MedWorm.com provides a medical RSS filtering service. Over 6000 RSS medical sources are combined and output via different filters. This feed contains the latest items from the 'The Knee' source. Mon, 15 Mar 2010 15:15:23 +0100 http://www.medworm.com/index.php?rid=3226183&cid=s_38549_31_f&fid=38549&url=http%3A%2F%2Fwww.thekneejournal.com%2Farticle%2FPIIS0968016010000165%2Fabstract%3Frss%3Dyes (Source: The Knee) The Knee journals http://www.medworm.com/rss/comments.php?id=3226183 Mon, 01 Feb 2010 16:06:54 +0100 3226183 http://www.medworm.com/index.php?rid=3226182&cid=s_38549_31_f&fid=38549&url=http%3A%2F%2Fwww.thekneejournal.com%2Farticle%2FPIIS0968016010000153%2Fabstract%3Frss%3Dyes (Source: The Knee) The Knee journals http://www.medworm.com/rss/comments.php?id=3226182 Mon, 01 Feb 2010 16:06:54 +0100 3226182 http://www.medworm.com/index.php?rid=3226163&cid=s_38549_31_f&fid=38549&url=http%3A%2F%2Fwww.thekneejournal.com%2Farticle%2FPIIS0968016010000141%2Fabstract%3Frss%3Dyes (Source: The Knee) The Knee journals http://www.medworm.com/rss/comments.php?id=3226163 Mon, 01 Feb 2010 16:06:51 +0100 3226163 http://www.medworm.com/index.php?rid=3226162&cid=s_38549_31_f&fid=38549&url=http%3A%2F%2Fwww.thekneejournal.com%2Farticle%2FPIIS096801601000013X%2Fabstract%3Frss%3Dyes (Source: The Knee) The Knee journals http://www.medworm.com/rss/comments.php?id=3226162 Mon, 01 Feb 2010 16:06:50 +0100 3226162 http://www.medworm.com/index.php?rid=3226181&cid=s_38549_31_f&fid=38549&url=http%3A%2F%2Fwww.thekneejournal.com%2Farticle%2FPIIS0968016010000025%2Fabstract%3Frss%3Dyes The authors regret that when this paper was published, the authors' names were displayed incorrectly. The correct names are now displayed above. (Source: The Knee) The Knee journals http://www.medworm.com/rss/comments.php?id=3226181 Mon, 18 Jan 2010 00:00:00 +0100 3226181 http://www.medworm.com/index.php?rid=3021227&cid=s_38549_31_f&fid=38549&url=http%3A%2F%2Fwww.thekneejournal.com%2Farticle%2FPIIS0968016009002336%2Fabstract%3Frss%3Dyes (Source: The Knee) The Knee journals http://www.medworm.com/rss/comments.php?id=3021227 Tue, 24 Nov 2009 15:42:46 +0100 3021227 http://www.medworm.com/index.php?rid=3021226&cid=s_38549_31_f&fid=38549&url=http%3A%2F%2Fwww.thekneejournal.com%2Farticle%2FPIIS0968016009002324%2Fabstract%3Frss%3Dyes (Source: The Knee) The Knee journals http://www.medworm.com/rss/comments.php?id=3021226 Tue, 24 Nov 2009 15:42:46 +0100 3021226 http://www.medworm.com/index.php?rid=3021206&cid=s_38549_31_f&fid=38549&url=http%3A%2F%2Fwww.thekneejournal.com%2Farticle%2FPIIS0968016009002312%2Fabstract%3Frss%3Dyes (Source: The Knee) The Knee journals http://www.medworm.com/rss/comments.php?id=3021206 Tue, 24 Nov 2009 15:42:44 +0100 3021206 http://www.medworm.com/index.php?rid=3021205&cid=s_38549_31_f&fid=38549&url=http%3A%2F%2Fwww.thekneejournal.com%2Farticle%2FPIIS0968016009002300%2Fabstract%3Frss%3Dyes (Source: The Knee) The Knee journals http://www.medworm.com/rss/comments.php?id=3021205 Tue, 24 Nov 2009 15:42:43 +0100 3021205 http://www.medworm.com/index.php?rid=2910637&cid=s_38549_31_f&fid=38549&url=http%3A%2F%2Fwww.thekneejournal.com%2Farticle%2FPIIS0968016009001872%2Fabstract%3Frss%3Dyes (Source: The Knee) The Knee journals http://www.medworm.com/rss/comments.php?id=2910637 Wed, 21 Oct 2009 14:03:54 +0100 2910637 http://www.medworm.com/index.php?rid=2910636&cid=s_38549_31_f&fid=38549&url=http%3A%2F%2Fwww.thekneejournal.com%2Farticle%2FPIIS0968016009001860%2Fabstract%3Frss%3Dyes (Source: The Knee) The Knee journals http://www.medworm.com/rss/comments.php?id=2910636 Wed, 21 Oct 2009 14:03:54 +0100 2910636 http://www.medworm.com/index.php?rid=2910617&cid=s_38549_31_f&fid=38549&url=http%3A%2F%2Fwww.thekneejournal.com%2Farticle%2FPIIS0968016009001914%2Fabstract%3Frss%3Dyes (Source: The Knee) The Knee journals http://www.medworm.com/rss/comments.php?id=2910617 Wed, 21 Oct 2009 14:03:51 +0100 2910617 http://www.medworm.com/index.php?rid=2910616&cid=s_38549_31_f&fid=38549&url=http%3A%2F%2Fwww.thekneejournal.com%2Farticle%2FPIIS0968016009001859%2Fabstract%3Frss%3Dyes (Source: The Knee) The Knee journals http://www.medworm.com/rss/comments.php?id=2910616 Wed, 21 Oct 2009 14:03:51 +0100 2910616 http://www.medworm.com/index.php?rid=2910615&cid=s_38549_31_f&fid=38549&url=http%3A%2F%2Fwww.thekneejournal.com%2Farticle%2FPIIS0968016009001847%2Fabstract%3Frss%3Dyes (Source: The Knee) The Knee journals http://www.medworm.com/rss/comments.php?id=2910615 Wed, 21 Oct 2009 14:03:51 +0100 2910615 http://www.medworm.com/index.php?rid=3226179&cid=s_38549_31_f&fid=38549&url=http%3A%2F%2Fwww.thekneejournal.com%2Farticle%2FPIIS0968016009001318%2Fabstract%3Frss%3Dyes We report a case of a near fatal complication of an open wedge high tibial osteotomy held by a Puddu plate. CT-scan and lysis therapy revealed a compression of the popliteal artery by the implanted hydroxyapatite wedge resulting in ischaemia of the lower limb. Revision surgery was performed and the prominent part of the wedge was removed, however two toes had to be amputated due to the initial tissue damage. (Source: The Knee) The Knee journals http://www.medworm.com/rss/comments.php?id=3226179 Sun, 27 Sep 2009 00:00:00 +0100 3226179 http://www.medworm.com/index.php?rid=3226164&cid=s_38549_31_f&fid=38549&url=http%3A%2F%2Fwww.thekneejournal.com%2Farticle%2FPIIS0968016009001252%2Fabstract%3Frss%3Dyes Abstract: Synovial plicae around the knee are a relatively common occurrence but one that is rarely responsible for symptoms. The Plica syndrome has been well described but controversy still exists regarding its diagnosis and treatment.We have reviewed and studied the published literature both past and present in detail regarding synovial plicae around the knee to provide a comprehensive and up-to-date review on the subject.The aim is to outline previous significant research into the embryology and pathology of synovial plicae as well as providing a review of the current thinking on treatment options available for the different synovial plicae with reference to the evidence available. (Source: The Knee) The Knee journals http://www.medworm.com/rss/comments.php?id=3226164 Fri, 25 Sep 2009 00:00:00 +0100 3226164 http://www.medworm.com/index.php?rid=3226174&cid=s_38549_31_f&fid=38549&url=http%3A%2F%2Fwww.thekneejournal.com%2Farticle%2FPIIS0968016009001343%2Fabstract%3Frss%3Dyes Abstract: The incidence of postoperative complications following computer navigated total knee arthroplasty is unknown. There is no published evidence to support decreased morbidity compared to standard conventional technique. The Nationwide Inpatient Sample database was used to identify 101,596 patients who underwent total knee arthroplasty in 2005. Of these patients, 1156 were coded as having a computer-assisted procedure. Bivariate analysis and regression modeling were used to compare postoperative in-hospital outcomes between the computer-assisted and non-navigated cohorts. We found no differences in postoperative mortality or complications for the majority of our measured outcomes. Under multivariate regression analysis, computer navigation was associated with a lower rate of postoper... The Knee journals http://www.medworm.com/rss/comments.php?id=3226174 Wed, 16 Sep 2009 00:00:00 +0100 3226174 http://www.medworm.com/index.php?rid=3226180&cid=s_38549_31_f&fid=38549&url=http%3A%2F%2Fwww.thekneejournal.com%2Farticle%2FPIIS0968016009001367%2Fabstract%3Frss%3Dyes We report a case of pretibial sinus and abscess after anterior cruciate ligament reconstruction using a polylactic acid tricalcium phosphate bioabsorbable screw for tibial fixation. Mycobacterium fortuitum was identified as the pathogen after specific mycobacterial cultures were obtained from operative specimens. M. fortuitum is a known but rare cause of periprosthetic infection. Diagnosis is often delayed as routine microbiological cultures do not utilise specific culture requirements for mycobacterial growth. There have been several reports in the literature of sterile abscesses associated with bioabsorbable screws. To our knowledge, this is the first case report of a non-tuberculous mycobacterial infection associated with a bioabsorbable implant. This case illustrates that post-operativ... The Knee journals http://www.medworm.com/rss/comments.php?id=3226180 Thu, 10 Sep 2009 00:00:00 +0100 3226180 http://www.medworm.com/index.php?rid=3021222&cid=s_38549_31_f&fid=38549&url=http%3A%2F%2Fwww.thekneejournal.com%2Farticle%2FPIIS0968016009001094%2Fabstract%3Frss%3Dyes In this study, we hypothesized that parameters such as gender, height, age, and body mass index (BMI) can be used pre-operatively to reveal the true graft diameter. All hamstring ACL reconstructions from 1994 to 2002 were reviewed. 536 cases (302 females, 234 males) met the inclusion criteria. Quadruple hamstring constructs and femoral tunnel diameters were measured using 1mm increment graft sizers. Pre-operative measures of height, weight, body mass index, gender, and age were obtained. Multiple regression analysis was used to build a predictive model of the quadruple hamstring graft diameter. The results of the study demonstrated that males had significantly larger grafts than females (8.1±0.8 vs. 7.5±0.6mm). Multiple regression analysis on the entire group showed that pre-operative he... The Knee journals http://www.medworm.com/rss/comments.php?id=3021222 Wed, 09 Sep 2009 00:00:00 +0100 3021222 http://www.medworm.com/index.php?rid=3021221&cid=s_38549_31_f&fid=38549&url=http%3A%2F%2Fwww.thekneejournal.com%2Farticle%2FPIIS0968016009001161%2Fabstract%3Frss%3Dyes Abstract: Tears of the posterior root of the medial meniscus are becoming increasingly recognized. Early identification and treatment of these tears help halt the progression of cartilage degeneration and osteoarthritis of the knee. Repair of these tears is essential for recreating the hoop stress of the medial meniscus. In this note, we describe a successful arthroscopic technique to repair this lesion. A posteromedial portal is established by which two 2-0 PDS sutures are placed through the meniscus root and pulled down through a trans-tibial tunnel and fixed using an EndoButton distally along the anterolateral cortex of the tibia. This has been performed successfully in five patients with no complications. (Source: The Knee) The Knee journals http://www.medworm.com/rss/comments.php?id=3021221 Wed, 09 Sep 2009 00:00:00 +0100 3021221 http://www.medworm.com/index.php?rid=3226175&cid=s_38549_31_f&fid=38549&url=http%3A%2F%2Fwww.thekneejournal.com%2Farticle%2FPIIS0968016009001483%2Fabstract%3Frss%3Dyes Abstract: Osteoarthritis (OA) is the most common form of destructive joint disease that is characterized by the degeneration of the articular cartilage, synovial membrane, joint capsule, and subchondral bone. The knee is a joint commonly affected for OA. Calcitonin (CT) has been suggested to have chondroprotective effects; therefore, could play a role in the pathogenesis of OA of the knee. Genetic variations in or adjacent to the CT gene may be associated with primary OA development. We conducted a case-control association study in which we examined the correlation between a dinucleotide (cytosine-adenine, CA) repeat polymorphism at the CT locus and OA of the knee in 88 patients with OA and in 111 control subjects from the Mexican mestizo population. Allele A and genotype AG frequencies we... The Knee journals http://www.medworm.com/rss/comments.php?id=3226175 Mon, 07 Sep 2009 00:00:00 +0100 3226175 http://www.medworm.com/index.php?rid=3021214&cid=s_38549_31_f&fid=38549&url=http%3A%2F%2Fwww.thekneejournal.com%2Farticle%2FPIIS0968016009001239%2Fabstract%3Frss%3Dyes This study is a retrospective comparative cohort radiographic analysis of 114 consecutive patients who underwent posterior cruciate retaining (PCR) total knee arthroplasty (TKA), medial and patellofemoral compartment bicruciate retaining arthroplasty (BCR), or bicruciate substituting (BCS) TKA. In an effort to obtain a quantitative measurement of both anteroposterior (AP) tibiofemoral position and active knee flexion we have routinely taken post-operative lateral radiographs in a position of maximal active flexion. Passive range of motion (PRoM) after TKA was significantly greater than pre-operative passive range of motion for each cohort (p (Source: The Knee) The Knee journals http://www.medworm.com/rss/comments.php?id=3021214 Fri, 04 Sep 2009 00:00:00 +0100 3021214 http://www.medworm.com/index.php?rid=3226178&cid=s_38549_31_f&fid=38549&url=http%3A%2F%2Fwww.thekneejournal.com%2Farticle%2FPIIS096801600900132X%2Fabstract%3Frss%3Dyes We report a case of osteochondritis dissecans in the patella of Francesco de' Medici, Prince of Capistrano, who lived from 1594 to 1614. He was known to play Florentine kick ball, a precursor of Rugby and American football, and speculate that trauma from this activity may have led to the lesion. (Source: The Knee) The Knee journals http://www.medworm.com/rss/comments.php?id=3226178 Thu, 03 Sep 2009 00:00:00 +0100 3226178 http://www.medworm.com/index.php?rid=3226176&cid=s_38549_31_f&fid=38549&url=http%3A%2F%2Fwww.thekneejournal.com%2Farticle%2FPIIS0968016009001264%2Fabstract%3Frss%3Dyes Abstract: Osteoarthritis of the knee has consistently been linked to obesity, defined as a body mass index (BMI) >30kg/m2. It has been hypothesized that obesity may lead to osteoarthritis through increased joint pressure, accumulated microtrauma, and disruption of normal chondrocyte metabolism. These changes in chondrocyte metabolism have not been thoroughly investigated, and it is the purpose of this study to identify a relationship between BMI and altered chondrocyte metabolism in osteoarthritic tissue. Articular cartilage was harvested from the femoral condyles of patients after total knee arthroplasty, and analyzed in explant and alginate models. Glycosaminoglycan (GAG) content was measured using a dimethylmethylene blue assay and normalized to DNA content using a PicoGreen® assay. St... The Knee journals http://www.medworm.com/rss/comments.php?id=3226176 Thu, 03 Sep 2009 00:00:00 +0100 3226176 http://www.medworm.com/index.php?rid=3226165&cid=s_38549_31_f&fid=38549&url=http%3A%2F%2Fwww.thekneejournal.com%2Farticle%2FPIIS096801600900129X%2Fabstract%3Frss%3Dyes Abstract: The purpose of this study was to evaluate the long-term results of arthroscopic resection of a medial plica and to describe the usefulness of the clinical findings and MRI for preoperative diagnostics. From the baseline population of 172,777 military conscripts, thirty-three consecutive young adult patients with normal preoperative MRIs of the knee and a sole postoperative diagnosis of medial plica were treated with arthroscopic plica resection. Functional outcome was evaluated at a final follow-up in 25 patients with 34 knees with Kujala, Lysholm and visual analog scale (VAS) scores. Functional results were excellent to good in 17 patients, fair in three patients, and poor in 3 patients. The median Kujala score was 92 (25–100), the median Lysholm score 89 (26–100), and the m... The Knee journals http://www.medworm.com/rss/comments.php?id=3226165 Thu, 03 Sep 2009 00:00:00 +0100 3226165 http://www.medworm.com/index.php?rid=3226173&cid=s_38549_31_f&fid=38549&url=http%3A%2F%2Fwww.thekneejournal.com%2Farticle%2FPIIS0968016009001240%2Fabstract%3Frss%3Dyes