Clinical Orthopaedics and Related Research ®

A Publication of The Association of Bone and Joint Surgeons ®

Knee 448 articles

Articles

Decreased Length of Stay After TKA Is Not Associated With Increased Readmission Rates in a National Medicare Sample

John S. Vorhies BA, Yun Wang PhD, James H. Herndon MD, MBA, William J. Maloney MD, James I. Huddleston MD

There is a trend toward decreasing length of hospital stay (LOS) after TKA although it is unclear whether this trend is detrimental to the overall postoperative course. Such information is important for future decisions related to cost containment.

Revision ACL Reconstruction in Skeletally Mature Athletes Younger Than 18 Years

Keith R. Reinhardt MD, Sommer Hammoud MD, Andrea L. Bowers MD, Ben-Paul Umunna BA, Frank A. Cordasco MD

Young, active, skeletally mature patients have higher failure rates after various surgical procedures, including stabilization for shoulder instability and primary ACL reconstruction. It is unclear whether young, active, skeletally mature patients share similarly high failure rates after revision ACL reconstruction.

Preoperative Patient Education Reduces In-hospital Falls After Total Knee Arthroplasty

Henry D. Clarke MD, Vickie L. Timm BSN, Brynn R. Goldberg MSN, Steven J. Hattrup MD

Inpatient hospital falls after orthopaedic surgery represent a major problem, with rates of about one to three falls per 1000 patient days. These falls result in substantial morbidity for the patient and liability for the institution.

Surgical Technique: Revision ACL Reconstruction With a Rectangular Tunnel Technique

Konsei Shino MD, Tatsuo Mae MD, Norimasa Nakamura MD

We developed the rectangular tunnel ACL reconstruction (RT ACLR) using a 10-mm wide bone-patellar tendon-bone (BTB) graft through rectangular tunnels with a rectangular aperture to reduce tunnel size: the cross-sectional area of the tunnels of 50 mm(5 × 10 mm) in RT ACLR is less than that of 79 mmin a conventional 10-mm round tunnel technique presuming the technique would be more suitable in revision ACLR with previous improperly placed tunnels.

Surgical Technique: Medial Collateral Ligament Reconstruction Using Achilles Allograft for Combined Knee Ligament Injury

Robert G. Marx MD, MSc, FRCSC, Iftach Hetsroni MD

Previous approaches for medial collateral ligament (MCL) reconstruction have been associated with extensive exposure, risk of donor site morbidity with autografts, loss of motion, nonanatomic graft placement, and technical complexity with double-bundle constructs. Therefore, we implemented a technique that uses Achilles allograft, small incisions, and anatomic insertions to reconstruct the MCL.

Single- versus Double-bundle ACL Reconstruction: Is There Any Difference in Stability and Function at 3-year Followup?

Alberto Gobbi MD, Vivek Mahajan MD, Georgios Karnatzikos MD, Norimasa Nakamura MD, PhD

Despite a number of studies comparing postoperative stability and function after anatomic double-bundle and single-bundle anterior cruciate ligament reconstruction (ACLR), it remains unclear whether double-bundle reconstruction improves stability or function.

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.