Assessment of Fresh Homologous Osteochondral Transplantation in Knees as a Salvage Treatment: A Prospective Case Series with a Minimum Follow-up Period of 10 Months.

 The present study evaluated the clinical outcomes and satisfaction of patients undergoing fresh homologous osteochondral transplantation in the knee as a salvage method.  We analyzed eight knees from seven male patients who underwent fresh homologous osteochondral transplantation by a single surgeon. Their follow-up period ranged from 10 months to 5 years and 5 months.

Editorial Commentary: Surgical Treatment Algorithm for Patellofemoral Recurrent Instability.

As a frame of reference, the patella can be "out" of the trochlea owing to extensor mechanism malalignment, such as an increased tibial tuberosity (TT)-trochlear groove (TG) distance, or the trochlea can be "out" of the patella if the TG is misplaced owing to increased internal femoral torsion. Both lead to an increased Q angle and patellofemoral maltracking. Medial patellofemoral ligament reconstruction acts as a medial checkrein against instability, but it does not solve maltracking in every case.

Gait kinematics of osteoarthritic knees after intra-articular viscosupplementation: A double-blinded randomized controlled trial.

Background: The utilization of subjective questionnaires for assessing conservative treatment in knee osteoarthritis may present challenges in identifying differences due to inadequate statistical power. Objective tools, such as three-dimensional (3D) kinematic analysis, are accurate and reproducible methods. However, no high-quality studies assessing the effects of intra-articular viscosupplementation (VS) have been published.

Variables Associated With Knee Valgus in Male Professional Soccer Players During a Single-Leg Vertical Landing Task.

Prior studies have explored the relationship between knee valgus and musculoskeletal variables to formulate injury prevention programs, primarily for females. Nonetheless, there is insufficient evidence pertaining to professional male soccer players. Here, the aim was to test the correlation of lateral trunk inclination, hip adduction, hip internal rotation, ankle dorsiflexion range of motion, and hip isometric strength with knee valgus during the single-leg vertical jump test.

Extensor mechanism injury, infection, and an extended time between trauma and surgical approach are related to the need for total knee arthroplasty removal after traumatic dehiscence.

Background: Surgical wound-related traumatic complications are rarely reported in the literature. Traumatic dehiscence is unpredictable because of the trauma magnitude and the potential of associated injuries. This study aims to report the clinical outcomes and complications of a case series due to traumatic dehiscence after total knee arthroplasty (TKA) and establish possible criteria for prognosis for maintaining the implant.

Three-dimensional printing models increase inter-rater agreement for classification and treatment of proximal humerus fractures.

Background: Proximal humerus fractures (PHF) are frequent, however, several studies show low inter-rater agreement in the diagnosis and treatment of these injuries. Differences are usually related to the experience of the evaluators and/or the diagnostic methods used. This study was designed to investigate the hypothesis that shoulder surgeons and diagnostic imaging specialists using 3D printing models and shoulder CT scans in assessing proximal humerus fractures.

Remnant preserving ACL reconstruction with a functional remnant is related to improved laxity but not to improved clinical outcomes in comparison to a nonfunctional remnant.

Purpose: The Anterior cruciate ligament (ACL) remnant has been pointed out as a ligamentization enhancer. Nonetheless, the remaining tissue can be functional if it still provides some stability or nonfunctional. This study intends to compare the clinical results and knee stability of functional vs.

Trochlear Dysplasia Does Not Affect the Outcomes of Patellofemoral Autologous Chondrocyte Implantation.

Purpose: To evaluate the influence of trochlear dysplasia on clinical outcomes after autologous chondrocyte implantation (ACI) for the treatment of large cartilage lesions in the patellofemoral joint (PFJ) with a minimum of 2 years' follow-up.

Methods: We performed a retrospective review of prospectively collected data of all patients submitted to cartilage repair with ACI for focal cartilage defects in the PFJ by a single surgeon. Patient factors, lesion morphology, and preoperative and postoperative patient-reported outcome measures including the Knee Injury and Osteoarthritis Score, Lysholm score, Tegner activity level, and International Knee Documentation Committee Subjective Knee Evaluation Form score were collected.

The development of the intercondylar notch in the pediatric population.

Background: Anterior cruciate ligament (ACL) repair is increasing in frequency in younger children. Recognition of the normal development of the intercondylar notch is important for successful ACL graft placement, allowing surgeons to better understand the anatomy and risk factors related to ACL tears and its reconstruction. The purpose of this study was to compile normative data on the intercondylar notch in the pediatric population with magnetic resonance imaging (MRI), emphasizing the differences between males and females.

