Implant breakage and revision factors for modular fluted tapered stems in revision total hip arthroplasty.

Purpose: Modular stems in revision total hip arthroplasties allow diaphyseal fixation and optimal restoration of the architecture of the proximal femur. Several studies report metaphyseal implant breakage having a negative impact on survivorship. The aim of the study was to evaluate the outcome of an uncemented modular fluted tapered stem (MFT) in revision surgery.

Dislocation fracture of the femoral head in adult.

The smaller the head fragment, the more likely it is located at the bottom and in front of the femoral head, which then determines the most suitable approach. A CT scan is essential after reduction and before resumption of weight-bearing to verify the size and congruence of the fragments and whether there are foreign bodies and/or a fracture of the posterior wall. Classifications should include the size of the fragment and whether or not there is an associated fracture of the acetabulum or femoral neck (historical 'Pipkin', modernised 'Chiron').

Comparative study of total hip arthroplasties with dual mobility cups versus hemiarthroplasties in management of femoral neck fractures: Survival and dislocation rate at 5 years of follow-up?

Background: Instability after hip arthroplasty, whether it is a total (THA) or intermediate (HA), poses a major risk, however arthroplasty is the standard treatment for displaced intracapsular fractures of the femoral neck of the elderly. Three types of arthroplasties can be proposed: total prostheses with or without a dual mobility cup (DM THA) reducing the risk of dislocation, and hemiarthroplasties. In the absence of clear recommendations regarding the type of implant to be used and the scarcity of studies comparing HA and DM THA, we conducted a monocentric comparative retrospective study using the propensity score method to compare DM THA versus HA on recently displaced femoral neck fractures: (1) survival and risk of dislocation, (2) functional results, (3) mortality.

Does augmented core decompression decrease the rate of collapse and improve survival of femoral head avascular necrosis? Case-control study comparing 184 augmented core decompressions to 79 standard core decompressions with a minimum 2 years' follow-up.

Introduction: Avascular necrosis of the femoral head often progresses to femoral head collapse if not treated. Conservative treatment yields highly variable results and is not standardised, mainly because it is typically evaluated in small patient populations. This led us to conduct a large retrospective comparative study with the goals of 1) analysing survival and functional outcomes, 2) looking for differences in survival between core decompression techniques (standard versus augmented), and 3) studying the risk factors for femoral head collapse and revision by arthroplasty.

Periprosthetic joint infection in aseptic total hip arthroplasty revision.

Purpose: There is no consensus regarding systematic screening for infection in aseptic revision total hip arthroplasty (THA). The rationale for systematic intra-operative samples is to increase the sensitivity of latent infections detection, which may require specific treatment. However, the incidence of occult infection in revision THAs is not precisely known.

Patient Participation During Anterior Cruciate Ligament Reconstruction Improves Comprehension, Satisfaction, and Functional Outcomes: A Simple Way to Improve Our Practices.

Background: It is estimated that 28% of patients are dissatisfied after anterior cruciate ligament (ACL) reconstruction, in part because they do not understand the procedure well enough.

Purpose: To assess the postoperative comprehension, satisfaction, and functional outcomes of 2 patient groups: 1 undergoing a standard surgical procedure (standard group) and 1 involved in their surgery (participation group).

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

The Delta of Correction: a novel, more reliable variable than limb-length discrepancy at predicting outcome after total hip arthroplasty.

Background: Leg-length discrepancy (LLD) is a frequent and recurring issue after total hip arthroplasty (THA). It can lead to discomfort and litigation due to the patient's perception of this inequality.

Purpose: The aim of this study was to evaluate the functional impact of postoperative LLD and length correction in patients after primary THA.

Determination of normal KOOS and WOMAC values in a healthy population.

Purpose: The KOOS questionnaire is used to assess the symptoms and function of patients with traumatic or degenerative knee pathology. The WOMAC score has been validated mainly in the context of knee osteoarthritis. The distribution of these scores in a non-diseased population is not known.

Distal femoral torsion: Differences between caucasians and asians. A multicentre computed tomography study of 515 distal femurs.

Background: The posterior condylar angle (PCA) is formed by the posterior condylar line (PCL) and the clinical (or anatomic) transepicondylar line (TEL). The primary objective of this study was to compare the distribution of PCA values in Caucasians and Asians free of knee osteoarthritis. The secondary objectives were to assess PCA variability according to age, gender, and side.

Editorial Commentary: Knee Anterolateral Ligament Bashing-Why So Much Negativity?

Articles on the anterolateral ligament have generated lots of discussion, but a worldwide consensus has been recently reached: the anterolateral ligament exists. Cadaver studies on a small number of subjects should not be used to draw conclusions as they do not replicate real life. We place our faith in clinical studies with a large number of patients as they capture the variability encountered in our practices.

Evaluation of reproducibility of robotic knee testing device (GNRB) on 60 healthy knees.

Introduction: There is a main concern about the usefulness and the accuracy of the different laximeters. The GnrB device is becoming more popular, but according to the literature it's not clear whether it is fully reliable.

Objective: GNRB laxity measurements are not reproducible for measurement of anterior translation of the tibia.

