Journal of Knee Surgery最新文献

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Comparison of the Cost-Effectiveness and Safety between Staged Bilateral Total Knee Arthroplasty and Simultaneous Bilateral Total Knee Arthroplasty: A Retrospective Cohort Study between 2001 and 2022. 分期双侧全膝关节置换术与同期双侧全膝关节置换术的成本效益和安全性比较:2001 年至 2022 年间的回顾性队列研究。
IF 1.6 4区 医学
Journal of Knee Surgery Pub Date : 2024-09-02 DOI: 10.1055/a-2368-4516
Omar W K Tsui, Ping-Keung Chan, Amy Cheung, Vincent W K Chan, Michelle H Luk, Man-Hong Cheung, Lawrence C M Lau, Thomas K C Leung, Henry Fu, Kwong-Yuen Chiu
{"title":"Comparison of the Cost-Effectiveness and Safety between Staged Bilateral Total Knee Arthroplasty and Simultaneous Bilateral Total Knee Arthroplasty: A Retrospective Cohort Study between 2001 and 2022.","authors":"Omar W K Tsui, Ping-Keung Chan, Amy Cheung, Vincent W K Chan, Michelle H Luk, Man-Hong Cheung, Lawrence C M Lau, Thomas K C Leung, Henry Fu, Kwong-Yuen Chiu","doi":"10.1055/a-2368-4516","DOIUrl":"10.1055/a-2368-4516","url":null,"abstract":"<p><p>A substantial proportion of Hong Kong's aging population suffers from osteoarthritis in both knees. Bilateral total knee arthroplasty (BTKA) is a surgical option for addressing this condition and can be performed via two approaches: simultaneous BTKA (SimBTKA) and staged BTKA (StaBTKA). We compared the cost-effectiveness and safety of these two methods in our institution. We retrospectively reviewed 2,372 patients (SimBTKA, 772; StaBTKA, 1,600; females, 1,780; males, 592; mean age at SimBTKA, 70.4 ± 7.99 years; mean age at StaBTKA, 66.4 ± 7.50 years; <i>p</i> < 0.001) who underwent BTKA in our institution from 2001 to 2022. Patients were categorized according to the surgical approach. Patients undergoing BTKA in our institution were included. Particularly for SimBTKA, patients were assessed by anesthetists to be medically fit before undergoing the procedure according to their age, American Society of Anesthesiologists status, and osteoarthritis severity. The primary outcome was the length of stay (LOS) after surgery. The secondary outcomes were the 30-day unintended readmission, intensive care unit (ICU) admission, and death. SimBTKA had a shorter mean total LOS (acute hospital + rehabilitation center; SimBTKA, 13.09 days; StaBTKA, 18.12 days; <i>p</i> < 0.001) and mean LOS in acute hospital (SimBTKA, 7.70 days; StaBTKA, 10.42 days; <i>p</i> < 0.001). However, no significant difference was found in the mean LOS in rehabilitation centers (SimBTKA, 5.47 days; StaBTKA, 6.32 days; <i>p</i> > 0.05) between the two approaches. The 30-day unintended readmission rate was lower in SimBTKA (SimBTKA, 2.07%; StaBTKA, 3.30%; odds ratio [OR] = 1.60; <i>p</i> > 0.05) but statistically insignificant. SimBTKA was less costly than StaBTKA by US$ 8,422.22 per patient. No significant differences in ICU admission and death rates were found (<i>p</i> > 0.05) between the two groups. SimBTKA had a shorter LOS and lower cost than StaBTKA and comparable complication rates. Therefore, SimBTKA should be indicated in medically stable patients.</p>","PeriodicalId":48798,"journal":{"name":"Journal of Knee Surgery","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141635068","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}
引用次数: 0
Computer Patient-Specific 3D Modeling and Custom-Made Guides for Revision ACL Surgery. 用于前交叉韧带翻修手术的特定患者计算机三维建模和定制指南。
IF 1.6 4区 医学
Journal of Knee Surgery Pub Date : 2024-09-01 Epub Date: 2024-04-27 DOI: 10.1055/a-2315-7873
Armando Del Prete, Piero Franco, Matteo Innocenti, Fabrizio Matassi, Filippo Leggieri, Rosario Jr Sagliocco, Roberto Civinini
