Does robotic arm-assisted total knee arthroplasty have a role to play in large deformities?

Background: Total knee arthroplasty (TKA) for patients with a large preoperative deformity (more than 10° varus or valgus) remains a challenge leading to a high rate of outliers, unsatisfactory functional results, or early prosthetic loosening. Robotic arm-assisted TKA (RATKA) has shown improvements in implant positioning accuracy. This study aimed to assess RATKA implant positioning accuracy and functional results at one year postoperative for patients with a large preoperative deformity.

Oblique or short incisions reduce the risk of saphenous nerve damage during hamstrings harvesting: A model for mapping nerve pathways at the harvest site.

Introduction: Hamstring autografts are frequently used for ligament reconstruction surgery. Between 12% and 84% of patients report hypoesthesia or dysaesthesia secondary to injury of the saphenous nerve or one of its branches after hamstring harvesting. Type of incision (orientation and length) is subject of much regarding limiting the risk of nerve damage.

Contribution of the Medial Hamstrings to Valgus Stability of the Knee.

Background: Multiligament knee injuries involving the medial side are common. When performing surgical reconstruction, use of the medial hamstrings (HS) as grafts remains controversial in this setting.

Purpose: To determine the role of the medial HS in stabilizing the valgus knee for different types of medial-sided knee injury.

Is there any biomechanical justification to use hopping as a return to running test? A cross-sectional study.

Objective: To assess the agreement and the correlation between asymmetry indexes of leg stiffness (AI(K)) in running and hopping and the correlation between leg stiffness (K) in running and hopping.

Design: Cross-sectional study.

Setting: Clinical facility.

Towards a validated musculoskeletal knee model to estimate tibiofemoral kinematics and ligament strains: comparison of different anterolateral augmentation procedures combined with isolated ACL reconstructions.

Background: Isolated ACL reconstructions (ACLR) demonstrate limitations in restoring native knee kinematics. This study investigates the knee mechanics of ACLR plus various anterolateral augmentations using a patient-specific musculoskeletal knee model.

Materials And Methods: A patient-specific knee model was developed in OpenSim using contact surfaces and ligament details derived from MRI and CT data.

Return-to-sport criteria after isolated meniscus suture: Scoping review of the literature.

Background: Follow-up care including rehabilitation therapy after isolated meniscal repair remains to be standardized. Thus, no standard criteria are available for the return-to-running (RTR) or return-to-sport (RTS). The objective of this study was to identify criteria for RTR and RTS after isolated meniscal repair, based on a review of the literature.

Lateral augmentation procedures in anatomic anterior cruciate ligament reconstruction. How to avoid tunnel collision with intraoperative tunnel visualization: A technical note.

Lateral extra-articular tenodesis (LET) or anterolateral ligament (ALL) reconstruction can be used as an augmentation procedure in anatomic anterior cruciate ligament (ACL) reconstruction and are thought to minimize rotational instability, lower re-rupture rates of the ACL graft and improve functional outcomes after surgery. Young patients with high-grade pivot shift or generalized laxity participating in high demand/pivoting sports are considered as the ideal candidates for such a procedure. Both in LET and in ALL reconstruction, femoral fixation of the graft using an interference screw remains a challenge due to the possibility of tunnel convergence of the two tunnels created in the femur, namely the ACL femoral tunnel and the tunnel created in the lateral femur for the LET or ALL procedure.

After MPFL reconstruction, femoral tunnel widening and migration increase with poor tunnel positioning and are related to poor clinical outcomes.

Purpose: Isolated MPFL reconstruction (iMPFLR) is increasingly used for the surgical treatment of treatment for recurrent patella dislocation. The purpose of this study was to evaluate the influence of tunnel widening and migration on clinical outcomes after iMPFL using a CT-scannographic analysis at 6 months postoperatively.

Methods: One hundred and sixty patients (91 females for 69 males) with an average age of 23 years [14-54] who underwent iMPFLR and had an evaluation scan at 6 months postoperatively were evaluated with a mean follow-up of 97 ± 89 months [12 to 166].

