Journal of Joint Surgery and Research最新文献

{"title":"Preoperative factors associated with patient satisfaction after modified kinematically aligned total knee arthroplasty in varus knees","authors":"Kemmei Ikuta,&nbsp;Tomoyuki Matsumoto,&nbsp;Naoki Nakano,&nbsp;Yuichi Kuroda,&nbsp;Shinya Hayashi,&nbsp;Ryosuke Kuroda","doi":"10.1016/j.jjoisr.2024.03.001","DOIUrl":"https://doi.org/10.1016/j.jjoisr.2024.03.001","url":null,"abstract":"<div><h3>Purpose</h3><p>Kinematically aligned-total knee arthroplasty (KA-TKA) has recently attracted significant interest because it delivers better clinical outcomes than mechanically aligned (MA)-TKA. However, the optimal preoperative factors that maximize the effectiveness of KA-TKA remain controversial. Therefore, we aimed to determine the preoperative factors that are appropriate for and might benefit from modified KA-TKA, based on patient-reported outcome measures (PROMs).</p></div><div><h3>Methods</h3><p>The relationships between postoperative satisfaction and other variables in 84 patients with varus-type osteoarthritis of the knee who underwent primary modified KA-TKAs were investigated using stepwise multiple regression analysis. Patients were assigned to groups that were satisfied or dissatisfied with their outcomes after KA-TKA according to the 2011 Knee Society Scores. The cutoff for preoperative advanced activities scores (AASs) for excellent satisfaction were determined by analyzing receiver operating characteristic (ROC) curves. The variables correlated with excellent satisfaction were identified using logistic regression models.</p></div><div><h3>Results</h3><p>A preoperative variable relevant to patient satisfaction was AAS (β ​= ​0.465). The results of the ROC curve analysis revealed eight optimal cut-offs for preoperative AASs that predicted excellent satisfaction, with a sensitivity and specificity of 0.700 and 0.625, respectively. Logistic regression analysis revealed that AASs significantly contributed to excellent patient satisfaction (odds ratio, 1.181; p ​= ​0.001).</p></div><div><h3>Conclusions</h3><p>Individuals who were highly active preoperatively were good candidates for KA-TKA. This modified kinematically aligned surgical technique can satisfy the demands of highly active patients.</p></div>","PeriodicalId":100795,"journal":{"name":"Journal of Joint Surgery and Research","volume":"2 2","pages":"Pages 46-50"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949705124000045/pdfft?md5=dc03514f33de8b51126635761b82dcd8&pid=1-s2.0-S2949705124000045-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140296256","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":"Pre- and post-operative knee alignment phenotypes in restricted kinematic alignment, mechanical alignment total knee arthroplasty, and unicompartmental knee arthroplasty","authors":"Shotaro Araki,&nbsp;Takafumi Hiranaka,&nbsp;Takaaki Fujishiro,&nbsp;Koji Okamoto","doi":"10.1016/j.jjoisr.2024.04.003","DOIUrl":"https://doi.org/10.1016/j.jjoisr.2024.04.003","url":null,"abstract":"<div><h3>Purpose</h3><p>The coronal plane alignment of the knee (CPAK) classification has been introduced as a simple system to classify knee phenotypes based on leg alignment [hip–knee–ankle angle (HKA) and joint line obliquity (JLO)]. Differences in post-operative phenotype between mechanical alignment (MA) and kinematic alignment (KA) total knee arthroplasty (TKA) have been reported, but not the phenotypes after unicompartmental knee arthroplasty (UKA). Moreover, most studies have focused upon Western populations. This study compared pre- and post-operative knee phenotypes between MA-TKA, KA-TKA, and UKA in a Japanese cohort.</p></div><div><h3>Methods</h3><p>In this study, 230 knees in 165 patients who underwent UKA, 124 knees in 80 patients who underwent MA-TKA, and 80 knees in 51 patients who underwent restricted KA-TKA in Takatsuki General Hospital between March 2019 and January 2021 were retrospectively investigated. Pre- and post-operative lateral distal femoral angle (LDFA) and medial proximal tibial angle (MPTA) were measured, and JLO (MPTA ​+ ​LDFA) and arithmetic HKA (aHKA) (MPTA – LDFA) were calculated and compared between the surgeries.</p></div><div><h3>Results</h3><p>Pre-operative JLO and aHKA did not significantly differ between the three groups (pre. JLO, <em>p</em> ​= ​0.164; pre. aHKA, <em>p</em> ​= ​0.13). Pre-operatively, 62.0% of knees were categorized as type I (varus leg alignment and medially sloped joint line). After UKA, 59.1% of type I inherited the pre-operative phenotype, whereas most cases were altered in MA-TKA and KA-TKA (4.8% and 30.0%, respectively, inherited the pre-operative phenotype).