Robot-Assisted versus Conventional Total and Unicompartmental Knee Arthroplasty: A Meta-analysis of Radiological and Functional Outcomes
This study was conducted according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) and MOOSE (Meta-analysis of Observational Studies in Epidemiology) guidelines. All studies in PubMed, EMBASE, Medline, and Cochrane that reported radiological and functional outcomes after TKA or UKA with either robotic or conventional methods were included in the review. Selected endpoints for random effects, pairwise meta-analysis included operative details, radiological outcomes (mechanical axis, component angle deviation, and outliers), and functional outcomes (American Knee Society Score, Knee Society Func...
Source: Journal of Knee Surgery - March 17, 2020 Category: Orthopaedics Authors: Chin, Brian Zhaojie Tan, Sharon Si Heng Chua, Kasia Chen Xi Budiono, Gideon Richard Syn, Nicholas Li-Xun O'Neill, Gavin Kane Tags: Original Article Source Type: research

Additional Factors in Evaluating Opioid Use following Arthroscopic Knee Surgery
J Knee Surg DOI: 10.1055/s-0040-1702168 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 17, 2020 Category: Orthopaedics Authors: Curran, Sean Tags: Letter to the Editor Source Type: research

Comparison of Periarticular Infiltration and Combination Delivery of Local Anesthetics for Reducing Pain and Opioid Consumption after Total Knee Arthroplasty
J Knee Surg DOI: 10.1055/s-0040-1702181Surgical-site delivery of local anesthetics decreases pain and opioid consumption after total knee arthroplasty (TKA). The optimal route of administration is unknown. We compared local anesthetic delivery using periarticular soft-tissue infiltration to delivery using a combination of preimplantation immersion and intra-articular injection (combination treatment). The records of patients who underwent unilateral, cemented, primary TKA with spinal anesthesia and adductor canal blocks at a single Veterans Affairs Medical Center were retrospectively reviewed. Three subgroups were compared...
Source: Journal of Knee Surgery - March 6, 2020 Category: Orthopaedics Authors: Ward, Derek T. Grotkopp, Eva Detch, Robert C. Kim, Hubert T. Kuo, Alfred C. Tags: Original Article Source Type: research

Factors Influencing Graft Function following MPFL Reconstruction: A Dynamic Simulation Study
J Knee Surg DOI: 10.1055/s-0040-1702185Medial patellofemoral ligament (MPFL) reconstruction is currently the primary surgical procedure for treating recurrent lateral patellar instability. The understanding of graft function has largely been based on studies performed with normal knees. The current study was performed to characterize graft function following MPFL reconstruction, focusing on the influence of pathologic anatomy on graft tension, variations with knee flexion, and the influence on patellar tracking. Knee squatting was simulated with 15 multibody dynamic simulation models representing knees being treated for re...
Source: Journal of Knee Surgery - March 6, 2020 Category: Orthopaedics Authors: Tanaka, Miho J. Cosgarea, Andrew J. Forman, Jared M. Elias, John J. Tags: Original Article Source Type: research

Application of Personalized Navigation Templates to Oxford Single Condylar Replacement in a Chinese Population
This study introduces a novel navigational template to UKA, the accuracy of which is proven by clinical operation. This is a Level III, 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 - March 6, 2020 Category: Orthopaedics Authors: Gan, Yudong Zhuang, Jian Jiang, Wenxiao Sun, Wei Zhang, Yijun Tags: Original Article Source Type: research

Physical Activity Mediates the Relationship between Gait Function and Fall Incidence after Total Knee Arthroplasty
J Knee Surg DOI: 10.1055/s-0040-1702165The present study aims to examine (1) the preoperative factors that can predict postoperative falls, (2) whether postoperative physical activity (PA) mediates the relationship between fall incidence and gait function, and (3) whether postoperative PA levels are associated with fall risk in total knee arthroplasty (TKA) patients. Ninety-six patients (mean age: 72.0 ± 6.1 years) who were observed postoperatively for 6 months were selected. Timed up and go (TUG) was assessed as an indicator of gait function. Fall incidence and PA were investigated for 6 months post-T...
Source: Journal of Knee Surgery - March 4, 2020 Category: Orthopaedics Authors: Taniguchi, Masashi Sawano, Shinichiro Maegawa, Shoji Ikezoe, Tome Ichihashi, Noriaki Tags: Original Article Source Type: research

CT Validation of Intraoperative Implant Position and Knee Alignment as Determined by the MAKO Total Knee Arthroplasty System
J Knee Surg DOI: 10.1055/s-0040-1701447Robotic-assisted technology in total knee arthroplasty (TKA) aims to increase implantation accuracy, with real-time data being used to estimate intraoperative component alignment. Postoperatively, Perth computed tomography (CT) protocol is a valid measurement technique in determining both femoral and tibial component alignments. The aim of this study was to evaluate the accuracy of intraoperative component alignment by robotic-assisted TKA through CT validation. A total of 33 patients underwent TKA using the MAKO robotic-assisted TKA system. Intraoperative measurements of both femoral...
Source: Journal of Knee Surgery - March 4, 2020 Category: Orthopaedics Authors: Sires, James D. Wilson, Christopher J. Tags: Original Article Source Type: research

