Clinical Orthopaedics and Related Research ®

A Publication of The Association of Bone and Joint Surgeons ®

Knee 440 articles

Articles

A Novel Posteromedial Approach for Tibial Inlay PCL Reconstruction in KDIIIM Injuries: Avoiding Prone Patient Positioning

Dustin Richter MD, Daniel C. Wascher MD, Robert C. Schenck MD

Treatment of traumatic knee dislocations remains controversial and challenging. Current techniques for PCL reconstruction utilize either a transtibial approach with potential risk of vascular injury from drilling toward the popliteal artery or a tibial inlay technique with prone patient positioning, which is cumbersome and adds operative time. We therefore developed a surgical technique using a supine posteromedial approach for PCL tibial inlay reconstruction for the treatment of Schenck KDIIIM (ACL/PCL/medial collateral ligament) knee dislocations. In patients undergoing this technique, we evaluated patient-reported outcome scores, ROM, stability, and complications.

Two-stage Approach to Primary TKA in Infected Arthritic Knees Using Intraoperatively Molded Articulating Cement Spacers

Aseem Arif Shaikh MS, Chul-Won Ha MD, Yong-Geun Park MD, Yong-Beom Park MD

The treatment of knee arthritis with coexistent bone or joint sepsis is challenging. Despite the condition causing considerable morbidity, there is no generally agreed-upon approach to its treatment.

No Benefit of Patient-specific Instrumentation in TKA on Functional and Gait Outcomes: A Randomized Clinical Trial

Matthew P. Abdel MD, Sébastien Parratte MD, PhD, Guillaume Blanc MD, Matthieu Ollivier MD, Vincent Pomero PhD, Elke Viehweger MD, PhD, MHA, Jean-Noël A. Argenson MD, PhD

Although some clinical reports suggest patient-specific instrumentation in TKA may improve alignment, reduce surgical time, and lower hospital costs, it is unknown whether it improves pain- and function-related outcomes and gait.

Current Modes of Failure in TKA: Infection, Instability, and Stiffness Predominate

David H. Le MD, Stuart B. Goodman MD, PhD, William J. Maloney MD, James I. Huddleston MD

Historically, polyethylene wear and its sequelae (osteolysis, late instability, aseptic loosening) were common causes for revision total knee arthroplasty (TKA). Recently, polyethylene manufacturing has become more consistent; furthermore, a clearer understanding of the importance of oxidation on polyethylene performance led to packaging of the polyethylene bearings in an inert environment. This improved the quality and consistency of polyethylene used in TKA, raising the question of whether different failure modes now predominate after TKA.

Rotating-platform TKA No Different from Fixed-bearing TKA Regarding Survivorship or Performance: A Meta-analysis

Joseph T. Moskal MD, Susan G. Capps PhD

Mobile bearings have been compared with fixed bearings used in TKA. However, rotating platforms, a specific type of mobile bearing, have not been compared with fixed-bearings using meta-analysis.

Posterior Tibial Tendon Transfer Improves Function for Foot Drop After Knee Dislocation

Marius Molund MD, Lars Engebretsen MD, PhD, Kjetil Hvaal MD, PhD, Jan Hellesnes PT, Elisabeth Ellingsen Husebye MD, PhD

Knee dislocation may be associated with an injury to the common peroneal nerve with a subsequent foot drop. Previous studies have demonstrated good functional results after posterior tibial tendon transfer in patients with foot drop. No studies, to our knowledge, have focused exclusively on knee dislocation as the cause of common peroneal nerve injury leading to foot drop.

A 30-mm Cemented Stem Extension Provides Adequate Fixation of the Tibial Component in Revision Knee Arthroplasty

Paul F. Lachiewicz MD, Elizabeth S. Soileau BSN

The optimal stem length and method of fixation for the tibial component in revision knee arthroplasty remains controversial. The use of a cemented 30-mm stem extension provides certain advantages compared with other methods of fixation, but there are few published results.

Vascular and Nerve Injury After Knee Dislocation: A Systematic Review

Omar Medina BS, Gabriel A. Arom BS, Michael G. Yeranosian MD, Frank A. Petrigliano MD, David R. McAllister MD

Vascular injury is a devastating complication of acute knee dislocation. However, there are wide discrepancies in the reported frequency of vascular injury after knee dislocations, as well as important differences among approaches for diagnosis of this potentially limb-threatening problem.

Medial Injury in Knee Dislocations: What Are the Common Injury Patterns and Surgical Outcomes?

Brian C. Werner MD, Michael M. Hadeed BS, F. Winston Gwathmey MD, Cree M. Gaskin MD, Joseph M. Hart PhD, ATC, Mark D. Miller MD

When associated with a knee dislocation, management of the medial ligamentous injury is challenging, with little literature available to guide treatment.

Arthrodesis Should Be Strongly Considered After Failed Two-stage Reimplantation TKA

Chia H. Wu MD, MBA, Chancellor F. Gray MD, Gwo-Chin Lee MD

A two-stage reimplantation procedure is a well-accepted procedure for management of first-time infected total knee arthroplasty (TKA). However, there is a lack of consensus on the treatment of subsequent reinfections.