High Varus Angle and Lower Posterior Tibial Slope Associated with PCL Injury in Cruciate Retaining Total Knee Arthroplasty: An MRI Study
In this study, the amount of PCL fibers sacrificed under simulated tibial cuts with varying posterior inclinations was evaluated using magnetic resonance images (MRIs) of osteoarthritic varus knees. Knee X-rays, orthoroentgenograms, and MRIs of 113 Kellgren and Lawrence grades 3 to 4 osteoarthritic knees were included. Four different simulated tibial cuts were performed at 0, 3, 5 degrees and parallel to the tibia plateau 3 mm below of the most defective part of the cartilage in the medial plateau. Correlations between the PCL avulsion amount and the PTS and varus alignment of the lower extremity were analyzed for a...
Source: Journal of Knee Surgery - May 23, 2017 Category: Orthopaedics Authors: Çabuk, Haluk İmren, Yunus Tekin, Ali Çağrı Dedeo ğlu, Süleyman Semih G ürbüz, Hakan Tags: Original Article Source Type: research

Revision Total Knee Arthroplasty Using a Constrained Condylar Knee Prosthesis Combined with a Posterior Stabilized Articular Surface
In conclusion, revision TKA using a CCK prosthesis combined with a PS articular surface might provide satisfactory mid-term outcomes. Delayed infection was the most common cause of implant failure. Dislocation might occur in middle-old or older patients despite careful intraoperative examination of valgus–varus stability, extension–flexion gap balancing, and signs of recurvatum. [...] 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 - May 23, 2017 Category: Orthopaedics Authors: Tsai, Shang-Wen Chen, Cheng-Fong Wu, Po-Kuei Chen, Chao-Ming Chen, Wei-Ming Tags: Original Article Source Type: research

Hematologic Malignancies Are Associated with Adverse Perioperative Outcomes Following Total Knee Arthroplasty
This study used the Nationwide Inpatient Sample (NIS) to identify patients who underwent TKA in the United States from 2000 to 2011. Patients diagnosed with any hematologic malignancy (N = 24,714) were then stratified by Hodgkin's disease (N = 791), Non-Hodgkin's lymphoma (N = 7,096), plasma cell dyscrasias (N = 1,621), leukemia (N = 8,005), myeloproliferative disease (N = 5,746), and/or myelodysplastic syndromes (N = 1,608) for determining the complications that occurred during admission. Propensity matching was performed for...
Source: Journal of Knee Surgery - May 23, 2017 Category: Orthopaedics Authors: Newman, Jared M. Wagner, Timothy C. Naziri, Qais North, W. Trevor Navale, Suparna M. Klika, Alison K. Barsoum, Wael K. Higuera, Carlos A. Tags: Original Article Source Type: research

Different Kinematics of Knees with Varus and Valgus Deformities
This study revealed significant differences in tibiofemoral kinematics between osteoarthritic knees with a varus or valgus deformity before and after TKA. Valgus deformities showed a paradoxic movement pattern. These in vivo intraoperative results need to be confirmed using fluoroscopic or radiographic three-dimensional matching before and after TKA. [...] Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of contents  |  Abstract  |  Full text (Source: Journal of Knee Surgery)
Source: Journal of Knee Surgery - May 23, 2017 Category: Orthopaedics Authors: Baier, C. Benditz, A. Koeck, F. Keshmiri, A. Grifka, J. Maderbacher, G. Tags: Original Article Source Type: research

Does Gender Influence How Patients Rate Their Patient Experience after Total Knee Arthroplasty?
J Knee Surg DOI: 10.1055/s-0037-1603338The Centers for Medicare and Medicaid Services has implemented the Value-Based Purchasing (VBP) score as a pay-for-performance reimbursement model. Patient experience, as measured by the Press Ganey (PG) survey, currently comprises 20% of total VBP score. It is therefore beneficial for the orthopaedist to become familiar with these changes to maximize profits. Currently, a paucity of data exists that elucidates which factors influence PG scores between men and women following total knee arthroplasty (TKA). Therefore, we asked: (1) which PG survey factors most influences hospital ratin...
Source: Journal of Knee Surgery - May 15, 2017 Category: Orthopaedics Authors: Siqueira, Marcelo B. P. Chughtai, Morad Khlopas, Anton Gwam, Chukwuweike U. Mistry, Jaydev B. Yakubek, George A. Delanois, Ronald E. Mont, Michael A. Tags: Special Focus Section Source Type: research

Tranexamic Acid Effectively Reduces Blood Loss and Transfusion Rates during Simultaneous Bilateral Total Knee Arthroplasty
J Knee Surg DOI: 10.1055/s-0037-1603333Tranexamic acid (TXA) can reduce blood loss and decrease transfusion rates after total knee arthroplasty (TKA). The purpose of our study was to evaluate the efficacy of TXA in a homogenous, consecutive cohort of patients undergoing simultaneous bilateral primary TKA. This was a retrospective study of 50 consecutive patients who underwent bilateral simultaneous primary TKA between 2011 and 2015. Of these, 20 patients received TXA and 30 patients did not receive TXA and served as the control group. Primary outcome measurements were intraoperative estimated blood loss, hemoglobin (Hb) an...
Source: Journal of Knee Surgery - May 15, 2017 Category: Orthopaedics Authors: Prieto, Hernan A. Vincent, Heather K. Deen, Justin T. Iams, Dane A. Parvataneni, Hari K. Tags: Original Article Source Type: research

