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Journal of Knee Surgery

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https://www.readbyqxmd.com/read/27907935/a-meta-analysis-of-functional-outcomes-in-patient-specific-instrumented-knee-arthroplasty
#1
Ashim Mannan, Deji Akinyooye, Fahad Hossain
Alignment data in patient-specific instrumented (PSI) knee arthroplasty have been examined in several meta-analyses, with demonstration of comparative but not improved restitution of a neutral mechanical axis and favorable outcomes in femoral implant axial alignment. To date, no comprehensive synthesis of data has been conducted specifically for functional outcomes. Relevant databases were searched according to Preferred Reporting Items for Systematic reviews and Meta-analyses guidelines during the period 2000 to 2015 of Levels 1 and 2 studies comparing functional outcomes of patient-specific instrumentation (PSI) versus conventional instrumentation...
December 1, 2016: Journal of Knee Surgery
https://www.readbyqxmd.com/read/27907934/restriction-of-postoperative-joint-loading-in-a-murine-model-of-anterior-cruciate-ligament-reconstruction-botulinum-toxin-paralysis-and-external-fixation
#2
Amir Lebaschi, Xiang-Hua Deng, Nathan W Coleman, Christopher L Camp, Jianchun Zong, Andrew Carbone, Camila B Carballo, Guang-Ting Cong, Zoe M Album, Scott A Rodeo
Control of knee motion in small animal models is necessary to study the effect of mechanical load on the healing process. This can be especially challenging in mice, which are being increasingly used for various orthopedic reconstruction models. We explored the feasibility of botulinum toxin (Botox; Allergan, Dublin, Ireland) paralysis and a newly designed external fixator to restrict motion of the knee in mice undergoing anterior cruciate ligament (ACL) reconstruction. Nineteen C57BL/6 mice were allocated to two groups: (1) Botox group (n = 9) and (2) external fixator group (n = 10)...
December 1, 2016: Journal of Knee Surgery
https://www.readbyqxmd.com/read/27903009/temperature-controlled-continuous-cold-flow-device-after-total-knee-arthroplasty-a-randomized-controlled-trial-study
#3
Alberto Ruffilli, Francesco Castagnini, Francesco Traina, Isabella Corneti, Domenico Fenga, Sandro Giannini, Cesare Faldini
Total knee arthroplasty (TKA) is a widely accepted and successful procedure for end-stage arthritis. Nevertheless, fast-track may be compromised by many factors, such as pain, edema, and blood loss. Cryotherapy has been advocated as a safe and effective strategy to improve the postoperative results, acting on pain, edema, and blood loss. This study is a prospective randomized controlled study, involving 50 patients after primary TKA. A power analysis was performed preoperatively. Twenty-four patients were addressed to a postoperative treatment with a continuous cold flow device (Hilotherm, Hilotherm GmbH, Germany)...
November 30, 2016: Journal of Knee Surgery
https://www.readbyqxmd.com/read/27898989/identifying-an-ideal-time-frame-for-staged-bilateral-total-knee-arthroplasty-to-maximize-functional-outcome
#4
Jared Ze Yang Yeh, Jerry Yongqiang Chen, Wu Chean Lee, Hwei Chi Chong, Hee Nee Pang, Darren Keng Jin Tay, Shi-Lu Chia, Ngai Nung Lo, Seng Jin Yeo
Compared with staged bilateral total knee arthroplasty (TKA), simultaneous bilateral TKA carries a higher risk of cardiac complications, pulmonary complications, and mortality, especially in patients with preexisting cardiopulmonary disease or advanced age. However, the period of time between staged TKAs that would eliminate these increased risks has yet to be determined. The purpose of this study is to evaluate complication rates and functional outcome in patients who underwent staged bilateral TKA and to determine an optimal time frame for the second knee...
November 29, 2016: Journal of Knee Surgery
https://www.readbyqxmd.com/read/27894148/catastrophic-failure-of-regenerex-tibial-components-a-case-series
#5
Gavin Stormont, Daniel Stormont
The aim of this study was to analyze short-term metal failures in well-placed Signature-guided Regenerex (Zimmer Biomet, Warsaw, IN) tibial components in a limited patient series. A retrospective, consecutive, nonrandomized, unblinded study from a limited cohort of young active osteoarthritis patients was conducted. All cases received a Regenerex tibial component which we evaluated for metal failure. Patients met the then current indications from the Center for Medicare and Medicaid Services Guidelines for knee replacement...
