Relatively Loose Flexion Gap Improves Patient-Reported Clinical Scores in Cruciate-Retaining Total Knee Arthroplasty
In conclusion, intraoperative soft tissue balance influenced the postoperative clinical outcomes, where a relatively loose flexion gap resulted in higher scores for the parameters of pain, patient satisfaction, and patient expectations. [...] 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 - July 30, 2017 Category: Orthopaedics Authors: Matsumoto, Tomoyuki Takayama, Koji Muratsu, Hirotsugu Ishida, Kazunari Hashimoto, Shingo Hayashi, Shinya Kuroda, Ryosuke Tags: Original Article Source Type: research

Infrapatellar Fat Pad Impingement: A Systematic Review
J Knee Surg DOI: 10.1055/s-0037-1604447Infrapatellar fat pad impingement represents a source of anterior knee pain that is often overlooked. Due to the scarcity of reports related to this disorder, we conducted a systematic review of the literature related to infrapatellar fat pad impingement in evaluating the following: (1) clinical presentation, (2) imaging, (3) management, and (4) clinical outcomes. A systematic review was conducted investigating all available primary literature related to the clinical presentation, imaging, management, and outcomes of infrapatellar fat pad impingement syndrome. A total of 15 studies (9...
Source: Journal of Knee Surgery - July 25, 2017 Category: Orthopaedics Authors: Genin, Jason Faour, Mhamad Ramkumar, Prem N. Yakubek, George Khlopas, Anton Chughtai, Morad Mont, Michael A. King, Dominic Tags: Special Focus Section Source Type: research

Variations in Tibial Tuberosity to Trochlear Groove and Posterior Cruciate Ligament Distances due to Tibial External and Valgus Rotations
This study utilized computational modeling to quantify how the tibial tuberosity to trochlear groove (TT-TG) and tibial tuberosity to posterior cruciate ligament attachment (TT-PCL) distances vary with tibial internal/external and varus/valgus rotations. Computational models were developed from magnetic resonance imaging data to represent eight knees with patellar instability. TT-TG and TT-PCL distances were quantified from the computational models for a neutral orientation and with the tibia rotated internally and externally and into varus and valgus in 1-degree increments to 5 degrees. Regression analyses related tibial ...
Source: Journal of Knee Surgery - July 25, 2017 Category: Orthopaedics Authors: Smith, Bradley W. Millar, Emily A. Jones, Kerwyn C. Elias, John J. Tags: Original Article Source Type: research

A Comparison of Rollback Ratio between Bicruciate Substituting Total Knee Arthroplasty and Oxford Unicompartmental Knee Arthroplasty
In this study, 64 subjects (64 knees) undergoing BCS-TKA (Journey II: Smith and Nephew) and 50 subjects (50 knees) undergoing Oxford UKA (Zimmer-Biomet holdings, Inc., IN) were included. Approximately 6 months after surgery, and when the subjects had recovered their knee range of motion, following the Laidlow's method, lateral radiographic imaging of the knee was performed with active full knee flexion. The most posterior tibiofemoral contact point was measured for the evaluation of femoral rollback (rollback ratio). Flexion angle was also measured using the same radiograph and the correlation of rollback and flexion angle...
Source: Journal of Knee Surgery - July 25, 2017 Category: Orthopaedics Authors: Iriuchishima, Takanori Ryu, Keinosuke Tags: Original Article Source Type: research

Isolated Group of Failures without Denominator
J Knee Surg DOI: 10.1055/s-0037-1604441 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 25, 2017 Category: Orthopaedics Authors: Mont, Michael A. Tags: Letter to the Editor Source Type: research

Implantation of a Novel Cryopreserved Viable Osteochondral Allograft for Articular Cartilage Repair in the Knee
We report the results of a retrospective case series of three patients who presented with articular cartilage lesions more than 2 cm2 and were treated with the CVOCA using the presented surgical technique. Patients were followed up to 2 years after implantation of the CVOCA and all three patients had satisfactory outcomes without adverse events. Controlled randomized studies are suggested for evaluation of CVOCA efficacy, safety, and long-term outcomes. [...] Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of contents  |  Abstract  |&nbs...
Source: Journal of Knee Surgery - July 24, 2017 Category: Orthopaedics Authors: Vangsness, C. Thomas Higgs, Geoffrey Hoffman, James K. Farr, Jack Davidson, Philip A. Milstein, Farrell Geraghty, Sandra Tags: Original Article Source Type: research

The Stem-Cell Market for the Treatment of Knee Osteoarthritis: A Patient Perspective
J Knee Surg DOI: 10.1055/s-0037-1604443The use of stem-cell therapies for the treatment of various musculoskeletal conditions, especially knee osteoarthritis (OA), is rapidly expanding, despite only low-level evidence to support its use. Centers offering these therapies are often marketing and charging patients out-of-pocket costs for such services. Therefore, the purpose of this study was to determine the current marketed: (1) prices and (2) clinical efficacy of stem-cell therapies for knee OA. This was a prospective cross-sectional study which queried 317 U.S. centers that offered direct-to-consumer stem-cell therapies f...
Source: Journal of Knee Surgery - July 24, 2017 Category: Orthopaedics Authors: Piuzzi, Nicolas S. Ng, Mitchell Chughtai, Morad Khlopas, Anton Ng, Kenneth Mont, Michael A. Muschler, George F. Tags: Original Article Source Type: research

