Acute Total Knee Replacement in Rheumatoid Arthritis Patients with Proximal Tibial Fractures: A Case Series
J Knee Surg DOI: 10.1055/s-0040-1710563Management of proximal tibial fractures is a challenging issue in patients with rheumatoid arthritis (RA). In the present study, we aimed to describe our experience of acute total knee replacement in RA patients.This case series included 11 RA patients with simultaneous insufficiency fractures of the proximal tibia, who were treated by acute total knee replacement. Midterm functional results, severity of pain, Hospital for Special Surgery (HSS), and Knee Society Score (KSS) parameters were evaluated in this study. The patients were followed up for 24 months.Eleven women with proximal ...
Source: Journal of Knee Surgery - May 25, 2020 Category: Orthopaedics Authors: Mirzatolooei, Fardin Tabrizi, Ali Safari, Mir Bahram Shishavan, Seyed Amir Mahlisha Kazemi Tags: Original Article Source Type: research

Should Sequential Bilateral Total Knee Arthroplasty Be Limited to Patients Younger than 80? A Two-Arm Propensity Matched Study
This study included 89 patients aged 80 years and older undergoing sequential BTKA over 14 years were identified in a prospectively collected database. Two matched comparison groups were created: patients under 80 undergoing sequential BTKA and patients over 80 undergoing unilateral TKA (UTKA). An analysis of complications, mortality, revision, and patient-reported outcome measures was performed. Mean age of the elderly cohorts was similar: 82.6 for BTKA and 82.9 for UTKA. The average age BTKA cohort had a mean age of 69.1. Complication rates were higher in bilateral cohorts, more so in the elderly BTKA cohort. Pulmonary e...
Source: Journal of Knee Surgery - May 25, 2020 Category: Orthopaedics Authors: Klasan, Antonio Putnis, Sven Edward Yeo, Wai Weng Myat, Darli Fritsch, Brett Andrew Coolican, Myles Raphael Parker, David Anthony Tags: Original Article Source Type: research

Polyurethane Meniscal Scaffold: Does Preoperative Remnant Meniscal Extrusion Have an Influence on Postoperative Extrusion and Knee Function?
The objective of this study was to determine whether preoperative meniscal remnant extrusion (MRE) was correlated with postoperative scaffold extrusion (SE) or with functional outcomes at the 2-year follow-up. Retrospective study included all polyurethane scaffolds implanted with a minimum 2-year follow-up. A magnetic resonance imaging (MRI) was performed preoperatively and postoperatively at 2 years. Extrusion was measured in millimeters in a coronal view. Patients were assigned to either group 1 or 2 depending on the preoperative MRE being either
Source: Journal of Knee Surgery - May 25, 2020 Category: Orthopaedics Authors: Gelber, Pablo E. Torres-Claramunt, Ra úl Poggioli, Francesco P érez-Prieto, Daniel Monllau, Joan C. Tags: Original Article Source Type: research

All-Polyethylene Tibial Component Does Not Affect Survivorship of Medial Unicompartmental Knee Arthroplasty at Mid-Term Follow-Up
J Knee Surg DOI: 10.1055/s-0040-1710360The present study's primary aim was to determine the survivorship of a large cohort of patients implanted with a single design all-polyethylene tibial component medial unicompartmental knee arthroplasty (UKA). Its secondary purpose was to investigate the reasons underlying implant failure, with specific attention to component positioning and limb alignment. Between 2007 and 2013, 166 patients underwent medial UKA with a single design all-polyethylene tibial component at two centers. Preoperatively and postoperatively, patients were administered clinical outcome scores and radiographic...
Source: Journal of Knee Surgery - May 25, 2020 Category: Orthopaedics Authors: Gagliardi, Michele Zambianchi, Francesco Franz, Alois Digennaro, Vitantonio Catani, Fabio Tags: Original Article Source Type: research

The In fluence of Patellofemoral Degenerative Changes on the Outcome of the Unicompartmental Knee Replacement: A Prospective Study
We examined the validity of this preconception using information gathered prospectively on 147 consecutive patients who underwent the Repicci II UKA for medial compartment osteoarthritis between July 1999 and September 2000 by the same surgeon. The status of the PF joint was assessed intraoperatively in all patients, and accordingly patients were divided into two groups. Among them, 69 had associated PF osteoarthritis (group A), while 78 patients had a normal PF compartment (group B). Variables measured included the International Knee Society (IKS) score, limb alignment, and range of motion. Radiographs, demographic data, ...
Source: Journal of Knee Surgery - May 25, 2020 Category: Orthopaedics Authors: Abdulkarim, Ali Newton, Ayla C. O'Donnell, Turlough Neil, Michael J. Tags: Original Article Source Type: research

Feasibility and 3D Planning of a Novel Patient-Specific Instrumentation Technique in Medial Opening-Wedge High Tibial Osteotomy
J Knee Surg DOI: 10.1055/s-0040-1710379A novel approach for opening-wedge high tibial osteotomy (OWHTO) with patient-specific instrumentation (PSI) was evaluated for its safety, feasibility, and accuracy. Next, the mechanical medial proximal tibial angle (mMPTA) was assessed as a potential planning angle by investigating the relation with the mechanical femorotibial angle (mFTA). Ten OWHTO cases were 3D planned using the mMPTA and operated with a customized 3D-printed wedge and cast which resembled the intended osteotomy opening. Patients were closely monitored for intraoperative and postoperative complications up to 1 yea...
Source: Journal of Knee Surgery - May 22, 2020 Category: Orthopaedics Authors: Van Genechten, Wouter Van Tilborg, Wouter Van den Bempt, Maxim Van Haver, Annemieke Verdonk, Peter Tags: Original Article Source Type: research

