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Cureus 2022 Apr 12;14(4):e24091. Epub 2022 Apr 12.

Orthopedic Surgery, King Fahad Specialist Hospital, Dammam, SAU.

Rotating hinged knee replacements are used to restore knee stability when intrinsic stability is lost in the form of soft tissue compression. With medical engineering advancements and improvements in arthroplasty, intrinsic stability can be achieved by an implant post system. We present the case of a 44-year-old female who presented with post-traumatic right knee multi-ligamentous instability and advanced secondary osteoarthritis following a traumatic knee dislocation two years ago. Read More

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2022 May;36(5):573-581

Department of Sports Medicine, First Affiliated Hospital of Kunming Medical University, Kunming Yunnan, 650032, P. R. China.

Objective: To establish a three-dimensional finite element analysis model of the knee joint in fresh frozen cadavers, to verify the validity of the model and to simulate the stress distribution characteristics of the patellofemoral joint after combined proximal and distal knee extension rearrangement surgery for recurrent patellar dislocation.

Methods: One male and one female fresh frozen cadavers (4 knees in total), using voluntary body donations, were used to measure the maximum pressure on the patellofemoral articular surface at each passive flexion angle (0°, 30°, 60°, 90°, 120°) of the normal knee joint and the model after combined proximal and distal knee extension rearrangement surgery for recurrent patellar dislocation with tibial tuberosity-trochlear groove distance (TT-TG) value >2.00 cm using pressure-sensitive paper, respectively. Read More

J Orthop Surg Res 2022 May 15;17(1):276. Epub 2022 May 15.

Department of Orthopaedic Surgery, Third Hospital of Hebei Medical University, Ziqiang Road 139, Shijiazhuang, 050051, Hebei, China.

Purpose: To investigate the difference of trochlear width between normal and dysplastic trochlear and to analyze whether the medialization of trochlear groove was correlated with abnormal width of trochlear facets in trochlear dysplasia.

Methods: This study involved CT scans of fifty knees with trochlear dysplasia (TD group) and fifty knees without obvious trochlear dysplasia (Normal group). The linear distance from the medial femoral epicondyle to the various reference points was measured on axial CT images which included the medial edge of medial trochlear facet (dMTE), trochlear groove (dTG), and the lateral edge of lateral trochlear facets (dLTE). Read More

Eur J Med Genet 2022 May 11;65(6):104521. Epub 2022 May 11.

Department of Medical Genetics, Antwerp University Hospital and University of Antwerp, Antwerp, Belgium; Current affiliation: Center for Human Genetics, University Hospitals Leuven and KU Leuven, Leuven, Belgium. Electronic address:

Steel syndrome (MIM# 615155) is an autosomal recessive skeletal disorder, characterized by dislocations of the hips and radial heads, carpal coalition, short stature, facial dysmorphism, and scoliosis. Until date 47 patients have been reported. However, disease causing variants have been identified only in twenty Puerto Rican and nine non-Puerto Rican families. Read More

Korean J Radiol 2022 May 9. Epub 2022 May 9.

Devision of Pediatric Orthopedic Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.

Patellofemoral instability (PFI) is common in pediatric knee injuries. PFI results from loss of balance in the dynamic relationship of the patella in the femoral trochlear groove. Patellar lateral dislocation, which is at the extreme of the PFI, results from medial stabilizer injury and leads to the patella hitting the lateral femoral condyle. Read More

Arch Orthop Trauma Surg 2022 May 12. Epub 2022 May 12.

Klinik Für Orthopädie Und Unfallchirurgie Klinikum, Buger Straße 80, 96049, Bamberg, Germany.

Introduction: A 'inwardly pointing knee' syndrome is a combined torsional deformity with increased femoral internal and tibial external torsion. After clinical and radiological verification of the torsional deformity and unsuccessful conservative therapy approach, a combined (double level) torsional osteotomy of femur and tibia might be the appropriate treatment. Here, we present the diagnostic algorithms, treatment, and outcome of combined torsional osteotomies of femur and tibia. Read More

Front Bioeng Biotechnol 2022 25;10:861788. Epub 2022 Apr 25.

Department of Orthopedic Surgery, The Second Affiliated Hospital of Nantong University, Nantong, China.

Irreducible knee dislocation (IKD) is a very rare but serious type of knee dislocation; it can lead to soft tissue necrosis due to incarceration of the medial structures and faces great difficulty in the postoperative rehabilitation, too. IKD needs careful pre-operative planning. There is no universal agreement about the appropriate surgical strategy for IKD. Read More

J ISAKOS 2022 Feb 5;7(1):35-38. Epub 2021 Oct 5.

