Combined Meniscal Saucerization and Repair Versus Subtotal Meniscectomy for Symptomatic Discoid Lateral Meniscal Tears in Children and Adolescents.

Background: Meniscal saucerization combined with repair of a symptomatic discoid lateral meniscus (DLM) has been expanding. However, the significance of meniscal saucerization with repair involving complex or degenerative tears remains uncertain.

Purpose/hypothesis: The purpose of this study was to assess the radiological and clinical outcomes of saucerization with repair performed for symptomatic DLM tears in children and adolescents in comparison with a historical control cohort undergoing subtotal meniscectomy.

Functional Recovery and Clinical Outcome After Internal Fixation Using Osteochondral Autologous Transplantation for Osteochondritis Dissecans of the Knee.

Background: Functional recovery and return to sports after fixation of osteochondritis dissecans (OCD) lesions of the knee with osteochondral autologous transplantation (OAT) have not been well investigated.

Purpose: To retrospectively evaluate the functional recovery and clinical outcomes after internal fixation with OAT for knee OCD.

Study Design: Case series; Level of evidence, 4.

Return to sports after unilateral medial opening wedge high tibial osteotomy in highly active patients: Analysis of factors affecting functional recovery.

Purpose: The purpose of this study was to examine the outcomes following opening-wedge high tibial osteotomy (HTO) focusing on return to sports in a consecutive series of highly active patients who underwent a unilateral osteotomy procedure.

Methods: Sixty-three consecutive patients with preoperative Tegner's activity score of five or more who underwent unilateral HTO for varus osteoarthritic knees were included in this study. The clinical results were evaluated using the Knee Injury and Osteoarthritis Outcome Score (KOOS) and the International Knee Documentation Committee (IKDC) Subjective Score.

Arthroscopic Belt Capsulodesis Using a Knotless Soft Suture Anchor for Extruded Medial Meniscus.

In recent years, degenerative meniscal lesions have received increasing attention as an etiologic factor of knee osteoarthritis. Among various relevant factors, medial meniscal extrusion has been shown to be an independent predictor of the onset and progression of knee osteoarthritis. Therefore, surgical reduction of the extruded medial meniscus to restore meniscal function is key to preventing osteoarthritis of the knee.

Preoperative Joint Line Convergence Angle as an Indicator of Clinical Outcomes and Accuracy of Alignment Correction After Double-Level Osteotomy.

Background: The relationship between postoperative alignment and clinical outcomes after double-level osteotomy (DLO) has not been clarified.

Purpose: To examine the radiological and clinical outcomes after DLO and specifically evaluate the influence of the joint-line convergence angle (JLCA) on the accuracy of alignment correction and surgical outcomes.

Study Design: Case-control study; Level of evidence, 3.

Osteochondral autologous transplantation for large steroid-induced osteonecrosis lesion of the knee in a young patient yielding satisfactory results despite only partial coverage: a case report.

Osteochondral autologous transplantation (OAT) is one of the most common surgical options for osteochondral disorders of the knee. In cases where OAT is performed for steroid-induced osteonecrosis, there are several problems potentially affecting the surgical outcomes such as large chondral damage area and compromised host bone. In addition, steroid administration for a long period of time may lead to extensive lesion, which poses difficulty in obtaining sufficient donor tissue.

Optimal additional support screw position for prevention of hinge fracture in biplanar closed wedge distal femoral osteotomy.

Background: The purpose of this study was to examine the biomechanical significance of supplemental fixation using a positional screw in prevention of the hinge fracture in lateral closed-wedge distal femoral osteotomy (LCW-DFO) by means of a three-dimensional finite element analysis.

Methods: The three-dimensional numerical knee models with LCW-DFO were developed. To assess the mechanical efficacy of the positional screw and determine its optimal position and orientation, in total, 13 screwing methods were analyzed.

Augmenting ACL Repair With Suture Tape Improves Knee Laxity: A Biomechanical Study.

Background: Anterior cruciate ligament (ACL) repair is an alternative to reconstruction; however, suture tape support may be necessary to achieve adequate outcomes.

Purposes: To investigate the influence of suture tape augmentation (STA) of proximal ACL repair on knee kinematics and to evaluate the effect of the 2 flexion angles of suture tape fixation.

Study Design: Controlled laboratory study.

Postoperative Tunnel Widening, Elliptical Aperture Shape, and No Preservation of the Remnant Are Related to the Tendon Graft-Bone Tunnel Gap Formation at the Intra-Articular Aperture After Double-Bundle Anterior Cruciate Ligament Reconstruction.