Correction of Femoral Valgus Deformity
This article provides an overview of the basic principles behind the correction of femoral valgus deformity. Both the analysis and planning of femoral valgus deformity correction as well as the results of systematic clinical reviews are provided. The current recommended surgical technique of biplanar medial closing-wedge supracondylar osteotomy is explained, and the first clinical results are reported. Finally, the authors describe some of the future directions and needs for treatment optimization of patients with femoral valgus deformity. [...] Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article ...
Source: Journal of Knee Surgery - May 5, 2017 Category: Orthopaedics Authors: van Heerwaarden, Ronald Brinkman, Justus-Martijn Pronk, Yvette Tags: Special Focus Section Source Type: research

Patient-Reported Outcomes following Single- and Multiple-Radius Total Knee Replacement: A Randomized, Controlled Trial
J Knee Surg DOI: 10.1055/s-0037-1602132Although single-radius (SR) designs of total knee replacement (TKR) have theoretical benefits, the clinical advantage conferred by such designs is unknown. The aim of this randomized, controlled study was to compare the short-term clinical outcomes of the two design rationales. A total of 105 knees were randomized to receive either a single radius (Scorpio, Stryker; SR Group) or multiple radius (AGC, Zimmer Biomet; MR group) TKR. Patient-reported outcomes (Oxford Knee Score [OKS] and Knee Society Score [KSS]) were collected at 6 weeks, 6 months, and 1 year following surgery. No knees ...
Source: Journal of Knee Surgery - May 5, 2017 Category: Orthopaedics Authors: Mushtaq, Nadeem Liddle, Alexander D. Isaac, David Dillow, Katherine Gill, Paul Tags: Original Article Source Type: research

Does Addition of Adductor Canal Blockade to Multimodal Periarticular Analgesia Improve Discharge Status, Pain Levels, Opioid Use, and Length of Stay after Total Knee Arthroplasty?
J Knee Surg DOI: 10.1055/s-0037-1602131Total knee arthroplasty (TKA) can be associated with substantial postoperative pain that may affect satisfaction and return to function. Various forms of pain control have been used; however, multimodal periarticular analgesia (MPA) and adductor canal block (ACB) have recently gained popularity. The purpose of this study was to compare (1) discharge status, (2) pain levels, (3) postoperative opioid consumption, and (4) length of stay (LOS) between TKA patients who received MPA only and those who received both MPA and ACB. A single surgeon database was reviewed for TKA patients who rec...
Source: Journal of Knee Surgery - May 2, 2017 Category: Orthopaedics Authors: Gwam, Chukwuweike U. Mistry, Jaydev B. Richards, Ifie V. Patel, Dhrudeep Patel, Nirav G. Thomas, Melbin Adamu, Hephzibah Delanois, Ronald E. Tags: Original Article Source Type: research

Augmentation Techniques for Meniscus Repair
This article reviews the current state of clinical management of meniscus tears (primary repair) as well as augmentation techniques to improve healing by meniscus wrapping with extracellular matrix materials, trephination, synovial rasping and abrasion, fibrin/blood clot placement, and platelet-rich plasma injections. In addition, the rationale for using polymer/autologous blood component implants to improve meniscus repair will be discussed. [...] Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of contents  |  Abstract  |  Ful...
Source: Journal of Knee Surgery - May 2, 2017 Category: Orthopaedics Authors: Ghazi zadeh, Leili Chevrier, Anik Farr, Jack Rodeo, Scott A. Buschmann, Michael D. Tags: Original Article Source Type: research

Comment on: “The ‘Hoop’ Plate for Posterior Bicondylar Shear Tibial Plateau Fractures: Description of a New Surgical Technique”
J Knee Surg DOI: 10.1055/s-0037-1602137 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 2, 2017 Category: Orthopaedics Authors: Soni, Ashwani Gupta, Ravi K. Tags: Letter to the Editor Source Type: research

Response to “Comment on: The ‘Hoop’ Plate for Posterior Bicondylar Shear Tibial Plateau Fractures: Description of a New Surgical Technique”
J Knee Surg DOI: 10.1055/s-0037-1602139 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 2, 2017 Category: Orthopaedics Authors: Giordano, Vincenzo Kfuri, Mauricio Tags: Letter to the Editor Source Type: research

