A Network Meta-Analysis of Randomized Controlled Trials Assessing Intraoperative Anesthetic Therapies for Analgesic Efficacy and Morphine Consumption Following Total Knee Arthroplasty.

Background: The purpose of this study was to compare intraoperative anesthetic therapies for total knee arthroplasty (TKA) regarding postoperative analgesic efficacy and morphine consumption by conducting a systematic literature search.

Methods: Randomized controlled trials of TKA using various anesthetic therapies were identified from various databases from conception through December 31, 2021. A network meta-analysis of relevant literature was performed to investigate which treatment showed better outcomes.

Medial patellofemoral ligament reconstruction appears to be a better treatment than repair, proximal realignment, or conservative management for primary patellar dislocation: A network meta-analysis.

Background: The purpose of this study was to compare the functional outcomes and re-dislocation rates of medial patellofemoral ligament (MPFL) reconstruction, MPFL repair, combined proximal realignment (CPR), and conservative management for primary patellar dislocation by conducting a systematic literature search of the available studies. The hypothesis was that MPFL repair and MPFL reconstruction would be better options for treating primary patellar dislocation.

Methods: Randomized controlled trials or prospective studies of primary patellar dislocation treated with MPFL reconstruction, MPFL repair, CPR, or conservative management were identified from the MEDLINE, EMBASE, and the Cochrane Library databases through December 31, 2021.

Risk of revision in UKA versus HTO: a nationwide propensity score-matched study.

Introduction: Our study aims to investigate the incidence rate and risk factors for subsequent revision in patients treated with UKA compared with those treated with HTO.

Methods: In this retrospective nationwide cohort study, we used data from the Korean National Health Insurance claims database from January 1, 2009 to December 31, 2017. We compared patients who had undergone UKA or HTO as the primary surgical procedure longer than two years prior.

Potential Utility of SPECT/CT for Early Detection of Spontaneous Osteonecrosis of the Knee.

Spontaneous osteonecrosis of the knee (SONK) is the most common phenotype of osteonecrosis of knee joints in older adults. Early diagnosis with appropriate management is crucial for improving the prognosis of the SONK. We present SONK in bone scintigraphy and SPECT/CT in 65-year-old man with sudden worsening knee pain and normal radiographs.

Endoscopic Spinal Surgery (BESS and UESS) Versus Microscopic Surgery in Lumbar Spinal Stenosis: Systematic Review and Meta-Analysis.

Study Design: Systematic Review and Meta-Analysis.

Objectives: Various minimally invasive surgical techniques have been developed as alternatives to conventional surgery. According to recent studies, endoscopic spinal surgery (ESS) (biportal ESS [BESS] or uniportal ESS [UESS]) is more favorable compared with microscopic spinal surgery (MSS).

Risk of stroke after unilateral or bilateral TKA (simultaneous and staged without discharge) in 327,438 matched patients using data from the National Health Insurance Claims for South Korea.

Purpose: This study aims to investigate the incidence rate and risk factors of stroke in patients treated with bilateral TKA compared with patients with unilateral TKA.

Methods: In this retrospective nationwide cohort study, we compared patients undergoing unilateral TKA or bilateral TKA using data from the Korean National Health Insurance claims database between January 1, 2009 and August 31, 2017 and included patients older than 40 years of age who underwent primary TKA by the index date as documented primary diagnosis and first additional diagnosis without a history of stroke during the preceding 1 year. We used matched Cox regression models to compare the incidence rate and risk factors of newly acquired stroke among patients treated with unilateral TKA or bilateral TKA after propensity score (PS) matching.

Bone healing on serial plain radiographs occurs slowly but adequately after medial opening wedge high tibial osteotomy without bone graft.

Purpose: The purpose of this study was to prospectively investigate osteotomy gap filling rates on serial plain radiographs, and to evaluate whether alignment correction is maintained after medial opening wedge high tibial osteotomy (MOWHTO) using a locking plate without bone graft.

Methods: Between March 2014 and June 2017, MOWHTO was performed without bone graft regardless of gap size. Radiographs were taken preoperatively, postoperatively, at 1, 3, 6, 12, 18, and 24 months after surgery.

Comparison of stemless and conventional stemmed shoulder arthroplasties in shoulder arthropathy: A meta-analysis.

Background: It is unclear whether stemless shoulder prosthesis lead to better clinical outcomes than conventional stemmed shoulder prosthesis. The purpose is to compare clinical outcomes and complication rates after surgery in patients with shoulder arthropathy treated with stemless or conventional stemmed shoulder prosthesis.

Method: All studies comparing the constant score (CS), range of motion (ROM), and complication rates after surgery in patients with shoulder arthropathy treated with stemless or conventional stemmed shoulder prosthesis were included.

