Patients with Revision Modern Megaprostheses of the Distal Femur Have Improved Disease-Specific and Health-Related Outcomes Compared to Those with Primary Replacements
In conclusion, patients undergoing a revision have similar joint-specific functional outcome but improved disease-specific and health-related outcomes. Implant survival are similar between groups. [...] 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, 2017 Category: Orthopaedics Authors: Heyberger, Cl émence Auberger, Guillaume Babinet, Antoine Anract, Philippe Biau, David J. Tags: Original Article Source Type: research

Accuracy of Coronal Plane Mechanical Alignment in a Customized, Individually Made Total Knee Replacement with Patient-Specific Instrumentation
The objective of this study was to evaluate the accuracy of a customized individually made total knee implant used in conjunction with patient-specific cutting guides in restoring coronal plane mechanical axis alignment using computer-assisted surgery (CAS). A consecutive series of 63 total knee arthroplasty (TKA) patients were prospectively measured with intraoperative CAS. The patient-specific instruments and implants were created utilizing a preoperative CT scan. CAS system was used for all patients, to determine mechanical alignment. Bone cuts were made using the patient-specific instruments. Both bone cuts and final c...
Source: Journal of Knee Surgery - December 14, 2017 Category: Orthopaedics Authors: Levengood, Gary A. Dupee, Jack Tags: Original Article Source Type: research

Chondrocyte Viability at Time of Transplantation for Osteochondral Allografts Preserved by the Missouri Osteochondral Preservation System versus Standard Tissue Bank Protocol
J Knee Surg DOI: 10.1055/s-0037-1608947The Missouri Osteochondral Preservation System (MOPS) has been reported to effectively preserve osteochondral allografts (OCAs) twice as long as current tissue bank protocols in preclinical studies. However, viability of OCAs preserved using the MOPS protocol at the time of clinical implantation compared with the current standard of care (SOC) is not known. Viable chondrocyte density (VCD) at time of transplantation will be significantly higher in OCAs preserved using the MOPS protocol compared with OCAs preserved using the current tissue bank protocol and will significantly affect cl...
Source: Journal of Knee Surgery - December 11, 2017 Category: Orthopaedics Authors: Stoker, Aaron M. Stannard, James P. Cook, James L. Tags: Original Article Source Type: research

Anterior Cruciate Ligament Mechanoreceptors and their Potential Importance in Remnant-Preserving Reconstruction: A Review of Basic Science and Clinical Findings
J Knee Surg DOI: 10.1055/s-0037-1608941Mechanoreceptors, within the anterior cruciate ligament (ACL), are believed to have importance in proprioception, contributing to dynamic knee stability. The potential for reinnervation of the ACL graft is one of the proposed advantages of remnant-preserving reconstruction. The aim of this review is to summarize advances in the basic science underpinning this function, alongside recent clinical studies, to define the current role for remnant-preservation.A comprehensive systematic review was performed using PubMed and Medline searches. Studies were analyzed with particular focus place...
Source: Journal of Knee Surgery - December 11, 2017 Category: Orthopaedics Authors: Kosy, Jonathan David Mandalia, Vipul I. Tags: Original Article Source Type: research

Impact of Clinical Presentation on Imaging Evaluation to Direct Effective Treatment Strategies
J Knee Surg DOI: 10.1055/s-0037-1608880A multitude of musculoskeletal disorders of the knee are commonly encountered in clinical practice. Ensuring an accurate diagnosis can be challenging. It is critical to establish a thoughtful and systematic approach to assessing the patient using history and physical exam followed by appropriate imaging studies. The physical exam may be complicated due to various test maneuvers designed to help make the diagnosis. It is also important to understand the limitations of each physical exam maneuver. When appropriate, imaging is obtained to help make the diagnosis and guide treatment. Ther...
Source: Journal of Knee Surgery - December 7, 2017 Category: Orthopaedics Authors: Roller, Brandon L. Schumacher, Christopher W. V. Torabi, Maha Lenchik, Leon Ferguson, Cristin M. Tags: Special Focus Section Source Type: research

Effect of Obesity on Total Knee Arthroplasty Costs and Revision Rate
J Knee Surg DOI: 10.1055/s-0037-1608933An increasing number of total knee arthroplasties (TKAs) are performed on obese patients. It is imperative to remain up to date on the effect of obesity on surgical outcomes and reimbursement trends. The purpose of this study was to evaluate the impact different severities of obesity have on primary and revision TKA, specifically: (1) incidence and trends over time; (2) annual growth rate; and (3) admission costs from 2010 to 2014. A retrospective review of a large commercial private payer database within the PearlDiver Supercomputer application (Warsaw, IN) of TKA procedures was cond...
Source: Journal of Knee Surgery - December 7, 2017 Category: Orthopaedics Authors: Roche, Martin Law, Tsun Yee Kurowicki, Jennifer Rosas, Samuel Rush, Augustus J. Tags: Special Focus Section Source Type: research