{"title":"Computer Patient-Specific 3D Modeling and Custom-Made Guides for Revision ACL Surgery.","authors":"Armando Del Prete, Piero Franco, Matteo Innocenti, Fabrizio Matassi, Filippo Leggieri, Rosario Jr Sagliocco, Roberto Civinini","doi":"10.1055/a-2315-7873","DOIUrl":"10.1055/a-2315-7873","url":null,"abstract":"<p><p>Revision anterior cruciate ligament reconstruction (ACLR) is a challenging surgery occurring in 3 to 24% of primary reconstructions. A meticulous planning to study the precise size and location of both femoral and tibial bone tunnels is mandatory. The aim of the study was to evaluate the intra- and interoperator differences in the decision-making process between experienced surgeons after they were asked to make preoperative planning for ACL revision reconstruction with the use of both the computed tomography (CT) scan and a three-dimensional (3D)-printed model of the knee. Data collected from 23 consecutive patients undergoing revision of ACLR for graft failure at a single institute between September 2018 and February 2020 were prospectively reviewed. The double-blinded collected data were presented to three board-certificate attending surgeons. Surgeons were asked to decide whether to perform one-stage or two-stage revision ACLR based on the evaluation of the CT scan images and the 3D-printed custom-made models at two different rounds, T0 and T1, respectively, 7 days apart one from the other. Interoperator consensus following technical mistake was 52% at T0 and 56% at T1 using the CT scans, meanwhile concordance was 95% at T0 and 94% at T1 using the 3D models. Concordance between surgeons following new knee injury was 66% at T0 and 70% at T1 using CT scans, while concordance was 96% both at T0 and T1 using 3D models. Intraoperative variability using 3D models was extremely low: concordance at T0 and T1 was 98%. McNemar test showed a statistical significance in the use of 3D model for preoperative planning (<i>p</i> < 0.005). 3D-printed model reliability resulted to be higher compared with CT as intraoperator surgery technique selection was not modified throughout time from T0 to T1 (<i>p</i> < 0.005). The use of 3D-printed models had the most impact when evaluating femoral and tibial tunnels, resulting to be a useful instrument during preoperative planning of revision ACLR between attending surgeons with medium-high workflow.</p>","PeriodicalId":48798,"journal":{"name":"Journal of Knee Surgery","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140856656","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}
引用次数: 0
Isolated, Proximal Tibiofibular Injuries in Athletic Patients: A Critical Analysis Review. 运动员胫腓骨近端孤立性损伤:批判性分析综述。
IF 1.6 4区 医学
Journal of Knee Surgery Pub Date : 2024-09-01 Epub Date: 2024-04-27 DOI: 10.1055/a-2315-7691
Derrick M Knapik, Varun Gopinatth, Garrett R Jackson, Robert F LaPrade, Jorge Chahla, Robert H Brophy, Matthew J Matava, Matthew V Smith
{"title":"Isolated, Proximal Tibiofibular Injuries in Athletic Patients: A Critical Analysis Review.","authors":"Derrick M Knapik, Varun Gopinatth, Garrett R Jackson, Robert F LaPrade, Jorge Chahla, Robert H Brophy, Matthew J Matava, Matthew V Smith","doi":"10.1055/a-2315-7691","DOIUrl":"10.1055/a-2315-7691","url":null,"abstract":"<p><p>While infrequently reported, isolated injuries to the proximal tibiofibular (TF) joint primarily occur in young, athletic patients participating in sporting activities requiring explosive, high-impact movements, increasing the risk for potential twisting injuries, especially across a hyperflexed knee. The proximal TF joint is stabilized by bony, muscular and ligamentous structures, including both the anterior and posterior proximal TF complexes, with the anterior complex providing more robust stability. Proximal TF injuries frequently involve anterior and lateral displacement of the proximal fibula relative to its native articulation with the tibia. Proper diagnosis is dependent on careful and meticulous history and physical examination, as missed injuries are common, leading to the potential for continued pain, weakness and disability, especially in athletic patients. While spontaneous joint reduction has been reported, injuries may require formal closed reduction, with irreducible and chronic injuries requiring open reduction and stabilization, with recent investigations reporting satisfactory outcomes following anatomic reconstruction of the proximal TF ligament.</p>","PeriodicalId":48798,"journal":{"name":"Journal of Knee Surgery","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140872398","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}
