Robotic arm-assisted unicondylar knee arthroplasty resulted in superior radiological accuracy: a propensity score-matched analysis.

Introduction: Unicompartmental knee arthroplasty (UKA) is an effective surgical treatment for medial compartment arthritis of the knee, yet surgical outcomes are directly related to surgical execution. Robotic arm-assisted surgery aims to address these difficulties by allowing for detailed preoperative planning, real-time intraoperative assessment and haptic-controlled bone removal. This study aimed to compare the clinical and radiological outcomes between conventional manual mobile bearing and robot arm-assisted fixed bearing medial UKA in our local population.

The association between tibial torsion, knee flexion excursion and foot progression during gait in people with knee osteoarthritis: a cross-sectional study.

Background: Lower limb malalignment is associated with gait kinematics, but there is limited information on the relationship between gait kinematics and tibial torsion in individuals with knee osteoarthritis (OA). This study aimed to investigate possible associations between tibial torsion and early stance kinematics during gait in people with mild and moderate medial knee OA.

Methods: Forty-seven participants (age: 62.

Pain, balance, and mobility in people 1 year after total knee arthroplasty: a non-randomized cross-sectional pilot study contrasting posterior-stabilized and medial-pivot designs.

Background: Total knee arthroplasty (TKA) is a common treatment for severe knee osteoarthritis. Medial-pivot TKA systems (MP-TKA) are theoretically better than posterior-stabilized TKA systems (PS-TKA) in improving static and dynamic balance of patients although it is difficult to objectively quantify these balance parameters in a clinical setting. Therefore, this pilot study aimed to evaluate the feasibility of using wearable devices in a clinical setting to examine whether people with MP-TKA have better postoperative outcomes than PS-TKA, and their balance control is more akin to age-matched asymptomatic controls.

Adipokine Signaling Pathways in Osteoarthritis.

Osteoarthritis (OA) is a debilitating joint disease that affects millions of individuals. The pathogenesis of OA has not been fully elucidated. Obesity is a well-recognized risk factor for OA.

Artificial intelligence in diagnosis of knee osteoarthritis and prediction of arthroplasty outcomes: a review.

Background: Artificial intelligence is an emerging technology with rapid growth and increasing applications in orthopaedics. This study aimed to summarize the existing evidence and recent developments of artificial intelligence in diagnosing knee osteoarthritis and predicting outcomes of total knee arthroplasty.

Methods: PubMed and EMBASE databases were searched for articles published in peer-reviewed journals between January 1, 2010 and May 31, 2021.

The application of close incisional negative pressure wound therapy in revision arthroplasty among asian patients: a comparative study.

Introduction: Peri-prosthetic joint infection (PJI) was one of the main causes of revision of arthroplasty. In order to reduce wound complications and surgical site infections, close incisional negative pressure wound therapy (ciNPWT) has been introduced into arthroplasty. This study was designed to review the clinical benefits of the application of ciNPWT in revision arthroplasty.

Use of a modular hip dual-mobility articulation in patients with high risk of dislocation: a relatively small-sized acetabulum in Asian patients may limit its use.

Background: Dual-mobility hip component is widely used in Europe and North America, because it effectively reduces hip dislocation in primary and revision total hip arthroplasties. However, reports were limited on the use of dual-mobility articulation in Asian populations.

Purpose: The aim of this retrospective study was to review the use of modular dual-mobility hip articulation in Asian patients with the high risk factor for hip dislocation.

Hemodynamic stress shapes subchondral bone in osteoarthritis: An emerging hypothesis.

Unlabelled: Osteoarthritis (OA) is no longer regarded as a simple wear-and-tear problem of articular cartilage. Instead, OA is a whole joint disorder involving both cartilaginous and non-cartilaginous tissues such as subchondral bone and synovium. Among them, subchondral bone undergoes constant remodeling in response to the changes of mechanical environment.

A Randomized Controlled Study on the Use of Tourniquet in Primary Total Knee Arthroplasty.

Background:  The use and the optimal timing of tourniquet during primary total knee arthroplasty (TKA) is controversial. Most previous studies failed to show clinically significant differences in different strategies. The aim of this study was to determine how three strategies of tourniquet application affect the outcome in TKA patients.

Lessons learnt from the impact of COVID-19 on arthroplasty services in Hong Kong: how to prepare for the next pandemic?

Background: Arthroplasty services worldwide have been significantly disrupted by the pandemic of coronavirus disease 2019 (COVID-19). This retrospective comparative study aimed to characterize its impact on arthroplasty services in Hong Kong.

Methods: From January 1 to June 30, 2020, the patients of "COVID-19 cohort" underwent elective total hip or knee replacement in Hong Kong public hospitals.

Exploring the relationship between pain intensity and knee moments in participants with medial knee osteoarthritis: a cross-sectional study.

Background: High biomechanical loading is believed to be a risk factor to pain in people with knee osteoarthritis (OA), but controversial findings have been reported on the relationship between external knee adduction moment (KAM) and pain. A more comprehensive analysis considering other factor such as external knee flexion moment (KFM) could help better reveal this relationship. This study explored the relationship between external knee adduction moment and pain intensity in participants with knee osteoarthritis (OA) using an integrated path analysis model.

Knee joint loadings are related to tibial torsional alignments in people with radiographic medial knee osteoarthritis.

