Tibial Fixation Properties of a Continuous-Loop ACL Hamstring Graft Construct with Suspensory Fixation in Porcine Bone
J Knee SurgDOI: 10.1055/s-0034-1394167The aim of this article is to compare tibial fixation strength of suspensory fixation for a quadrupled semitendinosus continuous loop all-inside anterior cruciate ligament (ACL) construct versus a doubled semitendinosus and gracilis graft fixated with an interference screw. Biomechanical testing was conducted using human hamstring allografts and porcine tibias. Constructs were cycled from 50 to 250 N for 500 cycles followed by a pull to failure. The average load to failure of tibial suspensory fixation of the all-inside continuous loop construct (1,012 N) was statistically diffe...
Source: Journal of Knee Surgery - October 27, 2014 Category: Orthopaedics Authors: Smith, Patrick A.DeBerardino, Thomas M. Tags: Original Article Source Type: research

A Novel Small Animal Model of Differential Anterior Cruciate Ligament Reconstruction Graft Strain
J Knee SurgDOI: 10.1055/s-0034-1390331The aim of the study was to establish a small animal research model of anterior cruciate ligament (ACL) reconstruction where ACL graft force can be predictably altered with knee motion. Cadaveric rat knees (n = 12) underwent ACL resection followed by reconstruction. Six knees received anterior (high-tension) femoral graft tunnels and six knees received posterior (isometric) graft tunnels. All the 12 knees and ACL grafts were pretensioned to 3 N at 15 or 45 degrees of knee flexion. ACL graft force (N) was recorded as the knee was ranged from extension to 90-degree f...
Source: Journal of Knee Surgery - October 24, 2014 Category: Orthopaedics Authors: Ma, RichardJu, XiaodongDeng, Xiang-HuaRodeo, Scott A. Tags: Original Article Source Type: research

Characterization of Meniscal Pathology Using Molecular and Proteomic Analyses
J Knee SurgDOI: 10.1055/s-0034-1394164The meniscus is a complex tissue and is integral to knee joint health and function. Although the meniscus has been studied for years, a relatively large amount of basic science data on meniscal health and disease are unavailable. Genomic and proteomic analyses of meniscal pathology could greatly improve our understanding of etiopathogenesis and the progression of meniscal disease, yet these analyses are lacking in the current literature. Therefore, the objective of this study was to use microarray and proteomic analyses to compare aged-normal and pathologic meniscal tissues. Meniscal t...
Source: Journal of Knee Surgery - October 23, 2014 Category: Orthopaedics Authors: Roller, Brandon L.Monibi, FarrahStoker, Aaron M.Bal, B. SonnyStannard, James P.Cook, James L. Tags: Original Article Source Type: research

Efficacy and Safety of a Biweekly Viscosupplementation Regimen for Knee Osteoarthritis
J Knee SurgDOI: 10.1055/s-0034-1394300Osteoarthritis is the most common form of arthritis in the Western world, causing disabling symptoms in 10% of people older than 55 years. Hyaluronic acid injections can reduce osteoarthritic pain but require three to five doses administered weekly. This preliminary study aims to assess the efficacy of a more flexible viscosupplementation regimen. Patients were given three sodium hyaluronate isotonic solution injections (Ostenil; TRB Chemedica SA, Vouvry, Switzerland), biweekly. They were then asked to record their pain before and after administration of the injections, on a visual ana...
Source: Journal of Knee Surgery - October 22, 2014 Category: Orthopaedics Authors: Yiasemidou, MarinaMunir, UsamaGlassman, DanielTeanby, David Tags: Original Article Source Type: research

Identification of Novel Synovial Fluid Biomarkers Associated with Meniscal Pathology
J Knee SurgDOI: 10.1055/s-0034-1394165The menisci are integral components within the knee for ensuring optimal joint function. The overall goal of this study was to identify proteomic markers of meniscal disease within synovial fluid samples obtained from control knees versus knees affected with varying degrees of meniscal injury and osteoarthritis. Joint fluid samples were collected before the patient underwent an arthroscopic knee procedure or total knee arthroplasty. Normal controls included patients younger than 30 years with no history of anterior cruciate ligament, posterior cruciate ligament, or meniscal injury. A t...
Source: Journal of Knee Surgery - October 22, 2014 Category: Orthopaedics Authors: Roller, Brandon L.Monibi, FarrahStoker, Aaron M.Bal, B. SonnyCook, James L. Tags: Original Article Source Type: research

