Anatomical rectangular tunnels identified with the arthroscopic landmarks result in excellent outcomes in ACL reconstruction with a BTB graft
ConclusionBy identifying arthroscopic landmarks, the entire femoral tunnel aperture and at least 75% of the entire tibial tunnel aperture area were consistently located inside the anatomical attachment areas. With properly created tunnels inside the anatomical attachment areas, the ART ACLR using a BTB graft could provide satisfactory outcomes both subjectively and objectively in more than 95% of patients.Level of evidenceCase series, Level IV. (Source: Knee Surgery, Sports Traumatology, Arthroscopy)
Source: Knee Surgery, Sports Traumatology, Arthroscopy - November 20, 2018 Category: Orthopaedics Source Type: research

Good clinical and radiological results of total knee arthroplasty using varus valgus constrained or rotating hinge implants in ligamentous laxity
ConclusionsRotating hinge knees did not perform better than mobile-bearing varus valgus constrained knees clinically. Both prosthesis types showed equally good clinical outcomes with regard to stability, mobility, satisfaction, pain and operating time.Level of evidenceRetrospective case series, Level IV. (Source: Knee Surgery, Sports Traumatology, Arthroscopy)
Source: Knee Surgery, Sports Traumatology, Arthroscopy - November 20, 2018 Category: Orthopaedics Source Type: research

Alignment factors affecting the medial meniscus extrusion increases the risk of osteoarthritis development
ConclusionVarus alignment factors are related to MME distance especially in extruded meniscus knees, as the OA grade progressed. Therefore, the coexistence of varus alignment and MME can be the risk factors for OA progression. As the low MPTA was an independent alignment factor for generating varus alignment, patients with osteoarthritis of the knee with both, low MPTA and MME could be the appropriate candidates for early intervention by high tibial osteotomy.Level of evidenceIII. (Source: Knee Surgery, Sports Traumatology, Arthroscopy)
Source: Knee Surgery, Sports Traumatology, Arthroscopy - November 19, 2018 Category: Orthopaedics Source Type: research

Bone autografting in medial open wedge high tibial osteotomy results in improved osseous gap healing on computed tomography, but no functional advantage: a prospective, randomised, controlled trial
ConclusionsIliac crest autograft significantly increases healing of the osteotomy gap after owHTO. Increased preoperative varus and older patient age are independent factors that delay early healing of the osteotomy. However, no functional advantage was found at 3 or 12  months postoperatively. Therefore, routine use of iliac crest autograft cannot be recommended.Level of evidenceII. (Source: Knee Surgery, Sports Traumatology, Arthroscopy)
Source: Knee Surgery, Sports Traumatology, Arthroscopy - November 19, 2018 Category: Orthopaedics Source Type: research

Lower patient-reported function at 2 years is associated with elevated knee cartilage T1rho and T2 relaxation times at 5 years in young athletes after ACL reconstruction
AbstractPurposeThe purpose was to test the following hypotheses: (1) magnetic resonance imaging (MRI) markers of early knee cartilage degeneration would be present in the involved limb of young athletes after anterior cruciate ligament reconstruction (ACLR) and (2) poor knee function would be associated with MRI markers of cartilage degeneration.MethodsTwenty-five young athletes after primary, unilateral ACLR (mean age,  16.7 years) were followed to 5-year post-return-to-sport (RTS) clearance, as a part of a larger, prospective cohort study in young athletes post-ACLR. At 2-year post-RTS, patient-reported knee ...
Source: Knee Surgery, Sports Traumatology, Arthroscopy - November 16, 2018 Category: Orthopaedics Source Type: research

The 6-m timed hop test is a prognostic factor for outcomes in patients with meniscal tears treated with exercise therapy or arthroscopic partial meniscectomy: a secondary, exploratory analysis of the Odense –Oslo meniscectomy versus exercise (OMEX) trial
ConclusionsThe 6-m timed hop test result was a significant prognostic factor for 2-year patient-reported outcomes in middle-aged patients with degenerative meniscal tears, especially in those treated with APM.Level of evidenceII. (Source: Knee Surgery, Sports Traumatology, Arthroscopy)
Source: Knee Surgery, Sports Traumatology, Arthroscopy - November 16, 2018 Category: Orthopaedics Source Type: research

