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

{"title":"The Million Dollar Question: Can I Return to Sports After Unicompartmental Knee Arthroplasty, Doc?","authors":"Kevin D Plancher, Noah Li, Geoffrey E Braun, Stephanie C Petterson","doi":"10.1016/j.jisako.2024.100338","DOIUrl":"https://doi.org/10.1016/j.jisako.2024.100338","url":null,"abstract":"<p><p>Knee osteoarthritis (OA) is a widespread and potentially debilitating condition that can interfere with the growing demand for a healthy and active lifestyle. In people under the age of 55, the prevalence of OA is expected to increase substantially in the coming decades. High tibial osteotomy and cartilage repair operations have been used to treat OA in young, active individuals; however, these procedures require lengthy rehabilitation periods and result in poor return to preoperative levels of activity that make them unsuitable for the young, active patient. Unicompartmental knee arthroplasty (UKA) is a less invasive treatment alternative, especially for younger, active, middle-aged persons with a desire to return to sporting activities. UKA yields successful return to activities with excellent functional outcomes and mid- to long-term survivorship. This article will review the ability of patients to return to sports after UKA, the type and nature of the sporting activities, as well as the timing to return to these sports.</p>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142476778","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":"Long-Term Outcomes in Unicompartmental Knee Arthroplasty: Survivorship of Medial versus Lateral Unicompartmental Knee Arthroplasty.","authors":"Constant Foissey, Cécile Batailler, Andreas Fontalis, Elvire Servien, Sébastien Lustig","doi":"10.1016/j.jisako.2024.100329","DOIUrl":"https://doi.org/10.1016/j.jisako.2024.100329","url":null,"abstract":"<p><p>Unicompartmental knee arthroplasties (UKAs) currently represent an important portion of knee arthroplasty procedures and their usage is on an upward trend. Despite offering better functional outcomes and a quicker recovery compared to total knee arthroplasties (TKAs), UKAs are often scrutinized for their longevity. This article provides an in-depth examination of the technical nuances and survival rates of medial versus lateral UKAs, drawing on recent advances and findings in the field. This manuscript thoroughly evaluates the comparability of patient populations undergoing medial and lateral UKAs, considering their anatomical, biomechanical, and demographic differences. It delves into the specific technical challenges associated with each type and systematically assesses the factors that influence failure, including the intricacies of implant design and patient-specific variables. Despite relevant anatomical and biomechanical contrasts between medial and lateral UKAs, recent literature points to comparable survival rates. The prevalence of early failures within the initial five years post-operation underscores the criticality of precise patient selection and refined surgical techniques. The paper succinctly summarizes pivotal literature and provides essential guidance for optimizing UKA survivorship. It underscores the importance of meticulous patient selection and precise surgical techniques, alongside the identification and mitigation of potential pitfalls that impact outcomes. Finally, robotic technology in UKA has considerably enhanced the precision and reproducibility, representing a viable solution to effectively meet and achieve the recommended technical objectives.</p>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142476770","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":"Does robotic-assisted unicompartmental knee arthroplasty improve alignment and outcomes?","authors":"Rhett MacNeille, Tsun Yee Law, Martin Roche, James Chow","doi":"10.1016/j.jisako.2024.100336","DOIUrl":"10.1016/j.jisako.2024.100336","url":null,"abstract":"<p><p>Unicompartmental knee arthroplasty (UKA) continues to increase in popularity as an excellent option for patients with single compartment disease. Robotic-assisted UKA has emerged as an optional tool with hopes for improvement in component placement, limb alignment, and patient outcomes. Furthermore, as patients continue to educate themselves, robotic assistance will become increasingly prevalent. There are now various robotic platforms on the market, each with varying differences, and more published data are emerging on alignment and outcomes. The literature to date largely concludes that robotic-assisted UKA provides more accuracy than manual UKA. Short- to mid-term outcomes may be improved with robotic UKA, but definitive differences in outcomes are uncertain. Survivorship with robotic UKA is non-inferior to reported manual UKA survivorship rates, and more long-term data are needed to fully elucidate this point. Orthopaedic surgeons should weigh these potential advantages against the drawbacks including cost and operative time when making a decision about whether robotic technology is right for their practice.