Clinical Orthopaedics and Related Research ®

A Publication of The Association of Bone and Joint Surgeons ®

Knee 447 articles


Low Albumin Levels, More Than Morbid Obesity, Are Associated With Complications After TKA

Charles L. Nelson MD, Nabil M. Elkassabany MD, MSCE, Atul F. Kamath MD, Jiabin Liu MD, PhD

Morbid obesity and malnutrition are thought to be associated with more frequent perioperative complications after TKA. However, morbid obesity and malnutrition often are co-occurring conditions. Therefore it is important to understand whether morbid obesity, malnutrition, or both are independently associated with more frequent perioperative complications. In addition, assessing the magnitude of an increase in complications and whether these complications are major or minor is important for both conditions.

Knee Society Award Papers Are Highly Cited Works

Tommy P. Mroz, Henry D. Clarke MD, Yu-Hui H. Chang PhD, Giles R. Scuderi MD

Since 1993, The Knee Society has presented three annual awards recognizing the best research papers presented at the annual meetings. To date, no quantitative evaluation has determined whether the selection process identifies the most meritorious papers based on subsequent citations. In the absence of validation of this process, it is unclear whether the journal readership should view the award-winning papers as those with potentially greater impact for the specialty.

Arthroscopic Transplantation of Synovial Stem Cells Improves Clinical Outcomes in Knees With Cartilage Defects

Ichiro Sekiya MD, PhD, Takeshi Muneta MD, PhD, Masafumi Horie MD, PhD, Hideyuki Koga MD, PhD

Transplantation of mesenchymal stem cells (MSCs) is one possible strategy to achieve articular cartilage repair. We previously reported that synovial MSCs were highly proliferative and able to undergo chondrogenesis. We also found that placing a suspension of synovial MSCs on a cartilage defect for 10 minutes promoted cartilage repair in rabbit and pig models. However, the in vivo efficacy of this approach has not been tested clinically.

Subchondral Calcium Phosphate is Ineffective for Bone Marrow Edema Lesions in Adults With Advanced Osteoarthritis

Dipal Chatterjee MD, Alan McGee MD, Eric Strauss MD, Thomas Youm MD, Laith Jazrawi MD

Injury to subchondral bone is associated with knee pain and osteoarthritis (OA). A percutaneous calcium phosphate injection is a novel approach in which subchondral bone marrow edema lesions are percutaneously injected with calcium phosphate. In theory, calcium phosphate provides structural support while it is gradually replaced by bone. However, little clinical evidence supports the efficacy of percutaneous calcium phosphate injections.

Does Combined Intra- and Extraarticular ACL Reconstruction Improve Function and Stability? A Meta-analysis

Fernando Cury Rezende MD, Vinicius Ynoe Moraes MD, Ana Luiza Cabrera Martimbianco Bsc, Marcus Vinícius Luzo PhD, Carlos Eduardo Silveira Franciozi PhD, João Carlos Belloti PhD

ACL reconstruction aims to restore knee function and stability; however, rotational stability may not be completely restored by use of standard intraarticular reconstruction alone. Although individual studies have not shown the superiority of combined ACL reconstruction compared with isolated intraarticular reconstruction in terms of function and stability, biomechanical principles suggest a combined approach may be helpful, therefore pooling (meta-analyzing) the available randomized clinical studies may be enlightening.

Morbid Obesity: Increased Risk of Failure After Aseptic Revision TKA

Chad D. Watts MD, Eric R. Wagner MD, Matthew T. Houdek MD, David G. Lewallen MD, Tad M. Mabry MD

Patients with obesity are known to have a higher risk of complications after primary TKA; however, there is a paucity of data regarding the effects of obesity with revision TKAs.

The John Insall Award: No Functional Benefit After Unicompartmental Knee Arthroplasty Performed With Patient-specific Instrumentation: A Randomized Trial

Matthieu Ollivier MD, Sebastien Parratte MD, PhD, Alexandre Lunebourg MD, Elke Viehweger MD, PhD, Jean-Noel Argenson MD, PhD

Component alignment can influence implant longevity as well as perhaps pain and function after unicompartmental knee arthroplasty (UKA), but correct alignment is not consistently achieved. To increase the likelihood that good alignment will be achieved during surgery, smart tools such as robotics or patient-specific instrumentation (PSI) have been introduced.

Is There a Benefit to Highly Crosslinked Polyethylene in Posterior-stabilized Total Knee Arthroplasty? A Randomized Trial

Paul F. Lachiewicz MD, Elizabeth S. Soileau BSN

Polyethylene wear and osteolysis remain a concern with the use of modular, fixed-bearing total knee arthroplasty (TKA). A variety of highly crosslinked polyethylenes (XLPs) have been introduced to address this problem, but there are few data on the results and complications of this polyethylene in posterior-stabilized knee prostheses.

Do Psychological Factors Predict Poor Outcome in Patients Undergoing TKA? A Systematic Review

Yasser Khatib MBBS, MSports Med, FRACS(Orth), Aman Madan BSc(Med), MBBS, Justine M. Naylor PhD, BAppSc(Phty), Ian A. Harris MBBS, MMed(Clin Epi), PhD, FRACS(Orth)

A subgroup of patients undergoing TKA is unhappy with the outcome of surgery and preoperative psychological factors may play a role in their dissatisfaction.

Bicruciate-retaining Total Knee Replacement Provides Satisfactory Function and Implant Survivorship at 23 Years

James W. Pritchett MD

One of the goals of a TKA is to approximate the function of a normal knee. Preserving the natural ligaments might provide a method of restoring close to normal function. Sacrifice of the ACL is common and practical during a TKA. However, this ligament is functional in more than 60% of patients undergoing a TKA and kinematic studies support the concept of bicruciate-retaining (that is, ACL-preserving) TKA; however, relatively few studies have evaluated patients treated with bicruciate-retaining TKA implants.