Anterior cruciate ligament reconstruction with six and eight-strand hamstring tendon autografts produces adequate graft dimensions and functional outcomes: A systematic review.

Purpose: This study aims to summarize the graft dimensions, failure rates, return-to-sport rates and patient-reported outcome measures (PROMs) following anterior cruciate ligament reconstruction (ACLR) with six or eight-strand hamstring tendon autografts (6SHG or 8SHG).

Methods: Three databases were searched from inception to 12 February 2024. The authors adhered to PRISMA guidelines and the Cochrane Handbook for Systematic Reviews of Interventions.

Specific considerations in female patients with patellar instability: current concepts.

Prior literature suggests that patellofemoral instability (PFI) is significantly more prevalent in women than in men. This higher prevalence is commonly attributed to anatomical differences between sexes, particularly with patellofemoral alignment. These differences encompass a higher rate of trochlear dysplasia (TD), patella alta, an increased Q angle, and soft tissue imbalances.

A prospective comparison of total knee arthroplasty using ultra-congruent, condylar-stabilizing, and posterior-stabilized devices implanted with kinematic alignment: better 2-year outcomes with ultra-congruent.

Purpose: This study compared the 5-year results of posterior cruciate ligament (PCL)-sacrificing total knee arthroplasty (TKA) with either a post and cam posterior-stabilized (PS) device, a dished, congruent condylar-stabilizing (CS) device, or a deep-dished ultra-congruent (UC) device. The hypothesis was that the clinical and radiographic outcomes would be equivalent. CS and PS participants were part of a prospective, randomized trial, and UC participants were part of a separate prospective, non-randomized protocol that was otherwise identical.

Both low and high knee flexion angles during tibial graft fixation yield comparable outcomes following ACL reconstruction with quadriceps tendon autograft: A systematic review.

Importance: A paucity of clinical evidence surrounds the effect of the knee flexion angle during tibial fixation of the graft during anterior cruciate ligament (ACL) reconstruction. While biomechanical studies have recently sought to revive this area of study in both single- and double-bundle graft populations, they have done so using variants of the hamstring graft. This does not shed light on the optimal fixation of other autograft options, namely, the quadriceps tendon (QT) autograft.

Current trends in anterior cruciate ligament surgery. A worldwide benchmark study.

Objectives: To benchmark current trends on anterior cruciate ligament reconstruction (ACLR) surgery.

Methods: The largest worldwide ACLR survey to date was performed during May 2020, targeted to reach representation of all continents. It was submitted electronically to all International Society of Arthroscopy, Knee Surgery and Orthopaedic Sports surgeons (n = 3,026), asking those who perform ACLR to respond.

Comparison of Anterior-Posterior Axis Versus Transepicondylar Axis in Patients Undergoing Simultaneous Bilateral Total Knee Arthroplasty: One Technique per Knee.

Background: In primary total knee arthroplasty (TKA), the preferred reference line for setting femoral component rotation is debatable. This study compared the anterior-posterior axis line (APAL) versus the transepicondylar axis line (TEAL) in patients undergoing simultaneous bilateral TKA using a measured resection technique where one reference line was randomized to each knee.

Methods: This prospective study compared the two reference lines using posterior knee referencing with a cemented posterior stabilized knee.

Comparison of Gap Balancing vs Measured Resection Technique in Patients Undergoing Simultaneous Bilateral Total Knee Arthroplasty: One Technique per Knee.

Background: Total knee arthroplasty requires careful surgical technique to attain the goal of a well-aligned and symmetrically balanced knee. Soft tissue balance and correct femoral component rotation are paramount in achieving these goals. The two competing techniques to select femoral component rotation and soft tissue balance are the gap balance technique and the measured resection technique.

Release of the medial collateral ligament is mandatory in medial open-wedge high tibial osteotomy.

Purpose: The purpose of this study was to quantify the effect of clinically relevant open-wedge high tibial osteotomies on medial collateral ligament (MCL) strain and the resultant tibiofemoral contact mechanics during knee extension and 30° knee flexion.

