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Int J Surg Open 2022 May 11:100488. Epub 2022 May 11.

Department of Surgery, University Hospital Limerick, Ireland.

Necrotising fasciitis (NF) is a severe soft tissue infection that is associated with a high risk of morbidity and mortality. During the coronavirus disease 19 (COVID-19) pandemic, the population has been actively discouraged from presenting to emergency medical services unless absolutely necessary. While this was an important step in allowing for preservation of limited resources in a time of crisis, it may have resulted in immeasurable 'secondary victims' of the pandemic as patients with time-critical conditions delay hospital presentation. Read More

Orthop Traumatol Surg Res 2022 May 9:103295. Epub 2022 May 9.

Department of Orthopaedics, The Second Hospital of Shanxi Medical University, Shanxi Key Laboratory of Bone and Soft Tissue Injury Repair, 030000, Taiyuan, Shanxi, PR China.

Introduction: The application of antibiotics loaded bone cement (ALBC) in the revision of failed total knee arthroplasty (TKA) has been widely accepted to reduce risk of peri-prosthetic infection. However, the prophylactic use of ALBC in primary TKA remains controversial. This study was aimed to identify the prophylactic effect on peri-prosthetic infection and safety of ALBC in primary TKA. 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

J Arthroplasty 2022 May 6. Epub 2022 May 6.

Introduction: The objective of this study was to investigate the impact of alignment and soft tissue release on patient outcomes following total knee arthroplasty (TKA).

Methods: In a multicenter study, soft tissue releases during TKA were prospectively documented in 330 robotic-assisted TKAs. Knee Injury and Osteoarthritis Outcome Scores (KOOS) were captured post-operatively. Read More

Ann Med Surg (Lond) 2022 Apr 4;76:103580. Epub 2022 Apr 4.

Department of Nephrology, Al Assad and Al Mouwasat University Hospitals, Damascus University- Faculty of Medicine, Damascus, Syria.

Introduction And Importance: Gustilo-Anderson type 3 open tibial fractures are commonly accompanied by extensive damage and serious complications, especially in types 3B and 3C.

Case Presentation: A 25-year-old male was transferred after motor vehicle accident and the emergent choice was an above-knee amputation in other two hospital. A left open distal tibial fracture (Gustilo type 3C) with a wide and contaminated soft tissues defect, that extended from the knee to the midfoot, is accompanied by wasting of the anterior compartment muscles and ruptured of the anterior tibial artery. Read More

Arthrosc Tech 2022 Apr 16;11(4):e583-e589. Epub 2022 Mar 16.

Department of Orthopaedic Surgery, University of Connecticut, Farmington, Connecticut, U.S.A.

The medial collateral ligament (MCL) is the most commonly injured ligament of the knee; however, only a minority of cases require surgical intervention. Classically, isolated grade I and II MCL injuries are treated nonoperatively whereas isolated grade III injuries may be treated with surgery. High-grade MCL injuries are frequently associated with concomitant knee ligamentous injuries, particularly the anterior cruciate ligament. Read More

Bone Joint J 2022 05;104-B(5):604-612

Whitlam Orthopaedic Research Centre, Ingham Institute for Applied Medical Research, Sydney, Australia.

Aims: Intraoperative pressure sensors allow surgeons to quantify soft-tissue balance during total knee arthroplasty (TKA). The aim of this study was to determine whether using sensors to achieve soft-tissue balance was more effective than manual balancing in improving outcomes in TKA.

Methods: A multicentre randomized trial compared the outcomes of sensor balancing (SB) with manual balancing (MB) in 250 patients (285 TKAs). Read More

Cochrane Database Syst Rev 2022 04 26;4:CD009261. Epub 2022 Apr 26.

Division of Nursing, Midwifery and Social Work, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK.

Background: Indications for the use of negative pressure wound therapy (NPWT) are broad and include prophylaxis for surgical site infections (SSIs). Existing evidence for the effectiveness of NPWT on postoperative wounds healing by primary closure remains uncertain.

Objectives: To assess the effects of NPWT for preventing SSI in wounds healing through primary closure, and to assess the cost-effectiveness of NPWT in wounds healing through primary closure. Read More

Zhonghua Shao Shang Za Zhi 2022 Apr;38(4):369-372

Department of Burns and Plastic Surgery, Maoming People's Hospital, Maoming 525099, China.

