Implant Design and Effects on Patellofemoral Crepitus
Conclusion Femoral component design with a smoother intercondylar box transition zone resulted in a lower incidence of operative patellofemoral crepitus. No statistical differences were noted regarding the incidence of total and symptomatic patellofemoral crepitus. Mobile bearing TKA exhibited greater total crepitus within group B. Level of Evidence III. [...] Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of contents  |  Abstract  |  Full text (Source: Journal of Knee Surgery)
Source: Journal of Knee Surgery - January 23, 2017 Category: Orthopaedics Authors: McNabb, David Clinton Dennis, Douglas A. Jennings, Jason M. Daines, Brian Laz, Peter Kim, Raymond H. Tags: Original Article Source Type: research

Discoid Lateral Meniscus
J Knee Surg DOI: 10.1055/s-0036-1598021Partial and total meniscectomies are the most common treatments for patients with discoid lateral meniscus (DLM). We conducted this study to quantitatively assess and compare the outcomes of partial and total meniscectomies for DLM. We also assessed whether the outcomes differed by the type of DLM, duration of follow-up, and age of patients. We searched PubMed, Embase, and the Cochrane database to identify relevant studies that reported outcomes, including Ikeuchi grade, the International Knee Documentation Committee (IKDC) Subjective Knee score, Lysholm score, or failure rate, in pat...
Source: Journal of Knee Surgery - January 23, 2017 Category: Orthopaedics Authors: Dai, Wen-Li Zhang, Hua Zhou, Ai-Guo Zhang, Gang Zhang, Jian Tags: Original Article Source Type: research

Use of All-polyethylene Tibial Components in Unicompartmental Knee Arthroplasty Increases the Risk of Early Failure
This study compared the clinical outcomes and prevalence of early failure between all-poly and metal-backed modular components in UKA. We retrospectively reviewed the records and radiographs of 101 consecutive UKAs. In total, 51 UKAs were performed using all-poly tibial components; 50 others used metal-backed modular components. Clinical and radiographic outcomes, adaptive bone remodeling assessed by radiographic bone density, and early failure prevalence rates were compared. Despite a lack of group differences in clinical and radiographic outcomes (p > 0.1 in all comparisons), adaptive bone remodeling at ...
Source: Journal of Knee Surgery - January 13, 2017 Category: Orthopaedics Authors: Koh, In Jun Suhl, Kyung Hwan Kim, Min Woo Kim, Man Soo Choi, Keun Young In, Yong Tags: Original Article Source Type: research

Approach to Total Knee Replacement: A Randomized Double Blind Study between Medial Parapatellar and Midvastus Approach in the Early Postoperative Period in Asian Population
J Knee Surg DOI: 10.1055/s-0036-1597978The purpose of this randomized study was to compare clinical and surgical outcomes of total knee replacements (TKRs) in the early postoperative period using midvastus approach versus medial parapatellar approach in Asian population in a double blind manner. Forty-two knees each were operated using midvastus approach and the medial parapatellar approach. Clinical parameters that were evaluated included Knee Society score (KSS); knee pain using visual analogue scale (VAS) on day 1, 1 week, and 1 month; time required to straight leg raise (SLR); patellar tracking; mean exte...
Source: Journal of Knee Surgery - January 13, 2017 Category: Orthopaedics Authors: Aslam, Mohammed Ammar Sabir, Aamir Bin Tiwari, Vivek Abbas, Sohail Tiwari, Anurag Singh, Pritish Tags: Original Article Source Type: research

What Arthroscopic Skills Need to Be Trained Before Continuing Safe Training in the Operating Room?
J Knee Surg DOI: 10.1055/s-0036-1597755The purpose of this study was to generate consensus among experienced surgeons on “what skills a resident should possess before continuing safe training in the operating room (OR).” An online survey of 65 questions was developed and distributed to surgeons in the European community. A total of 216 responded. The survey included 15 questions regarding generic and specific skills; 16 on patient and tissue manipulation, 11 on knowledge of pathology and 6 on inspection of e-anatomical structures; 5 methods to prepare residents; and 12 on specific skills exercises. The importan...
Source: Journal of Knee Surgery - January 12, 2017 Category: Orthopaedics Authors: Tuijthof, Gabrielle Cabitza, Federico Ragone, Vincenza Compagnoni, Riccardo Randelli, Pietro Tags: Original Article Source Type: research

Comparison of Muscle Recovery Following Bi-cruciate Substituting versus Posterior Stabilized Total Knee Arthroplasty in the Asian Population
J Knee Surg DOI: 10.1055/s-0036-1597977The purpose of this study was to compare muscle recovery in the lower extremities following the newly developed bi-cruciate substituting (BCS) to posterior stabilized (PS) total knee arthroplasty (TKA) in the Asian population. Forty-one knees in 41 patients undergoing BCS-TKA (41 female, average age: 71 ± 8.8) and 34 knees in 34 patients undergoing PS-TKA (33 female, average age: 73 ± 7.2) were included in this study. The maximum isometric power of the quadriceps and hamstring muscles was measured preoperatively, and at 1, 3, 6, and 12 months ...
Source: Journal of Knee Surgery - January 9, 2017 Category: Orthopaedics Authors: Takubo, Akihito Ryu, Keinosuke Iriuchishima, Takanori Tokuhashi, Yasuaki Tags: Original Article Source Type: research

