Risk Factors for Tibial Component Oversizing in Total Knee Arthroplasty among African Americans
J Knee Surg DOI: 10.1055/s-0039-1677817Incidences and risk factors for tibial component oversizing in total knee arthroplasty (TKA) have been well described, predominantly in Caucasian samples. Component oversizing has been linked to variations in proximal tibial shape and morphology, which has been found to be objectively different in African Americans compared with Caucasians. These anthropometric differences may affect the conformity of modern TKA systems to the anatomy of African Americans undergoing TKA. We sought to investigate the incidence and risk factors for tibial baseplate oversizing in an exclusively African A...
Source: Journal of Knee Surgery - February 6, 2019 Category: Orthopaedics Authors: Padmanabha, Anand Li, Michael T. Tybor, David J. Smith, Eric L. Tags: Original Article Source Type: research

Total Knee Arthroplasty for Fixed Valgus Deformity Correction Using a Modified Lateral Parapatellar Approach
We present a case series of a single institution's experience with use of a modified LPA using a Z-capsuloplasty for 35 primary TKA cases in 30 patients with osteoarthritis and Ranawat's type-II fixed valgus deformity with attenuation of medial soft tissues. The mean age of patients was 64.8 years (range: 42–78 years). Follow-up duration was a mean of 47.3 months (range: 3–130 months). The patients were assessed pre- and postoperatively using radiographic measurement of the anatomic femorotibial angle (FTA) and clinical measurement of range of motion (ROM) and the Chinese knee society score (KSS). Complications...
Source: Journal of Knee Surgery - February 6, 2019 Category: Orthopaedics Authors: Li, Hu Ponzio, Danielle Y. Ong, Alvin Wei, Wei Wang, Baicheng Li, Zhichang Zhou, Diange Tags: Original Article Source Type: research

Revision Single-Stage Anterior Cruciate Ligament Reconstruction Using an Anterolateral Tibial Tunnel
This study showed that ACL revision surgery with ALTT can reliably restore stability and provide fair functional outcomes in patients with ACL retear. One could expect acceptable lateral tibial tunnel length compared with medial tibial tunnel in classic ACL revision, intact bony surround, and good graft fixation. This technique is clinically relevant in that making an anterolateral tunnel in one-stage ACL revision surgery had a good subjective result with low complication rate in midterm follow-up. [...] Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of contents&nbs...
Source: Journal of Knee Surgery - February 6, 2019 Category: Orthopaedics Authors: Keyhani, Sohrab Hanafizadeh, Behzad Verdonk, Ren é Sajjadi, Mohammadreza Minator Soleymanha, Mehran Tags: Original Article Source Type: research

Kinematic Alignment in Cruciate Retaining Implants Improves the Biomechanical Function in Total Knee Arthroplasty during Gait and Deep Knee Bend
J Knee Surg DOI: 10.1055/s-0039-1677846Kinematic alignment (KA), which co-aligns the rotational axes of the components with three kinematic axes of the knee by aligning the components to the prearthritic joint lines, has been a recently introduced surgical technique. However, whether KA and cruciate retaining (CR) implants provide better biomechanical function during activities than mechanical alignment (MA) in posterior stabilized (PS) implants is unclear. We evaluated the biomechanical functions during the stance phase gait and deep knee bend, with a computer simulation and measured forces in the medial and lateral colla...
Source: Journal of Knee Surgery - February 6, 2019 Category: Orthopaedics Authors: Kang, Kyoung-Tak Koh, Yong-Gon Nam, Ji Hoon Kwon, Sae Kwang Park, Kwan Kyu Tags: Original Article Source Type: research

The Impact of Gender on Postoperative Complications after Revision Total Knee Arthroplasty
This study included 9,914 patients who underwent revision TKA (females = 5,728 [57.8%]; males = 4 186 [42.2%]). Male patients were shown to be at greater risk for developing 7 of 17 complications compared with female patients, and female patients were shown to be at greater risk for urinary tract infection (UTI) development. Multivariate analysis showed males as an independent risk factor for four complications and females as an independent risk factor for UTI development. Male patients were more likely to develop more complications postoperatively than female patients. Although the possibility ...
Source: Journal of Knee Surgery - February 6, 2019 Category: Orthopaedics Authors: Gu, Alex Wei, Chapman Bernstein, Simone A. Nguyen, Nam Tran T. Sobrio, Shane A. Liu, Jiabin Sculco, Peter K. Tags: Original Article Source Type: research

Medium-Term Results after Surgical Treatment of High-Energy Tibial Plateau Fractures
J Knee Surg DOI: 10.1055/s-0039-1677822The aim of the article is to present the medium-term results of surgical treatment of Schatzker's IV, V, and VI tibial plateau fractures, in a retrospective study of 22 patients at a level-1 trauma center. Twenty-two of 34 patients with Schatzker's IV–VI fractures completed follow-up at a mean of 56 months (range: 7–103 months). Patients' mean age was 47.6 years (range: 18–76 years). Open reduction and internal fixation were performed in 16 patients, while external fixators were used in the remaining six patents. Patients were assessed radiologically for the presence...
Source: Journal of Knee Surgery - February 6, 2019 Category: Orthopaedics Authors: Evangelopoulos, Dimitrios Chalikias, Stavros Michalos, Mihail Vasilakos, Dimitrios Pappa, Eleni Zisis, Konstantinos Koundis, George Kokoroghiannis, Constantine Tags: Original Article Source Type: research

