Clinical Orthopaedics and Related Research ®

A Publication of The Association of Bone and Joint Surgeons ®

Knee 442 articles


The John Insall Award: No Functional Advantage of a Mobile Bearing Posterior Stabilized TKA

Ormonde M. Mahoney MD, Tracy L. Kinsey MSPH, Theresa J. D’Errico MSHS, Jianhua Shen MS

Mobile bearing (MB) total knee design has been advocated as a means to enhance the functional characteristics and decrease the wear rates of condylar total knee arthroplasty (TKA). However, it is unclear if these designs achieve these goals.

A Cell-free Scaffold-based Cartilage Repair Provides Improved Function Hyaline-like Repair at One year

Alberto Siclari MD, Gennaro Mascaro MD, Chiara Gentili MD, Ranieri Cancedda PhD, Eugenio Boux MD

Bone marrow stimulation techniques in cartilage repair such as drilling are limited by the formation of fibrous to hyaline-like repair tissue. It has been suggested such techniques can be enhanced by covering the defect with scaffolds. We present an innovative approach using a polyglycolic acid (PGA)-hyaluronan scaffold with platelet-rich-plasma (PRP) in drilling.

Perioperative Closure-related Complication Rates and Cost Analysis of Barbed Suture for Closure in TKA

Jeremy M. Gililland MD, Lucas A. Anderson MD, Grant Sun BS, Jill A. Erickson PA-C, Christopher L. Peters MD

The use of barbed suture for surgical closure has been associated with lower operative times, equivalent wound complication rate, and comparable cosmesis scores in the plastic surgery literature. Similar studies would help determine whether this technology is associated with low complication rates and reduced operating times for orthopaedic closures.

Can a High-flexion Total Knee Arthroplasty Relieve Pain and Restore Function Without Premature Failure?

Ryan D. Bauman MD, Derek R. Johnson MD, Travis J. Menge MD, Raymond H. Kim MD, Douglas A. Dennis MD

High-flexion TKA prostheses are designed to improve flexion and clinical outcomes. Increased knee flexion can increase implant loads and fixation stresses, creating concerns of premature failure. Whether these goals can be achieved without premature failures is unclear.

Minimizing Dynamic Knee Spacer Complications in Infected Revision Arthroplasty

Aaron J. Johnson MD, Siraj A. Sayeed MD, Qais Naziri MD, Harpal S. Khanuja MD, Michael A. Mont MD

Deep infections are devastating complications of TKA often treated with component explantation, intravenous antibiotics, and antibiotic-impregnated cement spacers. Historically, the spacers have been static, which may limit patients’ ROM and ability to walk. Several recent reports describe dynamic spacers, which may allow for improved ROM and make later reimplantation easier. However, because of several dynamic spacer problems noted at our institution, we wanted to assess their associated failures, reinfection rates, and functionality.

Three-dimensional Morphology of the Knee Reveals Ethnic Differences

Mohamed Mahfouz PhD, Emam ElHak Abdel Fatah Bsc, Lyndsay Smith Bowers MSc, Giles Scuderi MD

Studies have demonstrated sex differences in femoral shape and quadriceps angle raising a question of whether implant design should be sex-specific. Much of this research has addressed shape differences within the Caucasian population and little is known about differences among ethnic groups.

Reinfected Revised TKA Resolves With an Aggressive Protocol and Antibiotic Infusion

Leo A. Whiteside MD, Tariq A. Nayfeh MD, PhD, Renee LaZear RN, Marcel E. Roy PhD

Revision of failed two-stage revision TKA for infection is challenging, and amputation often is the only alternative.

Surgical Technique: Articulated External Fixator for Treatment of Complex Knee Dislocation

Maurilio Marcacci MD, Stefano Zaffagnini MD, Tommaso Bonanzinga MD, Andrea Pizzoli MD, Mario Manca MD, Enzo Caiaffa MD

Knee dislocation is a severe but relatively uncommon injury caused by violent trauma that can result in long-term complications, such as arthrofibrosis, stiffness, instability, and pain. Perhaps owing in part to its rarity, treatment of this injury is controversial. We therefore describe a treatment approach for these complex cases involving a novel dynamic knee external fixator.

Surgical Technique: Development of an Anatomic Medial Knee Reconstruction

Robert F. LaPrade MD, PhD, Coen A. Wijdicks PhD

The main static stabilizers of the medial knee are the superficial medial collateral and posterior oblique ligaments. A number of reconstructive techniques have been advocated including one we describe here. However, whether these reconstructions restore function and stability is unclear.

Posterior Cruciate Ligament and Posterolateral Corner Deficiency Results in a Reverse Pivot Shift

Frank A. Petrigliano MD, Clayton G. Lane MD, Eduardo M. Suero MD, Answorth A. Allen MD, Andrew D. Pearle MD

As measured via static stability tests, the PCL is the dominant restraint to posterior tibial translation while the posterolateral corner is the dominant restraint to external tibial rotation. However, these uniplanar static tests may not predict multiplanar instability. The reverse pivot shift is a dynamic examination maneuver that may identify complex knee instability.