Spacer-Based Gap Balancing in Total Knee Arthroplasty: Clinical Success with a Reproducible Technique
Conclusion The described surgical technique appears to be reliable to obtain well-balanced knees and good patellar tracking when performing a primary TKA, even in knees with important coronal misalignment. [...] Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of contents  |  Abstract  |  Full text (Source: Journal of Knee Surgery)
Source: Journal of Knee Surgery - January 6, 2017 Category: Orthopaedics Authors: Lavoie, Fr édéric Tags: Original Article Source Type: research

The Business of Arthroplasty: Understanding the Horse Out of the Barn
J Knee Surg 2017; 30: 01-02 DOI: 10.1055/s-0036-1597622 Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of contents  |  Full text (Source: Journal of Knee Surgery)
Source: Journal of Knee Surgery - January 6, 2017 Category: Orthopaedics Authors: Jacofsky, David Tags: Special Focus Section Source Type: research

Readability of Online Sources Regarding Meniscal Tears
J Knee Surg DOI: 10.1055/s-0036-1598009Meniscal injuries are extremely common, with an incidence of 8.3 per 1,000 person/years in young, active individuals. Patients often turn to the internet to glean information about their injuries, and even to guide decision making about treatment. Much research has been done demonstrating that a reading level of eighth grade or lower is appropriate for accurately communicating written information to patients, yet medical practitioners often fail to meet this requirement. To better examine the information patients receive about meniscal injuries, we set out to evaluate the reading leve...
Source: Journal of Knee Surgery - December 30, 2016 Category: Orthopaedics Authors: Hodax, Jonathan D. Baird, Grayson L. McBride, Trevor Owens, Brett D. Tags: Original Article Source Type: research

A Canine Arthroscopic Anterior Cruciate Ligament Reconstruction Model for Study of Synthetic Augmentation of Tendon Allografts
The objective of this study was to describe and validate a translational canine model for all-inside arthroscopic complete ACL reconstruction using a quadriceps tendon allograft with internal brace (QTIB). With institutional approval, adult research hounds underwent complete transection of the native ACL followed by all-inside ACL reconstruction using the novel QTIB construct with suspensory fixation (n = 10). Contralateral knees were used as nonoperated controls (n = 10). Dogs were assessed over a 6-month period using functional, diagnostic imaging, gross, biomechanical, and histologic outcome ...
Source: Journal of Knee Surgery - December 26, 2016 Category: Orthopaedics Authors: Cook, James L. Smith, Pat Stannard, James P. Pfeiffer, Ferris Kuroki, Keiichi Bozynski, Chantelle C. Cook, Cristi Tags: Original Article Source Type: research

Efficacy of Two Techniques in Anterior Cruciate Ligament Reconstruction
J Knee Surg DOI: 10.1055/s-0036-1593966The purpose of this study is to compare failure rate and functional outcome in young, active patients (
Source: Journal of Knee Surgery - December 15, 2016 Category: Orthopaedics Authors: Hurt, James A. Berry, John H. Replogle, William Thibodeaux, Kasey Hydrick, Josie M. Barrett, Austin M. Barrett, Gene R. Tags: Original Article Source Type: research

An MRI Evaluation of Patients Who Underwent Treatment with a Cell-Mediated Gene Therapy for Degenerative Knee Arthritis: A Phase IIa Clinical Trial
J Knee Surg DOI: 10.1055/s-0036-1597275Multiple therapies have been developed to slow down the progression of knee osteoarthritis (OA), with the aim of avoiding or delaying TKA. One such potential method is cell-mediated gene therapy, which utilizes allogeneic human chondrocytes modified to express transforming growth factor-β1. Using magnetic resonance imaging (MRI), we evaluated patients who underwent treatment with this injection in a Phase II study and assessed structural changes in: (1) bone marrow edema lesions, (2) cartilage defect depth and surface area, (3) articular bone surface and osteophytes, and (4) meni...
Source: Journal of Knee Surgery - December 13, 2016 Category: Orthopaedics Authors: Cho, Jung Jong Totterman, Saara Elmallah, Randa K. Kim, Tae Won Lee, Bumsup Mont, Michael A. Tags: Original Article Source Type: research

A Meta-analysis of Functional Outcomes in Patient-Specific Instrumented Knee Arthroplasty
J Knee Surg DOI: 10.1055/s-0036-1593869Alignment data in patient-specific instrumented (PSI) knee arthroplasty have been examined in several meta-analyses, with demonstration of comparative but not improved restitution of a neutral mechanical axis and favorable outcomes in femoral implant axial alignment. To date, no comprehensive synthesis of data has been conducted specifically for functional outcomes. Relevant databases were searched according to Preferred Reporting Items for Systematic reviews and Meta-analyses guidelines during the period 2000 to 2015 of Levels 1 and 2 studies comparing functional outcomes of patient-...
Source: Journal of Knee Surgery - December 1, 2016 Category: Orthopaedics Authors: Mannan, Ashim Akinyooye, Deji Hossain, Fahad Tags: Original Article Source Type: research

