Journal of Joint Surgery and Research最新文献

{"title":"What are the most difficult steps in total hip arthroplasty for early-career surgeons and how can future technology help most? A survey of the American Association of Hip and Knee Surgeons Young Arthroplasty Group","authors":"Ken Tashiro ,&nbsp;Yasuhiro Homma ,&nbsp;Jesse Wolfstadt ,&nbsp;Christopher M. Melnic ,&nbsp;Muneaki Ishijima ,&nbsp;Atul F. Kamath","doi":"10.1016/j.jjoisr.2024.09.002","DOIUrl":"10.1016/j.jjoisr.2024.09.002","url":null,"abstract":"<div><h3>Purpose</h3><p>While technology in total hip arthroplasty (THA) is generally developed by experienced surgeons, particular difficulties in surgical steps and technical demands experienced by early-career surgeons remain important. This study investigated the challenges early-career surgeons currently face in THA in order to obtain insights into how they perceive future innovative technologies might reduce the difficulties and complications associated with THA.</p></div><div><h3>Methods</h3><p>Members of the American Association of Hip and Knee Surgeons Young Arthroplasty Group were surveyed. The perceived degree of difficulty with key THA surgical steps and the utility of adjunctive technology were recorded (scale 1–10, from no difficulty/not important to very difficult/very important).</p></div><div><h3>Results</h3><p>The membership response rate was 16.1%. The most common THA approach was the direct anterior approach (DAA) (67.4%). Four of the top five most difficult surgical steps were associated with cup preparation/placement. Fluoroscopy was the most used technology (56.7%), followed by no technology use (21.2%) and robot arm assistance (12.1%). With respect to the importance of technology, accurate cup placement ranked first. Dislocation and stem subsidence were the top two complications for which technological advances were thought to be most beneficial. Subgroup analysis based on surgical approach suggested that DAA users had significantly more difficulty with direction of stem rasping than non-DAA users (<em>p</em> ​&lt; ​0.0001).</p></div><div><h3>Conclusion</h3><p>This is the first survey to reveal data about perceived difficulties in THA surgical steps from the perspective of early-career arthroplasty surgeons and the role of technology in mitigating these complications. Future technological developments may take these needs of early-career surgeons into account.</p></div>","PeriodicalId":100795,"journal":{"name":"Journal of Joint Surgery and Research","volume":"2 4","pages":"Pages 157-162"},"PeriodicalIF":0.0,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949705124000239/pdfft?md5=ec3389e929d99dfbe76509b80d584033&pid=1-s2.0-S2949705124000239-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142241530","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Plain radiograph evaluation of concurrent filling of tibial peg holes with bone in cementless total knee arthroplasty","authors":"Kazue Hayakawa,&nbsp;Hideki Date,&nbsp;Sho Nojiri,&nbsp;Yosuke Kaneko,&nbsp;Kohei Shibata,&nbsp;Nobuyuki Fujita","doi":"10.1016/j.jjoisr.2024.09.001","DOIUrl":"10.1016/j.jjoisr.2024.09.001","url":null,"abstract":"<div><h3>Purpose</h3><p>This study aimed to evaluate the effectiveness of a novel technique for securing the tibial component in cementless total knee arthroplasty (TKA) by utilizing resected cancellous bone to fill the peg holes. It was hypothesized that this method would reduce the incidence of radiolucent lines (RLLs) on plain radiographs. To test this hypothesis, a retrospective comparison of plain radiographs from patients who underwent the bone-filling technique (bone filling group) versus those who did not receive this treatment (conventional group) was conducted.</p></div><div><h3>Methods</h3><p>Participants were 151 patients (213 joints) who underwent TKA with the NexGen trabecular metal (TM) modular tibia (Zimmer Biomet) from 2011 to 2016 [bone filling group, 54 patients (69 joints); conventional group, 100 patients (144 joints); 3 patients had 1 joint in each group]. Clinical evaluations, plain radiographs, and operative time were compared between groups.