Knee

Latest journal articles about knee arthroplasty and reconstruction from Journal of Arthroplasty, Knee Surgery, Sports Traumatology, Arthroscopy, Knee, The Bone & Joint Journal, Journal of Bone and Joint Surgery, Clinical Orthopaedics and Related Research, Acta Orthopaedica, Orthopedic Clinics of North, America, Journal of Orthopaedic Surgery and Research, Orthopedics

Related Articles Use of a gyroscope sensor to quantify tibial motions during a pivot shift test. Knee Surg Sports Traumatol Arthrosc. 2013 Jul 25; Authors: Borgstrom PH, Markolf KL, Foster B, Petrigliano FA, McAllister DR Abstract PURPOSE: The purpose of this preliminary study was to evaluate the use of a gyroscope sensor to record rotations of the tibia about its long axis during a clinical pivot shift examination. METHODS: Ten patients with a unilateral ACL injury were tested under anaesthesia prior to surgery. Each ankle was placed in neutral position, wrapped and stabilized with athletic tape, and a small aluminium plate was taped to the bottom of the foot. A data recovery module was attached to the bottom of each plate using a swivel bracket that allowed alignment of the gyro axis with the long axis of the tibia. The module contained a triaxial gyroscope, battery and circuitry for wireless data broadcast to a laptop computer. Ten pivot shift tests were performed on both knees, and the surgeon's clinical grading of the pivot shift was noted for each limb. Mean values (10 trials) of peak tibial rotational velocity and integrated tibial rotation were compared between knees for each patient during the pivot shift reduction event (external tibial rotation during knee flexion). RESULTS: Five patients (50 %) had significantly greater tibial rotation in their injured knee, four showed no difference between knees, and one had significantly greater

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Related Articles Joint line reconstruction in medial unicompartmental knee arthroplasty: development and validation of a measurement method. Knee Surg Sports Traumatol Arthrosc. 2013 Jul 24; Authors: Weber P, Schröder C, Laubender RP, Baur-Melnyk A, von Schulze Pellengahr C, Jansson V, Müller PE Abstract PURPOSE: Preservation of the joint line in total knee arthroplasty (TKA) has shown to be an important factor for the long-term outcome, especially in revision TKA. For unicompartmental knee arthroplasty (UKA), the role of the joint line has neither been investigated nor is it consciously respected during implantation. Thus, the aim was to establish and validate a standardised measurement method to determine the joint line in UKA. METHODS: As there is no established method to evaluate changes in the joint line radiologically, we introduced two methods and correlated them. The methods were first validated in a cadaver model by a controlled rotational study. Then, the joint line of 29 patients with an UKA (Oxford, Biomet, Bridgend, UK) was determined on pre- and post-operative radiographs. Both methods were tested by intra- and inter-rater reliability. RESULTS: Both methods showed a good intra- and inter-rater reliability. Furthermore, there was only little bias in agreement between both methods and raters. Measurements of the 29 UKA patients revealed that the joint line was more distally by a mean of 4.4 ± 1.2 mm after surgery.

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Related Articles Preoperative asymmetry in load distribution during quite stance persist following total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc. 2013 Jul 24; Authors: Thewlis D, Hillier S, Hobbs SJ, Richards J Abstract PURPOSE: Preoperative function has been shown to persist posttotal knee arthroplasty. However, it remains unclear whether asymmetries are task specific. Therefore, we investigated postoperative asymmetries in loading during quiet stance and walking gait. METHODS: Ten patients with end-stage knee osteoarthritis scheduled for total knee arthroplasty were studied at baseline (preoperative), 6-week, 3- and 6-month postoperative. Load distribution and balance were quantified during quiet stance. Furthermore, dynamic loading was quantified during walking gait. Patient satisfaction was assessed using the Knee Osteoarthritis and injury Outcome Score. RESULTS: Preoperatively, load distribution was significantly different between limbs, with approximately 70 % of the load through the contralateral or 'good' side. Asymmetries persisted and up to 6-month postoperative during quiet stance. No significant change was found in balance. During walking, preoperative loading asymmetry was present; however, no significant postoperative loading asymmetries were identified.

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Related Articles Intra-articular clonidine for post-operative analgesia following arthroscopic knee surgery: a systematic review and meta-analysis. Knee Surg Sports Traumatol Arthrosc. 2013 Jul 24; Authors: Sun R, Zhao W, Hao Q, Tian H, Tian J, Li L, Jia W, Yang K Abstract PURPOSE: To assess the efficacy and safety of a single dose of intra-articular clonidine for post-operative pain following arthroscopic knee surgery by analyzing relevant randomized controlled trials (RCTs). METHODS: PubMed, EMBASE, Cochrane Library, ISI Web of knowledge, Chinese Biomedical Literature Database, Google Scholar and other databases were searched for RCTs comparing a single dose of intra-articular clonidine with placebo for post-operative pain following arthroscopic knee surgery. Risk of bias of included studies was assessed by Cochrane Collaboration's tool, and data were analyzed by RevMan 5.1 software. Pain intensity, supplementary analgesic use and side effects were evaluated as the outcomes. RESULTS: Seven RCTs were included, and the results of the meta-analysis showed that intra-articular clonidine reduced the pain intensity for the first 4 h after surgery, reduced the risk of using rescue analgesics and the incidence of post-operative nausea, but increased the risk of hypotension after surgery.