Initial Assessment and Implications for Surgery: The Missed Diagnosis of Irreducible Knee Dislocation
J Knee Surg DOI: 10.1055/s-0037-1602135Irreducible knee dislocation is a rare but devastating orthopedic emergency. Limited discussion about its characteristics has been undertaken due to its low incidence. The purpose of this study was to present a series of irreducible dislocated knees and cumulatively reviewed all existing publications in this filed. A retrospective case series study was undertaken in patients with irreducible knee dislocation. Patients' data were carefully collected and presented. Historical cases of irreducible knee dislocation in published papers were reviewed, and their diagnosis, treatment, and pro...
Source: Journal of Knee Surgery - May 1, 2017 Category: Orthopaedics Authors: Xu, Bin Xu, Honggang Tu, Jun Guo, Ruipeng Tags: Original Article Source Type: research

Comparative Study for Alignment of Extramedullary Guides versus Portable, Accelerometer-Based Navigation in Total Knee Arthroplasty
In conclusion, the coronal and sagittal alignments for the femoral components was less accurate compared with tibial component alignment, especially in the PN group, and the sagittal alignment of the femoral component was less accurate than coronal alignment for both groups. Both the PN and EM systems provide satisfactory coronal and sagittal component alignments in TKA. Further technical improvement of the PN system could further improve its application for accurate component implantation in TKAs. [...] Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of contents&nbs...
Source: Journal of Knee Surgery - May 1, 2017 Category: Orthopaedics Authors: Matsumoto, Kazu Ogawa, Hiroyasu Fukuta, Masashi Mori, Nobuyuki Akiyama, Haruhiko Tags: Original Article Source Type: research

Tranexamic Acid Reduces Occult Blood Loss, Blood Transfusion, and Improves Recovery of Knee Function after Total Knee Arthroplasty: A Comparative Study
This study intends to explore the effects of tranexamic acid (TA) on occult blood loss, blood transfusion, and recovery of knee function in patients undergoing total knee arthroplasty (TKA). From October 2013 to April 2015, 224 patients undergoing TKA were enrolled in this study. These patients were randomly assigned into the control group (intravenous infusion of normal saline), 10 mg/kg TA group (intravenous infusion of 10 mg/kg TA) and 15 mg/kg TA group (intravenous infusion of 15 mg/kg TA). Compared with the control group, the 10 and 15 mg/kg TA groups were lower in postoperative blood loss, occult blood loss, blood tr...
Source: Journal of Knee Surgery - May 1, 2017 Category: Orthopaedics Authors: Liu, Wei Yang, Chunmei Huang, Xiujun Liu, Ruizhong Tags: Original Article Source Type: research

Does Kinematic Alignment Improve Short-Term Functional Outcomes after Total Knee Arthroplasty Compared with Mechanical Alignment? A Systematic Review and Meta-analysis
J Knee Surg DOI: 10.1055/s-0037-1602136This meta-analysis was conducted to study whether kinematically aligned total knee arthroplasty (TKA) improves short-term functional outcomes compared with mechanical alignment without changing the hip–knee–ankle angle. Prospective cohort studies were searched from electronic literature databases, including PubMed, Web of Science, Embase (Ovid interface), and Cochrane Library (Ovid interface). Total 1,159 records were identified. Six trials involving 561 patients were eligible for data extraction and meta-analysis. The included studies recorded outcomes in the follow-up ra...
Source: Journal of Knee Surgery - May 1, 2017 Category: Orthopaedics Authors: Li, Yanhong Wang, Shuanke Wang, Yuliang Yang, Mingxuan Tags: Original Article Source Type: research

Inter- and Intraobserver Reliabilities of Four Different Radiographic Grading Scales of Osteoarthritis of the Knee Joint
J Knee Surg DOI: 10.1055/s-0037-1602249The purpose of this study was to investigate the interobserver and intraobserver reliabilities of four different radiographic grading scale of osteoarthritis (OA) of the knee joint, namely, Kellgren–Lawrence (KL), Ahlback, Brandt, and OA Research Society International (OARSI). One consultant orthopaedic surgeon and one rheumatologist who were familiar with these OA grading scales participated in the study. Radiological assessments were performed in random order by each observer on two separate occasions, at least 2 weeks apart. K-statistics were used to establish a relative leve...
Source: Journal of Knee Surgery - May 1, 2017 Category: Orthopaedics Authors: K öse, Özkan Acar, Baver Çay, Hasan Fatih Yilmaz, Baris G üler, Ferhat Y üksel, Halil Yalçın Tags: Original Article Source Type: research

Effect of Transcutaneous Electric Nerve Stimulation on Pain after Total Knee Arthroplasty: A Blind Randomized Controlled Trial
This study found no effects of burst TENS compared with sham burst TENS on pain during hospitalization after TKA. [...] Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of contents  |  Abstract  |  Full text (Source: Journal of Knee Surgery)
Source: Journal of Knee Surgery - May 1, 2017 Category: Orthopaedics Authors: Beckw ée, David Bautmans, Ivan Lefeber, Nina Lievens, Pierre Scheerlinck, Thierry Vaes, Peter Tags: Original Article Source Type: research

