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Journal of Knee Surgery

Michael A Mont, Belinda Lovelace, An T Pham, Ryan N Hansen, Morad Chughtai, Chukwuweike U Gwam, Anton Khlopas, John W Barrington
The purpose of this study was (1) to evaluate 30-day readmission rates in total knee arthroplasty (TKA) patients who either received intravenous (IV) or oral (PO) acetaminophen (APAP) perioperatively and (2) to extrapolate the potential annual cost savings on the national level. This was a review of 190,691 TKA recipients between the years 2012 and 2015 who received either IV ( n  = 56,475) or PO APAP ( n  = 134,216). All-cause readmissions that occurred between patient discharge and 30 days postdischarge were recorded...
May 7, 2018: Journal of Knee Surgery
Charles Cody White, Josef K Eichinger, Richard J Friedman
Blood loss management is critical to positive outcomes in patients undergoing total knee arthroplasty (TKA). Transfusions are associated with an increased risk of major and minor adverse events, length of hospitalization, and overall cost associated with surgery. Many techniques have been investigated and compared. Tranexamic acid (TXA), an antifibrinolytic drug widely known to reduce blood loss, may be a bridge to the goal of eliminating blood transfusions from TKA. Administration of TXA can be performed intravenously, topically at the knee joint, orally, or in combination...
May 4, 2018: Journal of Knee Surgery
Richard Ma, Mark Stasiak, Xiang-Hua Deng, Scott A Rodeo
The purpose of this study is to establish a small animal anterior cruciate ligament (ACL) reconstruction research model where ACL graft force can be varied to create different graft force patterns with controlled knee motion. Cadaveric ( n  = 10) and in vivo ( n  = 10) rat knees underwent ACL resection followed by reconstruction using a soft tissue autograft. Five cadaveric and five in vivo knees received a nonisometric, high-force femoral graft tunnel position. Five cadaveric and five in vivo knees received a more isometric, low-force graft tunnel position...
May 4, 2018: Journal of Knee Surgery
Sohrab Keyhani, Seyyed Morteza Kazemi, Jin Hwan Ahn, René Verdonk, Mehran Soleymanha
The purpose of this study was to evaluate and describe the clinical results of complete arthroscopic synovectomy through the four arthroscopic portals in the knees affected by diffuse pigmented villonodular synovitis (DPVNS). Between 2009 and 2012, 21 patients (15 men and 6 women) with the diffuse form of PVNS of the knee were enrolled in the study after qualification. The clinical diagnosis was confirmed by magnetic resonance imaging and postsurgical pathologic examination. All patients underwent complete synovectomy through posteromedial, posterolateral, anteromedial, and anterolateral portals...
May 4, 2018: Journal of Knee Surgery
Oded Hershkovich, Ran Thein, Barak Gordon, Gideon Burstein, Shay Tenenbaum, Estela Derazne, Dorit Tzur, Arnon Afek
Our aim was to report the prevalence of knee varus-valgus malalignment (KVVM) and its association with body mass index (BMI) and body height in a healthy and fit young adult population. Information on the disability codes associated with KVVM according to the Regulations of Medical Fitness Determination was retrieved from a medical database containing records of 17-year-old males and females before their recruitment into mandatory military service. Logistic regression models assessed the association between the BMI and body height to KVVM...
May 4, 2018: Journal of Knee Surgery
Daniel Berman, Kelly Rogers, Kevin Bonner, Justin Griffin
Surgical repair of articular cartilage defects in the knee currently utilizes surgical algorithms based on absolute defect size. These algorithms, which have not been validated, are currently utilized not only by surgeons but also by insurance carriers for justification of reimbursement policy. However, current algorithms do not account for morphological differences between individual patients and defect size relative to condylar dimension. We hypothesized that a significant difference in relative defect size compared with condylar dimension may exist between individuals...
May 4, 2018: Journal of Knee Surgery
Umile Giuseppe Longo, Mauro Ciuffreda, Vincenzo Candela, Giacomo Rizzello, Valerio D'Andrea, Nicholas Mannering, Alessandra Berton, Giuseppe Salvatore, Vincenzo Denaro
The purpose of this study was to study the clinical and radiographic changes in the knee after arthroscopic partial meniscectomy (APM) at a long-term follow-up compared with the contralateral knee. We assessed 57 patients (38 males and 19 females) with pre- and postoperative weight-bearing radiography with a follow-up ranging from 5.1 to 12.1 years (mean: 8.1) to analyze prevalence and progression of knee osteoarthritis (OA) after APM. We stratified patients according to body mass index (BMI), type of lesion (degenerative vs...
