Journal of Orthopaedic Surgery最新文献

{"title":"Comparison of anterior cervical discectomy and fusion versus anterior cervical corpectomy and fusion in the treatment of localized ossification of the posterior longitudinal ligament.","authors":"Tangyiheng Chen,&nbsp;Yujie Wang,&nbsp;Hong Zhou,&nbsp;Cheng Lin,&nbsp;Xuefeng Li,&nbsp;Huilin Yang,&nbsp;Yijie Liu,&nbsp;Weimin Jiang","doi":"10.1177/10225536231167704","DOIUrl":"https://doi.org/10.1177/10225536231167704","url":null,"abstract":"<p><strong>Background: </strong>The retrospective study was conducted to compare the efficacy of anterior cervical discectomy and fusion (ACDF) and anterior cervical corpectomy and fusion (ACCF) for localized ossification of the posterior longitudinal ligament (OPLL) by evaluating clinical and radiologic outcomes.</p><p><strong>Methods: </strong>We reviewed 151 patients to assess the effects of treatment for one or two levels localized OPLL. Perioperative parameters, such as blood loss, operation time and complications, were recorded. Radiologic outcomes, such as the occupying ratio (OR), fusion status, cervical lordosis angle, segmental angle, disc space height, T1 slope, and C2-C7 sagittal vertical axis (SVA), were assessed. Clinical indices, such as the JOA scores and VAS scores, were investigated to compare the two surgical options.</p><p><strong>Results: </strong>There were no significant differences in the JOA scores or VAS scores between the two groups (<i>p</i> > 0.05). The operation time, volume of blood loss and incidence of dysphagia were significantly less in the ACDF group than in the ACCF group (<i>p</i> < 0.05). In addition, cervical lordosis, segmental angle and disc space height were significantly different from their preoperative evaluations. No adjacent segment degenerated in the ACDF group. The subsidence rates of implants were 5.2% in the ACDF group and 28.4% in the ACCF group. The degeneration of the ACCF group was 4.1%. The incidence of CSF leaks was 7.8% in the ACDF group and 13.5% in the ACCF group. All the patients ultimately achieved successful fusion.</p><p><strong>Conclusion: </strong>Although both options achieved satisfactory primary clinical and radiographic efficacies, ACDF was associated with a shorter surgical procedure, less intraoperative blood loss, better radiologic outcomes, and lower incidence of dysphagia than ACCF.</p>","PeriodicalId":48794,"journal":{"name":"Journal of Orthopaedic Surgery","volume":"31 1","pages":"10225536231167704"},"PeriodicalIF":1.6,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9246148","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of tibial implant positioning between symmetrical and anatomical design implants in unicompartmental knee arthroplasty for Japanese patients.","authors":"Yoshiaki Miyake,&nbsp;Yoshifumi Namba,&nbsp;Shigeru Mitani,&nbsp;Norifumi Umehara,&nbsp;Toyohiro Kawamoto,&nbsp;Shuro Furuichi","doi":"10.1177/10225536221149485","DOIUrl":"https://doi.org/10.1177/10225536221149485","url":null,"abstract":"<p><strong>Purpose: </strong>In unicompartmental knee arthroplasty (UKA) procedures, maximizing the bone coverage of the tibial implant and eliminating the medial and posterior overhang would be optimal. We commonly used Physica ZUK^® (ZUK), which is a symmetrical design. Alternatively, since Persona Partial Knee^® (PPK) was developed in 2017 with an anatomical design to improve bone coverage, we started PPK. We hypothesized that the PPK facilitated better bone coverage than the ZUK without obvious overhangs. This study evaluated the bone coverage and the medial and posterior overhang of these differently designed tibial implants.</p><p><strong>Methods: </strong>Seventy-nine knees from 68 patients who underwent UKA were evaluated. Cases were categorized into the ZUK (41 knees) and PPK (38 knees) groups. CT images were acquired before surgery and 1 week after surgery. We measured the tibial bone coverage, and the medial and posterior overhang by 3D software.</p><p><strong>Results: </strong>The bone coverages were 103.8 ± 4.8% and 102.0 ± 3.0%, the medial overhangs were 2.2 ± 1.2 mm and 1.4 ± 1.1 mm, and the posterior overhangs were 0.6 ± 1.3 mm and 0.4 ± 1.2 mm for the ZUK and PPK groups, respectively. The bone coverage and medial overhang were significantly different between the groups, with ZUK being larger.