Anterior Closing-Wedge High Tibial Osteotomy Using Patient-Specific Cutting Guide in Chronic Anterior Cruciate Ligament-Deficient Knees.

An increased posterior tibial slope has been identified as an independent risk factor for anterior cruciate ligament (ACL) graft rupture, with a critical threshold of 12°. Surgical slope correction by anterior closing wedge (ACW)-high tibial osteotomy (HTO) can reduce ACL force and anterior tibial translation with good clinical outcomes when combined with revision ACL reconstruction. Performing ACW-HTO preserving the tibial tubercule can be challenging for inexperienced surgeons.

Patient specific instrumentation allow precise derotational correction of femoral and tibial torsional deformities.

Background: Rotational malalignment deformities of the lower limb in adults mostly arise from excessive femoral anteversion and/or excessive external tibial torsion. The aim of this study was to assess the correction accuracy of a patient specific cutting guides (PSCG) used in tibial and femoral correction for lower-limb torsional deformities.

Methods: Forty knees (32 patients) were included prospectively.

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.

The effect of index finger distal interphalangeal joint arthrodesis on muscle forces and adjacent joint contact pressures.

Distal interphalangeal joint arthrodesis is a frequent surgical operation performed to treat severe arthritis. Nevertheless, the angle selected when fusing the joint is arbitrarily chosen without any quantified data concerning its mechanical effects, thus preventing the optimal choice for the patient. In the current study, we realized an experiment and developed a numerical model to investigate the effect of fusion angle on the biomechanics of adjacent non-operated joints.

Failure analysis of articulating polymethyl methacrylate spacers in two-stage revision total hip arthroplasty.

Aims: Two-stage exchange revision total hip arthroplasty (THA) performed in case of periprosthetic joint infection (PJI) has been considered for many years as being the gold standard for the treatment of chronic infection. However, over the past decade, there have been concerns about its safety and its effectiveness. The purposes of our study were to investigate our practice, collecting the overall spacer complications, and then to analyze their risk factors.

Tetrodotoxin Poisoning in Mainland France and French Overseas Territories: A Review of Published and Unpublished Cases.

Tetrodotoxin is one of the most potent neurotoxins in the aquatic world. This review of published and unpublished reports aims to describe the poisoning cases that have occurred in mainland France and overseas territories. Six articles were included, with 13 poisoning events, individuals or collective (number () = 53 patients).

Is sequential bilateral robotic total knee arthroplasty a safe procedure? A matched comparative pilot study.

Introduction: To our knowledge, no papers have reported the results of robotic-assisted surgery for sequential bilateral Total Knee Arthroplasty (TKA). Indeed, sequential bilateral TKA present several benefits, as one single anesthesia, surgical episode, hospitalization, and rehabilitation. The purpose of our study was to evaluate peri-operative outcomes and compare the complication rates, clinical outcomes, and implant positioning of sequential bilateral TKA performed with a robotic-assisted system versus a conventional technique.

Staged BiCompartmental Knee Arthroplasty has Greater Functional Improvement, but Equivalent Midterm Survivorship, as Revision TKA for Progressive Osteoarthritis After Partial Knee Arthroplasty.

Background: Progressive arthritis in the unresurfaced compartments of the knee is one failure mode after partial knee arthroplasty (PKA). While progressive arthritis after PKA is typically treated with revision to TKA (rTKA), staged bicompartmental knee arthroplasty (sBiKA) -the addition of another PKA - is an alternative. This study compared outcomes of sBiKA and rTKA for progressive arthritis after PKA.

Implantation of the Femoral Component Relative to the Tibial Component in Medial Unicompartmental Knee Arthroplasty: A Clinical, Radiological, and Biomechanical Study.

Background: Unicompartmental knee arthroplasty (UKA) is a procedure with low morbidity and fast recovery. Anatomic implants or robotic-assisted UKA has been proposed to improve outcomes with precise positioning. Femoral component position (FCP) relative to the tibial insert could be a factor influencing the contact stresses.