Validation of a New Web-Based System for Point-of-Care Implant Documentation in Total Knee Arthroplasty
This study evaluated implant documentation using this system and hypothesized that it would be as reliable as the current standard. This was a retrospective study of all primary and revision TKA performed at a single academic institution from January 1, 2015 to March 31, 2015, by eight adult reconstruction surgeons who used the web-based system. Electronic medical records and implant logbooks were chosen as a composite standard reference for implant documentation. Cohen's kappa statistic and Pearson's correlation coefficients were used to determine agreement between the system and the standard reference. Mean kappa value f...
Source: Journal of Knee Surgery - December 7, 2017 Category: Orthopaedics Authors: Ramanathan, Deepak Gad, Bishoy V. Luckett, Matthew R. Klika, Alison K. Spindler, Kurt P. Higuera, Carlos A. Tags: Original Article Source Type: research

Radiographic Morphology and Method for Localization of the Adductor Tubercle on Anterior –Posterior Knee Radiographs
J Knee Surg DOI: 10.1055/s-0037-1608872The adductor tubercle (AT) is a landmark for joint line identification in knee arthroplasty. Up to now, there has not been a dedicated study to define its morphology on an anterior–posterior (AP) radiograph. As a result, radiographic localization of the AT has been inconsistent and confusing. Ten bone specimens, each with the AT labeled with a metal marker, were radiographed to demonstrate the AT appearance on AP radiographs. Based on this knowledge, a method to locate the AT was developed. A total of 200 clinical radiographs were examined to further confirm the observed radiogr...
Source: Journal of Knee Surgery - December 7, 2017 Category: Orthopaedics Authors: Liu, Kuan-Lin Wang, Chen-Chie Chen, Ing-Ho Chang, Chia-Ming Wu, Wen-Tien Yeh, Kuang-Ting Tags: Original Article Source Type: research

Factors Affecting Longer Surgical Times in Total Knee Arthroplasty for Obese Patients —A Comparative Study between High- and Nonhigh-Volume Surgeons
J Knee Surg DOI: 10.1055/s-0037-1608879Obesity has a negative influence on surgical times in total knee arthroplasty (TKA). Our purpose in this multicenter study was to compare surgical times between high- (HV) and nonhigh-volume (NHV) surgeons and clarify the important factors affecting longer surgical times in primary TKA for obese patients. A total of 798 knees, average age 75.1 years, were enrolled. All TKAs were done using the same measured resection technique by 25 surgeons at 12 facilities and were divided into three groups based on body mass index (kg/m2) of the patients (Group A: 100 TKAs annually for many years, ...
Source: Journal of Knee Surgery - December 7, 2017 Category: Orthopaedics Authors: Harato, Kengo Kobayashi, Shu Nagashima, Masaki Hasegawa, Takayuki Tanikawa, Hidenori Maeno, Shinichi Nomoto, So Tags: Original Article Source Type: research

Conservative Management after Intraoperative Over-Release of the Medial Collateral Ligament from its Tibial Insertion Site in Patients Undergoing Total Knee Arthroplasty
This study showed that even MCL was over-released inadvertently, but it did not affect the clinical outcome. Preoperative femoral–tibial angle was the only predictable risk factor for MCL over-release. [...] 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 7, 2017 Category: Orthopaedics Authors: Choi, Young Joon Lee, Ki Won Seo, Dong Kyo Lee, Suk Kyu Kim, Sang Bum Lee, Hyun Il Tags: Original Article Source Type: research

New Advances in Surgical Approaches for Total Knee Arthroplasty
J Knee Surg DOI: 10.1055/s-0037-1608934 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 - December 7, 2017 Category: Orthopaedics Authors: Harwin, Steven F. Sodhi, Nipun Khlopas, Anton Sultan, Assem A. Mont, Michael A. Tags: Foreword Source Type: research

Biomechanical Implications of an Oblique Knee Joint Line
In this study, we evaluate the effect of knee joint obliquity on tibial plateau contact pressures and knee instability. Three cadaveric knees were dissected and put through biomechanical testing to simulate loading of an oblique knee joint. We observed 
Source: Journal of Knee Surgery - November 28, 2017 Category: Orthopaedics Authors: Hooper, Jessica M. Walker, Peter Hsu, Tzu-Ting Kurtz, Anton Reynolds, Ryan Hennessy, Daniel Chu, Alice Tags: Original Article Source Type: research

Does Posterior Condylar Offset Affect Clinical Results following Total Knee Arthroplasty?
In conclusion, increasing or decreasing PCO or AP femoral dimension with this PS TKA design did not significantly affect postoperative ROM or PROM. Similarly, maintenance of PCO within one implant size with this system compared with optimal sizing had no deleterious effect on TKA outcomes. [...] 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 - November 28, 2017 Category: Orthopaedics Authors: Degen, Ryan M. Matz, Jacob Teeter, Matthew G. Lanting, Brent A. Howard, James L. McCalden, Richard W. Tags: Original Article Source Type: research

