Arthroscopic Anterior Cruciate Ligament Reconstruction: A Meta-Analysis Comparing Semitendinosus Alone and Semitendinosus with Gracilis Tendon Autografts
This study was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and Meta-Analysis of Observational Studies in Epidemiology (MOOSE) guidelines. All studies in PubMed and Embase that reported functional knee parameters and patient-reported outcomes after ACL reconstruction with ST and ST-G grafts independently were included in the review. Selected end points for random effects, pairwise meta-analysis included side-to-side deficit (%) in isokinetic peak torque, peak torque ratio (%), side-to-side difference (mm) in anterior laxity, and patient-reported outcome scores at minimu...
Source: Journal of Knee Surgery - September 11, 2018 Category: Orthopaedics Authors: Chin, Brian Zhaojie Wee, Ian Jun Yan Syn, Nicholas Li-Xun Krishna, Lingaraj Tags: Original Article Source Type: research

Incidence of Drug Abuse in Revision Total Knee Arthroplasty Population
J Knee Surg DOI: 10.1055/s-0038-1669915Substance abuse can have strong negative impacts on surgical outcomes. Therefore, this study assessed the effects of drug abuse in total knee arthroplasty (TKA) patients. Specifically, we identified revision TKA (RTKA): (1) incidence, (2) causes, (3) time to revision, and (4) patient demographics in patients with a history of drug abuse. The Medicare database within the PearlDiver Supercomputer (Warsaw, IN) was queried to identify 2,159,221 TKAs performed between 2005 and 2012. Drug abuse was subdivided into cocaine, cannabis, opioids, sedatives/hypnotics/anxiolytics (SHA), amphetamin...
Source: Journal of Knee Surgery - September 7, 2018 Category: Orthopaedics Authors: Roche, Martin Law, Tsun Yee Sodhi, Nipun Rosas, Samuel Kurowicki, Jennifer Disla, Shanell Wang, Kevin Mont, Michael A. Tags: Special Focus Section Source Type: research

Neutral or Natural? Functional Impact of the Coronal Alignment in Total Knee Arthroplasty
J Knee Surg DOI: 10.1055/s-0038-1669788Total knee arthroplasty (TKA) is a very successful procedure. The alignment in TKA has been identified as being of importance to prevent early implant failure and patient dissatisfaction. Our hypothesis was that patients with a preoperative varus deformation remaining in a slight varus alignment as their natural alignment after TKA will have superior clinical results compared with patients who are restored in neutral alignment. A total of 115 patients were corrected from varus to neutral (varus–neutral) and in 33 patients a preoperative varus alignment was kept in varus (varus)....
Source: Journal of Knee Surgery - September 7, 2018 Category: Orthopaedics Authors: Schiffner, Erik Wild, Michael Regenbrecht, Bertram Schek, Alberto Hakimi, Mohssen Thelen, Simon Jungbluth, Pascal Schneppendahl, Johannes Tags: Original Article Source Type: research

Similar Outcomes of Two-Stage Revisions for Infection and One-Stage Revisions for Aseptic Revisions of Knee Endoprostheses
J Knee Surg DOI: 10.1055/s-0038-1670627Two-stage revision knee arthroplasty using an antibiotic-loaded spacer is the most widely performed procedure for infected knee arthroplasties. The clinical outcome of this type of surgery compared with aseptic joint revision with exchange of tibial and femoral components is still controversial. Therefore, we analyzed clinical outcomes of septic two-stage revisions compared with aseptic one-stage revision total knee arthroplasties (TKAs). In a retrospective study, we assessed 135 consecutive patients who underwent two-stage revision for septic TKA (52 patients) and one-stage aseptic t...
Source: Journal of Knee Surgery - September 7, 2018 Category: Orthopaedics Authors: Konrads, Christian Franz, Arno Hoberg, Maik Rudert, Maximilian Tags: Original Article Source Type: research

Anterior Cruciate Ligament Reconstruction Using Bone-Patellar Tendon-Bone Autograft with Remnant Preservation: Comparison of Outcomes According to the Amount of Remnant Tissue
J Knee Surg DOI: 10.1055/s-0038-1669902There has been controversy about whether remnant tissue of anterior cruciate ligament (ACL) has to be preserved in ACL reconstruction. The purpose of the study was to compare clinical outcomes between groups of patients who underwent ACL reconstruction with bone-patellar tendon-bone (BPTB) autograft divided according to amount of ACL remnant and investigate effect of remnant preservation on outcomes of ACL reconstruction. A total of 185 patients who underwent ACL reconstruction with BPTB autograft were retrospectively reviewed. Patients were divided into four groups according to propo...
Source: Journal of Knee Surgery - September 7, 2018 Category: Orthopaedics Authors: Kim, Sung-Jae Choi, Chong Hyuk Chun, Yong-Min Kim, Sung-Hwan Lee, Su-Keon Jung, Woo Seok Jung, Min Tags: Original Article Source Type: research

Comparing Cementing Techniques in Total Knee Arthroplasty: An In Vitro Study
J Knee Surg DOI: 10.1055/s-0038-1669917Aseptic loosening remains to be a major reason for revision in total knee arthroplasty. Cement penetration of 2 to 5 mm increases the interface strength and consequently decreases the likelihood of loosening. But despite this overall accepted optimal cement penetration, there is still a wide variety of cementing techniques used in total knee arthroplasty. The purpose of this study was to evaluate two cementing techniques on the tibial and femoral sides, with regard to cement penetration. Five paired cadaveric knees were used. A total knee arthroplasty was placed according to st...
Source: Journal of Knee Surgery - September 6, 2018 Category: Orthopaedics Authors: Wetzels, Thomas van Erp, Joost Brouwer, Reinoud W. Bulstra, Sjoerd K. van Raay, Jos J. A. M. Tags: Original Article Source Type: research