Poisoning After Ingestion of Mucuna pruriens Seeds on Reunion Island.

Mucuna pruriens seeds contain levodopa, a dopamine precursor that composes the standard treatment to manage symptoms of Parkinson's disease. Also known as velvet bean, this plant is often involved in cases of intense pruritus after contact with the hair that grows on its beans. This case report describes the effects in a 58-y-old woman after ingestion of 5 raw seeds of M pruriens on Reunion Island, a French tropical island territory close to Mauritius, in the Indian Ocean.

The aspiration test reveals an instability of the posterior horn of the lateral meniscus in almost one-third of ACL-injured patients.

Purpose: Anterior cruciate ligament (ACL) injuries often lead to associated injuries of the posterior horn of the lateral meniscus (PHLM). Arthroscopic, assessment of PHLM instability may be difficult in the absence of a visible meniscus damage. The main objective of this prospective multi-center study was to compare the ability of the probing and aspiration tests to identify PHLM instability in a population of patients undergoing ACL reconstruction (ACLR) and a control group of patients with an intact ACL undergoing knee arthroscopy.

Double level knee osteotomy using patient-specific cutting guides is accurate and provides satisfactory clinical results: a prospective analysis of a cohort of twenty-two continuous patients.

Purpose: Double level osteotomy (DLO) (femoral and tibial) is a technically demanding procedure for which pre-operative planning accuracy and intraoperative correction are key factors. The aim of this study was to assess the accuracy of the achieved correction using patient-specific cutting guides (PSCGs) compared to the planned correction, its ability to maintain joint line obliquity (JLO), and to evaluate clinical outcomes and level of patient satisfaction at a follow-up of two years.

Methods: A single-centre, prospective observational study including 22 patients who underwent DLO by PSCGs between 2014 and 2018 was performed.

Side-to-side anterior tibial translation on monopodal weightbearing radiographs as a sign of knee decompensation in ACL-deficient knees.

Purpose: To evaluate the influence of time from injury and meniscus tears on the side-to-side difference in anterior tibial translation (SSD-ATT) as measured on lateral monopodal weightbearing radiographs in both primary and secondary ACL deficiencies.

Methods: Data from 69 patients (43 males/26 females, median age 27-percentile 25-75: 20-37), were retrospectively extracted from their medical records. All had a primary or secondary ACL deficiency as confirmed by MRI and clinical examination, with a bilateral weightbearing radiograph of the knees at 15°-20° flexion available.

Grade III pivot shift as an early sign of knee decompensation in chronic ACL-injured knees with bimeniscal tears.

Purpose: To analyse possible associations between the preoperative pivot shift (PS) test and both patient and injury characteristics in anterior cruciate ligament (ACL)-injured knees, considering previously neglected meniscal injuries such as ramp and root tears. The hypothesis was that a preoperative grade III PS was associated with the amount of intra-articular soft-tissue damage and chronicity of the injury.

Methods: The cohort involved 376 patients who underwent primary ACL reconstruction (239 males/137 females; median age 26).

Does practice of meniscus surgery change over time? A report of the 2021 'THE MENISCUS' Webinar.

Purpose: The aim of this paper was to report the results presented in the session "Does practice of meniscus surgery change over time?" of the 2021 MENISCUS webinar held online on January 30 2021.

Method: During the 2021 MENISCUS webinar, an evaluation of meniscus surgery practices was performed by analyzing: (1) The presentation of the results of a survey conducted among ESSKA members and assessing their current practices in the field of meniscus surgery, (2) Four reports by national experts analyzing the trends in Arthroscopic Partial Meniscectomy (APM) and meniscus repair procedures in their respective countries (France, Belgium, Germany and Japan).

Results: (1) ESSKA Survey: Among the 461 respondents, 75% of surgeons claimed to perform more meniscus repairs and 85% less APM than 5 years ago.