引用次数: 0
Short-term Comparison of Survivorship and Functional Outcomes for Metaphyseal Cones with Short and Long Stems in Revision Total Knee Arthroplasty. 在翻修全膝关节置换术中使用带短柄和长柄的骺锥体的存活率和功能效果的短期比较。
IF 1.6 4区 医学
Journal of Knee Surgery Pub Date : 2024-09-01 Epub Date: 2024-04-27 DOI: 10.1055/a-2315-7778
Nicolas S Piuzzi, Emily L Hampp, Sarah Shi, Manoshi Bhowmik-Stoker, Nickelas Huffman, Kevin M Denehy, David C Markel, Daniel D Li, Michael A Mont
{"title":"Short-term Comparison of Survivorship and Functional Outcomes for Metaphyseal Cones with Short and Long Stems in Revision Total Knee Arthroplasty.","authors":"Nicolas S Piuzzi, Emily L Hampp, Sarah Shi, Manoshi Bhowmik-Stoker, Nickelas Huffman, Kevin M Denehy, David C Markel, Daniel D Li, Michael A Mont","doi":"10.1055/a-2315-7778","DOIUrl":"10.1055/a-2315-7778","url":null,"abstract":"<p><p>Printed porous titanium metaphyseal cones have become a mainstay for managing bone loss in revision total knee arthroplasty (rTKA). A short or long stem is routinely used when implanting a cone to augment fixation and offload stresses. This retrospective analysis compared the short-term survivorships and functional outcomes for use of a short or long stem with a metaphyseal cone.A total of 179 cases using metaphyseal cones and stems with median follow-up of 1.95 years (interquartile range, 1.00-2.14) were compared based on stem type. There were 55 cases with long stem(s) and 124 cases with short stem(s). Cases with both long and short stems were excluded. Demographics, Kaplan-Meier survivorships, and preoperative and 1-year postoperative patient-reported outcome measures (PROMs; 2011 Knee Society Score [KSS] objective knee score, function, and satisfaction scores; EuroQol five-dimension scale; and Short Form Survey Physical Component Summary and Mental Component Summary scores) were compared using <i>t</i>-tests with a significance level of α = 0.05. There were no significant differences in body mass index (mean ± standard deviation) or sex (men [%]) between the short and long stem cohorts (32.3 ± 5.3, 36.3% and 31.5 ± 5.5, 38.2%, respectively; <i>p</i> > 0.05). Patients who had short stems were younger (65.9 ± 8.8 vs. 69.0 ± 9.4, <i>p</i> = 0.0323).Revision-free survivorship for the femoral or tibial component was 100% for long stems and 98.2% for short stems at 1 and 2 years, respectively (log-rank <i>p</i> = 0.6330). The two revisions in the short group were for infection, thus the survivorship for aseptic loosening was 100% at 2 years for both cohorts. There were no significant differences in preoperative or postoperative PROMs.This study demonstrated that highly porous printed metaphyseal cones provided rTKA with excellent early survivorship and similar PROMs whether a short or long stem was used. Additional studies will be needed to discern longer term differences.</p>","PeriodicalId":48798,"journal":{"name":"Journal of Knee Surgery","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140872259","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}
引用次数: 0
Patient Demographic Factors Impact KOOS JR Response Rates for Total Knee Arthroplasty Patients. 患者人口统计学因素对全膝关节置换术患者 KOOS JR 响应率的影响
IF 1.6 4区 医学
Journal of Knee Surgery Pub Date : 2024-09-01 Epub Date: 2024-05-22 DOI: 10.1055/s-0044-1787055
Yixuan Tong, Vinaya Rajahraman, Rajan Gupta, Ran Schwarzkopf, Joshua C Rozell