Results of Arthroscopic Synovectomy for Treatment of Synovial Lipomatosis (Lipoma Arborescens) of the Knee
J Knee Surg DOI: 10.1055/s-0037-1604440Synovial lipomatosis (SL; lipoma arborescens) is a tumor-like condition with villous proliferation of the synovium. The exact etiology of SL is still unknown. The knee is the most commonly involved part. The goal of this retrospective study was to report the results of arthroscopic synovectomy in patients with SL in their knee joints as well as to emphasize the importance of considering this pathology when treating patients with recurrent knee joint effusions. In total, 21 patients (8 females and 13 males) were evaluated retrospectively from May 2009 to July 2014. The mean follow-up p...
Source: Journal of Knee Surgery - July 24, 2017 Category: Orthopaedics Authors: Malkoc, Melih Korkmaz, Özgur Tags: Original Article Source Type: research

Postoperative Stiffening after Bicruciate-Retaining Total Knee Arthroplasty
J Knee Surg DOI: 10.1055/s-0037-1604145Bicruciate-retaining (BCR) total knee arthroplasty (TKA) has recently experienced a resurgence of popularity. It may be a good option among a younger, more active population because it restores knee kinematics better than other prosthetic designs. Results obtained in the first 100 BCR TKAs implanted with a simplified gap-balancing technique are reported, with special attention paid to knee flexion, through comparison with a cohort of 100 posterior-stabilized (PS) TKAs. We conducted a retrospective comparative cohort study of 100 BCR TKAs (90 patients) and 100 PS TKAs (88 patients). Kn...
Source: Journal of Knee Surgery - July 24, 2017 Category: Orthopaedics Authors: Lavoie, Fr édéric Al-Shakfa, Fidaa Moore, James Reuben Mychaltchouk, Lydia Iguer, Khaled Tags: Original Article Source Type: research

Erratum: Tibial Tubercle Osteotomy: Indication and Techniques
J Knee Surg DOI: 10.1055/s-0037-1604462 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 24, 2017 Category: Orthopaedics Authors: Grawe, Brian Shubin Stein, Beth E. Tags: Erratum Source Type: research

Management of Injuries to the Medial Patellofemoral Ligament: A Review
J Knee Surg DOI: 10.1055/s-0037-1604142The medial patellofemoral ligament (MPFL) is thought to be the most important medial structure providing restraint to lateral subluxation of the patella. After an initial patellar dislocation, the MPFL is frequently injured and can usually be treated with conservative measures. However, these patients often suffer from recurrent dislocations, which thereby necessitate operative intervention. In the setting of normal anatomy and kinematics, isolated reconstruction of the MPFL is an effective treatment for preventing recurrent dislocations. Various surgical techniques have been describe...
Source: Journal of Knee Surgery - July 18, 2017 Category: Orthopaedics Authors: Mistry, Jaydev B. Bonner, Kevin F. Gwam, Chukwuweike U. Thomas, Melbin Etcheson, Jennifer I. Delanois, Ronald E. Tags: Original Article Source Type: research

Radiographic and Functional Outcomes following Knee Arthrodesis Using the Wichita Fusion Nail
J Knee Surg DOI: 10.1055/s-0037-1604148The purpose of this study was to report both the radiographic and functional outcomes of patients undergoing knee arthrodesis with the Wichita Fusion Nail (WFN) within the Republic of Ireland and compare the results to existing literature. Patient charts and radiographs were reviewed on all patients who had a WFN implanted in Ireland to date. Patients were invited to complete a Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score as a functional assessment. Twenty-three patients were identified. Patients had an average of 8 (range: 0–26) knee surgeries pr...
Source: Journal of Knee Surgery - July 18, 2017 Category: Orthopaedics Authors: McQuail, Paula McCartney, Ben Baker, Joseph Green, James Keogh, Peter Kenny, Patrick Tags: Original Article Source Type: research

Treatment with Circular External Fixation of Bicondylar Tibial Fractures: Potential in Accurate Reduction and Efficacy on Functional Results
J Knee Surg DOI: 10.1055/s-0037-1604139Surgical reconstruction of bicondylar tibial fractures with external fixation relies on indirect fracture reduction that could affect anatomical restoration. The aim of the present study is to evaluate the radiographic and clinical outcomes of tibial bicondylar fractures treated with circular external fixation. A total of 20 bicondylar fractures of the proximal tibia in 20 patients treated with circular external fixation were included in the study. Two fractures were open. Mean clinical and radiographic follow-up was 37.3 months after frame removal. Angular, translation, and length de...
Source: Journal of Knee Surgery - July 18, 2017 Category: Orthopaedics Authors: Lovisetti, Giovanni Vulcano, Ettore Bettella, Lorenzo Tasarib, Rohoman Tondolo, Tania Sala, Francesco Tags: Original Article Source Type: research

