A high rate of children and adolescents return to sport after surgical treatment of osteochondritis dissecans of the elbow: a systematic review and meta-analysis
ConclusionSurgical management of osteochondritis dissecans of the elbow resulted in a high rate of return to sport, including in competitive and overhead athletes. Similar rates of return to sport were noted across both open and arthroscopic procedures.Level of evidenceLevel IV. (Source: Knee Surgery, Sports Traumatology, Arthroscopy)
Source: Knee Surgery, Sports Traumatology, Arthroscopy - February 23, 2021 Category: Orthopaedics Source Type: research

Hamstring graft diameter above 7  mm has a lower risk of failure following anterior cruciate ligament reconstruction
AbstractPurposeMulti-stranded hamstring-tendon autografts have been widely used for anterior cruciate ligament reconstruction (ACLR) surgeries. Recently, smaller diameter hamstring autografts have been linked with the risk of failure or graft rupture. However, there is limited evidence concerning the optimal diameter of the hamstring autografts for ACLR. The current systematic review and meta-analysis analysed the association of ACLR failure with the diameter of hamstring autografts.MethodsA systematic search of three major scientific databases (Pubmed, EMBASE, and Cochrane library) was conducted to identify studies that p...
Source: Knee Surgery, Sports Traumatology, Arthroscopy - February 23, 2021 Category: Orthopaedics Source Type: research

Italian version of the anterior cruciate ligament-return to sport after injury scale (IT ACL-RSI): translation, cross-cultural adaptation, validation and ability to predict the return to sport at medium-term follow-up in a population of sport patients
AbstractPurposeThe timing of psychological and physical recovery after anterior cruciate ligament reconstruction represents an open issue in current orthopedic practice. Several tools have been developed to evaluate these factors, with the most recent being represented by the anterior cruciate ligament (ACL) return to sport injury scale (ACL-RSI). The aims of this study were to provide a validated Italian translation of the ACL-RSI in a population of sport patients, and to identify a possible correlation of the ACL-RSI score with the return to sport (RTS) time and the level of sport participation in comparison to the pre-i...
Source: Knee Surgery, Sports Traumatology, Arthroscopy - February 23, 2021 Category: Orthopaedics Source Type: research

Anatomic medial knee reconstruction restores stability and function at minimum 2 years follow-up
AbstractPurposeChronic grade 3 tears of the medial collateral ligament and posterior oblique ligament may result in valgus laxity and anteromedial rotational instability after an isolated or multiligament injury. The purpose of this study was to prospectively analyze the restoration of physiologic medial laxity as assessed on stress radiography and patient reported subjective functional outcomes in patients who undergo an anatomic medial knee reconstruction.MethodsThis was a prospective study which included patients with chronic (>  6 weeks old) posteromedial corner injury with or without other ligament and ...
Source: Knee Surgery, Sports Traumatology, Arthroscopy - February 22, 2021 Category: Orthopaedics Source Type: research

Anatomic single- and double-bundle ACL reconstruction both restore dynamic knee function: a randomized clinical trial —part II: knee kinematics
ConclusionsContrary to the study hypothesis, double-bundle reconstruction did not show superior kinematic outcomes compared to the single-bundle ACLR. While neither procedure fully restored normal knee kinematics, both anatomic reconstructions were similarly effective for restoring near-normal dynamic knee function. The findings of this study indicate both SB and DB techniques can be used for patients with average size ACL insertion sites.Level of evidenceLevel I (Source: Knee Surgery, Sports Traumatology, Arthroscopy)
Source: Knee Surgery, Sports Traumatology, Arthroscopy - February 22, 2021 Category: Orthopaedics Source Type: research

High union rates following surgical treatment of proximal fifth metatarsal stress fractures
ConclusionSurgical treatment of stress fractures of the proximal fifth metatarsal results in a higher bone union rate and a shorter union time than non-surgical treatment. Additionally, surgical and non-surgical treatment both showed a high return to sport rate (at any level), albeit with limited clinical evidence for non-surgical treatment due to the underreporting of data.Level of evidenceLevel IV, systematic review. (Source: Knee Surgery, Sports Traumatology, Arthroscopy)
Source: Knee Surgery, Sports Traumatology, Arthroscopy - February 22, 2021 Category: Orthopaedics Source Type: research

