Knee Surgery and Related Research最新文献

{"title":"Efficacy and safety of different bupivacaine concentrations in periarticular infiltration combined with adductor canal block for bilateral total knee arthroplasty: a randomized controlled trial.","authors":"Sukanya Dej-Arkom, Pawinee Pangthipampai, Weerawadee Chandranipapongse, Somruedee Chatsirichareonkul, Rapeepat Narkbunnam, Keerati Charoencholvanich, Suwida Tangchittam, Arissara Iamaroon","doi":"10.1186/s43019-024-00211-y","DOIUrl":"10.1186/s43019-024-00211-y","url":null,"abstract":"<p><strong>Background: </strong>Pain management for bilateral total knee arthroplasty (BTKA) often combines adductor canal block (ACB) with periarticular infiltration (PAI). However, concerns arise regarding local anesthetic toxicity. This study evaluated the efficacy and safety of different bupivacaine concentrations in simultaneous BTKA.</p><p><strong>Methods: </strong>Patients undergoing simultaneous BTKA under spinal anesthesia were included in the study. They received ACB with 50 mg bupivacaine for each thigh. The patients were then randomized into two groups. Group A was administered a PAI of 100 mg bupivacaine per knee (totaling 300 mg bupivacaine for ACB and PAI). Group B received a PAI with 50 mg bupivacaine per knee (totaling 200 mg bupivacaine for ACB and PAI). Postoperative pain was assessed using a visual analog scale at 4-h intervals for 48 h after surgery. Plasma bupivacaine concentrations were measured at eight specified times. Postsurgery walking ability was also evaluated.</p><p><strong>Results: </strong>Among the 57 participants analyzed, visual analog scale pain scores revealed no significant differences between the two groups. An interim analysis of plasma bupivacaine concentrations in both groups indicated no significant disparities. In group B, 93.1% managed to walk with assistance within 48 h, as opposed to group A's 71.4% (P = 0.041).</p><p><strong>Conclusions: </strong>Combining ACB with 100 mg bupivacaine and PAI with another 100 mg bupivacaine provided effective pain relief. This combination also had a better safety profile and led to more patients walking postsurgery than when combining ACB with 100 mg bupivacaine and PAI with 200 mg bupivacaine. Thus, ACB combined with PAI with a total dose of 200 mg bupivacaine appears suitable for simultaneous BTKA.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov (NCT03249662).</p>","PeriodicalId":36317,"journal":{"name":"Knee Surgery and Related Research","volume":"36 1","pages":"5"},"PeriodicalIF":0.0,"publicationDate":"2024-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10799479/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139503057","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":"Enhanced deep learning model enables accurate alignment measurement across diverse institutional imaging protocols.","authors":"Sung Eun Kim, Jun Woo Nam, Joong Il Kim, Jong-Keun Kim, Du Hyun Ro","doi":"10.1186/s43019-023-00209-y","DOIUrl":"10.1186/s43019-023-00209-y","url":null,"abstract":"<p><strong>Background: </strong>Achieving consistent accuracy in radiographic measurements across different equipment and protocols is challenging. This study evaluates an advanced deep learning (DL) model, building upon a precursor, for its proficiency in generating uniform and precise alignment measurements in full-leg radiographs irrespective of institutional imaging differences.</p><p><strong>Methods: </strong>The enhanced DL model was trained on over 10,000 radiographs. Utilizing a segmented approach, it separately identified and evaluated regions of interest (ROIs) for the hip, knee, and ankle, subsequently integrating these regions. For external validation, 300 datasets from three distinct institutes with varied imaging protocols and equipment were employed. The study measured seven radiologic parameters: hip-knee-ankle angle, lateral distal femoral angle, medial proximal tibial angle, joint line convergence angle, weight-bearing line ratio, joint line obliquity angle, and lateral distal tibial angle. Measurements by the model were compared with an orthopedic specialist's evaluations using inter-observer and intra-observer intraclass correlation coefficients (ICCs). Additionally, the absolute error percentage in alignment measurements was assessed, and the processing duration for radiograph evaluation was recorded.