Abstract: Patellar position during knee flexion was studied in 41 patients with bicruciate substituting (BCS), 41 patients with posterior cruciate retaining (CR) and 41 patients with posterior stabilized (PS) TKA's. The perpendicular height of the patella above the tibial tubercle was compared to the length of the patellar tendon on maximum flexion lateral radiographs. BCS knees had greater active flexion compared to PS and CR knees (BCS=124±9.8, PS=112±9.5, CR=110±10.9). In flexion, apparent patella infera (API) or the height of the patella above the tibial tubercle was 3.5% lower than the patellar tendon length for BCS knees, 1.7% lower in PS knees and 0.5% lower in CR knees. API in PS and BCS knees correlated with active knee flexion, but not in CR knees. Our findings indicate that a... The Knee journals http://www.medworm.com/rss/comments.php?id=3226173 Tue, 01 Sep 2009 00:00:00 +0100 3226173 http://www.medworm.com/index.php?rid=3226171&cid=s_38549_31_f&fid=38549&url=http%3A%2F%2Fwww.thekneejournal.com%2Farticle%2FPIIS0968016009001331%2Fabstract%3Frss%3Dyes Abstract: Patellofemoral disorders, such as osteoarthritis and patellofemoral pain, are thought to be associated with abnormal patellar kinematics. However, assessments of three-dimensional patellar kinematics are time consuming and expensive. The aim of this study was to determine whether a single static measure of three-dimensional patellar kinematics provides a surrogate marker for three-dimensional patellar kinematics over a range of flexion angles. We assessed three-dimensional patellar kinematics (flexion, tilt and spin; lateral, anterior and proximal translation) at sequential static angles through approximately 45° of loaded knee flexion in 40 normal subjects using a validated, MRI-based method. The surrogate marker was defined as the static measure at 30° of knee flexion and the... The Knee journals http://www.medworm.com/rss/comments.php?id=3226171 Tue, 01 Sep 2009 00:00:00 +0100 3226171 http://www.medworm.com/index.php?rid=3226170&cid=s_38549_31_f&fid=38549&url=http%3A%2F%2Fwww.thekneejournal.com%2Farticle%2FPIIS0968016009001276%2Fabstract%3Frss%3Dyes This study found that patellar position was significantly changed following the application of tape. Furthermore, the study found that though low intensity exercise resulted in a significant change in the patellar position compared to the taped position prior to exercise, that change was most likely to have occurred due to random chance or measurement error. (Source: The Knee) The Knee journals http://www.medworm.com/rss/comments.php?id=3226170 Tue, 01 Sep 2009 00:00:00 +0100 3226170 http://www.medworm.com/index.php?rid=3226169&cid=s_38549_31_f&fid=38549&url=http%3A%2F%2Fwww.thekneejournal.com%2Farticle%2FPIIS0968016009001288%2Fabstract%3Frss%3Dyes Abstract: Single-leg and double-leg landing techniques are common athletic maneuvers typically performed from various landing heights during intensive sports activities. However, it is still unclear how the knee joint responds in terms of kinematics and energetics to the combined effects of different landing heights and techniques. We hypothesized that the knee displays greater flexion angles and angular velocities, joint power and work in response to the larger peak ground reaction force from 0.6-m height, compared to 0.3-m height. We further hypothesized that the knee exhibits elevated flexion angles and angular velocities, joint power and work during double-leg landing, relative to single-leg landing. Ground reaction force, knee joint kinematics and energetics data were obtained from 10... The Knee journals http://www.medworm.com/rss/comments.php?id=3226169 Tue, 01 Sep 2009 00:00:00 +0100 3226169 http://www.medworm.com/index.php?rid=3226166&cid=s_38549_31_f&fid=38549&url=http%3A%2F%2Fwww.thekneejournal.com%2Farticle%2FPIIS0968016009001306%2Fabstract%3Frss%3Dyes The objective evaluation showed functional impairment in 29.4% with an average reduction of 3 points in the Tegner activity scale.The osteoarthritis observed in all patients prompted us to avoid the diffusion of this surgical technique. Although in theory well-conceived, studies have yet to substantiate the function of these augmentation devices or to show clinical better results than those achieved with isolated autograft or allograft ACL substitutes. (Source: The Knee) The Knee journals http://www.medworm.com/rss/comments.php?id=3226166 Tue, 01 Sep 2009 00:00:00 +0100 3226166 http://www.medworm.com/index.php?rid=3021216&cid=s_38549_31_f&fid=38549&url=http%3A%2F%2Fwww.thekneejournal.com%2Farticle%2FPIIS0968016009001197%2Fabstract%3Frss%3Dyes Abstract: The aim of this study was to determine the prognostic value of preoperative patellofemoral osteoarthritis, BMI and age for implant survival of unicompartmental knee arthroplasty (UKA) performed in patients meeting strict admission criteria. The data and radiographs of 437 unilateral Oxford phase III procedures (Biomet, Bridgend, UK) were analysed. All procedures were carried out or supervised by 13 specialised knee surgeons in three different hospitals. The study group comprised 437 patients with a median follow of 2.6 years (0.1–7.9). The cumulative standard case survival rate at 5 years, when there were still 101 patients at risk, was 84.7% (CI-95%: 80.1–89.3%). Young age (30 kg/m2, gender, the surgeon performing the operation (either as an individual or categorised by a... The Knee journals http://www.medworm.com/rss/comments.php?id=3021216 Tue, 01 Sep 2009 00:00:00 +0100 3021216 http://www.medworm.com/index.php?rid=2746810&cid=s_38549_31_f&fid=38549&url=http%3A%2F%2Fwww.thekneejournal.com%2Farticle%2FPIIS0968016009001458%2Fabstract%3Frss%3Dyes (Source: The Knee) The Knee journals http://www.medworm.com/rss/comments.php?id=2746810 Mon, 31 Aug 2009 12:41:15 +0100 2746810 http://www.medworm.com/index.php?rid=2746809&cid=s_38549_31_f&fid=38549&url=http%3A%2F%2Fwww.thekneejournal.com%2Farticle%2FPIIS0968016009001446%2Fabstract%3Frss%3Dyes (Source: The Knee) The Knee journals http://www.medworm.com/rss/comments.php?id=2746809 Mon, 31 Aug 2009 12:41:15 +0100 2746809 http://www.medworm.com/index.php?rid=2746784&cid=s_38549_31_f&fid=38549&url=http%3A%2F%2Fwww.thekneejournal.com%2Farticle%2FPIIS0968016009001434%2Fabstract%3Frss%3Dyes (Source: The Knee) The Knee journals http://www.medworm.com/rss/comments.php?id=2746784 Mon, 31 Aug 2009 12:41:12 +0100 2746784 http://www.medworm.com/index.php?rid=2746783&cid=s_38549_31_f&fid=38549&url=http%3A%2F%2Fwww.thekneejournal.com%2Farticle%2FPIIS0968016009001422%2Fabstract%3Frss%3Dyes (Source: The Knee) The Knee journals http://www.medworm.com/rss/comments.php?id=2746783 Mon, 31 Aug 2009 12:41:12 +0100 2746783 http://www.medworm.com/index.php?rid=2746808&cid=s_38549_31_f&fid=38549&url=http%3A%2F%2Fwww.thekneejournal.com%2Farticle%2FPIIS0968016009001215%2Fabstract%3Frss%3Dyes The author regrets that when this paper was published in 2005, contained some incorrect calculations. The correct is now displayed below. (Source: The Knee) The Knee journals http://www.medworm.com/rss/comments.php?id=2746808 Thu, 20 Aug 2009 23:00:00 +0100 2746808 http://www.medworm.com/index.php?rid=3226168&cid=s_38549_31_f&fid=38549&url=http%3A%2F%2Fwww.thekneejournal.com%2Farticle%2FPIIS0968016009001203%2Fabstract%3Frss%3Dyes Abstract: The purpose of this study was to compare the clinical outcomes of rehabilitation after ACL reconstruction using a water-filled soft brace to those using a hard brace.The method used in this study was a prospective randomised clinical trial including 36 patients wearing a hard brace and 37 patients wearing a water-filled soft brace for 6 weeks after surgery. Preoperative and postoperative (seven examinations) clinical evaluation within a follow-up period of 1 year including effusion status, swelling and range of motion (ROM), IKDC 2000, KT1000 Arthrometer™, Lysholm knee scoring scale and Tegner activity score. Mean values are presented with standard deviations. Data was analysed using descriptive statistics and Student's t-test for unpaired samples.Significantly less effusion ... The Knee journals http://www.medworm.com/rss/comments.php?id=3226168 Mon, 17 Aug 2009 00:00:00 +0100 3226168 http://www.medworm.com/index.php?rid=3021215&cid=s_38549_31_f&fid=38549&url=http%3A%2F%2Fwww.thekneejournal.com%2Farticle%2FPIIS0968016009001185%2Fabstract%3Frss%3Dyes Abstract: Application of prosthesis components during knee arthroplasty surgery involves impacting the femoral component using an impaction device and a heavy mallet. This could damage the component and may therefore be of concern to knee surgeons. Using a drop tower with a set-up that mimics the impaction generated clinically when a surgeon hits the femoral component, we investigated the possible surface damage to the femoral component. Three parameters were obtained and compared with a contact profilometer to characterize the roughness: Ra, Rpk and Rz. The effect of the impacts on the contour of the femoral components was also investigated. After 3 series of impactions, no difference in surface roughness of the femoral component important enough to increase the wear rate could be detecte... The Knee journals http://www.medworm.com/rss/comments.php?id=3021215 Tue, 11 Aug 2009 00:00:00 +0100 3021215 http://www.medworm.com/index.php?rid=3021223&cid=s_38549_31_f&fid=38549&url=http%3A%2F%2Fwww.thekneejournal.com%2Farticle%2FPIIS0968016009001227%2Fabstract%3Frss%3Dyes Abstract: We evaluated short- and medium-term results of the treatment of articular cartilage defects of the knee with autogenous cylindrical osteochondral grafts (mosaicplasty) in 69 patients (median age 33 years) with symptomatic articular cartilage defects. Data of Lysholm score and visual analogue scale (VAS) of pain (0=no pain; 100=worst possible pain) were collected before the surgery, at 12 months postoperatively and 5 to 9 (median 7) years after the surgery. At the last follow-up the patients were also asked to state their degree of satisfaction with the outcome on a VAS (0=not at all satisfied; 100=completely satisfied), and to answer if they would have undergone the surgery again if necessary (yes or no). The mean Lysholm score and VAS of pain improved from 48 and 62, respectiv... The Knee journals http://www.medworm.com/rss/comments.php?id=3021223 Mon, 10 Aug 2009 00:00:00 +0100 3021223 http://www.medworm.com/index.php?rid=3021212&cid=s_38549_31_f&fid=38549&url=http%3A%2F%2Fwww.thekneejournal.com%2Farticle%2FPIIS0968016009001173%2Fabstract%3Frss%3Dyes This study investigates a cohort of patients who required a manipulation after total knee arthroplasty (TKA) to determine whether there was an association between pre-TKA and post-manipulation range of motion (ROM). Thirty-seven of 800 TKAs were manipulated (4.6% incidence); complete data were available for 36 knees. The pre-TKA stiff group ( (Source: The Knee) The Knee journals http://www.medworm.com/rss/comments.php?id=3021212 Fri, 07 Aug 2009 00:00:00 +0100 3021212 http://www.medworm.com/index.php?rid=3021210&cid=s_38549_31_f&fid=38549&url=http%3A%2F%2Fwww.thekneejournal.com%2Farticle%2FPIIS0968016009001070%2Fabstract%3Frss%3Dyes Abstract: A retrospective study of a consecutive cohort of 109 patients, under the age of 60, who had either a Patellofemoral replacement (PFR), Unicompartmental replacement (UKR) or a Total knee replacement (TKR). They were operated on by two senior surgeons between 2002 and 2006 at the Avon Orthopaedic Centre in Bristol. The aim of this study was to look at the effect of knee replacement on the employment status of this group of patients. Data were collected from patient's hospital records and a questionnaire regarding occupational status was sent postoperatively to the patients. Statistical analysis showed that our groups were similar which meant that further comparison between them was valid.Eighty-two percent of the patients who were working prior to surgery and who had either a TKR o... The Knee journals http://www.medworm.com/rss/comments.php?id=3021210 Mon, 27 Jul 2009 00:00:00 +0100 3021210 http://www.medworm.com/index.php?rid=3021213&cid=s_38549_31_f&fid=38549&url=http%3A%2F%2Fwww.thekneejournal.com%2Farticle%2FPIIS0968016009001148%2Fabstract%3Frss%3Dyes Abstract: Knee arthroplasties are designed to accommodate flexion, axial rotation and anteroposterior (AP) translation. Axial rotation during extension varies, with some rotating platform devices allowing unrestricted rotation while some conforming fixed-bearing designs almost none. The purpose of this study was to examine in vivo kinematics of a fixed-bearing medial rotation-type arthroplasty (MRK) during weight-bearing activities. Fifteen knees with a medial pivot TKA design were studied during step and pivot activities using lateral fluoroscopy and model-image registration. Average knee kinematics during the step activity showed little AP translation or rotation from 0°–100° flexion. During the pivot activity, the mean tibial internal rotation in individual knees was 7° (3°–19°... The Knee journals http://www.medworm.com/rss/comments.php?id=3021213 Fri, 24 Jul 2009 00:00:00 +0100 3021213 http://www.medworm.com/index.php?rid=3226177&cid=s_38549_31_f&fid=38549&url=http%3A%2F%2Fwww.thekneejournal.com%2Farticle%2FPIIS0968016009001124%2Fabstract%3Frss%3Dyes This report presents a rare, atypical case of bicondylar spontaneous osteonecrosis of the knee in a young patient, and highlights the importance of a clear understanding of the clinical and radiographic characteristics of this condition to accurately diagnose and treat it when evaluating osteonecrotic lesions of the knee. (Source: The Knee) The Knee journals http://www.medworm.com/rss/comments.php?id=3226177 Tue, 21 Jul 2009 00:00:00 +0100 3226177 http://www.medworm.com/index.php?rid=3226172&cid=s_38549_31_f&fid=38549&url=http%3A%2F%2Fwww.thekneejournal.com%2Farticle%2FPIIS096801600900115X%2Fabstract%3Frss%3Dyes In conclusion, this systematic review has found that there is no advantage to using a tourniquet in knee replacement surgery for reduction of transfusion requirements. (Source: The Knee) The Knee journals http://www.medworm.com/rss/comments.php?id=3226172 Tue, 21 Jul 2009 00:00:00 +0100 3226172 http://www.medworm.com/index.php?rid=3021208&cid=s_38549_31_f&fid=38549&url=http%3A%2F%2Fwww.thekneejournal.com%2Farticle%2FPIIS0968016009001136%2Fabstract%3Frss%3Dyes Abstract: Total knee replacement is a well-established treatment for osteoarthritis with increasing numbers performed each year. Recurrent haemarthrosis is a relatively rare complication following TKR being reported in up to 1.6% of patients. While some causes are related to direct trauma to blood vessels, others are more obscure and may be difficult to diagnose. The purpose of this review is to give an overview of this unusual complication and summarise the current methods of management. (Source: The Knee) The Knee journals http://www.medworm.com/rss/comments.php?id=3021208 Tue, 21 Jul 2009 00:00:00 +0100 3021208 http://www.medworm.com/index.php?rid=2746785&cid=s_38549_31_f&fid=38549&url=http%3A%2F%2Fwww.thekneejournal.com%2Farticle%2FPIIS0968016009001033%2Fabstract%3Frss%3Dyes Receiving a referral letter to see a patient with patellofemoral syndrome causes a feeling of heart-sink