Knee最新文献

{"title":"Differences in knee joint moments between individuals who are living with obesity and those of a healthy weight when negotiating stairs","authors":"Todd J. Leutzinger ,&nbsp;David C. Kingston ,&nbsp;Danae M. Dinkel ,&nbsp;Elizabeth Wellsandt ,&nbsp;Brian A. Knarr","doi":"10.1016/j.knee.2024.07.006","DOIUrl":"10.1016/j.knee.2024.07.006","url":null,"abstract":"<div><h3>Background</h3><p>Individuals who are living with obesity often adopt alternative lower limb walking mechanics compared to persons with a healthy weight. Stair negotiation is a common activity of daily living that, when used consistently with diet and other physical activity, can help promote the reversal of health-related risk factors associated with people who are obese. The purpose of this study was to determine how stair negotiation affects normalized and non-normalized peak knee extension and abduction moments in young adults who live with obesity (BMI between 30 and 40 kg/m²) compared to adults with a healthy weight (BMI between 18.5 and 25 kg/m²).</p></div><div><h3>Methods</h3><p>Fifteen young adults living with obesity and fifteen with a healthy weight performed stair ascent and descent walking trials on a 3-step instrumented staircase at a self-selected walking speed. A one-way ANCOVA (covariate: gait speed) was used to compare knee moment variables between groups.</p></div><div><h3>Results</h3><p>No significant differences were found between groups in peak knee joint moments normalized to body mass. The individuals living with obesity demonstrated significantly larger non-normalized peak knee extension moments during stair ascent and descent but no differences in the non-normalized peak knee abduction moments for stair ascent or descent.</p></div><div><h3>Conclusion</h3><p>Results of this study indicate differences in non-normalized peak knee extension moments between BMI groups. The young age of the obese group may have contributed to minimal differences overall. Future research should determine how these findings differ in an older obese population and how using a handrail would affect these results.</p></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"49 ","pages":"Pages 217-225"},"PeriodicalIF":1.6,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141753493","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":"Exploratory study of the lateral body sway predictability as frame of reference for gait rehabilitation following a total knee arthroplasty","authors":"Werner A.F. van de Ven ,&nbsp;Jurjen Bosga ,&nbsp;Wim Hullegie ,&nbsp;Wiebe C. Verra ,&nbsp;Ruud G.J. Meulenbroek","doi":"10.1016/j.knee.2024.07.008","DOIUrl":"10.1016/j.knee.2024.07.008","url":null,"abstract":"<div><h3>Aims</h3><p>The aim of the present study was to investigate whether the predictability of fronto-parallel trunk rotations (lateral body sway) could serve as a frame of reference to monitor recovery after total knee arthroplasty (TKA).</p></div><div><h3>Methods</h3><p>Before surgery, 11 TKA patients were asked to perform a treadmill walking task at three different speeds. In addition, their gait abilities were scored on three standard clinical walking tests. The treadmill walking task was repeated at three different timepoints following surgery, i.e., at 3, 6 and 12 months post-TKA. The movements of the trunk were digitized with an inertial sensor to capture the amplitude and the sample entropy (SEn) of the lateral body sway that were evaluated in separate ANOVAs.</p></div><div><h3>Results</h3><p>Before surgery the TKA group showed larger body sway (<em>P</em> = 0.025) with smaller SEn values (<em>P</em> = 0.038), which both restored to levels of healthy adults in the 12 months following surgery. Systematic correlations between the SEn values and the clinical test scores were found.</p></div><div><h3>Conclusions</h3><p>The current findings show that movement behavior of the trunk in the fronto-parallel plane was affected by knee osteoarthritis and suggest that the predictability of the lateral body sway may serve as an index of recovery after TKA.