Management of traumatic meniscus tears: the 2019 ESSKA meniscus consensus.

Purpose: The importance of meniscus integrity in the prevention of early osteoarthritis is well known, and preservation is accepted as the primary goal. The purpose of the ESSKA (European Society for Sports Traumatology, Knee Surgery and Arthroscopy) European consensus on traumatic meniscus tears was to provide recommendations for the treatment of meniscus tears based on both scientific evidence and the clinical experience of knee experts.

Methods: Three groups of surgeons and scientists elaborated and ratified the so-called formal consensus process to define the recommendations for the management of traumatic meniscus tears.

Opening wedge high tibial osteotomy allows better outcomes than unicompartmental knee arthroplasty in patients expecting to return to impact sports.

Purpose: Prior studies have compared unicompartmental knee arthroplasty (UKA) with high tibial osteotomy (HTO) suggesting that both procedures had good functional outcomes. But none had established the superiority of one of the two procedures for patients with high expectation including return to impact sport. The aim of this study was to compare functional outcomes and ability to return to impact sport of active patients defined with a pre-arthritis University of California and Los Angeles activity (UCLA) score > 8, after UKA or HTO procedures.

Better functional outcomes for ORIF in tibial eminence fracture treatment: a national comparative multicentric study of ORIF vs ARIF.

Purpose: Tibial eminence fractures can occur in adults and are equivalent to an acute ACL rupture. The purpose of this retrospective study was to compare the therapeutic outcomes of ARIF versus ORIF in tibial eminence fractures. Our hypothesis was that ARIF does not offer better results.

A protective hinge wire, intersecting the osteotomy plane, can reduce the occurrence of perioperative hinge fractures in medial opening wedge osteotomy.

Purpose: A recent study reported that positioning a K-wire to intersect the cutting plane at the theoretical lateral hinge location increases the lateral hinge's resistance to fracture during the opening of opening wedge high tibial osteotomy (OWHTO). The purpose of this study was to evaluate the clinical relevance of the use of this K-wire and its benefits in terms of lateral hinge protection during OWHTO in daily practice.

Methods: A retrospective comparative study identified 206 patients who underwent OWHTO from January 2014 to December 2017.

Patient-specific high-tibial osteotomy's 'cutting-guides' decrease operating time and the number of fluoroscopic images taken after a Brief Learning Curve.

Purpose: Patient-specific cutting guides (PSCGs) have been advocated to improve the accuracy of deformity correction in opening-wedge high-tibial osteotomies (HTO). It was hypothesized that PSCGs for HTO would have a short learning curve. Therefore, the goals of this study were to determine the surgeons learning curve for PSCGs used for opening-wedge HTO assessing: the operating time, surgeons comfort levels, number of fluoroscopic images, accuracy of post-operative limb alignment and functional outcomes.

Non-operative treatment is a reliable option in over two thirds of patients with Garden I hip fractures. Rates and risk factors for failure in 298 patients.

Background: Non-operative treatment for impacted femoral neck fractures is a now rarely used strategy whose indications are controversial. No outcome predictors have been convincingly identified, in part due to the small sizes of available studies. We conducted a large retrospective study with the following objectives: (1) to evaluate the percentage of patients older than 65 years of age with non-operatively treated Garden I femoral neck fractures who experience secondary displacement, (2) to identify predictors of secondary displacement, and (3) to determine the frequency of non-operative treatment failure due to any cause and requiring joint replacement surgery.

Patient-specific cutting guides for open-wedge high tibial osteotomy: safety and accuracy analysis of a hundred patients continuous cohort.

Introduction: Several recent studies have reported accurate and reliable use of patient-specific cutting guides (PSCG) for medial opening-wedge high tibial osteotomy (OW-HTO); however, a majority of these are small cases series or ex-vivo reports. The hypothesis of this study was that performing an OW-HTO with PSCG results in a reliable and accurate correction with good or satisfactory patient-reported functional outcomes at a mean of two years. We also hypothesized that the use of PSCG would not increase the rate of specific or non-specific complications.