Outcomes of Medial Collateral Ligament Injuries during Total Knee Arthroplasty
J Knee SurgDOI: 10.1055/s-0034-1394166Intraoperative medial collateral ligament (MCL) disruption during total knee arthroplasty (TKA) is often managed with either primary repair or use of a constrained implant. A total of 23 patients with an MCL injury during TKA between 2003 and 2009 were compared with 92 matched controls. Of the 23 patients, 10 were treated with an unconstrained implant and primary MCL repair, 8 with constrained implants, 3 with constrained implants and MCL repair, and 2 with unconstrained implants and no MCL repair. After an average 5-year follow-up, patients had lower Knee Society Scores (KSS), 79 vers...
Source: Journal of Knee Surgery - October 16, 2014 Category: Orthopaedics Authors: Siqueira, Marcelo B. P.Haller, KathrynMulder, AndrewGoldblum, Andrew S.Klika, Alison K.Barsoum, Wael K. Tags: Original Article Source Type: research

Prolonged Epidural Infusion Improves Functional Outcomes Following Knee Arthroscopy in Patients with Arthrofibrosis after Total Knee Arthroplasty: A Retrospective Evaluation
J Knee SurgDOI: 10.1055/s-0034-1394163A total of 20 consecutive patients with knee stiffness post total knee arthroplasty (TKA) underwent arthroscopic lysis of adhesions and manipulation plus indwelling epidural were evaluated retrospectively. Epidural catheters were placed preoperatively for an intended 6 weeks of postoperative analgesia to facilitate intensive physical therapy. The mean loss of knee extension immediately before incision was 13.5 ± 9.1 degrees (range, 0–35 degrees) and flexion was 77.65 ± 19.2 degrees (range, 45–125 degrees). At the 6-week and final (m...
Source: Journal of Knee Surgery - October 9, 2014 Category: Orthopaedics Authors: Saltzman, Bryan M.Dave, AnkurYoung, AdamAhuja, MukeshAmin, Sandeep D.Bush-Joseph, Charles A. Tags: Original Article Source Type: research

Cellular Chondroplasty: A New Technology for Joint Regeneration
J Knee SurgDOI: 10.1055/s-0034-1390329Cellular therapy involves the isolation, expansion, and transplantation of human cells for the replacement or regeneration of injured tissues. It is one of the most significant tissue repair strategies in the emerging discipline of regenerative medicine. Cellular strategies have been applied in joint repair for the treatment of acute cartilage injury, meniscal repair, and osteoarthritis (OA). Many of these efforts have been motivated by the apparent incapacity of cartilage to repair itself and the observation that initial trauma is likely to lead to sustained joint degeneration. A part...
Source: Journal of Knee Surgery - September 30, 2014 Category: Orthopaedics Authors: Murphy, MaryBarry, Frank Tags: Special Focus Section Source Type: research

US Definitions, Current Use, and FDA Stance on Use of Platelet-Rich Plasma in Sports Medicine
J Knee SurgDOI: 10.1055/s-0034-1390030With increased utilization of platelet-rich plasma (PRP), it is important for clinicians to understand the United States, the Food and Drug Administration (FDA) regulatory role and stance on PRP. Blood products such as PRP fall under the prevue of FDA's Center for Biologics Evaluation and Research (CBER). CBER is responsible for regulating human cells, tissues, and cellular and tissue-based products. The regulatory process for these products is described in the FDA's 21 CFR 1271 of the Code of Regulations. Under these regulations, certain products including blood products such as PRP a...
Source: Journal of Knee Surgery - September 30, 2014 Category: Orthopaedics Authors: Beitzel, KnutAllen, DonaldApostolakos, JohnRussell, Ryan P.McCarthy, Mary BethGallo, Gregory J.Cote, Mark P.Mazzocca, Augustus D. Tags: Special Focus Section Source Type: research

How Should We Evaluate Outcomes for Use of Biologics in the Knee?
J Knee SurgDOI: 10.1055/s-0034-1390028In recent years, the use of biologics for the primary treatment and augmentation of treatment in patients with knee pathology has increased substantially. Techniques and applications for biologic preparations such as platelet-rich plasma (PRP) and mesenchymal stem cells (MSCs) have been developed and refined to increase the healing response in bone, ligaments, cartilage, meniscal tissue, and other areas of the knee. Beginning with basic science and animal models, and finally proceeding to clinical human trials, the effect of biologics on clinical outcomes has been widely studied; howev...
Source: Journal of Knee Surgery - September 26, 2014 Category: Orthopaedics Authors: LaPrade, Christopher M.James, Evan W.LaPrade, Robert F.Engebretsen, Lars Tags: Special Focus Section Source Type: research