</p><p><strong>Results: </strong>The DL model exhibited excellent performance, achieving an inter-observer ICC between 0.936 and 0.997, on par with an orthopedic specialist, and an intra-observer ICC of 1.000. The model's consistency was robust across different institutional imaging protocols. Its accuracy was particularly notable in measuring the hip-knee-ankle angle, with no instances of absolute error exceeding 1.5 degrees. The enhanced model significantly improved processing speed, reducing the time by 30-fold from an initial 10-11 s to 300 ms.</p><p><strong>Conclusions: </strong>The enhanced DL model demonstrated its ability for accurate, rapid alignment measurements in full-leg radiographs, regardless of protocol variations, signifying its potential for broad clinical and research applicability.</p>","PeriodicalId":36317,"journal":{"name":"Knee Surgery and Related Research","volume":"36 1","pages":"4"},"PeriodicalIF":0.0,"publicationDate":"2024-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10785531/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139433026","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":"Minimal clinically important difference (MCID), substantial clinical benefit (SCB), and patient-acceptable symptom state (PASS) in patients who have undergone total knee arthroplasty: a systematic review.","authors":"Filippo Migliorini, Nicola Maffulli, Luise Schäfer, Francesco Simeone, Andreas Bell, Ulf Krister Hofmann","doi":"10.1186/s43019-024-00210-z","DOIUrl":"10.1186/s43019-024-00210-z","url":null,"abstract":"<p><strong>Background: </strong>The present systematic review investigated the minimal clinically important difference (MCID), substantial clinical benefit (SCB), and patient-acceptable symptom state (PASS) of several frequent and established PROMs used to assess patients who have undergone TKA. This study was conducted according to the 2020 PRISMA statement.</p><p><strong>Methods: </strong>In September 2023, PubMed, Web of Science, and Embase were accessed with no time constraint All clinical studies investigating tools to assess the clinical relevance of PROMs used to evaluate patients having received TKA were accessed. Only studies which evaluated the MCID, PASS, or SCB were eligible. The PROMs of interest were the Forgotten Joint Score-12 (FJS-12), the Oxford Knee Score (OKS), the Knee Injury and Osteoarthritis Outcome Score (KOOS) and its related subscales activity of daily living (ADL), pain, quality of life (QoL), sports and recreational activities, and symptoms, the Western Ontario and McMaster Universities Osteoarthritis (WOMAC) score, the Knee Society Score (KSS) and related function score, and the Short Form-12 (SF-12) and Short Form-36 (SF-36).</p><p><strong>Results: </strong>Data from 29,737 patients were collected. The overall risk of bias was low to moderate. The great variability of thresholds for MCID, SCB and PASS between questionnaires but also between investigated aspects was noted, whereby MCIDs for the SF-36 appear lower than for knee-specific questionnaires.</p><p><strong>Conclusion: </strong>Despite its critical role from a patient's perspective, the dimension of SCB is still neglected in the literature. Moreover, thresholds for the different concepts need to be condition-specific. We encourage authors to specifically report such data in future studies and to adhere to previously reported definitions to allow future comparison. Level of evidence Level IV, systematic review and meta-analysis.</p>","PeriodicalId":36317,"journal":{"name":"Knee Surgery and Related Research","volume":"36 1","pages":"3"},"PeriodicalIF":0.0,"publicationDate":"2024-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10782530/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139425634","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":"Higher rates of fully preserved posterior cruciate ligament in total knee arthroplasty using a double tibial cut: a prospective randomized controlled trial.","authors":"Gianluca Cinotti, Francesca Romana Ripani, Beatrice Perciballi, Giuseppe La Torre, Giuseppe Giannicola","doi":"10.1186/s43019-023-00208-z","DOIUrl":"10.1186/s43019-023-00208-z","url":null,"abstract":"<p><strong>Purpose: </strong>In cruciate retaining total knee arthroplasty, posterior cruciate ligament damage may occur during tibial cutting. A prospective randomized study was conducted to investigate whether a novel tibial cutting technique was more effective than the currently used techniques.