Medial femoral epicondyle upsliding osteotomy with posterior stabilized arthroplasty provided good clinical outcomes such as constrained arthroplasty in primary total knee arthroplasty with severe valgus deformity
AbstractPurposeA modified technique referred to as a medial femoral epicondyle upsliding osteotomy was proposed to address severe valgus deformity with unconstrained posterior stabilized (PS) arthroplasty. The study compared the effectiveness of the technique and PS arthroplasty with constrained arthroplasty during primary total knee arthroplasty (TKA).MethodsFifty-three patients presenting with valgus knees with a mean valgus angle (VA) greater than 30 ° were prospectively randomized and divided into two groups, and both groups received primary TKA. Upsliding osteotomy with PS arthroplasty was performed on the knees o...
Source: Knee Surgery, Sports Traumatology, Arthroscopy - November 15, 2018 Category: Orthopaedics Source Type: research

Corticosteroid injection is the best treatment in plantar fasciitis if combined with controlled training
AbstractPurposePlantar fasciitis is a very common (lifetime incidence ~  10%) and long-lasting injury with major impact on daily function. Combining corticosteroid injection and physical training (strength training and stretching) was hypothesized to result in a superior effect compared to each treatment separately.MethodsA single blinded randomized controlled superiority trial conducted in 2013 –2014 with a 2-year follow-up (end Sept 2016). 123 consecutive patients (20–65 years) referred to two study centers in Denmark: Institute of Sports Medicine, Bispebjerg Hospital, University of Copenhagen and...
Source: Knee Surgery, Sports Traumatology, Arthroscopy - November 15, 2018 Category: Orthopaedics Source Type: research

The detached stump of the torn anterior cruciate ligament adheres to the femoral notch wall and then to the posterior cruciate ligament within 6 months from injury
AbstractPurposeTo evaluate the progressive changes in the morphology of traumatic ruptures of the anterior cruciate ligament (ACL) over time. A secondary objective was evaluating their correlation with meniscal tears or chondral lesions.MethodsThe study included one hundred and one patients who underwent ACL reconstruction surgery of the knee after a definite date of injury. The torn ACL remnant morphological pattern was assessed and classified during arthroscopy. A correlation analysis was performed between the pathological features of the remnant and the time length from injury. In addition, correlation between ACL remna...
Source: Knee Surgery, Sports Traumatology, Arthroscopy - November 14, 2018 Category: Orthopaedics Source Type: research

Treatment strategies for ischiofemoral impingement: a systematic review
ConclusionSeveral treatment strategies have been reported for IFI, and most of them have good short- to medium-term outcomes with a low rate of complications. However, there are no comparative studies to assess the superiority of one technique over another, thus further research with randomised controlled trials is required in this arena. This study explores the wide variety and categories of different treatments used for IFI to guide physicians and shed light on what can be done for this challenging cohort of patients.Level of evidenceIII. (Source: Knee Surgery, Sports Traumatology, Arthroscopy)
Source: Knee Surgery, Sports Traumatology, Arthroscopy - November 13, 2018 Category: Orthopaedics Source Type: research

The significant effect of the medial hamstrings on dynamic knee stability
This study seeks to quantify the contribution of the medial hamstrings to knee stability.MethodsValgus knee laxity, anterior tibial translation, and rotational motion were measured in eight fresh-frozen cadaveric knees after forces were applied on the tibia in each plane (coronal, sagittal, and axial). Four muscle loading conditions were tested: (1) physiologic fully loaded pes anserinus, (2) semitendinosus only loaded, (3) gracilis only loaded, and (4) unloaded pes anserinus. The protocol was then repeated with the ACL transected.ResultsIn the ACL intact knee, the neutral position of the tibia with an unloaded pes anserin...
Source: Knee Surgery, Sports Traumatology, Arthroscopy - November 12, 2018 Category: Orthopaedics Source Type: research

Kinematic alignment in total knee arthroplasty leads to a better restoration of patellar kinematics compared to mechanic alignment
ConclusionKinematically aligned TKAs showed a better overall restoration of patellar kinematics compared to a conventional mechanical alignment technique. In terms of clinical usefulness, the present study highlights the potential benefit for clinical outcome using a kinematically aligned implantation technique in TKA to achieve a better restoration of natural patellofemoral kinematics. (Source: Knee Surgery, Sports Traumatology, Arthroscopy)
Source: Knee Surgery, Sports Traumatology, Arthroscopy - November 12, 2018 Category: Orthopaedics Source Type: research

