A Combined Closing Wedge Distal Femoral Osteotomy and Medial Reefing Procedure for Recurrent Patellar Dislocation with Genu Valgum.

Purpose: Recurrent patellar dislocation is often associated with genu valgum. The purpose of this study was to analyze the short-term results of single-incision, closing-wedge distal femoral osteotomy (CWDFO) combined with medial reefing and lateral release for recurrent patellar instability with genu valgum.

Materials And Methods: Combined CWDFO/medial reefing/lateral release was performed on 10 knees.

Tunnel widening prevention with the allo-Achilles tendon graft in anterior cruciate ligament reconstruction: Surgical tips and short term followup.

Background: Tunnel widening (TW) after anterior cruciate ligament (ACL) reconstruction can be a serious complication, and there is controversy over how to prevent it. This study aimed to suggest surgical approaches to prevent TW using an allo-Achilles tendon graft, and then to evaluate TW after these surgical tips were applied.

Materials And Methods: Sixty two patients underwent ACL reconstruction with an allo-Achilles tendon graft.

Anatomical Single-bundle Anterior Cruciate Ligament Reconstruction Using a Freehand Transtibial Technique.

Purpose: In anatomical single-bundle (SB) anterior cruciate ligament (ACL) reconstruction, the traditional transtibial approach can limit anatomical placement of the femoral tunnel.

Surgical Technique: We present a novel three-point freehand technique that allows for anatomic SB ACL reconstruction with the transtibial technique.

Materials And Methods: Between January 2012 and December 2012, 55 ACL reconstructions were performed using the three-point freehand technique.

Radiographic evaluation of complete and incomplete discoid lateral meniscus.

Objectives: The aim of this retrospective study was (1) to evaluate the radiographic features to differentiate arthroscopically confirmed complete and incomplete discoid lateral meniscus (DLM) (2) to determine the cutoff values for any parameter that was found to differentiate complete from incomplete DLM.

Materials And Methods: We retrospectively analyzed plain knee radiographs of 130 arthroscopically proven DLM. Seventy-nine patients had complete DLM and 51 patients incomplete DLM.

Spontaneous healing of a displaced bucket-handle tear of the lateral meniscus in a child.

Bucket-handle tears less frequently occur in the lateral meniscus than in the medial meniscus. An 11-year-old male patient complained of painful swelling and locking due to a displaced bucket-handle tear of the lateral meniscus. We recommended an arthroscopic surgery; however, the patient left the hospital without surgical treatment.

Localized pigmented villonodular synovitis of the proximal tibiofibular joint.

Pigmented villonodular synovitis (PVNS) is a rare disease. It is a benign neoplastic process typically affecting young to middle-aged adults and most commonly involving the knee, hip, and shoulder joints. The symptoms include diffuse pain and swelling with discomfort.

Biomechanical properties of a new anatomical locking metal block plate for opening wedge high tibial osteotomy: uniplane osteotomy.

Purpose: The purpose of this study was to evaluate the biomechanical properties of a new anatomical locking metal block plate by comparing the initial biomechanical stability of three different fixation constructs for open wedge high tibial osteotomy (HTO).

Materials And Methods: Sawbones composite tibiae were used to make a 10-mm opening osteotomy model with uniplane technique. The osteotomy was secured with three different types of plates: Group I, new osteotomy plate without a metal block (n=5); Group II, new osteotomy plate with a 10-mm metal block (n=5); and Group III, two short metal block plates (n=5).

Tunnel volume enlargement after posterior cruciate ligament reconstruction: comparison of achilles allograft with mixed autograft/allograft--a prospective computed tomography study.

Purpose: The purpose of this study was to evaluate and compare femoral and tibial tunnel volume enlargement (TVE) after arthroscopic posterior cruciate ligament (PCL) reconstruction by remnant bundle preservation using Achilles allograft or mixed graft.

Methods: Seventy-eight patients undergoing primary arthroscopic single-bundle PCL reconstruction were initially included. Fifty-six of these patients underwent follow-up for a minimum of 1 year postoperatively and were divided into 2 groups: group A received Achilles allograft (n = 27), and group B received mixed graft (n = 29).

Serial assessment of weight-bearing lower extremity alignment radiographs after open-wedge high tibial osteotomy.

Purpose: The purpose of this study was to perform a serial assessment of the radiologic parameters of the mechanical axis (MA) and the weight-bearing line (WBL) using a weight-bearing anteroposterior (AP) long-standing view of the lower extremity to determine whether the postoperative MA and WBL change with time.

Methods: A total of 90 consecutive lower limbs were examined retrospectively from a weight-bearing AP long-standing view of the lower extremity obtained from 120 patients who underwent open-wedge high tibial osteotomy (OWHTO). A total of 30 patients were excluded because of (1) complications (7 patients) such as bone graft collapse or broken screws, malunion, or nonunion arising after surgery and (2) no acquisition of a regular series of weight-bearing AP long-standing views of the lower extremity (23 patients).

Arthroscopic posteromedial drive-through test in posterior cruciate ligament insufficiency: a new diagnostic test.

Purpose: The study investigated the prevalence of the posteromedial drive-through sign in patients undergoing knee arthroscopy and determined its relationship to posterior cruciate ligament (PCL) insufficiency.

Methods: A retrospective review was performed on 1,015 patients undergoing knee arthroscopy from 2009 to 2012 at two institutions. During knee arthroscopy, the ability to pass the arthroscope easily between the medial femoral condyle and the PCL is considered a positive posteromedial drive-through sign.

