Journal of JISAKOS Joint Disorders & Orthopaedic Sports Medicine最新文献

{"title":"Unicompartmental knee arthroplasty: state of the art","authors":"L. J. Kleeblad, H. Zuiderbaan, G. Hooper, A. Pearle","doi":"10.1136/jisakos-2016-000102","DOIUrl":"https://doi.org/10.1136/jisakos-2016-000102","url":null,"abstract":"The popularity of unicompartmental knee arthroplasty (UKA) for the treatment of isolated compartment osteoarthritis of the knee has risen over the past 2 decades. Currently, UKA covers 10% of all knee arthroplasties worldwide. Although indications have been extended, results have proven that patient selection plays a critical role in the success of UKA. From the current perspective, age, body mass index, patellofemoral osteoarthritis, anterior cruciate ligament deficiency and chondrocalcinosis are no longer absolute contraindications for UKA. Motivated by the desire to improve survivorship rates, patient-reported outcomes and reduce complications, there have been many technological advances in the field of UKA over the recent years. The aim of this review was to evaluate the current indications, surgical techniques, modes of failure and survivorship results of UKA, by assessing a thorough review of modern literature. Several studies show that innovations in implant design, fixation methods and surgical techniques have led to good-to-excellent long-term survivorship, functional outcomes and less complications. Until now, resurgence of interest of cementless designs is noted according to large national registries to address problems associated with cementation. The future perspective on the usage of UKA, in particular the cementless design, looks promising. Furthermore, there is a growing interest in robotic-assisted techniques in order to optimise result by controlled soft-tissue balancing and reproduce alignment in UKA. Future advances in robotics, most likely in the field of planning and setup, will be valuable in optimising patient-specific UKA.","PeriodicalId":193067,"journal":{"name":"Journal of JISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"104 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"119160938","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":"Anterior knee pain and patellofemoral osteoarthritis: what should we do?","authors":"C. V. van Dijk","doi":"10.1136/jisakos-2016-000106","DOIUrl":"https://doi.org/10.1136/jisakos-2016-000106","url":null,"abstract":"With primary total knee arthroplasty, there are three schools-of-thought about the patella: always resurface, never resurface or selectively resurface (bearing in mind the patient’s articular cartilage, and patellofemoral congruence at the time of surgery). In Scandinavia, about 2% of patellas are resurfaced (according to knee arthroplasty registries), while in USA more than 90% of patients get a patellar button. Is this a genuine difference of opinion? Or is resurfacing the defensive option in a litigious climate, where a persistently painful knee might end up in court? A recent meta-analysis of 16 randomised controlled trials has shown no difference between resurfaced or nonresurfaced groups, as regards anterior knee pain and functional scores. We do not, it seems, yet understand why some patients experience anterior knee pain and others do not, regardless of their preoperative peripatellar conditions and patella resurfacing. Meanwhile, always resurface is doing a lot of unnecessary surgery. But what about isolated patellofemoral arthritis? Such patients present a particular difficulty. If conservative treatment proves unsuccessful, we have various other options, such as realignment procedures, arthroscopic debridement, patellofemoral arthroplasty (PFA), total knee arthroplasty (TKA) and patellectomy. Recently, and because of secondgeneration prostheses, there has been renewed interest in patellofemoral joint replacement, for which there are good mid-term results. But it remains unclear, whether an isolated PFA does offer any advantage over a TKA? In this issue, Vasta et al make a systematic comparison between PFA and TKA. The overall survivorship rate of inlay design PFAs is 82%, with a mean follow-up of 89 months (all figures rounded). The survivorship rate of the latest generation onlay design PFAs is 95%, with a mean follow-up of 46 months. This seems to be an improvement, and compares favourably with TKA, but we still lack the requisite longterm data. In those patients where a PFA has been deemed correct, a major concern remains the later progression to all-compartment knee osteoarthritis. For the first generation of inlay design PFAs, progression to all compartment knee osteoarthritis occurred in 8% of knees. These patients would have been better off with an initial TKA instead of a PFA. Initial patient selection is important here, as are factors which affect the disease’s progress. Patellofemoral osteoarthritis develops faster, for example, where there had been