Clinical Orthopaedics and Related Research ®

A Publication of The Association of Bone and Joint Surgeons ®

Knee 440 articles

Articles

Does Operative Time Affect Infection Rate in Primary Total Knee Arthroplasty?

Sameer Naranje MD, Lisa Lendway PhD, Susan Mehle BS, Terence J. Gioe MD

Prolonged operative time may increase the risk of infection after total knee arthroplasty (TKA). Both surgeon-related and patient-related factors can contribute to increased operative times.

Polished Trays Reduce Backside Wear Independent of Post Location in Posterior-stabilized TKAs

Matthew P. Abdel MD, Mark W. Gesell MD, Christen W. Hoedt BS, Kathleen N. Meyers MS, Timothy M. Wright PhD, Steven B. Haas MD

Backside damage of the polyethylene in TKA is a potential source of debris. The location of the tibial post in posterior-stabilized implants may influence micromotion, and thus affect backside damage, as may surface roughness.

Intraoperative Angiography Provides Objective Assessment of Skin Perfusion in Complex Knee Reconstruction

Cody C. Wyles BS, Michael J. Taunton MD, Steven R. Jacobson MD, Nho V. Tran MD, Rafael J. Sierra MD, Robert T. Trousdale MD

Wound necrosis is a potentially devastating complication of complex knee reconstruction. Laser-assisted indocyanine green angiography (LA-ICGA) is a technology that has been described in the plastic surgery literature to provide an objective assessment of skin perfusion in the operating room. This novel technology uses a plasma protein bound dye (ICG) and a camera unit that is calibrated to view the frequency emitted by the dye. The intention of this technology is to offer real-time visualization of blood flow to skin and soft tissue in a way that might help surgeons make decisions about closure or coverage of a surgical site based on blood flow, potentially avoiding soft tissue reconstruction while preventing skin necrosis or wound breakdown after primary closures, but its efficacy is untested in the setting of complex TKA.

The Chitranjan Ranawat Award: Periarticular Injections and Femoral & Sciatic Blocks Provide Similar Pain Relief After TKA: A Randomized Clinical Trial

Mark J. Spangehl MD, Henry D. Clarke MD, Joseph G. Hentz MS, Lopa Misra MD, Joshua L. Blocher PA-C, David P. Seamans MD

Two of the more common methods of pain management after TKA are peripheral nerve blocks and intraarticular/periarticular injections. However, we are not aware of any study directly comparing the commonly used combination of a continuous femoral block given with a single-shot sciatic block with that of a periarticular injection after TKA.

The Mark Coventry Award

Luis Pulido MD, Matthew P. Abdel MD, David G. Lewallen MD, Michael J. Stuart MD, Joaquin Sanchez-Sotelo MD, PhD, Arlen D. Hanssen MD, Mark W. Pagnano MD

Although highly porous metals have demonstrated excellent bone ingrowth properties and so are an intriguing option for fixation in total knee arthroplasty (TKA), some surgeons are skeptical about the durability of uncemented tibial fixation and the potential for soft tissues to adhere to these porous metals and perhaps cause knee stiffness or pain.

Does Intraarticular Inflammation Predict Biomechanical Cartilage Properties?

Wenzel Waldstein MD, Giorgio Perino MD, Shari T. Jawetz MD, Susannah L. Gilbert MS, Friedrich Boettner MD

Intact cartilage in the lateral compartment is an important requirement for medial unicompartmental knee arthroplasty (UKA). Progression of cartilage degeneration in the lateral compartment is a common failure mode of medial UKA. Little is known about factors that influence the mechanical properties of lateral compartment cartilage.

Is Stability of the Proximal Tibiofibular Joint Important in the Multiligament-injured Knee?

Michael Jabara MD, Jeffrey Bradley MD, Michael Merrick MD

The incidence of proximal tibiofibular joint instability in the setting of the multiligament-injured knee has not been previously reported. The integrity of the proximal tibiofibular joint is required to perform a fibular-based, lateral-sided knee reconstruction.

Does Preoperative Psychologic Distress Influence Pain, Function, and Quality of Life After TKA?

Alfonso Utrillas-Compaired MD, PhD, Basilio J. Torre-Escuredo MD, PhD, Ana J. Tebar-Martínez MD, MPH, Ángel Asúnsolo-Del Barco MD, PhD

Preoperative psychologic distress is considered to be a risk factor for clinical dissatisfaction stemming from persistent pain and physical limitations after elective orthopaedic procedures such as lower-extremity arthroplasty. However, the degree to which psychologic distress, specifically in the form of anxiety and depression, influences surgical results has been poorly characterized.

What Is the Frequency of Vascular Injury After Knee Dislocation?

Kyle M. Natsuhara BS, Michael G. Yeranosian MD, Jeremiah R. Cohen BS, Jeffrey C. Wang MD, David R. McAllister MD, Frank A. Petrigliano MD

Vascular injury secondary to an acute knee dislocation is a known complication. However, there exist wide discrepancies in the reported rate of vascular injury in this setting.

High Satisfaction Yet Decreased Activity 4 Years After Transphyseal ACL Reconstruction

Gregory A. Schmale MD, Christopher Kweon MD, Roger V. Larson MD, Viviana Bompadre PhD

ACL injuries in preteens and teens are common occurrences. Reconstruction is believed to be optimum treatment for those wishing to return to running, cutting, and jumping sports. Rates of reoperation, satisfaction, and long-term return to and maintenance of preinjury activity after ACL reconstruction in young athletes are important information for physicians, patients, and parents.