Journal of orthopaedic surgery (Hong Kong)最新文献

{"title":"The anatomic - magnetic resonance imaging study of distal triceps brachii tendon.","authors":"Erica Kholinne,&nbsp;Jae-Man Kwak,&nbsp;Yijin Heo,&nbsp;Seung-Jun Hwang","doi":"10.1177/10225536221122262","DOIUrl":"https://doi.org/10.1177/10225536221122262","url":null,"abstract":"<p><strong>Purpose: </strong>The study aimed to describe the distal triceps brachii insertion on the olecranon and to correlate the findings with those seen in normal MR (Magnetic Resonance) anatomy of the triceps brachii insertion.</p><p><strong>Materials and methods: </strong>14 un-paired fresh frozen elbows were included according to the institution guidelines and dissected. Histologic examination was performed to the distal triceps brachii insertion. The dimension of the distal triceps brachii tendon insertion was measured and defined based on its layer. The measurement of distal triceps brachii insertion was performed with image processing program (Image J, National Institute of Health, Bethesda, Maryland). T1-weighted elbow MR images (3.0 T) of a 102 patients were acquired and analyzed according to its sagittal plane.</p><p><strong>Results: </strong>All specimens shows that distal triceps brachii tendon is with three distinct insertional areas in the olecranon which are: (1) capsular, (2) deep muscular, (3) superficial tendinous insertion with the areas of 80.7 mm², 56.4 mm², and 175.2 mm², respectively. The superficial tendinous insertion was observed with a thickened portion, the \"central cord\" with 0.5 occupation ratio. MR analysis showed that 30% (31/102) of the distal biceps brachii insertion was with a cleft between the bipartite insertion of the superficial tendinous and the deep muscular insertion on olecranon which designated as the \"lacuna\" which was also found in 35% (5/14) of the specimens.</p><p><strong>Conclusions: </strong>The distal triceps brachii has three distinct insertion on the olecranon. The superficial tendinous layer was separated with the deep muscular layer by a cleft in one third of the cases. Knowledge of this anatomy will help surgeon to understand the partial triceps injury and to avoid iatrogenic injury to the distal triceps tendon during surgery.</p>","PeriodicalId":520682,"journal":{"name":"Journal of orthopaedic surgery (Hong Kong)","volume":" ","pages":"10225536221122262"},"PeriodicalIF":1.6,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40375101","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":"Can American Orthopaedic Foot and Ankle Society (AOFAS) score prevent unnecessary MRI in isolated ankle ligament injuries?","authors":"Veysel Kandemir,&nbsp;Mehmet Sait Akar,&nbsp;Şeyhmus Yiğit,&nbsp;Fatih Durgut,&nbsp;Ramazan Atiç,&nbsp;Emin Özkul","doi":"10.1177/10225536221131374","DOIUrl":"https://doi.org/10.1177/10225536221131374","url":null,"abstract":"<p><strong>Introduction and objective: </strong>Ankle injuries are the most common musculoskeletal injuries. Its incidence is also high among sports injuries. Direct X-ray, ultrasound and MRI can be requested after the history and physical examination in the patient who presents with ankle ligament injury. Some classifications are used for requesting direct X-ray after ankle injury. Since clear limits are not specified in the literature for MRI, the rate of unnecessary MRI examinations is high. We argue that the decision can be made according to the AOFAS score to be checked before MR is requested, and thus unnecessary MR requests can be reduced.</p><p><strong>Material and method: </strong>Ankle MRI images of patients who underwent ankle MRI due to ankle trauma between January 2018 and December 2020 were scanned. 328 patients who met the criteria were included in the study. Patients with AOFAS scores in their outpatient clinic records were identified. AOFAS scores of patients with at least one ligament injury and those with normal MR images were statistically compared. Sensitivity and specificity were determined for the AOFAS score using ROC analysis.