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Just A van der Linde, Anthony K L Leong
BACKGROUND: Soft tissue tension significantly affects the function of total knee arthroplasties. This study aims to evaluate if there is a difference in soft tissue tension, comparing trails to cemented definitive components in TKA. METHODS: We prospectively compared femorotibial compartment pressures before and after cement fixation of the components in 40 primary TKA. Femorotibial pressures were measured in the medial and lateral compartment with the knee in 10°, 45°, and 90° of flexion (six measurements per TKA), and the difference in pressure between both compartments was calculated in the three positions...
January 10, 2019: Knee
David Campbell, Stuart Callary, John Field, Kjell G Nilsson
BACKGROUND: All-polyethylene (AP) tibial components in patients aged greater than 60 years have stable tibial migration patterns and favorable survival rates when compared to identical Metal-backed (MB) designs. Tibial component migration in younger patients has not been reported. The aim of this study was to examine the migration characteristics of patients aged less than 60 years compared to a previous cohort of AP and MB tibial components of identical design in older patients. METHODS: A prospective consecutive study examined tibial component migration in 21 patients aged less than 60 years undergoing a cemented total knee arthroplasty with an AP tibial component by radiostereometric analysis (RSA) to 24 months...
January 8, 2019: Knee
Caleb M Gulledge, Timothy G Baumer, Lauren Juliano, Margaret Sweeney, Michael McGinnis, Alexandria Sherwood, Vasilios Moutzouros, Michael J Bey
PURPOSE: Anterior cruciate ligament (ACL) ruptures are common and are frequently reconstructed using a patellar tendon (PT) autograft. Unfortunately, the time course of PT healing after ACL reconstruction is not particularly well understood. Thus, the primary objective of this study was to use shear wave elastography (SWE) to evaluate the extent to which shear wave speed (SWS) is associated with time after ACL reconstruction. METHODS: Longitudinal SWE images were acquired from lateral, central, and medial regions of the PT from two groups: 30 patients who had undergone ACL reconstruction with a PT autograft within the preceding 40 months, and 30 age-matched asymptomatic control subjects...
January 8, 2019: Knee
Ryunosuke Oikawa, Goro Tajima, Jun Yan, Moritaka Maruyama, Atsushi Sugawara, Shinya Oikawa, Takaaki Saigo, Hirotaka Takahashi, Minoru Doita
BACKGROUND: To clarify, with three-dimensional (3D) images, the morphological properties of the patellar tendon and both of its insertion sites. METHODS: Thirty-two human cadaveric left knees were evaluated, and 3D computed tomography images were created. These images were used to analyse the morphology of both insertion sites of the patellar tendon, and the width, length and thickness of each region of the patellar tendon. RESULTS: The insertion sites of the patellar tendon on the patellar and tibial sides were V-shaped and crescent-shaped, respectively, with the respective bony apexes located at 44...
January 8, 2019: Knee
Camilo Partezani Helito, Marcel Faraco Sobrado, Pedro Nogueira Giglio, Marcelo Batista Bonadio, Marco Kawamura Demange, José Ricardo Pécora, Gilberto Luis Camanho, Fabio Janson Angelini
BACKGROUND: To report the functional outcomes and complications from reconstructing the knee posterolateral complex (PLC), associated with one-stage opening-wedge tibial valgus osteotomy, and discuss the technical feasibility of this procedure. METHODS: Five patients with chronic PLC injuries and varus deviation of the mechanical axis, associated with central pivot injuries or not, underwent medial opening-wedge high tibial osteotomy combined with PLC reconstruction...
January 8, 2019: Knee
Sophie Heywood, Jodie McClelland, Paula Geigle, Ann Rahmann, Elizabeth Villalta, Benjamin Mentiplay, Ross Clark
BACKGROUND: Closed kinetic chain and plyometric exercises are commonly used in aquatic rehabilitation because they are believed to reduce joint loading whilst replicating functional tasks. However, the forces and relationship to land-based functional movement is unknown. This study aims to compare vertical ground reaction force during squats, calf raises and jumping in older adults with and without knee osteoarthritis on land and in water. METHODS: Forty one participants (Healthy n = 21; Knee osteoarthritis n = 20; Age 68...