On December 22, 2017, a 35-year-old male hemophilia A patient with a secondary chronic refractory wound after left knee joint surgery was transferred from the Department of Hematology of Maoming People's Hospital to the Department of Burns and Plastic Surgery in the same hospital. The physical examination revealed that the patient's left knee joint was swollen, with a full-thickness skin defect wound of 4 cm×4 cm on the lateral side of the joint and a large number of dark red blood clots at the bottom of the wound. The wound bleeding was controlled by intravenous infusion of plasma, cryoprecipitate, and human coagulation factor Ⅷ. 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

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

P D Hinduja Hospitals Mumbai, Global Hospital Parel, Mumbai, India.

Purpose: There is a lack of consensus regarding need for Venous Thrombo Embolism (VTE) prophylaxis following arthroscopic knee surgery and open soft tissue knee reconstruction. Clear cut guidelines like ones for trauma surgery and arthroplasty do not exist and the published literature is limited to case reports with a few society guidelines. Given this lack of consensus, we conducted a modified Delphi questionnaire of international experts to provide recommendations on this topic. Read More

J Orthop Case Rep 2021 Sep;11(9):1-6

Department of Plastic Surgery, Apollo Hospital Kolkata, India.

Introduction: Tissue engineered reconstruction is a minimally invasive approach for healing major complex wounds successfully. It combines accurate, conservative debridement with a specially adapted suction method, platelet-rich plasma (PRP) injections, and biomaterial application to salvage injured tissues and grows new soft tissues over wounds.

Case Presentation: A healthy young man in his early 30s presented to our emergency department with complex knee-thigh injuries following a high-velocity automobile accident. Read More

Injury 2022 Apr 1. Epub 2022 Apr 1.

University Hospitals Leuven, Department of Trauma Surgery, B-3000 Leuven, Belgium; KU Leuven, University of Leuven, Department of Development and Regeneration, B-3000 Leuven, Belgium. Electronic address:

Background: Fracture-related infection (FRI) after the operative management of patella fractures is a serious complication that can result in prolonged hospitalization, multiple revision procedures and permanent functional impairment. Till today, treatment modalities and outcome of FRI of the patella are not well described. Therefore, the main objective of this retrospective cohort study was to evaluate treatment options, functional outcome and healthcare costs related to FRI of the patella. Read More

Data Brief 2022 Jun 21;42:108082. Epub 2022 Mar 21.

Department of Pharmacology, Faculty of Medicine, Universiti Malaya, Kuala Lumpur 50603, Malaysia.

Degradation of articular cartilage is the defining feature of end-stage osteoarthritis (OA) with osteophytes, subchondral sclerosis, malalignment and joint space narrowing being additional indicators of advanced disease. Obesity, older age and female gender are OA risk factors. Differing degrees of synovitis are observed in OA, soft tissue and traumatic injuries of the knee. Read More

Injury 2022 Mar 21. Epub 2022 Mar 21.

Harvard Orthopaedic Trauma Initiative, Harvard Medical School, Boston, MA, USA; Department of Orthopaedic Surgery, Brigham and Women's Hospital, Boston, MA, USA; Department of Orthopaedic Surgery, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.

Background: The surgical management of bicondylar tibial plateau (BTP) fractures in elderly patients aims to restore knee stability while minimizing soft tissue complications. The purpose of this study was to compare injury characteristics and surgical outcomes after ORIF of BTP fractures (AO/OTA 41-C (Schatzker VI)) in young (< 50 years) versus elderly (> 65 years) patients.

Methods: A retrospective cohort study was conducted using data from two American College of Surgeons (ACS) level I trauma centers. Read More

Am J Sports Med 2022 03;50(4):984-993

Rush University Medical Center, Chicago, Illinois, USA.

Background: The lateral patellofemoral complex (LPFC) is an important stabilizer of the patella composed of the lateral retinacular structures including the lateral patellofemoral ligament (LPFL), the lateral patellomeniscal ligament (LPML), and the lateral patellotibial ligament (LPTL). While the isolated anatomy of the LPFL has been previously described, no previous study has investigated the entirety of the LPFC structure, length changes, and radiographic landmarks. An understanding of LPFC anatomy is important in the setting of LPFL injury or previous lateral release resulting in iatrogenic medial instability requiring LPFC reconstruction. Read More

Med Sci Monit 2022 Apr 3;28:e936619. Epub 2022 Apr 3.

Office of Human Research, Memorial Hospital System, Hollywood, FL, USA.