Does Body Mass Index Cause a Clinical Difference in Simultaneous Bilateral and Unilateral Knee Arthroplasty?
This study aims to investigate clinical and functional factors in patients undergoing unilateral and simultaneous bilateral total knee arthroplasty (TKA) who were classified into subgroups of nonobese, obese, and morbidly obese, and to determine perioperative and postoperative complications. We conducted an evaluation of 489 nonobese, obese, and morbidly obese patients who underwent TKA due to primary knee osteoarthritis between January 2006 and December 2013. The arthroplasties were performed by three different surgeons. Patients who underwent unilateral (group 1) or simultaneous bilateral (group 2) TKAs were divided into...
Source: Journal of Knee Surgery - March 4, 2020 Category: Orthopaedics Authors: Ogur, Hasan Ulas Cicek, Hakan Seyfettinoglu, F ırat Tuhanioglu, Ümit Aydo ğdu, Ali K ılıcarslan, Kasım Tags: Original Article Source Type: research

Opioid Naive Surgeons and Opioid-Tolerant Patients: Can Education Alter Prescribing Patterns to Total Knee Arthroplasty Patients?
This study demonstrates that an educational intervention is associated with decreased opioid prescribing among opioid-tolerant TKA patients. While the effective management of these patients is challenging, surgeon education should be a key focus to optimizing their care. [...] Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of contents  |  Abstract  |  Full text (Source: Journal of Knee Surgery)
Source: Journal of Knee Surgery - March 4, 2020 Category: Orthopaedics Authors: King, Connor A. Landy, David C. Bradley, Alexander T. Scott, Bryan Curran, John Devanagondi, Shwetha Balach, Tessa Mica, Megan Conti Tags: Original Article Source Type: research

Flash Sterilization and Component Reimplantation Is a Viable Option for Articulating Antibiotic Spacers in Periprosthetic Knee Infections
J Knee Surg DOI: 10.1055/s-0040-1701518The articulating antibiotic spacer is a treatment utilized for two-stage revision of an infected total knee arthroplasty. The original femoral component is retained and reused in one described variation of this technique. The purpose of this study is to determine the safety and efficacy of flash sterilization of the femoral component for reimplantation in an articulating antibiotic spacer for the treatment of chronic periprosthetic joint infection. A total of 10 patients were identified prospectively with a culture positive infected total knee arthroplasty. The patients underwent expl...
Source: Journal of Knee Surgery - March 4, 2020 Category: Orthopaedics Authors: Karas, Vasili Rutherford, Richard W. Herschmiller, Thomas A. Plate, Johannes F. Bolognesi, Michael P. Joyce, Maria J. Wellman, Samuel S. Tags: Original Article Source Type: research

Trends in Utilization of Total and Unicompartmental Knee Arthroplasty in the United States
J Knee Surg DOI: 10.1055/s-0040-1702189Total knee replacement (TKR) and unicompartmental knee replacement (UKR) are successful procedures for patients with knee arthritis. While strict criteria were proposed early on for UKR, some surgeons have expanded these indications to include younger and heavier patients. The purpose of this study is to analyze trends in usage of TKR and UKR in the United States. This retrospective study analyzed an insurance administrative dataset. Patients who underwent primary TKR and UKR were identified via current procedural terminology codes. Information on incidence, obesity, use of computer n...
Source: Journal of Knee Surgery - March 4, 2020 Category: Orthopaedics Authors: Kahlenberg, Cynthia A. Richardson, Shawn S. Gruskay, Jordan A. Cross, Michael B. Tags: Original Article Source Type: research

Risk Factors for Patellar Clunk or Crepitation after Primary Total Knee Arthroplasty: A Systematic Review and Meta-analysis
This study identified intraoperative variables (patellar retention and lateral reticular release), clinical variables (previous surgery), and radiographic measurements (increased anterior tibial offset, increased joint line changes, and increased postoperative knee flexion angle) that contribute to an increased risk for PCC. Modifiable factors (patellar retention and lateral reticular release) should be considered and addressed to limit the risk for PCC following TKA. Patients with conditions that may not be modifiable may benefit from counseling about their increased risks for PCC to limit potential dissatisfaction with t...
Source: Journal of Knee Surgery - March 4, 2020 Category: Orthopaedics Authors: Duan, Guman Cai, Sijia Lin, Weiwei Pan, Yongwei Tags: Original Article Source Type: research

Outcomes Following Revision Total Knee Arthroplasty Septic versus Aseptic Failure: A National Propensity-Score-Matched Comparison
J Knee Surg DOI: 10.1055/s-0040-1702187Although periprosthetic joint infection (PJI) has been hypothesized to increase the risk of complications following revision total knee arthroplasty (TKA), strong evidence linking the two is lacking. The aim of this study was to determine whether PJI is an independent risk factor for inpatient perioperative complications, and increased resource use in patients undergoing revision TKA. We relied on the US Nationwide Inpatient Sample (NIS) to identify patients with PJI or non-PJI treated with revision TKA between 2002 and 2014. Overall, 5,316 (16.4%) and 27,033 (83.6%) patients were cat...
Source: Journal of Knee Surgery - March 4, 2020 Category: Orthopaedics Authors: Dai, Wen-Li Lin, Ze-Ming Shi, Zhan-Jun Wang, Jian Tags: Original Article Source Type: research