</p><p><strong>Conclusion: </strong>Patients who received PPK had significantly smaller medial overhangs and better bone coverage. PPK is more likely to give better results than ZUK.</p>","PeriodicalId":48794,"journal":{"name":"Journal of Orthopaedic Surgery","volume":"31 1","pages":"10225536221149485"},"PeriodicalIF":1.6,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10761516","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mid-term follow-up results of gradual capitate lengthening for the treatment of stage IIIA Kienbock's disease.","authors":"Mesut Kariksiz,&nbsp;Ozgur Karakoyun","doi":"10.1177/10225536231166205","DOIUrl":"https://doi.org/10.1177/10225536231166205","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to evaluate the mid-term radiological and clinical results of gradual lengthening of capitate for the treatment of stage IIIA Kienbock's disease.</p><p><strong>Methods: </strong>We retrospectively reviewed nine patients (five females, four males) with Lichtman stage IIIA Kienbock's disease who underwent gradual capitate lengthening at our hospital. Their clinical (range of motion (ROM), grip strength, visual analogue scale (VAS) value for pain, and Mayo wrist score (MWS)) and radiological outcomes (in terms of progression of arthritis and carpal height ratio) at the last follow-up were compared to the preoperative values.</p><p><strong>Results: </strong>The mean age of the nine patients was 30 years (range: 20-38 years). The mean follow-up period was 73.8 (60-83) months. The average grip strength increased from 14.3 kg preoperatively to 22.3 kg at the last follow-up. The mean MWS increased from 58.8 preoperatively to 79.4 postoperatively. The mean VAS values decreased from the preoperative values: from 1.9 to 0.36 at rest, from 3.75 to 1.6 during mild effort, and from 5.35 to 3 during severe effort. The average carpal height ratio changed from 0.38 preoperatively to 0.53 postoperatively. None of the patients had any arthritic changes in their wrists.</p><p><strong>Conclusion: </strong>Gradual lengthening of capitate offers satisfactory mid-term results for treating stage IIIA Kienbock's disease.</p>","PeriodicalId":48794,"journal":{"name":"Journal of Orthopaedic Surgery","volume":"31 1","pages":"10225536231166205"},"PeriodicalIF":1.6,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9252652","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Minimum effective volume of ropivacaine for ultrasound-guided adductor canal + IPACK block in total knee arthroplasty: A double-blind, randomized dose-finding trial.","authors":"Qiuru Wang,&nbsp;Ting Ma,&nbsp;Jian Hu,&nbsp;Jing Yang,&nbsp;Pengde Kang","doi":"10.1177/10225536231161873","DOIUrl":"https://doi.org/10.1177/10225536231161873","url":null,"abstract":"<p><strong>Background: </strong>Our previous study reported that when a respective 20 mL of ropivacaine was used for adductor canal block (ACB) combined with infiltration between the popliteal artery and capsule of the posterior knee (IPACK) block for patients undergoing total knee arthroplasty (TKA), the minimum concentration of 0.275% could provide successful block in almost all patients. Based on the results, the primary objective of this study was to investigate the minimum effective volume (MEV₉₀, defined as the volume which can provide successful block in 90% of patients) of ACB + IPACK block.</p><p><strong>Methods: </strong>This double-blind, randomized dose-finding trial was based on a biased coin up-and-down sequential design, where the volume of ropivacaine administered to a given patient depended on the previous patient's response. The first patient received 15 mL of 0.275% ropivacaine for ACB and again for IPACK. If the block failed, the next subject received a 1 mL higher volume for ACB and IPACK, respectively; otherwise, the next subject received either a 1 mL lower volume (probability of 0.11) or the same volume (probability of 0.89). The primary outcome was whether the block was successful. Block success was defined as the patient did not suffer significant pain and did not receive rescue analgesia within 6 h after surgery. Then the MEV₉₀ was estimated by isotonic regression.