Quantifying the Positional Deviation Between the True Flexion-Extension and Epicondylar Axes of the Elbow: A 3D Computational Study.

Background and objective The epicondyles are commonly used surgical reference landmarks for elbow arthroplasty and external fixator application. This study aimed to investigate whether the epicondylar axis differed from the elbow's true flexion-extension (F-E) axis in terms of both rotational difference and translational offset. Methods Three-dimensional (3D) models of 15 cadaver elbows were created.

Biomechanical Consequences of Proximal Screw Placement in Minimally Invasive Surgery for Hallux Valgus Correction.

Hallux valgus is one of the most common surgically corrected forefoot deformities. Studies evaluating clinical outcomes of minimally invasive chevron and akin (MICA) procedure have shown shorter operation time, faster recovery, and smaller scars compared to the open approach. Previous biomechanical cadaveric studies have largely focused on the open approach with minimal on MICA.

Determining patient acceptable symptom states from patient reported outcome measures following reverse shoulder arthroplasty: Constant-murley, UCLA, Oxford Shoulder Scores.

Aims: To establish cut-off values for Patient-Acceptable Symptom States (PASS) in three Patient Reported Outcome Measures (PROMs), the Constant-Murley Score (CMS) and University of California Los Angeles (UCLA) Shoulder Score and Oxford Shoulder Score (OSS) at 3, 6, and 12-months following reverse shoulder arthroplasty (RSA).

Methods: A retrospective study was conducted for individuals who were treated for massive rotator cuff tear, rotator cuff arthropathy or proximal humerus fractures with RSA from January 2011 and February 2020. This study included patients who have completed the patient reported outcome measures (PROMs) and satisfaction questions preoperatively, and at 3, 6 and 12-months after the procedure.

Functional outcome of direct anterior versus posterior approach in total hip arthroplasty: a propensity-matched Asian study.

Introduction: The direct anterior approach (DAA) to total hip arthroplasty (THA) is a surgical approach that minimises soft tissue trauma, resulting in faster rehabilitation when compared to a posterior approach (PA). This study aimed to evaluate the difference between the two groups in an Asian cohort using propensity score matching.

Methods: A retrospective review of prospectively collected registry data of 794 primary THAs was performed.

The double-lasso loop technique of Biceps tenodesis has lower displacement after cyclic loading, compared to interference screw fixation: Biomechanical analysis in an ovine model.

Background: Biceps tenodesis is an effective treatment for symptomatic long head of biceps tendon pathology. Recently the arthroscopic "double lasso-loop" suture anchor (DLSA) technique was described, advantaged by reduced cost, complexity, and operative time. We aimed to compare the in vitro strength of DLSA with conventional interference screws (IS).

Rotator cuff repair with an interposition polypropylene mesh: A biomechanical ovine study.

Background: Chronic large to massive rotator cuff tears are difficult to treat and re-tears are common even after surgical repair. We propose using a synthetic polypropylene mesh to increase the tensile strength of rotator cuff repairs. We hypothesize that using a polypropylene mesh to bridge the repair of large rotator cuff tears will increase the ultimate failure load of the repair.

Reduction of geometric misfit in straight antegrade humeral nailing by evaluating the effect of entry point angulation using a three-dimensional computational analysis.

Background: Straight antegrade intramedullary nails are generally inserted utilising the apex as the surgical entry point in accordance with the mechanical axis of the bone. Our objective is to optimise the bone-nail fit in intramedullary nailing by subjecting the surgical entry point to varying angulations in both the mediolateral and anterior-posterior directions via a quantitative fit assessment in each configuration to identify the optimal angulation, defined as the angulation with the lowest occurrence of thin-out to improve nail fitting within the humerus.

Methods: Computed tomography (CT) scans from 10 cadaveric humeri models were used to generate three-dimensional bone models.

Effect of implant length variations on stress shielding in proximal humeral replacement after tumor excision under torsion: Finite element study.