Restriction of Postoperative Joint Loading in a Murine Model of Anterior Cruciate Ligament Reconstruction: Botulinum Toxin Paralysis and External Fixation
This study introduces a robust research tool to allow control of postoperative joint loading in animal models such as ACL reconstruction, permitting study of the effects of mechanical load on the biologic aspects of tendon-to-bone healing. [...] 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 1, 2016 Category: Orthopaedics Authors: Lebaschi, Amir Deng, Xiang-Hua Coleman, Nathan W. Camp, Christopher L. Zong, Jianchun Carbone, Andrew Carballo, Camila B. Cong, Guang-Ting Album, Zoe M. Rodeo, Scott A. Tags: Original Article Source Type: research

Temperature-Controlled Continuous Cold Flow Device after Total Knee Arthroplasty: A Randomized Controlled Trial Study
This study is a prospective randomized controlled study, involving 50 patients after primary TKA. A power analysis was performed preoperatively. Twenty-four patients were addressed to a postoperative treatment with a continuous cold flow device (Hilotherm, Hilotherm GmbH, Germany). Twenty-six patients represented the control group, treated with crushed ice packs. All the patients shared the same analgesic strategy and the same rehabilitation protocol. Pain, analgesic consumption, active knee range of motion, drain output, transfusion requirement, and total blood loss were evaluated at different follow-ups (postoperative fi...
Source: Journal of Knee Surgery - November 30, 2016 Category: Orthopaedics Authors: Ruffilli, Alberto Castagnini, Francesco Traina, Francesco Corneti, Isabella Fenga, Domenico Giannini, Sandro Faldini, Cesare Tags: Original Article Source Type: research

Identifying an Ideal Time Frame for Staged Bilateral Total Knee Arthroplasty to Maximize Functional Outcome
J Knee Surg DOI: 10.1055/s-0036-1597273Compared with staged bilateral total knee arthroplasty (TKA), simultaneous bilateral TKA carries a higher risk of cardiac complications, pulmonary complications, and mortality, especially in patients with preexisting cardiopulmonary disease or advanced age. However, the period of time between staged TKAs that would eliminate these increased risks has yet to be determined. The purpose of this study is to evaluate complication rates and functional outcome in patients who underwent staged bilateral TKA and to determine an optimal time frame for the second knee. The authors retrospectivel...
Source: Journal of Knee Surgery - November 29, 2016 Category: Orthopaedics Authors: Yeh, Jared Ze Yang Chen, Jerry Yongqiang Lee, Wu Chean 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

Catastrophic Failure of Regenerex Tibial Components: A Case Series
J Knee Surg DOI: 10.1055/s-0036-1593876The aim of this study was to analyze short-term metal failures in well-placed Signature-guided Regenerex (Zimmer Biomet, Warsaw, IN) tibial components in a limited patient series. A retrospective, consecutive, nonrandomized, unblinded study from a limited cohort of young active osteoarthritis patients was conducted. All cases received a Regenerex tibial component which we evaluated for metal failure. Patients met the then current indications from the Center for Medicare and Medicaid Services Guidelines for knee replacement. Age, body mass index (BMI),and gender were compared between R...
Source: Journal of Knee Surgery - November 28, 2016 Category: Orthopaedics Authors: Stormont, Gavin Stormont, Daniel Tags: Original Article Source Type: research

Reliability, Concurrent Validity, and Minimal Detectable Change for iPhone Goniometer App in Assessing Knee Range of Motion
In conclusion, the i-Goni demonstrated superior reproducibility with smaller measurement error compared with UG in assessing knee ROM in the recruited cohort. Future research can expand the inquiry for assessing the reliability of the i-Goni to other joints. [...] 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, 2016 Category: Orthopaedics Authors: Mehta, Saurabh P. Barker, Katherine Bowman, Brett Galloway, Heather Oliashirazi, Nicole Oliashirazi, Ali Tags: Original Article Source Type: research

Variables Associated with Chondral and Meniscal Injuries in Anterior Cruciate Ligament Surgery
This article aims to evaluate factors associated with chondral and meniscal lesions in primary and revision anterior cruciate ligament (ACL) reconstructions. ACL reconstructions from 2001 to 2008 at a single institution were retrospectively analyzed. Logistic regression was used to estimate the association between chondral and meniscal injuries and age, gender, tear chronicity, additional ligamentous injuries, sport type, and participation level. Of the 3,040 ACL reconstructions analyzed, 90.4% were primary reconstructions and 9.6% were revisions. Meniscal injuries were significantly lower in the revision group (44.0 vs. 5...
Source: Journal of Knee Surgery - November 28, 2016 Category: Orthopaedics Authors: Cain, E. Lyle Fleisig, Glenn S. Ponce, Brent A. Boohaker, Hikel A. George, Martha P. McGwin, Gerald Andrews, James R. Lemak, Lawrence J. Clancy, William G. Dugas, Jeffrey R. Tags: Original Article Source Type: research

