Knee Surgery & Related Research最新文献

{"title":"Validity and reliability of performance tests as balance measures in patients with total knee arthroplasty","authors":"D. C. Saraç, B. Unver, V. Karatosun","doi":"10.1186/s43019-022-00136-4","DOIUrl":"https://doi.org/10.1186/s43019-022-00136-4","url":null,"abstract":"","PeriodicalId":17886,"journal":{"name":"Knee Surgery & Related Research","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2022-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89362455","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The use of tantalum cones and diaphyseal-engaging stems in tibial component revision: a consecutive series","authors":"P. Spinello, R. A. R. Thiele, K. Zepeda, N. Giori, P. Indelli","doi":"10.1186/s43019-022-00141-7","DOIUrl":"https://doi.org/10.1186/s43019-022-00141-7","url":null,"abstract":"","PeriodicalId":17886,"journal":{"name":"Knee Surgery & Related Research","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2022-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79898140","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of the flexion gap with a distal femoral trial component in posterior-stabilized total knee arthroplasty","authors":"G. Kamei, S. Ishibashi, Koki Yoshioka, S. Sakurai, H. Inoue, Y. Mochizuki, M. Ishikawa, N. Adachi","doi":"10.1186/s43019-022-00142-6","DOIUrl":"https://doi.org/10.1186/s43019-022-00142-6","url":null,"abstract":"","PeriodicalId":17886,"journal":{"name":"Knee Surgery & Related Research","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2022-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84737551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implant survivorship, functional outcomes and complications with the use of rotating hinge knee implants: a systematic review","authors":"Joshua Xu, Lennart von Fritsch, S. Sabah, A. Price, A. Alvand","doi":"10.1186/s43019-022-00138-2","DOIUrl":"https://doi.org/10.1186/s43019-022-00138-2","url":null,"abstract":"","PeriodicalId":17886,"journal":{"name":"Knee Surgery & Related Research","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2022-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76007052","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhanced recovery after surgery for major orthopedic surgery: a narrative review.","authors":"Yun Seong Choi,&nbsp;Tae Woo Kim,&nbsp;Moon Jong Chang,&nbsp;Seung-Baik Kang,&nbsp;Chong Bum Chang","doi":"10.1186/s43019-022-00137-3","DOIUrl":"https://doi.org/10.1186/s43019-022-00137-3","url":null,"abstract":"<p><strong>Background: </strong>With increasing interest in enhanced recovery after surgery (ERAS), the literature on ERAS in orthopedic surgery is also rapidly accumulating. This review article aims to (1) summarize the components of the ERAS protocol applied to orthopedic surgery, (2) evaluate the outcomes of ERAS in orthopedic surgery, and (3) suggest practical strategies to implement the ERAS protocol successfully.</p><p><strong>Main body: </strong>Overall, 17 components constituting the highly recommended ERAS protocol in orthopedic surgery were identified. In the preadmission period, preadmission counseling and the optimization of medical conditions were identified. In the preoperative period, avoidance of prolonged fasting, multimodal analgesia, and prevention of postoperative nausea and vomiting were identified. During the intraoperative period, anesthetic protocols, prevention of hypothermia, and fluid management, urinary catheterization, antimicrobial prophylaxis, blood conservation, local infiltration analgesia and local nerve block, and surgical factors were identified. In the postoperative period, early oral nutrition, thromboembolism prophylaxis, early mobilization, and discharge planning were identified. ERAS in orthopedic surgery reduced postoperative complications, hospital stay, and cost, and improved the patient outcomes and satisfaction with accelerated recovery. For successful implementation of the ERAS protocol, various strategies including the standardization of care system, multidisciplinary communication and collaboration, ERAS education, and continuous audit system are necessary.