The deep lateral femoral notch sign: a reliable diagnostic tool in identifying a concomitant anterior cruciate and anterolateral ligament injury
ConclusionsA DLFNS  >  1.8 mm could be a clinically relevant diagnostic tool for identifying a concomitant ACL/ALL rupture with high sensitivity and PPV. Patients with a DLFNS >  1.8 mm should be carefully evaluated for clinical and radiological signs of a concomitant ACL/ALL rupture and treated when needed with a combined intra-articular ACL reconstruction and extra-articular tenodesis to avoid a residual rotational instability and ACL graft rupture.Level of evidenceIII. (Source: Knee Surgery, Sports Traumatology, Arthroscopy)
Source: Knee Surgery, Sports Traumatology, Arthroscopy - May 17, 2021 Category: Orthopaedics Source Type: research

Arthritic progression secondary to meniscus root tear treated with knee arthroplasty demonstrates similar outcomes to primary osteoarthritis: a matched case –control comparison
ConclusionPatients treated with arthroplasty for secondary arthritis after a meniscus root tear demonstrated less severe radiographic arthritis, but similar pre-operative pain levels compared to matched controls with primary osteoarthritis. The root tear cohort patients demonstrated improved outcomes with respect to function, and similar outcomes with respect to pain, activity level, complication rates, and reoperation rates. The authors conclude that arthroplasty can be a reliable option for selected patients with an irreparable root tear and ongoing pain and dysfunction refractory to non-operative management, even in the...
Source: Knee Surgery, Sports Traumatology, Arthroscopy - May 17, 2021 Category: Orthopaedics Source Type: research

Posterior tibial slope: the fingerprint of the tibial bone
(Source: Knee Surgery, Sports Traumatology, Arthroscopy)
Source: Knee Surgery, Sports Traumatology, Arthroscopy - May 17, 2021 Category: Orthopaedics Source Type: research

Chronic ankle instability has no correlation with the number of ruptured ligaments in severe anterolateral sprain: a systematic review and meta-analysis
ConclusionA significant statistical correlation between a combined ATFL-CFL rupture and chronic ankle instability, compared to an isolated ATFL rupture, was not found. There is, however, fair evidence showing a worse clinical outcome score in the combined ruptures, as well as a decreased return to full sports activities. The use of reliable and accessible diagnostic methods to determine the number of ruptured ligaments might have a role in managing severe ankle sprains.Level of evidenceLevel III. (Source: Knee Surgery, Sports Traumatology, Arthroscopy)
Source: Knee Surgery, Sports Traumatology, Arthroscopy - May 15, 2021 Category: Orthopaedics Source Type: research

Increasing consensus on terminology of Achilles tendon-related disorders
ConclusionThe revised terminology for Achilles tendon-related disorders based on anatomic location, symptoms, clinical findings and histopathology is used by the majority of orthopedic surgeons and is increasingly used in the literature. However, the indistinct Haglund eponyms are still frequently used in Achilles tendon-related terminology.Level of evidenceLevel IV. (Source: Knee Surgery, Sports Traumatology, Arthroscopy)
Source: Knee Surgery, Sports Traumatology, Arthroscopy - May 15, 2021 Category: Orthopaedics Source Type: research

Evolving concepts and consensus in challenging shoulder problems: a European perspective
(Source: Knee Surgery, Sports Traumatology, Arthroscopy)
Source: Knee Surgery, Sports Traumatology, Arthroscopy - May 15, 2021 Category: Orthopaedics Source Type: research

Non-anatomic tunnel position increases the risk of revision anterior cruciate ligament reconstruction
AbstractPurposeAnterior cruciate ligament (ACL) graft failure is a complication that may require revision ACL reconstruction (ACL-R). Non-anatomic placement of the femoral tunnel is thought to be a frequent cause of graft failure; however, there is a lack of evidence to support this belief. The purpose of this study was to determine if non-anatomic femoral tunnel placement is associated with increased risk of revision ACL-R.MethodsAfter screening all 315 consecutive patients who underwent primary single-bundle ACL-R by a single senior orthopedic surgeon between January 2012 and January 2017, 58 patients were found to have ...
Source: Knee Surgery, Sports Traumatology, Arthroscopy - May 13, 2021 Category: Orthopaedics Source Type: research