</p></div><div><h3>Results</h3><p>The mean follow-up period was 5 years and 5 months. Knee Society Scores and Knee Society Functional Scores did not differ significantly between groups; however, the bone filling group had a significantly lower incidence of RLLs (<em>p</em> ​&lt; ​0.05) and significantly more longitudinal trabecular thickening below the pegs (<em>p</em> ​&lt; ​0.05). Multiple logistic regression analysis with the presence/absence of RLLs as the dependent variable revealed a significant effect of bone filling (odds ratio ​= ​2.820, 95% confidence interval 1.033–7.700; <em>p</em> ​&lt; ​0.05).</p></div><div><h3>Conclusion</h3><p>Concurrent peg hole bone filling significantly reduces the incidence of RLLs and significantly increases longitudinal trabecular thickening below the pegs during TKA with the NexGen TM modular tibial component.</p></div>","PeriodicalId":100795,"journal":{"name":"Journal of Joint Surgery and Research","volume":"2 4","pages":"Pages 151-156"},"PeriodicalIF":0.0,"publicationDate":"2024-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949705124000240/pdfft?md5=16cac605b90a9f1a297352fca61334b7&pid=1-s2.0-S2949705124000240-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142232759","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical intervention should be considered for sciatic nerve palsy following total hip arthroplasty using a posterolateral approach","authors":"Kazunari Ishida ,&nbsp;Nao Shibanuma ,&nbsp;Tomoyuki Matsumoto ,&nbsp;Yuichi Kuroda ,&nbsp;Naoki Nakano ,&nbsp;Masahiro Kurosaka ,&nbsp;Ryosuke Kuroda ,&nbsp;Shinya Hayashi","doi":"10.1016/j.jjoisr.2024.07.002","DOIUrl":"10.1016/j.jjoisr.2024.07.002","url":null,"abstract":"<div><h3>Purpose</h3><p>This single-center study aimed to determine whether surgical neurolysis influences muscle power recovery in sciatic nerve palsy following total hip arthroplasty (THA).</p></div><div><h3>Methods</h3><p>Among 1912 THAs performed between 2007 and 2019, a total of 1575 THAs using a posterolateral approach (primary THA, 1483 cases; revision THA, 92 cases) were retrospectively reviewed. Subjects who showed sciatic nerve palsy with motor disturbance were extracted. Demographic data, muscle power, and sensory disturbance at the onset of palsy and at final follow-up were examined. Subjects were divided into two groups (conservative treatment group and surgical treatment group) and clinical outcomes were compared between the two groups. Positive recovery was defined as muscle power greater than Manual Muscle Test grade 3.</p></div><div><h3>Results</h3><p>Thirteen cases (0.8%), including eight in the conservative treatment group and five in the surgical treatment group, showed post-operative sciatic nerve palsy. Four cases (80.0%) in the surgical treatment group achieved full muscle power recovery. All three subjects who received surgical treatment on the day of onset of palsy achieved full muscle power and sensory recovery. More patients recovered muscle power in the surgical treatment group than in the conservative treatment group.</p></div><div><h3>Conclusion</h3><p>Muscle power recovery was found in 80.0% of cases in the surgical treatment group and 12.5% of the conservative treatment group. All cases that received surgical intervention on the onset day of palsy achieved full muscle power and sensory recovery, whereas no cases achieved full muscle power recovery in the conservative treatment group. Immediate surgical intervention should be considered for sciatic nerve palsy following THA using a posterolateral approach.</p></div>","PeriodicalId":100795,"journal":{"name":"Journal of Joint Surgery and Research","volume":"2 3","pages":"Pages 146-150"},"PeriodicalIF":0.0,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949705124000215/pdfft?md5=08c81a049526a2576c2f4645c9801d56&pid=1-s2.0-S2949705124000215-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141963281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical outcomes of total knee arthroplasty for valgus knees caused by hip diseases: Coxitis knees and long leg arthropathies","authors":"Kensuke Wada,&nbsp;Yuichi Kuroda,&nbsp;Naoki Nakano,&nbsp;Masanori Tsubosaka,&nbsp;Tomoyuki Kamenaga,&nbsp;Shinya Hayashi,&nbsp;Ryosuke Kuroda,&nbsp;Tomoyuki Matsumoto","doi":"10.1016/j.jjoisr.2024.06.007","DOIUrl":"10.1016/j.jjoisr.2024.06.007","url":null,"abstract":"<div><h3>Purpose</h3><p>Coxitis knees and long leg arthropathies are similar pathological conditions; however, their clinical outcomes after total knee arthroplasty (TKA) have rarely been reported. The present study aimed to investigate clinical outcomes after TKA for these knee conditions, namely valgus knees caused by hip disease.