</p><p><strong>Results: </strong>Based on analysis of 53 patients, the MEV₉₀ was 17.99 mL (95% CI 17.47-18.61 mL), MEV₉₅ was 18.48 mL (95% CI 17.45-18.98 mL) and MEV₉₉ was 18.90 mL (95% CI 17.38-19.07 mL). Patients whose blocks succeeded had significantly lower NRS pain scores, lower morphine consumption, and shorter hospitalization.</p><p><strong>Conclusion: </strong>0.275% ropivacaine in 17.99 mL respectively can provide successful ACB + IPACK block in 90% of patients undergoing TKA. The minimum effective volume (MEV₉₀) of ACB + IPACK block was 17.99 mL.</p>","PeriodicalId":48794,"journal":{"name":"Journal of Orthopaedic Surgery","volume":"31 1","pages":"10225536231161873"},"PeriodicalIF":1.6,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9489907","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medial patellofemoral ligament reconstruction using a digital tensiometer to determine graft tension: Surgical technique and mid-term follow-up.","authors":"Wenhao Zhang,&nbsp;Limin Mou,&nbsp;Yingjie Deng,&nbsp;Wenyuan Xiang,&nbsp;Shiping Zhang,&nbsp;Remila Aimaiti,&nbsp;Zhiyu Yuan,&nbsp;Rui Fang","doi":"10.1177/10225536231167649","DOIUrl":"https://doi.org/10.1177/10225536231167649","url":null,"abstract":"<p><strong>Purpose: </strong>The optimal method for achieving proper graft tension during patellofemoral ligament reconstruction is a topic of debate. In the past, a digital tensiometer was used to simulate the knee structure, and a tension of approximately 2N was identified as suitable for restoring the patellofemoral track. However, it is unclear whether this tension level is sufficient during the actual surgery. The objective of this study was to verify the efficacy of graft tension using a digital tensiometer for medial patellofemoral ligament (MPFL) reconstruction and to conduct a mid-term follow-up.</p><p><strong>Methods: </strong>The study enrolled 39 patients who had experienced recurrent patellar dislocation. Preoperative computed tomography scans and X-rays confirmed patellar instability, patellar tilt angle patellar congruence angle and the history of dislocation and patellar apprehension test. Knee function was evaluated using preoperative and postoperative Lysholm and Kujala scores.</p><p><strong>Results: </strong>The study included 39 knees, comprising 22 females and 17 males, with an average age of 21.10 ± 7.26. The patients were followed up for at least 24 months through telephone or face-to-face questionnaires. All patients had a preoperative history of ≥2 patellar dislocations, none of which were surgically treated. During surgery, all patients underwent isolated MPFL reconstruction and lateral retinacula release. The mean Kujala and Lysholm scores were 91.28 ± 4.90 and 90.67 ± 5.15, respectively. The mean PTA and PCA were 11.5 ± 2.63 and 2.38 ± 3.58, respectively. The study found that a tension of approximately 27.39 ± 5.57N (14.3-33.5N) was required to restore the patellofemoral track in patients with recurrent patellar dislocation. No patients required reoperation during the follow-up period. Overall, 36 out of 39 patients (92.31%) reported no pain when completing daily activities at the last follow-up.</p><p><strong>Conclusion: </strong>In conclusion, a tension level of approximately 27.39 ± 5.57N is necessary to restore normal patellofemoral relationships during clinical practice, which indicates that using a tension of 2N is too low. The use of a tensiometer during patellofemoral ligament reconstruction is a more accurate and reliable surgical procedure for treating recurrent patellar dislocation.