</p><p><strong>Materials and methods: </strong>Patients undergoing cruciate retaining total knee arthroplasty were recruited in a prospective, randomized, controlled trial. In 25 patients (group 1) the tibial cut was performed using a double tibial cut technique; in 25 (group 2) and 25 (group 3) patients, the bone island and en bloc resection techniques were performed, respectively. Posterior cruciate ligament integrity and femoral rollback were assessed at the end of surgery. The Oxford Knee Score, WOMAC score and range of motion were assessed postoperatively.</p><p><strong>Results: </strong>Posterior cruciate ligament was completely preserved in 92% of patients in group 1 and in 64% in group 2 and 3, respectively (p = 0.03). The Oxford Knee Score and WOMAC scores did not differ between groups (p = 0.4). The mean knee flexion was 126.4°, 121.5° and 123.9° in groups 1, 2 and 3, respectively (p = 0.04). The femoral rollback at 120° flexion was 80.7%, 72.2% and 75.4% in groups 1, 2 and 3, respectively (p = 0.01).</p><p><strong>Conclusions: </strong>The double cut technique preserves the posterior cruciate ligament at significantly higher rates than the bone island or en bloc resection techniques. Better posterior cruciate ligament preservation may improve the femoral rollback and knee flexion.</p><p><strong>Level of evidence: </strong>Prospective randomized controlled trial, Level I.</p>","PeriodicalId":36317,"journal":{"name":"Knee Surgery and Related Research","volume":"36 1","pages":"2"},"PeriodicalIF":0.0,"publicationDate":"2024-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10777558/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139418241","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":"Preserving coronal knee alignment of the knee (CPAK) in unicompartmental knee arthroplasty correlates with superior patient-reported outcomes.","authors":"Sung Eun Kim, Kuk-Ro Yun, Jae Min Lee, Myung Chul Lee, Hyuk-Soo Han","doi":"10.1186/s43019-023-00204-3","DOIUrl":"10.1186/s43019-023-00204-3","url":null,"abstract":"<p><strong>Background: </strong>The optimal alignment target for unicompartmental knee arthroplasty (UKA) remains controversial, and literature suggests that its impact on patient-reported outcome measures (PROMs) varies. The purpose of this study was to identify the relationship between changes in the coronal plane alignment of the knee (CPAK) and PROMs in patients who underwent UKA.</p><p><strong>Methods: </strong>A retrospective analysis of 164 patients who underwent UKA was conducted. The types of CPAK types categorized into unchanged, minor (shift to an adjacent CPAK type, e.g., type I to II or type I to IV), and major changes (transitioning to a nearby diagonal CPAK type or two types across, such as type I to V or type I to III). PROMs were assessed preoperatively and 1 year postoperatively using the Hospital for Special Surgery (HSS) scores, Knee Society (KS) scores, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and Forgotten Joint Scores (FJS). Comparison was performed between patients who experienced and who did not experience any changes in the CPAK.</p><p><strong>Results: </strong>Patients with preserved native CPAK alignment demonstrated significantly superior 1 year postoperative outcomes, with higher HSS, KS knee, and WOMAC pain scores (p = 0.042, p = 0.009, and p = 0.048, respectively). Meanwhile, the degree of change in CPAK did not significantly influence the PROMs, and patients who experienced minor and major changes in the CPAK showed comparable outcomes.</p><p><strong>Conclusion: </strong>Preserving the native CPAK in UKA procedures is important for achieving favorable clinical outcomes at 1 year postoperative. The extent of change in the CPAK type exerted a limited impact on PROMs, thus emphasizing the importance of change in alignment itself.