Magnetic Resonance Imaging-Based Prevalence of Anterolateral Ligament Abnormalities and Associated Injuries in Knees with Acute Anterior Cruciate Ligament Injury
J Knee Surg DOI: 10.1055/s-0038-1669449The purpose of this study was to determine and compare the prevalence of anterolateral ligament abnormality and associated injuries among patients with complete and partial anterior cruciate ligament tears. In addition, the prevalence of associated injuries with anterolateral ligament abnormality was further analyzed. Of the 158 patients diagnosed with acute anterior cruciate ligament tear, 82 patients were diagnosed with acute complete anterior cruciate ligament confirmed by magnetic resonance imaging (MRI) and arthroscopic procedures (Group C), and 74 patients were diagnosed with ac...
Source: Journal of Knee Surgery - September 6, 2018 Category: Orthopaedics Authors: Song, Yoonah Yang, Jae-Hyuk Choi, Won Rak Lee, Jin Kyu Tags: Original Article Source Type: research

Biomechanical Evaluation of Suture Anchor versus Transosseous Tunnel Patellar Tendon Repair Techniques
The objective of this study is to compare the cyclic loading strength and ultimate failure load in suture anchor repair versus transosseous tunnel repair of patellar tendons using a cadaver model. Twelve cadaveric patella specimens were used (six matched pairs). Dual-energy X-ray absorptiometry (DXA) measurements were performed to ensure equal bone quality among groups. All right knees were assigned to the suture anchor repair group (n = 6), whereas all left knees were assigned to the transosseous bone tunnel group (n = 6). Suture type and repair configuration were equivalent. After the respecti...
Source: Journal of Knee Surgery - September 6, 2018 Category: Orthopaedics Authors: Sherman, Seth L. Black, Brandee Mooberry, Matthew A. Freeman, Katie L. Gulbrandsen, Trevor R. Milles, Jeffrey L. Evans, Laura Flood, David Pfeiffer, Ferris Tags: Original Article Source Type: research

Stacked Tantalum Cones as a Method for Treating Severe Distal Femoral Bone Deficiency in Total Knee Arthroplasty
This study aims to evaluate the mid-term outcomes and possible complications in patients treated with this novel technique. We retrospectively analyzed the prospectively maintained records of 16 knees (in 16 patients) presenting with severe distal femoral bone deficiency due to septic loosening (5), giant cell tumor (GCT; 4), periprosthetic fracture (3), aseptic loosening (3), and distal femoral comminuted fracture with severe osteoarthritis (1). A standard medial parapatellar approach was taken in all our cases followed by preparation of distal femoral bone defect and use of two bridging tantalum trabecular metal cones to...
Source: Journal of Knee Surgery - September 6, 2018 Category: Orthopaedics Authors: Rajgopal, Ashok Panda, Inayat Yadav, Sidharth Wakde, Om Tags: Original Article Source Type: research

What Is the Price and Claimed Efficacy of Platelet-Rich Plasma Injections for the Treatment of Knee Osteoarthritis in the United States?
J Knee Surg DOI: 10.1055/s-0038-1669953Platelet-rich plasma (PRP) injections are often used for the treatment of knee osteoarthritis (OA), despite clinical value and cost-effectiveness not being definitely established. PRP injections are considered as a potential means of reducing pain and improving function in patients with knee OA, in the hope of delaying or avoiding the need for surgical intervention. Centers that offer PRP injections usually charge patients out of pocket and directly market services. Therefore, the purpose of this study was to quantify the current (1) prices and (2) marketed clinical efficacy of autolo...
Source: Journal of Knee Surgery - September 6, 2018 Category: Orthopaedics Authors: Piuzzi, Nicolas S. Ng, Mitchell Kantor, Ariel Ng, Kenneth Kha, Stephanie Mont, Michael A. Muschler, George F. Tags: Original Article Source Type: research

Evaluation of Accuracy of a Three-Dimensional Printed Model in Open-Wedge High Tibial Osteotomy
This study retrospectively evaluated 20 patients with medial knee osteoarthritis and varus deformity. Between October 2015 and July 2016, the patients underwent open-wedge HTO using a 3D printed model. The mean age of patients was 55.2 years (range, 51–60 years). The mean preoperative mechanical femorotibial angle (mFTA) was varus 7.8 degrees (range, varus 4.7–11.6 degrees). After measuring the target angle using full-length lower limb weight-bearing radiography, the osteotomy was simulated using 3D images obtained from computed tomography (CT) with the 3D Slicer program. On the basis of the simulated osteotomy...
Source: Journal of Knee Surgery - September 6, 2018 Category: Orthopaedics Authors: Kim, Hee-June Park, Jaeyeong Park, Kyeong-Hyeon Park, Il-Hyung Jang, Jin-An Shin, Ji-Yeon Kyung, Hee-Soo Tags: Original Article Source Type: research