</p>","PeriodicalId":48794,"journal":{"name":"Journal of Orthopaedic Surgery","volume":"31 1","pages":"10225536231167649"},"PeriodicalIF":1.6,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9696779","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Why does knee flexion in the standing position occur? Spinal deformity or knee osteoarthritis.","authors":"Jili Wang,&nbsp;Hiroki Ushirozako,&nbsp;Yu Yamato,&nbsp;Tomohiko Hasegawa,&nbsp;Go Yoshida,&nbsp;Tomohiro Banno,&nbsp;Hideyuki Arima,&nbsp;Shin Oe,&nbsp;Tomohiro Yamada,&nbsp;Koichiro Ide,&nbsp;Keiichi Nakai,&nbsp;Kenta Kurosu,&nbsp;Hironobu Hoshino,&nbsp;Yukihiro Matsuyama","doi":"10.1177/10225536231169575","DOIUrl":"https://doi.org/10.1177/10225536231169575","url":null,"abstract":"<p><p><b>Background:</b> The interaction between knee osteoarthritis and spinal deformity and knee flexion (KF) remains unclear. We aimed to clarify the relationship between KF in the standing position and the severity of spinal deformity and knee osteoarthritis. <b>Methods:</b> We analyzed older volunteers aged over <b>60</b> years who participated in the musculoskeletal screening program. The participant's characteristics and standing radiographic parameters were assessed. After a preliminary analysis, a propensity score-matched model was established with adjustments for age, sex, and body mass index (BMI). Cases were divided into KF (knee angle [KA] ≥10°) and non-KF (KA <10°) groups. <b>Results:</b> In a preliminary analysis of 252 cases (42 KF and 210 non-KF), there were significant differences in age and BMI between the KF and non-KF groups (all <i>p</i> < 0.05). Using a one-to-one propensity score-matched analysis, 38 pairs of cases were selected. There were significantly higher values of C7 sagittal vertical axis, T1 pelvic angle, pelvic tilt, pelvic incidence minus lumbar lordosis, KA, ankle angle, and pelvic shift in the KF group than in the non-KF group (all <i>p</i> < 0.05). In the KF group, 71.1% of the cases had severe spinal deformity (defined as marked deformity by the SRS-Schwab classification), and 31.6% had severe knee osteoarthritis (defined as a Kellgren Lawrence grade ≥3). Of the 31.6%, 7.9% were attributable to knee osteoarthritis alone, and 23.7% to both knee osteoarthritis and spinal deformity. <b>Conclusions:</b> This study clarified that compensatory changes due to spinopelvic malalignment, not due to knee osteoarthritis alone, mainly affected KF in the standing position.</p>","PeriodicalId":48794,"journal":{"name":"Journal of Orthopaedic Surgery","volume":"31 1","pages":"10225536231169575"},"PeriodicalIF":1.6,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9697607","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Shared and unique risk factors for readmission exist following upper and lower extremity arthroplasty in the 30-day postoperative period.","authors":"Donald J Scholten,&nbsp;Chukwuweike U Gwam,&nbsp;Andrew J Recker,&nbsp;Johannes F Plate,&nbsp;Brian R Waterman","doi":"10.1177/10225536231155749","DOIUrl":"https://doi.org/10.1177/10225536231155749","url":null,"abstract":"<p><strong>Purpose: </strong>Joint arthroplasty has become increasingly more common in the United States, and it is important to examine the patient-based risk factors and surgical variables associated with hospital readmissions. The purpose of this study was to identify stratified rates and risk factors for readmission after upper extremity (shoulder, elbow, and wrist) and lower extremity (hip, knee, and ankle) arthroplasty.</p><p><strong>Methods: </strong>All patients undergoing upper and lower extremity arthroplasty from 2008-2018 were identified using the National Surgical Quality Improvement Program dataset. Patient demographics, medical comorbidities and surgical characteristics were examined utilizing uni- and multi-variate analysis for significant predictors of 30-days hospital readmission.</p><p><strong>Results: </strong>A total of 523,523 lower and 25,215 upper extremity arthroplasty patients were included in this study. A number of 22,183 (4.2%) lower and 1072 (4.4%) upper extremity arthroplasty patients were readmitted within 30 days of discharge. Significant risk factors for 30-days readmission after lower extremity arthroplasty included age, Body Mass Index (BMI), operative time, dependent functional status, American Society of Anesthesiologists (ASA) score ≥3, increased length of stay, and various medical comorbidities such as diabetes, tobacco dependency, and chronic obstructive pulmonary disease (COPD). An overweight BMI was associated with a lower odds of 30-days readmission when compared to a normal BMI for lower extremity arthroplasty. Analysis for upper extremity arthroplasty revealed similar findings of significant risk factors for 30-days hospital readmission, although diabetes mellitus was not found to be a significant risk factor.