Risk of a complete exchange or failure in total knee arthroplasty and unicompartmental knee arthroplasty: a nationwide population-based cohort study from South Korea.

Purpose: Few large-scale studies using adjusted data from national registries have explored the risk factors of subsequent revision in patients with unicompartmental knee arthroplasty (UKA) compared to those with total knee arthroplasty (TKA). We investigated the incidence rate and risk factors of subsequent revision in patients with UKA and TKA.

Methods: We enrolled all patients who had undergone TKA or UKA as the primary surgical procedure without histories of having undergone either procedure during the preceding 2 years.

Intra-Articular Injections of Hyaluronic Acid or Steroids Associated With Better Outcomes Than Platelet-Rich Plasma, Adipose Mesenchymal Stromal Cells, or Placebo in Knee Osteoarthritis: A Network Meta-analysis.

Purpose: To evaluate the clinical effects of hyaluronic acid (HA), steroids, platelet-rich plasma (PRP), or adipose mesenchymal stromal cell (MSC) injections in the treatment of knee osteoarthritis (OA).

Methods: Randomized controlled trials with OA of the knee that compared HA, steroids, PRP, adipose MSC, or their combination with placebo or in head-to-head combination were identified from the MEDLINE, EMBASE, Cochrane Library, Web of Science, and SCOPUS databases up to June 30, 2019. We performed a network meta-analysis of the relevant literature to determine whether there was benefit from HA, steroids, PRP, or adipose MSC treatment as compared with placebo.

Comparison of femoral tunnel length and obliquity of anatomic versus nonanatomic anterior cruciate ligament reconstruction: A meta-analysis.

Purpose: Theoretical considerations suggest that femoral tunnel length might cause graft mismatch, and femoral tunnel obliquity could be related to the longevity of graft in anterior cruciate ligament (ACL) reconstruction. However, controversy still exists regarding these issues in the context of the comparison of anatomic and nonanatomic ACL reconstructions. The purpose of this meta-analysis was to compare the length and obliquity of the femoral tunnel created by drilling through either anatomic or nonanatomic ACL reconstructions.

Repair versus nonrepair of medial meniscus posterior root tear: A systematic review of patients' selection criteria, including clinical and radiographic outcomes.

Background: The general consensus regarding a rational choice among various treatment strategies for medial meniscus posterior root tears (MMPRTs) has yet to be clearly established. The purpose of this systematic review was to analyze patient selection criteria based on index arthrosis, as well as clinical and radiological outcomes after repair or nonrepair treatment in patients with MMPRTs.

Methods: A systematic electronic search was performed with established medical databases.

Survival of medial versus lateral unicompartmental knee arthroplasty: A meta-analysis.

Many studies have found associations between unicompartmental knee arthroplasty (UKA) and implant survival, but controversy still exists regarding the relative survival of medial versus lateral UKA over mid-to long-term follow-up. The purpose of this study was to compare survival and clinical outcomes of medial and lateral UKAs. In this meta-analysis, we reviewed studies that assessed implant survival in patients who underwent medial or lateral UKA with short- to mid-term (<10years) or long-term (>10years) follow-up, and that used assessments, such as pain and function scores, to compare postoperative scores on knee outcome scales.

Collagenous Ultrastructure of the Torn Medial Meniscus Posterior Root: A Transmission Electron Microscopy Study.

Background: The collagen ultrastructure of torn medial meniscus posterior roots (MMPRs) has not been precisely defined.

Purpose: To investigate the ultrastructure of torn MMPRs, focusing on their collagen fibers, and to compare the collagen net architecture between intact and torn MMPRs using the Collagen Meniscal Architecture (CMA) scoring system.

Study Design: Descriptive laboratory study.

Survival of total knee arthroplasty after high tibial osteotomy versus primary total knee arthroplasty: A meta-analysis.

Background: Theoretical considerations suggest that total knee arthroplasty (TKA) is technically more challenging after high tibial osteotomy (HTO), resulting in inferior results compared to primary TKA. However, several studies on this issue have shown contradictory results. The purpose of this meta-analysis to compare survivorship and clinical outcomes between TKA with and without previous HTO.

Risk of Revision Following Total Knee Arthroplasty or High Tibial Osteotomy: A Nationwide Propensity-Score-Matched Study.

Background: High tibial osteotomy (HTO) is often performed to postpone or avoid the need for subsequent total knee arthroplasty (TKA). We designed the present study to investigate the incidence rate and risk factors for subsequent revision in patients treated with HTO compared with those managed with TKA.

Methods: In this retrospective nationwide cohort study, we reviewed the South Korean National Health Insurance claims database from January 1, 2009, to August 31, 2017.

Correction: Rotating hinge knee versus constrained condylar knee in revision total knee arthroplasty: A meta-analysis.