a pre-existing trochlear dysplasia as its underlying cause. For these reasons, TKA remains the ‘gold standard’, when operating on isolated patellofemoral joint osteoarthritis. This seems confirmed by Vasta et al’s survey, at least for older patients. For younger patients, however, where more is demanded of the functioning knee, PFA remains a favourable option. Preserving the femorotibial compartments and cruciate ligaments will improve the gait and knee kinematics. And, overall, P","PeriodicalId":193067,"journal":{"name":"Journal of JISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"167 2 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"118715299","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":"There is no best surgical treatment for chronic isolated syndesmotic instability: a systematic review","authors":"B. Lubberts, P. van Dijk, J. Calder, C. DiGiovanni","doi":"10.1136/jisakos-2016-000058","DOIUrl":"https://doi.org/10.1136/jisakos-2016-000058","url":null,"abstract":"Importance Appropriate management of chronic isolated ankle syndesmotic injuries is needed to prevent the development of concomitant pathology. Previous studies have evaluated treatment and outcomes of chronic syndesmotic injuries. However, these studies did not distinguish between isolated—an injury without associated fibula fracture—and non-isolated syndesmotic injuries. Objective We conducted a systematic review to assess the functional outcomes and determine evidence for optimal management of chronic isolated syndesmotic injuries. Evidence review A review of the literature was performed according to the PRISMA guidelines. PubMed, EMBASE and the Cochrane Library were searched on 2 May 2016. Studies were identified by using synonyms for ‘ankle syndesmosis’, ‘injury’, ‘delayed’, ‘chronic’ and ‘treatment’. Findings The search resulted in 216 reports on PubMed, 86 on EMBASE and 3 on the Cochrane Library. After reading the remaining full-text articles, we included 11 studies describing outcomes after surgical management of chronic unstable isolated injuries. Conclusions and relevance Currently, there is no evidence to support or refute any of the surgical interventions performed for chronic unstable isolated syndesmotic injuries. High level of evidence research is warranted if we want to establish optimal treatment.","PeriodicalId":193067,"journal":{"name":"Journal of JISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"8 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"118732788","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":"Review of Stieda's article (1908) on the Pellegrini-Stieda lesion","authors":"J. I. Wiegerinck, M. P. Somford","doi":"10.1136/jisakos-2016-000054","DOIUrl":"https://doi.org/10.1136/jisakos-2016-000054","url":null,"abstract":"This classic discusses the original publication of Dr Stieda: Über eine typische Verletzung am unteren Femurende, published in 1908, on the ossified post-traumatic lesion at or near the medial collateral ligament (MCL), adjacent to the margin of the medial femoral condyle which is nowadays known as the Pellegrini-Stieda lesion. One of the presumed mechanisms of injury is an avulsion fracture at the MCL origin. Most patients are asymptomatic, in case of pain, however it is called a Pellegrini-Stieda syndrome. Recently, there are signs directing towards a muscular lesion, in particular the insertion of the adductor magnus muscle. In 1908, Alfred Stieda described a case series of an ossification on the medial side of the knee, which was treated operatively. During this operation, the origin to his belief was an avulsion from the medial epicondyle by the medial head of the gastrocnemius muscle. Although the theory that it concerned an avulsion fracture of the epicondyle is no longer accepted, the part of his findings that it concerned a muscle/tendon ossification at the insertion of the medial head of the gastrocnemius is interesting. Treatment is only indicated in symptomatic cases. When confronted with an ossification on the medial side of the knee, one should be aware that the MCL, the insertion of the adductor magnus or the gastrocnemius muscle might be involved. The first known publication was by Köhler in 1903. Historically, this entity should therefore be named the Köhler-Pellegrini-Stieda lesion.","PeriodicalId":193067,"journal":{"name":"Journal of JISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"42 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"118587690","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 Classic from John Feagin and Walton Curl (1976) on the 5-year follow-up of the repair of the isolated tear of the anterior cruciate ligament. Is there a role for ACL repair in 2016?","authors":"M. Salzler, C. Harner","doi":"10.1136/jisakos-2015-000043","DOIUrl":"https://doi.org/10.1136/jisakos-2015-000043","url":null,"abstract":"‘Nothing ruins good results like long term follow-up.’Author unknown