Reconstruction of the medial patellofemoral ligament and reinforcement of the medial patellotibial ligament is an effective treatment for patellofemoral instability with patella alta
AbstractPurposeTo evaluate the clinical outcome of the combined reconstruction of the medial patellofemoral ligament (MPFL) and medial patellotibial ligament (MPTL) for patellar instability with patella alta.MethodsA total of 108 patients underwent a combined reconstruction of the MPFL and MPTL, and 58 patients were included in this study. The clinical results were evaluated and compared using the International Knee Documentation Committee (IKDC) scores, Kujala scores, and visual analogue scale (VAS) scores. The tibial tuberosity –trochlear groove (TT–TG) distance, three indices of patellar height (Insall&ndash...
Source: Knee Surgery, Sports Traumatology, Arthroscopy - November 12, 2018 Category: Orthopaedics Source Type: research

Tendon morphology and mechanical properties assessed by ultrasound show change early in recovery and potential prognostic ability for 6-month outcomes
AbstractPurposeOptimizing tendon structural recovery during the first 12  weeks after Achilles tendon rupture is a prime target to improve patient outcomes, but a comprehensive understanding of biomarkers is needed to track early healing. The purpose of this study was to observe healing of tendon structure over time using ultrasound-based, tendon-specific measures and t o identify relationships between tendon structural characteristics and clinical measures of gait and strength.MethodsTwenty-seven participants (21 males, mean (SD) age 39 (11)  years) were assessed at 4, 8, 12, and 24 weeks after injury or su...
Source: Knee Surgery, Sports Traumatology, Arthroscopy - November 10, 2018 Category: Orthopaedics Source Type: research

Lower limb alignment becomes more varus and hyperextended from supine to bipedal stance in asymptomatic, osteoarthritic and prosthetic neutral or varus knees
This study aimed to quantify the relationship between supine and standing lower limb alignment in asymptomatic, osteoarthritic (OA) and prosthetic (TKA) knees.MethodsA non-invasive position capture system was used to assess knee alignment for 30 asymptomatic controls and 31 patients with OA both before and after TKA. Coronal and sagittal mechanical femorotibial angles were measured supine with the lower limb in extension and in bipedal stance. Changes between conditions were analysed using pairedttests. Vector plots of ankle centre displacement relative to the knee centre from supine to standing were produced to allow thre...
Source: Knee Surgery, Sports Traumatology, Arthroscopy - November 10, 2018 Category: Orthopaedics Source Type: research

National injury prevention measures in team sports should focus on knee, head, and severe upper limb injuries
ConclusionsTo achieve the greatest impact in reducing the adverse effects of acute sport injuries nationwide in Sweden, preventive measures should focus on knee injuries in all the investigated team sports. The severe head/face and upper limb injuries also need attention. Protective equipment, neuromuscular training programs, rules enforcements, and fair-play interventions may reduce the incidence of injuries. (Source: Knee Surgery, Sports Traumatology, Arthroscopy)
Source: Knee Surgery, Sports Traumatology, Arthroscopy - November 9, 2018 Category: Orthopaedics Source Type: research

Higher age, female gender, osteoarthritis and blood transfusion protect against periprosthetic joint infection in total hip or knee arthroplasties: a systematic review and meta-analysis
ConclusionsThe main risk factors for PJI in each category were male gender, coagulopathy, alcohol abuse, surgical site infection (highest score) and high NNIS system surgical patient index score. Protective factors were age, female gender in TKA, osteoarthritis and blood transfusion. Optimization of modifiable risk factors for PJI should be attempted in clinical practice.Level of evidenceII. (Source: Knee Surgery, Sports Traumatology, Arthroscopy)
Source: Knee Surgery, Sports Traumatology, Arthroscopy - November 9, 2018 Category: Orthopaedics Source Type: research

Increased ATFL –PTFL angle could be an indirect MRI sign in diagnosis of chronic ATFL injury
This study ’s purpose was to evaluate the angle between the ATFL and posterior talofibular ligament (PTFL) as a new indirect MRI sign of chronic ATFL injury in patients with mechanical ankle instability (MAI).MethodsThis study included 200 participants: 105 patients with MAI and 95 patients seen at our institution for reasons unrelated to ankle instability. MR images of all 200 participants were reviewed. The ATFL –PTFL angle in the axial plane was measured and compared between groups. Receiver operating characteristic curves (ROC) were used to analyze ATFL–PTFL angles in participants with and without ATF...
Source: Knee Surgery, Sports Traumatology, Arthroscopy - November 9, 2018 Category: Orthopaedics Source Type: research

