Knee Surgery & Related Research最新文献

{"title":"Imaging evaluation of patellofemoral joint instability: a review.","authors":"Roberto M Barbosa,&nbsp;Manuel Vieira da Silva,&nbsp;Carlos Sampaio Macedo,&nbsp;Cristina P Santos","doi":"10.1186/s43019-023-00180-8","DOIUrl":"https://doi.org/10.1186/s43019-023-00180-8","url":null,"abstract":"<p><p>The multifactorial origin of anterior knee pain in patellofemoral joint disorders leads to a demanding diagnostic process. Patellofemoral misalignment is pointed out as one of the main causes of anterior knee pain. The main anatomical risk factors of patellofemoral instability addressed in the literature are trochlear dysplasia, abnormal patellar height, and excessive tibial tubercle-trochlear groove distance. Diagnostic imaging of the patellofemoral joint has a fundamental role in assessing these predisposing factors of instability. Extensive work is found in the literature regarding the assessment of patellofemoral instability, encompassing several metrics to quantify its severity. Nevertheless, this process is not well established and standardized, resulting in some variability and inconsistencies. The significant amount of scattered information regarding the patellofemoral indices to assess the instability has led to this issue. This review was conducted to collect all this information and describe the main insights of each patellofemoral index presented in the literature. Five distinct categories were created to organize the patellofemoral instability indices: trochlear dysplasia, patellar height, patellar lateralization, patellar tilt, and tibial tubercle lateralization.</p>","PeriodicalId":17886,"journal":{"name":"Knee Surgery & Related Research","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2023-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10012577/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9128441","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 effect of Parkinson's disease on total knee arthroplasty: a systematic review and meta-analysis.","authors":"Jung-Ro Yoon,&nbsp;Tae-Hyuck Yoon,&nbsp;Seung Hoon Lee","doi":"10.1186/s43019-023-00179-1","DOIUrl":"https://doi.org/10.1186/s43019-023-00179-1","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this systematic review was to determine the effect of Parkinson's disease (PD) on clinical outcomes and complications after total knee arthroplasty (TKA). Our systematic review was conducted to answer the following questions: (1) does TKA negatively affect clinical outcomes in patients with PD? and (2) does TKA cause more complications in patients with PD?</p><p><strong>Methods: </strong>A rigorous and systematic approach was used, and each selected study was evaluated for methodological quality. Data on study design, total number of cases enrolled, follow-up duration, PD severity, clinical outcome, and complications after TKA were analyzed.</p><p><strong>Results: </strong>Fourteen studies were included. Nine studies reported clinical scores. TKA significantly increased knee and functional scores in the PD group. However, compared with knee and functional scores in the non-PD group, the increase in scores in the PD group was not statistically significant, but tended to be less than that in the non-PD group. Eleven studies reported complications. In six studies, there was no difference in the complication rate between the PD and non-PD group or did not include a control group. In five studies, the PD group had higher medical complication rates and similar or higher surgical complication rates than the non-PD group.</p><p><strong>Conclusions: </strong>Patients with PD who underwent TKA showed satisfactory functional improvement and pain reduction. However, these outcomes were not as good as those in the non-PD group. The PD group had a higher probability of occurrence of medical complications than the non-PD group. Further, the PD group had a similar or higher surgical complication rate than the non-PD group.</p>","PeriodicalId":17886,"journal":{"name":"Knee Surgery & Related Research","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2023-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9930284/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10738595","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 additional tibial stem extension is not mandatory for the stability of 5 mm metal block augmented tibial prosthesis construct in primary total knee arthroplasty: 5-year minimum follow-up results.","authors":"Jae Joon Ryu,&nbsp;Yeong Hwan Kim,&nbsp;Choong Hyeok Choi","doi":"10.1186/s43019-023-00174-6","DOIUrl":"https://doi.org/10.1186/s43019-023-00174-6","url":null,"abstract":"<p><strong>Purpose: </strong>To determine whether additional stem extension for stability is necessary, we performed mid-term follow-up of patients who had been managed with 5-mm metal block augmentation for a tibial defect, where tibial prosthesis was fixed using bone cement without stem extension. Also, we evaluated clinical and radiologic results including survival rate of patients without stem extension.