Cementless Total Knee Arthroplasty in Patients Older Than 75 Years
J Knee Surg DOI: 10.1055/s-0037-1599253Some surgeons have been hesitant to use cementless fixation for total knee arthroplasty (TKA) in elderly patients due to concerns regarding successful bone biological fixation. Therefore, this study evaluated: (1) implant survivorship, (2) functional outcomes, (3) radiographic outcomes, and (4) complications in patients over 75 years of age who underwent cementless total knee arthroplasty. A total of 134 patients (142 TKAs) older than 75 years at a single institution between June 2008 and June 2014 were retrospectively reviewed. Their mean follow-up was 4 years (range: 2–8 years...
Source: Journal of Knee Surgery - April 11, 2017 Category: Orthopaedics Authors: Newman, Jared M. Khlopas, Anton Chughtai, Morad Gwam, Chukwuweike U. Mistry, Jaydev B. Yakubek, George A. Harwin, Steven F. Mont, Michael A. Tags: Original Article Source Type: research

Intra-articular Tranexamic Acid in Primary Total Knee Arthroplasty: Meta-analysis
J Knee Surg DOI: 10.1055/s-0037-1600092Total knee arthroplasty (TKA) is associated with an increased need for blood transfusions and thus an increase in risks associated with blood transfusion such as transfusion reactions, infections, fluid overload, and altered mental status. Tranexamic acid (TXA) is an antifibrinolytic medication that can reduce perioperative blood loss in TKA. However, the best method of delivery has not been defined although topical intra-articular TXA (IA-TXA) may have a theoretical advantage as it is applied directly when and where it is needed to control bleeding. Blinded and nonblinded randomized ...
Source: Journal of Knee Surgery - April 10, 2017 Category: Orthopaedics Authors: Moskal, Joseph T. Capps, Susan G. Tags: Original Article Source Type: research

Efficacy of Tranexamic Acid for Hemostasis in Patients Undergoing High Tibial Osteotomy
J Knee Surg DOI: 10.1055/s-0037-1600091Extensive bone bleeding and an uncomfortable hematoma can develop due to the opening gap and space during a medial open high tibial osteotomy (HTO). Tranexamic acid (TXA) has been used in various orthopaedic surgeries to reduce bleeding and wound complications. However, no study has investigated the effect of TXA during HTO. Therefore, the purpose of this study is to evaluate the efficacy of TXA in reducing postoperative blood loss in patients undergoing HTO. The hypothesis is that topical TXA administration will reduce postoperative bleeding in patients undergoing medial opening HTO....
Source: Journal of Knee Surgery - March 29, 2017 Category: Orthopaedics Authors: Suh, Dong Won Kyung, Bong Soo Han, Seung-Beom Cheong, Kuhoang Lee, Won Hee Tags: Original Article Source Type: research

A Biomechanical Study of Two Distinct Methods of Anterior Cruciate Ligament Rupture, and a Novel Surgical Reconstruction Technique, in a Small Animal Model of Posttraumatic Osteoarthritis
This study supports our hypothesis knee joint mechanics is differentially affected by injury mechanism in a small animal model. We also report a novel reconstruction technique in this model, using autograft tail tendon. [...] Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USAArticle in Thieme eJournals: Table of contents  |  Abstract  |  Full text (Source: Journal of Knee Surgery)
Source: Journal of Knee Surgery - March 29, 2017 Category: Orthopaedics Authors: Ramme, Austin J. Lendhey, Matin S. Strauss, Eric J. Kennedy, Oran D. Tags: Original Article Source Type: research

Function of the Anterior Intermeniscal Ligament
J Knee Surg DOI: 10.1055/s-0037-1600089The function and importance of the anterior intermeniscal ligament (AIML) of the knee are not fully known. The purpose of this study was to evaluate the biomechanical and sensorimotor function of the AIML. Computational analysis was used to assess AIML and tibiomeniscofemoral biomechanics under combined translational and rotational loading applied during dynamic knee flexion–extension. Histologic and immunohistochemical examination was used to identify and characterize neural elements in the tissue. The computational models were created from anatomy and passive motion of two fem...
Source: Journal of Knee Surgery - March 29, 2017 Category: Orthopaedics Authors: Guess, Trent M. Razu, Swithin S. Kuroki, Keiichi Cook, James L. Tags: Original Article Source Type: research

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-0037-1600090The use of suspensory graft fixation methods in arthroscopic reconstruction of the anterior cruciate ligament has become increasingly popular with the more frequent use of tendon grafts and anatomical techniques involving the creation of bone tunnels. An important technical step to ensure adequate fixation of the graft when using EndoButton-type implants, particularly in the femur, involves flipping the EndoButton plate at the correct length to avoid performing this maneuver before the appropriate time or leaving soft tissue between the plate and lateral cortex of the femur. In the pr...
Source: Journal of Knee Surgery - March 29, 2017 Category: Orthopaedics Authors: Fogagnolo, Fabricio Salim, Rodrigo Junior, Mauricio Kfuri Tags: Original Article Source Type: research

