Knee最新文献

{"title":"Exam Corner Q September 2024","authors":"","doi":"10.1016/S0968-0160(24)00172-8","DOIUrl":"10.1016/S0968-0160(24)00172-8","url":null,"abstract":"","PeriodicalId":56110,"journal":{"name":"Knee","volume":"50 ","pages":"Page I"},"PeriodicalIF":1.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142426598","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":"Exam Corner A September 2024","authors":"","doi":"10.1016/S0968-0160(24)00173-X","DOIUrl":"10.1016/S0968-0160(24)00173-X","url":null,"abstract":"","PeriodicalId":56110,"journal":{"name":"Knee","volume":"50 ","pages":"Page II"},"PeriodicalIF":1.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142426599","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":"Advancing indications for total knee arthroplasty","authors":"Oday Al-Dadah (Editors-in-Chief), Caroline Hing","doi":"10.1016/j.knee.2024.09.001","DOIUrl":"10.1016/j.knee.2024.09.001","url":null,"abstract":"","PeriodicalId":56110,"journal":{"name":"Knee","volume":"50 ","pages":"Pages A1-A2"},"PeriodicalIF":1.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142301884","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":"Masterclass in Research","authors":"","doi":"10.1016/S0968-0160(24)00174-1","DOIUrl":"10.1016/S0968-0160(24)00174-1","url":null,"abstract":"","PeriodicalId":56110,"journal":{"name":"Knee","volume":"50 ","pages":"Page III"},"PeriodicalIF":1.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142426600","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":"The difference in bone mineral density between femur and tibia is related to tibia deformation in endstage knee osteoarthritis","authors":"Yun Seong Choi,&nbsp;Jung-Ro Yoon,&nbsp;Young-Bin Shin,&nbsp;Seung Hoon Lee","doi":"10.1016/j.knee.2024.09.008","DOIUrl":"10.1016/j.knee.2024.09.008","url":null,"abstract":"<div><h3>Background</h3><div>This study investigated bone mineral density (BMD) around the knee joint to clarify the mechanism by which tibia deformation exceeds that of the femur in patients with end-stage knee osteoarthritis (KOA).</div></div><div><h3>Methods</h3><div>We retrospectively analyzed 193 patients who underwent total knee arthroplasty for end-stage KOA with varus alignment. Preoperative T-score of the femur neck and femur total using dual-energy X-ray absorptiometry (DXA) and hounsfield units (HU) of the distal femur and proximal tibia using computed tomography (CT) were measured to asess the BMD. HU was measured by dividing the femur and tibia into medial, lateral, and total parts, respectively. Patients with medial proximal tibial angle (MPTA) ≥ 85° were considered ‘group 1′, and MPTA &lt; 85° were ‘group 2′. The HU between femur and tibia were compared in group 1. T-score, HU, and HU difference between group 1 and group 2 were compared.</div></div><div><h3>Results</h3><div>The HU of the proximal tibia was lower than that of the distal femur (femur lateral &gt; femur medial &gt; tibia medial &gt; tibia lateral). T-score (femur neck, femur total) and HU (femur lateral, femur total, tibia lateral) were lower in group 2 than in group 1. There was no difference in femur-tibia HU difference between groups.</div></div><div><h3>Conclusion</h3><div>The medial tibia collapse more than the medial femur in varus endstage KOA was associated with the lower BMD of the proximal tibia than that of the distal femur, and the MPTA collapse was affected by the absolute value of BMD rather than by the femur-tibia BMD difference.