The Influence of Implant Position on Final Clinical Outcome and Gait Analysis after Total Knee Arthroplasty
J Knee Surg DOI: 10.1055/s-0038-1669913The aim of the study was to evaluate the impact of implant component alignment on objective and subjective outcomes after total knee arthroplasty (TKA). The rotation of the femoral component and its influence on the final results were also examined. After exclusion, the study examined 102 patients (mean age, 66.28 years; range, 51–79 years) who had undergone unilateral TKA. All of the operative procedures were performed by one surgeon with one type of implant. One year after the operation, improvements in Knee Society's Knee Scoring System, functional score, Western Ontario and ...
Source: Journal of Knee Surgery - September 6, 2018 Category: Orthopaedics Authors: Jab łoński, Jarosław Sibi ński, Marcin Polguj, Micha ł Kowalczewski, Jacek Marczak, Dariusz Faflik, Łukasz Jab łońska, Dorota Tags: Original Article Source Type: research

Operative Time, Length of Stay, Short-Term Readmission, and Complications after Hinged Primary Total Knee Arthroplasty: A Propensity Score Matched Analysis
J Knee Surg DOI: 10.1055/s-0038-1668580Despite the wide utilization of total knee arthroplasty (TKA), it can be technically challenging to perform in patients who have concomitant bone loss, ligamentous laxity, or high-grade deformity, whether in a revision situation or due to a primary pathology. Therefore, hinged knee prostheses have been developed to provide more stable fixation in these situations. The purpose of this study was to compare the short-term peri- and postoperative outcomes of patients undergoing primary TKA with and without hinged prosthesis. Specifically, we compared (1) mean operative times, (2) lengths ...
Source: Journal of Knee Surgery - August 29, 2018 Category: Orthopaedics Authors: Sodhi, Nipun Patel, Yatindra H. George, Jaiben Sultan, Assem A. Anis, Hiba K. Newman, Jared M. Kryzak, Thomas J. Khlopas, Anton Moskal, Joseph T. Mont, Michael A. Tags: Special Focus Section Source Type: research

Is ICD-9 Coding of Morbid Obesity Reliable in Patients Undergoing Total Knee Arthroplasty?
J Knee Surg DOI: 10.1055/s-0038-1668567Morbid obesity is considered to have a stronger association with complications after total knee arthroplasty (TKA). Although the impact of obesity coding errors has been previously reported, the extent of coding inaccuracies with respect to morbid obesity is unclear. Therefore, the purpose of this study was to assess (1) the utility of coding in identifying morbid obesity and (2) the effects of morbid obesity on 90-day complications after TKA when morbid obesity was defined by both body mass index (BMI) and International Classification of Diseases 9th edition (ICD-9) coding. A total o...
Source: Journal of Knee Surgery - August 29, 2018 Category: Orthopaedics Authors: George, Jaiben Sodhi, Nipun Anis, Hiba K. Khlopas, Anton Moskal, Joseph T. Klika, Alison K. Barsoum, Wael K. Mont, Michael A. Higuera, Carlos A. Tags: Special Focus Section Source Type: research

Is Knee Joint Distraction a Viable Treatment Option for Knee OA? —A Literature Review and Meta-Analysis
J Knee Surg DOI: 10.1055/s-0038-1669447Knee joint distraction (KJD) is a new application of an established technique to regenerate native cartilage using an external fixator. The purpose of this study is to perform a systematic review and meta-analysis of the literature to determine whether KJD is beneficial for knee osteoarthritis and how results compare with established treatments. Studies assessing the outcomes of KJD were retrieved, with three studies (one cohort and two randomized controlled trials), 62 knees, meeting the inclusion criteria. The primary outcome was functional outcome, assessed using a validated outcom...
Source: Journal of Knee Surgery - August 29, 2018 Category: Orthopaedics Authors: Takahashi, Tsuneari Baboolal, Thomas G. Lamb, Jonathan Hamilton, Thomas W. Pandit, Hemant G. Tags: Original Article Source Type: research

A Meta-Analysis of Arthroscopic Meniscal Repair: Inside-Out versus Outside-In versus All-Inside Techniques
J Knee Surg DOI: 10.1055/s-0038-1668123Meniscal repair has been introduced to preserve knee function and limit the accelerated degenerative changes associated with meniscal tissue resection. Arthroscopic techniques have evolved to improve morbidity. However, there are few clinical outcome studies in the peer-reviewed literature that compare the use of these approaches. Therefore, our purpose was to perform a meta-analysis of the existing literature on arthroscopic meniscal repair techniques. Specifically, we evaluated differences in: (1) operating time; (2) incidence of postoperative meniscal healing; (3) functional outcom...
Source: Journal of Knee Surgery - August 21, 2018 Category: Orthopaedics Authors: Elmallah, Randa Jones, LaRita C. Malloch, Lacy Barrett, Gene R. Tags: Original Article Source Type: research

Does the Robotic Arm and Preoperative CT Planning Help with 3D Intraoperative Total Knee Arthroplasty Planning?
J Knee Surg DOI: 10.1055/s-0038-1668122Although several studies highlight the advantages of robotic arm-assisted total knee arthroplasty (RA-TKA), few investigate its intraoperative outcome. Therefore, the purpose of this study was to analyze the RA-TKA's ability to assist with intraoperative correction of: (1) flexion and (2) extension gaps, as well as its ability to (3) accurately predict implant sizes. Additionally, in this RA-TKA cohort, length of stay, complications, and readmissions were assessed. A total of 335 patients who underwent RA-TKA were included. The robotic software virtually measured the intraoperative pr...
Source: Journal of Knee Surgery - August 15, 2018 Category: Orthopaedics Authors: Marchand, Robert C. Sodhi, Nipun Bhowmik-Stoker, Manoshi Scholl, Laura Condrey, Caitlin Khlopas, Anton Sultan, Assem A. Newman, Jared M. Mont, Michael A. Tags: Original Article Source Type: research

