Platelet-Rich Plasma Injections Do Not Improve the Recovery After Arthroscopic Partial Meniscectomy: A Double-Blind Randomized Controlled Trial.

Background: Arthroscopic meniscectomy is one of the most performed surgical procedures in orthopaedics. Different approaches have been proposed to improve patient recovery but with unsatisfactory results. Platelet-rich plasma (PRP) augmentation has been proposed as a strategy to improve the recovery after meniscectomy.

Good stability and mid-term subjective outcomes after repeated anterior cruciate ligament (ACL) revision surgery using allografts.

Purpose: To evaluate the mid-term clinical outcomes of a cohort of patients who underwent multiple ACL revision reconstructions. The hypothesis was that patients with pre-existing meniscal deficiency conditions, malalignment and cartilage degeneration would have obtained lower results.

Methods: All cases of multiple ACL revisions performed with allograft tissue at one single sport-medicine institution were extracted and patients with a minimum 2 years of follow-up were included.

Intra- and inter-operator reliability assessment of a novel extramedullary accelerometer-based smart cutting guide for total knee arthroplasty: an in vivo study.

Purpose: The purpose is to verify the intra- and inter-operator reliability of an extramedullary (EM) accelerometer-based smart cutting guide for distal femoral resection during primary total knee arthroplasty (TKA). The hypothesis of the present study was that the use of the device would result in a good correlation between different operators with a difference between repeated measurements of less than 1°.

Methods: Twenty-five not consecutive patients with knee osteoarthritis undergone to primary TKA using an EM inertial-based cutting guide to perform distal femoral resection.

Adipose-derived Stromal Vascular Fraction Injection in a Competitive High-level Athlete Affected by Insertional Achilles Tendinopathy.

Achilles tendinopathy is one of the most common ankle and foot overuse injuries, especially among athletes. Despite this, the management of this injury lacks an evidence-based support, and patients are at risk of long-term morbidity with unpredictable clinical outcome. Recently, injective approach has gained more and more attention, and in particular the intratendinous injection with adipose-derived stromal vascular fraction.

White Blood Cell Count Is the Most Reliable Test for the Diagnosis of Septic Arthritis After Anterior Cruciate Ligament Reconstruction: An Observational Study of 38 Patients.

Purpose: (1) To evaluate the diagnostic testing performance of the synovial white blood cell (WBC) count, polymorphonuclear cell percentage, and synovial glucose, synovial protein, synovial lactate dehydrogenase, and synovial C-reactive protein levels as diagnostic markers for the diagnosis of septic arthritis after anterior cruciate ligament (ACL) reconstruction; (2) to define the ideal thresholds of the aforementioned tests, leading to the optimal sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy; and (3) to define the sensitivity of synovial fluid culture and synovial tissue sample culture, as well as determine whether previous antibiotic treatment may affect the accuracy of these tests.

Methods: We performed a retrospective analysis of all patients readmitted from January 2009 to September 2019 with signs suggestive of septic arthritis and undergoing a knee aspiration for synovial fluid analysis and culture. The receiver operating characteristic curve and the associated area under the curve were constructed for the aforementioned synovial markers.

Graft-Preserving Arthroscopic Debridement With Hardware Removal Is Effective for Septic Arthritis After Anterior Cruciate Ligament Reconstruction: A Clinical, Arthrometric, and Magnetic Resonance Imaging Evaluation.

Background: Arthroscopic debridement with graft preservation has been advocated as the treatment of choice for septic arthritis after anterior cruciate ligament (ACL) reconstruction, but no previous studies have investigated if hardware removal, while retaining the graft in situ, improves the success rate. Moreover, it is unclear whether the premature removal of fixation devices may affect graft integration and knee stability.

Purpose/hypothesis: The purpose was to assess the clinical and functional outcomes of patients with septic arthritis after ACL reconstruction who underwent arthroscopic debridement, while retaining the graft in situ but removing fixation devices, and to determine if premature hardware removal affects graft integrity and function.

Bearing thickness of unicompartmental knee arthroplasty is a reliable predictor of tibial bone loss during revision to total knee arthroplasty.

Background: Bone defects during revision procedures for failed UKA represent a challenge even for the most experienced surgeons; therefore, an accurate preoperative planning remains essential to prevent dramatic scenarios in the surgical theatre.

Hypothesis: Our hypothesis is that bearing thickness used in original UKA represents a reliable predictor of severe tibial bone loss, requiring a metallic augment or constrained implant, during revision to TKA.

Patients And Methods: Forty-two patients who underwent a total knee arthroplasty from failed UKA were identified from our institutional database and evaluated clinically using the Knee Society Score (KSS).

Difficult primary total knee arthroplasty requiring a varus-valgus constrained implant is at higher risk of periprosthetic infection.

