Journal of Joint Surgery and Research最新文献

{"title":"Hip injuries in young athletes: intra-articular hip pathologies and treatments","authors":"Hironobu Hoshino","doi":"10.1016/j.jjoisr.2023.01.004","DOIUrl":"10.1016/j.jjoisr.2023.01.004","url":null,"abstract":"<div><h3>Purpose</h3><p>There are various pathologies of sports injuries that cause hip and groin pain. Sports-related hip pain is often difficult to diagnose and necessitates long-term suspension of sports activities. The purpose of this review is to provide an overview of sports-related hip pathologies and the results of various treatments in young athletes.</p></div><div><h3>Methods</h3><p>A systematic search was conducted to assess English-language articles indexed in the PubMed database within the past 15 years. The search terminology including sports, young athletes, femoroacetabular impingement (FAI), borderline dysplasia, labrum, and ligamentum teres was used to search for all relevant articles.</p></div><div><h3>Results</h3><p>The search identified 189 articles. After reviewing the articles, 61 articles were included in this literature review. Hip labrum injury, FAI, and ligamentum teres injury were common sports-related hip pathologies. Hip arthroscopic surgery was found to be a successful procedure in treating FAI and labral tears in young athletes.</p></div><div><h3>Conclusions</h3><p>Hip arthroscopic surgery is minimally invasive and serves both for diagnosis and treatment. Athletes undergoing arthroscopic hip surgery in the setting of hip labrum injury, FAI, and ligamentum teres injury exhibit significant functional improvement.</p></div>","PeriodicalId":100795,"journal":{"name":"Journal of Joint Surgery and Research","volume":"2 ","pages":"Pages 41-45"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S294970512300004X/pdfft?md5=956ba841808416ca33386fc03c443353&pid=1-s2.0-S294970512300004X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50194905","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":"Lateral meniscal status, chronicity of anterior cruciate ligament (ACL) deficiency, and initial graft tension were associated with abnormal knee laxity after anatomical ACL reconstruction","authors":"Shuji Taketomi,&nbsp;Ryota Yamagami,&nbsp;Kohei Kawaguchi,&nbsp;Kenichi Kono,&nbsp;Ryo Murakami,&nbsp;Tomofumi Kage,&nbsp;Takahiro Arakawa,&nbsp;Hiroshi Inui,&nbsp;Sakae Tanaka","doi":"10.1016/j.jjoisr.2022.12.005","DOIUrl":"10.1016/j.jjoisr.2022.12.005","url":null,"abstract":"<div><h3>Purpose</h3><p>Graft failure or recurrence of instability without obvious trauma remains one of the problems following anterior cruciate ligament (ACL) reconstruction. This retrospective study aimed to identify risk factors for abnormal knee laxity after anatomical ACL reconstruction.</p></div><div><h3>Methods</h3><p>A total of 291 patients who underwent primary anatomical ACL reconstruction were included in this study. Sex, age, body mass index (BMI), time to surgery, medial meniscal status, lateral meniscal status, graft materials, initial graft tension protocol, preoperative and postoperative pivot shift test and side-to-side differences in anterior tibial translation using the arthrometer were reviewed. Abnormal knee laxity was defined as constituting one or both of the following criteria: (i) a side-to-side difference of ≥3 mm by arthrometer; and (ii) a positive pivot shift test, being “glide,” “clunk”, or “gross”.</p></div><div><h3>Results</h3><p>Abnormal knee laxity occurred in 30 patients (10.3%) at a median follow-up of 25 months. Results of univariate analysis indicated that a higher likelihood of abnormal knee laxity was associated with female sex, greater BMI, longer time to surgery, higher initial graft tension protocol, and lateral meniscus resection. Multivariate logistic regression analysis showed that abnormal knee laxity was significantly associated with time to surgery [1-month increase; odds ratio (OR), 1.01], higher initial graft tension protocol (<em>vs.</em> lower tension; OR, 3.5), and lateral meniscus resection (<em>vs.</em> intact and repaired lateral meniscus; OR, 12.8).</p></div><div><h3>Conclusion</h3><p>Higher initial graft tension protocol, chronicity of ACL deficiency, and lateral meniscus resection were risk factors for abnormal knee laxity after anatomical ACL reconstruction.</p></div><div><h3>Level of evidence</h3><p>Level III retrospective prognostic study.