Highly Variable Femoral Morphology in Osteoarthritic Chinese: Are Prostheses Today Sufficiently Suitable?
J Knee Surg DOI: 10.1055/s-0037-1599250 Background We aimed to retrospectively investigate the morphology of the resected surfaces of femurs in Chinese patients who underwent total knee arthroplasty (TKA) and to assess the suitability of contemporary femoral components. Methods Measurements on three-dimensional reconstruction after virtual bone cutting were performed on 142 knees from Chinese TKA candidates. The anteroposterior (AP) and mediolateral (ML) dimensions, aspect ratio (ML/AP), and posterior condylar angle (PCA) were measured in the axial plane; the height and length of medial and lateral anterior...
Source: Journal of Knee Surgery - March 14, 2017 Category: Orthopaedics Authors: Zhang, Yunjie Wang, Xiaofeng Wu, Zongming Xia, Qing Shao, Yunchao Tags: Original Article Source Type: research

Patellar Height Measurements on Radiograph and Magnetic Resonance Imaging in Patellar Instability and Control Patients
J Knee Surg DOI: 10.1055/s-0037-1599249Insall–Salvati (IS) ratio, modified IS ratio (mIS), Caton–Deschamps (CD) index, and Blackburne–Peel (BP) index are patellar height measurements commonly made on lateral radiographs (XRs) in patients with patellofemoral instability. More recently, magnetic resonance imaging (MRI) has been used as an additional imaging modality to measure patellar height. However, different imaging modalities have not been previously compared for all of these measurements. First, to compare the patellar height measurements of IS, mIS, CD, and BP on XR and MRI in first-time lateral pate...
Source: Journal of Knee Surgery - March 10, 2017 Category: Orthopaedics Authors: Yue, R. Alexander Arendt, Elizabeth A. Tompkins, Marc A. Tags: Original Article Source Type: research

Five-Strand versus Four-Strand Hamstring Tendon Graft Technique for Anterior Cruciate Ligament Reconstruction: A Biomechanical Comparison
J Knee Surg DOI: 10.1055/s-0037-1599248The aim of this article is to compare diameter and stiffness, displacement, and strain in a five-strand versus four-strand hamstring graft for anterior cruciate ligament reconstruction. Eight matched pairs of lower extremities underwent four-strand or five-strand hamstring graft reconstruction. Diameter was significantly higher in the five-strand versus the four-strand construct (p = 0.002). No significant difference was found between the groups in construct displacement or stiffness. Significantly higher strain was observed in the inner limb versus the outer limb in the...
Source: Journal of Knee Surgery - March 10, 2017 Category: Orthopaedics Authors: Vaillant, Eric R. Parks, Brent G. Camire, Lyn M. Hinton, Richard Y. Tags: Original Article Source Type: research

All-Arthroscopic Autologous Matrix-Induced Chondrogenesis-Aided Repair of a Patellar Cartilage Defect Using Dry Arthroscopy and a Retraction System
We report the first clinical and radiological data at a short-term follow-up. Twelve patients underwent AMIC-aided cartilage repair for a patellar lesion. All steps of the procedure were performed arthroscopically, which include the use of an intra-articularly placed retraction plate for distraction of the patellofemoral joint and evacuation of saline solution for collagen matrix insertion and fixation. Clinical assessment performed before surgery and at a mean follow-up time of 38 months (range: 24–70) included the following scores: Knee Injury and Osteoarthritis Outcome Score (KOOS), International Knee Documentatio...
Source: Journal of Knee Surgery - March 10, 2017 Category: Orthopaedics Authors: Sadlik, Boguslaw Puszkarz, Mariusz Kosmalska, Lidia Wiewiorski, Martin Tags: Original Article Source Type: research

Pedobarographic Analysis in Total Knee Arthroplasty
J Knee Surg DOI: 10.1055/s-0037-1599247Pedobarographic gait analysis is a useful tool for the determination of loading distributions and alterations on the lower extremity and their reflection on the foot sole after many orthopaedic surgical applications. To date, there have been no studies evaluating the relationship between component alignment and changes of pedobarographic gait analysis in total knee arthroplasty (TKA). We aimed to investigate the effects of TKA and prosthetic alignment on the distribution of pedobarographic parameters. Quantitative gait patterns of 47 patients were prospectively evaluated by using pedo...
Source: Journal of Knee Surgery - March 10, 2017 Category: Orthopaedics Authors: G üven, Melih Kocadal, Onur Akman, Budak Şayli, Uğur Alt ıntaş, Faik Tags: Original Article Source Type: research

The Transseptal Arthroscopic Knee Portal Is in Close Proximity to the Popliteal Artery: A Cadaveric Study
J Knee Surg DOI: 10.1055/s-0037-1599252The purpose of this study was to use fluoroscopy to measure the distance between the transseptal portal and the popliteal artery under arthroscopic conditions with an intact posterior knee capsule, and to determine the difference between 90 degrees of knee flexion and full extension. The popliteal artery of eight fresh-frozen cadaveric knees was dissected and cannulated proximal to the knee joint. The posterolateral, posteromedial, and transseptal portals were then established at 90 degrees of flexion. A 4-mm switching stick was placed through the transseptal portal, and barium contra...
Source: Journal of Knee Surgery - March 10, 2017 Category: Orthopaedics Authors: Cancienne, Jourdan M. Werner, Brian C. Burrus, M. Tyrrell Kandil, Abdurrahman Conte, Evan J. Gwathmey, Frank W. Miller, Mark D. Tags: Original Article Source Type: research

