A Systematic Review of Randomized Controlled Trials in Anterior Cruciate Ligament Reconstruction: Standard Techniques Are Comparable (299 Trials With 25,816 Patients).

Purpose: To provide an overview of all published randomized controlled trials (RCTs) in anterior cruciate ligament reconstruction (ACLR) summarizing the available evidence.

Methods: Following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, we searched the Cochrane FIGCentral Register of Controlled Trials, Ovid MEDLINE, and Embase for RCTs of ACLR from their inception to August 26, 2020. Outcome measure was whether RCTs reported statistically significant findings.

Long-Term Survivorship of Modular Cementless Femoral Stem in Complex Primary Total Hip Arthroplasty: A Concise Minimum 15-Year Follow-Up Report.

Background: S-ROM hip is a well-established and versatile prosthesis that offers extensive metaphyseal and diaphyseal geometries providing solutions for a variety of surgical scenarios. The aim of this study is to report on long-term survivorship and radiographic outcomes of complex primary total hip arthroplasty (THA) using a modular cementless stem (S-ROM).

Methods: Retrospective consecutive study was conducted of 167 patients (167 hips): 97 males and 70 females with average age at the time of surgery of 55 years (range 22-76).

Catastrophic Polyethylene Failure and Fractured Femoral Component in Modern Knee Arthroplasty Design: A Case Report.

Case: We report a 67-year-old gentleman who presented with a painful unstable knee. He had undergone a successful total knee arthroplasty 12 years earlier and was highly functional. He presented with a 10-month history of mild pain, instability, and gait alteration.

Overview of Randomized Controlled Trials in Total Knee Arthroplasty (47,675 Patients): What Have We Learnt?

Background: The aim of this study is to provide an overview of randomized controlled trials (RCTs) in primary total knee arthroplasty summarizing the available high-quality evidence.

Methods: Following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, we searched the Cochrane Central Register of Controlled Trials (CENTRAL, 2019, Issue 3), Ovid MEDLINE, and Embase. We excluded nonrandomized trials, trials on unicompartmental knee arthroplasty or revision surgery, systematic reviews, and meta-analyses.

Long-Term Comparison of Porous Versus Hydroxyapatite Coated Sleeve of a Modular Cementless Femoral Stem (SROM) in Primary Total Hip Arthroplasty.

Unlabelled: Hydroxyapatite (HA) is commonly used on femoral stems to assist in osseous integration but there is limited evidence of the benefit it provides. We report a prospective comparison of 117 and 102 patients receiving either porous or HA coated sleeves respectively. Patients were evaluated at mean of 12.

Nineteen year results of THA using modular 9 mm S-ROM femoral component in patients with small femoral canals.

A retrospective analysis was undertaken of 30 consecutive THA performed in 25 patients with hypoplastic proximal femurs, who had received a 9-mm uncemented modular S-ROM stem. The mean patient age was 42 years (17-69 years), mean height was 152.5 cm (130-170.

Coupling failure between stem and femoral component in a constrained revision total knee arthroplasty.

Knee revision using constrained implants is associated with greater stresses on the implant and interface surfaces. The present report describes a case of failure of the screw coupling between the stem and the femoral component. The cause of the failure is surmised with outline of the treatment in this case with extensive femoral bone loss.

The treatment of acquired patella baja with proximalize the tibial tuberosity.

Purpose: Acquired patella baja may result in decreased range of motion of the knee, extensor lag, and anterior knee pain. The aim of the study was to evaluate the efficacy of tibial tubercle osteotomy with proximal displacement.

Methods: Between 1998 and 2011, a proximalization of the tibial tuberosity was performed in 15 patients (15 knees) with patella baja diagnosed using the Blackburne-Peel ratio.

The proximal modular neck in THA: a bridge too far: opposes.

Neck/cup impingement is a serious issue, especially with hard/hard bearings. It can produce noise, locking mechanism failure, and an increase in wear debris and dislocation. The double taper neck used by the author has cogs on the neck/stem taper junction for additional rotational stability.

The role of modularity in primary total hip arthroplasty.

A combined series of 795 primary SROM (DePuy, Warsaw, Ind) stems have been reviewed. The mean follow-up is 11 years; 2 (0.25%) were revised for aseptic stem loosening.

The patulous proximal femur.

Patients with patulous proximal femurs who have hip revision surgery can be treated with reduction osteotomies or with large ingrowth sleeves used with proximally modular stems. Three hundred nine patients had hip revision with >5-years' follow-up (mean 8.6 years).

Modular junctions.

A concern about modular stems is that the taper will not provide an adequate seal, causing the stem distal to the taper to become part of the effective joint space. In this study, 380 primary patients and 309 revision patients were treated with a proximally modular stem. Follow-up was between 5 and 17 years (mean 9.

What would you do? Case challenges in knee surgery.

These knee arthroplasty cases were presented to a panel of surgeon and they represent classic clinical problems: (1) indications for unicompartmental arthroplasty; (2) total knee arthroplasty after a high tibial osteotomy complicated by infection and extensor mechanism rupture; (3) neuropathic arthropathy; (4) posttraumatic osteoarthritis with extraarticular deformity; (5) degenerative arthritis in the young patient; (6) osteoarthritis with a valgus deformity, fixed flexion contracture, degenerative scoliosis, and leg length discrepancy.

A comedy of errors: the bad knee.

A review of 241 consecutive total knee revisions has been carried out. Other than loosening, wear, and stiffness, at present, a commoner reason is an unsatisfactory result due to minor errors of tibial and femoral placement. Currently, about 16% of femoral components required derotation during revision.

Intraoperative hip fractures: ruining your day.

The results of treatment of 116 intraoperative femoral fractures were reviewed. Excluding calcar and greater trochanter fractures, there were 14 Type I cases (Vancouver classification). All healed with cerclage wiring.

Case challenges in knee surgery: what would you do?

This case discussion features knee arthroplasty cases presented to a panel of surgeons. The cases were chosen to represent common clinical problems encountered in everyday practice.