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Int Orthop 2022 Jun 14. Epub 2022 Jun 14.

Department of Orthopaedic Surgery, University of Health Sciences, Haseki Training and Research Hospital, Istanbul, Turkey.

Background: This study aimed to investigate the clinical and radiological progression of the patients who underwent proximal fibular partial excision (PFPE) for medial compartment knee osteoarthritis.

Methods: Patients with medial compartment knee osteoarthritis who did not benefit from conservative treatment and accepted the PFPE surgery were involved in this study. Patients with traumatic arthritis, inflammatory arthritis, previous lower extremity fractures, valgus malalignment of the knee, and infection at the planned surgical site, however, were kept apart. Read More

JBJS Essent Surg Tech 2021 Oct-Dec;11(4). Epub 2021 Oct 7.

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

Meniscal root tears are soft-tissue and/or osseous injuries characterized by an avulsion of, or tear within 1 cm of, the native meniscal insertion. These injuries account for 10% to 21% of all meniscal tears, affecting nearly 100,000 patients annually. Medial meniscal posterior-root tears (MMPRTs) expose the tibiofemoral joint to supraphysiologic contact pressure, decreased contact area, and altered knee kinematics similar to a total meniscectomy. Read More

Arthroscopy 2022 Jun;38(6):1966-1968

High tibial osteotomy (HTO) is enjoying somewhat of a resurgence as a treatment for medial compartment arthritis with a varus deformity. An inverted V-shaped high tibial osteotomy (IVHTO), which is essentially a combined lateral closing-wedge high tibial osteotomy (CWHTO) and medial opening-wedge high tibial osteotomy (OWHTO), has some theoretical benefits over more conventional techniques. This also has been termed a combined HTO or a hemi-wedge osteotomy. Read More

Arthroscopy 2022 Jun;38(6):1916-1918

A medial opening wedge high tibial osteotomy is a cost-effective procedure for younger patients with symptomatic medial compartment knee arthritis. A high rate of success can be expected, but excessive postoperative joint line obliquity is associated with inferior clinical outcomes. If preoperative planning predicts that the postoperative medial proximal tibial angle, the medial angle between the tibial anatomical axis and the joint line of the proximal tibia, will exceed 95°, a surgeon should consider performing a double-level osteotomy (combined proximal tibial and distal femoral osteotomies). Read More

Comput Methods Programs Biomed 2022 Jun 29;221:106923. Epub 2022 May 29.

Pain Department, Changji State Hospital of Traditional Chinese Medicine, Changji, China.

Objective: To observe the cartilage repair of the medial compartment and the biomechanical changes of the lower extremities after single-plane high tibial osteotomy of distal tibial tuberosity (DTT-HTO).

Methods: A total of 30 patients, including 11 males and 19 females, who underwent DTT-HTO with arthroscopic operation in our hospital from January 2020 to January 2021 and underwent arthroscopic exploration again during the second operation for internal fixation were enrolled. There were 32 knees, including 13 left knees and 19 right knees. Read More

Med Eng Phys 2022 06 14;104:103800. Epub 2022 Apr 14.

Department of Orthopaedics, Huashan Hospital affiliated to Fudan University, 12 Middle Wulumuqi Road, Shanghai, China.

Aims: Therapeutic footwear with variable-stiffness properties has been shown to be effective in reducing the external knee adduction moment. However, the exact changes of internal tissue stresses following intervention with variable-stiffness footwear remains unknown. The objective of this study is to construct a finite element model of the foot-ankle-knee complex to investigate the therapeutic efficacy of the variable-stiffness footwear in modulating internal knee joint stress distributions. Read More

Acta Orthop 2022 May 24;93:478-487. Epub 2022 May 24.

Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences University of Oxford, Nuffield Orthopaedic Centre, Oxford.

Background And Purpose: The main treatments for severe medial compartment knee arthritis are unicompartmental (UKR) and total knee replacement (TKR). UKRs have higher revision rates, particularly for aseptic loosening, therefore the cementless version was introduced. We compared the outcomes of matched cementless UKRs and TKRs. Read More

BMC Musculoskelet Disord 2022 May 24;23(1):489. Epub 2022 May 24.

Department of Orthopedics and Trauma Surgery, Faculty of Medicine, Medical Center - Albert-Ludwigs-University of Freiburg, Albert-Ludwigs-University of Freiburg, Freiburg, Germany.

Background: Patients suffering cartilage defects of the medial compartment with underlying varus deformity do benefit from high tibial osteotomy (HTO) even in the long term. Nonetheless, kinematic and geometric changes especially in the patellofemoral joint have been described. Purpose of the present study was to evaluate the influence of patellofemoral cartilage defects detected during the diagnostic arthroscopy and their influence on HTO's postoperative outcome. Read More

Knee 2022 Jun 20;36:114-119. Epub 2022 May 20.