Knee Injuries in the Military
J Knee Surg 2019; 32: 117-117 DOI: 10.1055/s-0038-1677014 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 5, 2019 Category: Orthopaedics Authors: Haley, Chad A. Posner, Matthew A. Tags: Special Focus Section Source Type: research

The Correlation of Shoe Size and Component Size of Primary Total Knee Arthroplasty
J Knee Surg DOI: 10.1055/s-0039-1677841Preoperative planning is an important phase of total joint arthroplasty. Current template programs and methods only provide moderate accuracy for implant size prediction. Recently, a relationship between shoe size and implant size was found. We hypothesized that shoe size shows a high percentage of agreement for implant size of both femoral and tibial component size in primary total knee arthroplasty (TKA). The aim of this study was to investigate the correlation and agreement between shoe size and TKA implant size. We performed a retrospective cohort study. Of all patients, who under...
Source: Journal of Knee Surgery - February 4, 2019 Category: Orthopaedics Authors: van Egmond, Jeroen Cornelis Verburg, Hennie Hesseling, Brechtje Mathijssen, Nina Maria Cornelia Tags: Original Article Source Type: research

Total Articular Knee Replacement Using Polyurethane
This study reviewed the early use of polyurethane for total knee resurfacing, the long-term results of polycarbonate urethane (PCU) for total knee replacement and conducted wear simulator testing of PCU. In 1959 and 1960, 10 patients underwent total articular polyurethane knee replacement (polyethylene was not available). The polyurethane was placed on the articular surface of the femur with metal surfaces on the tibia and patella. In 1996 and 1997, four patients received a newer PCU tibial insert in revision procedures; all had well-fixed prostheses, but no revision polyethylene implants were available. In addition, this ...
Source: Journal of Knee Surgery - February 4, 2019 Category: Orthopaedics Authors: Pritchett, James W. Tags: Original Article Source Type: research

Body Mass Index Classification Is Independently Associated with Health-Related Quality of Life after Primary Total Knee Arthroplasty: An Institutional Registry-Based Study
J Knee Surg DOI: 10.1055/s-0039-1677811The purpose of this study was to compare the health-related quality of life (HRQoL) before and after successful total knee arthroplasty (TKA) across World Health Organization (WHO) body mass index (BMI) classifications. Through an institutional registry, patients with end-stage knee osteoarthritis who received elective primary unilateral TKA were identified and categorized based on WHO BMI classification. Age, gender, laterality, year of surgery, and Charlson–Deyo comorbidity index were recorded. The primary outcome was the EQ-5D-3L index and visual analog scale (VAS) at 2 years...
Source: Journal of Knee Surgery - February 1, 2019 Category: Orthopaedics Authors: Steinhaus, Michael E. Buller, Leonard T. Romero, Jose A. Lee, Yuo-Yu Figgie, Mark P. McLawhorn, Alexander S. Tags: Original Article Source Type: research

A New Total Knee Arthroplasty Design Has Significantly Better Early Implant Survivorship than a Previous Gold-Standard Design —A Retrospective Analysis of 1,000 Cases
This study examined whether a new total knee arthroplasty (TKA) prosthesis improved implant survivorship and reoperation rates compared with a gold-standard, established TKA. A retrospective analysis of the first 500 consecutive new TKAs was compared with a consecutive series of the last 500 currently available TKAs performed by a single senior surgeon in one center. The primary outcome measure was revision of the femoral, tibial, or patellar component. A secondary outcome was reoperation for any reason. The new-TKA group had a significantly reduced revision rate at up to 5 years follow-up (p = 0.02). Reopera...
Source: Journal of Knee Surgery - February 1, 2019 Category: Orthopaedics Authors: Bloch, Benjamin V. Palan, Jeya Shahid, Mohammad James, Peter J. Tags: Original Article Source Type: research

Autologous Patellar Tendon Reconstruction after Total Knee Arthroplasty Infection with Skin Loss: Anatomical Study and Case Report
J Knee Surg DOI: 10.1055/s-0038-1677498Disruption of patellar tendon after total knee arthroplasty (TKA) is a devastating complication. If associated with infection or soft tissue defect, knee arthrodesis is usually indicated. The purpose of this study is to analyze, by means of an anatomical study, the feasibility of our novel technique for reconstruction of extensor apparatus after TKA infections with skin defects, combining gracilis (G) and semitendinosus (ST) tendon autografts and chimeric medial gastrocnemius-sural artery perforator (SAP) flap. In addition, to report on the use of this reconstruction, we described an ...
Source: Journal of Knee Surgery - January 29, 2019 Category: Orthopaedics Authors: P érez-García, Alberto Esteban-Vico, Juan Ramon Garc ía-Sánchez, Jose María Baeza, Jos é Soriano, Francisco Mart ínez Valverde Navarro, Alfonso Amador Garc ía-Granero, Álvaro Sim ón-Sanz, Eduardo Tags: Original Article Source Type: research