</p><p><strong>Methods: </strong>We retrospectively analyzed patients with tibial bone defect, had undergone primary total knee arthroplasty, and had been treated with 5-mm metal block augmentation without stem extension between March 2003 and September 2013. Among 74 patients (80 cases), 47 patients (52 cases) were followed up for at least 5 years.</p><p><strong>Results: </strong>Mean flexion contracture improved from 8.8° (0-40°) preoperatively to 0.4° (-5° to 15°) at final follow-up (P < 0.01), but there was no significant change in the mean angle of great flexion: 124.6° (75-150°) preoperatively and 126.2° (90-145°) at final follow-up (P = 0.488). Mean range of motion improved from 115.8° (35-150°) preoperatively to 125.5° (90-145°) at final follow-up (P < 0.01). Mean knee score improved from 38.7 points (0-66 points) preoperatively to 93.2 points (79-100 points) at final follow-up (P < 0.01), and mean functional score also improved from 50.4 points (10-70 points) preoperatively to 81.8 points (15-100 points) at final follow-up (P < 0.01). The mean postoperative Western Ontario and McMaster University osteoarthritis score was 19.5 points (0-66.0 points). The mean femorotibial angle was corrected from 9.0° varus (23.0° varus-6.3° valgus) preoperatively to 5.5° valgus (2.2° varus-11.1° valgus) at final follow-up (P < 0.01). There was no change in the mean β-angle, which was 90.7° (87.2-94.9°) immediately postoperative and 90.8° (87.2-94.9°) at final follow-up (P = 0.748) and in the mean δ-angle, which was 86.2° (81.3-90.0°) immediately postoperative and 87.2° (83.1-96.5°) at final follow-up (P = 0.272). Radiolucent lines (RLL) were observed in ten cases (26.3%), and the mean RLL scores at final follow-up were 0.34 points (0-3 points) in the anteroposterior view and 0.42 points (0-6 points) in the lateral view. Scores for the RLL were ≤ 4 points in 36 cases, 5-9 points in two cases. Revision surgery due to aseptic loosening (three cases) is rarely required, and the Kaplan-Meier survival rate at 10 postoperative years was 96.4% CONCLUSION: When performing 5-mm metal block augmentation for a proximal tibial defect, no additional tibial stem extension can be a good surgical option for the stability of tibial prosthetic construct and mid-term clinical and radiologic results.</p><p><strong>Level of evidence: </strong>IV.</p>","PeriodicalId":17886,"journal":{"name":"Knee Surgery & Related Research","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9890779/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10707619","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 current utilization of the patient-reported outcome measurement information system (PROMIS) in isolated or combined total knee arthroplasty populations.","authors":"Puneet Gupta,&nbsp;Natalia Czerwonka,&nbsp;Sohil S Desai,&nbsp;Alirio J deMeireles,&nbsp;David P Trofa,&nbsp;Alexander L Neuwirth","doi":"10.1186/s43019-023-00177-3","DOIUrl":"https://doi.org/10.1186/s43019-023-00177-3","url":null,"abstract":"<p><p>Patient reported outcome measures (PROMs) are essential for clinical research and patient-centric care because they allow us to capture patient perspectives on their health condition. In knee arthroplasty, PROMs are frequently used to assess the risks and benefits of new interventions, surgical approaches, and other management strategies. A few examples of PROMs used in total knee arthroplasty (TKA) include the Oxford Knee Score (OKS), Knee Injury and Osteoarthritis Outcome Score (KOOS), and the Forgotten Joint Score (FJS) (collectively referred to as \"legacy\" PROMs). More recently, attention has been brought to another PROM called the Patient-Reported Outcomes Measurement Information System (PROMIS). PROMIS was developed by the National Institute of Health (NIH) and has over 300 domains assessing various aspects of patient health, including pain, physical function, and mental health. With the use of PROMIS increasing in TKA literature, there is a need to review the advancements being made in understanding and applying PROMIS for this population. Thus, the purpose of this study is to provide insight on the utilization, advantages, and disadvantages of PROMIS within the field of knee arthroplasty and to provide a comparison to legacy PROMs.