Journal of Joint Surgery and Research最新文献

{"title":"Smartphone-based navigation system enables low-volume surgeons to perform accurate acetabular cup placement: A single-center retrospective study","authors":"Chihiro Hiraoka ,&nbsp;Tatsuhiko Kutsuna ,&nbsp;Tomofumi Kinoshita ,&nbsp;Ryosuke Nishimura ,&nbsp;Satoru Otowa ,&nbsp;Yuji Mandai ,&nbsp;Masaki Takao","doi":"10.1016/j.jjoisr.2023.11.001","DOIUrl":"10.1016/j.jjoisr.2023.11.001","url":null,"abstract":"<div><h3>Purpose</h3><p>Using navigation systems during total hip arthroplasty (THA) has been reported to be useful for preventing acetabular cup malpositioning. However, only few studies have reported on the application of navigation systems to THA at low-volume hospitals owing to cost and usage complexity. Therefore, the aim of this study was to determine whether smartphone-based portable navigation using augmented reality technology would enable low-volume surgeons to perform acetabular cup placement more accurately than with the conventional manual technique.</p></div><div><h3>Methods</h3><p>We retrospectively compared acetabular cup placement between the navigation (n ​= ​28) and conventional (n ​= ​24) groups. The acetabular cup inclination and anteversion angles were measured using computed tomography (CT)-based planning software. Furthermore, the absolute difference between the postoperative and target angles was compared between the groups.</p></div><div><h3>Results</h3><p>The absolute difference between the postoperative and target angles of cup inclination was 2.6° ​± ​2.3° in the navigation group and 5.6° ​± ​5.2° in the conventional group (<em>p</em> ​&lt; ​0.01). Additionally, the cup anteversion was 3.2° ​± ​3.0° in the navigation group and 9.4° ​± ​7.1° in the conventional group (<em>p</em> ​&lt; ​0.01).</p></div><div><h3>Conclusions</h3><p>Using a smartphone-based portable navigation system could allow for appropriate cup placement even by low-volume surgeons.</p></div>","PeriodicalId":100795,"journal":{"name":"Journal of Joint Surgery and Research","volume":"2 ","pages":"Pages 241-245"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949705123000373/pdfft?md5=6bb9ff112517c2cdd8531f7a7ad92c05&pid=1-s2.0-S2949705123000373-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138395804","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":"Favorable clinical outcomes of simultaneous ACL reconstruction and UKA or HTO: A systematic surveillance","authors":"Junya Itou ,&nbsp;Masafumi Itoh ,&nbsp;Umito Kuwashima ,&nbsp;Shinya Imai ,&nbsp;Ken Okazaki ,&nbsp;Kiyotaka Iwasaki","doi":"10.1016/j.jjoisr.2023.09.001","DOIUrl":"10.1016/j.jjoisr.2023.09.001","url":null,"abstract":"<div><h3>Purpose</h3><p>Outcomes after combination of anterior cruciate ligament (ACL) reconstruction (ACLR) with unicompartmental knee arthroplasty (UKA) or high tibial osteotomy (HTO) have been widely reported, but previous systematic reviews have included articles published before 2000 and do not necessarily reflect recent trends. We conducted a thorough investigation to address (1): What are the recent surgical trends in simultaneous ACLR and UKA or HTO? and (2) What are the issues in these surgeries? based on a comprehensive systematic analysis.</p></div><div><h3>Methods</h3><p>A systematic surveillance was performed in accordance with the PRISMA guideline. The inclusion criteria were as follows: simultaneous ACLR and UKA or HTO for medial osteoarthritis (OA) with ACL deficiency; clinical outcomes and complications recorded; publication date after 2000.</p><p>A total of 1466 potentially relevant articles were identified; after exclusions, 31 articles that included 744 knees were analyzed. Fourteen articles included 330 knees underwent simultaneous ACLR and UKA (UKA group) and 17 articles included 414 knees underwent simultaneous ACLR and HTO (HTO group).</p></div><div><h3>Results</h3><p>Overall, complications were found in 14 knees (4.2%) in the UKA group and 47 knees (11.3%) in the HTO group. Re-rupture of the ACL was observed in only the HTO group (6 knees: 1.4%). Revision to TKA occurred in 8 knees (2.4%) in the UKA group and 1 knee (0.2%) in the HTO group. No standardized outcome measures for clinical assessment were used for all studies.