Purpose: To examine the bone-tendon healing at the posterolateral (PL) femoral tunnel aperture by second-look arthroscopy after double-bundle anterior cruciate ligament reconstruction (ACLR), and assess the risk factors for impaired healing at the tendon-bone interface.

Methods: A consecutive series of knees undergoing primary double-bundle ACLR using hamstring tendon autografts were enrolled in the study. The exclusion criteria were as follows: previous knee surgeries, concomitant ligamentous and osseous procedures, and a lack of second-look arthroscopy or postoperative computed tomography data for the analysis.

Efficacy of intravenous tranexamic acid administration in medial opening-wedge distal tibial tuberosity osteotomy (MOWDTO) for varus knee osteoarthritis: a randomized control trial.

Background: This randomized controlled study was undertaken to investigate the efficacy of intravenous tranexamic acid (TXA) administration in reducing perioperative blood loss in patients undergoing medial opening-wedge distal tibial tuberosity osteotomy (MOWDTO). It was hypothesized that TXA would reduce perioperative blood loss in MOWDTO.

Methods: A total of 61 knees in 59 patients who underwent MOWDTO during the study period were randomly assigned to either of the groups with intravenous TXA administration (TXA group) or without TXA administration (control group).

Preoperative Ahlbäck radiographic classification grade significantly influences clinical outcomes of double level osteotomy for osteoarthritic knees with severe varus deformity.

Purpose: The purpose of this study was to examine the relationship between preoperative Ahlbäck radiographic classification grade and the clinical outcomes of double level osteotomy (DLO) performed for osteoarthritic knees with severe varus deformity.

Methods: The study population comprised a consecutive series of 99 knees (68 patients) for which DLO was performed and follow-up results for a minimum of two years were available. The Ahlbäck radiographic classification system was used to determine the osteoarthritic grade.

Effect of Cross-sectional Area of the Hamstring Tendon Autograft on Failure Rate or Clinical Outcomes After Double-Bundle ACL Reconstruction: Tendon Autograft.

Background: In previous studies examining the relationship between graft size and failure rate after anterior cruciate ligament reconstruction (ACLR), graft size was determined as diameter of the bone tunnel, and graft failure was defined as revision surgery. Consequently, the correlation between graft size and postoperative recurrent instability could not be assessed.

Purpose: (1) To intraoperatively measure the cross-sectional area (CSA) of the hamstring tendon (HT) autograft and compare the CSA of the autograft with the bone tunnel and (2) to assess the effect of the graft CSA on postoperative graft failure among patients who underwent double-bundle ACLR.

No Difference in Knee Kinematics Between Anterior Cruciate Ligament-First and Posterior Cruciate Ligament-First Fixation During Single-Stage Multiligament Knee Reconstruction: A Biomechanical Study.

Background: For combined reconstruction of both the anterior cruciate ligament (ACL) and the posterior cruciate ligament (PCL), there is no consensus regarding which graft should be tensioned and fixed first.

Purpose: The purpose of this study was to determine which sequence of graft tensioning and fixation better restores normal knee kinematics. The hypothesis was that ACL-first fixation would more closely restore normal knee kinematics, graft force, and the tibiofemoral orientation in the neutral (resting) position compared with PCL-first fixation.

Arthroscopic centralization reduces extrusion of the medial meniscus with posterior root defect in the ACL reconstructed knee.

Purpose: The purpose of this study was to evaluate the effects of arthroscopic meniscal centralization reinforcement for a medial meniscus (MM) posterior root defect on knee kinematics and meniscal extrusion in the anterior cruciate ligament reconstructed (ACLR) knee. The hypothesis was that the medial meniscus centralization would reduce extrusion and anterior laxity in ACLR knee with a medical meniscal defect.

Methods: Fourteen fresh-frozen human cadaveric knees were tested using a six-degrees-of-freedom robotic system under the following loading conditions: (a) an 89.

Increased posterior slope and coronal inclination of the tibial joint line after opening wedge high tibial osteotomy may induce mucoid degeneration of the anterior cruciate ligament: A case report.

A mucoid degeneration of the anterior cruciate ligament (ACL) is regarded as a degenerative change in the ligament, which is clinically presented with pain on full extension or flexion. Regarding morphological factors, it has been reported that an increased posterior tibial slope can be a cause of ACL degeneration secondary to the repetitive overload. The increase in the tibial slope is among the potential problems after medial opening wedge high tibial osteotomy (OWHTO).

Morphological Evaluation of the Quadriceps Tendon Using Preoperative Ultrasound in Anterior Cruciate Ligament Reconstruction.