Tibial Tray with a Stem: Does It Have Any Role in Primary Cemented Total Knee Replacement?
J Knee Surg DOI: 10.1055/s-0040-1712085Over many decades, total knee replacement (TKR) becomes the ideal treatment option for advanced arthritis. Many designs were introduced to increase the stability of the tibial tray, hence the longevity of the prosthesis. This retrospective study was performed on 168 patients who received NexGen cemented primary total knee either with standard tibial tray (group A) or tibial tray with an intramedullary stem (group B) between May 2008 and May 2017. We reviewed all preoperative and postoperative clinical and radiological data retrospectively. In addition, a prospective clinical and radio...
Source: Journal of Knee Surgery - May 22, 2020 Category: Orthopaedics Authors: Samy, Ahmed M. Azzam, Wael Tags: Original Article Source Type: research

The Rise of Obesity among Total Knee Arthroplasty Patients
This study utilizes a national database to evaluate incidence, demographics, outcomes, charges, and cost in nonobese, overweight, nonmorbidly obese, and morbidly obese TKA patients. We queried the National Inpatient Sample from 2009 to 2016 for primary TKA patients identifying 4,053,037 nonobese patients, 40,077 overweight patients, 809,649 nonmorbidly obese patients, and 428,647 morbidly obese patients. Chi-square was used to analyze categorical variables, and one-way analysis of variance was used to analyze continuous variables. Nonmorbidly obese and morbidly obese patients represented 23.2% of all TKAs. TKA utilization ...
Source: Journal of Knee Surgery - May 22, 2020 Category: Orthopaedics Authors: Mohamed, Nequesha S. Wilkie, Wayne A. Remily, Ethan A. D ávila Castrodad, Iciar M. Jean-Pierre, Mirlande Jean-Pierre, Nancy Gbadamosi, Wahab A. Halik, Abraham K. Delanois, Ronald E. Tags: Original Article Source Type: research

Magnesium Sulfate Combined with a Levobupivacaine Periarticular Cocktail for Analgesia in the Early Postoperative Period after Total Knee Arthroplasty
This study aimed to evaluate the analgesic effect of magnesium sulfate combined with a levobupivacaine periarticular cocktail in the early postoperative period after total knee arthroplasty (TKA). A total of 60 patients who underwent primary unilateral TKA in our department from March 2018 to May 2019 were prospectively selected and randomly divided into the trial group (30 patients with 20 mL of magnesium sulfate 250 mg + levobupivacaine 50 mg + triamcinolone 25 mg + 0.9% normal saline) and the control group (30 patients with 20 mL of levobupivac...
Source: Journal of Knee Surgery - May 20, 2020 Category: Orthopaedics Authors: Zhao, Zhenrui Zhang, Xiaozhou Peng, Hao Li, Wei Liu, Hengzhong Wu, Hang Tags: Original Article Source Type: research

Patellar Resurfacing Does Not Improve Clinical Outcome in Patients with Symptomatic Tricompartmental Knee Osteoarthritis. An RCT Study of 40 Patients Receiving Primary Cruciate Retaining Total Knee Arthroplasty
J Knee Surg DOI: 10.1055/s-0040-1710369There is some evidence that patellofemoral (PF) joint osteoarthritis (OA) causes anterior knee pain (AKP) after total knee arthroplasty (TKA). We hypothesized that patellar resurfacing in primary TKA for patients with symptomatic tricompartmental knee OA yields better clinical results after 2 years than non-resurfacing. A single center randomized controlled clinical trial comparing 40 patients receiving 42 cruciate retaining TKAs with (n = 21) or without patellar resurfacing (n = 21) was conducted. Primary outcome was the specific PF joint score HSS Baldini...
Source: Journal of Knee Surgery - May 20, 2020 Category: Orthopaedics Authors: Raaij, Tom M. van Meij, Evelien van der Vries, Astrid J. de Raay, Jos J.A.M. van Tags: Original Article Source Type: research

Knee Arthroplasty with Prior Ligamentous Knee Surgery: A Matched Case –Control Study
J Knee Surg DOI: 10.1055/s-0040-1710375We aimed to evaluate the timing, operative details, and outcomes of total knee arthroplasty (TKA) in patients with prior ligamentous knee surgery (LKS). All consecutive patients undergoing TKA with prior LKS at a single institution were identified from a large prospectively collected database. Patients were matched on a 2:1 basis according to age, sex, and body mass index to a group of patients without previous LKS undergoing primary TKA. A total of 39 patients with prior LKS and a mean age of 55.6 years (range: 42.8–76.4) were identified and matched with 78 patients without LKS...
Source: Journal of Knee Surgery - May 20, 2020 Category: Orthopaedics Authors: Patel, Nirav K. Hadley, Christopher J. Leite, Samantha Brahmabhatt, Shyam Mazur, Donald Parvizi, Javad Ciccotti, Michael G. Tags: Original Article Source Type: research

Topical Tranexamic Acid in Total Knee Arthroplasty: Does It Augment the Effect of the Intravenous Administration in Patients with Moderate-to-High Risk of Bleeding? A Randomized Clinical Trial
In conclusion, the combined use of topical and IV tranexamic acid resulted in a significant reduction in postoperative blood loss and hemoglobin level following TKA but did not influence the rate of allogeneic blood transfusion. This is a Level I, therapeutic study. [...] 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 20, 2020 Category: Orthopaedics Authors: Abdallah, Ahmed A. Sallam, Asser A. Arafa, Mohamed S. Henawy, Ayman T. Tags: Original Article Source Type: research