</p><p><strong>Conclusion: </strong>Nearly one in 25 patients undergoing upper and lower extremity arthroplasty experiences hospital readmission within 30-days of index surgery. There are several modifiable risk factors for 30-days hospital readmission shared by both lower and upper extremity arthroplasty, including tobacco smoking, COPD, and hypertension. Optimization of these medical comorbidities may mitigate the risk short-term readmission following joint arthroplasty procedures and improve overall cost effectiveness of perioperative surgical care.</p>","PeriodicalId":48794,"journal":{"name":"Journal of Orthopaedic Surgery","volume":"31 1","pages":"10225536231155749"},"PeriodicalIF":1.6,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9114960","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Functional results and return to sports on recurrent anterior glenohumeral instability. Influence of the COVID-19 pandemic; Comparative retrospective study and short-term results.","authors":"Diego J Gómez,&nbsp;Daniel Veloz Serrano,&nbsp;Daniel Moya,&nbsp;Juan I Crosa,&nbsp;Matias L Cullari,&nbsp;Juan P Taleb,&nbsp;Gonzalo Quiroga,&nbsp;Xavier A Maya,&nbsp;Álvaro Muratore","doi":"10.1177/10225536231160308","DOIUrl":"https://doi.org/10.1177/10225536231160308","url":null,"abstract":"<p><strong>Aims: </strong>Our objective is to compare the functional results in patients that underwent surgery for recurrent anterior shoulder instability (RAGHI) during the COVID-19 pandemic with remotely-based rehabilitation, to those who had surgery before the pandemic and had in-person rehabilitation therapy.</p><p><strong>Methods: </strong>A retrospective case series of 68 patients were included and divided into two groups: In person-group and Home-based group. Western Ontario Shoulder Instability Index (WOSI) and Subjective Shoulder Value (SSV) scores were used to evaluate objective and subjective clinical parameters. Time and level of return to sports was studied by the Subjective Patient Outcome for Return to Sports (SPORTS) score.</p><p><strong>Results: </strong>The mean SSV score was 82% (40-100) on the In-Person group compared with 87% (65-100) for the Home-Based group. Results for WOSI score were similar, with an average of 210.42 (90%) for In-Person and 261.45 (88%) for the Home-Based group (<i>p</i> 0.12). Return to sports was carried out in an average of 6.6 (4-16) months for In-Person group, compared to 6.5 (5-8) months for Home-Based.</p><p><strong>Conclusion: </strong>Follow-up and rehabilitation methods for patients who underwent surgery for RAGHI, during COVID-19 lockdown, were not significantly (<i>p</i> 0.12) affected on functional and athletic return in comparison to traditional methods according to WOSI scale.</p><p><strong>Level of evidence: </strong>IV Retrospective series of cases.</p>","PeriodicalId":48794,"journal":{"name":"Journal of Orthopaedic Surgery","volume":"31 1","pages":"10225536231160308"},"PeriodicalIF":1.6,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/fd/bf/10.1177_10225536231160308.PMC9982427.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9697591","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Can radiological findings detect neuropathic pain in patients with osteoarthritis of the knee undergoing surgery?","authors":"Hiroyasu Ogawa,&nbsp;Yutaka Nakamura,&nbsp;Masaya Sengoku,&nbsp;Tetsuya Shimokawa,&nbsp;Kazuki Sohmiya,&nbsp;Kazuichiro Ohnishi,&nbsp;Kazu Matsumoto,&nbsp;Haruhiko Akiyama","doi":"10.1177/10225536231158149","DOIUrl":"https://doi.org/10.1177/10225536231158149","url":null,"abstract":"<p><strong>Objectives: </strong>The mechanism underlying neuropathic pain (NP) in osteoarthritis (OA) of the knee is not completely understood. This study aimed to investigate whether possible NP in patients with knee OA undergoing knee surgery is associated with specific radiological findings.