Clinical Orthopaedics and Related Research ®

A Publication of The Association of Bone and Joint Surgeons ®

Knee 450 articles


No Decrease in Knee Survivorship or Outcomes Scores for Patients With HIV Infection Who Undergo TKA

Kimona Issa MD, Todd P. Pierce MD, Steven F. Harwin MD, Anthony J. Scillia MD, Anthony Festa MD, Michael A. Mont MD

HIV is prevalent worldwide and numerous patients with this diagnosis ultimately may become candidates for TKA. Although some studies have suggested that complications are more common in patients with HIV who undergo TKA, these studies largely were done before the contemporary era of HIV management; moreover, it is unclear whether patients with HIV achieve lower patient-reported outcome scores or inferior implant survivorship.

What Differences in Morphologic Features of the Knee Exist Among Patients of Various Races? A Systematic Review

T. K. Kim MD, PhD, Mark Phillips BSc, Mohit Bhandari MD, PhD, John Watson, Rajesh Malhotra MS, FRCS

Most TKA prostheses are designed based on the anatomy of white patients. Individual studies have identified key anthropometric differences between the knees of the white population and other major ethnic groups, yet there is limited understanding of what these findings may indicate if analyzed collectively.

Does the Utilization of Allograft Tissue in Medial Patellofemoral Ligament Reconstruction in Pediatric and Adolescent Patients Restore Patellar Stability?

Eric Hohn MD, Nirav K. Pandya MD

Medial patellofemoral ligament (MPFL) reconstruction is one of several surgical procedures used to treat patellofemoral instability. Use of allograft tissue can preserve autogenous tissue and may be preferable in patients with connective tissue disorders or ligamentous laxity. Although there are successful reports in adults, it is unclear if the use of allograft tissue in MPFL reconstruction can restore patellofemoral stability in children and adolescents.

Osteochondritis Dissecans Lesions in Family Members: Does a Positive Family History Impact Phenotypic Potency?

Alex L. Gornitzky MD, R. Justin Mistovich MD, Brittany Atuahuene BA, Eileen P. Storey BA, Theodore J. Ganley MD

Although repetitive microtrauma and athletic overuse patterns are most commonly associated with osteochondritis dissecans (OCD), recent studies have identified a potential genetic predisposition for OCD. Several case series have documented family pedigrees that support autosomal-dominant inheritance, but the families in these studies were all selected as a result of unique histories that may not accurately represent OCD inheritance patterns at large. Because there has been little investigation beyond these case reports, we aimed to describe a broader, more representative pattern of OCD inheritance applicable to all affected patients.

Novel Augmentation Technique for Patellar Tendon Repair Improves Strength and Decreases Gap Formation: A Cadaveric Study

James C. Black MD, William M. Ricci MD, Michael J. Gardner MD, Christopher M. McAndrew MD, MSc, Avinesh Agarwalla BS, Robert D. Wojahn MD, Orchid Abar, Simon Y. Tang PhD

Patellar tendon ruptures commonly are repaired using transosseous patellar drill tunnels with modified-Krackow sutures in the patellar tendon. This simple suture technique has been associated with failure rates and poor clinical outcomes in a modest proportion of patients. Failure of this repair technique can result from gap formation during loading or a single catastrophic event. Several augmentation techniques have been described to improve the integrity of the repair, but standardized biomechanical evaluation of repair strength among different techniques is lacking.

No Difference in Early Analgesia Between Liposomal Bupivacaine Injection and Intrathecal Morphine After TKA

John W. Barrington MD, Roger H. Emerson MD, Scott T. Lovald PhD, Adolph V. Lombardi MD, Keith R. Berend MD

Opioid analgesics have been a standard modality for postoperative pain management after total knee arthroplasty (TKA) but are also associated with increased risk of nausea, pruritus, vomiting, respiratory depression, prolonged ileus, and cognitive dysfunction. There is still a need for a method of anesthesia that can deliver effective long-term postoperative pain relief without incurring the high cost and health burden of opioids and nerve blocks.

Disparities in TKA Outcomes: Census Tract Data Show Interactions Between Race and Poverty

Susan M. Goodman MD, Lisa A. Mandl MD, MPH, Michael L. Parks MD, Meng Zhang PhD, Kelly R. McHugh MA, Yuo-Yu Lee MS, Joseph T. Nguyen MPH, Linda A. Russell MD, Margaret H. Bogardus BA, Mark P. Figgie MD, Anne R. Bass MD

Race is an important predictor of TKA outcomes in the United States; however, analyses of race can be confounded by socioeconomic factors, which can result in difficulty determining the root cause of disparate outcomes after TKA.

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.