in most orthopaedic surgeons. It predicts an unhappy patient, a prolonged clinic appointment, and an unsatisfactory outcome. Especially as a reliable operation is an unlikely management outcome. Orthopaedic surgeons tend to be mechanically minded and see their main task as correcting abnormalities surgically. Patellofemoral syndrome is the antithesis of this. As Teitge said “patellofemoral syndrome: What does it mean? Historically a wastebasket term for pain and dysfunction … patellofemoral syndrome is not a diagnosis but rather an admission of ignorance” . (Source: The Knee) The Knee journals http://www.medworm.com/rss/comments.php?id=2746785 Mon, 20 Jul 2009 23:00:00 +0100 2746785 http://www.medworm.com/index.php?rid=3021207&cid=s_38549_31_f&fid=38549&url=http%3A%2F%2Fwww.thekneejournal.com%2Farticle%2FPIIS0968016009001100%2Fabstract%3Frss%3Dyes This article illustrates the range of MR appearances of BME around the knee and describes secondary signs that allow the reader to determine the cause of disease and to distinguish BME from normal marrow signal changes. (Source: The Knee) The Knee journals http://www.medworm.com/rss/comments.php?id=3021207 Fri, 17 Jul 2009 00:00:00 +0100 3021207 http://www.medworm.com/index.php?rid=3021209&cid=s_38549_31_f&fid=38549&url=http%3A%2F%2Fwww.thekneejournal.com%2Farticle%2FPIIS0968016009001112%2Fabstract%3Frss%3Dyes Abstract: We asked the question of what are the patient level predictors (age, gender, body mass index, education, ethnicity, mental health, and comorbidity) for a sustained functional benefit at a minimum of 1 year follow-up after total knee arthroplasty(TKA). Five hundred fifty-one consecutive patients were reviewed from our joint registry between the years of 1998 and 2005. Baseline demographic data and the outcome scores of the Western Ontario McMaster University Osteoarthritis Index (WOMAC) and Medical Outcomes Short-Form 36 (SF36) scores were extracted from the database. Longitudinal regression modeling was performed to identify the predictive factors of interest. We had 27% of data points missing. The mean follow-up in our cohort was 3.0 years (range 1–8 years) and there were n... The Knee journals http://www.medworm.com/rss/comments.php?id=3021209 Thu, 09 Jul 2009 00:00:00 +0100 3021209 http://www.medworm.com/index.php?rid=3021211&cid=s_38549_31_f&fid=38549&url=http%3A%2F%2Fwww.thekneejournal.com%2Farticle%2FPIIS0968016009001082%2Fabstract%3Frss%3Dyes Abstract: While computer assisted total knee arthroplasty (TKA) has been documented to increase the surgical accuracy in the planning process, there is little information about the accuracy in execution processes. We aimed to determine the accuracy of execution processes for bone resections and implant fixation in TKAs performed with the techniques of computer assisted navigation and minimally invasive surgery. Execution deviations, defined as the differences between planned targets and executed results, were evaluated for bone resections and implant fixation in 107 TKAs. In tibia resection, the mean resection thickness, coronal alignment, and sagittal alignment were 0.2mm smaller, 0.3° more valgus, 0.3° less posterior slope than the planned, respectively. In femur resection, the mean re... The Knee journals http://www.medworm.com/rss/comments.php?id=3021211 Wed, 08 Jul 2009 00:00:00 +0100 3021211 http://www.medworm.com/index.php?rid=3021225&cid=s_38549_31_f&fid=38549&url=http%3A%2F%2Fwww.thekneejournal.com%2Farticle%2FPIIS0968016009001057%2Fabstract%3Frss%3Dyes Abstract: The aim was to investigate inter-tester and intra-tester reliability and parallel reliability between a visual assessment method and a method using a pachymeter for locating the mid-point of the patella in determining the medial/lateral patella orientation. Fifteen asymptomatic subjects were assessed and the mid-point of the patella was determined by both methods on two separate occasions two weeks apart. Inter-tester reliability was obtained by ANOVA and by intraclass correlation coefficient (ICC); intra-tester reliability was obtained by a paired t-test and ICC; and parallel reliability was obtained by Pearson's Correlation and ICC, for the measurement on the first and second evaluations. There was acceptable inter-tester agreement (p=0.490) and reliability for the visual inspe... The Knee journals http://www.medworm.com/rss/comments.php?id=3021225 Thu, 02 Jul 2009 00:00:00 +0100 3021225 http://www.medworm.com/index.php?rid=3226167&cid=s_38549_31_f&fid=38549&url=http%3A%2F%2Fwww.thekneejournal.com%2Farticle%2FPIIS0968016009001045%2Fabstract%3Frss%3Dyes Abstract: Four patients, aged 37–50 years, with chronic anterior cruciate ligament (ACL) deficiency, medial compartment osteoarthritis and varus deformity, underwent simultaneous arthroscopic ACL reconstruction and opening wedge high tibial osteotomy using the TomoFix fixation device and hydroxyapatite wedges. The simultaneous procedure allowed our patients to perform a full weight-bearing exercise at 4 weeks after surgery. At device removal and concomitant second-look arthroscopy, all patients had either a cyclops-like lesion or partial tears at the point of contact between the reconstructed ACL and intercondylar notch. Therefore, subsequent notchplasty or re-notchplasty was required.Because of the small number of patients, the results should be considered preliminary. Given our findi... The Knee journals http://www.medworm.com/rss/comments.php?id=3226167 Mon, 29 Jun 2009 00:00:00 +0100 3226167 http://www.medworm.com/index.php?rid=3021220&cid=s_38549_31_f&fid=38549&url=http%3A%2F%2Fwww.thekneejournal.com%2Farticle%2FPIIS096801600900101X%2Fabstract%3Frss%3Dyes Abstract: The aim was to examine the biomechanics of level- and stair-walking in men with knee osteoarthritis (OA) at different pre-determined gait speeds and to compare the results with those obtained from healthy control subjects. Special emphasis was placed on the estimation of joint loading. Fifty-four men with knee OA (50–69 years) and 53 healthy age- and sex-matched controls were enrolled in the study. The participants walked barefoot in the laboratory (1.2 m/s±5%), corridor (1.2; 1.5 and 1.7 m/s±5%), and climbing and coming down stairs (0.5 and 0.8 m/s±5%) separately. Joint loading was assessed with skin mounted accelerometers (SMAs) attached just above and below the more affected knee joint. The 3-D ground reaction forces (GRFs) and muscle activation with surface-electromy... The Knee journals http://www.medworm.com/rss/comments.php?id=3021220 Fri, 26 Jun 2009 00:00:00 +0100 3021220 http://www.medworm.com/index.php?rid=3021217&cid=s_38549_31_f&fid=38549&url=http%3A%2F%2Fwww.thekneejournal.com%2Farticle%2FPIIS0968016009001069%2Fabstract%3Frss%3Dyes Abstract: Refined prosthetic designs and surgical techniques for unicompartmental knee arthroplasty have recently been associated with improved outcomes. The purpose of the present study was to evaluate the clinical and radiographic outcomes of the EIUS unicompartmental design, which has an all-polyethylene tibial component, and to compare these outcomes with published reports of other unicompartmental prostheses. Between February 2002 and March 2005, 113 patients (144 knees) underwent a medial unicompartmental knee arthroplasty, all performed by a single surgeon who used the EIUS prosthesis. At a mean follow-up of 36 months (range, 24–54 months), the mean Knee Society objective and functional scores improved from 55 points (range, 31–77 points) and 49 points (range, 35–60 points) ... The Knee journals http://www.medworm.com/rss/comments.php?id=3021217 Wed, 24 Jun 2009 00:00:00 +0100 3021217 http://www.medworm.com/index.php?rid=3021218&cid=s_38549_31_f&fid=38549&url=http%3A%2F%2Fwww.thekneejournal.com%2Farticle%2FPIIS0968016009001021%2Fabstract%3Frss%3Dyes Abstract: Periprosthetic tibial plateau fractures (TPF) are rare but represent a serious complication of unicompartmental knee arthroplasty (UKA). As TPFs usually occur perioperatively, these can be associated with extended sagittal saw cuts during surgery. The aim of the study was to evaluate TPF as a function of extended sagittal saw cuts. The hypothesis was that extended sagittal saw cuts reduce the loading capacity of the tibial plateau and increase the risk of periprosthetic TPF.In a randomised study, standardised cemented Oxford UKA tibial component implantation was performed in six matched, paired fresh-frozen tibiae. In group A, a regular preparation of the tibial plateau was performed, whereas in group B a standardised extended sagittal saw cut was made at the dorsal cortex of the... The Knee journals http://www.medworm.com/rss/comments.php?id=3021218 Fri, 19 Jun 2009 00:00:00 +0100 3021218 http://www.medworm.com/index.php?rid=2461250&cid=s_38549_31_f&fid=38549&url=http%3A%2F%2Fwww.thekneejournal.com%2Farticle%2FPIIS0968016009000921%2Fabstract%3Frss%3Dyes (Source: The Knee) The Knee journals http://www.medworm.com/rss/comments.php?id=2461250 Mon, 08 Jun 2009 00:53:15 +0100 2461250 http://www.medworm.com/index.php?rid=2461249&cid=s_38549_31_f&fid=38549&url=http%3A%2F%2Fwww.thekneejournal.com%2Farticle%2FPIIS096801600900091X%2Fabstract%3Frss%3Dyes (Source: The Knee) The Knee journals http://www.medworm.com/rss/comments.php?id=2461249 Mon, 08 Jun 2009 00:53:14 +0100 2461249 http://www.medworm.com/index.php?rid=2461248&cid=s_38549_31_f&fid=38549&url=http%3A%2F%2Fwww.thekneejournal.com%2Farticle%2FPIIS0968016009000908%2Fabstract%3Frss%3Dyes (Source: The Knee) The Knee journals http://www.medworm.com/rss/comments.php?id=2461248 Mon, 08 Jun 2009 00:53:14 +0100 2461248 http://www.medworm.com/index.php?rid=2461247&cid=s_38549_31_f&fid=38549&url=http%3A%2F%2Fwww.thekneejournal.com%2Farticle%2FPIIS0968016009000891%2Fabstract%3Frss%3Dyes (Source: The Knee) The Knee journals http://www.medworm.com/rss/comments.php?id=2461247 Mon, 08 Jun 2009 00:53:11 +0100 2461247 http://www.medworm.com/index.php?rid=3021224&cid=s_38549_31_f&fid=38549&url=http%3A%2F%2Fwww.thekneejournal.com%2Farticle%2FPIIS0968016009000842%2Fabstract%3Frss%3Dyes Abstract: Meniscal allograft transplantation (MAT) is generally associated with good outcomes. However, the likelihood of a successful outcome is reduced by various complications, and a meniscal tear is one of the most common of these after MAT. Meniscal tears usually occur at the periphery of the meniscal allografts at the capsular junction or the posterior horn, and biomechanical factors, such as high contact stress areas, are possible causing mechanism. We encountered three unusual cases with multiple radial or horizontal tears possibly induced by the suture materials used for meniscus allograft fixation. (Source: The Knee) The Knee journals http://www.medworm.com/rss/comments.php?id=3021224 Mon, 08 Jun 2009 00:00:00 +0100 3021224 http://www.medworm.com/index.php?rid=3021219&cid=s_38549_31_f&fid=38549&url=http%3A%2F%2Fwww.thekneejournal.com%2Farticle%2FPIIS0968016009000830%2Fabstract%3Frss%3Dyes Abstract: Successful focal articular surface injury (FAI) repair depends on appropriate matching of the geometrical/material properties of the repaired site, and on the overall dynamic response of the knee to in-vivo loading. There is evidence linking the pathogenesis of lesion progression (e.g. osteoarthritis) to weightbearing site and defect size. The paper investigates further this link by studying the effects of osteochondral defect size on the load distribution at the human knee. Experimental data from cadaver knees (n=8) loaded at 30° of flexion was used as input to a validated finite element (FE) model. Contact pressure was assessed for the intact knees and over a range of circular osteochondral defects (5 mm to 20 mm) at 30° of flexion with 700 N axial load. Patient specific F... The Knee journals http://www.medworm.com/rss/comments.php?id=3021219 Mon, 25 May 2009 00:00:00 +0100 3021219 http://www.medworm.com/index.php?rid=2910633&cid=s_38549_31_f&fid=38549&url=http%3A%2F%2Fwww.thekneejournal.com%2Farticle%2FPIIS096801600900074X%2Fabstract%3Frss%3Dyes We report a case of bilateral congenital lateral dislocations of the patellae treated with bilateral tibial rotational osteotomies with an 8 year and a 4 year follow up. (Source: The Knee) The Knee journals http://www.medworm.com/rss/comments.php?id=2910633 Sun, 24 May 2009 23:00:00 +0100 2910633 http://www.medworm.com/index.php?rid=2910628&cid=s_38549_31_f&fid=38549&url=http%3A%2F%2Fwww.thekneejournal.com%2Farticle%2FPIIS0968016009000763%2Fabstract%3Frss%3Dyes Abstract: Primary repair of a disrupted midsubstance MCL during TKA can provide satisfactory stability. However, in cases with poor soft tissue quality or a gap between the ligament ends, primary repair may not be feasible. In these cases, we have used an augmented repair. The purpose of this study is to describe the technique of augmented repair using a quadriceps tendon free graft and present our experience of five patients.A total of five patients underwent augmented repair of a transected MCL substance using a quadriceps tendon free graft. The patients were followed-up for a mean of 16 months.Augmented repair of the transected MCL substance was successful in all five patients, with a mean additional surgery time of 17 min, no coronal instability, a mean Knee Society Score of 87.0±2.... The Knee journals http://www.medworm.com/rss/comments.php?id=2910628 Sun, 24 May 2009 23:00:00 +0100 2910628 http://www.medworm.com/index.php?rid=2910627&cid=s_38549_31_f&fid=38549&url=http%3A%2F%2Fwww.thekneejournal.com%2Farticle%2FPIIS0968016009000775%2Fabstract%3Frss%3Dyes Abstract: The viability of unicondylar knee arthroplasty (UKA) as a stand-alone or temporising option for the management of gonarthrosis is a topic of considerable contention. Despite recent advances in prosthesis design and surgical technique, as well as mounting evidence of long-term survivorship, UKA remains infrequently used, accounting for just 8–15% of all knee arthroplasties. Instead this group is more typically managed using total knee arthroplasty (TKA). For UKA to warrant increased usage the candidacy for UKA must be prevalent, the outcome must be equivalent or superior to that of TKA, and the costs should be comparatively low. Here we address three issues regarding UKA: 1) a prospective assessment of the proportion of knees needing arthroplasty that are candidates for UKA; 2) ... The Knee journals http://www.medworm.com/rss/comments.php?id=2910627 Sun, 24 May 2009 23:00:00 +0100 2910627 http://www.medworm.com/index.php?rid=2910625&cid=s_38549_31_f&fid=38549&url=http%3A%2F%2Fwww.thekneejournal.com%2Farticle%2FPIIS0968016009000805%2Fabstract%3Frss%3Dyes Abstract: The kneeling view is a method to objectively measure posterior knee laxity. However, the actual amount of load applied and the reliability of this method in term of side to side difference are not known. We studies these issues in a group a 25 healthy volunteers who underwent measurements of posterior knee laxity in both knees. A standard digital scale was positioned under both kneeling supports to measure the actual amounts of posterior displacement forces applied. We measured the mass of the subject, the side-to-side difference of the weight applied into anterior aspect of the tibia, and the ratio weight of the subject/ amount of posterior displacement