</p><p><strong>Methods: </strong>This study included 197 patients who underwent knee surgery for symptomatic knee OA. Clinical evaluation was performed using the Central Sensitization Inventory (CSI), Western Ontario and McMaster Universities Arthritis Index (WOMAC), and PainDETECT questionnaire. Radiological evaluation was performed using the hip-knee-ankle (HKA) angle, posterior tibial slope (PTS), varus and valgus laxities, and magnetic resonance imaging OA Knee Score (MOAKS). Radiological findings were compared between patients with possible and unlikely NP. Logistic regression analysis was performed to identify the predictive factors for NP.</p><p><strong>Results: </strong>There were 163 and 34 patients with unlikely NP and with possible NP, respectively. The percentage of patients with CSI score ≥ 40 was significantly higher in the possible NP group than in the unlikely NP group (17.6% vs. 6.1%). Patients with possible NP had worse WOMAC scores than patients with unlikely NP. There were no significant positive associations between the possible NP and radiological findings in knee OA. Regression analysis showed no predictive factors for possible NP.</p><p><strong>Conclusions: </strong>Possible NP is not associated with specific radiological findings in knee OA. Patients with possible NP may mediate CS and experience more severe symptoms, including decreased knee function and lower quality of life, than patients with unlikely NP.</p>","PeriodicalId":48794,"journal":{"name":"Journal of Orthopaedic Surgery","volume":"31 1","pages":"10225536231158149"},"PeriodicalIF":1.6,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9117897","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Robotic-arm assisted lateral unicompartmental knee arthroplasty: 5-Year outcomes & survivorship.","authors":"Michael A Gaudiani,&nbsp;Linsen T Samuel,&nbsp;John N Diana,&nbsp;Jennifer L DeBattista,&nbsp;Thomas M Coon,&nbsp;Ryan E Moore,&nbsp;Atul F Kamath","doi":"10.1177/10225536221138986","DOIUrl":"https://doi.org/10.1177/10225536221138986","url":null,"abstract":"<p><strong>Introduction: </strong>Robotic-arm assisted unicompartmental knee arthroplasty (RA-UKA) has demonstrated accurate component positioning and excellent outcomes for medial components. However, there is a paucity of literature on lateral compartment RA-UKA. The purpose of our study was to assess the midterm clinical outcomes and survivorship of lateral RA-UKA.</p><p><strong>Methods: </strong>This study was a retrospective review of a single-center prospectively maintained cohort of 33 patients (36 knees) indicated for lateral UKA. Perioperative, and postoperative two- and five-year Knee injury Osteoarthritis Outcome Score (KOOS), Western Ontario and McMaster Universities Osteoarthritis Score (WOMAC), and Forgotten Joint Score (FJS) patient reported outcome measures were collected. Five-year follow-up was recorded in 29 patients (32 knees).</p><p><strong>Results: </strong>Mean follow up was 5.1 ± 0.1 years. Mean age and BMI was 70.9 ± 7.2 years and 29.0 ± 4.2 kg/m2, respectively. At discharge, mean distance walked was 273.4 ± 70.4 feet, and mean pain score was 2.0 ± 2.5. At 2-year follow up, mean KOOS, WOMAC, and FJS were 75.1 ± 13.5, 15.0 ± 7.2, and 81.0 ± 23.3, respectively. At 5-year follow up, mean KOOS, WOMAC, and FJS were 75.3 ± 14.6, 14.9 ± 5.0, and 75.8 ± 27.4, respectively. Mean change in KOOS and WOMAC were 35.6 ± 27.1 and 11.7 ± 13.4 (<i>p</i>< .001 and <i>p</i>< .001). 94% of patients were very satisfied/satisfied, 3% neutral, and 3% dissatisfied. 91% met activity expectations, and 59% were more active than before. Survivorship was 100% at 5 years.</p><p><strong>Discussion: </strong>In this study, lateral RA-UKA demonstrated significantly improved clinical outcomes, high patient satisfaction, met expectations, and excellent functional recovery at midterm follow up. Comparative studies are needed to determine differences between robotic-assisted and conventional lateral UKA, as well as TKA.</p>","PeriodicalId":48794,"journal":{"name":"Journal of Orthopaedic Surgery","volume":"31 1","pages":"10225536221138986"},"PeriodicalIF":1.6,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9120623","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}