Factors Contributing to Patient Satisfaction and Expectations following Computer-Assisted Total Knee Arthroplasty
In conclusion, midflexion instability was associated with worse expectations. [...] 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 - July 18, 2017 Category: Orthopaedics Authors: Hasegawa, Masahiro Naito, Yohei Yamaguchi, Toshio Wakabayashi, Hiroki Sudo, Akihiro Tags: Original Article Source Type: research

Pain Control in Total Knee Arthroplasty
J Knee Surg DOI: 10.1055/s-0037-1604152As surgical techniques and pharmacology advance, the management of postoperative pain in patients undergoing total knee arthroplasty (TKA) continues to evolve. The current standards of care are composed of multimodal pain management including opioids, nonsteroidal anti-inflammatory drugs and gabapentinoids, peripheral nerve blocks, and periarticular injections. Newer modalities are composed of delayed release local anesthetics and cryoneurolysis. To summarize the current evidence-based treatment modalities and forecast changes in the management of patients having TKAs, we reviewed ava...
Source: Journal of Knee Surgery - July 18, 2017 Category: Orthopaedics Authors: Elmallah, Randa K. Chughtai, Morad Khlopas, Anton Newman, Jared M. Stearns, Kim L. Roche, Martin Kelly, Michael A. Harwin, Steven F. Mont, Michael A. Tags: Original Article Source Type: research

Surgical Repair of Neglected Bucket-Handle Meniscal Tears Displaced into the Intercondylar Notch: Clinical and Radiological Results
This study showed that good results could be achieved with the repair of neglected, chronic period bucket-handle meniscal tears flipping to the intercondylar notch, whether with an accompanying ACL tear or not. [...] 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 - July 18, 2017 Category: Orthopaedics Authors: Cetinkaya, Engin Gursu, Sarper Gul, Murat Aykut, Umit Selcuk Ozcafer, Rasit Tags: Original Article Source Type: research

Biomechanics and Microstructural Analysis of the Mouse Knee and Ligaments
J Knee Surg DOI: 10.1055/s-0037-1604151The purpose of this study is to determine the feasibility of using murine models for translational study of knee ligament injury, repair, and reconstruction. To achieve this aim, we provide objective, quantitative data detailing the gross anatomy, biomechanical characteristics, and microscopic structure of knee ligaments of 44 male mice (C57BL6, 12 weeks of age). Biomechanical testing determined the load-to-failure force, stiffness, and the site of ligament failure for the anterior cruciate ligament (ACL), posterior cruciate ligament (PCL), and the medial and lateral collateral ligame...
Source: Journal of Knee Surgery - July 18, 2017 Category: Orthopaedics Authors: Carballo, Camila B. Hutchinson, Ian D. Album, Zoe M. Mosca, Michael J. Hall, Arielle Rodeo, Scott Ying, Liang Deng, Xiang-Hua Rodeo, Scott A. Tags: Original Article Source Type: research

Terminal Condylar Facets of the Femur: Implications for Knee Arthroplasty
This study focused on a holistic description of terminal condylar articular facet (TCAF; part of the femoral articular area in contact with the tibia in high flexion) of medial and lateral condyles and their quantification. In total, 104 dry femora and 16 dissected cadaveric knee joints (10 adult and 6 fetal) were studied. In most cases, the medial TCAF showed a tongue- or wedge-shaped extension in its lateral half, which has been referred to as extended condylar facet (ECF). The surface area of the ECF was approximately 0.5 cm2. In adult cadaveric dissections, the fibrous capsule showed the lax attachment beyond the ECF, ...
Source: Journal of Knee Surgery - July 18, 2017 Category: Orthopaedics Authors: Athavale, Sunita Kotgirwar, Sheetal Deopujari, Rashmi Sinha, Urmila Trivedi, Soumitra Lalwani, Rekha Tags: Original Article Source Type: research

How Do Axial Scan Orientation Deviations Affect the Measurements of Knee Anatomical Parameters Associated with Patellofemoral Instability? A Simulated Computed Tomography Study
J Knee Surg DOI: 10.1055/s-0037-1604141The purpose of this study was to detect the correlation between axial scan orientation discrepancy and the knee anatomical parameters associated with patellofemoral instability during computed tomography (CT) scanning. CT scan data of 16 knees from 16 healthy subjects were retrieved. The reslicing processes were performed to simulate different axial scan orientations generated due to leg adduction/abduction during CT scanning. Eight parameters (tibial tubercle to trochlear groove [TT-TG], tibial tubercle to posterior cruciate ligament [TT-PCL], patellar tilt, lateral trochlear inclina...
Source: Journal of Knee Surgery - July 12, 2017 Category: Orthopaedics Authors: Xiong, Ran Chen, Cheng Yin, Li Gong, Xiaoyuan Luo, Jiangming Wang, Fuyou Yang, Liu Guo, Lin Tags: Original Article Source Type: research

