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

{"title":"Avoiding complications in medial unicompartmental knee arthroplasty","authors":"Daniel B. Buchalter,&nbsp;Michael P. Ast","doi":"10.1016/j.jisako.2024.100331","DOIUrl":"10.1016/j.jisako.2024.100331","url":null,"abstract":"<div><div>Medial unicompartmental knee arthroplasty (mUKA) is a highly effective treatment for the management of isolated osteoarthritis in the medial compartment. While favorable long-term survivorship is seen in most series, the long-term rate of revision after mUKAs remains higher than that for total knee arthroplasty. Poor indications and poor surgical technique are often responsible for mUKA failure. Understanding why these complications occur and how to avoid them will optimize clinical outcomes, reduce revision rates, and lead to lower healthcare costs. This review will discuss the five most common causes of mUKA failure including progression of arthritis, aseptic loosening, bearing dislocation, periprosthetic fracture, and polyethylene wear and how to avoid them with proper patient selection and meticulous surgical technique.</div></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"9 6","pages":"Article 100331"},"PeriodicalIF":2.7,"publicationDate":"2024-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142476763","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":"Conversion of high tibial osteotomy to unicompartmental knee arthroplasty: Surgical pearls to ensure a successful outcome","authors":"Claudia Arias ,&nbsp;Roberto Negrín","doi":"10.1016/j.jisako.2024.100321","DOIUrl":"10.1016/j.jisako.2024.100321","url":null,"abstract":"<div><div>Historically, high tibial osteotomy (HTO) was considered a contraindication for medial unicompartmental knee arthroplasty (UKA). While some recent reports demonstrate good outcomes after UKA for failed HTO, revision to UKA after failed HTO remains controversial. UKA after HTO is a demanding procedure primarily related to preoperative valgus alignment, residual medial knee laxity and abnormal proximal tibia geometry. The aim of this technical note is to present surgical pearls and strategies to ensure a successful outcome of UKA after a failed HTO.</div></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"9 6","pages":"Article 100321"},"PeriodicalIF":2.7,"publicationDate":"2024-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142476765","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 majority of the patient achieved both patient-acceptable symptom state and minimal clinically important difference of International Knee Documentation Committee Subjective Knee Form score at one year after anatomical double-bundle anterior cruciate ligament reconstruction","authors":"Takeo Tokura,&nbsp;Yuichi Hoshino,&nbsp;Kanto Nagai,&nbsp;Kyohei Nishida,&nbsp;Noriyuki Kanzaki,&nbsp;Takehiko Matsushita,&nbsp;Ryosuke Kuroda","doi":"10.1016/j.jisako.2024.100344","DOIUrl":"10.1016/j.jisako.2024.100344","url":null,"abstract":"<div><h3>Objectives</h3><div>There is a paucity of data about clinical outcomes after double-bundle anterior cruciate ligament reconstruction (DB-ACLR) using the concepts of patient-acceptable symptom state (PASS) and minimal clinically important difference (MCID). The aim of the present study was to evaluate the one-year clinical outcomes of patients who underwent DB-ACLR using PASS and MCID.</div></div><div><h3>Methods</h3><div>Achievement of PASS and MCID were retrospectively evaluated for 298 (mean age 26.9 years; 145 men/153 women) and 214 patients (mean age 23.9 years; 114 males/100 females), respectively, who underwent primary DB-ACLR using a hamstring autograft. For patients who achieved PASS or MCID, demographics, preoperative and postoperative data were statistically analyzed.</div></div><div><h3>Results</h3><div>Of 298 patients, 254 (85.2%) achieved International Knee Documentation Committee-Subjective Knee Form (IKDC-SKF) PASS and 191 out of 214 patients (88.8%) achieved MCID. The dichotomous logistic regression analyses to assess the achievement of PASS showed that younger age (odds ratio [OR], 0.96; 95% confidence interval [CI], 0.93–0.99; <em>P</em> ​= ​0.013), male sex (OR, 2.2; 95% CI, 1.08–4.83; <em>P</em> ​= ​0.030) and better one-year quadriceps strength symmetry (OR, 1.05; 95% CI, 1.03–1.07; <em>P</em> ​&lt; ​0.001) were independent predictors of PASS achievement. For MCID, preoperative IKDC-SKF score below the 50th percentile (OR, 14.39; 95% CI, 2.90–71.25; <em>P</em> ​= ​0.001) and better one-year quadriceps strength symmetry (OR, 1.035; 95% CI, 1.007–1.064; <em>P</em> ​= ​0.014) were independent predictors for MCID achievement.</div></div><div><h3>Conclusions</h3><div>More than 85% of the patients achieved PASS and MCID for the IKDC-SKF score one year after undergoing DB-ACLR with hamstring tendon autograft. Better quadriceps strength symmetry at one year contributed to the achievement of both PASS and MCID. Rehabilitation dedicated to quadriceps strength recovery may be important for achieving good clinical outcomes after DB-ACLR.