Correction to: Restricted kinematic alignment leads to uncompromised osseointegration of cementless total knee arthroplasty
Authors would like to correct the error in in their original publication of the article. (Source: Knee Surgery, Sports Traumatology, Arthroscopy)
Source: Knee Surgery, Sports Traumatology, Arthroscopy - February 22, 2021 Category: Orthopaedics Source Type: research

Learning curve for active robotic total knee arthroplasty
AbstractPurposeTotal Knee Arthroplasty (TKA) procedures incorporate technology in an attempt to improve outcomes. The Active Robot (ARo) performs a TKA with automated resections of the tibia and femur in efforts to optimize bone cuts. Evaluating the Learning Curve (LC) is essential with a novel tool. The purpose of this study was to assess the associated LC of ARo for TKA.MethodsA multi-center prospective FDA cohort study was conducted from 2017 to 2018 including 115 patients that underwent ARo. Surgical time of the ARo was defined as Operative time (OT), segmented as surgeon-dependent time (patient preparation and registr...
Source: Knee Surgery, Sports Traumatology, Arthroscopy - February 20, 2021 Category: Orthopaedics Source Type: research

Limited evidence for biological treatment measures for cartilage and tendon injuries of the shoulder
ConclusionConclusions from individual studies cannot be generalized. Currently, no evidence supports that platelet-rich plasma provides clinical benefits in rotator cuff repair. Similar is reported for microfracture in rotator cuff repair, however, despite no clinical benefits, microfracture has shown to reduce the appearance of structural failures. Although some evidence exists for the use of stem cells form bone marrow aspirate concentrate, results from large case series are still lacking.Level of evidenceLevel V. (Source: Knee Surgery, Sports Traumatology, Arthroscopy)
Source: Knee Surgery, Sports Traumatology, Arthroscopy - February 20, 2021 Category: Orthopaedics Source Type: research

The bone microstructure from anterior cruciate ligament footprints is similar after ligament reconstruction and does not affect long-term outcomes
ConclusionThe similarities in the microstructure of bone blocks from ACL footprints from the femur and tibia allow the variable use of these blocks to stabilize grafts in the Felmet method. The bone microstructure is not dependent on the time from injury to surgery. Histomorphometric values of the structure of the femoral and tibial ACL footprints have no impact on the long-term stability of the operated knee joint.Trial registrationThe approval of the Bioethics Committee of the Silesian Medical Chamber in Katowice, Poland (resolution 16/2014) was given for this research.Level of evidenceII. (Source: Knee Surgery, Sports T...
Source: Knee Surgery, Sports Traumatology, Arthroscopy - February 20, 2021 Category: Orthopaedics Source Type: research

Bone marrow aspirate concentrate and scaffold for osteochondral lesions of the talus in ankle osteoarthritis: satisfactory clinical outcome at 10 years
AbstractPurposeTo evaluate at long-term follow-up patients undergoing a one-step procedure of debridement and BMAC seeded in situ onto a scaffold for the treatment of osteochondral lesions of the talus (OLT) in ankles affected by osteoarthritis (OA), documenting the duration of the clinical benefit and its efficacy in postponing end-stage procedures.MethodsThis series included 56 consecutive patients. Patients were evaluated preoperatively and up to a mean of 10  years of follow-up with the AOFAS score and the AOS scale, including pain and disability subscales. Furthermore, patients were asked to rate the satisfaction...
Source: Knee Surgery, Sports Traumatology, Arthroscopy - February 19, 2021 Category: Orthopaedics Source Type: research

Mild radiographic osteoarthritis is associated with increased pain and dissatisfaction following total knee arthroplasty when compared with severe osteoarthritis: a systematic review and meta-analysis
AbstractPurposeThe association between severity of radiographic osteoarthritis with patient pain, function, and satisfaction following total knee arthroplasty has been disputed. The discrepancies in current literature prompt us to further examine this association in a systematic review and meta-analysis.MethodsThe OVID-Medline, Embase, and Web of Science databases were searched from their inception up to Mar 2020. The main independent variable was osteoarthritis severity as defined by preoperative radiographs. The outcomes measured were pain, function and satisfaction following total knee arthroplasty. A minimum of three s...
Source: Knee Surgery, Sports Traumatology, Arthroscopy - February 18, 2021 Category: Orthopaedics Source Type: research