How to Test the Anterolateral Ligament With Ultrasound.

Ultrasonography (US) is a nonirradiating, low-cost, real-time imaging modality that has very good spatial resolution. US can be used to view the anterolateral ligament (ALL) and injuries to the ALL. Several authors have sought to analyze the anterolateral aspect of the knee using US with varying luck.

Hamstring Graft Incorporation According to the Length of the Graft Inside Tunnels.

Background: Anterior cruciate ligament (ACL) reconstruction with a quadrupled semitendinosus (ST4) graft is an evolution of the standard technique with 2 hamstring tendons (semitendinosus + gracilis [STG]). However, there is no published comparison of how well these 2 types of hamstring grafts are incorporated into the bone tunnels. Because the ST4 graft is shorter, there is less graft material inside the tunnels.

Geometric morphometric analysis reveals age-related differences in the distal femur of Europeans.

Background: Few studies have looked into age-related variations in femur shape. We hypothesized that three-dimensional (3D) geometric morphometric analysis of the distal femur would reveal age-related differences. The purpose of this study was to show that differences in distal femur shape related to age could be identified, visualized, and quantified using three-dimensional (3D) geometric morphometric analysis.

Three-dimensional geometric morphometric analysis reveals ethnic dimorphism in the shape of the femur.

Background: Ethnic dimorphism in the distal femur has never been studied in a three-dimensional analysis focused on shape instead of size. Yet, this dimorphism has direct implications in orthopedic surgery and in anthropology. The goal of this study was to show that differences in distal femur shape related to ethnic dimorphism could be identified, visualized, and quantified using 3D geometric morphometric analysis.

Ultrasonographic Evaluation of Anterolateral Ligament Injuries: Correlation With Magnetic Resonance Imaging and Pivot-Shift Testing.

Purpose: (1) To compare the diagnostic ability of ultrasonography (US) and magnetic resonance imaging (MRI) to detect anterolateral ligament (ALL) injuries in anterior cruciate ligament (ACL)-deficient patients, and (2) to evaluate the correlation between ALL injury status (as determined by US and MRI) and the knee's rotational stability.

Methods: Thirty patients with an isolated ACL injury were included prospectively over a 3-month period. The condition of the ALL was evaluated by 2 experienced radiologists using both US and MRI.

Historical perspective on the "discovery" of the anterolateral ligament of the knee.

Unlabelled: There is a lively debate about the existence, origins and discoverer of the anterolateral ligament of the knee. The complex anatomy of the lateral aspect of the knee has made it difficult to differentiate between various structures such as the iliotibial band, capsulo-osseous layer, Kaplan's fibres and the anterolateral capsule. The "discovery" of a new anterolateral structure in 2013 was the culmination of many historical studies.

Cadaveric Study Comparing the Biomechanical Properties of Grafts Used for Knee Anterolateral Ligament Reconstruction.

Purpose: To measure the biomechanical properties (maximum load, stiffness, and elongation) of the anterolateral ligament (ALL), gracilis, and iliotibial band (ITB) within the same subject.

Methods: Thirteen unpaired knees were used (7 women, 6 men). The donors had a mean age at death of 54 years (range: 37 to 70 years).

Geometric morphometric analysis reveals sexual dimorphism in the distal femur.

An individual's sex can be determined by the shape of their distal femur. The goal of this study was to show that differences in distal femur shape related to sexual dimorphism could be identified, visualized, and quantified using 3D geometric morphometric analysis. Geometric morphometric analysis was carried out on CT scans of the distal femur of 256 subjects living in the south of France.

Can the gracilis replace the anterior cruciate ligament in the knee? A biomechanical study.

Purpose: The purpose of this study was to determine whether a four-strand gracilis-only construct possesses the biomechanical properties needed to act as an anterior cruciate ligament (ACL) reconstruction graft.

Methods: This was a pilot study with 32 cadaver specimens. The biomechanical properties of three types of grafts were determined using validated tensile testing methods: patellar tendon (BTB), both hamstring tendons together (GST4) and gracilis alone (G4).

Ultrasonographic Identification of the Anterolateral Ligament of the Knee.

Purpose: To determine ultrasonography's sensitivity for identifying the anterolateral ligament (ALL).

Methods: A descriptive study of 18 cadaveric knees was performed. Ultrasonography was used to locate any anterolateral structures at the knee that could correspond to the ALL.

Modified head-neck offset for diagnosing anterior femoro-acetabular impingement.

Purpose: The head-neck offset described by Eijer et al. (eHNO), which is used to diagnose anterior femoro-acetabular impingement (FAI), can be difficult to measure. The aim of this study was to verify if a modified head-neck offset (mHNO) provides more accurate and reproducible values than those of the eHNO.

Fixation of a fractured femoral head through a medial hip approach: an original approach to the femoral head.

The decision to treat a femoral head fracture conservatively or surgically is the subject of ongoing debate. Several surgical approaches have been proposed for the open reduction and internal fixation of femoral head fractures. To our knowledge, fixation through a minimally invasive medial approach has not been described until now.