</p></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"49 ","pages":"Pages 192-200"},"PeriodicalIF":1.6,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0968016024001078/pdfft?md5=22ea944063c0c3a39470acf264f5bf6d&pid=1-s2.0-S0968016024001078-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141753494","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exam Corner A August 2024","authors":"","doi":"10.1016/S0968-0160(24)00130-3","DOIUrl":"10.1016/S0968-0160(24)00130-3","url":null,"abstract":"","PeriodicalId":56110,"journal":{"name":"Knee","volume":"49 ","pages":"Page III"},"PeriodicalIF":1.6,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142011415","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":"Quadriceps tendon versus hamstring tendon graft for primary anterior cruciate ligament reconstruction: A systematic review and meta-analysis of randomised trials","authors":"Siddarth Raj,&nbsp;Ali Ridha,&nbsp;Henry K.C. Searle,&nbsp;Chetan Khatri,&nbsp;Imran Ahmed,&nbsp;Andrew Metcalfe,&nbsp;Nicholas Smith","doi":"10.1016/j.knee.2024.07.002","DOIUrl":"10.1016/j.knee.2024.07.002","url":null,"abstract":"<div><h3>Background</h3><p>Anterior cruciate ligament reconstruction (ACLR) is most commonly performed with hamstring tendon (HT) or bone-patellar tendon–bone (BTB) autografts, although the quadriceps tendon (QT) autograft has recently increased in popularity. This systematic review and <em>meta</em>-analysis review compares QT and HT autografts for primary ACLR with a sole focus on randomised controlled trials (RCTs).</p></div><div><h3>Methods</h3><p>A prospective protocol was registered on PROSPERO (CRD42023427339). The search included MEDLINE, Embase and Web of Science until February 2024. Only comparative RCTs were included. The primary outcome was the International Knee Documentation Committee (IKDC) Subjective Knee Evaluation Form score. Secondary outcomes included: other validated patient-reported outcome measures (PROMs), objective strength scores, complications, and return to sport and work.</p></div><div><h3>Results</h3><p>From 2,609 articles identified, seven were included (<em>n</em> = 474 patients). This <em>meta</em>-analysis did not identify a significant difference in post-operative IKDC scores (5 articles; <em>p</em> = 0.73), Lysholm scores (3 studies; <em>p</em> = 0.80) or Tegner activity scales (2 studies; <em>p</em> = 0.98). There were no differences in graft failure rates (4 studies; <em>p</em> = 0.92) or in overall adverse events (4 studies; <em>p</em> = 0.83) at 24 months post-ACLR as per <em>meta</em>-analysis. Donor site morbidity scores were significantly lower in the QT group (MD −4.67, 95% CI −9.29 to −0.05; 2 studies, 211 patients; <em>p</em> = 0.05, I² = 34%).</p></div><div><h3>Conclusion</h3><p>There were no differences between QT and HT in PROMs, graft failure rates or overall complications based on low- to moderate-quality evidence. There may possibly be lower donor site morbidity with the QT autograft, however, the evidence is not sufficient to draw definitive conclusions.</p></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"49 ","pages":"Pages 226-240"},"PeriodicalIF":1.6,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141753498","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":"What’s new with the anterior cruciate Ligament?","authors":"Oday Al-Dadah,&nbsp;Caroline Hing (Editor-in-Chief)","doi":"10.1016/j.knee.2024.07.024","DOIUrl":"10.1016/j.knee.2024.07.024","url":null,"abstract":"","PeriodicalId":56110,"journal":{"name":"Knee","volume":"49 ","pages":"Pages A1-A2"},"PeriodicalIF":1.6,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141861812","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":"Navigated versus conventional medial unicompartmental knee arthroplasty: Minimum 18 years clinical outcomes and survivorship of the original Cartier design","authors":"Luca Andriollo ,&nbsp;Alice Montagna ,&nbsp;Giovan Giuseppe Mazzella ,&nbsp;Rudy Sangaletti ,&nbsp;Francesco Benazzo ,&nbsp;Stefano Marco Paolo Rossi","doi":"10.1016/j.knee.2024.07.009","DOIUrl":"10.1016/j.knee.2024.07.009","url":null,"abstract":"<div><h3>Background</h3><p>Unicompartmental knee arthroplasty (UKA) is a viable option of treatment in case of osteoarthritis (OA) or avascular osteonecrosis (AVN) isolated to either the medial or the lateral compartment of the knee. The aim of this study was to retrospectively present clinical outcomes and survivorship at minimum 18 years follow up of a fixed bearing (FB) UKA comparing the results of conventional technique and navigation.</p></div><div><h3>Methods</h3><p>Patients treated with a medial FB UKA between June 2003 and December 2006 were retrospectively evaluated. From March 2005 all UKAs were performed using a computer navigation system. Patients were divided into two groups: UKAs assisted by navigation (n-UKAs) versus standard UKAs (s-UKAs). For all patients, at final follow up, patient-reported outcome measures (PROMs) were collected: Western Ontario and McMaster Universities (WOMAC) score, Oxford Knee Score (OKS) and Forgotten Joint Score (FJS-12). Survival rate and outcomes were compared between groups.