The aspiration test: an arthroscopic sign of lateral meniscus posterior horn instability.

The suspensory mechanism of the posterior horn of the lateral meniscus (PHLM) is an anatomically complex structure including the popliteomeniscal fascicles, the meniscotibial posterior root attachment and the meniscofemoral ligaments. Damage to one or several of these structures - either through knee trauma or congenital abnormalities-can result in an instability of the PHLM that may lead to lateral knee pain, locking sensations or lack of rotational control of the knee (e.g.

A Case-Control Comparison of Single-Stage Bilateral vs Unilateral Medial Unicompartmental Knee Arthroplasty.

Background: We aimed to compare postoperative pain, functional recovery, and patient satisfaction among patients receiving one-stage medial bilateral or medial unilateral UKA (unicompartmental knee arthroplasty). Our main hypothesis was that during the first 72 postoperative hours, patients who underwent medial bilateral UKA did not consume more analgesics than those who underwent medial unilateral UKA.

Methods: A prospective case-control study was undertaken involving 148 patients (74 one-stage medial bilateral vs 74 medial unilateral Oxford UKA).

Mechanical performance comparison of two surgical constructs for wrist four-corner arthrodesis via dorsal and radial approaches.

Background: Four-corner arthrodesis, which involves fusing four carpal bones while removing the scaphoid bone, is a standard surgery for the treatment of advanced stages of wrist arthritis. Nowadays, it can be performed using a dorsal approach by fixing a plate to the bones and a new radial approach is in development. To date, there is no consensus on the biomechanically optimal and most reliable surgical construct for four-corner arthrodesis.

Global varus malalignment increase from double-leg to single-leg stance due to intra-articular changes.

Purpose: Preoperatively planned correction for tibial osteotomy surgery is usually based on weightbearing long-leg Xrays, while the surgery is performed in a supine non-weightbearing position. The purpose of this study was to assess the differences in lower limb alignment in three different weightbearing conditions: supine position, double-leg (DL) stance and single-sleg (SL) stance prior to performing a medial opening wedge high tibial osteotomy (MOWHTO) for varus malalignment. The hypothesis of this study was that progressive limb-loading would lead to an increased preoperative varus deformity.

Bony asymmetry in patellofemoral morphology and risk factors of instability are mostly clinically negligible.

Purpose: Previous investigations suggested that femoral side-to-side differences were located in the upper femur anatomy. However, little is known about the asymmetry between distal femur and patella. The degree of bony asymmetry in the patellofemoral joint was evaluated using pairs of CT-scans with emphasis on morphometric measurements and risk factors relevant to patellofemoral disorders.

Patients with varus knee osteoarthritis undergoing high tibial osteotomy exhibit more femoral varus but similar tibial morphology compared to non-arthritic varus knees.

Purpose: The aim of this study was to compare alignment parameters between patients undergoing high tibial osteotomy (HTO) for knee osteoarthritis (OA) and non-arthritic controls.

Methods: Pre-operative computed tomography images from 194 patients undergoing HTO for medial knee OA and 118 non-arthritic controls were utilized. All patients had varus knee alignment (mean age: 57 ± 11 years; 45% female).

Knee arthroplasty for acute fractures around the knee.

Results of open reduction and internal fixation for complex articular fractures around the knee are poor, particularly in elderly osteoporotic patients.Open reduction and internal fixation may lead to an extended hospital stay and non-weight-bearing period.This may lead to occurrence of complications related to decubitus such as thrombo-embolic events, pneumonia and disorientation.

Trabecular Metal Cones Combined With Short Cemented Stem Allow Favorable Outcomes in Aseptic Revision Total Knee Arthroplasty.

Background: The purpose of this study was to compare the functional outcomes and implant survivorship at a minimum of 5 years of follow-up of several reconstruction techniques with or without metaphyseal cone and stems of variable length.

Methods: A retrospective comparative matched analysis was performed from 2 prospectively collected databases. Only patients who underwent revision total knee arthroplasty procedures for aseptic causes using a single design of rotating hinge knee with a minimum of 5 years of follow-up were analyzed.

Managing intra-articular deformity in high Tibial osteotomy: a narrative review.

The joint line convergence angle (JLCA) has a normal range between 0° to 2°, which increases in magnitude depending on the severity and stage of osteoarthritis in the knee.The JLCA represents the interaction of the intra-articular deformity arising from the osteoarthritis and the surrounding soft tissue laxity. Therefore, the JLCA has become a vital parameter in analysing the long leg alignment views for corrective planning before osteotomy surgery.

Posteromedial Opening-Wedge Tibial Osteotomy for Metaphyseal Varus and Abnormal Posterior Slope Correction in Failed Anterior Cruciate Ligament Reconstructions Using a Custom Cutting Guide.

Anterior cruciate ligament reconstruction after graft failure may need associated bone correction to ensure stability of the knee. This article presents a technique of posteromedial opening-wedge osteotomy using a custom cutting guide to correct increased tibial slope and metaphyseal varus deformity after recurrent graft failure. An autograft quadriceps tendon graft was selected for the revision anterior cruciate ligament graft.

Litigation in arthroscopic surgery: a 20-year analysis of legal actions in France.

Purpose: The main objective of this study was to identify the epidemiological characteristics of litigation following arthroscopic procedures, performed in private practice and public hospitals in France. The secondary objective was to establish a risk profile for medical malpractice lawsuits after arthroscopic surgery.

