Intrafocal injection of tranexamic acid decreases early return to hospital after high tibial osteotomy.

Introduction: High tibial osteotomy (HTO) is a surgery performed to treat the symptoms and prevent the progression of medial osteoarthritis. Post-operative bleeding has led to early returns to hospital following surgery. Intrafocal injection of tranexamic acid (TXA) could reduce this bleeding complication.

Epigenetic regulation of 15-lipoxygenase-1 expression in human chondrocytes by promoter methylation.

Objective And Design: 15-Lipoxygenase-1 (15-LOX-1) catalyzes the biosynthesis of many anti-inflammatory and immunomodulatory lipid mediators and was reported to have protective properties in several inflammatory conditions, including osteoarthritis (OA). This study was designed to evaluate the expression of 15-LOX-1 in cartilage from normal donors and patients with OA, and to determine whether it is regulated by DNA methylation.

Methods: Cartilage samples were obtained at autopsy from normal knee joints and from OA-affected joints at the time of total knee joint replacement surgery.

Unsupervised registration of 3D knee implant components to biplanar X-ray images.

Background: Registration of three-dimensional (3D) knee implant components to radiographic images provides the 3D position of the implants which aids to analyze the component alignment after total knee arthroplasty.

Methods: We present an automatic 3D to two-dimensional (2D) registration using biplanar radiographic images based on a hybrid similarity measure integrating region and edge-based information. More precisely, this measure is herein defined as a weighted combination of an edge potential field-based similarity, which represents the relation between the external contours of the component projections and an edge potential field estimated on the two radiographic images, and an object specificity property, which is based on the distinction of the region-label inside and outside of the object.

3D biplanar reconstruction of lower limbs using nonlinear statistical models.

Three-dimensional (3D) reconstruction of lower limbs is of great interest in surgical planning, computer assisted surgery, and for biomechanical applications. The use of 3D imaging modalities such as computed tomography (CT) scan and magnetic resonance imaging (MRI) has limitations such as high radiation and expense. Therefore, three-dimensional reconstruction methods from biplanar X-ray images represent an attractive alternative.

A Medicoeconomic Evaluation of a Telehealth Platform for Elective Outpatient Surgeries: Protocol for a Randomized Controlled Trial.

Background: The number of elective outpatient surgeries in Canada has increased markedly in the last 10 years. However, unanticipated cancellations on the day of surgery and adverse postoperative events are frequent. Modern technologies have been shown to be of great help in the medical field in improving patient care.

Complications of Bicruciate-Retaining Total Knee Arthroplasty: The Importance of Alignment and Balance.

Bicruciate-retaining total knee arthroplasty (BCR TKA) results in kinematics closer to the native knee and in greater patient satisfaction but information concerning its outcome and complications is lacking.The goal of this study is to report the clinical and radiological outcomes of BCR prosthesis implanted using a spacer-based gap balancing technique and to assess if some preoperative factors are associated with a worse prognosis.A cohort of 207 knees in 194 patients who underwent BCR TKA, with a minimum 1-year follow-up, was retrospectively analyzed.

Suction drainage in total knee replacement does not influence early functional outcomes or blood loss: a randomized control trial.

Introduction: The use of wound drainage following total knee arthroplasty (TKA) remains controversial. The purpose of this study was to evaluate the impact of suction drainage on early postoperative outcomes in patients who underwent TKA with concomitant administration of intravenous tranexamic acid (TXA).

Method: One hundred forty-six patients undergoing primary TKA with systematic intravenous TXA were prospectively selected and randomly divided into two groups.

Bicruciate-retaining total knee arthroplasty non-inferior to posterior-stabilized prostheses after 5 years: a randomized, controlled trial.

Purpose: Bicruciate-retaining (BCR) prostheses may improve satisfaction of patient undergoing total knee arthroplasty (TKA). The objective of this randomized controlled trial was to assess whether BCR prostheses provide better clinical outcomes than posterior-stabilized (PS) prostheses.

Materials And Methods: This is a randomized single-blind control trial involving a total of 77 patients with knee osteoarthritis, randomly assigned to undergo TKA with a BCR or PS implant between 2015 and 2019.

