...
Source: Journal of Knee Surgery - December 30, 2019 Category: Orthopaedics Authors: Pierce, Todd P. Kurowicki, Jennifer Kelly, John J. Issa, Kimona Festa, Anthony McInerney, Vincent K. Scillia, Anthony J. Tags: Original Article Source Type: research

Radiographic Comparison of the Mechanical Axis Including Calcaneus to the Conventional Mechanical Axis in Medial Unicompartmental Knee Arthroplasty
J Knee Surg DOI: 10.1055/s-0039-3402044Since a hindfoot alignment is not included in the conventional mechanical axis (hip–ankle [HA] line), a mechanical axis including the calcaneus (hip–calcaneus [HC] line) has recently attracted attention as an alternative weight-bearing line. However, there are few reports on unicompartmental knee arthroplasty (UKA) regarding the HC line. Therefore, this study aimed to compare postoperative alignments after UKA between the HA line and the HC line. Postoperatively, HC radiographs were taken in 88 consecutive patients who underwent medial UKA. The hip–knee–ankle (...
Source: Journal of Knee Surgery - December 30, 2019 Category: Orthopaedics Authors: Kuroda, Yuichi Takayama, Koji Ishida, Kazunari Hayashi, Shinya Hashimoto, Shingo Tsubosaka, Masanori Kamenaga, Tomoyuki Matsushita, Takehiko Niikura, Takahiro Kuroda, Ryosuke Matsumoto, Tomoyuki Tags: Original Article Source Type: research

Appropriate Timing for Evaluation of the Short-Term Effectiveness of Unicompartmental Knee Arthroplasty
J Knee Surg DOI: 10.1055/s-0039-3402480Satisfactory results have been achieved with unicompartmental knee arthroplasty (UKA) for the treatment of isolated unicompartmental knee disease. However, UKA is associated with a significantly higher rate of revision. There is a tendency toward early revision of UKA for persistent pain because surgeons are not aware that outcomes can spontaneously improve with time. The aim of this study was to identify the time period that patients achieved the highest clinical outcomes following UKA. In total, we examined 72 knees that underwent Oxford UKA. We evaluated the range of motion and cli...
Source: Journal of Knee Surgery - December 30, 2019 Category: Orthopaedics Authors: Inui, Hiroshi Taketomi, Shuji Yamagami, Ryota Kono, Kenichi Kawaguchi, Kohei Nakazato, Keiu Takagi, Kentarou Kage, Tomofumi Tanaka, Sakae Tags: Original Article Source Type: research

Preoperative Performance of Patient-Reported Outcomes Measurement Information System in Patients with Meniscal Root Tears
J Knee Surg DOI: 10.1055/s-0039-3402076The purpose of this study was to establish preoperative validity of the Patient-Reported Outcomes Measurement Information System physical function computer adaptive test (PROMIS PF-CT) with legacy patient-reported outcome measures (PROMs) for meniscal root tears (MRTs). Our study included 51 patients (52 knees) with MRT. Patients completed PROMIS PF-CT, Short Form 36 (SF-36 physical function, pain, general health, vitality, social function, emotional well-being, role limitations due to physical health, and role limitations due to emotional problems), Knee Injury and Osteoarthritis Out...
Source: Journal of Knee Surgery - December 30, 2019 Category: Orthopaedics Authors: Gulbrandsen, Trevor R. Khazi, Zain M. Bollier, Matthew Wolf, Brian Larson, Christopher Duchman, Kyle An, Qiang Westermann, Robert W. Tags: Original Article Source Type: research

Local Vancomycin Concentrations after Intra-articular Injection into the Knee Joint: An Experimental Porcine Study
J Knee Surg DOI: 10.1055/s-0039-3402078Intra-articular injection of vancomycin may be an important antimicrobial prophylactic supplement to systemic administration in the prevention of prosthetic joint infections. In eight female pigs, 500 mg of diluted vancomycin was given by intra-articular injection into the knee joint. Microdialysis was used for dense sampling of vancomycin concentrations over 12 hours in the synovial fluid of the knee joint, and in the adjacent femoral and tibial cancellous bone and subcutaneous tissue. Venous blood samples were obtained as reference. The mean (standard deviation [SD]) p...
Source: Journal of Knee Surgery - December 30, 2019 Category: Orthopaedics Authors: Bue, Mats Thomassen, Maja B. Larsen, Ole H. J ørgensen, Andrea R. Stilling, Maiken S øballe, Kjeld Hanberg, Pelle Tags: Original Article Source Type: research