Pie Crust Technique of the Deep Medial Collateral Ligament in Knee Arthroscopy: Ultrasound and Anatomic Study
This article determines compartment opening of the medial articular space of the knee after pie crust (PC) technique of the medial collateral ligament (MCL) by ultrasound measurements and anatomic dissection. This is a cadaveric study of 12 specimens. Four anatomic references were marked on the skin. Distances between the femur and tibia in the internal compartment at 30 degrees of flexion were obtained with ultrasound measurements in four situations: with and without applying valgus force both prior and after the PC technique. Ultrasound measurements of the medial articular compartment were made twice and mean value was c...
Source: Journal of Knee Surgery - August 15, 2018 Category: Orthopaedics Authors: Claret-Garcia, Guillem Monta ñana-Burillo, Jordi Tornero-Dacasa, Eduard Llus á-Pérez, Manel Popescu, Dragos Combalia-Aleu, Andreu Sastre-Solsona, Sergi Tags: Original Article Source Type: research

Clinical Outcomes of Closing- and Opening-Wedge High Tibial Osteotomy for Treatment of Anteromedial Unicompartmental Knee Osteoarthritis
This study included 79 patients who underwent high tibial osteotomy (HTO) between 2002 and 2008. Pre- and postoperative radiography and computed tomography were used to evaluate the posterior tibial slope, the patellar height, the tibiofemoral angle, and the lateral and medial tibiofemoral joint space. Pre- and postoperative severity of arthritis was assessed with the Kellgren–Lawrence grading system. Pre- and postoperative American Knee Society (AKS) score and Lysholm Knee Score (LKS) were determined to evaluate functional outcomes. The duration of follow-up was 86.1 ± 6.2 months. Postoperativel...
Source: Journal of Knee Surgery - August 13, 2018 Category: Orthopaedics Authors: Lu, Jiangfeng Tang, Shiyu Wang, Yanru Li, Yao Liu, Chang Niu, Yingzhen Cao, Pengkai Wang, Fei Tags: Original Article Source Type: research

Similar Outcome, but Different Surgical Requirement in Conversion Total Knee Arthroplasty following High Tibial Osteotomy and Unicompartmental Knee Arthroplasty: A Meta-Analysis
J Knee Surg DOI: 10.1055/s-0038-1666999The present systematic review and meta-analysis were conducted to find out how effective any subsequent conversion total knee arthroplasty (TKA) would be after unicompartmental knee arthroplasty (UKA) and high tibial osteotomy (HTO) and which is better in outcomes. A rigorous and systematic approach was used. Each of the selected studies was evaluated for methodological quality. Data were extracted by the following standardized protocol: study design, level of evidence, cases enrolled, age, sex ratio, follow-up, kind of index surgery, type of index surgery, average time to failure, mo...
Source: Journal of Knee Surgery - August 6, 2018 Category: Orthopaedics Authors: Lee, Yong Seuk Kim, Hyun Jung Mok, Su Jung Lee, O-Sung Tags: Original Article Source Type: research

Response to: Reliability of Roentgenographic Knee Alignment Measurements in Gonarthrosis: Methodological Issues to Avoid Misinterpretation
J Knee Surg DOI: 10.1055/s-0038-1660842 Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of contents  |  Full text (Source: Journal of Knee Surgery)
Source: Journal of Knee Surgery - August 6, 2018 Category: Orthopaedics Authors: Wu, Chang-Chin Tags: Letter to the Editor Source Type: research

Gender Differences in Intra-articular and Extra-articular Injuries Associated with Acute Anterior Cruciate Ligament Ruptures
In conclusion, males and females have similar rates of associated intra-articular and extra-articular injuries after ACL rupture in the acute setting. These include associated collateral ligament injuries, meniscal injuries, chondral injuries, and bone contusions. The level of evidence is Level II. [...] Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of contents  |  Abstract  |  Full text (Source: Journal of Knee Surgery)
Source: Journal of Knee Surgery - August 1, 2018 Category: Orthopaedics Authors: Sharon Tan, Si Heng Kripesh, Aishwarya Chan, Chloe Xiaoyun Krishna, Lingaraj Tags: Original Article Source Type: research

Preoperative CT-Based Three-Dimensional Templating in Robot-Assisted Total Knee Arthroplasty More Accurately Predicts Implant Sizes than Two-Dimensional Templating
J Knee Surg DOI: 10.1055/s-0038-1666829Patient dissatisfaction after total knee arthroplasty (TKA) is a concern. Surgical error is a common, avoidable cause of failed TKA. Correct femoral and tibial component sizing improves implant longevity, clinical outcomes, knee balance, and pain scores. We hypothesized that preoperative three-dimensional (3D) templating for robot-assisted TKA (RA-TKA) is more accurate than two-dimensional (2D) digital templating. Prospectively collected data from 31 RA-TKAs were assessed to determine accuracy pertaining to implant sizing and positioning. All cases undergoing RA-TKA undergo preoperati...
Source: Journal of Knee Surgery - August 1, 2018 Category: Orthopaedics Authors: Pietrzak, J. R. T. Rowan, F. E. Kayani, B. Donaldson, M. J. Huq, S. S. Haddad, F. S. Tags: Original Article Source Type: research