Trends in Periprosthetic Knee Infection and Associated Costs: A Population-Based Study Using National Data
J Knee Surg DOI: 10.1055/s-0040-1701516Given increasing demand for primary knee arthroplasties, revision surgery is also expected to increase, with periprosthetic joint infection (PJI) a main driver of costs. Recent data on national trends is lacking. We aimed to assess trends in PJI in total knee arthroplasty revisions and hospitalization costs. From the National Inpatient Sample (2003–2016), we extracted data on total knee arthroplasty revisions (n = 782,449). We assessed trends in PJI prevalence and (inflation-adjusted) hospitalization costs (total as well as per-day costs) for all revisions and stra...
Source: Journal of Knee Surgery - March 4, 2020 Category: Orthopaedics Authors: Brochin, Robert Poeran, Jashvant Vig, Khushdeep S. Keswani, Aakash Zubizarreta, Nicole Galatz, Leesa M. Moucha, Calin Tags: Original Article Source Type: research

Associations between Anterior Cruciate Ligament Injuries and Patella Alta and Trochlear Dysplasia in Adults Using Magnetic Resonance Imaging
J Knee Surg DOI: 10.1055/s-0040-1702198The aim of this study was to research the associations between anterior cruciate ligament (ACL) injuries and patella alta and trochlear dysplasia in adult patients using magnetic resonance imaging (MRI). This retrospective study included 221 adult patients: 110 with acute complete noncontact ACL tears and 111 without ACL injuries who underwent knee MRI procedures between May 2016 and July 2018. After the ACL injuries were verified using the sagittal proton density images, the patellar height and patellar tendon length were measured on the sagittal T1-weighted images, and the Insall&nd...
Source: Journal of Knee Surgery - March 4, 2020 Category: Orthopaedics Authors: Akg ün, Ayşe Serap Agirman, Mehmet Tags: Original Article Source Type: research

Erratum: Total Knee Arthroplasty for Fixed Valgus Deformity Correction Using a Modified Lateral Parapatellar Approach
J Knee Surg DOI: 10.1055/s-0039-3399509 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 4, 2020 Category: Orthopaedics Authors: Li, Hu Ponzio, Danielle Y. Ong, Alvin Wei, Wei Wang, Baicheng Li, Zhichang Zhou, Diange Tags: Erratum Source Type: research

Erratum: Obesity Is Associated with Significant Morbidity after Multiligament Knee Surgery
J Knee Surg DOI: 10.1055/s-0040-1705126 Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of contents  |  Full text (Source: Journal of Knee Surgery)
Source: Journal of Knee Surgery - February 26, 2020 Category: Orthopaedics Authors: Lian, Jayson Patel, Neel K. Nickoli, Michael Vaswani, Ravi Irrgang, James J. Lesniak, Bryson P. Musahl, Volker Tags: Erratum Source Type: research

Medial-Sided Injuries in the Multiple Ligament Knee Injury
J Knee Surg DOI: 10.1055/s-0039-3402768Multiligament knee injuries (MLKI) are complex and challenging to treat. The posteromedial corner (PMC) structures are commonly torn in MLKI. A thorough and systematic evaluation is imperative to avoid a missed diagnosis and for planning treatment. With several structures injured, the treatment method (operative vs. nonoperative, repair vs. reconstruction), availability of allografts, timing of surgery, and rehabilitation are some of the factors that have to be considered in the decision-making. Persistent valgus instability because of untreated or not healed medial collateral ligamen...
Source: Journal of Knee Surgery - February 19, 2020 Category: Orthopaedics Authors: Moatshe, Gilbert Vap, Alexander R. Getgood, Alan LaPrade, Robert F. Engebretsen, Lars Tags: Special Focus Section Source Type: research

Association between Type of Anesthesia and Risk of Blood Transfusion Events in Primary Unilateral Total Knee Arthroplasty: A Secondary Analysis Based on a Cohort Study in Singapore
This study evaluated whether the type of anesthesia independently related to risk of blood transfusion events in patients undergoing total knee arthroplasty (TKA) after adjusting for other covariates. This was a secondary analysis of a retrospective cohort study of patients undergoing primary unilateral TKA in Singapore. The independent variable was the type of anesthesia and the dependent variable was blood transfusion events. A multivariable logistic regression analysis was performed adjusting for variables that might affect the choice of anesthesia or blood transfusion events. Additional analyses examined this associati...
Source: Journal of Knee Surgery - February 19, 2020 Category: Orthopaedics Authors: Zhu, Zhongxin Tong, Peijian Tags: Original Article Source Type: research

Surgical Wound Complications after Knee Cruciate Ligament Reconstruction in Patients with Atopic Dermatitis
This study aimed to report four patients with AD who developed foreign body reactions to FiberWire sutures with or without surgical wound infection (SSI) after knee cruciate ligament reconstruction (CLR). The mean age was 19.8 (range, 16–25) years, and patients 1 and 3 underwent reconstructions of the posterior and anterior cruciate ligament, respectively. At a mean of 7.5 (range, 4–10) weeks postoperatively, discharge from the surgical wound at the tibial side of the fixed graft was identified. All patients were treated with continuous saline lavage and antibiotics; however, their wounds did not heal. Second-l...
Source: Journal of Knee Surgery - February 19, 2020 Category: Orthopaedics Authors: Yokoe, Takuji Tajima, Takuya Yamaguchi, Nami Morita, Yudai Chosa, Etsuo Tags: Original Article Source Type: research

