Knee Surgery & Related Research最新文献

{"title":"An increasing trend of posterior cruciate ligament reconstruction in South Korea: epidemiologic analysis using Korean National Health Insurance System Database.","authors":"Kyu Sung Chung","doi":"10.1186/s43019-021-00126-y","DOIUrl":"https://doi.org/10.1186/s43019-021-00126-y","url":null,"abstract":"<p><strong>Background: </strong>The posterior cruciate ligament is crucial for posterior stability of the knee joint, and, as well as anterior cruciate ligament reconstruction, posterior cruciate ligament reconstruction (PCLR) has attracted interest in orthopedic literature. A few studies have investigated epidemiologic data of PCLR in Western countries. However, there has been no report on the epidemiological pattern of PCLR in the Asian population, including South Korea. Therefore, this study investigated the incidence and trends of PCLR in South Korea using the Korean National Health Insurance (NHI) System Database.</p><p><strong>Methods: </strong>The data was collected by the Korean Health Insurance Review and Assessment Service (HIRA) from 2008 to 2016 in South Korea. Patients with a record of cruciate ligament reconstruction and PCLR were allocated from the database. An analysis of the total number and incidence per 100,000 people/year of PCLR procedures and other epidemiologic parameters was conducted according to sex and age.</p><p><strong>Results: </strong>The incidence of PCLR procedures rose from 2.3 to 2.6 per 100,000 people (from 1101 to 1299 total cases; 13% increase) between 2008 and 2016: from 3.8 to 4.0 (from 901 to 1000) in males, and from 0.8 to 1.2 (from 200 to 299) in females. PCLR was performed more frequently in males than in females, however, the rate of increase was higher in females than males. The incidence of PCLR over 9  years was highest in patients in their 20s, followed by patients in their 40s and 30s.</p><p><strong>Conclusion: </strong>The incidence of PCLR procedures increased by 13% over 9 years in South Korea. PCLR was performed approximately three times more in men than in women. The incidence of PCLR was highest in patients in their 20s, followed by those in their 40s. The current study will enhance our understanding of the epidemiology of PCLR.</p><p><strong>Study design: </strong>Descriptive Epidemiology Study.</p>","PeriodicalId":17886,"journal":{"name":"Knee Surgery & Related Research","volume":"33 1","pages":"44"},"PeriodicalIF":3.1,"publicationDate":"2021-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8645088/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39803902","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":"Appropriate determination of the surgical transepicondylar axis can be achieved following distal femur resection in navigation-assisted total knee arthroplasty.","authors":"Sang Jun Song,&nbsp;Hyun Woo Lee,&nbsp;Kang Il Kim,&nbsp;Cheol Hee Park","doi":"10.1186/s43019-021-00123-1","DOIUrl":"https://doi.org/10.1186/s43019-021-00123-1","url":null,"abstract":"<p><strong>Background: </strong>Many surgeons have determined the surgical transepicondylar axis (sTEA) after distal femur resection in total knee arthroplasty (TKA). However, in most navigation systems, the registration of the sTEA precedes the distal femur resection. This sequential difference can influence the accuracy of intraoperative determination for sTEA when considering the proximal location of the anatomical references for sTEA and the arthritic environment. We compared the accuracy and precision in determinations of the sTEA between before and after distal femur resection during navigation-assisted TKA.</p><p><strong>Methods: </strong>Ninety TKAs with Attune posterior-stabilized prostheses were performed under imageless navigation. The sTEA was registered before distal femur resection, then reassessed and adjusted after distal resection. The femoral component was implanted finally according to the sTEA determined after distal femur resection. Computed tomography (CT) was performed postoperatively to analyze the true sTEA (the line connecting the tip of the lateral femoral epicondyle to the lowest point of the medial femoral epicondylar sulcus on axial CT images) and femoral component rotation (FCR) axis. The FCR angle after distal femur resection (FCRA-aR) was defined as the angle between the FCR axis and true sTEA on CT images. The FCR angle before distal resection (FCRA-bR) could be presumed to be the value of FCRA-aR minus the difference between the intraoperatively determined sTEAs before and after distal resection as indicated by the navigation system. It was considered that the FCRA-bR or FCRA-aR represented the differences between the sTEA determined before or after distal femur resection and the true sTEA, respectively.