Joint-line obliquity angle is significantly affected by hip abduction and adduction: A simulated analysis.

Purpose: Different methods for quantifying joint-line obliquity (JLO) have been described, including joint-line obliquity angle (JLOA), Mikulicz joint-line angle (MJLA) and medial proximal tibial angle (MPTA). The goal of the present study was to quantify the variation of JLOA based on the position of the hip. The hypothesis of our study is that JLO is significantly influenced by the abduction/adduction of the limb, unlike MJLA.

Mathematical explanations for knee osteotomies: "Dear engineer, how would you explain it in a simple way?".

Introduction: Knee osteotomies are effective procedures to treat different deformities and to redistribute the load at the joint level, reducing the risk of wear and, consequently, the need for invasive procedures. Particularly, knee osteotomies are effective in treating early arthritis related to knee deformities in young and active patients with high functional demands, with excellent long-term results. Precise mathematical calculations are imperative during the preoperative phase to achieve tailored and accurate corrections for each patient and avoid complications, but sometimes those formulas are challenging to comprehend and apply.

How to manage a native stiff knee.

Knee stiffness is a widely known and worrying condition in several postoperative knees. Less is known about native stiff knee. The aim of this manuscript is to summarize the available literature on native stiff knee epidemiology, classification and treatment.

Pediatric Anterior Cruciate Ligament Reconstruction With Over-the-Top Femoral Position and All-Epiphyseal Tibial Tunnel.

In pediatric anterior cruciate ligament reconstruction, many factors should be considered: (1) risk of growth disturbance; (2) high risk of re-tear; (3) determination of the skeletal age, which is sometimes challenging; and (4) no single technique indicated for all patients. The choice of the technique mostly depends on the patients' age and growth potential. Whereas prepubescent patients can be safely treated with physeal sparing techniques (i.

Transepicondylar distance measured on MRI can predict the length of the graft required for different anterior cruciate ligament reconstruction (ACLR) techniques useful for revision surgery.

Background: The aim of this study is to find a correlation between linear measurements and the graft length required for different anterior cruciate ligament (ACL) revision techniques, to extract formulas to predict required graft length during the preoperative planning.

Methods: At time 0 and 30 days later, two observers measured eight linear distances on standard 2D knee magnetic resonance imaging (MRI), and nine curved distances on 3D MRI sequences, corresponding to different techniques for ACL revision, anatomic anterolateral ligament (ALL) reconstruction, and lateral extrarticular tenodesis (LET). Intra- and interobserver reliability was tested for 2D and 3D measurements.

Primary TKA in patients with major deformities and ligament laxities: promising results of an intermediate constrained implant at mid-term follow-up.

Background: Total knee arthroplasty (TKA) in major deformities with ligament insufficiency may require a higher constraint, with bone sacrifice and concerns about long-term survivorship. Mid-level constraint liners have been recently introduced, but few studies described their outcomes. The aim of this study is to evaluate the short to mid-term outcomes of a constrained postero-stabilized (CPS) insert for primary TKA in moderate to severe deformities.

Tibial tubercle osteotomy for patellofemoral malalignment and chondral disease provided good outcomes: A systematic review.

Importance: Tibial tubercle osteotomy (TTO) is indicated to treat patellofemoral (PF) malalignment and chondral disease refractory to conservative treatment. However, there are no systematic reviews describing TTO outcomes in chondral damages without instability.

Aim: The aims of this study were to (1) assess the quality of the published studies, (2) identify indication for TTO to treat PFP with chondral disease without instability, (3) evaluate the most common TTO techniques, (4) evaluate the clinical outcomes, and (5) evaluate TTO's complication and failure rates.

Joint Line Obliquity Does Not Affect the Outcomes of Opening Wedge High Tibial Osteotomy at an Average 10-Year Follow-up.

Background: A significant number of high tibial osteotomies (HTOs) result in an overcorrected tibia and subsequent excessive lateral joint line obliquity (JLO). The correlation between excessive JLO and poor outcomes is controversial.

Purpose: To evaluate the prognostic factors (including a pathological postoperative JLO) related with the outcomes of opening wedge HTO at 10 years of follow-up.

Transepicondylar Distance Can Predict Graft and Tunnel Length for Different Pediatric Anterior Cruciate Ligament Reconstruction Techniques: A Magnetic Resonance Imaging Study.

Purpose: To find a correlation and mathematical formulas between a linear 2-dimensional (2D) magnetic resonance imaging (MRI) measurement around the knee and the length of the grafts and tunnels required for both all-inside-all-epiphyseal and Kocher-Micheli pediatric anterior cruciate ligament (ACL) reconstruction techniques.

Methods: At time 0 and 30 days after, 2 observers measured: (1) on standard 2D knee MRI, 7 linear distances, representing morphologic measurements, such as transepicondylar distance (TD), and (2) on 3-dimensional (3D) MRI, 5 curved distances, corresponding to Kocher-Micheli and all-epiphyseal ACL reconstruction techniques. Intra- and interobserver reliability was tested for all measurements.

Modifiable and Nonmodifiable Predictive Factors Associated with the Outcomes of Total Knee Arthroplasty.

Total knee arthroplasty (TKA) is a valuable treatment option for advanced osteoarthritis in patients unresponsive to conservative treatments. Despite overall satisfactory results, the rate of unsatisfied patients after TKA remains high, ranging from 5 to 40%. Different modifiable and nonmodifiable prognostic factors associated with TKA outcomes have been described.