Aseptic Loosening of Porous Metaphyseal Sleeves and Tantalum Cones in Revision Total Knee Arthroplasty: A Systematic Review
J Knee Surg DOI: 10.1055/s-0040-1701434Bone loss often complicates revision total knee arthroplasty (TKA). Management of metaphyseal defects varies, with no clearly superior technique. Two commonly utilized options for metaphyseal defect management include porous-coated metaphyseal sleeves and tantalum cones. A systematic review was conducted according to the international Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We combined search terms “Total knee arthroplasty” AND/OR “Sleeve,” “Cone” as either keywords or medical subject heading (MeSH) te...
Source: Journal of Knee Surgery - February 19, 2020 Category: Orthopaedics Authors: Roach, Ryan P. Clair, Andrew J. Behery, Omar A. Thakkar, Savyasachi C. Iorio, Richard Deshmukh, Ajit J. Tags: Original Article Source Type: research

Association of Lumbar Degenerative Disease and Revision Rate following Total Knee Arthroplasty
J Knee Surg DOI: 10.1055/s-0040-1701651Recently, a variety of studies have analyzed the potential correlation between lumbar degenerative disease (LDD) and inferior clinical outcomes after total hip arthroplasty. However, there has been limited data concerning the role of LDD as a risk factor for failure after total knee arthroplasty (TKA). The aim of our study was to determine: (1) what is the association of LDDs with TKA failure (all-cause revision) within 2 years of index arthroplasty and (2) if patients with LDD and lumbar fusion are at increased risk of TKA revision within 2 years compared with LDD patients without fu...
Source: Journal of Knee Surgery - February 19, 2020 Category: Orthopaedics Authors: Malahias, Michael-Alexander Gu, Alex Richardson, Shawn S. De Martino, Ivan Mayman, David J. Sculco, Thomas P. Sculco, Peter K. Tags: Original Article Source Type: research

Navigation Improves the Survival Rate of Mobile-Bearing Total Knee Arthroplasty by Severe Preoperative Coronal Deformity: A Propensity Matched Case –Control Comparative Study
J Knee Surg DOI: 10.1055/s-0040-1701441The primary hypothesis of this study was that the survival rate over 10 years of total knee arthroplasties (TKAs) implanted with a navigation system was superior to that of TKAs implanted with a conventional technique. The secondary hypothesis was that the severity of the initial coronal deformity had a negative influence on the survival rate. A national, multicentric, retrospective study was performed in France, including eight university or private centers with high volumes in knee surgery. Cases operated on with either a conventional (control group) or a navigated (study group) tec...
Source: Journal of Knee Surgery - February 19, 2020 Category: Orthopaedics Authors: Jenny, Jean-Yves Saragaglia, Dominique Bercovy, Michel Cazenave, Alain Gaillard, Thierry Ch âtain, Frédéric Jolles-Haeberli, Brigitte Rouvillain, Jean-Louis Tags: Original Article Source Type: research

Can Computer-Assisted Total Knee Arthroplasty Support the Prediction of Postoperative Three-Dimensional Kinematics of the Tibiofemoral and Patellofemoral Joints at the Replaced Knee?
J Knee Surg DOI: 10.1055/s-0040-1701265The aim of this study was to analyze the extent to which postoperative patellofemoral joint (PFJ) kinematics assessed at 6-month follow-up after total knee arthroplasty (TKA) mimics the intraoperative kinematics after final component implantation. The study hypothesis, already proved in terms of tibiofemoral joint (TFJ) kinematics, is that the intraoperative assessment of PFJ kinematics after component implantation is also capable of predicting postoperative knee kinematics during activities of daily living. Twenty patients selected for TKA with patellar resurfacing were implanted usi...
Source: Journal of Knee Surgery - February 19, 2020 Category: Orthopaedics Authors: Belvedere, Claudio Tamarri, Silvia Ensini, Andrea Durante, Stefano Ortolani, Maurizio Leardini, Alberto Tags: Original Article Source Type: research

The Effects of Tourniquet Application in Total Knee Arthroplasty on the Recovery of Thigh Muscle Strength and Clinical Outcomes
J Knee Surg DOI: 10.1055/s-0040-1701454The present randomized controlled study aims to evaluate whether tourniquet application during total knee arthroplasty (TKA) has an effect on (1) thigh muscle strength (quadriceps and hamstring muscle strength) and (2) clinical outcomes (postoperative knee range of motion [ROM], postoperative pain level, and Knee Society Score [KSS]). The effects of tourniquet application during TKA were investigated in 65 patients randomly allocated to one of two groups: TKA with a tourniquet and TKA without a tourniquet. Patients in both groups were comparable in terms of the demographic and clinica...
Source: Journal of Knee Surgery - February 19, 2020 Category: Orthopaedics Authors: Ayik, Omer Demirel, Mehmet Birisik, Fevzi Ersen, Ali Balci, Halil I. Sahinkaya, Turker Batibay, Sefa Giray Ozturk, Irfan Tags: Original Article Source Type: research