Consultant Sports Knee and Arthroplasty Surgeon, Royal Derby Hospital, Derby, England, UK.

Background (including The Aim Of The Study): Young and more active patients with medial compartment osteoarthritis (OA) in conjunction with anterior cruciate ligament (ACL) deficiency are difficult to treat. The aim of this study was to explore the outcomes of combined fixed bearing Physica ZUK medial unicompartmental knee replacement (UKR) (Lima Corporate, Udine Italy) with ACL reconstruction for patients presenting with isolated medial compartment OA and symptomatic ACL deficiency.

Methods: Patients who underwent simultaneous single stage ACL reconstruction and medial UKR between 2012 and 2020 by a single surgeon (GG) were included. Read More

Am J Sports Med 2022 Jul 23;50(8):2075-2082. Epub 2022 May 23.

Department of Orthopaedic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.

Background: Arthroscopic partial meniscectomy (APM) is widely performed and remains an important therapeutic option for patients with a meniscal tear. However, it is debated whether or not APM accelerates the progression of osteoarthritis (OA) in the long term.

Purpose/hypothesis: The purpose was to compare the progression of OA measured by the change in tibiofemoral joint space width (JSW)-a quantitative measure of OA radiographic severity-across 3 groups with a midterm follow-up: (1) patients undergoing APM; (2) those with a meniscal tear treated nonoperatively; and (3) those without a tear. Read More

Acta Biomed 2022 03 10;92(S3):e2021558. Epub 2022 Mar 10.

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Background And Aim: High tibial osteotomies (HTO) are effective procedures to treat younger patients affected by moderate but symptomatic arthritis. Open-wedge HTO (OW-HTO) is more often performed compared to a closing wedge osteotomy to treat varus arthritis of the knee due to a lower incidence of complications and better results: lateral hinge fracture (LHF) is the most common complication of OW-HTO. Intra articular fractures of the lateral tibial plateau (Takeuchi type III) appear as a particularly serious complication due to its extension to the subchondral bone of the compartment towards which the load is shifted. Read More

Clin Biomech (Bristol, Avon) 2022 Jun 6;96:105659. Epub 2022 May 6.

Department of Orthopaedic Surgery, Beijing Jishuitan Hospital, Fourth Clinical College of Peking University, Beijing 100035, China. Electronic address:

Background: To the best of our knowledge, no report has analyzed the postoperative results of poor prosthesis position, particularly when the femoral and tibial components are abnormally positioned relative to neutral lower limb alignment. We aimed to investigate pressure distribution in the knee at different lower limb alignments with diverse positions of femoral and tibial components.

Methods: We established a three-dimensional model of the lower limb using computed tomography and simulated total knee arthroplasty. Read More

Orthop Surg 2022 May 4;14(5):789-806. Epub 2022 May 4.

Department of Orthopaedic Surgery, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an Shaanxi, China.

Unicompartmental knee osteoarthritis (UKOA) is the early stage of knee joint degeneration, which is characterized by unicompartmental degeneration and mostly occurs in medial compartment. Pain and limited motion are main symptoms, which affect patients' life quality. Periarticular knee osteotomy (PKO) for lower extremity alignment correction is an effective treatment for UKOA with abnormal alignment, which could relieve pain and improve joint function by adjusting lower extremity alignment. Read More

Int Orthop 2022 Jul 13;46(7):1573-1582. Epub 2022 Apr 13.

Orthopedic Department, Buyanov V.M. Moscow City Clinical Hospital, ul. Bakinskaya, 26, bild. 10, 115516, Moscow, Russia.

Purpose: A varus deformity (VD) of the lower limbs results in greater loading of the medial compartment of the knee joint (KJ), leading to its degenerative changes and, eventually, to progressive osteoarthritis (OA) of the joint. The aim of the study was to investigate the mid-term changes in gait biomechanics and clinical symptoms in patients with VD of KJ and OA before and six months after surgical correction.

Methods: The study enrolled 25 patients with medial OA of grade 2-3 according to Kellgren-Lawrence and a VD of > 3°, who underwent arthroscopic lavage and debridement of the knee joint followed by corrective osteotomy. Read More

Indian J Orthop 2022 Apr 12;56(4):655-663. Epub 2021 Nov 12.

Department of Biostatistics, Amrita Institute of Medical Sciences and Research Centre, Kochi, Kerala, 682026 India.

Background: Lateral UKA is a technically more challenging procedure than medial UKA accounting for < 1% of all knee arthroplasties. Robotic UKA for lateral compartment arthritis is rare and has not been reported in India.