</p><p><strong>Results: </strong>Patients with ligament damage as a result of MRI examination were 21.3% (n=70), and patients without any ligament damage were 78.7% (n=258). There was a statistically significant difference in terms of AOFAS between the group with ligament damage and the group without ligament damage (p&lt; 0.05). In the ROC analysis, the AOFAS threshold value for MR request was determined as 80.5 (84.3% sensitivity and 72.3% specificity). Based on the determined threshold value, 73 patients who had unnecessary MRI would have been eliminated, thus reducing the number of MRIs by 42.6%.</p><p><strong>Conclusion: </strong>The AOFAS scores of patients with ligament damage were statistically significantly lower than those of patients without ligament pathology. Unnecessary MRI can be significantly prevented by using the AOFAS score in ankle traumas without bone fractures.</p>","PeriodicalId":520682,"journal":{"name":"Journal of orthopaedic surgery (Hong Kong)","volume":" ","pages":"10225536221131374"},"PeriodicalIF":1.6,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40395071","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":"Closing-opening wedge osteotomy for the treatment of congenital kyphosis in children.","authors":"Hui-Fa Xu,&nbsp;Chao Li,&nbsp;Zhen-Sheng Ma,&nbsp;Zi-Xiang Wu,&nbsp;Jia Sha,&nbsp;Wei-Long Diwu,&nbsp;Ya-Bo Yan,&nbsp;Zhi-Chen Liu,&nbsp;Zong-Zhi Fan,&nbsp;Lu-Yu Huang","doi":"10.1177/10225536221118600","DOIUrl":"https://doi.org/10.1177/10225536221118600","url":null,"abstract":"<p><strong>Background: </strong>To evaluate the safety and effectiveness of posterior closed-open wedge osteotomy for treatment of congenital kyphosis in children.</p><p><strong>Methods: </strong>Imaging and clinical data from January 2010 to December 2019 of posterior closed-open wedge osteotomy of congenital kyphosis with at least 2-year follow up was analyzed retrospectively. Perioperative indicators such as operation time, osteotomy site, osteotomy method and occurrence of complications, and imaging indicators were observed. The 3D printed models were used to measure the expanded distance of anterior edge vertebra and closed length of spinal canal line. The clinical effect was evaluated through SRS-22 questionnaires.</p><p><strong>Results: </strong>There were 15 CK patients in this study. The osteotomy segments and details are as follows: 1 case each for T6-9 and L2, 2 cases at T11, 3 cases at T12, and 6 cases at L1. The average operation time was 314 min, the average blood loss was 970 mL, the average fusion range was 6.3 segments, and the average time of follow up was 70.5 months. The Cobb angle of local kyphosis was corrected from 65.6 ± 18.8° to 11.3 ± 7.1°(<i>p</i> < .001). The range of kyphosis correction was 40-90°, and average correction rate was 83.2% (67.7-95.7%). The correction was stable in follow-up, and the kyphotic angle was 11.0 ± 7.6 (<i>p</i> = .68). The preoperative SVA was 31.5 ± 21.8 mm, and the postoperative recovery was 18.0 ± 15.5, while the last follow-up was 9.1 ± 7.9. The <i>p</i> values were 0.02 and 0.07 respectively. By using 3D printed models, the expanded distance of anterior edge vertebra and closed length of spinal canal line were 14.5 ± 7.5 mm and 24.5 ± 8.0 mm respectively. Self-image and satisfaction in SRS-22 improved significantly. There was no recurrence of deformity and junctional kyphosis.</p><p><strong>Conclusions: </strong>The posterior closing-opening wedge osteotom for treatment of congenital kyphosis in children is satisfactory, if selected appropriately. During the longitudinal follow-up, the patients could achieve solid fusion and the correction could be well maintained.<b>Evidence of Confidence:</b> IVa.</p>","PeriodicalId":520682,"journal":{"name":"Journal of orthopaedic surgery (Hong Kong)","volume":" ","pages":"10225536221118600"},"PeriodicalIF":1.6,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40368048","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":"Effects of a graphene oxide-alginate sheet scaffold on rotator cuff tendon healing in a rat model.","authors":"Jong Pil Yoon,&nbsp;Dong Hyun Kim,&nbsp;Seung Gi Min,&nbsp;Hun-Min Kim,&nbsp;Jin-Hyun Choi,&nbsp;Hyun Joo Lee,&nbsp;Kyeong Hyeon Park,&nbsp;Seong Soo Kim,&nbsp;Seok Won Chung,&nbsp;Sung Hyuk Yoon","doi":"10.1177/10225536221125950","DOIUrl":"https://doi.org/10.1177/10225536221125950","url":null,"abstract":"<p><strong>Background: </strong>Natural polymer scaffolds used to promote rotator cuff healing have limitations in terms of their mechanical and biochemical properties. This animal study aimed to investigate the effects of combined graphene oxide (GO) and alginate scaffold and the toxicity of GO on rotator cuff healing in a rat model.