The Prevalence of Vitamin D Deficiency in Patients Undergoing Total Knee Arthroplasty: A Propensity Score Matching Analysis.

Purpose: We investigated and compared the serum 25-OH vitamin D [25(OH)D] level and prevalence of vitamin D deficiency (VDD) between patients who underwent total knee arthroplasty (TKA) and healthy participants through a matched analysis.

Methods: The unmatched case group consisted of 824 patients who underwent TKA and the unmatched control group 2,794 healthy participants examined at our institution. The control group was matched on the various characteristics-sex, age, weight, body mass index (BMI), blood chemistry, and season of sampling-through propensity score matching (PSM).

Preoperative vitamin D level does not affect the short-term functional outcome after total knee arthroplasty in elderly women.

Background: We aimed to evaluate the effect of vitamin D levels on the functional outcome of elderly women who underwent total knee arthroplasty (TKA).

Methods: Seven hundred and four patients (1013 knees) who underwent primary TKA were included in our retrospective study. Preoperative vitamin D levels were measured and the relationship analyzed between these and age, weight, height, body mass index, and bone mineral density.

Does posterior tibial slope affect the results of conservative treatment for anterior cruciate ligament tears?

Objective: To evaluate the association between posterior tibial slope (PTS) and the short-term results of conservative treatment for the patients with anterior cruciate ligament (ACL) tears.

Methods: Thirty-seven patients (37 knees: male 33, female 4) who were managed with the same treatment protocols for ACL tears were included. All patients applied ACL brace and underwent standardized rehabilitation protocol.

Pigmented villonodular synovitis after anterior cruciate ligament reconstruction using active bioprosthetic composite artificial ligament.

Pigmented villonodular synovitis (PVNS) is a proliferative disease that develops in the synovium of joints, especially the knee joints. A 52-year-old man visited our hospital with left knee pain, swelling and symptoms of collapse. Twenty-one years earlier, he had undergone anterior cruciate ligament (ACL) reconstruction using an active bioprosthetic composite (ABC) as an artificial ligament.

Iatrogenic Medial Collateral Ligament Injury by Valgus Stress During Arthroscopic Surgery of the Knee.

Purpose: To evaluate the radiographic and clinical follow-up results of iatrogenic medial collateral ligament (MCL) injuries caused by valgus stress during arthroscopic surgery of the knee.

Methods: This study retrospectively evaluated 15 knees in 15 patients (8 female and 7 male patients), with a mean age of 58 years (range, 45-66 years), with iatrogenic MCL injuries caused by valgus stress during arthroscopic surgery of the knee. All patients were treated conservatively without an immobilizer or brace.

Does Posterior Tibial Slope Affect Graft Rupture Following Anterior Cruciate Ligament Reconstruction?

Purpose: The purpose of this study was to evaluate the association between posterior tibial slope (PTS) and anterior cruciate ligament (ACL) graft rupture in patients who have undergone ACL reconstruction by comparing results in patients who experienced graft rupture and a matched control group.

Methods: The study included 64 knees of 64 patients (58 men and 6 women), of mean age 31 years (range, 18-60 years) who underwent revision ACL reconstruction for ACL graft rupture, as well as a control group without ACL graft rupture matched for age, sex, body mass index (BMI), and left or right side. The mean time to failure in study group was 48.

Synovial fluid levels of TWEAK and matrix metalloproteinase 1 in patients with osteoarthritis, and associations with disease severity.

Purpose: This study assessed the levels of soluble tumor necrosis factor-like weak inducer of apoptosis (TWEAK) and matrix metalloproteinase 1 (MMP-1) in the synovial fluid from osteoarthritic knees to determine their role as well as the relationship between these levels and the severity of osteoarthritis (OA).

Methods: Synovial fluid was obtained from 44 knees of 40 patients. The Kellgren-Lawrence (KL) grade was measured using radiograph.

Enhanced Reality Showing Long-Lasting Analgesia after Total Knee Arthroplasty: Prospective, Randomized Clinical Trial.

To overcome the limitation of short-term efficacy of virtual reality (VR), an enhanced reality (ER) analgesia, (combination of the VR, real-time motion capture, mirror therapy [MT]) involving a high degree of patients' presence or embodiment was explored. Patients, who underwent unilateral total knee arthroplasty (TKA), received ER analgesia. The duration was 5 times a week, for 2 weeks for one group and 5 times a week, for 1 week in the other.

Patterns and Influencing Factors of Medial Meniscus Tears in Varus Knee Osteoarthritis.