[This corrects the article DOI: 10.1371/journal.pone.

Rotating hinge knee versus constrained condylar knee in revision total knee arthroplasty: A meta-analysis.

There is debate in the literature whether rotating hinge knee (RHK) or constrained condylar knee (CCK) prostheses lead to better clinical outcomes and survival rates in patients undergoing revision total knee arthroplasty (RTKA). The purpose of this meta-analysis is to compare the survivorship and clinical outcomes of RHK and CCK prostheses. In this meta-analysis, we reviewed studies that evaluated pain and function scores, range of motion (ROM), complications, and survival rates in patients treated with RHK or CCK with short-term (<5 years) or midterm (5-10 years) follow-up.

Navigated versus Conventional Technique in High Tibial Osteotomy: A Meta-Analysis Focusing on Weight Bearing Effect.

Purpose: We aimed to determine whether navigated opening wedge high tibial osteotomy (HTO) is superior to the conventional technique in terms of accuracy of the coronal and sagittal alignment correction, functional outcome, and operative time.

Methods: Studies comparing navigated and conventional HTO were included in this meta-analysis. We compared the incidence of radiological outliers in coronal alignment and tibial slope maintenance, mean differences in functional outcome scales, and operative time.

Arthroscopic Treatment of Popliteal Cysts with and without Cystectomy: A Systematic Review and Meta-Analysis.

Purpose: To compare the clinical outcomes of the arthroscopic treatments for popliteal cysts with and without cystectomy.

Methods: PubMed/MEDLINE, EMBASE, KoreaMed, and Cochrane Library were searched from the earliest available date of indexing through August 2016. The methodological quality of all articles was assessed according to the Coleman methodology score (CMS).

Incidence and Predictors of Lateral Hinge Fractures Following Medial Opening-Wedge High Tibial Osteotomy Using Locking Plate System: Better Performance of Computed Tomography Scans.

Background: This study compared the rates of plain radiographs and computed tomography (CT) for detecting lateral hinge fractures and to evaluate factors affecting lateral hinge fractures in patients following medial opening-wedge high tibial osteotomy (MOWHTO).

Methods: This prospective study included 59 patients (65 knees) undergoing MOWHTO for primary medial compartment osteoarthritis with a 2-year follow-up between 2013 and 2016. Clinical and radiographic evaluations were performed using Knee Society Score and Western Ontario and McMaster Universities Arthritis Index, and we calculated the hip-knee-ankle angle, weight-bearing line ratio, lateral distal femoral angle, medial proximal tibial angle, posterior tibial slope, osteotomy gap height, and osteotomy gap filling rate.

D-hole breakage of 2 angular stable locking plates for medial opening-wedge high tibial osteotomy: Analysis of results from 12 cases.

An adequate stable fixation implant should be used for medial opening-wedge high tibial osteotomy (MOWHTO) to promote rapid bone healing without complications. To date, the highest fixation stability has been observed for angular stable locking plates. However, there is still little medical literature regarding breakage of these plates.

Gait comparison of unicompartmental knee arthroplasty and total knee arthroplasty during level walking.

This meta-analysis compared the gait patterns of unicompartmental knee arthroplasty (UKA) patients and total knee arthroplasty (TKA) patients during level walking by evaluating the kinetics, kinematics, and spatiotemporal parameters. Studies were included in the meta-analysis if they assessed the vertical ground reaction force (GRF), joint moment at stance, flexion at initial contact, flexion at swing, overall range of motion (ROM), coronal knee angle at stance, walking speed, cadence, and stride length in UKA patients or TKA patients. Seven non-randomized studies met the criteria for inclusion in this meta-analysis.

Intra-Articular Injection of Bone Marrow-Derived Mesenchymal Stem Cells Leading to Better Clinical Outcomes without Difference in MRI Outcomes from Baseline in Patients with Knee Osteoarthritis.

Purpose: Bone marrow (BM) is frequently used as a source of mesenchymal stem cells (MSCs) because they have a high potential for differentiation. However, it is unclear whether BM-derived MSCs lead to better clinical and magnetic resonance imaging (MRI) outcomes postoperatively.

Materials And Methods: This meta-analysis compared the clinical and MRI outcomes in patients with knee osteoarthritis (OA) treated with BM-derived MSCs.

Effect of shape on bone cement polymerization time in knee joint replacement surgery.

Background: Although many factors are known to influence the polymerization time of bone cement, it remains unclear which bone cement shape predicts the precise polymerization time. The purpose of this study was to investigate whether different cement shapes influenced polymerization time and to identify the relationship between cement shape and ambient operating theater temperature, relative humidity, and equilibration time.

Methods: Samples were gathered prospectively from 237 patients undergoing primary total knee arthroplasty.