May 3, 2018: Journal of Knee Surgery
Emily L Hampp, Morad Chughtai, Laura Y Scholl, Nipun Sodhi, Manoshi Bhowmik-Stoker, David J Jacofsky, Michael A Mont
This study determined if robotic-arm assisted total knee arthroplasty (RATKA) allows for more accurate and precise bone cuts and component position to plan compared with manual total knee arthroplasty (MTKA). Specifically, we assessed the following: (1) final bone cuts, (2) final component position, and (3) a potential learning curve for RATKA. On six cadaver specimens (12 knees), a MTKA and RATKA were performed on the left and right knees, respectively. Bone-cut and final-component positioning errors relative to preoperative plans were compared...
May 1, 2018: Journal of Knee Surgery
Wayne K Gersoff, Chantelle C Bozynski, Cristi R Cook, Ferris M Pfeiffer, Keiichi Kuroki, James L Cook
Tendon injury is common in sports. The standard of care (SOC) for tendon repair is surgical treatment. However, restored tendons often lack complete strength and functionality, and surgical repair is often unsuccessful. This controlled laboratory study investigates the healing of an Artelon patch (AP)-augmented tendon versus tendon repair alone in a preclinical canine patellar tendon defect model. Full-thickness proximal and distal flap defects were created in the patella tendons of eight purpose-bred research mongrel dogs...
April 27, 2018: Journal of Knee Surgery
Lasun O Oladeji, Tina K Dreger, Eli L Pratte, Charles A Baumann, James P Stannard, David A Volgas, Gregory J Della Rocca, Brett D Crist
Orthopaedic surgeons commonly have the misconception that patients with tibial plateau fractures will likely go on to posttraumatic knee arthritis requiring total knee arthroplasty (TKA). In younger patients, osteochondral allograft (OCA) transplantation is an alternative method to address posttraumatic knee arthritis. The purpose of this study was (1) to identify our institutional failure rate following tibial plateau open reduction and internal fixation (ORIF) (failure was defined as conversion to TKA or OCA); (2) to determine if there are patient- or injury-related risk factors predictive of failure; and (3) to characterize differences between patients treated with TKA versus those treated with OCA transplantation...
April 18, 2018: Journal of Knee Surgery
Rick W Wright, Lea Johnson, Robert H Brophy, Ljiljana Bogunovic, Matthew J Matava, Matthew V Smith
Revision anterior cruciate ligament (ACL) reconstruction typically has worse outcomes than primary reconstructions. Minimal long-term data exist regarding 5-year results. We chose to perform a systematic review to evaluate midterm (5-year) revision ACL reconstruction outcomes (patient-reported outcomes, reoperation, stability, arthritis) in comparison to primary ACL reconstructions at similar time points. Embase, Cochrane, and PubMed databases were queried, and four studies met the inclusion criteria. Two authors reviewed and performed data extraction...
April 13, 2018: Journal of Knee Surgery
Rajkishen Narayanan, Nathaniel Lenz, Jordan Alexander Werner, Michael B Cross, Dean Hughes, Scott Laster, Ran Schwarzkopf
Proper ligament tension in knee flexion within cruciate-retaining (CR) total knee arthroplasty has long been associated with clinical success; however, traditional balancing principles have assumed that the distal femoral joint line (DFJL) affects only extension. The purpose of this study was to determine the effect DFJL may have on ligament strains and tibiofemoral kinematics of CR knee designs in flexion. A computational analysis was performed using a musculoskeletal modeling system for two different knee implants, the high-flex CR (HFCR) and guided-motion CR (GMCR)...
April 13, 2018: Journal of Knee Surgery
Daoud Makki, Saleem Mastan, Daniel Ness, Raghuram Thonse
The objective of this study was to delineate the usefulness of clinical examination and magnetic resonance imaging (MRI) in acute knee injuries. We aim to establish whether the time period post acute knee injury is related to the diagnostic accuracy of clinical examination and to investigate the strength of specific clinical examination findings in predicting a clinically relevant MRI abnormality. Seventy patients were referred to fracture clinic with an acute knee injury who subsequently went on to be investigated with MRI over 12 months...