</p><p><strong>Results: </strong>The FCRA-bR was -1.3 ± 2.4° and FCRA-aR was 0.3 ± 1.7° (p < 0.001). The range of FCRA-bR was from -6.6° to 4.1° and that of FCRA-aR was from -2.7° to 3.3°. The proportion of appropriate FCRA (≤ ±3°) was significantly higher after distal femur resection than that before resection (91.1% versus 70%; p < 0.001).</p><p><strong>Conclusions: </strong>The FCR was more appropriate when the sTEA was determined after distal femur resection than before resection in navigation-assisted TKA. The reassessment and adjusted registration of sTEA after distal femur resection could improve the rotational alignment of the femoral component in navigation-assisted TKA.</p><p><strong>Level of evidence: </strong>IV.</p>","PeriodicalId":17886,"journal":{"name":"Knee Surgery & Related Research","volume":"33 1","pages":"41"},"PeriodicalIF":3.1,"publicationDate":"2021-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8579642/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39875169","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":"Normative FJS-12 scores for the knee in an Asian population: a cross-sectional study.","authors":"Jia Ying Lee,&nbsp;Wai Weng Yeo,&nbsp;Zi Yang Chia,&nbsp;Paul Chang","doi":"10.1186/s43019-021-00122-2","DOIUrl":"https://doi.org/10.1186/s43019-021-00122-2","url":null,"abstract":"<p><strong>Background: </strong>The Forgotten Joint Score is a patient-reported outcome measure validated in assessing patients post knee arthroplasty, anterior cruciate ligament (ACL) reconstruction surgery and patellar dislocation. A previous study had established the normative scores of a population in the USA but included knees with pathology. The aim of our study is to obtain normative Forgotten Joint Scores in young Asian adults without any pre-existing knee pathologies to increase the interpretability of the Forgotten Joint Score-12 (FJS-12) score.</p><p><strong>Methods: </strong>We conducted a cross-sectional study across young healthy Asian adults via electronic platforms. Participants who had sought either Western medical consultation, physiotherapy or traditional medical therapies were excluded. Demographic data, occupation, type of sport played, and FJS-12 scores were collected. Scores were stratified into subgroups and analysed.</p><p><strong>Results: </strong>There were 172 participants who met our inclusion criteria for this study. The average age of participants in our study was 28.1 ± 10.5 years (range 14-70 years), with 83 (47.7%) participants falling into the ages 21-25 years. Average body mass index (BMI) was 21.9 ± 3.3 kg/m² (range 14.7-36.3 kg/m²). The average FJS-12 score was 62.8 ± 25.6. The median FJS-12 was 63.5 with a range of 4.2-100. Nine participants (5.2%) scored the maximum score possible, and 56 (32.6%) participants scored below the midpoint score of 50. The percentiles for each subgroup of participants were tabulated and reported. Notably, males aged 46-70 years old scored the highest average FJS-12 score of 73.4 ± 5.5, and females aged 31-45 years old scored the lowest FJS-12 score of 57.1 ± 25.1. Females scored lower than males, although the difference was not statistically significant (p = 0.157). There were no significant correlations between BMI, age, or type of sport played with FJS-12; however, interestingly, we observed that women reported similar FJS-12 scores across all age groups, while men reported better scores with increasing age.Interestingly, we observed that women reported similar FJS-12 scores across all age groups, while men reported better scores with increasing age.  CONCLUSION: Having normative values provides opportunities for benchmarking and comparing individuals against age- and gender-matched peers in the general population. Knowledge of normative values for FJS-12 scores would aid evaluating and tracking progress in patients recovering from injuries or undergoing post-surgery rehabilitation. This would help clinicians  determine if they return to 'normal' post intervention.