Background: An evaluation of quadriceps tendon (QT) morphology preoperatively is an important step when selecting an individually appropriate autograft for anterior cruciate ligament (ACL) reconstruction. However, to our knowledge, there are no studies that have assessed the morphology of the entire QT in an ACL-injured knee preoperatively using ultrasound.

Purpose: We aimed to investigate the morphological characteristics of the QT using preoperative ultrasound in ACL-injured knees.

Low to moderate risk of nerve damage during peroneus longus tendon autograft harvest.

Purpose: This study aims to evaluate the proximity of the tendon stripper to both the peroneal and sural nerves during peroneus longus tendon (PLT) autograft harvesting.

Methods: Ten fresh-frozen human cadaveric lower extremities were used to harvest a full-thickness PLT autograft using a standard closed blunt-ended tendon stripper. The distance to the sural nerve from the PLT (at 0, 1, 2 and 3 cm proximal to lateral malleolus (LM), and the distance to the peroneal nerve and its branches from the end of the tendon stripper were measured by two separate observers using ImageJ software.

Double-level osteotomy for severe varus osteoarthritic knees can prevent change in leg length and restore physiological joint geometry.

Background: It is unclear whether double-level osteotomy (DLO) combining closed-wedge osteotomy in the distal femur and open-wedge osteotomy in the proximal tibia deformity can prevent change in leg length and excessive coronal inclination of the tibial articular surface in surgical correction of the severe varus knee. The purpose of this study was to examine the postoperative change in leg length as well as radiological and clinical outcomes following DLO compared with the results obtained from knees undergoing isolated open-wedge high tibial osteotomy (OW-HTO).

Methods: In cases of severe varus knee deformity (hip-knee-ankle angle (HKA) > 10°) 29 patients undergoing DLO and 35 patients undergoing OW-HTO were included.

Three dimensional CT analysis of the change in rotational alignment in double level osteotomy after double level osteotomy performed for varus osteoarthritic knees.

Purpose: To analyze the change in rotational alignment caused by double level osteotomy (DLO) based on comparative three-dimensional image analysis of pre- and postoperative CT images.

Methods: Pre- and postoperative CT examination of the lower extremities were performed with informed consent for 39 consecutive knees undergoing DLO for varus knee deformity. The DLO procedure consisted of closed wedge distal femoral osteotomy (CWDFO) and open wedge high tibial osteotomy (OWHTO).

Mucoid degeneration of the posterior cruciate ligament in a college soccer player: a case report.

Background: To the best of our knowledge, arthroscopic treatment for symptomatic mucoid degeneration of the posterior cruciate ligament in young athletes has not been reported before.

Case Presentation: An 18-year-old Asian male college soccer player presented with a 3-month history of right knee pain without episodes of trauma. Despite conservative treatment over the preceding 3 months, his symptoms persisted.

Cartilage repair examined by second-look arthroscopy following double-level osteotomy performed for osteoarthritic knees with severe varus deformity.

Background: The purpose of this study was to examine the status of cartilage repair by second-look arthroscopy following double-level osteotomy (DLO) performed for osteoarthritic knees with severe varus deformity.

Methods: Forty-seven consecutive knees in 33 patients who underwent DLO were included in the study. The surgical technique used was a minimally invasive DLO procedure combining lateral closed-wedge distal femoral and medial open-wedge high tibial osteotomies.

How the orientation of osteotomy in biplanar lateral closed-wedge distal femoral osteotomy influences the rotational alignment of the knee in all dimensional planes.

Background: Correction of coronal plane deformity by osteotomies around the knee is theoretically three-dimensional (3D) and can be associated with changes in other planes. It has been shown that 3D rotational changes are induced by biplanar high tibial osteotomy; however, relevant information in biplanar lateral closed-wedge distal femoral osteotomy (LCW-DFO) has not been reported in literatures. This study aimed to investigate rotational changes in axial and sagittal planes in LCW-DFO using computer-aided design (CAD) simulations.

Tibial Tubercle-Midepicondyle Distance Can Be a Better Index to Predict the Outcome of Medial Patellofemoral Ligament Reconstruction Than Tibial Tubercle-Trochlear Groove Distance.

Purpose: To compare the clinical utility of tibial tubercle-midepicondyle (TT-ME) and tibial tubercle-trochlear groove (TT-TG) distances in predicting the risk for recurrent instability after isolated MPFL reconstruction.

Methods: A consecutive series of patients with recurrent patellar dislocation who underwent isolated MPFL reconstruction made up the study population. The patients were followed for a minimum of 2 years.