{"title":"Patient Demographic Factors Impact KOOS JR Response Rates for Total Knee Arthroplasty Patients.","authors":"Yixuan Tong, Vinaya Rajahraman, Rajan Gupta, Ran Schwarzkopf, Joshua C Rozell","doi":"10.1055/s-0044-1787055","DOIUrl":"10.1055/s-0044-1787055","url":null,"abstract":"<p><p>The Knee injury and Osteoarthritis Outcome Score for Joint Replacement (KOOS JR) is a validated patient-reported measure for assessing pain and function following total knee arthroplasty (TKA). This study investigates how patient demographic factors (i.e., age, sex, and race) correlate with KOOS JR response rates. This was a retrospective cohort study of adult, English-speaking patients who underwent primary TKA between 2017 and 2023 at an academic institution. KOOS JR completion status-complete or incomplete-was recorded within 90 days postoperatively. Standard statistical analyses were performed to assess KOOS JR completion against demographic factors. Among 2,883 total patients, 70.2% had complete and 29.8% had incomplete KOOS JR questionnaires. Complete status (all <i>p</i> < 0.01) was associated with patients aged 60 to 79 (71.8%), white race (77.6%), Medicare (81.7%), marriage (76.8%), and the highest income quartile (75.7%). Incomplete status (all <i>p</i> < 0.001) was associated with patients aged 18 to 59 (64.4%), Medicaid (82.4%), and lower income quartiles (41.6% first quartile, 36.8% third quartile). Multiple patient demographic factors may affect KOOS JR completion rates; patients who are older, white, and of higher socioeconomic status are more likely to participate. Addressing underrepresented groups is important to improve the utility and generalizability of the KOOS JR.</p>","PeriodicalId":48798,"journal":{"name":"Journal of Knee Surgery","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141082003","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}
引用次数: 0
Relationship between Kinesiophobia and Dynamic Postural Stability after Anterior Cruciate Ligament Reconstruction: A Prospective Cohort Study. 前十字韧带重建术后运动恐惧与动态姿势稳定性之间的关系:一项前瞻性队列研究。
IF 1.6 4区 医学
Journal of Knee Surgery Pub Date : 2024-09-01 Epub Date: 2024-04-27 DOI: 10.1055/a-2315-8034
Derrick M Knapik, Aguri Kamitani, Matthew V Smith, John Motley, Amanda K Haas, Matthew J Matava, Rick W Wright, Robert H Brophy
{"title":"Relationship between Kinesiophobia and Dynamic Postural Stability after Anterior Cruciate Ligament Reconstruction: A Prospective Cohort Study.","authors":"Derrick M Knapik, Aguri Kamitani, Matthew V Smith, John Motley, Amanda K Haas, Matthew J Matava, Rick W Wright, Robert H Brophy","doi":"10.1055/a-2315-8034","DOIUrl":"10.1055/a-2315-8034","url":null,"abstract":"<p><p>Anterior cruciate ligament (ACL) injuries in young, active patients generally require ACL reconstruction (ACLR) to restore mechanical and postural stability. The fear of movement or reinjury (kinesiophobia) has become increasingly recognized in the post-ACLR population; however, the association between restoration of postural stability and kinesiophobia remains largely unknown. The purpose of this study was to investigate changes in mean Tampa Scale of Kinesiophobia-11 (TSK-11), dynamic motion analysis (DMA) scores, and time on the testing platform, as well as any correlation between TSK-11 and mean overall and individual translational and rotational DMA scores during the first 12 months following ACLR. Cohort study. Patients undergoing ACLR were prospectively enrolled and dynamic postural stability and kinesiophobia based on the TSK-11 were collected within 2 days prior to surgery and at 6 and 12 months following ACLR. Dynamic postural stability was quantified by calculating a DMA score, with score calculated in three translational (anterior/posterior [AP], up/down [UD], medial/lateral [ML]) and three rotational (left/right [LR], flexion/extension, and internal/external rotation) independent planes of motions. Correlations between DMA and TSK-11 scores at each time point were analyzed. A total of 25 patients meeting inclusion criteria were analyzed. Mean overall DMA and TSK-11 scores increased with each successive testing interval. At 6-month follow-up, a weakly positive association between TSK-11 and DMA scores was appreciated based on overall DMA, AP, UD, ML, and LR. At 12 months, a moderately positive correlation was appreciated between TSK-11 and the translational, but not rotational, planes of motion. Following ACLR, lower level of kinesiophobia were found to be moderately associated with improved dynamic stability, especially in the translation planes of motion.</p>","PeriodicalId":48798,"journal":{"name":"Journal of Knee Surgery","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140870509","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}