</p><p><strong>Conclusion: </strong>The ERAS pathway enhanced patient recovery with a shortened length of stay, reduced postoperative complications, and improved patient outcomes and satisfaction. However, despite the significant progress in ERAS implementation in recent years, it has mainly focused on major surgeries such as arthroplasty. Therefore, further efforts to apply, audit, and optimize ERAS in various orthopedic surgeries are necessary.</p>","PeriodicalId":17886,"journal":{"name":"Knee Surgery & Related Research","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2022-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8864772/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39806982","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":"Analysis of clinical and radiological outcomes of long tibial stemmed total knee arthroplasty in knee osteoarthritis complicated by tibial stress fracture.","authors":"Neelam V Ramana Reddy,&nbsp;Mukesh Kumar Saini,&nbsp;Pera Jayavardhan Reddy,&nbsp;Ajay Singh Thakur,&nbsp;Challa Dinesh Reddy","doi":"10.1186/s43019-022-00139-1","DOIUrl":"https://doi.org/10.1186/s43019-022-00139-1","url":null,"abstract":"<p><strong>Objective: </strong>Knee arthritis associated with tibial stress fractures represents an uncommon and difficult clinical scenario to treat. The use of long, fluted tibial extension rods has been vital in the management of such cases owing to immediate fracture stability and single-stage surgery without the need to open the fracture site. This study investigates clinical and radiological outcomes following total knee arthroplasty using a tibial extension stem in cases of knee osteoarthritis with tibial stress fracture.</p><p><strong>Methods: </strong>From February 2015 to December 2020, 17 patients who had total knee arthroplasty implanted with a long stemmed tibial component were included in the study. Patient data were analyzed for knee range of motion, deformities, Knee Society score, knee function score, and time to fracture union in the pre- and postoperative periods.</p><p><strong>Results: </strong>The mean follow-up duration was 22.7 ± 11.68 months (range 12-60 months), and mean time to fracture healing was 10.23 ± 2.81 weeks (range 8-20 weeks). The preoperative mean fixed flexion deformity improved from 8.53 ± 3.43° to a mean of 0.29°, and knee flexion improved from 79.4 ± 13.90° to 125.29 ± 8.74° on postoperative assessment. The Knee Society score improved from a mean preoperative score of 18.94 ± 5.55 (range 8-28) to 89.41 ± 7.5 (range 74-102, p value < 0.001). Similarly, the knee function score improved significantly from a mean preoperative score of 15.5 ± 4.48 (range 8-26) to a mean of 85 ± 6.09 (range 72-94, p value < 0.001).</p><p><strong>Conclusion: </strong>Total knee arthroplasty using long tibial extenders has been an effective and safe surgical option for patients with advanced osteoarthritis with tibial stress fractures.</p>","PeriodicalId":17886,"journal":{"name":"Knee Surgery & Related Research","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2022-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8864841/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39806987","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":"Quadriceps muscle volume has no effect on patellofemoral cartilage lesions in patients with end-stage knee osteoarthritis.","authors":"Jung-Ro Yoon,&nbsp;Hong Joon Joo,&nbsp;Seung Hoon Lee","doi":"10.1186/s43019-022-00134-6","DOIUrl":"https://doi.org/10.1186/s43019-022-00134-6","url":null,"abstract":"<p><strong>Purpose: </strong>The quadriceps muscle has a positive effect on anterior knee pain. However, its effect on the patellofemoral (PF) cartilage in patients with end-stage knee osteoarthritis is unknown. The present study aimed to evaluate whether the quadriceps muscle area had a positive effect on the PF cartilage and whether this muscle had a positive effect on the clinical scores.</p><p><strong>Materials and methods: </strong>Patients with confirmed cartilage status and clinical scores who underwent total knee arthroplasty (TKA) were included. The PF cartilage status was evaluated during TKA. The thickness and the area of the quadriceps muscle were measured using a knee computed tomography scan obtained before the surgery. The Q-angle, hip-knee-ankle angle, alignment, and Insall-Salvati ratio were measured by radiography.