</p><p><strong>Methods: </strong>First, the mechanical properties of a GO/alginate scaffold and a pure alginate scaffold were compared. The in vitro cytotoxicity of and proliferation of human tenocytes with the GO/alginate scaffold were evaluated by CCK-8 assay. For the in vivo experiment, 20 male rats were randomly divided into two groups (<i>n</i> = 10 each), and supraspinatus repair was performed: group 1 underwent supraspinatus repair alone, and group 2 underwent supraspinatus repair with the GO/alginate scaffold. Biomechanical and histological analyses were performed to evaluate the quality of tendon-to-bone healing 8 weeks after rotator cuff repair.</p><p><strong>Results: </strong>The GO/alginate scaffold exhibited an increased maximum load (<i>p = .001</i>) and tensile strength (<i>p = .001</i>). In the cytotoxicity test, the cell survival rate with the GO/alginate scaffold was 102.08%. The proliferation rate of human tenocytes was no significant difference between the GO/alginate and alginate groups for 1, 3, 5, and 7 days. Biomechanically, group 2 exhibited a significantly greater ultimate failure load (<i>p < .001</i>), ultimate stress (<i>p < .001</i>), and stiffness (<i>p < .001</i>) than group 1. The histological analysis revealed that the tendon-to-bone interface in group 2 showed more collagen fibers bridging, tendon-to-bone integration, longitudinally oriented collagen fibers, and fibrocartilage formation than in group 1.</p><p><strong>Conclusion: </strong>A small amount of GO added to alginate improved the mechanical properties of the scaffold without evidence of cytotoxicity. At 8 weeks after rotator cuff repair, the GO/alginate scaffold improved tendon-to-bone healing without causing any signs of toxicity in a rat model.</p>","PeriodicalId":520682,"journal":{"name":"Journal of orthopaedic surgery (Hong Kong)","volume":" ","pages":"10225536221125950"},"PeriodicalIF":1.6,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40369161","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":"Swelling assessment after total knee arthroplasty.","authors":"Li Ka Yau,&nbsp;F U Henry,&nbsp;Cheung Man Hong,&nbsp;Cheung Amy,&nbsp;Chan Wai Kwan Vincent,&nbsp;Chan Ping Keung,&nbsp;Chiu Kwong Yuen","doi":"10.1177/10225536221127668","DOIUrl":"https://doi.org/10.1177/10225536221127668","url":null,"abstract":"<p><strong>Background: </strong>Total knee arthroplasty is a commonly performed elective orthopaedic surgery. Patients may endure substantial knee swelling following surgery, which are attributable to both effusion and edema. Studies have been aiming to identify an accurate and reliable method to quantify post-operative knee swelling to aid monitoring progress and treatment. The aim of this article was to review the means of clinically applicable measurements for knee swelling post TKA.</p><p><strong>Methods: </strong>The medical literature was searched using PubMed to search for articles published using the terms knee edema, effusion, swelling, knee arthroplasty, knee replacement, total knee arthroplasty, total knee replacement, TKA, TKR. Year of publication was not restricted. Only English language publications were included. Only full-text published articles from peer-reviewed journals were eligible for inclusion. The knee swelling measurement methods used in post TKA were reviewed.</p><p><strong>Results: </strong>Advancement in bioimpedance spectroscopy and handheld 3D scanning technology allows quick and precise quantification of knee swelling volume that the traditional clinical circumferential measurement and volumetric measurement lack. Handheld 3D scanning is also a potential tool to estimate the change of knee effusion volume and muscular volume after the surgery. Magnetic resonance imaging is accurate in effusion measurement but also the most time and resource demanding method.</p><p><strong>Conclusion: </strong>Bioimpedance spectroscopy and 3D scanning technology can be the future tools for clinically measurement of knee swelling after total knee arthroplasty.