Neurologic Assessment and Management of the Multiple Ligament Injured Knee: A Review and Synthesis of Current Evidence
This article provides an overview of relevant injury demographics, anatomy, diagnosis, and prognosis, and suggests a treatment algorithm for nerve injury associated with multiligament knee injury. [...] 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 - December 24, 2019 Category: Orthopaedics Authors: Hoit, Graeme Farag, Jordan Whelan, Daniel B. Tags: Special Focus Section Source Type: research

Factors Associated with Knee Arthroplasty in a Knee Osteoarthritis Patient Cohort Treated with Intra-articular Injections of Hylan G-F 20
This study evaluated time to knee arthroplasty (KA), KA risk factors, and health care resource utilization in patients aged ≥18 years with claims in the Optum Clinformatics Data Mart database (2006–2016) for knee osteoarthritis treated with at least one course of hylan G-F 20. Kaplan–Meier analysis estimated KA risk from osteoarthritis diagnosis and first hylan G-F 20 treatment. KA risk factors were determined using multivariate Cox regression. Among 62,033 patients treated with hylan G-F 20 and/or hylan G-F 20 single intra-articular injection, 60 to 64% did not undergo KA 8 years following first injection. ...
Source: Journal of Knee Surgery - December 24, 2019 Category: Orthopaedics Authors: Ong, Kevin Lau, Edmund Runa, Maria Daley, William Altman, Roy Tags: Original Article Source Type: research

Is there a Threshold Preoperative WOMAC Score That Predicts Patient Satisfaction after Total Knee Arthroplasty?
J Knee Surg DOI: 10.1055/s-0039-3401826The aim of this study was to identify threshold preoperative Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores that were predictive of patient dissatisfaction 1 year after total knee arthroplasty (TKA). A retrospective cohort of 3,324 patients undergoing a primary TKA was identified from an established arthroplasty database. Patient demographics, comorbidities, and the WOMAC score were collected preoperatively. Patient satisfaction was assessed at 1 year using four questions that focused on: overall outcome, activity, work, and pain. Receiver operating char...
Source: Journal of Knee Surgery - December 12, 2019 Category: Orthopaedics Authors: Clement, Nicholas D. Weir, David J. Holland, James Deehan, David J. Tags: Original Article Source Type: research

The Effects of Patient Occupation, Hobbies, and Body Mass Index on Kneeling after Total Knee Arthroplasty
J Knee Surg DOI: 10.1055/s-0039-3400740A common patient concern after total knee arthroplasty (TKA) is the ability to kneel. Kneeling may have a substantial impact on the patients' ability to perform many activities of daily living, occupations, and hobbies. The purpose of this study was to quantify the percentage of patients able to kneel after TKA after 2 years and to evaluate preoperative patient characteristics that influence the patient's perceived ability to kneel after TKA such as obesity, occupation, and hobbies. We retrospectively assessed a cohort of 404 patients who underwent primary TKA with patellar resurfacin...
Source: Journal of Knee Surgery - December 9, 2019 Category: Orthopaedics Authors: Sabeh, Karim G. Hernandez, Victor H. Cohen-Levy, Wayne B. Ong, Alvin Orozco, Fabio Bennett, Veronica Post, Zachary Tags: Original Article Source Type: research

Long-Term Results of ACL Reconstruction Using a Nonanatomic Double-Bundle Technique with Extra-Articular Reinforcement
J Knee Surg DOI: 10.1055/s-0039-1700575Extra-articular procedures for the improvement in rotational stability after anterior cruciate ligament (ACL) reconstruction have gained popularity in the last decade. This surgical gesture hoped to improve resistance to the high tensional forces affecting the ACL graft during cutting and pivoting movements of the lower extremity and eventually prevent ACL reconstruction failure. We performed this study to analyze the long-term results of patients undergoing ACL reconstruction using a nonanatomic double-bundle technique with an additional extra-articular augmentation. All the cases th...
Source: Journal of Knee Surgery - December 9, 2019 Category: Orthopaedics Authors: Dalla-Rosa, J. Espejo-Reina, A. Tamimi, I. Espejo-Reina, M. J. Lombardo-Torre, M. Espejo-Baena, A. Tags: Original Article Source Type: research

ACL Reconstruction in the Multiple Ligament Injured Knee
We present a summary of the current knowledge with respect to the treatment of ACL injuries in the context of the multiple ligament injured 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 - December 3, 2019 Category: Orthopaedics Authors: Marx, Robert G. Wolfe, Isabel A. Tags: Special Focus Section Source Type: research