Open wedge high tibial osteotomy does not decrease patellar height relative to femur: A three-dimensional computer model analysis.

Background: Patellar height, which decreases after open wedge high tibial osteotomy (OWHTO), has conventionally been assessed by tibial references using lateral radiographs of the knee; however, changes in the proximal tibia shape after OWHTO may affect this method. We aimed to evaluate the changes in patellar height position relative to the transepicondylar axis of the femur after OWHTO using in vivo three-dimensional (3D) computer models.

Methods: Fourteen patients who underwent 3D magnetic resonance imaging (MRI) at 30° and 50° knee flexion before OWHTO and after hardware removal were included.

Factors Associated with Postoperative Knee Joint Line Obliquity After Medial Open Wedge High Tibial Osteotomy.

Background: There are still few reports on factors associated with postoperative knee joint line obliquity (KJLO).

Purpose: The purpose was to determine preoperative radiographic factors that are associated with KJLO postoperatively after open wedge high tibial osteotomy (OWHTO) using multivariable linear regression analysis and multivariable logistic regression analysis.

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

Abrasion arthroplasty promotes improvement of degenerated femoral trochlear cartilage after medial open wedge high tibial osteotomy.

Objectives: Several studies have reported negative effects of open wedge high tibial osteotomy (OWHTO) on patellofemoral joints with cartilage degeneration and recommended performing other procedures. However, if chondral resurfacing surgery could promote improvement of cartilage degeneration in the patellofemoral joint, OWHTO would be an acceptable option. The purposes of this study were to arthroscopically evaluate the femoral trochlear articular cartilage after abrasion arthroplasty combined with OWHTO and to investigate the factors promoting improvement of that cartilage.

Anterior tibial loading on the calf enhances anterior tibial translation in the anterior cruciate ligament deficient knee in the anterior gravity radiographic view.

Background: Lateral radiograph in the prone position with the knee flexed at 15° (anterior gravity view (AGV)) is useful as a screening for anterior cruciate ligament (ACL) injuries, while it is sometimes difficult to find the side-to-side difference (SSD) in anterior tibial translation. Thus, we applied a weight (three kilograms) around the lower leg to increase anterior tibial translation. We aimed to determine whether weight load confers an advantage in visualizing anterior knee laxity in ACL injuries.

Ultrasonographic Evaluation of the Early Healing Process After Achilles Tendon Repair.

Background: Little is known about early healing of repaired Achilles tendons on imaging, particularly up to 6 months postoperatively, when patients generally return to participation in sports.

Purpose: To examine changes in repaired Achilles tendon healing with ultrasonography for up to 12 months after surgery.

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

Safety of autologous bone marrow-derived mesenchymal stem cell transplantation for cartilage repair in 41 patients with 45 joints followed for up to 11 years and 5 months.

Among autologous somatic stem cells, bone marrow-derived mesenchymal stem cells (BMSCs) are the most widely used worldwide to repair not only mesenchymal tissues (bone, cartilage) but also many other kinds of tissues, including heart, skin, and liver. Autologous BMSCs are thought to be safe because of the absence of immunological reaction and disease transmission. However, it is possible that they will form tumours during long-term follow-up.

The location-specific healing response of damaged articular cartilage after ACL reconstruction: short-term follow-up.

Although many different interventions have been proposed for treating cartilage lesions at the time of ACL reconstruction, the normal healing response of these injuries has not been well documented. To address this point, we compared the arthroscopic status of chondral lesions at the time of ACL reconstruction with that obtained at second-look arthroscopy. We hypothesized that there might be a location-specific difference in the healing response of damaged articular cartilage.

Medial marginal fracture of the patella following patellar dislocation.

Among patients with patellar dislocation, a small fragment is occasionally found along the medial border of the patella. However, the detailed pathology of this fracture has not been clearly described, especially in relation to the medial patellofemoral ligament (MPFL). The purpose of this study was to describe the pathology of this fracture in relation to the MPFL.

Bi-socket ACL reconstruction using hamstring tendons: high versus low femoral socket placement.