</p></div><div><h3>Conclusion</h3><p>The systematic surveillance of studies published since 2000 on the outcomes and complications of simultaneous ACLR and UKA or HTO for medial OA with ACL deficiency indicates an increasing number of reports on simultaneous ACLR and HTO or UKA in recent years. Favorable clinical results were achieved in both treatment groups.</p></div>","PeriodicalId":100795,"journal":{"name":"Journal of Joint Surgery and Research","volume":"2 ","pages":"Pages 201-208"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949705123000294/pdfft?md5=1a2bda52d20afb2fe66143967c8f58b8&pid=1-s2.0-S2949705123000294-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50194758","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":"Alignment techniques in total knee arthroplasty","authors":"Yukihide Minoda","doi":"10.1016/j.jjoisr.2023.02.003","DOIUrl":"10.1016/j.jjoisr.2023.02.003","url":null,"abstract":"<div><h3>Purpose</h3><p>Total knee arthroplasty (TKA) reduces knee pain to improve knee function for painful knee osteoarthritis and provides excellent long-term survivorship. However, approximately 20% of patients remain dissatisfied. To improve patient satisfaction, several modifications of knee alignment have recently been introduced. The aim of this paper is to review various alignment techniques.</p></div><div><h3>Methods</h3><p>Principles, surgical techniques, and clinical results of various alignment techniques for TKA were searched in the PubMed database.</p></div><div><h3>Results</h3><p>Mechanical alignment aims to cut perpendicular to the mechanical axes of the femur and tibia in the coronal plane. The threshold of the deviation from the mechanical axis for long-term survivorship is still unknown. Anatomical alignment aims at neutral alignment but 2–3 varus joint line relative to the mechanical axis. Although catastrophic polyethylene wear was reported in the 1990s, excellent mid-term clinical results were recently reported using surgical robots. Kinematic alignment aims to restore the pre-arthritic native limb alignment and avoid soft tissue release. To avoid excessive alignment deviation, some modification such as inverse kinematic, restricted kinematic, and modified kinematic alignments are also introduced. Equal or better clinical scores have been reported in short term. Functional alignment TKA aims to restore pre-arthritic alignment and achieve balanced soft tissue tension by adjusting bone resections using robotic-assisted technology.</p></div><div><h3>Conclusion</h3><p>Wide range of clinical results exist for new alignment techniques in the short term. The safe range of alignment for long-term survivorship remains unknown. Further high-quality studies should be performed to warrant the widespread use of new alignment techniques.</p></div>","PeriodicalId":100795,"journal":{"name":"Journal of Joint Surgery and Research","volume":"2 ","pages":"Pages 108-116"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949705123000099/pdfft?md5=184c9d3a79292df92820707393ad5129&pid=1-s2.0-S2949705123000099-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50194807","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":"Knee joint line orientation after total knee arthroplasty is affected by the mechanical axis inclination of the lower limb according to foot position","authors":"Shuji Toyono ,&nbsp;Akemi Suzuki ,&nbsp;Taku Nakajima ,&nbsp;Yoshihiro Wanezaki ,&nbsp;Masashi Aso ,&nbsp;Takao Yamamoto ,&nbsp;Takashi Ito ,&nbsp;Shigenobu Fukushima ,&nbsp;Michiaki Takagi","doi":"10.1016/j.jjoisr.2023.05.001","DOIUrl":"10.1016/j.jjoisr.2023.05.001","url":null,"abstract":"<div><h3>Purpose</h3><p>Knee joint line orientation (KJLO), an essential component of knee kinematics, has recently been of interest as a clinical parameter, but the factors that determine this are unknown. This study aims to clarify the effect of mechanical axis inclination of the lower limb on KJLO after total knee arthroplasty.