Utilizing a contralateral hamstring autograft facilitates earlier isokinetic and isometric strength recovery after anterior cruciate ligament reconstruction: a randomised controlled trial
ConclusionThis study demonstrated that utilizing an  ST graft harvested from the uninjured limb for ACLR facilitates early isokinetic and isometric strength recovery, with no significant adverse outcomes demonstrated in other measurements and therefore be performed to reduce the risk of long-term strength deficits in the injured legLevel of evidenceII. (Source: Knee Surgery, Sports Traumatology, Arthroscopy)
Source: Knee Surgery, Sports Traumatology, Arthroscopy - February 18, 2021 Category: Orthopaedics Source Type: research

Low percentage of surgeons meet the minimum recommended unicompartmental knee arthroplasty usage thresholds: Analysis of 3037 Surgeons from Three National Joint Registries
ConclusionMore than 50% of knee surgeons in UK, Australian and New Zealand joint registries perform less than 5% of UKA yearly. The majority of experienced knee surgeons are not meeting the recommended minimum thresholds, which might indicate that the recommended thresholds are not feasible for the vast majority of knee surgeons. The reasons behind this require further research.Level of EvidenceLevel III retrospective registry study. (Source: Knee Surgery, Sports Traumatology, Arthroscopy)
Source: Knee Surgery, Sports Traumatology, Arthroscopy - February 17, 2021 Category: Orthopaedics Source Type: research

Quadriceps tendon autograft is becoming increasingly popular in revision ACL reconstruction
This study included 260 patients with a mean age of 26.2  ± 9.4 years at the time of the most recent revision ACL-R, representing the first, second, third, and fourth revision ACL-R for 214 (82%), 35 (14%), 10 (4%), and 1 (  30 years showed a significantly longer mean time from primary ACL-R to most recent revision ACL-R (11.1 years), compared to patients age 
Source: Knee Surgery, Sports Traumatology, Arthroscopy - February 16, 2021 Category: Orthopaedics Source Type: research

Reoperations are few and confined to the most valgus phenotypes 4  years after unrestricted calipered kinematically aligned TKA
ConclusionUnrestricted calipered KA ’s restoration of the wide range of phenotypes did not result in implant revision or poor FJS and OKS scores at a mean follow-up of 4 years. The few reoperated patients had a more valgus setting of the prosthetic trochlea than recommended for mechanical alignment. Designing a femoral component sp ecifically for KA that restores patellofemoral kinematics with all phenotypes, especially the more valgus ones, is a strategy for reducing reoperation risk.Level of evidenceTherapeutic, Level III (Source: Knee Surgery, Sports Traumatology, Arthroscopy)
Source: Knee Surgery, Sports Traumatology, Arthroscopy - February 13, 2021 Category: Orthopaedics Source Type: research

Satisfactory patient-reported outcomes at 5 years following primary repair with suture tape augmentation for proximal anterior cruciate ligament tears
This study assesses the 5-year patient-reported outcomes of primary repair with suture tape augmentation for proximal ACL tears.MethodsThirty-seven consecutive patients undergoing ACL repair with suture tape augmentation for an acute proximal rupture were prospectively followed up for a minimum of 5 years. Patients with midsubstance and distal ruptures, poor ACL tissue quality, retracted ACL remnants and multiligament injuries were excluded. Patient-reported outcome measures were collated using the Knee Injury and Osteoarthritis Outcomes Score (KOOS), Visual Analogue Pain Scale (VAS-pain), Veterans RAND 12-Item Health Surv...
Source: Knee Surgery, Sports Traumatology, Arthroscopy - February 13, 2021 Category: Orthopaedics Source Type: research

The effect of age on the outcomes of cementless mobile bearing unicompartmental knee replacements
AbstractPurposeUnicompartmental Knee Replacements (UKR) are being performed in patients with increasing demands and life expectancies with  surgical concerns that cemented fixation will not last. Cementless fixation may offer a solution, but the results in different age groups have not been assessed. The effect of age at surgery on the outcomes of cementless UKRs was investigated.MethodsA prospective cohort of 1000 medial cementless mobile bearing UKR were analysed. Patients were categorised into four age  groups (
Source: Knee Surgery, Sports Traumatology, Arthroscopy - February 12, 2021 Category: Orthopaedics Source Type: research

