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J Knee Surg 2021 May 4. Epub 2021 May 4.

Center for Joint Preservation and Replacement, Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore, Baltimore, Maryland.

To our knowledge, no studies have compared postoperative outcomes between patients who received a temporary short or long intramedullary (IM) nail in the setting of infected total knee arthroplasty (TKA). Therefore, the aim of this study was to compare short-term outcomes for patients who underwent long or short IM nail insertion for treatment of periprosthetic knee infection. Specifically, we compared: (1) success rates; (2) patient reported/functional outcomes; and (3) complications between patients implanted with a short or a long IM nail following PJI of the knee. Read More

J Robot Surg 2021 May 4. Epub 2021 May 4.

Department of Orthopedics, Lokmanya Hospital, Nigdi, Pradhikaran, Pune, India.

In recent years, robotic technology is becoming more pervasive in joint arthroplasty. The role of robotics in joint replacement surgery is to bring precision and accuracy in bone preparation, implant positioning and soft tissue balancing. However, there is yet to be a study conducted to determine the accuracy of bone preparation done by a new robotic system. Read More

Rev Bras Ortop (Sao Paulo) 2021 Apr 25;56(2):138-146. Epub 2020 Sep 25.

Centro de Cirurgia do Joelho, Instituto Nacional de Traumatologia e Ortopedia (INTO), Rio de Janeiro, RJ, Brasil.

The increase in the number of revision total knee arthroplasty surgeries has been observed in recent years, worldwide, for several causes. In the United States, a 601% increase in the number of total knee arthroplasties, between 2005 and 2030, is estimated. Among the enormous challenges of this complex surgery, the adequate treatment of bone defects is essential to obtain satisfactory and lasting results. Read More

Bone Joint J 2021 May;103-B(5):840-845

Sezione di Chirurgia Protesica ad Indirizzo Robotico - Unità di Traumatologia dello Sport, U.O. Ortopedia e Traumatologia, Fondazione Poliambulanza, Brescia, Italy.

Aims: In the last decade, interest in partial knee arthroplasties and bicruciate retaining total knee arthroplasties has increased. In addition, patient-related outcomes and functional results such as range of movement and ambulation may be more promising with less invasive procedures such as bicompartmental arthroplasty (BCA). The purpose of this study is to evaluate clinical and radiological outcomes after a third-generation patellofemoral arthroplasty (PFA) combined with a medial or lateral unicompartmental knee arthroplasty (UKA) at mid- to long-term follow-up. Read More

Knee Surg Sports Traumatol Arthrosc 2021 May 1. Epub 2021 May 1.

Department of Orthopaedics and Traumatology, Medical University of Innsbruck, Anichstrase 35, 6020, Innsbruck, Austria.

Purpose: To determine whether preoperative radiologic joint space width (JSW) is related to the outcome of medial unicondylar knee arthroplasty (UKA) (primary hypothesis).

Methods: A retrospective comparative analysis was performed. One group was comprised of UKA patients with preoperative JSW 0-1 mm. Read More

J Mech Behav Biomed Mater 2021 Apr 24;120:104554. Epub 2021 Apr 24.

Tecnologico de Monterrey, Campus Monterrey, School of Engineering and Science, Eugenio Garza Sada 2501 Sur, Col Tecnológico C.P., 64849, Monterrey, Nuevo León, Mexico.

This article focuses on obtaining ultra high molecular weight polyethylene (UHMWPE) material reinforced with functionalized single-walled carbon nanotubes (f-SWCNTs) and the manufacturing of unicompartmental knee implants via Single-Point Incremental Forming process (SPIF). The physicochemical properties of the developed UHMWPE reinforced with 0.01 and 0. Read More

J Arthroplasty 2021 Apr 13. Epub 2021 Apr 13.

Adult Reconstruction and Joint Replacement Service, Hospital for Special Surgery, New York, NY.

Background: This study examined a cohort of retrieved rotating hinge (RH) total knee arthroplasty implants of four different designs with emphasis on the surface damage observed on the polyethylene components. Our purpose was to determine if differences in polyethylene damage existed among the designs, and if those differences could be explained by differences in design characteristics.

Materials And Methods: Seventy-two RH implants from four manufacturers (DePuy LPS/SROM, Zimmer NexGen, Stryker Howmedica MRH, and Biomet Finn-OSS) removed at the time of revision performed between 2002 and 2017 were identified in our institutional retrieval registry. Read More

J Arthroplasty 2021 Apr 20. Epub 2021 Apr 20.

Department of Orthopaedic Surgery, Brigham and Women's Health, Boston, MA.