Coronal Correction for Severe Deformity Using Robotic-Assisted Total Knee Arthroplasty
J Knee Surg DOI: 10.1055/s-0037-1608840Although robotic-assisted total knee arthroplasty (TKA) has the potential to accurately reproduce neutral alignment, it is still unclear if this correction is attainable in patients who have severe varus or valgus deformities. Therefore, the purpose of this study was to assess a single surgeon's experience with correcting coronal deformities using the robotic-assisted TKA device. Specifically, we looked at correction of varying degrees of varus and valgus deformity in patients who underwent robotic arm-assisted TKA. A total of 330 robotic-assisted TKA cases performed by a single surge...
Source: Journal of Knee Surgery - November 27, 2017 Category: Orthopaedics Authors: Marchand, Robert C. Sodhi, Nipun Khlopas, Anton Sultan, Assem A. Higuera, Carlos A. Stearns, Kim L. Mont, Michael A. Tags: Special Focus Section Source Type: research

Gap-Balancing versus Measured Resection Technique in Total Knee Arthroplasty: A Comparison Study
J Knee Surg DOI: 10.1055/s-0037-1608820Proper femoral component alignment in the axial plane during total knee arthroplasty (TKA) depends on accurate bone cuts and soft tissue balancing. Two methods that are used to achieve this are “measured resection” and “gap balancing.” However, a controversy exists as to which method is more accurate and leads to better outcomes. Therefore, the purpose of this study was to evaluate: (1) implant survivorship, (2) patient outcomes, (3) complications, and (4) radiographic analysis comparing patients who underwent TKA with either gap-balancing or measured resection...
Source: Journal of Knee Surgery - November 27, 2017 Category: Orthopaedics Authors: Churchill, Jessica L. Khlopas, Anton Sultan, Assem A. Harwin, Steven F. Mont, Michael A. Tags: Special Focus Section Source Type: research

The Learning Curve Associated with Robotic Total Knee Arthroplasty
J Knee Surg DOI: 10.1055/s-0037-1608809As with most new surgical technologies, there is an associated learning curve with robotic-assisted total knee arthroplasty (TKA) before surgeons can expect ease of use to be similar to that of manual cases. Therefore, the purpose of this study was to (1) assess robotic-assisted versus manual operative times of two joint reconstructive surgeons separately as well as (2) find an overall learning curve. A total of 240 robotic-assisted TKAs performed by two board-certified surgeons were analyzed. The cases were sequentially grouped into 20 cases and a learning curve was created based on ...
Source: Journal of Knee Surgery - November 22, 2017 Category: Orthopaedics Authors: Sodhi, Nipun Khlopas, Anton Piuzzi, Nicolas S. Sultan, Assem A. Marchand, Robert C. Malkani, Arthur L. Mont, Michael A. Tags: Special Focus Section Source Type: research

Bone Marrow Cellular Therapies: Novel Therapy for Knee Osteoarthritis
J Knee Surg DOI: 10.1055/s-0037-1608844Cellular therapies are emerging as potentially promising treatments for numerous musculoskeletal conditions, such as knee osteoarthritis (OA). As orthopaedic surgeons represent a sizable portion of the providers who deliver these therapies, it is particularly essential for them to understand their fundamental principles. One major principle is to identify the appropriate sources for obtaining these cells, with bone marrow being most common. Therefore, the purpose of this review was to provide an overview of cell-based therapies available for the treatment of knee OA with a focus on bo...
Source: Journal of Knee Surgery - November 22, 2017 Category: Orthopaedics Authors: Piuzzi, Nicolas S. Khlopas, Anton Newman, Jared M. Ng, Mitchell Roche, Martin Husni, M. Elaine Spindler, Kurt P. Mont, Michael A. Muschler, George Tags: Special Focus Section Source Type: research

Difficult Cases in Robotic Arm-Assisted Total Knee Arthroplasty: A Case Series
J Knee Surg DOI: 10.1055/s-0037-1608839Sagittal deformity of the knee is commonly corrected to neutral biomechanical axis (±3 degrees) during total knee arthroplasty (TKA), which is a widely accepted goal. Recent advances in surgical technology have made it possible to accurately plan and fulfill these goals. One of these is robotic-assisted TKA, which has been noted to help increase accuracy and precision of restoring a neutral mechanical axis. While there are data confirming the ability of robotic devices to better correct knee alignment than the manual technique, there is a lack of data concerning the use of the ...
Source: Journal of Knee Surgery - November 22, 2017 Category: Orthopaedics Authors: Marchand, Robert C. Khlopas, Anton Sodhi, Nipun Condrey, Caitlin Piuzzi, Nicolas S. Patel, Rickesh Delanois, Ronald E. Mont, Michael A. Tags: Special Focus Section Source Type: research