</p>","PeriodicalId":36317,"journal":{"name":"Knee Surgery and Related Research","volume":"36 1","pages":"1"},"PeriodicalIF":0.0,"publicationDate":"2024-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10763258/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139088894","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":"Surgical accuracy of coronal and sagittal alignment in conventional closed-wedge high tibial osteotomy after computer-assisted surgery experience.","authors":"Sang Jun Song, Dae Kyung Bae, Se Hwan Park, Cheol Hee Park","doi":"10.1186/s43019-023-00205-2","DOIUrl":"10.1186/s43019-023-00205-2","url":null,"abstract":"<p><strong>Background: </strong>Although intraoperative navigation can improve the surgeon's proficiency, no studies have analyzed postoperative outcomes of high tibial osteotomy (HTO) after computer-assisted surgery (CAS) experience. The present study compared the clinical and radiographic results between conventional and CAS closed-wedge (CW) HTOs after CAS experience.</p><p><strong>Methods: </strong>Each of the 50 conventional and CAS CW HTOs performed by single surgeon between 2015 and 2017 were included. The surgeon had experience of 140 cases of CAS CW HTOs before the study period. The groups were not different in terms of demographics. Clinically, the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and range of motion (ROM) were investigated. Radiographically, the mechanical axis (MA), change in posterior tibial slope angle (PTS), and parallel angle were evaluated. The proportions of inlier groups for the postoperative MA (within valgus 2° ± 3°), change in the PTS (within ± 3°), and parallel angle (< 3°) were compared.</p><p><strong>Results: </strong>There were no significant differences in postoperative clinical results between the conventional and CAS groups. The MA was appropriately corrected in both groups (2.4° versus 2.9°, p = 0.317). The amount of change in PTS was significantly greater in the conventional group (-2.2° versus -0.8°, p = 0.018). The parallel angle was 5.3° in the conventional groups and 3.1° in the CAS group (p = 0.003). The proportion of inlier group was not significantly different in the postoperative MA (72% versus 78%) and change in the PTS (52% versus 66%). The proportion of inlier for the parallel angle was significantly lower in the conventional group (36% versus 60%, p = 0.027).</p><p><strong>Conclusions: </strong>The surgical proficiency after CAS experience could cover the advantages of an intraoperative navigation in coronal adjustment, not in the sagittal adjustments in CW HTOs. A larger cohort with multiple surgeons in multiple centers would be required to identify the general trend.</p><p><strong>Study design: </strong>Level of evidence III.</p>","PeriodicalId":36317,"journal":{"name":"Knee Surgery and Related Research","volume":"35 1","pages":"29"},"PeriodicalIF":0.0,"publicationDate":"2023-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10740261/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138831998","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":"Patient-reported outcomes measurement information system instruments in knee arthroplasty patients: a systematic review of the literature.","authors":"Natalia Czerwonka, Puneet Gupta, Sohil S Desai, Thomas R Hickernell, Alexander L Neuwirth, David P Trofa","doi":"10.1186/s43019-023-00201-6","DOIUrl":"10.1186/s43019-023-00201-6","url":null,"abstract":"<p><strong>Background: </strong>The purpose of this study is to provide a systematic review of the literature pertaining to Patient-Reported Outcome Measurement Information System (PROMIS) validation and utilization as an outcomes metric in total knee arthroplasty (TKA) patients. This is the first systematic review on PROMIS use in total knee arthroplasty patients.</p><p><strong>Methods: </strong>A systematic search of the Pubmed/MEDLINE and Embase databases was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Study characteristics, patient demographics, psychometric properties (Pearson and Spearman correlation) with legacy patient-reported outcome measurement (PROM) instruments, floor and ceiling effects, responsiveness, and minimum clinically important difference (MCID) and PROMIS outcomes were recorded and analyzed.