Upper Femur Anatomy Depends on Age and Gender: A Three-Dimensional Computed Tomography Comparative Bone Morphometric Analysis of 628 Healthy Patients' Hips.

Background: The knowledge of proximal femur geometry is essential in the understanding and treatment of hip pathologies. Our aim is to evaluate the range of "normal anatomical values of the proximal femur" and their relationship to age, gender, and ethnicity in a cohort of healthy population, using a 3-dimensional computed tomography automated software.

Methods: The pelvis and bilateral femora of 628 healthy individuals (394 males/234 females, mean age 61.

Contralateral preoperative templating of lower limbs' mechanical angles is a reasonable option.

Purpose: In cases where the femur or tibia exhibits abnormal mechanical angulation due to degenerative changes or fracture, the contralateral leg is often used to complete preoperative templating. The aim of this study was to determine the degree of asymmetry between knee joints in healthy individuals and to determine whether it is affected by differing demographic parameters.

Methods: A CT scan-based modelling and analysis system was used to examine the lower limb of 233 patients (102 males, 131 women; mean age 61.

Preservation Methods Influence the Biomechanical Properties of Human Lateral Menisci: An Ex Vivo Comparative Study of 3 Methods.

Background: Three main meniscal preservation methods have been used over the past decade: cryopreservation, freezing, and freezing with gamma irradiation.

Hypothesis: All 3 preservation methods will result in similar biomechanical properties as defined by tensile and compression testing.

Study Design: Controlled laboratory study.

Painful Hip Arthroplasty: What Should We Find? Diagnostic Approach and Results.

Introduction: Identifying the source of pain is paramount for determining appropriate treatment and ensuring successful outcome in terms of management and relief of pain. The difficulty is that each surgeon has his or her own way of seeing the problem, and there is no consensus for the evaluation of these patients. The study hypothesis was that it is possible to find the cause of the pain in most cases.

French translation and cultural adaptation of a questionnaire for patients with hip or knee prosthesis.

Introduction: The Kingsbury questionnaire offers the possibility of follow-up by means of an X-ray and a simple questionnaire sent to the home address of the patient, who will not need to come in consultation if there are no problems. The questionnaire detects any anomaly in follow-up. In case of anomaly in the questionnaire or radiograph, the patient is contacted and/or seen again, as appropriate.

Adding a protective K-wire during opening high tibial osteotomy increases lateral hinge resistance to fracture.

Purpose: It was hypothesized in this in-vitro study that positioning a K-wire intersecting the cutting plane at the theoretical lateral hinge location would limit the cut depth and help preserve the lateral hinge during the opening of the osteotomy. Objectives were (1) to compare the mechanical resistance of the hinge and the protective effect of leaving the K-wire during the opening procedure (2) to check if the K-wire would limit the depth of the osteotomy.

Methods: An ex-vivo mechanical study, testing 5 pairs of fresh-frozen tibias, was designed.

"More accurate correction using "patient-specific" cutting guides in opening wedge distal femur varization osteotomies.

Purpose: The distal femoral varization osteotomy (DFVO) by a lateral opening wedge osteotomy is an established intervention for patients suffering from lateral femoro-tibial osteoarthritis on a genu valgum deformity. In order to improve the accuracy of this correction, the use of a customized cutting guide (PSI) has been proposed as an alternative to conventional technique. The objective of our study was to compare the accuracy of post-operative alignment following DFVO in the coronal and sagittal plane using either a conventional abacus technique or PSI guide.

A 20-year follow-up evaluation of total hip arthroplasty in patients younger than 50 using a custom cementless stem.

Aim: The purpose of this study is to report the 20-year follow-up of a continuous series of 232 total hip arthroplasties (THAs) performed in patients aged less than 50 at the index surgery.

Patients And Methods: This is a retrospective monocentric study which reports the clinical, radiographical and survival results of 232 THAs performed with a custom cementless femoral stem in 212 patients evaluated at follow-up ranging from 14 to 27 years.