Knee Position during Surgical Wound Closure in Total Knee Arthroplasty: A Review
J Knee Surg DOI: 10.1055/s-0037-1608838Study areas concerning maximizing knee range of motion (ROM) following total knee arthroplasty (TKA) have come under focus by surgeons. Among the perioperative factors that were identified to affect ROM after TKAs is knee position during surgical wound closure. Therefore, the aim of this study was to review the impact of knee position during TKA wound closure on: (1) postoperative ROM, (2) wound-related complications, (3) Knee Society Score (KSS), (4) postoperative pain, and (5) muscle strength and home functional recovery. A literature search was performed using PubMed, Ovid, and Goo...
Source: Journal of Knee Surgery - November 22, 2017 Category: Orthopaedics Authors: Faour, Mhamad Sodhi, Nipun Khlopas, Anton Piuzzi, Nicolas S. Stearns, Kim L. Krebs, Viktor E. Higuera, Carlos A. Mont, Michael A. Tags: Special Focus Section Source Type: research

Patellofemoral Cartilage Restoration: Indications, Techniques, and Outcomes
J Knee Surg DOI: 10.1055/s-0037-1608642 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 - November 17, 2017 Category: Orthopaedics Authors: Sherman, Seth L. Tags: Foreword Source Type: research

Use of Fresh Osteochondral Allografts in the Patellofemoral Joint
J Knee Surg DOI: 10.1055/s-0037-1607324Fresh osteochondral allograft (OCA) transplantation has become a mainstay for the treatment of osteochondral defects in the tibiofemoral joint. With excellent outcomes and high survival times, this technology has recently become more interesting for use in the patellofemoral (PF) joint. This review article will point out the historical difficulties that the use of fresh OCA poses. With newer surgical approaches and a better understanding of the mechanical requirements of the PF joint, the use of OCA transplantation has shown increasingly better results. Illustrating the technique for ...
Source: Journal of Knee Surgery - October 16, 2017 Category: Orthopaedics Authors: Lattermann, Christian Kremser, Victor Altintas, Burak Tags: Special Focus Section Source Type: research

Patellofemoral Cartilage Restoration: Indications, Techniques, and Outcomes of Autologous Chondrocytes Implantation, Matrix-Induced Chondrocyte Implantation, and Particulated Juvenile Allograft Cartilage
J Knee Surg DOI: 10.1055/s-0037-1607294Focal chondral defects are common in the patellofemoral (PF) joint and can significantly impair the quality of life. The autologous chondrocytes implantation (ACI) technique has evolved over the past 20 years: the first-generation technique involves the use of a periosteal patch, the second-generation technique (collagen-cover) uses a type I/III collagen membrane, and the newest third-generation technique seeds and cultivates the collagen membrane with chondrocytes prior to implantation and is referred to as matrix-induced autologous chondrocyte implantation. Particulated juvenile all...
Source: Journal of Knee Surgery - October 16, 2017 Category: Orthopaedics Authors: Hinckel, Betina B. Gomoll, Andreas H. Tags: Special Focus Section Source Type: research

Erratum: Arthritis Progression on Serial MRIs Following Diagnosis of Medial Meniscal Posterior Horn Root Tear
J Knee Surg DOI: 10.1055/s-0037-1607351 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 - October 11, 2017 Category: Orthopaedics Authors: Krych, Aaron J. Johnson, Nick R. Mohan, Rohith Hevesi, Mario Stuart, Michael J. Littrell, Laurel A. Collins, Mark S. Tags: Erratum Source Type: research

Erratum: Comparison of Platelet-Rich Plasma, Stromal Vascular Fraction (SVF), or SVF with an Injectable PLGA Nanofiber Scaffold for the Treatment of Osteochondral Injury in Dogs
J Knee Surg DOI: 10.1055/s-0037-1607350 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 - October 11, 2017 Category: Orthopaedics Authors: Franklin, Samuel P. Stoker, Aaron M. Bozynski, Chantelle C. Kuroki, Keiichi Clarke, Kevin M. Johnson, Jed K. Cook, James L. Tags: Erratum Source Type: research

Patient Factors Associated with Failure of Flap Coverage Used during Revision Total Knee Arthroplasty
Conclusion Flap coverage in rTKA is a viable limb salvage option for patients with soft tissue defects; however, failure rates are much higher than in patients not requiring flap coverage. [...] 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 - October 10, 2017 Category: Orthopaedics Authors: Gad, Bishoy V. Styron, Joseph F. Goergy, Mark A. Klika, Alison K. Barsoum, Wael K. Higuera, Carlos A. Tags: Original Article Source Type: research

Accessory Anteromedial Portal may not Provide Clinically Superior Results Compared with the Anteromedial Portal in Anterior Cruciate Ligament Reconstruction
J Knee Surg DOI: 10.1055/s-0037-1607074Techniques using the anteromedial portal (AMP) and accessory anteromedial portal (AAMP) are commonly used in anterior cruciate ligament (ACL) reconstruction. The aim of this study was to investigate the radiological and clinical outcomes of arthroscopic single-bundle ACL reconstruction using the AMP or AAMP technique to drill the femoral tunnel. The records of 157 patients who underwent single-bundle ACL reconstruction using the AMP or AAMP technique between 2011 and 2015 were reviewed. The femoral tunnel clock-face position and femoral tunnel and tibial tunnel anterior–posterio...
Source: Journal of Knee Surgery - October 6, 2017 Category: Orthopaedics Authors: Ye, Shu-Ming Jing, Jue-Hua Lv, Hao Zhang, Ji-Sen Xu, Xin-Zhong Xu, Chun-Gui Zhou, Yun Xu, You-Jia Tags: Original Article Source Type: research

