Clinical Orthopaedics and Related Research ®

A Publication of The Association of Bone and Joint Surgeons ®

Knee 443 articles


No Difference Between Trabecular Metal Cones and Femoral Head Allografts in Revision TKA: Minimum 5-year Followup

Nemandra A. Sandiford MSc, FRCS(Tr&Orth), Peter Misur FRACS, Donald S. Garbuz MD, MHSc, FRCS(C), Nelson V. Greidanus MSc, FRCS (C), Bassam A. Masri MD, FRCS(C)

Encouraging clinical results have been reported with the use of femoral head structural allografts and, more recently, trabecular metal cones for the management of large structural defects of the femur and tibia during revision total knee arthroplasty (TKA). However, to our knowledge, there are no published studies comparing these two techniques.

The Mark Coventry, MD, Award: Oral Antibiotics Reduce Reinfection After Two-Stage Exchange: A Multicenter, Randomized Controlled Trial

Jonathan M. Frank MD, Erdan Kayupov MSE, Mario Moric MS, John Segreti MD, Erik Hansen MD, Curtis Hartman MD, Kamil Okroj BS, Katherine Belden MD, Brian Roslund PharmD, Randi Silibovsky MD, Javad Parvizi MD, Craig J. Valle MD

Many patients develop recurrent periprosthetic joint infection after two-stage exchange arthroplasty of the hip or knee. One potential but insufficiently tested strategy to decrease the risk of persistent or recurrent infection is to administer additional antibiotics after the second-stage reimplantation.

Can Original Knee Society Scores Be Used to Estimate New 2011 Knee Society Scores?

Susan M. Odum PhD, Thomas K. Fehring MD

The Knee Society Score (KSS) instrument is one of the most commonly reported primary outcome measures for total knee arthroplasty (TKA). Originally developed in 1989, the KSS was expanded and updated in 2011; however, the original KSS does not directly translate into the 2011 KSS. To date, no conversion algorithm has been developed, hindering the ability of researchers to adopt the 2011 KSS while maintaining their historical/longitudinal original KSS data.

Does Anteromedial Portal Drilling Improve Footprint Placement in Anterior Cruciate Ligament Reconstruction?

Sally Arno PhD, Christopher P. Bell MSc, Michael J. Alaia MD, Brian C. Singh BS, Laith M. Jazrawi MD, Peter S. Walker PhD, Ankit Bansal MD, Garret Garofolo BS, Orrin H. Sherman MD

Considerable debate remains over which anterior cruciate ligament (ACL) reconstruction technique can best restore knee stability. Traditionally, femoral tunnel drilling has been done through a previously drilled tibial tunnel; however, potential nonanatomic tunnel placement can produce a vertical graft, which although it would restore sagittal stability, it would not control rotational stability. To address this, some suggest that the femoral tunnel be created independently of the tibial tunnel through the use of an anteromedial (AM) portal, but whether this results in a more anatomic footprint or in stability comparable to that of the intact contralateral knee still remains controversial.

The Chitranjan S. Ranawat Award

Simon W. Young FRACS, Matthew L. Walker FRACS, Ali Bayan FRACS, Toby Briant-Evans FRCS, Paul Pavlou FRCS, Bill Farrington FRCS, FRACS

Neutral mechanical alignment (MA) in total knee arthroplasty (TKA) aims to position femoral and tibial components perpendicular to the mechanical axis of the limb. In contrast, kinematic alignment (KA) attempts to match implant position to the prearthritic anatomy of the individual patient with the aim of improving functional outcome. However, comparative data between the two techniques are lacking.

Length of Endoprosthetic Reconstruction in Revision Knee Arthroplasty Is Associated With Complications and Reoperations

Jeffrey J. Barry MD, Zachary Thielen MD, David C. Sing BS, Paul H. Yi MD, Erik N. Hansen MD, Michael Ries MD

Complex revision total knee arthroplasty (TKA) often calls for endoprosthetic reconstruction to address bone loss, poor bone quality, and soft tissue insufficiency. Larger amounts of segmental bone loss in the setting of joint replacement may be associated with greater areas of devascularized tissue, which could increase the risk of complications and worsen functional results.

Does a Patient-centered Educational Intervention Affect African-American Access to Knee Replacement? A Randomized Trial

Ernest R. Vina MD, MS, Diane Richardson PhD, Elina Medvedeva MS, C. Kent Kwoh MD, Aliya Collier BS, Said A. Ibrahim MD, MPH

A TKA is the most effective and cost-effective surgical option for moderate to severe osteoarthritis (OA) of the knee. Yet, black patients are less willing to undergo knee replacement surgery than white patients. Decision aids help people understand treatment options and consider the personal importance of possible benefits and harms of treatments, including TKA.

Crosslink Density Is Reduced and Oxidation Is Increased in Retrieved Highly Crosslinked Polyethylene TKA Tibial Inserts

Tong Liu MD, Christina I. Esposito PhD, Jayme C. Burket PhD, Timothy M. Wright PhD

The wear resistance of highly crosslinked polyethylene depends on crosslink density, which may decrease with in vivo loading, leading to more wear and increased oxidation. The relationship among large and complex in vivo mechanical stresses, breakdown of the polyethylene crosslinks, and oxidative degradation is not fully understood in total knee arthroplasty (TKA). We wished to determine whether crosslink density is reduced at the articular surfaces of retrieved tibial inserts in contact areas exposed to in vivo mechanical stress.

Higher Frequency of Reoperation With a New Bicruciate-retaining Total Knee Arthroplasty

Jesse C. Christensen PT, DPT, Justin Brothers MD, Gregory J. Stoddard MPH, MBA, Mike B. Anderson MSc, Christopher E. Pelt MD, Jeremy M. Gililland MD, Christopher L. Peters MD

With as many as 25% of patients reporting residual knee symptoms after primary total knee arthroplasty (TKA), alternative implant designs and surgical techniques have been proposed to further reduce these symptoms. There is growing evidence that retention of the anterior cruciate ligament (ACL) results in more natural knee kinematics; thus, implants with more normal joint mechanics could provide improved physical function postoperatively and reduce the amount of residual symptoms. Advancements in the bicruciate-retaining (BCR) TKA implant design have been made, and based on these, we wished to compare the BCR with a more traditional cruciate-retaining (CR) implant.

Do Stemmed Tibial Components in Total Knee Arthroplasty Improve Outcomes in Patients With Obesity?

S├ębastien Parratte MD, Matthieu Ollivier MD, Alexandre Lunebourg MD, Nicolas Verdier MD, Jean Noel Argenson MD, PhD

Recent clinical studies have reported that patients with higher body mass index (BMI) are more likely to experience premature failure of total knee arthroplasty (TKA), lower knee scores, and perhaps more pain in the prosthetic joint. However, it is not known whether certain implant design features such as tibial stems might be associated with differences in the frequency of tibial pain in patients with higher BMIs.