Perioperative Care of the TKA Patient
J Knee Surg 2018; 31: 593-593 DOI: 10.1055/s-0038-1641748 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 - July 17, 2018 Category: Orthopaedics Authors: Friedman, Richard J. Tags: Special Focus Section Source Type: research

Isolated Tibial Component Failure in Total Knee Arthroplasty: A Case Series Evaluating Inflammatory Response versus Mechanical Failure
J Knee Surg DOI: 10.1055/s-0038-1666831Total knee prostheses are routinely redesigned to improve performance, longevity, and to closer mimic the native kinematics of the knee. Despite continued improvements, all knee implants, even those with proven design features, have failures. We identified a cohort of patients with isolated tibial component failures that occurred in a popular and successful knee system. Our purpose was to (1) characterize the observed radiographic failure pattern; (2) investigate the biologic response that may have contributed to the failure; and (3) to determine if the failure mechanism was of a biol...
Source: Journal of Knee Surgery - July 10, 2018 Category: Orthopaedics Authors: Yokhana, Sanar S. Bergum, Christopher Ren, Weiping Markel, David C. Tags: Original Article Source Type: research

Predicting the Outcome of Total Knee Arthroplasty Using the WOMAC Score: A Review of the Literature
J Knee Surg DOI: 10.1055/s-0038-1666866It is estimated that up to a third of recipients of total knee arthroplasty (TKA) experience chronic pain postoperatively. However, there are no clear indications within the literature that predict which patients are at higher risk of being dissatisfied with their TKA. The Western Ontario and McMaster University Osteoarthritis Index (WOMAC) is one of the most commonly used, patient-reported outcome measures in patients with lower limb osteoarthritis. This review discusses the available evidence surrounding the predictability of the outcome of TKA using the WOMAC score as well as consi...
Source: Journal of Knee Surgery - July 10, 2018 Category: Orthopaedics Authors: Walker, Lucy Camilla Clement, Nick D. Deehan, David J. Tags: Original Article Source Type: research

The Pellegrini –Stieda Lesion of the Knee: An Anatomical and Radiological Review
J Knee Surg DOI: 10.1055/s-0038-1666867The Pellegrini–Stieda lesion is a calcification on the medial side of the knee. The origin of this tissue is controversial. The purpose of our study is to investigate the origin of the Pellegrini–Stieda lesion using conventional radiography as to recreate the circumstances in which Pellegrini and Stieda had to study this pathology. Six nonpaired fresh-frozen cadaveric knees were used. A surgical approach to the medial side of the knee was performed using the layered approach. The origin of the gastrocnemius muscle (GM) (n = 3) or the superficial medial collat...
Source: Journal of Knee Surgery - July 10, 2018 Category: Orthopaedics Authors: Somford, M. P. Janssen, R. P. A. Meijer, D. Roeling, T. A. P. Brown, C. Eygendaal, D. Tags: Original Article Source Type: research

Primary Allograft ACL Reconstruction in Skeletally Immature Patients —A Systematic Review of Surgical Techniques, Outcomes, and Complications
J Knee Surg DOI: 10.1055/s-0038-1666833The purpose of this systematic review is to ascertain the risk profile of allografts in primary anterior cruciate ligament reconstruction (ACLR) of skeletally immature patients. Three databases (PubMed, EMBASE, and MEDLINE) were searched for articles addressing primary ACLR in skeletally immature patients (i.e., open femoral and tibial physes). Inclusion criteria encompassed the use of allograft tissue with available postoperative outcomes data. The methodological index for non-randomized studies (MINORS) was used to assess all studies. Descriptive statistics such as means, 95% confid...
Source: Journal of Knee Surgery - July 10, 2018 Category: Orthopaedics Authors: Shanmugaraj, Ajaykumar de SA, Darren Skelly, Matthew M. Duong, Andrew Simunovic, Nicole Musahl, Volker Peterson, Devin C. Ayeni, Olufemi R. Tags: Original Article Source Type: research

The Role of Surgical Closure Position in Total Knee Arthroplasty: Flexion versus Extension —A Randomized Prospective Study
J Knee Surg DOI: 10.1055/s-0038-1666865We aimed to investigate the effect of the knee position during the surgical closure on isokinetic muscle strength, clinical score, and range of motion in total knee arthroplasty. Seventy-five eligible patients were enrolled in the study and randomly divided into two groups; wound closure was performed with the knee flexed at 90° in group 1 and knee extended in group 2. All the surgeries were performed by the same surgeon and by the same prosthesis type. All the patients received the same rehabilitation program postoperatively. The primary outcomes were the knee flexion degrees and...
Source: Journal of Knee Surgery - July 10, 2018 Category: Orthopaedics Authors: Pepe, Murad Calisal, Emre Kocadal, Onur Bicer, Eren Taskin, Suhan Aktekin, Cem Nuri Tags: Original Article Source Type: research

