The Teitge test.

Introduction: High tibial osteotomy (HTO) is used to treat medial knee osteoarthritis (OA). A simple clinical test to select the patients most likely to benefit from the procedure was suggested by R. A.

Identifying Lower Extremity Deformities in the Coronal Plane: Lessons From Remote Learning During the COVID-19 Pandemic.

Introduction During the COVID-19 pandemic, the AO Foundation, an orthopedic education organization, had to transition its live education programs to an online format. Skills that were previously evaluated and corrected in person by educators were now assessed through online lectures and discussion groups. Our goal was to evaluate an online course designed to teach the skill of "leg length and coronal deformity measurement" and to assess participants' ability to demonstrate this skill using online software.

Decision Making and Management of Anterior Knee Pain in Young Patients With Pathological Femoral Anteversion: A Critical Analysis Review.

Pathological femoral anteversion (FAV) or femoral maltorsion is often overlooked as a cause of anterior knee pain (AKP). Therefore, it should be routinely evaluated during physical examination of the patient with AKP. FAV is a problem because it changes the direction of the quadriceps and thereby the force acting on the patellofemoral joint.

Severe inwardly pointing knee after medial patellofemoral ligament reconstruction: a case report.

We report the case of a 26-year-old woman who presented with a profound gait disturbance and total disability following a medial patellofemoral ligament (MPFL) reconstruction for recurrent patellar dislocation. It is common knowledge that patellar instability is associated with multiple risk factors, including but not limited to loss of the MPFL, trochlear dysplasia, patella alta, an abnormally placed tibial tuberosity on the tibia, quadriceps contracture, genu valgum, excess of femoral anteversion, excess of external tibial torsion, and foot pronation. Since the relative importance of each is unknown, it is imperative that pre-operative evaluation considers these.

Torsional Abnormality: The Forgotten Issue in the Diagnosis and Treatment of the Anterior Knee Pain Patient.

Currently, no one doubts that the vast majority of anterior knee pain (AKP) cases do not need surgery [...

The incidence of complications after derotational femoral and/or tibial osteotomies in patellofemoral disorders in adolescents and active young patients: a systematic review with meta-analysis.

Purpose: To quantify the risk of perioperative and postoperative complications of derotational femoral and/or tibial osteotomies in patellofemoral disorders (anterior knee pain and patellar instability) in adolescents and active young patients.

Methods: MEDLINE, EMBASE, Cochrane and Scopus databases were used to identify studies published from database inception and June 30, 2021. Meta-analysis was performed to pool the rates of complications related to femur and tibia osteotomies.

Elimination of the Femoral Neck in Measuring Femoral Version Allows for Less Variance in Interobserver Reliability.

: Producing consistent measures of femoral version amongst observers are necessary to allow for an assessment of version for possible corrective procedures. The purpose of this study was to compare two computed tomography (CT)-based techniques for the reliability of measuring femoral version amongst observers. : Review was performed for 15 patients post-femoral nailing for comminuted (Winquist III and IV) femoral shaft fractures where CT scanograms were obtained.

A Validated, Automated, 3-Dimensional Method to Reliably Measure Tibial Torsion.

Background: Tibial torsion is a twist in the tibia measured as an angle between a proximal axis line and a distal axis line. Abnormal torsion has been associated with a variety of painful clinical syndromes of the lower limb. Measurements of normal tibial torsion reported by different authors vary by 100% (ranging from 20° to 42°), making it impossible to determine normal and pathological levels.

Healthy middle-aged Asian and Caucasian populations present with large intra- and inter-individual variations of lower limb torsion.

Purpose: There is a lack of standardization in the measurement of lower limb torsional alignment. Normal values published in the literature are inconsistent. A 3D-CT-scan-based method was used in a healthy population to define the femoral neck version (FNV) and the tibial torsion (TT) and their relationship with demographic parameters.

Successful two-stage revision of Lactobacillus infection of a total knee arthroplasty and literature review.

Background: Lactobacillus has been identified as the causative organism in only two total joint arthroplasties: one total hip arthroplasty (THA) and one total knee arthroplasty (TKA). The THA was a litigious case that was treated successfully with a one-stage revision, and the patient with the TKA ultimately required above-knee amputation. We present the first case report of a Lactobacillus infection of a TKA that was treated successfully with a two-stage revision TKA.

Unicompartmental knee replacement after high tibial osteotomy: Invalidating a contraindication.