Improved total knee arthroplasty pain outcome when joint gap targets are achieved throughout flexion
ConclusionGap thresholds identified in this study provide clinically relevant and achievable targets for optimising soft tissue balance in posterior cruciate ligament sacrificing gap balancing total knee arthroplasty. When all three balance windows were achieved, clinically meaningful pain improvement was observed.Level of EvidenceLevel II. (Source: Knee Surgery, Sports Traumatology, Arthroscopy)
Source: Knee Surgery, Sports Traumatology, Arthroscopy - February 12, 2021 Category: Orthopaedics Source Type: research

The effect of lateral extra-articular tenodesis on in vivo cartilage contact in combined anterior cruciate ligament reconstruction
AbstractPurposeLateral extra-articular tenodesis (LET) may confer improved rotational stability after anterior cruciate ligament reconstruction (ACLR). Little is known about how LET affects in vivo cartilage contact after ACLR. The aim of this study was to investigate the effect of LET in combination with ACLR (ACLR  + LET) on in vivo cartilage contact kinematics compared to isolated ACLR (ACLR) during downhill running. It was hypothesised that cartilage contact area in the lateral compartment would be larger in ACLR + LET compared with ACLR, and that the anterior–posterior (A–P) pos...
Source: Knee Surgery, Sports Traumatology, Arthroscopy - February 12, 2021 Category: Orthopaedics Source Type: research

Patient-specific instruments do not show advantage over conventional instruments in unicompartmental knee arthroplasty at 2  year follow-up: a prospective, two-centre, randomised, double-blind, controlled trial
AbstractPurposeThe aim of this two-centre RCT was to compare pre- and post-operative radiological, clinical and functional outcomes between patient-specific instrumentation (PSI) and conventional instrumented (CI) unicompartmental knee arthroplasty (UKA). It was hypothesised that both alignment methods would have comparable post-operative radiological, clinical and functional outcomes.MethodsOne hundred and twenty patients were included, and randomly allocated to the PSI or the CI group. Outcome measures were peri-operative outcomes (operation time, length of hospital stay and intra-operative changes of implant size) and p...
Source: Knee Surgery, Sports Traumatology, Arthroscopy - February 11, 2021 Category: Orthopaedics Source Type: research

Overweight patients benefit from high tibial osteotomy to the same extent as patients with normal weights but show inferior mid-term results
AbstractPurposeThe purpose of this prospective study was to analyze the impact of obesity on the clinical and radiological outcomes 6  years after open-wedge high tibial osteotomy (HTO).MethodsA total of 120 prospectively recorded patients with medial compartment osteoarthritis underwent open-wedge HTO between 2008 and 2011. The study cohort was frequently examined over a minimum of a 6-year follow-up. The cohort was divided into three groups according to body mass index (BMI): normal weight patients (BMI    30 kg/m2). Clinical and functional outcomes (Oxford Knee Score, Hospital for Special Surgery...
Source: Knee Surgery, Sports Traumatology, Arthroscopy - February 11, 2021 Category: Orthopaedics Source Type: research

Bacterial contamination of irrigation fluid and suture material during ACL reconstruction and meniscus surgery
ConclusionSince bacterial contamination of accumulated fluid increases over time the contact with the fluid reservoirs should be avoided.Level of evidenceIV. (Source: Knee Surgery, Sports Traumatology, Arthroscopy)
Source: Knee Surgery, Sports Traumatology, Arthroscopy - February 10, 2021 Category: Orthopaedics Source Type: research

Revision TKA with a distal femoral replacement is at high risk of reinfection after two-stage exchange for periprosthetic knee joint infection
ConclusionMegaprosthetic DFR as part of a two-stage exchange for PJI is a salvage treatment that has a high risk for reinfection compared to non-megaprosthetic TKA. Patients must therefore be counseled accordingly.Level of evidenceRetrospective observational study, Level IV. (Source: Knee Surgery, Sports Traumatology, Arthroscopy)
Source: Knee Surgery, Sports Traumatology, Arthroscopy - February 10, 2021 Category: Orthopaedics Source Type: research