Department of Orthopaedic Surgery, Sir HN Reliance Foundation Hospital, Mumbai, India. Electronic address:

Medial dislocation of patella has been commonly reported as a complication of the surgical release of the lateral patella-femoral ligament. A traumatic medial eversion-dislocation of the patella has not been earlier reported. We report an unusual case of traumatic medial patellar eversion-dislocation in a young adult patient whose magnetic resonance imaging (MRI) showed a discontinuity in medial and lateral patellar retinacula. Read More

J ISAKOS 2022 Feb 17;7(1):3-6. Epub 2021 Nov 17.

Department of Orthopedic Surgery, New York University Langone Health, 333 E 38(th) Street, New York, NY 10016, USA.

Objectives: An isolated medial patellofemoral ligament (MPFL) reconstruction (MPFLR) has been demonstrated to be an effective treatment option in the prevention of patellar instability, but there is growing support for performing a tibial tubercle osteotomy (TTO) in patients with an elevated tibial tubercle-trochlear groove distance. The purpose of this study was to evaluate the impact of adding a TTO to MPFLR on patient-reported outcomes.

Methods: A retrospective review of patients who underwent MPFLR with or without TTO with a minimum of 12-month follow-up was performed. Read More

Arch Orthop Trauma Surg 2022 May 10. Epub 2022 May 10.

NYU Langone Health, Division of Adult Reconstruction, Department of Orthopedic Surgery, Hospital of Joint Diseases, NYU Langone Orthopedic Hospital, 301 East 17th Street, New York, NY, 10003, USA.

Background: The knee-hip-spine syndrome has been well elucidated in the literature in recent years. The aim of this study was to evaluate the effect of total knee arthroplasty (TKA) on spinopelvic sagittal alignment in patients with and without pre-TKA lumber spinal fusion.

Methods: This is a retrospective cohort study of 113 patients who underwent TKA for primary osteoarthritis. Read More

BMC Musculoskelet Disord 2022 May 9;23(1):431. Epub 2022 May 9.

Department of Orthopedic and Trauma Surgery, Joint Reconstruction Research Center, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.

Background: Open knee fracture-dislocation is a rare orthopedic injury. However, the importance of its correct management could not be overstated. To the best of our knowledge, this is the fifth study reporting a case with simultaneous Hoffa fracture and knee dislocation and the 1 study describing a patient with open plateau fracture-dislocation accompanied with Hoffa fracture, patella fracture, and patellar tendon tear. Read More

Knee Surg Sports Traumatol Arthrosc 2022 May 7. Epub 2022 May 7.

Department of Orthopedic Surgery, University Medical Centre Ljubljana, Zaloška cesta 9, 1000, Ljubljana, Slovenia.

Purpose: To evaluate predicting factors for patient-reported outcomes and revision interventions following surgical treatment of patients with patellofemoral instability.

Methods: From a prospective database at the university Orthopedic Department, 138 knees from 116 patients who underwent patellofemoral instability surgery (2012-2019) were enrolled in a retrospective analysis: 34 cases of isolated MPFLrec; 92 cases of MPFLrec plus tibial tuberosity transfer; and 12 cases of MPFLrec plus trochleoplasty. Patient-reported outcome measures were recorded for knee-specific function (KOOS), general quality of life (EQ-5D), and activity level (Tegner scale). Read More

Int Orthop 2022 May 7. Epub 2022 May 7.

Department of Orthopaedics and Sports Orthopaedics, School of Medicine, Klinikum Rechts Der Isar, Technical University of Munich, Ismaninger Str. 22, 81675, Munich, Germany.

Purpose: Diagnosing periprosthetic joint infections (PJI) are challenging and may be hampered by the presence of other causes of local inflammation. Conventional synovial and serum markers are not reliable under these circumstances. Synovial calprotectin has been recently shown as a promising biomarker for PJI in total hip (THA) and total knee arthroplasty (TKA). Read More

Malays Orthop J 2022 Mar;16(1):115-118

Department of Orthopaedics, Hospital Serdang, Serdang, Malaysia.

This is a rare case report of medial femoral condyle fracture with irreducible incarcerated patella dislocation. Following the literature search, only a few cases have been reported in the literature. In this case, the patient had undergone open reduction and screw fixation of the femoral condyle, augmented with a distal femoral locking plate (LCP). Read More

Arch Bone Jt Surg 2022 Mar;10(3):278-285

Orthopaedic and Traumatology Department, Assiut University Hospital, Assiut, Egypt.

Background: Dislocation after total hip arthroplasty (THA) partly under the surgeon's control, by appropriate placement of the components. We aimed in this study to determine the accuracy of using intra-operative smartphone applications (Apps) to place the acetabular cup within the safe abduction angle by less experienced surgeons during THA surgery when compared to the conventional freehand technique for cup placement.