BACKGROUND Kinesiology tape indications of use include pain mitigation, neurosensory input, and promotion of circulation. Current evidence suggests that residual functional limitations following intramedullary nailing of the femoral shaft may be due to soft tissue injury and compromise. This retrospective study from a single center aimed to compare the effects of kinesiology taping on edema of the lower limb in 14 patients following intramedullary nailing for femoral shaft fracture. Read More

Injury 2022 Mar 24. Epub 2022 Mar 24.

Division of Orthopaedic Trauma and Complex Adult Reconstruction, Department of Orthopaedic Surgery, Jersey City Medical Center, Jersey City, NJ, USA.

Introduction: In the setting of periprosthetic total hip and knee arthroplasty (THA/TKA) infection, plating of the femur may be necessary for fracture fixation, prophylactic fixation of the femur, poor bone quality, or infected femoral shaft nonunion. The purpose of this study was to investigate infection control rates and fracture healing in patients receiving antibiotic cement coated plates in the setting of infected nonunion and periprosthetic infections.

Methods: We retrospectively reviewed a series of ten patients who had an antibiotic coated plate placed in the setting of periprosthetic infection or infected nonunion with a minimum follow-up of six months. Read More

Medicine (Baltimore) 2022 Mar;101(11)

Department of Minimally invasive Orthopaedics, Zhengzhou Orthopaedic Hospital, Zhengzhou, Henan, China,Department I of Neck, Shoulder, Waist and Leg pain, Zhengzhou Orthopaedic Hospital, Zhengzhou, Henan, China,Department of Preclinical, The Third Affiliated Hospital of Henan University of Traditional Chinese Medicine, Zhengzhou, Henan, China.

Background: After reduction and fixation of a fracture around the knee (FAK), excessive injury, improper treatment, soft tissue damage, and blood circulation damage often lead to limb dysfunction, which seriously affects limb rehabilitation and the patient's quality of life. Shaoyao Gancao Decoction (SGD) is an important means of treatment; however, it is not widely applied because of the lack of evidence about the effectiveness of oral drugs in the treatment of limb dysfunction. This study aimed to evaluate the effects of SGD on patients with limb dysfunction from the perspectives of pain, limb edema, stiffness, as well as physical dysfunction. Read More

Zhongguo Gu Shang 2022 Mar;35(3):292-9

Shanxi Key Laboratory of Bone and Soft Tissue Injury Repair, the Second Hospital of Shanxi Medical University, Taiyuan 030001, Shanxi, China.

Objective: To systematically evaluate the clinical efficacy of arthroscopy and traditional incision in the treatment of tibial avulsion fracture of anterior cruciate ligament (ACL).

Methods: From July 2010 to July 2020, clinical comparative trial about arthroscopy and traditional incision in the treatment of ACL tibial avulsion fracture was conducted by using computer-based databases, including Embase, Pubmed, Central, Cinahl, PQDT, CNKI, Weipu, Wanfang, Cochrane Library, CBM. Literature screening and data extraction were carried out according to the inclusion and exclusion criteria, and the quality of the included literature was evaluated by improved Jadad score and Ottawa Newcastle scale (NOS). Read More

Acta Biomed 2022 Mar 14;93(1):e2022005. Epub 2022 Mar 14.

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Background: The treatment of distal femur fractures represents a challenging task. General and local factors, including bone quality, articular surface involvement, fracture comminution, associated soft tissue injuries and ultimately fixation system, all play a role in the final clinical outcome. Current surgical approaches often undermine patellar vascularization and integrity of the extensor apparatus, not guaranteeing sufficient visualization of the medial condyle. Read More

Ortop Traumatol Rehabil 2022 Feb;24(1):43-60

Sutherland Medical Center, Warszawa, Polska / Sutherland Medical Center, Warsaw, Poland.

Background: The PRP method is widely used to support healing and regeneration in musculoskeletal and aesthetic medicine. The current literature, however, brings contradictory reports as to its effectiveness, which, at least in part, should be attributed to the diversity of methods for producing the concentrate, including the use of various volumes of whole blood, single vs double centrifugation vs filtration, use of thrombin vs calcium chloride to activate the process, and, finally, the use of an anticoagulant. The aim of the study was to retrospectively evaluate the effectiveness of high-volume PRP therapy with the Angel® system (Arthrex) in our patients. Read More

J Knee Surg 2022 Mar 8. Epub 2022 Mar 8.

Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Tokyo, Japan.