Mechanical evaluation of tibial fixation of the hamstring tendon in anterior cruciate ligament double-bundle reconstruction with and without interference screws.

Objective: The objective of this study was to compare two postero-lateral bundle (PLB) tibial fixation techniques for the reconstruction of the anterior cruciate ligament with double bundle: a technique without the use of an interference screw, preserving the native tibial insertion of the tendons of the gracilis and semitendineous muscles, and a technique with the use of an interference screw and without preserving the insertion of the tendons.

Methods: A comparative study was conducted in cadavers with a universal mechanical test machine. In total, 23 cadaver knees were randomized for tibial fixation of the PLB using the two techniques: Maintaining the tibial insertion of the tendons during reconstruction, without the use of an interference screw (group A, 11 cases); and fixating the graft with an interference screw, without maintaining the insertion of the tendons (group B, 12 cases).

Isolated MPTL reconstruction fails to restore lateral patellar stability when compared to MPFL reconstruction.

Purpose: To biomechanically evaluate MPTL reconstruction and compare it with two techniques for MPFL reconstruction in regard to changes in patellofemoral contact pressures and restoration of patellar stability.

Methods: This is an experimental laboratory study in eight human cadaveric knees. None had patellofemoral cartilage lesions or trochlear dysplasia as evaluated by conventional radiographs and MRI examinations.

A Hamstring-Based Anatomic Posterolateral Knee Reconstruction With Autografts Improves Both Radiographic Instability and Functional Outcomes.

Purpose: To report the subjective outcomes and objective stability in a series of chronically grade III posterolateral injured knees treated with a hamstring-based anatomic posterolateral corner (PLC) reconstruction technique using autografts.

Methods: An outcome study of patients with a chronic complete tear of all ligamentous structures of the PLC (>5 mm of varus gapping at 30, ≥10° of external tibial rotation during the dial test, ≥4 mm of increased lateral compartment opening during varus stress radiographs) was performed. The patients were evaluated subjectively with Lysholm, International Knee Documentation Committee (IKDC), and Tegner scores and objectively with varus stress radiographs at 20° of knee flexion, IKDC objective scores, and recurvatum evaluation.

Biomechanical Comparison of Vertical Mattress and Cross-stitch Suture Techniques and Single- and Double-Row Configurations for the Treatment of Bucket-Handle Medial Meniscal Tears.

Background: Given the variety of suturing techniques for bucket-handle meniscal repair, it is important to assess which suturing technique best restores native biomechanics.

Purpose/hypothesis: To biomechanically compare vertical mattress and cross-stitch suture techniques, in single- and double-row configurations, in their ability to restore native knee kinematics in a bucket-handle medial meniscal tear model. The hypothesis was that there would be no difference between the vertical mattress and cross-stitch double-row suture techniques but that the double-row technique would provide significantly improved biomechanical parameters versus the single-row technique.

Anteromedial Tibial Tubercle Osteotomy Improves Results of Medial Patellofemoral Ligament Reconstruction for Recurrent Patellar Instability in Patients With Tibial Tuberosity-Trochlear Groove Distance of 17 to 20 mm.

Purpose: To compare the midterm clinical outcomes of anteromedialization tibial tubercle osteotomy combined with medial patellofemoral ligament reconstruction (TTO+MPFLR) with MPFLR alone (MPFLRa) for the treatment of recurrent patellar instability (RPI) in patients with a tibial tuberosity-trochlear groove (TT-TG) of 17 to 20 mm.

Methods: From January 2008 to August 2013, patients with RPI and a TT-TG of 17 to 20 mm were divided into 2 groups: TTO+MPFLR or MPFLRa. Subjects were evaluated for J sign classification (1-4+); patellar glide (1-4+); the apprehension test; increased femoral anteversion; the Caton index; trochlear dysplasia; TT-TG; and Kujala, Lysholm, International Knee Documentation Committee (IKDC), and Tegner scores.

Bicruciate lesion biomechanics, Part 2-treatment using a simultaneous tensioning protocol: ACL fixation first is better than PCL fixation first to restore tibiofemoral orientation.

Purpose: An uncommon technique for bicruciate ligament reconstruction involving simultaneous tensioning of the anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) grafts with ACL graft fixation first has been pointed out as superior to the "gold-standard" PCL graft fixation first. The purpose of this study was to compare tibiofemoral biomechanics between ACL fixation first and PCL fixation first in a simultaneous tensioning protocol for bicruciate ligament reconstruction.