Torsional malalignment was detected in subjects with medial knee osteoarthritis (KOA) but few studies have reported the effect of torsional deformity on knee joint loads during walking. Therefore, this study examined the relationships between lower limb torsional alignments and knee joint loads during gait in people with symptomatic medial KOA using cross-sectional study design. Lower limb alignments including tibial torsion, tibiofemoral rotation and varus/valgus alignments in standing were measured by EOS low-dose bi-planar x-ray system in 47 subjects with mild or moderate KOA.

Psychometric Properties of Brief-Balance Evaluation Systems Test Among Multiple Populations: A Systematic Review and Meta-analysis.

Objective: To synthesize evidence regarding the psychometric properties of the Brief-Balance Evaluation Systems Test (BESTest) in assessing postural controls across various populations.

Data Sources: Articles were searched in 9 databases from inception to March 2020.

Study Selection: Two reviewers independently screened titles, abstracts, and full-text articles to include studies that reported at least 1 psychometric property of the Brief-BESTest.

Three-Dimensional Printing and Computer Navigation for Correction of Multiple Deformities in Osteogenesis Imperfecta: A Case Report.

Case: A 44-year-old man with osteogenesis imperfecta presented with multiple debilitating musculoskeletal deformities. Bi-level osteotomies, assisted by 3-dimensional (3D)-printed patient-specific cutting guides, were performed to correct extraarticular valgus and procurvatum tibial deformities. Concomitant computer-navigated total knee arthroplasty was performed to restore neutral mechanical alignment.

Acceptability and feasibility of a community-based strength, balance, and Tai Chi rehabilitation program in improving physical function and balance of patients after total knee arthroplasty: study protocol for a pilot randomized controlled trial.

Background: The rate of falls in patients after total knee arthroplasty (TKA) is high and related to lower limb muscle weakness and poor balance control. However, since routine post-TKA rehabilitation is uncommon, it is paramount to explore alternative strategies to enhance balance and physical functioning in post-TKA patients. As Tai Chi is a proven strategy for improving balance in older people, the proposed study aims to determine the feasibility and acceptability of a 12-week community-based post-TKA multimodal Tai Chi program and to collect preliminary data with respect to the efficacy of such a program in improving balance and physical functioning in post-TKA patients as compared to usual postoperative care.

Imaging of knee osteoarthritis: A review of current evidence and clinical guidelines.

Background: Knee osteoarthritis (OA) is one of the most common and debilitating degenerative joint diseases worldwide. While radiography is the most commonly used imaging modality, it is associated with drawbacks which newer modalities such as magnetic resonance imaging (MRI) and ultrasound could overcome. Nevertheless, the role of imaging in clinical practice and research in knee OA has not been clearly defined.

Robotic-Arm Assistance Simplifies Hip Arthrodesis Conversion to Total Hip Arthroplasty.

Hip fusion takedown to total hip replacement is a challenging operation. Neck osteotomy and acetabular component placement are technically demanding and often require fluoroscopic guidance. Robotic arm-assisted total hip arthroplasty enhances accuracy of preoperative planning and provides navigated guidance for neck osteotomy and haptic guidance on acetabular reaming and cup implantation.

Correcting severe flexion contracture with fusiform capsulectomy of posterior capsule during total knee arthroplasty.

Purpose: This study aimed to evaluate the safety and efficacy of fusiform capsulectomy of posterior capsule in correcting severe flexion contracture during total knee arthroplasty (TKA).

Methods: A retrospective analysis was performed in the patients who had preoperative severe flexion contracture (> 30 degrees) prior to TKA and received fusiform capsulectomy of posterior capsule during TKA between December 2013 and November 2018. Range of motion (ROM), knee functional score, forgotten joint score (FJS), post-operative complications, and radiographic results were collected and evaluated.

Effect of Steroid in Local Infiltration Analgesia in One-Stage Bilateral Total Knee Arthroplasty: A Paired-Randomized Controlled Study.

Although local infiltration analgesia (LIA) is effective in relieving pain after total knee arthroplasty (TKA), its effect is short lasting and the optimal combination of drugs is unknown. Steroids being a potent and long-acting anti-inflammatory drug might extend LIA's effect. This study aims to evaluate the role of steroids in LIA.

3D High-Frequency Ultrasound Imaging of Cartilage-Bone Interface Compared with Micro-CT.

Cartilage-bone interface (CBI) is a complex structure which bears important information in pathophysiology of osteoarthritis (OA). While high-frequency ultrasound (US) has been widely used for the investigation of articular cartilage, 3D imaging of CBI using US is less commonly reported in this field. Here, we adopted a 3D high-frequency ultrasound imaging approach specifically for the investigation of CBI in human knee samples.

How well do elderly patients do after total knee arthroplasty in the era of fast-track surgery?

Introduction: Total knee arthroplasty (TKA) in the elderly population is becoming increasingly prevalent. This study aimed to compare outcomes of patients aged ≥80 years with those aged < 80 years at time of TKA and to assess the effect of fast track peri-operative care on outcomes in the elderly.

Materials And Methods: 422 TKAs were performed in aged ≥80 at the time of surgery between 2009 and 2018.

The Medial Collateral Ligament in Primary Total Knee Arthroplasty: Anatomy, Biomechanics, and Injury.

Understanding the anatomy and biomechanics of the medial collateral ligament (MCL) is crucial in producing good outcomes after total knee arthroplasty. A solid grasp of the surgical techniques that address the MCL are necessary to ensure good coronal plane ligament balance. Furthermore, intraoperative injury to the MCL in total knee arthroplasty is an uncommon yet serious complication which often goes unrecognized.