Can blood flow restriction therapy improve quality of life and function in dissatisfied knee arthroplasty patients?

Aims: Approximately 10% to 20% of knee arthroplasty patients are not satisfied with the result, while a clear indication for revision surgery might not be present. Therapeutic options for these patients, who often lack adequate quadriceps strength, are limited. Therefore, the primary aim of this study was to evaluate the clinical effect of a novel rehabilitation protocol that combines low-load resistance training (LL-RT) with blood flow restriction (BFR).

Total knee arthroplasty: The need for better patient selection.

Total knee arthroplasty (TKA) is a widely performed surgical intervention designed to relieve pain and restore function in patients with severe knee joint degeneration, most commonly due to osteoarthritis. This procedure involves replacing the damaged knee joint with a prosthetic implant, providing significant improvements in mobility and quality of life. While TKA is beneficial for many, the individuals who stand to gain the most are those with advanced knee arthritis unresponsive to conservative treatments, typically aged 60 and above, experiencing activity-related pain and functional limitations.

Vascular occlusion for optimising the functional improvement in patients with knee osteoarthritis: a randomised controlled trial.

Objectives: Knee osteoarthritis (KOA) is a leading cause of global disability with conventional exercise yielding only modest improvements. Here we aimed to investigate the benefits of integrating blood flow restriction (BFR) into traditional exercise programmes to enhance treatment outcomes.

Methods: The Vascular Occlusion for optimizing the Functional Improvement in patients with Knee Osteoarthritis randomised controlled trial enrolled 120 patients with KOA at Ghent University Hospital, randomly assigning them to either a traditional exercise programme or a BFR-enhanced programme over 24 sessions in 12 weeks.

Application of external torque enhances the detection of subtle syndesmotic ankle instability in a weight-bearing CT.

Purpose: Acute syndesmotic ankle injuries continue to impose a diagnostic dilemma and it remains unclear whether weightbearing and/or external rotation should be added during the imaging process. Therefore, the aim of this study was to assess if combined weightbearing and external rotation increases the diagnostic sensitivity of syndesmotic ankle instability using weightbearing CT (WBCT) imaging, compared to isolated weightbearing.

Methods: In this retrospective study, patients with an acute syndesmotic ankle injury were analysed using a WBCT (N = 21; Age = 31.

Clinical outcomes in TKA are enhanced by both robotic assistance and patient specific alignment: a comparative trial in 120 patients.

Introduction: Robotically assisted surgery was introduced in total knee arthroplasty (TKA) to increase the precision of implant positioning and optimize clinical outcomes. However, the target implant position or alignment is debated. The aim of this study was twofold: to compare clinical outcomes of conventional TKA vs.

Inverse Kinematic Alignment for Total Knee Arthroplasty.

Patient specific alignment might improve clinical outcomes in total knee arthroplasty (TKA). Different alignment concepts are described, each providing specific features with theoretical benefits or possible disadvantages. Inverse kinematic alignment (iKA) is a new patient specific alignment concept with excellent reported clinical outcome and patient satisfaction at short-term follow-up.

Prevention of venous thromboembolism with aspirin following knee surgery: A systematic review and meta-analysis.

Venous thromboembolism (VTE) is a well-known complication following orthopaedic surgery. The incidence of this complication has decreased substantially since the introduction of routine thromboprophylaxis. However, concerns have been raised about increased bleeding complications caused by aggressive thromboprophylaxis.

The contralateral knee is a good predictor for determining normal knee stability: a cadaveric study.

Purpose: The goal is to evaluate contralateral knee joint laxity and ascertain whether or not contralateral symmetry is observable. Secondary, a validation of a knee laxity testing rig is provided.

Methods: Seven pairs of cadaveric knee specimens have been tested under passive conditions with and without external loads, involving a varus/valgus and an external/internal rotational torque and an anteroposterior shear force.

Biceps Femoris Compensates for Semitendinosus After Anterior Cruciate Ligament Reconstruction With a Hamstring Autograft: A Muscle Functional Magnetic Resonance Imaging Study in Male Soccer Players.

Background: Rates of reinjury, return to play (RTP) at the preinjury level, and hamstring strain injuries in male soccer players after anterior cruciate ligament reconstruction (ACLR) remain unsatisfactory, due to multifactorial causes. Recent insights on intramuscular hamstring coordination revealed the semitendinosus (ST) to be of crucial importance for hamstring functioning, especially during heavy eccentric hamstring loading. Scientific evidence on the consequences of ST tendon harvest for ACLR is scarce and inconsistent.

Knee arthroplasty for acute fractures around the knee.

Results of open reduction and internal fixation for complex articular fractures around the knee are poor, particularly in elderly osteoporotic patients.Open reduction and internal fixation may lead to an extended hospital stay and non-weight-bearing period.This may lead to occurrence of complications related to decubitus such as thrombo-embolic events, pneumonia and disorientation.

Higher satisfaction after total knee arthroplasty using restricted inverse kinematic alignment compared to adjusted mechanical alignment.

Purpose: Various alignment philosophies for total knee arthroplasty (TKA) have been described, all striving to achieve excellent long-term implant survival and good functional outcomes. In recent years, in search of higher functionality and patient satisfaction, a shift towards more tailored and patient-specific alignment is seen. The purpose of this study was to describe a restricted 'inverse kinematic alignment' (iKA) technique, and to compare clinical outcomes of patients that underwent robotic-assisted TKA performed by restricted iKA vs.