</p>","PeriodicalId":520682,"journal":{"name":"Journal of orthopaedic surgery (Hong Kong)","volume":" ","pages":"10225536221127668"},"PeriodicalIF":1.6,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40370675","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":"Kinematic alignment versus mechanical alignment in total knee arthroplasty: An up-to-date meta-analysis.","authors":"Gengshuang Tian,&nbsp;Lishan Wang,&nbsp;Linzhou Liu,&nbsp;Yali Zhang,&nbsp;Lixiong Zuo,&nbsp;Jianpeng Li","doi":"10.1177/10225536221125952","DOIUrl":"https://doi.org/10.1177/10225536221125952","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this meta-analysis was to compare the efficacy and imaging parameters of kinematic alignment (KA) and mechanical alignment (MA) in total knee arthroplasty (TKA) and to evaluate whether patients undergoing KA-TKA benefited more than those undergoing MA-TKA.</p><p><strong>Methods: </strong>Studies comparing the efficacy of KA-TKA and MA-TKA were included after searching and screening in the database, including PubMed, Embase, Web of Science and Cochrane Database Library. A total of 1420 patients were enrolled in the study, with 736 MA-TKA and 738 KA-TKA. The primary outcomes were postoperative knee function scores including KSS series, WOMAC, KOOS and OKS. Secondary outcomes included the operative time, the length of hospital stay, knee extension/flexion angle, and some imaging parameters. The risk of bias for included studies was assessed using the Cochrane Collaborative risk-of-bias assessment tool or the Newcastle-Ottawa Scale(NOS).</p><p><strong>Results: </strong>Sixteen studies were included in this meta-analysis (11 randomized controlled studies and 5 cohort studies). Primary outcomes: Knee Society score (KSS, MD = 8.36, 95% Cl: 0.83-15.90) and combined KSS (MD = 15.24, 95% CI: 5.41-25.07) were higher in KA-TKA than in MA-TKA, and other functional scores were not statistically significant in KA-TKA and MA-TKA, including knee injury and osteoarthritis outcome score (KOOS), Oxford knee score (OKS), Knee Function score (KFS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Secondary outcomes: KA-TKA resulted in smaller medial proximal tibial angle (MPTA) and lateral distal femoral angle (LDFA) compared to MA-TKA. For other outcome measures, KA-TKA showed similar results compared to MA-TKA, including hip-knee-ankle (HKA) angle, extension/flexion angle, tibial component slope angle, joint line orientation angle (JLOA), the operation time, the length of hospital stay and ligament release rate.</p><p><strong>Conclusions: </strong>In our analysis results, patients undergoing KA-TKA benefit as much as patients undergoing MA-TKA. KA may be a viable reference in total knee replacement.</p>","PeriodicalId":520682,"journal":{"name":"Journal of orthopaedic surgery (Hong Kong)","volume":" ","pages":"10225536221125952"},"PeriodicalIF":1.6,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33516813","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":"A retrospective case series of prophylactic neurectomy during total knee arthroplasty.","authors":"Christian G Guier,&nbsp;Glenn G Shi,&nbsp;Steven R Clendenen,&nbsp;Michael G Heckman,&nbsp;Lori A Chase,&nbsp;Benjamin K Wilke","doi":"10.1177/10225536221127460","DOIUrl":"https://doi.org/10.1177/10225536221127460","url":null,"abstract":"<p><strong>Introduction: </strong>Total knee arthroplasty is a common operation performed to relieve pain and restore functional activity. While overall widely successful, a subset of patients has continued pain postoperatively with no identifiable cause. Neuroma formation has been identified as a possible contributor to this unexplained pain, often necessitating an additional procedure for neuroma removal. The purpose of our study was to evaluate if prophylactic neurectomy could reduce the occurrence of postoperative pain.</p><p><strong>Methods: </strong>A total of 112 patients were compared, 44 control patients and 68 neurectomy patients. Demographic information, Numerical rating pain scale (NRS) and Knee Society Scores (KSS) were collected pre- and post-operatively. Patients were additional asked if they were overall satisfied with the operation.