The effect of frontal plane osteotomy angle on lateral cortex fracture in medial open wedge high tibial osteotomy procedure.

Background: Precise high tibial osteotomy is crucial, especially for middle-aged individuals with medial compartment arthritis, aiming to prevent complications like lateral cortex fractures. This study explores how frontal plane osteotomy inclination impacts lateral cortex fractures during medial open-wedge high tibial osteotomy.

Methods: Using finite element analysis, tibia models underwent osteotomies at angles of 10°, 13°, 16°, 19°, and 22°, forming five models.

Reoperations After Operatively and Non-Operatively Treated Periprosthetic Knee Fractures: A Nationwide Study on 1,931 Fractures After Primary Total Knee Arthroplasty.

Background: Periprosthetic knee fracture (PPKF) following total knee arthroplasty (TKA) can be difficult to treat. A PPKF can be treated both operatively and nonoperatively, and the treatment varies between fracture sites. This study aimed to assess the risk of reoperation according to the fracture site and treatment of the PPKF.

Floating knee: A new prognostic classification.

Introduction: Usually ipsilateral fractures of the femur and tibia are not compatible with good results and require surgery. The unsatisfactory results are more likely due to complex patterns of fractures, compromised soft tissue, associated ligament injuries, and concomitant vital organ injuries. There are many classifications to describe this type of fracture but none of them is a prognostic classification.

Fractures around the knee in elderly patients: Balancing fixation and arthroplasty approaches, a multicenter experience.

Introduction: In recent years, a discernible shift has occurred in the approach to knee pathologies, specifically in the management of acute fractures. Traditionally, fractures were primarily treated through osteosynthesis, whereas prosthesis replacement was primarily reserved for degenerative issues. Outcomes of this investigation aim to elucidate the potential indications and contraindications for the use of prosthetic interventions in the management of such fractures and to propose a scoring system that can be adopted for the choice between the two different approaches.

Weightlessness damaged the ultrastructure of knee cartilage and quadriceps muscle, aggravated the degeneration of cartilage.

Background: Long-term exposure to weightlessness can result in bone and muscle degradation, significantly impacting musculoskeletal function. Recent studies have also indicated damage to articular cartilage due to weightlessness. This study aims to observe the effects of simulated weightlessness on the cartilage microstructure of the quadriceps muscle and the muscular knee joint in rats.

Dual Plating for Periprosthetic Distal Femoral Fractures Using the Extensile Medial or Lateral Parapatellar Approach.

Periprosthetic distal femoral fractures (PDFFs) are increasing in incidence, typically affecting frail elderly patients who have complex needs. Although the use of distal femoral endoprostheses in the management of these fractures is increasing exponentially, concerns about their longevity and mechanical failures in younger patients should limit their use to older patients with limited life expectancies. In this study, we report the surgical technique for dual plating PDFFs using an extensile medial or lateral parapatellar approach and illustrate this technique with case examples.

Knee Instability Following Fractures Around the Knee Joint: Diagnostic Dilemma and Management Challenges.

Aim: Knee instability following fractures around the knee joint is not uncommon but is often missed. They present challenges in identifying them during index injury or at follow-up. We share our experience of knee instability following fractures around the knee joint.

[Transcutaneous osseointegrated prosthetic system (TOPS) with an intramedullary prosthesis : Management of the femoral stump with concurrent total hip arthroplasty].

Objective: Simultaneous implantation of a TOPS (transcutaneous osseointegrated prosthetic system) and THA (total hip arthroplasty) or staged approach.

Indications: Patients with a TOPS who have coxarthrosis. Patients with an existing THA who have required above-knee amputation and need a TOPS.

Evaluation of an Active Rehabilitation Program With Early Weightbearing and No Immobilization After Tibial Tubercle Distalization.

Background: Abnormal patellar height (patella alta) has been reported to be one of the main predisposing factors for recurrent patellar dislocation, and it can be surgically corrected by distalizing tibial tubercle osteotomy (DTTO). Rehabilitation after DTTO often includes limitations on weightbearing and restrictions on knee range of motion by means of bracing, increasing the risk of slow progression of the rehabilitation.

Hypothesis: An active rehabilitation program with no restrictions on weightbearing and range of movement would yield a low risk of postoperative complications and a fast recovery period.

Cryptococcus neoformans Periprosthetic Joint Infection in the Setting of Revision Shoulder Arthroplasty: A Case Report.

An 83-year-old male, status one year post-primary right reverse shoulder arthroplasty, presented with clinical and radiographic signs of shoulder instability. The patient subsequently underwent revision reverse shoulder arthroplasty with postoperative cultures growing in all five tissue samples. He was placed on temporary fluconazole since he demanded to leave the hospital during a holiday weekend with plans to get readmitted later.

Intertrochanteric Fracture Fixation Using a Traction Table in a Patient with Ipsilateral Above-knee Amputation - A Case Report and Review of Reduction Techniques.

Introduction: Although commonly encountered in clinical practice and considered among the "bread and butter" cases in trauma and orthopedics, intertrochanteric fractures of the femur in certain scenarios pose a challenge to the orthopedic surgeon. Good reduction and stable fixation are a key for good outcome, and certain anatomical limitations such as amputations make that difficult to achieve. Ipsilateral above-knee amputation is a scenario where positioning of the patient on an orthopedic fracture table and reduction of the fracture becomes challenging.