</p></div><div><h3>Results</h3><p>Fifty-two patients were analyzed in this retrospective evaluation. All UKAs were medial and the tibial component was all polyethylene (AP) in 26 cases and metal backed (MB) in 26. Twenty-six UKAs were implanted with standard technique (AP 10, MB 16) and 26 assisted by a navigation system (AP 16, MB 10). Three patients (5.7%) underwent revision; the average time to revision was 140.7 months (standard deviation 81.2). Average follow up was 216.4 months (standard deviation 10.6). The survivorship of the implant was 94.4% at final follow up. Survivorship and PROMs were not different between groups.</p></div><div><h3>Conclusions</h3><p>This study showed excellent survivorship and outcomes at long term follow up of the original fixed bearing Cartier designed implant in both groups with equivalent survivorship and PROMs.</p></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"49 ","pages":"Pages 183-191"},"PeriodicalIF":1.6,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141753497","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":"Midterm results for revision total knee arthroplasty for component malrotation","authors":"Matthew M. Levitsky,&nbsp;Catelyn A. Woelfle,&nbsp;Nicholas L. Kolodychuk,&nbsp;Alexander L. Neuwirth,&nbsp;Roshan P. Shah,&nbsp;H. John Cooper,&nbsp;Jeffrey A. Geller","doi":"10.1016/j.knee.2024.07.003","DOIUrl":"10.1016/j.knee.2024.07.003","url":null,"abstract":"<div><h3>Introduction</h3><p>Accurate positioning of components in total knee arthroplasty (TKA) is essential to a satisfactory outcome. Significant malrotation may lead to chronic pain, stiffness, and dysfunction. This study aims to quantify improvements in functional outcomes following revision surgery for malrotation of either one or both components in TKA versus revision for aseptic loosening.</p></div><div><h3>Methods</h3><p>This was a retrospective review of TKAs that matched and compared the two-year functional outcomes of the malrotation group to a functionally similar aseptic loosening group. Functional outcomes were compared between groups using Short Form (SF-12), Western Ontario and McMaster University Osteoarthritis Index (WOMAC), and Knee Society Functional Score (KSFS). Student <em>t</em>-tests and chi-squared or Fisher’s tests were used for statistical analysis.</p></div><div><h3>Results</h3><p>Of the patients revised, 24 had malrotation and 57 had aseptic loosening. A total of 16 femoral and 17 tibial components were revised for malrotation. All 16 femoral components were internally malrotated (mean –4.8 ± 4.1 degrees; range, −0.5 to −16.6). Of the tibial components, 15 were internally malrotated, (mean −9.5 ± 6.6 degrees; range, −2.2 to –23.5) and 2 were externally malrotated (mean 4.6 ± 2.1 degrees; range, 3.1 to 6.0). All functional outcome measures significantly improved comparably within both groups preoperatively to 24 months postoperatively. At 24 months, functional outcome measures were comparable between the groups and WOMAC function scores were significantly higher in the malrotation group.</p></div><div><h3>Conclusion</h3><p>Revision TKA for malrotation can yield clinically and statistically significant functional improvements, similar in magnitude to those seen following revision TKA for aseptic loosening.</p></div><div><h3>Level of Evidence</h3><p>Level III</p></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"49 ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141753496","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":"Effects of implant precoating and fat contamination on the stability of the tibial baseplate","authors":"Maya Maya Barbosa Silva ,&nbsp;Jan-Erik Gjertsen ,&nbsp;Irene Ohlen Moldestad ,&nbsp;Ove Nord Furnes ,&nbsp;Michelle Khan ,&nbsp;Paul Johan Høl","doi":"10.1016/j.knee.2024.07.007","DOIUrl":"10.1016/j.knee.2024.07.007","url":null,"abstract":"<div><h3>Background</h3><p>Approximately 5% of primary total knee arthroplasty patients require revision within 10 years, often due to distal component loosening. Application of a thin layer of PMMA cement as precoating on the tibial component aims to prevent aseptic loosening. This study investigates the impact of precoating and fat contamination on tibial baseplate stability.