Partial meniscectomy adversely affects return-to-sport outcome after anatomical double-bundle anterior cruciate ligament reconstruction
ConclusionOur study demonstrates that partial meniscectomy has an adverse effect on the return to sport phase following the anatomical double-bundle ACL reconstruction. Therefore, greater postoperative care would be needed to return to sport with partial meniscectomy in ACL reconstruction cases. On the contrary, partial meniscectomy is not considered to be the risk factor for graft failure at short-term follow-up.Level of evidenceCase –control study, Level III. (Source: Knee Surgery, Sports Traumatology, Arthroscopy)
Source: Knee Surgery, Sports Traumatology, Arthroscopy - November 9, 2018 Category: Orthopaedics Source Type: research

Synovitis following anterior cruciate ligament reconstruction using the LARS device
ConclusionsForeign body synovitis is a common finding in our series of patients undergoing a repeat arthroscopy following a LARS ACL reconstruction. The histological diagnosis of synovitis was more frequently encountered than an arthroscopic appearance of synovitis. Whilst the results of this case series cannot support a direct causative link between LARS failure and the development of synovitis, this study highlights the need to remain vigilant about the risk of reactive synovitis following LARS ACL reconstruction due to exposure of the knee to foreign body material.Level of evidenceLevel IV, case series. (Source: Knee Su...
Source: Knee Surgery, Sports Traumatology, Arthroscopy - November 8, 2018 Category: Orthopaedics Source Type: research

Midbody of the medial meniscus as a reference of preservation in partial meniscectomy for complete discoid lateral meniscus
ConclusionThe size of midbody of medial meniscus could be a reference for partial meniscectomy in symptomatic complete discoid meniscus. Preoperative shift represents a risk factor for decreased remaining meniscal width. These findings could be helpful in ensuring appropriate surgical planning and explaining poor prognostic factors.Level of evidenceProspective cohort study, Level II. (Source: Knee Surgery, Sports Traumatology, Arthroscopy)
Source: Knee Surgery, Sports Traumatology, Arthroscopy - November 7, 2018 Category: Orthopaedics Source Type: research

Anterior cruciate ligament reconstruction is associated with greater tibial tunnel widening when using a bioabsorbable screw compared to an all-inside technique with suspensory fixation
ConclusionTibial tunnel widening after ACLR using hamstring tendon autograft is significantly greater with suspensory femoral fixation and a bioabsorbable tibial interference screw when compared to an all-inside technique at a median follow-up of 2  years. The clinical relevance of this work lies in the rebuttal of concerns arising from biomechanical studies regarding the possibility of increased tunnel widening with an all-inside technique.Level of evidenceIII. (Source: Knee Surgery, Sports Traumatology, Arthroscopy)
Source: Knee Surgery, Sports Traumatology, Arthroscopy - November 7, 2018 Category: Orthopaedics Source Type: research

Medial soft tissue contracture does not always exist in varus osteoarthritis knees in total knee arthroplasty
ConclusionsConsideration of cartilage wear allowed knee laxity to be evaluated more precisely in this study than in previous reports. It was shown that medial soft tissue contracture did not always exist, even in varus OA knees. Regarding clinical relevance, surgeons should be aware that underestimating medial soft tissue laxity due to reliance on the absolute JLA might lead to excessive medial tissue release and result in postoperative instability and lower patient satisfaction.Level of evidenceIV. (Source: Knee Surgery, Sports Traumatology, Arthroscopy)
Source: Knee Surgery, Sports Traumatology, Arthroscopy - November 7, 2018 Category: Orthopaedics Source Type: research

Tunnel placement in ACL reconstruction surgery: smaller inter-tunnel angles and higher peak forces at the femoral tunnel using anteromedial portal femoral drilling —a 3D and finite element analysis
AbstractPurposeRecent studies have emphasized the importance of anatomical ACL reconstruction to restore normal knee kinematics and stability. Aim of this study is to evaluate and compare the ability of the anteromedial (AM) and transtibial (TT) techniques for ACL reconstruction to achieve anatomical placement of the femoral and tibial tunnel within the native ACL footprint and to determine forces within the graft during functional motion. As the AM technique is nowadays the technique of choice, the hypothesis is that there are significant differences in tunnel features, reaction forces and/or moments within the graft when...
Source: Knee Surgery, Sports Traumatology, Arthroscopy - November 7, 2018 Category: Orthopaedics Source Type: research