Medial Patellofemoral Ligament Reconstruction and Nonanatomic Stabilization Techniques in Skeletally Immature Patients.

Patellar instability is a common cause of knee disability in children and adolescent, with a high recurrence rate. When conservative treatment fails, surgical options should be considered. The femoral insertion of the medial patellofemoral ligament (MPFL) is in close proximity to the distal femoral growth plate and precautions should be taken to avoid injuries to the physis.

Revision total knee arthroplasty (TKA): mid-term outcomes and bone loss/quality evaluation and treatment.

Background: Revision total knee arthroplasty (rTKA) is a demanding procedure, with a high complication and failure rate and a high rate of bone losses and poor bone quality. Different classifications for bone losses have been proposed, but they do not consider bone quality, which may affect implant fixation. The aim of this study is to describe the outcomes of a consecutive series of rTKA.

Corrigendum to "Pulsed Electromagnetic Fields Improve Tenogenic Commitment of Umbilical Cord-Derived Mesenchymal Stem Cells: A Potential Strategy for Tendon Repair-An In Vitro Study".

[This corrects the article DOI: 10.1155/2018/9048237.].

Incidence and pattern of periprosthetic hip fractures around the stem in different stem geometry.

Background: The number of total hip arthroplasties (THA) is expected to increase worldwide; thus, complications are likely to increase at the same ratio. In this scenario, periprosthetic femoral fractures (PFFs) are an increasing concern. Identifying the predisposing factors is important in order to prevent as much as possible the risk of PFF in the future.

High Tibial Osteotomy and Anterior Cruciate Ligament Reconstruction/Revision.

High tibial osteotomy (HTO) may be performed in association with anterior cruciate ligament (ACL) reconstruction/revision in patients with medial osteoarthritis, varus malalignment, and anterior instability. Furthermore, it may be performed in patients with varus alignment and increased posterior tibial slope (exceeding 12°), because it is related to an increased risk for ACL failure. There are different techniques to perform HTO, and consequently, a concomitant HTO and ACL reconstruction/revision.

Lateral Opening Wedge Distal Femoral Osteotomy for Lateral Compartment Arthrosis/Overload.

Distal femoral osteotomy (DFO) is a valid option for the treatment of young and active patients with lateral compartment osteoarthritis/overload and valgus malalignment. DFOs can be performed with a closing wedge or opening wedge technique. Lateral opening wedge DFO is usually preferred for smaller corrections, whereas medial closing wedge for larger corrections and in patients with high risk of nonunion.

Uncommon Complications after Anterior Cruciate Ligament Reconstruction.

Anterior cruciate ligament reconstruction (ACL-R) is a common surgical procedure, with good outcome in 75 to 97% of the cases. However, different complications have been described including infection, hemarthrosis, deep vein thrombosis (DVT), and pulmonary embolism (PE) with a rate ranging from 1 to 15%. There are few case reports in the literature describing rare complications after ACL-R and they can be divided into: (1) complications related to the fixation device (rupture, migration); (2) fractures (tibial or femoral side); (3) infections due to uncommon bacteria, mycobacterium, and mycosis; (4) rare vascular injuries; (5) nerve injuries; and (6) other rare complications.

Efficacy and Safety of Subacromial Corticosteroid Injection in Type 2 Diabetic Patients.

Purpose: In type 2 diabetic patients affected by chronic shoulder pain, subacromial injection with corticosteroid could be an effective treatment. The aim of this study was to measure the risk-benefit ratio of this treatment.

Methods: Twenty patients with well-controlled diabetes were included in a prospective study.

Pulsed Electromagnetic Fields Improve Tenogenic Commitment of Umbilical Cord-Derived Mesenchymal Stem Cells: A Potential Strategy for Tendon Repair-An In Vitro Study.

Tendon repair is a challenging procedure in orthopaedics. The use of mesenchymal stem cells (MSCs) and pulsed electromagnetic fields (PEMF) in tendon regeneration is still investigational. In this perspective, MSCs isolated from the human umbilical cord (UC) may represent a possible candidate for tendon tissue engineering.

Total knee arthroplasty in the varus knee: tips and tricks.

Varus knee deformity is very common, and it can be classified according to the severity and reducibility of the deformity. Pre-operative planning is mandatory to obtain a good result. Both clinical and radiological planning should be carefully performed, particularly focused on collateral ligament deficiency.

Large Osteochondral Allografts of the Knee: Surgical Technique and Indications.

Large osteochondral allograft (OCA) transplant has become a valid alternative to restore articular surface in challenging articular lesions in young and active patients, either in primary or in revision procedures. Several studies support the effectiveness and safety of OCA, but costs and graft availability limit their use. The indications are the treatment of symptomatic full-thickness cartilage lesions greater than 3 cm , deep lesions with subchondral damage, or revision procedures when a previous treatment has failed.

Factors Affecting Subjective and Objective Outcomes and Return to Play in Anterior Cruciate Ligament Reconstruction: A Retrospective Cohort Study.

 To analyze the prognostic factors influencing subjective and objective outcomes and return to play (RTP) after anterior cruciate ligament reconstruction (ACL-R).  Primary ACL-Rs using a transtibial technique performed between 2008 and 2012 were included. Data regarding patients, surgery, sports, and rehabilitation, including an on-field rehabilitation (OFR) and duration of the rehabilitation program, were collected.