Erratum to: Gender Differences in Intra-articular and Extra-articular Injuries Associated with Acute Anterior Cruciate Ligament Ruptures
J Knee Surg DOI: 10.1055/s-0039-1678598 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 29, 2019 Category: Orthopaedics Authors: Tan, Si Heng Sharon Kripesh, Aishwarya Chan, Chloe Xiaoyun Krishna, Lingaraj Tags: Erratum Source Type: research

Erratum to: Correlation of Meniscal Tear with Timing of Anterior Cruciate Ligament Reconstruction in Patients without Initially Concurrent Meniscal Tear
J Knee Surg DOI: 10.1055/s-0039-1678599 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 29, 2019 Category: Orthopaedics Authors: Chen, Kun-Hui Chiang, En-Rung Wang, Hsin-Yi Ma, Hsiao-Li Tags: Erratum Source Type: research

The Difference between Cartilaginous and Bony Sulcus Angles for Patients with or without Patellofemoral Instability: A Systematic Review and Meta-analysis
J Knee Surg DOI: 10.1055/s-0038-1677541The cartilaginous sulcus angle and bony sulcus angle have been widely used to evaluate trochlea dysplasia. The current review aims to evaluate (1) whether there is a difference in measurement for cartilaginous and bony sulcus angles, (2) whether both the cartilaginous and bony sulcus angles could be used to differentiate between patients with or without trochlear dysplasia, and (3) whether the same cut-off of 145 degrees, originally used for radiographs, can be applied for the cartilaginous and bony sulcus angles measured on CT and MRI. The review was conducted using the Preferred Rep...
Source: Journal of Knee Surgery - January 24, 2019 Category: Orthopaedics Authors: Tan, Si Heng Sharon Chng, Kiat Soon Jason Lim, Beatrice Ying Wong, Keng Lin Doshi, Chintan Lim, Andrew Kean Seng Hui, James Hoipo Tags: Original Article Source Type: research

VIS-IT: Visualizing the Injured Tibia —A Cadaveric Study of Limb Positioning for Posterolateral Tibial Plateau Fracture Visualization
J Knee Surg DOI: 10.1055/s-0038-1676799Posterolateral tibial plateau (PLTP) fractures are often associated with anterior cruciate ligament (ACL) incompetence, such as tibial eminence fractures. Both occur from a pivot shift like mechanism. Malreductions of the tibial plateau most frequently occur in the posterolateral quadrant. Acquiring adequate intraoperative visualization of the PLTP poses a challenge. We hypothesized that visualization of PLTP could be improved by positioning the knee at 110 degrees of flexion with the addition of a varus anterolateral rotatory vector. This position and maneuver take advantage of both ...
Source: Journal of Knee Surgery - January 24, 2019 Category: Orthopaedics Authors: Kendal, Joseph K. Clark, Damian Longino, David Marion, Travis E. Buckley, Richard Schneider, Prism S. Martin, Ryan Tags: Original Article Source Type: research

The Occurrence of Meniscal and Chondral Injury in Two-Stage Revision Anterior Cruciate Ligament Reconstruction: A Consecutive Case Series
In conclusion, approximately 10% of patients developed a new meniscal tear and no difference in macroscopic chondral injury was observed between the first and second stages. [...] 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 18, 2019 Category: Orthopaedics Authors: van Tol, Floris R. Kernkamp, Willem A. van der Wal, Robert J. P. Swen, Jan-Willem A. Van de Velde, Samuel K. van Arkel, Ewoud R. A. Tags: Original Article Source Type: research

Benign Bone Tumors When They Coexist with Common Orthopaedic Conditions
This article aims to provide general guidelines and management strategies for benign bone tumors when they coincide with common orthopaedic conditions around the knee. [...] Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of contents  |  Abstract  |  Full text (Source: Journal of Knee Surgery)
Source: Journal of Knee Surgery - January 16, 2019 Category: Orthopaedics Authors: Hasan, Khalid Nguyen, Duc M. Conway, Sheila A. Tags: Special Focus Section Source Type: research

Residual Mild Varus Alignment and Neutral Mechanical Alignment Have Similar Outcome after Total Knee Arthroplasty for Varus Osteoarthritis in Five-Year Follow-Up
In this study, we compared the midterm clinical and functional outcomes in patients with different residual varus. A retrospective review of 175 patients (219 knees) with varus OA was > 3° for the hip-knee-ankle (HKA) who underwent primary TKA after exclusions and loss to follow-up from 237 patients (281 knees). The mean follow-up period was 5.2 ( ±  1.1) years. Patients were divided into four groups according to the first postoperative HKA angle from weight-bearing full-leg radiographs: “valgus” group (HKA angle > 0°, n = 44), ...
Source: Journal of Knee Surgery - January 16, 2019 Category: Orthopaedics Authors: Zhang, Zhiqi Liu, Can Li, Zhiwen Wu, Peihui Hu, Shu Liao, Weiming Tags: Original Article Source Type: research

Restoration of Constitutional Alignment in TKA with a Novel Osteotomy Technique
This study provides a novel technique to restore preoperative CA in patients with varus knees and BFLB. It is found that the distal femur should be cut perpendicular to DMA, so the lower limb alignment and soft tissue strains can be restored to the preoperative state, and the knees would be stable and in a natural status after TKA. [...] 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 16, 2019 Category: Orthopaedics Authors: Wang, Zhibing Cheng, Xingwang Zhang, Yuan Zhang, Xia Zhou, Yue Tags: Original Article Source Type: research