Modified Intervastus Approach to the Knee
This article presents the first description of this approach. The advantages of this approach include its extensile nature, similar to a medial parapatellar approach, and preservation of the extensor mechanism and the vastus medialis, leading to a more rapid return to active knee extension than is traditionally observed. The approach is also simple to perform, easy to close, and is compatible with more extensile approaches such as a quadriceps snip if required in revision scenarios. [...] Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of contents  | &...
Source: Journal of Knee Surgery - July 12, 2017 Category: Orthopaedics Authors: Sartawi, Muthana Kohlman, James Valle, Craig Della Tags: Original Article Source Type: research

Asymmetric Tibial Component Improved the Coverage and Rotation of the Tibial Component in a Medial Pivot Total Knee Prosthesis
J Knee Surg DOI: 10.1055/s-0037-1604143Malrotation of tibial components is one of the important causes of failure in total knee arthroplasty. The aim of this study is to determine the relationship between tibial rotational positioning and coverage of the tibial surface during the operation, using a symmetric and a newly introduced asymmetric medial pivot tibial components. The coverage and overhang were compared between a symmetric component (Advance medial pivot) and a newly introduced asymmetric medial pivot tibial component (Evolution medial pivot) in 31 knees during the operation. When the tibial component was placed p...
Source: Journal of Knee Surgery - July 12, 2017 Category: Orthopaedics Authors: Minoda, Yukihide Ikebuchi, Mitsuhiko Mizokawa, Shigekazu Ohta, Yoichi Nakamura, Hiroaki Tags: Original Article Source Type: research

Variance in Anterior Cruciate Ligament Reconstruction Graft Selection based on Patient Demographics and Location within the Multicenter Orthopaedic Outcomes Network Cohort
J Knee Surg DOI: 10.1055/s-0037-1604147The purpose of this study is to determine whether any regional or age-related patterns exist in graft choice for patients undergoing primary anterior cruciate ligament reconstruction (ACLR) within a large multicenter consortium. A retrospective cohort study was performed using data collected from the Multicenter Orthopaedic Outcomes Network (MOON) on patients having undergone primary ACLR. Patients were stratified by age group (younger than 20, 20–29, 30–39, 40–49, and 50+ years) and four demographic regions (Midwest, Southeast, Northeast, and West). A total of 2,149...
Source: Journal of Knee Surgery - July 12, 2017 Category: Orthopaedics Authors: Houck, Darby A. Kraeutler, Matthew J. Vidal, Armando F. McCarty, Eric C. Bravman, Jonathan T. Wolcott, Michelle L. Tags: Original Article Source Type: research

How Accurate is Intraoperative Alignment Measurement with a Navigation System in Primary Total Knee Arthroplasty?
J Knee Surg DOI: 10.1055/s-0037-1604149The primary objective was to compare the intraoperative data assessed by OrthoPilot (Aesculap AG, Tuttlingen, Germany) with postoperative coronal and sagittal long-leg standing radiographs. The secondary objective was to evaluate the influence of sex and body mass index (BMI) on the accuracy and effectiveness of the implantation of the knee prosthesis by OrthoPilot. We included 75 patients in our investigation. Participants received an e.motion (Aesculap AG) knee prosthesis using the OrthoPilot navigation system. Postoperative long-leg standing anteroposterior and lateral radiographs ...
Source: Journal of Knee Surgery - July 12, 2017 Category: Orthopaedics Authors: Feichtinger, Xaver Kolbitsch, Paul Kocijan, Roland Baierl, Andreas Giurea, Alexander Tags: Original Article Source Type: research

Does Patient Perception of Pain Influence How Patients Rate Their Experience after Total Knee Arthroplasty?
J Knee Surg DOI: 10.1055/s-0037-1603794Press Ganey (PG) is an increasingly used measure to determine patient satisfaction. It has yet to be determined which factors influence the PG scores most amongst patients with inadequate pain control after total knee arthroplasty (TKA). Therefore, we assessed (1) which PG factors influence overall hospital rating (OHR) in patients who had poor pain control in comparison to those with good pain control and (2) whether pain control influences OHR during hospital admission following TKA. An institutional database search was performed between November 2009 and January 2015 for all TKA pa...
Source: Journal of Knee Surgery - June 30, 2017 Category: Orthopaedics Authors: Gwam, Chukwuweike U. Mistry, Jaydev B. Delanois, Ronald E. Chughtai, Morad Khlopas, Anton Ramkumar, Prem N. Piuzzi, Nicolas S. Harwin, Steven F. Mont, Michael A. Tags: Special Focus Section Source Type: research