</p></div><div><h3>Conclusions</h3><p>The pre-operative phenotype was mostly inherited after UKA and to a lesser extent after KA-TKA, whereas it tended to be altered after MA-TKA.</p></div>","PeriodicalId":100795,"journal":{"name":"Journal of Joint Surgery and Research","volume":"2 2","pages":"Pages 77-83"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949705124000094/pdfft?md5=e5284da5a6b5c64404050b5fe95436de&pid=1-s2.0-S2949705124000094-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141083351","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":"Significant improvement in locomotive functions after total knee arthroplasty but worse than those of independent ambulatory community dwellers","authors":"Seiya Miyamoto ,&nbsp;Takehiko Sugita ,&nbsp;Naohisa Miyatake ,&nbsp;Nozomi Itou ,&nbsp;Akira Sasaki ,&nbsp;Ikuo Maeda ,&nbsp;Masayuki Kamimura ,&nbsp;Takashi Aki ,&nbsp;Toshimi Aizawa","doi":"10.1016/j.jjoisr.2024.04.001","DOIUrl":"https://doi.org/10.1016/j.jjoisr.2024.04.001","url":null,"abstract":"<div><h3>Purpose</h3><p>This study investigated the adequacy of improvements in locomotive syndrome (LS) and other clinical outcomes after total knee arthroplasty (TKA) for medial knee osteoarthritis.</p></div><div><h3>Methods</h3><p>A total of 74 patients who underwent unilateral primary TKA were evaluated pre-operatively and 3, 6, and 12 months post-TKA using the 25-question Geriatric Locomotive Function Scale (GLFS-25) to evaluate the severity of LS, the Japanese Knee Osteoarthritis Measure (JKOM), the Knee Society Score (KSS), the timed up and go (TUG) test, and range of motion of the knee joint (ROM). The GLFS-25 score and the severity of LS were compared between these patients and independent ambulatory community dwellers (273 males and 477 females).</p></div><div><h3>Results</h3><p>The GLFS-25, JKOM, KSS, TUG scores, and ROM significantly improved post-operatively. The pre-operative incidence of LS stage 3, indicating the worst locomotive function, decreased from 81.1% to 24.3% at the final follow-up. However, the median (interquartile range) GLFS-25 score of 13 (6–23) seemed much worse, and the incidence of LS stage 3 of 24.3% seemed much higher even 12 months post-TKA compared with independent ambulatory community dwellers.</p></div><div><h3>Conclusions</h3><p>The GLFS-25 score and other clinical outcome scales significantly improved after TKA. However, improvements in locomotive functions were not adequate as approximately 25% of patients remained with LS stage 3. Besides ordinary rehabilitation programmes after TKA, some interventions, such as more rigorous muscle exercises, would be necessary to obtain greater improvements in LS.</p></div>","PeriodicalId":100795,"journal":{"name":"Journal of Joint Surgery and Research","volume":"2 2","pages":"Pages 66-70"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949705124000070/pdfft?md5=c0bef383cc57bbd227e0c90559980b2f&pid=1-s2.0-S2949705124000070-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140645523","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":"Fluoro HIP, a new software for intraoperative evaluation of the cup angles based on fluoroscopic images","authors":"Hiroki Kobayashi ,&nbsp;Hiroyuki Ogawa ,&nbsp;Kazuki Nakamura ,&nbsp;Taro Yamashita ,&nbsp;Keisuke Horiuchi ,&nbsp;Kazuhiro Chiba","doi":"10.1016/j.jjoisr.2024.02.002","DOIUrl":"https://doi.org/10.1016/j.jjoisr.2024.02.002","url":null,"abstract":"<div><h3>Purpose</h3><p>Despite its clinical benefits, intraoperative navigation is currently used only in approximately 20% of total hip arthroplasties (THA) partly due to the high cost of the systems and time-consuming preoperative preparation. By providing a simpler and less expensive alternative, the use of intraoperative navigation is likely to increase among surgeons. In this study, we sought to validate the accuracy and utility of Fluoro HIP, a newly developed cup angle measurement software that runs on iOS devices.</p></div><div><h3>Methods</h3><p>Twenty-seven patients who underwent primary total hip arthroplasty between June and September 2022 were included in the study. All patients underwent surgery in the supine position. Inclination and anteversion angles were determined using Fluoro HIP software based on the fluoroscopic images captured during surgery. Navigation errors were calculated by comparing with the values obtained from postoperative CT images.