Comparison of Anterior Cruciate Ligament Graft Isometry between Paired Femoral and Tibial Tunnels
J Knee Surg DOI: 10.1055/s-0037-1599251Accurate tunnel placement is important for a successful anterior cruciate ligament (ACL) reconstruction. Controversy exists concerning the preferred method of femoral tunnel preparation, with proponents of both medial portal and transtibial drilling techniques. Current ACL literature suggests that placement of the femoral ACL attachment site posterior or “low” in the ACL footprint leads to more anatomically correct ACL mechanics and better rotational control. There is limited literature focusing on ACL graft displacement through knee range of motion based on specific paire...
Source: Journal of Knee Surgery - March 10, 2017 Category: Orthopaedics Authors: Cain, E. Lyle Biggers, Marcus D. Beason, David P. Emblom, Benton A. Dugas, Jeffrey R. Tags: Original Article Source Type: research

Erratum: The Relationship between Body Mass Index and Risk of Failure following Meniscus Repair
J Knee Surg DOI: 10.1055/s-0037-1600087 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 - March 9, 2017 Category: Orthopaedics Authors: Sommerfeldt, Mark F. Magnussen, Robert A. Randall, Kyle L. Tompkins, Marc Perkins, Bryan Sharma, Avijit Blackwell, Ryan Flanigan, David C. Tags: Erratum Source Type: research

The Importance of Facts and the Role of Academic Publishers in Today's World —A Publisher's View
J Knee Surg 2017; 30: v-v DOI: 10.1055/s-0037-1600096 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 - March 7, 2017 Category: Orthopaedics Authors: Schiff, Daniel Tags: Publisher's Note Source Type: research

Special Techniques for Managing Problem Fractures about the Knee
J Knee Surg 2017; 30: 193-193 DOI: 10.1055/s-0037-1600115 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 - March 6, 2017 Category: Orthopaedics Authors: Volgas, David Tags: Special Focus Section Source Type: research

Revision of Total Knee Arthroplasties Performed in Young, Active Patients with Posttraumatic and Osteoarthritis
This study reports on the 25 knees in this series that required revision surgery. Twenty-five revisions were performed in 24 patients. Indication for revision, clinical outcomes, and radiographs were reviewed at their most recent follow-up. Revisions were performed in 5 cases of infection, 2 cases of fracture/trauma, 17 cases of wear/loosening, and 1 case of instability. The average duration from primary TKA to revision surgery for the 25 knees was 12.5 years (range, 2–26 years). Follow-up was obtained in 24 of 25 TKAs. Nine of the 24 patients (10 knees) had died at the time of follow-up. The average duration from re...
Source: Journal of Knee Surgery - March 1, 2017 Category: Orthopaedics Authors: Old, Andrew Brian Long, William John Scott, W. Norman Tags: Original Article Source Type: research

Methicillin-Resistant Staphylococcus aureus Infection Is a Risk Factor for Unplanned Return to the Operating Room in the Surgical Treatment of a Septic Knee
This study did not detect a difference in success of single washout between arthroscopic and open treatment of septic arthritis. However, MRSA was identified as a risk factor for an unplanned return to the OR after arthroscopic treatment. Consideration should be made for open surgical treatment in the setting of MRSA infections of a native knee. [...] Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of contents  |  Abstract  |  Full text (Source: Journal of Knee Surgery)
Source: Journal of Knee Surgery - March 1, 2017 Category: Orthopaedics Authors: Jaffe, David Costales, Timothy Greenwell, Patrick Christian, Matthew Henn, III Ralph Frank Tags: Original Article Source Type: research

Patient Self-Assessed Passive Range of Motion of the Knee Cannot Replace Health Professional Measurements
J Knee Surg DOI: 10.1055/s-0037-1598174The purpose of this study was to investigate whether patients can accurately self-assess their knee passive range of motion (PROM). A picture-based questionnaire for patient self-assessment of knee PROM was developed and posted to patients. The self-assessed PROM from 58 patients was compared with surgeon-assessed PROM using a short-arm goniometer. Agreement between the measurement methods was calculated with the Bland-Altman method. We calculated the sensitivity and specificity of patient-assessed PROM in dichotomously detecting knee motion impairment in both flexion (≤ 100 degree...
Source: Journal of Knee Surgery - March 1, 2017 Category: Orthopaedics Authors: Borgbjerg, Jens Madsen, Frank Odgaard, Anders Tags: Original Article Source Type: research