</p></div>","PeriodicalId":100795,"journal":{"name":"Journal of Joint Surgery and Research","volume":"2 ","pages":"Pages 26-31"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949705122000056/pdfft?md5=96802dcf050a28c65d71cc1a764acf2f&pid=1-s2.0-S2949705122000056-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50194808","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":"Association between stem bypass and union failure of subtrochanteric shortening osteotomy in total hip arthroplasty for high hip dislocations","authors":"Kazuya Makida,&nbsp;Taisuke Seki,&nbsp;Yasuhiko Takegami,&nbsp;Yusuke Osawa,&nbsp;Shiro Imagama","doi":"10.1016/j.jjoisr.2023.03.002","DOIUrl":"10.1016/j.jjoisr.2023.03.002","url":null,"abstract":"<div><h3>Purpose</h3><p>Clinical evidence of risk factors for union failure at osteotomy sites after total hip arthroplasty (THA) using subtrochanteric shortening osteotomy (SSO) in patients with high hip dislocations is limited because of the rarity of this dislocation type. The aim of this study was to identify the factors influencing bone union at osteotomy sites in patients with high hip dislocations undergoing this procedure.</p></div><div><h3>Methods</h3><p>This retrospective, case-control study included a total of 28 hips of 24 patients with high hip dislocations who had undergone THA using SSO at a single institution from 1993 to 2018. Fourteen hips were categorized into the union-failure group at 6 months after surgery and compared with a control group including the other 14 hips. We compared various demographic, clinical, and radiological characteristics between the two groups, including age, sex, body mass index, cement usage of stem, stem bypass characteristics, clinical evaluations, and implant survival.</p></div><div><h3>Results</h3><p>The union-failure group had inferior results for clinical evaluations and implant survival. Multivariable analysis found that the stem bypass ratio was significantly shorter in the union-failure group than in the control group (48 vs 64%; odds ratio, 1.18; 95% confidence interval, 1.02 to 1.38; p ​= ​.028).</p></div><div><h3>Conclusion</h3><p>Our results demonstrated that shorter stem bypasses were related to union failure at osteotomy sites in patients with high hip dislocations who underwent THA using SSO. We recommend that the femoral stem be inserted more than 50% of the stem length below the osteotomy site, especially for cemented THA.</p></div>","PeriodicalId":100795,"journal":{"name":"Journal of Joint Surgery and Research","volume":"2 ","pages":"Pages 80-85"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949705123000117/pdfft?md5=7a0bd43fa08c59ac2e5da5228f5618e6&pid=1-s2.0-S2949705123000117-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50194865","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":"A new journal for joint surgery!","authors":"Shuichi Matsuda","doi":"10.1016/j.jjoisr.2023.01.003","DOIUrl":"10.1016/j.jjoisr.2023.01.003","url":null,"abstract":"","PeriodicalId":100795,"journal":{"name":"Journal of Joint Surgery and Research","volume":"2 ","pages":"Page 1"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949705123000038/pdfft?md5=4a5668504b05c68f0ef2f9e70407ab54&pid=1-s2.0-S2949705123000038-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50194872","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":"Collared fully hydroxyapatite-coated stem decreases the risk of early postoperative periprosthetic femoral fracture after direct anterior total hip arthroplasty","authors":"Tatsuya Tamaki ,&nbsp;Tetsuya Kimura ,&nbsp;Yoko Miura ,&nbsp;Kazuhiro Oinuma","doi":"10.1016/j.jjoisr.2023.05.002","DOIUrl":"10.1016/j.jjoisr.2023.05.002","url":null,"abstract":"<div><h3>Purpose</h3><p>Postoperative periprosthetic femoral fracture (PPFF) is one of the major complications following total hip arthroplasty (THA). The purpose of this study was to investigate the epidemiology of early PPFF (within 90 days) after THA.</p></div><div><h3>Methods</h3><p>Primary THA was performed for hip osteoarthritis through a direct anterior approach in 6769 cases. Among these, we retrospectively investigated the occurrence of postoperative PPFF that required surgical intervention.</p></div><div><h3>Results</h3><p>Postoperative PPFF was seen in 29 hips (29/6769; 0.43%), and the mean period from primary THA to fracture occurrence was 9.2 ​± ​8.5 days. Of these, 13 (13/2170; 0.60%) fractures were observed in prosthesis with flat tapered-wedge stems, 7 (7/1652; 0.42%) in straight tapered stems, 4 (4/1082; 0.37%) in cemented stems, and 1 (1/1.060; 0.09%) in collared fully hydroxyapatite-coated stem. The prevalence of PPFF in collared fully hydroxyapatite-coated stems was significantly lower than that of flat tapered-wedge stems. Five hips (5/29; 17.2%) required re-surgical intervention.</p></div><div><h3>Conclusion</h3><p>Our results indicate that, compared to the flat tapered-wedge stem, use of the collared fully hydroxyapatite-coated stem decreases the risk of early postoperative PPFF following direct anterior THA.