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First revision ACL reconstruction combined with tibial deflexion osteotomy improves clinical scores at 2 to 7 years follow-up
ConclusionAt 2-7 years following revision ACLR combined with TDO, net improvement exceeded the MCID in 93% of patients for IKDC subjective score and in 80% of patients for Lysholm score, with no retears or major complications. These results suggest that TDO is a safe technique to protect the ACL graft and might be considered as of first revision ACLR to correct excessive PTS.Level of evidenceLevel IV (Source: Knee Surgery, Sports Traumatology, Arthroscopy)
Source: Knee Surgery, Sports Traumatology, Arthroscopy - August 31, 2023 Category: Orthopaedics Source Type: research

Normo-or slightly overcorrection show better results after medial closing wedge high tibial osteotomy
ConclusionFunctional results and revision-free survival after MCWHTO are satisfactory when the deformity is located in the proximal tibia. The joint line obliquity is not significantly altered with small tibial correction and, obtaining an overall neutral or slightly varus alignment under the conditions of this study allowed an improvement in the postoperative clinical scores. The literature is still inconclusive on the ideal alignment for valgus deformities and larger series are needed to draw definitive conclusions.Level of evidenceIV, case series. (Source: Knee Surgery, Sports Traumatology, Arthroscopy)
Source: Knee Surgery, Sports Traumatology, Arthroscopy - August 31, 2023 Category: Orthopaedics Source Type: research

Free tendon grafts for surgical management of chronic tears of the main body of the Achilles tendon: a systematic review
ConclusionIn chronic tears of the Achilles tendon, with a gap of at least 6  cm, free tendon grafts allow predictable return to sport and acceptable recovery function.Level of evidenceLevel IV. (Source: Knee Surgery, Sports Traumatology, Arthroscopy)
Source: Knee Surgery, Sports Traumatology, Arthroscopy - August 31, 2023 Category: Orthopaedics Source Type: research

Clinical relevance of joint line obliquity after high tibial osteotomy for medial knee osteoarthritis remains controversial: a systematic review
ConclusionBased on current evidence, the actual association between postoperative KJLO and clinical consequences after HTO for medial knee osteoarthritis cannot be ascertained. The clinical relevance of KJLO after HTO remains controversial.Level of evidenceIV. (Source: Knee Surgery, Sports Traumatology, Arthroscopy)
Source: Knee Surgery, Sports Traumatology, Arthroscopy - August 31, 2023 Category: Orthopaedics Source Type: research

Higher sensitivity and accuracy of synovial next-generation sequencing in comparison to culture in diagnosing periprosthetic joint infection: a systematic review and meta-analysis
ConclusionsNGS has a potential role in diagnosing hip and knee PJIs due to its high sensitivity, specificity, and accuracy. However, the sensitivity and specificity reported by the studies varied according to the time of synovial sampling (preoperative, postoperative, or mixed). (Source: Knee Surgery, Sports Traumatology, Arthroscopy)
Source: Knee Surgery, Sports Traumatology, Arthroscopy - August 18, 2023 Category: Orthopaedics Source Type: research

Trochlea dysplasia, increased TT-TG distance and patella alta are risk factors for developing first-time and recurrent patella dislocation: a systematic review
ConclusionThere is strong evidence in the literature that abnormalities of bony stabilizers, trochlear dysplasia, increased TT –TG distance, and patella alta are risk factors for patella dislocation. There is less evidence that soft-tissue stabilizers are risk factors. The study emphasizes the importance of a thorough investigation of bony stabilizers in clinical decision-making.Level of evidenceLevel IV. (Source: Knee Surgery, Sports Traumatology, Arthroscopy)
Source: Knee Surgery, Sports Traumatology, Arthroscopy - August 18, 2023 Category: Orthopaedics Source Type: research

Previously failed Bankart repair and the duration from first dislocation to surgery were the risk factors associated with the level of return to sports after coracoid transfer
ConclusionAlthough a large majority of athletes were able to RTS at the pre-injury level after the modified arthroscopic Bristow procedure, about two-thirds of the athletes felt difference in shoulders on both sides and could not completely “forget” the operated shoulder during exercise. Previously failed Bankart repair and the duration from first dislocation to surgery were the risk factors associated with the level of RTS after the modified arthroscopic Bristow procedure.Level of evidenceIV. (Source: Knee Surgery, Sports Traumatology, Arthroscopy)
Source: Knee Surgery, Sports Traumatology, Arthroscopy - August 18, 2023 Category: Orthopaedics Source Type: research

Larger bone marrow lesion volume before medial open-wedge high tibial osteotomy correlates with better improvement of clinical scores in patients with knee osteoarthritis
ConclusionTibial BML volume was positively correlated with one post-operative KOOS scale and all delta KOOS scales. A larger pre-operative tibial BML and appropriate alignment correction were associated with a better post-operative KOOS scales. Pre-operative large BML had no negative influence on post-operative clinical outcomes; hence, surgeons need not hesitate to perform MOWHTO in patients with large BMLs in the medial condyles.Level of evidenceRetrospective case series, Level IV. (Source: Knee Surgery, Sports Traumatology, Arthroscopy)
Source: Knee Surgery, Sports Traumatology, Arthroscopy - August 18, 2023 Category: Orthopaedics Source Type: research