</p>","PeriodicalId":17886,"journal":{"name":"Knee Surgery & Related Research","volume":"33 1","pages":"40"},"PeriodicalIF":3.1,"publicationDate":"2021-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8557544/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39843175","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":"Botulinum toxin injections as salvage therapy is beneficial for management of patellofemoral pain syndrome.","authors":"Yuval Kesary, Vivek Singh, Tal Frenkel-Rutenberg, Arie Greenberg, Shmuel Dekel, Ran Schwarzkopf, Nimrod Snir","doi":"10.1186/s43019-021-00121-3","DOIUrl":"10.1186/s43019-021-00121-3","url":null,"abstract":"<p><strong>Purpose: </strong>Patellofemoral pain syndrome (PFPS) is a common pathology usually presenting with anterior or retropatellar pain. It is associated with a relative imbalance between the vastus medialis oblique (VMO) and the vastus lateralis (VL) muscles. This can lead to considerable morbidity and reduced quality of life (QOL). This study aims to assess the long-term functional outcome of PFPS treated with VL muscle botulinum toxin A (BoNT-A) injection.</p><p><strong>Materials and methods: </strong>A retrospective review was performed on 26 consecutive patients (31 knees) with a mean age of 50.1 years (± 19.7 years) who were treated with BoNT-A injections to the VL muscle followed by physiotherapy between 2008 and 2015. Pre- and post-treatment pain levels (numerical rating scale, NRS), QOL (SF-6D), and functional scores (Kujala and Lysholm questionnaires) were measured. Demographics, physical therapy compliance, previous surgeries, perioperative complications, and patient satisfaction levels were collected.</p><p><strong>Results: </strong>The mean follow-up time was 58.8 ± 36.4 months. There were significant improvements in all the examined domains. The average pain score (NRS) decreased from 7.6 to 3.2 (P < 0.01), and the Kujala, Lysholm, and SF-6D scores improved from 58.9 to 82.7 (P < 0.001), 56.2 to 83.2 (P < 0.001), and 0.6 to 0.8 (P < 0.001), respectively. Similar delta improvement was achieved irrespective of gender, age, compliance to post-treatment physical therapy, or coexisting osteoarthritis. Patients who presented with a worse pre-treatment clinical status achieved greater improvement. Prior to BoNT-A intervention, 16 patients (18 knees) were scheduled for surgery, of whom 12 (75%, 13 knees) did not require further surgical intervention at the last follow-up.</p><p><strong>Conclusions: </strong>A single intervention of BoNT-A injections to the VL muscle combined with physiotherapy is beneficial for the treatment of patients with persistent PFPS.</p><p><strong>Level iii evidence: </strong>Retrospective cohort study.</p>","PeriodicalId":17886,"journal":{"name":"Knee Surgery & Related Research","volume":"33 1","pages":"39"},"PeriodicalIF":4.1,"publicationDate":"2021-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8555335/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39575085","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":"Graft tunnel integration occurs early in the tibial tunnel compared with the femoral tunnel after anterior cruciate ligament reconstruction with preserved insertion hamstring tendon graft.","authors":"Ravi Gupta, Sandeep Singh, Anil Kapoor, Ashwani Soni, Ravinder Kaur, Narinder Kaur","doi":"10.1186/s43019-021-00119-x","DOIUrl":"10.1186/s43019-021-00119-x","url":null,"abstract":"<p><strong>Background: </strong>Preservation of hamstring tendon insertion at the time of anterior cruciate ligament (ACL) reconstruction is a well-known technique; however, its effect on graft integration is not well studied. The present study was conducted to study the graft integration inside the tibial and femoral tunnels, respectively, after ACL reconstruction using hamstring tendon graft with preserved insertion.</p><p><strong>Methods: </strong>Twenty-five professional athletes who underwent ACL reconstruction using hamstring tendon graft with preserved tibia insertion were enrolled in the study. Functional outcomes were checked at final follow-up using Lysholm score and Tegner activity scale. Magnetic resonance imaging (MRI) was done at 8 months and 14 months follow-up to study the graft tunnel integration of the ACL graft at both tibial and femoral tunnels.</p><p><strong>Results: </strong>The mean Fibrous interzone (FI) score (tibial tunnel) decreased from 2.61 (1-5) at 8 months to 2.04 (1-4) at 14 months follow-up (p = 0.02). The mean FI score (femoral side) decreased from 3.04 (2-5) at 8 months to 2.57 (2-4) at 14 months (p = 0.02).</p><p><strong>Conclusions: </strong>Graft integration occurs early in the tibial tunnel as compared with the femur tunnel with preserved insertion hamstring tendon autograft. Trial registration CTRI/2019/07/020320 [registered on 22/07/2019]; http://www.ctri.nic.in/Clinicaltrials/pdf_generate.php?trialid=33884&EncHid=&modid=&compid=%27,%2733884det%27.