Allo- and autografts show comparable outcomes in chronic acromioclavicular joint reconstruction: a systematic review
ConclusionsA systematic review of the available peer-reviewed literature addressing allograft and autograft reconstruction of unstable coracoclavicular ligaments shows that the published studies are generally of low quality with low levels of evidence. The published literature shows no significant difference in clinical outcomes between the use of autografts or allografts in ACJ reconstruction surgery. Surgical techniques utilizing additional horizontal stabilization may contribute to lower rates of LOR. In cases where allograft tissue is used for ACJ reconstruction the use of suture/tape augmentation may reduce LOR rates ...
Source: Knee Surgery, Sports Traumatology, Arthroscopy - February 10, 2021 Category: Orthopaedics Source Type: research

Anterior cruciate ligament reconstruction with lateral extraarticular tenodesis better restores native knee kinematics in combined ACL and meniscal injury
ConclusionFor combined ACL and meniscus injury, ACLR with LET restores native knee kinematics at toe off but excessively decreases ATT at heel strike in the early post-operative period (6  months) without altering knee kinematics in the long term. Future large-scale clinical studies are needed to better understand the function of LET and ultimately improve patient outcomes.Level of evidenceIII. (Source: Knee Surgery, Sports Traumatology, Arthroscopy)
Source: Knee Surgery, Sports Traumatology, Arthroscopy - February 10, 2021 Category: Orthopaedics Source Type: research

Distal posterolateral corner injury in the setting of multiligament knee injury increases risk of common peroneal palsy
ConclusionDistal PLC injuries have a strong association with clinical CPN palsy, with suboptimal resolution in the initial post-operative period. Specifically, the presence of a biceps femoris avulsion injury was highly associated with a clinical CPN palsy. Additionally, CPN palsy in the context of PLC injury has a strong association with concomitant ACL injury. Furthermore, the relative rates of involvement of the ACL vs. PCL suggest that specific injury mechanism may have an important role in CPN palsy.Level of evidenceIV. (Source: Knee Surgery, Sports Traumatology, Arthroscopy)
Source: Knee Surgery, Sports Traumatology, Arthroscopy - February 9, 2021 Category: Orthopaedics Source Type: research

Preoperative risk factors in hip arthroscopy
ConclusionsThe presence of chondral injuries such as acetabular labrum articular disruption (ALAD) 4, radiographic Grade 2 T önnis classification, higher age, higher BMI, and worse WOMAC, along with mHHS and HOS-ADL preoperative results, are factors which lead to a poor prognosis following FAI hip arthroscopic surgery, increasing the risk of prosthetic conversion in the short or medium term.Level of evidenceLevel IV. (Source: Knee Surgery, Sports Traumatology, Arthroscopy)
Source: Knee Surgery, Sports Traumatology, Arthroscopy - February 8, 2021 Category: Orthopaedics Source Type: research

An improved quantitative ultrasonographic technique could assess anterior translation of the glenohumeral joint accurately and reliably
AbstractPurposeSince poor repeatability of the load and shift test using a grading scale has been reported, an objective and quantitative method to assess anterior translation should be established to assess glenohumeral joint function. The purpose of this study was to assess the accuracy and repeatability of the ultrasonographic techniques to quantify anterior translation of the glenohumeral joint.MethodsEight fresh-frozen cadaveric shoulders were used. For the standard technique, the ultrasound transducer was positioned on the anterolateral aspect of the shoulder viewing the coracoid process, glenoid, and humeral head. F...
Source: Knee Surgery, Sports Traumatology, Arthroscopy - February 8, 2021 Category: Orthopaedics Source Type: research

In patients eligible for meniscal surgery who first receive physical therapy, multivariable prognostic models cannot predict who will eventually undergo surgery
AbstractPurposeAlthough physical therapy is the recommended treatment in patients over 45  years old with a degenerative meniscal tear, 24% still opt for meniscal surgery.The aim was to identify those patients with a degenerative meniscal tear who will undergo surgery following physical therapy.MethodsThe data for this study were generated in the physical therapy arm of the ESCAPE trial, a randomized clinical trial investigating the effectiveness of surgery versus physical therapy in patients of 45 –70 years old, with a degenerative meniscal tear. At 6 and 24 months patients were divided into two group...
Source: Knee Surgery, Sports Traumatology, Arthroscopy - February 7, 2021 Category: Orthopaedics Source Type: research