The proximal humerus is the most common site of occurrence of primary bone tumors in the upper limb. Endoprosthetic replacement is deemed as the preferred reconstructive option following primary resection of bone tumors. However, it has been also associated with complications such as stress shielding and aseptic loosening compromising prosthetic survival.

Relooking at double-bundle versus single-bundle anterior cruciate ligament reconstruction: A biomechanical model to evaluate which can confer better rotatory stability.

Background: To treat anterior cruciate ligament (ACL) injuries, double-bundle ACL reconstruction has been proposed as a more anatomical approach relative to single-bundle reconstruction. However, controversy remains over which technique is superior in addressing knee instability, particularly rotational laxity. We hypothesize that double-bundle reconstruction better restores rotational knee laxity, while both methods are similar in restoring anterior knee laxity, to intact knee levels.

Selective bundle versus complete anterior-cruciate ligament reconstruction: A systematic review and meta-analysis.

Purpose: Selective bundle reconstruction (SLB) refers to preservation of the intact bundle and reconstruction of the ruptured bundle in a partial tear while complete ACL reconstruction involves the removal of all remnant tissue and reconstruction of one or both bundles. As the evidence for SLB versus complete ACL reconstruction remains unclear, this study aimed to compare the two techniques. This study's hypothesis was that SLB reconstruction allows better function and stability compared to complete ACL reconstruction.

Bony Anatomy around the Watershed Line of the Distal Radius.

 An important surgical landmark in the distal radius is the watershed line. The watershed line is a landmark for the positioning of volar locking plates (VLP) in the distal radius. Inconsistencies remain in the literature as to the presence and dimensions of landmarks in this compact area.

Hematopoietic Wnts Modulate Endochondral Ossification During Fracture Healing.

Wnt signaling plays a critical role in bone formation, homeostasis, and injury repair. Multiple cell types in bone have been proposed to produce the Wnts required for these processes. The specific role of Wnts produced from cells of hematopoietic origin has not been previously characterized.

Studies of the criteria for determining optimal location of medial patellofemoral ligament attachment sites.

Identifying appropriate attachment sites is important in the planning of medial patellofemoral ligament (MPFL) reconstruction. Two criteria are advanced to describe normal MPFL function, namely isometric criterion and desired pattern criterion. Subsequently, computational methods have applied these criteria to determine optimal attachment sites.

No Difference in Outcome Between Articular-Sided and Bursal-Sided Tears: Comparative Study With Minimum 2-Year Follow-Up of Arthroscopic Repairs in 104 Patients in a Single-Surgeon Series.

Purpose: To evaluate and compare the functional outcomes after arthroscopic repair of bursal-sided versus articular-sided partial-thickness rotator cuff tears.

Methods: We conducted a retrospective analysis of patients who had undergone arthroscopic tear completion and subsequent repair of symptomatic partial-thickness rotator cuff tears in a single institution from 2010 to 2015. Range of motion (ROM) (forward flexion and abduction), the pain score as measured on the Numeric Pain Rating Scale, and outcome scores (Constant-Murley score, University of California, Los Angeles shoulder score, and Oxford Shoulder Score) were calculated preoperatively and at 1 year and 2 years postoperatively.

Biomechanical comparison of vertical suture techniques for repairing radial meniscus tear.

Purpose: The aim of this study was to (1) develop suture techniques in repairing radial meniscal tear; (2) to compare the biomechanical properties of the proposed repair techniques with the conventional double horizontal technique.

Methods: Thirty-six fresh-frozen porcine medial menisci were randomly assigned into four groups and a complete tear was made at the midline of each meniscus. The menisci were subsequently repaired using four different repair techniques: double vertical (DV), double vertical cross (DVX), hybrid composing one vertical and one horizontal stitch, and conventional double horizontal (DH) suture technique with suturing parallel to the tibia plateau.

Kinematic aligned femoral rotation leads to greater patella tilt but similar clinical outcomes when compared to traditional femoral component rotation in total knee arthroplasty. A propensity score matched study.

