Nonanatomic Posteromedial Bundle Augmentation of the Posterior Cruciate Ligament after Hyperextension Trauma.

The surgical management of posterior cruciate ligament (PCL) injuries can be challenging. As most PCL injuries occur in a flexed knee position, the anterolateral bundle is thought to be more commonly injured than the posteromedial bundle (PMB); however, in hyperextension, the PMB plays a more significant role. The smaller size of the PMB compared with the anterolateral bundle and its lower strength may explain why isolated hyperextension PMB injuries can be easily overlooked.

Blood and urine biomarkers for the diagnosis of early stages of knee osteoarthritis: A systematic review.

Purpose: To identify biomarkers in human blood or urine at an early stage of knee osteoarthritis (OA) and to elucidate if any can accurately differentiate between healthy controls and early knee OA patients and be considered as a candidate for widespread clinical use for early diagnosis of the disease.

Methods: Medline, Embase and Web of Science were screened to identify comparative studies measuring differences in blood or urine biomarkers between healthy controls and knee OA patients at an early stage (grade 1 or 2 Kellgren-Laurence). Two independent reviewers screened the abstracts for eligibility, reviewed the full texts, assessed the methodological quality and extracted the data.

Injuries of the posteromedial bundle of the posterior cruciate ligament after knee hyperextension trauma: A new clinical entity based on an original case series.

Purpose: This original case series aims to describe an uncommon triad of clinical signs in patients presenting with persistent pain and inability to resume physical activities after knee hyperextension trauma.

Methods: Patient history, clinical examination, arthroscopic findings and investigations of 12 patients who consulted with the senior author are presented.

Results: Twelve patients (seven males/five females) presented with persistent pain after knee hyperextension trauma either in sport or a traffic accident.

Surgical strategy and complication management of osteotomy around the painful degenerative varus knee: ESSKA Formal Consensus Part II.

Purpose: The purpose of the European consensus was to provide recommendations for the treatment of patients with a painful degenerative varus knee using a joint preservation approach. Part II focused on surgery, rehabilitation and complications after tibial or femoral correction osteotomy.

Methods: Ninety-four orthopaedic surgeons from 24 countries across Europe were involved in the consensus, which focused on osteotomies around the knee.

Osteotomy around the painful degenerative varus knee has broader indications than conventionally described but must follow a strict planning process: ESSKA Formal Consensus Part I.

Purpose: The European consensus was designed with the objective of combining science and expertise to produce recommendations that would educate and provide guidance in the treatment of the painful degenerative varus knee. Part I focused on indications and planning.

Methods: Ninety-four orthopaedic surgeons from 24 European countries were involved in the consensus, which focused on the most common indications for osteotomy around the knee.

Joint line and knee osteotomy.

This review explores the intricate relationship between knee osteotomy and frontal plane joint line orientation, emphasizing the dynamic nature of the joint line's influence on knee forces and kinematics. Consideration of coronal alignments, knee phenotypes, and associated angles (medial proximal tibial angle (MTPA), lateral distal femoral angle (LDFA), joint line convergence angle (JLCA)) becomes crucial in surgical planning to avoid joint line deformities. The double-level osteotomy is to be considered a valid option, especially for severe deformities; however, the target patient cannot be selected solely based on high predicted postoperative joint line obliquity (JLO) and MPTA.

Information videos posted on Instagram by orthopaedics and sports traumatology surgeons mostly explain surgical technique, and the least mentioned topics are injury prevention and complications.

Purpose: Social media has become the new information acquisition platform for all content producers. In the current literature, there are no studies examining the content quality and the strengths and weaknesses of videos on Instagram that explain anterior cruciate ligament (ACL) injuries, which is the most discussed topic of sports surgery. The aim of this study was to evaluate the quality, strengths and weaknesses of information pertaining to ACL surgery that is disseminated on Instagram.

Females show worse functional outcome and quality of life compared to males 2 years after meniscus surgery: Data analysis from the German Arthroscopy Registry.

Purpose: The purpose of this study was to investigate the impact of sex on knee function, activity and quality of life following meniscus surgery using data from the German Arthroscopy Registry.

Methods: This is a retrospective cohort study with data collected between 2017 and 2022. Patient-reported outcome measures (PROMs), namely Knee Injury and Osteoarthritis Outcome Score (KOOS), EuroQol Visual Analogue Scale (EQ Scale), and Marx Activity Rating Scale (MARS), were collected preoperatively and at 6, 12 and 24 months postoperatively.

Case report: unusual posteromedial capsular lesion with posterior lateral meniscus root tear in two patients with constitutional genu recurvatum presenting after an acute ACL injury.

Ramp lesions of the medial meniscus and posterior lateral meniscus root tears (LMPRT) can be present simultaneously in up to 8% of patients undergoing anterior cruciate ligament (ACL) reconstruction. The prevalence of these complex and highly unstable meniscal tears increases exponentially with the severity of the injury. The posteromedial capsule (PMC) has often been disregarded in the past when discussing ligamentous and meniscal injuries, but the recent interest in ramp lesions has drawn surgeons' attention to the posteromedial structures of the ACL injured knee.