</p></div><div><h3>Results</h3><p>The inclination and anteversion angles measured were 38.7 ​± ​3.9 and 15.0 ​± ​3.1°, respectively. The absolute value errors were 2.7 ​± ​1.9 and 3.0 ​± ​2.1° for the inclination and anteversion, respectively. Although Fluoro HIP software-based system may not be as precise as the conventional CT-based or portable navigation systems, the intraoperative evaluation of the cup angles by this system was considered to have acceptable accuracy and reproducibility for most THA cases performed in the supine position. Most importantly, our system requires no preoperative preparation and is significantly less expensive than other types of navigation systems currently in use.</p></div><div><h3>Conclusion</h3><p>The Fluoro HIP software-based system is a highly cost-effective and affordable alternative to the conventional navigation systems.</p></div>","PeriodicalId":100795,"journal":{"name":"Journal of Joint Surgery and Research","volume":"2 2","pages":"Pages 35-39"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949705124000033/pdfft?md5=832a7c8346dc67434e9bffaec38046b1&pid=1-s2.0-S2949705124000033-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140113565","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":"Impact of prognostic nutritional index on the occurrence of post-operative delirium after total knee arthroplasty","authors":"Kensuke Hotta,&nbsp;Mitsuru Hanada,&nbsp;Yukihiro Matsuyama","doi":"10.1016/j.jjoisr.2024.04.004","DOIUrl":"https://doi.org/10.1016/j.jjoisr.2024.04.004","url":null,"abstract":"<div><h3>Purpose</h3><p>Delirium has been reported to cause delayed functional recovery, prolonged hospitalization, future institutionalization, increased mortality, and increased healthcare costs. However, there are no reports on how prognostic nutritional index (PNI), Controlling Nutritional Status (CONUT) score, and geriatric nutritional risk index (GNRI) are related to delirium after total knee arthroplasty (TKA). This study aimed to identify risk factors for post-operative delirium after TKA using various pre-operative nutritional assessments (PNI, CONUT score, and GNRI).</p></div><div><h3>Methods</h3><p>In total, 289 patients who underwent primary TKA between September 2011 and April 2022 in our institute (Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan) were enrolled. Patients were divided into two groups: those who developed post-operative delirium (Group D), and those who did not (Group ND). Pre-operative risk factors, including nutritional indices, for post-operative delirium were evaluated.</p></div><div><h3>Results</h3><p>Group D comprised 16 participants, while Group ND comprised 273 participants. Comparisons between the two groups revealed significant differences in age, PNI, CONUT score, GNRI, and history of cerebrovascular disease. Multiple logistic regression analysis revealed that significant risk factors for delirium after TKA were age, PNI, and history of cerebrovascular disease. A receiver operating characteristic curve indicated that the cutoff values for delirium were 47.4 for PNI (sensitivity, 0.810; specificity, 0.875) and 78.5 years for age (sensitivity, 0.813; specificity, 0.722).</p></div><div><h3>Conclusions</h3><p>Risk factors for post-operative delirium after TKA were PNI &lt;47.4, age &gt;78.5 years, and history of cerebrovascular disease. Patients exceeding these pre-operative cutoff values or with a history of cerebrovascular disease should receive counseling about delirium before surgery.</p></div>","PeriodicalId":100795,"journal":{"name":"Journal of Joint Surgery and Research","volume":"2 2","pages":"Pages 71-76"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949705124000100/pdfft?md5=4fc7f0e0e6dc526e38580c8fff16fbfa&pid=1-s2.0-S2949705124000100-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141068849","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":"Changes in ulnar and median nerve conduction velocity after reverse total shoulder arthroplasty: Correlation with distalization and lateralization","authors":"Kotaro Yamakado","doi":"10.1016/j.jjoisr.2024.03.003","DOIUrl":"https://doi.org/10.1016/j.jjoisr.2024.03.003","url":null,"abstract":"<div><h3>Purpose</h3><p>The purpose of this study was to assess ulnar and median nerve injury after reverse total shoulder arthroplasty (RSA) by measuring the sensory nerve conduction velocity (SCV). The secondary objective was to evaluate the impact of lateralization and/or distalization on SCV changes.