Arthroscopic microfracture vs. arthroscopic autologous matrix-induced chondrogenesis for the treatment of articular cartilage defects of the talus
ConclusionGood clinical results were observed for arthroscopic microfracture with or without an additional acellular collagen I/III matrix in the treatment for articular cartilage defects of the talus. It appears that for defects as treated in this study, it is not worthwhile adding the collagen I/III matrix to the microfractures.Level of evidenceIII. (Source: Knee Surgery, Sports Traumatology, Arthroscopy)
Source: Knee Surgery, Sports Traumatology, Arthroscopy - November 3, 2018 Category: Orthopaedics Source Type: research

Steep lateral tibial slope and lateral-to-medial slope asymmetry are risk factors for concomitant posterolateral meniscus root tears in anterior cruciate ligament injuries
AbstractPurposeTo compare sagittal and coronal tibial slopes between anterior cruciate ligament (ACL) injured subjects with and without posterolateral meniscus root tear (PLRT).MethodsA chart review was conducted to identify patients with isolated ACL tears and patients with an associated PLRT. Patients with other concomitant injuries and patients who underwent surgery  >  6 months after the injury were excluded. Magnetic resonance image data were used to compare the medial and lateral sagittal tibial slope (MTS and LTS), lateral-to-medial slope asymmetry (LTS–MTS), and coronal slope of the tibial pl...
Source: Knee Surgery, Sports Traumatology, Arthroscopy - November 2, 2018 Category: Orthopaedics Source Type: research

Correction to: More tendon degeneration in patients with shoulder osteoarthritis
Unfortunately, the given name and the family name of the authors were incorrectly identified in the original article. The author names are corrected here by this correction paper. The original article has been corrected. (Source: Knee Surgery, Sports Traumatology, Arthroscopy)
Source: Knee Surgery, Sports Traumatology, Arthroscopy - November 2, 2018 Category: Orthopaedics Source Type: research

Correction to: Femoral insertion site of the graft used to replace the medial patellofemoral ligament influences the ligament dynamic changes during knee flexion and the clinical outcome
Unfortunately, the author missed out to indicate the affiliation which is basic requirement as a part of his thesis. The affiliation is now updated here. (Source: Knee Surgery, Sports Traumatology, Arthroscopy)
Source: Knee Surgery, Sports Traumatology, Arthroscopy - November 2, 2018 Category: Orthopaedics Source Type: research

Unloader knee brace increases medial compartment joint space during gait in knee osteoarthritis patients
ConclusionThe unloader brace has the significant effect of increasing medial compartment DJS during gait, which supports the underlying premise that the unloader brace reduces pain by increasing medial joint space during dynamic loading activities.Level of evidenceIII. (Source: Knee Surgery, Sports Traumatology, Arthroscopy)
Source: Knee Surgery, Sports Traumatology, Arthroscopy - November 1, 2018 Category: Orthopaedics Source Type: research

Nearly 90% participation in sports activity 12  years after non-surgical management for anterior cruciate ligament injury relates to physical outcome measures
This study aimed to establish long-term RTS levels in ACL-ruptured individuals treated conservatively, and to investigate the relationship between outcome measures and RTS, in particular, pivoting sports.MethodFifty-five patients from a cohort of 132 ACL-deficient patients were followed-up for  12 (IQR 8,19) years post injury. Mean-aged 42 years, 22 patients were females and 33 males, 35 had meniscal injuries. Patients were treated with physiotherapy focussing on strength and dynamic stability training and not reconstructive surgery. Return to sport was measured on a 6-point scale. Out come measures included...
Source: Knee Surgery, Sports Traumatology, Arthroscopy - November 1, 2018 Category: Orthopaedics Source Type: research

The incidence of symptomatic in-hospital VTEs in Asian patients undergoing joint arthroplasty was low: a prospective, multicenter, 17,660-patient-enrolled cohort study
ConclusionsThe incidence of symptomatic VTEs in Asian regions was low compared with that reported in studies targeting Western populations. Approximately 1 in 500 patients undergoing THA and approximately 1 in 300 patients undergoing TKA developed symptomatic VTEs prior to hospital discharge. Old age, high BMI, history of venous thromboembolism, hypertension, cerebrovascular disease, and no medication prophylaxis were risk factors identified in this study.Level of evidenceProspective cohort study; Level 2. (Source: Knee Surgery, Sports Traumatology, Arthroscopy)
Source: Knee Surgery, Sports Traumatology, Arthroscopy - November 1, 2018 Category: Orthopaedics Source Type: research

