Knee Surgery & Related Research最新文献

{"title":"Predisposing factors for Hoffa's fat pad syndrome: a systematic review.","authors":"Diego Agustín Abelleyra Lastoria,&nbsp;Clerin Kulangara Benny,&nbsp;Caroline Blanca Hing","doi":"10.1186/s43019-023-00192-4","DOIUrl":"https://doi.org/10.1186/s43019-023-00192-4","url":null,"abstract":"<p><strong>Background: </strong>Hoffa's fat pad syndrome has been defined as impingement of Hoffa's fat pad, leading to oedema and fibrosis. The primary aim of this systematic review was to identify morphological differences in Hoffa's fat pad between patients with and without Hoffa's fat pad syndrome, evaluating them as risk factors predisposing to its development. The secondary aim was to summarize and evaluate current evidence pertaining to the management of Hoffa's fat pad syndrome.</p><p><strong>Materials and methods: </strong>The protocol for this review was prospectively registered (PROSPERO registration: CRD42022357036). Electronic databases, currently registered studies, conference proceedings and the reference lists of included studies were searched. All studies evaluating differences in Hoffa's fat pad anatomy under imaging between patients with and without Hoffa's fat pad syndrome were included, as well as those exploring epidemiological factors predisposing to its development (ethnicity, employment status, sex, age and BMI), and studies reporting on the effect of treatment on Hoffa's fat pad morphology.</p><p><strong>Results: </strong>A total of 3871 records were screened. Twenty one articles satisfied the inclusion criteria, evaluating 3603 knees of 3518 patients. Patella alta, increased tibial tubercle-tibial groove distance, and increased trochlear angle were found to predispose the development of Hoffa's fat pad syndrome. Trochlear inclination, sulcus angle, patient age and BMI were not associated with this condition. The link between Hoffa's fat pad syndrome and ethnicity, employment, patellar alignment, Hoffa's fat pad composition, physical activity and other pathological processes cannot be established due to lack of evidence. No studies reporting on treatment for Hoffa's fat pad syndrome were identified. Though weight loss and gene therapy may provide symptomatic relief, further research is required to corroborate these claims.</p><p><strong>Conclusion: </strong>Current evidence suggests that high patellar height, TT-TG distance, and trochlear angle predispose the development of Hoffa's fat pad syndrome. In addition, trochlear inclination, sulcus angle, patient age and BMI do not seem to be associated with this condition. Further research should explore the link between Hoffa's fat pad syndrome and sport as well as other conditions pertaining to the knee. In addition, further study evaluating treatment approaches for Hoffa's fat pad syndrome is required.</p>","PeriodicalId":17886,"journal":{"name":"Knee Surgery & Related Research","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2023-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10251569/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9614050","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 effects of continuous catheter adductor canal block for pain management in knee replacement therapy: a meta-analysis.","authors":"Aiden Jabur,&nbsp;Hyun Jae Nam,&nbsp;Asher Dixon,&nbsp;Tynan Cox,&nbsp;Hayden Randall,&nbsp;Jing Sun","doi":"10.1186/s43019-023-00188-0","DOIUrl":"https://doi.org/10.1186/s43019-023-00188-0","url":null,"abstract":"<p><strong>Purpose: </strong>Adductor canal block has emerged as a favourable element of multimodal analgesia regimens for total knee arthroplasty, due to the exclusive sensory blockade it provides. However, it is controversial as to whether a single shot or continuous technique adductor canal block is superior. This meta-analysis examined the effect of both these techniques on pain management associated with total knee arthroplasty.</p><p><strong>Methods: </strong>All randomised controlled trials published on Cochrane Library, PubMed, and EMBASE, Scopus, and PsychINFO were systematically searched. The PEDro scale was used to assess the quality of studies. A total of 8 articles, 2 of which were split by subgroup analyses to create 10 studies, with 828 adults were selected for inclusion in the analysis. The mean difference and effect size with a 95% confidence interval (CI) were analysed for the pooled results.</p><p><strong>Results: </strong>Statistically significant pooled effects of analgesia technique in favour of catheter use were found in the reduction of pain scores and VAS scores, and total rescue analgesia dosage. No significant changes were observed in the hospital stay time. Subgroup analysis revealed that patients with BMI 30 or more reported higher pain scores than those with BMI below 30.</p><p><strong>Conclusion: </strong>Based upon studies that are currently available, our meta-analysis appears to demonstrate that continuous administration of analgesia through an adductor canal catheter provides greater pain reduction in total knee arthroplasty than single shot analgesia. Despite these current findings, future studies with larger sample sizes and greater control of study parameters are required to confirm the current findings.