We have an academic medical center (AMC), an associated community-based hospital (CBH) and several ambulatory care centers which are being prepared to provide same day discharge (SDD) total joint arthroplasty (TJA) and unicompartmental knee arthroplasty (UKA). The near-capacity AMC cared for medically and technically complicated TJA patients. The CBH wanted to increase volume, improve margins, and become a center of excellence with an efficient hospital outpatient department and SDD TJA experience. Read More

J Arthroplasty 2021 May;36(5):e35

Department of Orthopaedic Surgery, NYU Langone Health, New York, NY.

J Knee Surg 2021 Apr 30. Epub 2021 Apr 30.

The Stavros Niarchos Foundation Complex Joint Reconstruction Center, Hospital for Special Surgery, New York City, New York.

Concerns persist that the Optetrak Logic posterior-stabilized (PS) total knee arthroplasty (TKA) femoral component might correlate with early failures due to aseptic loosening. The primary aim of this study was to examine if the use of the Optetrak Logic PS femoral component is associated with early (<5 years) and more extensive aseptic loosening compared with other PS femoral components. This is a single-institution retrieval analysis and revision registry study (based on prospectively collected data) of 27 failed primary PS TKA patients with loose femoral components that underwent revision TKAs between 2016 and 2019. Read More

Osteoporos Int 2021 Apr 30. Epub 2021 Apr 30.

Orozco Orthopaedics, Linwood, NJ, USA.

Osteoporosis is a disease of low bone mass which leads to an increased risk of fracture. The prevalence of osteoporosis is greatest amongst postmenopausal women who also form a large portion of patients with osteoarthritis presenting for total knee arthroplasty. We present a case of a 77-year-old female with knee osteoarthritis and osteoporosis on denosumab who underwent robotic-assisted total knee arthroplasty. Read More

Life (Basel) 2021 Apr 27;11(5). Epub 2021 Apr 27.

Adult Reconstruction and Joint Replacement Division, Hospital for Special Surgery, 535 E 70th Street, New York, NY 10021, USA.

Focal chondral defects are common lesions of the articular cartilage. They are predominantly found on the medial femoral condyle and often progress to osteoarthritis of the knee. Various conservative treatment options are available. Read More

Materials (Basel) 2021 Apr 20;14(8). Epub 2021 Apr 20.

Department of Mechanical Engineering, Opole University of Technology, 45-758 Opole, Poland.

Total knee replacement (TKR) is a remarkable achievement in biomedical science that enhances human life. However, human beings still suffer from knee-joint-related problems such as aseptic loosening caused by excessive wear between articular surfaces, stress-shielding of the bone by prosthesis, and soft tissue development in the interface of bone and implant due to inappropriate selection of TKR material. The choice of most suitable materials for the femoral component of TKR is a critical decision; therefore, in this research paper, a hybrid multiple-criteria decision-making (MCDM) tactic is applied using the degree of membership (DoM) technique with a varied system, using the weighted sum method (WSM), the weighted product method (WPM), the weighted aggregated sum product assessment method (WASPAS), an evaluation based on distance from average solution (EDAS), and a technique for order of preference by similarity to ideal solution (TOPSIS). Read More

Materials (Basel) 2021 Apr 22;14(9). Epub 2021 Apr 22.

Dipartimento di Ingegneria Dell'Innovazione, Università del Salento, 73100 Lecce, Italy.

Success of total knee replacement (TKR) depends on the prosthetic design and materials. The use of metal components is well established with the disadvantage of allergic reactions. Ceramics have been recently proposed because of high wear resistance, excellent biocompatibility, wettability, and suitable mechanical properties. Read More

J Clin Med 2021 Apr 10;10(8). Epub 2021 Apr 10.

Department of Health Sciences, University of Jaén, 23071 Jaén, Spain.

Total knee replacement (TKR) surgery ameliorates knee function and the quality of life of patients, although 20% still experience dissatisfaction due to pain limiting their function. Radiofrequency Diathermy (MDR) has shown improvements in knee osteoarthritis and patellofemoral pain syndrome. As such, this study aims to assess the effects of MDR in the postoperative treatment of TKR patients. Read More

J Clin Med 2021 Apr 14;10(8). Epub 2021 Apr 14.

Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Göteborgsvägen 31, 431 80 Mölndal, Sweden.

Purpose: We aimed to study the influence of fast-track care programs in total hip and total knee replacements (THR and TKR) at Swedish hospitals on the risk of revision and mortality within 2 years after the operation.

Methods: Data were collected from the Swedish Hip and Knee Arthroplasty Registers (SHAR and SKAR), including 67,913 THR and 59,268 TKR operations from 2011 to 2015 on patients with osteoarthritis. Operations from 2011 to 2015 Revision and mortality in the fast-track group were compared with non-fast-track using Kaplan-Meier survival analysis and Cox regression analysis with adjustments. Read More

J Clin Med 2021 Apr 1;10(7). Epub 2021 Apr 1.

