The 45° and 60° of sagittal femoral tunnel placement in anterior cruciate ligament reconstruction provide similar knee stability.

Purpose: The aim of the present study was to compare 45° and 60° of sagittal femoral tunnel angles in terms of anterior tibial translation (ATT), valgus angle and graft in situ force following anterior cruciate ligament reconstruction (ACLR).

Methods: Ten porcine knees were subjected to the following loading conditions: (1) 89 N anterior tibial load at 35° (full extension), 60° and 90° of knee flexion and (2) 5 N m valgus tibial moment at 35° and 45° of knee flexion. ATT and graft in situ force of the intact anterior cruciate ligament (ACL) and ACLR were collected using a robotic universal force/moment sensor (UFS) testing system for (1) ACL intact, (2) ACL-deficient (ACLD) and (3) two different ACLR using different sagittal femoral tunnel angles (coronal 45°/sagittal 45° and coronal 45°/sagittal 60°).

Optimal intersurface stability for unicompartmental femoral component design with two pegs placed on the distal resection surface: 5 mm peg length increment and 10° peg inclination.

Purpose: The present study aimed to identify the optimal design of the unicompartmental femoral component through parameter analysis and stability evaluation.

Methods: A finite element (FE) analysis was applied to analyse and adjust the parameter combinations of the anterior tilt angle of the posterior condyle resection surface, the position of the peg, the length of the peg and the inclination angle of the peg, resulting in 10 different FE models. Setting three knee flexion angles of 8.

Perioperative Intravenous Dexamethasone Significantly Reduces Postoperative Opioid Requirement and Nausea After Unilateral Elective Hip Arthroscopy: A Randomized Double-blinded Placebo-controlled Trial.

Background: Previous studies have shown that dexamethasone has a positive effect on postoperative pain control, opioid consumption, nausea, and vomiting and length of hospital stay after arthroplasty surgery.

Purpose/hypothesis: The purpose of this study was to assess whether adding perioperative dexamethasone to our current pain regimen after hip arthroscopy is more effective than a placebo. It was hypothesized that dexamethasone would reduce postoperative pain, reduce opioid consumption, improve subjective pain and nausea scores, and reduce the number of vomiting events.

Femoro-Epiphyseal Acetabular Roof Index Values on Anteroposterior Pelvic Radiographs Significantly Increase With Hip Adduction and Decrease With Abduction.

Purpose: To investigate the impact of hip adduction and abduction on the femoro-epiphyseal acetabular roof (FEAR) index using conventional anteroposterior pelvic radiographs of patients with borderline hip dysplasia (BHD).

Methods: Patients with BHD (lateral center edge angle [LCEA] with values of 18° ≤ LCEA <25°) and who were subject to periacetabular osteotoym were selected from a consecutive retrospective cohort from January 2009 to January 2016. The hip ad-/abduction (adduction handled as negative values) and the FEAR index (lateral opening angles handled as positive values) were measured in the initially standardized acquired pelvic radiographs.

Race and Gender Differences in Anterior Cruciate Ligament Femoral Footprint Location and Orientation: A 3D-MRI Study.

Objective: The femoral tunnel position is crucial to anatomic single-bundle anterior cruciate ligament (ACL) reconstruction, but the ideal femoral footprint position are mostly based on small-sized cadaveric studies and elderly patients with a single ethnic background. This study aimed to identify potential race- or gender-specific differences in the ACL femoral footprint location and ACL orientation, determine the correlation between the ACL orientation and the femoral footprint location.

Methods: Magnetic resonance images (MRIs) of 90 Caucasian participants and 90 matched Chinese subjects were used for reconstruction of three-dimensional (3D) femur and tibial models.

Significant race and gender differences in anterior cruciate ligament tibial footprint location: a 3D-based analysis.

Background: The aim of the present study was to identify potential race- or gender-specific differences in anterior cruciate ligament (ACL) tibial footprint location from the tibia anatomical coordinate system (tACS) origin, investigate the distances from the tibial footprint to the anterior root of the lateral meniscus (ARLM) and the medial tibial spine (MTS), determine how reliable the ARLM and MTS can be in locating the ACL tibial footprint, and assess the risk of iatrogenic ARLM injuries caused by using reamers with various diameters (7-10 mm).