Increased occurrence of ACL injuries for football players in teams changing coach and for players going to a higher division
ConclusionNeuromuscular training programs have proven to reduce ACL injuries, but greater adherence to these remains a challenge as only 1 in 5 of the ACL-injured football players report using them. Teams changing coach and players going to a higher division appear to have an increased risk of ACL injury warranting attention and further investigations.Level of evidenceIV. (Source: Knee Surgery, Sports Traumatology, Arthroscopy)
Source: Knee Surgery, Sports Traumatology, Arthroscopy - May 13, 2021 Category: Orthopaedics Source Type: research

High variability and lack of standardization in the evaluation of return to sport after ACL reconstruction: a systematic review
ConclusionThis review demonstrates high variability in defining, evaluating and reporting RTS following ACLR. The findings of this study reveal low reliability and unproven validity of methods used to evaluate RTS and highlight the challenges in interpreting and using RTS data reported in literature.Level of evidenceIV. (Source: Knee Surgery, Sports Traumatology, Arthroscopy)
Source: Knee Surgery, Sports Traumatology, Arthroscopy - May 12, 2021 Category: Orthopaedics Source Type: research

Journey-Deuce bicompartmental knee arthroplasty with the addition of computer navigation achieves good clinical outcomes and implant survival  at 10 years
AbstractPurposeTo report 10-year outcomes and survivorship in patients undergoing bicompartmental knee arthroplasty (BCKA) using the Journey-Deuce prosthesis in a consecutive prospective case series.MethodsBetween November 2006 and November 2009, 41 patients with a mean age of 69.6  years (range 51–86) underwent 51 bicompartmental knee arthroplasties with the Journey-Deuce knee prosthesis. All patients presented with symptomatic medial and patellofemoral compartment osteoarthritis, with intact cruciate ligaments and a preserved lateral compartment on plain radiographs and M agnetic Resonance Imaging. Clinical as...
Source: Knee Surgery, Sports Traumatology, Arthroscopy - May 11, 2021 Category: Orthopaedics Source Type: research

Posterior tibial slope measurements based on the full-length tibial anatomic axis are significantly increased compared to those based on the half-length tibial anatomic axis
This study aimed to compare the difference in posterior tibial slope (PTS) measurements based on the full-length and half-length tibial anatomic axes of the same group of patients. It was hypothesized that the obtained PTS values would be affected by the length of tibia chosen during the measurements.MethodsFull-length true lateral tibia radiographs were obtained for each patient who underwent anterior cruciate ligament reconstruction (ACLR) in our department. PTS measurements were obtained by measuring the angle between the full-length or half-length tibial anatomic axis and an average of the lateral and medial tibial pla...
Source: Knee Surgery, Sports Traumatology, Arthroscopy - May 11, 2021 Category: Orthopaedics Source Type: research

Incidence and risk factors for symptomatic venous thromboembolism following anterior cruciate ligament reconstruction
AbstractPurposeTo determine the incidence of symptomatic venous thromboembolism (VTE) following anterior cruciate ligament (ACL) reconstruction using a large national database and to identify corresponding independent risk factors.MethodsThe Humana administrative claims database was reviewed for patients undergoing ACL reconstruction from 2007 to 2017. Patient demographics, medical comorbidities, as well as concurrent procedures were recorded. Postoperative incidence of VTE was measured by identifying symptomatic deep vein thrombosis (DVT) and pulmonary embolism (PE) at 30 days, 90 days, and 1 year postoperatively. Univari...
Source: Knee Surgery, Sports Traumatology, Arthroscopy - May 10, 2021 Category: Orthopaedics Source Type: research

Anatomic single vs. double-bundle ACL reconstruction: a randomized clinical trial –Part 1: clinical outcomes
ConclusionsDue to the early termination of the study, there were no detectable differences in clinical outcome between anatomic SB and DB ACLR when performed with a quadriceps tendon autograft with a bone block in individuals with ACL insertion sites that range from 14 to 18  mm.Level of EvidenceLevel 2 (Source: Knee Surgery, Sports Traumatology, Arthroscopy)
Source: Knee Surgery, Sports Traumatology, Arthroscopy - May 10, 2021 Category: Orthopaedics Source Type: research