load applied. The average amount of forces applied was at least 75% of the body weight of each subject, with a side-to-side var... The Knee journals http://www.medworm.com/rss/comments.php?id=2910625 Sun, 24 May 2009 23:00:00 +0100 2910625 http://www.medworm.com/index.php?rid=2910621&cid=s_38549_31_f&fid=38549&url=http%3A%2F%2Fwww.thekneejournal.com%2Farticle%2FPIIS0968016009000829%2Fabstract%3Frss%3Dyes The objective of the present study was to investigate whether an examiner without specialist expertise in arthrosonography can achieve similar positive results and whether this technique is effective as a screening tool that can help reduce the number of undetected ACL injuries.After a short period of training, a single examiner prospectively measured anterior tibial translation by ultrasonography in the injured and healthy knees of 41 patients with acute knee trauma. An ACL rupture was presumed to be present if the side-to-side difference in tibial translation exceeded 1 mm (ΔD>1 mm). All patients who were enrolled in the study underwent arthroscopy or at least magnetic resonance imaging (MRI).Ultrasonography revealed the presence of an ACL lesion in 32 of 33 patients with arthroscopic... The Knee journals http://www.medworm.com/rss/comments.php?id=2910621 Sun, 24 May 2009 23:00:00 +0100 2910621 http://www.medworm.com/index.php?rid=2910620&cid=s_38549_31_f&fid=38549&url=http%3A%2F%2Fwww.thekneejournal.com%2Farticle%2FPIIS0968016009000751%2Fabstract%3Frss%3Dyes Abstract: While gender-based differences in knee joint anatomies/laxities are well documented, the potential for them to precipitate gender-dimorphic ACL loading and resultant injury risk has not been considered. To this end, we generated gender-specific models of ACL strain as a function of any six degrees of freedom (6DOF) knee joint load state via a combined cadaveric and analytical approach. Continuously varying joint forces and torques were applied to five male and five female cadaveric specimens and recorded along with synchronous knee flexion and ACL strain data. All data (~10,000 samples) were submitted to specimen-specific regression analyses, affording ACL strain predictions as a function of the combined 6 DOF knee loads. Following individual model verifications, generalized gend... The Knee journals http://www.medworm.com/rss/comments.php?id=2910620 Sun, 24 May 2009 23:00:00 +0100 2910620 http://www.medworm.com/index.php?rid=2910618&cid=s_38549_31_f&fid=38549&url=http%3A%2F%2Fwww.thekneejournal.com%2Farticle%2FPIIS0968016009000799%2Fabstract%3Frss%3Dyes Abstract: The benefits and risks of Simultaneous Bilateral Total Knee Replacement (SBTKR) remain controversial. A review of the English speaking literature was undertaken and found that many papers took staunch positions either for or against the procedure. It was also noted that earlier papers supporting SBTKR suggested cost benefits. There was a huge disparity in the incidence of mortality and morbidity and it was not possible to compare many papers, because in some medically frail patients were excluded from the SBTKR cohorts. In large published series the proportion of patients having a SBTKR varied between 3% and 70%. Many, but not all, series highlighted age and co-morbidity as risk factors. Overall there was no clear case for or against SBTKR. The evidence suggested that careful pre... The Knee journals http://www.medworm.com/rss/comments.php?id=2910618 Sun, 24 May 2009 23:00:00 +0100 2910618 http://www.medworm.com/index.php?rid=2910623&cid=s_38549_31_f&fid=38549&url=http%3A%2F%2Fwww.thekneejournal.com%2Farticle%2FPIIS0968016009000817%2Fabstract%3Frss%3Dyes Abstract: Clinical assessments after Total Knee Arthroplasty (TKA) show persisting pain after implantation in over 20% of patients. Impingement of soft tissue around the knee, due to imprecise geometry of the tibial implant, can be one reason for persisting ailment. Two hundred and thirty seven MRI scans were evaluated using an active contour detection algorithm (snake) to obtain a high-resolution mean anatomical shape of the tibial plateau. Differences between female and male, older and younger (≤40/>40) and left and right averaged shapes were determined. The shapes obtained were asymmetric throughout. Absolute differences between the subgroups fell short of inter-individual variations represented by calculated one-σ confidence intervals. Our results indicate that a differentiation in ... The Knee journals http://www.medworm.com/rss/comments.php?id=2910623 Thu, 21 May 2009 23:00:00 +0100 2910623 http://www.medworm.com/index.php?rid=2910632&cid=s_38549_31_f&fid=38549&url=http%3A%2F%2Fwww.thekneejournal.com%2Farticle%2FPIIS0968016009000726%2Fabstract%3Frss%3Dyes Abstract: We performed a retrospective chart and radiograph review of 10 patients with a history of poliomyelitis involving a limb that subsequently underwent primary total knee arthroplasty between 2000 and 2008. One posterior stabilized (PS), two condylar constrained (CCK), and seven rotating hinge (RHK) prostheses belonging to the same system were implanted. Eight patients were followed for a minimum of 2 years (mean 4.3 years, range 2 to 8.5 years); one patient required revision for prosthesis infection. The last patient was followed for just six months reporting excellent pain relief, and without complications.American Knee Society Score (AKSS) improved postoperatively in all eight patients with at least 2 years follow-up. The improvement was more marked for the knee score, which ... The Knee journals http://www.medworm.com/rss/comments.php?id=2910632 Thu, 14 May 2009 23:00:00 +0100 2910632 http://www.medworm.com/index.php?rid=2746807&cid=s_38549_31_f&fid=38549&url=http%3A%2F%2Fwww.thekneejournal.com%2Farticle%2FPIIS0968016009000283%2Fabstract%3Frss%3Dyes Abstract: Two cases of asymmetrical closure of the proximal tibial epiphysis without a clear aetiological factor were presented. In both cases premature closure of the growth plate resulted in progressive recurvatum and valgus deformity of the knee with leg length discrepancy. The correction of deformity was obtained using Taylor Spatial frame with excellent results at 2 years follow-up. We hypothesize that repetitive trauma or chronic overloading during sports activities might be a factor of growth arrest in reported cases. Orthopedic surgeons should be aware of the possibility of subtle physeal injuries, causing angular deformities, in the cases of even minor knee trauma in skeletally immature population. (Source: The Knee) The Knee journals http://www.medworm.com/rss/comments.php?id=2746807 Thu, 14 May 2009 23:00:00 +0100 2746807 http://www.medworm.com/index.php?rid=2910631&cid=s_38549_31_f&fid=38549&url=http%3A%2F%2Fwww.thekneejournal.com%2Farticle%2FPIIS0968016009000738%2Fabstract%3Frss%3Dyes Conclusion: For persons at high risk of knee arthroplasty, the two year incidence of knee arthroplasty is very low. The most powerful predictors were those that accounted for disease severity and functional loss. These data could assist physicians in advising patients with knee osteoarthritis on future surgical care. (Source: The Knee) The Knee journals http://www.medworm.com/rss/comments.php?id=2910631 Thu, 07 May 2009 23:00:00 +0100 2910631 http://www.medworm.com/index.php?rid=2910630&cid=s_38549_31_f&fid=38549&url=http%3A%2F%2Fwww.thekneejournal.com%2Farticle%2FPIIS0968016009000428%2Fabstract%3Frss%3Dyes Abstract: Infected Total Knee Replacement with significant bone loss and loss of extensor mechanism poses a difficult management problem. Arthrodesis relying on bony union can be difficult to achieve and can result in significant limb shortening. We retrospectively looked at the outcome of seven patients with significant bone loss and extensor mechanism insufficiency following infected TKR who underwent knee stabilisation using a modular cemented nail. The nail relied on the strong coupling mechanism between the modular femoral and tibial components. Pain score improved from a mean of 7.9 pre-operatively to 1.5 post-operatively at a mean follow up of 39.6 months (range 7–68) months. Two patients underwent technically easy revision nailing for recurrent infection and aseptic loosening. ... The Knee journals http://www.medworm.com/rss/comments.php?id=2910630 Thu, 07 May 2009 23:00:00 +0100 2910630 http://www.medworm.com/index.php?rid=2910622&cid=s_38549_31_f&fid=38549&url=http%3A%2F%2Fwww.thekneejournal.com%2Farticle%2FPIIS0968016009000714%2Fabstract%3Frss%3Dyes Abstract: Composite interference screws containing calcium phosphate for anterior cruciate ligament graft fixation could improve implant/bone integration and thereby reduced tunnelwidening and graft slippage. The present study investigated the effect of polylactate/hydroxyapatite interference screw (HA/PLLA) screw used for tibial graft fixation on tunnel widening and clinical outcomes compared with a metal interference screw. We hypothesized less tibial tunnelwidening with HA/PLLA screws compared to metal screws. Hundred patients with HA/PLLA screw tibial fixation was compared with 100 patients with metal screw tibial fixation. Tibial tunnel widening was measured on AP and lateral radiographs taken at 12 months follow-up. Clinical outcome was assessed by objective and subjective internati... The Knee journals http://www.medworm.com/rss/comments.php?id=2910622 Thu, 07 May 2009 23:00:00 +0100 2910622 http://www.medworm.com/index.php?rid=2910619&cid=s_38549_31_f&fid=38549&url=http%3A%2F%2Fwww.thekneejournal.com%2Farticle%2FPIIS0968016009000702%2Fabstract%3Frss%3Dyes Abstract: The purpose of this study was to evaluate whether any of the following factors are related to knee anterior laxity in healthy sportswomen: anthropometric characteristics, lower limb alignment characteristics, hormone-related factors and sport history. Six hundred and sixteen sportswomen were tested in the pre-season. The data have been analysed using linear regression for possible association of knee anterior laxity with other variables. Univariate linear regression indicated a positive association of knee anterior laxity with knee extension and navicular drop and a negative association with body height. Multivariate linear regression analysis showed statistically significant associations between knee anterior laxity and the combination of passive knee extension and the chosen sp... The Knee journals http://www.medworm.com/rss/comments.php?id=2910619 Thu, 07 May 2009 23:00:00 +0100 2910619 http://www.medworm.com/index.php?rid=2371851&cid=s_38549_31_f&fid=38549&url=http%3A%2F%2Fwww.thekneejournal.com%2Farticle%2FPIIS0968016009000544%2Fabstract%3Frss%3Dyes (Source: The Knee) The Knee journals http://www.medworm.com/rss/comments.php?id=2371851 Wed, 29 Apr 2009 03:41:51 +0100 2371851 http://www.medworm.com/index.php?rid=2371850&cid=s_38549_31_f&fid=38549&url=http%3A%2F%2Fwww.thekneejournal.com%2Farticle%2FPIIS0968016009000660%2Fabstract%3Frss%3Dyes (Source: The Knee) The Knee journals http://www.medworm.com/rss/comments.php?id=2371850 Wed, 29 Apr 2009 03:41:51 +0100 2371850 http://www.medworm.com/index.php?rid=2371849&cid=s_38549_31_f&fid=38549&url=http%3A%2F%2Fwww.thekneejournal.com%2Farticle%2FPIIS0968016009000532%2Fabstract%3Frss%3Dyes (Source: The Knee) The Knee journals http://www.medworm.com/rss/comments.php?id=2371849 Wed, 29 Apr 2009 03:41:51 +0100 2371849 http://www.medworm.com/index.php?rid=2371848&cid=s_38549_31_f&fid=38549&url=http%3A%2F%2Fwww.thekneejournal.com%2Farticle%2FPIIS0968016008002032%2Fabstract%3Frss%3Dyes We report a case in a 16 year old boy who underwent plication of the medial patellofemoral ligament, vastus medialis obliquus advancement and percutaneous lateral release, for recurrent instability. Interruption of the blood supply with subsequent avascular necrosis is one possible mechanism for this complication. Another more likely mechanism is that of failure of the repair and re-dislocation, which may have been contributed to by prolonged cast immobilization. (Source: The Knee) The Knee journals http://www.medworm.com/rss/comments.php?id=2371848 Wed, 29 Apr 2009 03:41:45 +0100 2371848 http://www.medworm.com/index.php?rid=2371847&cid=s_38549_31_f&fid=38549&url=http%3A%2F%2Fwww.thekneejournal.com%2Farticle%2FPIIS0968016008002196%2Fabstract%3Frss%3Dyes We present four cases of glomus tumors presenting as knee pain. All cases were treated by surgical excision of the tumor. All patients made an immediate recovery with return to full normal function.The presentation of this is unique in that the patient has exquisite pain and tenderness when the area affected is palpated. Occasionally, local infiltration or an ischaemia test can assist with diagnosis. To our knowledge, this is the largest case series in the literature. (Source: The Knee) The Knee journals http://www.medworm.com/rss/comments.php?id=2371847 Wed, 29 Apr 2009 03:41:42 +0100 2371847 http://www.medworm.com/index.php?rid=2371846&cid=s_38549_31_f&fid=38549&url=http%3A%2F%2Fwww.thekneejournal.com%2Farticle%2FPIIS0968016008002081%2Fabstract%3Frss%3Dyes In conclusion, our results suggest that the clinical method reported here provides a simple and reliable way of localizing the centre of the femoral head in knee arthroplasty. (Source: The Knee) The Knee journals http://www.medworm.com/rss/comments.php?id=2371846 Wed, 29 Apr 2009 03:41:32 +0100 2371846 http://www.medworm.com/index.php?rid=2371845&cid=s_38549_31_f&fid=38549&url=http%3A%2F%2Fwww.thekneejournal.com%2Farticle%2FPIIS0968016008002068%2Fabstract%3Frss%3Dyes Abstract: Mobile bearing (MB) total knee arthroplasty (TKA) was developed to provide low contact stress and unconstrained joint motion. We studied a consecutive series of 41 knees with mobile-bearing, posterior cruciate-retaining (CR) TKAs to determine if kinematics resembled normal knees or if kinematics changed over time. Patients were studied at 3 and 21 months average follow-up with weight-bearing radiographs at full extension, 30° flexion and maximum flexion. Shape-matching techniques were used to measure TKA kinematics. Implant hyperextension, maximum flexion and total ROM increased with follow-up. Tibial rotation and condylar translations did not change with time. The medial condyle did not translate from extension to 30°, but translated 5 mm anteriorly from 30° to maximum flex... The Knee journals http://www.medworm.com/rss/comments.php?id=2371845 Wed, 29 Apr 2009 03:41:31 +0100 2371845 http://www.medworm.com/index.php?rid=2371844&cid=s_38549_31_f&fid=38549&url=http%3A%2F%2Fwww.thekneejournal.com%2Farticle%2FPIIS0968016008002214%2Fabstract%3Frss%3Dyes Abstract: In a prospective single-centre longitudinal randomized controlled trial 116 patients were allocated to the sub-vastus approach, and 115 to the medial parapatellar approach. At one week follow-up, compared to baseline, range of motion, Knee Society (KS) global, KS knee, and KS pain scores were significantly better in the sub-vastus group. At the one year follow-up, WOMAC global and pain scores, SF36 physical function and role-physical scores, and EuroQol utility and pain score were significantly better in the sub-vastus group. The ease of exposure in the sub-vastus approach was significantly worse. There was no significant difference in length of stay or analgesia intake. The sub-vastus approach to total knee arthroplasty was