Extended Anterolateral Approach for Complex Lateral Tibial Plateau Fractures
J Knee Surg DOI: 10.1055/s-0037-1598077Complex fractures of the lateral tibial plateau may extend to the posterior rim of the knee and to the tibial spines. Displaced fractures of the posterolateral corner of the tibial plateau may result in joint incongruity and instability, especially with the knee in flexion. Anatomical reduction of the joint surface and containment of the tibial rim are the primary goals of the treatment in such cases. Dedicated surgical approaches including dissection of the peroneal nerve, sometimes in association with an osteotomy of the fibular head are typically used to address these injuries. Som...
Source: Journal of Knee Surgery - February 24, 2017 Category: Orthopaedics Authors: Kfuri, Mauricio Schatzker, Joseph Castiglia, Marcello Teixeira Giordano, Vincenzo Fogagnolo, Fabricio Stannard, James P. Tags: Special Focus Section Source Type: research

Should We Resect Hoffa's Fat Pad during Total Knee Replacement?
J Knee Surg DOI: 10.1055/s-0037-1598039Resection of Hoffa's fat pad during total knee arthroplasty is sometimes performed to improve access and view. Opponents of this technique argue that sacrificing the fat pad potentially compromises blood supply to the patellar tendon and it can subsequently shorten. Our objective was to identify any difference in the Insall-Salvati ratio of knees undergoing total knee arthroplasty between a cohort that had Hoffa's fat pad preserved and the one that had Hoffa's fat pad completely excised. The total knee arthroplasties by two surgeons at our institution were reviewed over a 3-year perio...
Source: Journal of Knee Surgery - February 24, 2017 Category: Orthopaedics Authors: Sellars, Hannah Yewlett, Alun Trickett, Ryan Forster, Mark Ghandour, Adel Tags: Original Article Source Type: research

Erratum: The Use of Biologic Agents in Athletes with Knee Injuries
J Knee Surg DOI: 10.1055/s-0037-1599135 Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of contents  |  Full text (Source: Journal of Knee Surgery)
Source: Journal of Knee Surgery - February 24, 2017 Category: Orthopaedics Authors: Kopka, Michaela Bradley, James P. Tags: Erratum Source Type: research

Quality-of-Life Outcomes of Patients following Patellofemoral Stabilization Surgery: The Influence of Trochlear Dysplasia
J Knee Surg DOI: 10.1055/s-0037-1598038Trochlear dysplasia is a well-described risk factor for recurrent patellofemoral instability. Despite its clear association with the incidence of patellofemoral instability, it is unclear whether the presence of high-grade trochlear dysplasia influences clinical outcome after patellofemoral stabilization. The purpose of this study was to assess whether trochlear dysplasia influenced patient-reported, disease-specific outcomes in surgically treated patellar instability patients, when risk factors were addressed in accordance with the à la carte surgical approach to the treatment...
Source: Journal of Knee Surgery - February 20, 2017 Category: Orthopaedics Authors: Hiemstra, Laurie Anne Kerslake, Sarah Lafave, Mark R. Tags: Original Article Source Type: research

Arthroscopic Treatment of Isolated Hoffa Fractures
J Knee Surg DOI: 10.1055/s-0037-1598108The goal of this study was to evaluate the results of a novel method, arthroscopic fixation of isolated Hoffa fractures.This is a prospective, case series and set at Level 1 trauma center. A total of eight patients with isolated Hoffa fractures who were operated by arthroscopic screw fixation method in the anterior posterior direction with 6.5 mm cannulated screws were followed up prospectively. Same surgical method used for all patients. All patients underwent the same rehabilitation program and active range of motion (ROM) exercises were started immediately. The International...
Source: Journal of Knee Surgery - February 20, 2017 Category: Orthopaedics Authors: Ercin, Ersin Baca, Emre Kural, Cemal Tags: Original Article Source Type: research

Single-Bundle versus Double-Bundle Anterior Cruciate Ligament Reconstruction: A Prospective Randomized Controlled Trial with 6-Year Follow-up
J Knee Surg DOI: 10.1055/s-0037-1598176Single-bundle (SB) anterior cruciate ligament (ACL) reconstruction is increasingly used in a large number of patients and it allows obtaining very good clinical and subjective results; however, functional tests show a persistent rotational instability. Biomechanical studies seem to indicate that double-bundle (DB) ACL reconstruction allows to obtain increased anterior and rotational stability compared with SB. The aim of this prospective randomized controlled study was to compare the clinical outcome and the possible osteoarthritic evolution of patients treated either with a SB (freeh...
Source: Journal of Knee Surgery - February 20, 2017 Category: Orthopaedics Authors: Adravanti, Paolo Dini, Francesco de Girolamo, Laura Cattani, Massimo Rosa, Michele Attilio Tags: Original Article Source Type: research

Does Manipulation under Anesthesia Increase the Risk of Revision Total Knee Arthroplasty? A Matched Case Control Study
J Knee Surg DOI: 10.1055/s-0037-1598040Manipulation under anesthesia (MUA) can help patients regain an adequate range of motion (ROM) following total knee arthroplasty (TKA). Although there are studies reporting that MUA can assist in improving ROM, there is a paucity of studies regarding whether requiring an MUA is associated with an increased risk of revision. The purpose of this study was to assess the: (1) incidence of revision TKA and (2) outcomes of those undergoing MUA and compare it with a matched cohort who did not require MUA. A prospectively collected database of two high-volume institutions was assessed for pat...
Source: Journal of Knee Surgery - February 14, 2017 Category: Orthopaedics Authors: Pierce, Todd P. Issa, Kimona Festa, Anthony Scillia, Anthony J. McInerney, Vincent K. Mont, Michael A. Tags: Original Article Source Type: research