A larger side-to-side difference in anterior knee laxity increases the prevalence of medial and lateral meniscal injuries in patients with ACL injuries
ConclusionGreater anterior knee laxity, age, a longer duration between injury and surgery, and a higher pivot shift test grade predicted medial meniscal injury. Greater anterior knee laxity and the male sex predicted lateral meniscal injury. In patients with ACL injuries, the importance of side-to-side differences in anterior knee laxity should be rediscovered from the viewpoint of meniscal conditions.Level of evidenceLevel III. (Source: Knee Surgery, Sports Traumatology, Arthroscopy)
Source: Knee Surgery, Sports Traumatology, Arthroscopy - May 10, 2021 Category: Orthopaedics Source Type: research

Tendinopathy VISAs have expired —is it time for outcome renewals?
(Source: Knee Surgery, Sports Traumatology, Arthroscopy)
Source: Knee Surgery, Sports Traumatology, Arthroscopy - May 10, 2021 Category: Orthopaedics Source Type: research

Femoral tunnel malposition is the most common indication for revision medial patellofemoral ligament reconstruction with promising early outcomes following revision reconstruction: a systematic review
ConclusionThe most common causes of MPFL failure in literature published to date, in order of decreasing frequency, are: malposition of the femoral tunnel, unaddressed trochlear dysplasia, and patellar fracture. Although surgical techniques of revision MPFL-R to manage these failures were varied, promising outcomes have been reported to date. Larger prospective comparative studies would be useful to clarify optimal surgical management of MPFL-R failure at long-term follow-up.Level of evidenceIV. (Source: Knee Surgery, Sports Traumatology, Arthroscopy)
Source: Knee Surgery, Sports Traumatology, Arthroscopy - May 8, 2021 Category: Orthopaedics Source Type: research

First-time anterior cruciate ligament injury in adolescent female elite athletes: a prospective cohort study to identify modifiable risk factors
ConclusionFour distinct ACL injury risk factors related to the side-cutting manoeuvre were identified in a population of adolescent female elite football and team handball players with no previous ACL injury. As ACL injury typically occur during side-cutting, intervention programmes to modify these risk factors pose a promising strategy for ACL injury prevention in adolescent female elite football and team handball.Level of evidenceII. (Source: Knee Surgery, Sports Traumatology, Arthroscopy)
Source: Knee Surgery, Sports Traumatology, Arthroscopy - May 7, 2021 Category: Orthopaedics Source Type: research

Imageless robotic-assisted total knee arthroplasty leads to similar 24-month WOMAC scores as compared to conventional total knee arthroplasty: a retrospective cohort study
This study investigates perioperative outcomes, complications, and early patient-reported outcome measures (PROMs) of one imageless RA-TKA system compared to conventional method TKA (CM-TKA) at 24-month follow-up.MethodsThis multi-surgeon retrospective cohort analysis compared 111 imageless RA-TKA patients to 110 CM-TKA patients (n  = 221). Basic demographic information, intraoperative and postoperative data, and PROMs, including the functional score of the Knee Society Score (KSS-FS), The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and the Short Form 12 Mental and Physical scores ...
Source: Knee Surgery, Sports Traumatology, Arthroscopy - May 7, 2021 Category: Orthopaedics Source Type: research

Bilateral coracohumeral distance discrepancy is associated with subscapularis tear in rotator cuff rupture patients
AbstractPurposeTo describe the bilateral coracohumeral morphological discrepancy in rotator cuff rupture patients with and without subscapularis (SSC) involvement and to investigate its association with SSC tears.MethodsTwo hundred and thirteen consecutive patients who were scheduled to have arthroscopic rotator cuff repair were prospectively enrolled in the current study. Patients with acute traumatic rotator cuff rupture, glenohumeral osteoarthritis, bilateral rotator cuff rupture, recurrent shoulder instability, systemic inflammatory disease, and previous shoulder surgery history were excluded. Coracohumeral distance (C...
Source: Knee Surgery, Sports Traumatology, Arthroscopy - May 6, 2021 Category: Orthopaedics Source Type: research