About 43 years ago, 2 bright young academic orthopaedic team doctors decided to review the results of anterior cruciate ligament (ACL) repair in their West Point cadet population. These initial results seemed very promising (greater than 80% good-to-excellent outcomes) at the 2-year follow-up published as an abstract in the Journal of Bone and Joint Surgery in 1972; however, instead of resting on their 2-year outcomes, they made the decision to look at this same group 5 years after surgery. What they found was very alarming and humbling in that the majority of this population had poor outcomes. Being of the highest moral integrity and calibre, they wrote up their results and submitted it to the American Journal of Sports Medicine in 1976. Ironically, the editor of the journal was the legendary Jack Hughston who was well known not to be an advocate of ACL surgery. This article most likely further fuelled his beliefs (‘gasoline on the fire’, so to say!). Since this publication over 40 years ago, there has been an explosion of basic science and clinical papers on ACL anatomy, biomechanics, healing, injury and surgical techniques. The purpose of revisiting this ‘Classic’ article is to acquire perspectives from both the original authors, Dr John Feagin and Dr Walton Curl, in conjunction with Dr Martha Murray, who is considered one of the leading experts on the science of ACL repair. This article begins with a detailed review of this ‘Classic’ and highlights the main take home points. Next, there is a discussion about the historical perspectives, the scientific and societal impact, and where we are today with basic and clinical science studies. We conclude with where we are with ACL repair in 2016 and make recommendations based on current evidence for this procedure in the spectrum of ACL surgery. The ultimate goal of this review is to expose our readership to the potential use of these techniques for select patients with ACL injuries. Most importantly, one must not overlook the primary take home message of this ‘Classic Revisited’, that careful and honest long-term follow-up is the key to evidence-based medicine.","PeriodicalId":193067,"journal":{"name":"Journal of JISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"7 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"118283367","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":"KOOS and IKDC scales may be inadequate in evaluating patients with multiple ligament knee injuries: a systematic review","authors":"Dean Wang, K. Yamaguchi, Morgan H. Jones, A. Miniaci","doi":"10.1136/jisakos-2015-000038","DOIUrl":"https://doi.org/10.1136/jisakos-2015-000038","url":null,"abstract":"Importance Standardised, validated patient-reported outcome measures are crucial in understanding the impact of multiple ligament knee injury and surgery. Aim Evaluate the validity and responsiveness of the Knee Injury and Osteoarthritis Outcome Score (KOOS) and International Knee Documentation Committee (IKDC) score in patients with multiple ligament knee injuries through existing studies in the literature. Evidence Review A systematic review of the literature was performed using MEDLINE and Cochrane databases. The search terms ‘multiple ligament,’ ‘multiligament,’ ‘knee dislocation,’ and ‘combined ligament’ were used in conjunction with ‘KOOS’ or ‘IKDC’. Multiple ligament injury was defined as the disruption of ≥2 major knee ligaments. Validity was assessed through floor/ceiling effects, comparing scores between single and multiple ligament injuries, and correlation with Lysholm scores. Responsiveness was assessed by calculating effect sizes (ES) and standardised response means (SRM). Findings 8 studies reported KOOS scores, and 45 studies reported IKDC scores. No studies specifically evaluated the validity or responsiveness of either measure in patients with multiligament knee injuries. Owing to a lack of available data, the validity and responsiveness of the KOOS could not be thoroughly evaluated. The IKDC may have a ceiling effect and indifference to the disparity between single and multiple ligament injuries, indicating poor content and construct validity. Correlations between IKDC and Lysholm scores ranged from 0.65 to 0.93. The IKDC demonstrated good responsiveness in this population, with ES and SRM ranging from 1.9 to 8.0 and 0.9 to 5.1, respectively. Conclusions and Relevance The KOOS and IKDC may be inadequate in evaluating patients with multiple ligament knee injuries. Future studies should consider using the Multiligament Quality of Life (MLQOL) questionnaire, a recently developed multiligament knee injury-specific instrument, when evaluating patients with multiple ligament knee injuries.","PeriodicalId":193067,"journal":{"name":"Journal of JISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"26 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"119447766","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}