</div></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"51 ","pages":"Pages 173-180"},"PeriodicalIF":1.6,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142357678","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":"Percutaneous isometric reconstruction of medial collateral and posterior oblique ligaments offers similar outcomes to open techniques with reduced complication rates at a medium-term follow-up: A retrospective comparative study","authors":"E. Ortiz,&nbsp;S. Fornell,&nbsp;P. Barrena","doi":"10.1016/j.knee.2024.09.004","DOIUrl":"10.1016/j.knee.2024.09.004","url":null,"abstract":"<div><h3>Background</h3><div>Knee Injuries involving the superficial medial collateral ligament (sMCL) and posterior oblique ligament (POL) can cause severe instability. The open surgical technique involves larger incisions. A percutaneous technique may offer similar outcomes with reduced morbidity and a shorter recovery time. The purpose of this study was to compare the clinical and functional outcomes of percutaneous and open reconstruction using isometric allografts.</div></div><div><h3>Methods</h3><div>A retrospective comparative analysis was conducted on 21 patients between 2010 and 2021. Eleven patients underwent open surgery, while 10 underwent percutaneous surgery. The subjective IKDC, Lysholm, and Tegner scores, and valgus laxity were evaluated. Complications were also recorded.</div></div><div><h3>Results</h3><div>Both the groups demonstrated significant improvements in functional scores and a reduction in valgus laxity postoperatively, with no significant differences. The mean improvements were 32.3 for the IKDC score and 37.9 for the Lysholm score. The average reduction in the Tegner score was 1.1 points. Postoperative radiographic measurements of medial joint opening were &lt; 2 mm in all patients. The percutaneous group had fewer complications, with arthrofibrosis being significantly less frequent (0 vs. 4 in the open group). The mean follow-up was 3.5 years.</div></div><div><h3>Conclusion</h3><div>Percutaneous reconstruction of the medial side of the knee with an isometric technique is a safe and effective procedure that provides results similar to those of open reconstruction. The advantages of percutaneous reconstruction include smaller incisions, less pain and scarring, shorter recovery time, and lower risk of complications. Allografts are preferred over autografts to avoid donor site morbidity and weakening of the medial stabilizers.</div></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"51 ","pages":"Pages 153-164"},"PeriodicalIF":1.6,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142319455","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":"MCP-1 in synovial fluid as a predictor of inferior clinical outcomes after meniscectomy","authors":"Isabel Wolfe,&nbsp;Alexander J. Egol,&nbsp;Michael R. Moore,&nbsp;Ryan Isber,&nbsp;Daniel J. Kaplan,&nbsp;Thorsten Kirsch,&nbsp;Eric J. Strauss","doi":"10.1016/j.knee.2024.09.002","DOIUrl":"10.1016/j.knee.2024.09.002","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate knee intra-articular cytokine concentrations in patients undergoing isolated meniscectomy and determine if these concentrations are associated with clinical outcomes.</div></div><div><h3>Methods</h3><div>Concentrations of ten biomarkers were quantified in synovial fluid aspirated from the operative knees of patients who underwent isolated meniscectomy from 10/2011-12/2019. Patients completed a survey at final follow-up<!--> <!-->including VAS, Lysholm, Tegner, and KOOS Physical Function Short Form (KOOS-PS). Failure was defined as subsequent TKA or non-achievement of the Patient Acceptable Symptom State (PASS) for knee pain defined as VAS &gt; 27/100. Regression analysis investigating the relationship between cytokine concentrations and failure was performed.</div></div><div><h3>Results</h3><div>The study consisted of 100 patients, including 50 males (50.0%) with a mean age of 51.1 ± 11.7 years, a median BMI of 28.9 kg/m² [25.5, 32.4], and a mean follow-up of 8.0 ± 2.2 years. There were no demographic or clinical differences between failures (n = 41) and non-failures (n = 59) at baseline. Monocyte Chemotactic Protein 1 (MCP-1) concentration was significantly higher in failures than in non-failures (344.3 pg/ml vs. 268.6 pg/ml, <em>p</em> = 0.016). In a regression analysis controlling for age, sex, BMI, symptom duration, length of follow-up, and ICRS grade, increased MCP-1 was associated with increased odds of failure (<em>p</em> = 0.002).