The ischiofemoral space of the hip is influenced by the frontal knee alignment
AbstractPurposeThe ischiofemoral distance (IFD), defined as the distance between the ischial tuberosity and the lesser trochanter  of the femur, is gaining recognition as an extra-articular cause of hip pain. It is unknown whether the IFD is influenced by the frontal knee alignment. The aim of this study was to determine the influence of realignment surgery around the knee on the IFD. It was hypothesized that valgisation ost eotomy around the knee is associated with reduction of the IFD.MethodsA consecutive series of 154 patients undergoing frontal realignment procedures around the knee in 2017 were included in t...
Source: Knee Surgery, Sports Traumatology, Arthroscopy - May 5, 2021 Category: Orthopaedics Source Type: research

Similar kinematic patterns between revision total stabilized (TS) and primary posterior stabilized (PS) knee prostheses: a prospective case –controlled study with gait assessment
ConclusionSingle radius TS TKA has gait parameters similar to single radius PS TKA. Use of a single radius TS TKA in revision TKA is not detrimental to a patient ’s gait pattern. Both designs approached closely the normal gait patterns of the control group.Level of evidenceProspective, case –control study; Level III. (Source: Knee Surgery, Sports Traumatology, Arthroscopy)
Source: Knee Surgery, Sports Traumatology, Arthroscopy - May 4, 2021 Category: Orthopaedics Source Type: research

Lower revision rates for cemented fixation in a long-term survival analysis of three different LCS designs
ConclusionLong-term survival for patients undergoing cemented or uncemented TKA using the LCS MB system revealed lower revision rates for cemented fixation. Revision risk was higher in younger, non-IJD patients who had the PCR design, regardless of the type of fixation. For the LCS MB TKA design, it is recommended to use cemented fixation. (Source: Knee Surgery, Sports Traumatology, Arthroscopy)
Source: Knee Surgery, Sports Traumatology, Arthroscopy - May 2, 2021 Category: Orthopaedics Source Type: research

Bilateral Looser zones or pseudofractures in the anteromedial tibia as a component of medial tibial stress syndrome in athletes
ConclusionIn conclusion, deficient vitamin D levels may lead to pseudofractures due to localized deterioration of mineralization, representing a pivotal component of MTSS in athletes with increased repetitive mechanical loading of the lower limbs. Moreover, the manifestation of pseudofractures is not a consequence of an altered BMD nor microarchitecture but appears in patients with exercise-induced BMD increase in combination with reduced 25-OH-D levels. The screening of MTSS patients for pseudofractures is crucial for the initiation of an appropriate treatment such as vitamin D supplementation to prevent a prolonged cours...
Source: Knee Surgery, Sports Traumatology, Arthroscopy - April 11, 2021 Category: Orthopaedics Source Type: research

Large variation in management of talar osteochondral lesions among foot and ankle surgeons: results from an international survey
ConclusionThe management of OLT by foot and ankle surgeons from around the world remains extremely varied. The main clinical relevance of this study is that it provides updated information with regard to the management of OLT internationally, which could be used by surgeons worldwide in their decision-making and to inform the patient about available surgical options.Level of evidenceLevel IV. (Source: Knee Surgery, Sports Traumatology, Arthroscopy)
Source: Knee Surgery, Sports Traumatology, Arthroscopy - April 11, 2021 Category: Orthopaedics Source Type: research

Pre-operative patella alta does not affect midterm clinical outcomes and survivorship of patellofemoral arthroplasty
ConclusionsThis study suggests that there are no significant differences in clinical outcome scores or survivorship from TKA between patella alta and non-patella alta patients who underwent onlay design PFA. Both patella alta and non-patella alta patients demonstrated excellent improvement in outcome scores from pre-operative to post-operative.Level of evidenceIV. (Source: Knee Surgery, Sports Traumatology, Arthroscopy)
Source: Knee Surgery, Sports Traumatology, Arthroscopy - April 11, 2021 Category: Orthopaedics Source Type: research