November 28, 2016: Journal of Knee Surgery
https://www.readbyqxmd.com/read/27894147/reliability-concurrent-validity-and-minimal-detectable-change-for-iphone-goniometer-app-in-assessing-knee-range-of-motion
#6
Saurabh P Mehta, Katherine Barker, Brett Bowman, Heather Galloway, Nicole Oliashirazi, Ali Oliashirazi
Much of the published works assessing the reliability of smartphone goniometer apps (SG) have poor generalizability since the reliability was assessed in healthy subjects. No research has established the values for standard error of measurement (SEM) or minimal detectable change (MDC) which have greater clinical utility to contextualize the range of motion (ROM) assessed using the SG. This research examined the test-retest reproducibility, concurrent validity, SEM, and MDC values for the iPhone goniometer app (i-Goni; June Software Inc...
November 28, 2016: Journal of Knee Surgery
https://www.readbyqxmd.com/read/27894146/variables-associated-with-chondral-and-meniscal-injuries-in-anterior-cruciate-ligament-surgery
#7
E Lyle Cain, Glenn S Fleisig, Brent A Ponce, Hikel A Boohaker, Martha P George, Gerald McGwin, James R Andrews, Lawrence J Lemak, William G Clancy, Jeffrey R Dugas
This article aims to evaluate factors associated with chondral and meniscal lesions in primary and revision anterior cruciate ligament (ACL) reconstructions. ACL reconstructions from 2001 to 2008 at a single institution were retrospectively analyzed. Logistic regression was used to estimate the association between chondral and meniscal injuries and age, gender, tear chronicity, additional ligamentous injuries, sport type, and participation level. Of the 3,040 ACL reconstructions analyzed, 90.4% were primary reconstructions and 9...
November 28, 2016: Journal of Knee Surgery
https://www.readbyqxmd.com/read/27880971/the-risk-factors-of-postoperative-delirium-after-total-knee-arthroplasty
#8
Lih Wang, Sangyun Seok, Sungsoo Kim, Kyungtaek Kim, Seunghyun Lee, Kyungho Lee
We investigated the results of delirium which developed after total knee arthroplasty (TKA) and the risk factors for delirium in the patients who are older than 65 years. From March 2008 to March 2012, we performed a retrospective study on 296 knees of 265 patients who were treated with TKA. They were divided into two groups: 216 patients without delirium and 49 patients diagnosed with delirium by psychiatry. We analyzed the risk factors into three categories: First, the preoperative factors including gender, age, body mass index (BMI), clinical and functional knee joint score (Knee Society Knee Score and Knee Society Function Score) and the number of underlying diseases and associations with each disease; Second, the operative factors including the anesthesia method, amount of blood loss, operating time, laboratory factors, and transfusion count; Third, the postoperative factors such as start time of walking and duration of hospital stay were analyzed...
November 23, 2016: Journal of Knee Surgery
https://www.readbyqxmd.com/read/27880970/total-knee-arthroplasty-what-to-expect-a-survey-of-the-members-of-the-dutch-knee-society-on-long-term-recovery-after-total-knee-arthroplasty
#9
Jaap J Tolk, Marieke C van der Steen, Rob P A Janssen, Max Reijman
The rate of satisfaction after total knee arthroplasty (TKA) is consistently reported around 80%, leaving one in five patients unsatisfied to some extent. Fulfillment of expectations is reported as the strongest predictor of treatment satisfaction. In this study, we aimed to evaluate what Dutch orthopedic surgeons assume are realistic expectations for recovery 1 year after TKA. We invited the members of the Dutch Knee Society (DKS) to fill out a web-based questionnaire. For expectation measurement, the validated Dutch version of the Hospital for Special Surgery (HSS) knee replacement expectations survey was used...
November 23, 2016: Journal of Knee Surgery
https://www.readbyqxmd.com/read/27880969/the-prevalence-of-cruciate-ligament-and-meniscus-knee-injury-in-young-adults-and-associations-with-gender-body-mass-index-and-height-a-large-cross-sectional-study
#10
Ran Thein, Oded Hershkovich, Barak Gordon, Gideon Burstein, Shay Tenebaum, Estela Derazne, Dorit Tzur, Ari Shamis, Arnon Afek, Yitshak Kreiss
Anterior cruciate ligament and meniscal injuries are associated with secondary osteoarthrosis which may lead to functional impairment and economic burden. The prevalence of knee injury has not been studied in depth. Our purpose was to report the prevalence of knee ligament and meniscal injuries and their associations with gender, body mass index (BMI), and height in young adults and to characterize individuals with meniscal injuries who gained full recovery. A cross-sectional, population-based study was conducted...