Materials And Methods: This is a prospective single-centre clinical study of six patients (five females and one male) who underwent robotic-arm-assisted lateral UKA (RALUKA) between May 2018 and January 2020 with patient-specific 3D-CT preoperative plan. Read More

Pain Physician 2022 03;25(2):E319-E329

Division of Rheumatology, Allergy, Immunology, Massachusetts General Hospital, Harvard Medical School, Boston, MA.

Background: Medial knee pain is a common complaint in the adult population. When conservative measures fail, intraarticular knee corticosteroid injections are often offered through the superolateral approach into the suprapatellar recess to provide short-term relief. However, some patients fail to respond and require alternative approaches. Read More

J Bone Joint Surg Am 2022 05 23;104(10):910-918. Epub 2022 Mar 23.

Department of Orthopedic Surgery, Osaka City University Graduate School of Medicine, Osaka City, Japan.

Background: Medial-pivot total knee arthroplasty (TKA) is designed with high articular conformity in the medial compartment in order to achieve stability. The subjective outcome of patients has been reported to be good postoperatively; however, the association between the objective and subjective knee stability and the influence of subjective stability on the overall outcomes of TKA remained unknown. Our hypothesis was that postoperative flexion joint-gap imbalance could affect subjective knee instability following TKA in medial-pivot prostheses. Read More

Knee 2022 Mar 18;35:124-132. Epub 2022 Mar 18.

Exercise Physiology Research Center, Lifestyle Institute, Department of Rheumatology, Baqiyatallah University of Medical Sciences, Tehran, Iran.

Background: Subject-specific foot progression angle (SSFPA) as a personalized gait modification is a novel approach to specifically reducing knee adduction.

Objective: This study aimed to investigate the effect of gait modification with SSFPA on the knee adduction moment and muscle activity in people with moderate knee osteoarthritis (KOA).

Methods: In this clinical trial, nineteen volunteers with moderate KOA were instructed to walk in four different foot progression angle conditions (5° toe-out, 10° toe-out, 5° toe-in, and 10° toe-in) to determine SSFPA that caused the greatest reduction in the greater peak of the knee adduction moment (PKAM). Read More

BMC Musculoskelet Disord 2022 Mar 8;23(1):218. Epub 2022 Mar 8.

Department of Radiology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China.

Background: Meniscal morphological changes are associated with knee OA. However, the correlation of meniscal height and OA-related knee structural abnormalities is still not well understood. The purpose of present study is to investigate whether and how meniscal anterior and posterior horn heights are associated with structural abnormalities in knees with symptomatic OA. Read More

JAMA Netw Open 2022 03 1;5(3):e220632. Epub 2022 Mar 1.

Department of Medicine, University of Utah, Salt Lake City.

Importance: Osteoarthritis (OA) is a major cause of disability in the US, with no approved treatments to slow progression, but animal models suggest that pulsed low-intensity ultrasonography (PLIUS) may promote cartilage growth.

Objective: To evaluate the efficacy of PLIUS in providing symptom reduction and decreased loss of tibiofemoral cartilage thickness in patients with knee OA.

Design, Setting, And Participants: A phase 2A, sham-controlled, parallel, double-blind randomized clinical trial was conducted at 2 Veterans Affairs hospitals in Salt Lake City, Utah, and San Diego, California, from May 22, 2015, to January 31, 2019. Read More

J Orthop Surg Res 2022 Mar 5;17(1):146. Epub 2022 Mar 5.

Nuffield Orthopaedic Centre, Oxford University Hospitals NHS Foundation Trust, Windmill Road, Headington, Oxford, OX3 7LD, UK.

Background: Isolated lateral compartment knee arthritis is less prevalent than medial. While the reported results of medial unicompartmental knee replacement (UKR) have been good and comparable to total knee replacement, the results of lateral UKR have been mixed. We present the short-term results and survivorship of a fixed-bearing UKR designed specifically for the lateral compartment. Read More

Osteoarthritis Cartilage 2022 05 28;30(5):756-764. Epub 2022 Feb 28.

Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia. Electronic address:

Objective: To describe the associations between osteoarthritis (OA)-related biochemical markers (COMP, MMP-3, HA) and MRI-based imaging biomarkers in middle-aged adults over 10-13 years.

Methods: Blood serum samples collected during the Childhood Determinants of Adult Health (CDAH)-1 study (year:2004-06; n = 156) and 10-13 year follow-up at CDAH-3 (n = 167) were analysed for COMP, MMP-3, and HA using non-isotopic ELISA. Knee MRI scans obtained during the CDAH-knee study (year:2008-10; n = 313) were assessed for cartilage volume and thickness, subchondral bone area, cartilage defects, and BML. Read More

J Arthroplasty 2022 06 26;37(6S):S94-S97. Epub 2022 Feb 26.