Lateral femoral closing wedge osteotomy in genu varum.

The distal femoral valgisation osteotomy has a variety of indications due to enhanced understanding of segmental deformities of the lower limb. Historically, an overall varus deformity was corrected at the tibia, and a valgus deformity at the femur. This approach of performing an "all in the tibia" correction for an overall varus can nevertheless lead to abnormal postoperative morphology because it is non-anatomical; creating joint line obliquity, and potentially shear stress on the cartilage.

Highly Crosslinked Polyethylene Can Reduce Wear Rate in THA for High-Demand Patients: A Matched-Paired Controlled Study.

Background: The average age of patients benefiting from total hip arthroplasty (THA) has been declining. In addition to pain relief, patients seek to return to physical activity. However, the latter may increase polyethylene wear and therefore the potential risk of early aseptic loosening.

Incidence and Risk Factors for Residual High-Grade Pivot Shift After ACL Reconstruction With or Without a Lateral Extra-articular Tenodesis.

Background: Residual rotatory knee laxity at midterm follow-up after isolated anterior cruciate ligament reconstruction (ACLR) versus ACLR with lateral extra-articular tenodesis (LET) remains an issue.

Purpose/hypothesis: To evaluate the outcomes of ACLR with or without additional LET at a minimum 2-year follow-up in patients with preoperative high-grade pivot shift (PS). Our hypothesis was that the addition of LET would decrease the risk of secondary meniscal injury and the presence of residual high-grade PS at follow-up.

Editorial Commentary: Surgical Management of Degenerative Meniscus Lesions Is a Second- But Not a First-Line Treatment.

The 20-year progression of osteoarthritis (OA) after arthroscopic partial meniscectomy (APM) in patients aged between 50 and 70 bears a long-term risk of conversion to total knee arthroplasty of 15.7%. Negative predictors at the time of surgery are the degree of knee OA, lateral meniscectomy, age at surgery, and malalignment.

Osteotomy around the knee is planned toward an anatomical bone correction in less than half of patients.

Introduction: In cases where the femur or tibial deformity is not correctly analysed, the corrective osteotomies may result in an oblique joint line. The aim of this study was to assess the preoperative deformity of patients due to undergo corrective osteotomy and the resulting abnormal tibial and femoral morphologies after the planned correction using 3D software.

Methods: CT scans of 327 patients undergoing corrective osteotomy were retrospectively included.

Minimum Five Years Follow-Up of Total Knee Arthroplasty Using Morphometric Implants in Patients With Osteoarthritis.

Background: The use of morphometric implants in total knee arthroplasty (TKA) has shown better early clinical outcomes compared to conventional implants. The primary objective of this study is to evaluate the functional outcome and the implant survivorship of a morphometric TKA at a minimum of 5 years of follow-up.

Methods: From May 2012 to June 2015, all patients undergoing primary TKA with a single design of morphometric posterior-stabilized prosthesis (Persona; Zimmer) in a prospective observational single-center study were evaluated.

Minimally Invasive High Tibial Osteotomy Using a Patient-Specific Cutting Guide.

Medial opening wedge high tibial osteotomy (OW-HTO) is an excellent surgical option for patients with varus knee osteoarthritis. This article presents a technique of performing a minimally invasive OW-HTO using a patient-specific cutting guide (PSCG). Preoperative 3-dimensional planning with computed tomography imaging is essential.

Soft-Tissue Management and Neurovascular Protection During Opening-Wedge High Tibial Osteotomy.

Medial opening-wedge high tibial osteotomy (OW-HTO) is an excellent surgical option for patients with varus knee osteoarthritis. Medial collateral ligament (MCL) release and posterior neurovascular structure protection during OW-HTO are steps that often induce stress and nervousness during surgery, especially for surgeons in the earlier stages of their learning curve. While is it well-known that the MCL should be released during OW-HTO, the standard retraction techniques pose challenges in visualization and instrument placement in the surgical field.