Additional anteromedial staple fixation prevents changes in the posterior tibial slope in retrotuberosity bi-planar open-wedge high tibial osteotomy
ConclusionAdditional anteromedial staple fixation could prevent changes in the PTS in RT-OWHTO. It is a simple method for preventing an increase in the PTS after RT-OWHTO.Level of evidenceIII. (Source: Knee Surgery, Sports Traumatology, Arthroscopy)
Source: Knee Surgery, Sports Traumatology, Arthroscopy - August 18, 2023 Category: Orthopaedics Source Type: research

Insufficient restoration of meniscal extrusion by transtibial pullout repair for medial meniscus posterior root tears
ConclusionSurgery did not reduce the extrusion in the no weight-bearing and weight-bearing positions at knee extension, and these values increased in the postoperative period. In addition, while the surgery reduced the extrusion in the knee flexion position, the restoration achieved by the surgery was not sustained in the long term.Level of evidence: Level IV. (Source: Knee Surgery, Sports Traumatology, Arthroscopy)
Source: Knee Surgery, Sports Traumatology, Arthroscopy - August 13, 2023 Category: Orthopaedics Source Type: research

Coronal and sagittal alignment of ankle joint is significantly affected by high tibial osteotomy
ConclusionBased on the present study, coronal and sagittal alignment of ankle joint was significantly affected by HTO. After HTO, AAWBL ratio increased due to lateralization of the ankle joint axis, and KLAS increased due to increased posterior tibial slope.Level of EvidenceIII. (Source: Knee Surgery, Sports Traumatology, Arthroscopy)
Source: Knee Surgery, Sports Traumatology, Arthroscopy - August 12, 2023 Category: Orthopaedics Source Type: research

Application of external torque enhances the detection of subtle syndesmotic ankle instability in a weight-bearing CT
ConclusionApplication of combined weightbearing-external rotation reveals an increased ATFD in patients with syndesmotic ligament injuries. This study provides the first insights based on 3D measurements to support the potential relevance of applying external rotation during WBCT imaging. In clinical practice, this could enhance the current diagnostic accuracy of subtle syndesmotic instability in a non-invasive manner. However, to what extent certain displacement patterns require operative treatment strategies has yet to be determined in future studies.Level of evidenceLevel III. (Source: Knee Surgery, Sports Traumatology, Arthroscopy)
Source: Knee Surgery, Sports Traumatology, Arthroscopy - August 12, 2023 Category: Orthopaedics Source Type: research

High tibial osteotomy versus unicompartmental knee arthroplasty for Kellgren –Lawrence grade 3–4 knee osteoarthritis in younger patients: comparable improvements in patient-reported outcomes, adjusted for osteoarthritis grade and sex
ConclusionUKA patients had better OKS scores, pain and satisfaction scores over time than HTO patients. However, the observed differences were below their established minimal clinically important differences. Therefore, from the patients ’ perspective, HTO did not appear to be inferior to UKA under the indications outlined in this study.Level of evidence Level IV. (Source: Knee Surgery, Sports Traumatology, Arthroscopy)
Source: Knee Surgery, Sports Traumatology, Arthroscopy - August 12, 2023 Category: Orthopaedics Source Type: research

Similar outcomes after anterior cruciate ligament reconstruction in paediatric and adult populations: a 1-year follow-up of 506 paediatric operations in Denmark
ConclusionACL reconstruction resulted in a clinically meaningful increase in Pedi-IKDC, an improved instrumented stability, a reduction in the grade of pivot shift and the complication rate was low at 1-year follow-up. The risk of graft insufficiency at 1-year follow-up was the same as in an adult population.Level of EvidenceII. (Source: Knee Surgery, Sports Traumatology, Arthroscopy)
Source: Knee Surgery, Sports Traumatology, Arthroscopy - August 12, 2023 Category: Orthopaedics Source Type: research

Image-free handheld robotic-assisted technology improved  the accuracy of implant positioning compared to conventional instrumentation in patients undergoing simultaneous bilateral total knee arthroplasty, without additional benefits in improvement of clinical outcomes
ConclusionThis comparative study in patients undergoing SB-TKA found reduction of outliers in femoral and tibial implant positioning with RA-TKA as compared to C-TKA. There were no differences in both groups for pain, function, and satisfaction at a minimum of 2  years of follow-up.Level of evidenceIII Therapeutic Study. (Source: Knee Surgery, Sports Traumatology, Arthroscopy)
Source: Knee Surgery, Sports Traumatology, Arthroscopy - August 10, 2023 Category: Orthopaedics Source Type: research