</div></div><div><h3>Conclusions</h3><div>The concentration of MCP-1 on the day of arthroscopic meniscectomy was predictive of failure as defined by an unacceptable pain level at intermediate- to long-term follow-up. This finding may help identify patients at high risk for poor postoperative outcomes following isolated meniscectomy and serve as a target for future postoperative immunomodulation research.</div></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"51 ","pages":"Pages 165-172"},"PeriodicalIF":1.6,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142319454","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":"Tibial contact points cannot be used to determine internal-external axial rotation of the native tibiofemoral joint","authors":"Alexander Simileysky ,&nbsp;M.L. Hull","doi":"10.1016/j.knee.2024.08.019","DOIUrl":"10.1016/j.knee.2024.08.019","url":null,"abstract":"<div><h3>Background</h3><div>In the study of tibiofemoral kinematics of the native knee, internal-external (IE) axial rotation is a motion of interest. Locations of contact by the femur on the tibia (termed tibial contact points) have been used to determine IE rotations but such rotations might not be useful due to large error. Hence, our objective was to determine whether tibial contact points are useful in quantifying IE rotations of the native knee.</div></div><div><h3>Method</h3><div>Fluoroscopic images of the native knee were analyzed from 25 subjects who performed a weight-bearing deep knee bend. For each subject, 3D bone + cartilage models were created. Following 3D model-to-2D image registration, anterior-posterior (AP) positions of the lowest points and the tibial contact points were computed for each femoral condyle at 0°, 30°, 60°, and 90° of flexion. IE rotations were the angles between lines connecting points in the medial and lateral tibial compartments at different flexion angles.</div></div><div><h3>Results</h3><div>Based on the lowest points, the tibia rotated internally on the femur primarily during the first 30° of flexion. In this range, mean internal tibial rotation based on tibial contact points was negligible but internal tibial rotation was significantly greater based on lowest points (0° vs 7°, p = 0.0002). At 90° of flexion, the difference was maintained (1.8° vs 8.3°, p = 0.0007).</div></div><div><h3>Conclusion</h3><div>While tibial contact points are useful in the study of wear of tibial inserts in total knee arthroplasty (TKA), tibial contact points considerably underestimate internal tibial rotation during flexion in the native knee and should not be used to quantify tibiofemoral kinematics.</div></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"51 ","pages":"Pages 145-152"},"PeriodicalIF":1.6,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142301885","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":"Unicompartmental knee arthroplasty in octogenarians: An analysis of 1,466 patients with 2-year follow-up","authors":"Alexander J. Acuña,&nbsp;Enrico M. Forlenza,&nbsp;Joseph Serino III,&nbsp;Vince K. Morgan,&nbsp;Tad L. Gerlinger,&nbsp;Craig J. Della Valle","doi":"10.1016/j.knee.2024.08.016","DOIUrl":"10.1016/j.knee.2024.08.016","url":null,"abstract":"<div><h3>Introduction</h3><p>Unicompartmental knee arthroplasty (UKA) has been shown to improve pain and function in appropriately selected patients. Limited data exists regarding outcomes and complication rates following UKA among octogenarians.</p></div><div><h3>Methods</h3><p>The PearlDiver Mariner database was queried for patients undergoing primary UKA between 2010–2022. Patients &lt; 80 years old were matched 4:1 to the octogenarian cohort (≥80 years old) by sex, year, Elixhauser Comorbidity Index (ECI), tobacco use, obesity, and diabetes. A total of 1,334 octogenarians and 5,313 controls were included in our analysis. Multivariate logistic regression was utilized to compare medical complications at 90-days post-operatively and surgical complications at 1- and 2-years post-operatively. Our regression analysis controlled for sex, ECI, tobacco use, obesity, and diabetes.