Comparison and Validation of Preoperative Planning Techniques for Distal Femoral Osteotomies and Proximal Tibial Osteotomies
In this study, we aim to compare the Sectra osteotomy tool versus the mCORA technique to measure the osteotomy angles as well as wedge sizes in both DFOs and PTOs to validate this new tool.We enrolled n = 30 consecutive patients with DFOs and n = 30 PTOs from the last year. The Pearson correlation coefficient (PCC) along with descriptive statistics was used to evaluate for similarity between the two techniques. We also compared interobserver and intraobserver reliability using intraclass correlation coefficients (ICC).The PCC for osteotomy angles in DFOs and PTOs were both 0.998 (p 
Source: Journal of Knee Surgery - May 19, 2020 Category: Orthopaedics Authors: Zhang, David T. Principe, Peter S. Fragomen, Austin T. Rozbruch, S Robert Tags: Original Article Source Type: research

Clinical and Radiographic Outcomes of Double-Bundle Anterior Cruciate Ligament Reconstruction for Asian Patients with Bone-Patellar Tendon-Bone and Gracilis Tendon Grafts: A Matched-Control Comparison
This study aimed to assess the clinical and radiographic outcomes of BPTB and gracilis (G) composite autografts for primary double-bundle ACL reconstruction in Asian athletes. Thirty-two Asian patients undergoing double-bundle ACL reconstruction with 7.0 to 7.5 mm of BPTB and 5.0 to 5.5 mm of G composite grafts were compared with 43 double-bundle ACL reconstruction with hamstring graft cases. The BPTB graft was used for the anteromedial bundle (AMB), with the G graft for the posterolateral bundle (PLB). Percentage of femoral bone tunnel enlargement compared with the original size was determined by computed di...
Source: Journal of Knee Surgery - May 19, 2020 Category: Orthopaedics Authors: Tajima, Takuya Yamaguchi, Nami Morita, Yudai Nagasawa, Makoto Ota, Tomomi Nakamura, Yoshihiro Yokoe, Takuji Chosa, Etsuo Tags: Original Article Source Type: research

Factors Influencing the Valgus Cut Angle —during Total Knee Arthroplasty—in Indian Population
J Knee Surg DOI: 10.1055/s-0040-1710564The number of total knee arthroplasties performed in India and the world is increasing exponentially. The valgus cut angle (VCA) of the distal femur decides the final alignment achieved in the coronal plane. Little data are available regarding the ideal value for an Indian population and there is little consensus whether to use a single value for all knees or to individualize the angle for each patient. The parameters that can influence the value of this angle have not been evaluated thoroughly.Standard long leg X-ray (orthoscanogram) was used to calculate the VCA in 302 lower limbs (...
Source: Journal of Knee Surgery - May 19, 2020 Category: Orthopaedics Authors: Marya, Sanjiv Singh, Chandeep Kacker, Shitij Velayutham, Sarthy Desai, Rahul Tags: Original Article Source Type: research

Outcomes after Surgical Repair of Medial Meniscal Root Tears: A Review
J Knee Surg DOI: 10.1055/s-0040-1710565At the present time, there is a paucity of literature regarding medial meniscal posterior root repair and outcomes. This review seeks to examine the currently available data to further elucidate the clinical risks and benefits and any associated risks of medial meniscal posterior root repair. A systematic literature search was performed up to July 2018 in the databases of Medline via PubMed, EBSCOhost, and EMBASE. The results were reviewed independently by two authors and appropriate articles were reviewed and eligibility determined based on established criteria. The best-evidence syn...
Source: Journal of Knee Surgery - May 19, 2020 Category: Orthopaedics Authors: Edwards, Chad Goldman, Brian H. Turley, Jeffery Richey, Bradley Deal, Matthew Jordan Kalbac, Daniel Tags: Original Article Source Type: research

Improved Visualization by Central Subluxation of the Lateral Meniscus in Comminuted Lateral Tibial Plateau Fractures
J Knee Surg DOI: 10.1055/s-0040-1709518The goal of surgical reconstruction of comminuted tibial plateau fractures is an anatomical reconstruction and stable fixation of the articular surface. This can be difficult due to poor visualization of the posterolateral and central segments of the articular surface of the proximal tibia. To improve visualization, the lateral approach can be extended with an osteotomy of the femoral epicondyle. In most cases, use of the extended lateral approach allows the whole lateral plateau to be visualized. Nevertheless, in some cases, an osteotomy alone is not enough to expose the entire fract...
Source: Journal of Knee Surgery - May 15, 2020 Category: Orthopaedics Authors: Guttowski, Dario Krause, Matthias P üschel, Klaus Kolb, Jan Philipp Hartel, Maximilian Frosch, Karl-Heinz Tags: Original Article Source Type: research

Primary Total Knee Arthroplasty: Correlation between Preoperative Radiographic Severity of Arthritis and Postoperative Patient Satisfaction
This study focuses on patient-reported outcomes and satisfaction in relation to preoperative radiographic arthritis severity. A retrospective chart review of 420 TKAs was performed. Patient satisfaction was determined using a structured telephone survey with questions focused on degree of satisfaction whether they would have surgery again and their ability to kneel. The radiographic severity of the arthritis of the tibiofemoral joint was graded by a musculoskeletal radiologist using the Kellgren–Lawrence grading scale. The patellofemoral compartment was graded using the scale described by Jones et al. Those grouped a...
Source: Journal of Knee Surgery - May 13, 2020 Category: Orthopaedics Authors: Rooks, Katie Houdek, Devon Obaid, Haron Dust, William Tags: Original Article Source Type: research