Purpose: External rotation of femoral component in total knee arthroplasty (TKA) with reference to the posterior condyles is recommended in mechanical alignment (MA) to ensure optimum patella tracking. In kinematic knee alignment (KA) technique, femoral component is more internally rotated as the femoral resection is based on flexion-extension axis. This study aims to investigate the clinical and radiological outcomes of the patellofemoral joint in patients who underwent TKA using KA versus mechanical alignment.

An anatomical and biomechanical assessment of the interosseous membrane of the cadaveric forearm.

Ten cadaveric specimens underwent biomechanical assessment on a motorized jig with an in-built torque sensor. A differential variable reluctance transducer was placed on the central bundle of the interosseous membrane to detect changes in strain. Torque was measured with an intact interosseous membrane and a sectioned central bundle of the interosseous membrane.

Effects of continuing use of aspirin on blood loss in patients who underwent unilateral total knee arthroplasty.

Purpose: Concerning the ongoing debate on the effects of continuing aspirin therapy on blood loss in knee arthroplasty, we conducted a retrospective investigation to test the hypothesis that continuation of aspirin prior total knee arthroplasty (TKA) will not cause more blood loss.

Methods: From a database of patients who underwent unilateral TKA between 2011 and 2016, we identified two groups: the aspirin group (patients continued aspirin during perioperative period) and the nonaspirin group (patients had no current or recent history of aspirin usage). We extracted and compared patient demographic information, comorbidity index, baseline serum hemoglobin (Hb), and creatinine level between the two groups.

Functional outcome and quality of life in patients with hip fracture after total knee arthroplasty.

Introduction: Hip fractures are a cause of significant morbidity. While rare, ipsilateral hip fractures within 12 months after total knee arthroplasty (TKA) can negatively affect the functional outcome and the quality of life for patients who have had TKA. This aim of this study is to investigate (1) the incidence of hip fracture within 12 months after TKA and (2) the influence of hip fracture after TKA on functional outcome and quality of life in patients.

The Effect of Renal Transplantation in End-Stage Renal Failure Patients Undergoing Total Hip Replacement.

Background: Patients with end-stage renal failure (ESRF) undergoing elective orthopedic surgery generally have higher postoperative morbidity and mortality compared to the general population. Studies on the outcome of ESRF patients undergoing total hip replacement (THR), especially those with a functioning renal transplant, are conflicting. We aim to evaluate the impact of renal transplantation on functional outcome and postoperative complications in patients with ESRF undergoing THR.

Gap formation after single lateral row versus dual-row suture bridge cuff repair: An ovine biomechanical model.

Background: The aim of this study is to compare two types of suture bridging constructs; a laterally based bridging single row (SR) construct and a classic dual row (DR) suture bridge construct. The hypothesis is that the DR construct will demonstrate superior biomechanical properties.

Methods: Six matched pairs of sheep infraspinatus tendon tears repaired with these two different types of suture bridging techniques were tested for gap formation, ultimate failure load and mode of failure.

Comparison of a simplified skin pointer device compared with a skeletal marker for knee rotation laxity: A cadaveric study using a rotation-meter.

Aim: To compare the measurements of knee rotation laxity by non-invasive skin pointer with a knee rotation jig in cadaveric knees against a skeletally mounted marker.

Methods: Six pairs of cadaveric legs were mounted on a knee rotation jig. One Kirscher wire was driven into the tibial tubercle as a bone marker and a skin pointer was attached.

Surgical Correction of Haglund's Triad Using a Central Tendon-Splitting Approach: A Retrospective Outcomes Study.

We evaluated the surgical outcomes of Haglund's triad using a central tendon-splitting approach, with Achilles tendon partial detachment and debridement, excision of the retrocalcaneal bursa, resection of Haglund's prominence, and reattachment of the Achilles tendon. The medical records of 22 patients (22 heels) who had undergone surgical correction of Haglund's triad from January 2010 to December 2015 were reviewed retrospectively. The visual analog scale pain score, American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot scale score, and 36-item Short-Form Health Survey physical and mental component scores were prospectively collected preoperatively, 6 months postoperatively, and at the last visit.