</p></div><div><h3>Methods</h3><p>The study included 95 knees of 95 patients who underwent kinematically aligned total knee arthroplasty in which two postoperative whole-leg standing radiographs (open and closed stance) were evaluated. We measured hip-knee-ankle angle, mechanical lateral distal femoral angle, medial proximal tibial angle, KJLO, joint line convergence angle, ankle joint line orientation and the inclination angle of lower limb mechanical axis (θ); the amount of change in each measurement was defined as delta (Δ). The correlation between ΔKJLO and each measured value was analysed, and a multiple linear regression analysis was performed to identify significant factors related to ΔKJLO.</p></div><div><h3>Results</h3><p>The open and closed stance radiographs had differences in KJLO (3.4 ​± ​2.2° vs. −0.2 ​± ​2.3°,<em>p ​&lt;</em> ​0.001), ankle joint line orientation (−3.3 ​± ​4.4° vs. −6.8 ​± ​4.1°, <em>p</em> ​&lt; ​0.001) and θ (−0.3 ​± ​1.6 vs. 3.3 ​± ​1.5, <em>p ​&lt;</em> ​0.001). We found that Δθ determined ΔKJLO, with a strong negative correlation (r ​= ​−0.847, <em>p</em> ​&lt; ​0.001). According to the ΔKJLO equation, ΔKJLO (°) ​= ​0.361 ​− ​0.898 ​× ​θ (°), KJLO changed by 0.9° per 1° of θ.</p></div><div><h3>Conclusion</h3><p>The KJLO after total knee arthroplasty is affected by the mechanical axis inclination of the lower limb; KJLO changed by 0.9° per 1° of θ.</p></div>","PeriodicalId":100795,"journal":{"name":"Journal of Joint Surgery and Research","volume":"2 ","pages":"Pages 123-127"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949705123000154/pdfft?md5=fe86285f3f17c9db84e843d5c17d3563&pid=1-s2.0-S2949705123000154-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50194874","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":"Meniscus repair and centralization: Preserving meniscus function","authors":"Nobutake Ozeki ,&nbsp;Tomomasa Nakamura ,&nbsp;Yusuke Nakagawa ,&nbsp;Ichiro Sekiya ,&nbsp;Hideyuki Koga","doi":"10.1016/j.jjoisr.2023.01.001","DOIUrl":"10.1016/j.jjoisr.2023.01.001","url":null,"abstract":"<div><h3>Purpose</h3><p>Meniscus injury and meniscus extrusion cause meniscus dysfunction, which then leads to the initiation and progression of knee osteoarthritis. Meniscus preservation surgery therefore plays an important role in preventing long-term cartilage degeneration. The purpose of this paper was to review the current information about meniscus preservation surgeries, such as meniscal repair and centralization.</p></div><div><h3>Methods</h3><p>We reviewed recent articles related to meniscus preservation surgery. We compiled sections for some special meniscus pathologies, including ramp lesion, discoid lateral meniscus, degenerative meniscus tear, posterior root tear, and meniscus extrusion.</p></div><div><h3>Results</h3><p>Reoperation rates are higher after meniscal repair compared with arthroscopic partial meniscectomy; however, long-term follow-up studies have demonstrated better clinical outcomes and less severe degenerative changes for meniscal repair than for partial meniscectomy. Therefore, meniscal repair should be considered the first option for any meniscus injury when surgical intervention is necessary. Posterior root tears of the meniscus substantially affect meniscal hoop function and accelerate cartilage degeneration and accompanying meniscus extrusion. Therefore, surgical repair should be considered as early as possible. A centralization procedure has been developed to reduce meniscus extrusion and improve meniscus hoop function. Long-term follow-up should also be considered essential for the prevention of osteoarthritis.</p></div><div><h3>Conclusions</h3><p>Meniscus preservation surgery provides satisfactory clinical outcomes at short- and mid-term follow-up. Further understanding of meniscus pathology and continued development of surgical techniques will improve the outcomes of meniscus preservation surgery. The long-term efficacy of these procedures should also be confirmed to validate this treatment strategy for meniscus dysfunction.