Knee

BACKGROUND: Obtaining an accurate tibial lateral view is important during high tibial osteotomy. This study investigated whether the posterior edge of the medial/lateral tibial condyle (PEMTC/PELTC) and the posterior edge of the fibular head (PEFH) in a lateral view could be a reference for determining the accurate tibial lateral view. METHODS: A total of 75 lower limbs in 38 subjects were evaluated in this study. In order to target healthy knees, subjects undergoing primary total hip arthroplasty were selected...

BACKGROUND: Routine patellar resurfacing is a controversial issue in total knee replacement (TKR), especially for rheumatoid arthritis (RA). Anterior knee pain (AKP) is a common complaint after TKR that may be related to patellofemoral joint condition. The aim of this study was to investigate the prevalence and factors associated with AKP after TKR for RA compared between non-resurfaced patella (NRP) and resurfaced patella (RP). METHODS: This retrospective study included RA patients who underwent TKR at our institute from 2002 to 2019...

BACKGROUND: Excessive posterior tibial slope (PTS) is an independent risk factor for anterior cruciate ligament reconstruction (ACLR) failure, but it remains unclear how PTS relates to other proximal tibial morphologic parameters. The purpose of this study was to analyse sagittal tibial metaphysis morphology, and to calculate the correlation coefficients of PTS with anatomical features. METHODS: The authors retrospectively reviewed lateral radiographs of 350 patients that were scheduled to receive primary ACLR to digitize 15 landmarks on the patella, femur, fibula, and tibia, and measure PTS, patellar height, as well as metaphysis height and inclination...

BACKGROUND: Unicompartmental knee arthroplasty (UKA) offers a less invasive alternative to total knee arthroplasty (TKA), but is accompanied by a high revision risk. The aim of our study was to perform a meta-analysis comparing outcomes of UKA revised to TKA versus primary TKA, to assess if UKA is an effective treatment option, despite its potential need for revision. METHODS: Studies comparing matched cohorts of patients with UKA revised to TKA versus primary TKA were identified via the PubMed, Ovid EMBASE, and Scopus databases...

BACKGROUND: Patient satisfaction following primary total knee arthroplasty (TKA) is a crucial part to evaluate the success of the procedure. The purpose of this study was to develop to predict patient satisfaction following TKA. METHODS: Satisfaction outcome data after 435 consecutive conventional TKAs performed between August 2020 and December 2021 were retrospectively collected. The total 26 input data were collected. The most favorable algorithm was first found using logistic regression (LR) and machine learning (ML) algorithms...

BACKGROUND: The aims of this study were (1) to compare the incidence of lateral hinge fractures (LHFs) in medial opening-wedge high tibial osteotomy (OWHTO) and medial opening-wedge distal tibial tuberosity osteotomy (DTO), and (2) to investigate the risk factors for LHFs. The incidence of LHFs was hypothesized to be higher in the DTO group than the OWHTO group. The DTO procedure is also a risk factor for LHFs. METHODS: A total of 167 knees that underwent OWHTO (n = 65) and DTO (n = 102) were subjected to propensity score matching for the comparison of the groups...

BACKGROUND: Tibial vertical cut is crucial for rotational position and bony coverage in Oxford mobile-bearing medial unicompartmental knee arthroplasty (UKA). This study aimed to determine whether the footprint of the anterior horn of medial meniscus (FAM) is a reliable landmark for tibial vertical cut. METHODS: The FAM and the line through FAM and the edge of anterior cruciate ligament insertion (FAMA line) were identified by dissection five knee joint specimens...

BACKGROUND: The significance of lateral meniscus injury and its impact on success rates with medial unicompartmental knee arthroplasty (UKA) is still debated among scholars. This study aims to investigate whether preoperative magnetic resonance imaging (MRI) findings of lateral meniscus injury influence midterm outcomes following UKA. METHODS: This study recruited 104 patients who underwent medial mobile-bearing UKA. Based on the extent of lateral meniscus injury indicated by the preoperative MRI and Stoller's classification system, patients were divided into two groups: the normal group (grade 0), and the lateral meniscus injury group (grade 3)...

BACKGROUND: Recurrent patella instability is a common and debilitating condition which affects mainly adolescents and young adults. Medial patellofemoral ligament (MPFL) reconstruction is the most popular surgical treatment for recurrent patella instability. The most common graft choice in the literature is ipsilateral hamstring tendon (gracilis or semitendinosis) but the complication rate remains high (11-26%). Conversely, there are very few papers on the use of modern, synthetic grafts...

BACKGROUND: Previous authors have utilized gait kinematics to categorize knee osteoarthritis patients into four distinct profiles: (1) flexed knee; (2) externally rotated knee; (3) stiff knee; and (4) knee varus thrust and rotational rigidity. However, the relationship between these gait profiles and patients' characteristics remains poorly understood. Thus, this study aimed to investigate whether differences in clinical and radiographic characteristics were associated with these four gait profiles...