The Risk Factors of Postoperative Delirium after Total Knee Arthroplasty
J Knee Surg DOI: 10.1055/s-0036-1593872We investigated the results of delirium which developed after total knee arthroplasty (TKA) and the risk factors for delirium in the patients who are older than 65 years. From March 2008 to March 2012, we performed a retrospective study on 296 knees of 265 patients who were treated with TKA. They were divided into two groups: 216 patients without delirium and 49 patients diagnosed with delirium by psychiatry. We analyzed the risk factors into three categories: First, the preoperative factors including gender, age, body mass index (BMI), clinical and functional knee joint score (Knee S...
Source: Journal of Knee Surgery - November 23, 2016 Category: Orthopaedics Authors: Wang, Lih Seok, Sangyun Kim, Sungsoo Kim, Kyungtaek Lee, Seunghyun Lee, Kyungho Tags: Original Article Source Type: research

Total Knee Arthroplasty: What to Expect? A Survey of the Members of the Dutch Knee Society on Long-Term Recovery after Total Knee Arthroplasty
In this study, we aimed to evaluate what Dutch orthopedic surgeons assume are realistic expectations for recovery 1 year after TKA. We invited the members of the Dutch Knee Society (DKS) to fill out a web-based questionnaire. For expectation measurement, the validated Dutch version of the Hospital for Special Surgery (HSS) knee replacement expectations survey was used. A total of 150 invitations were successfully sent; 84 orthopedic surgeons responded (56%). The overall HSS knee replacement expectation score was 66.0 (standard deviation, 14.0) on a 0 to 100 scale. Most improvement was predicted for the items “...
Source: Journal of Knee Surgery - November 23, 2016 Category: Orthopaedics Authors: Tolk, Jaap J. van der Steen, Marieke C. Janssen, Rob P. A. Reijman, Max Tags: Original Article Source Type: research

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-0036-1593620Anterior cruciate ligament and meniscal injuries are associated with secondary osteoarthrosis which may lead to functional impairment and economic burden. The prevalence of knee injury has not been studied in depth. Our purpose was to report the prevalence of knee ligament and meniscal injuries and their associations with gender, body mass index (BMI), and height in young adults and to characterize individuals with meniscal injuries who gained full recovery. A cross-sectional, population-based study was conducted. Information on the disability codes of knee ligament and meniscal injur...
Source: Journal of Knee Surgery - November 23, 2016 Category: Orthopaedics Authors: Thein, Ran Hershkovich, Oded Gordon, Barak Burstein, Gideon Tenebaum, Shay Derazne, Estela Tzur, Dorit Shamis, Ari Afek, Arnon Kreiss, Yitshak Tags: Original Article Source Type: research

Results of a New Treatment Concept for Concomitant Lesion of Medial Collateral Ligament in Patients with Rupture of Anterior Cruciate Ligament
This study presents results of a new treatment concept for concomitant MCL lesions in patients with ACL rupture. In this study, 67 recreational athletes with ACL injury and concomitant MCL lesion were treated according to a distinct treatment concept. Patients were classified in six different types of concomitant MCL lesion depending on grade of MCL lesion and presence of anteromedial rotatory instability (AMRI). Final classification and surgical indication were determined 6 weeks posttraumatic. All patients received ACL reconstruction. MCL was treated by surgical or conservative regime due to type of concomitant MCL lesio...
Source: Journal of Knee Surgery - November 23, 2016 Category: Orthopaedics Authors: Blanke, Fabian Paul, Jochen Haenle, Maximilian Sailer, Jannes Pagenstert, Geert Wehren, Lutz von Vogt, Stephan Majewski, Martin Tags: Original Article Source Type: research

The Variable Emergence of the Infrapatellar Branch of the Saphenous Nerve
This study utilized cadaveric (n = 100) and ultrasonography (n = 30) assessments, and meta-analysis. In the cadaveric study, the presence of IPBSN and its emergence mode in relation to the sartorius muscle (SaM) was determined (type A-anterior; type B-posterior; type C-penetrating the SaM). Ultrasonography examinations were conducted on healthy volunteers to determine the presence and mode of the emergence of the nerve. Finally, from electronic databases searching, all studies reporting the IPBSN emergence data were pooled into a meta-analysis. The mean distance between the medial border of the ...
Source: Journal of Knee Surgery - November 15, 2016 Category: Orthopaedics Authors: Henry, Brandon Michael Tomaszewski, Krzysztof A. P ękala, Przemysław A. Ramakrishnan, Piravin Kumar Taterra, Dominik Saganiak, Karolina Mizia, Ewa Walocha, Jerzy A. Tags: Original Article Source Type: research

The Use of Metaphyseal Cones for Bone Defects in Revision Total Knee Arthroplasty
J Knee Surg 2016; 29: 613-613 DOI: 10.1055/s-0036-1593343 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 9, 2016 Category: Orthopaedics Authors: Khlopas, Anton Chughtai, Morad Elmallah, Randa K. Harwin, Steven F. Gwam, Chukwuweike U. Mont, Michael A. Tags: Foreword Source Type: research

Contracting Strategies for Arthroplasty —Bundles to Population Health
J Knee Surg DOI: 10.1055/s-0036-1593613Orthopedics, and especially total joint replacement (TJR), is growing in payer prominence due to large projected increases in volume. The unsustainability of the fee-for-service payment system has lead Centers for Medicare and Medicaid Services to employ new value and risk-based contracting strategies on a population health basis and on an episode of care basis, with programs such as the Bundled Payment for Care Improvement program and the Comprehensive Care for Joint Replacement program. These trends are forcing hospitals and physicians to align to improve quality and reduce costs th...
Source: Journal of Knee Surgery - November 4, 2016 Category: Orthopaedics Authors: Jacofsky, David J. Jawin, Paul Walton, Geoff Fraser, Lisa Tags: Special Focus Section Source Type: research