</p></div><div><h3>Methods</h3><p>This retrospective cohort study included 19 TKAs performed on valgus knees caused by hip osteoarthritis (OA). Two years post-operatively, clinical outcomes, including range of motion and 2011 Knee Society Score (2011KSS), were assessed and were compared with pre-operative values. Pre-operative knee phenotypes, including lateral distal femoral angle and medial proximal tibial angle, were assessed, and their associations with clinical outcomes were investigated.</p></div><div><h3>Results</h3><p>All subscales of the 2011KSS improved significantly post-operatively (<em>P</em> ​&lt; ​0.05). There was also a significant improvement in extension post-operatively (<em>P</em> ​&lt; ​0.05). The mean femorotibial angle improved post-operatively from 157.7° to 175.2°(<em>P</em> ​&lt; ​0.05). There were five coxitis knee patients who had knee OA on the ipsilateral side of the hip, and five long leg arthropathy patients who had knee OA on the contralateral side of the hip.</p></div><div><h3>Conclusions</h3><p>Satisfactory clinical outcomes were observed after TKA for valgus knees caused by hip OA, such as coxitis knees and long leg arthropathies.</p></div>","PeriodicalId":100795,"journal":{"name":"Journal of Joint Surgery and Research","volume":"2 3","pages":"Pages 141-145"},"PeriodicalIF":0.0,"publicationDate":"2024-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949705124000197/pdfft?md5=dea64b053b2831ca78e6a462fd709410&pid=1-s2.0-S2949705124000197-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141731747","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of intravenous and periarticular administration of dexamethasone in total knee arthroplasty","authors":"Hibiki Kakiage ,&nbsp;Kazuhisa Hatayama ,&nbsp;Masanori Terauchi ,&nbsp;Atsufumi Oshima ,&nbsp;Shogo Hashimoto ,&nbsp;Hirotaka Chikuda","doi":"10.1016/j.jjoisr.2024.07.001","DOIUrl":"10.1016/j.jjoisr.2024.07.001","url":null,"abstract":"<div><h3>Purpose</h3><p>Corticosteroids are widely used in total knee arthroplasty (TKA) to ameliorate post-operative pain. This study compared the effects of intravenous administration (IVA) and periarticular injection (PAI) of dexamethasone on pain, nausea, and blood glucose levels following TKA.</p></div><div><h3>Methods</h3><p>An institutional database was used to retrospectively examine two cohorts of patients who had undergone unilateral TKA from August 2018 to September 2020. The IVA group (<em>n</em> ​= ​50) received 10 ​mg dexamethasone 1 ​h before surgery and 24 ​h after surgery. The PAI group (<em>n</em> ​= ​50) received 10 ​mg dexamethasone during surgery. Pain scores at rest and during walking as well as nausea scores were recorded using the 0–10 numerical rating scale after surgery. Fasting blood glucose (FBG) levels were measured post-operatively.</p></div><div><h3>Results</h3><p>A total of 100 patients were enrolled (mean age, 71 years; 86% female). The rest pain score 24 ​h post-operatively was significantly lower in the PAI group than in the IVA group (3.3 <em>vs.</em> 4.3; absolute difference 1.0, 95% confidence interval, 0.4–1.3; <em>P</em> ​= ​0.007). The nausea score did not differ markedly between groups. FBG was significantly higher in the PAI group than in the IVA group in the morning of post-operative Day 1.</p></div><div><h3>Conclusion</h3><p>PAI with dexamethasone was found to control pain more effectively at 24 ​h than IVA. FBG on the morning of post-operative Day 1 was significantly higher in the PAI group. Level of evidence, III; retrospective cohort.