January 2, 2019: Knee
David Klein, Robert Goldman
There is very little data on the incidence or treatment options for late developing patella baja following uncomplicated total knee arthroplasty (TKA). In this article we present the course, surgical treatment, rationale, and one-year outcome of our treatment of this complication with extensor mechanism allograft reconstruction. In our patient, the index TKA produced good results in the early postoperative period, but the patient went on to develop pain, decreased range of motion (ROM), and patella baja, which was resistant to extensive physical therapy and MUA...
January 2, 2019: Knee
Jesse C Christensen, Ryan L Mizner, K Bo Foreman, Paul C LaStayo, Christopher L Peters, Christopher E Pelt
BACKGROUND: Nearly all patients with total knee arthroplasty show aberrant movement patterns during tasks requiring greater joint demand compared to matched peers. Greater movement compensation leads to increased loading onto other joints, decreased functional capacity and limited reserve for independence later in life. Understanding how preoperative predictors contribute to postoperative aberrant movement patterns is needed to make better decisions for patients considering total knee arthroplasty...
December 29, 2018: Knee
Jeremy Mejane, Jocelyn Faubert, Thomas Romeas, David R Labbe
BACKGROUND: A large majority of anterior cruciate ligament (ACL) injuries are non-contact, most often occurring during a landing or change of direction. Recent research indicates that cognitive factors may be involved in non-contact ACL injuries. The aim of this study was to determine if a game-situation perceptual-cognitive load leads to altered landing kinematics in physically fatigued female athletes. METHODS: Nineteen female recreational athletes were recruited to perform a series of jumping and landing trials...
December 21, 2018: Knee
Matthias Steinwachs, Nicola Cavalcanti, Santhosh Mauuva Venkatesh Reddy, Clement Werner, Daniel Tschopp, Hema N Choudur
BACKGROUND: CARGEL (Smith & Nephew Inc.), a chitosan-based polymer scaffolding biomaterial, has been used since 2012 for treating articular cartilage lesions. Limited data are available on patient outcomes following CARGEL treatment. This study aimed to describe short-term clinical and radiographic outcomes in a cohort of patients treated with CARGEL and microfracture surgery for articular cartilage defects in the knee. METHODS: A retrospective cohort study was conducted of consecutive patients with articular cartilage defects who had undergone microfracture surgery with CARGEL, or in patellar lesions microfracture and CARGEL plus Chondro-Gide (at SportsClinic Zurich)...
December 19, 2018: Knee
Kyoung-Tak Kang, Sae Kwang Kwon, Oh-Ryong Kwon, Jun-Sang Lee, Yong-Gon Koh
BACKGROUND: The effect of the changes in the femoral posterior condylar offset (PCO) on anterior-posterior (AP) translation and internal-external (IE) rotation in cruciate-retaining (CR) and posterior-stabilized (PS) total knee arthroplasty (TKA) remains unknown. The purpose of this study was to compare the kinematics in CR and PS TKA with respect to the difference in prosthetic design and PCO change through a computational simulation. METHODS: We developed three-dimensional finite element models with the different PCOs of ±1, ±2 and ±3 mm in the posterior direction using CR and PS TKA...
December 18, 2018: Knee
Kohei Kawaguchi, Hiroshi Inui, Shuji Taketomi, Ryota Yamagami, Kenichi Kono, Keiu Nakazato, Manabu Kawata, Sakae Tanaka
Meniscal bearing dislocation while rolling over in sleep has never been reported in Oxford unicompartmental knee arthroplasty (UKA). This study reports two cases of meniscal bearing dislocation into the intercondylar ridge while rolling over in sleep. In the case of one patient, closed reduction of the bearing was performed, and the use of a knee brace was effective in preventing re-dislocation. In the second patient, closed reduction was possible; however, bearing dislocation was repeated. Therefore, revision surgery was performed by replacing the tibial component and using a thicker bearing...
December 14, 2018: Knee
Michael J Dan, James Crowley, David Broe, Mervyn Cross, Chris Tan, William R Walsh
BACKGROUND: Patella tendinopathy is an overuse condition. Pathogenesis and identification of intrinsic risk factors have largely eluded the orthopaedic world. The cranial cruciate ligament (CrCL) in dogs is the equivalent to the human anterior cruciate ligament (ACL). We report the effect of two canine proximal tibial osteotomy procedures in the veterinary literature on patella tendon moment arm and describe the biomechanical rationale for a tibial tubercle osteotomy for treatment of patella tendinopathy in the human...