Outcomes of Posterior-Stabilized Compared with Cruciate-Retaining Total Knee Arthroplasty
J Knee Surg DOI: 10.1055/s-0037-1603902The aim of this systematic review is to compare clinical outcome scores, rate of complications, and range of motion (ROM) of posterior-stabilized (PS) and cruciate-retaining (CR) total knee arthroplasties (TKAs) both pre- and postoperatively to establish which of the two kinds of implants have the best efficiency. A comprehensive search was performed of studies comparing CR and PS TKAs on PubMed, OVID/Medline, Cochrane, CINAHL, Google scholar, and Embase databases. Finally, 37 studies were selected with a total of 5,407 knees in 4,445 patients. For the PS knees, the Knee Society funct...
Source: Journal of Knee Surgery - June 30, 2017 Category: Orthopaedics Authors: Longo, Umile Giuseppe Ciuffreda, Mauro Mannering, Nicholas D'Andrea, Valerio Locher, Joel Salvatore, Giuseppe Denaro, Vincenzo Tags: Original Article Source Type: research

Biomechanics of Knee Joints after Anterior Cruciate Ligament Reconstruction
In conclusion, computer-aided ACL reconstruction has advantages over conventional surgery approach in restoring the biomechanical properties of knee joints, thus reducing the risk of damage to the knee joint cartilage and meniscus after ACL reconstruction. [...] 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 30, 2017 Category: Orthopaedics Authors: He, Chuan He, Wu Li, Yanlin Wang, Fuke Tong, Lu Zhang, Zhengguang Jia, Di Wang, Guoliang Zheng, Jiali Chen, Guangchao Tags: Original Article Source Type: research

High Tibial Osteotomy following Biologic Replacement of the Knee
J Knee Surg DOI: 10.1055/s-0037-1603792Biologic unicondylar replacement with fresh osteoarticular allografts of the femoral condyle and tibial plateau plus a meniscus transplant provides an option for young or active patients with severe articular cartilage loss. The timing of osteotomy procedures to correct malalignment either before, concurrent, or after allograft implantation has become an area of research interest. Concurrent osteotomies and allograft transplantation have become increasingly popular due to the decreased patient morbidity from multiple surgeries that require a period of toe-touch weight bearing (TTWB) p...
Source: Journal of Knee Surgery - June 28, 2017 Category: Orthopaedics Authors: Stannard, James T. Stannard, James P. Tags: Special Focus Section Source Type: research

Early Outpatient Physical Therapy May Improve Range-of-Motion in Primary Total Knee Arthroplasty
J Knee Surg DOI: 10.1055/s-0037-1603793Knee stiffness is a relatively common complication following a primary total knee arthroplasty (TKA). Following this procedure, rehabilitation is essential to maintain, improve, and prevent the loss of knee range-of-motion (ROM). Currently, there is a paucity of studies describing whether the timing of physical therapy (PT) post-TKA plays a role in ROM outcomes. Therefore, the purpose of this study was to compare (1) flexion and (2) extension ROM at final follow-up of TKA patients who either began outpatient physical therapy (OPT) within 6 weeks or after 6 weeks of their TKA. Surgical...
Source: Journal of Knee Surgery - June 24, 2017 Category: Orthopaedics Authors: McGinn, Tanner Chughtai, Morad Khlopas, Anton Grasmick, Paige Mullaji, Arun B. Harwin, Steven F. Bhave, Anil Mont, Michael A. Tags: Special Focus Section Source Type: research

Bone Marrow Aspirate Concentrate versus Platelet Rich Plasma to Enhance Osseous Integration Potential for Osteochondral Allografts
This study sought to determine and compare the potential of bone marrow aspirate concentrate (BMC) and leukoreduced platelet rich plasma (PRP) to repopulate the osseous portion of an OCA with cells and deliver osteogenic proteins. It was hypothesized that BMC would have significantly higher colony forming units (CFUs)/mL and seed the osseous portion of OCA with more cells than PRP. Finally, we hypothesized that the media of BMC and PRP treated OCAs would have significantly higher concentrations of osteogenic proteins compared with negative control OCAs. Cylindrical OCAs (n = 36) created from tissue stored for...
Source: Journal of Knee Surgery - June 24, 2017 Category: Orthopaedics Authors: Stoker, Aaron M. Baumann, Charles A. Stannard, James P. Cook, James L. Tags: Original Article Source Type: research

Does the Surgical Correction of Tibial Torsion with Genu Varum Produce Outcomes Similar to Those in Varus Correction Alone?
In this study, 69 patients (138 limbs) underwent bilateral proximal tibial osteotomy for the correction of genu varum. Patients with simple coronal plane deformity (varus alone) were treated with either a monolateral external fixator or a hexapod frame. Those with concomitant external tibial torsion were treated with circular external fixation. The primary outcome was the ability to achieve the desired correction of alignment in the coronal, sagittal, and axial planes. Secondary outcomes included a postoperative Knee Injury and Osteoarthritis Outcome Score (KOOS) and a routine patient satisfaction questionnaire. The incide...
Source: Journal of Knee Surgery - June 24, 2017 Category: Orthopaedics Authors: Fragomen, Austin T. Meade, Matthew Borst, Eugene Nguyen, Joseph Rozbruch, S. Robert Tags: Original Article Source Type: research