</p><p><strong>Results: </strong>Altogether, 204 patients were included in the study. Logistic regression was performed including factors associated with PF cartilage lesions. The regression model was found to be statistically significant (Hosmer-Lemeshow test, χ² = 0.493). A smaller hip-knee-ankle (HKA) angle was associated with a higher incidence of PF cartilage lesions (p = 0.033) and only the alignment had an effect on the PF cartilage lesions. PF cartilage lesions did not correlate with the clinical scores. A thicker medial portion of the quadriceps muscle was associated with a significantly higher Knee Society Knee Score (KSKS) (p = 0.028).</p><p><strong>Conclusions: </strong>Quadriceps muscle thickness and area, Q-angle, and patellar height were not associated with PF cartilage lesions, while a smaller HKA angle was associated with PF cartilage lesions. The presence of PF cartilage lesions did not affect the clinical symptoms. However, a thicker medial portion of the quadriceps muscle was associated with a higher KSKS.</p>","PeriodicalId":17886,"journal":{"name":"Knee Surgery & Related Research","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2022-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8858450/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39937036","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":"Knee joint line related to bony landmarks of the knee: a radiologic study in a Thai population.","authors":"S Tantavisut,&nbsp;C Amarase,&nbsp;S Ngarmukos,&nbsp;C Tanavalee,&nbsp;A Tanavalee","doi":"10.1186/s43019-022-00135-5","DOIUrl":"https://doi.org/10.1186/s43019-022-00135-5","url":null,"abstract":"<p><strong>Background: </strong>During revision total knee arthroplasty (TKA), knee joint line restoration may be difficult due to bone loss or structural changes. Although bony landmarks are consistent and can be used as references, there are limited data in Asian patients. We studied the knee joint line related to bony landmarks of the knee in a Thai population.</p><p><strong>Materials and methods: </strong>Magnetic resonance imaging (MRI) of 140 healthy knees of Thai patients (70 males, 70 females) were investigated. In all knees, a perpendicular line from knee joint line to the medial epicondyle (distance A) and the lateral epicondyle (distance B) in the coronal plane were measured. In the sagittal plane, a perpendicular line from the knee joint line to the fibular head (distance C), the tibial tubercle (distance D), and the inferior patellar pole (distance E) were measured. The femoral transepicondylar width (FW) was measured along the transepicondylar axis. The ratios of distances A, B, C, D, and E related to FW were evaluated (epicondylar ratio).</p><p><strong>Results: </strong>The mean and standard deviation (SD) of distances A, B, C, D, E, and FW were 27.1 ± 2.7 mm, 21.7 ± 2.5 mm, 12.6 ± 3 mm, 21.3 ± 3.6 mm, 7.6 ± 4.8 mm, and 76.7 ± 3.99, respectively. There was wide variation of measured values, with statistically significant differences between genders in distances A, B, C, and FW. The mean and SD of epicondylar ratios A/FW, B/FW, C/FW, D/FW, and E/FW were 0.35 ± 0.02, 0.29 ± 0.02, 0.16 ± 0.05, 0.28 ± 0.04, and 0.09 ± 0.04, respectively. All epicondylar ratios demonstrated less variation than all measured distances, with statistical differences between genders in the A/FW and D/FW ratios. However, the B/FW ratio had the highest consistent mean value. In addition, it had narrower SD than the rest (0.29 ± 0.02; range, 0.22-0.33).</p><p><strong>Conclusions: </strong>In Thai knees, the measured distances from bony landmarks to the knee joint line had higher variation than the epicondylar ratio. Among all studied epicondylar ratios, the ratio between lateral epicondyle to joint line distance (distance B)/FW demonstrated the narrowest range of mean and SD values; therefore, this could be the most reliable landmark for intraoperative knee joint line verification by multiplying the FW of the patient by 0.29 to get distance B in that patient.