Preoperative Opioid Use in Knee Surgery Patients
The objectives of the study were to determine the demographic, diagnostic, and psychologic factors associated with opioid use; and to determine the clinical correlates of opioid use. We hypothesized that preoperative opioid use would be associated with worse patient-reported outcome (PRO) measures. The sample consisted of 383 patients undergoing knee surgery. The patients were classified as either opioid or nonopioid users on the basis of medical record review. All participants completed a battery of clinical assessments, including the Patient-Reported Outcomes Measurement Information System computer adaptive testing in si...
Source: Journal of Knee Surgery - July 10, 2018 Category: Orthopaedics Authors: Meredith, Sean J. Nadarajah, Vidushan Jauregui, Julio J. Smuda, Michael P. Medina, Shaun H. Bennett, Craig H. Packer, Jonathan D. Henn, R. Frank Tags: Original Article Source Type: research

Value of Preoperative MRI and Examination under Anesthesia for Differentiating Complete from Partial Anterior Cruciate Ligament Tears
J Knee Surg DOI: 10.1055/s-0038-1666827Partial tears of the anterior cruciate ligament (ACL) recently regained attention due to a better understanding of the two distinct bundles of the ligament and the possibility of single-bundle reconstruction procedures. An accurate diagnosis is important as it influences treatment options and patient prognosis. The aim of this study was to evaluate the value of examination under anesthesia (EUA) and magnetic resonance imaging (MRI) for differentiating partial from complete ACL tears. For this purpose, this prospective case series included 95 consecutive patients undergoing primary ACL...
Source: Journal of Knee Surgery - July 10, 2018 Category: Orthopaedics Authors: Cavinatto, Leonardo Gupta, Sunny Morgan, Craig Bartolozzi, Arthur R. Tags: Original Article Source Type: research

Posterolateral Rotatory Knee Instability —MRI Evaluation of Anatomic Landmarks for Tibial Drill Tunnel Placement in Open and Arthroscopic Popliteus Tendon Reconstruction
J Knee Surg DOI: 10.1055/s-0038-1666832Anatomic reconstruction of the popliteus tendon and arcuate complex results in superior functional and a biomechanically more stable outcome compared with extra-anatomic techniques in posterolateral rotatory knee instability. Although specific characteristics of the femoral and fibular footprint of the anatomic posterolateral reconstruction have been described, data for tibial tunnel placement while popliteus tendon reconstruction do not exist. The purpose of this study was to quantify reasonable parameters, which could be used in arthroscopy, fluoroscopy, or open surgery to determine...
Source: Journal of Knee Surgery - July 6, 2018 Category: Orthopaedics Authors: Krause, Matthias Akoto, Ralph Drenck, Tobias Claus Frosch, Karl-Heinz Preiss, Achim Tags: Original Article Source Type: research

Can Preoperative Magnetic Resonance Imaging Predict Intraoperative Autograft Size for Anterior Cruciate Ligament Reconstruction? A Systematic Review
J Knee Surg DOI: 10.1055/s-0038-1666830This systematic review explored the utility of preoperative magnetic resonance imaging (MRI) as a tool for predicting intraoperative graft size for anterior cruciate ligament (ACL) reconstruction. Three databases (EMBASE, PubMed, and MEDLINE) were searched in November 2017 for English-language studies of all levels of evidence that aimed to correlate preoperative MRI measurements of common primary ACL autograft sources to intraoperative measurements of the harvested graft. Two reviewers applied predetermined inclusion/exclusion criteria to independently complete title, abstract, and f...
Source: Journal of Knee Surgery - July 6, 2018 Category: Orthopaedics Authors: Agarwal, Suhail de SA, Darren Peterson, Devin C. Parmar, Daniel Simunovic, Nicole Ogilvie, Rick Musahl, Volker Ayeni, Olufemi R. Tags: Original Article Source Type: research

Right TKR Patients Treated with Enhanced Pain and Rehabilitation Protocols Can Drive at 2 Weeks
J Knee Surg DOI: 10.1055/s-0038-1660478An important milestone in the recovery following total knee replacement (TKR) is the ability to return to driving. With advances in pain control and the widespread introduction of rapid rehab programs, we hypothesized that the ability to drive would also return sooner than had been traditionally observed. In our group of consecutive right TKR patients, using a driving simulator, we showed that at the 2-week mark, 36 of the 40 patients tested had returned to their preoperative driving capabilities and the other 4 had reached baseline at 3 weeks. While the eventual decision to return to...
Source: Journal of Knee Surgery - June 20, 2018 Category: Orthopaedics Authors: Dalury, David F. Chapman, Danielle M. Tags: Original Article Source Type: research

Medium- to Long-Term Results of the Nexgen Legacy Posterior Stabilized Fixed-Bearing Knee Replacement
This study revealed excellent mid- to long-term results with the NexGen LPS prosthesis. [...] 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 - June 20, 2018 Category: Orthopaedics Authors: Arikupurathu, Oommen Mathew Johnston, Linda MacInnes, Alasdair Nicol, Graeme Nassif, Manhal Tags: Original Article Source Type: research

Pediatric Knee Trauma
J Knee Surg 2018; 31: 485-485 DOI: 10.1055/s-0038-1637019 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 - June 19, 2018 Category: Orthopaedics Authors: Schmidt, Andrew H. Tags: Special Focus Section Source Type: research

Incidence of Concurrent Peroneal Nerve Injury in Multiligament Knee Injuries and Outcomes after Knee Reconstruction
This study contributes to our understanding of patient outcomes in patients with concurrent MLKI and peroneal nerve injury, with a focus on the patient's ability to return to work and sporting activity. [...] 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 - June 13, 2018 Category: Orthopaedics Authors: Worley, John R. Brimmo, Olubusola Nuelle, Clayton W. Cook, James L. Stannard, James P. Tags: Original Article Source Type: research