Department of Orthopaedic Surgery and Traumatology, Hospital Clínico Universitario Virgen de la Arrixaca, Ctra. Madrid-Cartagena, s/n, 30120 Murcia, Spain.

There have been remarkable advances in knee replacement surgery over the last few decades. One of the concerns continues to be the accuracy in achieving the desired alignment. Patient-specific instrumentation (PSI) was developed to increase component placement accuracy, but the available evidence is not conclusive. Read More

Medicina (Kaunas) 2021 Apr 1;57(4). Epub 2021 Apr 1.

Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University, Via Alvaro del Portillo, 200, Trigoria, 00128 Rome, Italy.

: Unicompartmental knee arthroplasty (UKA) is a valid alternative to total knee arthroplasties (TKAs) in selected cases. After surgery, patients' experience and satisfaction were traditionally evaluated by pre- and postsurgical scores and Patient-Reported Outcome Measures (PROMs). Otherwise, a statistically significant change does not necessarily correlate to a clinically meaningful improvement when measured using PROMs. Read More

Proc Inst Mech Eng H 2021 Apr 29:9544119211011827. Epub 2021 Apr 29.

Technology Implementation Research Center, Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, MA, USA.

Unicompartmental knee arthroplasty has been shown to provide superior functional outcomes compared to total knee arthroplasty and have motivated development of advanced implant designs including bicruciate retaining knee arthroplasty. However, few validated frameworks are available to directly compare the effect of implant design and surgical techniques on ligament function and joint kinematics. In the present study, the subject-specific lower extremity models were developed based on musculoskeletal modeling framework using force-dependent kinematics method, and validated against in vivo telemetric data. Read More

Knee Surg Sports Traumatol Arthrosc 2021 Apr 28. Epub 2021 Apr 28.

Department of Orthopaedic Surgery, Singapore General Hospital, 20 College Road, Academia, Level 4, Singapore, 169865, Singapore.

Purpose: The patient acceptable symptom state (PASS) is a target value on a patient-reported outcome measures (PROM) scale beyond which patients deem themselves to have attained an acceptable outcome. This study aimed to define the PASS thresholds for generic and knee-specific PROMs at 2 years after unicompartmental knee arthroplasty (UKA).

Methods: Prospectively collected data of 955 patients who underwent UKA for medial osteoarthritis at a single institution was reviewed. Read More

Can J Surg 2021 Apr 28;64(3):E253-E264. Epub 2021 Apr 28.

Health and Rehabilitation Sciences Program, Western University, London, Ont. (Lebedeva); School of Physical Therapy, Western University, London, Ont. (Churchill, Marsh, Bryant); Fowler Kennedy Sport Medicine Clinic, London, Ont. (Churchill, Giffin); Division of Orthopaedic Surgery, Schulich School of Medicine and Dentistry, Western University, London, Ont. (MacDonald, Giffin); University Hospital, London Health Sciences Centre, London, Ont. (MacDonald); Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ont. (Bryant).

Background: The escalating socioeconomic burden of knee osteoarthritis (OA) underscores the need for innovative strategies to reduce wait times for total knee arthroplasty (TKA). The purpose of this study was to evaluate resource use, costs and health-related quality of life (HRQoL) across the continuum of care for patients with knee OA.

Methods: This was a prospective study of 383 patients recruited from a high-volume teaching hospital at different stages of care (referral, consultation and presurgery). Read More

Yonsei Med J 2021 May;62(5):439-445

Department of Orthopedic Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.

Purpose: We aimed to investigate the accuracy of two-dimensional computed tomography (2D-CT)-based methods for measuring rotational alignment of the femoral component during total knee arthroplasty in comparison to reference values for three-dimensional (3D) reconstruction.

Materials And Methods: We selected the "most protruding transepicondylar axis section," "most protruding posterior condylar line section," and "distal femoral cut section" on 2D-CT images for 100 knees. We investigated posterior condylar angle (PCA) and condylar twist angle (CTA) values using three different methods on 2D-CT and compared to these values to those obtained using a 3D model. Read More

Cureus 2021 Mar 25;13(3):e14112. Epub 2021 Mar 25.

Trauma and Orthopaedics, Kettering General Hospital, Kettering, GBR.

The Risk Assessment and Prediction Tool (RAPT) was developed to predict patient discharge destination for arthroplasty operations. However, since Enhanced Recovery After Surgery (ERAS) programs have been utilized in the UK, the RAPT score has not been validated for use. The aim of the current study was to evaluate the predictive validity of the RAPT score in an ERAS environment with short length of stay. Read More

J Arthroplasty 2021 Apr 2. Epub 2021 Apr 2.

Department of Orthopaedics, Konkuk University Chungju Hospital, South Korea.