Similar rates of return to sports and BMI reduction regardless of age, gender and preoperative BMI as seen in matched cohort of hypoallergenic and standard Cobalt Chromium medial unicompartmental knee arthroplasty
AbstractPurposeTo compare the rate of return to sports and body mass index (BMI) reduction in patients who underwent surgery for unicompartmental knee arthroplasty (UKA) with either Cobalt-Chromium (CoCr) alloy UKA or with hypoallergenic UKA, stratified by age, gender and BMI.MethodsTwo consecutive cohorts of patients with a total of 172 UKA and a minimum 2-year follow-up period were prospectively included in this comparative study. The first cohort consisted of 136 consecutive series of standard Cobalt-Chromium (CoCr Group). The second cohort consisted of 36 consecutive mobile-bearing hypoallergenic Titanium Niobium Nitri...
Source: Knee Surgery, Sports Traumatology, Arthroscopy - February 7, 2021 Category: Orthopaedics Source Type: research

Failed meniscal repair increases the risk for osteoarthritis and poor knee function at an average of 9 years follow-up
ConclusionsThere was an increased risk for OA in the affected compartment with a failed meniscus fixation. This supports the fact that the meniscus is an important protector of the cartilage in the knee. The meniscus injury affects the long-term health-related quality of life according to KOOS and in light of this study we recommend repair of a torn meniscus whenever possible.Level of evidenceIII. (Source: Knee Surgery, Sports Traumatology, Arthroscopy)
Source: Knee Surgery, Sports Traumatology, Arthroscopy - February 6, 2021 Category: Orthopaedics Source Type: research

High inter- and intraindividual differences in medial and lateral posterior tibial slope are not reproduced accurately by conventional TKA alignment techniques
ConclusionA high interindividual range of MPTS and LPTS as well as considerable intraindividual differences were shown. When implementing the recommended slope values for PS and CR prostheses, changes in native slope must be accepted. Further research is needed to evaluate the impact of altering a patient ’s native slope on the clinical outcome.Level of evidenceIV. (Source: Knee Surgery, Sports Traumatology, Arthroscopy)
Source: Knee Surgery, Sports Traumatology, Arthroscopy - February 6, 2021 Category: Orthopaedics Source Type: research

Robotic-arm assisted total knee arthroplasty is associated with improved accuracy and patient reported outcomes: a systematic review and meta-analysis
AbstractThis systematic review and meta-analysis were conducted to compare the accuracy of component positioning, alignment and balancing techniques employed, patient-reported outcomes, and complications of robotic-arm assisted total knee arthroplasty (RATKA) with manual TKA (mTKA) and the associated learning curve. Searches of PubMed, Medline and Google Scholar were performed in October 2020 using PRISMA guidelines. Search terms included “robotic”, “knee” and “arthroplasty”. The criteria for inclusion were published clinical research articles reporting the learning curve for RATKA and t...
Source: Knee Surgery, Sports Traumatology, Arthroscopy - February 6, 2021 Category: Orthopaedics Source Type: research

Peritrochanteric space disorders: the future is now!
(Source: Knee Surgery, Sports Traumatology, Arthroscopy)
Source: Knee Surgery, Sports Traumatology, Arthroscopy - February 6, 2021 Category: Orthopaedics Source Type: research

The clinical outcome of minimally invasive popliteal tendon recess procedure is comparable to arthroscopic popliteal tendon reconstruction in patients with type A posterolateral rotational instability
ConclusionBoth minimally invasive PT recess procedure and arthroscopic PT reconstruction significantly improved the knee stability and subjective outcome comparing with preoperative value. In a comparison with arthroscopic PT reconstruction, the recess procedure demonstrated comparable subjective and objective clinical outcome. When both PT reconstruction and PT recess procedure are indicated, the minimally invasive and graft-free recess procedure can be a viable option.Level of evidenceIII. (Source: Knee Surgery, Sports Traumatology, Arthroscopy)
Source: Knee Surgery, Sports Traumatology, Arthroscopy - February 5, 2021 Category: Orthopaedics Source Type: research

Correction to: Clinical and radiological hip parameters do not precede, but develop simultaneously with cam morphology: a 5-year follow-up study
Due to typographic mistakes made by the editorial office, several corrections have been made.The original article has been corrected. (Source: Knee Surgery, Sports Traumatology, Arthroscopy)
Source: Knee Surgery, Sports Traumatology, Arthroscopy - February 5, 2021 Category: Orthopaedics Source Type: research