</p>","PeriodicalId":17886,"journal":{"name":"Knee Surgery & Related Research","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10236883/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9945665","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 time to revision total knee arthroplasty on outcomes following aseptic failure.","authors":"Mackenzie A Roof,&nbsp;Shankar Narayanan,&nbsp;Nathan Lorentz,&nbsp;Vinay K Aggarwal,&nbsp;Morteza Meftah,&nbsp;Ran Schwarzkopf","doi":"10.1186/s43019-023-00191-5","DOIUrl":"https://doi.org/10.1186/s43019-023-00191-5","url":null,"abstract":"<p><strong>Introduction: </strong>Prior studies have demonstrated an association between time to revision total knee arthroplasty (rTKA) and indication; however, the impact of early versus late revision on post-operative outcomes has not been reported.</p><p><strong>Materials and methods: </strong>A retrospective, observational study examined patients who underwent unilateral, aseptic rTKA at an academic orthopedic hospital between 6/2011 and 4/2020 with > 1-year of follow-up. Patients were early revisions if they were revised within 2 years of primary TKA (pTKA) or late revisions if revised after greater than 2 years. Patient demographics, surgical factors, and post-operative outcomes were compared.</p><p><strong>Results: </strong>470 rTKA were included (199 early, 271 late). Early rTKA patients were younger by 2.5 years (p = 0.002). The predominant indications for early rTKA were instability (28.6%) and arthrofibrosis/stiffness (26.6%), and the predominant indications for late rTKA were aseptic loosening (45.8%) and instability (26.2%; p < 0.001). Late rTKA had longer operative times (119.20 ± 51.94 vs. 103.93 ± 44.66 min; p < 0.001). There were no differences in rTKA type, disposition, hospital length of stay, all-cause 90-day emergency department visits and readmissions, reoperations, and number of re-revisions.</p><p><strong>Conclusions: </strong>Aseptic rTKA performed before 2 years had different indications but demonstrated similar outcomes to those performed later. Early revisions had shorter surgical times, which could be attributed to differences in rTKA indication.</p><p><strong>Level of evidence: </strong>III, retrospective observational analysis.</p>","PeriodicalId":17886,"journal":{"name":"Knee Surgery & Related Research","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2023-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10230807/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9553322","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":"Upsurge in publications on ramp lesions of the meniscus: A bibliometric study.","authors":"Riccardo D'Ambrosi,&nbsp;Srinivas B S Kambhampati","doi":"10.1186/s43019-023-00190-6","DOIUrl":"https://doi.org/10.1186/s43019-023-00190-6","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study was to analyze the trends in publications on ramp lesions of the meniscus in the current literature. We hypothesized that publications on ramp lesions have increased rapidly in recent years due to increased knowledge of both clinical and radiological pathology.</p><p><strong>Methods: </strong>A Scopus search performed on 21/01/23 retrieved 171 documents. A similar search strategy was employed to carry out a search for ramp lesions on PubMed with no time filters and only English articles. The articles were downloaded into Excel software, and citations for PubMed articles were determined from the iCite website. Analysis was performed using Excel. Using Orange software, data mining was performed from the titles of all articles.</p><p><strong>Results: </strong>There are a total of 126 publications from 2011 to 2022 with a total of 1778 citations in PubMed. Of all publications, 72% were published in the last 3 years, from 2020 to 2022, indicating an exponential increase in interest in this subject in recent years. Similarly, 62% of the citations were aggregated by the years 2017-2020, both years included. When the journals were analyzed according to the number of citations, the American Journal of Sports Medicine (AJSM) topped with 822 citations (46% of all citations) and 25 publications, followed by Knee Surgery, Sports Traumatology, Arthroscopy (KSSTA) with 27 articles and 388 citations (22% of all citations). When analyzed by citations per publication for different types of studies, randomized clinical trials (RCTs) were the most cited, with 32 citations per publication, followed by basic science articles with 31.5. Most of the basic science articles were cadaver studies examining anatomy, technique, and biomechanics. Technical notes were the third most cited at 18.64 per publication. While the USA is the country that leads publications, France is in a significant second position contributing to research on this topic, followed by Germany and Luxembourg.</p><p><strong>Conclusions: </strong>Global trend analysis suggests that ramp lesion research has significantly increased and that the number of papers on the topic is steadily increasing. We found that the publications and citations presented a rising trend, the majority of the highly cited papers were contributed by a few centers, and the most cited were randomized clinical trials and basic science studies. The long-term outcomes of conservatively and surgically treated ramp lesions have attracted the most research interest.