Arthroscopic-assisted robotic bi-unicompartmental knee arthroplasty: a pilot cadaveric study.

Introduction: Although bicondylar arthroplasty showed great functional results, it encounters some difficulties to be performed routinely. On the other hand, arthroscopic techniques tend to replace open surgical techniques in sports medicine but strive to be developed in the field of arthroplasty. This study aimed to assess the feasibility of a micro-invasive bi-compartmental knee arthroplasty using both arthroscopic and robotic technologies (A-BiUKA).

Healthcare Professional Perspectives on the Use of Remote Patient-Monitoring Platforms during the COVID-19 Pandemic: A Cross-Sectional Study.

The COVID-19 pandemic created an urgent need to act to reduce the spread of the virus and alleviate congestion in healthcare services, protect health professionals, and help them maintain satisfactory quality and safety of care. Remote monitoring platforms (RPM) emerged as potential solutions. In this study, we evaluate, from health professionals' perspectives, the capacity and contribution of two different digital platforms to maintain quality, safety, and patient engagement in care.

Use of IMMPACT Recommendations to Explore Pain Phenotypes in People with Knee Osteoarthritis.

Objective: Knee osteoarthritis (OA) is a disease of multiple phenotypes of which a chronic pain phenotype (PP) is known. Previous PP studies have focused on one domain of pain and included heterogenous variables. We sought to identify multidimensional PPs using the IMMPACT recommendations and their relationship to clinical outcomes.

Remote Patient Monitoring Program for COVID-19 Patients Following Hospital Discharge: A Cross-Sectional Study.

The COVID-19 pandemic created an urgent need to act to reduce the spread of the virus and alleviate congestion from healthcare services, protect healthcare providers, and help them maintain satisfactory quality and safety of care. Remote COVID-19 monitoring platforms emerged as potential solutions. The purpose of this study was to evaluate the capacity and contribution of two different platforms used to remotely monitor patients with COVID-19 to maintain quality, safety, and patient engagement in care, as well as their acceptability, usefulness, and user-friendliness from the user's perspective.

Tibial Tunnel Placement in ACL Reconstruction Using a Novel Grid and Biplanar Stereoradiographic Imaging.

Background: Nonanatomic graft placement is a frequent cause of anterior cruciate ligament reconstruction (ACLR) failure, and it can be attributed to either tibial or femoral tunnel malposition. To describe tibial tunnel placement in ACLR, we used EOS, a low-dose biplanar stereoradiographic imaging modality, to create a comprehensive grid that combines anteroposterior (AP) and mediolateral (ML) coordinates.

Purpose: To (1) validate the automated grid generated from EOS imaging and (2) compare the results with optimal tibial tunnel placement.

Medial Opening Wedge Proximal Tibial Osteotomy: Lessons Learned from a Series of 175 Consecutive Cases.

Introduction: High tibial osteotomy (HTO) is a surgical procedure aimed at inhibiting the progression of osteoarthritis of the knee joint. The aim of this study was to identify factors influencing the functional outcome after opening wedge valgus HTO.

Methods: A total of 175 cases (155 patients) of varus-correcting high tibial open-wedge osteotomies using the Tomofix plate were reviewed retrospectively.

A method for quantitative evaluation of a valgus knee orthosis using biplane x-ray images.

Knee orthoses are designed to reestablish the normal kinematics of the knee joint. However, the data on the effectiveness of them on modifying the internal joint kinematics are scarce. The aim of this study was to develop a method to allow accurate comparison of the knee contact kinematics in osteoarthritic (OA) subjects with and without wearing a valgus knee orthosis using imaging techniques.

Femoral Tunnel Placement Analysis in ACL Reconstruction Through Use of a Novel 3-Dimensional Reference With Biplanar Stereoradiographic Imaging.

Background: The femoral-sided anatomic footprint of the anterior cruciate ligament (ACL) has been widely studied during the past decades. Nonanatomic placement is an important cause of ACL reconstruction (ACLR) failure.