An older age, a longer duration between injury and surgery, and positive pivot shift test results increase the prevalence of articular cartilage injury during ACL reconstruction in all three compartments of the knee in patients with ACL injuries
ConclusionAn older age, a longer duration between injury and surgery, and a positive pivot shift test result were positively associated with the prevalence of cartilage injury in three compartments in patients with ACL injuries. Early ACL reconstruction is recommended to prevent cartilage injury.Level of EvidenceLevel III. (Source: Knee Surgery, Sports Traumatology, Arthroscopy)
Source: Knee Surgery, Sports Traumatology, Arthroscopy - February 4, 2021 Category: Orthopaedics Source Type: research

The orthopaedic community does not oppose the non-surgical treatment of degenerative meniscal lesions
(Source: Knee Surgery, Sports Traumatology, Arthroscopy)
Source: Knee Surgery, Sports Traumatology, Arthroscopy - February 3, 2021 Category: Orthopaedics Source Type: research

Low grade of radiographic osteoarthritis predicts unsatisfactory response of the contralateral knee replacement in two-stage bilateral total knee arthroplasty
ConclusionIn a patient who has an unsatisfactory response to their first knee replacement, the best predictor of achieving a satisfactory response to his/her contralateral knee replacement is the level of radiographic osteoarthritis in that knee.Level of evidenceIV: Retrospective Cohort study. (Source: Knee Surgery, Sports Traumatology, Arthroscopy)
Source: Knee Surgery, Sports Traumatology, Arthroscopy - February 2, 2021 Category: Orthopaedics Source Type: research

Development of new cartilage lesions after ACL reconstruction is associated with abnormal knee rotation
ConclusionAbnormally increased tibial rotation that persists after ACL-R is significantly associated with the development of new articular cartilage lesions at mean 8.4  years after reconstruction which were located mainly at the central region of the LFC and secondarily in the central and anterior regions of the MFC (more superficial lesions). These findings suggest that there is emerging evidence that abnormal rotational kinematics is a potential risk factor for the pathogenesis and onset of posttraumatic articular cartilage degeneration after ACLR.Level of evidenceIV. (Source: Knee Surgery, Sports Traumatology, Arthroscopy)
Source: Knee Surgery, Sports Traumatology, Arthroscopy - February 2, 2021 Category: Orthopaedics Source Type: research

Comparable incidence of periprosthetic tibial fractures in cementless and cemented unicompartmental knee arthroplasty: a systematic review and meta-analysis
ConclusionComparable low incidences of periprosthetic tibial fractures in cementless and cemented UKA can be achieved. However, surgeons should be aware that an excessive interference fit in cementless UKAs in combination with an impaction technique may introduce an additional risk, and could therefore be less forgiving to surgical errors and patients who are at higher risk of periprosthetic tibial fractures.Level of evidenceV. (Source: Knee Surgery, Sports Traumatology, Arthroscopy)
Source: Knee Surgery, Sports Traumatology, Arthroscopy - February 2, 2021 Category: Orthopaedics Source Type: research

Increased posterior tibial slope results in increased incidence of posterior lateral meniscal root tears in ACL reconstruction patients
ConclusionIn conclusion, LMPRTs in the setting of primary ACL injuries were associated with significantly increased lateral and medial PTSs, and increased asymmetry between lateral and medial PTSs. In addition, clinicians should be aware of the increased incidence of concurrent medial meniscal ramp lesions in patients with LMPRTs. Knowledge of these associations helps guide clinical decision-making and counselling of patients in the setting of ACL tears with concomitant LMPRTs.Level of evidenceIV. (Source: Knee Surgery, Sports Traumatology, Arthroscopy)
Source: Knee Surgery, Sports Traumatology, Arthroscopy - February 1, 2021 Category: Orthopaedics Source Type: research

Meniscal tears are more common than previously identified, however, less than a quarter of people with a tear undergo arthroscopy
ConclusionMeniscal tears were found to be more common than previously described. However, less than half present to secondary care and only 22% undergo arthroscopy. These findings should inform future study design and recruitment strategies. In agreement with previous literature, bucket handle tears and root tears were significant predictors of subsequent surgery.Level of evidenceIII. (Source: Knee Surgery, Sports Traumatology, Arthroscopy)
Source: Knee Surgery, Sports Traumatology, Arthroscopy - February 1, 2021 Category: Orthopaedics Source Type: research