Purpose: The goal of this study was to compare the risk of periprosthetic infection of a consecutive cohort of primary varus-valgus constrained (VVC) total knee arthroplasties (TKAs), with a matched 1:1 cohort of primary posterior-stabilized (PS) TKAs.

Methods: 74 primary VVC TKAs performed in 66 patients were identified and matched 1:1 with a cohort of 74 primary PS TKAs performed in 73 patients. At last follow up, patients were clinically evaluated using the Knee Society Score (KSS).

The 90-day Readmission Rate after Single-Bundle ACL Reconstruction Plus LET: Analysis of 2,559 Consecutive Cases from a Single Institution.

The aim of the present study is to examine the readmission rate within 90 days of a cohort of patients, who underwent an arthroscopic anterior cruciate ligament (ACL) reconstruction with a lateral extraarticular tenodesis, from a single highly specialized sports traumatology department. From our institutional database, we identified 2,559 patients (78.5% males and 21.

Knee kinematics after cruciate retaining highly congruent mobile bearing total knee arthroplasty: An in vivo dynamic RSA study.

Purpose: This work presents a kinematic evaluation of a cruciate retaining highly congruent mobile bearing total knee arthroplasty design using dynamic Roentgen sterephotogrammetric analysis. The aim was to understand the effect of this implant design on the kinematics of prosthetic knees during dynamic activities.

Methods: A cohort of 15 patients was evaluated at nine month follow-up after surgery.

Age over 50 years is not a contraindication for anterior cruciate ligament reconstruction.

Purpose: To report clinical and functional results of ACL reconstruction in patients over 50 years old and investigate the influence of surgery on osteoarthritis progression in this cohort of patients.

Methods: A systematic review was performed on PubMed, Scopus, Google scholar, Cochrane library and EMBASE, using a strategy search design to collect clinical studies reporting outcomes of ACL reconstruction in patients aged 50 years or older. The primary outcome measure was clinical and functional results, including failure rate defined as reoperation for revision ACL surgery or conversion to total knee arthroplasty; secondary outcomes included radiological findings, expressed according to the validated grading score.

Metal-Backed Tibial Components Do Not Reduce Risk of Early Aseptic Loosening in Unicompartmental Knee Arthroplasty: A Systematic Review and Meta-Analysis.

Long-term results of unicompartmental knee arthroplasty (UKA) have shown a slightly higher revision rate than total knee arthroplasty (TKA), and implant fixation geometry seems to affect prosthetic survivorship. Whether metal-backed tibial component leads to superior performance over the all-polyethylene design is unclear, and a lack of evidence exists in literature. Our purpose was to demonstrate which implant design of UKA (all-polyethylene or metal-backed tibial component) is clinically superior regarding revision rates and clinical functioning, and investigate the role of potential factors that could affect the revision rate.

Early Failure in Medial Unicondylar Arthroplasty: Radiographic Analysis on the Importance of Joint Line Restoration.

Survivorship of unicondylar knee arthroplasty (UKA) remains a drawback, especially compared with the outcome of total knee arthroplasty. This could be improved by identifying and correcting failure mechanisms. To this purpose, this study aimed at exploring failure modalities of UKA, with particular focus on the role of joint line (JL) position and alignment as variable to be optimized for a successful outcome.

The efficacy of dual-mobility cup in preventing dislocation after total hip arthroplasty: a systematic review and meta-analysis of comparative studies.

Purpose: Although long-term reports of total hip arthroplasty (THA) showed successful results, instability remains a major complication. Recently, dual-mobility cups (DMC) have gained more and more interest among clinicians, with encouraging results in terms of lower rate of dislocation associated with good clinical results, but a lack of evidence exists regarding the real efficacy of this implant design compared to traditional fixed-bearing total hip arthroplasties.

Methods: A systematic search was performed in PubMed, Google scholar, Cochrane Library, and EMBASE by two independent reviewers for comparative studies available till December 2017, with the primary objective to demonstrate a real lower dislocation rate of DMC implants compared to unipolar fixed-bearing cup designs.

Return to Sports after Unicompartmental Knee Arthroplasty: Reality or Utopia? A 48-Month Follow-Up Prospective Study.

Unicompartmental knee arthroplasty (UKA) has increased in popularity in the last years, also in younger and more active patients with great expectancies. The purpose of our study was to investigate the change in sports activities before and after medial UKA. We surveyed 53 athletic patients; all underwent cemented medial UKA, to determine not only their subjective and objective evaluation of clinical status with Hospital for Special Surgery (HSS) and visual analog score (VAS) score, but also their sporting and recreational activities at a mean follow-up of 48 ± 6 months (range, 18-56 months).

No Effects of Early Viscosupplementation After Arthroscopic Partial Meniscectomy: A Randomized Controlled Trial.