Purpose: To describe femoral tunnel placement in ACLR through use of a comprehensive 3-dimensional (3D) cylindrical coordinate system combining both the traditional clockface technique and the quadrant method.

Role of constraining staple on tibial slope in open wedge osteotomy: A comparative study.

Background: Medial opening-wedge high tibial osteotomy (HTO) corrects varum deformities in osteoarthritic knees. This procedure has been shown to increase tibial slope, which may limit knee extension and provoke an anterior tibial translation. The purpose of this research was to study the impact of a constraining staple on the variation of the tibial slope in medial opening-wedge HTO.

Can total knee arthroplasty restore the correlation between radiographic mechanical axis angle and dynamic coronal plane alignment during gait?

Background: Total knee arthroplasty (TKA) is the treatment of choice for end-stage knee osteoarthritis. Postoperative static knee alignment has been recognized as a key component of successful surgery. A correction toward the kinematics of a native knee is expected after TKA, with an aim for neutral mechanical alignment.

The impact of bone morphology on the outcome of the pivot shift test: a cohort study.

Background: The presence of a positive pivot shift after surgical repair of the ACL is considered an important indicator of a failed reconstruction. The ability to predict the result of a pivot shift test after an ACL reconstruction using variables that can be measured prior to surgery could provide an indication of which patients may be at-risk of a poor surgical outcome.The purpose of this study was to determine whether structural characteristics of the femur and tibia, measured using plain radiographs, were associated with the result of the pivot shift test in unilateral ACL reconstructed patients.

The Effect of Adductor Canal Block on Knee Extensor Muscle Strength 6 Weeks After Total Knee Arthroplasty: A Randomized, Controlled Trial.

Background: Total knee arthroplasty (TKA) reduces knee extensor muscle strength (KES) in the operated limb for several months after the surgery. Immediately after TKA, compared to either inguinal femoral nerve block or placebo, adductor canal block (ACB) better preserves KES. Whether this short-term increase in KES is maintained several weeks after surgery remains unknown.

Postoperative Stiffening after Bicruciate-Retaining Total Knee Arthroplasty.

Bicruciate-retaining (BCR) total knee arthroplasty (TKA) has recently experienced a resurgence of popularity. It may be a good option among a younger, more active population because it restores knee kinematics better than other prosthetic designs. Results obtained in the first 100 BCR TKAs implanted with a simplified gap-balancing technique are reported, with special attention paid to knee flexion, through comparison with a cohort of 100 posterior-stabilized (PS) TKAs.

Spacer-Based Gap Balancing in Total Knee Arthroplasty: Clinical Success with a Reproducible Technique.

Proper coronal and transverse ligament balancing is an important aspect of total knee arthroplasty (TKA) and has an impact on postoperative outcome. Many variations of the gap balancing technique were described to address this challenge, most of them using various tensioning devices, but none for which the use is widespread. The aim of this paper is to describe a gap technique variant for TKA using spacer blocks and report the clinical results for a cohort of patients on which it was used.

Applicability of a modified angular correction measurement method for open-wedge high tibial osteotomy.

Purpose: The purpose of this study was to evaluate the clinical potential of a new measurement technique for open-wedge high tibial osteotomy (HTO) based on the medial cortex opening (MCO) associated with the Miniaci preoperative planning technique.

Methods: A retrospective review of 97 cases of valgus-producing HTO that were performed between 2008 and 2013, using the intra-operative fluoroscopic mechanical axis technique, was carried out. The Miniaci-based measurement technique was then used as a theoretical point of comparison with the intent to compare the disparity between postoperative and ideal lower extremity (LE) mechanical axis with the measured disparity between postoperative and Miniaci-based planned MCO.

Robotic axial lower leg testing: repeatability and reproducibility.

Purpose: The purpose of this study was to determine the test-retest reliability and the repeatability over multiple days of a robotic testing device when used to measure laxity of the lower leg during a simulated dial test.

Methods: Ten healthy subjects were evaluated using an instrumented robotic lower leg testing system over 4 days. Three testing cycles were performed each day.