Increased external tibial torsion is an infratuberositary deformity and is not correlated with a lateralized position of the tibial tuberosity
AbstractPurposeTo perform a segmental analysis of tibial torsion in patients, with normal and increased external tibial torsion, suffering from chronic patellofemoral instability (PFI) and to investigate a possible correlation between tibial torsion and the position of the tibial tuberosity.MethodsPatients with chronic PFI who underwent torsional analysis of the lower limb using a standardized hip-knee-ankle MRI between 2016 and 2018 were included. For segmental analysis of tibial torsion, three axial levels were defined which divided the tibia into two segments: a distal, infratuberositary segment and a proximal, supratub...
Source: Knee Surgery, Sports Traumatology, Arthroscopy - April 11, 2021 Category: Orthopaedics Source Type: research

Return to sport after hip arthroscopy: are you ready?
(Source: Knee Surgery, Sports Traumatology, Arthroscopy)
Source: Knee Surgery, Sports Traumatology, Arthroscopy - April 11, 2021 Category: Orthopaedics Source Type: research

Centrally sensitized patients undergoing total knee arthroplasty have higher expectations than do non-centrally sensitized patients
AbstractPurposeThe goal of this retrospective observational study is to determine whether patients with and without central sensitization (CS) undergoing total knee arthroplasty (TKA) have similar preoperative expectations. It was hypothesized that the degree of preoperative expectations is higher in patients with CS than in those without.MethodsThe data of 324 patients who underwent primary unilateral TKA for knee osteoarthritis were reviewed and CS was measured using the Central Sensitization Inventory (CSI), which is a validated self-reported questionnaire consisting of a total of 25 questions. CS was defined as a CSI s...
Source: Knee Surgery, Sports Traumatology, Arthroscopy - April 10, 2021 Category: Orthopaedics Source Type: research

The translated Danish version of the Western Ontario Meniscal Evaluation Tool (WOMET) is reliable and responsive
ConclusionThe Danish version of the WOMET is a reliable and responsive measure of health-related quality of life in patients with meniscal pathology.Level of evidenceLevel II. (Source: Knee Surgery, Sports Traumatology, Arthroscopy)
Source: Knee Surgery, Sports Traumatology, Arthroscopy - April 10, 2021 Category: Orthopaedics Source Type: research

Significant increase in quantity and quality of knee arthroplasty related research in KSSTA over the past 15  years
This study aimed to evaluate both publication and authorship characteristics in Knee Surgery, Sports Traumatology, Arthroscopy journal (KSSTA) regarding knee arthroplasty over the past 15  years.MethodsPubMed was searched for articles published in KSSTA between January 1, 2006, and December 31st, 2020, utilising the search term ‘knee arthroplasty’. 1288 articles met the inclusion criteria. The articles were evaluated using the following criteria: type of article, type of study, main topic and special topic, use of patient-reported outcome scores, number of references and citations, level of evidence (LOE),...
Source: Knee Surgery, Sports Traumatology, Arthroscopy - April 10, 2021 Category: Orthopaedics Source Type: research

Unicompartmental knee arthroplasty: the Italian version of the Forgotten Joint Score-12 is valid and reliable to assess prosthesis awareness
This study aims to perform a psychometric validation of the It alian version of FJS-12 for UKA for the first time.MethodsBetween January 2019 and October 2019, 44 patients were included. Each patient completed both the FJS-12 Italian version and the WOMAC Italian version in preoperative follow-up, after 2-week and 1-month, 3-month, and 6-month postoperative follow-up. Cronbach ’s α, intraclass correlation coefficient (ICC), standard error of measurement (SEM), and minimal detectable change (MDC) were calculated to evaluate the reliability. The Pearson coefficient was used to assess validity. The Effect Size (ES...
Source: Knee Surgery, Sports Traumatology, Arthroscopy - April 10, 2021 Category: Orthopaedics Source Type: research

Ipsilateral patellofemoral morphological abnormalities are more severe than those of contralateral joints in patients with unilateral patellar dislocation
ConclusionIn patients with unilateral patellar dislocation, the ipsilateral TT-TG distance, patella tilt, and patellar height values were larger in the ipsilateral knees than in the contralateral knees, and trochlear dysplasia was more severe in the ipsilateral joints. The risks of contralateral pathological tibial torsion and LTI were 8.8- and 7.6-fold higher, respectively, in patients with abnormal ipsilateral LTI.Level of evidenceLevel IV. (Source: Knee Surgery, Sports Traumatology, Arthroscopy)
Source: Knee Surgery, Sports Traumatology, Arthroscopy - April 9, 2021 Category: Orthopaedics Source Type: research