Can We Quantify Functional Improvement Following Total Knee Arthroplasty in the Clinical Setting?
J Knee SurgDOI: 10.1055/s-0034-1390330The purpose of this study was to determine if improvements in knee function after arthroplasty could be practicably measured in the clinical setting using available, validated technology. The tools we assessed included a timed test of common activities, a platform posturography analysis, and a portable gait laboratory device to quantify body segment motion. We measured the function of 25 total knee arthroplasty patients before surgery and at 1, 4, 12, and 24 months after surgery. Assessment of sit-to-stand, walking, stair climbing, lunging, Knee Society Scores, and Oxford Survey Scores...
Source: Journal of Knee Surgery - September 26, 2014 Category: Orthopaedics Authors: Parks, Nancy L.Whitney, Catherine E.Engh, Gerard A. Tags: Original Article Source Type: research

Patellar Tendon Reconstruction in Total Knee Arthroplasty: A New Technique
J Knee SurgDOI: 10.1055/s-0034-1390332Patellar tendon disruption is one of the most dreaded complications following total knee arthroplasty (TKA) impacting both implant function and implant longevity. To overcome the concerns regarding allografts and improve outcomes with augmentation techniques, we describe a technique, which we have successfully used over the past 4 years with good results. Seven patients underwent reconstruction for patellar tendon disruption using our technique from a cohort of eight patients. Extensor lag improved from a mean of 40 degrees to less than 5 degrees postoperatively. Range of motion improv...
Source: Journal of Knee Surgery - September 24, 2014 Category: Orthopaedics Authors: Rajgopal, AshokVasdev, AttiqueDahiya, Vivek Tags: Original Article Source Type: research

Femoral Revision Arthroplasty for Su Type 3 Supracondylar Periprosthetic Knee Fractures
J Knee SurgDOI: 10.1055/s-0034-1390029Periprosthetic distal femoral fractures can present significant reconstructive challenges when associated with poor bone stock, comminution, or component loosening. Revision arthroplasty with stemmed components or distal femoral replacement arthroplasty often becomes necessary. This retrospective study reviewed the results of femoral revision arthroplasty in 16 knees with acute, extreme distal (Su type 3), supracondylar periprosthetic fractures using cemented, midlevel constrained implants. The mean patient age was 71 years and mean follow-up was 5 years. All fractures united with mean...
Source: Journal of Knee Surgery - September 24, 2014 Category: Orthopaedics Authors: Deshmukh, Ajit J.Thakur, Raman R.Rasquinha, Vijay J.Rodriguez, José A. Tags: Original Article Source Type: research

ACL Reconstruction
J Knee Surg 2014; 27: 325-326DOI: 10.1055/s-0034-1390082Thieme 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 - September 9, 2014 Category: Orthopaedics Authors: Smith, Patrick A. Tags: Foreword Source Type: research

Does Tourniquet Time in Primary Total Knee Arthroplasty Influence Clinical Recovery?
J Knee SurgDOI: 10.1055/s-0034-1388654There are limited data on the influence of a reduced tourniquet time strategy on the clinical outcome of primary total knee arthroplasty (TKA). The aim of our study was to prospectively compare clinical recovery in two groups of patients undergoing TKA based on differences in tourniquet strategy at the same institution. Group A (40 patients) consisted of TKAs performed by a surgeon using tourniquet from incision to arthrotomy closure, and group B (40 patients) consisted of TKAs performed by another surgeon using tourniquet only during cementation. The surgical technique, implants, peri...
Source: Journal of Knee Surgery - September 2, 2014 Category: Orthopaedics Authors: Rathod, ParthivDeshmukh, AjitRobinson, JonathanGreiz, MichelleRanawat, AmarRodriguez, Jose Tags: Original Article Source Type: research

A Prospective, Longitudinal Study of Patient Activity Levels Following Total Knee Arthroplasty Stratified by Demographic and Comorbid Factors
J Knee SurgDOI: 10.1055/s-0034-1388658With the marked increase in the annual number of total knee arthroplasties (TKAs) in the United States, there has been an increased interest in evaluating patient-reported outcomes. The purpose of this study was to prospectively and longitudinally evaluate temporal trends in patient activity levels following TKA and to identify potential demographic and comorbid factors that may affect these outcomes. This prospective study evaluated 281 patients, including 108 men and 173 women, who had a mean age of 66 years (39–80 years) and underwent primary TKA. All patients were followed fo...
Source: Journal of Knee Surgery - August 27, 2014 Category: Orthopaedics Authors: Issa, KimonaJauregui, Julio J.Given, KristinHarwin, Steven F.Mont, Michael A. Tags: Original Article Source Type: research