Medial Meniscus Scaffold Implantation in Combination with Concentrated Bone Marrow Aspirate Injection: Minimum 3-Year Follow-up
The objective of this study is to show the short-term clinical and radiological outcomes of concentrated bone marrow aspirate (CBMA) injection administered in combination with medial meniscus scaffold implantation. Twenty-three patients who received intra-articular CBMA injection in combination with polyurethane-based medial meniscus scaffold implantation were evaluated within the scope of this study. The International Knee Documentation Committee (IKDC) questionnaire and the Knee injury and Osteoarthritis Outcome Score (KOOS) were used to evaluate the results, and the visual analog scale was used to assess the pain scores...
Source: Journal of Knee Surgery - February 10, 2020 Category: Orthopaedics Authors: Akkaya, Mustafa Şimşek, Mehmet Emin G ürsoy, Safa Çay, Nurdan Bozkurt, Murat Tags: Original Article Source Type: research

Periprosthetic Joint Infections in Total Knee Arthroplasty
J Knee Surg 2020; 33: 099-099 DOI: 10.1055/s-0040-1701248 Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of contents  |  Full text (Source: Journal of Knee Surgery)
Source: Journal of Knee Surgery - February 6, 2020 Category: Orthopaedics Authors: Higuera-Rueda, Carlos A. Tags: Foreword Source Type: research

Clinical Results of Combined ACL and Anterolateral Ligament Reconstruction: A Narrative Review from the SANTI Study Group
J Knee Surg DOI: 10.1055/s-0040-1701220Lateral extraarticular procedures (LEAPs) in the anterior cruciate ligament (ACL)-injured knee were widely abandoned in the 1990s but have seen a recent resurgence. The aim of this review was to demonstrate that anterolateral ligament reconstruction (ALLR) is associated with evidence of significant advantages and no evidence of historical concerns. A narrative review of the literature was performed. Combined ACL + ALLR is associated with improved outcomes when compared against isolated ACL reconstruction, including a significantly lower risk of ACL graft rupture (hazard ...
Source: Journal of Knee Surgery - February 5, 2020 Category: Orthopaedics Authors: Saithna, Adnan Daggett, Matt Helito, Camilo Partezani Monaco, Edoardo Franck, Florent Vieira, Thais Dutra Pioger, Charles Kim, Jin Goo Sonnery-Cottet, Bertrand Tags: Original Article Source Type: research

Higher Component Malposition Rates with Patient-Specific Cruciate Retaining TKA than Contemporary Posterior Stabilized TKA
J Knee Surg DOI: 10.1055/s-0040-1701453Customized individually manufactured total knee arthroplasty (CIM-TKA) was developed to improve kinematic total knee arthroplasty (TKA) performance. Component placement accuracy may influence the success of CIM-TKA designs. We performed this study to compare radiographic component alignment and revision rates of a cruciate retaining (CR) CIM-TKA and a contemporary posterior stabilized TKA (PS-TKA). After obtaining Institutional Review Board approval, we identified 94 CR CIM-TKAs (76 patients) and 91 PS-TKAs (82 patients) performed between July 1, 2013 and December 31, 2014 with a mini...
Source: Journal of Knee Surgery - February 4, 2020 Category: Orthopaedics Authors: Kumar, Prakrit Elfrink, Jacob Daniels, James P. Aggarwal, Ajay Keeney, James A. Tags: Original Article Source Type: research

Extramedullary Guide Alignment Is not Affected by Obesity in Primary Total Knee Arthroplasty
J Knee Surg DOI: 10.1055/s-0040-1701438Coronal alignment of the tibial implant correlates with survivorship of total knee arthroplasty (TKA), especially in obese patients. The purpose of this study was to determine if obesity affects coronal plane alignment of the tibial component when utilizing standard extramedullary tibial guide instrumentation during primary TKA. A retrospective review from June 2017 to February 2018 identified 142 patients (162 primary TKAs). There were 88 patients (100 knees) with body mass index (BMI) 
Source: Journal of Knee Surgery - February 4, 2020 Category: Orthopaedics Authors: Compton, Jocelyn Owens, Jessell Otero, Jesse Noiseux, Nicolas Brown, Timothy Tags: Original Article Source Type: research

Robotic-Assisted versus Manual Unicompartmental Knee Arthroplasty: Contemporary Systematic Review and Meta-analysis of Early Functional Outcomes
J Knee Surg DOI: 10.1055/s-0040-1701455Robotic-assisted unicompartmental knee arthroplasty (RA-UKA) aims to improve accuracy of component placement. Studies have shown improvement in radiographic positioning/alignment with RA-UKA but have not addressed clinical outcome measures (COMs). The purpose of this study was to determine if RA-UKA is associated with improved early revision rates and functional outcome scores (FOS) compared with manual UKA. A systematic review of all English language articles from 1999 to 2019 on RA-UKA using Medline, EMBASE, Scopus, and Web of Science databases identified 277 studies. Seven (three r...
Source: Journal of Knee Surgery - January 30, 2020 Category: Orthopaedics Authors: Gaudiani, Michael A. Samuel, Linsen T. Kamath, Atul F. Courtney, P. Maxwell Lee, Gwo-Chin Tags: Original Article Source Type: research

Vascular Injuries following Knee Dislocation
J Knee Surg DOI: 10.1055/s-0040-1701210Knee dislocations (KDs) are frequently found in high-energy impact injuries, ranging from automobile accidents to contact sports. KDs require careful examination due to the limb-threatening nature of these injuries. A key examination in any KD comprises a proper assessment of the vascular status. The risk of popliteal artery injury with a KD has varied from 7 to 40%, with more contemporary studies reporting injury in the range of 7 to 15%. The notion of mandatory emergent arteriography was challenged in the trauma literature as several small retrospective studies suggested that select...
Source: Journal of Knee Surgery - January 27, 2020 Category: Orthopaedics Authors: Stannard, James P. Schreiner, Anna J. Tags: Special Focus Section Source Type: research