A Best-Fit of an Anatomic Tibial Baseplate Closely Parallels the Flexion-Extension Plane and Covers a High Percentage of the Proximal Tibia
J Knee Surg DOI: 10.1055/s-0040-1710367There are no reports of in vivo internal–external (I–E) rotational alignment and coverage of the proximal tibia after performing a best-fit method of an anatomically designed and asymmetrically shaped tibial baseplate during calipered kinematically aligned (KA) total knee arthroplasty (TKA). We hypothesized that a best-fit plane sets the anterior–posterior (A–P) axis of the anatomic baseplate closely parallel to the flexion–extension (F–E) plane of the knee and covers a high percentage of the proximal tibia. A total of 145 consecutive primary TKAs w...
Source: Journal of Knee Surgery - May 13, 2020 Category: Orthopaedics Authors: Nedopil, Alexander J. Zamora, Tomas Shelton, Trevor Howell, Stephen M. Hull, Maury Tags: Original Article Source Type: research

Synovial Fluid Mesenchymal Stem Cells for Knee Arthritis and Cartilage Defects: A Review of the Literature
J Knee Surg DOI: 10.1055/s-0040-1710366Mesenchymal stem cells (MSCs) are adult stem cells that have the ability to self-renew and differentiate into several cell lineages including adipocytes, chondrocytes, tenocytes, bones, and myoblasts. These properties make the cell a promising candidate for regenerative medicine applications, especially when dealing with sports injuries in the knee. MSCs can be isolated from almost every type of adult tissue. However, most of the current research focuses on MSCs derived from bone marrow, adipose, and placenta derived products. Synovial fluid-derived MSCs (SF-MSCs) are relatively overl...
Source: Journal of Knee Surgery - May 13, 2020 Category: Orthopaedics Authors: Fang, William Sun, ZhiTao Chen, Xiao Han, Bo Vangsness, C. Thomas Tags: Original Article Source Type: research

Comparison of Clinical and Radiological Parameters with Two Different Surgical Methods for Anterior Cruciate Ligament Reconstruction
This study compared the clinical and radiological findings of nonanatomic transtibial (TT) technique with intraspongious fixation and anatomical anteromedial portal (AMP) technique with extracortical button implant in anterior cruciate ligament (ACL) reconstruction. A total of 54 patients with isolated ACL rupture were included in this prospective study. The patients who had the intraspongious fixation by nonanatomical TT technique were allocated to Group 1 (n = 27). The patients with extracortical fixation by anatomical AMP technique were placed in Group 2 (n = 27). The clinical scores of the p...
Source: Journal of Knee Surgery - May 11, 2020 Category: Orthopaedics Authors: Çiloğlu, Osman Çiçek, Hakan Y ılmaz, Ahmet Özalay, Metin S öker, Gökhan Leblebici, Berrin Tags: Original Article Source Type: research

Patient-Reported Outcomes for Large Bipolar Osteochondral Allograft Transplantation in Combination with Realignment Osteotomies for the Knee
J Knee Surg DOI: 10.1055/s-0040-1710361Effective treatment for bipolar articular cartilage lesions in the knee remains a clinical challenge. Lower extremity malalignment is a risk factor for treatment failures, which can be addressed by tibial or femoral osteotomy. The purpose of this study was to compare outcomes among patients who underwent knee joint restoration by osteochondral allograft (OCA) transplantation with concurrent or staged realignment osteotomy. With Institutional Review Board approval, patients undergoing bipolar OCA transplantation with concurrent or staged distal femoral osteotomy (DFO) or high tibial os...
Source: Journal of Knee Surgery - May 5, 2020 Category: Orthopaedics Authors: Zitsch, Bradford P. Stannard, James P. Worley, John R. Cook, James L. Leary, Emily V. Tags: Original Article Source Type: research

Anterolateral Ligament Reconstruction Improves Anteroposterior Stability As Well As Rotational Stability in Revision Anterior Cruciate Ligament Reconstruction with High-Grade Pivot Shift
In conclusion, ALLR in revision ACLR with high-grade pivot shift improves anteroposterior stability as well as rotational stability at 2-year follow-up. Therefore, ALLR is recommended with revision ACLR, especially in patients with high-grade pivot shift. This is a Level III, retrospective cohort review. [...] 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 5, 2020 Category: Orthopaedics Authors: Yoon, Kyoung Ho Hwang, In Uk Kim, Eung Ju Kwon, Yoo Beom Kim, Sang-Gyun Tags: Original Article Source Type: research

Anatomical Anterior Cruciate Ligament Reconstruction with Hamstring Tendon Autografts: A Comparative Study of Three Different Techniques
J Knee Surg DOI: 10.1055/s-0040-1702164The ideal procedure for anterior cruciate ligament (ACL) reconstruction is one that can achieve anatomical restoration for a better ACL function. This retrospective comparative study was conducted to evaluate the objective and subjective clinical results of the conventional single-bundle femoral round (SBR) tunnel technique, the single-bundle femoral oval (SBO) tunnel technique, and the double-bundle (DB) surgical technique for anatomical ACL reconstruction with hamstring tendon autografts. Patients who underwent the SBO, SBR, and DB ACL reconstructions from January 2016 to August 201...
Source: Journal of Knee Surgery - May 5, 2020 Category: Orthopaedics Authors: Wen, Zhenxing Zhang, Hua Yan, Wenlong Mohamed, Sheikh Ibrahimrashid Zhao, Pei Huang, Xiao Xu, Zijie Zhang, Jian Zhou, Aiguo Tags: Original Article Source Type: research