Platelet-Rich Plasma for the Treatment of Knee Osteoarthritis: A Review
J Knee Surg DOI: 10.1055/s-0037-1603795Platelet-rich plasma (PRP) consists of a volume of plasma with a platelet concentration above whole blood baseline values. Based on the group of bioactive molecules that platelets release when activated and the regenerative and healing potential they have, the use of PRP has followed a rapid development and application in orthopedics, with applications that frequently outpaces the basic science and clinical evidence supporting its use. Currently, significant heterogeneity and discrepancies exist between the different types of available PRP formulations. Because of this, although there...
Source: Journal of Knee Surgery - June 23, 2017 Category: Orthopaedics Authors: Piuzzi, Nicolas S. Chughtai, Morad Khlopas, Anton Harwin, Steven F. Miniaci, Anthony Mont, Michael A. Muschler, George F. Tags: Special Focus Section Source Type: research

Osteochondral Autologous Transplantation Compared to Microfracture for Treating Osteochondral Defect: An Updated Meta-analysis of Randomized Controlled Trials
J Knee Surg DOI: 10.1055/s-0037-1603798Various techniques have proven to be effective for treating articular cartilage defect of the knee joint, but knowledge regarding which method is best still remains uncertain. Osteochondral autologous transplantation (OAT) provides hyaline or hyaline-like repair for articular defects, whereas microfracture (MF) provides fibrocartilage repair tissue. To compare the OAT with MF procedure for the treatment of articular cartilage defect, we present an update of previous meta-analysis of randomized controlled trials.We searched for the published results of relevant trials. Then, we pooled ...
Source: Journal of Knee Surgery - June 23, 2017 Category: Orthopaedics Authors: Haien, Zhao Jiachang, Wu Qiang, Li Yufeng, Mei Zhenwei, Ji Tags: Original Article Source Type: research

Sustained Release of Transforming Growth Factor- β1 from Platelet-Rich Chondroitin Sulfate Glycosaminoglycan Gels
The objective of this study was to compare the release of transforming growth factor (TGF)-β1 from PRF and from PRP combined with a novel chondroitin sulfate glycosaminoglycan (CS-GAG) gel. PRP was prepared from nine healthy dogs and split into two aliquots: one activated with bovine thrombin and calcium chloride (CaCl2) to form PRF and the other aliquot was used to rehydrate a lyophilized CS-GAG gel. Both PRF and the CS-GAG gels were incubated in media for 13 days and media were collected, stored, and replaced every 48 hours and the concentration of TGF-β1 quantified in the media using an enzyme-linked immunosor...
Source: Journal of Knee Surgery - June 23, 2017 Category: Orthopaedics Authors: Birdwhistell, Kate E. Karumbaiah, Lohitash Franklin, Samuel P. Tags: Original Article Source Type: research

Osteotomies around the Knee —Part I
J Knee Surg 2017; 30: 385-385 DOI: 10.1055/s-0037-1603754 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 23, 2017 Category: Orthopaedics Authors: Kfuri, Mauricio Lobenhoffer, Philipp Tags: Special Focus Section Source Type: research

Use of Shorter Intramedullary Guide for Ipsilateral Total Knee Arthroplasty following prior Total Hip Arthroplasty
J Knee Surg DOI: 10.1055/s-0037-1603796Alignment after total knee arthroplasty (TKA) plays an important role with respect to patient satisfaction and implant survivorship. In patients undergoing ipsilateral TKA with prior total hip arthroplasty (THA), the femoral intramedullary (IM) guide cannot be fully inserted into the femoral canal because of the prior THA. The purpose of this study was to determine the effect of femoral component alignment using a shorter IM guide during TKA in patients with an ipsilateral THA. We identified 42 patients undergoing ipsilateral TKA with the use of a short IM guide in the setting of a pr...
Source: Journal of Knee Surgery - June 22, 2017 Category: Orthopaedics Authors: Webb, Bradley T. Ulrich, Slif D. MacKinlay, Kenneth G. W. Smith, Langan S. Malkani, Arthur L. Tags: Original Article Source Type: research

Erratum: Early Removal of Drainage Tube after Fast-Track Primary Total Knee Arthroplasty
J Knee Surg DOI: 10.1055/s-0037-1599280 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 20, 2017 Category: Orthopaedics Authors: Zhang, Shaoyun Xu, Bin Huang, Qiang Yao, Huan Xie, Jinwei Pei, Fuxing Tags: Erratum Source Type: research