</div></div><div><h3>Level of evidence</h3><div>IV, retrospective cohort.</div></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"9 6","pages":"Article 100344"},"PeriodicalIF":2.7,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142476762","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 characteristics influencing knee injury and osteoarthritis outcome scores vary with time from patellar dislocation and number of dislocations","authors":"Patrick G. Tate ,&nbsp;Lutul D. Farrow ,&nbsp;Gina R. Tubo ,&nbsp;Xiaojuan Li ,&nbsp;John J. Elias","doi":"10.1016/j.jisako.2024.100335","DOIUrl":"10.1016/j.jisako.2024.100335","url":null,"abstract":"<div><h3>Objectives</h3><div>Demographic characteristics of the patient population influence patient reported outcome measures (PROMs) following patellar dislocations. The time from injury and number of dislocations can also vary within the patient population. The hypothesis of the study is that characteristics of the patient population influencing Knee injury and Osteoarthritis Outcome Score (KOOS) measures of pain, function, and quality of life vary with time from patellar dislocation and number of dislocations.</div></div><div><h3>Methods</h3><div>Outcome scores were evaluated for subjects in four groups: within five months of a first patellar dislocation (first-time group, n ​= ​24), within five months of a recurrent dislocation (multiple group, n ​= ​15), five to twelve months after a first dislocation (post-acute group, n ​= ​14), and two years or longer after a first dislocation (two-year group, n ​= ​14). For each group, KOOS pain, physical function, and quality of life scores were compared between males and females. KOOS scores were also correlated against age, body mass index (BMI), and time since first and most recent dislocation.</div></div><div><h3>Results</h3><div>For the first-time dislocation group, physical function, and quality of life scores were higher for men than women (p ​&lt; ​0.05). For the multiple dislocation group, pain and physical function improved as BMI decreased (p ​&lt; ​0.025), while quality of life improved as age decreased (p ​= ​0.014). For the post-acute group, all three scores improved as BMI decreased (p ​&lt; ​0.05). For the two-year group, all three scores worsened as time since first dislocation increased (p ​&lt; ​0.01).</div></div><div><h3>Conclusions</h3><div>Following patellar dislocation, relationships between characteristics of the patient population and PROMs vary with time from injury and number of dislocations. In the acute phase following a first dislocation, PROMs likely reflect the traumatic injury. Based on relationships with BMI, outcomes likely reflect functional capacity of the knee in the acute phase of multiple dislocations and post-acute phase of a first dislocation. After multiple years, progressive degradation of the knee over time seems to influence PROMs.</div></div><div><h3>Level of evidence</h3><div>Retrospective study with more than one negative criterion (Level 4).</div></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"9 6","pages":"Article 100335"},"PeriodicalIF":2.7,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142381874","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 management and rehabilitation of ultra-low velocity bilateral multi-ligament knee injury: A case report","authors":"Stephen G. Melancon ,&nbsp;Michelle E. Kew ,&nbsp;Michael R. Dunne ,&nbsp;Scott A. Rodeo","doi":"10.1016/j.jisako.2024.100332","DOIUrl":"10.1016/j.jisako.2024.100332","url":null,"abstract":"<div><div>Bilateral low-velocity multi-ligament knee Injury (MLKI) is a rare injury increasing in prevalence along with obesity. Early surgical intervention is indicated to improve long-term outcomes. We describe the surgical and postoperative management of a bilateral MLKI. The patient underwent staged multi-ligament knee reconstruction 17 and 35 days after injury. Return to light duty was achieved 4 weeks following each procedure and progression to exercise at 6 months. The patient is 2 years postoperative and returned to all activity without complaint. We describe successful surgical and rehabilitation management, which encourages early surgery and rehabilitation strategies to improve long-term outcomes.</div></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"9 6","pages":"Article 100332"},"PeriodicalIF":2.