Postoperative Complications and Impact of Diabetes Mellitus Severity on Revision Total Knee Arthroplasty
J Knee Surg DOI: 10.1055/s-0038-1677542Total knee arthroplasty (TKA) is a common and effective treatment of knee osteoarthritis. As the amount of TKAs performed increases, so does the number of TKA failures and subsequent revisions. Diabetes mellitus (DM) has been shown to increase complications following orthopaedic procedures. For these reasons, it is important to understand the association between severity of DM and the risk of postoperative adverse events following revision TKA. A retrospective cohort study was conducted using the American College of Surgeons' National Surgical Quality Improvement Program database. Pat...
Source: Journal of Knee Surgery - January 16, 2019 Category: Orthopaedics Authors: Gu, Alex Wei, Chapman Robinson, Hannah N. Sobrio, Shane A. Liu, Jiabin Sculco, Thomas P. Sculco, Peter K. Tags: Original Article Source Type: research

Metal-Backed Tibial Components Do Not Reduce Risk of Early Aseptic Loosening in Unicompartmental Knee Arthroplasty: A Systematic Review and Meta-Analysis
J Knee Surg DOI: 10.1055/s-0038-1677506Long-term results of unicompartmental knee arthroplasty (UKA) have shown a slightly higher revision rate than total knee arthroplasty (TKA), and implant fixation geometry seems to affect prosthetic survivorship. Whether metal-backed tibial component leads to superior performance over the all-polyethylene design is unclear, and a lack of evidence exists in literature. Our purpose was to demonstrate which implant design of UKA (all-polyethylene or metal-backed tibial component) is clinically superior regarding revision rates and clinical functioning, and investigate the role of potentia...
Source: Journal of Knee Surgery - January 16, 2019 Category: Orthopaedics Authors: Costa, Giuseppe Gianluca Lo Presti, Mirco Grassi, Alberto Agr ò, Giuseppe Cialdella, Sergio Mosca, Massimiliano Caravelli, Silvio Zaffagnini, Stefano Tags: Original Article Source Type: research

Management of Chronic Infected Intra-Articular Fractures of the Proximal Tibia with Ilizarov Ring Fixation
This study assessed the outcome of chronic infected intra-articular proximal tibial fractures with and without metaphyseal bone loss managed with the Ilizarov ring fixator. A series of six patients of intra-articular infected nonunion of the tibial plateau and two patients with malunited plateau with metaphyseal nonunion were treated in a tertiary care hospital. Three of these eight patients had a metaphyseal bone loss or bone gap after debridement and underwent internal transport with distal corticotomy to obtain the bone length. The remaining five patients underwent static ring fixation after correction of the articular ...
Source: Journal of Knee Surgery - January 16, 2019 Category: Orthopaedics Authors: Bhowmick, Kaushik Boopalan, P.R.J.V.C. Gunasekeran, Chandrasekaran Livingston, Abel Jepegnanam, Thilak Samuel Tags: Original Article Source Type: research

Knee Cell-Based Cartilage Restoration
J Knee Surg DOI: 10.1055/s-0038-1676378As our patients become more physically active at all ages, the incidence of injuries to articular cartilage is increasing causing significant pain and disability. The intrinsic healing response of articular cartilage is poor because of its limited vascular supply and capacity for chondrocyte division. Nonsurgical management for the focal cartilage lesion is successful in the majority of patients. Those patients who fail conservative management may be candidates for a cartilage reparative or reconstructive procedure. The type of treatment available depends on a multitude of lesion-spec...
Source: Journal of Knee Surgery - January 10, 2019 Category: Orthopaedics Authors: Pickett, Adam M. Hensley, Dana T. Tags: Special Focus Section Source Type: research

Meniscus Injuries in the Military Athlete
J Knee Surg DOI: 10.1055/s-0038-1676959Meniscal injuries in the young, active patient are often challenging injuries for the orthopaedic surgeon whose goal is to provide pain-free return to play/military duty and preserve maximal meniscal integrity. In the U.S. military, the incidence rate of meniscal tears is almost 10 times higher than that of the civilian population; although, the rates of reoperation following meniscal repair are fairly similar. The decision to pursue meniscal debridement versus repair is multifactorial depending on tear characteristics, concomitant injury, patient characteristics, and goals. Meniscal ...
Source: Journal of Knee Surgery - January 10, 2019 Category: Orthopaedics Authors: Donohue, Michael A. Zhou, Liang Haley, Chad A. Tags: Special Focus Section Source Type: research

Thirty-Day Unplanned Readmission after Total Knee Arthroplasty at a Teaching Community Hospital: Rates, Reasons, and Risk Factors
This study identified 7,482 primary TKA procedures of which 210 (2.8%) were unplanned readmissions. Gastrointestinal bleed (9.05%) and periprosthetic infection (8.10%) were the most common causes of readmission. Age 65 and older (odds ratio [OR], 1.64; 95% confidence interval [CI], 1.21–2.21; p = 0.0012), male (OR, 1.37; 95% CI, 1.03–1.83; p = 0.0302), length of stay > 3 days (OR, 2.04; 95% CI, 1.45–2.86; p 
Source: Journal of Knee Surgery - January 10, 2019 Category: Orthopaedics Authors: Workman, Kalain K. Angerett, Nathan Lippe, Ronald Shin, Alex King, Scott Tags: Original Article Source Type: research