To clarify the importance of the femoral socket location in bi-socket Anterior cruciate ligament (ACL) reconstruction. Subjects included 261 patients with an average age of 26 years who received ACL reconstruction via the high-femoral socket procedure (Group H) and 43 patients with an average age of 29 years who received ACL reconstruction via the low-femoral socket procedure (Group L) with a minimal follow-up of 24 months. In Group H, the femoral sockets were created at 1:00 or 11:00 and 2:00-2:30 or 9:30-10:00 of the intercondylar notch.

Changes in cross-sectional area of hamstring anterior cruciate ligament grafts as a function of time following transplantation.

Purpose: To measure the cross-sectional area (CSA) of hamstring anterior cruciate ligament (ACL) grafts in humans up to 2 years postoperatively and to estimate the appropriate graft-notch distance (the distance between ACL graft and roof or wall of the notch) at surgery.

Type Of Study: Case series.

Methods: Fifty-nine patients, who had consented to have a magnetic resonance imaging (MRI) evaluation postoperatively, underwent endoscopic ACL reconstruction using 3- to 5-strand autogenous hamstring tendons.

Autologous bone marrow stromal cell transplantation for repair of full-thickness articular cartilage defects in human patellae: two case reports.

This study assessed the effectiveness of autologous bone marrow stromal cell transplantation for the repair of full-thickness articular cartilage defects in the patellae of a 26-year-old female and a 44-year-old male. These two patients presented in our clinic because their knee pain prevented them from walking normally. After thorough examination, we concluded that the knee pain was due to the injured articular cartilage and decided to repair the defect with bone marrow stromal cell transplantation.

Second-look arthroscopy of anterior cruciate ligament grafts with multistranded hamstring tendons.

Purpose: The purpose of this study was to clarify the fate of intra-articularly transplanted multistranded hamstring tendon grafts used for anterior cruciate ligament (ACL) reconstruction.

Type Of Study: Consecutive samples.

Methods: The subjects were 153 patients (156 knees) with a mean age of 24 years, who had been evaluated as experiencing clinical success.

Acute grade III medial collateral ligament injury of the knee associated with anterior cruciate ligament tear. The usefulness of magnetic resonance imaging in determining a treatment regimen.

Background: The appropriate management of acute grade III medial collateral ligament injury when it is combined with a torn anterior cruciate ligament has not been determined.

Hypothesis: Magnetic resonance imaging grading of grade III medial collateral ligament injury in patients who also have anterior cruciate ligament injury correlates with the outcome of their nonoperative treatment.

Study Design: Prospective cohort study.

Prediction of reparability of isolated semilunar lateral meniscus tears by magnetic resonance imaging.

Sixty-one menisci in 60 patients who underwent preoperative MRI and subsequent arthroscopic operation for symptomatic isolated semilunar lateral meniscus tears were evaluated. The MRI criterion of reparability was the presence of a longitudinal or oblique high signal intensity line within 3 mm meniscosynovial junction without a high signal intensity area in the meniscal body, and the criterion of irreparability was high signal intensity line greater than 5 mm from the meniscosynovial junction and/or abnormal high intensity area in the meniscal body. Perioperatively the menisci were repaired for longitudinal unstable tears located at the outer one-half and were excised for other type of tears.

Evaluation of active knee flexion and hamstring strength after anterior cruciate ligament reconstruction using hamstring tendons.

Purpose: The purpose of this study was to evaluate active knee flexion range of motion and hamstring strength following hamstring anterior cruciate ligament (ACL) reconstruction.

Type Of Study: Case control study, consecutive sample.

Methods: Seventy-four consecutive patients who had undergone hamstring ACL reconstruction underwent isokinetic muscle strength testing at 2 years post surgery.

Subchondral microfracture of the knee without osteonecrosis after arthroscopic medial meniscectomy.

We report a case of an osteonecrosis-like lesion of the knee that developed shortly after an arthroscopic medial meniscectomy. Clinical presentation, physical findings, and imaging of the knee including magnetic resonance imaging were similar to those of the cases that have been reported as osteonecrosis after meniscectomy. However, histologic analysis of the lesion revealed that there was no osteonecrosis but rather a subchondral microfracture with active callus formation.