</p></div>","PeriodicalId":100795,"journal":{"name":"Journal of Joint Surgery and Research","volume":"2 ","pages":"Pages 46-55"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949705123000014/pdfft?md5=10807b2af0342c833696735568b98bc6&pid=1-s2.0-S2949705123000014-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50194909","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":"Tibial rotational realignment has no noticed negative effect on the patellar cartilage 1-year after open-wedge high tibial osteotomy","authors":"Kazuha Kizaki ,&nbsp;Sachiyuki Tsukada ,&nbsp;Takashi Takemae ,&nbsp;Masunao Miyao ,&nbsp;Motohiro Wakui","doi":"10.1016/j.jjoisr.2023.07.002","DOIUrl":"10.1016/j.jjoisr.2023.07.002","url":null,"abstract":"<div><h3>Purpose</h3><p>Proximal tibial plateau/distal tibial rotational realignment, which is defined as tibial rotational realignment (TRR), is uncertain in open-wedge high tibial osteotomy (OWHTO). This study descriptively analysed TRR outliers in OWHTO, and also examined influence of TRR on the patellar cartilage at a 1-year postoperative examination.</p></div><div><h3>Methods</h3><p>In total, 206 consecutive cases with computer-navigated OWHTO were reviewed. Patellar cartilage aggravation was evaluated in reference to the International Cartilage Repair Society grade (ICRS) at a 1-year postoperative arthroscopic view. Also, the lateral patella tilt correction and the Iwano classification deterioration grades were examined using axial radiographic views at a 1-year postoperative follow-up visit.</p></div><div><h3>Results</h3><p>The TRR ranged from −12° (the distal tibia was externally rotated based on the proximal tibia) to 13° (internal rotation (IR): the distal tibia was internally rotated based on the proximal tibia) with mean 1.9° IR and standard deviation 5.4°. The inter-quantile range (IQR) was 8°, suggesting that there was no outlier in this cohort, (outliers were defined as either more than Q3+1.5IQR (upper limit: 18°), or Q1-1.5IQR (lower limit: −14°)). In univariate regression models, the TRR did not exhibit any significant influence to the patellar cartilage damage (odds ratio (OR) 1.047, 95% confidence interval (95%CI) 0.976–1.122), the patella tilt correction (OR 1.010, 95%CI 0.953–1.071), or the Iwano classification degradation scale (OR 1.041, 95%CI 0.971–1.116).</p></div><div><h3>Conclusion</h3><p>We found no outlier in the TRR with OWHTO, and an insignificant negative impact of the TRR with OWHTO on the patellar cartilage in the 1-year follow-up examinations.</p></div>","PeriodicalId":100795,"journal":{"name":"Journal of Joint Surgery and Research","volume":"2 ","pages":"Pages 145-151"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S294970512300021X/pdfft?md5=b7e20fcba164556f8d7d162d3322998c&pid=1-s2.0-S294970512300021X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50195371","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":"Effects of anterior capsule repair during total hip arthroplasty using the anterolateral approach in the supine position","authors":"Sei Yano ,&nbsp;Shigeo Hagiwara ,&nbsp;Satoshi Iida ,&nbsp;Junichi Nakamura ,&nbsp;Yuya Kawarai ,&nbsp;Seiji Ohtori","doi":"10.1016/j.jjoisr.2023.07.004","DOIUrl":"10.1016/j.jjoisr.2023.07.004","url":null,"abstract":"<div><h3>Purpose</h3><p>Soft-tissue tension is an important factor for preventing dislocations after total hip arthroplasty. The purpose of this study was to evaluate the effects of anterior capsule repair for preventing dislocation during primary total hip arthroplasty using the anterolateral approach in the supine position (ALS).</p></div><div><h3>Methods</h3><p>This study retrospectively compared the clinical and radiographic outcomes between patients who underwent total hip arthroplasty via the ALS with or without anterior capsule repair at our institute. The cup (radiographic inclination and radiographic anteversion) and stem alignment, operative time, clinical score, and complication were evaluated.</p></div><div><h3>Results</h3><p>Among the 393 hips evaluated, 193 and 200 belonged to the resection and repair groups, respectively. There were significant differences in the inclination and anteversion of the cup and flexion insertion of the stem (42.3° vs. 40.3°, 15.8° vs. 19.8°, and 27.5% vs. 34.0%, respectively). No significant differences in operative time and postoperative Japanese Orthopedic Association hip score were noted. Early dislocation was more common in the resection group compared to the repair group (2 hips vs. 0 hip, respectively), albeit not significantly (1.03% vs. 0%, p ​= ​0.241).