</p>","PeriodicalId":17886,"journal":{"name":"Knee Surgery & Related Research","volume":"33 1","pages":"37"},"PeriodicalIF":4.1,"publicationDate":"2021-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8501577/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39500146","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 characteristic MRI finding to diagnose a partial tear of the medial meniscus posterior root: an ocarina sign.","authors":"Takayuki Furumatsu,&nbsp;Takaaki Hiranaka,&nbsp;Keisuke Kintaka,&nbsp;Yuki Okazaki,&nbsp;Naohiro Higashihara,&nbsp;Masanori Tamura,&nbsp;Toshifumi Ozaki","doi":"10.1186/s43019-021-00120-4","DOIUrl":"https://doi.org/10.1186/s43019-021-00120-4","url":null,"abstract":"<p><strong>Background: </strong>Diagnosing partial tears of the medial meniscus (MM) posterior root is difficult. The aim of this study was to evaluate diagnostic values involved in conventional magnetic resonance imaging (MRI) features of MM posterior root tears (MMPRTs) and find other MRI-based findings in patients with partial MMPRTs.</p><p><strong>Methods: </strong>Eighteen patients who had arthroscopically confirmed partial MMPRTs were included. As a control, 18 patients who underwent partial meniscectomy for other types of MM tears were evaluated. Isolated partial MMPRTs were classified into the following three types: type A, accurate partial stable tear (cleavage < 1/2 of root width); type B, bridged unstable root tear (cleavage ≥ 1/2 of root width); type C, complex horn tear expanded to the root. Conventional MRI-based findings of MMPRTs were evaluated between two groups (n = 23). Posterior root irregularity, bone marrow spot, and ocarina-like appearance showing several condensed circles in triangular meniscal horn (ocarina sign) were also evaluated.</p><p><strong>Results: </strong>Posterior root irregularity and bone marrow spot were frequently observed in the partial MMPRTs (47.8%), compared with the other MM tears (P = 0.007 and 0.023, respectively). The ocarina sign was detected in 69.6% of patients with partial MMPRTs. A significant difference between two groups was observed in a positive ratio of ocarina sign (P < 0.001). Types A, B, and C of the partial tear/damage were observed in three, eight, and seven patients, respectively. The ocarina sign was the most common MRI finding in each type of partial MMPRT.</p><p><strong>Conclusions: </strong>This study demonstrated that a characteristic MRI finding, \"ocarina sign,\" was frequently observed in patients with partial tear/damage of the MM posterior root. The ocarina sign was the most common MRI finding in several types of partial MMPRTs. Our results suggest that the ocarina sign may be useful to diagnose unnoticed partial MMPRTs.</p><p><strong>Level of evidence: </strong>IV, retrospective comparative study.</p>","PeriodicalId":17886,"journal":{"name":"Knee Surgery & Related Research","volume":"33 1","pages":"38"},"PeriodicalIF":3.1,"publicationDate":"2021-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8502318/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39501131","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":"Surgery-related predictors of kneeling ability following total knee arthroplasty: a systematic review and meta-analysis.","authors":"Shaheer Nadeem,&nbsp;Raman Mundi,&nbsp;Harman Chaudhry","doi":"10.1186/s43019-021-00117-z","DOIUrl":"https://doi.org/10.1186/s43019-021-00117-z","url":null,"abstract":"<p><strong>Purpose: </strong>Kneeling ability is among the poorest outcomes following total knee arthroplasty (TKA). The purpose of this meta-analysis was to: (1) quantify kneeling ability after TKA; (2) identify surgical approaches and prosthesis designs that improve kneeling ability following TKA; and (3) quantify the effectiveness of these approaches.</p><p><strong>Methods: </strong>We performed a systematic review in accordance with the PRISMA guidelines of multiple medical databases. Data relating to demographics, TKA technique, prosthesis design, and kneeling-specific outcomes were extracted. Comparative outcomes data were pooled using a random effects model.</p><p><strong>Results: </strong>Thirty-six studies met the eligibility criteria. The proportion of patients able to kneel increased with longer follow-up (36.8% at a minimum of 1 year follow-up versus 47.6% after a minimum of 3 years follow-up, p < 0.001). The odds of kneeling were greater for patients undergoing an anterolateral incision compared with an anteromedial incision (OR 3.0, 95% CI 1.3-6.9, p = 0.02); a transverse incision compared with a longitudinal incision (OR 3.5, 95% CI 1.4-8.7, p = 0.008); and a shorter incision compared with a longer incision (OR 8.5, 95% CI 2.3-30.9, p = 0.001). The odds of kneeling were worse for a mobile prosthesis compared with a fixed platform design (OR 0.3, 95% CI 0.1-0.7, p = 0.005).