Evaluation of Graft Tensioning Effects in Anterior Cruciate Ligament Reconstruction between Hamstring and Bone –Patellar Tendon Bone Autografts
This article investigates the clinical, functional, and radiographic outcomes in anterior cruciate ligament (ACL) reconstruction patients over 7 years to determine the effects of initial graft tension on outcomes when using patellar tendon (bone–tendon–bone [BTB]) and hamstring tendon (HS) autografts. Ninety patients, reconstructed with BTB or HS, were randomized using two initial graft tension protocols: (1) normal anteroposterior (AP) laxity (“low-tension”; n = 46) and (2) AP laxity overconstrained by 2 mm (“high-tension”; n = 44). Seventy-two patient...
Source: Journal of Knee Surgery - January 21, 2020 Category: Orthopaedics Authors: DeFroda, Steven F. Karamchedu, Naga Padmini Budacki, Ross Wiley, Taylor Fadale, Paul D. Hulstyn, Michael J. Shalvoy, Robert M. Badger, Gary J. Fleming, Braden C. Owens, Brett D. Tags: Original Article Source Type: research

Effectiveness of High Tibial Osteotomy with or without Other Procedures for Medial Compartment Osteoarthritis of Knee: An Update Meta-Analysis
J Knee Surg DOI: 10.1055/s-0039-1700978To improve the long-term outcomes of high tibial osteotomy (HTO) for gonarthritis, many cartilage repair procedures appeared, but their effects were controversial. To evaluate the efficacy of cartilage repair procedures during HTO for gonarthritis, we performed this update meta-analysis. We performed the system retrieval for clinical trials using various databases and then pooled the outcomes of the included studies. Fifteen studies were involved. The pooled results indicated that there were no significant differences in Kellgren and Lawrence (KL) scale (mean difference [MD] =&...
Source: Journal of Knee Surgery - January 17, 2020 Category: Orthopaedics Authors: Yao, Ru-Zhan Liu, Wei-Qiang Sun, Liang-Zhi Yu, Ming-Dong Wang, Guang-Lin Tags: Original Article Source Type: research

The Comparison of Intrathecal Ropivacaine with Bupivacaine for Knee Arthroscopy: A Meta-analysis of Randomized Controlled Trials
J Knee Surg DOI: 10.1055/s-0039-3402795The comparison of intrathecal ropivacaine with bupivacaine for knee arthroscopy remains controversial. We conduct a systematic review and meta-analysis to explore the efficacy of intrathecal ropivacaine versus bupivacaine for knee arthroscopy. We search PubMed, EMbase, Web of science, EBSCO, and Cochrane library databases through August 2019 for randomized controlled trials (RCTs) assessing the effect of intrathecal ropivacaine versus bupivacaine for knee arthroscopy. This meta-analysis is performed using the random effects model. Five RCTs are included in the meta-analysis. Overall, ...
Source: Journal of Knee Surgery - January 17, 2020 Category: Orthopaedics Authors: Xie, Zhiwei Nie, Xiaoying Pan, Linlin Zhang, Na Xue, Huiqin Tags: Original Article Source Type: research

Simultaneous Bilateral Total Knee Arthroplasty Becomes Safer after Institution of Optimal Perioperative Management: A Longitudinal Cohort Study
This study aimed to evaluate whether optimal perioperative management could improve the safety of SBTKA. From 2005 to 2017, 1,166 cases of SBTKA were identified from 14,209 TKA procedures. We retrospectively examined the SBTKA patients' demographics, comorbidity profiles, procedure-related complications, and perioperative management during two time periods. Optimal perioperative workup for managing SBTKA significantly decreased the incidences of major complication from 6.2 to 2.4% (p = 0.001) and minor complications from 28.9 to 21.5% (p = 0.004) during period I and period II, respectively. The ...
Source: Journal of Knee Surgery - January 17, 2020 Category: Orthopaedics Authors: Chen, Shih-Hao Chen, Jen-Yuh Wong, Tze-Hong Buechel, Frederick Wu, Meng-Huang Tags: Original Article Source Type: research

Biofilms in Periprosthetic Joint Infections: A Review of Diagnostic Modalities, Current Treatments, and Future Directions
J Knee Surg DOI: 10.1055/s-0040-1701214As the number of total joint arthroplasties continues to rise, periprosthetic joint infection (PJI), a significant and devastating complication of total joint arthroplasty, may also increase. In PJI, bacterial biofilms are formed by causative pathogens surrounded by extracellular matrix with relatively dormant cells that can persist, resulting in a barrier against the host immune system and antibiotics. These biofilms not only contribute to the pathogenesis of PJI but also result in diagnostic challenges, antibiotic resistance, and PJI treatment failure. This review discusses the deve...
Source: Journal of Knee Surgery - January 14, 2020 Category: Orthopaedics Authors: Shoji, Monica M. Chen, Antonia F. Tags: Special Focus Section Source Type: research