The role of a scientific society in the training and development of an orthopaedic surgeon
(Source: Knee Surgery, Sports Traumatology, Arthroscopy)
Source: Knee Surgery, Sports Traumatology, Arthroscopy - October 19, 2018 Category: Orthopaedics Source Type: research

The infrapatellar fat pad is a dynamic and mobile structure, which deforms during knee motion, and has proximal extensions which wrap around the patella
ConclusionProximal IFP extensions are a novel description. The IFP is a dynamic structure, displacing significantly during knee motion, which is, therefore, vulnerable to interference from trauma or repetitive overload. Given that this trauma is often surgical, it may be appropriate that surgeons learn to minimize injury to the fat pad at surgery. (Source: Knee Surgery, Sports Traumatology, Arthroscopy)
Source: Knee Surgery, Sports Traumatology, Arthroscopy - October 19, 2018 Category: Orthopaedics Source Type: research

Intraoperative soft tissue balance using novel medial preserving gap technique in posterior-stabilized total knee arthroplasty: comparison to measured resection technique
ConclusionsMedial preserving gap technique provided more consistent intraoperative soft tissue balance during knee flexion than the measured resection technique, suggesting that this novel technique can be utilized to obtain a more stable joint gap in PS TKA.Level of evidenceIII. (Source: Knee Surgery, Sports Traumatology, Arthroscopy)
Source: Knee Surgery, Sports Traumatology, Arthroscopy - October 19, 2018 Category: Orthopaedics Source Type: research

Satisfactory functional and radiological outcomes can be expected in young patients under 45  years old after open wedge high tibial osteotomy in a long-term follow-up
AbstractPurposeTo report the long-term outcomes of medial open wedge high tibial osteotomy (MOWHTO) for the treatment of medial compartment knee osteoarthritis in patients younger than 45  years old. It was hypothesized that the correction of knee alignment would result in preservation of knee function in a long-term follow-up.MethodsPatients under 45  years old, who underwent MOWHTO for symptomatic medial compartment knee osteoarthritis between 2001 and 2005 were retrospectively reviewed after a minimum of 10 years. The osteotomy was performed utilizing a locking plate without the use of bone graft. Patient...
Source: Knee Surgery, Sports Traumatology, Arthroscopy - October 19, 2018 Category: Orthopaedics Source Type: research

Training with biofeedback devices improves clinical outcome compared to usual care in patients with unilateral TKA: a systematic review
ConclusionsThis review suggests that biofeedback in early postoperative rehabilitation after TKA is effective in improving gait symmetry, reducing pain and increasing activity level. It should be noted that the great variety of devices used for feedback limits comparisons between studies.Level of evidenceIIa. (Source: Knee Surgery, Sports Traumatology, Arthroscopy)
Source: Knee Surgery, Sports Traumatology, Arthroscopy - October 17, 2018 Category: Orthopaedics Source Type: research

A small difference in recovery between total knee arthroplasty with and without tourniquet use the first 3 months after surgery: a randomized controlled study
ConclusionsThe hypothesis that the rehabilitation-related results would be improved without a tourniquet is not supported by the results. When the results in this study for surgery performed with and without tourniquet are compared, no clear benefit for either procedure was observed, as the more pain exhibited by the nontourniquet group was only evident for a short period and the improved mobility in this group was not at a clinically relevant level.Level of evidenceInconsistent results, Level II. (Source: Knee Surgery, Sports Traumatology, Arthroscopy)
Source: Knee Surgery, Sports Traumatology, Arthroscopy - October 17, 2018 Category: Orthopaedics Source Type: research

Effect of polyethylene conformity on total knee arthroplasty early clinical outcomes
ConclusionThis study evaluated two biomechanically different polyethylene inserts in the same TKA design, showing that reducing the level of intra-articular conformity had minimal effects on PROMs and objective short-term clinical results but a potentially beneficial effect on ROM. This study suggests that, once a satisfactory intra-operative stability is obtained, the minimal level of constraint should be used.Level of evidenceIII. (Source: Knee Surgery, Sports Traumatology, Arthroscopy)
Source: Knee Surgery, Sports Traumatology, Arthroscopy - October 17, 2018 Category: Orthopaedics Source Type: research