Methods: All court decisions related to arthroscopic surgery between 1994 and 2020 were collected and reviewed cases from the two main French legal databases (Legifrance and Doctrine).

Estimation of joint contact pressure in the index finger using a hybrid finite element musculoskeletal approach.

The knowledge of local stress distribution in hand joints is crucial to understand injuries and osteoarthritis occurrence. However, determining cartilage contact stresses remains a challenge, requiring numerical models including both accurate anatomical components and realistic tendon force actuation. Contact forces in finger joints have frequently been calculated but little data is available on joint contact pressures.

Every layer of quadriceps tendon's central and medial portion offers similar tensile properties than Hamstrings or Ilio-Tibial Band Grafts.

Purpose: The aim of our cadaveric study was to compare the mechanical properties of different parts of the quadriceps' tendon in a load to failure analysis as compared to three other, and most common types of grafts that are used to perform ligament's reconstruction.

Methods: Ten fresh-frozen cadavers (5 women, 5 men) were selected from our anatomical department. Mean age at death was 64 years (48-87 years).

Knee surgery trends and projections in France from 2008 to 2070.

Introduction: Knee surgery makes up a large share of the orthopedic surgery practice. Data on how this activity has changed over time is not available in France, thus we wanted to do a study to determine 1) how many knee surgeries were performed in France in 2018, 2) how this changed between 2012 and 2018, and 3) how it is projected to change by 2070. The hypothesis is that the number of knee surgeries will increase over the next 50 years.

First Evidence of the Presence of Anatoxin-A in Sea Figs Associated with Human Food Poisonings in France.

From January 2011 to March 2018, 26 patients aged from 20 to 80 years old reported being sick in France after eating sea figs of the genus . The patients had symptoms evoking a cerebellar syndrome: blurred or double vision, ataxia and dizziness, asthenia, headache, muscle cramps, paresthesia and digestive disorders (nausea, vomiting and diarrhea). Three of the 18 food poisoning events recorded by the Poison Control Center in Marseille and involving four patients were further investigated as the meal leftovers were collected and analyzed.

Neutral alignment resulting from tibial vara and opposite femoral valgus is the main morphologic pattern in healthy middle-aged patients: an exploration of a 3D-CT database.

Purpose: Given the goal of achieving optimal correction and alignment after knee arthroplasty or high tibial osteotomy, literature focusing on the inter-individual variability of the native knee, tibia and femur with regards to the coronal or sagittal alignment is lacking. The aim of this study was to analyse normal angular values in the healthy middle-aged population and determine differences of angular values according to inter-individual features. The first hypothesis was that common morphological patterns may be identified in the healthy middle-aged non-osteoarthritic population.

Evaluation of the "Minimal Clinically Important Difference" (MCID) of the KOOS, KSS and SF-12 scores after open-wedge high tibial osteotomy.

Purpose: Defining a Minimal Clinically Important Difference (MCID) value for Patient-Reported Outcome Measures (PROMs) is crucial for determining the effectiveness of a procedure and calculating the sample size for trial planning. The purpose of this study was to determine the MCID of several PROMs (Knee injury and Osteoarthritis Outcome Score (KOOS), Knee Society Score (KSS) and the SF-12) in patients who underwent medial opening-wedge High-Tibial Osteotomy (owHTO) with Patient-Specific Cutting Guides (PSCGs), using anchor-based methods.

Methods: Patients undergoing isolated medial owHTO with PSCGs between January 2013 and January 2017 were enrolled in this single-center, prospective, observational study.

Presoaking of Semitendinosus Graft With Vancomycin Does Not Alter Its Biomechanical Properties: A Biomechanical In Vitro-Controlled Study Using Graft From Living Donors.

Purpose: To compare the biomechanical properties of human semitendinosus graft presoaked with or without vancomycin under a load to failure tensile test.

Methods: Thirty semitendinosus grafts harvested during anterior cruciate ligament reconstruction were included. These were dissected equally into 2 halves and subsequently randomly allocated to a vancomycin group and to a control group.

Can dual mobility cups prevent dislocation without increasing revision rates in primary total hip arthroplasty? A systematic review.

Background: Dislocation is one of the leading causes for early revision surgery after total hip arthroplasty (THA). To address this problem, the dual mobility (DM) cup was developed in the 1970s by the French. Despite the increased and, in some countries, broad use of DM cups, high quality evidence of their effectiveness compared to traditional unipolar (UP) cups is lacking.

Long-term results of custom-made femoral stems.

Background: The progress of 3D imaging and manufacturing of implants has made it possible to achieve a custom-made concept in THA. The custom-made cementless femoral stem provides optimal implant stability combined with restoration of the native hip mechanics.

Objective: The purpose of this study was to evaluate the long-term survivorship of custom-made hip femoral stems in two populations of patients undergoing THA: patients under 50 years old (young patients group) and patients with high-grade developmental dysplasia of the hip (DDH group).

Adding a protective screw improves hinge's axial and torsional stability in High Tibial Osteotomy.

Backgrounds: Despite the use of a locking plate a 30% incidence of lateral hinge fracture after Open-Wedge High Tibial Ostetomy was described in the literature. A finite element model was used to analyze if the presence of a hinge-securing screw in the osteotomy area, using Patient Specific Cutting Guides with a locking plate, decreases the stresses within the lateral hinge during compression and torsion.

Methods: A 3D model of a tibial sawbone was used to simulate an opening wedge of 10°.