Total Knee Arthroplasty Is Safe in Jehovah's Witness Patients —A 12-Year Perspective
J Knee Surg DOI: 10.1055/s-0038-1676372Despite the evolution of blood management protocols, total knee arthroplasty (TKA) occasionally requires allogeneic blood transfusion. This poses a particular challenge for Jehovah's Witnesses (JW) who believe that the Bible strictly prohibits the use of blood products. The aim of this study was to compare JW and a matched-control cohort of non-JW candidates undergoing TKA to assess the safety using modern blood management protocols. Fifty-five JW patients (63 knees) who underwent TKA at our institution between 2005 and 2017 were matched to 63 non-JW patients (63 knees). Patient demog...
Source: Journal of Knee Surgery - January 8, 2019 Category: Orthopaedics Authors: Wolfson, Theodore S. Novikov, David Chen, Kevin K. Kim, Kelvin Y. Anoushiravani, Afshin A. Deshmukh, Ajit J. Lajam, Claudette M. Tags: Original Article Source Type: research

Distribution of the Force in the Knee Joint during Daily Activities after Open Wedge High Tibial Osteotomy: A Rationale for the Proper Postoperative Management
J Knee Surg DOI: 10.1055/s-0038-1676772The present study was conducted to evaluate the force distribution in knee joint during daily activities after open-wedge high tibial osteotomy (OWHTO). A three-dimensional proximal tibial finite element model (FEM) was created using Mimics software to evaluate computed tomography (CT) scans of the tibia after OWHTO. The anterior and posterior gaps were 7.0 and 12.1 mm, respectively, and the target opening angle was 12 degrees. The loading ratio of the medial and lateral tibial plateaus was 6:4. To evaluate force distribution in the knee joint during activities of daily living ...
Source: Journal of Knee Surgery - January 8, 2019 Category: Orthopaedics Authors: Seo, Hansol Lim, Dohyung Jang, Young Woong Kang, Kwan-su Lee, Myung Chul Lee, O-Sung Im, Byeong-Eun Lee, Yong Seuk Tags: Original Article Source Type: research

The Effects of Surgical Technique in Total Knee Arthroplasty for Varus Osteoarthritic Knee on the Rotational Alignment of Femoral Component: Gap Balancing Technique versus Measured Resection Technique
J Knee Surg DOI: 10.1055/s-0038-1676766Few studies have compared the accuracy of femoral component rotation in the measured resection technique according to the preoperative computed tomography (CT) and gap balancing technique. The aim of this study was to evaluate whether there is a difference in accuracy and outlier incidence of femoral component rotation between gap balancing and measured resection techniques with or without preoperative CT and to evaluate the difference in patellofemoral alignment on simple radiographs and clinical outcomes. In this retrospective study, we evaluated femoral component rotation angle on ...
Source: Journal of Knee Surgery - January 8, 2019 Category: Orthopaedics Authors: Kim, Chang-Wan Lee, Chang-Rack Gwak, Heui-Chul Kim, Jung-Han Kwon, Yong-Uk Kim, Doo-Yeol Tags: Original Article Source Type: research

Primary and Posttraumatic Knee Osteoarthritis in the Military
J Knee Surg DOI: 10.1055/s-0038-1676956Osteoarthritis is a particularly burdensome and career-limiting condition for military service members. The daily demands of military service place the service members at a baseline increased risk of developing primary OA as well as increased risk of acute knee injuries that further predispose to developing posttraumatic OA. There are multiple treatment options available for primary and posttraumatic OA from osteotomy to arthroplasty. [...] Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of contents  |  Abstr...
Source: Journal of Knee Surgery - January 4, 2019 Category: Orthopaedics Authors: Rodriguez, Marina J. Garcia, E'Stephan J. Dickens, Jon F. Tags: Special Focus Section Source Type: research

Results of a Phase II Study to Determine the Efficacy and Safety of Genetically Engineered Allogeneic Human Chondrocytes Expressing TGF- β1
J Knee Surg DOI: 10.1055/s-0038-1676803Genetically engineered chondrocytes virally transduced with a transforming growth factor (TGF)-β1 (TG-C [TissueGene-C]) expression vector have been shown to have potential benefits in the nonoperative management of knee osteoarthritis. Previous literature has reported on safe dosages of TG-C. Therefore, the purpose of this study was to evaluate the Phase II results and a 24-month efficacy of this injectable mixture compared with placebo in patients with Kellgren–Lawrence (K–L) grade III knee osteoarthritis. Specifically, we assessed (1) functional outcomes, (2) pain s...
Source: Journal of Knee Surgery - January 4, 2019 Category: Orthopaedics Authors: Lee, Bumsup Parvizi, Javad Bramlet, Dale Romness, David W. Guermazi, Ali Noh, Moon Sodhi, Nipun Khlopas, Anton Mont, Michael A. Tags: Original Article Source Type: research