Demographic and surgical factors affect quadriceps strength after ACL reconstruction
AbstractPurposeTo investigate the effects of graft source, time since surgery, age, and sex on unilateral and symmetry-based measures of knee extension strength among individuals with ACL reconstruction (ACLR).MethodsThree hundred and eight individuals aged 13 –40 years old with primary, unilateral ACLR in the last 60 months were enrolled in this multi-site clinical measurement study. Participants completed bilateral knee extension maximal voluntary isometric contraction (MVIC) torque assessments which were normalized to body mass (Nm/kg) and limb sym metry indices (LSI) were calculated. The effects of graf...
Source: Knee Surgery, Sports Traumatology, Arthroscopy - October 16, 2018 Category: Orthopaedics Source Type: research

Medial compartment defects progress at a more rapid rate than lateral cartilage defects in older adults with minimal to moderate knee osteoarthritis (OA): data from the OA initiative
AbstractPurposeTo determine: (1) rates and risk factors for progression of lateral and medial full-thickness cartilage defect size in older adults without severe knee osteoarthritis (OA), and (2) whether risk factors for defect progression differ for knees with Kellgren –Lawrence OA grade 3 (moderate) OA versus grades 0–2 (none to mild) OA.MethodsThree-hundred and eighty adults enrolled in the Osteoarthritis Initiative were included (43% male, mean age 63.0 SD 9.2  years). Ethical approval was obtained at all study sites prior to enrollment. All participants had full-thickness tibial or weight-bearing femo...
Source: Knee Surgery, Sports Traumatology, Arthroscopy - October 15, 2018 Category: Orthopaedics Source Type: research

A novel diagnostic method to predict subscapularis tendon tear with sagittal oblique view magnetic resonance imaging
ConclusionSeveral measurement parameters in two additional views in sagittal –oblique MRI (en-face view and Y-view) showed different degrees of subscapularis tendon tears. Grading of base-to-tip line is easy to use and helps diagnose partial subscapularis tear.Level of evidenceIII. (Source: Knee Surgery, Sports Traumatology, Arthroscopy)
Source: Knee Surgery, Sports Traumatology, Arthroscopy - October 13, 2018 Category: Orthopaedics Source Type: research

The lateral femoral notch sign: a reliable diagnostic measurement in acute anterior cruciate ligament injury
ConclusionThis was the first study to investigate the inter- and intra-observer agreement of the depth and location of the LFNS. The depth of the LFNS had a very high predictive value for ACL-injured patients and could be used in the emergency department without any additional cost. A depth of>  1.0 mm was a good predictor for ACL injury. Measuring the depth of the LFNS is a simple and clinically relevant tool for diagnosing ACL injury in the acute setting and should be used by clinicians in patients with acute knee trauma.Level of evidenceDiagnostic study, level II. (Source: Knee Surgery, Sports Traumatology, Arthroscopy)
Source: Knee Surgery, Sports Traumatology, Arthroscopy - October 13, 2018 Category: Orthopaedics Source Type: research

Insall –Salvati ratio stabilizes one year after mobile-bearing total knee arthroplasty and does not correlate with mid-to-long-term clinical outcomes
AbstractPurposeIt has not been established whether changes in the length of the patellar tendon (LPT) after total knee arthroplasty (TKA) affect clinical outcomes. Therefore, this prospective cohort study aimed to evaluate changes in the LPT over time postoperatively and clarify their impact on clinical outcomes after bilateral TKA, performed with differently designed mobile-bearing (meniscal-bearing and rotating-platform) implants on contralateral knees.Methods51 patients who required staged bilateral mobile-bearing TKA were recruited. LPT was evaluated by measuring the Insall –Salvati ratio (ISR) preoperatively and...
Source: Knee Surgery, Sports Traumatology, Arthroscopy - October 13, 2018 Category: Orthopaedics Source Type: research

Meniscal extrusion is positively correlated with the anatomical position changes of the meniscal anterior and posterior horns, following medial meniscal allograft transplantation
ConclusionTransplanting the meniscus close to its native position may reduce subluxation in medial meniscal allograft transplantation. As position changes in the coronal plane can affect the meniscal subluxation more than changes in the sagittal plane, the tibial bone tunnel should be carefully created in the correct anatomical position to avoid a large amount of coronal deviation.Level of evidenceRetrospective case series, IV. (Source: Knee Surgery, Sports Traumatology, Arthroscopy)
Source: Knee Surgery, Sports Traumatology, Arthroscopy - October 13, 2018 Category: Orthopaedics Source Type: research