Internal Fixation of Osteochondritis Dissecans Lesions in the Patellofemoral Joint
J Knee Surg DOI: 10.1055/s-0037-1607199Osteochondritis dissecans (OCD) lesions of the patellofemoral joint can be difficult to identify and treat. Asymptomatic or stable lesions in skeletally immature patients may be treated nonoperatively, but symptomatic lesions often require surgical intervention. Evidence of instability should be carefully evaluated with preoperative magnetic resonance imaging or computed tomography arthrogram. Careful preoperative planning is necessary to ensure the appropriate surgical approach and implants are selected for surgical management. Multiple techniques have been described, but internal fi...
Source: Journal of Knee Surgery - October 4, 2017 Category: Orthopaedics Authors: Nuelle, Clayton W. Farr, Jack Tags: Special Focus Section Source Type: research

Quantitative Evaluation of Joint Space Width in the Lateral Compartment after Medial Unicompartmental Knee Arthroplasty: Comparison of Three Radiographic Views
Conclusion After evaluating the patients 3 days after surgery or following them for approximately 18 months after medial UKA, we determined that weight-bearing AP, supine AP, and supine valgus stress knee radiographs were comparable when used to assess residual cartilage thickness of the lateral compartment. [...] 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 - October 4, 2017 Category: Orthopaedics Authors: Yue, Ju'an Guo, Wanshou Wan, Fuyin Wen, Pengfei Liu, Zhaohui Cheng, Liming Zhang, Qidong Chen, Yan Tags: Original Article Source Type: research

Current Knee Imaging
J Knee Surg DOI: 10.1055/s-0037-1607220 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 - October 4, 2017 Category: Orthopaedics Authors: Roller, Brandon L. Cook, James L. Tags: Foreword Source Type: research

Arthritis Progression on Serial MRIs Following Diagnosis of Medial Meniscal Posterior Horn Root Tear
J Knee Surg DOI: 10.1055/s-0037-1607038Medial meniscus posterior root tears (MMPRTs) are a significant source of pain and dysfunction. The purpose of this study was to evaluate changes in the medial compartment of the knee over time following the diagnosis of a MMPRT on MRI. A retrospective review of the institutional database was performed for patients with an initial MRI diagnosis of a MMPRT. Patients were included if they had a subsequent follow-up MRI on the same knee. Patients with surgical intervention, including debridement or repair, were excluded. MRIs were evaluated by two board-certified musculoskeletal radiolog...
Source: Journal of Knee Surgery - September 26, 2017 Category: Orthopaedics Authors: Krych, Aaron J. Johnson, Nick R. Mohan, Rohith Hevesi, Mario Stuart, Michael J. Littrell, Laurel A. Collins, Mark S. Tags: Original Article Source Type: research

Comparison of Platelet-Rich Plasma, Stromal Vascular Fraction (SVF), or SVF with an Injectable PLGA Nanofiber Scaffold for the Treatment of Osteochondral Injury in Dogs
J Knee Surg DOI: 10.1055/s-0037-1606575Stromal vascular fraction (SVF) contains a small number of mesenchymal stem cells and has been used as a treatment for osteoarthritis and cartilage injury. Due to limited evidence of successful cartilage regeneration with injected stem cell therapies, there is interest in combining cellular therapies with injectable scaffolding materials to increase intra-articular residence times of stem cells and improve tissue regeneration. However, the safety of intra-articular injection of SVF combined with injectable scaffolds is unestablished. Also, it is unclear if SVF therapy is superior to m...
Source: Journal of Knee Surgery - September 15, 2017 Category: Orthopaedics Authors: Franklin, Samuel P. Stoker, Aaron M. Bozynski, Chantelle C. Kuroki, Keiichi Clarke, Kevin M. Johnson, Jed K. Cook, James L. Tags: Original Article Source Type: research

Comparative Analysis of Gene Expression between Cartilage and Menisci in Early-Phase Osteoarthritis of the Knee —An Animal Model Study
J Knee Surg DOI: 10.1055/s-0037-1606549Cartilage degeneration is believed to be the primary event in the development of osteoarthritis (OA). On the other hand, meniscal degeneration is observed with high prevalence, and some researchers have pointed out that pathological changes in menisci precede that of cartilage. The purpose of the present study is to investigate comprehensive gene expression pattern of cartilage and menisci in the initial phase of surgically induced OA and to compare them. Secondary OA was surgically induced in 10-week-old male Wistar rats by anterior cruciate ligament transection (ACLT). Articular car...
Source: Journal of Knee Surgery - September 15, 2017 Category: Orthopaedics Authors: Endo, Jun Sasho, Takahisa Akagi, Ryuichiro Muramatsu, Yuta Watanabe, Atsuya Akatsu, Yorikazu Fukawa, Taisuke Tahara, Masamichi Yamaguchi, Satoshi Tags: Original Article Source Type: research