Alternative Therapies for Knee Pain
J Knee Surg 2019; 32: 001-001 DOI: 10.1055/s-0038-1669910 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 4, 2019 Category: Orthopaedics Authors: Cook, James L. Tags: Special Focus Section Source Type: research

Kneeling after Total Knee Arthroplasty
J Knee Surg DOI: 10.1055/s-0038-1676801The ability to kneel is one of the many patient goals after total knee arthroplasty (TKA). Few studies have addressed patients' ability to kneel after TKA as a primary outcome. Given the altered biomechanics of the knee after TKA, the various implant designs, and multiple surgical approaches, there is a need to further understand the patient's kneeling ability after TKA. We evaluated the available literature on this topic to help to guide postoperative care recommendations. Biomechanical data show that the load borne by the patellofemoral joint is elevated significantly at all flexion...
Source: Journal of Knee Surgery - January 2, 2019 Category: Orthopaedics Authors: Amin, Raj M. Vasan, Vikram Oni, Julius K. Tags: Original Article Source Type: research

The Military ACL
J Knee Surg DOI: 10.1055/s-0038-1676565Anterior cruciate ligament (ACL) injuries in the U.S. Military Service members have a 10-fold higher incidence than that of the general population due to the physically demanding aspects of military duties. Although some controversy exists on the specific techniques or reconstruction, these injuries are uniformly reconstructed due to the requirements of their occupation and the effect of these injuries on their future careers. As such, understanding the care of the military Service member's ACL may help optimize the care of the physically active injured knee. [...] Thieme Medical Publ...
Source: Journal of Knee Surgery - December 28, 2018 Category: Orthopaedics Authors: Tennent, David Jackson Posner, Matthew Adam Tags: Special Focus Section Source Type: research

Pain Intensity: How Press Ganey Survey Domains Correlate in Total Knee Arthroplasty Patients
This study analyzes which PG survey domains are truly associated with pain intensity in the immediate postoperative period following TKA. We queried our PG database for all primary TKA patients between November 2012 and January 2015, yielding a total of 214 patients. Multivariate regression analysis was performed utilizing pain intensity as the dependent variable. Predictor variables included body mass index (BMI), Charlson's comorbidity index, opioid consumption, and PG survey domains. Patient ratings of “communication with doctors” (B = 58.147; p = 0.001), “responsiveness of ...
Source: Journal of Knee Surgery - December 28, 2018 Category: Orthopaedics Authors: Mohamed, Nequesha S. Gwam, Chukwuweike U. Etcheson, Jennifer I. Castrodad, Iciar M. D ávila Gitarts, Steven L. Jetty, Avnish S. Srour, Brandon A. Delanois, Ronald E. Tags: Original Article Source Type: research

Medial Tibial Slope Determined by Plain Radiography Is Not Associated with Primary or Recurrent Anterior Cruciate Ligament Tears
J Knee Surg DOI: 10.1055/s-0038-1676456Increased tibial slope may be associated with anterior cruciate ligament (ACL) injuries, although potential confounding effects from various patient characteristics and radiographic quantification methods have not been rigorously studied. The association of the slope of the lateral plateau with recurrent ACL injury after primary ACL reconstruction has recently been reported, but the role of medial slope is less well defined. The purpose of this study was to (1) assess medial tibial slope measurement reliability among examiners, (2) compare medial tibial slope values between patients u...
Source: Journal of Knee Surgery - December 21, 2018 Category: Orthopaedics Authors: Su, Alvin W. Bogunovic, Ljiljana Smith, Matthew V. Gortz, Simon Brophy, Robert H. Wright, Rick W. Matava, Matthew J. Tags: Original Article Source Type: research

Effect of Tibial Component Alignment and Posterior Slope on Tibial Coverage in a Chinese Population: A Three-dimensional Anthropometric Study
This study aimed to evaluate the effect of tibial component alignment and posterior slope on tibial coverage. Computer tomographic scans of 101 tibial specimens were used to reconstruct three-dimensional tibia models. A virtual surgery was performed to generate a resection plane with different posterior slopes on the proximal tibia. Symmetrical and anatomical tibial components were placed aligning to the medial one-third of tibial tubercle (Insall) and the medial edge of patella tendon (Akagi), respectively. Differences in coverage and mismatch were evaluated and statistically compared across alignments, slope angles, and ...
Source: Journal of Knee Surgery - December 21, 2018 Category: Orthopaedics Authors: Shao, Long Wang, Ting Liao, Junyi Xu, Wei Liang, Xi Huang, Wei Tags: Original Article Source Type: research

Is There a Relationship between Patellofemoral Alignment and Osgood –Schlatter Disease? A Case-Control Study
This study was aimed to investigate the role of anatomic variations in patellofemoral alignment in patients with or without Osgood-Schlatter disease (OSD) and to determine the potential anatomic risk factors that may play role in the etiology. This prospective observational case-control study was conducted on two groups of adolescent patients. Group 1 comprised patients who were diagnosed as having OSD and group 2 consisted of an equal number of age-matched patients who presented to the outpatient clinic with traumatic knee injury and underwent knee radiographic examination but without a diagnosis of OSD. Age, height, weig...
Source: Journal of Knee Surgery - December 21, 2018 Category: Orthopaedics Authors: Seyfettino ğlu, Fırat K öse, Özkan O ğur, Hasan Ulaş Tuhanio ğlu, Ümit Çiçek, Hakan Acar, Baver Tags: Original Article Source Type: research

