Mechanical stability of the proximal tibia with different bone formations after plate removal in medial opening-wedge high tibial osteotomy: a finite element analysis.

Background: No clear agreement exists on the degree of bone formation required to remove a metal plate without correction loss after medial opening-wedge high tibial osteotomy (MOWHTO). We aimed to investigate the mechanical stability of the proximal tibia with different bone formations after plate removal in MOWHTO using finite element models and determine the extent of bone formation when the plate can be removed without correction loss.

Methods: The MOWHTO models with 5, 10, and 15 mm opening gaps were generated.

Incidence and Risk Factors of Osteonecrosis of the Femoral Head after Cephalomedullary Nailing for Pertrochanteric Fractures: Observational Single-Center Study.

Background: The objective of this study was to investigate the incidence of osteonecrosis of the femoral head (ONFH) after cephalomedullary nailing in elderly patients with pertrochanteric fractures and to analyze the risk factors related to ONFH.

Methods: A total of 689 consecutive patients with cephalomedullary nailing for pertrochanteric fractures at our hospital were recruited. Of these, 368 patients who met the inclusion criteria were finally enrolled.

The posterior tibial slope affects the measurement reliability regarding the radiographic parameter of the knee.

Background: Posterior tibial slope (PTS) exhibits considerable variability among individuals and is anticipated to influence the accuracy of radiographic measurements related to the knee. Despite this potential impact, there is a lack of prior research investigating how PTS affects the accuracy of these measurements. Therefore, this study aimed to investigate the effect of PTS on the measurement reliability regarding the radiographic parameter of the knee.

Small Intercondylar Notch Size Is Not Associated with Poor Surgical Outcomes of Anatomical Single-Bundle Anterior Cruciate Ligament Reconstructions.

Background: Although many studies have been conducted on the association between the intercondylar notch size and the risk of anterior cruciate ligament (ACL) injury, few studies have examined its relationship with the condition after surgical treatment. Therefore, this study aimed to investigate the surgical outcomes of anatomical single-bundle ACL reconstruction according to intercondylar notch volumes.

Methods: Medical records of patients who underwent anatomical single-bundle ACL reconstruction using a tibialis anterior allograft between 2015 and 2019 were retrospectively reviewed.

Surgical drain has no benefits in hemiarthroplasty for femoral neck fractures in elderly patients.

Femoral neck fracture is a common osteoporotic fracture in elderly patients and is effectively managed with arthroplasty. However, the benefits and risks of a surgical drain after arthroplasty in these patients are still debatable. Hence, we conducted this study to investigate the necessity of a surgical drain after hemiarthroplasty in elderly patients with femoral neck fracture.

Marrow stimulation procedures for high-grade cartilage lesions during surgical repair of medial meniscus root tear yielded suboptimal outcomes, whilst small lesions showed surgical eligibility.

Purpose: To investigate the surgical outcomes of arthroscopic pull-out repair for medial meniscus root tear (MMRT) combined with the marrow stimulation procedures (MSP) for accompanying high-grade cartilage lesions.

Methods: Patients who underwent arthroscopic pull-out repair for MMRT between 2010 and 2019 were retrospectively reviewed. Patients who had at least 3 years of follow-up were included and classified into two groups according to whether MSP (microfracture or microdrilling) were performed on cartilage lesions in the medial tibiofemoral joint (group 1, patients with International Cartilage Repair Society [ICRS] grade 0-3a lesions and did not undergo MSP; group 2, patients with ICRS grade 3b-3d lesions and underwent MSP).

Risk Factors of Proximal Screw Breakage of Locking Plate (ZPLP) after MIPO for Distal Femur Fractures -Analysis of Patients with Plate Removal after Bony Union.

Background: Locking a compression plate is a more favorable surgical technique than intramedullary nailing in the treatment of distal femur fractures. This study analyzed the risk factors of proximal screw breakage retrospectively, which was confirmed in the patients with plate removal after bony union.

Methods: A total of 140 patients who were fixed by MIPO using ZPLP from 2009 to 2019 were identified.

Treatment of Femoral Neck Fractures in the Elderly: A Survey of the Korean Hip Society Surgeons.

Purpose: This study examined the methods for treatment of femoral neck fracture (FNF) preferred by members of the Korean Hip Society (KHS) and identified factors that influence decisions regarding the surgical intervention of choice.

Materials And Methods: A total of 97 members of the KHS responded to the 16-question survey which included questions about the mean number of surgeries performed each month for treatment of femoral neck fractures, the cut-off age for deciding between internal fixation and arthroplasty, the implant used most often, usage of cement, and factors influencing each decision.

Results: The mean cut-off age used when deciding between internal fixation and arthroplasty was 64 years old.

Prevention of Venous Thromboembolism in Patients Undergoing Hip Fracture Surgery: A Survey of the Korean Hip Society.

Purpose: The aim of this study was to assess the current status of venous thromboembolism (VTE) prevention in Korean patients with hip fractures.

Materials And Methods: A survey using a questionnaire on the experiences and protocols of VTE prevention was conducted among 570 members of the Korean Hip Society.

Results: A total of 97 surgeons responded, with a response rate of 17.

Factor affecting the discrepancy in the coronal alignment of the lower limb between the standing and supine radiographs.

Background: Conflicting results have been reported regarding the factors that can predict the discrepancy in the coronal alignment of the lower limb between radiographs taken in the standing and supine positions. Therefore, this study aimed to investigate factors that can predict discrepancies in the coronal alignment of the lower limb between radiographs taken in the standing and supine positions.

