Effect of Infratuberosity Anterior Closing Wedge Osteotomy for Posterior Tibial Slope Correction on Patellar Height in Patients Undergoing Revision ACL Reconstruction.

Background: An excessive posterior tibial slope (PTS) is a risk factor for anterior cruciate ligament (ACL) rupture or rerupture, and it can be managed by an anterior closing wedge high tibial osteotomy (ACW-HTO). The effect of slope-changing osteotomies on patellar height is poorly described after infratuberosity ACW-HTO.

Purpose: To assess the effect of ACW-HTO on patellar height using an infratuberosity approach.

Morphological Analysis of the Retrotalar Pulley and Its Role in Flexor Hallucis Longus Impingement: Insights from a CT-Based Study.

The Flexor Hallucis Longus (FHL) is a muscle that can be subject to multiple conflicts. The most common conflict is due to inflammation of the tendon at the retrotalar pulley. The constraints exerted on the FHL are responsible for a pathology called functional Hallux Limitus.

Individualized total knee arthroplasty achieves better functional results than off-the-shelf implants in patients undergoing personalized coronal alignment.

Background: Several studies have demonstrated the interest in patient-specific custom cutting guides in total knee arthroplasty (TKA), but clinical improvement remains debated. The purpose of this study was to evaluate the functional outcomes (Forgotten Joint Score, FJS) of patients undergoing individualized TKA compared with those receiving off-the-shelf (OTS) implants, both using patient-specific cutting guides with personalized alignment over a minimum follow up period of 12 months. We hypothesized that individualized TKA demonstrates significantly better functional outcomes than OTS TKA (FJS and percentage of patients reaching the minimum clinically important difference).

Ultrasound-Guided Percutaneous Fasciotomies for Patients With Chronic Exertional Compartment Syndrome.

Chronic exertional compartment syndrome is a well-described potential cause of leg pain in high-level athletes and soldiers. Surgical treatment of chronic exertional compartment syndrome usually involves fasciotomy, with a reported rate of complications of up to 16%, including failure of complete compartmental release and delayed return to normal daily activity, which can take up to 6 to 12 weeks. The use of a minimally invasive approach under ultrasound guidance seems to improve clinical outcomes in young active patients.

Infratuberositary slope-decreasing anterior closed wedge proximal tibial osteotomy is safe and shows rapid bone healing.

Purpose: Different techniques of slope-decreasing anterior closed-wedge proximal tibial osteotomy (ACW-PTO) have been described. To determine the peri- and post-operative complication rate and obtain data on bone healing in ACW-PTO with an infratuberositary approach.

Methods: A total of 170 consecutive ACW-PTO of two sports-orthopaedic centres were retrospectively evaluated (97 and 73, respectively).

Effectiveness of adductor canal block combined with posterior capsular infiltration on pain and return to walking after total knee arthroplasty: comparative analysis with femoral and popliteal sciatic nerves blocks.

Introduction: Perioperative analgesia after total knee arthroplasty (TKA) reduces morphine consumption and speeds up rehabilitation. The primary objective of this study was to compare the pain experienced by patients with an adductor canal and posterior capsule block with those with a continuous femoral nerve block combined with a popliteal sciatic nerve block. The secondary objectives were to analyze the time to recovery from early walking, length of hospital stay, and block-related complications between the two groups.

Results of the AMIC® method in patients operated on for an osteochondral lesion of the talar dome (OLTD) at a mean follow-up of 34 months. A retrospective multicenter study.

Background: Symptomatic osteochondral lesions of the talar dome (OLTD) represent a real therapeutic challenge. In the absence of appropriate treatment, these lesions can evolve into tibiotalar osteoarthritis. Stage 3 lesion of the SFA classification and resistant to medical non-operative treatment may require surgical treatment.

The presence of an aberrant anterior tibial artery does not depend on the patient's morphotype.

Purpose: The aberrant anterior tibial artery (ATA) runs along the posterior surface of the tibial cortex making it, particularly, at risk during high tibial osteotomy (HTO). This study aimed to analyze the prevalence of the ATA according to global morphotype and its anatomical features in consideration of knee surgery.

Methods: This retrospective study included 1589 knees on magnetic resonance imaging (MRI) studies with long-leg radiographs.

Restoring the Preoperative Phenotype According to the Coronal Plane Alignment of the Knee Classification After Total Knee Arthroplasty Leads to Better Functional Results.

Background: Mechanical alignment after total knee arthroplasty (TKA) is still widely used in the surgical community, but the alignment finally obtained by conventional techniques remains uncertain. The recent Coronal Plane Alignment of the Knee (CPAK) classification distinguishes 9 knee phenotypes according to constitutional alignment and joint line obliquity (JLO). The aim of this study was to assess the phenotypes of osteoarthritic patients before and after TKA using mechanical alignment and to analyze the influence of CPAK restoration on functional outcomes.

Total blood loss after hip hemiarthroplasty for femoral neck fracture: Anterior versus posterior approach.