</p><p><strong>Results: </strong>Fifteen studies investigating PROMIS in 11,140 patients were included. The weighted-average Pearson correlation coefficient comparing PROMIS domains with legacy patient-reported outcome measurements in total knee arthroplasty patients was 0.62 [standard error (SE) = 0.06] and the weighted-average Spearman correlation comparing PROMIS domains with legacy patient-reported outcome measurements in total knee arthroplasty patients was 0.59 (SE = 0.06), demonstrating moderate-to-strong correlation and validity. There were no differences in weighted average floor [0.03% (SE = 3.1) versus 0% (SE = 0.1) versus 0.01% (SE = 1.1); p = 0.25] or ceiling effects [0.01% (SE = 0.7) versus 0.02% (SE = 1.4) versus 0.04% (SE = 3.5); p = 0.36] between PROMIS and legacy instruments. The weighted average for percentage of patients achieving MCID was 59.1% for global physical health (GPH), 26.0% for global mental health (GMH), 52.7% for physical function (PF), 67.2% for pain interference (PI), and 37.2% for depression.</p><p><strong>Conclusion: </strong>Notably, PROMIS global physical health, physical function, and pain interference were found to be significantly responsive, with PROMIS pain interference most effectively capturing clinical improvement as evidenced by the achievement of MCID.</p>","PeriodicalId":36317,"journal":{"name":"Knee Surgery and Related Research","volume":"35 1","pages":"27"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10690965/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138471035","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":"Effect of anteromedial portal location on femoral tunnel inclination, length, and location in hamstring autograft-based single-bundle anterior cruciate ligament reconstruction: a prospective study.","authors":"Abdulaziz Z Alomar, Baraa Baltow, Ismail AlMogbil","doi":"10.1186/s43019-023-00202-5","DOIUrl":"10.1186/s43019-023-00202-5","url":null,"abstract":"<p><strong>Background: </strong>Portal positioning in arthroscopic anterior cruciate ligament reconstruction is critical in facilitating the drilling of the femoral tunnel. However, the traditional approach has limitations. A modified inferior anteromedial portal was developed. Therefore, this study aims to compare the modified and conventional far anteromedial portals for femoral tunnel drilling, assessing factors such as tunnel length, inclination, iatrogenic chondral injury risk, and blowout.</p><p><strong>Material and methods: </strong>Patients scheduled for hamstring autograft-based anatomical single-bundle arthroscopic anterior cruciate ligament reconstruction were divided into two groups: modified and far anteromedial groups. Primary outcomes include differences in femoral tunnel length intraoperatively, tunnel inclination on anteroposterior radiographs, and exit location on lateral radiographs. Secondary outcomes encompass tunnel-related complications and reconstruction failures. To identify potential risk factors for shorter tunnel lengths and posterior exits, regression analysis was conducted.</p><p><strong>Results: </strong>Tunnel parameters of 234 patients were analyzed. In the modified portal group, femoral tunnel length and inclination were significantly higher, with tunnels exhibiting a more anterior exit position (p < 0.05). A higher body mass index exerted a negative influence on tunnel length and inclination. However, obese patients in the modified portal group had longer tunnels, increased inclination, and a lower risk of posterior exit. Only a few tunnel-related complications were observed in the far anteromedial group.</p><p><strong>Conclusion: </strong>The modified portal allowed better control of tunnel length and inclination, ensuring a nonposterior femoral tunnel exit, making it beneficial for obese patients.</p>","PeriodicalId":36317,"journal":{"name":"Knee Surgery and Related Research","volume":"35 1","pages":"26"},"PeriodicalIF":0.0,"publicationDate":"2023-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10680354/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138446526","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":"Reference value of knee position sense in weight-bearing and non-weight-bearing conditions.","authors":"Yubin Lee, Chaegil Lim","doi":"10.1186/s43019-023-00199-x","DOIUrl":"10.1186/s43019-023-00199-x","url":null,"abstract":"<p><strong>Background: </strong>Our study aimed to identify age-related changes in knee proprioception to provide reference values for weight-bearing (WB) and non-weight-bearing (NWB) conditions and to identify factors (age, WB condition, dominance, and sex) that can affect knee proprioception.