December 13, 2018: Knee
Jae S You, Anne R Wright, Ian Hasegawa, Brandon Kobayashi, Matthew Kawahara, Jordan Wang, Cass K Nakasone
BACKGROUND: Tibial osseous defects can present a serious challenge in primary total knee arthroplasty. We describe a technique of using porous tantalum cones along with primary arthroplasty implants to address large tibial osseous defects in primary total knee arthroplasty and present the short-term results. METHODS: We present 17 cases (15 patients) in which primary total knee implants and porous tantalum cones were used to address large tibial bony defects. Clinical results were evaluated using Knee Society Scores, pre- and postoperative knee range of motion, and serial radiographs...
December 13, 2018: Knee
Kristoffer W Barfod, Julian A Feller, Taylor Hartwig, Brian M Devitt, Kate E Webster
BACKGROUND: Knee extensor strength and single limb hop for distance have been suggested as useful measures to evaluate readiness to return to sport after anterior cruciate ligament (ACL) reconstruction. The aim of the study was to examine the association between knee extensor strength and single leg hop for distance following ACL reconstruction and to determine the proportion of patients with knee extensor strength symmetry deficits at six and 12 months. METHODS: From December 2013 to December 2015 69 patients aged 14 to 45 undergoing primary ACL reconstruction were recruited...
December 13, 2018: Knee
Mai Katakura, Masafumi Horie, Toshifumi Watanabe, Hiroki Katagiri, Koji Otabe, Toshiyuki Ohara, Kaori Nakamura, Kenta Katagiri, Hiroko Ueki, Stefano Zaffagnini, Ichiro Sekiya, Takeshi Muneta, Hideyuki Koga
BACKGROUND: Some types of meniscus tear, especially lateral meniscus tear, have been reported to be associated with rotatory knee laxity. However, precise information regarding the effect of meniscus repair on rotatory laxity is limited. The purpose of this study was to investigate the effects of lateral and medial meniscus repair on rotatory laxity in anterior cruciate ligament (ACL) injured knees. METHODS: Forty-one patients who underwent ACL reconstruction were included in the study...
December 13, 2018: Knee
W Kyle Wilson, Randal Morris, Andrew Coskey, Brian Smith, Zbigniew Gugala
BACKGROUND: Double hamstring autograft for anterior cruciate ligament (ACL) reconstruction is a well-established graft option; however, a major concern with this method arises when the prepared graft is too small. Resorting to allograft can be a solution to this problem, but some surgeons prefer to use autograft in particular situations and some patients may refuse allograft. We investigate the merits of using autogenous quadriceps tendons to augment the insufficient hamstrings and compare the autograft composite graft to a standard hamstrings graft of equal size...
December 13, 2018: Knee
M C Fennema, R A Bloomfield, B A Lanting, T B Birmingham, M G Teeter
BACKGROUND: As assessment with inertial-measurement-units (IMUs) increases in research and in clinics, it is important to be aware of the repeatability of these sensors. The objectives of this experiment were to evaluate the measurement repeatability of IMU joint angles using a repeatable robot controller and an anthropomorphic leg phantom and to determine effects of joint speed and sensor positioning on the angles collected by these sensors. Comparisons to an electro-goniometer and three-dimensional (3D) motion capture cameras were also completed...
December 13, 2018: Knee
Kevin D Stockwell, Sarfraz Malleck, Trevor C Gascoyne, Thomas R Turgeon
BACKGROUND: Despite the extensive study of primary arthroplasty, revision surgery is rarely discussed due to the reduced frequency and variability between patients. A new revision knee system was introduced to build off the geometry of a successful knee replacement system. This study seeks to assess the survival, clinical outcomes and radiographic assessment of this revision system at the early to mid-term. METHODS: A consecutive cohort of 234 rTKAs was identified from an institutional database...
December 12, 2018: Knee
Cedric Maillot, Anthony Leong, Ciara Harman, Alberto Morelli, Richard Mospan, Justin Cobb, Charles Rivière
BACKGROUND: The kinematic alignment (KA) technique for total knee arthroplasty (TKA) is an emerging implant positioning philosophy that aims to restore constitutional knee anatomy to improve knee kinematics. At present, the KA technique aims to reconstruct native femorotibial (FT) joint alignment, however there is still insufficient consideration towards the inter-individual trochlear anatomy variability. Poor trochlear restoration may compromise clinical outcomes. Our study aimed at assessing the anatomical relationship between the native trochlea and other FT anatomical parameters...
December 10, 2018: Knee
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