The 50 Most Cited Articles in the Indications, Risk Factors, Techniques, and Outcomes of ACL Revision Surgery
This article aims to establish and evaluate “classic” articles. With consideration of these articles, this article also aims to evaluate gaps in the field and determine where future research should be directed. The general approach for data collection and analysis consisted of planning objectives, employing a defined strategy, reviewing search results using a multistep and multiauthor approach with specific screening criteria, and analyzing data. The collective number of citations for all publications within the list was 5,203 with an average of 104 citations per publication. “Biomechanical Measures durin...
Source: Journal of Knee Surgery - May 5, 2020 Category: Orthopaedics Authors: Ennis, Hayley E. Bondar, Kevin McCormick, Johnathon Chen, Clark Jia-Long Donnally, Chester J. Kaplan, Lee Tags: Original Article Source Type: research

Maryland's Global Budget Revenue Model: How Do Costs and Readmission Rates Fare for Patients Undergoing Total Knee Arthroplasty?
This study evaluated GBR's effect on demographics and outcomes for patients who underwent primary total knee arthroplasty (TKA) by comparing Maryland to the United States (U.S.). We identified primary TKA patients in Maryland's State Inpatient Database (n = 71,022) and the National Inpatient Sample (n = 4,045,245) between 2011 and 2016 utilizing International Classification of Disease (ICD)-9 and ICD-10 diagnosis codes. Multiple regression was used for difference-in-difference (DID) analyses to compare the intervention cohort (Maryland) to the nonintervention cohort (U.S.) between the pre-GBR (2...
Source: Journal of Knee Surgery - May 5, 2020 Category: Orthopaedics Authors: Delanois, Ronald E. Wilkie, Wayne A. Mohamed, Nequesha S. Remily, Ethan A. Pollak, Andrew N. Mont, Michael A. Tags: Original Article Source Type: research

Implant Alignment and Patient Factors Affecting the Short-Term Patient-Reported Clinical Outcomes after Oxford Unicompartmental Knee Arthroplasty
This study aims at clarifying implant alignment and other patient factors' influence on clinical outcomes, particularly on patient-reported outcomes (PRO), following Oxford unicompartmental knee arthroplasty (OUKA). A total of 142 patients after OUKA were divided into two groups according to the validated Japanese version of the knee injury and osteoarthritis outcome score (KOOS) for each subscale of pain, symptoms, and activities of daily living (ADL) at postoperative year 1 and 2: group 1 had ≥80 scores and group 2 had
Source: Journal of Knee Surgery - April 30, 2020 Category: Orthopaedics Authors: Yamagami, Ryota Inui, HIroshi Taketomi, Shuji Kono, Kenichi Kawaguchi, Kohei Takagi, Kentaro Kage, Tomofumi Sameshima, Shin Tanaka, Sakae Tags: Original Article Source Type: research

Routine Histopathological Analysis of the Synovium in Patients with Primary Total Knee Arthroplasty
J Knee Surg DOI: 10.1055/s-0040-1709181Although there are numerous studies about routine histopathological analysis during arthroplasty surgeries, most of them showed that new diagnoses have rarely been obtained as a result. The aim of this study was to evaluate the efficacy of routine pathological analyses of synovia resected during primary total knee arthroplasty in patients with osteoarthritis and its relevance in the treatment process. Of the 47 included patients who were followed up prospectively, 26 patients had clinical and histopathological concordant diagnoses and 21 patients had discrepant diagnoses. Oxford knee ...
Source: Journal of Knee Surgery - April 30, 2020 Category: Orthopaedics Authors: Utkan, Ali Caliskan, Emrah Gencer, Batuhan Ozkurt, Bulent Tags: Original Article Source Type: research

Routine Preoperative Group Crossmatching and Postoperative Check Hemoglobin Is not Necessary in Patients Undergoing Total Knee Arthroplasty
This study aims to find out if routine preoperative group crossmatch and postoperative check hemoglobin for total knee arthroplasty (TKA) patients is necessary. A retrospective analysis was performed on patients who underwent unilateral TKAs for osteoarthritis from January 1, 2004 to December 31, 2014. The main outcome measures were postoperative hemoglobin levels and transfusion requirements. Patients' demographics, comorbidities, laboratory results, and surgical details were analyzed. A total of 955 TKAs were included in this study (males = 207, females = 748; mean age = 66.1 yea...
Source: Journal of Knee Surgery - April 30, 2020 Category: Orthopaedics Authors: Tay, Adriel You Wei Thever, Yogen Bin Abd Razak, Hamid Rahmatullah Hao, Ying Tan, Andrew Hwee Chye Tags: Original Article Source Type: research

The Relationships between the Rotational Axes of the Distal Femur in the Arthritic Caucasian Knee: A Magnetic Resonance Imaging Analysis
J Knee Surg DOI: 10.1055/s-0040-1709676Four distal femoral axes have been described to aid in the accuracy of transverse plane component alignment in total knee arthroplasty (TKA). These include the surgical epicondylar axis (SEA), the posterior condylar axis (PCA), and the anteroposterior (AP) axis. Therefore, the primary purpose of this study is to identify the axial femoral relationship with the least variation in a Caucasian population awaiting TKA for osteoarthritis. Secondarily, we further plan to determine if these femoral axis relationships differ with respect to sex or preoperative coronal alignment. These anatomi...
Source: Journal of Knee Surgery - April 30, 2020 Category: Orthopaedics Authors: Halai, Mansur Kooner, Sahil Jamal, Bilal McMillan, Jacquelyn Syme, Brian Holt, Graeme Tags: Original Article Source Type: research