Bipolar Sealers Do not Improve Blood Loss nor Functional Outcomes of Primary Total Knee Arthroplasty
J Knee Surg DOI: 10.1055/s-0038-1676516Several methods were introduced to limit perioperative blood loss in total knee arthroplasty (TKA). By transcollation of soft tissues below 100°C, bipolar sealers intend to reduce bleeding and tissue damage, compared with conventional electrocautery. Existing studies report contradictory findings about the performance of bipolar sealers. The purpose of this study was to evaluate the effect of a bipolar sealer on blood loss, transfusions, hospital length of stay (LOS), and functional scores in primary TKA. In this single-center prospective study, 101 patients, undergoing primary TK...
Source: Journal of Knee Surgery - December 21, 2018 Category: Orthopaedics Authors: Pasqualotto, Stefano Demey, Guillaume Michelet, Aude Nover, Luca Saffarini, Mo Dejour, David Tags: Original Article Source Type: research

The Comparison of Postoperative Outcomes Open and Closed Reduction for Patellar Fractures
This study aimed to compare the surgical outcomes of open reduction and closed reduction for patellar fractures. This retrospective study included 62 patients (63 cases) who underwent surgical treatment of patellar fractures from 2008 to 2013. Of the 63 cases, open and closed reductions were performed in 42 and 21 cases, respectively. Plain radiography was used to assess fracture healing. Comminuted patellar fracture was the most common fracture type in both groups. Tension band wiring and cannulated screw fixation were mainly used in the open and closed reduction groups, respectively. There was no significant difference i...
Source: Journal of Knee Surgery - December 21, 2018 Category: Orthopaedics Authors: Lee, Si Young Choi, Jun Young Lee, Hyun Il Lee, Jung Min Cho, Jin Ho Tags: Original Article Source Type: research

The Forced Active Buckling Sign: A New Clinical Test for the Diagnosis of ACL Insufficiency
This study shows that the introduced FAB-sign test can detect an ACL insufficiency more sensitive and more specific compared to the pivot shift and Lachman's tests in the subacute phase. This is a randomized controlled diagnostic study, level 1b. [...] 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 21, 2018 Category: Orthopaedics Authors: Blanke, Fabian Haenle, Maximilian Feitenhansl, Andreas Vogt, Stephan Camathias, Carlo Tags: Original Article Source Type: research

Intra-articular Corticosteroids for Knee Pain —What Have We Learned from the Equine Athlete and Current Best Practice
J Knee Surg DOI: 10.1055/s-0038-1676449The use of intra-articular corticosteroids for traumatic arthritis and osteoarthritis (OA) is common in the horse. The beneficial and deleterious effects of the principal corticosteroids used betamethasone esters (Celestone [Soluspan], methylprednisolone acetate [Depo Medrol], and triamcinolone acetonide [TA] [Vetalog or Kenalog]) have been defined for the horse. While TA has both disease-modifying as well as symptom-modifying effects, methyl prednisolone acetate has deleterious effects on the articular cartilage. Studies in traumatically injured joints show the same rationale (suppre...
Source: Journal of Knee Surgery - December 18, 2018 Category: Orthopaedics Authors: McIlwraith, C. Wayne Lattermann, Christian Tags: Special Focus Section Source Type: research

Rabbit Model of Extending Knee Joint Contracture: Progression of Joint Motion Restriction and Subsequent Joint Capsule Changes after Immobilization
This study aimed to develop a rabbit model of knee contracture in extension and investigate the natural history of motion loss and time-dependent changes in the joint capsule after immobilization. We immobilized the unilateral knee joints of 32 rabbits by maintaining the knee joint in a plaster cast at full extension. Eight rabbits were euthanized at 2, 4, 6, and 8 weeks after casting, respectively, and the lower extremities were disarticulated at the hip joint. Eight control group rabbits that did not undergo immobilization were also examined. We assessed the progression of joint contracture by measuring the joint range o...
Source: Journal of Knee Surgery - December 18, 2018 Category: Orthopaedics Authors: Zhou, Yun Zhang, Quan Bing Zhong, Hua Zhang Liu, Yi Li, Jun Lv, Hao Jing, Jue Hua Tags: Original Article Source Type: research

The Effects of Resection Technique on Implant Migration in Single Radius Posterior-Stabilized Total Knee Replacement
J Knee Surg DOI: 10.1055/s-0038-1676462The purpose of the present study was to measure the effects of gap balancing and resection techniques on migration of a single total knee replacement implant design. A total of 23 patients (24 knees) were recruited on referral to either a surgeon performing gap balancing or a surgeon performing measured resection and followed prospectively. All patients received a fixed bearing, posterior stabilized total knee replacement implant of a single radius femoral component design with cement fixation, and all aspects of care outside of resection technique were identical. Patients underwent r...
Source: Journal of Knee Surgery - December 18, 2018 Category: Orthopaedics Authors: Teeter, Matthew G. Perry, Kevin Yuan, Xunhua Howard, James L. Lanting, Brent A. Tags: Original Article Source Type: research