Use of Transcutaneous Electrical Nerve Stimulation Device in Early Osteoarthritis of the Knee
In conclusion, the use of TENS for 3 months has shown encouraging results to improve pain, function, and QOL in patients with painful osteoarthritic knees, and could positively contribute as an adjunct to current nonoperative treatment of knee arthritis. However, given our small sample size, larger randomized studies are needed to further evaluate these outcomes.[...]Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals:Table of contents  |  Abstract  |  Full text (Source: Journal of Knee Surgery)
Source: Journal of Knee Surgery - August 27, 2014 Category: Orthopaedics Authors: Cherian, Jeffrey J.Kapadia, Bhaveen H.Bhave, AnilMcElroy, Mark J.Cherian, ChristopherHarwin, Steven F.Mont, Michael A. Tags: Original Article Source Type: research

Treatment of Tibial Eminence Fractures: A Systematic Review
J Knee SurgDOI: 10.1055/s-0034-1388657Fractures of the tibial eminence are rare, accounting for less than 1% of the injuries involving the anterior cruciate ligament (ACL). Most agree that nondisplaced fractures can be managed nonoperatively, but debate exists over the ideal treatment of displaced fractures. This systematic review evaluates the outcome of nonoperatively and operatively managed displaced tibial eminence fractures. The PubMed, Embase, and Cochrane databases were queried. Inclusion criteria included reported outcomes of displaced tibial eminence fractures, minimum 2-year follow-up, and English language. Outco...
Source: Journal of Knee Surgery - August 27, 2014 Category: Orthopaedics Authors: Bogunovic, LjiljanaTarabichi, MajdHarris, DavidWright, Rick Tags: Original Article Source Type: research

Bleeding in Knee Arthroplasty: Age, Drained Volume, and Ischemia Time
J Knee SurgDOI: 10.1055/s-0034-1388655Drainages in primary knee arthroplasty remain unclear. Our aim is to analyze variables that may affect bleeding in knee arthroplasty (age, drained volume, and ischemia time). We included 188 knee arthroplasties, divided into three groups: conventional approach for total knee arthroplasty (TKA), minimally invasive total knee arthroplasty (MIS), and unicompartmental knee arthroplasty (UNI). Main variables analyzed for the present study were age, drained volume, and ischemia time. Other recorded variables were operated knee, pre- and postoperative hematocrit, diagnosis, comorbidities, and...
Source: Journal of Knee Surgery - August 27, 2014 Category: Orthopaedics Authors: Ares, OscarSeijas, RobertoSallent, AndreaPopescu, DragosLozano, Luis Tags: Original Article Source Type: research

Can Platelet-Rich Plasma Enhance Anterior Cruciate Ligament and Meniscal Repair?
This article endeavors to relate clinical and basic science strategies focused on biological augmentation of the healing response in anterior cruciate ligament (ACL) and meniscus repair and replacement using PRP. Therein, a translational feedback loop is created in the literature and targeted towards the entire multidisciplinary team. Ultimately, it is hoped that the theoretical benefits of PRP on soft-tissue interfacial healing will emerge clinically following a careful, focused characterization at the benchtop, and prospective randomized controlled clinical study.[...]Thieme Medical Publishers 333 Seventh Avenue, New Yor...
Source: Journal of Knee Surgery - August 7, 2014 Category: Orthopaedics Authors: Hutchinson, Ian D.Rodeo, Scott A.Perrone, Gabriel S.Murray, Martha M. Tags: Special Focus Section Source Type: research

Role of Platelet-Rich Plasma in Articular Cartilage Injury and Disease
This article provides an overview of the basic science behind the use of PRP in the treatment of cartilage injury and disease. Both initial and current examples of the use of intra-articular PRP in clinical human studies are provided. These include the use of PRP either alone or as an augmentation device with various other procedures, including arthroscopic microfracture and cell-free resorbable polyglycolic acid-hyaluronan implantation. Finally, the authors describe some of the potential future roles of PRP in clinical settings based on recent literature. These include Achilles tendon rupture, chronic tendinosis, chronic ...
Source: Journal of Knee Surgery - July 28, 2014 Category: Orthopaedics Authors: Mascarenhas, RandySaltzman, Bryan M.Fortier, Lisa A.Cole, Brian J. Tags: Special Focus Section Source Type: research

How Do Spanning External Fixators on Knee Dislocation Patients Affect the Use of MRI and Knee Stability?
This study sought to determine the following: (1) Does the external fixator compromise quality of imaging obtained? (2) How do findings from the evaluation under anesthesia at the time of external fixator removal compare with the initial magnetic resonance imaging (MRI) findings? This was a retrospective study of a consecutive patient series at an academic level 1 trauma center. There were 19 consecutive patients with traumatic knee dislocations and spanning external fixator applied. Each patient had a knee MRI with the external fixator in place and examination at the time of external fixator removal. A review of knee stab...
Source: Journal of Knee Surgery - July 28, 2014 Category: Orthopaedics Authors: Javidan, PooyaOwen, JoshuaCutuk, AdnanWatson, TracyKaar, Scott Tags: Original Article Source Type: research