Patellofemoral Osteochondral Allografts: Can We Improve the Matching Process?
J Knee Surg DOI: 10.1055/s-0037-1598107An important consideration for the successful use of fresh osteochondral allografts for the patellofemoral joint is selection of appropriately sized donor allografts. This is particularly challenging for matching grafts to the patella because of the substantial variability in articular contour that exists. At present, selection of donor patellae is based only on the width of the proximal tibia, with no established means of quantifying basic patellar size, facet configuration, or articular contour. We hypothesized that using a combination of standard radiographic measurements to genera...
Source: Journal of Knee Surgery - February 14, 2017 Category: Orthopaedics Authors: Determann, Jason R. Fleischli, James E. D'Alessandro, Donald F. Piasecki, Dana P. Tags: Original Article Source Type: research

The Use of Mesh Plates for Difficult Fractures of the Patella
J Knee Surg DOI: 10.1055/s-0037-1598078Patella fractures present some of the more complicated fracture patterns in orthopaedic trauma care. This is partially due to the small size of the fragments but also the articular nature of each fragment. Fixation methods such as cerclage wiring, excision of smaller fragments, and screw fixation of larger fragments all have their own challenges. Our study examined our Level I trauma center's experience with variable angle locked 2.7 mm titanium plates for treatment of comminuted patella fractures or treatment of patellar nonunion. After Institutional Review Board approval, we ...
Source: Journal of Knee Surgery - February 13, 2017 Category: Orthopaedics Authors: Volgas, David Dreger, Tina K. Tags: Special Focus Section Source Type: research

The Management of Bone Defects in Periarticular Knee Injuries: A Review Article
This article will describe the surgical options for these difficult problems. [...] 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 - February 13, 2017 Category: Orthopaedics Authors: Buck, Brian Murtha, Yvonne M. Tags: Special Focus Section Source Type: research

Dynamic Alignment Analysis in the Osteoarthritic Knee Using Computer Navigation
J Knee Surg DOI: 10.1055/s-0037-1598037The lower limb alignment is influenced by the geometry of the joint surfaces and surrounding soft tissue tension. The mechanical behavior changes in a normal, osteoarthritic, and postoperative knee. The purpose of this study is to determine the dynamic coronal femoral tibial mechanical angle (FTMA) in osteoarthritic knees using computer navigation. The authors hypothesize that there are different varus-valgus patterns between flexion and extension in the osteoarthritic knee. We conducted a transversal observational study and included patients with osteoarthritis who underwent primary ...
Source: Journal of Knee Surgery - February 13, 2017 Category: Orthopaedics Authors: Larrainzar-Garijo, Ricardo Murillo-Vizuete, David Garcia-Bogalo, Raul Escobar-Anton, David Horna-Casti ñeiras, Lissette Peralta-Molero, Juan Vicente Tags: Original Article Source Type: research

Accuracy and Learning Curve of Femoral Tunnel Placement in Medial Patellofemoral Ligament Reconstruction
J Knee Surg DOI: 10.1055/s-0037-1598175The purpose of this study was to assess the accuracy of femoral tunnel placement in a medial patellofemoral ligament reconstruction (MPFL-R) cohort. The secondary purpose was to establish the evidence of a learning curve to achieve acceptable femoral tunnel placement during MPFL-R. Two surgeons, using lateral radiographs, assessed 73 subjects post–MPFL-R. Femoral tunnel accuracy and direction of tunnel error were measured in relation to Schöttle's point (A–T distance). Interrater reliability (intraclass correlation coefficient 2,k) of these measures was calculated. Le...
Source: Journal of Knee Surgery - February 13, 2017 Category: Orthopaedics Authors: Hiemstra, Laurie Anne Kerslake, Sarah O'Brien, Catherine L. Lafave, Mark R. Tags: Original Article Source Type: research

Clinical Study of 3D Imaging and 3D Printing Technique for Patient-Specific Instrumentation in Total Knee Arthroplasty
In this study, 3D printing technique based on the image data of computed tomography (CT) has been utilized for optimal controlling of the surgical parameters. Two groups of TKA cases have been randomly selected as PSI group and control group with no significant difference of age and sex (p > 0.05). The PSI group is treated with 3D printed cutting guides whereas the control group is treated with conventional instrumentation (CI). By evaluating the proximal osteotomy amount, distal osteotomy amount, valgus angle, external rotation angle, and tibial posterior slope angle of patients, it can be found that the ...
Source: Journal of Knee Surgery - January 25, 2017 Category: Orthopaedics Authors: Qiu, Bing Liu, Fei Tang, Bensen Deng, Biyong Liu, Fang Zhu, Weimin Zhen, Dong Xue, Mingyuan Zhang, Mingjiao Tags: Original Article Source Type: research