Reimbursement Based on Value in Knee Surgery: What You Need to Know about the Medicare Access and Children's Health Insurance Program Reauthorization Act of 2015
J Knee Surg DOI: 10.1055/s-0036-1593614Health care cost is consuming a large portion of the nation's gross domestic product while placing added economic burdens on physicians and their patients. With total joint replacement being one of the early-targeted procedures in the evolving health care environment, knee surgeons will benefit from developing a critical knowledge on health care reforms and their financial implications. The Medicare Access and Children's Health Insurance Program Reauthorization Act represents a cohesive movement toward value-based payment reform and contains several unchartered rulings that require de...
Source: Journal of Knee Surgery - November 2, 2016 Category: Orthopaedics Authors: Saleh, Khaled J. Sayeed, Zain Anoushiravani, Afshin A. Darwiche, Hussein F. Little, Bryan Frush, Todd James El-Othmani, Mouhanad M. Tags: Special Focus Section Source Type: research

Factors Associated with Knee Stiffness following Surgical Management of Multiligament Knee Injuries
J Knee Surg DOI: 10.1055/s-0036-1593624Postoperative knee stiffness can influence outcomes following operative treatment of multiligament knee injuries (MLKIs). The purpose of this study was to evaluate patient and surgical factors that may potentially contribute to stiffness following surgery for MLKIs. All surgically managed MLKIs involving two or more ligaments over a 10-year period at a single level one trauma center were included in this study. A retrospective review was performed to gather objective data related to the development of knee stiffness after surgery. Patients were classified as “stiff” postop...
Source: Journal of Knee Surgery - October 27, 2016 Category: Orthopaedics Authors: Hanley, Jessica Westermann, Robert Cook, Shane Glass, Natalie Amendola, Ned Wolf, Brian R. Bollier, Matthew Tags: Original Article Source Type: research

Infection following Anterior Cruciate Ligament Reconstruction: An Analysis of 6,389 Cases
J Knee Surg DOI: 10.1055/s-0036-1593617Infection following anterior cruciate ligament reconstruction (ACLR) is rare. Previous authors have concluded that diabetes, tobacco use, and previous knee surgery may influence infection rates following ACLR. The purpose of this study was to identify a cohort of patients undergoing ACLR and define (1) the incidence of infection after ACLR from a large multicenter database and (2) the risk factors for infection after ACLR. We identified patients undergoing elective ACLRs in the American College of Surgeons National Surgical Quality Improvement Program database between 2007 and 2013. T...
Source: Journal of Knee Surgery - October 25, 2016 Category: Orthopaedics Authors: Westermann, Robert Anthony, Chris A. Duchman, Kyle R. Gao, Yubo Pugely, Andrew J. Hettrich, Carolyn M. Amendola, Ned Wolf, Brian R. Tags: Original Article Source Type: research

Preoperative Ultrasonographic Prediction of Hamstring Tendon Diameter for Anterior Cruciate Ligament Repair
J Knee Surg DOI: 10.1055/s-0036-1593622The incidence of anterior cruciate ligament (ACL) injuries is rising every year. The autologous hamstring tendon graft, using semitendinosus tendon (SMT) and gracilis tendon (GR), is a common repair technique in the management of ACL injuries due to its multiple advantages. Using a final graft with a minimum diameter of 8 mm is necessary to avoid graft failure. The aim of this study was to find a correlation between preoperative ultrasound (USG) measurement of the SMT and GR tendon diameters (SMTd and GRd) and their actual diameters measured during the grafting procedure. In th...
Source: Journal of Knee Surgery - October 25, 2016 Category: Orthopaedics Authors: Rodriguez-Mendez, Luis Manuel Martinez-Ruiz, Jose de Jesus Perez-Manzo, Ruben Corona-Hernandez, Jorge Luis Alcala-Zermeno, Juan Luis Sanchez-Enriquez, Sergio Tags: Original Article Source Type: research

Biomechanical Comparison of Five Posterior Cruciate Ligament Reconstruction Techniques
J Knee Surg DOI: 10.1055/s-0036-1593625No surgical technique recreates native posterior cruciate ligament (PCL) biomechanics. We compared the biomechanics of five different PCL reconstruction techniques versus the native PCL. Cadaveric knees (n = 20) were randomly assigned to one of five reconstruction techniques: Single bundle all-inside arthroscopic inlay, single bundle all-inside suspensory fixation, single bundle arthroscopic-assisted open onlay (SB-ONL), double bundle arthroscopic-assisted open inlay (DB-INL), and double bundle all-inside suspensory fixation (DB-SUSP). Each specimen was potted and connec...
Source: Journal of Knee Surgery - October 25, 2016 Category: Orthopaedics Authors: Nuelle, Clayton W. Milles, Jeffrey L. Pfeiffer, Ferris M. Stannard, James P. Smith, Patrick A. Kfuri, Mauricio Cook, James L. Tags: Original Article Source Type: research