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142373050","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The mobile bearing prosthesis: How to know when it's right for my patient and tips for surgical success","authors":"Patricia R. Melvin ,&nbsp;Todd Bertrand ,&nbsp;Keith Berend ,&nbsp;Adolph V. Lombardi","doi":"10.1016/j.jisako.2024.100330","DOIUrl":"10.1016/j.jisako.2024.100330","url":null,"abstract":"<div><div>Unicompartmental knee arthroplasty (UKA) has seen a revival of popularity in the last thirty years in the United States. The benefits of a medial UKA over the previous ‘gold standard’ for knee osteoarthritis, the total knee arthroplasty, include increased postoperative range of motion (ROM), maintenance of natural knee mechanics, faster recovery, similar pain relief and decreased morbidity. Mobile-bearing UKA (MB-UKA) implants have been developed to improve polyethylene wear while maintaining normal knee kinematics. In this review, we will cover indications and contraindications for aN MB-UKA, patient selection, and technical tips and tricks.</div></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"9 6","pages":"Article 100330"},"PeriodicalIF":2.7,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142366794","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":"Sex specific considerations in anterior cruciate ligament injuries in the female athlete: State of the art","authors":"Arianna L. Gianakos ,&nbsp;Claudia Arias ,&nbsp;Cecile Batailler ,&nbsp;Elvire Servien ,&nbsp;Mary K. Mulcahey","doi":"10.1016/j.jisako.2024.100325","DOIUrl":"10.1016/j.jisako.2024.100325","url":null,"abstract":"<div><div>The increased participation of females in sports has been accompanied by an increase in the rate of anterior cruciate ligament (ACL) injuries. The literature has identified risk factors for noncontact ACL injuries in female athletes, including anatomic, hormonal, biomechanical, neuromuscular, and environmental factors. This review will provide an overview of sex-specific considerations when managing female athletes with ACL injuries. A discussion of sex-specific surgical and rehabilitative treatment strategies with the goal of optimizing return to sport after ACL reconstruction will be emphasized.</div></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"9 6","pages":"Article 100325"},"PeriodicalIF":2.7,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142355695","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":"Trends of ankle arthroscopy in Italy: Analysis of an official national database","authors":"Umile Giuseppe Longo ,&nbsp;Alessandro Mazzola ,&nbsp;Sergio De Salvatore ,&nbsp;Ilaria Piergentili ,&nbsp;Alessandro Tancioni ,&nbsp;Valentina Piccioni ,&nbsp;Antonio Sarubbi ,&nbsp;Riccardo Picozzi ,&nbsp;MaCalus V. Hogan","doi":"10.1016/j.jisako.2024.100326","DOIUrl":"10.1016/j.jisako.2024.100326","url":null,"abstract":"<div><h3>Objectives</h3><div>Ankle arthroscopy has become increasingly popular as a less invasive surgical diagnostic and therapeutic procedure for a variety ankle disorder previously managed with open surgery. Despite literature reports encouraging outcomes and low complication rates, nationwide trends in ankle arthroscopy have been poorly investigated. To fully understand the burden of an emerging surgical approach as well as helping to create global standards for the diagnosis and treatment of ankle diseases, this study aimed to evaluate the incidence and demographics of patients undergoing ankle arthroscopy in Italy from 2001 to 2016.</div></div><div><h3>Methods</h3><div>Data were obtained from the National Hospital Discharge Records (SDO) provided by the Italian Ministry of Health. The patient's age, gender, length of hospital stays, primary diagnosis, and primary procedure are among the anonymized data. Population data were obtained from the National Institute for Statistics (ISTAT). According to the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) ankle arthroscopy was defined by the following procedure code: 80.27.</div></div><div><h3>Results</h3><div>A total of 23,644 procedures were performed in Italy. The 25 to 29 and 30 to 34 age groups underwent this type of surgery at most. The majority of patients were males. The median length of hospital stay was 2.1 ​± ​2.3 days. Each year in Italy, this surgery costs an average of 2,133,401€ ± 342,143€. The main primary codified diagnoses were: “contracture of joint, ankle and foot” (13.4 ​%), “articular cartilage disorder, ankle and foot” (8.6 ​%), “late effect of sprain and strain without mention of tendon injury” (7.5 ​%) and “other joint derangement, not elsewhere classified, ankle and foot” (6.4 ​%).</div></div><div><h3>Conclusions</h3><div>The present study evaluated the burden of ankle arthroscopy on the national health care system and the distribution of the main diseases requiring this type of surgery. Surgeons and policy makers can allocate healthcare resources more effectively and provide patients with high-quality care by having a better understanding of national practice patterns.</div></div><div><h3>Level of Evidence</h3><div>III.