The Effect of Remnant Tissue Preservation in Anatomic Double-Bundle ACL Reconstruction on Knee Stability and Graft Maturation
This article evaluates the effectiveness of RTP in ACLR on knee stability and graft maturation. In total, 75 patients with unilateral ACL injury who had undergone anatomic double-bundle ACLR using autografted hamstring tendon either with RTP (Group P, n = 43) or without (Group N, n = 32) were enrolled. Clinical scores, pre- and postoperative side-to-side differences (SSDs) obtained using Telos, radiological evaluations of the grafted tendon using the signal/noise quotient (SNQ) measured using magnetic resonance imaging, and arthroscopic evaluations of the grafted tendon were retrospectively comp...
Source: Journal of Knee Surgery - June 13, 2018 Category: Orthopaedics Authors: Takahashi, Tsuneari Kimura, Masashi Hagiwara, Keiichi Ohsawa, Takashi Takeshita, Katsushi Tags: Original Article Source Type: research

Mucoid Degeneration of the Anterior Cruciate Ligament: Characterization of Natural History, Femoral Notch Width Index, and Patient Reported Outcome Measures
J Knee Surg DOI: 10.1055/s-0038-1660514The presentation and clinical course of mucoid degeneration of the anterior cruciate ligament (MD-ACL) are poorly documented within the literature. Subsequently, it is under-diagnosed and the optimal management strategy remains ill-defined. Here, we characterize the syndrome associated with MD-ACL and compare the natural clinical course with the outcomes of arthroscopic management. Thirty-one patients with radiological features of MD-ACL over a 2-year period had their clinical notes retrospectively reviewed. Seven patients underwent arthroscopic debridement of the ACL for MD. These we...
Source: Journal of Knee Surgery - June 13, 2018 Category: Orthopaedics Authors: Hotchen, Andrew J. Demetriou, Charis Edwards, Dennis Melton, Joel T. K. Tags: Original Article Source Type: research

Arthroscopic and 3D CT Scan Evaluation of Femoral Footprint of the Anterior Cruciate Ligament in Chronic ACL Deficient Knees
J Knee Surg DOI: 10.1055/s-0038-1660515The outcome of single-bundle anterior cruciate ligament (ACL) reconstruction depends largely on the anatomic placement of bone tunnel. The lateral intercondylar ridge (LIR) and bifurcate ridge (BR) are useful bony landmarks for femoral tunnel placement. The purpose of our study was to compare the bony landmarks of ACL footprint on femur by three-dimensional computed tomography (3D CT) scan and arthroscopy in chronic ACL-deficient knees. Fifty patients above 18 years of age who were diagnosed of having ACL tear were selected for the study. All the cases were more than 6 months old sinc...
Source: Journal of Knee Surgery - June 13, 2018 Category: Orthopaedics Authors: Das, Anupam Yadav, C. S. Gamanagatti, Shivanand Pandey, R. M. Mittal, Ravi Tags: Original Article Source Type: research

Reliability of Roentgenographic Knee Alignment Measurements in Gonarthrosis: Methodological Issues to Avoid Misinterpretation
J Knee Surg DOI: 10.1055/s-0038-1660840 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 - June 13, 2018 Category: Orthopaedics Authors: Sabour, Siamak Tags: Letter to the Editor Source Type: research

Erratum to: Gender Disparity between Absolute versus Relative Size of Condylar Chondral Defects: An MRI Analysis
J Knee Surg DOI: 10.1055/s-0038-1656512 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 - June 5, 2018 Category: Orthopaedics Authors: Berman, Daniel Rogers, Kelly Griffin, Justin Bonner, Kevin Tags: Erratum Source Type: research

Sonographic Evaluation of the Anterolateral Ligament of the Knee: A Cadaveric Study
This study evaluated the effectiveness of high-resolution ultrasound (US) examination to detect the ALL. We studied 8 cadaveric knees (8 ALLs). On each knee, high-resolution real-time ultrasonography examination was performed by an experienced musculoskeletal radiologist before and after the procedure, with the surgeons blind to the results of the scan both before and after dissection. The ALL was identified in each cadaver limb by the musculoskeletal radiologist. US is a useful imaging modality to identify and evaluate the ALL. The ability of US to fully evaluate injuries involving the ALL still needs to be demonstrated i...
Source: Journal of Knee Surgery - May 31, 2018 Category: Orthopaedics Authors: Zappia, Marcello Oliva, Francesco Chianca, Vito Di Pietto, Francesco Maffulli, Nicola Tags: Original Article Source Type: research

Trends in Anterior Cruciate Ligament Reconstruction in the Last Decade: A Web-Based Analysis
J Knee Surg DOI: 10.1055/s-0038-1655764Anterior cruciate ligament (ACL) injury is known to be one of the most common knee joint injuries. ACL reconstruction can be similar to the native ACL in respect of graft morphology, tension, position, and orientation. ACL reconstruction can be applied with different surgery techniques, graft and fixation devices, and rehabilitation as ACL reconstruction is just as important as surgery. Although commonly known as a sports injury, ACL injuries are increasingly seen in the general population. The aim of this study was to investigate the trends in ACL injury treatment in the last decade ...
Source: Journal of Knee Surgery - May 31, 2018 Category: Orthopaedics Authors: Yucens, Mehmet Aydemir, Ahmet Nadir Tags: Original Article Source Type: research