Methods: Sixty primary THAs were performed, 30 using the conventional freehand technique (control group) and 30 using the smartphone app technique (study group) to determine the acetabular cup abduction angle by the same young surgeon with less than one year of experience. Read More

J Knee Surg 2022 May 5. Epub 2022 May 5.

Department of Joint Surgery, Hebei Medical University Affiliated Third Hospital, Shijiazhuang, Hebei, China.

The purpose was to investigate morphological changes of the hip joint in patients with recurrent dislocation of the patella combined with trochlear dysplasia. There was a retrospective analysis of 148 patients and 150 control subjects. The selection of participants was randomized. Read More

J Am Acad Orthop Surg Glob Res Rev 2022 May 1;6(5). Epub 2022 May 1.

From the Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, OH (Dr. Rajan), and the Department of Orthopaedic Surgery, MetroHealth Medical Center, Cleveland, OH (Dr. Rajan, Dr. Ramski, and Dr. Romeo).

Introduction: Traumatic proximal tibiofibular joint dislocations occur infrequently and are typically the result of high-energy trauma. These injuries can be a marker of limb injury severity because patients often sustain vascular injury and are at high risk of amputation. The purpose of this study was to present a systematic review of traumatic proximal tibiofibular joint dislocations and compare rates of associated injuries with a retrospective series of patients at a level 1 trauma center. Read More

Arthrosc Sports Med Rehabil 2022 Apr 20;4(2):e359-e370. Epub 2021 Dec 20.

University of Utah, Department of Orthopaedic Surgery, Salt Lake City, Utah, U.S.A.

Purpose: To evaluate mid-term outcomes after medial patellofemoral ligament (MPFL) reconstruction with and without tape augmentation in the skeletally mature adolescent population.

Methods: All patients under age 18 with recurrent patellar instability treated with surgery at a single institution by a single surgeon from January 2013 through June 2017 were identified by current procedural terminology codes. Inclusion criteria were (1) primary MPFL reconstruction, (2) minimum 3 years' follow-up, (3) skeletal maturity. Read More

Bone Joint J 2022 May;104-B(5):589-597

Division of Orthopaedics, University of Toronto, Toronto, Canada.

Aims: Total hip arthroplasty (THA) is one of the most successful surgical procedures. The objectives of this study were to define whether there is a correlation between socioeconomic status (SES) and surgical complications after elective primary unilateral THA, and investigate whether access to elective THA differs within SES groups.

Methods: We conducted a retrospective, population-based cohort study involving 202 hospitals in Ontario, Canada, over a 17-year period. Read More

J Am Acad Orthop Surg 2022 Apr 28. Epub 2022 Apr 28.

From the Shriners Hospital for Children-Philadelphia, Philadelphia, PA (Nossov and Franklin), Temple University College of Public Health, Philadelphia, PA (Hollin), and Colorado Joint Replacement, Porter Adventist Hospital, Denver, CO (Phillips).

Proximal focal femoral deficiency is a congenital transverse deficiency in which the femur is globally smaller with a typical proximal deformity at the hip that may include distal involvement of knees, leg, and feet. Congenital femoral deficiency (CFD) describes a broader spectrum of longitudinal deficiency inclusive of proximal focal femoral deficiency. CFD may also include lateral distal femoral hypoplasia, knee cruciate ligament deficiency, rotational instability, patellar dislocation, fibular hemimelia, ray absence, and contralateral limb involvement. Read More

Asian J Surg 2022 Apr 21. Epub 2022 Apr 21.

Department of Pediatric Orthopedics, The Second Affiliated Hospital of Inner Mongolia Medical University, Hohhot, Inner Mongolia Autonomous, 010030, China.

Knee Surg Sports Traumatol Arthrosc 2022 Apr 22. Epub 2022 Apr 22.

Department of Orthopaedic Sports Medicine, Technical University of Munich, Ismaninger Str. 22, 81675, Munich, Germany.

Purpose: To evaluate immediate loss of reduction in patients undergoing hardware removal after arthroscopically assisted acromioclavicular (AC) joint stabilization using a high-tensile suture tape suspensory fixation system and to identify risk factors associated with immediate loss of reduction.

Materials And Methods: Twenty-two consecutive patients with a mean age of 36.4 ± 12. Read More

Acta Ortop Mex 2021 Sep-Oct;35(5):425-428

Medicina deportiva del Hospital Ángeles Lomas. Ciudad de México. México.

Introduction: Alterations of the patellofemoral joint are one of the most common causes of pain and inflammation as well as joint damage and instability of the knee. Patellofemoral instability is a common multifactorial entity, requiring realignment by proximal, distal, or a combination of techniques. Within the proximal procedures in soft tissues, is the medial patellofemoral ligament plasty (MPFL), which aims to realign the patella medially and restore the anatomy between the quadricipital tendon, patella and tubercle of the tibia. Read More

Int Orthop 2022 Apr 21. Epub 2022 Apr 21.