</div></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"9 6","pages":"Article 100326"},"PeriodicalIF":2.7,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142355696","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":"Can ChatGPT answer patient questions regarding reverse shoulder arthroplasty?","authors":"Benjamin T. Lack ,&nbsp;Edwin Mouhawasse ,&nbsp;Justin T. Childers ,&nbsp;Garrett R. Jackson ,&nbsp;Shay V. Daji ,&nbsp;Payton Yerke-Hansen ,&nbsp;Filippo Familiari ,&nbsp;Derrick M. Knapik ,&nbsp;Vani J. Sabesan","doi":"10.1016/j.jisako.2024.100323","DOIUrl":"10.1016/j.jisako.2024.100323","url":null,"abstract":"<div><h3>Introduction</h3><div>In recent years, artificial intelligence (AI) has seen substantial progress in its utilization, with Chat Generated Pre-Trained Transformer (ChatGPT) is emerging as a popular language model. The purpose of this study was to test the accuracy and reliability of ChatGPT's responses to frequently asked questions (FAQ) pertaining to reverse shoulder arthroplasty (RSA).</div></div><div><h3>Methods</h3><div>The ten most common FAQs were queried from institution patient education websites. These ten questions were then input into the chatbot during a single session without additional contextual information. The responses were then critically analyzed by two orthopedic surgeons for clarity, accuracy, and the quality of evidence-based information using The Journal of the American Medical Association (JAMA) Benchmark criteria and the DISCERN score. The readability of the responses was analyzed using the Flesch-Kincaid Grade Level.</div></div><div><h3>Results</h3><div>In response to the ten questions, the average DISCERN score was 44 (range 38–51). Seven responses were classified as fair and three were poor. The JAMA Benchmark criteria score was 0 for all responses. Furthermore, the average Flesch-Kincaid Grade Level was 14.35, which correlates to a college graduate reading level.</div></div><div><h3>Conclusion</h3><div>Overall, ChatGPT was able to provide fair responses to common patient questions. However, the responses were all written at a college graduate reading level and lacked reliable citations. The readability greatly limits its utility. Thus, adequate patient education should be done by orthopedic surgeons. This study underscores the need for patient education resources that are reliable, accessible, and comprehensible.</div></div><div><h3>Level of evidence</h3><div>IV.</div></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"9 6","pages":"Article 100323"},"PeriodicalIF":2.7,"publicationDate":"2024-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142297494","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":"Isolated in-situ mosaicplasty fixation of unstable knee osteochondritis dissecans in skeletally mature patients; a combined mechanical and biological solution with excellent outcomes and a low re-operation rate","authors":"AIW Mayne ,&nbsp;PSE Davies ,&nbsp;L. Lam ,&nbsp;M. Finsterwald ,&nbsp;S. Dalgleish ,&nbsp;S. Gohil ,&nbsp;PA D'Alessandro","doi":"10.1016/j.jisako.2024.100322","DOIUrl":"10.1016/j.jisako.2024.100322","url":null,"abstract":"<div><h3>Objectives</h3><div>Unstable osteochondritis dissecans (OCD) of the knee can result in substantial morbidity; the aims of surgical management are to provide stability to the lesion and to stimulate biological healing. The aim of this study was to review the outcomes of a previously described, but uncommonly used, technique involving isolated mosaicplasty fixation of unstable knee OCD.</div></div><div><h3>Methods</h3><div>A retrospective review of skeletally mature patients treated with in-situ mosaicplasty fixation of unstable OCD of the knee was performed. Two out of thirteen knees also underwent concomitant realignment osteotomy. Postoperative magnetic resonance imaging (MRI) and patient-reported outcome measures were reviewed.</div></div><div><h3>Results</h3><div>Twelve patients (13 knees) were included; there were 5 females and 7 males. The mean age at time of surgery was 22 years (range 16–32). The lesion location was lateral femoral condyle in 7 cases and medial femoral condyle in 6 cases. Follow-up MRI scans confirmed fragment healing in 12 knees (92%). One patient required further surgical intervention for ongoing symptoms and radiological non-union: the patient underwent an off-loading distal femoral osteotomy to correct valgus mal-alignment.</div></div><div><h3>Conclusion</h3><div>This series describes the outcomes following an uncommonly performed, yet reproducible and effective method of fixation of unstable knee OCDs. We believe in-situ mosaicplasty fixation represents an opportunity to provide both mechanical stability and biological augmentation of OCD healing, and the series confirms that excellent results can be achieved with a low re-operation rate.</div></div><div><h3>Level of evidence</h3><div>Level IV.</div></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"9 6","pages":"Article 100322"},"PeriodicalIF":2.7,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142297495","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}