Journal of Joint Surgery and Research最新文献

{"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}

{"title":"Clinical evaluation of knee joint diseases","authors":"Kohei Nishitani,&nbsp;Shinichiro Nakamura,&nbsp;Shinichi Kuriyama","doi":"10.1016/j.jjoisr.2022.12.003","DOIUrl":"10.1016/j.jjoisr.2022.12.003","url":null,"abstract":"<div><h3>Purpose</h3><p>This article aimed to comprehensively introduce clinical scoring of pathological conditions of the knee.</p></div><div><h3>Methods</h3><p>Review articles on the clinical scores of knee joints were searched. The frequency of the clinical scores used in said articles are presented as whole-knee pathological conditions or according to specific knee diseases. Frequently used scoring systems are separately explained in terms of validity and clinically important values.</p></div><div><h3>Results</h3><p>Of 132 review articles, 95 were included in this review. Among these 95, the top five frequently used scoring systems were the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Knee Injury and Osteoarthritis Outcome Score (KOOS), International Knee Documentation Committee Subjective Knee Form (IKDC subjective score), Knee Society Score (KSS), and Lysholm Knee Scoring Scale. Patient-reported outcome measures to evaluate patients’ health-related quality of life, such as the EuroQol 5 dimensions (EQ5D), MOS 36-Item Short-Form Health Survey (SF-36), and SF-12 Health Survey (SF-12), were frequently used. Activity and functional ratings, such as the Tegner activity score and University of California Los Angeles (UCLA) Activity Scale, were also frequently used. Usage trends of scoring systems differed according to the pathological conditions of the knee, and some disease-specific scoring systems, such as the Kujala score for patellofemoral problems or Forgotten Joint Score for arthroplasty, have been reported.</p></div><div><h3>Conclusions</h3><p>Various scoring systems are used for pathological conditions of the knee. Even for knee diseases, trends in scoring systems differ according to pathological conditions, necessitating the selection of appropriate scoring systems.</p></div>","PeriodicalId":100795,"journal":{"name":"Journal of Joint Surgery and Research","volume":"2 ","pages":"Pages 9-17"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949705122000032/pdfft?md5=13bdb6d6880a18b925fb302ac23dfa6b&pid=1-s2.0-S2949705122000032-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50194908","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 plain radiography may underestimate the steep posterior tibial slope of the medial condyle in elderly Japanese with varus knee osteoarthritis undergoing arthroplasties","authors":"Kohei Nishitani,&nbsp;Shinichi Kuriyama,&nbsp;Shinichiro Nakamura,&nbsp;Taisuke Yabe,&nbsp;Young-Dong Song,&nbsp;Hiromu Ito,&nbsp;Shuichi Matsuda","doi":"10.1016/j.jjoisr.2023.06.002","DOIUrl":"10.1016/j.jjoisr.2023.06.002","url":null,"abstract":"<div><h3>Purpose</h3><p>Understanding the native posterior tibial slope (PTS) is important especially in cruciate ligament retaining total knee arthroplasty (TKA) and uni-compartmental knee arthroplasty (UKA). This study investigated the efficacy of PTS with lateral knee radiograph (radiographic PTS) by comparing it with PTS of medial and lateral tibial condyles (MPTS and LPTS) by computed tomography (CT).</p></div><div><h3>Methods</h3><p>In patients who underwent TKA and UKA on varus knee osteoarthritis, radiographic PTS, MPTS, and LPTS were measured. Spearman's correlation was used to compare the radiographic PTS and PTS on CT. More than 3° delta PTS (CT PTS - radiographic PTS) were defined as positive outliers.</p></div><div><h3>Results</h3><p>Three-hundred and twenty-six osteoarthritic knees (278 TKAs and 48 UKAs) were evaluated. The mean radiographic PTS, MPTS, LPTS was 8.0 ​± ​2.9°, 10.2 ​± ​4.2°, and 8.3 ​± ​3.3°, respectively. Plain radiograph tended to underestimate steep MPTS, and its correlations to LPTS (ρ ​= ​0.65, p ​&lt; ​0.001) and MPTS (ρ ​= ​0.54, p ​&lt; ​0.001) were moderate. The positive outliers were observed in 136/326 (42%) and 36/326 (12%) knees in medial and lateral condyles, respectively. Even in UKA, the positive outliers were observed in 13/48 (28%) knees in medial condyle.</p></div><div><h3>Conclusions</h3><p>Radiographic PTS better reproduced LPTS, but did not accurately reproduce MPTS in varus knee osteoarthritis. Radiographic PTS may not detect steep medial PTS. Surgeons should be cautious because the actual PTS of the medial tibial condyle may be different from that preoperatively measured on plain radiographs.</p></div>","PeriodicalId":100795,"journal":{"name":"Journal of Joint Surgery and Research","volume":"2 ","pages":"Pages 139-144"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949705123000191/pdfft?md5=172cc9567cf1419d58a050202bc124f2&pid=1-s2.0-S2949705123000191-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50195369","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":"Does lateral incision reduce perceptual deficits and improve postoperative kneeling ability after total knee arthroplasty?","authors":"Yutaka Suetomi ,&nbsp;Hiroshi Fujii ,&nbsp;Atsunori Tokushige ,&nbsp;Patricio Ⅲ Dumlao ,&nbsp;Takashi Sakai","doi":"10.1016/j.jjoisr.2023.05.003","DOIUrl":"10.1016/j.jjoisr.2023.05.003","url":null,"abstract":"<div><h3>Purpose</h3><p>Kneeling is often difficult after a total knee arthroplasty. However, the reasons behind kneeling difficulties are not yet fully understood. According to several studies, a lateral incision reduces perceptual deficits and improves kneeling performance. This study compared two different skin incisions (lateral and midline) as they relate to postoperative perceptual deficits, as well as kneeling on a mat or in daily life following TKA, and demonstrates the advantage of the lateral incision in postoperative kneeling ability.</p></div><div><h3>Methods</h3><p>This study included 99 patients with lateral incisions and 104 patients with midline incisions. Sensory disturbance was evaluated with a brush on the nine subdivisions of the kneeling area. Patients were tested in the outpatient clinic to determine whether they could kneel on a mat. The level of discomfort in the kneeling area was assessed using a visual analog scale. Questionnaires were used to assess kneeling ability.</p></div><div><h3>Results</h3><p>Compared to a midline incision, a lateral incision significantly reduced the perceptual deficits in the center of the kneeling area and the discomfort associated with kneeling on a mat. There was no significant difference between the two groups in kneeling on a mat in the clinic or kneeling in daily activities. However, less than 30% of patients in both groups could kneel in daily living. The reasons for being unable to kneel were mainly anxiety and pain, rather than numbness.</p></div><div><h3>Conclusion</h3><p>Lateral incisions alone did not improve kneeling in patients' daily living following TKA.</p></div>","PeriodicalId":100795,"journal":{"name":"Journal of Joint Surgery and Research","volume":"2 ","pages":"Pages 158-162"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949705123000178/pdfft?md5=e56e2e80d944c2355f9d72e75bb3ad8b&pid=1-s2.0-S2949705123000178-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50195370","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}