</p>","PeriodicalId":17886,"journal":{"name":"Knee Surgery & Related Research","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2023-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10225076/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9542173","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 medial patellofemoral ligament reconstruction result in femoral tunnel enlargement? A systematic review.","authors":"Diego Agustín Abelleyra Lastoria,&nbsp;Vathana Gopinath,&nbsp;Omkaar Divekar,&nbsp;Toby Smith,&nbsp;Tobias R W Roberts,&nbsp;Caroline B Hing","doi":"10.1186/s43019-023-00187-1","DOIUrl":"10.1186/s43019-023-00187-1","url":null,"abstract":"<p><strong>Background: </strong>Medial patellofemoral ligament (MPFL) reconstruction is a common surgical procedure for treating patellar instability. The primary aim of this systematic review was to determine whether MPFL reconstruction (MPFLR) leads to femoral tunnel enlargement (FTE). The secondary aims were to explore the clinical effects and risk factors of FTE. Electronic databases (MEDLINE, Global Health, Embase), currently registered studies, conference proceedings and the reference lists of included studies were searched independently by three reviewers. There were no constraints based on language or publication status. Study quality assessment was conducted. 3824 records were screened in the initial search. Seven studies satisfied the inclusion criteria, evaluating 380 knees in 365 patients. Rates of FTE following MPFLR ranged from 38.7 to 77.1%. Five low quality studies reported FTE did not lead to detrimental clinical outcomes as assessed with the Tegner, Kujala, IKDC, and Lysholm scores. There is conflicting evidence regarding change in femoral tunnel width over time. Three studies (of which two had a high risk of bias) reported age, BMI, presence of trochlear dysplasia and tibial tubercle-tibial groove distance did not differ between patients with and without FTE, suggesting these are not risk factors for FTE.</p><p><strong>Conclusion: </strong>FTE is a common postoperative event following MPFLR. It does not predispose poor clinical outcomes. Current evidence lacks the ability to identify its risk factors. The reliability of any conclusions drawn is hindered by the low level of evidence of the studies included in this review. Larger prospective studies with long-term follow up are required to reliably ascertain the clinical effects of FTE.</p>","PeriodicalId":17886,"journal":{"name":"Knee Surgery & Related Research","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2023-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10152597/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9405536","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":"Medial patellofemoral ligament reconstruction and tibial tuberosity transfer can be used to successfully manage patellofemoral instability in the setting of trochlea dysplasia.","authors":"Varun Dewan,&nbsp;Suribabu Gudipati,&nbsp;Joanna Rooney,&nbsp;Adam Lloyd,&nbsp;Sanjiv Chugh,&nbsp;Ejaz Mughal","doi":"10.1186/s43019-023-00181-7","DOIUrl":"https://doi.org/10.1186/s43019-023-00181-7","url":null,"abstract":"<p><strong>Background: </strong>Management of patella instability remains a challenge particularly in the presence of trochlea dysplasia. The aim of this study is to assess the recurrence rates of those with patellar instability who have undergone a combined tibial tuberosity transfer (TTT) and medial patellofemoral ligament reconstruction (MPFLR) in the setting of trochlea dysplasia.</p><p><strong>Methods: </strong>All skeletally mature patients who underwent combined TTT and MPFLR for recurrent patella instability were identified between January 2009 and December 2019. A retrospective review was conducted, with information regarding re-dislocation/subluxation and complications collected.</p><p><strong>Results: </strong>Seventy patients with a mean age 25.3 years were identified and evaluated. Thirteen patients were found to have low-grade dysplasia (Dejour A), with 57 patients having high-grade dysplasia (Dejour B/C/D). No patients in the low,grade dysplasia group suffered a recurrence of their symptoms, with four in the high-grade group suffering episodes of re-dislocation/subluxation. Three patients subsequently underwent a trochleoplasty, with the other patient managed successfully non-operatively. There were a total of 13 complications in 11 patients.</p><p><strong>Conclusions: </strong>A combined procedure of MPFLR and TTT can be used to manage patellofemoral instability even in the setting of trochlea dysplasia with a low rate of recurrence. Trochlea dysplasia, however, remains an anatomical risk factor for recurrence and patients should be counselled accordingly. The anatomical risk factors should be assessed in all patients to allow for the development of the most appropriate management plan, of which this combined procedure represents a potentially successful option.</p><p><strong>Level of evidence: </strong>IV (Case Series).