Meniscal Ramp Repair: Double-Row Anatomic Repair in Acute Anterior Cruciate Ligament Tears.

The surgical management of medial meniscus ramp lesions can be challenging. Currently, repairs are performed via a trans-notch view, combined with a single posteromedial working portal. This technique, however, does not allow for a direct and complete visualization of the structures being injured, making a precise appreciation of the injured structures, as well as an anatomical repair, difficult.

Presentation of an intraosseous suspensory fixation technique for pediatric and adult ACL reconstruction.

The aim is to present a technique for pediatric and adult ACL reconstruction using an intraosseous suspensory fixation. This technique uses a 4-strands hamstring graft fixed in the femoral tunnel, with a loop locked in a polyetheretherketone (PEEK) cage. The ACLip® device offers an inside-out drilling system and a closer fixation to the joint than an extracortical button fixation.

Ramp Lesions of the Medial Meniscus.

Purpose Of Review: To provide an overview of the recent scientific literature about ramp lesions of the medial meniscus and to summarise the current evidence on their prevalence, classification, biomechanics, surgical techniques and clinical outcomes.

Recent Findings: Ramp lesions may be present in more than 1 patient undergoing ACL reconstruction out of 5 and almost half of the medial meniscal tears observed in this population. Due to the risk of persistent anterior and rotational laxity after ACL reconstruction, their repair has been advocated.

MCID and PASS in Knee Surgeries. Theoretical Aspects and Clinical Relevance References.

The application and interpretation of patient-reported outcome measures (PROM), following knee injuries, pathologies, and interventions, can be challenging. In recent years, the literature has been enriched with metrics to facilitate our understanding and interpretation of these outcome measures. Two commonly utilized tools include the minimal clinically important difference (MCID) and the patient acceptable symptoms state (PASS).

Double-level knee osteotomy accurately corrects lower limb deformity and provides satisfactory functional outcomes in bifocal (femur and tibia) valgus malaligned knees.

Purpose: Double-level knee osteotomy (DLO) is a challenging procedure that requires precision in preoperative planning and intraoperative execution to achieve the desired correction. It is indicated in cases of severe varus or valgus deformities where a single-level osteotomy would yield significantly tilted joint line obliquity (JLO). This study aimed to evaluate the effectiveness of DLO in achieving accurate correction without compromising JLO, using patient-specific cutting guides (PSCGs), in cases of bifocal valgus maligned knees.

Lateral-medial asymmetry of posterior tibial slope and small lateral tibial plateau articular surface depth are morphological factors of lateral meniscus posterior root tears in ACL-injured patients.

Purpose: To investigate whether knee morphological features, patient characteristics, and intraoperative findings are associated with a lateral meniscus (LM) posterior root tear (LMPRT) in anterior cruciate ligament (ACL) injuries with the integrated data from two academic centres.

Methods: This retrospective study used registry data acquired prospectively at two academic centres. Patients with ACL reconstruction (ACLR) with LMPRT and no other LM injury were selected (LMPRT group) from each database.

The SFA datalake platform and anterior cruciate ligament tear registry of the French Society of Arthroscopy (SFA): Rationale, statutes and plans.

SFA Datalake is the registry platform of the French Society of Arthroscopy (SFA). It was designed to collect and store data on arthroscopic orthopedic surgery and joint-sparing surgery in French-speaking countries. The anterior cruciate ligament (ACL) tear registry is the first registry to be set up based on SFA Datalake.

The posterior cruciate ligament-posterior femoral cortex angle: a reliable and accurate MRI method to quantify the buckling phenomenon of the PCL in ACL-deficient knees.

Purpose: The aim was to validate a new MRI method to measure the buckling phenomenon of the PCL, representative of anterior tibial translation, by comparing its reliability and accuracy to identify anterior cruciate ligament (ACL)-deficient knees with existing methods.

Methods: Patients were selected retrospectively and separated into a group of primary ACL injuries and ACL-intact knees. Exclusion criteria were: skeletal immaturity, PCL or a concomitant collateral ligament injury, signs of osteoarthritis (> 1 Kellgren and Lawrence score), tibial plateau fracture, previous ACL reconstruction or displaced meniscal bucket handle tear.

Meniscal Ramp Repair: A 2-Portal Posteromedial Approach.

The management of medial meniscus ramp lesions can be challenging. The current gold standard technique to repair these lesions is the transnotch view combined with a single instrumental posteromedial portal. However, it does not provide direct visualization of the ramp and does not allow for an anatomic repair.

Motivational Interviewing to Increase Physical Activity Behavior in Cancer Patients: A Pilot Randomized Controlled Trials.

Objective: This pilot randomized controlled trial (RCT) aimed at evaluating the feasibility and potential efficacy of a motivational interviewing (MI) intervention to increase physical activity (PA) behavior in cancer patients.

Methods: Participants were randomly assigned to an experimental group with standard care plus 12 MI sessions within 12 weeks or a control group with standard care only. The number of recruited participants and the modality of recruitment were recorded to describe the reach of the study.

Correction to: Rotational profile alterations after anatomic posterolateral corner reconstructions in multiligament injured knees.

The original article can be found online.