Does contemporary total knee designs replicate the anatomy of the native trochlea?

Purpose: Registry data shows that less surgeons are resurfacing the patella during total knee arthroplasty (TKA). This tendency highlights the importance of matching trochlear and native patellar anatomy. Currently, there is a lack of consensus on implant design that best accommodates native patellae.

Variations in Trochlear Morphology of Contemporary and Legacy Total Knee Arthroplasty Prostheses: A Review of 22 Designs.

Background: The morphology of the trochlear compartment of total knee arthroplasty (TKA) prostheses is a major determinant of postoperative patello-femoral kinematics, particularly with unresurfaced patellae. The objective of this study was to quantify and compare the trochlear morphology of a large series of contemporary and legacy TKA designs.

Methods: The 3-dimensional surface models of 22 femoral components (13 contemporary and 9 legacy) were created using high-resolution laser scanning.

Does Capsular Laxity Lead to Microinstability of the Native Hip?

Background: Hip "microinstability" is commonly cited as the cause of symptoms that occur in the presence of translation of the femoral head away from conformity with the acetabular fossa. However, there is still no consistent objective criteria defining its presence and biomechanical basis. One hypothesis is that abnormal motion of the articular surfaces occurs because of capsular laxity, ultimately leading to clinical symptoms.

Meniscal Root Tears: Identification and Repair.

Intact menisci are capable of converting the axial load of tibiofemoral contact into hoop stress that protects the knee joint. Total meniscectomy leads to rapid degeneration of the knee. Strong clinical and biomechanical data show meniscal root tears and avulsions are the functional equivalent of total meniscectomy.

Peer-reviewed, evidence-based analysis of vitamin D and primary hyperparathyroidism.

Background: Research into the actions of vitamin D on the human body has been increasing at an exponential rate, as has understanding of the impact of vitamin D on various aspects of the endocrine system. Primary hyperparathyroidism (PHPT) is a disease of the endocrine system that can result in debility if not diagnosed. New understanding about the effect of vitamin D on parathyroid hormone regulation may provide an opportunity to better understand the coexistence of PHPT and vitamin D deficiency.

Improved preoperative planning for directed parathyroidectomy with 4-dimensional computed tomography.

Background: Four-dimensional computed tomography (4D-CT) provides both functional and highly detailed anatomic information about parathyroid tumors. The purpose of this study was to compare 4D-CT with sestamibi imaging and ultrasonography as methods for the accurate preoperative localization of hyperfunctioning parathyroid glands before parathyroidectomy.

Methods: A study of 75 patients with primary hyperparathyroidism was performed at a tertiary-care institution.