Derotational osteotomy at the distal femur is effective to treat patients with patellar instability
AbstractPurposeIncreased femoral antetorsion influences patellofemoral joint kinematics. The aim of this study was to retrospectively evaluate the clinical outcome after derotational osteotomies and combined procedures in patients with patellofemoral instability.MethodsAll patients with derotational osteotomies and combined procedures in patients with patellofemoral instability and increased femoral antetorsion performed between 2007 and 2016 were retrospectively analyzed. Exclusion criteria were open growth plates, posttraumatic deformities, and a follow-up period less than 12  months. Simple radiography and magnetic...
Source: Knee Surgery, Sports Traumatology, Arthroscopy - October 13, 2018 Category: Orthopaedics Source Type: research

Contact times of change-of-direction manoeuvres are influenced by age and the type of sports: a novel protocol using the SpeedCourt ® system
AbstractPurposeSide-to-side asymmetry in side-cutting manoeuvres is a known risk factor for severe knee injury. Potential leg asymmetry during ground contact times of different change-of-direction manoeuvres was evaluated in athletes by means of the recently developed SpeedCourt® system. The hypotheses were that ground contact times and the limb symmetry index are affected by age and the type of sports.MethodsOne-hundred and sixty-five athletes (149 men, 16 women, age 16.5  ± 5.1) of popular team sports such as football, team handball and baseball were assessed by means of three different tests [si...
Source: Knee Surgery, Sports Traumatology, Arthroscopy - October 12, 2018 Category: Orthopaedics Source Type: research

The concomitant lateral meniscus injury increased the pivot shift in the anterior cruciate ligament-injured knee
AbstractPurposeConcomitant meniscus injuries in the anterior cruciate ligament (ACL) have been suggested to exacerbate rotational laxity. However, the effect is supposed to be so small, if any, that some quantitative pivot-shift measurement is needed. The purpose of this prospective study was to determine the effect of meniscus tear on rotational laxity in ACL-deficient knees by an quantitative measurement. It was hypothesized that a concomitant meniscus tear, especially a lateral one, would induce greater pivot shift.MethodsFifty-seven unilateral ACL-injured patients (26 men and 31 women, mean age: 24  ±&thi...
Source: Knee Surgery, Sports Traumatology, Arthroscopy - October 11, 2018 Category: Orthopaedics Source Type: research

Anterior cruciate ligament reconstruction improves subjective ability but not neuromuscular biomechanics during dynamic tasks
AbstractPurposeThe purpose of this study was to identify high-functioning anterior cruciate ligament-deficient patients and assess the effects of reconstruction on their self-reported functionality, muscle activations and biomechanical properties.MethodsTwenty young and active patients participated pre- (11.5  ± 14.3 months post-injury) and again 10.5 ± 1.7 months post-reconstruction and were individually matched to 20 healthy controls. Participants completed hop and side cut movements while patient-related outcome measures, lower limb electromyography, kinetic, and whole body...
Source: Knee Surgery, Sports Traumatology, Arthroscopy - October 10, 2018 Category: Orthopaedics Source Type: research

Asymmetric polyethylene inserts promote favorable kinematics and better clinical outcome compared to symmetric inserts in a mobile bearing total knee arthroplasty
ConclusionThe biomechanical analysis justifies the clinical findings. TKA kinematics is similar for the two designs, although the asymmetric solution shows less bone stress, thus resulting as more suitable to be cemented, avoiding lift-off issues, inducing less pain. Clinically, and biomechanically, an asymmetric mobile bearing insert could be a valid alternative to symmetric mobile bearing insert.Level of evidenceCase –control study retrospective comparative study, III. (Source: Knee Surgery, Sports Traumatology, Arthroscopy)
Source: Knee Surgery, Sports Traumatology, Arthroscopy - October 10, 2018 Category: Orthopaedics Source Type: research

Repair of the entire superior acromioclavicular ligament complex best restores posterior translation and rotational stability
AbstractPurposeThe acromioclavicular ligament complex (ACLC) is the primary stabilizer against horizontal translation with the superior ACLC providing the main contribution. The purpose of this study was to evaluate the specific regional contributions in the superior half of ACLC, where the surgeon can easily access and repair or reconstruct, for posterior translational and rotational stability.MethodsThe superior half of ACLC was divided into three regions; Region A (0 °–60°): an anterior 1/3 region of the superior half of ACLC, Region B (60°–120°): a superior 1/3 region of the superior half of...
Source: Knee Surgery, Sports Traumatology, Arthroscopy - October 10, 2018 Category: Orthopaedics Source Type: research