Patients And Methods: Magnetic resonance images of 91 Chinese and 91 Caucasian subjects were used for the reconstruction of three-dimensional (3D) tibial and ACL tibial footprint models. The anatomical coordinate system was applied to reflect the anatomical locations of scanned samples.

Combined Anteversion Threshold to Avoid Anterior Dislocation in Primary Total Hip Arthroplasty Performed Through the Direct Anterior Approach.

Background: Component malposition in total hip arthroplasty (THA) can lead to dislocation, early implant failure, and revision surgery. As the surgical approach might affect the targeted combined anteversion (CA) of THA components, the present study aimed to evaluate the optimal CA threshold to avoid anterior dislocation in primary THA performed through a direct anterior approach (DAA).

Methods: A total of 1,176 THAs in 1,147 consecutive patients (men: 593, women: 554) who had an average age of 63 years (range, 24 to 91) and a mean body mass index of 29 (range, 15 to 48) were identified.

The effect of experimentally induced gluteal muscle weakness on joint kinematics, reaction forces, and dynamic balance performance during deep bilateral squats.

Squatting is a common daily activity and fundamental exercise in resistance training and closed kinetic chain programs. The aim of this study was to investigate the effects of an experimentally induced weakness of the gluteal muscles on joint kinematics, reactions forces (JRFs), and dynamic balance performance during deep bilateral squats in healthy young adults. Ten healthy adults received sequential blocks of (1) branch of the superior gluteal nerve to the tensor fasciae latae (SGNtfl) muscle, (2) superior gluteal nerve (SGN), and (3) inferior gluteal nerve (IGN) on the dominant right leg.

A novel method for evaluating combined component anteversion in total hip arthroplasty on cross-table lateral hip radiographs.

Introduction: Accurate measurement of combined component anteversion (CA) is important in evaluating the radiographic outcomes following total hip arthroplasty (THA). The aim of the present study was to evaluate the accuracy and reliability of a novel radiographic method in estimating CA in THA.

Materials And Methods: The radiographs and computer tomography of patients who underwent a primary THA were retrospectively reviewed, to measure the radiographic CA (CAr), defined as the angle between a line connecting the center of the femoral head to the most anterior rim of the acetabular cup and a line connecting the center of the femoral head to the base of the femoral head to allow a comparison with the CA measured on the CT (CACT).

Altered In Vivo Knee Kinematics and Lateral Compartment Contact Position During the Single-Leg Lunge After Medial Unicompartmental Knee Arthroplasty.

Background: Osteoarthritis (OA) progression in the lateral compartment is the most common reason for revision after medial unicompartmental knee arthroplasty (UKA). Altered contact kinematics in the lateral compartment may be related to the pathogenesis of OA.

Purpose: To quantify the in vivo 6 degrees of freedom (6-DOF) knee kinematics and contact points in the lateral compartment during a single-leg lunge in knees after medial UKA and compare them with the contralateral native knee.

A Simple Preoperative Score Predicting Failure Following Decompression Surgery for Degenerative Lumbar Spinal Stenosis.

Background Context: Proper patient selection is crucial for the outcome of surgically treated degenerative lumbar spinal stenosis (DLSS). Nevertheless, there is still not a clear consensus regarding the optimal treatment option for patients with DLSS.

Purpose: To investigate the treatment failure rate and introduce a simple, preoperative score to aid surgical decision-making.

Medial stability and lateral flexibility of the collateral ligaments during mid-range flexion in medial-pivot total knee arthroplasty patients demonstrates favorable postoperative outcomes.

Purpose: The objectives of the present study were to investigate the length change in different bundles of the superficial medial collateral ligament (sMCL) and lateral collateral ligament (LCL) during lunge, and to evaluate their association with Knee Society Score (KSS) following medial-pivot total knee arthroplasty (MP-TKA).

Methods: Patients with unilateral MP-TKA knees performed a bilateral single-leg lunge under dual fluoroscopy surveillance to determine the in-vivo six degrees-of-freedom knee kinematics. The contralateral non-operated knees were used as the control group.

Reverse Total Shoulder Arthroplasty in Patients Who Exceeded Their Life-Expectancy: A Retrospective Study.

Background: Reverse total shoulder arthroplasty (RTSA) has become an established treatment for cuff arthropathy, severe osteoarthritis and in certain fracture cases. Due to the increasingly aging population, patients who have already exceeded their life-expectancy pose a significant challenge to the shoulder surgeon.