Non-anatomic repair of medial meniscus posterior root tears to the posterior capsule provided favourable outcomes in middle-aged and older patients
AbstractPurposeTo describe a non-anatomic arthroscopic all-inside repair technique for middle-aged and older patients with medial meniscus posterior root tears (MMPRTs) and to evaluate the short- to mid-term clinical and radiologic results. The hypothesis was that this procedure would yield good clinical outcome results and structural healing in middle- and older-aged patients.MethodsThis was a retrospective study evaluating patients who had undergone MMPRT repair by suturing the meniscal root directly to the capsule, rather than by the transtibial technique, between 2013 and 2016. This all-inside repair technique was perf...
Source: Knee Surgery, Sports Traumatology, Arthroscopy - April 9, 2021 Category: Orthopaedics Source Type: research

Satisfactory clinical results and low failure rate of medial collagen meniscus implant (CMI) at a minimum 20  years of follow-up
ConclusionThe medial CMI is a safe procedure: satisfactory clinical results and a low failure rate could be expected even at a long-term follow-up. For this purpose, the correct indication as well as correcting axial malalignment and addressing knee instability at the time of the index surgery is mandatory. On the other hand, a mild osteoarthritis progression could be expected even after meniscus replacement.Level of evidenceIV. (Source: Knee Surgery, Sports Traumatology, Arthroscopy)
Source: Knee Surgery, Sports Traumatology, Arthroscopy - April 9, 2021 Category: Orthopaedics Source Type: research

No effect of fixation type on early and late mortality after total knee arthroplasty: a Dutch arthroplasty register study
ConclusionBased on register data, method of fixation does not influence early mortality after primary TKA. This suggests that there is no preferred fixation technique for primary TKA based on the mortality rates.Level of evidenceIV. (Source: Knee Surgery, Sports Traumatology, Arthroscopy)
Source: Knee Surgery, Sports Traumatology, Arthroscopy - April 8, 2021 Category: Orthopaedics Source Type: research

Short distance from the keel to the posterior tibial cortex is associated with fracture after cementless Oxford UKA in Asian patients
This study examined where the fracture lines arises and evaluated the keel –cortex distances (KCDs) using three-dimensional computed tomography (3D-CT) and the effects of technical error (assessed by tibial component positions) and proximal tibial morphology on the KCDs.MethodsThis retrospective study included 217 OUKAs with cementless tibial components. Fifteen patients had tibial fractures after surgery. Anterior and posterior KCDs and fracture line origins were assessed using 3D-CT postoperatively. Proximal tibial morphology was assessed using the medial eminence line (MEL), which runs parallel to the tibial axis ...
Source: Knee Surgery, Sports Traumatology, Arthroscopy - April 7, 2021 Category: Orthopaedics Source Type: research

Anatomic all-epiphyseal ACL reconstruction with “inside-out” femoral tunnel placement in immature patients yields high return to sport rates and functional outcome scores a minimum of 24 months after reconstruction
AbstractPurposeTo understand if anatomic physeal-sparing ACL reconstruction in the immature host preserves range of motion, permits a return to sports, and avoids limb length discrepancy and accelerated intra-articular degeneration with a cross-sectional radiographic, physical examination and patient-reported outcomes analysis.MethodsA cross-sectional recall study included 38 patients aged 7 –15 who underwent all-epiphyseal ACL reconstruction with hamstring allograft performed by a single surgeon at a large academic medical center. All-epiphyseal reconstructions were performed using a modified Anderson physeal-sparin...
Source: Knee Surgery, Sports Traumatology, Arthroscopy - April 3, 2021 Category: Orthopaedics Source Type: research

The lack of retropatellar resurfacing at index surgery is significantly associated with failure in patients following patellofemoral inlay arthroplasty: a multi-center study of more than 260 patients
ConclusionPatellofemoral inlay arthroplasty shows high patient satisfaction with good functional outcomes at short-term follow-up and thus can be considered a viable treatment option in young patients suffering from isolated patellofemoral arthritis. Patellar resurfacing at index surgery is recommended to decrease the risk of failure.Level of evidenceRetrospective case series, Level IV. (Source: Knee Surgery, Sports Traumatology, Arthroscopy)
Source: Knee Surgery, Sports Traumatology, Arthroscopy - April 2, 2021 Category: Orthopaedics Source Type: research