Methods: We retrospectively evaluated the medical records of patients who underwent full-length anteroposterior radiographs of the lower limb in both standing and supine positions between January 2019 and September 2021.

Simultaneous reduction and fixation using an anatomical suprapectineal quadrilateral surface plate through modified Stoppa approach in superomedially displaced acetabular fractures.

Treatment of superomedially displaced acetabular fractures including a quadrilateral surface (QLS) is challenging. We present a surgical technique using an anatomical suprapectineal QLS plate through the modified Stoppa approach and report the availability of this plate to treat this fracture type along with the surgical outcomes. Sixteen consecutive patients (14 men and 2 women) who underwent surgical treatment using an anatomical suprapectineal QLS plate through a modified Stoppa approach for superomedially displaced acetabular fractures between June 2018 and June 2020, were enrolled retrospectively.

Effect of the additional anteroposterior blocking screw on nail/medullary canal mismatch after cephalomedullary nailing in unstable pertrochanteric fracture : a finite element analysis.

Aims: There are concerns regarding nail/medullary canal mismatch and initial stability after cephalomedullary nailing in unstable pertrochanteric fractures. This study aimed to investigate the effect of an additional anteroposterior blocking screw on fixation stability in unstable pertrochanteric fracture models with a nail/medullary canal mismatch after short cephalomedullary nail (CMN) fixation.

Methods: Eight finite element models (FEMs), comprising four different femoral diameters, with and without blocking screws, were constructed, and unstable intertrochanteric fractures fixed with short CMNs were reproduced in all FEMs.

Clinical results of short external rotators preserving posterolateral approach for hemiarthroplasty after femoral neck fractures in elderly patients.

Introduction: Even though the dislocation rate is lower in the hemiarthroplasty (HA) than total hip arthroplasty, it has still developed as one of serious complications in elderly patients. We have used short external rotators (SER) preserving posterolateral approach to reduce dislocation after hip arthroplasty, especially in elderly patients. The present study was conducted to introduce SER preserving posterolateral approach and report the dislocation rate after HA via this approach in elderly patients with femoral neck fractures.

Graft isometry during anatomical ACL reconstruction has little effect on surgical outcomes.

Purpose: To investigate the surgical outcomes of anatomical anterior cruciate ligament (ACL) reconstruction according to the graft isometry measured during surgery.

Methods: Electrical medical records of patients who underwent an arthroscopic ACL reconstruction through the transportal technique using hamstring tendon autograft between 2012 and 2016 were retrospectively reviewed. The patients were classified into two groups based on the graft length change throughout the knee range of motion measured just before graft fixation (Group 1, graft length change ≤ 2 mm; Group 2, graft length change > 2 mm).

Biomechanics of subtrochanteric fracture fixation using short cephalomedullary nails: A finite element analysis.

A finite element analysis was performed to evaluate the stresses around nails and cortical bones in subtrochanteric (ST) fracture models fixed using short cephalomedullary nails (CMNs). A total 96 finite element models (FEMs) were simulated on a transverse ST fracture at eight levels with three different fracture gaps and two different distal locking screw configurations in both normal and osteoporotic bone. All FEMs were fixed using CMNs 200 mm in length.

Research Update on Stress Riser Fractures.

Stress fractures are fatigue-induced fractures which are caused by repetitive force, often from overuse. They are well-established and frequently encountered in the field of orthopedics. Stress fractures occur in the bone because of low-bone strength and high chronic mechanical stress placed on the bone.

The Graft Insertion Length in the Femoral Tunnel During Anterior Cruciate Ligament Reconstruction With Suspensory Fixation and Tibialis Anterior Allograft Does Not Affect Surgical Outcomes but Is Negatively Correlated With Tunnel Widening.

Purpose: To investigate the surgical outcomes of anterior cruciate ligament (ACL) reconstruction using a low-dose irradiated tibialis anterior allograft with a fixed-loop cortical suspension device for the femur based on the graft insertion length (GIL) in the femoral tunnel.

Methods: Between January 2010 and January 2018, the medical records of consecutive patients who underwent arthroscopic ACL reconstruction with a tibialis anterior allograft fixed with the EndoButton CL for the femur and who had at least 2 years of follow-up were retrospectively evaluated. Patients were classified into 3 groups based on the GIL in the femoral tunnel (group 1, GIL < 15 mm; group 2, GIL of 15-20 mm; and group 3, GIL > 20 mm), and their functional scores, knee laxity, and radiographic parameters were evaluated.

Effect of stem position and length on bone-stem constructs after cementless hip arthroplasty.

Aims: There are concerns regarding initial stability and early periprosthetic fractures in cementless hip arthroplasty using short stems. This study aimed to investigate stress on the cortical bone around the stem and micromotions between the stem and cortical bone according to femoral stem length and positioning.

Methods: In total, 12 femoral finite element models (FEMs) were constructed and tested in walking and stair-climbing.

Mild to Moderate Varus Alignment in Relation to Surgical Repair of a Medial Meniscus Root Tear: A Matched-Cohort Controlled Study With 2 Years of Follow-up.

Background: Increased varus alignment of the lower extremity is known to be a poor prognostic factor for the surgical repair for a medial meniscus root tear (MMRT). However, given the concept of constitutional varus, which is present in a substantial portion of the normal population, the generally accepted surgical indication for MMRT concerning a varus alignment of 5° may be unnecessarily narrow.

Purpose: To compare the surgical outcomes of arthroscopic transtibial pullout repair of MMRT according to the degree of varus alignment of the lower extremity.