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Journal of Knee Surgery

Sanar S Yokhana, Christopher Bergum, Weiping Ren, David C Markel
Total knee prostheses are routinely redesigned to improve performance, longevity, and to closer mimic the native kinematics of the knee. Despite continued improvements, all knee implants, even those with proven design features, have failures. We identified a cohort of patients with isolated tibial component failures that occurred in a popular and successful knee system. Our purpose was to (1) characterize the observed radiographic failure pattern; (2) investigate the biologic response that may have contributed to the failure; and (3) to determine if the failure mechanism was of a biological or a mechanical nature...
July 10, 2018: Journal of Knee Surgery
Lucy Camilla Walker, Nick D Clement, David J Deehan
It is estimated that up to a third of recipients of total knee arthroplasty (TKA) experience chronic pain postoperatively. However, there are no clear indications within the literature that predict which patients are at higher risk of being dissatisfied with their TKA. The Western Ontario and McMaster University Osteoarthritis Index (WOMAC) is one of the most commonly used, patient-reported outcome measures in patients with lower limb osteoarthritis. This review discusses the available evidence surrounding the predictability of the outcome of TKA using the WOMAC score as well as considering further patient factors that have been implicated in the level of improvement post TKA...
July 10, 2018: Journal of Knee Surgery
M P Somford, R P A Janssen, D Meijer, T A P Roeling, C Brown, D Eygendaal
The Pellegrini-Stieda lesion is a calcification on the medial side of the knee. The origin of this tissue is controversial. The purpose of our study is to investigate the origin of the Pellegrini-Stieda lesion using conventional radiography as to recreate the circumstances in which Pellegrini and Stieda had to study this pathology. Six nonpaired fresh-frozen cadaveric knees were used. A surgical approach to the medial side of the knee was performed using the layered approach. The origin of the gastrocnemius muscle (GM) ( n  = 3) or the superficial medial collateral ligament (sMCL) ( n  = 3) were marked with a radio-opaque fluid...
July 10, 2018: Journal of Knee Surgery
Ajaykumar Shanmugaraj, Darren de Sa, Matthew M Skelly, Andrew Duong, Nicole Simunovic, Volker Musahl, Devin C Peterson, Olufemi R Ayeni
The purpose of this systematic review is to ascertain the risk profile of allografts in primary anterior cruciate ligament reconstruction (ACLR) of skeletally immature patients. Three databases (PubMed, EMBASE, and MEDLINE) were searched for articles addressing primary ACLR in skeletally immature patients (i.e., open femoral and tibial physes). Inclusion criteria encompassed the use of allograft tissue with available postoperative outcomes data. The methodological index for non-randomized studies (MINORS) was used to assess all studies...
July 10, 2018: Journal of Knee Surgery
Murad Pepe, Emre Calisal, Onur Kocadal, Eren Bicer, Suhan Taskin, Cem Nuri Aktekin
We aimed to investigate the effect of the knee position during the surgical closure on isokinetic muscle strength, clinical score, and range of motion in total knee arthroplasty. Seventy-five eligible patients were enrolled in the study and randomly divided into two groups; wound closure was performed with the knee flexed at 90° in group 1 and knee extended in group 2. All the surgeries were performed by the same surgeon and by the same prosthesis type. All the patients received the same rehabilitation program postoperatively...
July 10, 2018: Journal of Knee Surgery
Sean J Meredith, Vidushan Nadarajah, Julio J Jauregui, Michael P Smuda, Shaun H Medina, Craig H Bennett, Jonathan D Packer, R Frank Henn
A cross-sectional analysis of data derived from patients undergoing knee surgery at a single institution was conducted. The objectives of the study were to determine the demographic, diagnostic, and psychologic factors associated with opioid use; and to determine the clinical correlates of opioid use. We hypothesized that preoperative opioid use would be associated with worse patient-reported outcome (PRO) measures. The sample consisted of 383 patients undergoing knee surgery. The patients were classified as either opioid or nonopioid users on the basis of medical record review...