Is There a Difference between Cemented and Uncemented Femoral Stem Extensions in Revision Knee Arthroplasty?
J Knee Surg DOI: 10.1055/s-0038-1676567A stem is usually recommended for the femoral component in revision total knee arthroplasty (TKA) for reasons of alignment, fixation, and bone loss. However, the optimal method of fixation for the femoral component stem remains controversial. We queried the prospective revision TKA database of one surgeon and performed a clinical and radiographic evaluation of 84 knee revisions in which a femoral component stem extension was implanted. There was no established protocol for fixation of the femoral stem during this time. There were 34 knees with cemented (C) fixation and 50 with uncemen...
Source: Journal of Knee Surgery - December 18, 2018 Category: Orthopaedics Authors: Lachiewicz, Paul F. O'Dell, Jane Ann Tags: Original Article Source Type: research

Osteochondral Allograft Transplantation: Identifying the Biomechanical Impact of Using Shorter Grafts and Pulsatile Lavage on Graft Stability
This study seeks to identify the ability of shorter osteochondral allografts (OCAs) to resist displacement/failure. Additionally, this study seeks to evaluate the effect of pulsatile lavage (PL) on the biomechanical stability of the OCA. Fifteen-millimeter diameter, human cadaveric, OCAs of 4, 7, and 10 mm in depth were harvested for comparison of resistance to compressive and tensile loads. For each group, seven specimens were subjected to tensile loads and three specimens subjected to compressive loads until failure (pullout or subsidence). An additional study group of 10 pulsatile-lavaged OCAs of 15 mm in ...
Source: Journal of Knee Surgery - December 18, 2018 Category: Orthopaedics Authors: Babu, Jacob M. Hodax, Jonathan D. Fadale, Paul D. Owens, Brett D. Tags: Original Article Source Type: research

Amniotic Tissue Modulation of Knee Pain —A Focus on Osteoarthritis
J Knee Surg DOI: 10.1055/s-0038-1676370The use of intra-articular therapies as sources of growth factors, anti-inflammatory mediators, and medicinal signaling cells for osteoarthritis (OA) is rapidly evolving. Amnion, chorion, amniotic fluid, and the umbilical cord are distinct placental tissues that have been investigated for use in OA. Amniotic membrane (AM) synthesizes a variety of growth factors, cytokines, and vasoactive peptides that modulate inflammation. In addition, they contain amniotic epithelial cells and amniotic mononuclear undifferentiated stromal cells, which have chondrogenic and osteogenic differentiation...
Source: Journal of Knee Surgery - December 13, 2018 Category: Orthopaedics Authors: Hannon, Charles P. Yanke, Adam B. Farr, Jack Tags: Special Focus Section Source Type: research

Empty Sunrise Sign: An Arthroscopic Finding in Recurrent Patellar Dislocation
We describe an arthroscopic finding we noted in recurrent patellar dislocation. Arthroscopic photos were evaluated from 50 knees with a history patellar dislocation and 100 control patients. We quantified the amount of patellar subluxation seen on a single arthroscopic view and coined it Empty Sunrise Sign if the patella did not overlap the trochlea. Empty Sunrise Sign was found in 82% of 50 cases with recurrent patellar dislocation and none of the 100 control cases. The finding was 100% specific for identifying a recurrent patellar dislocator. High interobserver agreement was noted. Empty Sunrise Sign suggests significant...
Source: Journal of Knee Surgery - December 13, 2018 Category: Orthopaedics Authors: Smith, Craig Otte, Jeffrey Steensen, Robert Tags: Original Article Source Type: research

Incidence and Risk Factors for Posterior Cruciate Ligament Avulsion during Cruciate Retaining Total Knee Arthroplasty
J Knee Surg DOI: 10.1055/s-0038-1676068During cruciate retaining (CR) total knee arthroplasty (TKA), the posterior cruciate ligament (PCL) may avulse at its insertion. The incidence of PCL avulsion fracture has not been previously studied. The aim of this study is to report on the incidence and clinical significance of intraoperative PCL avulsion during primary CR TKA and to identify potential risk factors. Our institutional joint registry was retrospectively reviewed for PCL avulsion occurring during CR TKA implanted between April 2008 and April 2016. Patient demographics, preoperative range of motion (ROM), complications...
Source: Journal of Knee Surgery - December 13, 2018 Category: Orthopaedics Authors: Kim, Eric Talmo, Carl T. Anderson, Marie C. Bono, Olivia J. Bono, James V. Tags: Original Article Source Type: research

Femoral Intramedullary Alignment in Total Knee Arthroplasty: Indications, Results, Pitfalls, Alternatives, and Controversies
We present case studies as examples of indications for use of an extramedullary femoral guide. In addition, we demonstrate two different techniques for extramedullary femoral alignment using fluoroscopic guidance in cases incompatible with intramedullary alignment. [...] 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 13, 2018 Category: Orthopaedics Authors: Bono, Olivia J. Olcott, Christopher W. Carangelo, Robert Jamison, James P. Tigges, Russell G. Talmo, Carl T. Bono, James V. Tags: Original Article Source Type: research