</p></div><div><h3>Methods</h3><p>Two groups of NexGen® stemmed tibial implants (size 4) were studied: Option implants (N = 12) and PMMA Precoat implants (N = 12). Each implant design was divided into two subgroups, (N = 6), with one subgroup featuring bone marrow fat at the implant-cement interface and the other without contamination. In a mechanical testing machine, the implants underwent uniaxial loading for 20,000 cycles, while recording vertical micromotion and migration of the tibial baseplates. Subsequently, a push-out test assessed fixation strength at the cement interfaces. Results were compared using non-parametric statistics and presented as median and min-to-max ranges.</p></div><div><h3>Results</h3><p>Option implants exhibited higher micromotion in dry conditions compared to precoated implants (p = 0.03). Under contamination, both designs demonstrated similar micromotion values. Fixation strength did not significantly differ between designs under dry, uncontaminated conditions (p &gt; 0.99). However, under contaminated conditions, the failure load for the non-coated Option implant was nearly half that of the uncontaminated counterparts (3517 N, 2603–4367 N vs 7531 N, 5163–9000 N; p = 0.002). Precoat implants displayed less susceptibility to fat contamination (p = 0.30).</p></div><div><h3>Conclusion</h3><p>NexGen® implant PMMA precoating might reduce the risk of aseptic loosening and revision surgery in case of eventual bone-marrow fat contamination.</p></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"49 ","pages":"Pages 266-278"},"PeriodicalIF":1.6,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0968016024001042/pdfft?md5=e1d74c01e0ba0ebd4a97cfd1526524bf&pid=1-s2.0-S0968016024001042-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141768118","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long term follow up of 257 consecutive cementless Oxford medial compartment knee arthroplasties at a non-designer centre","authors":"Paul Karayiannis ,&nbsp;Roslyn Cassidy ,&nbsp;Ian Dobie ,&nbsp;David Beverland","doi":"10.1016/j.knee.2024.07.001","DOIUrl":"10.1016/j.knee.2024.07.001","url":null,"abstract":"<div><h3>Aims</h3><p>This study aimed to review the survivorship, indication for revision and patient reported outcomes for 257 consecutive Oxford cementless unicompartmental knee arthroplasties (OUKA’s) in 238 patients at 12–14 years post-operatively.</p></div><div><h3>Methods</h3><p>Patients underwent surgery between April 2008 and October 2010 by two non-design surgeons including their learning curve. The 5-year clinical and radiological outcomes have already been reported. Oxford knee scores (OKS) were recorded at 1, 5 and 12–14 years with delayed review a result of the COVID-19 pandemic. Revision indication and imaging were reviewed.</p></div><div><h3>Results</h3><p>Revision was required in 28 OUKA’s (10.9%) with a 10-year cumulative survival of 93.0%, reducing to 78.8% at 14 years. 59 patients had died prior to this review and 24 were not contactable. Those not contactable had electronic records reviewed to ensure they did not have a revision elsewhere. Half of the revisions were for progression of lateral compartment arthritis (14/28). Four of 6 cases with a full revision for polyethylene wear may have benefited from a bearing exchange instead. OKSs in non-revised patients were good (median score 38, IQR 30–44) with no significant deterioration noted from 5 to 12–14 years.</p></div><div><h3>Conclusions</h3><p>Cementless OUKA in this series had a long-term survival rate comparable to other OUKA’s outside of the designer centre. OKSs remain good for those patients not revised. Progression of lateral compartment arthritis was the primary reason for revision with no revisions for component loosening or bearing spinout. Ideally UKA patients who experience problems should be under the care of revisions surgeons who perform UKA. Improving patient selection and understanding of the pathophysiology of lateral disease progression, remain crucial to improve the long-term survivorship of OUKA.</p></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"49 ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141753495","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)00131-5","DOIUrl":"10.1016/S0968-0160(24)00131-5","url":null,"abstract":"","PeriodicalId":56110,"journal":{"name":"Knee","volume":"49 ","pages":"Page IV"},"PeriodicalIF":1.6,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142011416","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}