Methods: 12 fresh-frozen cadaveric knees (six matched pairs) were tested using a custom testing system.

Bicruciate lesion biomechanics, Part 1-Diagnosis: translations over 15 mm at 90° of knee flexion are indicative of a complete tear.

Purpose: Understanding the pathomechanics of a bicruciate injury (BI) is critical for its correct diagnosis and treatment. The purpose of this biomechanical study aims to quantify the effects of sequential sectioning of the anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) bundles on knee laxity.

Methods: Twelve cadaveric knees (six matched pairs) were used.

Forgotten Joint Score - Portuguese translation and cultural adaptation of the instrument of evaluation for hip and knee arthroplasties.

Objective: To translate and adapt culturally to Brazilian Portuguese the Forgotten Joint Score (FJS) patient-reported outcome questionnaire.

Methods: Forty-five patients in the postoperative period (3-12 months) of total knee and hip arthroplasty were asked to answer the Br FJS questionnaire, translated into Portuguese based on the guidelines of the International Society for Pharmacoeconomics and Outcomes Research (ISPOR).

Results: Twenty-three patients completed the questionnaire correctly, suggesting changes when pertinent.

Anatomic Posterolateral Corner Reconstruction With Autografts.

Anatomic posterolateral corner reconstruction reproduces 3 main structures: the lateral collateral ligament, the popliteofibular ligament, and the popliteus tendon. The LaPrade technique reproduces all 3 main stabilizers. However, it requires a long graft, limiting its indication to clinical settings in which allograft tissue is available.

Quadriceps Strength Deficit at 6 Months After ACL Reconstruction Does Not Predict Return to Preinjury Sports Level.

Background: There is a lack of literature-based objective criteria for return to sport after anterior cruciate ligament (ACL) injury. Establishing such objective criteria is crucial to improving return to sport after ACL reconstruction (ACLR).

Hypotheses: Patients who return to their preinjury level of sport will have higher isokinetic, postural stability, and drop vertical jump test scores 6 months after surgery and greater patient satisfaction compared with those who did not.

Drug-induced modulation of gp130 signalling prevents articular cartilage degeneration and promotes repair.

Objective: Human adult articular cartilage (AC) has little capacity for repair, and joint surface injuries often result in osteoarthritis (OA), characterised by loss of matrix, hypertrophy and chondrocyte apoptosis. Inflammation mediated by interleukin (IL)-6 family cytokines has been identified as a critical driver of proarthritic changes in mouse and human joints, resulting in a feed-forward process driving expression of matrix degrading enzymes and IL-6 itself. Here we show that signalling through glycoprotein 130 (gp130), the common receptor for IL-6 family cytokines, can have both context-specific and cytokine-specific effects on articular chondrocytes and that a small molecule gp130 modulator can bias signalling towards anti-inflammatory and antidegenerative outputs.

One-incision versus two-incision techniques for arthroscopically assisted anterior cruciate ligament reconstruction in adults.

Background: Anterior cruciate ligament (ACL) tears are serious knee injuries that are frequently treated surgically in the form of arthroscopically assisted reconstruction with grafts from the patella or hamstrings tendons. We reviewed the evidence for the choice of arthroscopically assisted ACL reconstruction technique in terms of whether it should involve one incision (femoral tunnel drilled from inside the knee joint under arthroscopic visualisation) or two incisions (femoral tunnel drilled from outside to inside the knee joint).

Objectives: To assess the effects (benefits and harms) of one-incision versus two-incision techniques for arthroscopically assisted ACL reconstruction in adults.

Anterior cruciate ligament and meniscal injuries in sports: incidence, time of practice until injury, and limitations caused after trauma.

Objective: To analyze the incidence of ACL and meniscal injuries in a population of recreational and elite athletes from Brazil and the relation of these injuries with their sports activities.

Methods: This was a prospective observational study of 240 patients with ACL and/or meniscal injuries submitted to surgical treatment. Data of patients and sport modality, as well as Tegner score were registered in the first clinical evaluation.

Surgical interventions (microfracture, drilling, mosaicplasty, and allograft transplantation) for treating isolated cartilage defects of the knee in adults.

Background: Cartilage defects of the knee are often debilitating and predispose to osteoarthritis. Microfracture, drilling, mosaicplasty, and allograft transplantation are four surgical treatment options that are increasingly performed worldwide. We set out to examine the relative effects of these different methods.