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Related Articles Knee temperatures measured in vivo after arthroscopic ACL reconstruction followed by cryotherapy with gel-packs or computer controlled heat extraction. Knee Surg Sports Traumatol Arthrosc. 2013 Jul 23; Authors: Rashkovska A, Trobec R, Avbelj V, Veselko M Abstract PURPOSE: To obtain in vivo data about intra- and extra-articular knee temperatures to assess the effectiveness of two cryotherapeutic methods-conventional cooling with gel-packs and computer controlled cryotherapy following anterior cruciate ligament (ACL) reconstructive surgery. METHODS: Twenty patients were arbitrarily assigned for cryotherapy after ACL reconstruction: 8 patients with frozen gel-packs and 12 patients with computer controlled cryotherapy with constant temperatures of the cooling liquid in the knee pads. The treatment was performed for 12 h. Temperatures were measured with two thermo sensors in catheters placed intraarticularly and subcutaneously, four sensors on the skin and one sensor under protective bandage, every second for 16 h after surgery. RESULTS: In the first 2 h of treatment, there were no significant differences (n.s.) between the groups in temperatures in the intracondylar notch. After 4 h of cryotherapy, the temperatures were significantly lower on the skin (24.6 ± 2.8 and 31.4 ± 1.3 °C, p < 0.01) and in the subcutaneous tissue (28.6 ± 5.7 and 34.6 ± 1.4 °C, p = 0.01), and the difference between the temperature in

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Related Articles Coronal Limb Alignment and Indications for High Tibial Osteotomy in Patients Undergoing Revision ACL Reconstruction. Clin Orthop Relat Res. 2013 Jul 23; Authors: Won HH, Chang CB, Je MS, Chang MJ, Kim TK Abstract BACKGROUND: Failed ACL reconstruction frequently is accompanied by irreparable medial meniscal tear and/or visible osteoarthritis (OA) in the medial tibiofemoral joint. Thus, assessment for the presence of varus malalignment is important in caring for patients in whom revision ACL reconstruction is considered. QUESTIONS/PURPOSES: We determined whether patients undergoing revision ACL reconstruction (1) have more frequent varus malalignment coupled with more severe degrees of medial meniscal injury and/or medial tibiofemoral OA, and (2) would meet potential indications for high tibial osteotomy more frequently than patients undergoing primary ACL reconstruction. METHODS: We compared 58 patients undergoing revision ACL reconstruction and 116 patients undergoing primary ACL reconstruction. The mechanical tibiofemoral angle and the weight loading line (%) of the knee were measured. Additionally, radiographic degrees of OA in the tibiofemoral joints, and meniscal conditions were assessed. Then, proportions of potential candidates for high tibial osteotomy between the two groups were compared based on the following indications: (1) weight loading line less than 5%, (2) weight loading line less than 25% and medial tibiofemoral OA

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Related Articles Evaluation of the morphological variations of the meniscus: a cadaver study. Knee Surg Sports Traumatol Arthrosc. 2013 Jul 20; Authors: Ryu K, Iriuchishima T, Oshida M, Saito A, Kato Y, Tokuhashi Y, Aizawa S Abstract PURPOSE: The purpose of this study was to reveal the prevalence of the subtypes of the meniscus using human cadaver knees. METHODS: Four hundred and thirty-seven cadaveric knees in 219 subjects (formalin fixed, Japanese population) with a median age of 83 years (54-97) were included in this study. All soft tissues surrounding the knee, excluding the meniscus, were resected, and macroscopic assessment of the meniscus was performed. Meniscus subtypes were classified as: (1) normal meniscus, (2) complete discoid, (3) incomplete discoid, (4) ring-shaped, and (5) double-layered. RESULTS: All subtypes of the meniscus were observed in the lateral meniscus. Complete discoid lateral meniscus was observed in 27 knees (6.2 %), incomplete discoid lateral meniscus was observed in 139 knees (31.8 %), ring-shaped lateral meniscus was observed in 4 knees (0.9 %), and double-layered meniscus was observed in 2 knees (0.5 %).

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Related Articles Mid-term results of total knee arthroplasty with a porous tantalum monoblock tibial component. Knee. 2013 Jul 18; Authors: Hayakawa K, Date H, Tsujimura S, Nojiri S, Yamada H, Nakagawa K Abstract BACKGROUND: The objectives of the present study were to assess the mid-term results of cementless total knee arthroplasty (TKA) with the porous tantalum monoblock tibial component and to examine the time course of bone changes on plain radiographs. METHODS: The subjects were 32 patients, 29 patients were available for follow-up. We investigated the mid-term results of TKA after a mean follow-up period of 7years and 8months. We also examined changes of the bone over time on plain radiographs.

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