more effective than a medial parapatellar approach at b... The Knee journals http://www.medworm.com/rss/comments.php?id=2371844 Wed, 29 Apr 2009 03:41:31 +0100 2371844 http://www.medworm.com/index.php?rid=2371843&cid=s_38549_31_f&fid=38549&url=http%3A%2F%2Fwww.thekneejournal.com%2Farticle%2FPIIS0968016008001993%2Fabstract%3Frss%3Dyes Abstract: Evaluation of a cemented biconvex inset patellar component used in revision knee arthroplasty at minimum five year follow-up was undertaken. Of the initial cohort of 89 knees in 85 patients, two patellar implants were revised for aseptic loosening following a transverse fracture of the patella associated with avascular necrosis. A further four implants were judged radiographically loose. Aseptic loosening of the implant was strongly correlated with the presence of avascular necrosis radiographically. Fracture of the patellar bone remnant was associated with a radiographically measured thickness of residual patellar bone of less than 6 mm. Survivorship of the implant using aseptic revision as the endpoint was 98% at 10 years and 86% at 14 years given one late failure. We conclu... The Knee journals http://www.medworm.com/rss/comments.php?id=2371843 Wed, 29 Apr 2009 03:41:30 +0100 2371843 http://www.medworm.com/index.php?rid=2371842&cid=s_38549_31_f&fid=38549&url=http%3A%2F%2Fwww.thekneejournal.com%2Farticle%2FPIIS0968016008002007%2Fabstract%3Frss%3Dyes Abstract: The correlation between radiographic and clinical outcome was investigated for total knee arthroplasty. One hundred three total knee arthroplasties in 98 patients were investigated at an average follow-up of 10.8 years (range, 2–17 years). For radiographic evaluation the Radiographic Evaluation System of the Knee Society was used. For assessment of clinical outcome four disease-specific scores, and the Nottingham Health Profile were applied. A significant correlation was found between the extent of radiolucent lines of the tibial component and the Nottingham Health Profile (correlation coefficient: 0.61, p (Source: The Knee) The Knee journals http://www.medworm.com/rss/comments.php?id=2371842 Wed, 29 Apr 2009 03:41:29 +0100 2371842 http://www.medworm.com/index.php?rid=2371841&cid=s_38549_31_f&fid=38549&url=http%3A%2F%2Fwww.thekneejournal.com%2Farticle%2FPIIS0968016008002044%2Fabstract%3Frss%3Dyes Abstract: The optimal mode of femoral fixation in total knee arthroplasty (TKA) remains controversial, especially for the young patient. In a prospective randomised study we compared the magnitude and pattern of the fixation of cemented versus uncemented femoral components during 2 years in patients younger than 60 years. Forty-one knees in 41 patients were randomised to receive a NexGen (Zimmer, Warsaw, USA) cruciate-retaining TKA with either a cemented or an uncemented non HA-coated femoral component. The patients were examined by radiostereometric analysis (RSA), as well as clinical and radiological evaluation. The magnitude and pattern of migration as measured by RSA did not differ significantly between the cemented and uncemented fixation during the 2-year follow-up, nor were there ... The Knee journals http://www.medworm.com/rss/comments.php?id=2371841 Wed, 29 Apr 2009 03:41:26 +0100 2371841 http://www.medworm.com/index.php?rid=2371840&cid=s_38549_31_f&fid=38549&url=http%3A%2F%2Fwww.thekneejournal.com%2Farticle%2FPIIS0968016008002020%2Fabstract%3Frss%3Dyes This study's aim was to assess the effect of component mal-alignment on outcome of Oxford Unicompartmental Knee Replacement (UKR). Two hundred and eleven knees implanted with a medial UKR, using a minimally invasive approach, were followed up at a minimum of 4 years. Sagittal and frontal plane femoral and tibial component alignments were determined from antero-posterior and lateral radiographs. The cohort was divided into alignment groups which represented consecutive 2.5° intervals over the range of measured values for femoral varus/valgus, femoral flexion/extension, tibial varus/valgus and tibial tilt. The Oxford Knee Score (OKS) and incidence of radiolucency (RL) were compared between alignment groups for each alignment parameter. In 98% of cases the femoral components were positioned ... The Knee journals http://www.medworm.com/rss/comments.php?id=2371840 Wed, 29 Apr 2009 03:41:25 +0100 2371840 http://www.medworm.com/index.php?rid=2371839&cid=s_38549_31_f&fid=38549&url=http%3A%2F%2Fwww.thekneejournal.com%2Farticle%2FPIIS0968016008001981%2Fabstract%3Frss%3Dyes Abstract: The aim of this study was to compare real time spatial compound ultrasound (RTCS) and conventional ultrasound with MRI in the evaluation of meniscal injuries. Thirty five patients with clinical suspicion of meniscal injury underwent ultrasound of knee alternating between conventional and compound sonography followed by MRI of the knee on a 1.5 T MR system. The images were compared for their quality and ability to detect meniscal tear. Compound ultrasound significantly improved definition of soft tissue planes, reduced speckle and other noise, improved contrast resolution (p value (Source: The Knee) The Knee journals http://www.medworm.com/rss/comments.php?id=2371839 Wed, 29 Apr 2009 03:41:24 +0100 2371839 http://www.medworm.com/index.php?rid=2371838&cid=s_38549_31_f&fid=38549&url=http%3A%2F%2Fwww.thekneejournal.com%2Farticle%2FPIIS096801600800207X%2Fabstract%3Frss%3Dyes This study examined the prevalence of degenerative changes of knee menisci in aging and evaluated the diagnostic values of magnetic resonance (MR) imaging for assessing meniscal pathology in an older population. Eighty-five knees of asymptomatic volunteers over the age of 40 were scanned using MR imaging. Meniscal abnormalities were graded from 0 to 3 according to intrameniscal MR signals. The subjects were divided into two groups based on the presence or absence of radiographic osteoarthritis. Group I included 43 knees that had normal radiographs and group II consisted of 42 knees that had radiographic evidence of osteoarthritis. Degenerative changes in the menisci involved primarily the posterior segment of the medial meniscus in both groups. Signal changes in the other segments were of ... The Knee journals http://www.medworm.com/rss/comments.php?id=2371838 Wed, 29 Apr 2009 03:41:23 +0100 2371838 http://www.medworm.com/index.php?rid=2371837&cid=s_38549_31_f&fid=38549&url=http%3A%2F%2Fwww.thekneejournal.com%2Farticle%2FPIIS0968016008002056%2Fabstract%3Frss%3Dyes Abstract: The purpose of this study was to determine whether the type of hamstring tendon harvester used can influence harvested tendon characteristics and soft tissue disruption. We compared two different types of tendon harvesters with regard to the length of tendon obtained and soft tissue disruption during hamstring tendon harvesting. Thirty six semitendinosus and gracilis tendons were harvested using either a closed stripper or a blade harvester in 18 paired knees from nine human fresh cadavers. Use of the blade harvester gave longer lengths of usable tendon whilst minimising the stripping of muscle and of any non-usable tendon. Our results suggest that the type of harvester per se can influence the length of tendon harvested as well as soft tissue disruption. Requesting such data fro... The Knee journals http://www.medworm.com/rss/comments.php?id=2371837 Wed, 29 Apr 2009 03:41:20 +0100 2371837 http://www.medworm.com/index.php?rid=2371836&cid=s_38549_31_f&fid=38549&url=http%3A%2F%2Fwww.thekneejournal.com%2Farticle%2FPIIS0968016008002202%2Fabstract%3Frss%3Dyes Abstract: The forward lunge movement may be used as a functional performance test of anterior cruciate ligament (ACL) deficient and reconstructed subjects. The purposes were 1) to determine the test–retest reliability of a forward lunge in healthy subjects and 2) to determine the required numbers of repetitions necessary to yield satisfactory reliability. Nineteen healthy subjects performed four trials of a forward lunge on two different days. The movement time, impulses of the ground reaction forces (IFz, IFy), knee joint kinematics and dynamics during the forward lunge were calculated. The relative reliability was determined by calculation of Intraclass Correlation Coefficients (ICC). The IFz, IFy and the positive work of the knee extensors showed excellent reliability (ICC >0.75). All... The Knee journals http://www.medworm.com/rss/comments.php?id=2371836 Wed, 29 Apr 2009 03:41:18 +0100 2371836 http://www.medworm.com/index.php?rid=2371835&cid=s_38549_31_f&fid=38549&url=http%3A%2F%2Fwww.thekneejournal.com%2Farticle%2FPIIS0968016008001701%2Fabstract%3Frss%3Dyes Abstract: Physical therapy is common following a knee surgery. With rising healthcare costs there is debate as to the appropriateness of outpatient physical therapy following such interventions. Many of the existing controlled trials have concluded that there is no benefit to subjects that receive supervised physical therapy when compared to subjects that perform their exercises at home. The purpose of this systematic review was to consider the existing evidence regarding benefit following knee surgery and evaluate the quality, internal and external validity of such evidence. Ten studies, all randomized control trials, were found to be applicable to our review. Using the PEDro scale all studies were considered at least moderate in quality. Many of the studies had designs that biased the ho... The Knee journals http://www.medworm.com/rss/comments.php?id=2371835 Wed, 29 Apr 2009 03:41:16 +0100 2371835 http://www.medworm.com/index.php?rid=2371834&cid=s_38549_31_f&fid=38549&url=http%3A%2F%2Fwww.thekneejournal.com%2Farticle%2FPIIS0968016009000635%2Fabstract%3Frss%3Dyes (Source: The Knee) The Knee journals http://www.medworm.com/rss/comments.php?id=2371834 Wed, 29 Apr 2009 03:41:16 +0100 2371834 http://www.medworm.com/index.php?rid=2371833&cid=s_38549_31_f&fid=38549&url=http%3A%2F%2Fwww.thekneejournal.com%2Farticle%2FPIIS0968016009000520%2Fabstract%3Frss%3Dyes (Source: The Knee) The Knee journals http://www.medworm.com/rss/comments.php?id=2371833 Wed, 29 Apr 2009 03:41:16 +0100 2371833 http://www.medworm.com/index.php?rid=2371832&cid=s_38549_31_f&fid=38549&url=http%3A%2F%2Fwww.thekneejournal.com%2Farticle%2FPIIS0968016009000519%2Fabstract%3Frss%3Dyes (Source: The Knee) The Knee journals http://www.medworm.com/rss/comments.php?id=2371832 Wed, 29 Apr 2009 03:41:15 +0100 2371832 http://www.medworm.com/index.php?rid=2910634&cid=s_38549_31_f&fid=38549&url=http%3A%2F%2Fwww.thekneejournal.com%2Farticle%2FPIIS0968016009000416%2Fabstract%3Frss%3Dyes We report a first documented case of Serratia fonticola infection in a child with septic arthritis, after falling off his bicycle and an infection with hawthorn thorns. The aetiologic agent was found to be a S. fonticola strain which was first isolated from two synovial fluid samples, only after culture enrichment, with failure of DNA amplification. Accurate diagnostic was done, despite S. fonticola is often considered as an opportunistic pathogenic bacterium. Alone ciprofloxacin treatment was not sufficient to counteract the infection, which was eradicated only after surgical drainage performed twice successively, with secondary removal of a remaining thorn, and treatment with third generation cephalosporin combined with ciprofloxacin for another three months. (Source: The Knee) The Knee journals http://www.medworm.com/rss/comments.php?id=2910634 Tue, 28 Apr 2009 23:00:00 +0100 2910634 http://www.medworm.com/index.php?rid=2746790&cid=s_38549_31_f&fid=38549&url=http%3A%2F%2Fwww.thekneejournal.com%2Farticle%2FPIIS0968016009000386%2Fabstract%3Frss%3Dyes Abstract: The St. Leger total knee replacement (Zynergy Orthopaedics Ltd, Rotherham, UK) was developed as a cheaper alternative to similar implants of its time. Between October 1993 and June 1999, 144 St. Leger total knee replacements were implanted into 114 patients. Seventy-three patients (99 knees) were recalled for assessment (mean follow-up of 10.2 years). Eighteen patients had had their prostheses revised, 11 had died and 12 were lost to follow-up. Functional Score showed 90% poor results and the Objective Knee Score showed 31% poor results. Radiological assessment identified 12 arthroplasties that had failed and 58 that required close follow. Kaplan–Meier cumulative survivorship was 87% at 10 years. The St. Leger knee replacement did not perform as well as others of the same gen... The Knee journals http://www.medworm.com/rss/comments.php?id=2746790 Sun, 19 Apr 2009 23:00:00 +0100 2746790 http://www.medworm.com/index.php?rid=2910626&cid=s_38549_31_f&fid=38549&url=http%3A%2F%2Fwww.thekneejournal.com%2Farticle%2FPIIS0968016009000465%2Fabstract%3Frss%3Dyes Abstract: Evaluation of gait performance and muscle activity patterns as well as clinical efficacy and safety after intraarticular injections with hyaluronan (Ostenil) compared with triamcinolone (Volon A10) injections in patients with knee osteoarthritis.This was a prospective, randomised, double-blind clinical trial evaluating the influence of five injections of hyaluronan or triamcinolone on gait pattern and muscle activity. For the clinical evaluation visual analogue scale, Lequesne index, and Knee Society Score were used. Quality of life was estimated with the SF-36.The definitive analysis was performed on the population who received all five injections and were examined in the two follow-up visits. Fifteen patients were treated with triamcinolone and 20 with hyaluronan. Significant i... The Knee journals http://www.medworm.com/rss/comments.php?id=2910626 Sun, 12 Apr 2009 23:00:00 +0100 2910626 http://www.medworm.com/index.php?rid=2910624&cid=s_38549_31_f&fid=38549&url=http%3A%2F%2Fwww.thekneejournal.com%2Farticle%2FPIIS0968016009000441%2Fabstract%3Frss%3Dyes This study determines if osteochondral harvest technique (arthroscopic versus mini-open) or donor site location affects suitable graft harvest. One hundred and twenty eight osteochondral grafts were harvested in 16 cadaver knees utilizing a 7 mm OATS chisel from four donor sites: lateral supracondylar ridge, lateral femoral condyle, lateral intercondylar notch and medial femoral condyle. Mini-open and arthroscopic harvesting techniques were equally employed. Radiographic methods were used to analyze graft perpendicularity. Statistical analysis comparing graft suitability based on technique and donor site location was performed. There were no statistically significant differences (p>0.05) in graft suitability regardless of the technique used or donor site location. 