Clinical Orthopaedics and Related Research ®

A Publication of The Association of Bone and Joint Surgeons ®

Knee 440 articles

Articles

Is There a Preferred Articulating Spacer Technique for Infected Knee Arthroplasty?: A Preliminary Study

Niraj V. Kalore MD, Aditya Maheshwari MD, Amit Sharma MD, Edward Cheng MD, Terence J. Gioe MD

Periprosthetic infection in TKA is a devastating and challenging problem for both patients and surgeons. Two-stage exchange arthroplasty with an interval antibiotic spacer reportedly has the highest infection control rate. Studies comparing static spacers with articulating spacers have reported varying ROM after reimplant, which could be due to differences in articulating spacer technique.

Revision Surgery for Patellofemoral Problems: Should We Always Resurface?

Todd C. Johnson MD, Penny J. Tatman MPH, Susan Mehle BS, Terence J. Gioe MD

Routine patellar resurfacing performed at the time of knee arthroplasty is controversial, with some evidence of utility in both TKA (tricompartmental) and bicompartmental knee arthroplasty. However, whether one approach results in better implant survival remains unclear.

Surgical Technique: When to Arthroscopically Repair the Torn Posterior Cruciate Ligament

Gregory S. DiFelice MD, Micah Lissy MD, Paul Haynes MD

Posterior cruciate ligament injuries can occur as isolated ligament ruptures or in association with the multiligament-injured knee. Delayed reconstruction, at 2–3 weeks post-injury, is predominantly recommended for posterior cruciate ligament tears in the multiligament-injured knee. While acute bone and soft tissue avulsion patterns of injury can be amenable to repair, the described techniques have been associated with some difficulties attaching the avulsed ligament.

Are African American Patients More Likely to Receive a Total Knee Arthroplasty in a Low-quality Hospital?

Xueya Cai PhD, Peter Cram MD, MBA, Mary Vaughan-Sarrazin PhD

Total joint arthroplasty is widely performed in patients of all races with severe osteoarthritis. Prior studies have reported that African American patients tend to receive total joint arthroplasties in low-volume hospitals compared with Caucasian patients, suggesting potential racial disparity in the quality of arthroplasty care.

Two-stage Exchange Arthroplasty for Infected Total Knee Arthroplasty: Predictors of Failure

S. M. Javad Mortazavi MD, David Vegari MD, Anthony Ho BA, Benjamin Zmistowski BS, Javad Parvizi MD, FRCS

In North America, a two-stage exchange arthroplasty remains the preferred surgical treatment for chronic periprosthetic joint infection (PJI). Currently, there are no proper indicators that can guide orthopaedic surgeons in patient selection for two-stage exchange or the appropriate conditions in which to reimplant.

Rectus Femoris Distal Tendon Resection Improves Knee Motion in Patients With Spastic Diplegia

Ana Presedo MD, Fabrice Megrot PhD, Brice Ilharreborde MD, Keyvan Mazda MD, Georges-François Penneçot MD

Children with spastic diplegia frequently show excessive knee extension (stiff-knee gait) throughout swing phase, which may interfere with foot clearance. Abnormal rectus femoris activity is commonly associated with a stiff-knee gait. Rectus femoris transfer has been recommended to enhance knee flexion during swing. However, recent studies suggest the transfer does not generate a knee flexor moment but diminishes knee extension moment in swing and MRI studies show the transferred tendons can be constrained by scarring to underlying muscles. Thus, it is possible knee flexion would be improved by distal rectus release rather than transfer since it would not be adherent to the underlying muscles.

Surgical Technique: Does Mini-invasive Medial Collateral Ligament and Posterior Oblique Ligament Repair Restore Knee Stability in Combined Chronic Medial and ACL Injuries?

Gian Luigi Canata MD, Alfredo Chiey MD, Tommaso Leoni MD

Residual laxity remains after ACL reconstruction in patients with combined chronic ACL and medial instability. The question arises whether to correct medial capsular and ligament injuries when Grade II and III medial laxity is present.

Can Surgeons Predict What Makes a Good TKA?: Intraoperative Surgeon Impression of TKA Quality Does Not Correlate With Knee Society Scores

Gwo-Chin Lee MD, Paul A. Lotke MD

Surgeons generally agree on what they want to achieve when performing TKA. However, we do not know which technical quality goals are correct, important, or irrelevant to achieve adequate function or durability.

Can Stress Radiography of the Knee Help Characterize Posterolateral Corner Injury?

F. Winston Gwathmey MD, Marc A. Tompkins MD, Cree M. Gaskin MD, Mark D. Miller MD

Conventional MRI is limited for characterizing the posterolateral corner of the knee due to the region’s anatomic variability and complexity; further, MRI is a static study and cannot demonstrate pathologic laxity. Stress radiography may provide additional information about instability.

Lateral Unicompartmental Knee Arthroplasty Through a Lateral Parapatellar Approach Has High Early Survivorship

Keith R. Berend MD, Michael C. Kolczun MD, Joseph W. George MD, Adolph V. Lombardi MD

The literature suggests lateral unicompartmental knee arthroplasties are associated with low revision rates. However, there are fewer reports describing techniques for lateral unicompartmental arthroplasty and whether technique influences ROM and function compared to reports for medial unicompartmental arthroplasty.