</p><p><strong>Results: </strong>There were no differences between groups with respect to age (Median: 71 vs 69 years, <i>p</i> = 0.28), male sex (41% vs 44%, <i>p</i> = 0.85), or body mass index (Median: 32.2 vs 31.3, <i>p</i> = 0.80). When comparing the degree of change following surgery there were no statistically significant differences observed in NRS pain scores (Median change: -7 vs -6, <i>p</i> = 0.89) or KSS scores (Median change: +44 vs +40, <i>p</i> = 0.14). Similarly, there was no statistically significant difference in overall patient-reported satisfaction with the knee replacement (82.5% vs 86.6%, <i>p</i> = 0.59).</p><p><strong>Conclusion: </strong>We did not find a statistically significant difference in NRS, KSS, or overall patient satisfaction between the prophylactic neurectomy and control patient groups. Larger studies with evaluation of the nerve diameter will be needed to determine which patients are at risk for symptomatic neuroma development following total knee arthroplasty.</p>","PeriodicalId":520682,"journal":{"name":"Journal of orthopaedic surgery (Hong Kong)","volume":" ","pages":"10225536221127460"},"PeriodicalIF":1.6,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40369858","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":"The sonographic posterolateral rotatory stress test: Normal ulnohumeral gap difference in healthy volunteers.","authors":"Nattakorn Mahasupachai,&nbsp;Nutthakorn Samathi,&nbsp;Arnakorn Premsiri,&nbsp;Cholawish Chanlalit","doi":"10.1177/10225536221128861","DOIUrl":"https://doi.org/10.1177/10225536221128861","url":null,"abstract":"<p><p><b>Background:</b> The sonographic posterolateral rotatory stress test may be a good preoperative diagnostic tool for posterolateral rotatory instability, especially in atraumatic or occult cases. However, there is lack of study on the living population or the normal elbow. <b>Hypothesis/Purpose:</b> This study evaluates the ulnohumeral opening gap difference between elbows in resting and stress positions while performing ultrasonography in normal healthy volunteers. The hypothesis is that the normal ulnohumeral opening gap difference is less than 2 mm. <b>Methods:</b> A total of 21 participants (9 males and 12 females) who presented at our institution between May and June 2021 were recruited. First, participants with elbow deformity, major elbow trauma, history of injection or surgery around the elbow, or evidence of elbow instability were excluded. Only healthy elbows without symptoms were included in this study. Participants' both elbows were examined using ultrasonography. The ulnohumeral gap was measured in millimeters, and the difference was calculated from the means of ulnohumeral gap in resting and stress positions. <b>Results:</b> The mean age of participants was 36.14 years old. No samples with hyperlaxity were included. Overall, the means of ulnohumeral gap in resting and stress positions were 2.55 ± 0.69 mm and 3.16 ± 0.80 mm, respectively. The average mean of overall ulnohumeral opening gap difference was 0.61 ± 0.32 mm. There was no statistically significant difference between males and females (<i>p</i> = .989). The intraobserver reliability was 0.89 and 0.9 for resting and stress positions, respectively. <b>Conclusion:</b> The sonographic posterolateral rotatory stress test shows that the ulnohumeral opening gap difference between resting and stress positions is less than 2 mm in healthy volunteers. <b>Clinical Relevance:</b> In patients with inconclusively-diagnosed PLRI, the sonographic posterolateral rotatory stress test may be a reliable preoperative diagnosis tool, providing its non-invasiveness and the ability to assess the contralateral side as a comparison.</p>","PeriodicalId":520682,"journal":{"name":"Journal of orthopaedic surgery (Hong Kong)","volume":" ","pages":"10225536221128861"},"PeriodicalIF":1.6,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40371508","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":"Management of talar lesions with cement augmentation and autologous bone graft.","authors":"Do Hun Kim,&nbsp;Wanlim Kim,&nbsp;Youngrak Choi","doi":"10.1177/10225536221131159","DOIUrl":"https://doi.org/10.1177/10225536221131159","url":null,"abstract":"<p><strong>Background: </strong>Treatment of bone lesions involved with the articular cartilage at the talus is challenging. We report the management of talus lesions, particularly tumors and avascular necrosis (AVN), at the articular surface through treatment with cement augmentation and autologous bone graft.