A high tibial slope, allograft use, and poor patient-reported outcome scores are associated with multiple ACL graft failures
AbstractPurposeTo compare clinical outcomes, radiographic characteristics, and surgical factors between patients with single and multiple anterior cruciate ligament (ACL) graft failures. It was hypothesized that patients experiencing multiple ACL graft failures exhibit lower patient-reported outcome scores (PROs) and a higher (steeper) posterior tibial slope (PTS) than patients with single ACL graft failure.MethodsPatients undergoing revision ACL reconstruction with a minimum follow-up of 12  months were included in this retrospective cohort study. Based on the number of ACL graft failures, patients were assigned eith...
Source: Knee Surgery, Sports Traumatology, Arthroscopy - January 31, 2021 Category: Orthopaedics Source Type: research

Sexual dimorphism and racial diversity render bone –implant mismatch inevitable after off-the-shelf total knee arthroplasty: a systematic review and meta-analysis
ConclusionAnthropometric studies reported considerable sexual dimorphism and racial diversity of femoral geometric ratios. Since a surgeon generally only uses one or a few TKA brands, bone –implant mismatch remains unavoidable in a large proportion of knees. These findings support the drive towards personalized medicine, and accurate bone–implant fit may only be achievable through customisation of implants, though the clinical benefits of custom TKA remain to be confirmed.Level of evidenceIV. (Source: Knee Surgery, Sports Traumatology, Arthroscopy)
Source: Knee Surgery, Sports Traumatology, Arthroscopy - January 29, 2021 Category: Orthopaedics Source Type: research

Long-term outcomes were similar between hybrid and cemented TKAs performed on paired knees at a minimum 15  years of follow-up
ConclusionThe long-term outcomes were similar between hybrid and cemented TKAs performed on paired knees at a minimum 15  years of follow-up. The method of femoral component fixation did not have a significant effect on long-term TKA success.Level of evidenceIII. (Source: Knee Surgery, Sports Traumatology, Arthroscopy)
Source: Knee Surgery, Sports Traumatology, Arthroscopy - January 29, 2021 Category: Orthopaedics Source Type: research

Posterior condylar offset and posterior tibial slope targets to optimize knee flexion after unicompartmental knee arthroplasty
AbstractPurposeTo evaluate the relationship between posterior tibial slope (PTS), posterior condylar offset (PCO), femoral sagittal angle (FSA) on clinical outcomes, and propose optimal sagittal plane alignments for unicompartmental knee arthroplasty (UKA).MethodsProspectively collected data of 265 medial UKA was analysed. PTS, PCO, FSA were measured on preoperative and postoperative lateral radiographs. Clinical assessment was done at 6-month, 2-year and 10-year using Oxford Knee Score, Knee Society Knee and Function scores, Short Form-36, range of motion (ROM), fulfilment of satisfaction and expectations. Implant survivo...
Source: Knee Surgery, Sports Traumatology, Arthroscopy - January 29, 2021 Category: Orthopaedics Source Type: research

The majority of athletes fail to return to play following anterior cruciate ligament reconstruction due to reasons other than the operated knee
AbstractPurposeThe purpose of this study is to evaluate the reasons why athletes do not return to play (RTP) following anterior cruciate ligament (ACL) reconstruction from a large single-centre database.MethodsThe institutional ACL registry was screened for patients that had undergone a primary ACLR and had RTP status reported at 24-month follow-up. The reasons that patients were unable to RTP at 24  months were evaluated. The ACL-Return to Sport Index (ACL-RSI) was evaluated at baseline and 24-month follow-up to evaluate psychological ability to RTP.ResultsAt 2 years, 1140 patients returned to play, and 222 had not r...
Source: Knee Surgery, Sports Traumatology, Arthroscopy - January 28, 2021 Category: Orthopaedics Source Type: research

St Georg Sled medial unicompartmental arthroplasty: survivorship analysis and function at 20  years follow up
ConclusionMedial UKA demonstrates good long-term function and survivorship, and represents an excellent surgical option for patients aged over 65  years of age, where few patients will require a revision procedure.Level of evidenceIV. (Source: Knee Surgery, Sports Traumatology, Arthroscopy)
Source: Knee Surgery, Sports Traumatology, Arthroscopy - January 27, 2021 Category: Orthopaedics Source Type: research