</p></div>","PeriodicalId":100795,"journal":{"name":"Journal of Joint Surgery and Research","volume":"2 3","pages":"Pages 136-140"},"PeriodicalIF":0.0,"publicationDate":"2024-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949705124000203/pdfft?md5=f9c27a1c504f47639d54811f066de18f&pid=1-s2.0-S2949705124000203-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141731746","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship between hip contact force during gait and patient-reported outcome measures 6 months after total hip arthroplasty","authors":"Yasushi Kurihara ,&nbsp;Hironori Ohsugi ,&nbsp;Tomonari Tosaka ,&nbsp;Tadamitsu Matsuda ,&nbsp;Yoshikazu Tsuneizumi ,&nbsp;Tadashi Tsukeoka","doi":"10.1016/j.jjoisr.2024.06.005","DOIUrl":"https://doi.org/10.1016/j.jjoisr.2024.06.005","url":null,"abstract":"<div><h3>Purpose</h3><p>Evaluating the hip contact force (HCF) during gait is important for assessing treatment outcomes after total hip arthroplasty (THA). This study investigated the relationship between patient-reported outcome measures (PROMs) and HCF during gait after THA as well as gait biomechanical factors affecting HCF during gait in relation to PROMs.</p></div><div><h3>Methods</h3><p>In total, 29 female patients who underwent THA with a 6-month follow-up were included in this study. Musculoskeletal model analysis was performed to obtain the first and second peak values of the HCF during gait and the minimum value between both peaks. PROMs were evaluated using the Japanese Orthopaedic Association Hip Disease Evaluation Questionnaire (JHEQ). The relationship between JHEQ and selected HCFs and between the HCF and gait biomechanical factors was examined.</p></div><div><h3>Results</h3><p>The second peak value of HCF was positively related to the total JHEQ, movement, and mental health scores (<em>r</em> ​= ​−0.551, 0.410, and 0.495, respectively). A positive relationship was found between the second peak value of the HCF and hip flexion–extension range of motion (<em>r</em> ​= ​0.518), maximum hip abduction moment (<em>r</em> ​= ​0.432), and maximum knee extension moment (<em>r</em> ​= ​0.417). A negative relationship was found between the second peak value of the HCF and the maximum knee abduction moment (<em>r</em> ​= ​−0.458).</p></div><div><h3>Conclusions</h3><p>The second peak value of HCF during gait after THA was related to PROMs. The second peak value was related to the hip flexion–extension range of motion, maximum hip abduction moment, and maximum knee extension and abduction moment.</p></div>","PeriodicalId":100795,"journal":{"name":"Journal of Joint Surgery and Research","volume":"2 3","pages":"Pages 129-135"},"PeriodicalIF":0.0,"publicationDate":"2024-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949705124000173/pdfft?md5=e5b3efb018f0b6568f444045e5775b0e&pid=1-s2.0-S2949705124000173-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141596529","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comorbid frailty and sarcopenia in older patients after total hip arthroplasty: An observational study","authors":"Takashi Ikeda ,&nbsp;Kazunari Ninomiya ,&nbsp;Koji Suzuki ,&nbsp;Kazuo Hirakawa","doi":"10.1016/j.jjoisr.2024.06.004","DOIUrl":"https://doi.org/10.1016/j.jjoisr.2024.06.004","url":null,"abstract":"<div><h3>Purpose</h3><p>Frailty and sarcopenia may progressively worsen physical function, and studies have noted the frequent presence of sarcopenia in patients who undergo total hip arthroplasty (THA). This study aimed to examine the prevalence of comorbid frailty and sarcopenia in older patients undergoing THA and to determine the impact of these conditions on lower limb strength and hip function.</p></div><div><h3>Methods</h3><p>Patients aged ≥65 years who had undergone THA at least 1 year previously were divided into five groups according to the presence and severity of frailty and sarcopenia. Lower limb strength [hip abductor (HA) and knee extensor (KE)], balance, and hip function were compared.</p></div><div><h3>Results</h3><p>Sarcopenia and frailty affected lower limb muscle strength and hip function in a staircase-like manner, with mean ​± ​standard deviation values for the five groups as follows: HA muscle strength (in Nm/body weight), robust 0.80 ​± ​0.23, pre-frail ​+ ​non-sarcopenia 0.69 ​± ​0.17, pre-frail ​+ ​sarcopenia 0.58 ​± ​0.20, frail ​+ ​non-sarcopenia 0.54 ​± ​0.16, frail ​+ ​sarcopenia 0.50 ​± ​0.16; KE muscle strength (in kgf/body weight), robust 1.17 ​± ​0.23, pre-frail ​+ ​non-sarcopenia 1.03 ​± ​0.32, pre-frail ​+ ​sarcopenia 0.90 ​± ​0.31, frail ​+ ​non-sarcopenia 0.84 ​± ​0.27, frail ​+ ​sarcopenia 0.74 ​± ​0.21; and Harris Hip Score, robust 96.8 ​± ​4.6, pre-frail ​+ ​non-sarcopenia 94.3 ​± ​7.9, pre-frail ​+ ​sarcopenia 88.6 ​± ​9.6, frail ​+ ​non-sarcopenia 87.5 ​± ​10.3, frail ​+ ​sarcopenia 83.5 ​± ​8.6.