</p></div><div><h3>Methods</h3><p>Twenty consecutive cases were prospectively included and retrospectively reviewed. SCV of the ulnar and median nerves as well as humeral lateralization/distalization quantified by plain radiography were evaluated pre-operatively and at 1 week post-operatively. Changes in SCV were tested using the paired <em>t</em>-test, and correlations between humeral lateralization/distalization and SCV changes were tested using Kendall's rank correlation coefficient and maximal information coefficient (MIC).</p></div><div><h3>Results</h3><p>The SCV of the ulnar nerve was delayed from 55.4 ​m/s pre-operatively to 53.0 ​m/s post-operatively (<em>p</em> ​= ​0.021), whereas there was no significant change in the median nerve (<em>p</em> ​= ​0.17). There was a weak to moderate correlation between ulnar nerve SCV delay and lateralization (τ ​= ​−0.38; <em>p</em> ​= ​0.021; MIC ​= ​0.70) but no significant correlation with distalization (<em>p</em> ​= ​0.65; MIC ​= ​0.56).</p></div><div><h3>Conclusions</h3><p>Following RSA, a small but significant delay in SCV of the ulnar nerve was observed. A negative correlation was found between lateralization and SCV delay of the ulnar nerve.</p></div>","PeriodicalId":100795,"journal":{"name":"Journal of Joint Surgery and Research","volume":"2 2","pages":"Pages 51-57"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949705124000069/pdfft?md5=d87ce27d744f0bd771a2a9cb3277aace&pid=1-s2.0-S2949705124000069-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140543842","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":"Five-year clinical and radiographic outcomes of Accolade TMZF and Accolade II stem use","authors":"Ken Ueoka ,&nbsp;Tamon Kabata ,&nbsp;Yoshitomo Kajino ,&nbsp;Daisuke Inoue ,&nbsp;Takaaki Ohmori ,&nbsp;Yuki Yamamuro ,&nbsp;Atsushi Taninaka ,&nbsp;Tomoyuki Kataoka ,&nbsp;Yu Yanagi ,&nbsp;Yoshitomo Saiki ,&nbsp;Musashi Ima ,&nbsp;Hiroyuki Tsuchiya","doi":"10.1016/j.jjoisr.2023.09.004","DOIUrl":"10.1016/j.jjoisr.2023.09.004","url":null,"abstract":"<div><h3>Purpose</h3><p>Although good mid-term results of the first- and second-generation cementless stems have been reported, no study has compared outcomes between generations. This study aimed to compare the mid-term results of Accolade Ti–12Mo–6Zr–2Fe (TMZF) and Accolade II over a 5-year period.</p></div><div><h3>Methods</h3><p>This retrospective, single-institution, single-surgeon observational study included patients who underwent primary total hip arthroplasty using the Accolade TMZF (n ​= ​71, group I) or Accolade II (n ​= ​73, group II) between January 2009 and July 2015. Revision and conversion cases were excluded. Functional evaluations were performed using the Japanese Orthopaedic Association hip (JOA) score. Radiographic evaluations were performed using anteroposterior radiographs. Spot welds, radiolucency, cortical hypertrophy, and stress shielding around the stem were assessed for each Gruen zone. Subsidence and stem alignment were evaluated.</p></div><div><h3>Results</h3><p>The 5-year postoperative stem survival rate was 100% in both groups. The JOA score improved from 44.0 ​± ​10.2 to 90.6 ​± ​7.6 in group I and from 49.1 ​± ​10.1 to 91.7 ​± ​6.6 in group II. There were no significant differences in preoperative and postoperative JOA scores and subscale scores in either group. Significant spot welds were observed in group II in Gruen zones 3 and 5. Stress shielding progressed over time in both groups, and the prevalence of grade 3 shielding was significantly lower in group II (p ​= ​0.028).</p></div><div><h3>Conclusion</h3><p>Both stems had a survival rate of 100%. The incidence of severe stress shielding seemed to be lower with Accolade II, but further investigations should be needed.</p></div>","PeriodicalId":100795,"journal":{"name":"Journal of Joint Surgery and Research","volume":"2 1","pages":"Pages 7-12"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949705123000324/pdfft?md5=72147711666367a3c038fd66d6ca3e8c&pid=1-s2.0-S2949705123000324-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138502044","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":"Anatomical landmark for medialized patellar component in TKA","authors":"Ryosuke Tsurui ,&nbsp;Shinya Kawahara ,&nbsp;Satoshi Hamai ,&nbsp;Yukio Akasaki ,&nbsp;Hidetoshi Tsushima ,&nbsp;Yasuhiko Kokubu ,&nbsp;Taro Mawatari ,&nbsp;Yasuharu Nakashima","doi":"10.1016/j.jjoisr.2023.12.002","DOIUrl":"https://doi.org/10.1016/j.jjoisr.2023.12.002","url":null,"abstract":"<div><h3>Purpose</h3><p>The aim of this study was to show a concrete setting landmark in two component types of round and anatomical oval shapes using three-dimensional (3D) simulation analyses in total knee arthroplasty (TKA).