Methods: Six human cadaveric knee joints were axially loaded (1 kN) in knee extension and 30° knee flexion. Strains at the anterior and posterior regions of the MCL were determined using strain gauges.

No Growth Disturbance After Trochleoplasty for Recurrent Patellar Dislocation in Adolescents With Open Growth Plates.

Background: Trochlear dysplasia is the most important risk factor for patellofemoral instability among adolescents; therefore, trochleoplasty to reshape the trochlear groove is the treatment of choice for patients with high-grade trochlear dysplasia. However, in the presence of open growth plates, there is a potential risk of injury to the distal femoral growth plate and subsequent growth disturbance. As such, most authors do not recommend trochleoplasty for skeletally immature patients.

Knotless Medial Meniscus Posterior Root Repair.

Medial meniscus posterior root tears are common injuries, especially in the Asian world. This injury must be repaired where indicated to restore knee biomechanics and prevent arthritis. Suturing the meniscus using suture tapes provides good hold of the tissue.

Awareness of common paediatric orthopaedic problems among paediatricians and family medicine physicians.

Background: Most paediatric orthopaedic problems referred to paediatric orthopaedists are usually self-limited, requiring observation and reassurance. Higher parental expectations may have resulted in higher referral rates. This study was conducted to assess awareness and knowledge about the diagnosis and management of some common normal variants of musculoskeletal paediatric development among paediatricians and primary health care physicians.

Femoral Derotational Osteotomies.

Purpose Of Review: Femoral derotational osteotomies are performed to correct residual symptomatic increased femoral torsion in adolescents and adults. Typical indications are anterior knee pain caused by patellar maltracking and patellofemoral instability. There is still no consensus as to what the correct indication is and which surgical techniques lead to the best outcomes in performing a femoral derotational osteotomy.

Anatomic reconstruction of the medial patellofemoral ligament in children and adolescents using a pedicled quadriceps tendon graft shows favourable results at a minimum of 2-year follow-up.

Purpose: In adults, reconstruction of the medial patellofemoral ligament (MPFL) has shown good results. Treatment for recurrent patellar instability in children and adolescents with open growth plates, however, requires alternative MPFL reconstruction techniques. This study presents the outcomes of a minimally invasive technique for anatomic reconstruction of the MPFL in children using a pedicled superficial quadriceps tendon graft, hardware-free patellar graft attachment, and anatomic femoral fixation that spares the distal femoral physis.

The effects of femoral external derotational osteotomy on frontal plane alignment.

Purpose: Femoral osteotomies are the preferred treatment in significant torsional deformity of the femur. The influence of torsional osteotomies on frontal plane alignment is poorly understood. Therefore, the aim of the present study was to evaluate the effects of external derotational osteotomies on proximal, mid-shaft and distal levels onto frontal plane alignment.

Arthroscopic evaluation of trochlear dysplasia as an aid in decision making for the treatment of patellofemoral instability.

Purpose: Trochlear dysplasia is an important aetiological factor for the development of patellofemoral instability (PFI). The aim of the study was to identify the arthroscopic morphology of trochlear dysplasia that can be helpful when planning operative treatment for PFI.

Methods: Magnetic resonance imaging (MRI) scans and strict lateral radiographs of 46 patients treated for PFI were assigned according to Dejour and matched with arthroscopic views from the lateral superior arthroscopic portal.

Combined trochleoplasty and medial patellofemoral ligament reconstruction for recurrent patellar dislocations in severe trochlear dysplasia: a minimum 2-year follow-up study.

Background: Trochlear dysplasia is an important etiological factor for the development of patellofemoral instability. Because a dislocation of the patella as a result of trochlear dysplasia results in a traumatic disruption of the medial patellofemoral ligament (MPFL), a combined trochleoplasty and patellofemoral ligament reconstruction appears to be the most appropriate procedure to treat patients with severe trochlear dysplasia.

Hypothesis: Combined trochleoplasty and anatomic reconstruction of the MPFL will prevent redislocations of the patella and will lead to improved knee function.