Purpose: To investigate the patterns of medial meniscus (MM) tears in patients with varus knee osteoarthritis who underwent total knee arthroplasty and analyze the factors that could affect MM tears.

Materials And Methods: The patients (365 knees, 268 patients) were classified into three groups; group I with MM posterior horn (PH) tear only; group II with MM root tear only; and group III with MMPH plus root tear. The following factors were evaluated: age, gender, body mass index, varus deviation of the mechanical axis, medial proximal tibial angle, posterior tibial slope (PTS), and anterior cruciate ligament (ACL) integrity (normal, degeneration, and tear or absence).

Relationship between Mucoid Degeneration of the Anterior Cruciate Ligament and Posterior Tibial Slope in Patients with Total Knee Arthroplasty.

Purpose: The purpose was to analyze the relationship between posterior tibial slope (PTS) and mucoid degeneration of the anterior cruciate ligament (ACL) in patients with total knee arthroplasty.

Materials And Methods: Four hundred and twenty-four patients (24 males and 400 females; 636 knees) who received total knee arthroplasty for osteoarthritis were included. Their mean age was 68.

Preemptive Femoral Nerve Block Could Reduce the Rebound Pain After Periarticular Injection in Total Knee Arthroplasty.

Background: We evaluated the effectiveness of postoperative pain management using intraoperative periarticular injection (PAI) and/or electromyography-guided preoperative femoral nerve block (FNB) in knees undergoing total knee arthroplasty (TKA).

Methods: This study included 90 patients (90 knees) who underwent primary TKA. Thirty patients received a single injection of electromyography-guided FNB, 30 received intraoperative PAI, and 30 received both.

Modified transtibial versus anteromedial portal technique in anatomic single-bundle anterior cruciate ligament reconstruction: comparison of femoral tunnel position and clinical results.

Background: Although several studies have compared a conventional transtibial technique with an anteromedial (AM) portal technique for single-bundle (SB) anterior cruciate ligament (ACL) reconstruction, no study to date has investigated whether the modified transtibial technique results in the femoral tunnel being in a similar anatomic position and produces similar clinical outcomes with those of the AM portal technique.

Purpose: To compare the clinical outcomes and femoral tunnel position of SB ACL reconstruction using a modified transtibial technique (creating a femoral tunnel with varus and internal rotation of the tibia as well as modification of the tibial tunnel orientation) with those of SB ACL reconstruction using an AM portal technique.

Study Design: Randomized controlled trial; Level of evidence, 1.

Total Knee Arthroplasty Using a Posterior Cruciate Ligament Sacrificing Medial Pivot Knee: Minimum 5-year Follow-up Results.

Purpose: To evaluate minimum 5-year follow-up clinical and radiological results of total knee arthroplasty (TKA) using a posterior cruciate ligament sacrificing (PS), non-substituting Advance Medial Pivot Knee.

Materials And Methods: One hundred and twenty knees in 80 patients who could be followed up for more than 5 years after TKA using the PS Advance Medial Pivot Knee were evaluated retrospectively. The evaluations included the preoperative and postoperative range of motion (ROM), tibiofemoral angle, Knee Society (KS) knee and function scores, and Western Ontario and McMaster Universities Arthritis Index (WOMAC) score.

Prospective, double-blind, randomized controlled trial of electrophysiologically guided femoral nerve block in total knee arthroplasty.

Background: The purpose of this study was to compare electrophysiologically guided and traditional nerve stimulator analgesia femoral nerve block after total knee arthroplasty.

Methods: Patients scheduled for unilateral total knee arthroplasty were randomized to electrophysiologically guided or traditional nerve stimulator analgesia by pre-emptive single injection femoral nerve block with corresponding assistance. We assessed pain scores using a visual analog scale (VAS, 0 = no pain, 100 = the worst pain) and the volumes of morphine consumed at 4, 24, 48, and 72 hours after total knee arthroplasty.

3D CT analysis of femoral and tibial tunnel positions after modified transtibial single bundle ACL reconstruction with varus and internal rotation of the tibia.

Introduction: We analyzed the location of femoral and tibial tunnels by three-dimensional (3D) CT reconstruction images after modified transtibial single bundle (SB) anterior cruciate ligament (ACL) reconstruction, creating a femoral tunnel with varus and internal rotation of the tibia.

Material And Methods: Data from 50 patients (50 knees) analyzed by 3D CT after modified transtibial SB ACL reconstructions were evaluated. 3D CT images were analyzed according to the quadrant method by Bernard at the femur and the technique of Forsythe at the tibia.

Mucoid degeneration of both ACL and PCL.

