Clinical Orthopaedics and Related Research ®

A Publication of The Association of Bone and Joint Surgeons ®

Knee 442 articles


Cementless Revision TKA with Bone Grafting of Osseous Defects Restores Bone Stock with a Low Revision Rate at 4 to 10 years

S. A. Hanna MRCS, W. J. S. Aston FRCS (Orth), N. J. Roeck FRCS (Orth), A. Gough-Palmer FRCR, D. P. Powles MD, FRCS

Addressing bone loss in revision TKA is challenging despite the array of options to reconstruct the deficient bone. Biologic reconstruction using morselized loosely-packed bone graft potentially allows for augmentation of residual bone stock while offering physiologic load transfer. However it is unclear whether the reconstructions are durable.

The Chitranjan Ranawat Award: Is Neutral Mechanical Alignment Normal for All Patients?: The Concept of Constitutional Varus

Johan Bellemans MD, PhD, William Colyn MD, Hilde Vandenneucker MD, Jan Victor MD, PhD

Most knee surgeons have believed during TKA neutral mechanical alignment should be restored. A number of patients may exist, however, for whom neutral mechanical alignment is abnormal. Patients with so-called “constitutional varus” knees have had varus alignment since they reached skeletal maturity. Restoring neutral alignment in these cases may in fact be abnormal and undesirable and would likely require some degree of medial soft tissue release to achieve neutral alignment.

Spontaneous Healing in Complete ACL Ruptures: A Clinical and MRI Study

Matias Costa-Paz MD, Miguel Angel Ayerza MD, Ignacio Tanoira MD, Juan Astoul MD, Domingo Luis Muscolo MD

Most authors believe the ACL does not spontaneously heal after a complete rupture. Although several studies have reported spontaneous healing of torn ACLs, it is difficult to determine its healing potential and whether patients will be able to return to sports activities.

Partial Tibial Nerve Transfer to the Tibialis Anterior Motor Branch to Treat Peroneal Nerve Injury After Knee Trauma

Jennifer L. Giuffre MD, Allen T. Bishop MD, Robert J. Spinner MD, Bruce A. Levy MD, Alexander Y. Shin MD

Injuries to the deep peroneal nerve result in tibialis anterior muscle paralysis and associated loss of ankle dorsiflexion. Nerve grafting of peroneal nerve injuries has led to poor function; therefore, tendon transfers and ankle-foot orthotics have been the standard treatment for foot drop.

Women Recover Faster Than Men after Standard Knee Arthroplasty

Thoralf R. Liebs MD, Wolfgang Herzberg MD, Annette Maria Roth-Kroeger MD, Wolfgang Rüther MD, PhD, Joachim Hassenpflug MD, PhD

Specific anatomic differences are believed to account for gender-specific function and health-related quality of life after TKA. However, there are conflicting data in the literature regarding these gender-specific outcomes, especially as woman appear to have surgery later in the course of the disease compared with men.

Cannulated Screw and Cable are Superior to Modified Tension Band in the Treatment of Transverse Patella Fractures

Yun Tian MD, Fang Zhou MD, Hongquan Ji MD, Zhishan Zhang MD, Yan Guo MD

Although the modified tension band technique (eg, tension band supplemented by longitudinal Kirschner wires) has long been the mainstay for fixation of transverse fractures of the patella, it has shortcomings, such as bad reduction, loosening of implants, and skin irritation.

Stereologic Analysis of Tibial-Plateau Cartilage and Femoral Cancellous Bone in Guinea Pigs With Spontaneous Osteoarthritis

Susanne X. Wang MD, PhD, Larry Arsenault PhD, Ernst B. Hunziker MD, PhD

Two strains of guinea pig develop spontaneous osteoarthritis of the knee. Although the disease evolves at different rates in the two strains, it is not known whether these differences are reflected in the structure of the cartilage and cancellous bone.

Internal Rotation of the Tibial Component is Frequent in Stiff Total Knee Arthroplasty

Martin Bédard MD, FRCS(C), Kelly G. Vince MD, FRCS(C), John Redfern MD, Stacy R. Collen MS

Stiffness complicating TKA is a complex and multifactorial problem. We suspected internally rotated components compromised motion because of pain, patellar maltracking, a tight medial flexion gap, and limited femoral rollback on a conforming lateral tibial condyle.

Can Tantalum Cones Provide Fixation in Complex Revision Knee Arthroplasty?

Paul F. Lachiewicz MD, Michael P. Bolognesi MD, Robert A. Henderson MSc, Elizabeth S. Soileau BSN, Thomas Parker Vail MD

The best method for managing large bone defects during revision knee arthroplasty is unknown. Metaphyseal fixation using porous tantalum cones has been proposed for severe bone loss. Whether this approach achieves osseointegration with low complication rates is unclear.

Can Arthroscopically Assisted Treatment of Chronic Patellar Tendinopathy Reduce Pain and Restore Function?

Jorge Santander MD, Eduardo Zarba MD, Horacio Iraporda MD, Sebastián Puleo MD

Patellar tendinopathy is a common source of pain in athletes, especially those involved in sports with a high incidence of jumping and cutting. Changes in training programs and exercises based on eccentric quadriceps contractions often relieve patients’ symptoms. For athletes unresponsive to this treatment, some authors suggest open and arthroscopic procedures débriding either the tendon alone, or the tendon and bone.