</p><p><strong>Conclusion: </strong>A large majority of patients are unable to kneel following TKA, although the ability to kneel improves over time. This evidence may facilitate preoperative patient counseling. Variations in choice of incision location and length may affect ability to kneel; however, high-quality randomized trials are needed to corroborate our findings.</p>","PeriodicalId":17886,"journal":{"name":"Knee Surgery & Related Research","volume":"33 1","pages":"36"},"PeriodicalIF":3.1,"publicationDate":"2021-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8487473/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39479187","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":"Relationship between early physical activity after total knee arthroplasty and postoperative physical function: are these related?","authors":"Daisuke Takamura,&nbsp;Kentaro Iwata,&nbsp;Tatsuya Sueyoshi,&nbsp;Tadashi Yasuda,&nbsp;Hideki Moriyama","doi":"10.1186/s43019-021-00118-y","DOIUrl":"https://doi.org/10.1186/s43019-021-00118-y","url":null,"abstract":"<p><strong>Background: </strong>Physical activity is associated with physical function; however, the relationship between early physical activity after total knee arthroplasty (TKA) and postoperative physical function remains unclear. The purpose of this study was to evaluate the association of early physical activity after TKA with postoperative physical function.</p><p><strong>Methods: </strong>Timed Up and Go test (TUG) of 47 patients was assessed preoperatively and at 10 days, 3 months, and 6 months postoperatively. Physical activity from the second to the ninth day after TKA was measured with accelerometer, and the correlation with pre- and postoperative physical function was evaluated . A multiple linear regression was used to predict TUG at 6 months after TKA.</p><p><strong>Results: </strong>Postoperative physical activity correlated with preoperative TUG (ρ = -0.485, p < 0.001), TUG at 10 days (ρ = -0.675, p < 0.001), 3 months (ρ = -0.441, p < 0.01), and 6 months (ρ = -0.368, p < 0.05) after surgery. Multiple linear regression indicated that only the preoperative TUG was associated with TUG at 6 months. Postoperative physical activity was not an independent factor predicting TUG at 6 months after TKA.</p><p><strong>Conclusion: </strong>Our study demonstrated that patients with better physical function have higher physical activity in the early postoperative period, whereas it does not affect physical function at 6 months after TKA. In the early postoperative period, increasing physical activity may not always be necessary to improve postoperative physical function. We also confirmed that preoperative physical function affects postoperative physical function. These findings may be beneficial in improving rehabilitation programs in the early postoperative period.</p>","PeriodicalId":17886,"journal":{"name":"Knee Surgery & Related Research","volume":"33 1","pages":"35"},"PeriodicalIF":3.1,"publicationDate":"2021-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8480087/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39468530","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":"Open reduction and internal fixation using multiple nonabsorbable suture materials in acute patella fracture: comparison of clinical and radiological outcome with tension band wiring.","authors":"Kwang Won Lee,&nbsp;Sang Beom Ma,&nbsp;Dae Suk Yang,&nbsp;Seung Hak Oh,&nbsp;Seong Ho Park","doi":"10.1186/s43019-021-00116-0","DOIUrl":"https://doi.org/10.1186/s43019-021-00116-0","url":null,"abstract":"<p><strong>Background: </strong>For treating displaced patella fractures, tension band wiring is the most widely used technique. However, implant removal surgery is often necessary to alleviate discomfort caused by fixation materials. On the contrary, fixation using nonabsorbable suture materials is anticipated to result in comparable outcomes without need for further implant removal surgery. However, there is a lack of clinical studies comparing the two fixation techniques (wire and nonabsorbable suture materials) for acute patella fractures.