Orthopaedics Department, Ain Shams University, Cairo, Egypt.

Background: Charcot neuroarthropathy is a destructive disease characterized by progressive bony fragmentation as a result of the isolated or accumulative trauma in patients with decreased sensation that manifests as dislocation, periarticular fractures, and instability. In this study, we present the results of salvage procedure of the ankle Charcot neuroarthropathy using aggressive debridement and Ilizarov frame fusion with early weight bearing.

Methods: Twenty-three patients with severely infected ulcerated and unstable Charcot neuroarthropathy of the ankle were treated between 2013 and 2018. Read More

Am J Sports Med 2022 May 19;50(6):1627-1634. Epub 2022 Apr 19.

Department of Orthopedic Surgery, University of Minnesota, Minneapolis, Minnesota, USA.

Background: Previous research supports that distal translation of the tibial tubercle osteotomy (dTTO) for patients with recurrent lateral patellar dislocation (R-LPD) and patella alta is effective for surgical patellar stabilization.

Hypothesis/purpose: The main purpose of this article is to evaluate (1) the results of modifying the surgical threshold and postoperative goal of patellar height measurements for surgical stabilization originated in the "menu à la carte" approach to patellar surgical stabilization and (2) the relationship between the distance distalized in millimeters and postoperative complications. Our hypothesis was that dTTO with medial patellofemoral ligament reconstruction (MPFL-R) will successfully stabilize the patella with improvement in outcome scores and few complications, using a modification of the original menu à la carte as our surgical algorithm. Read More

Am J Sports Med 2022 Apr 19:3635465221090644. Epub 2022 Apr 19.

Unit of Musculoskeletal Surgery, Department of Orthopaedics, Tampere University Hospital, Tampere, Finland.

Background: A traumatic lateral patellar dislocation is a common injury in adolescents and young adults. The majority of first-time dislocations can be treated nonoperatively. Various types of knee braces are used for nonoperative treatment, but evidence on the most preferable bracing method is lacking. Read More

Knee Surg Sports Traumatol Arthrosc 2022 Apr 18. Epub 2022 Apr 18.

Department of Orthopaedics, Shamir Medical Center (Assaf Harofeh), POB 2007, 48810, Zerifin, Kfar-Qassim, Israel.

Purpose: To evaluate the intra/inter-rater and diagnostic reliability of the sagittal plane adjusted patellar instability ratios (PIRs) compared to tibial tubercle-trochlear groove (TT-TG) distance alone while employing a matched case-control analysis for age and sex to minimize a potential confounding effect.

Methods: A retrospective case-control study was performed of all knee MRI studies of patients diagnosed with patellar instability, between 2005 and 2020 at a regional tertiary medical centre. Using a 1:1 case-control matching of sex and age at the time of the diagnosis, one control subject was assigned to each case of patellar instability. Read More

Knee Surg Sports Traumatol Arthrosc 2022 Apr 18. Epub 2022 Apr 18.

Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy.

Purpose: To compare the clinical outcome of arthroscopic capsulolabral repair for traumatic anterior shoulder instability with PEEK knotless and knotted biodegradable suture anchors.

Methods: Arthroscopic stabilization was performed in 78 patients with recurrent traumatic anterior shoulder instability. They were divided into 2 groups of 39 patients each, according to suture anchors used: knotless PEEK anchors in group 1, and biodegradable anchors in group 2. Read More

Knee Surg Sports Traumatol Arthrosc 2022 Apr 17. Epub 2022 Apr 17.

Department of Orthopaedics, Trauma and Plastic Surgery, University Hospital Leipzig, Leipzig, Germany.

Purpose: Glenohumeral joint injuries frequently result in shoulder instability. However, the biomechanical effect of cartilage loss on shoulder stability remains unknown. The aim of the current study was to investigate biomechanically the effect of two severity stages of cartilage loss in different dislocation directions on shoulder stability. Read More

Prog Rehabil Med 2022 8;7:20220018. Epub 2022 Apr 8.

Department of Orthopaedic Surgery, Faculty of Medicine, University of Yamanashi, Yamanashi, Japan.

Objectives: We investigated the clinical situation of fractures that occurred in patients in the severely disabled patients' ward of our hospital. The study aimed to identify risk factors for the occurrence of long bone fractures in the extremities, which pose problems in nursing care.

Methods: We retrospectively studied fractures that occurred between April 2015 and March 2021 among a total of 126 patients in the severely disabled patients' ward of our hospital. Read More