Clinical Orthopaedics and Related Research ®

A Publication of The Association of Bone and Joint Surgeons ®

Knee 443 articles


Three Osteochondritis Dissecans Lesions in One Knee: A Case Report

Nathan L. Grimm BS, Breann Tisano BS, James L. Carey MD, MPH

Osteochondritis dissecans (OCD) has been defined as a localized process in which a focus of subchondral bone and adjacent articular cartilage separates from the surrounding bone. With the knee being the most common location for OCD development and the propensity for this lesion to be found in those who participate in sports, a repetitive microtrauma hypothesis for its cause has gained favor. However, the cause of OCD remains controversial, as does the most appropriate treatment for the varying degrees of OCD lesions.

Most Effective Regimen of Tranexamic Acid in Knee Arthroplasty: A Prospective Randomized Controlled Study in 240 Patients

Rajesh N. Maniar MS Orth, MCh Orth, Gaurav Kumar MS, Tushar Singhi MS, Ravi Mohan Nayak MS, Parul R. Maniar MS, FRCO

The antifibrinolytic tranexamic acid reduces surgical blood loss, but studies have not identified an optimal regimen.

Current Treatments of Isolated Articular Cartilage Lesions of the Knee Achieve Similar Outcomes

Hong-Chul Lim MD, PhD, Ji-Hoon Bae MD, Sang-Heon Song MD, Young-Eun Park MD, Seung-Ju Kim MD

Many surgical techniques, including microfracture, periosteal and perichondral grafts, chondrocyte transplantation, and osteochondral grafts, have been studied in an attempt to restore damaged articular cartilage. However, there is no consensus regarding the best method to repair isolated articular cartilage defects of the knee.

Reason for Revision Influences Early Patient Outcomes After Aseptic Knee Revision

Paul Baker MBBS, MSc, FRCS (Trauma & Orthop), Paul Cowling MBBS, MRCS, Steven Kurtz PhD, Simon Jameson MBBS, MRCS, Paul Gregg MD, FRCS (Ed), FRCS, David Deehan MD, MSc, FRCS (Trauma & Orthop)

Revision TKA less consistently produces improvements in clinical function and quality of life when compared with primary TKA. The reasons for this difference are unclear.

Knee Wear Measured in Retrievals: A Polished Tray Reduces Insert Wear

Daniel J. Berry MD, John H. Currier MS, Michael B. Mayor MD, John P. Collier DE

Polyethylene wear is often cited as the cause of failure of TKA. Rotating platform (RP) knees show notable surface damage on the rotating surface raising concerns about increased wear compared to fixed bearing inserts.

Is Unicompartmental Arthroplasty an Acceptable Option for Spontaneous Osteonecrosis of the Knee?

Danilo Bruni MD, Francesco Iacono MD, Giovanni Raspugli MD, Stefano Zaffagnini MD, Maurilio Marcacci MD

The literature suggests survivorship of unicompartmental knee arthroplasties (UKAs) for spontaneous osteonecrosis of the knee ranges from 93% to 97% at 10 to 12 years. However, these data arise from small series (23 to 33 patients), jeopardizing meaningful conclusions.

Drilling Juvenile Osteochondritis Dissecans: Retro- or Transarticular?

Matthew J. Gunton MD, James L. Carey MD, MPH, Colin R. Shaw BSc (Hons), MSc, M. Lucas Murnaghan MD, MEd, FRCSC

Early diagnosis and successful treatment of juvenile osteochondritis dissecans (JOCD) is essential in preventing articular degeneration at a young age. Surgical treatment of stable JOCD lesions failing nonoperative treatment involves retroarticular or transarticular drilling to induce revascularization and healing. Multiple case series report high healing rates and infrequent complications for both retroarticular and transarticular drilling modalities; however, it is unclear from these individual reports whether one mode of drilling provides higher healing rates.

Do Patient-specific Guides Improve Coronal Alignment in Total Knee Arthroplasty?

Ryan M. Nunley MD, Bradley S. Ellison MD, Jinjun Zhu MD, PhD, Erin L. Ruh MS, Stephen M. Howell MD, Robert L. Barrack MD

Coronal alignment may impact clinical outcome and survivorship in TKA. Patient-specific instrumentation has been developed to restore mechanical or kinematic axis and potentially reduce component malpositioning. Although it is clear these instruments add cost, it is unclear whether they improve alignment.

Are Patient-specific Cutting Blocks Cost-effective for Total Knee Arthroplasty?

Ryan M. Nunley MD, Bradley S. Ellison MD, Erin L. Ruh MS, Brandon M. Williams DC, Keith Foreman RN, BS, CNOR, Adrienne D. Ford MPH, Robert L. Barrack MD

Using patient-specific cutting blocks for TKA increases the cost to the hospital for these procedures, but it has been proposed they may reduce operative times and improve implant alignment, which could reduce the need for revision surgery.

Does Using Autograft Bone Chips Achieve Consistent Bone Ingrowth in Primary TKA?

Roy D. Bloebaum PhD, Karyn E. Koller MD, MPH, Bettina M. Willie PhD, Aaron A. Hofmann MD

Cementless fixation remains controversial in TKA due to the challenge of achieving consistent skeletal attachment. Factors predicting durable fixation are not clearly understood, but we presumed bone ingrowth could be enhanced by the quantity of host bone and application of autograft bone chips.