November 23, 2016: Journal of Knee Surgery
https://www.readbyqxmd.com/read/27880968/results-of-a-new-treatment-concept-for-concomitant-lesion-of-medial-collateral-ligament-in-patients-with-rupture-of-anterior-cruciate-ligament
#11
Fabian Blanke, Jochen Paul, Maximilian Haenle, Jannes Sailer, Geert Pagenstert, Lutz von Wehren, Stephan Vogt, Martin Majewski
Anteromedial knee injury with rupture of anterior cruciate ligament (ACL) and concomitant lesion of medial collateral ligament (MCL) is common in athletes. No standardized treatment concept can be found within the literature. This study presents results of a new treatment concept for concomitant MCL lesions in patients with ACL rupture. In this study, 67 recreational athletes with ACL injury and concomitant MCL lesion were treated according to a distinct treatment concept. Patients were classified in six different types of concomitant MCL lesion depending on grade of MCL lesion and presence of anteromedial rotatory instability (AMRI)...
November 23, 2016: Journal of Knee Surgery
https://www.readbyqxmd.com/read/27846646/the-variable-emergence-of-the-infrapatellar-branch-of-the-saphenous-nerve
#12
Brandon Michael Henry, Krzysztof A Tomaszewski, Przemysław A Pękala, Piravin Kumar Ramakrishnan, Dominik Taterra, Karolina Saganiak, Ewa Mizia, Jerzy A Walocha
The infrapatellar branch of the saphenous nerve (IPBSN) is a cutaneous nerve of the lower limb, which arises distal to the adductor canal. High variability in the emergence, course, branching, termination, and morphometrics of the IPBSN poses an increased risk of injury to the nerve during surgical interventions on the anteromedial aspect of the knee. The aim of this study was to describe the anatomical characteristics of the IPBSN. This study utilized cadaveric (n = 100) and ultrasonography (n = 30) assessments, and meta-analysis...
November 15, 2016: Journal of Knee Surgery
https://www.readbyqxmd.com/read/27824404/contracting-strategies-for-arthroplasty-bundles-to-population-health
#13
David J Jacofsky, Paul Jawin, Geoff Walton, Lisa Fraser
Orthopedics, and especially total joint replacement (TJR), is growing in payer prominence due to large projected increases in volume. The unsustainability of the fee-for-service payment system has lead Centers for Medicare and Medicaid Services to employ new value and risk-based contracting strategies on a population health basis and on an episode of care basis, with programs such as the Bundled Payment for Care Improvement program and the Comprehensive Care for Joint Replacement program. These trends are forcing hospitals and physicians to align to improve quality and reduce costs through new structures such as Accountable Care Organizations, comanagement programs, and gainsharing...
November 4, 2016: Journal of Knee Surgery
https://www.readbyqxmd.com/read/27806385/reimbursement-based-on-value-in-knee-surgery-what-you-need-to-know-about-the-medicare-access-and-children-s-health-insurance-program-reauthorization-act-of-2015
#14
Khaled J Saleh, Zain Sayeed, Afshin A Anoushiravani, Hussein F Darwiche, Bryan Little, Todd James Frush, Mouhanad M El-Othmani
Health care cost is consuming a large portion of the nation's gross domestic product while placing added economic burdens on physicians and their patients. With total joint replacement being one of the early-targeted procedures in the evolving health care environment, knee surgeons will benefit from developing a critical knowledge on health care reforms and their financial implications. The Medicare Access and Children's Health Insurance Program Reauthorization Act represents a cohesive movement toward value-based payment reform and contains several unchartered rulings that require detailed attention by knee surgeons...
November 2, 2016: Journal of Knee Surgery
https://www.readbyqxmd.com/read/27788528/factors-associated-with-knee-stiffness-following-surgical-management-of-multiligament-knee-injuries
#15
Jessica Hanley, Robert Westermann, Shane Cook, Natalie Glass, Ned Amendola, Brian R Wolf, Matthew Bollier
Postoperative knee stiffness can influence outcomes following operative treatment of multiligament knee injuries (MLKIs). The purpose of this study was to evaluate patient and surgical factors that may potentially contribute to stiffness following surgery for MLKIs. All surgically managed MLKIs involving two or more ligaments over a 10-year period at a single level one trauma center were included in this study. A retrospective review was performed to gather objective data related to the development of knee stiffness after surgery...