Radiographic Evaluation of Medial Opening-Wedge High Tibial Osteotomy Using a New Internal Fixator with a Wedge-Shaped Spacer Block
J Knee Surg DOI: 10.1055/s-0039-1700977We developed a new internal fixator: a rigid T-shaped plate with locking screws and wedge-shaped spacer block for high tibial osteotomy. The purpose of the present study was to evaluate the radiographic outcome of opening-wedge high tibial osteotomy (OWHTO) using this new internal fixator. Sixty OWHTOs were performed in patients with medial compartment osteoarthritis and varus deformity (28 males and 23 females). Patients' mean age was 60.4 years. Preoperative and postoperative radiographs were obtained. The paired t-test was used to evaluate the differences over time with respect to ...
Source: Journal of Knee Surgery - January 13, 2020 Category: Orthopaedics Authors: Okimura, Shinichiro Teramoto, Atsushi Watanabe, Kota Nuka, Satoshi Kamiya, Tomoaki Yamashita, Toshihiko Tags: Original Article Source Type: research

Do We Need Chemoprophylaxis to Prevent Venous Thromboembolism following Medial Open-Wedge High Tibial Osteotomy?
J Knee Surg DOI: 10.1055/s-0039-1700976The aim of this study was to investigate the overall incidence of venous thromboembolism (VTE) and to assess the efficacy of chemoprophylaxis to prevent VTE following medial open-wedge high tibial osteotomy (MOWHTO) in Asian patients. A total of 133 patients who consecutively underwent MOWHTO for the treatment of knee osteoarthritis with varus deformity were enrolled. All patients underwent preoperative ultrasonography and computed tomography venography on postoperative day 5 to detect deep vein thrombosis (DVT). Patients were divided into two groups: chemoprophylaxis group included p...
Source: Journal of Knee Surgery - January 13, 2020 Category: Orthopaedics Authors: Kim, Kang-Il Kim, Gi Beom Lee, Myeong Gu Song, Sang Jun Tags: Original Article Source Type: research

Impact of Medial Meniscotibial Ligament Disruption Compared to Peripheral Medial Meniscal Tear on Knee Biomechanics
J Knee Surg DOI: 10.1055/s-0039-3402483Medial meniscotibial ligament (MTL) lesions may go unrecognized and untreated and have detrimental impact on knee biomechanics and joint pathology. Therefore, this study was designed to compare the biomechanical impact of midbody MTL disruption to corresponding peripheral medial meniscal (PMM) tears in anterior cruciate ligament (ACL) intact and ACL-deficient cadaveric knees. Cadaveric knees (n = 12; 6 matched pairs) were tested for laxity and ACL strain under anterior, valgus, and external rotation loading at 0, 30, and 90 degree of flexion. Knees were randomly assigned...
Source: Journal of Knee Surgery - January 8, 2020 Category: Orthopaedics Authors: Smith, Patrick A. Humpherys, Joseph L. Stannard, James P. Cook, James L. Tags: Original Article Source Type: research

Different Patellar Indices and Their Role in Decision-Making: An MRI-Based Study
J Knee Surg DOI: 10.1055/s-0039-3402045Magnetic resonance imaging (MRI) of knee has become the integral part of knee evaluation, hence any MRI based study adds more value if it helps in the decision-making process, especially for surgery in treating patellofemoral pain. We tried to determine normal patellar indices using knee MR images and the correlation between them and also compared the results with different ethnic population. We analyzed the prospectively collected MR images of 117 knees/patients, and Insall–Salvati (IS) index, modified IS index, patellotrochlear (PT) index, and patellophyseal (PP) index were ca...
Source: Journal of Knee Surgery - January 8, 2020 Category: Orthopaedics Authors: Raju, Sivashanmugam Chinnakkannu, Karthikeyan Balakumar, Balasubramanian Sundareyan, Ramanivas Kaliappan, Saravanakumar P. Puttaswamy, Mohan K. Tags: Original Article Source Type: research

Erratum to: The Irreducible Knee Dislocation
J Knee Surg DOI: 10.1055/s-0039-3402743 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 7, 2020 Category: Orthopaedics Authors: Malik, Shahbaz S. MacDonald, Peter B. Tags: Erratum Source Type: research

Posterior Cruciate Ligament Reconstruction in the Multiple Ligament Injured Knee
J Knee Surg DOI: 10.1055/s-0039-3402792Multiligamentous knee injuries are challenging to treat and diagnose. Posterior cruciate ligament (PCL) injuries are commonly found in the constellation of injuries included in a multiligamentous knee injury and are caused by a posteriorly directed force on the proximal tibia with relation to the femoral condyles. A thorough history and physical examination should be performed to evaluate for associated neurovascular injuries and associated ligamentous, chondral, or bony injuries. Nonsurgical management is reserved for patients who are critically ill or have very low activity demands....
Source: Journal of Knee Surgery - January 6, 2020 Category: Orthopaedics Authors: Kew, Michelle E. Miller, Mark D. Tags: Special Focus Section Source Type: research

Complications following Suture Button Use for Femoral Graft Fixation in Arthroscopic Anterior Cruciate Ligament Reconstruction: A Systematic Review
J Knee Surg DOI: 10.1055/s-0039-3400753Understanding any potential complications that may occur in relation to the use of a suture button for femoral graft fixation in arthroscopic anterior cruciate ligament reconstruction can help raise awareness among surgeons and improve safety when using such implants. This is a systematic review of suture button related complications. A literature search was conducted using the PubMed, Embase, and CINAHL (Cumulative Index to Nursing and Allied Health Literature) databases from their year of inception until January 3, 2019. We included studies reporting on suture button related complic...
Source: Journal of Knee Surgery - January 6, 2020 Category: Orthopaedics Authors: Yassa, R. Adams, J. R. Charalambous, C. P. Tags: Original Article Source Type: research