July 10, 2018: Journal of Knee Surgery
Leonardo Cavinatto, Sunny Gupta, Craig Morgan, Arthur R Bartolozzi
Partial tears of the anterior cruciate ligament (ACL) recently regained attention due to a better understanding of the two distinct bundles of the ligament and the possibility of single-bundle reconstruction procedures. An accurate diagnosis is important as it influences treatment options and patient prognosis. The aim of this study was to evaluate the value of examination under anesthesia (EUA) and magnetic resonance imaging (MRI) for differentiating partial from complete ACL tears. For this purpose, this prospective case series included 95 consecutive patients undergoing primary ACL reconstruction surgeries...
July 10, 2018: Journal of Knee Surgery
Matthias Krause, Ralph Akoto, Tobias Claus Drenck, Karl-Heinz Frosch, Achim Preiss
Anatomic reconstruction of the popliteus tendon and arcuate complex results in superior functional and a biomechanically more stable outcome compared with extra-anatomic techniques in posterolateral rotatory knee instability. Although specific characteristics of the femoral and fibular footprint of the anatomic posterolateral reconstruction have been described, data for tibial tunnel placement while popliteus tendon reconstruction do not exist. The purpose of this study was to quantify reasonable parameters, which could be used in arthroscopy, fluoroscopy, or open surgery to determine the anatomic tibial drill tunnel position in popliteus tendon reconstruction...
July 6, 2018: Journal of Knee Surgery
Suhail Agarwal, Darren de Sa, Devin C Peterson, Daniel Parmar, Nicole Simunovic, Rick Ogilvie, Volker Musahl, Olufemi R Ayeni
This systematic review explored the utility of preoperative magnetic resonance imaging (MRI) as a tool for predicting intraoperative graft size for anterior cruciate ligament (ACL) reconstruction. Three databases (EMBASE, PubMed, and MEDLINE) were searched in November 2017 for English-language studies of all levels of evidence that aimed to correlate preoperative MRI measurements of common primary ACL autograft sources to intraoperative measurements of the harvested graft. Two reviewers applied predetermined inclusion/exclusion criteria to independently complete title, abstract, and full-text review of eligible studies...
July 6, 2018: Journal of Knee Surgery
David F Dalury, Danielle M Chapman
An important milestone in the recovery following total knee replacement (TKR) is the ability to return to driving. With advances in pain control and the widespread introduction of rapid rehab programs, we hypothesized that the ability to drive would also return sooner than had been traditionally observed. In our group of consecutive right TKR patients, using a driving simulator, we showed that at the 2-week mark, 36 of the 40 patients tested had returned to their preoperative driving capabilities and the other 4 had reached baseline at 3 weeks...
June 20, 2018: Journal of Knee Surgery
Oommen Mathew Arikupurathu, Linda Johnston, Alasdair MacInnes, Graeme Nicol, Manhal Nassif
The NexGen legacy posterior stabilized (LPS) prosthesis was introduced in 1997 after many design changes to its predecessor, the Insall-Burstein II prosthesis. However, there have been no reported long-term studies on the performance of this implant. Prospectively, collected data from a local database comprising primary total knee replacements (TKRs) with LPS between 1997 and 2002 was analyzed. All implants were fixed with cement. Patients were followed up at 1, 3, 5, 7, and 10 years, with patient satisfaction, range of movement, and Knee Society score (KSS) assessed...
June 20, 2018: Journal of Knee Surgery
John R Worley, Olubusola Brimmo, Clayton W Nuelle, James L Cook, James P Stannard
The purpose of this study was to determine incidence of concurrent peroneal nerve injury and to compare outcomes in patients with and without peroneal nerve injury after surgical treatment for multiligament knee injuries (MLKIs). A retrospective study of 357 MLKIs was conducted. Patients with two or more knee ligaments requiring surgical reconstruction were included. Mean follow-up was 35 months (0-117). Incidence of concurrent peroneal nerve injury was noted and patients with and without nerve injury were evaluated for outcomes...