Staged Bilateral Total Knee Arthroplasty: Time of the Second Side
J Knee SurgDOI: 10.1055/s-0034-1384215The purpose of this study was to determine if there was a safe time frame for performing the second total knee arthroplasty (TKA) in staged bilateral TKAs. Retrospectively, 589 TKAs were studied at a single institution from January 2000 to June 2012. Patients were excluded if they underwent simultaneous or staggered bilateral TKA during the same hospitalization. Patients were included if they underwent bilateral staged TKA during a different hospitalization within 21 to 90, 91 to 180, 181 to 270, and 271 to 360 days after the first TKA. In-hospital complications were determined using I...
Source: Journal of Knee Surgery - July 28, 2014 Category: Orthopaedics Authors: Chen, Antonia F.Rasouli, Mohammad R.Vegari, David N.Huang, Ronald C.Maltenfort, Mitchell G.Parvizi, Javad Tags: Original Article Source Type: research

Reliability of Intra-articular Rotational Axes at Standard Tibial Resection Level and Effect of Resecting Distally
J Knee SurgDOI: 10.1055/s-0034-1378193We determine the most reliable tibial intra-articular axis for rotational alignment of the tibial component at the standard resection level and at a distal resection level. The angles between the surgical transepicondylar axis and posterior condylar line, perpendicular to Akagi line, tibial anterior condylar line (ACL), and tibial maximum mediolateral line were measured at the standard resection level and 5 mm distal to the standard resection level. All axes exhibited relatively large standard deviations and ranges at the standard and distal resection level. t-test showed that t...
Source: Journal of Knee Surgery - July 16, 2014 Category: Orthopaedics Authors: Sunnassee, YoshvinZhang, HenghuiSouthern, Edward P.Wang, YiShen, Yuhui Tags: Original Article Source Type: research

Use of Platelet-Rich Plasma for Patellar Tendon and Medial Collateral Ligament Injuries: Best Current Clinical Practice
J Knee SurgDOI: 10.1055/s-0034-1384671Platelet-rich plasmas (PRPs) are complex molecular therapies prepared from the patient's own blood through minimal manipulation. Clinical studies examining the efficacy of PRPs to manage patellar tendinopathy and medial collateral ligament (MCL) injuries have been reviewed. We found three controlled trials, two of them randomized, and seven case series in the management of patellar tendinopathy. In addition, three other randomized studies showed that PRPs help to regenerate the patellar tendon harvest site for anterior cruciate ligament reconstruction and to reduce patellar donor site ...
Source: Journal of Knee Surgery - July 4, 2014 Category: Orthopaedics Authors: Andia, IsabelMaffulli, Nicola Tags: Special Focus Section Source Type: research

Femoral Mechanical–Anatomical Angle Measurements in Total Knee Arthroplasty: Analog versus Digital
J Knee SurgDOI: 10.1055/s-0034-1384214Preoperative planning in total knee arthroplasty with intramedullary guiding systems requires the measurement of the femoral mechanical–anatomical angle (FMAA) for optimal alignment correction. The main goal of this study was to assess the agreement between two digital FMAA measurements and the analog FMAA measurement. Overall 41 anteroposterior weight-bearing hip-to-ankle radiographs of patients undergoing total knee arthroplasty were used for the measurements of the FMAA. The analog method (gold standard, GS) was compared with two new digital methods (DIG1 and DIG2) using intra...
Source: Journal of Knee Surgery - June 26, 2014 Category: Orthopaedics Authors: van Groningen, B.den Teuling, J. W. A. M.Houterman, S.Janssen, R. P. A. Tags: Original Article Source Type: research

Prevalence of Self-Reported Metal Allergy in Patients Undergoing Primary Total Knee Arthroplasty
This study was performed to determine the rate of self-reported cutaneous metal allergy, or sensitivity, in patients undergoing knee replacement, and to evaluate whether there is a higher prevalence in females. A retrospective chart review was performed on 194 consecutive patients who underwent primary knee arthroplasty with a single surgeon between 2010 and 2011. During this period, all patients, except those with a previous well-functioning orthopedic device, were asked preoperatively about a history of metal allergy or sensitivity. The prevalence of self-reported cutaneous metal allergy, or sensitivity, was 14%; 22% (19...
Source: Journal of Knee Surgery - June 20, 2014 Category: Orthopaedics Authors: Bloemke, Adam D.Clarke, Henry D. Tags: Original Article Source Type: research

