Journal of Knee Surgery最新文献

筛选
英文 中文
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":" ","pages":"773-783"},"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":" ","pages":"765-772"},"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":" ","pages":"784-788"},"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
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":" ","pages":"789-795"},"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
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":" ","pages":"796-803"},"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
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":" ","pages":"812-819"},"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":" ","pages":""},"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
What Is the Correlation between Coronal Plane Alignment Measured on Pre- and Postoperative Weight-bearing Radiographs and Intraoperative Navigation When Stress Is Applied to the Knee? 当膝关节受到压力时,术前和术后负重 X 光片上测量的冠状面对齐情况与术中导航之间的相关性如何?
IF 1.6 4区 医学
Journal of Knee Surgery Pub Date : 2024-08-01 Epub Date: 2024-02-09 DOI: 10.1055/a-2265-9896
Anthony O'Neill, Michael McAuliffe, Tristan Pillay, Gautam Garg, Sarah Whitehouse, Ross Crawford
{"title":"What Is the Correlation between Coronal Plane Alignment Measured on Pre- and Postoperative Weight-bearing Radiographs and Intraoperative Navigation When Stress Is Applied to the Knee?","authors":"Anthony O'Neill, Michael McAuliffe, Tristan Pillay, Gautam Garg, Sarah Whitehouse, Ross Crawford","doi":"10.1055/a-2265-9896","DOIUrl":"10.1055/a-2265-9896","url":null,"abstract":"<p><p>This study examines the correlation between the weight-bearing (WB) long leg radiograph (LLR)-derived hip-knee-ankle angle (HKAA) and intraoperative supine computer-assisted surgery (CAS)-derived HKAA measurements at the beginning and end of total knee arthroplasty (TKA). The primary aim of the study was to determine if WB alignment could be mimicked or inferred based on intraoperative alignment findings. We conducted a prospective analysis from a cohort of 129 TKAs undergoing a CAS TKA at a single center by a single surgeon. The HKAA was recorded using the CAS navigation system immediately postregistration of navigation data and after implantation of the prosthesis. The intraoperative HKAA was recorded in both the supine \"resting\" position of the knee and also while the knee was manipulated in an effort to replicate the patient's WB alignment. These measurements were compared with the HKAA recorded on pre- and postoperative WB LLRs. There was a strong correlation between the preoperative WB LLR HKAA and the intraoperative preimplant CAS-derived stressed HKAA (<i>R</i> = 0.946). However, there was no correlation between the postoperative WB LLR HKAA and the postimplant insertion HKAA as measured intraoperatively via CAS for either a \"resting\" or \"stressed\" position of the operated knee (<i>R</i> = 0.165 and <i>R</i> = 0.041, respectively). Thus, the interpretation of intraoperative alignment data is potentially problematic. Despite technological advances in the development and utilization of computer navigation and robotics in arthroplasty to help obtain the optimal alignment, it would seem apparent from our study that this alignment does not correlate to upright stance postoperatively. Surgeons should apply caution to the strength of assumptions they place on intraoperative coronal plane alignment findings.</p>","PeriodicalId":48798,"journal":{"name":"Journal of Knee Surgery","volume":" ","pages":"702-709"},"PeriodicalIF":1.6,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139713247","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
Preoperative Predictors of Patient-Reported Outcomes Following Arthroscopic Partial Meniscectomy. 关节镜半月板部分切除术后患者报告结果的术前预测因素
IF 1.6 4区 医学
Journal of Knee Surgery Pub Date : 2024-08-01 Epub Date: 2024-04-30 DOI: 10.1055/a-2317-2420
Sarah C Kurkowski, Michael J Thimmesch, Henry A Kuechly, Brian Johnson, John Bonamer, Brian Newyear, A Scottie Emmert, Brian M Grawe
{"title":"Preoperative Predictors of Patient-Reported Outcomes Following Arthroscopic Partial Meniscectomy.","authors":"Sarah C Kurkowski, Michael J Thimmesch, Henry A Kuechly, Brian Johnson, John Bonamer, Brian Newyear, A Scottie Emmert, Brian M Grawe","doi":"10.1055/a-2317-2420","DOIUrl":"10.1055/a-2317-2420","url":null,"abstract":"<p><p>The purpose of this study is to evaluate the effect of patient demographics and injury characteristics on post-arthroscopic partial meniscectomy (post-APM) patient-reported outcomes (PROs). We hypothesize that the presence of high-grade (Kellgren-Lawrence grades 3-4) arthritis at any location of the knee (medial and lateral compartments, patella, trochlea), comorbidities (psychiatric history, chronic pain, diabetes, smoking, body mass index [BMI] ≥ 30), and lower scores on preoperative patient-reported measures (36-Item Short Form Health Survey [SF-36]) would predict poor outcomes after APM. We conducted a single-center prospective study of 92 patients who underwent APM surgery for associated knee pain. General demographic