BACKGROUND: Approximately 20% of patients undergoing total knee arthroplasty (TKA) do not experience long-term improvements. Our aim was to identify prognostic factors of knee pain and function 12 months after TKA. METHODS: In a prospective cohort study, 1026 patients underwent primary TKA between 2018 and 2020. Main outcome was measured by the Oxford Knee Score (OKS) categorized in five categories (0-9, 10-19, 20-29, 30-39 and 40-48). Potential prognostic factors obtained at baseline included sex, age, baseline OKS, pain catastrophizing scale, EuroQol 5 dimensions, previous surgery, BMI, ASA classification, opioid consumption, living and employment conditions as well as educational level...

BACKGROUND: Deteriorating meniscal function is thought to play a role in knee osteoarthritis. Meniscal proteoglycans maintain mechanical stiffness of the tissue through electrostatic effects. This study aimed to investigate whether the mechanical properties of macroscopically intact meniscus are preserved in osteoarthritis. METHODS: Discs of lateral meniscal tissue two millimetres thick and of five millimetres diameter from osteoarthritic knees and from healthy donors were placed within a confined compression chamber, mounted in a materials testing machine and bathed in isotonic 0...

BACKGROUND: Rotating-platform posterior-stabilized total knee arthroplasty (PS-TKA) has become a commonly used procedure. It has the potential risk of causing mobile-bearing spinout. In our study, we investigated the factors affecting the bearing thickness when performing rotating-platform PS-TKA. METHODS: This single-arm, prospective, single-hospital cohort study included 100 consecutive patients who underwent rotating-platform PS-TKA between September 2020 and August 2022...

BACKGROUND: This study was conducted with patients with anterior and medial extrusion of the medial meniscus (MM-AE, MM-ME) to investigate the relationship of the amount of extrusion with damage to the meniscus, meniscofemoral ligament (MFL), meniscotibial ligament (MTL), presence of effusion, osteoarthritis (OA) grade and other medial stablizers. A cut-off value for significant MM-ME was also suggested. METHODS: All patients aged 18 and above who had measurable MM extrusion on knee MRI were included...

BACKGROUND: During robotic and computer-navigated primary total knee arthroplasty (TKA), the center of the femoral head is utilized as the proximal reference point for femoral component position rather than the intramedullary axis. We sought to analyze the effect on femoral component flexion-extension position between these two reference points. METHODS: We obtained CT 3D-reconstructions of 50 cadaveric intact femurs. We defined the navigation axis as the line from center of the femoral head to center of the knee (lowest point of the trochlear groove) and the intramedullary axis as the line from center of the knee to center of the canal at the isthmus...

BACKGROUND: Pharmacologic thromboprophylaxis is controversial for hemophiliacs who undergo total joint replacements. The purpose of this study was to assess the safety of tranexamic acid (TXA) utilization with respect to the incidence of deep venous thrombosis (DVT) in hemophiliacs undergoing total knee arthroplasty (TKA). METHODS: A total of 104 patients with hemophilic arthritis were included in the study. The patients were randomly divided into two groups of 52 subjects...

BACKGROUND: This study describes the implementation of Enhanced Recovery After Surgery (ERAS) total knee arthroplasty (TKA) with day-surgery protocol to assess the outcome of ERAS day surgery TKA compared with traditional ERAS inpatient TKA in terms of length of stay (LOS), 30-day readmission, complications, and patient-reported outcome measures (PROMs). METHODS: Patients who underwent unilateral primary TKA from August 2020 to July 2021 were followed up. All TKAs were performed with the ERAS protocol...

BACKGROUND: With the standardization of surgical techniques and continuous development of plate fixators, medial open-wedge high tibial osteotomy (OWHTO) has become an option for the treatment of medial knee osteoarthritis. However, it is also associated with several complications. To reduce the risk of these complications, it is essential for surgeons to accurately understand the three-dimensional (3D) anatomical structures, including the surroundings of the surgical field. Gross dissection using a cadaver provides a large surgical field and is the best learning method for studying anatomical structures in three dimensions; however, it is not available at all medical institutions...

BACKGROUND: Patient selection is key to the success of medial unicondylar knee arthroplasty (UKA). Progression of arthritis is the most common indication for revision surgery. Per-operative arthroscopy is a means of directly assessing the integrity of the lateral compartment. The aim of the study is to assess the long-term survivorship of UKA performed when per-operative arthroscopy is used as a final means of deciding whether to proceed with UKA. METHODS: We used per-operative arthroscopy as a means to confirm suitability for UKA in a consecutive series of 279 Oxford medial UKA...

BACKGROUND: Imaging the lower limb during weight-bearing conditions is essential to acquire advanced functional joint information. The horizontal bed position of CT systems however hinders this process. The purpose of this study was to validate and test a device to simulate realistic knee weight-bearing motion in a horizontal position during dynamic CT acquisition and process the acquired images. METHODS: "Orthostatic squats" was compared to "Horizontal squats" on a device with loads between 35% and 55% of the body weight (%BW) in 20 healthy volunteers...