Arthroplasty Registries: Improving Clinical and Economic Outcomes
J Knee Surg DOI: 10.1055/s-0036-1593615With renewed focus on achieving value for patients in total hip and knee arthroplasty, payors, hospitals, and physicians strive to provide quality care while minimizing cost. Large registry datasets have gained popularity in the United States to track implant survivorship and outcomes after joint replacement. Partnerships among surgeons, insurers, and health systems have improved on earlier administrative datasets from Medicare to measure quality and outcomes. Participation in state and national registries can help surgeons and hospitals gain a financial advantage in several insurers'...
Source: Journal of Knee Surgery - October 24, 2016 Category: Orthopaedics Authors: Courtney, P. Maxwell Markel, David C. Tags: Special Focus Section Source Type: research

Early Removal of Drainage Tube after Fast-Track Primary Total Knee Arthroplasty
J Knee Surg DOI: 10.1055/s-0036-1593618There is no consensus as to whether drainage tube should be used and how long it should remain in use after primary total knee arthroplasty (TKA). As fast-track (FT) program has been implemented in TKA, whether drainage tube could be removed early, and the ideal timing for removal after FT primary TKA has been a new topic. The purpose of this prospective cohort study was to evaluate the safety and feasibility of early removal of drainage tube when FT program was implemented in primary TKA. A total of 101 patients undergoing FT primary TKA were prospectively allocated into three groups...
Source: Journal of Knee Surgery - October 24, 2016 Category: Orthopaedics Authors: Zhang, Shaoyun Xu, Bin Huang, Qiang Yao, Huan Xie, Jinwei Pei, Fuxing Tags: Original Article Source Type: research

Total Knee Arthroplasty in the Younger Patient
J Knee Surg DOI: 10.1055/s-0036-1593619The rate of total knee arthroplasty (TKA) utilization in younger patients (
Source: Journal of Knee Surgery - October 24, 2016 Category: Orthopaedics Authors: Shah, Sapan H. Schwartz, Brian E. Schwartz, Aaron R. Goldberg, Benjamin A. Chmell, Samuel J. Tags: Original Article Source Type: research

Complications Related to Implant Fixation of Patellar Fractures: Comparison of Ring Pins versus Bent K-Wires
J Knee Surg DOI: 10.1055/s-0036-1593621Patellar fractures are characterized by injuries to the extensor and typically require surgical fixation. Among the methods used for fixation, the most common is the modified AO tension-band wiring technique. However, using this technique, implant migration occurs due to the lack of connections between the K-wires and the tension-band wire, which causes irritation and reduces fracture stability. Recently, new methods for tension-band wiring have been developed in which tension bands lock the K-wires through an attached “ring” to prevent migration. The purpose of this study...
Source: Journal of Knee Surgery - October 24, 2016 Category: Orthopaedics Authors: Kyung, Min Gyu Lee, Seung Hoo Kim, Min Bom Tags: Original Article Source Type: research

Detection of Total Knee Arthroplasties at Airport Security Checkpoints: How Do Updated Security Measures Affect Patients?
J Knee Surg DOI: 10.1055/s-0036-1593626Airport security measures continue to be updated with the incorporation of the new body scanners and automatic target recognition software. The purpose of this study was analyze the incidence of: (1) triggering the security alarm; (2) extra security searches; (3) perceived inconvenience; and (4) presence of other surgical hardware in those who underwent total knee arthroplasty (TKA) and passed through airport security. A questionnaire was given to 125 consecutive patients with a TKA. Those who passed through airport security after January 2014 were considered for inclusion. A question...
Source: Journal of Knee Surgery - October 24, 2016 Category: Orthopaedics Authors: Issa, Kimona Pierce, Todd P. Gwam, Chukwuweieke Goljan, Peter Festa, Anthony Scillia, Anthony J. Mont, Michael A. Tags: Original Article Source Type: research

Erratum: Research in Osteochondritis Dissecans of the Knee: 2016 Update
J Knee Surg DOI: 10.1055/s-0036-1593804 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 24, 2016 Category: Orthopaedics Authors: Nepple, Jeffrey J. Milewski, Matthew D. Shea, Kevin G. Tags: Erratum Source Type: research

Clinical Outcomes of a Pneumatic Unloader Brace for Kellgren –Lawrence Grades 3 to 4 Osteoarthritis: A Minimum 1-Year Follow-Up Study
This study randomized patients who had Kellgren–Lawrence grades 3 to 4 to receive either a pneumatic unloader brace and conventional treatment or conventional treatment alone. The brace cohort comprised 11 patients with a mean age of 55 years (range, 37–70 years). The final matched cohort comprised 25 patients with a mean age of 63 years (range, 41–86 years). The minimum follow-up was 1 year. There was a lower proportion of patients who underwent an eventual TKA in the bracing cohort as compared with the nonbracing cohort (18 vs. 36%). The mean time to TKA was longer in the bracing cohort as compared with...
Source: Journal of Knee Surgery - October 17, 2016 Category: Orthopaedics Authors: Chughtai, Morad Bhave, Anil Khan, Sabahat Z. Khlopas, Anton Ali, Osman Harwin, Steven F. Mont, Michael A. Tags: Special Focus Section Source Type: research