Postoperative Computed Tomography Evaluation of Posterior Tibial Plateau Fractures: Mean 7-Year Clinical Follow-Up
J Knee Surg DOI: 10.1055/s-0037-1606561The aim is to assess the association between computed tomography (CT) findings and clinical outcomes in posterior tibial plateau fractures (TPF). This is a retrospective analysis of the records of 23 patients with posterior TPF treated at our institution between 2004 and 2011. Two indices of residual articular displacement of posterior TPF (gap and step-off) were measured from CT images, and clinical outcomes were assessed using the Short Musculoskeletal Function Assessment (SMFA) questionnaire. Spearman's rank correlation coefficient analysis was used to evaluate the correlations bet...
Source: Journal of Knee Surgery - September 14, 2017 Category: Orthopaedics Authors: Li, Dongzhe Fang, Yue Liang, Yu Ma, Kunlong Zou, Chang Tags: Original Article Source Type: research

Comparative Analysis between Cone and Sleeve in Managing Severe Bone Defect during Revision Total Knee Arthroplasty: A Systematic Review and Meta-Analysis
J Knee Surg DOI: 10.1055/s-0037-1606564This review aims to compare the outcomes of revision total knee arthroplasty (TKA) performed using a tantalum cone and a titanium sleeve. A rigorous and systematic search was performed. Each of the selected studies was evaluated for methodological quality. Data were extracted according to the following: study design, level of evidence, cases enrolled, age, sex ratio, follow-up, involved part, bone defect, degree of constraint, augments (cone and/or sleeve), pre-clinical score, post-clinical score, radiological results, major complications, and endpoint analysis. Nineteen articles were...
Source: Journal of Knee Surgery - September 14, 2017 Category: Orthopaedics Authors: Kim, Hyun Jung Lee, O-Sung Lee, Seung Hoon Lee, Yong Seuk Tags: Original Article Source Type: research

Most Effective Regimen of Tranexamic Acid for Reducing Bleeding and Transfusions in Primary Total Knee Arthroplasty: A Meta-Analysis of Randomized Controlled Trials
J Knee Surg DOI: 10.1055/s-0037-1606376The use of tranexamic acid (TXA) during primary total knee arthroplasty (TKA) is well documented. However, considering the potential side effects, including deep vein thrombosis (DVT) and pulmonary embolism (PE), the ideal route of administration remains controversial. Therefore, we performed a meta-analysis to compare the efficacy of topical versus intravenous TXA and explore the most effective regimen in patients undergoing primary TKA. We conducted a systematic literature search in PubMed, Embase, and the Cochrane database through July 2016 to identify randomized controlled trials ...
Source: Journal of Knee Surgery - September 11, 2017 Category: Orthopaedics Authors: Dai, Wen-Li Zhou, Ai-Guo Zhang, Hua Zhang, Jian Tags: Original Article Source Type: research

No Difference in Functional Outcomes after Total Knee Arthroplasty with or without Pinless Navigation
This study aims to investigate the functional outcomes of pinless navigation (BrainLAB VectorVision Knee 2.5 navigation system; Munich, Germany) as an intraoperative alignment guide in total knee arthroplasty (TKA). A prospective, 24-month follow-up study of 100 patients who were scheduled and randomized into two groups, the pinless navigation and conventional surgery, was conducted. All TKAs were performed with the surgical aim of achieving neutral coronal alignment with the 180-degree mechanical axis. The outcomes measured in this study were Oxford Knee Score (OKS), Knee Society Score (KSS), Short Form-36 (SF-36), and ra...
Source: Journal of Knee Surgery - September 8, 2017 Category: Orthopaedics Authors: Zhu, Meng Chen, Jerry Yongqiang Chong, Hwei Chi Pang, Hee Nee Tay, Darren Keng Jin Chia, Shi-Lu Lo, Ngai Nung Yeo, Seng Jin Tags: Original Article Source Type: research

Effectiveness and Safety of Needle Medial Collateral Ligament Pie-Crusting in Total Knee Arthroplasty: A Cadaveric Study
J Knee Surg DOI: 10.1055/s-0037-1606377Medial collateral ligament (MCL) pie-crusting technique in total knee arthroplasty (TKA) is one of the methods of medial release. The effects and risks of blade pie-crusting have been reported in previous studies. However, only a few have reported the safety and efficacy of needle pie-crusting. In this cadaveric study, we quantitatively evaluated the amount of gap change by MCL needle pie-crusting. We investigated five knees of four fresh human cadavers and performed posterior-stabilized TKA. Only deep MCL release as the medial release was conducted. We punctured the MCL from the deep...
Source: Journal of Knee Surgery - September 5, 2017 Category: Orthopaedics Authors: Ohmori, Takaaki Kabata, Tamon Kajino, Yoshitomo Takagi, Tomoharu Tsuchiya, Hiroyuki Tags: Original Article Source Type: research