Efficacy of Arthroscopic Arthrolysis in the Treatment of Arthrofibrosis: A Systematic Review
J Knee Surg DOI: 10.1055/s-0040-1709182Stiffness after total knee arthroplasty (TKA) remains a clinical challenge for health care professionals. Historically, arthroscopic arthrolysis is a treatment modality that has been reserved for patients that have failed other conservative modalities, including manipulation under anesthesia. However, a systematic review of the literature evaluating the clinical efficacy and complications of arthroscopic arthrolysis for stiffness after TKA has not been performed. A systematic review of medical databases (PubMed, EMBASE, Cochrane Library) was undertaken for articles published from Janu...
Source: Journal of Knee Surgery - April 30, 2020 Category: Orthopaedics Authors: Cohen, Jordan S. Gu, Alex Kapani, Nisha Asadourian, Paul A. Stake, Seth Quan, Theodore Malahias, Michael A. Sculco, Peter K. Tags: Original Article Source Type: research

Special Focus Section: The Dislocated Knee —Part 2
J Knee Surg 2020; 33: 417-417 DOI: 10.1055/s-0040-1708043 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 - April 30, 2020 Category: Orthopaedics Authors: Fanelli, Gregory C. Tags: Special Focus Section Source Type: research

Two-Stage Exchange Using a Short Intramedullary Nail for Treatment of Periprosthetic Knee Infections: A Technique Worth Questioning
This study reports on (1) success rates, (2) functional and pain outcomes, (3) and complications for patients receiving a temporary short intramedullary nail for the treatment of PJI. Our institutional database was queried for all repeat knee PJI patients between March 1st, 2009 and February 28th, 2015. Patients with type II/III Anderson Orthopaedic Research Institute (AORI) bone defects who underwent two-stage exchange arthroplasty with a short antibiotic-coated intramedullary nail were included for analysis (n = 31). Treatment success was determined using the Delphi-based consensus definition of a successfu...
Source: Journal of Knee Surgery - April 24, 2020 Category: Orthopaedics Authors: Mohamed, Nequesha S. Etcheson, Jennifer I. Wilkie, Wayne A. Remily, Ethan A. Kluk, Matthew W. Thompson, John Plate, Johannes F. Mont, Michael A. Delanois, Ronald E. Tags: Original Article Source Type: research

Subintermeniscal Ligament Pullout Suture Technique for Anterior Cruciate Ligament Avulsion Fracture Fixation —AIIMS Technique
J Knee Surg DOI: 10.1055/s-0040-1709180Many methods have been described, including pullout suture technique, for arthroscopic fixation of displaced tibial eminence fracture. We are describing our technique of pullout suture, which is a modification of previously described techniques. We passed two sutures arthroscopically through anterior cruciate ligament (ACL) just above the avulsed fragment and then pulled them out through medial and lateral bone tunnel in anterior aspect of crater in tibial plateau. The third suture passed through ACL was pulled out anteriorly under the transverse intermeniscal ligament through a subme...
Source: Journal of Knee Surgery - April 24, 2020 Category: Orthopaedics Authors: Mittal, Ravi Digge, Vijaykumar Selvanayagam, Rajkumar Tags: Original Article Source Type: research

Effect of Manipulation under Anesthesia of the First Knee in Staged Bilateral Total Knee Arthroplasty on Clinical Outcome and Satisfaction
This study aimed to evaluate whether manipulation under anesthesia (MUA) affect clinical outcome including range of motion (ROM) and patient satisfaction after total knee arthroplasty (TKA). It is hypothesized that MUA improves clinical outcomes and patient satisfaction after primary TKA. This retrospective study analyzed 97 patients who underwent staged bilateral primary TKA. MUA of knee flexion more than 120 degrees was performed a week after index surgery just before operation of the opposite site. The first knees with MUA were classified as the MUA group and the second knees without MUA as the control group. ROM...
Source: Journal of Knee Surgery - April 24, 2020 Category: Orthopaedics Authors: Lim, Jung-Won Park, Yong-Beom Lee, Dong-Hoon Lee, Han-Jun Tags: Original Article Source Type: research

The Role of Knee Position in Blood Loss and Enhancement of Recovery after Total Knee Arthroplasty
J Knee Surg DOI: 10.1055/s-0040-1708042The study aimed to investigate the effects of postoperative position of knee on blood loss and functional recovery after total knee arthroplasty (TKA). We enrolled patients who underwent TKA from 2017 to 2019 in our department with osteoarthritis of the knee in this prospective and randomized study. The patients were randomly allocated to flexion or extension group. In the flexion group, the affected leg was elevated by 30 degrees at the hip and the knee was flexed by 30-degree, postoperatively, while in the extension group, the affected knee was fully extended postoperatively. Patien...
Source: Journal of Knee Surgery - April 24, 2020 Category: Orthopaedics Authors: Cao, Le Yang, Haitao Sun, Kai Wang, Hanbang Fan, Haitao Cheng, Wendan Tags: Original Article Source Type: research

Inpatient Opioid Consumption Variability following Total Knee Arthroplasty: Analysis of 4,038 Procedures
This study examined an early iteration of an inpatient opioid administration-reporting tool, which standardized patient opioid consumption as an average daily morphine milligram equivalence per surgical encounter (MME/day/encounter) among total knee arthroplasty (TKA) recipients. The objective was to assess the variability of inpatient opioid administration rates among surgeons after implementation of a multimodal opioid sparing pain protocol. We queried the electronic medical record at our institution for patients undergoing elective primary TKA between January 1, 2016 and June 30, 2018. Patient demographics, inpatient an...
Source: Journal of Knee Surgery - April 20, 2020 Category: Orthopaedics Authors: Roof, Mackenzie A. Sullivan, Connor W. Feng, James E. Anoushiravani, Afshin A. Waren, Daniel Friedlander, Scott Lajam, Claudette M. Schwarzkopf, Ran Slover, James D. Tags: Original Article Source Type: research