Quality and Variability of Online Physical Therapy Protocols for Isolated Meniscal Repairs
J Knee Surg DOI: 10.1055/s-0038-1655742The ideal meniscal repair postoperative rehabilitation protocol has yet to be determined. Further, patients are attempting to access health care content online at a precipitously increasing rate given the efficiency of modern search engines. The purpose of this investigation was to assess the quality and variability of meniscal repair rehabilitation protocols published online with the hypothesis that there would be a high degree of variability found across available protocols. To this end, Web-based meniscal repair physical therapy protocols from U.S. academic orthopaedic programs as ...
Source: Journal of Knee Surgery - May 31, 2018 Category: Orthopaedics Authors: Trofa, David P. Parisien, Robert L. Noticewala, Manish S. Noback, Peter C. Ahmad, Christopher S. Moutzouros, Vasilios Makhni, Eric C. Tags: Original Article Source Type: research

Intra-Articular Biocompatibility of Multistranded, Long-Chain Polyethylene Suture Tape in a Canine ACL Model
J Knee Surg DOI: 10.1055/s-0038-1655765The purpose of this study was to assess intra-articular use of a nonabsorbable braided suture tape for its biocompatibility when implanted adjacent to the native anterior cruciate ligament (ACL) in a canine model. Establishing biocompatibility of suture tape in the knee is an important foundational step for clinicians considering use of suture tape augmentation for ACL reconstruction or repair. The study hypothesis was that a nonabsorbable braided suture tape would be biocompatible in the knee with no resultant adverse functional consequences, and no significant intra-articular synovi...
Source: Journal of Knee Surgery - May 31, 2018 Category: Orthopaedics Authors: Smith, Patrick A. Bozynski, Chantelle C. Kuroki, Keiichi Henrich, Sarah M. Wijdicks, Coen A. Cook, James L. Tags: Original Article Source Type: research

Reconstruction of Knee Defects Using Pedicled Gastrocnemius Muscle Flap with Split-Thickness Skin Grafting: A Single Surgeon's Experience with 21 Patients
J Knee Surg DOI: 10.1055/s-0038-1653965Generally, reconstruction of knee defects with exposed bone, joint, tendon, and/or hardware requires a vascularized muscle flap for coverage. Although there are several surgical options for a knee defect reconstruction, the pedicled gastrocnemius muscle still remains the workhorse flap. Although this flap is commonly used for knee defect reconstruction and the technique is described very well, there is an absence of information in the literature detailing the technique of harvesting and insetting of the gastrocnemius flap step by step with illustrations. The purpose of this article is...
Source: Journal of Knee Surgery - May 31, 2018 Category: Orthopaedics Authors: Kilic, Ali Denney, Brad de la Torre, Jorge Tags: Original Article Source Type: research

Predictors of Knee Arthrofibrosis and Outcomes after Arthroscopic Lysis of Adhesions following Ligamentous Reconstruction: A Retrospective Case –Control Study with Over Two Years' Average Follow-Up
J Knee Surg DOI: 10.1055/s-0038-1655741Arthrofibrosis can be a devastating complication after ligamentous knee reconstruction. Beyond early range of motion (ROM), manipulation under anesthesia (MUA) and arthroscopic lysis of adhesions (LOAs) are the most frequently employed interventions for the condition. There is a paucity of data regarding predictive factors of arthrofibrosis requiring MUA and LOA, and even less data regarding changes in validated patient-reported outcome measures following the procedure. A retrospective case–control study was performed at an academic, urban Level I trauma center of patients that ...
Source: Journal of Knee Surgery - May 31, 2018 Category: Orthopaedics Authors: Bodendorfer, Blake M. Keeling, Laura E. Michaelson, Evan M. Shu, Henry T. Apseloff, Nicholas A. Spratt, James D. Malone, Patrick S. Argintar, Evan H. Tags: Original Article Source Type: research

In Vivo Tibial Fit and Rotational Analysis of a Customized, Patient-Specific TKA versus Off-the-Shelf TKA
J Knee Surg DOI: 10.1055/s-0038-1653966In total knee arthroplasty (TKA), surgeons often face the decision of maximizing tibial component fit and achieving correct rotational alignment at the same time. Customized implants (CIMs) address this difficulty by aiming to replicate the anatomical joint structure, utilizing data from patient-specific knee geometry during the manufacturing. We intraoperatively compared component fit in four tibial zones of a CIM to that of three different off-the-shelf (OTS) TKA designs in 44 knees. Additionally, we assessed the rotational alignment of the tibia using computed tomography (CT)-based...
Source: Journal of Knee Surgery - May 25, 2018 Category: Orthopaedics Authors: Schroeder, Lennart Martin, Gregory Tags: Original Article Source Type: research

Erratum to: Total Knee Arthroplasty versus Osteochondral Allograft: Prevalence and Risk Factors following Tibial Plateau Fractures
J Knee Surg DOI: 10.1055/s-0038-1654705 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 24, 2018 Category: Orthopaedics Authors: Oladeji, Lasun O. Dreger, Tina K. Pratte, Eli L. Baumann, Charles A. Stannard, James P. Volgas, David A. Della Rocca, Gregory J. Crist, Brett D. Tags: Erratum Source Type: research