information and PROs were prospectively collected using SF-12, SF-36, and International Knee Documentation Committee (IKDC) surveys presurgery and at 6-month follow-up. Postsurgery outcomes were patient-reported satisfaction (yes/no) and obtaining a patient-acceptable symptom state (PASS) on IKDC. Data were analyzed with odds ratios (ORs), binomial logistic regression, and Mann-Whitney <i>U</i> test using IBM SPSS software. Demographic and injury characteristics that were poor prognostic indicators (had a decreased likelihood of obtaining PASS on IKDC postsurgery) included having Medicaid insurance (OR: 0.056; 0.003-1.00), chronic pain (OR: 0.106; 0.013-0.873), acute injury (OR: 0.387; 0.164-0.914), and high-grade (KL grades 3-4) medial compartment arthritis (OR: 0.412; 0.174-0.980), and preoperative SF-36 physical health score (PHS; <i>p</i> = 0.023) and mental health score (MHS; <i>p</i> = 0.006) values less than 47 and 48, respectively. Additionally, former smoking history (OR: 0.271; 0.079-0.928) showed a lower likelihood of being satisfied postsurgery. Not having psychiatric history (OR: 14.925; <i>p</i> < 0.001; increased likelihood of obtaining PASS on IKDC score postsurgery) and not having patellar arthritis (OR: 4.082; <i>p</i> = 0.025; increased likelihood of PASS on IKDC) were positive prognostic indicators. This study identifies predictive factors of poor outcomes post-APM; particularly, it highlights the usefulness of SF-36 surveys prior to APM surgery. Patients with low SF-36 score preoperatively may not find APM acceptable. Additional attention should be put on patient demographics (such as psychiatric history, chronic pain, and insurance type) and injury characteristics (presence of arthritis and acute injury) prior to performing APM. LEVEL OF EVIDENCE:  II.</p>","PeriodicalId":48798,"journal":{"name":"Journal of Knee Surgery","volume":" ","pages":"749-756"},"PeriodicalIF":1.6,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140870683","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
Accelerated versus Standard Rehabilitation after Meniscus Allograft Transplantation in the Knee. 膝关节半月板同种异体移植术后加速康复与标准康复的比较
IF 1.6 4区 医学
Journal of Knee Surgery Pub Date : 2024-08-01 Epub Date: 2024-02-22 DOI: 10.1055/a-2274-6914
Kylee Rucinski, James P Stannard, Cory Crecelius, Clayton Nuelle, James L Cook
{"title":"Accelerated versus Standard Rehabilitation after Meniscus Allograft Transplantation in the Knee.","authors":"Kylee Rucinski, James P Stannard, Cory Crecelius, Clayton Nuelle, James L Cook","doi":"10.1055/a-2274-6914","DOIUrl":"10.1055/a-2274-6914","url":null,"abstract":"<p><p>Meniscus allograft transplantation (MAT) is a proven treatment option for patients with symptomatic irreparable meniscus deficiency. When patients are adherent to prescribed postoperative restriction and rehabilitation protocols, outcomes after MAT are considered good to excellent. However, nonadherence to standard protocols is common and can be associated with undesirable outcomes and patient dissatisfaction. Based on demonstrated safety for early weight-bearing following MAT in conjunction with significant advances in graft preservation and surgical techniques, our joint preservation center implemented a shift in practice toward accelerated weight-bearing following MAT and designed this study to test the hypothesis that accelerated rehabilitation would be associated with superior adherence, patient-reported outcomes, and patient satisfaction, without diminishing patient safety, when compared with standard rehabilitation. Patients were included for analyses when they had undergone fresh or fresh-frozen MAT using a double bone plug technique for treatment of medial or lateral meniscus deficiency and had at least 1-year treatment outcomes recorded. The results of this study revealed that patients who were prescribed accelerated rehabilitation after MAT were significantly more adherent than patients who were prescribed standard rehabilitation and reported statistically significant and clinically meaningful improvements in knee pain and function for at least 1-year following MAT, whereas those in the standard cohort did not. While not statistically different, treatment failure rate was lower in the accelerated rehabilitation cohort when compared with the standard rehabilitation cohort (11 vs. 29%). Importantly, initial outcomes for revision MAT were associated with short-term success in all the patients who opted for this option in the study population. These data suggest that accelerated weight-bearing after MAT is safe, promotes patient adherence, and is associated with statistically significant and clinically meaningful improvements in patient-reported knee pain and function at early and mid-term follow-up.</p>","PeriodicalId":48798,"journal":{"name":"Journal of Knee Surgery","volume":" ","pages":"710-717"},"PeriodicalIF":1.6,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139933733","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
0
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
相关产品
×
本文献相关产品
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信