Background: The purpose of the present study was to compare the functional outcomes of medial unicompartmental knee arthroplasty (UKA) between patients with lateral meniscal abnormalities (LM [+] group) on the preoperative magnetic resonance imaging and those without lateral meniscal pathology (LM [-] group) and to evaluate the effect of a lateral meniscus lesion on functional outcomes after minimal 5 year follow-ups of medial UKA.

Methods: The outcomes of 66 knees (LM (+) group) were compared with the outcomes of 59 knees (LM (-) group) with a mean follow-up period of 75 months (range 60-93 months). The clinical outcomes were examined including the KS object/function score, Knee Injury and Osteoarthritis Outcome score, lateral side pain, and squatting ability at the last follow-up. Read More

Knee Surg Sports Traumatol Arthrosc 2021 Apr 26. Epub 2021 Apr 26.

Department of Orthopaedic Surgery, Martini Hospital Groningen, PO Box 30033, 9700 RM, Groningen, The Netherlands.

Purpose: The aim of this study was to investigate whether computer-assisted cryotherapy is effective in reducing postoperative pain and analgesics consumption, next to improving functional outcome and patient satisfaction after total knee arthroplasty (TKA). The hypothesis is that computer-assisted cryotherapy has positive effects on postoperative pain after TKA.

Methods: A single-centre non-blinded randomised controlled trial was designed to study the early (first postoperative week) and late (2 and 6 weeks postoperatively) additive effect of computer-assisted cooling after TKA. Read More

Cureus 2021 Mar 22;13(3):e14048. Epub 2021 Mar 22.

Orthopedic Surgery, Center for Hip and Knee Replacement, Providence Saint John's Health Center, Santa Monica, USA.

Introduction The deformities of protrusio acetabuli (PA) present unique reconstructive challenges. An incarcerated femoral head, medialized center of rotation, deficient bone stock, and associated leg length discrepancy add significant technical complexity to total hip arthroplasty (THA). Methods We retrospectively reviewed 23 THAs in 21 patients with PA who underwent direct anterior (DA) approach THA with intraoperative fluoroscopy. Read More

Rev Esp Cir Ortop Traumatol 2021 Apr 22. Epub 2021 Apr 22.

Departamento de Cirugía, Facultad de Medicina y Ciencias de la Salud, Universidad de Oviedo, Oviedo, Asturias, España. Electronic address:

Correct alignment of the limb after knee replacement implantation has been a commonly pursued goal since the beginning of this procedure. The mechanical alignment aims to maintain the axis of the limb at 180±3°, and for this it uses the standard instrumentation and the necessary tendon releases until achieving a symmetrical separation between femur and tibia and similar in flexion and extension. Kinematic alignment is based on the high frequency of the constitutional varus and to achieve this it is recommended to resect the damaged bone surface without altering the preoperative axis of the limb and without adding soft tissue release. Read More

J Biomech 2021 Apr 15;121:110420. Epub 2021 Apr 15.

Center for Biomedical Engineering and School of Engineering, Brown University, Providence, RI 02912, United States; Department of Orthopedics, The Warren Alpert Medical School of Brown University and Rhode Island Hospital, Providence, RI 02903, United States. Electronic address:

Total wrist arthroplasty (TWA) designs suffer from relatively high complication rates when compared to other arthroplasties. Understanding the contact pattern of hip and knee replacement has improved their design and function; however, the in vivo contact pattern of TWA has not yet been examined and is thus the aim of this study. We hypothesized that the center of contact (CoC) is located at the geometric centers of the carpal component and radial component in the neutral posture and that the CoC moves along the principal arcs of curvature throughout primary anatomical motions. Read More

Arthroplast Today 2021 Apr 2;8:171-175. Epub 2021 Apr 2.

Department of Orthopaedic Surgery, Hospital for Special Surgery, West Palm Beach, FL.

A 59-year-old woman with nail patella syndrome (NPS) presented with progressive and severe right knee pain for the past 3 years. Imaging demonstrated laterally dislocated patella, with asymmetric femoral trochlea, and advanced lateral compartment arthritis. The patient underwent robotic-assisted lateral unicompartmental knee arthroplasty (RAUKA). Read More

Cureus 2021 Mar 20;13(3):e14013. Epub 2021 Mar 20.

Orthopaedic Surgery, Jichi Medical University, Shimotsuke, JPN.

Transtibial pull-out repair is routinely performed to treat medial meniscal posterior root tear (MMPRT). However, data on the postoperative histological evaluation of the repaired medial meniscus posterior attachment after the procedure is scarce. In this report, we present a histological evaluation of the harvested specimen of a patient who underwent unicompartmental knee arthroplasty (UKA) approximately two years and six months after MMPRT transtibial pull-out repair. Read More