</p>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142476766","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":"POLYETHYLENE WEAR IN METAL-BACKED TIBIAL COMPONENTS IN UNICOMPARTMENTAL KNEE PROSTHESES.","authors":"Navnit S Makaram, Liam Z Yapp, Abigail L W Bowley, Amy Garner, Chloe E H Scott","doi":"10.1016/j.jisako.2024.100324","DOIUrl":"https://doi.org/10.1016/j.jisako.2024.100324","url":null,"abstract":"<p><p>The utilization of unicompartmental knee arthroplasty (UKA) has increased worldwide and has become a favorable alternative to total knee arthroplasty in patients with isolated single compartment knee osteoarthritis. With the increase in UKA utilization, there has been an increase in the number of revisions. The two most common causes of revision include the progression of osteoarthritis in other compartments and aseptic loosening with polyethylene wear, periprosthetic fracture, bearing dislocation, infection, instability, and unexplained pain being other causes. This narrative review will provide an overview of the current literature related to polyethylene wear-related implant failure in UKA. The evolution of the UKA implant design and the important differences in wear biomechanics, survival, and clinical outcomes between metal-backed (MB), all polyethylene (AP), fixed-bearing (FB), and mobile-bearing (MoB) MB tibial components will be discussed.</p>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142476775","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":"Preface.","authors":"Kevin D Plancher","doi":"10.1016/j.jisako.2024.100346","DOIUrl":"https://doi.org/10.1016/j.jisako.2024.100346","url":null,"abstract":"","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142476776","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":"Fixed-Bearing Medial Unicompartmental Knee Arthroplasty: New Indications and the Anterior Cruciate Ligament-Deficient Knee.","authors":"Kevin D Plancher, Geoffrey E Braun, Stephanie C Petterson","doi":"10.1016/j.jisako.2024.100337","DOIUrl":"https://doi.org/10.1016/j.jisako.2024.100337","url":null,"abstract":"<p><p>The anterior cruciate ligament (ACL)-deficient osteoarthritic knee is a challenging disease entity which requires careful thought to restore function and return to activities. Advancements in technology and surgical techniques have expanded indications for unicompartmental knee arthroplasty (UKA), to include ACL-deficiency in select patients. An improved understanding of the ACL-deficient osteoarthritic knee can aid in clinical and surgeon decision-making to restore knee function. This review will discuss current practice guidelines for the ACL-deficient knee with single-compartment osteoarthritis including pathoanatomy, indications, contraindications, technical considerations, and clinical outcomes.</p>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142476768","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":"Avoiding Complications in Medial Unicompartmental Knee Arthroplasty.","authors":"Daniel B Buchalter, Michael P Ast","doi":"10.1016/j.jisako.2024.100331","DOIUrl":"https://doi.org/10.1016/j.jisako.2024.100331","url":null,"abstract":"<p><p>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.</p>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":null,"pages":null},"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":"","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":null,"pages":null},"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":null,"pages":null},"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, Lutul D Farrow, Gina R Tubo, Xiaojuan Li, John J Elias","doi":"10.1016/j.jisako.2024.100335","DOIUrl":"10.1016/j.jisako.2024.100335","url":null,"abstract":"<p><strong>Objectives: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>For the first-time dislocation group, physical function, and quality of life scores were higher for men than women (p ​< ​0.05). For the multiple dislocation group, pain and physical function improved as BMI decreased (p ​< ​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 ​< ​0.05). For the two-year group, all three scores worsened as time since first dislocation increased (p ​< ​0.01).</p><p><strong>Conclusions: </strong>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.</p><p><strong>Level of evidence: </strong>Retrospective study with more than one negative criterion (Level 4).</p>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":null,"pages":null},"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":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}