Methods: Patients older than 83 years who received a RTSA were included.

Hybrid fixation of unicompartmental knee arthroplasty shows equivalent short-term implant survivorship and clinical scores compared to standard fixation techniques.

Introduction: There is a paucity of data regarding hybrid-fixated unicompartmental knee arthroplasty (UKA), and no study directly compared all three available fixation techniques (cementless, cemented, and hybrid). The hypothesis was that hybrid fixation might have a lower incidence of radiolucent lines (RLL) than cemented UKA, with equivalent outcomes to uncemented UKA.

Materials And Methods: A total of 104 UKA with a minimal follow-up of 1 year were retrospectively included, of which 40 were cemented, 41 cementless, and 23 hybrid prostheses.

A deep learning approach for anterior cruciate ligament rupture localization on knee MR images.

To develop and evaluate a deep learning-based method to localize and classify anterior cruciate ligament (ACL) ruptures on knee MR images by using arthroscopy as the reference standard. We proposed a fully automated ACL rupture localization system to localize and classify ACL ruptures. The classification of ACL ruptures was based on the projection coordinates of the ACL rupture point on the line connecting the center coordinates of the femoral and tibial footprints.

Surgical Outcomes and Analysis of Quality of Life Following Knee Arthroplasty in Very Elderly Patients.

In an aging population, the incidence of severe knee osteoarthritis in very elderly patients increases, leading to functional impairment and loss of independence. Knee replacement could be an effective treatment but is often denied due to fear of increased complication rate with advanced age. The objective of this study was to investigate complication rate, mortality, clinical outcome, and quality-adjusted life years (QALYs) of primary knee replacement in very elderly patients, defined as 83 years or older.

The effect of lumbar spinal fusion on native acetabular anteinclination in standing position.

Purpose: The complex and dynamic spinopelvic interplay is not well understood. The aims of the present study were to investigate the following: (1) whether native acetabular anteinclination (AI) in standing position changes following lumbar spinal fusion (LSF); (2) potential correlations between AI change (ΔAI) and several spinopelvic parameters such as the change in lumbar lordosis (ΔLL), pelvic tilt (ΔPT), and anterior pelvic plane angle (ΔaPP).

Methods: A total of 485 patients (Males: 262, Females: 223) with an average age of 64 ± 13 years who underwent a primary LSF were identified from our institutional database.

Influence of the Anteromedial Portal and Transtibial Drilling Technique on Femoral Tunnel Lengths in ACL Reconstruction: Results Using an MRI-Based Model.

Background: In anatomic anterior cruciate ligament (ACL) reconstruction, graft placement through the anteromedial (AM) portal technique requires more horizontal drilling of the femoral tunnel as compared with the transtibial (TT) technique, which may lead to a shorter femoral tunnel and affect graft-to-bone healing. The effect of coronal and sagittal femoral tunnel obliquity angle on femoral tunnel length has not been investigated.

Purpose: To compare the length of the femoral tunnels created with the TT technique versus the AM portal technique at different coronal and sagittal obliquity angles using the native femoral ACL center as the starting point of the femoral tunnel.

An Efficient Needleless Grasping Suture Technique for Graft Preparation in Anterior Cruciate Ligament Reconstruction.

Objective: Several needleless techniques have been developed to outcome the inherent disadvantages of the traditional needle stitching technique for graft preparation, such as tendon damage through the needle, time consumption, and the potential risk of needlestick injury. The purpose of the present study is to compare the graft preparation time and the biomechanical performance between an efficient needleless technique and the traditional needle stitching technique for graft preparation in anterior cruciate ligament reconstruction (ACLR).

Methods: The time required to perform a complete suture on 20 hamstring tendons during ACLRs was measured.

Lower effectiveness of facet joint infiltration in patients with concurrent facet joint degeneration and active endplate changes.

Background Context: Facet joint degeneration (FJD) and disc degeneration (DD) with associated endplate (EP) changes, specifically Modic 1 changes, might occur concurrently and therefore pose a challenge in the treatment of lower back pain (LBP).

Purpose: The aim of the present study was to investigate if the presence of active EP changes (Modic 1) would alter the effect of facet joint infiltrations (FJI) for the treatment of concurrent FJD.

Study Design: Prospective cohort study, Level III.