</p>","PeriodicalId":17886,"journal":{"name":"Knee Surgery & Related Research","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2022-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8845375/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39802718","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 the patient aware of the difference between resurfaced and nonresurfaced patella after bilateral total knee arthroplasty? A systematic review of simultaneous bilateral randomized trials.","authors":"Keun Young Choi,&nbsp;Yong In,&nbsp;Man Soo Kim,&nbsp;Sueen Sohn,&nbsp;In Jun Koh","doi":"10.1186/s43019-022-00133-7","DOIUrl":"https://doi.org/10.1186/s43019-022-00133-7","url":null,"abstract":"<p><strong>Purpose: </strong>The optimal practice of patellar management in total knee arthroplasty (TKA) remains controversial. This systematic review was conducted to compare patella-related (1) patient-reported outcome measures (PROMs), (2) clinical outcomes, and (3) reoperation rates after TKA with patellar resurfacing (PR) and nonresurfacing (NPR) in single patients undergoing bilateral patellar procedures during simultaneous bilateral TKA.</p><p><strong>Methods: </strong>This review included prospective bilateral randomized trials investigating patella-related PROMs, clinical outcomes, and reoperation (secondary resurfacing and patellar component revision) and other patella-related complications in single patients undergoing randomly assigned PR and NPR during bilateral TKA.</p><p><strong>Results: </strong>Six studies were included. There was no difference in PROMs between PR and NPR in five studies, whereas PR was found to be superior to NPR in one study. Five studies reported similar functional outcomes and complication rates between PR and NPR, while one study found better clinical outcomes and a lower complication rate in PR. Between-group secondary resurfacing and patellar revision rates were similar in all studies.</p><p><strong>Conclusions: </strong>The majority of patients who underwent bilateral patellar procedures could not tell the difference between PR and NPR following bilateral TKA. There were no differences in clinical outcomes or reoperation and complication rates between PR and NPR. No evidence was found to support routine PR.</p><p><strong>Level of evidence: </strong>Therapeutic Level 1.</p>","PeriodicalId":17886,"journal":{"name":"Knee Surgery & Related Research","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2022-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8842956/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39923407","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":"How to achieve an optimal alignment in medial opening wedge high tibial osteotomy?","authors":"Byoung Youl Kang,&nbsp;Do Kyung Lee,&nbsp;Hyeon Soo Kim,&nbsp;Joon Ho Wang","doi":"10.1186/s43019-021-00130-2","DOIUrl":"https://doi.org/10.1186/s43019-021-00130-2","url":null,"abstract":"<p><p>Medial opening wedge high tibial osteotomy (MOWHTO) is a widely used surgical treatment option for medial compartmental osteoarthritis with varus deformity. It is important that proper lower limb alignment is achieved. However, there has been no consensus about an optimal alignment in MOWHTO. Most studies suggest that achieving valgus alignment is necessary, and recent studies support slight valgus mechanical alignment of less than 3° of mechanical femorotibial angle. Overcorrection and undercorrection is not recommended for achieving good surgical outcomes. To prevent undercorrection and overcorrection in MOWHTO, the method of placing the weight-bearing line in the target range must be precise. There are several ways to place a weight-bearing line within the target range. While the most important factor for a successful MOWHTO is achieving an ideal mechanical axis correction, there are a few other factors to consider, including joint line obliquity, posterior tibial slope, ligament balancing, and patellar height. Several factors exist that lead to undercorrection and overcorrection. Preoperative amount of varus deformity, lateral hinge fracture, and fixation failure can result in undercorrection, while medial soft tissue laxity and the amount of correction angle and target point beyond hypomochlion can result in overcorrection. This study aimed to review the literature on optimal alignment in MOWHTO and report on the factors to be considered to prevent correction errors and how to achieve an optimal alignment.</p>","PeriodicalId":17886,"journal":{"name":"Knee Surgery & Related Research","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2022-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8822774/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39604945","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}