</p>","PeriodicalId":17886,"journal":{"name":"Knee Surgery & Related Research","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2023-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9850535/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10560008","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":"Single-stage long-stem total knee arthroplasty in severe arthritis with stress fracture: a systematic review.","authors":"Shubhankar Shekhar,&nbsp;Alok Rai,&nbsp;Saket Prakash,&nbsp;Tarun Khare,&nbsp;Rajesh Malhotra","doi":"10.1186/s43019-023-00178-2","DOIUrl":"https://doi.org/10.1186/s43019-023-00178-2","url":null,"abstract":"<p><strong>Purpose: </strong>Proximal tibia stress fractures present a challenge when performing total knee arthroplasty (TKA) in knee arthritis (KA). The literature on treatment modalities for stress fractures with arthritis is varied and not systematically reviewed. We aimed to answer the questions: (1) Is long-stem TKA sufficient for stress fractures in arthritic knees? (2) Should stress fracture and KA be addressed simultaneously? (3) What is the role of augmentative procedures in stress fractures with knee arthritis? (4) Can a unified algorithm be established?</p><p><strong>Methods: </strong>The PubMed and Cochrane databases were searched for keywords such as stress fracture, knee arthritis and total knee arthroplasty, published from January 1995 to 29 May 2022. A total of 472 records were screened down to 13 articles on the basis of our selection criteria. Ten data items were recorded from the included studies. The methodological index for non-randomised studies (MINORS) score for the included studies was 17 ± 3.</p><p><strong>Results: </strong>We found long-stem TKA to be sufficient for most cases and advocated for single-stage treatment of stress fractures and arthritis. Augmentative procedures play a role in the treatment, and a unified algorithm was drafted to guide treatment.</p><p><strong>Conclusion: </strong>Single-stage management of advanced KA with a stress fracture causes less morbidity than a staged procedure. Long-stem TKA, with or without an augmentative procedure, is an excellent option.</p>","PeriodicalId":17886,"journal":{"name":"Knee Surgery & Related Research","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2023-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9850688/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10560003","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":"Radiographic measurement of the congruence angle according to Merchant: validity, reproducibility, and limits.","authors":"M Severyns,&nbsp;J Mallet,&nbsp;B Santoni,&nbsp;T Barnavon,&nbsp;A Germaneau,&nbsp;T Vendeuvre,&nbsp;M Drame","doi":"10.1186/s43019-023-00175-5","DOIUrl":"https://doi.org/10.1186/s43019-023-00175-5","url":null,"abstract":"<p><strong>Purpose: </strong>The objective of this study was to analyze the intra- and interobserver variability of this measurement according to a strict methodology and on a representative sample of the general population, as well as to identify the possible difficulties of measurement in case of patellar or trochlear dysplasia.</p><p><strong>Methods: </strong>This observational study involved radiographic analysis by three independent observers of a total of 50 patients who had a loaded patellofemoral X-ray taken with the knee flexed to 45°. An initial reading was taken to measure the angle of the trochlear sulcus, the Merchant angle, and to classify the knees according to a possible trochlear dysplasia and/or patellar dysplasia according to Wiberg. A second measurement was then performed to analyze intraobserver agreement. Interobserver agreement was measured on all radiographic measurements (n = 100).</p><p><strong>Results: </strong>The Merchant patellofemoral congruence angle showed good intraobserver concordance ranging from 0.925 (95% CI 0.868-0.957) to 0.942 (95% CI 0.898-0.967), as well as interobserver concordance ranging from 0.795 (95% CI 0.695-0.862) to 0.914 (95% CI 0.872-0.942). Poor results were found in terms of interobserver concordance on the measurement of the Merchant angle in case of stage 3 Wiberg patella ranging from 0.282 (95% CI -0.920 to 0.731) to 0.611 (95% CI 0.226-0.892).</p><p><strong>Conclusion: </strong>Congruence angle is one of most commonly used measurements for patellar tracking. However, the convexity of the patellar surface makes it difficult to identify the patellar apex on its intraarticular facet, making the measurement of the Merchant congruence angle unreliable and not very reproducible in cases of stage 3 Wiberg patella. Registration N°IRB 2021/139.