引用次数: 0
Specific Preoperative Factors Increase Manipulations under Anesthesia Following Primary TKA. 特定的术前因素会增加初级 TKA 术后麻醉下的操作。
IF 1.6 4区 医学
Journal of Knee Surgery Pub Date : 2024-09-01 Epub Date: 2024-04-27 DOI: 10.1055/a-2315-7955
Anson G Bautista, Nicholas L Kolodychuk, Jeremy S Frederick, Michael B Held, H John Cooper, Roshan P Shah, Jeffrey A Geller
{"title":"Specific Preoperative Factors Increase Manipulations under Anesthesia Following Primary TKA.","authors":"Anson G Bautista, Nicholas L Kolodychuk, Jeremy S Frederick, Michael B Held, H John Cooper, Roshan P Shah, Jeffrey A Geller","doi":"10.1055/a-2315-7955","DOIUrl":"10.1055/a-2315-7955","url":null,"abstract":"<p><p>Arthrofibrosis following primary total knee arthroplasty (TKA) can result in pain and limit postoperative range of motion (ROM), jeopardizing clinical outcomes and patient satisfaction. This study aims to identify preoperative risk factors associated with necessitating a manipulation under anesthesia (MUA) following primary TKA.We retrospectively reviewed 950 cases of consecutive primary TKAs performed at one institution by three arthroplasty surgeons between May 2017 and May 2019. Recorded preoperative variables included smoking status, race, preoperative ROM, presence of effusion or positive anterior drawer, and medical comorbidities. Demographic characteristics were compared with Student's <i>t</i>-tests or chi-square tests as appropriate. For each preoperative factor, we obtained an odds ratio (OR) for MUA risk using multivariate logistic regression.Twenty (2.3%) patients underwent MUA following their index primary TKA surgery. History of ipsilateral knee surgery (OR: 2.727, <i>p</i> = 0.047) and diagnosed hypertension (OR: 4.764, <i>p</i> = 0.016) were identified as risk factors associated with significantly increased risk of MUA. The greater the preoperative ROM, the higher likelihood needed of MUA (OR: 1.031, <i>p</i> = 0.034).Patients who had diagnosed hypertension or a history of prior ipsilateral knee surgery were associated with increased risk of necessitating an MUA following primary TKA. Additionally, a greater total arc of motion preoperatively increased the odds of needing MUA.Level III of evidence was present.</p>","PeriodicalId":48798,"journal":{"name":"Journal of Knee Surgery","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140867068","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}
引用次数: 0
Cell-Mediated Immune Responses May Play Roles in Osteochondral Allograft Transplantation Osteointegration Failures. 细胞介导的免疫反应可能在骨软骨异体移植骨整合失败中发挥作用
IF 1.6 4区 医学
Journal of Knee Surgery Pub Date : 2024-09-01 Epub Date: 2024-05-16 DOI: 10.1055/s-0044-1787058
Josephine Luk, Chantelle C Bozynski, Jonathan Williams, Aaron M Stoker, James P Stannard, Emma Teixeiro, James L Cook
{"title":"Cell-Mediated Immune Responses May Play Roles in Osteochondral Allograft Transplantation Osteointegration Failures.","authors":"Josephine Luk, Chantelle C Bozynski, Jonathan Williams, Aaron M Stoker, James P Stannard, Emma Teixeiro, James L Cook","doi":"10.1055/s-0044-1787058","DOIUrl":"10.1055/s-0044-1787058","url":null,"abstract":"<p><p>Prolonged and incomplete osteochondral allograft (OCA) osteointegration is consistently cited as a major mechanism for OCA treatment failure. Subrejection immune responses may play roles in this mode of failure. Preimplantation OCA preparation techniques, including subchondral bone drilling, thorough irrigation, and autogenous bone marrow aspirate concentrate saturation, may dampen immune responses and improve OCA osteointegration. This study