Eighteen-year outcome of anterior cruciate ligament reconstruction with patellar tendon or hamstring autograft.

Purpose: To evaluate patient reported outcomes and radiographic arthritic changes of transtibial anterior cruciate ligament reconstruction (ACLR) with either bone-patellar tendon-bone (BPTB) or hamstrings (HS) auto-grafts at a minimum of 15-year follow-up.

Methods: Ninety-four patients (51 of the HS group, 43 of BPTB group) who were operated between the years 2000 to 2005 in two tertiary referral hospitals were contacted and invited to a retrospective evaluation. The interview included subjective outcomes using the Lysholm knee scoring questionnaire, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Tegner activity level scale, Visual Analogue Scale (VAS) for pain and patients' satisfaction scale.

Pearls and pitfalls of PROMIS clinically significant outcomes in orthopaedic surgery.

Introduction: Patient-Reported Outcome Measurement Information System (PROMIS) was developed as a uniform and generalizable PROM system using item response theory and computer adaptive testing. We aimed to assess the utilization of PROMIS for clinically significant outcomes (CSOs) measurements and provide insights into its use in orthopaedic research.

Materials And Methods: We reviewed PROMIS CSO reports for orthopaedic procedures via PubMed, Cochrane Library, Embase, CINAHL, and Web of Science from inception to 2022, excluding abstracts and missing measurements.

The meniscotibial ligament role in meniscal extrusion: a systematic review and meta-analysis.

Introduction: The meniscotibial ligament (MTL) limits extrusion of the medial meniscus (MM). While meniscal extrusion may be detrimental to knee joint biomechanics, the role of the MTL in meniscal extrusion is debatable. We sought to perform a systematic review and meta-analysis to evaluate the role of the MTL and surgical techniques for MTL repair.

Efficacy of Intra-articular Versus Extra-articular Bupivacaine Injection in Arthroscopic Partial Meniscectomy: A Prospective, Randomized, Double-Blind Clinical Trial.

Background: Immediate postoperative pain relief following arthroscopic partial meniscectomy remains a critical contributor to improved patient experience, early recovery of range of motion, and enhanced rehabilitation.

Purpose: To evaluate the effect of intra-articular versus extra-articular bupivacaine on pain intensity and analgesic intake after arthroscopic partial meniscectomy.

Study Design: Randomized controlled trial; Level of evidence, 1.

Meniscal extrusion under increasing varus in stress patients with a medial meniscus posterior root-tear.

Posterior root-tear of the medial meniscus and accompanied meniscal extrusion can lead to functional loss of the meniscus. The aim of this study is to assess medial meniscus extrusion at increasing varus forces utilizing magnetic resonance imaging (MRI), in order to evaluate the contribution of the adduction moment of the knee during gait. We prospectively enrolled 19 patients (38 knees).

Return to Driving After Hip Arthroscopy: A Systematic Review and Meta-analysis.

Background: Hip arthroscopy is an increasingly common procedure; however, recommendations for safely returning to driving after hip arthroscopy vary among surgeons.

Purpose: To systematically review and analyze the current available evidence on the optimal time to safely return to driving after hip arthroscopy.

Study Design: Systematic review; Level of evidence, 3.

[SEPTIC KNEE - DIAGNOSIS AND TREATMENT].

Acute septic arthritis of the knee joint is an orthopedic emergency, potentially devastating, which can lead to high morbidity and may even be life-threatening. While any synovial joint can be infected, the knee is the most often affected joint and is involved in about 50 % of the cases. The infection is usually caused by a gram-positive bacteria.

Intrathoracic scapular dislocation following radical surgical chondrosarcoma resection from chest wall.

Locked scapula or intrathoracic scapular dislocation is an extremely rare entity encountered in the emergency department, with very few cases reported in literature. Conservative vs surgical approach in treating intrathoracic scapular dislocation is not well defined in literature. In this case report, we present a rare case of intrathoracic scapular dislocation, following multiple ribs resection due to malignant bone tumour, which was treated by closed manipulation reduction technique.

Individualized tibial tubercle-trochlear groove distance-to-patellar length ratio (TT-TG/PL) is a more reliable measurement than TT-TG alone for evaluating patellar instability.

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.

Reliability and validity of the Hebrew version of the forgotten joint score for assessing the outcomes of total knee arthroplasty.

Background: This prospective study aimed to assess the reliability and validity of the Hebrew version of the forgotten joint score-12 in patients undergoing total knee arthroplasty, because it is going to be used in the Hebrew-speaking populations in Israel.

Methods: The English version of forgotten joint score-12 was translated into Hebrew version by using the standard procedures and in collaboration with its authors. The consecutive patients who had undergone total knee arthroplasty in a single hospital were asked to fill out the Hebrew version of forgotten joint score-12, Oxford knee score, Short Form 12, and visual analog scale.

The impact of body mass index on the accuracy of the physical examination of the knee.

Purpose: Obesity is a worldwide pandemic; however, no adaptations were made to the physical examination of obese patient's knees. The accuracy of the physical examination is critical for correct assessment and selection of treatment. We aimed to assess whether body mass index (BMI) affects the sensitivity and specificity of common provocative knee tests.

Impact of Body Mass Index on the Accuracy of Physical Examination and MRI of the Shoulder.

Background: The physical examination of overweight patients can require specific adaptations. Orthopaedic literature on the impact of body mass index (BMI) on the physical examination of the shoulder is virtually nonexistent.

Purpose: To assess whether BMI affects the sensitivity and specificity of common shoulder tests, using arthroscopy as a gold standard.

Patients undergoing staged bilateral knee arthroplasty are less aware of their kinematic aligned knee compared to their mechanical knee.