</p>","PeriodicalId":17886,"journal":{"name":"Knee Surgery & Related Research","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2023-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9830856/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10523865","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":"Acceptable clinical outcomes despite high reoperation rate at minimum 12-month follow-up after concomitant arthroscopically assisted anterior cruciate ligament reconstruction and medial meniscal allograft transplantation.","authors":"Dhruv S Shankar,&nbsp;Kinjal D Vasavada,&nbsp;Amanda Avila,&nbsp;Brittany DeClouette,&nbsp;Hadi Aziz,&nbsp;Eric J Strauss,&nbsp;Michael J Alaia,&nbsp;Laith M Jazrawi,&nbsp;Guillem Gonzalez-Lomas,&nbsp;Kirk A Campbell","doi":"10.1186/s43019-023-00176-4","DOIUrl":"https://doi.org/10.1186/s43019-023-00176-4","url":null,"abstract":"<p><strong>Background: </strong>Single-stage medial meniscus allograft transplantation (MAT) with concomitant anterior cruciate ligament reconstruction (ACLR) is a technically challenging procedure for management of knee pain and instability in younger patients, but clinical and functional outcomes data are sparse. The purpose of this study was to assess surgical and patient-reported outcomes following concomitant ACLR and medial MAT.</p><p><strong>Methods: </strong>We conducted a retrospective case series of patients who underwent medial MAT with concomitant primary or revision ACLR at our institution from 2010 to 2021 and had minimum 12-month follow-up. Complications, reoperations, visual analog scale (VAS) pain, satisfaction, Lysholm score, return to sport, and return to work outcomes were assessed. Patient-Reported Outcomes Measurement Information System (PROMIS) Pain Interference, Pain Intensity, and Physical Function Scores were used to measure patients' functional status relative to the US population. P-values < 0.05 were considered significant.</p><p><strong>Results: </strong>The cohort consisted of 17 knees of 16 individual patients. The cohort was majority male (82.4%) with mean age of 31.9 years (range 19-49 years) and mean body mass index (BMI) of 27.9 kg/m² (range 22.5-53.3 kg/m²). Mean follow-up time was 56.8 months (range 13-106 months). Most patients underwent revision ACLR (64.7%). The 1-year reoperation rate was high (23.5%), with two patients (11.8%) tearing their meniscus graft. Patient-reported outcomes indicated low VAS pain (mean 2.2), high satisfaction (mean 77.9%), and fair Lysholm score (mean 81.1). Return to work rate was high (92.9%), while return to sport rate was low (42.9%). Postoperative PROMIS scores were comparable or superior to the national average and correlated significantly with patient satisfaction (p < 0.05).</p><p><strong>Conclusions: </strong>The concomitant ACLR and MAT procedure is associated with excellent knee pain and functional outcomes and high rate of return to work after surgery, though the 1-year reoperation rate is high and rate of return to sport is low.</p><p><strong>Level of evidence: </strong>IV.</p>","PeriodicalId":17886,"journal":{"name":"Knee Surgery & Related Research","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2023-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9832613/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10524680","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":"An eponymous history of the anterolateral ligament complex of the knee.","authors":"Allison M Morgan,&nbsp;Andrew S Bi,&nbsp;Daniel J Kaplan,&nbsp;Michael J Alaia,&nbsp;Eric J Strauss,&nbsp;Laith M Jazrawi","doi":"10.1186/s43019-022-00172-0","DOIUrl":"https://doi.org/10.1186/s43019-022-00172-0","url":null,"abstract":"<p><strong>Background: </strong>Recent interest has surged in the anterolateral ligament (ALL) and complex (ALC) of the knee. Its existence and role in rotary stability of the knee, particularly in the setting of anterior cruciate ligament (ACL) reconstruction, remains a contentious and controversial topic.</p><p><strong>Understanding the alc: </strong>We must review our history and recognize the pioneers who pushed our understanding of the ALL forward before it was popularly recognized as a discrete structure. Additionally, given that many eponyms remain in common use related to the ALC, we must standardize our nomenclature to prevent misuse or misunderstanding of terms in the literature. In this review, modern understanding of the anterolateral ligament complex (ALC) is traced to 1829 by exploring eponymous terms first in anatomy and then in surgical technique. Understanding our history and terminology will allow us to better understand the ALC itself.</p><p><strong>Conclusion: </strong>This review aims to provide historical context, define terminology, and provide insight into the clinical relevance of the ALC.