69% of arthroscopic and ... The Knee journals http://www.medworm.com/rss/comments.php?id=2910624 Thu, 09 Apr 2009 23:00:00 +0100 2910624 http://www.medworm.com/index.php?rid=2746791&cid=s_38549_31_f&fid=38549&url=http%3A%2F%2Fwww.thekneejournal.com%2Farticle%2FPIIS0968016009000404%2Fabstract%3Frss%3Dyes We report on 15 patients (15 knees) followed at a mean of 5.4 years (33–115 months) who underwent revision total knee replacement for severe tibial bone loss using shaped femoral head allograft and Freeman–Samuelson revision components (Zimmer, Winterthur, Switzerland). The mean American Knee Society Score pre-operatively was 22.7 points (0–45) increasing to a mean of 77.2 points (15–95) after operation. The survivorship for the series at 6 years was seven out of nine knees. One patient required an above knee amputation at 3.5 years, whilst another underwent a second revision TKR procedure at 3.4 years. Thirteen knees did not require further surgery and showed a mean time for allograft incorporation of 1.9 years (12–36 months) with no component migration.Severe tibial bone... The Knee journals http://www.medworm.com/rss/comments.php?id=2746791 Tue, 07 Apr 2009 23:00:00 +0100 2746791 http://www.medworm.com/index.php?rid=2910629&cid=s_38549_31_f&fid=38549&url=http%3A%2F%2Fwww.thekneejournal.com%2Farticle%2FPIIS0968016009000453%2Fabstract%3Frss%3Dyes This study demonstrates satisfactory mid-term clinical results for this knee design. (Source: The Knee) The Knee journals http://www.medworm.com/rss/comments.php?id=2910629 Sun, 05 Apr 2009 23:00:00 +0100 2910629 http://www.medworm.com/index.php?rid=2910635&cid=s_38549_31_f&fid=38549&url=http%3A%2F%2Fwww.thekneejournal.com%2Farticle%2FPIIS096801600900043X%2Fabstract%3Frss%3Dyes We report on a glomus tumour causing pain on the anterolateral aspect of the knee, 2 years after an otherwise successful total knee replacement for osteoarthritis. The tumour was treated by excision biopsy under general anaesthesia and the diagnosis confirmed by histopathological examination. The removal of the tumour relieved the pain and the patient regained good function. We conclude that a thorough clinical assessment of a patient with a painful knee following TKR is essential to detect and treat coincidental painful pathology. (Source: The Knee) The Knee journals http://www.medworm.com/rss/comments.php?id=2910635 Mon, 30 Mar 2009 23:00:00 +0100 2910635 http://www.medworm.com/index.php?rid=2493567&cid=s_38549_31_f&fid=38549&url=http%3A%2F%2Fwww.thekneejournal.com%2Farticle%2FPIIS0968016008002342%2Fabstract%3Frss%3Dyes Abstract: Total knee replacements provide cost effective treatment for debilitating conditions such as osteoarthritis. Their long term performance is governed by ultra-high molecular weight polyethylene (UHMWPE) wear which produces wear debris leading to osteolysis and aseptic loosening of the implant. An oxidised zirconium alternative to cobalt chrome is being used to reduce wear debris formation in the younger patients.Two TKRs of cobalt chrome and two of zirconium oxide coated zirconium were tested in a six degrees of freedom of motion, Stanmore-Instron force controlled knee wear simulator over 4 million increased force cycles.Oxidised zirconium was demonstrated to be more scratch resistant than CoCr. Increases in Ra (mean average roughness) of 12-fold compared to 1.9 fold rise for ZrO... The Knee journals http://www.medworm.com/rss/comments.php?id=2493567 Thu, 26 Mar 2009 00:00:00 +0100 2493567 http://www.medworm.com/index.php?rid=2746786&cid=s_38549_31_f&fid=38549&url=http%3A%2F%2Fwww.thekneejournal.com%2Farticle%2FPIIS0968016008002408%2Fabstract%3Frss%3Dyes Conclusions: Biomechanical variables such as varus malalignment are associated with KAM and therefore may affect the disease process. These variables should be taken into considerations when developing therapeutic interventions for individuals suffering from knee OA. (Source: The Knee) The Knee journals http://www.medworm.com/rss/comments.php?id=2746786 Wed, 25 Mar 2009 00:00:00 +0100 2746786 http://www.medworm.com/index.php?rid=2493568&cid=s_38549_31_f&fid=38549&url=http%3A%2F%2Fwww.thekneejournal.com%2Farticle%2FPIIS0968016008002366%2Fabstract%3Frss%3Dyes Abstract: Restoration of lost bone support and joint stability are the primary challenges in revision total knee arthroplasty (TKA). Normally, the defects type 2B and type 3 are associated with several damaged metaphyseal bone and loss of cortical bone. Structural allografts have been used for the treatment of large, contained, or uncontained osseous defect in revision TKA. Disadvantages of using structural allografts include late resorption or nonunion and risk of disease transmission. Alone, the structural allograft can not provide the initial support for revision implants. In these cases the stems are frequently used to provide the necessary load sharing and increase initial component stability. When evaluating whether stems should be cemented or press-fit, there isn't a simple answer, ... The Knee journals http://www.medworm.com/rss/comments.php?id=2493568 Fri, 20 Mar 2009 00:00:00 +0100 2493568 http://www.medworm.com/index.php?rid=2493569&cid=s_38549_31_f&fid=38549&url=http%3A%2F%2Fwww.thekneejournal.com%2Farticle%2FPIIS096801600800241X%2Fabstract%3Frss%3Dyes This study revealed that intra-articular cocktail analgesic injection reduced the need for morphine and offered a better pain control, without apparent risks following TKA. (Source: The Knee) The Knee journals http://www.medworm.com/rss/comments.php?id=2493569 Thu, 19 Mar 2009 00:00:00 +0100 2493569 http://www.medworm.com/index.php?rid=2493570&cid=s_38549_31_f&fid=38549&url=http%3A%2F%2Fwww.thekneejournal.com%2Farticle%2FPIIS0968016008002378%2Fabstract%3Frss%3Dyes Abstract: Efforts to use growth factors to enhance the healing potential of the meniscus have been impeded because their half-lives are too short to maintain the biological activity. The thread was coated with gelatin hydrogel and fibroblast growth factor 2 (FGF 2) was biologically stabilized by incorporating in a gelatin hydrogel-coated thread. The purpose of this study is to investigate the effect of gelatin hydrogel-coated thread incorporating FGF 2 on human meniscal cells in an organ culture. Twenty-five menisci were cut into small pieces, and selected pieces were sutured with gelatin hydrogel-coated thread incorporating FGF 2 (FGF(+) group) or physiologic saline (FGF(−) group), followed by organ culture. The meniscal samples histologically evaluated 4, 7, and 14 days later. The cel... The Knee journals http://www.medworm.com/rss/comments.php?id=2493570 Wed, 18 Mar 2009 00:00:00 +0100 2493570 http://www.medworm.com/index.php?rid=2746800&cid=s_38549_31_f&fid=38549&url=http%3A%2F%2Fwww.thekneejournal.com%2Farticle%2FPIIS0968016009000350%2Fabstract%3Frss%3Dyes Abstract: An electromyographical analysis (EMG) of knee muscle activation patterns and time delays has rarely been discussed in the literature. The purpose of this study was to compare the activation time and EMG amplitude of the dominant vastus medialis and medial hamstring muscles during stair climbing. Fifteen male and 18 female subjects participated in this study. The subjects were asked to ascend and descend 14 steps, five times. There was a significant time delay difference between genders during stair climbing (F=8.37, p=0.008). The female subjects demonstrated longer time delays while descending the steps. In addition, the female subjects demonstrated significantly lower normalized EMG amplitude during down stair climbing (F=5.77, p=0.025) while the male subjects demonstrated highe... The Knee journals http://www.medworm.com/rss/comments.php?id=2746800 Mon, 16 Mar 2009 00:00:00 +0100 2746800 http://www.medworm.com/index.php?rid=2746805&cid=s_38549_31_f&fid=38549&url=http%3A%2F%2Fwww.thekneejournal.com%2Farticle%2FPIIS0968016009000398%2Fabstract%3Frss%3Dyes In conclusion clinicians and therapists should emphasise restoration of post-surgical range of motion and strength in order to enhance functional recovery. (Source: The Knee) The Knee journals http://www.medworm.com/rss/comments.php?id=2746805 Mon, 09 Mar 2009 00:00:00 +0100 2746805 http://www.medworm.com/index.php?rid=2746804&cid=s_38549_31_f&fid=38549&url=http%3A%2F%2Fwww.thekneejournal.com%2Farticle%2FPIIS0968016009000362%2Fabstract%3Frss%3Dyes This study has assessed the relative proportions of type I and II collagens and IIA procollagen in full depth biopsies of repair tissue in a large sample of patients treated with autologous chondrocyte implantation (ACI). Sixty five full depth biopsies were obtained from knees of 58 patients 8–60 months after treatment by ACI alone (n=55) or in combination with mosaicplasty (n=10). In addition articular cartilage was examined from eight individuals (aged 10–50) as controls. Morphology and semi-quantitative immunohistochemistry for collagen types I and II and procollagen IIA in the repair tissue were studied. Repair cartilage thickness was 2.89±1.5 mm and there was good basal integration between the repair cartilage, calcified cartilage and subchondral bone. Sixty five percent of the... The Knee journals http://www.medworm.com/rss/comments.php?id=2746804 Mon, 09 Mar 2009 00:00:00 +0100 2746804 http://www.medworm.com/index.php?rid=2746795&cid=s_38549_31_f&fid=38549&url=http%3A%2F%2Fwww.thekneejournal.com%2Farticle%2FPIIS0968016009000337%2Fabstract%3Frss%3Dyes Abstract: The use of highly cross-linked polyethylene in total knee prostheses is still controversial. The aim of the present study was to compare radiographic and clinical results of using conventional and highly cross-linked polyethylene in cruciate retaining total knee prostheses of completely the same design. Two hundred and two consecutive total knee arthroplasties (NexGen CR, Zimmer) were performed using the same procedure. The first consecutive 113 knees had conventional polyethylene insert and following consecutive 89 knees had highly cross-linked polyethylene insert (Prolong, Zimmer). Differences in the age, gender, and diagnosis between two groups were not statistically significant. Preoperative range of motion (ROM) of the knee, and Knee Society Score (KSS) was better in highly ... The Knee journals http://www.medworm.com/rss/comments.php?id=2746795 Fri, 06 Mar 2009 00:00:00 +0100 2746795 http://www.medworm.com/index.php?rid=2746806&cid=s_38549_31_f&fid=38549&url=http%3A%2F%2Fwww.thekneejournal.com%2Farticle%2FPIIS0968016009000301%2Fabstract%3Frss%3Dyes We present the first case of late spontaneous dislocation of a high flexion polyethylene insert after Genesis II total knee arthroplasty. Dislocation of the fixed insert occurred at 14 months post surgery while walking down a steep aircraft staircase. The total knee arthroplasty had been uneventful till that moment. The clinical presentation, possible causes and management are discussed. A surgical error, failure to remove a posterior femoral osteophyte, seems the most probable cause for the late insert dislocation in our case. (Source: The Knee) The Knee journals http://www.medworm.com/rss/comments.php?id=2746806 Thu, 05 Mar 2009 00:00:00 +0100 2746806 http://www.medworm.com/index.php?rid=2746793&cid=s_38549_31_f&fid=38549&url=http%3A%2F%2Fwww.thekneejournal.com%2Farticle%2FPIIS0968016009000349%2Fabstract%3Frss%3Dyes Abstract: A “hot patella” is a bone scan finding of increased tracer uptake in the patella, greater than the ipsilateral distal femur or the proximal tibia. Increased patellar uptake on the bone scans is a relatively frequent finding; this is often not commented upon. The aim of our study was to define the incidence of a “hot patella” on bone scans following total knee replacements with ongoing symptoms unrelated to sepsis. We wanted to investigate the correlation between the adverse retropatellar symptomatology following total knee replacement with bone scan findings.We undertook a retrospective study of 55 symptomatic total knee replacement patients, who had bone scans. The incidence of a “hot patella” in patients without primary patellar resurfacing was 51% (28/55). Ninety-f... The Knee journals http://www.medworm.com/rss/comments.php?id=2746793 Tue, 03 Mar 2009 00:00:00 +0100 2746793 http://www.medworm.com/index.php?rid=2746801&cid=s_38549_31_f&fid=38549&url=http%3A%2F%2Fwww.thekneejournal.com%2Farticle%2FPIIS0968016009000374%2Fabstract%3Frss%3Dyes Abstract: Ground reaction forces (GRF), knee flexion angles, angular velocities and joint powers are unknown at large landing heights, which are infeasible for laboratory testing. However, this information is important for understanding lower extremity injury mechanisms. We sought to determine regression relationships of landing height with these parameters during landing so as to facilitate estimation of these parameters at large landing heights. Five healthy male subjects performed landing tasks from heights of 0.15–1.05 m onto a force-plate. Motion capture system was used to obtain knee flexion angles during landing via passive markers placed on the lower body. An iterative regression model, involving simple linear/exponential/natural logarithmic functions, was used to fit regression... The Knee journals http://www.medworm.com/rss/comments.php?id=2746801 Mon, 02 Mar 2009 00:00:00 +0100 2746801 http://www.medworm.com/index.php?rid=2746798&cid=s_38549_31_f&fid=38549&url=http%3A%2F%2Fwww.thekneejournal.com%2Farticle%2FPIIS0968016009000295%2Fabstract%3Frss%3Dyes The objective of this study was to evaluate the characteristics of a new fixation implant (Anthony-K plate - France Bloc S.A, CE n0499, ISO 9001, EN 46001), in terms of its clinical improvement, correction of the deformity, and slope alteration. Twenty adult patients with varus deformity were evaluated, and submitted to open wedge high tibial osteotomy using the Anthony plate, between October 2004 and November 2006. The varus deformity was corrected in all cases, and there was a significant increase in the Lysholm score. Correlation analysis has shown that the greater the preoperative varus deformity, the larger the opening wedge used. Also, the greater the initial posterior tibial slope, the larger the final posterior tibial slope (p=0.0168). There were no complications. The Anthony plate... The Knee journals http://www.medworm.com/rss/comments.php?id=2746798 Mon, 02 Mar 2009 00:00:00 +0100 2746798 http://www.medworm.com/index.php?rid=2361561&cid=s_38549_31_f&fid=38549&url=http%3A%2F%2Fwww.thekneejournal.com%2Farticle%2FPIIS096801600900009X%2Fabstract%3Frss%3Dyes (Source: The Knee) The Knee journals http://www.medworm.com/rss/comments.php?id=2361561 Sun, 01 Mar 2009 05:00:00 +0100 2361561 http://www.medworm.com/index.php?rid=2361560&cid=s_38549_31_f&fid=38549&url=http%3A%2F%2Fwww.thekneejournal.com%2Farticle%2FPIIS0968016009000088%2Fabstract%3Frss%3Dyes (Source: The Knee) The Knee journals http://www.medworm.com/rss/comments.php?id=2361560 Sun, 01 Mar 2009 05:00:00 +0100 2361560 http://www.medworm.com/index.php?rid=2361559&cid=s_38549_31_f&fid=38549&url=http%3A%2F%2Fwww.thekneejournal.com%2Farticle%2FPIIS096801600800224X%2Fabstract%3Frss%3Dyes The Publisher regrets that an unrelated ‘Conflict of interest’ section was included in the published version of this ‘Short communication’ paper. The section was included in error and should not be considered when reading the article. (Source: The Knee) The Knee journals http://www.medworm.com/rss/comments.php?id=2361559 Sun, 01 Mar 2009 05:00:00 +0100 2361559 http://www.medworm.com/index.php?rid=2361558&cid=s_38549_31_f&fid=38549&url=http%3A%2F%2Fwww.thekneejournal.com%2Farticle%2FPIIS0968016008001889%2Fabstract%3Frss%3Dyes Abstract: Positioning of the femoral tunnel is very important in ACL reconstruction and it is often recommended to use an anteromedial portal technique in order to create the tunnel. This technique is more demanding but it gives a surgeon more freedom to place the ACL graft in an anatomical position compared to the transtibial technique.A case of an intraarticular femoral guide breakage associated with this particular technique is presented. That