What Are the Sonographic Outcomes of Acute Achilles Tendon Rupture? Nonoperative Versus Surgical Repair?

Introduction: The objective was to compare the two-year ultrasonographic outcomes in a consecutive series of patients with acute Achilles tendon rupture (ATr), either treated surgically or nonoperatively.

Materials And Methods: This is a prospective, single-center, consecutive series. All patients presenting with acute ATr were included and divided into two groups: surgical or nonoperative groups.

The anatomy of Kaplan fibers.

Purpose: Kaplan fibers (KF) have been described as connections between the iliotibial band and the distal femur. They are divided into two distinct structures, proximal (PKF) and distal (DKF) fibers, which may participate in the control of the rotatory knee stability. Their anatomical characteristics have not been investigated completely, in particular with respect to reconstruction procedures.

Predictors of Functional Outcome After Microfracture Treatment of Cartilage Defects of the Knee.

Introduction: Microfracture (MFx) is a widely used technique in the treatment of articular cartilage defects of the knee. The objective of this study was to determine the prognostic factors of functional outcomes after MFx treatment of knee cartilage defects ≤ 4 cm2.

Materials And Methods: Forty-eight patients who were to be treated by MFx for knee cartilage defects ≤ 4 cm2 were prospectively included.

Ileus, Gastrointestinal Bleeding and Clostridium difficile Colitis after Hip and Knee Replacement - a Systematic Review.

Introduction: Major gastrointestinal complications after arthroplasty are rare, but can have detrimental effects on the patient and can substantially increase the overall cost of treatment. This systematic review provides an overview of ileus, gastrointestinal bleeding and C. difficile colitis after total hip and knee arthroplasty.

Dual mobility cups for total hip arthroplasty: tips and tricks.

Since its creation in 1974, the Dual Mobility Cup (DMC) has been gaining in popularity, especially in the past decade. This intensive use could lead to inappropriate use and consequently to an increased complication rate. Compliance with conceptual requirements and surgical techniques will prevent the occurrence of complications that can be wrongly attributed to implants.

Outcomes of Augmented Dual Mobility Acetabular Cups.

Introduction: Total hip arthroplasty (THA) in patients with acetabular bone defects is associated with a high risk of dislocation and aseptic loosening. No studies to date have examined the use of uncemented and augmented dual mobility cups (DMC) in patients with acetabular defects. We hypothesized that the use of augmented DMC under these conditions would reduce the dislocation rate and lead to satisfactory bone integration in the medium term despite acetabular bone defects.

Clinical and Radiological Predictors of Functional Outcome After Isolated Medial Patellofemoral Ligament Reconstruction at Midterm Follow-up.

Background: Isolated medial patellofemoral ligament reconstruction (iMPFLR) is increasingly used for the surgical treatment of recurrent patellofemoral instability.

Purpose: The purpose of this study was to identify the clinical and radiological predictors that can significantly influence the functional outcomes after an iMPFLR.

Study Design: Case series; Level of evidence, 4.

Correction to: Intraprosthetic dislocation of dual mobility total hip arthroplasty: still occurring?

The published online version contains mistake in the author list for the author name "Di Iorio Alexandre" was incorrectly presented.

Intraprosthetic dislocation of dual mobility total hip arthroplasty: still occurring?

Purpose: The objective was to identify predictive factors for intraprosthetic dislocation (IPD) and to understand how improvements in dual mobility cups (DMC) have helped to reduce dramatically the occurrence of this complication.

Methods: DM mobile inserts retrieved from 93 hips were divided into three groups: first-generation DMC with IPD ("firstDMC-IPD"), first-generation DMC with over 15 years of implantation without IPD ("firstDMC-noIPD"), and latest-generation DMC ("newDMC"). The predictive factors for IPD based on clinical, prosthetic, radiological and intraoperative characteristics were analysed by multivariate analysis.