</p></div><div><h3>Conclusion</h3><p>Our results demonstrated that the clinical benefit of the anterior capsule repair for preventing dislocation was limited in ALS.</p></div>","PeriodicalId":100795,"journal":{"name":"Journal of Joint Surgery and Research","volume":"2 ","pages":"Pages 163-167"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949705123000233/pdfft?md5=255b4623e855fca8cbc16123a133e951&pid=1-s2.0-S2949705123000233-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50194876","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 the cost analysis in total hip arthroplasty of anterior versus posterior approaches: A propensity score-matched cohort study in a single center","authors":"Tetsuya Tachibana ,&nbsp;Hiroki Katagiri ,&nbsp;Hideyuki Koga ,&nbsp;Takahisa Ogawa ,&nbsp;Moe Suzuki ,&nbsp;Tetsuya Jinno","doi":"10.1016/j.jjoisr.2023.10.001","DOIUrl":"10.1016/j.jjoisr.2023.10.001","url":null,"abstract":"<div><h3>Purpose</h3><p>The advantage of total hip arthroplasty (THA) in an anterior approach compared with a posterior approach in terms of early postoperative pain and function and lowering dislocation risks is controversial. This study aimed to identify whether THA using the anterior approach lowers costs compared with the posterior approach.</p></div><div><h3>Methods</h3><p>We identified 294 patients who underwent primary THA and compared the cost of total inpatient stay, inpatient length of stay (LOS), cost of operating room, and the rates of discharged patients, complications, and reoperation between the anterior and posterior approaches using propensity score matching analysis.</p></div><div><h3>Results</h3><p>One-to-one matching resulted in 135 pairs of patients who underwent THA using both approaches. The cost of total inpatient stay was significantly lower in the anterior approach (anterior vs. posterior [1,322,800 vs. 1,445,219 yen]; <em>p</em> ​= ​0.04). Furthermore, in the anterior approach, the inpatient LOS was shorter (anterior vs. posterior [19.9 vs. 25.0 days]; <em>p</em> ​&lt; ​0.001). However, there was no significant difference in the cost of the operating room and the rates of patients discharged home, total complications (anterior vs. posterior [5.2 vs. 11.1 ​%]; <em>p</em> ​= ​0.08), or revisions between the two approaches.</p></div><div><h3>Conclusions</h3><p>Using propensity score matching, the current study demonstrated that THA in the anterior approach shortened inpatient LOS and rendered an 8 ​% reduction in the total inpatient cost compared with the posterior approach.</p></div>","PeriodicalId":100795,"journal":{"name":"Journal of Joint Surgery and Research","volume":"2 ","pages":"Pages 222-227"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949705123000348/pdfft?md5=2a8d5de5d251f16fac6150875f67cb22&pid=1-s2.0-S2949705123000348-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50194757","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 treatment of cartilage lesions in the knee: A narrative review","authors":"Takehiko Matsushita ,&nbsp;Takeo Tokura ,&nbsp;Kenjiro Okimura,&nbsp;Shohei Sano,&nbsp;Kyohei Nishida,&nbsp;Kanto Nagai,&nbsp;Yuichi Hoshino","doi":"10.1016/j.jjoisr.2023.02.001","DOIUrl":"10.1016/j.jjoisr.2023.02.001","url":null,"abstract":"<div><h3>Purpose</h3><p>The treatment of cartilage injury is challenging owing to its low self-healing capacity. Here we describe a literature review of the current diagnostic methods, surgical treatment options, and techniques for knee cartilage injuries, including possible future treatments and augmentations.</p></div><div><h3>Methods</h3><p>Studies describing surgical techniques for knee cartilage injuries were searched and arbitrarily selected in PubMed. Possible future treatments and augmentations, growth factors, and cell-based treatments are also discussed.