Background: The management of the postoperative period after knee arthroscopic surgery may be challenging because surgical trauma deeply alters the joint microenvironment, causing the release of several catabolic molecules and proinflammatory factors that might slow down functional recovery. The possibility of using hyaluronic acid (HA) to promote postoperative pain relief and expedite functional improvement seems attractive, considering its biological properties.

Purpose: The aim of the present double-blind randomized controlled trial was to evaluate the effects, in terms of pain control and functional recovery, provided by a single HA injection performed at the end of arthroscopic meniscectomy.

Early Viscosupplementation After Anterior Cruciate Ligament Reconstruction: A Randomized Controlled Trial.

Background: Hyaluronic acid (HA) has been widely used to treat osteoarthritis given its biological and mechanical properties. Because HA is an "intra-articular" treatment approach that affects the joints, it could be used in the management of acute conditions, such as during the early postsurgical phase, to reduce inflammatory stress and improve articular function.

Purpose: The aim of the present double-blind, randomized controlled trial was to evaluate pain control and functional recovery provided by a single injection of HA performed the day after anterior cruciate ligament (ACL) reconstruction.

Unicompartmental knee arthroplasty in patients over 75 years: a definitive solution?

Introduction: The purpose of this study was to perform a mid-long-term clinical and radiographic evaluation of the results obtained in patients older than 75 years treated with minimally invasive unicompartmental knee arthroplasty (UKA). The hypothesis was that UKA is a viable solution for the definitive treatment of localized disease in this age group, with good results and a low failure rate.

Methods: An all-poly tibial component UKA was applied with a minimally invasive technique.

The adductor tubercle: an important landmark to determine the joint line level in revision total knee arthroplasty.

Purpose: The restoration of the physiological femoro-tibial joint line (JL) is important to obtain a good outcome in revision total knee arthroplasty (RTKA). However, its assessment is challenging. The ratio of the distance between the adductor tubercle (AT) JL (ATJL) and the trans-epicondylar femoral width (FW) was proposed as a reliable method.

High rate of implant loosening for uncemented resurfacing-type medial unicompartmental knee arthroplasty.

Purpose: To determine the medium-term implant survivorship, the clinical results and the failure mechanisms of a novel unicompartmental arthroplasty for uncemented resurfacing of the medial tibio-femoral compartment.

Methods: Seventy-six consecutive patients were prospectively evaluated with a mean final follow-up of 6 years (SD 5.3 months).

Arthrodesis After Infected Revision TKA: Retrospective Comparison of Intramedullary Nailing and External Fixation.

Background: Infection after revision total knee arthroplasty (TKA) for previous septic TKA can be a challenging problem to treat due to loss of bone stock and soft tissue integrity. In these cases, arthrodesis is a well-recognized salvage procedure.

Questions/purposes: The aim of this retrospective study was to compare the results as described by a Visual Analogue Scale (VAS) and the Lequesne Algofunctional Score (LAS) of knee arthrodeses performed by using either an external fixator (EF) or an intramedullary nail (IM).

The adductor tubercle: a reliable landmark for analysing the level of the femorotibial joint line.

Purpose: The ratio of femoral width and distance from medial epicondyle to joint line helps estimate the femoral joint line position from femoral width. The approximately radial position of the medial epicondyle on femoral condyle spheres is probably responsible for this relationship, The adductor tubercle approximately lies diametrically opposite to the joint line on condylar sphere. Then, a linear correlation could also exist between the femoral width and distance of adductor tubercle to joint line and is the purpose of the current study.

Knee arthrodesis with a press-fit modular intramedullary nail without bone-on-bone fusion after an infected revision TKA.

Introduction: Knee arthrodesis can be an effective treatment after an infected revision Total Knee Arthroplasty (TKA). The main hypothesis of this study is that a two-stage arthrodesis of the knee using a press-fit, modular intramedullary nail and antibiotic loaded cement, to fill the residual gap between the bone surfaces, prevents an excessive limb shortening, providing satisfactory clinical and functional results even without direct bone-on-bone fusion.

Material And Methods: The study included 22 patients who underwent knee arthrodesis between 2004 and 2009 because of recurrent infection following revision-TKA (R-TKA).

Arthroscopic-assisted focal resurfacing of the knee: surgical technique and preliminary results of 13 patients at 2 years follow-up.

Purpose: The purpose of this study is to describe an arthroscopic-assisted surgical technique for focal resurfacing of medial tibio-femoral compartment and to present the preliminary clinical and radiographic results in a case series of 13 consecutive patients at a mean follow-up of 29 months.

Methods: All patients were treated with the presented procedure for Ahlback grade 3 medial compartment osteoarthritis. Subjective evaluation was based on a visual analog scale for pain self-assessment.