</p></div><div><h3>Results</h3><p>Octogenarians had an increased risk of acute kidney injury (OR: 2.306, 95% CI: 1.393–3.749; <em>p</em> &lt; 0.001), pneumonia (OR: 2.367, 95% CI: 1.301–4.189; <em>p</em> = 0.003), UTI (OR: 1.846, 95% CI: 1.304–2.583; <em>p</em> &lt; 0.001), ED visits (OR: 2.229, 95% CI: 1.586–3.105; <em>p</em> &lt; 0.001), and any complication (OR: 1.575, 95% CI: 1.304–1.895; <em>p</em> &lt; 0.001) at 90-days post-operatively. Octogenarians had lower odds of all-cause revision at 2-years (OR: 0.607, 95% CI: 0.382–0.923; <em>p</em> = 0.026). No differences were demonstrated between cohorts in rates of PJI (OR: 0.832, 95% CI: 0.334–1.796; <em>p</em> = 0.664), periprosthetic fracture (OR: 0.516, 95% CI: 0.120–1.520; <em>p</em> = 0.289), or aseptic loosening (OR: 0.285, 95% CI: 0.045–1.203; <em>p</em> = 0.088) at 2-years.</p></div><div><h3>Discussion</h3><p>These findings suggest that despite an increased risk of certain medical complications within the acute post-operative period, octogenarians undergoing UKA experienced similar rates of surgical complications to younger matched controls at 2-year follow-up.</p></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"51 ","pages":"Pages 130-135"},"PeriodicalIF":1.6,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142164745","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":"Morphology of the popliteomeniscal fascicles around the popliteal hiatus on three-dimensional images reconstructed from 7 T magnetic resonance imaging: A cadaveric study","authors":"Goro Tajima ,&nbsp;Hiroki Kaneko ,&nbsp;Ryunosuke Oikawa ,&nbsp;Moritaka Maruyama ,&nbsp;Atsushi Sugawara ,&nbsp;Shinya Oikawa ,&nbsp;Ken Hayashi ,&nbsp;Minoru Doita","doi":"10.1016/j.knee.2024.08.018","DOIUrl":"10.1016/j.knee.2024.08.018","url":null,"abstract":"<div><h3>Background</h3><p>This study aimed to clarify the characteristic features of the anteroinferior and posterosuperior popliteomeniscal fascicles (aiPMF and psPMF, respectively) and popliteal hiatus using three-dimensional (3D) reconstructions of 7 T magnetic resonance imaging (MRI) arthrography.</p></div><div><h3>Methods</h3><p>Six knees from human cadavers fixed using the Thiel embalming method were examined using 7 T MRI arthrography. 3D Images of the structures around the popliteal hiatus were reconstructed. Morphologies of the psPMF, aiPMF, and popliteal hiatus were investigated and their positional relationships analyzed.</p></div><div><h3>Results</h3><p>The PMFs attached to the periphery of the lateral meniscus (LM) to form the popliteal hiatus. Each coursed in an oblique direction. The mean length of the psPMF and aiPMF attachments to the LM were 6.8 and 21.6 mm, respectively; mean popliteal hiatus length was 12.8 mm. These lengths corresponded to 7.5%, 24.3%, and 14.5% of the total length of the LM, respectively. The aiPMF was thick near the lateral aspect of the articular capsule and became thinner towards the posteromedial aspect of the LM. The psPMF was thick near the posterior aspect of the articular capsule and became thinner towards the posterolateral aspect of the LM.</p></div><div><h3>Conclusion</h3><p>Morphological properties of the aiPMF, psPMF, their attachments to the LM, and the popliteal hiatus were consistent across the cadaver specimens examined. Each PMF was thin near the popliteal hiatus and became thicker towards its attachment to the articular capsule. These findings may be useful for anatomical repair for the LM hypermobility.</p></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"51 ","pages":"Pages 136-144"},"PeriodicalIF":1.6,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0968016024001546/pdfft?md5=6cd546cdb6adaee240f1d5f9f18fd5c3&pid=1-s2.0-S0968016024001546-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142164744","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}