The outcome of high tibial osteotomy (HTO) deteriorates with time, and additional procedures may be required. The aim of this study was to compare the clinical and radiological outcomes between unicompartmental knee replacement (UKR) and total knee replacement (TKR) after HTO as well as after primary UKR. A total of 63 patients (63 knees) were studied retrospectively and divided into three groups: UKR after HTO (group A; n = 22), TKR after HTO (group B; n = 18) and primary UKR (group C; n = 22).

Implant and limb alignment outcomes for conventional and navigated unicompartmental knee arthroplasty.

Accurate implant positioning and restoration of lower limb alignment are major requirements for successful long-term results in unicompartmental knee arthroplasty (UKA). Alignment accuracy was compared between navigated-UKA (nUKA) and conventional-UKA (cUKA) groups using a retrospective matched case-control study (n=129, 58 nUKA, 71 cUKA). Mechanical axis (MA), hip-knee-ankle angle (HKA°), coronal implant alignment, and tibial implant posterior slope were measured.

The female knee: anatomic variations and the female-specific total knee design.

Unlabelled: The concept and need for a gender-specific or female-specific total knee prosthesis have generated interest and discussion in the orthopaedic community and the general public. This concept relies on the assumption of a need for such a design and the opinion that there are major anatomic differences between male and female knees. Most of the information regarding this subject has been disseminated through print and Internet advertisements, and through direct-to-patient television and magazine promotions.

Patellofemoral syndrome a paradigm for current surgical strategies.

The literature regarding suggested treatments for patellofemoral problems is often conflicting and confusing. In this discussion I present the approach I take in evaluating and considering surgery for patients with any of a wide variety of anterior knee pain problems. It has been useful to concentrate on the biomechanics--the mechanical consequence to each tissue affected by any surgical change.

Medial patellofemoral ligament reconstruction in patients with lateral patellar instability and trochlear dysplasia.

Background: Reconstruction of the medial patellofemoral ligament has been proven to restore stability in patients with lateral patellar instability. No study to date has examined the results in a patient population with the predisposing factor of femoral trochlear dysplasia.

Hypothesis: Reconstruction of the medial patellofemoral ligament restores stability and provides pain relief in patients who have lateral patellar instability in association with trochlear dysplasia.

Fresh osteochondral allografts for patellofemoral arthritis: long-term followup.

Unlabelled: Treatment of patellofemoral osteoarthritis in young patients is a challenge for orthopaedic surgeons. Concern about loosening and wear in active young people render arthroplasty more suitable for older patients. Osteochondral allografts may be a good alternative, but reports of experience with such grafts in patellofemoral joints are limited.

Stabilization of the clavicle after distal resection: a biomechanical study.

Background: The potential destabilizing effect of distal clavicle resection has received limited attention.

Hypothesis: Suturing the coracoacromial ligament to the undersurface of the distal clavicle after resection could counter clavicle instability.

Study Design: Controlled laboratory study.

Lateral patellofemoral ligament reconstruction.

Abstract Medial dislocation of the patella is a disabling condition; there are several reports in the literature describing this condition and its association with failed lateral retinacular release. The diagnosis and treatment of medial subluxation of the patella may be difficult. Direct repair or imbrication of the lateral retinaculum provides initial stability but a noticeable increase in medial excursion usually reappears.

Immune response in patients receiving fresh osteochondral allografts.

Immunologic response to cartilage-specific protein (CSP) antigens was tested in patients treated with fresh osteochondral allografts. Eight of 14 allograft recipients showed immune reactivity against CSP, whereas only 2 of 14 controls were reactive (P<.05).

Biologic resurfacing of the patella: current status.

The techniques of biologic resurfacing of the patella, like other joint surfaces, are still evolving. Currently none of them is free from criticism. In this regard it is our hope that progress in the basic science will offer in the near future new and more optimistic therapeutic possibilities (i.

Patellofemoral malalignment: looking beyond the viewbox.

A clear understanding of the pathophysiology of anterior knee pain is inhibited by the use of imprecise, poorly defined, and often interchanged words, such as malalignment, patellar alignment, maltracking, subluxation, dislocation, and congruence. The literature is filled with articles regarding the diagnosis, "malalignment of the patella," most of which give no precise diagnosis. This article presents a definition of malalignment and a plea for rational descriptive and scientific analysis.

Stress radiographs of the patellofemoral joint.

Patellar instability is usually diagnosed on the basis of the clinical presentation without radiographic confirmation. In the present report, we describe a new radiographic method to demonstrate patellar instability. Axial radiographs were made of the patellofemoral joint of ninety individuals (180 knees) and were then repeated while a medial or lateral force was applied to the patella.