</p></div><div><h3>Results</h3><p>Surgical options for cartilage injury, such as microfracture, osteochondral autografts or allografts, and autologous chondrocyte implantation, are well-established methods with overall satisfactory short- and long-term outcomes. However, the limitations and disadvantages of these treatments, such as repair with fibrous cartilage, donor site morbidity, and two-step surgery, have raised concerns. Various surgical treatments or augmentations have been developed to overcome these limitations, including autologous matrix-induced chondrogenesis, bone marrow aspirate concentrate, particulate chondrocyte implantation, and particulate juvenile allograft chondrocytes, and promising short-to mid-term results have been reported. Additionally, numerous studies are underway on the augmentation of biological healing including growth factor and stem cell therapies.</p></div><div><h3>Conclusions</h3><p>Although treating cartilage injuries remains challenging, advancements have been made. It is advisable for surgeons and clinicians to update their surgical techniques and knowledge of cartilage repair and regeneration to better treat patients with knee cartilage injuries.</p></div>","PeriodicalId":100795,"journal":{"name":"Journal of Joint Surgery and Research","volume":"2 ","pages":"Pages 70-79"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949705123000075/pdfft?md5=30c8205fb529781d9f9d592a3b9a3b78&pid=1-s2.0-S2949705123000075-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50194868","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":"Anterior cruciate ligament reconstruction: Recent evolution and technical improvement","authors":"Kiminari Kataoka,&nbsp;Yuichi Hoshino,&nbsp;Koji Nukuto","doi":"10.1016/j.jjoisr.2023.02.002","DOIUrl":"10.1016/j.jjoisr.2023.02.002","url":null,"abstract":"<div><h3>Purpose</h3><p>Anterior cruciate ligament (ACL) injury is one of the most common knee injuries in young and active patients. ACL reconstruction has been usually recommended to restore anterior-posterior as well as rotatory knee stability. However, there are still some issues to be addressed in ACL reconstruction. Therefore, the purpose of this review was to summarize the current literature regarding recent evolution and technical improvement of ACL reconstruction.</p></div><div><h3>Methods</h3><p>We performed a comprehensive review of the literature regarding graft selection in ACL reconstruction, surgical technique (especially double-bundle ACL reconstruction), and additional procedures.</p></div><div><h3>Results</h3><p>There is still no gold standard for graft selection, while it should be individualized for each patient. Hamstrings tendon autograft and bone-patellar tendon-bone autograft are often chosen, although quadriceps tendon autograft has increased in popularity. Double-bundle ACL reconstruction was introduced to restore normal knee kinematics by closely mimicking the native anatomy. Although clinical advantages of double-bundle ACL reconstruction such as improved clinical outcome and better anteroposterior and rotatory stability have been reported, current global trend of ACL reconstruction technique is unfavourable due to technical difficulty and surgical complications. Further evolution and technical improvement are required to achieve “true” double-bundle ACL reconstruction. An additional procedure such as lateral extra-articular tenodesis, anterolateral ligament reconstruction, and anterior closing wedge osteotomy, may be considered for ACL reconstruction, especially for revision ACL reconstruction, to prevent a graft re-rupture.</p></div><div><h3>Conclusion</h3><p>ACL reconstruction has evolved over time in terms of technique, graft selection, and additional procedures. However, there is still room for improvement.</p></div>","PeriodicalId":100795,"journal":{"name":"Journal of Joint Surgery and Research","volume":"2 ","pages":"Pages 97-102"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949705123000087/pdfft?md5=da00f71c45228dc21792fb38a32d2ca0&pid=1-s2.0-S2949705123000087-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50194870","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}