Erratum: The Prevalence of Cruciate Ligament and Meniscus Knee Injury in Young Adults and Associations with Gender, Body Mass Index, and Height a Large Cross-Sectional Study
J Knee Surg DOI: 10.1055/s-0037-1599281 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 20, 2017 Category: Orthopaedics Authors: Thein, Ran Hershkovich, Oded Gordon, Barak Burstein, Gideon Tenenbaum, Shay Derazne, Estela Tzur, Dorit Shamis, Ari Afek, Arnon Kreiss, Yitshak Tags: Erratum Source Type: research

Anteromedializing Tibial Tubercle Osteotomy for Patellofemoral Instability: Occupational and Functional Outcomes in U.S. Military Service Members
This study is a level IV therapeutic case series. [...] 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 15, 2017 Category: Orthopaedics Authors: Belmont, Philip J. Fisher, Tuesday F. Bader, Julia M. Lanzi, Joseph T. Owens, Brett D. Waterman, Brian R. Tags: Original Article Source Type: research

Concept of Combined Femoral and Tibial Osteotomies
J Knee Surg DOI: 10.1055/s-0037-1603640Medial knee osteoarthritis is not uncommon, and high tibial osteotomy (HTO) for some surgeons is a unique treatment option for young and active patients. However, the deformity is not always located at the level of proximal part of the tibia and the overcorrection needed to achieve a lasting functional result can lead to an oblique joint line. To avoid this undesirable effect to the joint line, a double-level osteotomy (DLO), one at the distal part of the femur and another one at the proximal part of the tibia, is a viable option. The aim of this article is to present the preoperative...
Source: Journal of Knee Surgery - June 14, 2017 Category: Orthopaedics Authors: Saragaglia, Dominique Sigwalt, Loic Rubens-Duval, Brice Chedal-Bornu, Billy Pailhe, Regis Tags: Special Focus Section Source Type: research

Lower Limb Deformity Analysis and the Planning of an Osteotomy
J Knee Surg DOI: 10.1055/s-0037-1603503This review article provides an overview of lower limb deformity analysis. A brief history and radiographic standards are presented. Deformity analysis is considered in the frontal, sagittal, and axial planes, from simple to more complex cases. The authors recommended analysis methods based on their own experience of deformity correction, while acknowledging that there may be different ways to treat individual cases. Subsequently, methods for osteotomy planning to address the identified deformities are discussed. [...] Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, ...
Source: Journal of Knee Surgery - June 9, 2017 Category: Orthopaedics Authors: Schr öter, Steffen Elson, David William Ateschrang, Atesch Ihle, Christoph St öckle, Ulrich Dickschas, J örg Harrer, J örg Tags: Special Focus Section Source Type: research

Reliability of Roentgenographic Knee Alignment Measurements in Gonarthrosis
J Knee Surg DOI: 10.1055/s-0037-1603638A reliable method of measuring knee alignment is critical in the preoperative planning of high tibial osteotomy (HTO). This radiological study, based on the measurements of the mechanical and anatomical axes of the lower limb, aimed to determine which method would be more reliable and reproducible. From 2004 to 2013, 50 consecutive patients (50 knees) with medial gonarthrosis were treated with valgus-producing HTO. Four independent investigators assessed preoperative standing lower limb radiography (including hip, knee, and ankle joints) to measure both anatomical and mechanical axes....
Source: Journal of Knee Surgery - June 9, 2017 Category: Orthopaedics Authors: Huang, Teng-Le Wang, Chen-Chie Yang, Kai-Chiang Wu, Chang-Chin Tags: Original Article Source Type: research

The Rationale of Osteotomy around the Knee
J Knee Surg DOI: 10.1055/s-0037-1603755Frontal plane varus or valgus deformity causes overload in the ipsilateral compartment and may induce and accelerate cartilage damage. Osteotomy around the knee should be considered in symptomatic constitutional and posttraumatic metaphyseal deformities of more than 3-degree deviation. Age, grade of osteoarthritis, obesity, and nicotine consumption are no exclusion criteria for osteotomy. For correction of varus deformity, biplanar open wedge osteotomy of the tibia with fixation by a plate fixator has proven to be a safe and stable construct allowing for early weight-bearing. Valgus d...
Source: Journal of Knee Surgery - June 7, 2017 Category: Orthopaedics Authors: Lobenhoffer, Philipp Tags: Special Focus Section Source Type: research

High Tibial Osteotomy for the Correction of Varus Knee Deformity
This article aims to cover the indications and contraindications of HTO with a focus on the unique aspects of the biplanar open wedge tibial osteotomy. [...] 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 7, 2017 Category: Orthopaedics Authors: Kfuri, Mauricio Lobenhoffer, Philipp Tags: Special Focus Section Source Type: research