Objective: To compare knee joint awareness following kinematic alignment (KA) TKA in patients who had previously undergone mechanical alignment (MA) on their contralateral knee.

Methods: We performed a retrospective study of all consecutive patients who underwent staged bilateral TKA, the first using MA technique and the second utilizing the KA technique, without patient specific instrumentations. Primary outcome was assessed by the Forgotten Joint Score (FJS) with a minimum 1-year follow-up.

Bacterial contamination of protective lead garments in an operating room setting.

Background: Protective lead garments (PLG) worn in the operating room are a potential source for bacterial colonisation and thus may increase the risk of intraoperative infection. The clinical significance of such bacterial contamination has yet been established. Although disinfection protocols have been employed, their effectiveness is also unknown.

T2 Mapping Values in Postmeniscectomy Knee Articular Cartilage after Running: Early Signs of Osteoarthritis?

Loading on the joints during running may have a deleterious effect on post-partial meniscectomy knee cartilage, leading to osteoarthritis. Utilizing T2-mapping measurements before and after running may enable the observation of changes in the articular cartilage of the postmeniscectomy knees compared with healthy knees. After medial partial meniscectomy, 12 volunteers underwent magnetic resonance imaging (MRI) of the both knees, before and immediately after 30 minutes of running.

A novel approach for knee osteoarthritis using high molecular weight hyaluronic acid conjugated to plasma fibrinogen - interim findings of a double-blind clinical study.

Objective: Osteoarthritis (OA) is a widespread degenerative joint disease leading to progressive loss of function and pain. Available treatments do not provide long-term relief or improvement. This study aimed to assess the safety and efficacy of a novel intra articular supplement, made of high molecular-weight hyaluronic acid (HA) uniquely conjugated to either purified (RegenoGel) or autologous plasma-derived fibrinogen (RegenoGel-OSP), as a long-term treatment for knee OA.

The Missing Piece: A Subtrochanteric Hip Fracture Presenting with Abdominal Pain: A Case Report.

Case: A 33-year-old man presented with acute abdominal and left hip pain after being struck by a motor vehicle. Radiographs revealed a comminuted left subtrochanteric femoral fracture. Computed tomography demonstrated a large pelvic hematoma and a radiopaque mass in the abdomen.

Piezo2 expressed in proprioceptive neurons is essential for skeletal integrity.

In humans, mutations in the PIEZO2 gene, which encodes for a mechanosensitive ion channel, were found to result in skeletal abnormalities including scoliosis and hip dysplasia. Here, we show in mice that loss of Piezo2 expression in the proprioceptive system recapitulates several human skeletal abnormalities. While loss of Piezo2 in chondrogenic or osteogenic lineages does not lead to human-like skeletal abnormalities, its loss in proprioceptive neurons leads to spine malalignment and hip dysplasia.

Mini Invasive Floating Metatarsal Osteotomy for Diabetic Foot Ulcers Under the First Metatarsal Head: A Case Series.

Diabetic foot ulcers under the first metatarsal head are difficult to treat and prevent recurrence. The aim of this study is to summarize the results of a distal first metatarsal minimally invasive floating osteotomy for ulcers under the first metatarsal head in patients with diabetic neuropathy. We reviewed files of patients with diabetic neuropathy undergoing a floating first metatarsal osteotomy.

Avoiding Injury to the Popliteal Neurovascular Bundle in All-Inside Suturing of the Posterior Horn of the Lateral Meniscus: A Magnetic Resonance Imaging Assessment of Portal Selection and Safety.

Purpose: We assessed the risk of injury to the popliteal neurovascular bundle (PNVB) while suturing the posterior horn of the lateral meniscus (PHLM).

Methods: We simulated all-inside suturing of the PHLM using magnetic resonance imaging of 60 knees. Lines were drawn from the medial and the lateral edges of the patellar tendon to the PHLM at increasing distances from the posterior cruciate ligament (PCL) to simulate suturing device trajectory.

Outpatient Negative-Pressure Wound Therapy Following Surgical Debridement: Results and Complications.

Objective: To present results and complications in a case series of outpatients with diabetic and neuropathic foot ulcers with exposed bone following surgical debridement treated with negative-pressure wound therapy (NPWT).

Methods: Retrospective data were obtained from digital medical records from the Maccabi Health Services High Risk Foot Clinic in Tel Aviv, Israel, between 2009 and 2014. Medical records examined were those of clinic outpatients with exposed bone following partial foot amputation or selective bone debridement (University of Texas grade III-A) treated with NPWT.

Surgical offloading procedures for diabetic foot ulcers compared to best non-surgical treatment: a study protocol for a randomized controlled trial.

Background: Diabetic foot ulcers are frequently related to elevated pressure under a bony prominence. Conservative treatment includes offloading with orthopaedic shoes and custom made orthotics or plaster casts. While casting in plaster is usually effective in achieving primary closure of foot ulcers, recurrence rates are high.

The Proprioceptive System Regulates Morphologic Restoration of Fractured Bones.

Successful fracture repair requires restoration of bone morphology and mechanical integrity. Recent evidence shows that fractured bones of neonatal mice undergo spontaneous realignment, dubbed "natural reduction." Here, we show that natural reduction is regulated by the proprioceptive system and improves with age.

The Proprioceptive System Masterminds Spinal Alignment: Insight into the Mechanism of Scoliosis.

Maintaining posture requires tight regulation of the position and orientation of numerous spinal components. Yet, surprisingly little is known about this regulatory mechanism, whose failure may result in spinal deformity as in adolescent idiopathic scoliosis. Here, we use genetic mouse models to demonstrate the involvement of proprioception in regulating spine alignment.