Design, Construction, and Early Results of a Formal Local Revision Knee Arthroplasty Registry
J Knee Surg DOI: 10.1055/s-0040-1708040National registries for primary and revision knee arthroplasty in Australia, New Zealand, and Europe have been successful in ensuring quality control and providing information to drive crucial research. However, they face challenges in delivering the granularity of data useful at a local hospital level. Our aim was to address these challenges by designing and initiating a local revision knee arthroplasty registry and combining the data with national figures to better evaluate the types of revisions undertaken, and improve patient outcomes and care. All revision knee arthroplasty cases...
Source: Journal of Knee Surgery - April 15, 2020 Category: Orthopaedics Authors: Visvanathan, Aravinthan Wilson, Christopher Jackman, Emma Wong, Geraldine Krishnan, Jegan Tags: Original Article Source Type: research

Evaluation of Meniscal Tissue after Meniscal Repair Using Ultrahigh Field MRI
J Knee Surg DOI: 10.1055/s-0040-1709135The study evaluates the meniscal tissue after primary meniscal suturing using 7-Tesla (T) magnetic resonance imaging with T2* mapping at 6 and 12 months after surgery to investigate the differences between repaired meniscal tissue and healthy meniscal tissue in the medial and lateral compartment. This prospective study included 11 patients (9m/2f) with a mean age of 30.6 years (standard deviation 9.0). Patients with a meniscal tear that was treated arthroscopically with meniscus suturing, using an all-inside technique, were included. All patients and seven healthy volunteers were imag...
Source: Journal of Knee Surgery - April 8, 2020 Category: Orthopaedics Authors: Stelzeneder, Beate Trabauer, Bernhard Michael Aldrian, Silke Stelzeneder, David Juras, Vladimir Albrecht, Christian Hajdu, Stefan Platzer, Patrick Trattnig, Siegfried Tags: Original Article Source Type: research

Benefits of CT Scanning for the Management of Knee Arthritis and Arthroplasty
J Knee Surg DOI: 10.1055/s-0040-1708041This review investigated the potential value of computed tomography (CT) scans for the evaluation and management of knee arthritis and arthroplasty. Specifically, we evaluated the following: (1) assessment of arthritis within knee compartments, (2) patellofemoral joint assessment, (3) implant sizing prediction, (4) component alignment, (5) soft-tissue protection, and (6) potential concerns with radiation exposure. To compare if CT or X-ray imaging is more accurate and clinically relevant, a search was performed using Boolean search operators and terms: “CT,” “radiogr...
Source: Journal of Knee Surgery - April 8, 2020 Category: Orthopaedics Authors: Sodhi, Nipun Jacofsky, David J. Chee, Alexander Mont, Michael A. Tags: Original Article Source Type: research

Treatment of Concomitant ACL and MCL Injuries: Spontaneous Healing of Complete ACL and MCL Tears
This study was conducted during 2013 to 2017. A total of 707 patient referred with combined ACL and MCL injuries. Patients were divided into three groups according to type of ACL and MCL management as follows: (1) group 1 as those who only had ACL reconstruction without any surgical treatment of MCL; (2) group 2 as those who had ACL reconstruction and MCL surgery (reconstruction, reefing, or both); (3) group 3 as those who showed spontaneous healing of ACL and MCL. Overall, 206 and 129 patients entered groups 1 and 2, respectively. Overall, 15 patients showed spontaneous healing of ACL and entered group 3. Skiing and socce...
Source: Journal of Knee Surgery - April 8, 2020 Category: Orthopaedics Authors: Razi, Mohammad Soufali, Amir Payman Ziabari, Elaheh Ziaei Dadgostar, Haleh Askari, Alireza Arasteh, Peyman Tags: Original Article Source Type: research

Fast Return to Sports and High Level of Activity after Cementless Oxford Unicompartmental Knee Arthroplasty
In conclusion, cementless OUKR allows a fast return to activity with a high level of physical exercise. Patients with increased BMI tend to practice less types of sports with decreased activity scores. [...] 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 - April 8, 2020 Category: Orthopaedics Authors: Panzram, Benjamin Mandery, Mira Reiner, Tobias Walker, Tilman Merle, Christian Gotterbarm, Tobias Tags: Original Article Source Type: research

A Pilot Study of a Novel Fixation Technique for Fixation of Comminuted Patellar Fractures: Arthroscopic-Controlled Reduction and Circular External Fixation
J Knee Surg DOI: 10.1055/s-0040-1708830Patella fractures represent for 0.5 to 1.5% of all bony injuries in adults. Open reduction and the modified tension-band technique is the most common surgical technique used for patellar fractures. The purpose of this study is to present the outcomes of 26 comminuted patellar fractures treated with circular external fixator (CEF) under arthroscopic control and discuss its potential advantages over conventional surgical methods. This retrospective study included 26 patients who had closed comminuted patellar fractures and treated by CEF under arthroscopic control between January 2002 a...
Source: Journal of Knee Surgery - April 8, 2020 Category: Orthopaedics Authors: Neyisci, Cagri Erdem, Yusuf Kilic, Erden Arsenishvili, Arsen K ürklü, Mustafa Tags: Original Article Source Type: research

In Vitro Kinematic Analysis of Single Axis Radius Posterior-Substituting Total Knee Arthroplasty
J Knee Surg DOI: 10.1055/s-0040-1708039This is an experimental study. As current posterior-substituting (PS) total knee arthroplasties have been reported to incompletely restore intrinsic joint biomechanics of the healthy knee, the recently designed single axis radius PS knee system was introduced to increase posterior femoral translation and promote ligament isometry. As there is a paucity of data available regarding its ability to replicate healthy knee biomechanics, this study aimed to assess joint and articular contact kinematics as well as ligament isometry of the contemporary single axis radius PS knee system. Implan...
Source: Journal of Knee Surgery - April 8, 2020 Category: Orthopaedics Authors: Arauz, Paul Peng, Yun Castillo, Tiffany Klemt, Christian Kwon, Young-Min Tags: Original Article Source Type: research