being said, the aim of this paper is not only to present this rare complication following arthroscopic reconstruction of ACL, but also to indicate how to prevent, diagnose and treat this undesired event. (Source: The Knee) The Knee journals http://www.medworm.com/rss/comments.php?id=2361558 Sun, 01 Mar 2009 05:00:00 +0100 2361558 http://www.medworm.com/index.php?rid=2361557&cid=s_38549_31_f&fid=38549&url=http%3A%2F%2Fwww.thekneejournal.com%2Farticle%2FPIIS0968016008001786%2Fabstract%3Frss%3Dyes We report one case that had an incidental finding of HPOA with initial complaint about an incidental solitary knee mass with painful swelling of right knee, leading to early diagnosis of occult bronchogenic carcinoma. The radiographs and magnetic resonance imaging (MRI) revealed periosteal reactions without definite intraosseous lesion. Chest radiography and CT scan disclosed an infiltrating right upper lobe lesion suspicious malignancy. Patient received right S2 segmentectomy of lung with pathological confirmation of adenocarcinoma of lung cancer. It is important for the clinician to be aware of the radiographic findings of periostitis of HPOA, which may be the clues leading to early detection of lung cancer without significant pulmonary symptoms and to avoid possible tumor progression an... The Knee journals http://www.medworm.com/rss/comments.php?id=2361557 Sun, 01 Mar 2009 05:00:00 +0100 2361557 http://www.medworm.com/index.php?rid=2361556&cid=s_38549_31_f&fid=38549&url=http%3A%2F%2Fwww.thekneejournal.com%2Farticle%2FPIIS0968016008001907%2Fabstract%3Frss%3Dyes We report a case of osteochondritis dissecans (OCD) in a 4000 year old mummy from ancient Chile. This middle-age female specimen had characteristic bilateral medial femoral condyle erosions consistent with modern day presentations of OCD. The knee joints also demonstrated associated loose bodies of fairly similar dimensions and shape. OCD belongs to a group of disorders, the so-called osteochondroses, affecting the joints of the skeleton producing fragmentation, collapse, sclerosis as well as re-ossification and reconstitution of the articular surface. This case represents an interesting example of the natural history of untreated OCD and is also the earliest example of this thus far found in South America. (Source: The Knee) The Knee journals http://www.medworm.com/rss/comments.php?id=2361556 Sun, 01 Mar 2009 05:00:00 +0100 2361556 http://www.medworm.com/index.php?rid=2361555&cid=s_38549_31_f&fid=38549&url=http%3A%2F%2Fwww.thekneejournal.com%2Farticle%2FPIIS0968016008001956%2Fabstract%3Frss%3Dyes This study was designed to compare biomechanical characteristics of the knee joint for several athletic tasks to elucidate their effects and to examine what tasks pose a risk for ACL injury.Three athletic tasks were performed by 24 female athletes: single-limb landing, plant and cutting, and both-limb jump landing. Angular displacements of flexion/extension, abduction/adduction, and external/internal tibial rotation were calculated. Angular excursion and the rate of excursion of abduction and internal tibial rotation were also calculated.During plant and cutting, from foot contact, subjects rotated the tibia more rapidly and to a greater degree toward internal tibial rotation. Moreover, excursion of knee abduction is greater than that during single-limb landing. During both-limb jump landi... The Knee journals http://www.medworm.com/rss/comments.php?id=2361555 Sun, 01 Mar 2009 05:00:00 +0100 2361555 http://www.medworm.com/index.php?rid=2361554&cid=s_38549_31_f&fid=38549&url=http%3A%2F%2Fwww.thekneejournal.com%2Farticle%2FPIIS0968016008001877%2Fabstract%3Frss%3Dyes Abstract: ACL injury has been associated with a decrease in proprioceptive performance and specifically postural control. Tests of postural control have been criticised for not being sufficiently challenging. The Star Excursion Balance Test (SEBT) has been proposed to offer sufficient challenge to be a sensitive test for detecting performance deficits related to pathology. The purpose of this study was to determine if decrements SEBT reach distance is associated with ACL deficiency (ACLD). Twenty five ACLD patients ACLD (17 male and 8 female, mean age 30 (SD 4.5) years) and twenty five matched controls were examined carrying out the SEBT. Factorial ANOVA showed the main effects of limb (p=0.006) and direction (p (Source: The Knee) The Knee journals http://www.medworm.com/rss/comments.php?id=2361554 Sun, 01 Mar 2009 05:00:00 +0100 2361554 http://www.medworm.com/index.php?rid=2361553&cid=s_38549_31_f&fid=38549&url=http%3A%2F%2Fwww.thekneejournal.com%2Farticle%2FPIIS0968016008001932%2Fabstract%3Frss%3Dyes Abstract: We measured the location of the popliteal artery (PA) in extension and 90 degree of knee flexion by magnetic resonance images (MRI) to provide practical information to avoid PA injury. The MRIs of 30 knees of Korean male subject whose mean age was 20.7 were acquired in knee extension and 90 degree flexion. The distance from the posterior aspect of knee joint to the PA was measured at three levels on the axial images and one sagittal image. At the joint line level, the PA was located lateral to the PCL 2.4 mm in extension and 3.2 mm in flexion (p=0.247), and 3.9 mm in extension and 7.6 mm in flexion from the posterior capsule (p (Source: The Knee) The Knee journals http://www.medworm.com/rss/comments.php?id=2361553 Sun, 01 Mar 2009 05:00:00 +0100 2361553 http://www.medworm.com/index.php?rid=2361552&cid=s_38549_31_f&fid=38549&url=http%3A%2F%2Fwww.thekneejournal.com%2Farticle%2FPIIS0968016008001798%2Fabstract%3Frss%3Dyes Abstract: The purpose of the study was to examine the clinical efficacy of individually prescribed laterally wedged orthoses and walking shoes in the treatment of medial knee osteoarthritis using a prospective, single-blind, block-randomized controlled design.Sixty-six subjects (29 males, 37 females, mean age 62.4 years, mean BMI 33.0 kg/m2) were block-randomized to a lateral wedge (treatment) or neutral (control) orthotic group. Both groups were issued a standardized walking shoe for use with the orthoses. Primary outcome measures included the pain, stiffness, and functional limitations subscales of the Western Ontario and McMaster Universities index. Secondary outcome measures included the 6-minute walk distance and pain change, and stair negotiation time and pain change.A significant ... The Knee journals http://www.medworm.com/rss/comments.php?id=2361552 Sun, 01 Mar 2009 05:00:00 +0100 2361552 http://www.medworm.com/index.php?rid=2361551&cid=s_38549_31_f&fid=38549&url=http%3A%2F%2Fwww.thekneejournal.com%2Farticle%2FPIIS0968016008001968%2Fabstract%3Frss%3Dyes Abstract: Although many surgical modalities for spontaneous osteonecrosis of the knee (SONK) of the medial femoral condyle have been reported, few reports have described these treatment options from the etiological point of view. Recently, osteochondral autografting has gained popularity for use in small cartilage injuries. The aims of this study were to characterize the SONK lesion histopathologically and to report on preliminary clinical results of autogenous osteochondral grafting for SONK.Six patients with SONK of the medial femoral condyle underwent osteochondral autografting. Average age was 54.2 years (range, 50–57 years). Using Koshino's classification, three patients' lesions were classified as stage III and three as stage IV. Classical histological investigation of the lesion... The Knee journals http://www.medworm.com/rss/comments.php?id=2361551 Sun, 01 Mar 2009 05:00:00 +0100 2361551 http://www.medworm.com/index.php?rid=2361550&cid=s_38549_31_f&fid=38549&url=http%3A%2F%2Fwww.thekneejournal.com%2Farticle%2FPIIS0968016008001749%2Fabstract%3Frss%3Dyes Abstract: We compared the distance of patellar subluxation (lateral patellar displacement) during MIS TKA arthrotomy among sequential variations of tourniquet application and soft tissue release in a consecutive series of 40 knees. The distance of patellar subluxation from the Whiteside's line was measured for every knee under four consecutive conditions; A) the tourniquet inflated with knee in full extension, B) no tourniquet pressure applied, C) the tourniquet inflated with knee in deep flexion, and D) the tourniquet inflated with knee in deep flexion and lateral tibial release (a limited subperiosteal soft tissue dissection including limited patellar fat pad excision and limited capsular release from the upper lateral tibial plateau). There were 28 women and 12 men with the average age ... The Knee journals http://www.medworm.com/rss/comments.php?id=2361550 Sun, 01 Mar 2009 05:00:00 +0100 2361550 http://www.medworm.com/index.php?rid=2361549&cid=s_38549_31_f&fid=38549&url=http%3A%2F%2Fwww.thekneejournal.com%2Farticle%2FPIIS0968016008001750%2Fabstract%3Frss%3Dyes Abstract: The outcome of total knee arthroplasty (TKA) with severe pre-operative varus deformity is significantly worse than in well aligned knees. Computer navigated TKA has addressed some of the problems by ensuring accurate post-operative alignment. Our aims were to see if navigation could reproducibly correct a varus deformity to 3° of the mechanical axis and to investigate the relationships between the tourniquet time and severity of the preoperative deformity, BMI and a surgeon's experience.The 172 e.motion floating platform TKA's were implanted using the OrthoPilot® Navigation system (B Braun-Aesculap, Tuttlingen, Germany). Pre-operative deformity and post-operative alignment were measured by the software. Tourniquet times were recorded automatically.All knees were corrected to wi... The Knee journals http://www.medworm.com/rss/comments.php?id=2361549 Sun, 01 Mar 2009 05:00:00 +0100 2361549 http://www.medworm.com/index.php?rid=2361548&cid=s_38549_31_f&fid=38549&url=http%3A%2F%2Fwww.thekneejournal.com%2Farticle%2FPIIS0968016008001944%2Fabstract%3Frss%3Dyes This study analyzed three dimensional (3D) in vivo kinematic data from the squatting to standing position for 18 Japanese subjects (18 knees) implanted with either Legacy® Posterior Stabilized (LPS) Flex Fixed Bearing TKA or LPS Flex Mobile Bearing TKA. Under weight-bearing conditions, for all patients, the average roll-forward motions for the medial and lateral condyles were 4.0±3.6 mm and 6.3±3.4 mm, and the average external axial rotation was 3.1°±4.1°. For both groups, the weight-bearing range-of-motion (ROM) (110.7°±12.7°) was less than pre (127.2±15.5°) and post (135.6±5.4°) operative non-weight bearing ROM. As hypothesized, the incidence, average and maximum liftoff for the squatting to standing activity were much less than those of deep knee bend (DKB), and condylar ... The Knee journals http://www.medworm.com/rss/comments.php?id=2361548 Sun, 01 Mar 2009 05:00:00 +0100 2361548 http://www.medworm.com/index.php?rid=2361547&cid=s_38549_31_f&fid=38549&url=http%3A%2F%2Fwww.thekneejournal.com%2Farticle%2FPIIS0968016008001920%2Fabstract%3Frss%3Dyes Abstract: The purpose of the current study was to investigate inpatient recovery process during relaxed standing, and to clarify the question of when postoperative standing function would improve beyond preoperative level of function following total knee arthroplasty (TKA).Thirty patients with bilateral knee osteoarthritis, averaged 75 years old, participated. Subjects underwent unilateral TKA. Evaluations were divided into two categories; subjective and objective components. Subjective component was based on pain level (Visual Analog Scale: 100 mm), and objective component consisted of vertical knee force (%BW) and knee flexion angle (degrees) during relaxed standing. Data evaluations were done pre- and post-operatively.Preoperative pain score was 69.1. After TKA, pain level became maxi... The Knee journals http://www.medworm.com/rss/comments.php?id=2361547 Sun, 01 Mar 2009 05:00:00 +0100 2361547 http://www.medworm.com/index.php?rid=2361546&cid=s_38549_31_f&fid=38549&url=http%3A%2F%2Fwww.thekneejournal.com%2Farticle%2FPIIS0968016008001804%2Fabstract%3Frss%3Dyes Abstract: Surgical therapeutic procedures such as knee osteotomy and knee replacement depend on proper knee alignment assessment. The aim of this study was to evaluate if femorotibial (FT) measurement on short knee films may be used in clinical settings. The study population comprised 68 patients with symptomatic medial compartmental knee osteoarthritis. We measured the FT angle with the use of mid-diaphyseal lines (FTa), and the knee joint centre (FTb) to determine anatomical knee alignment on a short knee image. Then, the accuracy of alignment was compared to the gold standard Hip–Knee–Ankle (HKA) angle on a full-limb view. FTa angle assessment correlated well (r=0.65) with the HKA angle. However, this method showed poor inter-observer agreement (ICC=0.37). 3% of patients were incorr... The Knee journals http://www.medworm.com/rss/comments.php?id=2361546 Sun, 01 Mar 2009 05:00:00 +0100 2361546 http://www.medworm.com/index.php?rid=2361545&cid=s_38549_31_f&fid=38549&url=http%3A%2F%2Fwww.thekneejournal.com%2Farticle%2FPIIS0968016008001543%2Fabstract%3Frss%3Dyes Abstract: Improved wear resistance in total knee replacement (TKR) is a suitable goal. Whereas the use of metal components is well established, mechanical loosening in recently introduced ceramic components are a cause of concern. The scope of this work was to test in vitro whether ceramic TKR femoral components are more prone to mechanical loosening than metal ones. Composite femurs were implanted with commercially available TKR metal components, and with ceramic components having identical shape to the metal ones. Implanted femurs were tested on a knee simulator for up to 5×10–6 cycles. Inducible micromotions and permanent migrations were recorded throughout the test. The cement layers were inspected for signs of damage or fracture. Micromotions and migrations were similar for metal a... The Knee journals http://www.medworm.com/rss/comments.php?id=2361545 Sun, 01 Mar 2009 05:00:00 +0100 2361545 http://www.medworm.com/index.php?rid=2361544&cid=s_38549_31_f&fid=38549&url=http%3A%2F%2Fwww.thekneejournal.com%2Farticle%2FPIIS0968016008001919%2Fabstract%3Frss%3Dyes We present a series of five patients who underwent total knee replacement with spinal anaesthesia and FNB who fell, sustaining complete wound disruption — including a patient with peri-prosthetic fracture requiring further surgery and prolonged hospital stay.The literature, which is largely in anaesthetic journals, reflects the high quality of analgesia of FNB but makes little or no mention of the delays or dangers in early mobilization. We believe that the potential risks to orthopaedic patients are underestimated. (Source: The Knee) The Knee journals http://www.medworm.com/rss/comments.php?id=2361544 Sun, 01 Mar 2009 05:00:00 +0100 2361544 http://www.medworm.com/index.php?rid=2361543&cid=s_38549_31_f&fid=38549&url=http%3A%2F%2Fwww.thekneejournal.com%2Farticle%2FPIIS0968016008001488%2Fabstract%3Frss%3Dyes Abstract: Patellar issues need to be carefully addressed during any revision TKA and the surgeon often faces the question of what to do with the patella at the time of revision. The choice of treatment is often made by balancing what is technically feasible with the risk of potential complications and takes