October 27, 2016: Journal of Knee Surgery
https://www.readbyqxmd.com/read/27780287/infection-following-anterior-cruciate-ligament-reconstruction-an-analysis-of-6-389-cases
#16
Robert Westermann, Chris A Anthony, Kyle R Duchman, Yubo Gao, Andrew J Pugely, Carolyn M Hettrich, Ned Amendola, Brian R Wolf
Infection following anterior cruciate ligament reconstruction (ACLR) is rare. Previous authors have concluded that diabetes, tobacco use, and previous knee surgery may influence infection rates following ACLR. The purpose of this study was to identify a cohort of patients undergoing ACLR and define (1) the incidence of infection after ACLR from a large multicenter database and (2) the risk factors for infection after ACLR. We identified patients undergoing elective ACLRs in the American College of Surgeons National Surgical Quality Improvement Program database between 2007 and 2013...
October 25, 2016: Journal of Knee Surgery
https://www.readbyqxmd.com/read/27780286/preoperative-ultrasonographic-prediction-of-hamstring-tendon-diameter-for-anterior-cruciate-ligament-repair
#17
Luis Manuel Rodriguez-Mendez, Jose de Jesus Martinez-Ruiz, Ruben Perez-Manzo, Jorge Luis Corona-Hernandez, Juan Luis Alcala-Zermeno, Sergio Sanchez-Enriquez
The incidence of anterior cruciate ligament (ACL) injuries is rising every year. The autologous hamstring tendon graft, using semitendinosus tendon (SMT) and gracilis tendon (GR), is a common repair technique in the management of ACL injuries due to its multiple advantages. Using a final graft with a minimum diameter of 8 mm is necessary to avoid graft failure. The aim of this study was to find a correlation between preoperative ultrasound (USG) measurement of the SMT and GR tendon diameters (SMTd and GRd) and their actual diameters measured during the grafting procedure...
October 25, 2016: Journal of Knee Surgery
https://www.readbyqxmd.com/read/27780285/biomechanical-comparison-of-five-posterior-cruciate-ligament-reconstruction-techniques
#18
Clayton W Nuelle, Jeffrey L Milles, Ferris M Pfeiffer, James P Stannard, Patrick A Smith, Mauricio Kfuri, James L Cook
No surgical technique recreates native posterior cruciate ligament (PCL) biomechanics. We compared the biomechanics of five different PCL reconstruction techniques versus the native PCL. Cadaveric knees (n = 20) were randomly assigned to one of five reconstruction techniques: Single bundle all-inside arthroscopic inlay, single bundle all-inside suspensory fixation, single bundle arthroscopic-assisted open onlay (SB-ONL), double bundle arthroscopic-assisted open inlay (DB-INL), and double bundle all-inside suspensory fixation (DB-SUSP)...
October 25, 2016: Journal of Knee Surgery
https://www.readbyqxmd.com/read/27776373/arthroplasty-registries-improving-clinical-and-economic-outcomes
#19
P Maxwell Courtney, David C Markel
With renewed focus on achieving value for patients in total hip and knee arthroplasty, payors, hospitals, and physicians strive to provide quality care while minimizing cost. Large registry datasets have gained popularity in the United States to track implant survivorship and outcomes after joint replacement. Partnerships among surgeons, insurers, and health systems have improved on earlier administrative datasets from Medicare to measure quality and outcomes. Participation in state and national registries can help surgeons and hospitals gain a financial advantage in several insurers' quality programs and alternative payment models...
October 24, 2016: Journal of Knee Surgery
https://www.readbyqxmd.com/read/27776372/early-removal-of-drainage-tube-after-fast-track-primary-total-knee-arthroplasty
#20
Shaoyun Zhang, Bin Xu, Qiang Huang, Huan Yao, Jinwei Xie, Fuxing Pei
There is no consensus as to whether drainage tube should be used and how long it should remain in use after primary total knee arthroplasty (TKA). As fast-track (FT) program has been implemented in TKA, whether drainage tube could be removed early, and the ideal timing for removal after FT primary TKA has been a new topic. The purpose of this prospective cohort study was to evaluate the safety and feasibility of early removal of drainage tube when FT program was implemented in primary TKA. A total of 101 patients undergoing FT primary TKA were prospectively allocated into three groups...
October 24, 2016: Journal of Knee Surgery
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