April 13, 2018: Journal of Knee Surgery
Ismail Fathalla, James Holton, Tanweer Ashraf
Surgical management of patellar instability is a matter of wide debate. While some authors believe that isolated medial patellofemoral ligament (MPFL) reconstruction is sufficient, others advocate procedures to treat the underlying pathology, namely, patella alta and trochlear dysplasia. Radiological studies have been traditionally used as a determinant of these pathologies and to determine the need for an additional procedure. The value of examination under anesthesia (EUA) in formulating a treatment plan remains unknown...
April 13, 2018: Journal of Knee Surgery
Chunli Wang, Qingjia Chi, Chunming Xu, Kang Xu, Yanjun Zhang, Yan Liu, Li Yang, K L Paul Sung
This study aims to confirm the effects of synoviocytes (SCs) on regulating lysyl oxidases (LOXs) and matrix metalloproteinase (MMP)-1, 2, 3 in the normal and injured anterior cruciate ligament (ACL) fibroblasts response to tumor necrosis factor-α(TNF-α). The gene and protein expression levels of LOXs and MMP-1, 2, 3 in SCs cocultured ACL fibroblasts (ACLfs) induced by TNF-α and mechanical injury were analyzed by real-time polymerase chain reaction (PCR) and western bolting; the MMP-2 activity were analyzed by zymography...
April 10, 2018: Journal of Knee Surgery
Wu Chean Lee, Hamid Rahmatullah Bin Abd Razak, John Carson Allen, Hwei Chi Chong, Hwee Chye Andrew Tan
Single-radius (SR) and multiradius (MR) total knee arthroplasties (TKAs) have produced similar outcomes, albeit most studies originate from Western nations. There are known knee kinematic differences between Western and Asian patients after TKA. The aim of this study is to compare the short-term patient-reported outcome measures (PROMs) of SR-TKA versus MR-TKA in Asians. Registry data of 133 SR-TKA versus 363 MR-TKA by a single surgeon were analyzed. Preoperative and 2-year postoperative range of motion (ROM) and PROMs were compared with Student's t -test and Mann-Whitney U-test...
April 10, 2018: Journal of Knee Surgery
Oisin Keenan, Ivan Brenkel, Phil Walmsley
Total knee arthroplasty (TKA) is reliant on safe and effective implants. The Press Fit Condylar Sigma Cobalt-Chrome (PFCSCC) was introduced in 2006, but no reports have examined long-term failure rates and patient-reported outcome measures (PROMs). The primary aim of this study was to assess survival outcomes of the PFCSCC at 10 years after implantation. Prospective data collection was performed on all patients undergoing primary TKA in one orthopaedic department using this prosthesis exclusively from February 1, 2006, to January 31, 2007...
April 10, 2018: Journal of Knee Surgery
Jing Ding, Lianping Wan, Xiaosheng Hou, Yudong Gan
This study evaluated clinical results of tension band wire fixation technique in the arthroscopic treatment of anterior cruciate ligament (ACL) tibial avulsion fracture. This study included 148 cases of ACL tibial avulsion fracture treated using arthroscopic tension band wire fixation technique. Patients were followed up for 25 to 36 months with an average of 27 months and evaluated in accordance with the International Knee Documentation Committee (IKDC) and Lysholm knee scoring scale. Fractures were united within 3 months after surgery in all cases...
April 10, 2018: Journal of Knee Surgery
Hao Sun, Zhiyu Huang, Zhiqi Zhang, Weiming Liao
Liposomal bupivacaine is a novel method for pain control after total knee arthroplasty (TKA), but recent studies showed no advantage for patients undergoing TKA compared with traditional periarticular injection (PAI). The purpose of this analysis was to compare the clinical outcomes between liposomal bupivacaine treatment and traditional PAI. We retrospectively reviewed data from 16 clinical trials in published databases from their inception to June 2017. The primary outcome was postoperative Visual Analogue Scale (VAS) score and secondary outcomes included opiate usage, narcotic consumption, range of motion, and length of stay...
April 4, 2018: Journal of Knee Surgery
Siddharth Mahesh Shah, Jason Roberts, Frederic Picard
Medial open wedge high tibial osteotomy (MOWHTO) is a commonly performed procedure for symptomatic medial compartment osteoarthritis (OA). However, little is known about its effects on ipsilateral ankle or hindfoot. The aim of our study was to determine the incidence of ankle or hindfoot problems after MOWHTO and examine its association with radiological indices. Thirty-five knees (32 patients) undergoing navigated MOWHTO were evaluated for the presence of new-onset ankle or hindfoot symptoms after surgery...
April 4, 2018: Journal of Knee Surgery
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