A Right Angle Guide for Distal Tuberosity Osteotomy With Medial Open Wedge High Tibial Osteotomy for Varus Knee Osteoarthritis.

Medial open wedge high tibial osteotomy (OWHTO) is usually performed with proximal tuberosity osteotomy or setting the osteotomy line proximal to the tuberosity. However, OWHTO can result in patellofemoral complications due to postoperative patella infera. A new OWHTO technique, biplanar osteotomy with a distal tuberosity osteotomy, was reported in 2004 to prevent postoperative patella infera.

Surgical Approach to Pigmented Villonodular Synovitis and Synovial Osteochondromatosis in Pathological Expansion of the Popliteus Bursa.

We orthopaedic surgeons are not familiar with the popliteus bursa. It is defined as the expansion in the synovial membrane of the posterolateral part of the knee that lies between the lateral meniscus and the tendon of the popliteus muscle. The popliteus bursa extends approximately 1 cm distal to the joint line and has 4 borders; the medial border is the peripheral margin of the lateral meniscus, the lateral border is the popliteus tendon, and the superior and inferior borders are formed by 2 fascicles.

Quality of life after staged bilateral total knee arthroplasty: a minimum five-year follow-up study of seventy-eight patients.

Purpose: Although many studies have been performed to evaluate the quality of life (QOL) and patient satisfaction after total knee arthroplasty (TKA), almost all evaluations were performed in patients after unilateral TKA or in patients after mixed unilateral and bilateral TKA. Accordingly, this study aimed to evaluate QOL after staged bilateral TKA.

Methods: A total of 78 patients who underwent staged bilateral TKA for varus knee osteoarthritis were included in this study.

Preliminary results of managing large medial tibial defects in primary total knee arthroplasty: autogenous morcellised bone graft.

Purpose: This study reports a case series of 44 primary total knee arthroplasties (TKAs) using autogenous morcellised bone grafting for large (≥10-mm-deep) medial tibial defects, which are generally repaired using metal augmentation. The bone-grafting technique is described in detail and the radiological outcomes are presented.

Methods: A total of 44 TKAs were followed up for a mean period of 58 months (range 24-139 months).

Effect of resorption rate and osteoconductivity of biodegradable calcium phosphate materials on the acquisition of natural bone strength in the repaired bone.

The purpose of this study was to compare the biodegradation rate and quality of regenerated bone among four materials. A short time period of 8 weeks was chosen to examine early bone healing. The rod-shaped implants of commercially available two β-tricalcium phosphate (β-TCP) ceramics with porosity 60% and 71-80%, respectively, laboratory prepared octacalcium phosphate/gelatin composite (OCP/Gel), which has been proven to have a highly osteoconductive and biodegradable property in rat calvarial defect, and gelatin sponge (Gelatin) were implanted in rabbit tibia defect of 6 mm diameter and 7 mm depth for 2, 4 and 8 weeks.

Femoral footprint of the popliteus tendon may be at the risk of damage during total knee arthroplasty.

Purpose: The present study focused on the prevalence of incidental excision of the femoral footprint of the popliteus tendon during total knee arthroplasty and its associated risk factors.

Methods: A total of 275 knee arthroplasties were performed for 226 patients with varus knee osteoarthritis. The status of the femoral footprint of the popliteus tendon was intraoperatively evaluated and classified into three groups (preserved, partially excised, and completely excised), and the prevalence of the excision was identified.

Evaluation of the size and position of the insertion of the anterior medial meniscus root in varus osteoarthritic knees.

Purpose: Recent studies have suggested radial displacement of the medial meniscus as a cause of varus knee osteoarthritis (OA). Two anatomical studies reported that such displacement may be associated with anterior insertion of the medial meniscus anterior horn. It was aimed to evaluate the location and area of this insertion in patients with advanced knee OA.

Potential risk of excising the femoral insertion of the popliteus tendon during primary total knee arthroplasty: a biometric study.

Background: During total knee arthroplasty (TKA), excision of the popliteus tendon leads to extensive static gaps and reduced mobility. The purpose of this study was to determine the positional relationship between the femoral insertion of the popliteus tendon and the bone cutting lines of various TKA systems.

Methods: This study included 21 cadaveric right femurs presenting no macroscopic deformity.

Autologous morselised bone grafting for medial tibial defects in total knee arthroplasty.

Purpose: To evaluate the outcome of autologous morselised bone grafting for a medial tibial defect of ≥10 mm deep in 45 total knee arthroplasties (TKAs).

Methods: 38 patients aged 46 to 85 (mean, 73) years underwent 45 TKAs and autologous morselised bone grafting for a medial tibial defect of ≥10 (range, 10-25) mm in depth by a single surgeon. In the first 19 TKAs, 2 resected subchondral bone plates from the lateral tibial plateau were driven into 2 gutters made on the floor of the medial tibial defect as bony support posts.

Quality of life after bilateral total knee arthroplasty determined by a 3-year longitudinal evaluation using the Japanese knee osteoarthritis measure.

Background: Recently, the Japanese knee osteoarthritis measure (JKOM), a new disease-specific and patient-derived quality of life (QOL) measure, has been developed. The objectives of this study were to longitudinally evaluate QOL assessed by JKOM and objective outcomes including knee society score (KSS), range of motion (ROM), and timed up and go test (TUG) of patients who underwent bilateral total knee arthroplasties (TKAs) for osteoarthritis; to evaluate correlations between JKOM and those objective outcomes; and to test our hypothesis that increased maximum flexion leads to better JKOM.

Methods: Forty patients with bilateral TKAs and ≥ 3-year follow-up were included.

Bone formation within the articular cartilage of the lateral compartment of varus osteoarthritic knees.

Background: One of the causes of failure after unicompartmental knee arthroplasty (UKA) for varus osteoarthritis is the progression of osteoarthritis in the lateral compartment. Bone formation within the articular cartilage has been reported as a possible cause of the deterioration of the osteoarthritis. However, its prevalence and histology are still uncertain.

Incidence of medial plica in 3,889 knee joints in the Japanese population.

Purpose: This study aimed to document the incidence of medial plicae (plica synovialis mediopatellaris) in a large sample of the Japanese population and classify them in a type-dependent manner.

Methods: The incidence of medial plicae was investigated during arthroscopic surgery of 3,889 knee joints in 3,563 patients (mean age, 35 years); medial plicae were classified according to Sakakibara's classification (type A, a cord-like elevation in the synovial wall; type B, a shelf-like appearance; type C, a large shelf-like appearance covering the anterior surface of the medial femoral condyle; and type D, double insertions into the medial wall or having a central defect). Of all the knee joints examined, 2,006 knees belonged to male patients and 1,883 to female patients.