Unlike meniscal tears and chondral defects, the mucoid degeneration of the anterior cruciate ligament (ACL) is a rare cause of knee pain and there have been no case reports of mucoid degeneration of both the ACL and the posterior cruciate ligament (PCL). A 48-year-old-male patient presented with knee pain and limitation of motion. The patient's magnetic resonance imaging, arthroscopic findings, and pathologic diagnosis confirmed a clinical diagnosis of mucoid degeneration of both the ACL and the PCL.

Can We Use the Posterior Condylar Off set as a Predictive Factor for Overhang of the Implant in Total Knee Arthroplasty?

Purpose: We tried to demonstrate whether the posterior condylar offset (PCO, the distance from the femoral diaphysis posterior cortex to the posterior condylar margin) and ratio (PCOR, dividing PCO by the maximum antero-posterior diameter of the distal femur) could be used as predictive factors for overhang of the implants or using gender implants in total knee arthroplasty (TKA).

Materials And Methods: One hundred and one women who underwent TKA using NexGen® (LPS) implants, were analyzed prospectively. After distal femoral resection, the mediolateral (ML) width was measured at four points (anterior, distal anterior, distal posterior and posterior) and compared with the ML width of the implant.

Symptomatic mucoid degeneration of the anterior cruciate ligament.

Purpose: Mucoid degeneration of the anterior cruciate ligament (ACL) is a little-known entity. The aim of this study was to detail the clinical, radiological, arthroscopic and pathological findings of this condition and to report clinical outcomes following arthroscopic partial excision of the ACL.

Methods: Between 1999 and 2009, 80 knees in 78 patients were diagnosed as having mucoid degeneration of the ACL based on MRI and clinical findings, and subsequently underwent arthroscopic treatment.

Relation between mucoid degeneration of the anterior cruciate ligament and posterior tibial slope.

Purpose: The purpose was to analyze the association between posterior tibial slope (PTS) and mucoid degeneration of the anterior cruciate ligament (ACL).

Methods: From October 1999 to May 2010, 84 arthroscopies were performed in 82 patients (18 men and 64 women) with mucoid degeneration of the ACL. The mean patient age was 53 years (range, 25 to 75 years).

Apoptosis in the osteonecrosis of the femoral head.

Background: Osteonecrosis of the femoral head is classified into idiopathic and secondary forms. A number of etiological factors in the development of osteonecrosis have been suggested but the biological mechanisms are still unclear. Recently, some reports suggested that the apoptosis is closely related to osteonecrosis of the femoral head.

Three- to six-year follow-up results after high-flexion total knee arthroplasty: can we allow passive deep knee bending?

Purpose: We evaluated 3- to 6-year clinical and radiological follow-up results after NexGen® LPS-flex total knee arthroplasty (TKA).

Methods: A retrospective evaluation was undertaken of 218 knees in 166 patients (22 males, 144 females) who were followed up for more than 3 years after TKA. Evaluations included preoperative and postoperative range of motion (ROM) measurement, Knee Society (KS) Score, tibiofemoral angle and assessment of postoperative complications.

What have we learned from LCS mobile-bearing knee system?

Three hundred and sixty-four low contact stress (LCS) total knee arthroplasties that could be followed up for more than 5 years were clinically and radiographically analyzed. The median postoperative Hospital for Special Surgery score improved from 56 (range 32-77) to 91 (range 64-100) points, but median range of motion did not change from 120° (range 50°-135°) to 120° (range 85°-135°). Complications occurred in 16 cases (4%), and included postoperative polyethylene dislocation and intraoperative tibial condylar fracture, while five knees (1%) required revision surgery due to mechanical reasons.

Should the 'no thumb technique' be the golden standard for evaluating patellar tracking in total knee arthroplasty?

We checked intraoperative patellar tracking with both 'towel clip technique' and the 'no thumb technique' on 97 patients (167 knees) who underwent primary total knee arthroplasty to decide whether to do or not to do lateral retinacular release. Patellar tracking was assessed under pneumatic tourniquet with the no thumb technique first and re-evaluated with the towel clip technique. The tracking was graded as total contact, good contact, lateral contact and subluxation.

The effect of patellar thickness changes on patellar tilt in total knee arthroplasty.

We hypothesized that changes in patellar thickness following patellar resurfacing affect patellar tilt in total knee arthroplasty (TKA) patients. The study enrolled 272 TKAs and categorized them into four groups according to change in patellar thickness: (A) thinner by 1 mm or more, (B) equal or thinner by less than 1 mm, (C) thicker by 1 mm or less, and (D) thicker by more than 1 mm. Patellar tilt angle was measured postoperatively using Merchant radiography.