sought to further characterize potential immune system contributions to OCA transplantation treatment failures by analyzing donor-recipient ABO and Rh-factor mismatches and histological and immunohistochemical assessments of transplanted OCA tissues recovered from revision surgeries. Using a dedicated registry, OCA transplant recipients with documented treatment failures who met inclusion criteria (<i>n</i> = 33) as well as age-, body mass index-, and joint-matched patients with successful outcomes (<i>n</i> = 70) were analyzed to compare matched cohorts of patients with successful versus failed OCA transplantation outcomes. Tissues recovered from 18 failed OCA transplants and portions of 7 nonimplanted OCA controls were further analyzed to provide contributing evidence for potential immune response mechanisms. For patients analyzed, no statistically significant differences in proportions for treatment success versus failure based on mismatches for ABO type, Rh factor, or both were noted. Further, no statistically significant differences in proportions for histological immune response presence or absence based on mismatches for ABO type, Rh factor, or both were noted. Twelve (67%) of the failed OCA tissues contained lymphocyte aggregations in the subchondral bone, which were comprised of combinations of CD3 + , CD4 + , CD8 + , and CD20+ lymphocytes. The mechanisms of failure for these 12 OCA transplants involved insufficient OCA osteointegration. Results of this study suggest that T- and B-cell-mediated subrejection immune responses may play roles in OCA transplant treatment failures independent of donor-recipient blood type mismatch effects.</p>","PeriodicalId":48798,"journal":{"name":"Journal of Knee Surgery","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140960464","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}
引用次数: 0
Patella Fractures after Total Knee Arthroplasty. 全膝关节置换术后髌骨骨折。
IF 1.6 4区 医学
Journal of Knee Surgery Pub Date : 2024-08-30 DOI: 10.1055/a-2376-6721
Gabrielle Swartz, Mohamed Albana, Jeremy A Dubin, Daniel Hameed, Sandeep S Bains, Michael A Mont, Ronald E Delanois, Giles R Scuderi
{"title":"Patella Fractures after Total Knee Arthroplasty.","authors":"Gabrielle Swartz, Mohamed Albana, Jeremy A Dubin, Daniel Hameed, Sandeep S Bains, Michael A Mont, Ronald E Delanois, Giles R Scuderi","doi":"10.1055/a-2376-6721","DOIUrl":"10.1055/a-2376-6721","url":null,"abstract":"<p><p>Periprosthetic patella fractures are a rare complication that can lead to severe disability following total knee arthroplasty (TKA). There are several factors that increase the risk of this injury, including patient comorbidities, anatomic considerations, and surgical technique. With these factors limiting healing ability in the area, periprosthetic patellar fractures can pose a major challenge to treat, with potentially lasting morbidity for affected patients. These fractures can occur at any time following TKA and are classified based on their associated implant stability and disruption of the extensor mechanism using the Ortiguera and Berry classification system. Each of the three types of fractures can be managed in their own unique way; however, outcomes remain poor, and the complication rates remain high regardless of fracture type. This article provides an overview of the current literature and the recommended management of periprosthetic patella fractures.</p>","PeriodicalId":48798,"journal":{"name":"Journal of Knee Surgery","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141861271","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}
引用次数: 0
Survey Results Concerning Current Trends in Meniscus Repair Indications and Preferences from Members of the Pediatric Research in Sports Medicine (PRiSM) Society. 儿科运动医学研究 (PRiSM) 学会成员关于半月板修复适应症和偏好的当前趋势调查结果。
IF 1.6 4区 医学
Journal of Knee Surgery Pub Date : 2024-08-22 DOI: 10.1055/a-2368-4049
J Lee Pace, John A Schlechter, Brian Haus, Rong Huang
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