Readmission Rates for Cruciate-Retaining Total Knee Arthroplasty
J Knee SurgDOI: 10.1055/s-0034-1378194Currently, the readmission rates for patients treated with cruciate-retaining (CR) prostheses have not been widely evaluated. The purpose of this study was to report on readmission rates after CR total knee arthroplasties (TKAs) and to evaluate the potential contributing factors for these events. We reviewed a prospectively collected database of 412 patients (441 TKAs) at 11 institutions. This included 170 men and 242 women who had a mean age of 66 years. Overall, there were 15 unplanned readmissions (3.4%) in 15 patients during the first 90 days following discharge after the index art...
Source: Journal of Knee Surgery - May 29, 2014 Category: Orthopaedics Authors: Issa, KimonaCherian, Jeffrey J.Kapadia, Bhaveen H.Robinson, KristinBhowmik-Stoker, ManoshiHarwin, Steven F.Mont, Michael A. Tags: Original Article Source Type: research

Infrapatellar Fat Pad Osteochondroma: Three Cases and a Systematic Review
We report three cases and a systematic review of the literature. Three females, aged 47, 54, and 70 years, presented with pain and a parapatellar knee mass. All three underwent marginal excision with no complications and no recurrence. In the literature, 32 reports describing 42 cases were identified. Mean age at presentation was 51.1 years (range: 12–75). There were 25 females and 20 males. Seven patients (15.6%) had a history of antecedent trauma. Mean duration of presenting symptoms was 63.9 months (range: 2–300). All patients except for one underwent open excision. Mean follow-up was 14.9 months (range: 3&n...
Source: Journal of Knee Surgery - May 29, 2014 Category: Orthopaedics Authors: Evaniew, NathanBayegan, DariusPopovic, SnezanaParasu, NaveenGhert, Michelle Tags: Original Article Source Type: research

Biomarkers Affected by Impact Severity during Osteochondral Injury
J Knee SurgDOI: 10.1055/s-0034-1376329Osteochondral injury elevates the risk for developing posttraumatic osteoarthritis (PTOA). Therefore, our objective was to evaluate the relationship between impact severity during injury to cell viability and biomarkers possibly involved in PTOA. Osteochondral explants (6 mm, n = 72) were harvested from cadaveric femoral condyles (N = 6). Using a test machine, each explant (except for No Impact) was subjected to mechanical impact at a velocity of 100 mm/s to 0.25, 0.5, 0.75, 1.0, or 1.25 mm maximum compression corresponding to Low, Low-Moderate...
Source: Journal of Knee Surgery - May 23, 2014 Category: Orthopaedics Authors: Waters, Nicole PoythressStoker, Aaron M.Pfeiffer, Ferris M.Cook, James L. Tags: Original Article Source Type: research

Limb Alignment, Subluxation, and Bone Density Relationship in the Osteoarthritic Varus Knee
This study highlights the relationship between limb alignment, knee subluxation, and bone density in the osteoarthritic knee. These preliminary results present a proof-of-principle, that bone mineral density affects the degree of coronal alignment and TF subluxation in OA.[...]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 12, 2014 Category: Orthopaedics Authors: Khamaisy, SakerNam, DenisThein, RanRivkin, GurionLiebergall, MeirPearle, Andrew Tags: Original Article Source Type: research

Differences in Readmission Rates for Two Total Knee Arthroplasty Prostheses
J Knee SurgDOI: 10.1055/s-0034-1376331The readmission rates of cruciate-retaining (CR) and a posterior-stabilizing (PS) total knee arthroplasty (TKA) have not been extensively evaluated. We aimed to determine the following: (1) What are the readmission rates of TKA performed with the use of CR and PS prostheses at 30, 60, and 90 days following discharge? (2) Were the causes of the unplanned readmission surgically or medically related? (3) What were the medical comorbidities associated with readmission? A prospectively collected database of 845 TKAs (441 CR and 404 PS TKAs) at 22 institutions (24 surgeons) was reviewed. Out...
Source: Journal of Knee Surgery - May 12, 2014 Category: Orthopaedics Authors: Cherian, Jeffrey J.Issa, KimonaRobinson, KristinBhowmik-Stoker, ManoshiHarwin, Steven F.Mont, Michael A. Tags: Original Article Source Type: research

Comparison of Efficacy and Tolerability of Hylan G-F 20 in Patients with and without Effusions at the Time of Initial Injection
This study compares efficacy of hylan G-F 20 in patients with and without an effusion. Patients with knee osteoarthritis (OA) received three weekly injections of hylan G-F 20. A total of 50 patients with an effusion requiring aspiration were compared with 50 matched patients without an effusion. Outcome measurements included Western Ontario and McMaster's Universities Osteoarthritis index (WOMAC) and visual analog scale (VAS). Patients were followed for 26 weeks. Both effusion and control group VAS was significantly lowered at all time points. WOMAC scores improved (p 
Source: Journal of Knee Surgery - May 7, 2014 Category: Orthopaedics Authors: Waddell, Bradford S.Waddell, W. HunterWaddell, David D. Tags: Original Article Source Type: research