into account the reason for the revision, the type of implant (i.e., metal-backing or all-polyethylene), the duration of implantation, the fixation, the stability, the sterilization technique, the wear, the presence of osteolysis, the compatibility with the femoral component, and most importantly the remaining bone stock. The various treatment options then include retention of the patellar component, revision of the patellar component, removal of the component with retention of the pate... The Knee journals http://www.medworm.com/rss/comments.php?id=2361543 Sun, 01 Mar 2009 05:00:00 +0100 2361543 http://www.medworm.com/index.php?rid=2361542&cid=s_38549_31_f&fid=38549&url=http%3A%2F%2Fwww.thekneejournal.com%2Farticle%2FPIIS0968016008002354%2Fabstract%3Frss%3Dyes Computer assisted orthopaedic surgery has become an important innovation in total knee arthroplasty (TKA) with very good clinical results and more reproducible and reliable implant positioning . However there is additional useful data that is recorded during the surgical procedure that can be used to develop new ways in performing the replacement. In TKA one of the main goals is to obtain flexion/extension gap equivalence where the geometry of flexion and extension gaps are homothetic. The gaps are created by the bone cuts and any soft-tissue releases that are performed, with the sectioning occurring in a structured order. Both mechanical devices and navigation with a computer can be used as aids in achieving gap equivalence. It is essential to have an instrumentation system that can be us... The Knee journals http://www.medworm.com/rss/comments.php?id=2361542 Sun, 01 Mar 2009 05:00:00 +0100 2361542 http://www.medworm.com/index.php?rid=2361541&cid=s_38549_31_f&fid=38549&url=http%3A%2F%2Fwww.thekneejournal.com%2Farticle%2FPIIS0968016009000076%2Fabstract%3Frss%3Dyes (Source: The Knee) The Knee journals http://www.medworm.com/rss/comments.php?id=2361541 Sun, 01 Mar 2009 05:00:00 +0100 2361541 http://www.medworm.com/index.php?rid=2361540&cid=s_38549_31_f&fid=38549&url=http%3A%2F%2Fwww.thekneejournal.com%2Farticle%2FPIIS0968016009000064%2Fabstract%3Frss%3Dyes (Source: The Knee) The Knee journals http://www.medworm.com/rss/comments.php?id=2361540 Sun, 01 Mar 2009 05:00:00 +0100 2361540 http://www.medworm.com/index.php?rid=2746802&cid=s_38549_31_f&fid=38549&url=http%3A%2F%2Fwww.thekneejournal.com%2Farticle%2FPIIS0968016009000325%2Fabstract%3Frss%3Dyes This study was undertaken to ascertain whether proprioception, muscle strength, and knee laxity are correlated with dynamic standing balance in patients with ACL deficiency. Ten young men with unilateral ACL deficiency participated in this study. The mean time interval from the injury to the study was 12.8 months. Knee laxity measurements, passive re-positioning (PRP) and threshold for detection of passive motion (TTDPM) proprioception tests, quadriceps and hamstring muscle strength tests, and dynamic single-limb balance tests were performed for both injured and uninjured limbs. Significant differences between the injured and uninjured sides were observed for all test parameters. As independent variables, knee laxity, PRP proprioception, and muscle strength did not correlate with dynamic ... The Knee journals http://www.medworm.com/rss/comments.php?id=2746802 Tue, 24 Feb 2009 00:00:00 +0100 2746802 http://www.medworm.com/index.php?rid=2746789&cid=s_38549_31_f&fid=38549&url=http%3A%2F%2Fwww.thekneejournal.com%2Farticle%2FPIIS0968016009000313%2Fabstract%3Frss%3Dyes Abstract: The purpose was to compare the intra- and post-operative outcomes of tourniquet assisted to non-tourniquet-assisted surgery during arthroscopic knee procedures. A systematic review was undertaken of the electronic databases MEDLINE, CINAHL, AMED and EMBASE, in addition to a review of unpublished material and a hand search of pertinent orthopaedic journals. The evidence-base was critically appraised using the Cochrane Bone, Joint and Muscle Trauma Group quality assessment tool. Study heterogeneity was statistically measured using the Chi2 and I2 statistical tests. When appropriate, a random-effect meta-analysis was undertaken to pool the results of the primary studies assessing the mean difference of each outcome. Nine studies were identified evaluating seven outcome measures and ... The Knee journals http://www.medworm.com/rss/comments.php?id=2746789 Tue, 24 Feb 2009 00:00:00 +0100 2746789 http://www.medworm.com/index.php?rid=2746794&cid=s_38549_31_f&fid=38549&url=http%3A%2F%2Fwww.thekneejournal.com%2Farticle%2FPIIS0968016009000143%2Fabstract%3Frss%3Dyes Abstract: Anthropometric data on the proximal tibia and distal femur of 172 normal knees (94 male knees, 78 female knees) were obtained using three dimensional computer tomographic measurements. We measured the tibial mediolateral (tML) and tibial anteroposterior (tAP) dimension in resected proximal tibia surface, femoral mediolateral (fML) and femoral anteroposterior (fAP) dimension in resected distal femur surface. The measurements were compared with the similar dimensions of five total knee prostheses conventionally used in China. We found that in the smaller sized prostheses the tibial mediolateral dimension was undersized, while in the larger size prostheses the tibial mediolateral dimension was overhang. For all sizes of prostheses the femoral mediolateral dimension was overhang. We ... The Knee journals http://www.medworm.com/rss/comments.php?id=2746794 Mon, 23 Feb 2009 00:00:00 +0100 2746794 http://www.medworm.com/index.php?rid=2746799&cid=s_38549_31_f&fid=38549&url=http%3A%2F%2Fwww.thekneejournal.com%2Farticle%2FPIIS0968016009000271%2Fabstract%3Frss%3Dyes This study evaluated flexion angles and mechanical loads at the knee during weight-bearing deep flexion in patients with knee osteoarthritis (OA). Thirty-eight knees of 26 patients (mean age, 73 years; range, 58–81 years) with medial knee OA and 16 knees of 8 healthy volunteers (mean age, 63.4 years; range, 60–65 years) were enrolled. Patients were subdivided into two groups based on Kellgren and Lawrence OA grade: moderate OA (grade 2, 17 knees) or severe OA (grade 3 or 4, 21 knees). Motion analysis was performed while rising from maximal knee flexion with one leg for each subject. Maximum knee flexion angles and net quadriceps moments in the weight-bearing motion were compared among the two OA groups and healthy subjects. Mean maximum flexion angle in patients was 91±9°. Angles... The Knee journals http://www.medworm.com/rss/comments.php?id=2746799 Thu, 12 Feb 2009 00:00:00 +0100 2746799 http://www.medworm.com/index.php?rid=2746796&cid=s_38549_31_f&fid=38549&url=http%3A%2F%2Fwww.thekneejournal.com%2Farticle%2FPIIS0968016009000131%2Fabstract%3Frss%3Dyes In this study, a novel device was developed and validated to compare isometricity in the entire soft tissue envelope for both the intact and TKA knee.A spring-loaded rod was inserted in six cadaver knee joints between the tibial shaft and the tibial plateau or tibial tray after removing a 7 mm slice of bone. The displacement of the rod during passive flexion represented variation in tissue tension around the joint. The rod position in the intact knee remained within 1 mm of its initial position between 15° and 135° of flexion, and within 2 mm (±1.2 mm) throughout the entire range of motion (0–150°). After insertion of a mobile-bearing TKA, the rod was displaced a mean of 6 mm at 150° (p (Source: The Knee) The Knee journals http://www.medworm.com/rss/comments.php?id=2746796 Thu, 12 Feb 2009 00:00:00 +0100 2746796 http://www.medworm.com/index.php?rid=2746797&cid=s_38549_31_f&fid=38549&url=http%3A%2F%2Fwww.thekneejournal.com%2Farticle%2FPIIS096801600900012X%2Fabstract%3Frss%3Dyes This study demonstrates low intra- and inter-observer variability in the CT registration of landmarks that define the coordinate system of the femur and the tibia. In the femur, the horizontal plane projections of the posterior condylar line and the surgical and anatomical transepicondylar axis can be determined precisely on a CT scan, using the described methodology. In the tibia, the best result is obtained for the tibial transverse axis. (Source: The Knee) The Knee journals http://www.medworm.com/rss/comments.php?id=2746797 Fri, 06 Feb 2009 00:00:00 +0100 2746797 http://www.medworm.com/index.php?rid=2746788&cid=s_38549_31_f&fid=38549&url=http%3A%2F%2Fwww.thekneejournal.com%2Farticle%2FPIIS0968016008002470%2Fabstract%3Frss%3Dyes Abstract: Unicompartmental knee arthroplasty (UKA) has become a frequently used treatment option for anteromedial osteoarthritis (OA) of the knee due to good clinical and functional results. However, serious complications like tibial plateau fractures have been reported. These can be associated with saw cuts during surgery. The purpose of this study was to analyse saw cuts during Sawbone® preparations at instructional unicompartmental knee courses and to identify potential sources of surgical error. One hundred Sawbone® preparations were performed by knee surgeons inexperienced with UKA. Sawing errors during preparation were analysed and quantified. Tibial and femoral errors can occur during preparation. At the proximal tibia three errors can be found: extended vertical cuts (A), extende... The Knee journals http://www.medworm.com/rss/comments.php?id=2746788 Thu, 05 Feb 2009 00:00:00 +0100 2746788 http://www.medworm.com/index.php?rid=2746792&cid=s_38549_31_f&fid=38549&url=http%3A%2F%2Fwww.thekneejournal.com%2Farticle%2FPIIS0968016008002494%2Fabstract%3Frss%3Dyes Abstract: Simulated partial weight bearing during magnetic resonance imaging of the knee was used to measure patellar tilt, medial–lateral patellar shift, and patellofemoral contact area in three groups of subjects; patients with posterior cruciate retaining (PCR) TKA, patients with bicruciate substituting (BCS) TKA, and healthy controls. Contact stress was also calculated based on the contact area and body weight-based estimates of contact force. Contact stress was significantly (p0.05) in early flexion. The results also indicate that patellar tilt (normal=2.4°±4.8°, BCS=5.5°±5.5°, PCR=−3.0°±6.9° change in lateral tilt when moving from full extension to early flexion) and contact area (full extension: normal=267±111 mm2, BCS=344±201 mm2, PCR=83±80 mm2; early flexion: no... The Knee journals http://www.medworm.com/rss/comments.php?id=2746792 Tue, 03 Feb 2009 00:00:00 +0100 2746792 http://www.medworm.com/index.php?rid=2746787&cid=s_38549_31_f&fid=38549&url=http%3A%2F%2Fwww.thekneejournal.com%2Farticle%2FPIIS0968016008002500%2Fabstract%3Frss%3Dyes Abstract: As implants are made in incremental sizes and usually do not fit perfectly, surgeons have to decide if it is preferable to over or undersize the components. This is particularly important for unicompartmental knee replacement (UKR) tibial components, as overhang may cause irritation of soft tissues and pain, whereas underhang may cause loosening.One hundred and sixty Oxford UKRs were categorised according to whether they had minor ( (Source: The Knee) The Knee journals http://www.medworm.com/rss/comments.php?id=2746787 Tue, 03 Feb 2009 00:00:00 +0100 2746787 http://www.medworm.com/index.php?rid=2493561&cid=s_38549_31_f&fid=38549&url=http%3A%2F%2Fwww.thekneejournal.com%2Farticle%2FPIIS0968016008002469%2Fabstract%3Frss%3Dyes Abstract: We reviewed 100 patients retrospectively following primary ACL reconstruction with quadruple hamstring autografts to evaluate the incidence and factors associated with postoperative stiffness. Stiffness was defined as any loss of motion using the contra-lateral leg as a control. The median delay between injury and operation was 15 months.The incidence of stiffness was 12% at 6 months post-reconstruction. Both incomplete attendance at physiotherapy (p (Source: The Knee) The Knee journals http://www.medworm.com/rss/comments.php?id=2493561 Mon, 02 Feb 2009 00:00:00 +0100 2493561 http://www.medworm.com/index.php?rid=2746803&cid=s_38549_31_f&fid=38549&url=http%3A%2F%2Fwww.thekneejournal.com%2Farticle%2FPIIS0968016008002482%2Fabstract%3Frss%3Dyes This study shows that using MBCP® wedges in combination with orientable locking screws and a plate is a simple, safe and fast surgical technique for HTVO. The is the first study to examine the results by histological analysis, which confirmed good outcomes. (Source: The Knee) The Knee journals http://www.medworm.com/rss/comments.php?id=2746803 Fri, 30 Jan 2009 00:00:00 +0100 2746803 http://www.medworm.com/index.php?rid=2493562&cid=s_38549_31_f&fid=38549&url=http%3A%2F%2Fwww.thekneejournal.com%2Farticle%2FPIIS0968016008002457%2Fabstract%3Frss%3Dyes This study seeks to address whether there is a relationship between the clinical findings and degeneration of the PTFJ in knees with severe tibiofemoral primary osteoarthritis. Sixty knees in 34 consecutive patients (31 females and 3 males; mean age 71 years; range 61–86 years) with Kellgren–Lawrence grades III–IV primary femorotibial arthritis were enrolled in this study in order to collect clinical data regarding the PTFJ. Radiographs showed 23 PTFJs were grade IV, 14 were grade III, and 23 were grade II. With regard to the type of PTFJ, 13 joints were horizontal and 47 were oblique. Pain and tenderness were observed in 13 PTFJs upon clinical exam (two horizontal and 11 oblique PTFJ types; grade II in five, grade III in two, and grade IV in six). Lateral hamstring tightness was f... The Knee journals http://www.medworm.com/rss/comments.php?id=2493562 Fri, 30 Jan 2009 00:00:00 +0100 2493562 http://www.medworm.com/index.php?rid=2493572&cid=s_38549_31_f&fid=38549&url=http%3A%2F%2Fwww.thekneejournal.com%2Farticle%2FPIIS0968016008002330%2Fabstract%3Frss%3Dyes We present a patient with a Type IIIb periprosthetic patellar fracture treated by a novel approach. Three Steinmann pins were used to reduce the patella and form scaffold for bone graft and a patellar button was cemented into the construct. At 7 years followup, the patient has maintained excellent range of motion, reports no knee pain, has healed the patella fracture, and has restored patellar bone stock. (Source: The Knee) The Knee journals http://www.medworm.com/rss/comments.php?id=2493572 Wed, 28 Jan 2009 00:00:00 +0100 2493572 http://www.medworm.com/index.php?rid=2493563&cid=s_38549_31_f&fid=38549&url=http%3A%2F%2Fwww.thekneejournal.com%2Farticle%2FPIIS0968016008002251%2Fabstract%3Frss%3Dyes In this study we evaluated the total amount of posterior displacement (PTD) and side to side difference (SSD), before and after surgical reconstruction of PCL or PCL and posterolateral complex (PLC), using two different stress radiography techniques (Telos stress and kneeling view). Twenty patients were included in this study. We found a statistical significant difference about both total PTD and SSD among the two techniques preoperatively and at follow-up, with greatest values occurring using the kneeling view. Although stress radiographies has been introduced to allow an objective quantification of laxity in ligamentous injured knee, we believe that further studies on a large numbers of subjects are required to define the relationship between PTD values, measured with stress knee radiogr... The Knee journals http://www.medworm.com/rss/comments.php?id=2493563 Tue, 27 Jan 2009 00:00:00 +0100 2493563