Does Increasing Patient Complexity Have an Effect on Medical Outcomes and Lengths-of-Stay after Total Knee Arthroplasty?
J Knee Surg DOI: 10.1055/s-0040-1708850A greater number of medically complex patients with multiple comorbidities are now more readily considered for total knee arthroplasty (TKA). Therefore, the purpose of this study was to determine whether comorbidity burden, measured with the Elixhauser Comorbidity Index (ECI), correlated with 90-day medical complications and longer in-hospital lengths-of-stay (LOS) in TKA patients. The PearlDiver supercomputer was queried for all primary TKA patients in the Medicare Standard Analytic Files from 2005 to 2014 using International Classification of Disease, 9th edition codes. Patients wer...
Source: Journal of Knee Surgery - April 8, 2020 Category: Orthopaedics Authors: Anis, Hiba K. Sodhi, Nipun Acu ña, Alexander J. Roth, Alexander Vakharia, Rushabh Newman, Jared M. Mufarrih, Syed H. Grossman, Eric Roche, Martin W. Mont, Michael A. Tags: Original Article Source Type: research

Cementless Fixation for Total Knee Arthroplasty in Various Patient Populations: A Literature Review
J Knee Surg DOI: 10.1055/s-0040-1708880The number of total knee arthroplasties (TKAs) performed in the United States has increased considerably in recent years, with a major contribution from younger patients. Maximizing survivorship of these implants has always been a point of emphasis. Early TKA designs with cementless fixation were associated with high rates of complications and implant failures. However, recent advances in cementless designs have shown excellent results. The decision to use cemented or cementless fixation for patients undergoing TKA is typically based on the surgeon's experience and preference. However...
Source: Journal of Knee Surgery - April 7, 2020 Category: Orthopaedics Authors: Salem, Hytham S. Tarazi, John M. Ehiorobo, Joseph O. Marchand, Kevin B. Mathew, Kevin K. Sodhi, Nipun Mont, Michael A. Tags: Special Focus Section Source Type: research

Trends of Obese and Morbidly Obese Patients in Same-Day Bilateral Total Knee Arthroplasty from 2009 to 2016
J Knee Surg DOI: 10.1055/s-0040-1708038As obesity in the United States increases, the proportion of obese and morbidly obese patients undergoing same-day bilateral total knee arthroplasty (sd-BTKA) remains unknown. Therefore, this study analyzed: (1) incidence, (2) patient demographics, (3) patient course, and (4) patient outcomes in obese and morbidly obese patients undergoing sd-BTKA in the United States from 2009 to 2016. The National Inpatient Sample was queried for all sd-BTKA patients from 2009 to 2016, yielding 39,901 obese and 20,394 morbidly obese patients. Analyzed variables included overall incidence, age, lengt...
Source: Journal of Knee Surgery - April 7, 2020 Category: Orthopaedics Authors: Remily, Ethan A. Wilkie, Wayne A. Mohamed, Nequesha S. Pastore, Mark Viola, Anthony Cho, Abraham H. Nace, James Delanois, Ronald E. Tags: Original Article Source Type: research

Special Focus Section: The Dislocated Knee —Part 1
J Knee Surg 2020; 33: 319-319 DOI: 10.1055/s-0040-1705185 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 20, 2020 Category: Orthopaedics Authors: Fanelli, Gregory C. Tags: Special Focus Section Source Type: research

Radiographic Prognostic Factors Relevant to Surgical Outcomes of Arthroscopic Partial Medial Meniscectomy in Elderly Patients with Mild Osteoarthritis
J Knee Surg DOI: 10.1055/s-0040-1702191The aim of this study was to investigate radiographic factors relevant to predict surgical outcomes of arthroscopic partial meniscectomy (APM) in elderly patients with mild osteoarthritis (Kellgren–Lawrence grades 1 and 2). Data of 172 consecutive patients aged>70 years who underwent arthroscopic meniscal surgery were reviewed retrospectively. The patients who met the inclusion criteria were classified into two groups based on the minimal clinically important difference value of the Lysholm knee scoring scale comparing the score of the last visit with that of the preoperative...
Source: Journal of Knee Surgery - March 17, 2020 Category: Orthopaedics Authors: Park, Sang Hoon Choi, Chong Hyuk Yoo, Ju Hyung Kim, Sung Hwan Yoon, Han Kook Jung, Min Choi, Ki Hong Moon, Hyun Soo Tags: Original Article Source Type: research

Multiple Ligament Knee Injuries: Does the Knee Dislocation Classification Predict the Type of Surgical Management?
This study aims to evaluate relationships among multiple ligament knee injury (MLKI) patterns as classified according to the knee dislocation (KD) classification and the types of surgical management pursued. We hypothesized that the KD classification would not be predictive of the types of surgical management, and that categorizing injuries according to additional injury features such as structure, chronicity, grade, and topographic location would be predictive of the types of surgical management. This is a Retrospective cohort study. This study was conducted at a level I trauma center with a 150-mile coverage radius. Quer...
Source: Journal of Knee Surgery - March 17, 2020 Category: Orthopaedics Authors: Maxwell, Garrett T. Warth, Ryan J. Amin, Adeet Darlow, Matthew A. Bailey, Lane Lowe, Walter R. Harner, Christopher D. Tags: Original Article Source Type: research