Bi-cruciate stabilized (BCS) total knee arthroplasty (TKA) was developed to approximate normal knee kinematics and is expected to improve clinical outcomes. However, the effects of soft tissue balance at the medial or lateral compartment on patient-reported outcome measures (PROMs) following BCS TKA are unclear. The purpose of this study was to clarify the relationship between the medial or lateral component gaps and PROMs following BCS TKA. Read More

Nano Lett 2022 03 3;22(6):2309-2319. Epub 2022 Mar 3.

Dr. Li Dak Sum & Yip Yio Chin Center for Stem Cells and Regenerative Medicine & Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310058, China.

Cartilage adheres to subchondral bone via a specific osteochondral interface tissue where forces are transferred from soft cartilage to hard bone without conferring fatigue damage over a lifetime of load cycles. However, the fine structure and mechanical properties of the osteochondral interface tissue remain unclear. Here, we identified an ultrathin ∼20-30 μm graded calcified region with two-layered micronano structures of osteochondral interface tissue in the human knee joint, which exhibited characteristic biomolecular compositions and complex nanocrystals assembly. Read More

Arthroplasty 2021 Apr 2;3(1). Epub 2021 Apr 2.

Arthroplasty Unit, Division of Orthopaedic Surgery, Charlotte Maxeke Johannesburg Academic Hospital, University of the Witwatersrand, 7 York Road, Parktown, Johannesburg, South Africa.

Background: A review of the literature revealed that only 9 total knee replacements were performed on patients with osteogenesis imperfecta (OI), with one being a revision procedure of a periprosthetic fracture. Of the 9 primary procedures, all used cemented prostheses, and 3 patients had an osteotomy at the same procedure. Our patient required a hinged prosthesis because of collateral ligament incompetence and is the first such case reported in the literature. Read More

J Knee Surg 2022 Apr 28;35(5):498-501. Epub 2022 Feb 28.

Department of Radiology, University of Missouri, Columbia, Missouri.

Knee dislocations, aka multiligamentous injuries, are uncommon but devastating injuries often following high-energy trauma. Tears of the major knee stabilizers are well documented; however, injuries of the knee extensor mechanism are less commonly reported. The extensor mechanism is comprised of the patella, patellar tendon, and quadriceps tendons. Read More

Sports (Basel) 2022 Feb 21;10(2). Epub 2022 Feb 21.

Department of Sport Science, Faculty of Social Sciences, Linnaeus University, 39182 Kalmar, Sweden.

There is evidence that a knee flexor exercise, the Nordic hamstring exercise (NHE), prevents hamstring injuries. The purpose of this study was therefore to develop, and to determine the reliability of, a novel NHE test device and, further, to determine the effectiveness of a 10-week low volume NHE program on NHE performance. Twenty female football (soccer) players, aged 16-30 years, participated in this study. Read More

J Orthop Surg Res 2022 Feb 22;17(1):121. Epub 2022 Feb 22.

Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi, Italy.

Purpose: This systematic review evaluated the clinical outcomes of hardware-free MPFL reconstruction techniques in patients with recurrent patellofemoral instability, focusing on patient-reported outcome measures (PROMs), redislocation rate, and complications. The hypothesis was that hardware-free MPFL reconstruction in patients with recurrent patellofemoral instability is safe and effective.

Methods: This systematic review was conducted following the PRISMA guidelines. Read More

Front Endocrinol (Lausanne) 2022 4;13:827512. Epub 2022 Feb 4.

Department of Orthopedics and Rehabilitation, University of Iowa Hospitals and Clinics, Iowa City, IA, United States.

Purpose: The aim of this review is to assess the current evidence regarding the impact of relaxin on incidence of soft tissue hip injuries in women.

Methods: A trained research librarian assisted with searches of PubMed, Embase, CINAHL, and SPORTDiscus, with a preset English language filter. The review was completed per the Joanna Briggs Institute (JBI) Manual for Evidence Synthesis methodology. Read More

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2022 Feb;36(2):170-176

Department of Trauma Orthopedics, Affiliated Hospital of Chengde Medical University, Chengde Hebei, 067000, P. R. China.

Objective: To compare the effects of cutting and retaining the pes anserinus tendon on effectiveness following tibial plateau fracture.

Methods: A clinical data of 40 patients with tibial plateau fracture treated with open reduction and internal fixation with plate via posteromedial approach between January 2015 and January 2020 was retrospectively analyzed, including 18 patients retained the pes anserinus tendon (study group) and 22 patients cut the pes anserinus tendon (control group) during operation. There was no significant difference in gender, age, side of affected knee, cause of injury, Schatzker classification, time from injury to operation, and associated ligament injury between the two groups ( >0. Read More