Application of computational lower extremity model to investigate different muscle activities and joint force patterns in knee osteoarthritis patients during walking.

Many experimental and computational studies have reported that osteoarthritis in the knee joint affects knee biomechanics, including joint kinematics, joint contact forces, and muscle activities, due to functional restriction and disability. In this study, differences in muscle activities and joint force patterns between knee osteoarthritis (OA) patients and normal subjects during walking were investigated using the inverse dynamic analysis with a lower extremity musculoskeletal model. Extensor/flexor muscle activations and torque ratios and the joint contact forces were compared between the OA and normal groups.

Arthroscopic hybrid fixation of a tibial eminence fracture in children.

The treatment of an anterior cruciate ligament (ACL) avulsion fracture is controversial, especially in skeletally immature patients, because of concerns about physeal damage. To reduce the risk of physeal injury, an arthroscopic technique was performed. A bioabsorbable suture anchor was inserted through anteromedial portals and fixed to a bioabsorbable suture anchor at the center of the fracture bed; it was then passed through the threads at the ACL avulsion fragment and tied with the ACL substance.

Patellar dislocation with genu valgum treated by DFO.

Congenital habitual patellar dislocation is a rare condition of the knee where the patella dislocates during flexion and relocates during extension. The congenital form is permanent, irreducible, and presents at birth. It is characterized by a short quadriceps and a major patellofemoral dysplasia and short height.

Arthroscopic Excision of Solitary Intra-articular Osteochondroma of the Knee.

Osteochondroma is the most common benign tumor of the growing bone commonly involving the knee joint region. It often involves the metaphysis of the long bone, occurring extra-articularly. In spite of this, solitary intra-articular osteochondroma has rarely been reported in the literature.

Predictive value of painful popping for a posterior root tear of the medial meniscus in middle-aged to older Asian patients.

Purpose: The purpose of this study was to determine the accuracy, sensitivity, specificity, and predictive values of a single event of painful popping in the presence of a posterior root tear of the medial meniscus in middle-aged to older Asian patients.

Methods: We conducted a retrospective review of medical records of 936 patients who underwent arthroscopic surgeries for an isolated medial meniscus tear between January 2000 and December 2010. There were 332 men and 604 women with a mean age of 41 years (range, 25 to 66 years).

Second-look arthroscopic findings after open-wedge high tibia osteotomy focusing on the posterior root tears of the medial meniscus.

Purpose: This study examined, at second-look arthroscopy, the results of open-wedge high tibial osteotomy (HTO) focusing on root tear of the medial meniscus posterior horn (RTMMP).

Methods: Among 31 consecutive patients who underwent HTO without a meniscectomy or pullout repair for RTMMP, 20 patients were available for second-look arthroscopic evaluation. All patients had medial unicompartmental arthritis.

Does press-fit technique reduce tunnel volume enlargement after anterior cruciate ligament reconstruction with autologous hamstring tendons? A prospective randomized computed tomography study.

Purpose: The purpose of this prospective, randomized, computed tomography-based study was to investigate whether the press-fit technique reduces tunnel volume enlargement (TVE) and improves the clinical outcome after anterior cruciate ligament reconstruction at a minimum follow-up of 1 year compared with conventional technique.

Methods: Sixty-nine patients undergoing primary ACL reconstruction using hamstring autografts were randomly allocated to either the press-fit technique group (group A) or conventional technique group (group B). All patients were evaluated for TVE and tunnel widening using computed tomography scanning, for functional outcome using International Knee Documentation Committee and Lysholm scores, for rotational stability using the pivot-shift test, and for anterior laxity using the KT-2000 arthrometer at a minimum of 1-year follow-up.

The weight-bearing scanogram technique provides better coronal limb alignment than the navigation technique in open high tibial osteotomy.

Background: Successful outcomes following high tibial osteotomy (HTO) require precise realignment of the mechanical axis of the lower extremity. The present study investigated whether the weight-bearing limb scanogram (WBS) technique provided a more accurate mechanical axis realignment than the navigation technique in open high tibial osteotomy (OHTO).

Methods: This prospective study involved 80 knees (78 patients) undergoing OHTO.

Second-look arthroscopic assessment of arthroscopic single-bundle posterior cruciate ligament reconstruction: comparison of mixed graft versus achilles tendon allograft.

Background: Although controversy continues over the choice of graft tissue, including autografts, allografts, and synthetic ligaments, for posterior cruciate ligament (PCL) reconstruction, the use of a mixed graft consisting of a hamstring (semitendinosus and gracilis) autograft plus tibialis anterior allograft tendon has not been studied in detail.

Hypothesis: Outcomes of PCL reconstructions performed with a mixed graft would be superior to those using solely an Achilles tendon allograft in terms of functional knee scores, posterior stability, and the graft appearance.

Study Design: Cohort study; Level of evidence, 2.

Peripheral nerve sheath tumor of the medial plantar nerve without tarsal tunnel syndrome: a case report.

Unlabelled: Peripheral nerve sheath tumors are relatively uncommon soft tissue tumors, and the incidence of peripheral nerve sheath tumors localized to the plantar surface of the foot, without symptoms of tarsal tunnel syndrome, is even more rare. In this report, we present the rare case of a patient with a peripheral nerve sheath tumor originating from the medial plantar nerve in the plantar vault. The tumor was enucleated and fully excised under microscopic inspection using fine-tipped instrumentation, without en bloc resection of the associated nerve trunk.