Anderson Orthopaedic Research Institute, Alexandria, Virginia.

Background: Debate still exists regarding the benefits of unicompartmental (UKA) versus total knee arthroplasty (TKA) for the treatment of medial compartment osteoarthritis. The purpose of this randomized trial is to compare the early outcomes of UKA versus TKA.

Methods: One-hundred and seven candidates for UKA were randomized at two centers; 57 candidates received UKA and 50 received TKA. Read More

Osteoarthritis Cartilage 2022 05 22;30(5):714-723. Epub 2022 Feb 22.

Quantitative Imaging Center (QIC), Department of Radiology, Boston University School of Medicine, Boston, MA, USA; Department of Radiology, VA Boston Healthcare System, West Roxbury, MA, USA.

Objective: Eligibility for clinical trials in osteoarthritis (OA) is usually limited to Kellgren-Lawrence (KL) grades 2 and 3 knees. Our aim was to describe the prevalence and severity of cartilage damage in KL 2 and 3 knees by compartment and articular subregion.

Design: The Multicenter Osteoarthritis (MOST) study is a cohort study of individuals with or at risk for knee OA. Read More

Orthop Traumatol Surg Res 2022 May 17;108(3):103253. Epub 2022 Feb 17.

Institut du mouvement et de l'appareil locomoteur, hôpital Sainte-Marguerite, Aix-Marseille université, 270, boulevard Sainte-Marguerite, 13009 Marseille, France. Electronic address:

Introduction: A valgus osteotomy around the knee is a conservative procedure performed to unload the medial tibiofemoral compartment. However, the optimal postoperative alignment target remains controversial. Many studies have applied a "Fujisawa point" at 62. Read More

Osteoarthritis Cartilage 2022 Jul 7;30(7):965-972. Epub 2022 Feb 7.

Department of Rheumatology & Clinical Immunology, University Medical Center Utrecht, Utrecht, the Netherlands. Electronic address:

Objective: Increased subchondral cortical bone plate thickness and trabecular bone density are characteristic of knee osteoarthritis (OA). Knee joint distraction (KJD) is a joint-preserving knee OA treatment where the joint is temporarily unloaded. It has previously shown clinical improvement and cartilage regeneration, indicating reversal of OA-related changes. Read More

J Med Case Rep 2022 Feb 4;16(1):43. Epub 2022 Feb 4.

Department of Orthopaedic Surgery, Nyon Hospital, Nyon, Switzerland.

Background: Open wedge high tibial osteotomy is a standard procedure for frontal realignment. It is indicated in varus knee with reduced mechanical medial proximal tibia angle. Overcorrection producing a mechanical medial proximal tibia angle out of the normal range (85-90°) is not recommended because this would lead to unphysiological joint-line orientation. Read More

J Orthop Surg Res 2022 Jan 28;17(1):50. Epub 2022 Jan 28.

Department of Sports Medicine, Affiliated Hospital of Qingdao University, 59 Haier Road, Laoshan District, Qingdao, 266000, Shandong Province, China.

Background: To identify medial open-wedge high tibial osteotomy (MOWHTO) prognostic factors with wedge-shaped spacer implantation (spacer-type MOWHTO) for varus medial compartment knee osteoarthritis.

Methods: Patients who underwent spacer-type MOWHTO between August 2018 and September 2019 were prospectively enrolled in this study. Patients were divided into effective group and invalid group based on the Western Ontario and McMasters University Osteoarthritis Index (WOMAC) score one year postoperatively. Read More

Arthritis Res Ther 2022 01 27;24(1):34. Epub 2022 Jan 27.

Clinical Research Centre, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China.

Background: To describe the longitudinal associations between the morphological parameters of proximal tibiofibular joint (PTFJ) and joint structural changes in tibiofemoral compartments in patients with knee osteoarthritis (OA).

Methods: The participants were selected from the Vitamin D Effects on Osteoarthritis (VIDEO) study. PTFJ morphological parameters were measured on coronal and sagittal MRI. Read More

J Clin Orthop Trauma 2021 Dec 1;23:101618. Epub 2021 Oct 1.

London Knee Osteotomy Centre, Harley Street Specialist Hospital, 18-22 Queen Anne St, London W1G 8HU, UK.

Knee osteoarthritis (OA) is the most common joint disorder worldwide. In particular, primary knee OA often presents with a varus malalignment. This increases the loads going through the medial compartment resulting in cartilage degeneration and symptomatic arthritis. Read More