Introduction: Femoral neck fractures constitute a public health problem due to significant associated morbidity and mortality amongst the ageing population. Perioperative blood loss can increase this morbidity. Blood loss, as well as the influence that the surgical approach exerts on it, remains poorly evaluated.

Can hip function be assessed with self-report questionnaires? Feasibility study of a French self-report version of the Harris Hip and Merle d'Aubigné scores.

Introduction: The Harris Hip Score (HHS) and the Merle D'Aubigné Postel (MDP) score both provide an objective and subjective evaluation of hip function. These scores are collected during the follow-up of patients who have a hip disease. The objectives of this prospective study were (1) to analyze the differences between the two new French self-report versions of the HHS and MDP, and the traditional surgeon-assessed HHS and MDP; (2) to analyze the correlation between the self-report HHS and MDP and the surgeon-assessed HHS and MDP; (3) to analyze the floor and ceiling effects of the two self-report scores and the reliability of these self-report scores in operated and non-operated patients.

Flexor Hallucis Longus decompression under ultrasound guidance: A cadaver study.

Introduction: The Flexor Hallucis Longus (FHL) is a muscle that can be subject to multiple impingements caused by exaggerated plantar flexion in athletes. The most common impingement is due to inflammation of the tendon at the retrotalar pulley. The constraints exerted on the FHL are responsible for a pathology called functional Hallux Limitus.

Clinical and Radiological Outcomes of Double-Level Osteotomy Versus Open-Wedge High Tibial Osteotomy for Bifocal Varus Deformity.

Background: In bifocal varus deformity, double-level osteotomy (DLO) is advocated to treat lower limb alignment to prevent an adverse increase in joint line obliquity.

Purpose/hypothesis: The purpose of this study was to compare the clinical and radiological results after DLO and open-wedge high tibial osteotomy (OWHTO) in patients with combined varus deformity. It was hypothesized that DLO would improve clinical results without increasing the complication rate compared with OWHTO.

Slope-decreasing anterior closing wedge proximal tibial osteotomies using the freehand technique are accurate to within 2̊.

Introduction: Anterior cruciate ligament (ACL) reconstruction requires a detailed analysis of the posterior tibial slope (PTS) as excessive values may cause the reconstruction to fail and require a slope-decreasing anterior closing wedge tibial osteotomy combined with revision of the failed ACL reconstruction. The main purpose of this study was to assess the accuracy of correction after slope-decreasing anterior closing wedge tibial osteotomy in cases of chronic anterior instability caused by ACL rerupture.

Materials And Methods: This single-center retrospective study included 19 patients (20 knees) operated on by slope-decreasing anterior closing wedge tibial osteotomy combined with a second revision ACL reconstruction.

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.

The reliability of the Neer classification for proximal humerus fractures: a survey of orthopedic shoulder surgeons.

Background: The Neer classification is among the most widely used systems to describe proximal humerus fractures (PHF) despite the poor interobserver agreement. The purpose of this study was to verify whether or not blinded shoulder surgeons and trainees agree with the authors of articles published in the highest impact-factor orthopedic journals.

Methods: All articles regarding PHF published between 2017 and 2019 in the top 10 orthopedic journals as rated by impact factor were searched.

Femoral and Tibial Bony Risk Factors for Anterior Cruciate Ligament Injuries Are Present in More Than 50% of Healthy Individuals.

Background: Anterior cruciate ligament (ACL) injuries are multifactorial events that may be influenced by morphometric parameters. Associations between primary ACL injuries or graft ruptures and both femoral and tibial bony risk factors have been well described in the literature.

Purpose: To determine values of femoral and tibial bony morphology that have been associated with ACL injuries in a reference population.

Patellar height is not modified after isolated open-wedge high tibial osteotomy without change in posterior tibial slope.

Introduction: Open-wedge high tibial osteotomy (OWHTO) corrects coronal deformity and can impact sagittal parameters such as posterior tibial slope and patellar height. The aim of the present study was to analyze change in patellar height after medial OWHTO with respect to tibial and femoral-referenced indices.

Material And Method: This single-center retrospective study included 129 patients undergoing isolated posteromedial OWHTO, without change in tibial slope, using patient-specific cutting-guides.

Arthroscopic Lateral Patellar Facetectomy and Lateral Release Can Be Recommended for Isolated Patellofemoral Osteoarthritis.

Purpose: To analyze the clinical outcomes and survival curve of arthroscopic lateral patellar facetectomy and lateral release for isolated patellofemoral osteoarthritis (PFOA).

Methods: All patients undergoing arthroscopic lateral patellar facetectomy and lateral release between January 2008 and January 2018 were evaluated retrospectively. The inclusion criteria were 1) diagnosis of isolated symptomatic lateral PFOA, 2) PFOA with kissing lesions (defined as a lesion on both the patella and trochlea, which were in direct contact, 3) arthroscopic lateral patellar facetectomy and lateral release, and 4) two-year minimum follow-up.

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.

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.

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.