The ankle syndesmosis pivot shift "Are we reviving the ACL story?".

In recent literature, there is a growing interest for the high ankle sprain with emerging evidence on biomechanical behavior, function, injury, and treatment. Interpretation of emerging publications on the distal tibiofibular syndesmosis may raise questions about striking similarities with the anterior cruciate ligament function and pivot-shift mechanism of injury in the knee. This editorial note puts to question whether identical entities, a continuum or separate injuries are faced by contemplating on the mechanism of injury, diagnostics, treatment, and outcome.

How should we evaluate robotics in the operating theatre?

The application of robotics in the operating theatre for knee arthroplasty remains controversial. As with all new technology, the introduction of new systems might be associated with a learning curve. However, guidelines on how to assess the introduction of robotics in the operating theatre are lacking.

Tunnel placement in ACL reconstruction surgery: smaller inter-tunnel angles and higher peak forces at the femoral tunnel using anteromedial portal femoral drilling-a 3D and finite element analysis.

Purpose: Recent studies have emphasized the importance of anatomical ACL reconstruction to restore normal knee kinematics and stability. Aim of this study is to evaluate and compare the ability of the anteromedial (AM) and transtibial (TT) techniques for ACL reconstruction to achieve anatomical placement of the femoral and tibial tunnel within the native ACL footprint and to determine forces within the graft during functional motion. As the AM technique is nowadays the technique of choice, the hypothesis is that there are significant differences in tunnel features, reaction forces and/or moments within the graft when compared to the TT technique.

Correction to: Peak stresses shift from femoral tunnel aperture to tibial tunnel aperture in lateral tibial tunnel ACL reconstructions: a 3D graft-bending angle measurement and finite-element analysis.

Unfortunately, one of the co-author's name was missed in the original online publication of this article. The name should be included as sixth author in the author group.

Peak stresses shift from femoral tunnel aperture to tibial tunnel aperture in lateral tibial tunnel ACL reconstructions: a 3D graft-bending angle measurement and finite-element analysis.

Purpose: To investigate the effect of tibial tunnel orientation on graft-bending angle and stress distribution in the ACL graft.

Methods: Eight cadaveric knees were scanned in extension, 45°, 90°, and full flexion. 3D reconstructions with anatomically placed anterior cruciate ligament (ACL) grafts were constructed with Mimics 14.

The anterior cruciate ligament: a study on its bony and soft tissue anatomy using novel 3D CT technology.

Purpose: The purpose of this study is twofold: first, to visualize both the tibial and femoral bony insertion surfaces and second, to describe the anterior cruciate ligament (ACL) geometrically, using novel 3D CT imaging. In addition, new concepts of best-fit cylinder and central axis are introduced and evaluated.

Methods: Eight unpaired knees of embalmed cadavers were used in this study.

Long-term follow-up of the anterior lumbar interbody fusion procedure.

Purpose: To evaluate the long-term clinical results and the effectiveness of the anterior lumbar interbody fusion procedure.

Methods: Between 1999 and 2005, 60 ALIFs were performed in 59 patients. Mean age was 41.

Does cruciate retention primary total knee arthroplasty affect proprioception, strength and clinical outcome?

Purpose: It remains unclear what the contribution of the PCL is in total knee arthroplasty (TKA). The goal of this study was to investigate the influence of the PCL in TKA in relationship to clinical outcome, strength and proprioception.

Methods: Two arthroplasty designs were compared: a posterior cruciate-substituting (PS) and a posterior cruciate-retaining (CR) TKA.

Revision of meniscal transplants: long-term clinical follow-up.

Purpose: The primary aim is to document objective and subjective clinical outcome after knee arthroplasty for failed meniscal allograft transplantation; secondly, to investigate the influence of previous meniscal allograft surgery on the clinical outcome after a knee arthroplasty procedure; thirdly, to identify possible prognostic factors for the failure of meniscal allograft, such as potential number of concomitant procedures or pre-transplantation HSS-scores. The study population was compared to a control group of primary total knee arthroplasties.

Methods: The pre-operative phase, prior to meniscal allograft transplantation, was evaluated by the HSS questionnaire.

The posterior cruciate ligament: a study on its bony and soft tissue anatomy using novel 3D CT technology.

Purpose: The bony insertion sites of the PCL have been studied and described extensively using 2D technology such as macroscopic images, plain radiograph, computerized tomography (CT) and MRI. The purpose of this study is to visualize both the tibial and the femoral bony insertion sites but also the soft tissue anatomy of the native PCL using novel 3D CT imaging. In addition, new concepts of best-fit cylinder and central axis are introduced and evaluated.

Intramedullary fixation of intertrochanteric hip fractures: a comparison of two implant designs. A prospective randomised clinical trial.

We report the results of a prospective randomized clinical trial comparing the Gamma 3 nail with the ACE trochanteric nail for the treatment of pertrochanteric femoral fractures. One hundred and twelve consecutive patients were enrolled in the study: 61 patients were treated with the Gamma 3 nail, 51 with the ACE trochanteric nail. The two groups were matched for age, fracture type and preoperative Merle d'Aubigné hip score.