Results: At the time of follow-up, the mean Harris Hip Score was 94.

Three- and four-part displaced proximal humeral fractures in patients older than 70 years: reverse shoulder arthroplasty or nonsurgical treatment?

Background: The objective of our study was to evaluate the results of surgical treatment by reverse shoulder arthroplasty (RSA) compared with nonsurgical treatment after 2 years of follow-up in patients aged 70 years or older with displaced 3-part or 4-part proximal humeral fractures.

Methods: Two groups were formed: the RSA group (n = 28) and the nonsurgical group (n = 32). Minimum follow-up was 2 years.

Ten-year epidemiological study in an orthopaedic and trauma surgery centre: Are there risks involved in increasing scheduled arthroplasty volume without increasing resources?

Background: Current trends in patient management include decreasing hospital stay lengths and reductions in available material and human resources. A shortening of hospital stays in university hospitals has been documented over the last decade. However, to our knowledge, no study has assessed possible relationships linking shorter stays to staffing levels or complication rates.

Update on the supply and use of allografts in locomotor system pathologies in France.

Unlabelled: Allografts are increasingly used in orthopedics. The main aim of the present study was to map the use of locomotor system allografts in France between 2012 and 2016. The study hypothesis was that there are great differences in the distribution and activity of tissue banks and graft preservation procedure quality, failing to meet national requirements.

Effect of 3 Preservation Methods (Freezing, Cryopreservation, and Freezing + Irradiation) on Human Menisci Ultrastructure: An Ex Vivo Comparative Study With Fresh Tissue as a Gold Standard.

Background: Three main meniscus preservation methods have been advocated: freezing (-80°C), freezing with gamma irradiation (-80°C + 25 kGy), and cryopreservation (-140°C).

Hypothesis: All preservation methods will result in structural and architectural properties similar to those of fresh meniscus, defined as the gold standard.

Study Design: Controlled laboratory study.

Fixation augmentation using calcium-phosphate bone substitute improves outcomes of complex tibial plateau fractures. A matched, cohort study.

Introduction: Injectable cements have been developed to improve fixation's stability and thus obtain early return to adequate joint function. We aimed to compare post-operative radiographic and clinical outcomes of patients suffering from a complex tibial plateau fracture (TPF) fixed with calcium-phosphate bone substitutes (CPBS) augmentation to a matched group of patients with identical fracture pattern, treated with the same fixation's type, but augmented with bone grafting.

Methods: After local ethic committee approval, we retrospectively identified in a prospectively collected database, patients with complex comminuted metaphyseal and epiphysial bicondylar TPF (Schatzker type VI) admitted in our emergency department between January 2011 and December 2013.

Minimum 10-Year Outcome of One-Stage Total Hip Arthroplasty Without Subtrochanteric Osteotomy Using a Cementless Custom Stem for Crowe III and IV Hip Dislocation.

Background: Options for total hip arthroplasty (THA) in high dislocated hips include subtrochanteric osteotomy (STO), high hip center positioning, and 2-stage surgery with progressive lowering using an external fixator before THA. We described the long-term results of 1-stage THA performed without STO, using a cementless customized stem associated if necessary with sequential tenotomies and/or greater trochanteric osteotomy.

Methods: Ninety-eight consecutive THA without STO were performed using this technique.

No Benefit of Computer-assisted TKA: 10-year Results of a Prospective Randomized Study.

Background: Previously published studies reported benefits of computer-assisted surgery (CAS) in terms of radiographic implant position in TKA, but whether these improvements result in clinically important survival differences or functional differences that a patient might perceive at a minimum 10-year followup remains largely unknown.

Questions/purposes: We performed a prospective randomized trial and asked whether CAS (1) improved survival free from aseptic loosening; and (2) demonstrated any clear difference in patient-reported outcomes at latest followup using validated outcome measures at minimum 10-year followup.

Methods: Between January 2004 and December 2005, 80 patients scheduled for TKA were randomly assigned either to the CAS group or to the conventional technique group by the Hospital Informatics Department.