Characterization of Knee Meniscal Pathology: Correlation of Gross, Histologic, Biochemical, Molecular, and Radiographic Measures of Disease
This study characterizes meniscal pathology in the presence of symptomatic osteoarthritis and correlates clinical and basic science data in an attempt to delineate clinically relevant mechanisms of disease. Twenty-seven knees from 23 patients who underwent total knee arthroplasty comprised the affected group and 6 aged nonsymptomatic knees were used as controls. All meniscal tissues were harvested and subjectively scored for gross and histologic pathology. Biochemical analyses were performed to determine glycosaminoglycan (GAG) content, collagen (hydroxyproline) content, and water content. Real-time polymerase chain reacti...
Source: Journal of Knee Surgery - May 7, 2014 Category: Orthopaedics Authors: Roller, Brandon L.Monibi, Farrah A.Stoker, Aaron M.Kuroki, KeiichiBal, B. SonnyCook, James L. Tags: Original Article Source Type: research

Outcomes following Microfracture of Full-Thickness Articular Cartilage Lesions of the Knee in Adolescent Patients
This study was approved by the Institutional Review Board. Patients 
Source: Journal of Knee Surgery - April 24, 2014 Category: Orthopaedics Authors: Steadman, J. RichardBriggs, Karen K.Matheny, Lauren M.Guillet, AlysonHanson, Chad M.Willimon, S. Clifton Tags: Original Article Source Type: research

Barbed Sutures in Total Knee Arthroplasty: Are These Safe, Efficacious, and Cost-Effective?
J Knee SurgDOI: 10.1055/s-0034-1373741The use of barbed sutures has become increasingly popular; however, their efficacy and safety continues to be debated. We review the records of 333 primary total knee arthroplasties (TKAs) to determine the difference in wound closure and total operative time between patients closed with a barbed versus standard sutures. We also evaluated complication rates and cost differences between the two groups. Overall, we saw no significant difference in either wound closure time (31 vs. 30 minutes) or total operative time (115 vs. 114 minutes). No significant differences were observed in the co...
Source: Journal of Knee Surgery - April 24, 2014 Category: Orthopaedics Authors: Maheshwari, Aditya V.Naziri, QaisWong, AndyBurko, IvanMont, Michael A.Rasquinha, Vijay J. Tags: Original Article Source Type: research

Can Cementing Technique Reduce the Cost of a Primary Total Knee Arthroplasty?
J Knee SurgDOI: 10.1055/s-0034-1373740Studies on cost containment of total knee arthroplasty (TKA) have generated substantial interest over the past decade. Although multiple studies have evaluated the various intraoperative methods to control cost, no prior study has evaluated the economic impact and the clinical outcome based on amount of bone cement needed for a primary TKA. At a minimum of 3 years follow-up, we observed no difference in implant survivorship or Knee Society scores, but did observe substantial cost savings when one versus two packets of bone cement were used in combination with a hand mixing technique. B...
Source: Journal of Knee Surgery - April 21, 2014 Category: Orthopaedics Authors: Maheshwari, AdityaArgawal, MayankNaziri, QaisPivec, RobertMont, Michael A.Rasquinha, Vijay J. Tags: Original Article Source Type: research

Joint Salvage Using Sandwich Technique for Giant Cell Tumors around Knee
This study was done to evaluate the results of sandwich technique in tumors around the knee joint. It was a prospective study of 26 consecutive patients (15 females and 11 males) with Campanacci grade II and grade III GCT around the knee, which qualified the inclusion criterion and underwent knee reconstruction with sandwich technique, after extended curettage of the tumor. The mean age of the patients at the time of surgery was 32.73 ± 11.30 years (range, 18–62 years), and the mean follow-up was 3.87 ± 1.26 years (range, 6.5–2 years). At final follow-up, the functional...
Source: Journal of Knee Surgery - April 21, 2014 Category: Orthopaedics Authors: Kundu, Zile SinghGogna, ParitoshSingla, RohitSangwan, Sukhbir SinghKamboj, PradeepGoyal, Shobit Tags: Original Article Source Type: research

Management of Intraoperative Complications in Arthroscopic Primary Anterior Cruciate Ligament Reconstruction
J Knee SurgDOI: 10.1055/s-0034-1373739Arthroscopic anterior cruciate ligament reconstruction is a commonly performed procedure which is technically demanding and involves multiple surgical steps with the potential for a wide range of intraoperative complications. In this article, we review these potential complications and give algorithms for dealing with them based on our experience and published evidence. We discuss the use of both bone-patellar tendon-bone and hamstring grafts and examine complications associated with suspensory button and interference screw fixation.[...]Thieme Medical Publishers 333 Seventh Avenue, Ne...
Source: Journal of Knee Surgery - April 21, 2014 Category: Orthopaedics Authors: Charalambous, Charalambos P.Alvi, FarhanSutton, Paul M. Tags: Original Article Source Type: research