</p><p><strong>Methods: </strong>From 2014 to 2018, we retrospectively reviewed 60 patients who underwent open reduction with internal fixation for acute patella fracture. Thirty patients (group 1) who received surgery using tension band wiring and 30 patients (group 2) who received surgery using nonabsorbable suture materials were enrolled. The average follow-up period was more than 1 year after operation. Operation time, postoperative bone union time, range of motion (ROM) of the knee joint, postoperative clinical results, and complications were compared between the two groups.</p><p><strong>Result: </strong>Operation time, clinical bone union, and radiologic bone union were not statistically different between groups 1 and 2. At 3 months postoperatively, flexion was 120.3 ± 9.4° in group 1 and 110.5 ± 7.7° in group 2, showing statistically significant difference (p = 0.037). At 6 and 12 months postoperatively, the ROM was similar in both groups. Hospital for special surgery score at 3 months postoperatively was 78.4 ± 8.2 in group 1 and 83.7 ± 8.7 in group 2, showing statistically significant differences (p = 0.032). However, at 6 and 12 months postoperatively, there were no statistical differences. Lysholm score at 3 months postoperatively was 73.5 ± 8.1 in group 1 and 80.4 ± 8.2 in group 2, showing statistically significant difference (p = 0.016), but at 6 and 12 months postoperatively, there were no statistical differences.</p><p><strong>Conclusion: </strong>Fixation using multiple nonabsorbable suture materials can be an alternative surgical method in managing patella fractures, along with tension band wiring.</p>","PeriodicalId":17886,"journal":{"name":"Knee Surgery & Related Research","volume":"33 1","pages":"34"},"PeriodicalIF":3.1,"publicationDate":"2021-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8477530/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39468532","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 outcomes of combined anterior cruciate ligament and anterolateral ligament reconstruction: a systematic review and meta-analysis.","authors":"Diego Ariel de Lima,&nbsp;Lana Lacerda de Lima,&nbsp;Nayara Gomes Reis de Souza,&nbsp;Rodrigo Amorim de Moraes Perez,&nbsp;Marcel Faraco Sobrado,&nbsp;Tales Mollica Guimarães,&nbsp;Camilo Partezani Helito","doi":"10.1186/s43019-021-00115-1","DOIUrl":"https://doi.org/10.1186/s43019-021-00115-1","url":null,"abstract":"<p><strong>Objectives: </strong>To compare the clinical outcomes of isolated anterior cruciate ligament (ACL) reconstruction with combined reconstruction of the ACL and anterolateral ligament (ALL) of the knee.</p><p><strong>Methods: </strong>A search was conducted on the PubMed, Medline, Google Scholar, EMBASE, and Cochrane library databases, in line with the PRISMA protocol. The indexation terms used were \"anterior cruciate ligament\" OR \"acl\" AND \"anterolateral ligament\" AND \"reconstruction.\" Articles that compared patients submitted to combined ACL and ALL reconstruction with those submitted to isolated reconstruction of the ACL, with levels of evidence I, II, and III, were included. Studies with follow-up of less than 2 years and articles that did not use \"anatomical\" techniques for ALL reconstruction, such as extraarticular tenodesis, were excluded. A meta-analysis with R software was conducted, with a random effects model, presented as risk ratio (RR) or mean difference (MD), with a 95% confidence level (CI) and statistically significant at p < 0.05.</p><p><strong>Results: </strong>Ten articles were selected, with a total of 1495 patients, most of whom were men, of whom 674 submitted to ACL and ALL reconstruction and 821 to isolated ACL reconstruction. Combined ACL and ALL reconstruction exhibited a statistically significant advantage in residual pivot shift (RR 0.34, 95% CI 0.24-0.47, I² = 0%, p < 0.01), rerupture rate (RR 0.34, 95% CI 0.19-0.62, I² = 0%, p < 0.01), Lachman test (RR 0.59, 95% CI 0.40-0.86, I² = 21%, p < 0.01), and postoperative Lysholm score (MD 2.28, CI 95% 0.75-3.81, I² = 73%, p < 0.01).</p><p><strong>Conclusions: </strong>Combined ACL and ALL reconstruction obtained better postoperative clinical outcomes when compared with isolated ACL reconstruction, especially in reducing residual pivot shift and rerupture rate.</p>","PeriodicalId":17886,"journal":{"name":"Knee Surgery & Related Research","volume":"33 1","pages":"33"},"PeriodicalIF":3.1,"publicationDate":"2021-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8461945/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39443044","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}