</p></div>","PeriodicalId":100795,"journal":{"name":"Journal of Joint Surgery and Research","volume":"2 ","pages":"Pages 128-132"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949705123000166/pdfft?md5=d74344d55edf511e8617659eff5cf530&pid=1-s2.0-S2949705123000166-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50194873","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":"Midterm clinical results of bi-cruciate stabilized total knee arthroplasty compared with posterior stabilized total knee arthroplasty with single radius design","authors":"Hiroshi Inui ,&nbsp;Ryota Yamagami ,&nbsp;Kenichi Kono ,&nbsp;Kohei Kawaguchi ,&nbsp;Shuji Taketomi ,&nbsp;Kazuo Saita ,&nbsp;Sakae Tanaka","doi":"10.1016/j.jjoisr.2023.04.001","DOIUrl":"10.1016/j.jjoisr.2023.04.001","url":null,"abstract":"<div><h3>Purpose</h3><p>Attempts have been made to enhance knee prostheses design to improve clinical outcomes including bi-cruciate stabilized (BCS) TKA design and single-radius (SR) femoral component design. The complication rate of first generation BCS (fBCS) TKA was higher than that of standard TKA. Regarding BCS TKA, modification of the fBCS TKA system to the second-generation BCS (sBCS) TKA system was performed to avoid complications. This study aimed to compare the midterm clinical results of sBCS TKA and SR TKA.</p></div><div><h3>Methods</h3><p>We retrospectively reviewed data from TKA patients. A total of 142 patients who were followed up for at least 5 years were enrolled: 61 TKAs using sBCS and 81 TKAs using the posterior stabilized (PS) single-radius (SR) design. The clinical results at 6 months, 2 years, and 5 years postoperatively were compared between the sBCS and SR PS groups.</p></div><div><h3>Results</h3><p>At 6 months postoperatively, the maximum flexion angle (MFA) of the sBCS group was larger than that of the SR PS group. At 2 years, MFA, KOOS subscales of pain and ADL in the sBCS group were better and at 5 years, the MFA, KOOS subscales of pain and QOL in the sBCS group were better than those in the SR group. There was no significant differences of the ratios of complications and revision surgeries between the two groups.</p></div><div><h3>Conclusion</h3><p>The midterm clinical results of sBCS TKA were better than those of SR PS TKA in terms of the MFA and KOOS subscales of pain and QOL.</p></div>","PeriodicalId":100795,"journal":{"name":"Journal of Joint Surgery and Research","volume":"2 ","pages":"Pages 117-122"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949705123000142/pdfft?md5=cede56a722cc7d6c7515deb04906ca92&pid=1-s2.0-S2949705123000142-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50194875","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":"The accuracy of an accelerometer-based portable navigation system for total hip arthroplasty using 3D CT measurement in the supine position: a prospective multicenter study","authors":"Yukihide Minoda ,&nbsp;Masayuki Ito ,&nbsp;Kentaro Iwakiri ,&nbsp;Katsufumi Uchiyama ,&nbsp;Masashi Kawasaki ,&nbsp;Akio Kanda ,&nbsp;Tetsuya Jinno ,&nbsp;Ryo Sugama ,&nbsp;Daisuke Chiba ,&nbsp;Masahiro Hasegawa ,&nbsp;Takaaki Fujishiro","doi":"10.1016/j.jjoisr.2023.06.001","DOIUrl":"10.1016/j.jjoisr.2023.06.001","url":null,"abstract":"<div><h3>Purpose</h3><p>This multicenter prospective study aimed to evaluate the accuracy of the cup alignment of an accelerometer-based portable navigation system (AP navigation) for a total hip arthroplasty (THA) in spine position.</p></div><div><h3>Methods</h3><p>This study prospectively enrolled 324 THAs using supine position in 9 hospitals. An AP navigation was used for cup fixation and the intraoperative navigation data (cup alignment, pelvic tilt, and pelvic rotation) were recorded. Computed tomography (CT) of the pelvis was performed 2 weeks post-operatively and cup alignment was measured on 3D-CT images.</p></div><div><h3>Result</h3><p>The accuracy (absolute difference in cup alignment between the intraoperative navigation record and postoperative 3D-CT measurements) was 3 ​± ​3° (mean ​± ​standard deviation) for cup inclination and 3 ​± ​3° for cup anteversion. The pelvis tilted anteriorly in 148 hips (46%) and posteriorly in 162 hips (50%), and did not tilt in 14 hips (4%). The pelvis rotated toward the operating side in 179 hips (55%), toward the contralateral side in 112 hips (35%), and did not rotate in 33 hips (10%). Multiple regression analysis showed that the patients’ characteristics (sex, body mass index, diagnosis, Crowe classification, laterality, intraoperative pelvic tilt, intraoperative pelvic rotation, and cup size) and the surgical factors (approach, preparation time, number of screws, and institution) did not affect the accuracy of the navigation system.</p></div><div><h3>Conclusions</h3><p>This is the first prospective multicenter study of this navigation system. The accuracy was not affected by patient characteristics, surgical factors, or substantial pelvic movement during cup fixation.</p></div>","PeriodicalId":100795,"journal":{"name":"Journal of Joint Surgery and Research","volume":"2 ","pages":"Pages 133-138"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S294970512300018X/pdfft?md5=1bfa41551c61c00c2400491036dc2c9d&pid=1-s2.0-S294970512300018X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50195368","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":"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}