</p><p><strong>Methods: </strong>Eight benign bone tumors and three cases of AVN were reviewed retrospectively at a mean follow-up of 56 months (range, 12-162). The mean age of all patients was 36.1 years old (range, 15-73) when assessed between February 2005 and November 2021. Curettage of tumorous and necrotic lesions resulted in significant bone defects filled with bone cement augmentation. Cartilage defects of the talar dome were supported with autologous cancellous bone graft. Tolerable weight-bearing ambulation was permitted immediately after surgery. Radiological and functional evaluations were recorded.</p><p><strong>Results: </strong>We observed an increase in the average The American Orthopaedic Foot and Ankle Score (AOFAS) (<i>p</i> = .003) and a decrease in the average Visual Analogue Scale pain score (<i>p</i> = .003). There was no statistically significant decrease in ROM before or after surgery (<i>p</i> = .114). Additionally, no talus collapse of the ankle joint occurred. Talar dome status did not aggravate before or after surgery, except for one patient. Despite no radiographic osteoarthritis exacerbation before or after surgery in six patients, five patients had osteoarthritic change.</p><p><strong>Conclusion: </strong>Cement implantation and autologous bone graft performed simultaneously for benign bone tumors with joint cartilage damage and AVN are technically simple, have good outcomes, and may be a suitable alternative to standard treatments.</p>","PeriodicalId":520682,"journal":{"name":"Journal of orthopaedic surgery (Hong Kong)","volume":" ","pages":"10225536221131159"},"PeriodicalIF":1.6,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40380807","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":"Revision lateral ankle ligament reconstruction for patients with a failed modified Brostrom procedure.","authors":"Yang Xu,&nbsp;Yong-Xing Cao,&nbsp;Xing-Chen Li,&nbsp;Xiang-Yang Xu","doi":"10.1177/10225536221125948","DOIUrl":"https://doi.org/10.1177/10225536221125948","url":null,"abstract":"<p><strong>Purpose: </strong>The Brostrom-Gould procedure has been considered as a gold standard operative technique for chronic lateral ankle instability. Despite the popularity and excellent outcomes of the modified Brostrom procedure, some patients still experience recurrence of ankle instability. Few studies reported outcomes of revision reconstruction for patients with a failed modified Brostrom procedure. This study aimed to evaluate the outcomes of a percutaneous anatomic revision lateral ankle ligament reconstruction for patients with a failed modified Brostrom procedure.</p><p><strong>Methods: </strong>From March 2017 to April 2020, 21 patients with persistent ankle instability after a modified Brostrom procedure underwent revision lateral ankle ligament reconstruction. The operation was performed through minimally invasive incisions. Functional assessment was performed using the Karlsson-Peterson ankle scoring system (KP) and the Visual Analogue Scale (VAS). The questionnaires of KP and VAS were completed before surgery and at the last follow-up. Patients' subjective satisfaction level was graded as excellent, good, fair, and poor. Preoperative and postoperative anterior talar displacement and varus talus tilt angle in stress radiographs were recorded.</p><p><strong>Results: </strong>The average age at the revision surgery time was 39.6years. The mean follow-up was 39.2months. The VAS score improved from 4.1 ± 1.5 preoperatively to 1.3 ± 1.3 at the final follow-up (<i>p</i> < .05). The KP score improved from 59.0 ± 20.2 preoperatively to 88.2 ± 9.6 at the last follow-up (<i>p</i> < .05). The mean varus talar tilt angle was 14.1 ± 3.9 mm preoperatively versus 4.9 ± 4.7 mm at the final follow-up (<i>p</i> < .05). The mean anterior talar displacement was 12.8 ± 2.2 mm versus 5.6 ± 3.7 mm at the last follow-up (<i>p</i> < .05).</p><p><strong>Conclusions: </strong>The revision anatomic reconstruction of the lateral ligaments of the ankle is effective for patients with recurrent instability after a failed modified Broström procedure.</p>","PeriodicalId":520682,"journal":{"name":"Journal of orthopaedic surgery (Hong Kong)","volume":" ","pages":"10225536221125948"},"PeriodicalIF":1.6,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40363623","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}