</p>","PeriodicalId":17886,"journal":{"name":"Knee Surgery & Related Research","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2023-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10141911/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9425940","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":"Is simultaneous bilateral unicompartmental knee arthroplasty and total knee arthroplasty better than simultaneous bilateral total knee arthroplasty?","authors":"Naosuke Nagata,&nbsp;Takafumi Hiranaka,&nbsp;Koji Okamoto,&nbsp;Takaaki Fujishiro,&nbsp;Toshikazu Tanaka,&nbsp;Anjiki Kensuke,&nbsp;Daiya Kitazawa,&nbsp;Ken Kotoura","doi":"10.1186/s43019-023-00183-5","DOIUrl":"https://doi.org/10.1186/s43019-023-00183-5","url":null,"abstract":"<p><strong>Introduction: </strong>This retrospective study aims to clarify if there are benefits of performing unicompartmental knee arthroplasty (UKA) on just one indicated side in patients who undergo simultaneous bilateral knee arthroplasty.</p><p><strong>Materials and methods: </strong>We compared 33 cases of simultaneous bilateral UKA/total knee arthroplasty (TKA) (S-UT) with 99 cases of simultaneous bilateral TKA (S-TT). Comparison included blood tests [C-reactive protein (CRP), albumin, and D-dimer], the incidence of deep vein thrombosis (DVT), range of motion (ROM), and clinical scores before and 1 year after surgery.</p><p><strong>Results: </strong>Clinical scores were not significantly different between the groups. The postoperative flexion angle was significantly better in UKA sides. Blood tests showed that the S-UT had a significantly higher albumin value at 4 and 7 days after surgery. The CRP value at 4 and 7 days, and the D-dimer value at 7 and 14 days after surgery were significantly lower in the S-UT. The S-UT had significantly lower incidence of DVT.</p><p><strong>Conclusions: </strong>In cases of bilateral arthroplasty, if there is an indication on only one side, a better flexion angle can be obtained by UKA on that side, and with less surgical invasion. Moreover, the incidence of DVT is low, which is considered to be a benefit of performing UKA on just one side.</p>","PeriodicalId":17886,"journal":{"name":"Knee Surgery & Related Research","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2023-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10142498/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9369949","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 influence of primary treatment approach on outcomes in patients with osteochondral fracture after patellar dislocation: a case series.","authors":"Mikko Uimonen,&nbsp;Ville Ponkilainen,&nbsp;Ville M Mattila,&nbsp;Heikki Nurmi,&nbsp;Juha Paloneva,&nbsp;Jussi P Repo","doi":"10.1186/s43019-023-00186-2","DOIUrl":"https://doi.org/10.1186/s43019-023-00186-2","url":null,"abstract":"<p><strong>Background: </strong>We characterized the relation of primary treatment approaches to the need of later surgical interventions and the outcomes of patellar dislocation in patients with patellofemoral osteochondral fracture (OCF).</p><p><strong>Methods: </strong>Overall, 134 patients with OCF were categorized in two groups according to treatment approach: primary surgery (operation within 90 days from injury) and conservative treatment. Data on surgical procedures, OCF characteristics, and patellofemoral anatomy were retrospectively collected. To measure subjective outcomes, 54 patients completed the knee-specific patient-reported outcome measures (PROMs) Kujala score, Tegner activity scale, the knee injury and osteoarthritis outcome score (KOOS) quality of life (QoL) subscale, and visual analog scale pain items.</p><p><strong>Results: </strong>The mean follow-up time was 4.9 years [standard deviation (SD) 2.7 years]. The primary treatment approach was surgery in 73 patients (54%) and conservative in 61 patients (46%) of whim 18 (30%) needed late surgery. Of primary surgery patients, the OCF was reimplanted in 45 patients (62%) and removed in the rest. Of all patients, 31 needed surgery in the later phase after the primary treatment approach (either reoperation or surgery after insufficient outcome of conservative treatment). In conservatively treated patients, OCF was smaller and patellofemoral joint malformation was more severe than in surgery group. Among patients who completed the PROMs, the outcomes appeared generally acceptable in both groups.</p><p><strong>Conclusions: </strong>Although a majority of the primary treatment approaches for OCF after patellar dislocation were definitive, one-fourth of patients required surgery in the later phase. PROMs did not indicate major differences between the study groups.</p>","PeriodicalId":17886,"journal":{"name":"Knee Surgery & Related Research","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2023-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10099836/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9359463","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":"Total knee arthroplasty in patients with severe obesity: outcomes of standard keeled tibial components versus stemmed universal base plates.","authors":"Katherine L Elcock,&nbsp;Deborah J MacDonald,&nbsp;Nick D Clement,&nbsp;Chloe E H Scott","doi":"10.1186/s43019-023-00184-4","DOIUrl":"https://doi.org/10.1186/s43019-023-00184-4","url":null,"abstract":"<p><strong>Background: </strong>Patients with severe obesity [body mass index (BMI) ≥ 40 kg/m²] potentially overload the tibial component after total knee arthroplasty (TKA), risking tibial subsidence. Using a cemented single-radius cruciate-retaining TKA design, this study compared the outcomes of two tibial baseplate geometries in patients with BMI ≥ 40 kg/m²: standard keeled (SK) or universal base plate (UBP), which incorporates a stem.