</p>","PeriodicalId":17886,"journal":{"name":"Knee Surgery & Related Research","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2022-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9756455/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10765356","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":"Fast-track surgery and telerehabilitation protocol in unicompartmental knee arthroplasty leads to superior outcomes when compared with the standard protocol: a propensity-matched pilot study.","authors":"Luca De Berardinis,&nbsp;Marco Senarighi,&nbsp;Carlo Ciccullo,&nbsp;Fabiana Forte,&nbsp;Marco Spezia,&nbsp;Antonio Pompilio Gigante","doi":"10.1186/s43019-022-00173-z","DOIUrl":"https://doi.org/10.1186/s43019-022-00173-z","url":null,"abstract":"<p><strong>Background: </strong>Several strategies have been devised to reduce the length of stay after orthopedic surgery. Telerehabilitation has proved effective in functional outcomes after orthopedic procedures and is appreciated by patients. There is limited information on fast-track surgery and telerehabilitation protocols for unicompartmental knee arthroplasty (UKA). The purpose of this pilot study was to report and compare functional outcomes and satisfaction levels during first 12 months of recovery in patients who underwent UKA according to a fast-track and telerehabilitation protocol (G1) or standard surgery and rehabilitation program (G2).</p><p><strong>Methods: </strong>Data were retrospectively collected and reviewed for all elective UKAs from January 2018 to November 2019. A total of seven patients undergoing UKA according to the fast-track and telerehabilitation protocol were propensity score matched (1:3 ratio) to 21 patients undergoing standard surgery and rehabilitation. Patients were matched for age, sex, body mass index (BMI), and laterality. The Western Ontario and McMaster University (WOMAC) osteoarthritis index and range of motion (ROM) were collected pre- and postoperatively in both groups for 12 months. In addition, patient' satisfaction was collected at 40 days.</p><p><strong>Results: </strong>The G1 group demonstrated significantly better outcomes in WOMAC index scores at 2, 15, and 40 days (p < 0.001, p < 0.001, p < 0.020, respectively) and a significantly greater knee ROM after surgery and at 2, 15, 40, and 12 months (p < 0.001, p < 0.001, p = 0.014, p < 0.001, p = 0.003, respectively). No patients in either group had postoperative complications. One patient was not completely satisfied in the G2, while no one in G1 reported not being completely satisfied (p = 1.000).</p><p><strong>Conclusions: </strong>This fast-track and telerehabilitation protocol after UKA can potentially be applied to patients as it is safe and effective. At 12-months follow-up, both groups reported favorable outcomes after UKA. However, the G1 score was better regarding WOMAC and ROM when compared with the propensity score-matched G2 program. A larger study is warranted to explore the role of fast-track and telerehabilitation in clinical and functional outcomes of UKA.</p>","PeriodicalId":17886,"journal":{"name":"Knee Surgery & Related Research","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2022-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9743114/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10337684","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":"Intramedullary rod insertion places the femoral component more laterally during Oxford medial unicompartmental knee arthroplasty.","authors":"Toshikazu Tanaka,&nbsp;Yoshihito Suda,&nbsp;Tomoyuki Kamenaga,&nbsp;Akira Saito,&nbsp;Takaaki Fujishiro,&nbsp;Koji Okamoto,&nbsp;Takafumi Hiranaka","doi":"10.1186/s43019-022-00171-1","DOIUrl":"https://doi.org/10.1186/s43019-022-00171-1","url":null,"abstract":"<p><strong>Background: </strong>This study aims to assess the influence of intramedullary rods on the implantation positions of femoral components using Microplasty instrumentation in Oxford unicompartmental knee arthroplasty. We hypothesized that femoral components can be laterally implanted incorrectly when using intramedullary rods.</p><p><strong>Methods: </strong>This prospective study included all 45 consecutive patients (53 knees) who underwent Oxford unicompartmental knee arthroplasty surgery for anteromedial osteoarthritis or spontaneous osteonecrosis of the knee at our hospital during the study period. A custom-made toolset comprising a triangular caliper and circular trial bearings was used to evaluate the distance between the bearing and the vertical wall of the tibia implant (wall-bearing space) using the caliper at 90° flexion both with and without intramedullary rods.</p><p><strong>Results: </strong>The wall-bearing space was significantly larger when the intramedullary rod was used than when intramedullary rod was not used (1.8 ± 1.1 mm versus 3.4 ± 1.2 mm, P < 0.001). The mean difference of wall-bearing space with and without intramedullary rod was 1.6 ± 0.7 mm.</p><p><strong>Conclusions: </strong>Femoral components can be laterally implanted incorrectly by an average of 1.6 mm when using intramedullary rods. The wall-bearing space should be evaluated using trial components, and if the relationship is improper, it should be corrected before keel slot preparation.</p>","PeriodicalId":17886,"journal":{"name":"Knee Surgery & Related Research","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2022-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9652838/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40462892","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}