Preoperative Measurement of ACL Insertion Sites
This study was designed to evaluate preoperative predictions of the femoral and tibial ACL insertion lengths. Intraoperative measurements were made of the femoral and tibial ACL insertion lengths with an arthroscopic ruler. A musculoskeletal radiologist and a sports medicine orthopedic surgeon measured the ACL insertions from preoperative magnetic resonance imagings (MRIs) in a blinded fashion. Correlations between height, weight, body mass index, and gender with intraoperative ACL insertion length measures were also evaluated. Patient height and male gender demonstrated strong correlations with intraoperative ACL insertio...
Source: Journal of Knee Surgery - March 12, 2014 Category: Orthopaedics Authors: Schwartzberg, RandySnyder, KevinReuss, Bryan Tags: Original Article Source Type: research

Adverse Effect of Femoral Nerve Blockade on Quadriceps Strength and Function after ACL Reconstruction
J Knee SurgDOI: 10.1055/s-0034-1371769The purpose of this study was to determine if quadriceps strength and functional outcomes were similar at 6 months following anterior cruciate ligament [ACL] reconstruction in patients receiving a continuous 48-hour femoral nerve blockade for postoperative analgesia (FNB group) versus patients with no FNB (control group). A retrospective cohort was designed including athletes who underwent primary ACL reconstruction with patellar tendon autograft between 2005 and 2010 at our institution with identical rehabilitation protocols. The FNB group included 96 patients with an average age of 2...
Source: Journal of Knee Surgery - March 12, 2014 Category: Orthopaedics Authors: Krych, AaronArutyunyan, GrigoriyKuzma, ScottLevy, BruceDahm, DianeStuart, Michael Tags: Original Article Source Type: research

Arthroscopic Training Resources in Orthopedic Resident Education
J Knee SurgDOI: 10.1055/s-0034-1368142The purpose of this study was to determine the frequency of use, perceived effectiveness, and preference for arthroscopic surgical skill training resources. An electronic survey was sent to orthopedics residents, residency program directors, and orthopedic sports medicine attending physicians in the United States. The frequency and perceived effectiveness of 10 types of adjunctive arthroscopic skills training was assessed. Residents and faculty members were asked to rate their confidence in resident ability to perform common arthroscopic procedures. Surveys were completed by 40 of 152 ...
Source: Journal of Knee Surgery - February 7, 2014 Category: Orthopaedics Authors: Koehler, RyanJohn, TamaraLawler, JeffreyMoorman, ClaudeNicandri, Gregg Tags: Original Article Source Type: research

Joint Line Restoration in a Contemporary Revision Knee System
J Knee SurgDOI: 10.1055/s-0034-1368144We investigated a new revision total knee arthroplasty device and associated instrumentation to determine if it could reduce intraoperative complexity and restore the joint line through the arc of motion. In a prospective multicenter study, a total of 95 consecutive patients undergoing a revision knee arthroplasty were evaluated. Medical history, functional health scores, and intraoperative data were collected. The joint line was restored to 28 mm ± 5 mm in full extension and 90-degree flexion. Significant improvements were noted in all functional and...
Source: Journal of Knee Surgery - February 6, 2014 Category: Orthopaedics Authors: Hitt, KirbyBhowmik-Stoker, ManoshiHoward, MichaelMittal, YogeshHeekin, R. DavidJacofsky, David Tags: Original Article Source Type: research

Shear Force at Failure and Stiffness of All-Inside Meniscal Repair Devices
J Knee SurgDOI: 10.1055/s-0033-1349181Thieme 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 11, 2013 Category: Orthopaedics Authors: Kesto, William K.Esquivel, Amanda O.Markel, David C. Tags: Erratum Source Type: research

Sixteen Years' Result of Posterior-Stabilized TKA
J Knee SurgDOI: 10.1055/s-0033-1343353Thieme 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 25, 2013 Category: Orthopaedics Authors: Cheung, Kin WingChiu, Kwok-Hing Tags: Erratum Source Type: research

Radiologically Hyperdense Zones of the Patella Seem to Be Partial Osteonecroses Subsequent to Fracture Treatment
J Knee SurgDOI: 10.1055/s-0033-1336595Thieme 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 26, 2013 Category: Orthopaedics Authors: Schüttrumpf, Jan PhilippBehzadi, CyrusBalcarek, PeterWalde, Tim AlexanderFrosch, StephanWachowski, Martin MichaelStürmer, Klaus MichaelFrosch, Karl-Heinz Tags: Erratum Source Type: research