</p><p><strong>Methods: </strong>A total of 84 healthy adult men and women were recruited. Active knee joint position sense (JPS) was measured using a digital inclinometer for knee proprioception. The participants performed the required movements actively, with verbal feedback from the examiner, slowly moving to the target angles (30° and 50°) and maintaining them for 5 s before returning to the starting position. Afterward, without assistance from the examiner, the participants actively moved back to the same angle, and the examiner confirmed the angles. This procedure was repeated twice for each target angle, and the average values were used as the data. The participants were barefoot, wearing shorts, and closed their eyes while the measurements were obtained. The measurements were first obtained on the dominant side under the NWB conditions. When a change in posture was needed during the measurement, the participants sat in a resting position for 2 min.</p><p><strong>Results: </strong>Except for age, all other factors (WB condition, dominance, sex) were not statistically significant. Age showed a significant difference in knee JPS, except for the non-dominant side at 30° and the dominant side at 50° in the NWB condition.</p><p><strong>Conclusion: </strong>This study indicates that the WB condition, dominant side, and sex need not be considered when measuring and assessing knee JPS. Age shows a negative correlation with knee joint position sense, and the reference values presented in this study can be used as objective target values during the rehabilitation process.</p>","PeriodicalId":36317,"journal":{"name":"Knee Surgery and Related Research","volume":"35 1","pages":"25"},"PeriodicalIF":0.0,"publicationDate":"2023-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10680216/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138446527","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":"Radiologic simulation of leg length change after double level osteotomy in preoperative surgical planning.","authors":"Shuntaro Nejima, Ken Kumagai, Shunsuke Yamada, Masaichi Sotozawa, Yutaka Inaba","doi":"10.1186/s43019-023-00198-y","DOIUrl":"10.1186/s43019-023-00198-y","url":null,"abstract":"<p><strong>Background: </strong>To evaluate the expected postoperative total leg length change using preoperative radiographs during surgical planning of four different methods of double level osteotomy (DLO).</p><p><strong>Methods: </strong>This study included 34 patients (44 knees) who underwent DLO for varus knee osteoarthritis. Surgical planning was performed so that the postoperative weight bearing line ratio was 62.5%. In DLO, lateral closed or medial open wedge distal femoral osteotomy (LCWDFO, MOWDFO) was performed so that the postoperative mechanical lateral distal femoral angle was 85°, and residual deformity was corrected with medial open or lateral closed wedge high tibial osteotomy (MOWHTO, LCWHTO). Pre- and surgical planning X-rays in the one-leg standing position were compared to assess the change in leg length, and the factors affecting it, in the various surgical groups. The proportion of cases in which Δ total leg length was greater than 6 mm (symptomatic change) was investigated.</p><p><strong>Results: </strong>The mean postoperative total leg length increased significantly with LCWDFO + MOWHTO, MOWDFO + MOWHTO, and MOWDFO + LCWHTO, while it decreased with LCWDFO + LCWHTO. The proportion of cases with a postoperative total leg length change > 6 mm was 72.7%, 2.3%, 100%, and 6.8% in LCWDFO + MOWHTO, LCWDFO + LCWHTO, MOWDFO + MOWHTO, and MOWDFO + LCWHTO, respectively. In addition, the preoperative hip-knee-ankle angle correlated negatively with the postoperative total leg length change in LCWDFO + MOWHTO, MOWDFO + MOWHTO, and MOWDFO + LCWHTO, but not in LCWDFO + LCWHTO.</p><p><strong>Conclusions: </strong>MOWDFO + MOWHTO had the largest postoperative leg length change and MOWDFO + LCWHTO had the smallest. Symptomatic leg length change (> 6 mm) should be considered in MOWDFO + MOWHTO and LCWDFO + MOWHTO.</p>","PeriodicalId":36317,"journal":{"name":"Knee Surgery and Related Research","volume":"35 1","pages":"24"},"PeriodicalIF":0.0,"publicationDate":"2023-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10510285/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41146590","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}