</p><p><strong>Methods: </strong>This was a retrospective, single-centre cohort study with minimum 2 years follow-up of 111 TKA patients with BMI ≥ 40 kg/m²: mean age 62.2 ± 8.0 (44-87) years, mean BMI 44.3 ± 4.6 (40-65.7) kg/m² and 82 (73.9%) females. Perioperative complications, reoperations, alignment and patient-reported outcomes (PROMS): EQ-5D, Oxford Knee Score (OKS), Visual Analogue Scale (VAS) pain score and satisfaction were collected preoperatively, and at 1 year and final follow-up postoperatively.</p><p><strong>Results: </strong>Mean follow-up was 4.9 years. SK tibial baseplates were performed in 57 and UBP in 54. There were no significant differences in baseline patient characteristics, post-operative alignment, post-operative PROMs, reoperations or revisions between the groups. Three early failures requiring revision occurred: two septic failures in the UBP group and one early tibial loosening in the SK group. Five-year Kaplan-Meier survival for the endpoint mechanical tibial failure was SK 98.1 [94.4-100 95% confidence interval (CI)] and UBP 100% (p = 0.391). Overall varus alignment of the limb (p = 0.005) or the tibial component (p = 0.031) was significantly associated with revision and return to theatre.</p><p><strong>Conclusions: </strong>At early to mid-term follow-up, no significant differences in outcomes were found between standard and UBP tibial components in patients with BMI ≥ 40 kg/m². Varus alignment of either tibial component or the limb was associated with revision and return to theatre.</p>","PeriodicalId":17886,"journal":{"name":"Knee Surgery & Related Research","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2023-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10088243/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9342839","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 extrusion is a predisposing factor for determining arthroscopic treatments in partial medial meniscus posterior root tears.","authors":"Takayuki Furumatsu,&nbsp;Keisuke Kintaka,&nbsp;Naohiro Higashihara,&nbsp;Masanori Tamura,&nbsp;Koki Kawada,&nbsp;Haowei Xue,&nbsp;Toshifumi Ozaki","doi":"10.1186/s43019-023-00182-6","DOIUrl":"https://doi.org/10.1186/s43019-023-00182-6","url":null,"abstract":"<p><strong>Background: </strong>Patients with partial medial meniscus posterior root tears (MMPRTs) sometimes require arthroscopic pullout repair because of their intolerable/repeated knee pains and continuous disturbance in gait during activities of daily living. However, the predisposing factors for future knee surgery in patients with partial MMPRTs remain unclear. We compared the findings of magnetic resonance imaging (MRI) between patients who underwent pullout repair and nonoperative management following partial MMPRTs.</p><p><strong>Methods: </strong>Twenty-five patients who required arthroscopic repair for partial MMPRTs and 23 patients who were managed nonoperatively were evaluated during a mean follow-up period of 27.1 months. Sex, age, height, body weight, body mass index, duration from onset to initial MRI, MRI findings, and medial meniscus (MM) extrusion were compared between the two groups. Linear regression analysis was used to assess the correlation between MM extrusion and duration from onset to MRI examination.</p><p><strong>Results: </strong>No significant differences were observed between the pullout repair and nonoperative management groups in terms of patient demographics and the positive ratio of MRI-based root tear signs. However, absolute MM extrusion in the pullout repair group (3.49 ± 0.82 mm) was larger than that in the nonoperative management group (2.48 ± 0.60 mm, P < 0.001). Extrusion of the MM (> 3 mm) was detected more frequently in the pullout repair group than in the nonoperative management group (P < 0.001). The odds ratio in the pullout repair and MM extrusion > 3 mm cases was 9.662. Linear regression analysis revealed a fair correlation between the duration from onset to MRI and MM extrusion only in the pullout repair group (0.462 mm/month increase in MM extrusion).</p><p><strong>Conclusions: </strong>This study demonstrated that more severe MM extrusions were observed in the pullout repair group than in the nonoperative management group. Major extrusion (> 3 mm) was also observed more in the pullout repair group than in the nonoperative group. Assessing MM extrusion and its severity can help determine a valid treatment for patients with partial MMPRTs.</p><p><strong>Level of evidence: </strong>IV, Retrospective comparative study.</p>","PeriodicalId":17886,"journal":{"name":"Knee Surgery & Related Research","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2023-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10012578/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9499526","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}