"Intra-Articular Intrusion of Broken Patella Cerclage Wire and the Importance of Higher Imaging in Its Rescue" - A Case Report.

Introduction: In this case report, we would like to discuss about a 51-year-old gentleman, who had underwent patella tension band wiring for transverse patella fracture 3 years ago and presented with a painful knee with broken cerclage wire with a fragment migrating into the joint.

Case Report: The aim of the study was to highlight the importance of higher imaging (Computed tomography) in deciding whether the retrieval of the fragment can be attempted through a minimally invasive arthroscopic technique.

Result: CT of the knee joint with 3D reconstruction was done and it showed the broken migrated fragment to be intra-articular and intracapsular.

Isolated Left Extensor Hallucis Longus Palsy Secondary to Deep Peroneal Nerve Injury in a 15-Year-Old Boy: A Case Report.

Introduction: Nerve palsies are potential consequences of fractures that can result in temporary loss of muscular function. Nerve palsies have not been extensively described in the context of tibial tubercle fractures in the pediatric population. Although the symptoms accompanying nerve palsies concern patients, evidence suggests that non-operative management often results in full functional recovery over time.

Long-term functional outcomes of BIFOLD osteosynthesis in distal femoral fractures with metaphyseal comminution: A retrospective analysis.

Background: This retrospective study aimed to evaluate the long-term functional outcomes of BIFOLD osteosynthesis, employing retrograde nailing and distal femoral locked plating, in patients with distal femoral fractures and metaphyseal comminution.

Methods: A retrospective analysis was conducted on patients treated for distal femur fractures with metaphyseal comminution between 2012 and 2022, with a minimum follow-up of 2 years. Inclusion criteria encompassed distal femur fractures with metaphyseal comminution, excluding specific conditions.

Prepatellar bursa mucosa: An unreported postoperative complication of patellar fracture.

Background: Patellar fracture is a common injury caused by overstrain of the extensor mechanism or a direct trauma to the knee. The most common complications after patellar fracture are nonunion, infection, post-traumatic arthritis, joint fibrosis, symptomatic hardware, and extensor mechanism failure. These are attributed to the post-fracture flexion and extension movements, the primary damage to the articular cartilage, and the thin soft tissue coverage over the knee.

Medial Opening Wedge (MOW) Versus Lateral Closing Wedge (LCW) High Tibial Osteotomies for Knee Medial Compartment Osteoarthritis Show Similar Outcomes and Survivorship, While MOW Has Higher Rates of Tibial Fracture and LCW Has Higher Rates of Nerve Injury and Conversion to Total Knee.

Purpose: To compare the clinical and radiographic outcomes and complications between medial opening wedge (MOW) and lateral closing wedge (LCW) high tibial osteotomies (HTOs) in the setting of medial compartment osteoarthritis with genu varus alignment.

Methods: This study was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Studies that reported on MOW or LCW HTOs in the setting of medial compartment osteoarthritis were included.

Comparison of the treatment of patellar inferior pole fractures with combined vertical wire and mini steel plate fixation versus independent vertical wire fixation.

Background: Patellar fractures, in particular inferior pole fractures, pose significant challenges due to the patella's complex biomechanics and crucial role in knee extension and stability. This study aimed to compare the therapeutic effectiveness and long-term efficacy of two fixation methods: combined vertical wire and mini steel plate fixation versus independent vertical wire fixation. The comparison was based on clinical classification, addressing the ongoing debate regarding optimal management strategies for patellar inferior pole fractures.

Prediction of Fractures After Open Wedge High Tibial Osteotomy Based on the Distance From the Tibial Osteotomy Point to the Medial Edge of the Tibia.

Background: To investigate the relationship between the distance from the medial tibial osteotomy point to the medial tibial edge and the development of lateral tibial hinge fracture (type II) and intra-articular tibial plateau fracture (type III) in patients who have degenerative disease undergoing open wedge high tibial osteotomy (OWHTO). This information will aid surgeons in avoiding the occurrence of fractures.

Methods: This retrospective study analyzed 304 patients who underwent OWHTO from January 2018 to January 2024 in the Affiliated Hospital of Qingdao University.

A New Non-Invasive Method for Positioning a Below-Knee Amputee with an Ipsilateral Intertrochanteric Fracture on a Traction table: A Case Report and Mini Review.

Introduction: Proximal femur fractures in below-knee amputees pose significant surgical challenges due to difficulties in positioning and stabilizing the residual limb for fracture reduction. In the current literature, there is no consensus on the optimal management strategy, but the inverted boot positioning method seems to be an adequate and non-invasive technique. However, in our case, this method was not possible due to limited knee flexion, so we describe our technique and compare the different modalities described in the literature, highlighting their advantages and disadvantages.

"Tension band wiring first" -an easy, fast and reproducible technique to reduce patellar fractures, a retrospective comparative study with traditional reduction technique.

Objective: To evaluate intraoperative and early postoperative clinical outcomes using the "tension band wiring first technique" to reduce C type patellar fractures.

Methods: Sixty-four patients with C type fractures were enrolled in this study. Thirty-four patients underwent open reduction and internal fixation (ORIF) surgeries using the traditional reduction technique by pointed clamps (TRT group).