Adequate union rates for the treatment of acute proximal fifth metatarsal fractures
ConclusionAcute zone 1 fractures are preferably treated conservatively as similar union rates were found after both conservative and surgical management. In contradistinction, acute zone 2 fractures demonstrate higher union rates and faster time to union when treated surgically. The outcomes of acute zone 3 fractures are rarely reported in the literature, so treatment recommendations remain unclear. Further research of proximal fifth metatarsal fractures is warranted to provide more definitive conclusions, but current findings can aid surgeons during the shared clinical decision making process.Level of evidence IV. (Source...
Source: Knee Surgery, Sports Traumatology, Arthroscopy - March 18, 2021 Category: Orthopaedics Source Type: research

Posterior cruciate ligament reconstruction with peroneus longus tendon versus hamstring tendon: a comparison of functional outcome and donor site morbidity
ConclusionPLT is a good choice as a graft in PCL reconstruction at the 2-year follow-up, with minimal donor site morbidity.Level of evidenceII. (Source: Knee Surgery, Sports Traumatology, Arthroscopy)
Source: Knee Surgery, Sports Traumatology, Arthroscopy - March 18, 2021 Category: Orthopaedics Source Type: research

Anterior cruciate ligament surgery and rehabilitation: does anybody really know what time it is?
(Source: Knee Surgery, Sports Traumatology, Arthroscopy)
Source: Knee Surgery, Sports Traumatology, Arthroscopy - March 18, 2021 Category: Orthopaedics Source Type: research

Preoperative varus alignment and postoperative meniscus extrusion are the main long-term predictive factors of clinical failure of meniscal root repair
ConclusionClinically, preoperative varus alignment and increased meniscal extrusion after surgery were found to be predictive for a clinical failure after meniscal root repair in a long-term perspective. Thus, these negative prognostic factors should be taken into consideration for performing root repair in MMPRTs.Level of evidenceLevel III. (Source: Knee Surgery, Sports Traumatology, Arthroscopy)
Source: Knee Surgery, Sports Traumatology, Arthroscopy - March 17, 2021 Category: Orthopaedics Source Type: research

High tibial osteotomy to neutral alignment improves medial knee articular cartilage composition
AbstractPurposeThe purpose of this study was to: (1) test the hypothesis that HTO improves articular cartilage composition in the medial compartment without adversely affecting the lateral compartment and patella, and; (2) explore associations between knee alignment and cartilage composition after surgery.Methods3T MRI and standing radiographs were obtained from 34 patients before and 1-year after HTO. Articular cartilage was segmented from T2 maps. Mechanical axis angle (MAA), posterior tibial slope, and patellar height were measured from radiographs. Changes in T2 and radiographic measures were assessed using pairedt tes...
Source: Knee Surgery, Sports Traumatology, Arthroscopy - March 16, 2021 Category: Orthopaedics Source Type: research

The technique of cement application has no influence on cement intrusion in total knee arthroplasty: randomized study comparing three different techniques
AbstractPurposeThe aim of the study was to compare the distance of intrusion of the cement into the bone in different areas both in the femur and the tibia in vivo, measured in the radiograph after implanting a total knee arthroplasty (TKA) with three different cement techniques.MethodsA prospective randomized study of 90 consecutive patients operated on at our institution with a cemented U2 Knee System TKA and medium viscosity Simplex P® bone cement. After pulse lavage, the cement was applied on the bone surfaces (group 1), on the implant surfaces (group 2) or both on the bone and the implant surfaces (group 3). The c...
Source: Knee Surgery, Sports Traumatology, Arthroscopy - March 14, 2021 Category: Orthopaedics Source Type: research