Can Preoperative Radiographic Analysis Help Us Evaluate When to Use Metaphyseal Cones?
In this study, three patients who were undergoing a revision TKA were evaluated radiographically. For each case, we used the Knee Society Roentgenographic Evaluation and Scoring System to assess for osteolysis and bone loss or defects. The intraoperative findings of bone loss that may have necessitated the use of cones were described and correlated with preoperative evaluation. The first patient had obvious osteolysis of both tibia and femur on anteroposterior (AP) and lateral radiographs. The preoperative radiographs predicted the need for a cone in both tibia and femur. The intraoperative findings correlated with preoper...
Source: Journal of Knee Surgery - October 17, 2016 Category: Orthopaedics Authors: Khlopas, Anton Mont, Michael A. Chughtai, Morad Molloy, Robert Ramkumar, Prem N. Harwin, Steven F. Tags: Original Article Source Type: research

Highly Porous Metaphyseal Cones in Revision Total Knee Arthroplasty: A Case Series
J Knee Surg DOI: 10.1055/s-0036-1593369Highly porous metaphyseal cones are used for the management of large bone defects in revision total knee arthroplasty. These cones fill defects and allow bony ongrowth while providing several sizing and offset options. In this case series, we evaluated three patients who received these latest generation metaphyseal cones. Specifically, these cases will be explored in detail with respect to history, indications, operative technique, and short-term outcomes. Overall, these newer generation porous coated cones are excellent options for large contained bone loss in the absence of infectio...
Source: Journal of Knee Surgery - October 6, 2016 Category: Orthopaedics Authors: Patel, Nirav K. Kim, Eric G. Chughtai, Morad Khlopas, Anton Elmallah, Randa D. K. Harwin, Steven F. Delanois, Ronald E. Mont, Michael A. Tags: Special Focus Section Source Type: research

Topical Tranexamic Acid in Total Knee Arthroplasty Patients with Increased Thromboembolic Risk
J Knee Surg DOI: 10.1055/s-0036-1593371The purpose of this study was to evaluate the efficacy and safety profiles of topical tranexamic acid (TXA) in patients undergoing elective total knee arthroplasty (TKA) with comorbid conditions precluding them from intravenous (IV) TXA use. A total of 104 patients were divided into two groups: 47 in the normal-risk group and 57 in the high-risk group, with the latter representing those with one or more risk factors for venous thromboembolism (VTE). Demographics were similar between groups, and there were no differences with regard to postoperative changes in hemoglobin (− 3.42 ...
Source: Journal of Knee Surgery - October 5, 2016 Category: Orthopaedics Authors: Spanyer, Jonathon Patel, Jay Emberton, Eric Smith, Langan S. Malkani, Arthur L. Tags: Original Article Source Type: research

Modified Elmslie –Trillat Procedure for Recurrent Dislocation of the Patella
J Knee Surg DOI: 10.1055/s-0036-1593363Many groups have reported good to excellent clinical outcomes of the Elmslie–Trillat (ET) procedure for recurrent dislocation of the patella. However, the mean follow-up period of these studies was no more than 5 years. We hypothesized that the long-term postoperative outcomes of the modified ET procedure for recurrent dislocation of the patella would be acceptable compared with those of other procedures. The long-term postoperative outcomes of patients treated with the modified ET procedure were examined. A total of 31 knees in 27 patients with recurrent dislocation of the pate...
Source: Journal of Knee Surgery - October 3, 2016 Category: Orthopaedics Authors: Mitani, Genya Maeda, Takashi Takagaki, Tomonori Hamahashi, Kosuke Serigano, Kenji Nakamura, Yutaka Sato, Masato Mochida, Joji Tags: Original Article Source Type: research

Arthroscopic Lateral Retinacular Release and Modified Elmslie –Trillat Operation Improve Severe Isolated Lateral Patello-Femoral Osteoarthritis
J Knee Surg DOI: 10.1055/s-0036-1593365To evaluate whether arthroscopic lateral retinacular release and the modified Elmslie–Trillat operation improve osteoarthritis (OA) progression and clinical outcomes in patients with severe isolated lateral patello-femoral OA. Nine women (11 knees) and one man (one knee) with isolated late-stage lateral patello-femoral OA underwent surgery. The severity of patello-femoral OA was recorded using the Merchant method, while the level of pain and anterior knee function were scored using the visual analogue scale (VAS) and Kujala knee scores, respectively. The articular cartilage was ...
Source: Journal of Knee Surgery - October 3, 2016 Category: Orthopaedics Authors: Lin, Renn-Chia Lue, Ko-Huang Lu, Ko-Hsiu Tags: Original Article Source Type: research

Comparing ε-Aminocaproic Acid and Tranexamic Acid in Reducing Postoperative Transfusions in Total Knee Arthroplasty
This study evaluated whether EACA is as efficacious as TXA in reducing postoperative blood transfusion rates and compared the cost per surgery between agents. A multicenter retrospective chart review of elective unilateral TKA from April 2012 through December 2014 was performed. Five hospitals within a health care system participated. Data collected included age, gender, severity of illness score, use of antifibrinolytic and dose, red blood cell (RBC) transfusions and the number of units, and preadmission and discharge hemoglobin (Hb). Dosing of the antifibrinolytic differed based on the agent used, 5 or 10 g (based...
Source: Journal of Knee Surgery - October 3, 2016 Category: Orthopaedics Authors: Churchill, Jessica L. Puca, Kathleen E. Meyer, Elizabeth Carleton, Matthew Anderson, Michael J. Tags: Original Article Source Type: research