Bilateral Hidden Isokinetic Quadriceps Performance before and after MPFL Reconstruction in Pediatric Patients
J Knee Surg DOI: 10.1055/s-0039-3402031We perform prospective study to evaluate the isokinetic performance of quadriceps before and 1 year after medial patella-femoral ligament (MPFL) reconstruction with the adductor magnus tendon in the case of recurrent patellar dislocation. The present study is the first to describe the isokinetic function of the quadriceps of the involved and uninvolved extremity, in such a wide range. The MPFL is a crucial passive stabilizer of patella and, along with the conditions of the anatomical shape of the femoral-patellar joint and the function of quadriceps, influences the overall patellar st...
Source: Journal of Knee Surgery - January 6, 2020 Category: Orthopaedics Authors: Ma łecki, Krzysztof Niedzielski, Kryspin Flont, Pawe ł Fabis-Strobin, Anna Fabis, Jaros ław Tags: Original Article Source Type: research

Use of a Mandatory Clinical Decision Unit Reduces Readmission Rates following Total Joint Arthroplasty
J Knee Surg DOI: 10.1055/s-0039-3402053Readmission penalties have encouraged the implementation of protocols to reduce readmission rates. We hypothesized that by keeping postoperative patients, who return to the emergency department (ED) in a clinical decision unit (CDU) until being evaluated by the orthopaedic team, there would be a reduction in the readmission rate after total joint arthroplasty (TJA) at our institution. Our institution mandated the use of the CDU for all potential orthopaedic TJA readmissions. A retrospective review of prospectively collected data was performed on 365 patients who presented to the ED af...
Source: Journal of Knee Surgery - January 6, 2020 Category: Orthopaedics Authors: Manoli, Arthur Markel, Jacob F. Pizzimenti, Natalie M. Markel, David C. Tags: Original Article Source Type: research

The 90-day Readmission Rate after Single-Bundle ACL Reconstruction Plus LET: Analysis of 2,559 Consecutive Cases from a Single Institution
In conclusion, this technique of arthroscopic ACL reconstruction with LET showed a low readmission rate within 90 days from surgery. However, patients and physicians should be aware of the risk of serious complications, such as deep and superficial infections, mostly in female patients and in cases of concurrent meniscal treatments. This is a Level IV, retrospective case series 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 - January 6, 2020 Category: Orthopaedics Authors: Grassi, Alberto Costa, Giuseppe Gianluca Cialdella, Sergio Lo Presti, Mirco Neri, Maria Pia Zaffagnini, Stefano Tags: Original Article Source Type: research

The Distance between Tibial Tubercle and Trochlear Groove Correlates with Knee Articular Torsion
This study aims to correlate the tibial tubercle to trochlear groove (TT-TG) distance with knee axial alignment. The hypothesis is that as internal torsion of the distal femur or external torsion of the proximal tibial increases, the TT-TG distance increases. We designed a cross-sectional study approved by our institutional ethics review board. We reviewed 32 computed tomography angiographies of patients that have nonjoint or bone-related symptoms. Distal femoral torsion, proximal tibial torsion, knee articular torsion (AT), and TT-TG distance were measured. A regression analysis between the TT-TG distance and the AT was p...
Source: Journal of Knee Surgery - January 6, 2020 Category: Orthopaedics Authors: Barahona, Maximiliano Guzm án, Mauricio Barrientos, Cristian Zamorano, Álvaro Palet, Miguel Hinzpeter, Jaime Tags: Original Article Source Type: research

Erratum to: A Randomized Controlled Single-Blind Study Demonstrating Superiority of Amniotic Suspension Allograft Injection over Hyaluronic Acid and Saline Control for Modification of Knee Osteoarthritis Symptoms
J Knee Surg 2019; 32: e2-e2 DOI: 10.1055/s-0039-3402742 Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of contents  |  open access Full text (Source: Journal of Knee Surgery)
Source: Journal of Knee Surgery - January 6, 2020 Category: Orthopaedics Authors: Farr, Jack Gomoll, Andreas H. Yanke, Adam B. Strauss, Eric J. Mowry, Katie C. Tags: Erratum Source Type: research

Revision Multiligament Knee Reconstruction Surgery
J Knee Surg DOI: 10.1055/s-0039-3402791Failed multiligament knee reconstruction is a challenging problem due to recurrent pathologic laxity that is often associated with limb malalignment, meniscus deficiency, articular cartilage insufficiency, decreased motion, compromised bone stock, and a paucity of graft sources. Revision surgical indications and techniques require a comprehensive evaluation of the patient, injury and treatment factors along with a focused physical examination and advanced imaging. A stepwise treatment approach can be effective in the evaluation of revision surgery and also in setting realistic patient...
Source: Journal of Knee Surgery - January 2, 2020 Category: Orthopaedics Authors: Stuart, Michael B. Woodmass, Jarret M. Krych, Aaron J. Levy, Bruce A. Stuart, Michael J. Tags: Special Focus Section Source Type: research