June 13, 2018: Journal of Knee Surgery
Tsuneari Takahashi, Masashi Kimura, Keiichi Hagiwara, Takashi Ohsawa, Katsushi Takeshita
Several investigators have developed anterior cruciate ligament reconstructions (ACLR) with remnant tissue preservation (RTP) and have reported better clinical outcomes. However, the effects of RTP remain controversial. To date, no reports have compared both clinical and radiological outcomes of anatomic double-bundle ACLR using the hamstring tendon and outside-in technique with/without RTP. This article evaluates the effectiveness of RTP in ACLR on knee stability and graft maturation. In total, 75 patients with unilateral ACL injury who had undergone anatomic double-bundle ACLR using autografted hamstring tendon either with RTP (Group P, n  = 43) or without (Group N, n  = 32) were enrolled...
June 13, 2018: Journal of Knee Surgery
Andrew J Hotchen, Charis Demetriou, Dennis Edwards, Joel T K Melton
The presentation and clinical course of mucoid degeneration of the anterior cruciate ligament (MD-ACL) are poorly documented within the literature. Subsequently, it is under-diagnosed and the optimal management strategy remains ill-defined. Here, we characterize the syndrome associated with MD-ACL and compare the natural clinical course with the outcomes of arthroscopic management. Thirty-one patients with radiological features of MD-ACL over a 2-year period had their clinical notes retrospectively reviewed...
June 13, 2018: Journal of Knee Surgery
Anupam Das, C S Yadav, Shivanand Gamanagatti, R M Pandey, Ravi Mittal
The outcome of single-bundle anterior cruciate ligament (ACL) reconstruction depends largely on the anatomic placement of bone tunnel. The lateral intercondylar ridge (LIR) and bifurcate ridge (BR) are useful bony landmarks for femoral tunnel placement. The purpose of our study was to compare the bony landmarks of ACL footprint on femur by three-dimensional computed tomography (3D CT) scan and arthroscopy in chronic ACL-deficient knees. Fifty patients above 18 years of age who were diagnosed of having ACL tear were selected for the study...
June 13, 2018: Journal of Knee Surgery
Siamak Sabour
No abstract text is available yet for this article.
June 13, 2018: Journal of Knee Surgery
Daniel Berman, Kelly Rogers, Justin Griffin, Kevin Bonner
No abstract text is available yet for this article.
June 5, 2018: Journal of Knee Surgery
Marcello Zappia, Francesco Oliva, Vito Chianca, Francesco Di Pietto, Nicola Maffulli
Rotational stability of the knee involves not only the cruciate ligaments but also another structure named anterolateral ligament (ALL), the function of which is still controversial. This study evaluated the effectiveness of high-resolution ultrasound (US) examination to detect the ALL. We studied 8 cadaveric knees (8 ALLs). On each knee, high-resolution real-time ultrasonography examination was performed by an experienced musculoskeletal radiologist before and after the procedure, with the surgeons blind to the results of the scan both before and after dissection...
May 31, 2018: Journal of Knee Surgery
Mehmet Yucens, Ahmet Nadir Aydemir
Anterior cruciate ligament (ACL) injury is known to be one of the most common knee joint injuries. ACL reconstruction can be similar to the native ACL in respect of graft morphology, tension, position, and orientation. ACL reconstruction can be applied with different surgery techniques, graft and fixation devices, and rehabilitation as ACL reconstruction is just as important as surgery. Although commonly known as a sports injury, ACL injuries are increasingly seen in the general population. The aim of this study was to investigate the trends in ACL injury treatment in the last decade especially the graft choice...
May 31, 2018: Journal of Knee Surgery
David P Trofa, Robert L Parisien, Manish S Noticewala, Peter C Noback, Christopher S Ahmad, Vasilios Moutzouros, Eric C Makhni
The ideal meniscal repair postoperative rehabilitation protocol has yet to be determined. Further, patients are attempting to access health care content online at a precipitously increasing rate given the efficiency of modern search engines. The purpose of this investigation was to assess the quality and variability of meniscal repair rehabilitation protocols published online with the hypothesis that there would be a high degree of variability found across available protocols. To this end, Web-based meniscal repair physical therapy protocols from U...
May 31, 2018: Journal of Knee Surgery
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