Multicenter, Multisurgeon Research Groups Updates
J Knee Surg 2016; 29: 527-527 DOI: 10.1055/s-0036-1593342 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 3, 2016 Category: Orthopaedics Authors: Wright, Rick W. Tags: Foreword Source Type: research

Evolving Beyond Craft Surgery Is Both Inevitable and Essential
J Knee Surg DOI: 10.1055/s-0036-1593368Given the increasing emphasis in health care on improving outcomes, reproducible results, and creating value for the patient, orthopedic surgery in particular must necessarily continue to progress away from an individualized and a surgeon-specific technical craft and toward a highly automated and computer-integrated process in which surgeon and digitized systems interact to provide the most reproducible and consistent outcomes possible. In doing so, orthopedic surgery would follow the same path that every other highly reliable and safety conscious industry has adopted by absolute nece...
Source: Journal of Knee Surgery - September 29, 2016 Category: Orthopaedics Authors: Scalise, Jason Dunbar, Michael Jacofsky, David Tags: Special Focus Section Source Type: research

Infrapatellar Fat Pad Excision during Total Knee Arthroplasty Did Not Alter the Patellar Tendon Length: A 5-Year Follow-Up Study
J Knee Surg DOI: 10.1055/s-0036-1593360Partial or total resection of the infrapatellar fat pad (IPFP) helps surgeon improve access to lateral tibial plateau for better placement of the knee prosthesis. We aimed to investigate the effect of IPFP excision on clinical and radiologic outcomes including patellar tendon length (PTL), range of motion, and functional scores after total knee arthroplasty (TKA) at 5-year follow-up. We retrospectively evaluated postoperative first X-rays (day 0) and postoperative final 5-year control views of 228 knees in patients with primary osteoarthritis who underwent TKA between September 2006 a...
Source: Journal of Knee Surgery - September 29, 2016 Category: Orthopaedics Authors: İmren, Yunus Dedeo ğlu, Süleyman Semih Çakar, Murat Çabuk, Haluk Bayraktar, Tahsin Olgun G ürbüz, Hakan Tags: Original Article Source Type: research

The “Hoop” Plate for Posterior Bicondylar Shear Tibial Plateau Fractures: Description of a New Surgical Technique
J Knee Surg DOI: 10.1055/s-0036-1593366High-energy fractures of the proximal tibia with extensive fragmentation of the posterior rim of the tibial plateau are challenging. This technique aims to describe a method on how to embrace the posterior rim of the tibial plateau by placing a horizontal precontoured one-third tubular plate wrapped around its corners. This method, which we named “hoop plating,” is mainly indicated for cases of crushed juxta-articular rim fractures, aiming to restore cortical containment of the tibial plateau. Through a lateral approach with a fibular head osteotomy (Lobenhoffer approach),...
Source: Journal of Knee Surgery - September 29, 2016 Category: Orthopaedics Authors: Giordano, Vincenzo Schatzker, Joseph Kfuri, Mauricio Tags: Original Article Source Type: research

Relationship between Widening and Position of the Tunnels and Clinical Results of Anterior Cruciate Ligament Reconstruction to Knee Osteoarthritis: 30 Patients at a Minimum Follow-Up of 10 Years
J Knee Surg DOI: 10.1055/s-0036-1593367To evaluate the relationship between tunnel position and widening and long-term clinical results in anterior cruciate ligament (ACL) reconstruction, a retrospective cohort of 30 patients undergoing ACL reconstruction with double semitendinous plus double gracilis (SAC technique) with longer than 10-year follow-up was selected. CT scans in the first 3 months and at final follow-up was evaluated. Position, angle, and widening of tunnels including Nebelung criteria were recorded in all CT scans. Physical, KT-1000, and clinical evaluation were performed at final follow-up. Outcomes and kn...
Source: Journal of Knee Surgery - September 29, 2016 Category: Orthopaedics Authors: Ayala-Mejias, Juan Diego Garcia-Gonzalez, Benjamin Alcocer-Perez-Espa ña, Luis Villafa ñe, Jorge Hugo Berjano, Pedro Tags: Original Article Source Type: research

The Varus –Valgus Constrained Knee Implant: Survivorship and Outcomes
In this study, 685 consecutive cases of primary (n = 247), aseptic (n = 315), and septic revision (n = 123) TKAs with VVC implants were performed between 1999 and 2008; 533 knees (78%) had a mean follow-up of 8.2 years (range, 2–15.1). Kaplan–Meier method was used to evaluate implant survival with mechanical failure as the end point. Clinical outcomes were measured with a modified Knee Society Score (mKSS) and modified Knee Function Score (mKFS) and modes of failure were determined. Cox proportional hazards models were performed to assess for factors associated with imp...
Source: Journal of Knee Surgery - September 28, 2016 Category: Orthopaedics Authors: Siqueira, Marcelo B. P. Jacob, Paul McLaughlin, John Klika, Alison K. Molloy, Robert Higuera, Carlos A. Barsoum, Wael K. Tags: Original Article Source Type: research