Unusually High Rate of Early Failure of Tibial Component in ATTUNE Total Knee Arthroplasty System at Implant –Cement Interface
J Knee Surg DOI: 10.1055/s-0037-1603756A novel design total knee arthroplasty (TKA) system has been introduced to improve patient outcomes and increase longevity. However, we have encountered a high rate of debonding of tibial implant–cement interface. In addition, multiple reports have been filed in Manufacturer and User Facility Device Experience database (MAUDE) with the same mechanism of failure. Therefore, we evaluated: clinical, radiographic, and intraoperative findings of patients who received this system and required a revision surgery, and findings from MAUDE database compiled to this date. We reviewed three...
Source: Journal of Knee Surgery - June 7, 2017 Category: Orthopaedics Authors: Bonutti, Petter M. Khlopas, Anton Chughtai, Morad Cole, Connor Gwam, Chukwuweike U. Harwin, Steven F. Whited, Brent Omiyi, Didi E. Drumm, Joshua E. Tags: Original Article Source Type: research

Erratum: Highly Variable Femoral Morphology in Osteoarthritic Chinese: Are Prostheses Today Sufficiently Suitable?
J Knee Surg DOI: 10.1055/s-0037-1603779 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 7, 2017 Category: Orthopaedics Authors: Zhang, Yunjie Wang, Xiaofeng Wu, Zongming Xia, Qing Shao, Yunchao Tags: Erratum Source Type: research

Sagittal Plane Corrections around the Knee
J Knee Surg DOI: 10.1055/s-0037-1603637Stability of the knee joint depends on soft tissues integrity and bony balance in the frontal and sagittal planes during gait. Although frontal plane imbalance is a well-known knee pathology, commonly treated by high tibial osteotomy, sagittal plane imbalance is less common, with fewer and more challenging surgical treatment options. The purpose of this review is to describe the biomechanical effects of sagittal knee imbalances and to outline the indications, techniques, and outcomes of sagittal knee osteotomies. The article details the reference axes and methods to measure posterior ...
Source: Journal of Knee Surgery - June 5, 2017 Category: Orthopaedics Authors: Dejour, David Barbera, Giuseppe La Pasqualotto, Stefano Valoroso, Marco Nover, Luca Reynolds, Ryan Saffarini, Mo Tags: Special Focus Section Source Type: research

Tibial Onlay Posterior Cruciate Ligament Reconstruction: Surgical Technique and Results
J Knee Surg DOI: 10.1055/s-0037-1603336The posterior cruciate ligament (PCL) is a fundamental structure in knee kinematics. PCL tears may lead to adverse consequences, such as impaired functional performance and an increased risk of osteoarthritis. Although surgical treatment is a well-established option for the patients of PCL rupture, many surgeons opt for conservative treatment because of the lack of consensus in the orthopedic literature concerning the best surgical method with less risk of iatrogenic lesions to the neurovascular structures in the popliteal region. Here, we describe an onlay technique for PCL reconstru...
Source: Journal of Knee Surgery - June 5, 2017 Category: Orthopaedics Authors: Salim, Rodrigo Nascimento, Felipe Marques do Ferreira, Aline Miranda Oliveira, Luciano Fonseca Lemos de Fogagnolo, Fabricio Kfuri, Mauricio Tags: Original Article Source Type: research

Correction of Tibial Valgus Deformity
J Knee Surg DOI: 10.1055/s-0037-1603504Valgus tibial malalignment may be the result of bony deformity, previous lateral meniscectomy, or lateral plateau fractures. The correction of such a problem is usually addressed through a tibial osteotomy, which affects the alignment both in flexion and extension. Two surgical options are available: medial closing wedge and lateral opening wedge. When planning a varisation osteotomy, it should be considered that the normal joint line is in 3 degrees of varus. Increasing this obliquity beyond 10 to 15 degrees ends up with increased loads on the patellofemoral joint and medial subluxat...
Source: Journal of Knee Surgery - June 2, 2017 Category: Orthopaedics Authors: Cerciello, Simone Lustig, Sebastien Servien, Elvire Batailler, Cecile Neyret, Philippe Tags: Special Focus Section Source Type: research

Implant Alternatives for Tibial Osteotomies
This article will serve to review the technological evolution of tibial osteotomy fixation devices, highlighting the comparative biomechanical evidence of available constructs. [...] 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 1, 2017 Category: Orthopaedics Authors: Degen, Ryan M. Getgood, Alan Tags: Special Focus Section Source Type: research

Does Age Influence How Patients Rate Their Experience of Care after Total Knee Arthroplasty?
J Knee Surg DOI: 10.1055/s-0037-1603339The Centers for Medicare and Medicaid Services (CMS) have recently modified models for physician compensation with the use of patient administered surveys, such as the Press Ganey (PG). Currently, it is not well understood how the age of total knee arthroplasty (TKA) patients influences PG scores and hospital ratings. Therefore, we asked: (1) is there a difference in how patients rate PG survey elements between patients  80 years of age and (2) what factors influence PG overall hospital rating in the various age groups? The PG database from our institution was queried fr...
Source: Journal of Knee Surgery - May 23, 2017 Category: Orthopaedics Authors: Gwam, Chukwuweike U. Mistry, Jaydev B. Mohamed, Nequesha Chughtai, Morad Thomas, Melbin Mont, Michael A. Delanois, Ronald E. Tags: Special Focus Section Source Type: research