Zonal Fixation in Revision TKA: The Key Is Metaphyseal Fixation
J Knee Surg DOI: 10.1055/s-0041-1735281As the volume of primary total knee arthroplasties continues to rise, so will the volume of revision arthroplasties. Bone loss is commonly encountered in revision surgery and must be managed appropriately to optimize outcomes. The concept of zonal fixation highlights the importance of attaining secure fixation within each of the three major osseous zones: the epiphysis, the metaphysis, and the diaphysis. While each zone is important, the metaphysis carries particular significance. The development of new implants such as metaphyseal cones and sleeves has greatly expanded the orthopedic...
Source: Journal of Knee Surgery - September 10, 2021 Category: Orthopaedics Authors: Oh, Jason H. Scuderi, Giles R. Tags: Special Focus Section Source Type: research
Ligament Balancing and Constraint in Revision Total Knee Arthroplasty
J Knee Surg DOI: 10.1055/s-0041-1735162Ligament balancing in revision knee arthroplasty is crucial to the success of the procedure. The medial collateral ligament and lateral ligament complex are the primary ligamentous structures that provide stability. Revisions can be performed with nonconstrained cruciate-retaining, posterior cruciate substituting, or anterior-stabilized/ultracongruent inserts when there are symmetrical flexion/extension gaps and intact collateral ligaments. When the collateral ligaments are insufficient either due to attenuation or incompetence from bone loss, a more constrained knee system is needed....
Source: Journal of Knee Surgery - September 10, 2021 Category: Orthopaedics Authors: Crawford, David A. Lombardi, Adolph V. Tags: Special Focus Section Source Type: research
Surgical Treatment for Avulsion Fractures of the Anterolateral Ligament Associated with Periarticular Fractures of the Knee
This study aims to confirm the existence of ALL and evaluate the clinical outcomes of surgical management for avulsion fractures, involving its insertion, when associated with periarticular knee fractures. Twenty-three patients (16 males and 7 females) with avulsion fractures of the ALL associated with periarticular knee fractures were fixed with a spider plate, cannulated screw, or suture anchor. Eight patients were diagnosed with distal femoral fracture, 10 with tibial plateau fracture, and 5 with tibial eminence avulsion fracture. All patients underwent X-rays at follow-up. Clinical and functional outcomes were assessed...
Source: Journal of Knee Surgery - September 10, 2021 Category: Orthopaedics Authors: Wei, Xuelei Wang, Zengliang Lu, Yandong Sun, Jie Riehl, John Tags: Original Article Source Type: research
Localized Pigmented Villonodular Synovitis Originating from the Lateral Meniscus in a 17-year-old: Case Report and Literature Review of Meniscal-Associated Localized PVNS
We present a case report of a 17-year- old male with symptoms and MRI findings consistent with a lateral meniscus tear. Intraoperatively, the patient was found to have a mass originating from the torn meniscal tissue, which was confirmed by pathology to be a TSGCT. We performed a literature review of intra-articular localized PVNS within the knee presenting as a meniscal tear. [...] Thieme Medical Publishers, Inc. 333 Seventh Avenue, 18th Floor, New York, NY 10001, USAArticle in Thieme eJournals: Table of contents | Abstract | Full text (Source: Journal of Knee Surgery)
Source: Journal of Knee Surgery - September 10, 2021 Category: Orthopaedics Authors: Talley-Bruns, Rachel C. Patel, Ruby G. Mangion, Jeremy E. Tags: Original Article Source Type: research
Radiographic Findings in Flexion Instability after Total Knee Arthroplasty
J Knee Surg DOI: 10.1055/s-0041-1735279Flexion instability (FI) is one of the leading causes of knee pain and revision surgery. Generally, the biomechanical etiology is considered to be a larger flexion than extension gap. This may be due to mismatch of components sizes to the bone or malalignment. Other factors such as muscle weakness may also play a role, and the diagnosis of FI after total knee arthroplasty (TKA) relies on a combination of patient's complaints during stair descent or walking and physical examination findings. Our study examines the role of implant positioning and sizes in the diagnosis of FI. A retrospe...
Source: Journal of Knee Surgery - September 10, 2021 Category: Orthopaedics Authors: Howie, Cole M. Mears, Simon C. Barnes, C. Lowry Mannen, Erin M. Stambough, Jeffrey B. Tags: Original Article Source Type: research