</p></div><div><h3>Conclusion</h3><p>Progression of sarcopenia and frailty affects lower limb muscle strength and physical function in a staircase-like fashion, suggesting the need to assess the cumulative effects of the two. Among this population, rather than interventions to improve muscle strength and balance in specific areas, interventions to maintain a comprehensive level of physical fitness and muscle mass (including nutrition and lifestyle changes) may be necessary.</p></div>","PeriodicalId":100795,"journal":{"name":"Journal of Joint Surgery and Research","volume":"2 3","pages":"Pages 123-128"},"PeriodicalIF":0.0,"publicationDate":"2024-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949705124000161/pdfft?md5=d6caafb120ee35126f7cd6387954bd1a&pid=1-s2.0-S2949705124000161-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141540017","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical course and risk factors for post-operative onset lateral hinge fracture following medial opening-wedge distal tibial tuberosity osteotomy","authors":"Hiroyasu Ogawa ,&nbsp;Yutaka Nakamura ,&nbsp;Masaya Sengoku ,&nbsp;Tetsuya Shimokawa ,&nbsp;Kazuichiro Ohnishi ,&nbsp;Haruhiko Akiyama","doi":"10.1016/j.jjoisr.2024.06.006","DOIUrl":"https://doi.org/10.1016/j.jjoisr.2024.06.006","url":null,"abstract":"<div><h3>Purpose</h3><p>This study aimed to investigate the clinical outcomes of and risk factors for post-operative onset lateral hinge fracture (LHF) following medial opening-wedge distal tibial tuberosity osteotomy (DTO).</p></div><div><h3>Methods</h3><p>A total of 68 patients who underwent DTO were stratified into non-LHF and post-operative onset LHF groups. The groups were compared in terms of radiographic parameters, including the hip–knee–ankle (HKA) angle, and were clinically evaluated using the Knee Society Score (KSS) and 2011KSS. Multiple logistic regression analysis was performed to identify risk factors for post-operative onset LHF.</p></div><div><h3>Results</h3><p>The non-LHF and post-operative onset LHF groups included 53 and 15 patients, respectively. The post-operative HKA angle was significantly smaller (valgus) in the post-operative onset LHF group than in the non-LHF group (<em>P</em> ​= ​0.005). Knee and function scores were significantly lower in the post-operative onset LHF group than the non-LHF group at 6 months (<em>P</em> ​= ​0.002 for each comparison). All 2011KSS subscores were significantly lower in the post-operative onset LHF group than the non-LHF group at 6 months (<em>P</em> ​= ​0.001, 0.010, 0.013, and 0.013, respectively). Post-operative HKA angle was a risk factor for post-operative onset LHF (odds ratio ​= ​0.589, 95% confidence interval 0.392–0.886; <em>P</em> ​= ​0.011).</p></div><div><h3>Conclusions</h3><p>Post-operative weight bearing may be delayed to prevent post-operative onset LHF, especially in patients with post-operative large valgus knee alignment.</p></div>","PeriodicalId":100795,"journal":{"name":"Journal of Joint Surgery and Research","volume":"2 3","pages":"Pages 117-122"},"PeriodicalIF":0.0,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949705124000185/pdfft?md5=d82304c216faad030de78a274f01bd86&pid=1-s2.0-S2949705124000185-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141540016","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic power of criteria for symptomatic early knee osteoarthritis from a 2-year longitudinal observation of the Iwaki cohort study","authors":"Eiji Sasaki ,&nbsp;Daisuke Chiba ,&nbsp;Seiya Ota ,&nbsp;Yuka Kimura ,&nbsp;Gentaro Kumagai ,&nbsp;Eiichi Tsuda ,&nbsp;Yoshiko Takahashi ,&nbsp;Takuro Iwane ,&nbsp;Yasuyuki Ishibashi","doi":"10.1016/j.jjoisr.2024.06.001","DOIUrl":"https://doi.org/10.1016/j.jjoisr.2024.06.001","url":null,"abstract":"<div><h3>Purpose</h3><p>This study aimed to investigate whether symptomatic early knee osteoarthritis (EKOA) effectively predicts the incidence of definitive knee osteoarthritis (DKOA) in the general Japanese population.