Meniscal Ramp Lesion Repair Using the FasT-Fix Technique: Evaluating Healing and Patient Outcomes with Second-Look Arthroscopy
This study evaluated results of arthroscopic FasT-Fix meniscal ramp lesion repair using second-look arthroscopy. From August 2010 to December 2014, 46 knees diagnosed with combined ACL injury and ramp lesion underwent ACL reconstruction with meniscal repair using the FasT-Fix technique. We classified ramp lesions into three types according to tear pattern: meniscotibial ligament tear, meniscocapsular tear, and combined meniscotibial/meniscocapsular tear. Second-look arthroscopy was performed postoperatively. The healing capacity of the ramp lesion was evaluated retrospectively. At the final follow-up (mean = ...
Source: Journal of Knee Surgery - September 5, 2017 Category: Orthopaedics Authors: Chen, Zhong Li, Wei-Ping Yang, Rui Song, Bin Jiang, Chuan Hou, Jing-Yi Luo, Huan Zhou, Yun-Feng Tags: Original Article Source Type: research

Indication for Unicompartmental Knee Replacement versus Osteotomy around the Knee
This article discusses the diagnostic algorithm and the most important decision factors. A long-leg radiograph and formal deformity analysis is mandatory. If constitutional or posttraumatic metaphyseal deformity in the frontal plane is detected and the opposite compartment is intact, an osteotomy should be considered. The result is not depending on age and grade of osteoarthritis. Unicompartmental knee arthroplasty is indicated in substantial osteoarthritis of one compartment (bone-on-bone) with intact ligaments and a functionally intact contralateral compartment. The anatomy of the femur and tibia should be normal with no...
Source: Journal of Knee Surgery - August 25, 2017 Category: Orthopaedics Authors: Lobenhoffer, Philipp Tags: Special Focus Section Source Type: research

Influence of Bone Marrow Edema on Medial Unicompartmental Knee Arthroplasty among Patients with Patellofemoral Osteoarthritis
In conclusion, there was no significant difference in clinical outcomes in patients without BME regardless of PF OA. However, the condition of BME should be taken serious consideration because of its indication of an adverse effect on the outcome after UKA. [...] 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 25, 2017 Category: Orthopaedics Authors: Yue, Jiaji Ma, Xiaojun Li, Yaqiang Wang, Yu Yang, Chunxi Zhu, Yuchang Cheng, Biao Tags: Original Article Source Type: research

Corrective Osteotomies for Complex Intra-Articular Tibial Plateau Malunions using Three-Dimensional Virtual Planning and Novel Patient-Specific Guides
J Knee Surg DOI: 10.1055/s-0037-1605563Corrective osteotomy of intra-articular tibial plateau malunions is technically demanding for orthopedic surgeons. The aim of our study was to evaluate the feasibility of the combination of three-dimensional (3D) virtual planning and novel patient-specific guides for assisting correction of complex intra-articular tibial plateau malunions. Six patients with posttraumatic intra-articular tibial plateau malunions were included. Preoperatively 3D models of the tibias were reconstructed using the computed tomography scan data. Virtual surgical planning was performed, and patient-specific ...
Source: Journal of Knee Surgery - August 25, 2017 Category: Orthopaedics Authors: Wang, Huixiang Newman, Simon Wang, Jiandong Wang, Qian Wang, Qiugen Tags: Original Article Source Type: research

Impact of Age on Patient-Reported Outcome Measures in Total Knee Arthroplasty
This study was a retrospective chart review that analyzed data from TKA patients to determine the impact of age on patient-reported outcomes measures following TKA. Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and Oxford knee scores were collected as primary outcome measures from 356 consecutive patients who underwent TKA. Oxford knee scores were further divided into pain and function subscores. Patients were age categorized as 79. Preoperative scores were compared among age categories including age category, gender, body mass index (BMI), and length of stay (LOS) in the model as fixed effects. Sc...
Source: Journal of Knee Surgery - August 25, 2017 Category: Orthopaedics Authors: Townsend, Luke A. Roubion, Ryan C. Bourgeois, Devin M. Leonardi, Claudia Fox, Rabun S. Dasa, Vinod Pollock, Grant R. Tags: Original Article Source Type: research

Is Knee Arthroscopy Beneficial in Treating Traumatic Meniscal Tears on Patients Older Than 60 Years?
J Knee Surg DOI: 10.1055/s-0037-1605562Knee arthroscopic surgery is usually performed on young or middle-aged patients with meniscal tears. However, we have noted an amount of active elderly patients who suffered from traumatic meniscal tear without significant degenerative changes. Outcome data were prospectively collected and retrospectively reviewed in patients older than 60 years who underwent partial arthroscopic meniscectomy between April 2008 and July 2013. The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores, Kellgren–Lawrence (K–L) grade, Knee Society Score (KSS), and pain ...
Source: Journal of Knee Surgery - August 25, 2017 Category: Orthopaedics Authors: Li, Ke Cavaignac, Etienne Chen, Hong Xu, Wei Chen, Cheng Huang, Wei Tags: Original Article Source Type: research