</p></div><div><h3>Methods</h3><p>The patellar resection surface was simulated three-dimensionally using preoperative CT data of 54 patients (68 knees) who underwent TKA with varus knee osteoarthritis. The mediolateral position of the original patellar ridge was examined. The round and anatomical oval patellar components were aligned in the following cases: medial edge setting, patellar ridge setting, maximal size setting. The component ridge position from the medial edge and size in each case were examined.</p></div><div><h3>Results</h3><p>The original patellar ridge was located nearly 40% from the medial edge. In aligning the component to reproduce the original patellar ridge, the medial bone width uncovered with the component was nearly 4 mm in both designs. The component size was significantly smaller as the component was placed more medially. In selecting the maximal size, the round component was aligned more laterally than the original patellar ridge. In contrast, the anatomical oval component enabled to be concomitant with a more appropriate position and size.</p></div><div><h3>Conclusion</h3><p>The position where the medial bone width uncovered with the component was nearly 4 mm, not the medial edge, was found as the best place to reproduce the original patellar ridge in both round and anatomical oval components. Specifically, the anatomical oval component might be more favorable with respect to the component position and size.</p></div>","PeriodicalId":100795,"journal":{"name":"Journal of Joint Surgery and Research","volume":"2 1","pages":"Pages 26-30"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949705123000415/pdfft?md5=4f2c65830304a8f8e6f50c20e22e10db&pid=1-s2.0-S2949705123000415-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139548394","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":"Appreciation to reviewers in 2022–2023","authors":"","doi":"10.1016/j.jjoisr.2024.01.001","DOIUrl":"https://doi.org/10.1016/j.jjoisr.2024.01.001","url":null,"abstract":"","PeriodicalId":100795,"journal":{"name":"Journal of Joint Surgery and Research","volume":"2 1","pages":"Page 25"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S294970512400001X/pdfft?md5=8be41d889bfa5cc5eef3dd0fb67673f7&pid=1-s2.0-S294970512400001X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139436063","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":"Preserved posterior cruciate ligament contributed to knee sagittal stability, but not to rollback and deep knee flexion in cruciate-retaining total knee arthroplasty with a cruciate-substituting insert","authors":"Seiju Hayashi,&nbsp;Satoshi Miyazaki","doi":"10.1016/j.jjoisr.2023.09.005","DOIUrl":"10.1016/j.jjoisr.2023.09.005","url":null,"abstract":"<div><h3>Purpose</h3><p>No previous report has compared the differences in postoperative functional outcomes between posterior cruciate ligament (PCL)-retaining (CR-) and PCL-sacrificing (CS-) total knee arthroplasty (TKA) with detailed intraoperative consideration of joint gap and balance. The purpose of this study was to evaluate the in vivo function of preserved PCL in TKA by comparing postoperative functional outcomes between CR- and CS-TKA with a cruciate-substituting insert (CS-insert), considering intraoperative influence factors, such as the posterior tibial slope, posterior condylar offset, joint gap, joint balance, and joint laxity.</p></div><div><h3>Methods</h3><p>A total of 55 knees in 38 patients (27 knees from 18 patients in the CR group, and 28 knees from 20 patients in the CS group) were analyzed. Fluoroscopic evaluation under anesthesia in sagittal laxity, rollback amount, and the maximum flexion angles were compared between the groups.</p></div><div><h3>Results</h3><p>There were no significant differences in intraoperative or postoperative all measurement values between the two groups, but the sagittal laxity was significantly smaller in the CR group [5.4% ± 4.5% (2.4 ± 2.1 mm)] than in the CS group [9.0 ± 3.8% (4.0 ± 1.7 mm)] (<em>P</em> ​&lt; 0.01). There were no significant differences in the amount of rollback and postoperative maximum knee flexion angle between the groups.</p></div><div><h3>Conclusions</h3><p>Preserved PCL in TKA with a CS-insert contributed to knee sagittal stability, but not to rollback and deep knee flexion.</p></div>","PeriodicalId":100795,"journal":{"name":"Journal of Joint Surgery and Research","volume":"2 1","pages":"Pages 13-18"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949705123000336/pdfft?md5=4bf3b70b626b9483a7eb3bddeacd08eb&pid=1-s2.0-S2949705123000336-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138502045","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}