</p></div><div><h3>Methods</h3><p>A total of 133 women from the Japanese Iwaki cohort study were enrolled and followed-up over 2 years in order to calculate the rate of progression of EKOA to DKOA. Weight-bearing anteroposterior bilateral knee radiographs and magnetic resonance imaging (MRI) were conducted at baseline and follow-up. Radiographs were classified according to the Kellgren–Lawrence grade. The presence of cartilage lesion, bone marrow lesions, attrition, cysts, osteophytes, and meniscal lesions was evaluated according to the Whole-Organ Magnetic Resonance Imaging Score (WORMS). Logistic regression analyses were performed to determine the predictive power of EKOA.</p></div><div><h3>Results</h3><p>Of 25 women with EKOA, 15 (60%) progressed to DKOA over 2 years, showing a relative risk (RR) of 1.44 compared with the non-osteoarthritis (non-OA) group (<em>P</em> ​= ​0.120). Logistic regression analysis showed associations of EKOA (<em>P</em> ​= ​0.048) and high body mass index (<em>P</em> ​&lt; ​0.001) with progression to DKOA. Combined EKOA and meniscal lesions increased the RR for osteoarthritis incidence to 2.32 (<em>P</em> ​= ​0.004) compared with the non-OA group. Also, meniscus and bone marrow lesion scores on MRI of the EKOA group maintained high scores over 2 years.</p></div><div><h3>Conclusions</h3><p>The prognostic power of EKOA criteria was confirmed with a RR of 1.44. The combination of symptomatic EKOA criteria and MRI-detected meniscal lesions was a valuable predictor of progression to DKOA over 2 years in women without radiographic abnormalities.</p></div>","PeriodicalId":100795,"journal":{"name":"Journal of Joint Surgery and Research","volume":"2 3","pages":"Pages 111-116"},"PeriodicalIF":0.0,"publicationDate":"2024-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949705124000136/pdfft?md5=d2d3103c771c3c030ce30917fe9999cf&pid=1-s2.0-S2949705124000136-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141444355","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship between intra-operative joint gap and knee flexion angle after posterior-stabilized total knee arthroplasty","authors":"Sachiyuki Tsukada,&nbsp;Hiroyuki Ogawa,&nbsp;Masayoshi Saito,&nbsp;Takuya Kusakabe,&nbsp;Masahiro Nishino,&nbsp;Naoyuki Hirasawa","doi":"10.1016/j.jjoisr.2024.06.003","DOIUrl":"https://doi.org/10.1016/j.jjoisr.2024.06.003","url":null,"abstract":"<div><h3>Purpose</h3><p>Conflicting evidence exists about the appropriate intra-operative soft tissue balance in posterior-stabilized (PS) total knee arthroplasty (TKA). The purpose of this prospective observational study was to investigate the impact of intra-operative soft tissue balance on post-operative knee flexion angle.</p></div><div><h3>Methods</h3><p>A single surgeon performed 164 TKAs using a single brand of PS prosthesis via the subvastus approach without using a pneumatic tourniquet. Intra-operative soft tissue balance was quantified as the gaps between the femoral component and tibial osteotomy surface with the knee flexed at 0°, 30°, 90°, and 120° with the patellofemoral joint reduced. Multiple regression analyses were employed to identify independent predictors of knee flexion angle 1 year after TKA.</p></div><div><h3>Result</h3><p>The pre-operative knee flexion angle and the gap difference between 120° and 0° flexion were positively correlated with knee flexion angle 1 year after TKA [β ​= ​0.37, 95% confidence interval (CI) 0.26–0.48, <em>P</em> ​&lt; ​0.001; and β ​= ​1.09, 95% CI 0.04–2.14, <em>P</em> ​= ​0.042, respectively]. There was no correlation with knee flexion angle 1 year after TKA for the gap difference between 30° flexion and 0° flexion and between 90° flexion and 0° flexion.</p></div><div><h3>Conclusions</h3><p>Intra-operative soft tissue balance at 120° flexion may affect the post-operative knee flexion angle in PS-TKA.</p></div>","PeriodicalId":100795,"journal":{"name":"Journal of Joint Surgery and Research","volume":"2 3","pages":"Pages 106-110"},"PeriodicalIF":0.0,"publicationDate":"2024-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S294970512400015X/pdfft?md5=5afcdc345e59204c6de612f700599430&pid=1-s2.0-S294970512400015X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141444354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}