Comparative Analysis of Hospital Length of Stay and Discharge Status of Two Contemporary Primary Total Knee Systems
This study compares the differences in hospital length of stay (LOS), operating room time (ORT), discharge status, and total hospital costs among primary total knee arthroplasty (TKA) patients implanted with one of two contemporary primary total knee systems. A retrospective cohort analysis of elective inpatient, primary, unilateral TKA patients in the United States from 2013 to 2014 was conducted using the Premier Perspective® hospital billing database. The included patients had a diagnosis for osteoarthritis and received an ATTUNE® Knee (Gradually Reducing Radius Knee) or Triathlon™ (Single Radius Knee) fro...
Source: Journal of Knee Surgery - August 25, 2017 Category: Orthopaedics Authors: Etter, Katherine Lerner, Jason Kalsekar, Iftekhar de Moor, Carl Yoo, Andrew Swank, Michael Tags: Original Article Source Type: research

Incidence and Characterization of Hypoesthesia in the Distribution of the Infrapatellar Branch of the Saphenous Nerve after Anterior Cruciate Ligament Reconstruction: A Prospective Study of Patient-Reported Numbness
J Knee Surg DOI: 10.1055/s-0037-1605559The purpose of this study was to determine the incidence of patient-reported numbness following anterior cruciate ligament reconstruction (ACLR), if postoperative numbness dissipates with time, and how the graft type affects numbness severity. A total of 218 patients undergoing ACLR were prospectively enrolled. At 6 weeks, 6 months, and 1 year postoperatively, patients completed a questionnaire assessing numbness severity and location. Each time, patients rated their sensory deficit from 0 to 10 (0 = no deficit; 10 = complete lack of sensation) and i...
Source: Journal of Knee Surgery - August 25, 2017 Category: Orthopaedics Authors: Cohen, Steven Brad Flato, Russell Wascher, Jocelyn Watson, Ryan Salminen, Matthew O'Brien, Daniel Tjoumakaris, Fotios Ciccotti, Michael Tags: Original Article Source Type: research

Sources and Management of Knee Pain
J Knee Surg 2017; 30: 617-617 DOI: 10.1055/s-0037-1606259 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 25, 2017 Category: Orthopaedics Authors: Sodhi, Nipun Khlopas, Anton Newman, Jared M. Mont, Michael A. Tags: Special Focus Section Source Type: research

Changes of Sagittal and Axial Alignments of Patella after Open- and Closed-Wedge High-Tibial Osteotomy: A Systematic Review and Meta-Analysis
J Knee Surg DOI: 10.1055/s-0037-1605561The present systematic review and meta-analysis were aimed to verify the effect of open-wedge (OW) and closed-wedge (CW) high-tibial osteotomy (HTO) on sagittal and axial alignments of the patella. A vigorous search was performed for studies that compared the changes of sagittal and axial alignments of patella after OW and CW HTO. After evaluating publication bias and heterogeneity, we aggregated variables by using the random-effects model. The weighted mean differences in sagittal and axial alignment of patella were estimated with 95% confidence intervals. Also, we analyzed the chang...
Source: Journal of Knee Surgery - August 14, 2017 Category: Orthopaedics Authors: Lee, O-Sung Ahn, Soyeon Lee, Yong Seuk Tags: Original Article Source Type: research

Erratum: Methicillin-Resistant Staphylococcus aureus Infection Is a Risk Factor for Unplanned Return to the Operating Room in the Surgical Treatment of a Septic Knee
J Knee Surg DOI: 10.1055/s-0037-1606193 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 3, 2017 Category: Orthopaedics Authors: Jaffe, David Costales, Timothy Greenwell, Patrick Christian, Matthew Henn, Ralph Frank Tags: Erratum Source Type: research

Erratum: A Simple Technique to Prevent Early or Late EndoButton Deployment in Anterior Cruciate Ligament Reconstructions: A Technical Note
J Knee Surg DOI: 10.1055/s-0037-1606195 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 3, 2017 Category: Orthopaedics Authors: Fogagnolo, Fabricio Salim, Rodrigo Kfuri, Mauricio Tags: Erratum Source Type: research

The Pellegrini –Stieda Lesion Dissected Historically
J Knee Surg DOI: 10.1055/s-0037-1604401The Pellegrini–Stieda lesion is a common finding on conventional X-rays. Whether it originates in the medial collateral ligament (MCL) of the knee or the medial head of the gastrocnemius muscle or another structure remains under debate. We discuss the difference in the articles by Pellegrini and Stieda and follow the vision on the origin of the lesion through time. A systematic research in PubMed/MEDLINE was conducted, identifying all articles on the Pellegrini–Stieda lesion and analyzing them for proposed origin of the lesion. The articles with their conclusion based on e...
Source: Journal of Knee Surgery - July 30, 2017 Category: Orthopaedics Authors: Somford, Matthijs Paul Lorusso, Lorenzo Porro, Alessandro Loon, Corn é Van Eygendaal, Denise Tags: Original Article Source Type: research