Subscapularis re-tears associated with preoperative advanced fatty infiltration and greater subscapularis involvement, leading to inferior functional outcomes and decreased acromiohumeral distance
This study aimed to investigate the influence of repaired subscapularis integrity on midterm results for anterosuperior massive rotator cuff tears (MRCTs) treated with partial rotator cuff repair.MethodsThis study included 57 patients who underwent arthroscopic partial repair for an anterosuperior MRCT. They were assigned to the healed subscapularis group (Group H 37 patients) or subscapularis re-tear group (Group R 20 patients). Preoperative and postoperative functional scores and active ranges of motion (ROMs) were assessed. Preoperative and 6-month follow-up magnetic resonance arthrography (MRA)/computed tomography arth...
Source: Knee Surgery, Sports Traumatology, Arthroscopy - March 12, 2021 Category: Orthopaedics Source Type: research

COVID-19-related cancellation of elective orthopaedic surgery caused increased pain and psychosocial distress levels
AbstractPurposeHealth care systems in most European countries were temporarily restructured to provide as much capacity as possible for the treatment of coronavirus disease 2019 (COVID-19) patients. Subsequently, all elective surgeries had to be cancelled and postponed for months. The aim of the present study was to assess the pretreatment health status before and after COVID-19-related cancellation and the psychosocial distress caused by the cancellation.MethodsFor this study, a questionnaire was developed collecting sociodemographic data and information on health status before and after the cancellation. To assess psycho...
Source: Knee Surgery, Sports Traumatology, Arthroscopy - March 12, 2021 Category: Orthopaedics Source Type: research

Medial meniscus posterior root repair reduces the extruded meniscus volume during knee flexion with favorable clinical outcome
ConclusionsThe progression of meniscus posterior extrusion and reduction of its volume at 90 ° knee flexion can be suppressed by MM posterior root repair. Postoperative clinical scores correlated with reductions of the posterior extrusion. Regarding clinical relevance, the dynamic stability of the meniscus can be maintained by MM posterior root repair, which is an effective therapeutic met hod for improving its clinical status.Level of evidenceLevel IV. (Source: Knee Surgery, Sports Traumatology, Arthroscopy)
Source: Knee Surgery, Sports Traumatology, Arthroscopy - March 11, 2021 Category: Orthopaedics Source Type: research

Preoperative pain sensitivity questionnaire helps customize pain management after arthroscopic partial meniscectomy
AbstractPurposeTo evaluate correlations between preoperative pain sensitivity and postoperative analgesic consumption together with pain perception shortly after arthroscopic partial meniscectomy in non-arthritic knees.MethodsNinety-nine patients who underwent primary arthroscopic meniscectomy were prospectively divided into three postoperative treatment groups that were prescribed with betamethasone injection (at the end of surgery), oral celecoxib or rescue analgesia (control). Preoperative pain sensitivity was evaluated by pain sensitivity questionnaires (PSQ). Patients were followed for the first three postoperative we...
Source: Knee Surgery, Sports Traumatology, Arthroscopy - March 11, 2021 Category: Orthopaedics Source Type: research

Anatomical repair and ligament bracing of Schenck III and IV knee joint dislocations leads to acceptable subjective and kinematic outcomes
ConclusionAnatomical repair with ligament bracing is a suitable surgical procedure in the treatment of KD and provides evidence in clinical practice with the benefit of early, definitive repair and preservation of the native ligaments. Patients reach acceptable subjective and objective functional outcomes, including mainly normalized gait patterns during short-term follow-up, with only minor changes in kinematics and spatial –temporal characteristics. Obese patients who suffered ULV trauma showed significantly inferior outcomes with larger deviations in joint kinematics.Level of evidenceLevel III. (Source: Knee Surge...
Source: Knee Surgery, Sports Traumatology, Arthroscopy - March 10, 2021 Category: Orthopaedics Source Type: research

The radiographic tibial spine area is correlated with the occurrence of ACL injury
ConclusionThe A –P and lateral tibial spine area was significantly smaller in the ACL tear group when compared with the ACL intact group. Although the sample size was limited, a small tibial spine might be a cause of knee instability, which may result in ACL injury.Level of evidenceLevel III. (Source: Knee Surgery, Sports Traumatology, Arthroscopy)
Source: Knee Surgery, Sports Traumatology, Arthroscopy - March 10, 2021 Category: Orthopaedics Source Type: research